1
|
Taleb S, Vahedian-Azimi A, Karimi L, Salim S, Mohammad F, Samhadaneh D, Singh K, Hussein NR, Ait Hssain A. Evaluation of psychological distress, burnout and structural empowerment status of healthcare workers during the outbreak of coronavirus disease (COVID-19): a cross-sectional questionnaire-based study. BMC Psychiatry 2024; 24:61. [PMID: 38254016 PMCID: PMC10804486 DOI: 10.1186/s12888-023-05088-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 08/08/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND In light of several recent studies, there is evidence that the coronavirus disease 2019 (COVID-19) pandemic has caused various mental health concerns in the general population, as well as among healthcare workers (HCWs). The main aim of this study was to assess the psychological distress, burnout and structural empowerment status of HCWs during the COVID-19 outbreak, and to evaluate its predictors. METHODS This multi-center, cross-sectional web-based questionnaire survey was conducted on HCWs during the outbreak of COVID-19 from August 2020 to January 2021. HCWs working in hospitals from 48 different countries were invited to participate in an online anonymous survey that investigated sociodemographic data, psychological distress, burnout and structural empowerment (SE) based on Depression Anxiety and Stress Scale 21 (DASS-21), Maslach Burnout Inventory (MBI) and Conditions for work effectiveness questionnaire (CWEQ_II), respectively. Predictors of the total scores of DASS-21, MBI and CWEQ-II were assessed using unadjusted and adjusted binary logistic regression analysis. RESULTS Out of the 1030 HCWs enrolled in this survey, all completed the sociodemographic section (response rate 100%) A total of 730 (70.9%) HCWs completed the DASS-21 questionnaire, 852 (82.6%) completed the MBI questionnaire, and 712 (69.1%) completed the CWEQ-II questionnaire. The results indicate that 360 out of 730 responders (49.3%) reported severe or extremely severe levels of stress, anxiety, and depression. Additionally, 422 out of 851 responders (49.6%) reported a high level of burnout, while 268 out of 712 responders (37.6%) reported a high level of structural empowerment based on the DASS-21, MBI, and CWEQ-II scales, respectively. In addition, the analysis showed that HCWs working in the COVID-19 areas experienced significantly higher symptoms of severe stress, anxiety, depression and higher levels of burnout compared to those working in other areas. The results also revealed that direct work with COVID-19 patients, lower work experience, and high workload during the outbreak of COVID-19 increase the risks of negative psychological consequences. CONCLUSION Health professionals had high levels of burnout and psychological symptoms during the COVID-19 emergency. Monitoring and timely treatment of these conditions is needed.
Collapse
Affiliation(s)
- Sara Taleb
- Division of Genomics and Translational Biomedicine, College of Health and Life Science, Hamad Bin Khalifa University, Doha, Qatar
- Proteomics Core, Research department, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Amir Vahedian-Azimi
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Leila Karimi
- Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Safa Salim
- Division of Biological and Biomedical Sciences, College of Health & Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Farhan Mohammad
- Division of Biological and Biomedical Sciences, College of Health & Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | | | - Kalpana Singh
- Nursing Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
| | | | - Ali Ait Hssain
- Medical Intensive Care Unit, Hamad General Hospital, Doha, Qatar.
- Department of Medicine, Weill Cornell Medical College, Doha, Qatar.
- College of Health and Life Science, Hamad Bin Khalifa University, Doha, Qatar.
