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Patel N, Rajabian A, George J. Unintended consequences of using collars with occipital extensions in neck support - Snapshot assessment at the largest tertiary spinal referral centre in the UK. Int J Orthop Trauma Nurs 2024:101083. [PMID: 38336571 DOI: 10.1016/j.ijotn.2024.101083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 01/16/2024] [Accepted: 02/04/2024] [Indexed: 02/12/2024]
Abstract
INTRODUCTION Upper cervical spine fractures are commonplace in the elderly following low energy trauma. These injuries carry high mortality rates, similar to patients sustaining hip fractures. A key aspect affecting clinical outcome is effective management in the first 12 weeks following injury. This study aims to assess the understanding of healthcare staff that may be required to care for such patients. MATERIALS AND METHODS A survey was carried out over a single day at the UK's largest Spine Specialist referral centre (Salford Royal Foundation Trust, SRFT) assessing the understanding of healthcare staff of the term, 'Collar with occipital extension', by asking staff to identify the safe position of the neck when looking at clinical images of a model in a collar in various different neck positions. The participants demographics were then taken, including profession, grade, spinal/post graduate experience, if English is their first language and their understanding of the term 'Collar with occipital extension'. RESULTS 102 participants were interviewed and the results showed almost half (45.1%) of participants selecting an incorrect hyperextended neck to be a safe position for conservative treatment and only 37.3% selecting the neutral position as satisfactory. The only positive predictors identified for those selective the neutral safe cervical spine alignment was if participants had >5 years of previous spinal experience (p = 0.0006) or if they understood the term 'Collar with occipital extension' to be describing the collar component (p = 0.000013) and not neck position. CONCLUSION Management of spinal injuries are classically poorly managed in non-spinal centres, possibly due to the lack of training and understanding within the spinal speciality. This study shows the importance of clearly communicating with referring hospitals exactly how to conservatively manage patients with high cervical injuries to best improve clinical outcome.
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Affiliation(s)
- N Patel
- Trauma & Orthopaedic Registrar, Wythenshawe Hospital, Southmoor Road, Wythenshawe, Manchester, M23 9LT, UK.
| | - A Rajabian
- Spinal Senior Clinical Fellow, Salford Royal Hospital, Stott Lane, Salford, M8 8HD, UK
| | - J George
- Salford Royal Hospital, Stott Lane, Salford, M8 8HD, UK
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Patel N, Greene N, Guynn N, Sharma A, Toleva O, Mehta PK. Ischemia but no obstructive coronary artery disease: more than meets the eye. Climacteric 2024; 27:22-31. [PMID: 38224068 DOI: 10.1080/13697137.2023.2281933] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 07/26/2023] [Accepted: 10/31/2023] [Indexed: 01/16/2024]
Abstract
Symptomatic women with angina are more likely to have ischemia with no obstructive coronary arteries (INOCA) compared to men. In both men and women, the finding of INOCA is not benign and is associated with adverse cardiovascular events, including myocardial infarction, heart failure and angina hospitalizations. Women with INOCA have more angina and a lower quality of life compared to men, but they are often falsely reassured because of a lack of obstructive coronary artery disease (CAD) and a perception of low risk. Coronary microvascular dysfunction (CMD) is a key pathophysiologic contributor to INOCA, and non-invasive imaging methods are used to detect impaired microvascular flow. Coronary vasospasm is another mechanism of INOCA, and can co-exist with CMD, but usually requires invasive coronary function testing (CFT) with provocation testing for a definitive diagnosis. In addition to traditional heart disease risk factors, inflammatory, hormonal and psychological risk factors that impact microvascular tone are implicated in INOCA. Treatment of risk factors and use of anti-atherosclerotic and anti-anginal medications offer benefit. Increasing awareness and early referral to specialized centers that focus on INOCA management can improve patient-oriented outcomes. However, large, randomized treatment trials to investigate the impact on major adverse cardiovascular events (MACE) are needed. In this focused review, we discuss the prevalence, pathophysiology, presentation, diagnosis and treatment of INOCA.
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Affiliation(s)
- N Patel
- J. Willis Hurst Internal Medicine Residency Program, Emory University, Atlanta, GA, USA
| | - N Greene
- Emory University School of Medicine, Atlanta, GA, USA
| | - N Guynn
- J. Willis Hurst Internal Medicine Residency Program, Emory University, Atlanta, GA, USA
| | - A Sharma
- Department of Internal Medicine, Grady Memorial Hospital, Atlanta, GA, USA
| | - O Toleva
- Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - P K Mehta
- Emory Women's Heart Center and Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
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3
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Abratenko P, Alterkait O, Andrade Aldana D, Arellano L, Asaadi J, Ashkenazi A, Balasubramanian S, Baller B, Barr G, Barrow D, Barrow J, Basque V, Benevides Rodrigues O, Berkman S, Bhanderi A, Bhat A, Bhattacharya M, Bishai M, Blake A, Bogart B, Bolton T, Book JY, Brunetti MB, Camilleri L, Cao Y, Caratelli D, Cavanna F, Cerati G, Chappell A, Chen Y, Conrad JM, Convery M, Cooper-Troendle L, Crespo-Anadón JI, Cross R, Del Tutto M, Dennis SR, Detje P, Devitt A, Diurba R, Djurcic Z, Dorrill R, Duffy K, Dytman S, Eberly B, Englezos P, Ereditato A, Evans JJ, Fine R, Finnerud OG, Foreman W, Fleming BT, Franco D, Furmanski AP, Gao F, Garcia-Gamez D, Gardiner S, Ge G, Gollapinni S, Gramellini E, Green P, Greenlee H, Gu L, Gu W, Guenette R, Guzowski P, Hagaman L, Hen O, Hilgenberg C, Horton-Smith GA, Imani Z, Irwin B, Ismail M, James C, Ji X, Jo JH, Johnson RA, Jwa YJ, Kalra D, Kamp N, Karagiorgi G, Ketchum W, Kirby M, Kobilarcik T, Kreslo I, Leibovitch MB, Lepetic I, Li JY, Li K, Li Y, Lin K, Littlejohn BR, Liu H, Louis WC, Luo X, Mariani C, Marsden D, Marshall J, Martinez N, Martinez Caicedo DA, Martynenko S, Mastbaum A, Mawby I, McConkey N, Meddage V, Micallef J, Miller K, Mogan A, Mohayai T, Mooney M, Moor AF, Moore CD, Mora Lepin L, Moudgalya MM, Mulleriababu S, Naples D, Navrer-Agasson A, Nayak N, Nebot-Guinot M, Nowak J, Oza N, Palamara O, Pallat N, Paolone V, Papadopoulou A, Papavassiliou V, Parkinson HB, Pate SF, Patel N, Pavlovic Z, Piasetzky E, Pophale I, Qian X, Raaf JL, Radeka V, Rafique A, Reggiani-Guzzo M, Ren L, Rochester L, Rodriguez Rondon J, Rosenberg M, Ross-Lonergan M, Rudolf von Rohr C, Safa I, Scanavini G, Schmitz DW, Schukraft A, Seligman W, Shaevitz MH, Sharankova R, Shi J, Snider EL, Soderberg M, Söldner-Rembold S, Spitz J, Stancari M, St John J, Strauss T, Szelc AM, Tang W, Taniuchi N, Terao K, Thorpe C, Torbunov D, Totani D, Toups M, Tsai YT, Tyler J, Uchida MA, Usher T, Viren B, Weber M, Wei H, White AJ, Wolbers S, Wongjirad T, Wospakrik M, Wresilo K, Wu W, Yandel E, Yang T, Yates LE, Yu HW, Zeller GP, Zennamo J, Zhang C. Search for Heavy Neutral Leptons in Electron-Positron and Neutral-Pion Final States with the MicroBooNE Detector. Phys Rev Lett 2024; 132:041801. [PMID: 38335355 DOI: 10.1103/physrevlett.132.041801] [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] [Received: 10/12/2023] [Accepted: 11/30/2023] [Indexed: 02/12/2024]
Abstract
We present the first search for heavy neutral leptons (HNLs) decaying into νe^{+}e^{-} or νπ^{0} final states in a liquid-argon time projection chamber using data collected with the MicroBooNE detector. The data were recorded synchronously with the NuMI neutrino beam from Fermilab's main injector corresponding to a total exposure of 7.01×10^{20} protons on target. We set upper limits at the 90% confidence level on the mixing parameter |U_{μ4}|^{2} in the mass ranges 10≤m_{HNL}≤150 MeV for the νe^{+}e^{-} channel and 150≤m_{HNL}≤245 MeV for the νπ^{0} channel, assuming |U_{e4}|^{2}=|U_{τ4}|^{2}=0. These limits represent the most stringent constraints in the mass range 35
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Affiliation(s)
- P Abratenko
- Tufts University, Medford, Massachusetts 02155, USA
| | - O Alterkait
- Tufts University, Medford, Massachusetts 02155, USA
| | - D Andrade Aldana
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - L Arellano
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Asaadi
- University of Texas, Arlington, Texas 76019, USA
| | - A Ashkenazi
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - S Balasubramanian
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - B Baller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Barr
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - D Barrow
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - J Barrow
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - V Basque
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | | | - S Berkman
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
- Michigan State University, East Lansing, Michigan 48824, USA
| | - A Bhanderi
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - A Bhat
- University of Chicago, Chicago, Illinois 60637, USA
| | - M Bhattacharya
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Bishai
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Blake
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - B Bogart
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - T Bolton
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - J Y Book
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - M B Brunetti
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - L Camilleri
- Columbia University, New York, New York 10027, USA
| | - Y Cao
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - D Caratelli
- University of California, Santa Barbara, California 93106, USA
| | - F Cavanna
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Cerati
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - A Chappell
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - Y Chen
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J M Conrad
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - M Convery
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | | | - J I Crespo-Anadón
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid E-28040, Spain
| | - R Cross
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - M Del Tutto
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - S R Dennis
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - P Detje
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - A Devitt
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - R Diurba
- Universität Bern, Bern CH-3012, Switzerland
| | - Z Djurcic
- Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
| | - R Dorrill
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - K Duffy
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - S Dytman
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - B Eberly
- University of Southern Maine, Portland, Maine 04104, USA
| | - P Englezos
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - A Ereditato
- University of Chicago, Chicago, Illinois 60637, USA
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J J Evans
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - R Fine
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - O G Finnerud
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - W Foreman
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - B T Fleming
- University of Chicago, Chicago, Illinois 60637, USA
| | - D Franco
- University of Chicago, Chicago, Illinois 60637, USA
| | - A P Furmanski
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - F Gao
- University of California, Santa Barbara, California 93106, USA
| | | | - S Gardiner
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Ge
- Columbia University, New York, New York 10027, USA
| | - S Gollapinni
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - E Gramellini
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - P Green
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - H Greenlee
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L Gu
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - W Gu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - R Guenette
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - P Guzowski
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Hagaman
- University of Chicago, Chicago, Illinois 60637, USA
| | - O Hen
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - C Hilgenberg
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | | | - Z Imani
- Tufts University, Medford, Massachusetts 02155, USA
| | - B Irwin
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - M Ismail
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - C James
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - X Ji
- Nankai University, Nankai District, Tianjin 300071, China
| | - J H Jo
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - R A Johnson
- University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - Y-J Jwa
- Columbia University, New York, New York 10027, USA
| | - D Kalra
- Columbia University, New York, New York 10027, USA
| | - N Kamp
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - G Karagiorgi
- Columbia University, New York, New York 10027, USA
| | - W Ketchum
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Kirby
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Kobilarcik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - I Kreslo
- Universität Bern, Bern CH-3012, Switzerland
| | - M B Leibovitch
- University of California, Santa Barbara, California 93106, USA
| | - I Lepetic
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - J-Y Li
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - K Li
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Y Li
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - K Lin
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - B R Littlejohn
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - H Liu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - W C Louis
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - X Luo
- University of California, Santa Barbara, California 93106, USA
| | - C Mariani
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Viriginia 24061, USA
| | - D Marsden
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Marshall
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - N Martinez
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - D A Martinez Caicedo
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - S Martynenko
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Mastbaum
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - I Mawby
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - N McConkey
- University College London, London WC1E 6BT, United Kingdom
| | - V Meddage
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - J Micallef
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
- Tufts University, Medford, Massachusetts 02155, USA
| | - K Miller
- University of Chicago, Chicago, Illinois 60637, USA
| | - A Mogan
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - T Mohayai
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
- Indiana University, Bloomington, Indiana 47405, USA
| | - M Mooney
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - A F Moor
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - C D Moore
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L Mora Lepin
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - M M Moudgalya
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | | | - D Naples
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Navrer-Agasson
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - N Nayak
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Nebot-Guinot
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - J Nowak
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - N Oza
- Columbia University, New York, New York 10027, USA
| | - O Palamara
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - N Pallat
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - V Paolone
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Papadopoulou
- Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
| | - V Papavassiliou
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - H B Parkinson
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - S F Pate
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - N Patel
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - Z Pavlovic
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - E Piasetzky
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - I Pophale
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - X Qian
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - J L Raaf
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - V Radeka
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Rafique
- Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
| | - M Reggiani-Guzzo
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Ren
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - L Rochester
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J Rodriguez Rondon
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - M Rosenberg
- Tufts University, Medford, Massachusetts 02155, USA
| | - M Ross-Lonergan
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | | | - I Safa
- Columbia University, New York, New York 10027, USA
| | - G Scanavini
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - D W Schmitz
- University of Chicago, Chicago, Illinois 60637, USA
| | - A Schukraft
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - W Seligman
- Columbia University, New York, New York 10027, USA
| | - M H Shaevitz
- Columbia University, New York, New York 10027, USA
| | - R Sharankova
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Shi
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - E L Snider
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Soderberg
- Syracuse University, Syracuse, New York 13244, USA
| | | | - J Spitz
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - M Stancari
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J St John
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Strauss
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - A M Szelc
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - W Tang
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - N Taniuchi
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - K Terao
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - C Thorpe
- Lancaster University, Lancaster LA1 4YW, United Kingdom
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - D Torbunov
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - D Totani
- University of California, Santa Barbara, California 93106, USA
| | - M Toups
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - Y-T Tsai
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J Tyler
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - M A Uchida
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - T Usher
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - B Viren
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Weber
- Universität Bern, Bern CH-3012, Switzerland
| | - H Wei
- Louisiana State University, Baton Rouge, Louisiana 70803, USA
| | - A J White
- University of Chicago, Chicago, Illinois 60637, USA
| | - S Wolbers
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Wongjirad
- Tufts University, Medford, Massachusetts 02155, USA
| | - M Wospakrik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - K Wresilo
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - W Wu
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - E Yandel
- University of California, Santa Barbara, California 93106, USA
| | - T Yang
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L E Yates
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - H W Yu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - G P Zeller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Zennamo
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - C Zhang
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
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Alharbi A, Mhanna M, Alyosif M, Pena C, Jabr A, Alsughayer A, Alfatlawi H, Safi M, Aldhafeeri A, Patel N, Khuder S, Eltahawy E. Safety and Efficacy of Direct Oral Anticoagulant in Addition to Antiplatelet Therapy After Acute Coronary Syndrome: A Systemic Review and Meta-analysis of 53,869 Patients. Clin Ther 2024; 46:e1-e6. [PMID: 37880055 DOI: 10.1016/j.clinthera.2023.09.027] [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: 01/09/2023] [Revised: 08/17/2023] [Accepted: 09/29/2023] [Indexed: 10/27/2023]
Abstract
INTRODUCTION Significant progress has been made in the management of patients with acute coronary syndrome (ACS) during the past few decades. However, the role of direct oral anticoagulants (DOACs) in post-ACS prophylactic therapy remains unknown. This study aims to assess the efficacy and safety of DOACs plus antiplatelet treatment (APT) after ACS. METHODS A systematic literature search was conducted to identify randomized clinical trials comparing DOACs plus APT with APT alone after ACS. The primary efficacy end points were cardiovascular mortality, myocardial infarction, all-cause mortality, and stroke and systemic embolization (SSE). The primary safety end point was major bleeding. The random-effects model was used to calculate relative risk (RR) and corresponding 95% CIs. RESULTS Nine trials with a total of 53,869 patients were identified, with 33,011 (61.2%) in the DOACs plus APT group and 20,858 (38.8%) in the APT alone group. The use of DOACs did not decrease the risk of cardiovascular death (RR = 0.87; 95% CI, 0.75-1.01; P = 0.08; I2 = 0%) or myocardial infarction (RR = 0.90; 95% CI, 0.80-1.02; P = 0.10; I2 = 6%). However, the risk of SSE was significantly lower in patients who received DOACs plus APT compared with APT alone (RR = 0.67; 95% CI, 0.50-0.90; P = 0.008). Moreover, all-cause mortality was significantly lower in the DOACs plus APT group (RR = 0.83; 95% CI, 0.71-98; P = 0.03; I2 = 0%). However, the risk of major bleeding was significantly higher in patients treated with DOACs plus APT compared with APT alone (RR = 2.53; 95% CI, 1.96-3.26; P < 0.01; I2 = 0%), as was the risk of nonmajor bleeding (RR = 2.27; 95% CI, 1.51-3.41; P < 0.01). IMPLICATIONS DOACs plus APT for the prevention of left ventricular thrombus in patients with ACS were associated with a lower risk of SSE and all-cause mortality but increased the risk of major and nonmajor bleeding. The benefits and risks of this approach should be weighed based on a patient's individual clinical characteristics.
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Affiliation(s)
- Abdulmajeed Alharbi
- Department of Internal Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio.
| | - Mohammed Mhanna
- Division of Cardiology, Department of Medicine, University of Iowa, Iowa City, Iowa
| | - Mohammed Alyosif
- Department of Cardiology, University of Libin Cardiovascular Institute, Calgary, Alberta, Canada
| | - Clarissa Pena
- Department of Internal Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Abed Jabr
- Department of Internal Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Anas Alsughayer
- Department of Internal Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Halah Alfatlawi
- Department of Internal Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Mohammad Safi
- Department of Internal Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Abdulaziz Aldhafeeri
- Department of Internal Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Neha Patel
- Department of Internal Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Sadik Khuder
- Department of Medicine, Statistics, and Public Health, College of Medicine and Life Sciences, The University of Toledo, Toledo, Ohio
| | - Ehab Eltahawy
- Department of Cardiology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
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5
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Lodhia C, Jufas N, Patel N. Patterns of online information use prior to middle-ear surgery: a retrospective cohort study. J Laryngol Otol 2024; 138:33-37. [PMID: 36938814 PMCID: PMC10772020 DOI: 10.1017/s0022215123000440] [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] [Accepted: 03/09/2023] [Indexed: 03/21/2023]
Abstract
OBJECTIVE This study aimed to identify what proportion of middle-ear surgery patients utilise the internet for information and to characterise which resources and media formats are used and for what durations. METHOD A single-arm, retrospective cohort study was performed using an online survey of English-speaking patients who underwent middle-ear surgery over a three-year period across two otology practices. RESULTS Of 260 invitees, 165 responded. A total of 122 used online resources: 9.8 per cent used online resources for less than 15 minutes, 27.0 per cent used them for 15 to 29 minutes, 27.0 per cent used them for 30 to 59 minutes and 36.1 per cent used them for 60 minutes or more. Of online users with complete responses (108 of 122), the most used resources (used for 12 minutes or more) were: written information (73.1 per cent); surgeons' websites (55.6 per cent); pictures, diagrams or photos (42.6 per cent); videos (37.0 per cent); and social media (10.2 per cent). CONCLUSION At least 46.9 per cent of patients undergoing elective ear surgery use online resources. Most time is spent using written information, pictures, diagrams, photos and videos. Therefore, it is increasingly essential that accurate and informative resources in these formats are readily available online.
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Affiliation(s)
- C Lodhia
- Department of Otolaryngology – Head and Neck Surgery, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - N Jufas
- Department of Otolaryngology – Head and Neck Surgery, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
- Division of Otolaryngology Head & Neck Surgery, Royal North Shore Hospital, Sydney, Australia
- Discipline of Surgery, Sydney Medical School, University of Sydney, Sydney, Australia
- Kolling Deafness Research Centre, Royal North Shore Hospital, Macquarie University and University of Sydney, Sydney, Australia
| | - N Patel
- Department of Otolaryngology – Head and Neck Surgery, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
- Division of Otolaryngology Head & Neck Surgery, Royal North Shore Hospital, Sydney, Australia
- Discipline of Surgery, Sydney Medical School, University of Sydney, Sydney, Australia
- Kolling Deafness Research Centre, Royal North Shore Hospital, Macquarie University and University of Sydney, Sydney, Australia
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Newman J, Patel N, Patel S, Sprague T, Bartlett F, Rao N, Andrade E, Rohan V, DuBay D, Casey MJ, Taber D. Impact of obesity on the conversion of immediate-release tacrolimus to extended-release tacrolimus in kidney transplant recipients. Clin Transplant 2023; 37:e15149. [PMID: 37788162 DOI: 10.1111/ctr.15149] [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: 05/11/2023] [Revised: 09/05/2023] [Accepted: 09/12/2023] [Indexed: 10/05/2023]
Abstract
Outcomes analyzing conversion from IR-tacrolimus (IR) to LCP-tacrolimus (LCP) in obesity are limited. This was a retrospective longitudinal cohort study of patients converted from IR to LCP from June 2019 to October 2020. Primary outcomes were conversion ratios for weight-based dose at a steady-state therapeutic level and identification of appropriate dosing weight. Other outcomes included tacrolimus coefficient of variation (CV), time in therapeutic range (TITR), adverse events, infections, donor specific antibodies (DSAs), and acute rejection. A total of 292 patients were included; 156 and 136 patients with a BMI < 30 and BMI ≥ 30 kg/m2 , respectively. Baseline characteristics were similar, except for pancreas transplant, diabetes, and HLA mismatch. IR to LCP conversion ratio ranged from .73 to .79. Mean LCP dose was similar (.08 vs. .07 mg/kg/day for BMI < 30 and BMI ≥ 30 kg/m2 , respectively); there was a significant difference in IR and LCP mg/kg dosing at steady state with TBW (.11 mg/kg vs.09 mg/kg and .08 mg/kg vs. .06 mg/kg, respectively). The most appropriate dosing weight was adjusted body weight (AdjBW), consistent across IR and LCP steady-state doses, and might yield more accurate steady-state dosing requirements. In multivariable modeling, BMI was a significant predictor of steady state mg/kg dosing at therapeutic goal for total body weight (TBW), but not ideal body weight (IBW) or AdjBW.
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Affiliation(s)
- Jessica Newman
- Department of Pharmacy Services, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Neha Patel
- Department of Pharmacy Services, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Shikha Patel
- Department of Pharmacy Services, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Taylor Sprague
- Department of Pharmacy Services, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Felicia Bartlett
- Department of Pharmacy Services, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Nikhil Rao
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Erika Andrade
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Vinayak Rohan
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Derek DuBay
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Michael J Casey
- Department of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - David Taber
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
- Department of Pharmacy, Ralph H Johnson VAMC, Charleston, South Carolina, USA
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Mandane B, Amirthanayagam A, Patel N, Darko N, Moss EL. Attitudes and barriers to participation in window-of-opportunity trials reported by White and Asian/Asian British ethnicity patients who have undergone treatment for endometrial cancer. Trials 2023; 24:754. [PMID: 38007461 PMCID: PMC10676569 DOI: 10.1186/s13063-023-07572-x] [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: 06/15/2022] [Accepted: 08/04/2023] [Indexed: 11/27/2023] Open
Abstract
PURPOSE Window-of-opportunity trials (WOT) are a study design that have been used to investigate drug activity in endometrial cancer (EC). Recruitment to cancer clinical trials by patients from ethnic minority groups is reported to be lower than for patients of White ethnicity. METHODS A verbal questionnaire was conducted with White and Asian/Asian British ethnicity patients who had undergone treatment for EC. Strategic purposeful sampling was used to recruit patients from diverse social/educational backgrounds. Questions explored: background knowledge of clinical research, WOT study design, and views on medications that might be investigated. Thematic analysis was used to explore motivations for WOT participation and perceived barriers. RESULTS In total, 21 patients were recruited to the study (15 White and 6 Asian/Asian British). Views on optimum time to receive trial information differed, preferences ranging from 'at the time of diagnosis' to 'a few days after diagnosis'. The choice of medication under investigation had a strong influence on potential willingness to participate, with greater interest reported in medications derived from vitamins or food supplements rather than hormone-based drugs. Potential barriers to participation included concern over potential side-effects and the emotional/physical burden of a cancer diagnosis prior to major surgery. DISCUSSION This study provides important insights into patients' views on WOT participation in EC and raises issues that need to be considered for future trial design and participant recruitment materials. The timing and format of study information and type of substance under investigation were factors influencing potential participation. Future studies should consider using multi-lingual visual information videos to address information needs, as this may encourage participation by ethnic minority patients.
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Affiliation(s)
- B Mandane
- Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
- University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, LE1 5WW, UK
| | - A Amirthanayagam
- College of Life Sciences, University of Leicester, University Road, Leicester, LE1 7RH, UK
| | - N Patel
- University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, LE1 5WW, UK
| | - N Darko
- College of Life Sciences, University of Leicester, University Road, Leicester, LE1 7RH, UK
| | - E L Moss
- University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, LE1 5WW, UK.
- College of Life Sciences, University of Leicester, University Road, Leicester, LE1 7RH, UK.
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Squillaro AI, Kohn J, Weaver L, Yankovsky A, Milky G, Patel N, Kreaden US, Gaertner WB. Intracorporeal or extracorporeal anastomosis after minimally invasive right colectomy: a systematic review and meta-analysis. Tech Coloproctol 2023; 27:1007-1016. [PMID: 37561350 DOI: 10.1007/s10151-023-02850-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/31/2023] [Indexed: 08/11/2023]
Abstract
PURPOSE As part of the wide adoption of minimally invasive surgery, intracorporeal anastomosis is becoming increasingly common. The benefits of minimally invasive versus open right colectomy are well known although the additional benefits of an intracorporeal anastomosis, performed laparoscopically or robotically, are unclear. The aim of this study was to assess the current literature comparing intracorporeal and extracorporeal anastomosis in the setting of laparoscopic and robotic-assisted right colectomy. METHODS A systematic review and meta-analysis was conducted according to PRISMA and AMSTAR methods. Studies included were randomized controlled trials and prospective or retrospective cohort studies, between January 1 2010 and July 1 2021, comparing intracorporeal and extracorporeal anastomosis with laparoscopic and robotic approaches. Four groups were identified: laparoscopic extracorporeal anastomosis (L-ECA), laparoscopic intracorporeal anastomosis (L-ICA), robotic extracorporeal anastomosis (R-ECA), and robotic intracorporeal anastomosis (R-ICA). Operative time, rate of conversion to an open procedure, surgical site infection, reoperation within 30 days, postoperative complications within 30 days, and length of hospital stay were assessed. RESULTS Twenty-one retrospective cohort studies were included in the final analysis. R-ICA and R-ECA had comparable operative times, but a robotic approach required more time than laparoscopic (68 min longer, p < 0.00001). Conversion to open surgery was 55% less likely in the R-ICA group vs. L-ICA, and up to 94% less likely in the R-ICA group in comparison to the R-ECA group. Length of hospital stay was shorter for R-ICA by a half day vs. R-ECA, and up to 1 day less vs. L-ECA. There were no differences in postoperative complications, reoperations, or surgical site infections, regardless of approach. However, the included studies all had high risks of bias due to confounding variables and patient selection. CONCLUSION Robotic-assisted right colectomy with intracorporeal anastomosis was associated with shorter length of hospitalization and decreased rate of conversion to open surgery, compared to either laparoscopic or extracorporeal robotic approaches. Prospective studies are needed to better understand the true impact of robotic approach and intracorporeal anastomosis in right colectomy.
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Affiliation(s)
- A I Squillaro
- Department of Surgery, University of Minnesota, 420 Delaware St. S.E., Minneapolis, MN, 55455, USA.
- Division of Colon and Rectal Surgery, University of Minnesota, Mayo Mail Code 450, 420 Delaware St. S.E., Minneapolis, MN, 55455-0341, USA.
| | - J Kohn
- Department of Surgery, University of Minnesota, 420 Delaware St. S.E., Minneapolis, MN, 55455, USA
| | - L Weaver
- Department of Surgery, University of Minnesota, 420 Delaware St. S.E., Minneapolis, MN, 55455, USA
| | - A Yankovsky
- Global Access, Value and Economics, Intuitive Surgical, 1020 Kifer Road, Sunnyvale, CA, 94086, USA
| | - G Milky
- Global Access, Value and Economics, Intuitive Surgical, 1020 Kifer Road, Sunnyvale, CA, 94086, USA
| | - N Patel
- Global Access, Value and Economics, Intuitive Surgical, 1020 Kifer Road, Sunnyvale, CA, 94086, USA
| | - U S Kreaden
- Global Access, Value and Economics, Intuitive Surgical, 1020 Kifer Road, Sunnyvale, CA, 94086, USA
| | - W B Gaertner
- Department of Surgery, University of Minnesota, 420 Delaware St. S.E., Minneapolis, MN, 55455, USA
- Division of Colon and Rectal Surgery, University of Minnesota, Mayo Mail Code 450, 420 Delaware St. S.E., Minneapolis, MN, 55455-0341, USA
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Alharbi A, Shah M, Mhanna M, Rejent K, Safi M, Alsughayer A, Patel N, Assaly R. Body Mass Index and Outcomes of Transcatheter Aortic Valve Replacement: A Retrospective Observational Study. Curr Probl Cardiol 2023; 48:101879. [PMID: 37343774 DOI: 10.1016/j.cpcardiol.2023.101879] [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: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 06/23/2023]
Abstract
The influence of body mass index (BMI) on Transcatheter Aortic Valve Replacement (TAVR) outcomes has been the focus of several previous studies. In this study, we examined the relationship between BMI and various clinical outcomes following TAVR procedures. A comprehensive analysis was conducted using a large cohort of patients who underwent TAVR. In this study, we identified patients who underwent Transcatheter aortic valve replacement (TAVR) in the year 2020. Procedure Classification System (ICD-10-PCS) codes were used to identify TAVR cases. The weighted final study sample included 77319 TAVR hospitalizations. Patients were categorized into 5 groups based on their Body Mass Index (BMI. Our findings revealed that there was no significant difference in in-hospital mortality among different BMI groups when compared to patients with a normal BMI (20 to 24.9). patients with a BMI of 25 or higher demonstrated a statistically significant shorter duration of hospitalization compared to those with a normal BMI. patients with a BMI ranging between 30 and 39.9 exhibited decreased hospitalization costs when compared to patients with a normal BMI. Moreover, our study revealed a decrease in atrial fibrillation, acute heart failure and acute kidney injury complications following TAVR in patients with above-normal BMI. Despite similar in-hospital mortality across BMI groups, having a BMI of 25 or greater is associated with improved immediate outcomes following TAVR. These benefits in overweight and obese patients are consistent with findings described in recent literature. Further studies are warranted to explore the underlying mechanisms and potential implications of these associations, as well as to optimize patient selection and management strategies for TAVR procedures.