| |
Collapse
|
2
|
Keyan KS, Salim S, Gowda S, Abdelrahman D, Amir SS, Islam Z, Vargas C, Bengoechea-Alonso MT, Alwa A, Dahal S, Kolatkar PR, Da'as S, Torrisani J, Ericsson J, Mohammad F, Khan OM. Control of TGFβ signalling by ubiquitination independent function of E3 ubiquitin ligase TRIP12. Cell Death Dis 2023; 14:692. [PMID: 37863914 PMCID: PMC10589240 DOI: 10.1038/s41419-023-06215-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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/27/2023] [Accepted: 10/05/2023] [Indexed: 10/22/2023]
Abstract
Transforming growth factor β (TGFβ) pathway is a master regulator of cell proliferation, differentiation, and death. Deregulation of TGFβ signalling is well established in several human diseases including autoimmune disorders and cancer. Thus, understanding molecular pathways governing TGFβ signalling may help better understand the underlying causes of some of those conditions. Here, we show that a HECT domain E3 ubiquitin ligase TRIP12 controls TGFβ signalling in multiple models. Interestingly, TRIP12 control of TGFβ signalling is completely independent of its E3 ubiquitin ligase activity. Instead, TRIP12 recruits SMURF2 to SMAD4, which is most likely responsible for inhibitory monoubiquitination of SMAD4, since SMAD4 monoubiquitination and its interaction with SMURF2 were dramatically downregulated in TRIP12-/- cells. Additionally, genetic inhibition of TRIP12 in human and murine cells leads to robust activation of TGFβ signalling which was rescued by re-introducing wildtype TRIP12 or a catalytically inactive C1959A mutant. Importantly, TRIP12 control of TGFβ signalling is evolutionary conserved. Indeed, genetic inhibition of Drosophila TRIP12 orthologue, ctrip, in gut leads to a reduced number of intestinal stem cells which was compensated by the increase in differentiated enteroendocrine cells. These effects were completely normalised in Drosophila strain where ctrip was co-inhibited together with Drosophila SMAD4 orthologue, Medea. Similarly, in murine 3D intestinal organoids, CRISPR/Cas9 mediated genetic targeting of Trip12 enhances TGFβ mediated proliferation arrest and cell death. Finally, CRISPR/Cas9 mediated genetic targeting of TRIP12 in MDA-MB-231 breast cancer cells enhances the TGFβ induced migratory capacity of these cells which was rescued to the wildtype level by re-introducing wildtype TRIP12. Our work establishes TRIP12 as an evolutionary conserved modulator of TGFβ signalling in health and disease.
Collapse
Affiliation(s)
- Kripa S Keyan
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Safa Salim
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Swetha Gowda
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | | | - Syeda Sakina Amir
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Zeyaul Islam
- Qatar Biomedical Research Institute, Doha, Qatar
| | - Claire Vargas
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, CNRS, Université Toulouse III-Paul Sabatier, Toulouse, France
| | | | - Amira Alwa
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Subrat Dahal
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | | | - Sahar Da'as
- Department of Research, Sidra Medicine, Doha, Qatar
| | - Jerome Torrisani
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, CNRS, Université Toulouse III-Paul Sabatier, Toulouse, France
| | - Johan Ericsson
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Farhan Mohammad
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar.
| | - Omar M Khan
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar.
| |
Collapse
|
3
|
Turner BRH, Machin M, Jasionowska S, Salim S, Onida S, Shalhoub J, Davies AH. Systematic Review and Meta-analysis of the Additional Benefit of Pharmacological Thromboprophylaxis for Endovenous Varicose Vein Interventions. Ann Surg 2023; 278:166-171. [PMID: 36205129 PMCID: PMC10321513 DOI: 10.1097/sla.0000000000005709] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The primary objective of this systematic review and meta-analysis was to elucidate the rate of venous thromboembolism (VTE) after endovenous interventions for varicose veins in the presence of pharmacological and mechanical thromboprophylaxis versus mechanical thromboprophylaxis alone. BACKGROUND The VTE rate after endovenous procedures for varicose veins is higher than other day-case procedures and could be reduced with pharmacological thromboprophylaxis. METHODS The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines with a registered protocol (PROSPERO: CRD42021274963). Studies of endovenous intervention for superficial venous incompetence reporting the predefined outcomes with at least 30 patients were eligible. Data were pooled with a fixed effects model. RESULTS There were 221 trials included in the review (47 randomized trial arms, 105 prospective cohort studies, and 69 retrospective studies). In randomized trial arms, the rate of deep venous thrombosis with additional pharmacological thromboprophylaxis was 0.52% (95% CI, 0.23%-1.19%) (9 studies, 1095 patients, 2 events) versus 2.26% (95% CI, 1.81%-2.82%) (38 studies, 6951 patients, 69 events) with mechanical thromboprophylaxis alone. The rate of pulmonary embolism in randomized trial arms with additional pharmacological thromboprophylaxis was 0.45% (95% CI, 0.09-2.35) (5 studies, 460 participants, 1 event) versus 0.23% (95% CI, 0.1%-0.52%) (28 studies, 4834 participants, 3 events) for mechanical measures alone. The rate of EHIT grade III to IV was 0.35% (95% CI, 0.09-1.40) versus 0.88% (95% CI, 0.28%-2.70%). There was 1 VTE-related mortality and 1 instance of major bleeding, with low rates of minor bleeding. CONCLUSIONS There is a significant reduction in the rate of DVT with additional pharmacological thromboprophylaxis and routine prescription of anticoagulation after endovenous varicose vein intervention should be considered. VTE risk for individual study participants is heterogeneous and risk stratification in future randomized interventional studies is critical to establish the clinical effectiveness and safety of additional pharmacological thromboprophylaxis.