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Affiliation(s)
| | - Momin Shah
- Department of Internal Medicine, University of Toledo, Toledo, OH
| | - Mohammed Mhanna
- Division of Cardiology, Department of Medicine, University of Iowa, Iowa City, IA
| | - Kassidy Rejent
- Department of Internal Medicine, University of Toledo, Toledo, OH
| | - Mohammad Safi
- Department of Internal Medicine, University of Toledo, Toledo, OH
| | - Anas Alsughayer
- Department of Internal Medicine, University of Toledo, Toledo, OH
| | - Neha Patel
- Department of Internal Medicine, University of Toledo, Toledo, OH
| | - Ragheb Assaly
- Department of Internal Medicine, University of Toledo, Toledo, OH; Department of Internal Medicine, Pulmonary and Critical Care Medicine, University of Toledo, Toledo, OH
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Elhalawani H, Chao ST, Suh JH, Song AJ, Zahler S, Peereboom D, Ahluwalia M, Stevens G, Patel N, Murphy ES. Three Decade Single-Institution Experience of Safety and Efficacy of Radiotherapy and Adjuvant Chemotherapy for Young Adult Patients with Medulloblastoma. Int J Radiat Oncol Biol Phys 2023; 117:e511-e512. [PMID: 37785601 DOI: 10.1016/j.ijrobp.2023.06.1769] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The rarity of medulloblastoma in the adult population limits information on optimal treatment and clinical outcomes. Adjuvant chemoradiation has been correlated to improved overall survival (OS) in a recent National Cancer Database (NCDB) analysis. We performed a retrospective safety and efficacy analysis of radiation (RT) +/- adjuvant chemotherapy (aCTH) in young adult patients with medulloblastoma to better understand outcomes, prognostic factors, and possibly optimal treatment strategies. MATERIALS/METHODS We conducted an IRB-approved retrospective chart review on young adult (age ≥18 - 39 years old) patients with medulloblastoma treated at our institution (1992-2018) with a minimum follow-up of 6 months from completion of therapy. We gathered data on patient and disease characteristics, treatment, and clinical outcomes, including OS, progression-free survival (PFS), local control (LC), and freedom from distant metastasis (FDM). We employed Cox regression model for univariable and multivariable analyses and Kaplan-Meier (KM) test methods for survival analyses, using JMP version 15.0 software. RESULTS Thirty-one patients were treated with postoperative RT including craniospinal irradiation (median dose: 2340 cGy/13 fractions) followed by tumor bed/posterior fossa (median total dose: 5580 cGy/31 fractions) either alone (n = 9; 29%) or with adjuvant chemotherapy (aCTH: n = 22; 71%); mostly as per COG A9961 Regimen A: oral lomustine, intravenous cisplatin, and intravenous vincristine (n = 12). 54.6% (n = 12) were known to complete the full aCTH course. Common RT acute toxicities included G1-2 nausea and/or vomiting (N/V; n = 8) and G1-2 fatigue (n = 6). Common aCTH acute toxicities included G1-2 N/V (n = 7) and peripheral neuropathy: G1-2 (n = 6) and G3 (n = 3). Late adverse events were primarily G1-2 peripheral neuropathy and gait imbalance (22.6%), G1-2 hormonal disturbances (19.4%) and G1-2 neurocognitive impairment (16.1%). Male patients had worse OS, PFS, FDM, and LC. Age at diagnosis, tumor location (lateral vs. central), and completion of aCTH course were shown on uni- and multi-variable analysis to be significantly associated with OS; p<0.05. KM survival analysis revealed superior 10-year PFS and OS in patients who completed aCTH compared to those who received RT alone or did not complete aCTH: 72.9% vs 59.3% vs 42%, p = 0.461, and 74.1% vs 63.5% vs 40%, p = 0.033, respectively. A similar trend was noted for LC and FDM. CONCLUSION Our series provides a report of acute and late side effects of treatment of young adult patients with medulloblastoma. Significant OS and PFS advantage are seen of aCTH completion in this patient population. Since optimal treatment of these patients is still an unmet need, prospective studies for this rare disease entity are needed.
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Affiliation(s)
- H Elhalawani
- Boston Children's Hospital, Boston, MA; Dana-Farber Brigham Cancer Center, Boston, MA
| | - S T Chao
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
| | - J H Suh
- Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH
| | - A J Song
- Department of Radiation Oncology, Sidney Kimmel Medical College & Cancer Center at Thomas Jefferson University, Philadelphia, PA
| | - S Zahler
- Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic, Cleveland, OH
| | - D Peereboom
- Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - M Ahluwalia
- Department of Medical Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - G Stevens
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
| | - N Patel
- Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic, Cleveland, OH
| | - E S Murphy
- Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH
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Abratenko P, Alterkait O, Andrade Aldana D, Anthony J, Arellano L, Asaadi J, Ashkenazi A, Balasubramanian S, Baller B, Barr G, Barrow J, Basque V, Benevides Rodrigues O, Berkman S, Bhanderi A, Bhattacharya M, Bishai M, Blake A, Bogart B, Bolton T, Book JY, Camilleri L, Caratelli D, Caro Terrazas I, Cavanna F, Cerati G, Chen Y, Cohen EO, Conrad JM, Convery M, Cooper-Troendle L, Crespo-Anadón JI, Del Tutto M, Dennis SR, Detje P, Devitt A, Diurba R, Djurcic Z, Dorrill R, Duffy K, Dytman S, Eberly B, Ereditato A, Evans JJ, Fine R, Finnerud OG, Foreman W, Fleming BT, Foppiani N, Franco D, Furmanski AP, Garcia-Gamez D, Gardiner S, Ge G, Gollapinni S, Goodwin O, Gramellini E, Green P, Greenlee H, Gu W, Guenette R, Guzowski P, Hagaman L, Hen O, Hicks R, Hilgenberg C, Horton-Smith GA, Irwin B, Itay R, James C, Ji X, Jiang L, Jo JH, Johnson RA, Jwa YJ, Kalra D, Kamp N, Karagiorgi G, Ketchum W, Kirby M, Kobilarcik T, Kreslo I, Leibovitch MB, Lepetic I, Li JY, Li K, Li Y, Lin K, Littlejohn BR, Louis WC, Luo X, Mariani C, Marsden D, Marshall J, Martinez N, Martinez Caicedo DA, Mason K, Mastbaum A, McConkey N, Meddage V, Miller K, Mills J, Mogan A, Mohayai T, Mooney M, Moor AF, Moore CD, Mora Lepin L, Mousseau J, Mulleriababu S, Naples D, Navrer-Agasson A, Nayak N, Nebot-Guinot M, Nowak J, Oza N, Palamara O, Pallat N, Paolone V, Papadopoulou A, Papavassiliou V, Parkinson HB, Pate SF, Patel N, Pavlovic Z, Piasetzky E, Ponce-Pinto ID, Pophale I, Prince S, Qian X, Raaf JL, Radeka V, Rafique A, Reggiani-Guzzo M, Ren L, Rochester L, Rodriguez Rondon J, Rosenberg M, Ross-Lonergan M, Rudolf von Rohr C, Scanavini G, Schmitz DW, Schukraft A, Seligman W, Shaevitz MH, Sharankova R, Shi J, Snider EL, Soderberg M, Söldner-Rembold S, Spitz J, Stancari M, John JS, Strauss T, Sword-Fehlberg S, Szelc AM, Tang W, Taniuchi N, Terao K, Thorpe C, Torbunov D, Totani D, Toups M, Tsai YT, Tyler J, Uchida MA, Usher T, Viren B, Weber M, Wei H, White AJ, Williams Z, Wolbers S, Wongjirad T, Wospakrik M, Wresilo K, Wright N, Wu W, Yandel E, Yang T, Yates LE, Yu HW, Zeller GP, Zennamo J, Zhang C. First Double-Differential Measurement of Kinematic Imbalance in Neutrino Interactions with the MicroBooNE Detector. Phys Rev Lett 2023; 131:101802. [PMID: 37739352 DOI: 10.1103/physrevlett.131.101802] [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] [Received: 01/11/2023] [Revised: 05/09/2023] [Accepted: 07/14/2023] [Indexed: 09/24/2023]
Abstract
We report the first measurement of flux-integrated double-differential quasielasticlike neutrino-argon cross sections, which have been made using the Booster Neutrino Beam and the MicroBooNE detector at Fermi National Accelerator Laboratory. The data are presented as a function of kinematic imbalance variables which are sensitive to nuclear ground-state distributions and hadronic reinteraction processes. We find that the measured cross sections in different phase-space regions are sensitive to different nuclear effects. Therefore, they enable the impact of specific nuclear effects on the neutrino-nucleus interaction to be isolated more completely than was possible using previous single-differential cross section measurements. Our results provide precision data to help test and improve neutrino-nucleus interaction models. They further support ongoing neutrino-oscillation studies by establishing phase-space regions where precise reaction modeling has already been achieved.
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Affiliation(s)
- P Abratenko
- Tufts University, Medford, Massachusetts 02155, USA
| | - O Alterkait
- Tufts University, Medford, Massachusetts 02155, USA
| | - D Andrade Aldana
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - J Anthony
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - L Arellano
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Asaadi
- University of Texas, Arlington, Texas 76019, USA
| | - A Ashkenazi
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - S Balasubramanian
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - B Baller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Barr
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - J Barrow
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - V Basque
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - O Benevides Rodrigues
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
- Syracuse University, Syracuse, New York 13244, USA
| | - S Berkman
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - A Bhanderi
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - M Bhattacharya
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Bishai
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Blake
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - B Bogart
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - T Bolton
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - J Y Book
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - L Camilleri
- Columbia University, New York, New York 10027, USA
| | - D Caratelli
- University of California, Santa Barbara, California 93106, USA
| | - I Caro Terrazas
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - F Cavanna
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Cerati
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - Y Chen
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - E O Cohen
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - J M Conrad
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - M Convery
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - L Cooper-Troendle
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - J I Crespo-Anadón
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid E-28040, Spain
| | - M Del Tutto
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - S R Dennis
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - P Detje
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - A Devitt
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - R Diurba
- Universität Bern, Bern CH-3012, Switzerland
| | - Z Djurcic
- Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
| | - R Dorrill
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - K Duffy
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - S Dytman
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - B Eberly
- University of Southern Maine, Portland, Maine 04104, USA
| | | | - J J Evans
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - R Fine
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - O G Finnerud
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - W Foreman
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - B T Fleming
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - N Foppiani
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - D Franco
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - A P Furmanski
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | | | - S Gardiner
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Ge
- Columbia University, New York, New York 10027, USA
| | - S Gollapinni
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - O Goodwin
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - E Gramellini
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - P Green
- The University of Manchester, Manchester M13 9PL, United Kingdom
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - H Greenlee
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - W Gu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - R Guenette
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - P Guzowski
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Hagaman
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - O Hen
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - R Hicks
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - C Hilgenberg
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | | | - B Irwin
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - R Itay
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - C James
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - X Ji
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - L Jiang
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - J H Jo
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - R A Johnson
- University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - Y-J Jwa
- Columbia University, New York, New York 10027, USA
| | - D Kalra
- Columbia University, New York, New York 10027, USA
| | - N Kamp
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - G Karagiorgi
- Columbia University, New York, New York 10027, USA
| | - W Ketchum
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Kirby
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Kobilarcik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - I Kreslo
- Universität Bern, Bern CH-3012, Switzerland
| | - M B Leibovitch
- University of California, Santa Barbara, California 93106, USA
| | - I Lepetic
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - J-Y Li
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - K Li
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Y Li
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - K Lin
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - B R Littlejohn
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - W C Louis
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - X Luo
- University of California, Santa Barbara, California 93106, USA
| | - C Mariani
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - D Marsden
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Marshall
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - N Martinez
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - D A Martinez Caicedo
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - K Mason
- Tufts University, Medford, Massachusetts 02155, USA
| | - A Mastbaum
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - N McConkey
- The University of Manchester, Manchester M13 9PL, United Kingdom
- University College London, London WC1E 6BT, United Kingdom
| | - V Meddage
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - K Miller
- University of Chicago, Chicago, Illinois 60637, USA
| | - J Mills
- Tufts University, Medford, Massachusetts 02155, USA
| | - A Mogan
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - T Mohayai
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Mooney
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - A F Moor
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - C D Moore
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L Mora Lepin
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Mousseau
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | | | - D Naples
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Navrer-Agasson
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - N Nayak
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Nebot-Guinot
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - J Nowak
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - N Oza
- Columbia University, New York, New York 10027, USA
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - O Palamara
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - N Pallat
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - V Paolone
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Papadopoulou
- Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - V Papavassiliou
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - H B Parkinson
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - S F Pate
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - N Patel
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - Z Pavlovic
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - E Piasetzky
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - I D Ponce-Pinto
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - I Pophale
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - S Prince
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - X Qian
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - J L Raaf
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - V Radeka
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Rafique
- Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
| | - M Reggiani-Guzzo
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Ren
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - L Rochester
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J Rodriguez Rondon
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - M Rosenberg
- Tufts University, Medford, Massachusetts 02155, USA
| | - M Ross-Lonergan
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | | | - G Scanavini
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - D W Schmitz
- University of Chicago, Chicago, Illinois 60637, USA
| | - A Schukraft
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - W Seligman
- Columbia University, New York, New York 10027, USA
| | - M H Shaevitz
- Columbia University, New York, New York 10027, USA
| | - R Sharankova
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Shi
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - E L Snider
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Soderberg
- Syracuse University, Syracuse, New York 13244, USA
| | | | - J Spitz
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - M Stancari
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J St John
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Strauss
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - S Sword-Fehlberg
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - A M Szelc
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - W Tang
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - N Taniuchi
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - K Terao
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - C Thorpe
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - D Torbunov
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - D Totani
- University of California, Santa Barbara, California 93106, USA
| | - M Toups
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - Y-T Tsai
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J Tyler
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - M A Uchida
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - T Usher
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - B Viren
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Weber
- Universität Bern, Bern CH-3012, Switzerland
| | - H Wei
- Louisiana State University, Baton Rouge, Louisiana 70803, USA
| | - A J White
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Z Williams
- University of Texas, Arlington, Texas 76019, USA
| | - S Wolbers
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Wongjirad
- Tufts University, Medford, Massachusetts 02155, USA
| | - M Wospakrik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - K Wresilo
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - N Wright
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - W Wu
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - E Yandel
- University of California, Santa Barbara, California 93106, USA
| | - T Yang
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L E Yates
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - H W Yu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - G P Zeller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Zennamo
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - C Zhang
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
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12
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Vyas VK, Bhati S, Sharma M, Gehlot P, Patel N, Dalai S. 3D-QSAR-based design, synthesis and biological evaluation of 2,4-disubstituted quinoline derivatives as antimalarial agents. SAR QSAR Environ Res 2023; 34:639-659. [PMID: 37651746 DOI: 10.1080/1062936x.2023.2247326] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/08/2023] [Indexed: 09/02/2023]
Abstract
2,4-Disubstituted quinoline derivatives were designed based on a 3D-QSAR study, synthesized and evaluated for antimalarial activity. A large dataset of 178 quinoline derivatives was used to perform a 3D-QSAR study using CoMFA and CoMSIA models. PLS analysis provided statistically validated results for CoMFA (r2ncv = 0.969, q2 = 0.677, r2cv = 0.682) and CoMSIA (r2ncv = 0.962, q2 = 0.741, r2cv = 0.683) models. Two series of a total of 40 2,4-disubstituted quinoline derivatives were designed with amide (quinoline-4-carboxamide) and secondary amine (4-aminoquinoline) linkers at the -C4 position of the quinoline ring. For the purpose of selecting better compounds for synthesis with good pEC50 values, activity prediction was carried out using CoMFA and CoMSIA models. Finally, a total of 10 2,4-disubstituted quinoline derivatives were synthesized, and screened for their antimalarial activity based on the reduction of parasitaemia. Compound #5 with amide linker and compound #19 with secondary amine linkers at the -C4 position of the quinoline ring showed maximum reductions of 64% and 57%, respectively, in the level of parasitaemia. In vivo screening assay confirmed and validated the findings of the 3D-QSAR study for the design of quinoline derivatives.
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Affiliation(s)
- V K Vyas
- Department of Pharmaceutical Chemistry, Institute of Pharmacy, Nirma University, Ahmedabad, India
| | - S Bhati
- Department of Pharmaceutical Chemistry, Institute of Pharmacy, Nirma University, Ahmedabad, India
| | - M Sharma
- Department of Pharmaceutical Chemistry, Institute of Pharmacy, Nirma University, Ahmedabad, India
| | - P Gehlot
- Department of Pharmaceutical Chemistry, Institute of Pharmacy, Nirma University, Ahmedabad, India
| | - N Patel
- Institute of Science, Nirma University, Ahmedabad, India
| | - S Dalai
- Institute of Science, Nirma University, Ahmedabad, India
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13
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Shah R, Patel N, Emin M, Celik Y, Jimenez A, Gao S, Garfinkel J, Wei Y, Jelic S. Statins Restore Endothelial Protection against Complement Activity in Obstructive Sleep Apnea: A Randomized Clinical Trial. Ann Am Thorac Soc 2023; 20:1029-1037. [PMID: 36912897 DOI: 10.1513/annalsats.202209-761oc] [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: 09/07/2022] [Accepted: 03/13/2023] [Indexed: 03/14/2023] Open
Abstract
Rationale: Increased cardiovascular risk in obstructive sleep apnea (OSA) persists after continuous positive airway pressure (CPAP) and alternative therapies are needed. Impaired endothelial protection against complement is a cholesterol-dependent process that initiates endothelial inflammation in OSA, which increases cardiovascular risk. Objectives: To investigate directly whether lowering cholesterol improves endothelial protection against complement and its proinflammatory effects in OSA. Methods: Newly diagnosed patients with OSA (n = 87) and OSA-free controls (n = 32) participated. Endothelial cells and blood were collected at baseline, after 4 weeks of CPAP therapy, and again after 4 weeks of 10 mg atorvastatin versus placebo using a randomized, double-blind, parallel-group design. Primary outcome was the proportion of a complement inhibitor, CD59, on the endothelial cell plasma membrane in OSA patients after 4 weeks of statins versus placebo. Secondary outcomes were complement deposition on endothelial cells and circulating levels of its downstream proinflammatory factor, angiopoietin-2, after statins versus placebo. Results: Baseline expression of CD59 was lower, whereas complement deposition on endothelial cells and levels of angiopoietin-2 were greater, in patients with OSA compared with controls. CPAP did not affect expression of CD59 or complement deposition on endothelial cells in patients with OSA, regardless of adherence. Compared with placebo, statins increased expression of endothelial complement protector CD59 and lowered complement deposition in patients with OSA. Good CPAP adherence was associated with increased angiopoietin-2 levels, which was reversed by statins. Conclusions: Statins restore endothelial protection against complement and reduce its downstream proinflammatory effects, suggesting a potential approach to reduce residual cardiovascular risk after CPAP in patients with OSA. Clinical trial registered with www.clinicaltrials.gov (NCT03122639).
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Affiliation(s)
- Riddhi Shah
- Division of Pulmonary, Allergy, and Critical Care Medicine
| | | | - Memet Emin
- Division of Pulmonary, Allergy, and Critical Care Medicine
| | - Yeliz Celik
- Division of Pulmonary, Allergy, and Critical Care Medicine
| | | | - Su Gao
- Division of Pulmonary, Allergy, and Critical Care Medicine
| | - Jared Garfinkel
- Department of Biostatistics, Columbia University College of Physicians and Surgeons, New York, New York
| | - Ying Wei
- Department of Biostatistics, Columbia University College of Physicians and Surgeons, New York, New York
| | - Sanja Jelic
- Division of Pulmonary, Allergy, and Critical Care Medicine
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14
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Abratenko P, Andrade Aldana D, Anthony J, Arellano L, Asaadi J, Ashkenazi A, Balasubramanian S, Baller B, Barr G, Barrow J, Basque V, Benevides Rodrigues O, Berkman S, Bhanderi A, Bhattacharya M, Bishai M, Blake A, Bogart B, Bolton T, Book JY, Camilleri L, Caratelli D, Caro Terrazas I, Cavanna F, Cerati G, Chen Y, Conrad JM, Convery M, Cooper-Troendle L, Crespo-Anadón JI, Del Tutto M, Dennis SR, Detje P, Devitt A, Diurba R, Djurcic Z, Dorrill R, Duffy K, Dytman S, Eberly B, Ereditato A, Evans JJ, Fine R, Finnerud OG, Foreman W, Fleming BT, Foppiani N, Franco D, Furmanski AP, Garcia-Gamez D, Gardiner S, Ge G, Gollapinni S, Goodwin O, Gramellini E, Green P, Greenlee H, Gu W, Guenette R, Guzowski P, Hagaman L, Hen O, Hicks R, Hilgenberg C, Horton-Smith GA, Irwin B, Itay R, James C, Ji X, Jiang L, Jo JH, Johnson RA, Jwa YJ, Kalra D, Kamp N, Karagiorgi G, Ketchum W, Kirby M, Kobilarcik T, Kreslo I, Leibovitch MB, Lepetic I, Li JY, Li K, Li Y, Lin K, Littlejohn BR, Louis WC, Luo X, Mariani C, Marsden D, Marshall J, Martinez N, Martinez Caicedo DA, Mason K, Mastbaum A, McConkey N, Meddage V, Miller K, Mills J, Mogan A, Mohayai T, Mooney M, Moor AF, Moore CD, Mora Lepin L, Mousseau J, Mulleriababu S, Naples D, Navrer-Agasson A, Nayak N, Nebot-Guinot M, Nowak J, Nunes M, Oza N, Palamara O, Pallat N, Paolone V, Papadopoulou A, Papavassiliou V, Parkinson HB, Pate SF, Patel N, Pavlovic Z, Piasetzky E, Ponce-Pinto ID, Pophale I, Prince S, Qian X, Raaf JL, Radeka V, Rafique A, Reggiani-Guzzo M, Ren L, Rochester L, Rodriguez Rondon J, Rosenberg M, Ross-Lonergan M, Rudolf von Rohr C, Scanavini G, Schmitz DW, Schukraft A, Seligman W, Shaevitz MH, Sharankova R, Shi J, Snider EL, Soderberg M, Söldner-Rembold S, Spitz J, Stancari M, John JS, Strauss T, Sword-Fehlberg S, Szelc AM, Tang W, Taniuchi N, Terao K, Thorpe C, Torbunov D, Totani D, Toups M, Tsai YT, Tyler J, Uchida MA, Usher T, Viren B, Weber M, Wei H, White AJ, Williams Z, Wolbers S, Wongjirad T, Wospakrik M, Wresilo K, Wright N, Wu W, Yandel E, Yang T, Yates LE, Yu HW, Zeller GP, Zennamo J, Zhang C. First Measurement of Quasielastic Λ Baryon Production in Muon Antineutrino Interactions in the MicroBooNE Detector. Phys Rev Lett 2023; 130:231802. [PMID: 37354393 DOI: 10.1103/physrevlett.130.231802] [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] [Received: 12/16/2022] [Revised: 04/07/2023] [Accepted: 04/28/2023] [Indexed: 06/26/2023]
Abstract
We present the first measurement of the cross section of Cabibbo-suppressed Λ baryon production, using data collected with the MicroBooNE detector when exposed to the neutrinos from the main injector beam at the Fermi National Accelerator Laboratory. The data analyzed correspond to 2.2×10^{20} protons on target running in neutrino mode, and 4.9×10^{20} protons on target running in anti-neutrino mode. An automated selection is combined with hand scanning, with the former identifying five candidate Λ production events when the signal was unblinded, consistent with the GENIE prediction of 5.3±1.1 events. Several scanners were employed, selecting between three and five events, compared with a prediction from a blinded Monte Carlo simulation study of 3.7±1.0 events. Restricting the phase space to only include Λ baryons that decay above MicroBooNE's detection thresholds, we obtain a flux averaged cross section of 2.0_{-1.7}^{+2.2}×10^{-40} cm^{2}/Ar, where statistical and systematic uncertainties are combined.
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Affiliation(s)
- P Abratenko
- Tufts University, Medford, Massachusetts 02155, USA
| | - D Andrade Aldana
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - J Anthony
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - L Arellano
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Asaadi
- University of Texas, Arlington, Texas 76019, USA
| | - A Ashkenazi
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - S Balasubramanian
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - B Baller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Barr
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - J Barrow
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - V Basque
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | | | - S Berkman
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - A Bhanderi
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - M Bhattacharya
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Bishai
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Blake
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - B Bogart
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - T Bolton
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - J Y Book
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - L Camilleri
- Columbia University, New York, New York 10027, USA
| | - D Caratelli
- University of California, Santa Barbara, California 93106, USA
| | - I Caro Terrazas
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - F Cavanna
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Cerati
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - Y Chen
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J M Conrad
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - M Convery
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - L Cooper-Troendle
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - J I Crespo-Anadón
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid E-28040, Spain
| | - M Del Tutto
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - S R Dennis
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - P Detje
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - A Devitt
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - R Diurba
- Universität Bern, Bern CH-3012, Switzerland
| | - Z Djurcic
- Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
| | - R Dorrill
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - K Duffy
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - S Dytman
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - B Eberly
- University of Southern Maine, Portland, Maine 04104, USA
| | | | - J J Evans
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - R Fine
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - O G Finnerud
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - W Foreman
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - B T Fleming
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - N Foppiani
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - D Franco
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - A P Furmanski
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | | | - S Gardiner
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Ge
- Columbia University, New York, New York 10027, USA
| | - S Gollapinni
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - O Goodwin
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - E Gramellini
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - P Green
- The University of Manchester, Manchester M13 9PL, United Kingdom
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - H Greenlee
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - W Gu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - R Guenette
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - P Guzowski
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Hagaman
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - O Hen
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - R Hicks
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - C Hilgenberg
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | | | - B Irwin
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - R Itay
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - C James
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - X Ji
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - L Jiang
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - J H Jo
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - R A Johnson
- University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - Y-J Jwa
- Columbia University, New York, New York 10027, USA
| | - D Kalra
- Columbia University, New York, New York 10027, USA
| | - N Kamp
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - G Karagiorgi
- Columbia University, New York, New York 10027, USA
| | - W Ketchum
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Kirby
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Kobilarcik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - I Kreslo
- Universität Bern, Bern CH-3012, Switzerland
| | - M B Leibovitch
- University of California, Santa Barbara, California 93106, USA
| | - I Lepetic
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - J-Y Li
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - K Li
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Y Li
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - K Lin
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - B R Littlejohn
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - W C Louis
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - X Luo
- University of California, Santa Barbara, California 93106, USA
| | - C Mariani
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - D Marsden
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Marshall
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - N Martinez
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - D A Martinez Caicedo
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - K Mason
- Tufts University, Medford, Massachusetts 02155, USA
| | - A Mastbaum
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - N McConkey
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - V Meddage
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - K Miller
- University of Chicago, Chicago, Illinois 60637, USA
| | - J Mills
- Tufts University, Medford, Massachusetts 02155, USA
| | - A Mogan
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - T Mohayai
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Mooney
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - A F Moor
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - C D Moore
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L Mora Lepin
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Mousseau
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | | | - D Naples
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Navrer-Agasson
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - N Nayak
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Nebot-Guinot
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - J Nowak
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - M Nunes
- Syracuse University, Syracuse, New York 13244, USA
| | - N Oza
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - O Palamara
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - N Pallat
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - V Paolone
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Papadopoulou
- Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - V Papavassiliou
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - H B Parkinson
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - S F Pate
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - N Patel
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - Z Pavlovic
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - E Piasetzky
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - I D Ponce-Pinto
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - I Pophale
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - S Prince
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - X Qian
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - J L Raaf
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - V Radeka
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Rafique
- Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
| | - M Reggiani-Guzzo
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Ren
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - L Rochester
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J Rodriguez Rondon
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - M Rosenberg
- Tufts University, Medford, Massachusetts 02155, USA
| | - M Ross-Lonergan
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | | | - G Scanavini
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - D W Schmitz
- University of Chicago, Chicago, Illinois 60637, USA
| | - A Schukraft
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - W Seligman
- Columbia University, New York, New York 10027, USA
| | - M H Shaevitz
- Columbia University, New York, New York 10027, USA
| | - R Sharankova
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Shi
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - E L Snider
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Soderberg
- Syracuse University, Syracuse, New York 13244, USA
| | | | - J Spitz
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - M Stancari
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J St John
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Strauss
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - S Sword-Fehlberg
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - A M Szelc
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - W Tang
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - N Taniuchi
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - K Terao
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - C Thorpe
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - D Torbunov
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - D Totani
- University of California, Santa Barbara, California 93106, USA
| | - M Toups
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - Y-T Tsai
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J Tyler
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - M A Uchida
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - T Usher
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - B Viren
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Weber
- Universität Bern, Bern CH-3012, Switzerland
| | - H Wei
- Louisiana State University, Baton Rouge, Louisiana 70803, USA
| | - A J White
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Z Williams
- University of Texas, Arlington, Texas 76019, USA
| | - S Wolbers
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Wongjirad
- Tufts University, Medford, Massachusetts 02155, USA
| | - M Wospakrik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - K Wresilo
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - N Wright
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - W Wu
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - E Yandel
- University of California, Santa Barbara, California 93106, USA
| | - T Yang
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L E Yates
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - H W Yu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - G P Zeller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Zennamo
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - C Zhang
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
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Carcella T, Patel N, Marable J, Bethi S, Fleming J, Baliga P, DuBay D, Taber D, Rohan V. Long-term Outcomes Following a Comprehensive Quality Assurance and Process Improvement Endeavor to Minimize Opioid Use After Kidney Transplant. JAMA Surg 2023; 158:618-624. [PMID: 37017945 PMCID: PMC10077134 DOI: 10.1001/jamasurg.2023.0276] [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: 06/21/2022] [Accepted: 11/20/2022] [Indexed: 04/06/2023]
Abstract
Importance Opioid use following kidney transplant is associated with an increased risk of graft loss and mortality. Opioid minimization strategies and protocols have shown reductions in short-term opioid use after kidney transplant. Objective To evaluate the long-term outcomes associated with an opioid minimization protocol following kidney transplant. Design, Setting, and Participants This single-center quality improvement study evaluated postoperative and long-term opioid use before and after the implementation of a multidisciplinary, multimodal pain regimen and education process in adult kidney graft recipients from August 1, 2017, through June 30, 2020. Patient data were collected from a retrospective chart review. Exposures Preprotocol and postprotocol implementation use of opioids. Main Outcomes and Measures Between November 7 and 23, 2022, opioid use before and after protocol implementation was evaluated up to 1 year after transplant using multivariable linear and logistic regression. Results A total of 743 patients were included, with 245 patients in the preprotocol group (39.2% female and 60.8% male; mean [SD] age, 52.8 [13.1 years]) vs 498 in the postprotocol group (45.4% female and 54.6% male; mean [SD] age, 52.4 [12.9 years]). The total morphine milligram equivalents (MME) in the 1-year follow-up in the preprotocol group was 1203.7 vs 581.9 in the postprotocol group. In the postprotocol group, 313 patients (62.9%) had 0 MME in the 1-year follow-up vs 7 (2.9%) in the preprotocol group (odds ratio [OR], 57.52; 95% CI, 26.55-124.65). Patients in the postprotocol group had 99% lower odds of filling more than 100 MME in the 1-year follow-up (adjusted OR, 0.01; 95% CI, 0.01-0.02; P < .001). Opioid-naive patients postprotocol were one-half as likely to become long-term opioid users vs preprotocol (OR, 0.44; 95% CI, 0.20-0.98; P = .04). Conclusions and Relevance The study's findings show a significant reduction in opioid use in kidney graft recipients associated with the implementation of a multimodal opioid-sparing pain protocol.