Collapse
|
4
|
Salim S, Hussain S, Banu A, Gowda SBM, Ahammad F, Alwa A, Pasha M, Mohammad F. The ortholog of human ssDNA-binding protein SSBP3 influences neurodevelopment and autism-like behaviors in Drosophila melanogaster. PLoS Biol 2023; 21:e3002210. [PMID: 37486945 PMCID: PMC10399856 DOI: 10.1371/journal.pbio.3002210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 08/03/2023] [Accepted: 06/21/2023] [Indexed: 07/26/2023] Open
Abstract
1p32.3 microdeletion/duplication is implicated in many neurodevelopmental disorders-like phenotypes such as developmental delay, intellectual disability, autism, macro/microcephaly, and dysmorphic features. The 1p32.3 chromosomal region harbors several genes critical for development; however, their validation and characterization remain inadequate. One such gene is the single-stranded DNA-binding protein 3 (SSBP3) and its Drosophila melanogaster ortholog is called sequence-specific single-stranded DNA-binding protein (Ssdp). Here, we investigated consequences of Ssdp manipulations on neurodevelopment, gene expression, physiological function, and autism-associated behaviors using Drosophila models. We found that SSBP3 and Ssdp are expressed in excitatory neurons in the brain. Ssdp overexpression caused morphological alterations in Drosophila wing, mechanosensory bristles, and head. Ssdp manipulations also affected the neuropil brain volume and glial cell number in larvae and adult flies. Moreover, Ssdp overexpression led to differential changes in synaptic density in specific brain regions. We observed decreased levels of armadillo in the heads of Ssdp overexpressing flies, as well as a decrease in armadillo and wingless expression in the larval wing discs, implicating the involvement of the canonical Wnt signaling pathway in Ssdp functionality. RNA sequencing revealed perturbation of oxidative stress-related pathways in heads of Ssdp overexpressing flies. Furthermore, Ssdp overexpressing brains showed enhanced reactive oxygen species (ROS), altered neuronal mitochondrial morphology, and up-regulated fission and fusion genes. Flies with elevated levels of Ssdp exhibited heightened anxiety-like behavior, altered decisiveness, defective sensory perception and habituation, abnormal social interaction, and feeding defects, which were phenocopied in the pan-neuronal Ssdp knockdown flies, suggesting that Ssdp is dosage sensitive. Partial rescue of behavioral defects was observed upon normalization of Ssdp levels. Notably, Ssdp knockdown exclusively in adult flies did not produce behavioral and functional defects. Finally, we show that optogenetic manipulation of Ssdp-expressing neurons altered autism-associated behaviors. Collectively, our findings provide evidence that Ssdp, a dosage-sensitive gene in the 1p32.3 chromosomal region, is associated with various anatomical, physiological, and behavioral defects, which may be relevant to neurodevelopmental disorders like autism. Our study proposes SSBP3 as a critical gene in the 1p32.3 microdeletion/duplication genomic region and sheds light on the functional role of Ssdp in neurodevelopmental processes in Drosophila.