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Affiliation(s)
- Taylor Carcella
- Department of Pharmacy, Medical University of South Carolina, Charleston
| | - Neha Patel
- Department of Pharmacy, Medical University of South Carolina, Charleston
| | - Jarrod Marable
- College of Medicine, Medical University of South Carolina, Charleston
| | - Shipra Bethi
- College of Medicine, Medical University of South Carolina, Charleston
| | - James Fleming
- Division of Transplant Surgery, Department of Surgery, Medical University of South Carolina, Charleston
| | - Prabhakar Baliga
- Division of Transplant Surgery, Department of Surgery, Medical University of South Carolina, Charleston
| | - Derek DuBay
- Division of Transplant Surgery, Department of Surgery, Medical University of South Carolina, Charleston
| | - David Taber
- Division of Transplant Surgery, Department of Surgery, Medical University of South Carolina, Charleston
| | - Vinayak Rohan
- Division of Transplant Surgery, Department of Surgery, Medical University of South Carolina, Charleston
- Division of Organ Transplantation, Department of Surgery, Northwestern University, Chicago, Illinois
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Mai J, Rösch B, Patel N, Langer J, Harder S. On the existence of low-valent magnesium-calcium complexes. Chem Sci 2023; 14:4724-4734. [PMID: 37181774 PMCID: PMC10171184 DOI: 10.1039/d3sc00909b] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/13/2023] [Indexed: 05/16/2023] Open
Abstract
DFT-Calculations predict that a low-valent complex (BDI)Mg-Ca(BDI) with bulky β-diketiminate (BDI) ligands is thermodynamically stable. It was attempted to isolate such a complex by salt-metathesis between [(DIPePBDI*)Mg-Na+]2 and [(DIPePBDI)CaI]2 (DIPePBDI = HC[C(Me)N-DIPeP]2; DIPePBDI* = HC[C(tBu)N-DIPeP]2; DIPeP = 2,6-CH(Et)2-phenyl). Whereas in alkane solvents no reaction was observed, salt-metathesis in C6H6 led to immediate C-H activation of benzene to give (DIPePBDI*)MgPh and (DIPePBDI)CaH, the latter crystallizing as a THF-solvated dimer [(DIPePBDI)CaH·THF]2. Calculations suggest reduction and insertion of benzene in the Mg-Ca bond. The activation enthalpy for the subsequent decomposition of C6H62- into Ph- and H- is only 14.4 kcal mol-1. Repeating this reaction in the presence of naphthalene or anthracene led to heterobimetallic complexes in which naphthalene2- or anthracene2- anions are sandwiched between (DIPePBDI*)Mg+ and (DIPePBDI)Ca+ cations. These complexes slowly decompose to their homometallic counterparts and further decomposition products. Complexes in which naphthalene2- or anthracene2- anions are sandwiched between two (DIPePBDI)Ca+ cations were isolated. The low-valent complex (DIPePBDI*)Mg-Ca(DIPePBDI) could not be isolated due to its high reactivity. There is, however, strong evidence that this heterobimetallic compound is a fleeting intermediate.
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Affiliation(s)
- Jonathan Mai
- Inorganic and Organometallic Chemistry, Friedrich-Alexander-Universität Erlangen-Nürnberg Egerlandstraße 1 Erlangen 91058 Germany
| | - Bastian Rösch
- Inorganic and Organometallic Chemistry, Friedrich-Alexander-Universität Erlangen-Nürnberg Egerlandstraße 1 Erlangen 91058 Germany
| | - Neha Patel
- Inorganic and Organometallic Chemistry, Friedrich-Alexander-Universität Erlangen-Nürnberg Egerlandstraße 1 Erlangen 91058 Germany
| | - Jens Langer
- Inorganic and Organometallic Chemistry, Friedrich-Alexander-Universität Erlangen-Nürnberg Egerlandstraße 1 Erlangen 91058 Germany
| | - Sjoerd Harder
- Inorganic and Organometallic Chemistry, Friedrich-Alexander-Universität Erlangen-Nürnberg Egerlandstraße 1 Erlangen 91058 Germany
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Thalia N, Patel K, Patel N. Nationwide Utilization, Cost, and Outcome of Temporary Mechanical Circulatory Support in Takotsubo Cardiomyopathy. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.823] [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: 04/05/2023] Open
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Coutance G, Jain R, Zhang X, Gragert L, Patel N, Patel J, Kransdorf E, Rushakoff J, Kobashigawa J. Homozygosity at Multiple HLA Loci Increases the Risk of Sensitization but Decreases the Risk of Rejection. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.119] [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: 04/05/2023] Open
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Stern L, Patel J, Kittleson M, Chang D, Patel N, Singer-Englar T, Velleca A, Norland K, Hamilton M, Czer L, Esmailian F, Kobashigawa J. Proceeding with Heart Transplant in Flow Positive Cyto-Negative Prospective Donor-Specific Crossmatch in Highly Sensitized Patients: Saving Lives. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1667] [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: 04/05/2023] Open
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Patel J, Kittleson M, Patel N, Singer-Englar T, Kim S, Thein S, Norland K, Hage A, Czer L, Emerson D, Kobashigawa J. High HDL Levels are Associated with Survival Benefit after Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.457] [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: 04/05/2023] Open
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Stachel M, Patel J, Kittleson M, Chang D, Patel N, Singer-Englar T, Ross V, De Leon F, Hamilton M, Czer L, Esmailian F, Kobashigawa J. Revisiting Hemodynamic Compromise Rejection in the Current Era of Heart Transplantation: Still Problematic. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1212] [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: 04/05/2023] Open
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Kittleson M, Patel J, Moriguchi J, Cole R, Singer-Englar T, Patel N, Runyan C, Welton M, Czer L, Catarino P, Kobashigawa J. Do Older LVAD Patients Have Compromised Outcome after Heart Transplantation: Should They Stay as Destination Therapy? J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.190] [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: 04/05/2023] Open
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Kittleson M, Patel J, Nikolova A, Patel N, Singer-Englar T, Hu J, De Leon F, Hamilton M, Czer L, Esmailian F, Kobashigawa J. What Should the GFR Threshold Be for Redo Heart Transplant Patients to Qualify for Combined Heart-Kidney Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.524] [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: 04/05/2023] Open
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Kittleson M, Patel J, Azarbal B, Patel N, Singer-Englar T, Yeomans T, Esmailian G, Nikolova A, Hage A, Emerson D, Czer L, Kobashigawa J. In-Stent Re-Stenosis for Cardiac Allograft Vasculopathy in the Current Era for Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.459] [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: 04/05/2023] Open
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Kittleson M, Patel J, Singer-Englar T, Kim S, Patel N, Wakefield Z, Welton M, Czer L, Esmailian F, Kobashigawa J. Are Redo Heart Transplant Patients Appropriately Listed as Status 4 on the Waitlist. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.525] [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: 04/05/2023] Open
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Kittleson M, Patel J, Chang D, Patel N, Esmailian G, Singer-Englar T, Runyan C, Moriguchi J, Czer L, Esmailian F, Kobashigawa J. Is Chronic Kidney Disease Truly a Contraindication for Total Artificial Heart Candidacy and Subsequent Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.774] [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: 04/05/2023] Open
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Patel N, Kittleson M, Chang D, Patel J, Azarbal B, Singer-Englar T, Geft D, Czer L, Esmailian F, Kobashigawa J. Validation of the Cardiac Allograft Vasculopathy (CAV) Trajectory Score after Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.458] [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: 04/05/2023] Open
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Dhillon M, Kobashigawa J, Patel N, Kittleson M, Zhang X, Patel J. Does Bortezomib Have an Effect on Pre-Transplant Desensitization Therapy or Benefit Post-Heart Transplant Outcomes for Highly Sensitized Patients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.122] [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: 04/05/2023] Open
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Patel N, Johnson MA, Vapniarsky N, Van Brocklin MW, Williams TK, Youngquist ST, Ford R, Ewer N, Neff LP, Hoareau GL. Elamipretide mitigates ischemia-reperfusion injury in a swine model of hemorrhagic shock. Sci Rep 2023; 13:4496. [PMID: 36934127 PMCID: PMC10024723 DOI: 10.1038/s41598-023-31374-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/10/2023] [Indexed: 03/20/2023] Open
Abstract
ischemia-reperfusion injury (IRI) after hemorrhage is potentiated by aortic occlusion or resuscitative endovascular balloon occlusion of the aorta (REBOA). Given the central role of mitochondrial injury in shock, we hypothesized that Elamipretide, a peptide that protects mitochondria, would mitigate IRI after hemorrhagic shock and REBOA. Twelve pigs were subjected to hemorrhagic shock and 45 min of REBOA. After 25 min of REBOA, animals received either saline or Elamipretide. Animals were transfused with autologous blood during balloon deflation, and pigs were resuscitated with isotonic crystalloids and norepinephrine for 4.25 h. Elamipretide-treated animals required less crystalloids than the controls (62.5 [50-90] and 25 [5-30] mL/kg, respectively), but similar amounts of norepinephrine (24.7 [8.6-39.3] and 9.7 [2.1-12.5] mcg/kg, respectively). Treatment animals had a significant reduction in serum creatinine (control: 2.7 [2.6-2.8]; Elamipretide: 2.4 [2.4-2.5] mg/dL; p = 0.04), troponin (control: 3.20 [2.14-5.47] ng/mL, Elamipretide: 0.22 [0.1-1.91] ng/mL; p = 0.03), and interleukin-6 concentrations at the end of the study. There were no differences in final plasma lactate concentration. Elamipretide reduced fluid requirements and protected the kidney and heart after profound IRI. Further understanding the subcellular consequences of REBOA and mitochondrial rescue will open new therapeutic avenues for patients suffering from IRI after hemorrhage.
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Affiliation(s)
- N Patel
- Department of Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | - M A Johnson
- Department of Emergency Medicine, University of Utah, Salt Lake City, UT, USA
| | - N Vapniarsky
- Department of Pathology, Microbiology, and Immunology, University of California-Davis, Davis, CA, USA
| | - M W Van Brocklin
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - T K Williams
- Department of Vascular/Endovascular Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | - S T Youngquist
- Department of Emergency Medicine, University of Utah, Salt Lake City, UT, USA
| | - R Ford
- Department of Emergency Medicine, University of Utah, Salt Lake City, UT, USA
| | - N Ewer
- Department of Emergency Medicine, University of Utah, Salt Lake City, UT, USA
| | - L P Neff
- Department of Pediatric Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | - G L Hoareau
- Department of Emergency Medicine, University of Utah, Salt Lake City, UT, USA.
- Nora Eccles-Harrison Cardiovascular Research and Training Institute, Salt Lake City, UT, USA.
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Ivanovici A, Laffont C, Larrainzar E, Patel N, Winning CS, Lee HC, Imin N, Frugier F, Djordjevic MA. The Medicago SymCEP7 hormone increases nodule number via shoots without compromising lateral root number. Plant Physiol 2023; 191:2012-2026. [PMID: 36653329 PMCID: PMC10022606 DOI: 10.1093/plphys/kiad012] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
Legumes acquire soil nutrients through nitrogen-fixing root nodules and lateral roots. To balance the costs and benefits of nodulation, legumes negatively control root nodule number by autoregulatory and hormonal pathways. How legumes simultaneously coordinate root nodule and lateral root development to procure nutrients remains poorly understood. In Medicago (Medicago truncatula), a subset of mature C-TERMINALLY ENCODED PEPTIDE (CEP) hormones can systemically promote nodule number, but all CEP hormones tested to date negatively regulate lateral root number. Here we showed that Medicago CEP7 produces a mature peptide, SymCEP7, that promotes nodulation from the shoot without compromising lateral root number. Rhizobial inoculation induced CEP7 in the susceptible root nodulation zone in a Nod factor-dependent manner, and, in contrast to other CEP genes, its transcription level was elevated in the ethylene signaling mutant sickle. Using mass spectrometry, fluorescence microscopy and expression analysis, we demonstrated that SymCEP7 activity requires the COMPACT ROOT ARCHITECTURE 2 receptor and activates the shoot-to-root systemic effector, miR2111. Shoot-applied SymCEP7 rapidly promoted nodule number in the pM to nM range at concentrations up to five orders of magnitude lower than effects mediated by root-applied SymCEP7. Shoot-applied SymCEP7 also promoted nodule number in White Clover (Trifolium repens) and Lotus (Lotus japonicus), which suggests that this biological function may be evolutionarily conserved. We propose that SymCEP7 acts in the Medicago shoot to counter balance the autoregulation pathways induced rapidly by rhizobia to enable nodulation without compromising lateral root growth, thus promoting the acquisition of nutrients other than nitrogen to support their growth.
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Affiliation(s)
- Ariel Ivanovici
- Division of Plant Sciences, Research School of Biology, The Australian National University, Canberra, Australian Capital Territory 2601, Australia
| | - Carole Laffont
- University of Paris-Saclay, CNRS, INRAE, University Paris-Cité, Univ. d’Evry, Gif-sur-Yvette, France
| | - Estíbaliz Larrainzar
- Sciences Department, Institute for Multidisciplinary Research in Applied Biology (IMAB), Universidad Pública de Navarra, Pamplona 31006, Spain
| | - Neha Patel
- Division of Plant Sciences, Research School of Biology, The Australian National University, Canberra, Australian Capital Territory 2601, Australia
| | - Courtney S Winning
- Division of Plant Sciences, Research School of Biology, The Australian National University, Canberra, Australian Capital Territory 2601, Australia
| | - Han-Chung Lee
- Division of Plant Sciences, Research School of Biology, The Australian National University, Canberra, Australian Capital Territory 2601, Australia
| | - Nijat Imin
- Division of Plant Sciences, Research School of Biology, The Australian National University, Canberra, Australian Capital Territory 2601, Australia
- School of Science, Western Sydney University, Penrith, New South Wales 2751, Australia
- School of Biological Sciences, Faculty of Science, The University of Auckland, Auckland, New Zealand
| | - Florian Frugier
- University of Paris-Saclay, CNRS, INRAE, University Paris-Cité, Univ. d’Evry, Gif-sur-Yvette, France
| | - Michael A Djordjevic
- Division of Plant Sciences, Research School of Biology, The Australian National University, Canberra, Australian Capital Territory 2601, Australia
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Patel N, Whittet C, Zhao D, Rees J, Stechman MJ, Scott-Coombes DM. A 15-year experience: intraoperative parathyroid hormone assay for the management of primary hyperparathyroidism in a UK endocrine surgical unit. Langenbecks Arch Surg 2023; 408:120. [PMID: 36920573 DOI: 10.1007/s00423-023-02848-x] [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: 07/18/2022] [Accepted: 02/18/2023] [Indexed: 03/16/2023]
Abstract
PURPOSE This study aims to evaluate the outcomes of first-time parathyroidectomy for primary hyperparathyroidism using intraoperative PTH (IOPTH) assay in the light of the UK National Institute for Health and Care Excellence (NICE) guidelines for the management of primary hyperparathyroidism. METHOD This is a retrospective cohort analysis of a prospectively maintained database of endocrine surgery in a tertiary centre. Preoperative radiological localisation (concordance and accuracy), intraoperative PTH parameters and adjusted serum calcium at minimum 6-month follow-up were analysed. The accuracy of IOPTH to predict post-operative normocalcaemia and the number needed to treat (NNT) within the cohort when IOPTH was utilised were determined. Differences between groups were evaluated with Chi-squared and Fisher's exact test. RESULTS Between January 2004 and September 2018, 849 patients (75.4% women), median age 64 years (IQR 54-72), were analysed. The median preoperative adjusted serum calcium was 2.80mmol/l (IQR 2.78-2.90), and the median preoperative PTH was 14.20pmol/l (IQR 10.70-20.25). The overall first-time cure (normocalcaemia) rate was 96.4%. The sensitivity, specificity, positive predictive value and negative predictive values of IOPTH were 96.8%, 83.2%, 97.6% and 78.8%, respectively, with an accuracy of 95.1%. For patients with concordant scans (48.3%), a targeted approach without IOPTH would have achieved a cure rate of 94.1% compared with 98.0% using IOPTH (p<0.01) CONCLUSION: The use of IOPTH assay significantly improved the rate of normocalcaemia at 6 months. The low NNT to benefit from IOPTH, particularly those patients with a single positive scan, and the inevitable reduction in the potential costs incurred from failure and reoperation justify its utilisation.