Collapse
Affiliation(s)
- Safa Salim
- Division of Biological and Biomedical Sciences (BBS), College of Health & Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | - Sadam Hussain
- Division of Biological and Biomedical Sciences (BBS), College of Health & Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | - Ayesha Banu
- Division of Biological and Biomedical Sciences (BBS), College of Health & Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | - Swetha B. M. Gowda
- Division of Biological and Biomedical Sciences (BBS), College of Health & Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | - Foysal Ahammad
- Division of Biological and Biomedical Sciences (BBS), College of Health & Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | - Amira Alwa
- Division of Biological and Biomedical Sciences (BBS), College of Health & Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | - Mujaheed Pasha
- HBKU Core Labs, Hamad Bin Khalifa University (HBKU): Doha, Qatar
| | - Farhan Mohammad
- Division of Biological and Biomedical Sciences (BBS), College of Health & Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Doha, Qatar
| |
Collapse
|
5
|
Salim S, Onida S, Davies A. The Population Burden of Chronic Venous Disease in the United Kingdom. J Vasc Surg Venous Lymphat Disord 2023. [DOI: 10.1016/j.jvsv.2022.12.058] [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: 02/24/2023]
|
6
|
Yazdanfard S, Majd Z, Atrooz F, Alrousan G, Zeidat S, Abughosh S, Salim S. Anxiety impact during COVID-19: Insight on a Houston-based Middle Eastern and North African community. Res Social Adm Pharm 2023. [DOI: 10.1016/j.sapharm.2022.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
7
|
Banu A, Gowda SBM, Salim S, Mohammad F. Serotonergic control of feeding microstructure in Drosophila. Front Behav Neurosci 2023; 16:1105579. [PMID: 36733453 PMCID: PMC9887136 DOI: 10.3389/fnbeh.2022.1105579] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 12/20/2022] [Indexed: 01/18/2023] Open
Abstract
To survive, animals maintain energy homeostasis by seeking out food. Compared to freely feeding animals, food-deprived animals may choose different strategies to balance both energy and nutrition demands, per the metabolic state of the animal. Serotonin mediates internal states, modifies existing neural circuits, and regulates animal feeding behavior, including in humans and fruit flies. However, an in-depth study on the neuromodulatory effects of serotonin on feeding microstructure has been held back for several technical reasons. Firstly, most feeding assays lack the precision of manipulating neuronal activity only when animals start feeding, which does not separate neuronal effects on feeding from foraging and locomotion. Secondly, despite the availability of optogenetic tools, feeding in adult fruit flies has primarily been studied using thermogenetic systems, which are confounded with heat. Thirdly, most feeding assays have used food intake as a measurement, which has a low temporal resolution to dissect feeding at the microstructure level. To circumvent these problems, we utilized OptoPAD assay, which provides the precision of optogenetics to control neural activity contingent on the ongoing feeding behavior. We show that manipulating the serotonin circuit optogenetically affects multiple feeding parameters state-dependently. Food-deprived flies with optogenetically activated and suppressed serotonin systems feed with shorter and longer sip durations and longer and shorter inter-sip intervals, respectively. We further show that serotonin suppresses and enhances feeding via 5-HT1B and 5-HT7 receptors, respectively.
Collapse
|
8
|
Gowda SB, Banu A, Salim S, Peker KA, Mohammad F. Serotonin distinctly controls behavioral states in restrained and freely moving Drosophila. iScience 2022; 26:105886. [PMID: 36654863 PMCID: PMC9840979 DOI: 10.1016/j.isci.2022.105886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 11/09/2022] [Accepted: 12/22/2022] [Indexed: 12/29/2022] Open
Abstract
When trapped in a physical restraint, animals must select an escape strategy to increase their chances of survival. After falling into an inescapable trap, they react with stereotypical behaviors that differ from those displayed in escapable situations. Such behaviors involve either a wriggling response to unlock the trap or feigning death to fend off a predator attack. The neural mechanisms that regulate animal behaviors have been well characterized for escapable situations but not for inescapable traps. We report that restrained vinegar flies exhibit alternating flailing and immobility to free themselves from the trap. We used optogenetics and intersectional genetic approaches to show that, while broader serotonin activation promotes immobility, serotonergic cells in the ventral nerve cord (VNC) regulate immobility states majorly via 5-HT7 receptors. Restrained and freely moving locomotor states are controlled by distinct mechanisms. Taken together, our study has identified serotonergic switches of the VNC that promote environment-specific adaptive behaviors.
Collapse
Affiliation(s)
- Swetha B.M. Gowda
- Division of Biological and Biomedical Sciences (BBS), College of Health & Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Doha 34110, Qatar
| | - Ayesha Banu
- Division of Biological and Biomedical Sciences (BBS), College of Health & Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Doha 34110, Qatar
| | - Safa Salim
- Division of Biological and Biomedical Sciences (BBS), College of Health & Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Doha 34110, Qatar
| | | | - Farhan Mohammad
- Division of Biological and Biomedical Sciences (BBS), College of Health & Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Doha 34110, Qatar,Corresponding author
| |
Collapse
|
9
|
Salim S, Ahmad F, Banu A, Mohammad F. Gut microbiome and Parkinson's disease: Perspective on pathogenesis and treatment. J Adv Res 2022:S2090-1232(22)00242-9. [PMID: 36332796 PMCID: PMC10403695 DOI: 10.1016/j.jare.2022.10.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/26/2022] [Accepted: 10/26/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a disease of ⍺-synuclein aggregation-mediated dopaminergic neuronal loss in the substantia nigra pars compacta, which leads to motor and non-motor symptoms. Through the last two decades of research, there has been growing consensus that inflammation-mediated oxidative stress, mitochondrial dysfunction, and cytokine-induced toxicity are mainly involved in neuronal damage and loss associated with PD. However, it remains unclear how these mechanisms relate to sporadic PD, a more common form of PD. Both enteric and central nervous systems have been implicated in the pathogenesis of sporadic PD, thus highlighting the crosstalk between the gut and brain. AIM of Review: In this review, we summarize how alterations in the gut microbiome can affect PD pathogenesis. We highlight various mechanisms increasing/decreasing the risk of PD development. Based on the previous supporting evidence, we suggest how early interventions could protect against PD development and how controlling specific factors, including our diet, could modify our perspective on disease mechanisms and therapeutics. We explain the strong relationship between the gut microbiota and the brain in PD subjects, by delineating the multiple mechanisms involved inneuroinflammation and oxidative stress. We conclude that the neurodetrimental effects of western diet (WD) and the neuroprotective effects of Mediterranean diets should be further exploredin humans through clinical trials. Key Scientific Concepts of Review: Alterations in the gut microbiome and associated metabolites may contribute to pathogenesis in PD. In some studies, probiotics have been shown to exert anti-oxidative effects in PD via improved mitochondrial dynamics and homeostasis, thus reducing PD-related consequences. However, there is a significant unmet need for randomized clinical trials to investigate the effectiveness of microbial products, probiotic-based supplementation, and dietary intervention in reversing gut microbial dysbiosis in PD.
Collapse
|
10
|
Salim S, Salleh NM, Abidin ZZ, Yunus N, Rahmat R, Ibrahim N. Physicomechanical properties of cobalt-chromium removable partial denture palatal major connectors fabricated by selective laser melting. J Prosthet Dent 2022; 128:530.e1-530.e7. [PMID: 35933173 DOI: 10.1016/j.prosdent.2022.06.013] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 06/25/2022] [Accepted: 06/28/2022] [Indexed: 10/16/2022]
Abstract
STATEMENT OF PROBLEM Additive manufacturing by selective laser melting (SLM) has been claimed to be less challenging than conventional casting of cobalt-chromium (Co-Cr) removable partial dentures (RPDs), providing significant improvements. However, how the physicomechanical properties of Co-Cr RPDs fabricated by SLM compare with those fabricated by conventional casting is unclear. PURPOSE The purpose of this in vitro study was to evaluate the physicomechanical properties of Co-Cr RPD palatal major connectors fabricated by SLM compared with those fabricated by conventional casting. MATERIAL AND METHODS A master die simulating a maxillary arch of Kennedy class III modification 1 was scanned to create a virtual 3-dimensional (3D) cast. Two groups of 5 Co-Cr RPD major connectors were fabricated. In the 3D printing group, the Co-Cr major connector was virtually designed and exported for direct SLM 3D printing. For the conventional group, Co-Cr major connectors were constructed conventionally. The Co-Cr major connectors were virtually superimposed with the master die for surface adaptation analysis. Additional comparative analyses of surface roughness, relative density, microhardness, and microstructure of the 2 groups were performed. Data were analyzed by using independent t tests (α=.05). RESULTS The overall volumetric and linear discrepancies were significantly higher (P<.05) in the 3D printing group. Significant differences in the surface roughness (P<.05) and microhardness (P<.05) were observed, with the 3D printing group having higher surface roughness and microhardness than the conventional group. Unlike conventional connectors, the microstructure of 3D-printed connectors showed fine homogeneous granules. CONCLUSIONS Compared with the conventional casting technique, SLM 3D printing enabled the fabrication of Co-Cr RPD major connectors with higher microhardness and fine homogenous microstructure. However, the surface adaptation and surface roughness of SLM 3D printing Co-Cr connectors were worse than those produced conventionally. Both techniques showed similar relative densities.