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Affiliation(s)
- N Patel
- Department of Endocrine and General Surgery, University Hospital of Wales, Heath Park Way, Heath Park, Cardiff, CF14 4XW, UK.
| | - C Whittet
- Department of Endocrine and General Surgery, University Hospital of Wales, Heath Park Way, Heath Park, Cardiff, CF14 4XW, UK
| | - D Zhao
- Department of Endocrine and General Surgery, University Hospital of Wales, Heath Park Way, Heath Park, Cardiff, CF14 4XW, UK
| | - J Rees
- Department of Radiology, University Hospital of Wales, Heath Park Way, Heath Park, Cardiff, CF14 4XW, UK
| | - M J Stechman
- Department of Endocrine and General Surgery, University Hospital of Wales, Heath Park Way, Heath Park, Cardiff, CF14 4XW, UK
| | - D M Scott-Coombes
- Department of Endocrine and General Surgery, University Hospital of Wales, Heath Park Way, Heath Park, Cardiff, CF14 4XW, UK
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Patel N, Taylor S, Morris S, Forcella JA. MALIGNANT INTRA-ARTERIAL COURSE OF THE LEFT MAIN CORONARY ARTERY FROM THE OSTIUM OF THE RIGHT CORONARY ARTERY BETWEEN THE AORTA AND THE PULMONARY ARTERY. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)03377-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Fereshtehnejad SM, Saleh PA, Oliveira LM, Patel N, Bhowmick S, Saranza G, Kalia LV. Movement disorders in hereditary spastic paraplegia (HSP): a systematic review and individual participant data meta-analysis. Neurol Sci 2023; 44:947-959. [PMID: 36441344 PMCID: PMC9925593 DOI: 10.1007/s10072-022-06516-8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/17/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hereditary spastic paraplegia (HSP) is a rare genetic disorder associated with mutations in > 80 loci designated SPG (SPastic parapleGia). The phenotypic spectrum of HSP can extend to include other neurologic features, including movement disorders. Our aim was to investigate genotype-phenotype associations in HSP with a focus on movement disorders. METHODS We performed a systematic review and individual participant data (IPD)-level meta-analysis by retrieving publications from Medline/EMBASE/Web of Science on HSP with a SPG genotype. Studies were included only if individual-level information was accessible and at least one patient with a movement disorder was reported for that genotype. Out of 21,957 hits, 192 manuscripts with a total of 1413 HSP cases were eligible. Data were compared between two HSP groups: manifested with (HSP-MD, n = 767) or without (HSP-nMD, n = 646) a movement disorder. RESULTS The HSP-MD group had an older age of onset (20.5 ± 16.0 vs. 17.1 ± 14.2 yr, p < 0.001) and less frequent autosomal dominant inheritance (7.6% vs. 30.1%, p < 0.001) compared to HSP-nMD. SPG7 (31.2%) and SPG11 (23.8%) were the most frequent genotypes in the HSP-MD group. HSP-MD with SPG7 had higher frequency of later onset during adulthood (82.9% vs. 8.5%), ataxia (OR = 12.6), extraocular movement disturbances (OR = 3.4) and seizure (OR = 3.7) compared to HSP-MD with SPG11. Conversely, SPG11 mutations were more frequently associated with consanguinity (OR = 4.1), parkinsonism (OR = 7.8), dystonia (OR = 5.4), peripheral neuropathy (OR = 26.9), and cognitive dysfunction (OR = 34.5). CONCLUSION This systematic IPD-level meta-analysis provides the largest data on genotype-phenotype associations in HSP-MD. Several clinically relevant phenotypic differences were found between various genotypes, which can possibly facilitate diagnosis in resource-limited settings.
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Affiliation(s)
- Seyed-Mohammad Fereshtehnejad
- Division of Neurology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
| | - Philip A Saleh
- Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, ON, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lais M Oliveira
- Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, ON, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Neha Patel
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Suvorit Bhowmick
- Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, ON, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Gerard Saranza
- Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, ON, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lorraine V Kalia
- Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, ON, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
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Villanueva Campos AM, Etxano Cantera J, Patel N, Villanueva Marcos AJ. Extrapleural fat: description, incidence, and relation with body mass index. Radiologia (Engl Ed) 2023; 65:106-111. [PMID: 37059576 DOI: 10.1016/j.rxeng.2021.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 03/24/2021] [Indexed: 04/16/2023]
Abstract
BACKGROUND AND AIMS Pleural appendages (PA) are portions of extrapleural fat that hang from the chest wall. They have been described on videothoracoscopy, however their appearance, frequency and possible relationship with the amount of patient's fat remain unknown. Our aim is to describe their appearances and prevalence on CT, and determinate whether their size and number is higher in obese patients. PATIENTS AND METHODS Axial images of 226 patients with pneumothorax on CT chest were retrospectively reviewed. Exclusion criteria included known pleural disease, previous thoracic surgery and small pneumothorax. Patients were divided in obese (BMI>30) and non-obese (BMI<30) groups. Presence, position, size and number of PA were recorded. Chi square and Fisher's exact test were used to evaluate differences between the two groups, considering p<0.05 as significant. RESULTS Valid CT studies were available for 101 patients. Extrapleural fat was identified in 50 (49.5%) patients. Most were solitary (n=31). Most were located in the cardiophrenic angle (n=27), and most measured <5cm (n=39). There was no significant difference between obese and non-obese patients regarding the presence or absence of PA (p=0.315), number (p=0.458) and size (p=0.458). CONCLUSIONS Pleural appendages were seen in 49.5% patients with pneumothorax on CT. There was no significant difference between obese and non-obese patients regarding presence, number and size of pleural appendages.
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Affiliation(s)
| | - J Etxano Cantera
- Departamento de Radiología, Hospital Universitario Araba, Sede Txagorritxu, Vitoria-Gasteiz, Araba/Álava, Spain
| | - N Patel
- Stanmore Road Medical Group, Stevenage, England
| | - A J Villanueva Marcos
- Department of Radiology, East Surrey Hospital, Surrey and Sussex Healthcare NHS Trust, England.
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Kirkman T, Nwaozuru D, Patel N, Hsu F, Ramireddy K. COVERED STENT OCCLUSION OF PROXIMAL LAD ANEURYSM IN A PATIENT WITH EHLERS-DANLOS SYNDROME PRIOR TO TAVR IMPLANTATION. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)03327-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Taber DJ, Bartlett F, Patel N, Sprague T, Patel S, Newman J, Andrade E, Rao N, Salas MAP, Casey M, Dubay D, Rohan V. Impact of converting adult kidney transplant recipients with high tacrolimus variability from twice daily immediate release tacrolimus to once daily LCP-Tacrolimus. Clin Transplant 2023; 37:e14941. [PMID: 36809653 DOI: 10.1111/ctr.14941] [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: 07/08/2022] [Revised: 01/14/2023] [Accepted: 02/08/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND The influence of converting to once daily, extended-release LCP-Tacrolimus (Tac) for those with high tacrolimus variability in kidney transplant recipients (KTRs) is not well-studied. METHODS Single-center, retrospective cohort study of adult KTRs converted from Tac immediate release to LCP-Tac 1-2 years post-transplant. Primary measures were Tac variability, using the coefficient of variation (CV) and time in therapeutic range (TTR), as well as clinical outcomes (rejection, infections, graft loss, death). RESULTS A total of 193 KTRs included with a follow-up of 3.2 ± .7 years and 1.3 ± .3 years since LCP-Tac conversion. Mean age was 52 ± 13 years; 70% were African American, 39% were female, 16% living donor and 12% donor after cardiac death (DCD). In the overall cohort, tac CV was 29.5% before conversion, which increased to 33.4% after LCP-Tac (p = .008). In those with Tac CV >30% (n = 86), conversion to LCP-Tac reduced variability (40.6% vs. 35.5%; p = .019) and for those with Tac CV >30% and nonadherence or med errors (n = 16), LCP-Tac conversion substantially reduced Tac CV (43.4% vs. 29.9%; p = .026). TTR significantly improved for those with Tac CV >30% with (52.4% vs. 82.8%; p = .027) or without nonadherence or med errors (64.8% vs. 73.2%; p = .005). CMV, BK, and overall infections were significantly higher prior to LCP-Tac conversion. In the overall cohort, 3% had rejection before conversion and 2% after (p = NS). At end of follow-up, graft and patient survival were 94% and 96%, respectively. CONCLUSIONS In those with high Tac CV, conversion to LCP-Tac is associated with a significant reduction in variability and improvement in TTR, particularly in those with nonadherence or medication errors.
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Affiliation(s)
- David J Taber
- Department of Surgery, Division of Transplant Surgery, MUSC, Charleston, South Carolina, USA
| | - Felicia Bartlett
- Department of Pharmacy Services, MUSC, Charleston, South Carolina, USA
| | - Neha Patel
- Department of Pharmacy Services, MUSC, Charleston, South Carolina, USA
| | - Taylor Sprague
- Department of Pharmacy Services, MUSC, Charleston, South Carolina, USA
| | - Shikha Patel
- Department of Pharmacy Services, MUSC, Charleston, South Carolina, USA
| | - Jessica Newman
- Department of Pharmacy Services, MUSC, Charleston, South Carolina, USA
| | - Erika Andrade
- College of Medicine, MUSC, Charleston, South Carolina, USA
| | - Nikhil Rao
- Department of Surgery, Division of Transplant Surgery, MUSC, Charleston, South Carolina, USA
| | | | - Michael Casey
- Department of Medicine, Division of Nephrology, MUSC, Charleston, South Carolina, USA
| | - Derek Dubay
- Department of Surgery, Division of Transplant Surgery, MUSC, Charleston, South Carolina, USA
| | - Vinayak Rohan
- Department of Surgery, Division of Transplant Surgery, MUSC, Charleston, South Carolina, USA
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Nazarian S, Koo H, Carrington E, Darzi A, Patel N. The future of endoscopy – what are the thoughts on artificial intelligence? J EXP THEOR ARTIF IN 2023. [DOI: 10.1080/0952813x.2023.2178516] [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: 02/22/2023]
Affiliation(s)
- S. Nazarian
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - H.F Koo
- Department of Surgery, Royal Free London NHS Foundation Trust, London, UK
| | - E. Carrington
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - A. Darzi
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - N. Patel
- Department of Surgery and Cancer, Imperial College London, London, UK
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Milling TJ, Middeldorp S, Xu L, Koch B, Demchuk A, Eikelboom JW, Verhamme P, Cohen AT, Beyer-Westendorf J, Michael Gibson C, Lopez-Sendon J, Crowther M, Shoamanesh A, Coppens M, Schmidt J, Albaladejo P, Connolly SJ, Bastani A, Clark C, Concha M, Cornell J, Dombrowski K, Fermann G, Fulmer J, Goldstein J, Kereiakes D, Milling T, Pallin D, Patel N, Refaai M, Rehman M, Schmaier A, Schwarz E, Shillinglaw W, Spohn M, Takata T, Venkat A, Welker J, Welsby I, Wilson J, Van Keer L, Verschuren F, Blostein M, Eikelboom J, Althaus K, Berrouschot J, Braun G, Doeppner T, Dziewas R, Genth-Zotz S, Greinacher P, Hamann F, Hanses F, Heide W, Kallmuenzer B, Kermer P, Poli S, Royl G, Schellong S, Schnupp S, Schwarze J, Spies C, Thomalla G, von Mering M, Weissenborn K, Wollenweber F, Gumbinger C, Jaschinski U, Maschke M, Mochmann HC, Pfeilschifter W, Pohlmann C, Zahn R, Bouzat P, Schmidt J, Vallejo C, Floccard B, Coppens M, van Wissen S, Arellano-Rodrigo E, Valles E, Alikhan R, Breen K, Hall R, Crowther M, Albaladejo P, Cohen A, Demchuk A, Schmidt J, Wyse D, Garcia D, Prins M, Nakamya J, Büller H, Mahaffey KW, Alexander JH, Cairns J, Hart R, Joyner C, Raskob G, Schulman S, Veltkamp R, Meeks B, Zotova E, Ahmad S, Pinto T, Baker K, Dykstra A, Holadyk-Gris I, Malvaso A, Demchuk A. Final Study Report of Andexanet Alfa for Major Bleeding With Factor Xa Inhibitors. Circulation 2023; 147:1026-1038. [PMID: 36802876 DOI: 10.1161/circulationaha.121.057844] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND Andexanet alfa is a modified recombinant inactive factor Xa (FXa) designed to reverse FXa inhibitors. ANNEXA-4 (Andexanet Alfa, a Novel Antidote to the Anticoagulation Effects of Factor Xa Inhibitors) was a multicenter, prospective, phase-3b/4, single-group cohort study that evaluated andexanet alfa in patients with acute major bleeding. The results of the final analyses are presented. METHODS Patients with acute major bleeding within 18 hours of FXa inhibitor administration were enrolled. Co-primary end points were anti-FXa activity change from baseline during andexanet alfa treatment and excellent or good hemostatic efficacy, defined by a scale used in previous reversal studies, at 12 hours. The efficacy population included patients with baseline anti-FXa activity levels above predefined thresholds (≥75 ng/mL for apixaban and rivaroxaban, ≥40 ng/mL for edoxaban, and ≥0.25 IU/mL for enoxaparin; reported in the same units used for calibrators) who were adjudicated as meeting major bleeding criteria (modified International Society of Thrombosis and Haemostasis definition). The safety population included all patients. Major bleeding criteria, hemostatic efficacy, thrombotic events (stratified by occurring before or after restart of either prophylactic [ie, a lower dose, for prevention rather than treatment] or full-dose oral anticoagulation), and deaths were assessed by an independent adjudication committee. Median endogenous thrombin potential at baseline and across the follow-up period was a secondary outcome. RESULTS There were 479 patients enrolled (mean age, 78 years; 54% male, 86% White; 81% anticoagulated for atrial fibrillation at a median time of 11.4 hours since last dose, with 245 (51%) on apixaban, 176 (37%) on rivaroxaban, 36 (8%) on edoxaban, and 22 (5%) on enoxaparin. Bleeding was predominantly intracranial (n=331 [69%]) or gastrointestinal (n=109 [23%]). In evaluable apixaban patients (n=172), median anti-FXa activity decreased from 146.9 ng/mL to 10.0 ng/mL (reduction, 93% [95% CI, 94-93]); in rivaroxaban patients (n=132), it decreased from 214.6 ng/mL to 10.8 ng/mL (94% [95% CI, 95-93]); in edoxaban patients (n=28), it decreased from 121.1 ng/mL to 24.4 ng/mL (71% [95% CI, 82-65); and in enoxaparin patients (n=17), it decreased from 0.48 IU/mL to 0.11 IU/mL (75% [95% CI, 79-67]). Excellent or good hemostasis occurred in 274 of 342 evaluable patients (80% [95% CI, 75-84]). In the safety population, thrombotic events occurred in 50 patients (10%); in 16 patients, this occurred during treatment with prophylactic anticoagulation that began after the bleeding event. No thrombotic episodes occurred after oral anticoagulation restart. Specific to certain populations, reduction of anti-FXa activity from baseline to nadir significantly predicted hemostatic efficacy in patients with intracranial hemorrhage (area under the receiver operating characteristic curve, 0.62 [95% CI, 0.54-0.70]) and correlated with lower mortality in patients <75 years of age (adjusted P=0.022; unadjusted P=0.003). Median endogenous thrombin potential was within the normal range by the end of andexanet alfa bolus through 24 hours for all FXa inhibitors. CONCLUSIONS In patients with major bleeding associated with the use of FXa inhibitors, treatment with andexanet alfa reduced anti-FXa activity and was associated with good or excellent hemostatic efficacy in 80% of patients. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT02329327.
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Affiliation(s)
- Truman J Milling
- Seton Dell Medical School Stroke Institute, Dell Medical School, University of Texas at Austin (T.J.M.)
| | - Saskia Middeldorp
- Department of Internal Medicine and Radboud Institute of Health Sciences, Nijmegenthe Netherlands (S.M.)
| | - Lizhen Xu
- Population Health Research Institute, McMaster University, HamiltonOntario Canada. (L.X., A.S., S.J.C.)
| | - Bruce Koch
- Alexion, AstraZeneca Rare Disease, BostonMA (B.K.)
| | - Andrew Demchuk
- Departments of Clinical Neurosciences and Radiology, Cumming School of Medicine, University of Calgary, AlbertaCanada (A.D.)
| | - John W Eikelboom
- Department of Medicine, McMaster University, HamiltonOntario Canada. (J.W.E., M. Crowther)
| | - Peter Verhamme
- Center for Molecular and Vascular Biology, University of Leuven, Belgium (P.V.)
| | | | - Jan Beyer-Westendorf
- Department of Medicine I, Division of Hematology and Hemostasis, University Hospital Dresden, Germany (J.B-W.)
| | | | - Jose Lopez-Sendon
- Instituto de Investigación Hospital Universitario, La PazMadridSpain (J. L-S.)
| | - Mark Crowther
- Department of Medicine, McMaster University, HamiltonOntario Canada. (J.W.E., M. Crowther)
| | - Ashkan Shoamanesh
- Population Health Research Institute, McMaster University, HamiltonOntario Canada. (L.X., A.S., S.J.C.)
| | - Michiel Coppens
- Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centers, University of Amsterdam, the Netherlands (M. Coppens)
| | - Jeannot Schmidt
- Centre Hospitalier Universitaire de Clermont-Ferrand, France (J.S.)
| | | | - Stuart J Connolly
- Population Health Research Institute, McMaster University, HamiltonOntario Canada. (L.X., A.S., S.J.C.)
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Coffman K, Patel N, Bartlett F, Newman J, Patel S, Sprague T, Rao N, Andrade E, Casey MJ, Rohan V, DuBay D, Taber D. Diabetes is a significant and independent predictor for tacrolimus immediate release and LCP-tacrolimus conversion ratios. Clin Transplant 2023; 37:e14944. [PMID: 36794749 DOI: 10.1111/ctr.14944] [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: 06/15/2022] [Revised: 01/26/2023] [Accepted: 02/08/2023] [Indexed: 02/17/2023]
Abstract
Diabetes (DM) is a common comorbidity in transplant patients with known effects on gastrointestinal (GI) motility and absorption; however, DM's impact on immediate release (IR) tacrolimus to LCP-tacrolimus (LCP) conversion ratios has not been studied. This multivariable analysis of a retrospective longitudinal cohort study included kidney transplant recipients converted from IR to LCP between 2019 and 2020. The primary outcome was IR to LCP conversion ratio based on DM status. Other outcomes included tacrolimus variability, rejection, graft loss, and death. Of the 292 patients included, 172 patients had DM and 120 did not. The IR:LCP conversion ratio was significantly higher with DM (67.5% ± 21.1% no DM vs. 79.8% ± 28.7% in DM; P < .001). In multivariable modeling, DM was the only variable significantly and independently associated with IR:LCP conversion ratios. No difference was observed in rejection rates. Graft (97.5% no DM vs. 92.4% in DM; P = .062) and patient survival (100% no DM vs. 94.8% in DM; P = .011) were lower with DM. The presence of DM significantly increased the IR:LCP conversion ratio by 13%-14%, compared to patients without DM. On multivariable analysis, DM was the only significant predictor of conversion ratios, potentially related to GI motility or absorption differences.
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Affiliation(s)
- Kelsey Coffman
- Department of Pharmacy Services, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Neha Patel
- Department of Pharmacy Services, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Felicia Bartlett
- Department of Pharmacy Services, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Jessica Newman
- Department of Pharmacy Services, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Shikha Patel
- Department of Pharmacy Services, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Taylor Sprague
- Department of Pharmacy Services, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Nikhil Rao
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Erika Andrade
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Michael J Casey
- Department of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Vinayak Rohan
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Derek DuBay
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - David Taber
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.,Department of Pharmacy, Ralph H Johnson VAMC, Charleston, South Carolina, USA
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40
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Saha S, Patel N. What Should I Eat? Dietary Recommendations for Patients with Inflammatory Bowel Disease. Nutrients 2023; 15:nu15040896. [PMID: 36839254 PMCID: PMC9966256 DOI: 10.3390/nu15040896] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/05/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic disorder thought to be caused by enteric inflammation in a genetically susceptible host. Although the pathogenesis of IBD is largely unknown, it is widely accepted that dietary components play an important role. Human and animal-based studies have explored the role of various dietary components such as meat, artificial sweeteners and food additives in causing enteric inflammation. Several diets have also been studied in patients with IBD, specifically their role in the induction or maintenance of remission. The most well-studied of these include exclusive enteral nutrition and specific carbohydrate diet. A diet low in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols), typically prescribed for patients with irritable bowel syndrome, has also been studied in a specific subgroup of patients with IBD. In this review, we describe the current evidence on how various dietary components can induce enteric and colonic inflammation, and the clinical-epidemiological evidence exploring their role in predisposing to or protecting against the development of IBD. We also discuss several special diets and how they affect clinical outcomes in IBD patients. Based on the available evidence, we provide guidance for patients and clinicians managing IBD regarding the best practice in dietary modifications.
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Affiliation(s)
- Srishti Saha
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Neha Patel
- Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- Correspondence: ; Tel.: +1-469-776-0671
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Scheive M, Patel N, Saeed Z. High-dose intravenous hydrocortisone for the treatment of hyperthyroidism: a rare precipitant of thyrotoxicosis periodic paralysis. Endocrinol Diabetes Metab Case Rep 2023; 2023:22-0358. [PMID: 36752701 PMCID: PMC9986374 DOI: 10.1530/edm-22-0358] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 01/17/2023] [Indexed: 02/09/2023] Open
Abstract
Summary Thyrotoxic periodic paralysis (TPP) is a rare complication of hyperthyroidism triggered by precipitants that increase the activity of the sodium-potassium pump in the skeletal muscle. In our case study, a previously healthy 34-year-old male presented to the emergency department with new onset thyrotoxicosis, secondary to Graves' disease. Given the severity of his triiodothyronine (T3) thyrotoxicosis, he was admitted and started on a high dose of beta-blocker, thioamides, and intravenous hydrocortisone. On the second day of his hospitalization, he developed acute flaccid paralysis of his lower extremities. Subsequent stroke workup was negative, and his electrolytes revealed severe hypokalemia and hyperglycemia consistent with TPP. He was treated with potassium and had a complete recovery of his paralysis and hypokalemia within hours. The patient has not had any recurrence since this singular episode in the hospital. This case highlights the scenario where the treatment of hyperthyroidism with high-dose corticosteroids to reduce the conversion of thyroxine to T3 inadvertently resulted in TPP. Clinicians should be aware of this potentially rare but serious consequence of using steroids to manage hyperthyroidism. Learning points High-dose steroids used to treat hyperthyroidism in hospitalized patients may rarely precipitate thyrotoxic periodic paralysis (TPP) by inducing hypokalemia and hyperglycemia. TPP should be included in the differential diagnosis for acute flaccid paralysis in hospitalized patients with hyperthyroidism. Since TPP is associated with trans-cellular shifts in potassium instead of total body potassium depletion, conservative repletion of potassium is recommended to avoid rebound hyperkalemia.
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Affiliation(s)
- Melanie Scheive
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Neha Patel
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Zeb Saeed
- Indiana University School of Medicine, Indianapolis, Indiana, USA
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42
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Patel N, Mahoney R, Scott-Coombes D, Stechman M. Prediction of long-term dependence on vitamin D analogues following total thyroidectomy for Graves' disease. Ann R Coll Surg Engl 2023; 105:157-161. [PMID: 35446722 PMCID: PMC9889183 DOI: 10.1308/rcsann.2022.0007] [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] [Accepted: 01/04/2022] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION This study aimed to identify patients at risk of long-term hypocalcaemia following total thyroidectomy for Graves' disease, and to determine the thresholds of postoperative day 1 serum calcium and parathyroid hormone (PTH) at which long-term activated vitamin D treatment can be safely excluded. METHODS This study was a retrospective analysis of 115 consecutive patients undergoing total thyroidectomy for Graves' disease at a university referral centre between 2010 and 2018. Outcome measures were the day 1 postoperative adjusted calcium and PTH results, and vitamin D analogue need at 6 months postoperatively. Logistic receiver operating curves were used to identify optimal cut-off values for adjusted serum calcium and serum PTH, and sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. RESULTS Temporary hypocalcaemia was observed in 20.9% of patients (mean day 1 serum adjusted calcium 2.2±0.14mmol/l and PTH 4.15±2.42pmol/l). Long-term (>6 months) activated vitamin D analogue therapy was required in five patients (4.3%), four of whom had normal serum PTH and one with undetectable PTH at 6 weeks post surgery. No patient with a day 1 postoperative calcium >2.05mmol/l and detectable PTH required vitamin D supplementation at 6 months post surgery (100% sensitivity, PPV 50%, NPV 100%). CONCLUSIONS The biochemical postoperative day 1 thresholds identified in this paper have a 100% NPV in the identification of patients who are likely to require either no or only temporary activated vitamin D supplementation. We were able to identify all patients requiring activated vitamin D supplementation 6 months postoperatively from the day 1 postoperative serum calcium and PTH values, while excluding those that may only need temporary calcium supplementation. These threshold levels could be used for targeted follow-up and management of this subset of patients most at risk of long-term hypocalcaemia.
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Affiliation(s)
- N Patel
- Cardiff and Vale University Health Board, UK
| | - R Mahoney
- Cardiff and Vale University Health Board, UK
| | | | - M Stechman
- Cardiff and Vale University Health Board, UK
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Patel N, Franklin A, Yaxley J, Hemamali S, Roberts M. Mri and psma in the primary staging of ductal variant prostate cancer. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01031-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: 02/12/2023]
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Abratenko P, Andrade Aldana D, Anthony J, Arellano L, Asaadi J, Ashkenazi A, Balasubramanian S, Baller B, Barr G, Barrow J, Basque V, Bathe-Peters L, Benevides Rodrigues O, Berkman S, Bhanderi A, Bhattacharya M, Bishai M, Blake A, Bogart B, Bolton T, Book JY, Camilleri L, Caratelli D, Caro Terrazas I, Cavanna F, Cerati G, Chen Y, Conrad JM, Convery M, Cooper-Troendle L, Crespo-Anadón JI, Del Tutto M, Dennis SR, Detje P, Devitt A, Diurba R, Dorrill R, Duffy K, Dytman S, Eberly B, Ereditato A, Evans JJ, Fine R, Finnerud OG, Foreman W, Fleming BT, Foppiani N, Franco D, Furmanski AP, Garcia-Gamez D, Gardiner S, Ge G, Gollapinni S, Goodwin O, Gramellini E, Green P, Greenlee H, Gu W, Guenette R, Guzowski P, Hagaman L, Hen O, Hicks R, Hilgenberg C, Horton-Smith GA, Irwin B, Itay R, James C, Ji X, Jiang L, Jo JH, Johnson RA, Jwa YJ, Kalra D, Kamp N, Karagiorgi G, Ketchum W, Kirby M, Kobilarcik T, Kreslo I, Leibovitch MB, Lepetic I, Li JY, Li K, Li Y, Lin K, Littlejohn BR, Louis WC, Luo X, Manivannan K, Mariani C, Marsden D, Marshall J, Martinez N, Martinez Caicedo DA, Mason K, Mastbaum A, McConkey N, Meddage V, Miller K, Mills J, Mogan A, Mohayai T, Mooney M, Moor AF, Moore CD, Mora Lepin L, Mousseau J, Mulleriababu S, Naples D, Navrer-Agasson A, Nayak N, Nebot-Guinot M, Nowak J, Nunes M, Oza N, Palamara O, Pallat N, Paolone V, Papadopoulou A, Papavassiliou V, Parkinson HB, Pate SF, Patel N, Pavlovic Z, Piasetzky E, Ponce-Pinto ID, Pophale I, Prince S, Qian X, Raaf JL, Radeka V, Reggiani-Guzzo M, Ren L, Rochester L, Rodriguez Rondon J, Rosenberg M, Ross-Lonergan M, Rudolf von Rohr C, Scanavini G, Schmitz DW, Schukraft A, Seligman W, Shaevitz MH, Sharankova R, Shi J, Smith A, Snider EL, Soderberg M, Söldner-Rembold S, Spitz J, Stancari M, St John J, Strauss T, Sword-Fehlberg S, Szelc AM, Tang W, Taniuchi N, Terao K, Thorpe C, Torbunov D, Totani D, Toups M, Tsai YT, Tyler J, Uchida MA, Usher T, Viren B, Weber M, Wei H, White AJ, Williams Z, Wolbers S, Wongjirad T, Wospakrik M, Wresilo K, Wright N, Wu W, Yandel E, Yang T, Yates LE, Yu HW, Zeller GP, Zennamo J, Zhang C. First Constraints on Light Sterile Neutrino Oscillations from Combined Appearance and Disappearance Searches with the MicroBooNE Detector. Phys Rev Lett 2023; 130:011801. [PMID: 36669216 DOI: 10.1103/physrevlett.130.011801] [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] [Received: 10/19/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
We present a search for eV-scale sterile neutrino oscillations in the MicroBooNE liquid argon detector, simultaneously considering all possible appearance and disappearance effects within the 3+1 active-to-sterile neutrino oscillation framework. We analyze the neutrino candidate events for the recent measurements of charged-current ν_{e} and ν_{μ} interactions in the MicroBooNE detector, using data corresponding to an exposure of 6.37×10^{20} protons on target from the Fermilab booster neutrino beam. We observe no evidence of light sterile neutrino oscillations and derive exclusion contours at the 95% confidence level in the plane of the mass-squared splitting Δm_{41}^{2} and the sterile neutrino mixing angles θ_{μe} and θ_{ee}, excluding part of the parameter space allowed by experimental anomalies. Cancellation of ν_{e} appearance and ν_{e} disappearance effects due to the full 3+1 treatment of the analysis leads to a degeneracy when determining the oscillation parameters, which is discussed in this Letter and will be addressed by future analyses.
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Affiliation(s)
- P Abratenko
- Tufts University, Medford, Massachusetts 02155, USA
| | - D Andrade Aldana
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - J Anthony
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - L Arellano
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Asaadi
- University of Texas, Arlington, Texas 76019, USA
| | - A Ashkenazi
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - S Balasubramanian
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - B Baller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Barr
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - J Barrow
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - V Basque
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | | | | | - S Berkman
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - A Bhanderi
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - M Bhattacharya
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Bishai
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Blake
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - B Bogart
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - T Bolton
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - J Y Book
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - L Camilleri
- Columbia University, New York, New York 10027, USA
| | - D Caratelli
- University of California, Santa Barbara, California 93106, USA
| | - I Caro Terrazas
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - F Cavanna
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Cerati
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - Y Chen
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J M Conrad
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - M Convery
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - L Cooper-Troendle
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - J I Crespo-Anadón
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid E-28040, Spain
| | - M Del Tutto
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - S R Dennis
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - P Detje
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - A Devitt
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - R Diurba
- Universität Bern, Bern CH-3012, Switzerland
| | - R Dorrill
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - K Duffy
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - S Dytman
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - B Eberly
- University of Southern Maine, Portland, Maine 04104, USA
| | | | - J J Evans
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - R Fine
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - O G Finnerud
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - W Foreman
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - B T Fleming
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - N Foppiani
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - D Franco
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - A P Furmanski
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | | | - S Gardiner
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Ge
- Columbia University, New York, New York 10027, USA
| | - S Gollapinni
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - O Goodwin
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - E Gramellini
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - P Green
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - H Greenlee
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - W Gu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - R Guenette
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - P Guzowski
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Hagaman
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - O Hen
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - R Hicks
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - C Hilgenberg
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | | | - B Irwin
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - R Itay
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - C James
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - X Ji
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - L Jiang
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - J H Jo
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - R A Johnson
- University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - Y-J Jwa
- Columbia University, New York, New York 10027, USA
| | - D Kalra
- Columbia University, New York, New York 10027, USA
| | - N Kamp
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - G Karagiorgi
- Columbia University, New York, New York 10027, USA
| | - W Ketchum
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Kirby
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Kobilarcik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - I Kreslo
- Universität Bern, Bern CH-3012, Switzerland
| | - M B Leibovitch
- University of California, Santa Barbara, California 93106, USA
| | - I Lepetic
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - J-Y Li
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - K Li
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Y Li
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - K Lin
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - B R Littlejohn
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - W C Louis
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - X Luo
- University of California, Santa Barbara, California 93106, USA
| | - K Manivannan
- Syracuse University, Syracuse, New York 13244, USA
| | - C Mariani
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - D Marsden
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Marshall
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - N Martinez
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - D A Martinez Caicedo
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - K Mason
- Tufts University, Medford, Massachusetts 02155, USA
| | - A Mastbaum
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - N McConkey
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - V Meddage
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - K Miller
- University of Chicago, Chicago, Illinois 60637, USA
| | - J Mills
- Tufts University, Medford, Massachusetts 02155, USA
| | - A Mogan
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - T Mohayai
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Mooney
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - A F Moor
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - C D Moore
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L Mora Lepin
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Mousseau
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | | | - D Naples
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Navrer-Agasson
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - N Nayak
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Nebot-Guinot
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - J Nowak
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - M Nunes
- Syracuse University, Syracuse, New York 13244, USA
| | - N Oza
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - O Palamara
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - N Pallat
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - V Paolone
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Papadopoulou
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - V Papavassiliou
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - H B Parkinson
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - S F Pate
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - N Patel
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - Z Pavlovic
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - E Piasetzky
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - I D Ponce-Pinto
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - I Pophale
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - S Prince
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - X Qian
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - J L Raaf
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - V Radeka
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Reggiani-Guzzo
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Ren
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - L Rochester
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J Rodriguez Rondon
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - M Rosenberg
- Tufts University, Medford, Massachusetts 02155, USA
| | - M Ross-Lonergan
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | | | - G Scanavini
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - D W Schmitz
- University of Chicago, Chicago, Illinois 60637, USA
| | - A Schukraft
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - W Seligman
- Columbia University, New York, New York 10027, USA
| | - M H Shaevitz
- Columbia University, New York, New York 10027, USA
| | - R Sharankova
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Shi
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - A Smith
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - E L Snider
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Soderberg
- Syracuse University, Syracuse, New York 13244, USA
| | | | - J Spitz
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - M Stancari
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J St John
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Strauss
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - S Sword-Fehlberg
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - A M Szelc
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - W Tang
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - N Taniuchi
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - K Terao
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - C Thorpe
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - D Torbunov
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - D Totani
- University of California, Santa Barbara, California 93106, USA
| | - M Toups
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - Y-T Tsai
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J Tyler
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - M A Uchida
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - T Usher
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - B Viren
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Weber
- Universität Bern, Bern CH-3012, Switzerland
| | - H Wei
- Louisiana State University, Baton Rouge, Louisiana 70803, USA
| | - A J White
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Z Williams
- University of Texas, Arlington, Texas 76019, USA
| | - S Wolbers
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Wongjirad
- Tufts University, Medford, Massachusetts 02155, USA
| | - M Wospakrik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - K Wresilo
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - N Wright
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - W Wu
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - E Yandel
- University of California, Santa Barbara, California 93106, USA
| | - T Yang
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L E Yates
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - H W Yu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - G P Zeller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Zennamo
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - C Zhang
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
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Elzanaty AM, Khalil M, Meenakshisundaram C, Alharbi A, Patel N, Maraey A, Zafarullah F, Elgendy IY, Eltahawy E. Outcomes of Coronary Artery Bypass Grafting in Patients With Previous Mediastinal Radiation. Am J Cardiol 2023; 186:80-86. [PMID: 36356429 DOI: 10.1016/j.amjcard.2022.10.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/25/2022] [Accepted: 10/08/2022] [Indexed: 11/09/2022]
Abstract
Studies have shown that patients with radiation therapy-associated coronary artery disease tend to have worse outcomes with percutaneous revascularization. Previous irradiation has been linked with future internal mammary artery graft disease. Studies investigating the outcomes of coronary artery bypass surgery (CABG) among patients with previous radiation are limited. The Nationwide Readmission Database for the years 2016 to 2019 was queried for hospitalizations with CABG and history of mediastinal radiation. Complex samples multivariable logistic and linear regression models were used to determine the association between the history of mediastinal radiation and in-hospital mortality, 90 days all-cause unplanned readmission rates, and acute coronary syndrome readmission rates. A total of 533,702 hospitalizations (2,070 in the irradiation history group and 531,632 in the control group) were included in this analysis. Patients with radiation therapy history were less likely to have traditional coronary artery disease risk factors and more likely to have associated valvular disease. Patients with a history of irradiation had similar in-hospital mortality and 90-day readmission risk at the expense of higher hospitalizations costs (β coefficient: $2,764; p = 0.005). They had a higher likelihood of readmission with acute coronary syndrome within 90 days (adjusted odds ratio 1.67, p = 0.02). In a conclusion, a history of mediastinal irradiation is not associated with increased rates of short-term mortality or increased all-cause readmission risk after CABG. However, it may be associated with increased acute coronary syndrome readmission rates.
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Affiliation(s)
- Ahmed M Elzanaty
- Division of Cardiovascular Medicine and Department of Internal Medicine, University of Toledo, Toledo, Ohio.
| | - Mahmoud Khalil
- Department of Internal Medicine, Lincoln Medical Center, New York, New York
| | | | | | - Neha Patel
- Department of Internal Medicine, University of Toledo, Toledo, Ohio
| | - Ahmed Maraey
- Department of Internal Medicine, University of North Dakota, Bismarck, North Dakota
| | - Fnu Zafarullah
- Division of Cardiovascular Medicine and Department of Internal Medicine, University of Toledo, Toledo, Ohio
| | - Islam Y Elgendy
- Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, Kentucky
| | - Ehab Eltahawy
- Division of Cardiovascular Medicine and Department of Internal Medicine, University of Toledo, Toledo, Ohio
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Patel N, Scambler S, Ranjbari M, Alhammad M, Bakhsh AA, Mannocci F. The influence of patient race on the outcome of endodontic treatments: a pooled analysis of one-year recall data from four cone beam computed tomography outcome studies. Br Dent J 2022:10.1038/s41415-022-5335-y. [PMID: 36513757 DOI: 10.1038/s41415-022-5335-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/08/2022] [Indexed: 12/15/2022]
Abstract
Objectives The aim of this pooled data analysis was to establish if there is an association between a patient's race and the proportion of successful outcomes of endodontic treatments, and if so, what factors may determine this association.Methodology Data collected from four prospective clinical outcome studies were pooled. Patients were recalled 12 months after the completion of the treatment. Treatment outcome was determined by clinical findings and cone beam computed tomography examination. Statistical analysis included the description of categorical and continuous variables and simple binary logistic regression models, chi-squared tests and Kruskal-Wallis tests.Results Data from 301 patients were available. Of these patients, 43 were Black (14.3%), 50 were from a Non-Black Minority Ethnic (NBME) group (16.6%) and 208 were white (69.1%). The risk of an unfavourable outcome was higher in teeth with short root canal fillings (OR = 3.36; p = 0.002), when a preoperative radiolucency was present (OR = 2.59; p = 0.019) and when an intra-operative root canal perforation was detected (OR = 5.25; p = 0.016).Multiple regression models showed that Black (OR = 2.28; p = 0.05) and NBME patients (OR = 3.07; p = 0.008) had a higher risk of an unfavourable result compared to white patients.Conclusions Black and NBME patients had a significantly higher failure rate of root canal treatments compared to white patients. All other known pre-, intra- and post-operative risk factors for root canal treatment failure were present in similar proportions in BME and white patients.
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Affiliation(s)
- Neha Patel
- Endodontics Department, King´s College London, Guys Hospital, Great Maze Pond, London, SE1 9RT, UK.
| | - Sasha Scambler
- Endodontics Department, King´s College London, Guys Hospital, Great Maze Pond, London, SE1 9RT, UK
| | - Mohammadreza Ranjbari
- Endodontics Department, King´s College London, Guys Hospital, Great Maze Pond, London, SE1 9RT, UK
| | - Mohammad Alhammad
- Endodontics Department, King´s College London, Guys Hospital, Great Maze Pond, London, SE1 9RT, UK
| | - Abdulaziz A Bakhsh
- Endodontics Department, King´s College London, Guys Hospital, Great Maze Pond, London, SE1 9RT, UK; Department of Restorative Dentistry, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Francesco Mannocci
- Endodontics Department, King´s College London, Guys Hospital, Great Maze Pond, London, SE1 9RT, UK
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Tartaglia G, Patel N, Fuentes I, Padron Z, Han L, South A. 593 Preventing fibrosis in patients with recessive dystrophic epidermolysis bullosa. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.610] [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: 11/19/2022]
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Tallon EM, Ebekozien O, Sanchez J, Staggs VS, Ferro D, McDonough R, Demeterco-Berggren C, Polsky S, Gomez P, Patel N, Prahalad P, Odugbesan O, Mathias P, Lee JM, Smith C, Shyu CR, Clements MA. Impact of diabetes status and related factors on COVID-19-associated hospitalization: A nationwide retrospective cohort study of 116,370 adults with SARS-CoV-2 infection. Diabetes Res Clin Pract 2022; 194:110156. [PMID: 36400172 PMCID: PMC9663407 DOI: 10.1016/j.diabres.2022.110156] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/01/2022] [Accepted: 11/09/2022] [Indexed: 11/17/2022]
Abstract
AIMS We examined diabetes status (no diabetes; type 1 diabetes [T1D]; type 2 diabetes [T2D]) and other demographic and clinical factors as correlates of coronavirus disease 2019 (COVID-19)-related hospitalization. Further, we evaluated predictors of COVID-19-related hospitalization in T1D and T2D. METHODS We analyzed electronic health record data from the de-identified COVID-19 database (December 2019 through mid-September 2020; 87 US health systems). Logistic mixed models were used to examine predictors of hospitalization at index encounters associated with confirmed SARS-CoV-2 infection. RESULTS In 116,370 adults (>=18 years old) with COVID-19 (93,098 no diabetes; 802 T1D; 22,470 T2D), factors that independently increased risk for hospitalization included diabetes, male sex, public health insurance, decreased body mass index (BMI; <25.0-29.9 kg/m2), increased BMI (>25.0-29.9 kg/m2), vitamin D deficiency/insufficiency, and Elixhauser comorbidity score. After further adjustment for concurrent hyperglycemia and acidosis in those with diabetes, hospitalization risk was substantially higher in T1D than T2D and in those with low vitamin D and elevated hemoglobin A1c (HbA1c). CONCLUSIONS The higher hospitalization risk in T1D versus T2D warrants further investigation. Modifiable risk factors such as vitamin D deficiency/insufficiency, BMI, and elevated HbA1c may serve as prognostic indicators for COVID-19-related hospitalization in adults with diabetes.
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Affiliation(s)
- Erin M Tallon
- Institute for Data Science and Informatics, University of Missouri, 22 Heinkel Building, Columbia, MO 65211, USA.
| | - Osagie Ebekozien
- T1D Exchange, 11 Avenue de Lafayette, Boston, MA 02111, USA; School of Population Health, University of Mississippi, 2500 North State Street, Jackson, MS 39216, USA
| | - Janine Sanchez
- University of Miami, 1601 NW 12th Avenue, Miami, FL 33136, USA
| | - Vincent S Staggs
- Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA; School of Medicine, University of Missouri-Kansas City, 2411 Holmes Street, Kansas City, MO 64108, USA
| | - Diana Ferro
- Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA; School of Medicine, University of Missouri-Kansas City, 2411 Holmes Street, Kansas City, MO 64108, USA
| | - Ryan McDonough
- Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA; School of Medicine, University of Missouri-Kansas City, 2411 Holmes Street, Kansas City, MO 64108, USA
| | | | - Sarit Polsky
- Barbara Davis Center for Diabetes, Adult Clinic, University of Colorado Anschutz Medical Campus, 1775 Aurora Court, MS A140, Aurora, CO 80045, USA
| | - Patricia Gomez
- University of Miami, 1601 NW 12th Avenue, Miami, FL 33136, USA
| | - Neha Patel
- Penn State Health Children's Hospital, 12 Briarcrest Square, Hershey, PA 17033, USA
| | - Priya Prahalad
- Stanford University, 730 Welch Road, Palo Alto, CA 94304, USA
| | - Ori Odugbesan
- T1D Exchange, 11 Avenue de Lafayette, Boston, MA 02111, USA
| | - Priyanka Mathias
- Albert Einstein College of Medicine, Montefiore Medical Center, 1800 Morris Park Avenue, Bronx, NY 10461, USA
| | - Joyce M Lee
- University of Michigan, Pediatric Endocrinology, Susan B. Meister Child Health Evaluation and Research Center, 2800 Plymouth Rd NCRC Building 16, Ann Arbor, MI 48109-2800, USA
| | - Chelsey Smith
- Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA
| | - Chi-Ren Shyu
- Institute for Data Science and Informatics, University of Missouri, 22 Heinkel Building, Columbia, MO 65211, USA; Department of Electrical Engineering and Computer Science, University of Missouri, 201 Naka Hall, Columbia, MO 65211, USA; School of Medicine, University of Missouri, 1 Hospital Drive, Columbia, MO 65212, USA
| | - Mark A Clements
- Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA; School of Medicine, University of Missouri-Kansas City, 2411 Holmes Street, Kansas City, MO 64108, USA
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Stenehjem K, Patel N, Brooks J. EFFICACY OF PINE NUT-SPECIFIC IGE TESTING PRIOR TO ORAL FOOD CHALLENGE. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.679] [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: 11/11/2022]
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50
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Hudson-Phillips S, Patel N, Akthar H, Morris A, Noor L. Accuracy of pre-operative axillary US and biopsy in breast cancer patients. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01424-1] [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: 11/19/2022]
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