Collapse
Affiliation(s)
- Safa Salim
- PhD student, Department of Restorative Dentistry, Faculty of Dentistry, University Malaya, Kuala Lumpur, Malaysia
| | - Nosizana Mohd Salleh
- Associated Professor, Department of Restorative Dentistry, Faculty of Dentistry, University Malaya, Kuala Lumpur, Malaysia
| | - Zubaidah Zanul Abidin
- Lecturer, Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Norsiah Yunus
- Professor, Department of Restorative Dentistry, Faculty of Dentistry, University Malaya, Kuala Lumpur, Malaysia
| | - Rabiah Rahmat
- Lecturer, Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Norliza Ibrahim
- Associated Professor, Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University Malaya, Kuala Lumpur, Malaysia.
| |
Collapse
|
11
|
Kirkilesis G, Kakkos SK, Bicknell C, Salim S, Kakavia K. Treatment of distal deep vein thrombosis. Emergencias 2022; 34:220-221. [PMID: 35736527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- George Kirkilesis
- Department of Vascular Surgery, University of Patras Medical School, Patras, Grecia
| | - Stavros K Kakkos
- Department of Vascular Surgery, University of Patras Medical School, Patras, Grecia
| | - Colin Bicknell
- Department of Vascular Surgery, Imperial College London, Londres, RU
| | - Safa Salim
- Transplant Department, Imperial College Healthcare NHS Trust, Londres, RU
| | - Kyriaki Kakavia
- Department of Surgery, Laiko Hospital, National and Kapodistrian University of Athens, Atenas, Grecia
| |
Collapse
|
12
|
Abstract
OBJECTIVES Abdominal aortic aneurysm (AAA) clinical practice guidelines (CPGs) provide evidence-based information on patient management; however, methodological differences exist in the development of CPGs. This study examines the methodological quality of AAA CPGs using a validated assessment tool. METHODS Medline, EMBASE and online CPG databases were searched from 1946 to 31 October 2021. Full-text, English language, evidence-based AAA CPGs were included. Consensus-based CPGs, summaries of CPGs or CPGs which were only available on purchase were excluded. Five reviewers assessed their quality using the Appraisal of Guidelines for Research and Evaluation II instrument. An overall guideline assessment scaled score of ≥80% was considered as the threshold to recommend CPG use in clinical practice. RESULTS Seven CPGs were identified. Scores showed good inter-reviewer reliability (intraclass correlation coefficient 0.943, 95% CI 0.915 to 0.964). On average, CPGs performed adequately with mean scaled scores of over 50% in all domains. However, between CPGs, significant methodological heterogeneity was observed in all domains. Four CPGs scored ≥80% (European Society of Cardiology, the Society of Vascular Surgery, the European Society of Vascular Surgery and the National Institute of Health and Care Excellence), supporting their use in clinical practice. CONCLUSIONS Four CPGs were considered of adequate methodological quality to recommend their use in clinical practice; nonetheless, these still showed areas for improvement, potentially through performing economic analysis and trial application of recommendations. A structured approach employing validated CPG creation tools should be used to improve rigour of AAA CPGs. Future work should also evaluate recommendation accuracy using validated appraisal tools.
Collapse
Affiliation(s)
- Kia Hau Matthew Tan
- Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Safa Salim
- Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Matthew Machin
- Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Aurélien Geroult
- Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Sarah Onida
- Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Tristan Lane
- Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
- Cambridge Vascular Unit, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - A H Davies
- Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| |
Collapse
|
13
|
Abstract
The idea that alterations in gut-microbiome-brain axis (GUMBA)-mediated communication play a crucial role in human brain disorders like autism remains a topic of intensive research in various labs. Gastrointestinal issues are a common comorbidity in patients with autism spectrum disorder (ASD). Although gut microbiome and microbial metabolites have been implicated in the etiology of ASD, the underlying molecular mechanism remains largely unknown. In this review, we have summarized recent findings in human and animal models highlighting the role of the gut-brain axis in ASD. We have discussed genetic and neurobehavioral characteristics of Drosophila as an animal model to study the role of GUMBA in ASD. The utility of Drosophila fruit flies as an amenable genetic tool, combined with axenic and gnotobiotic approaches, and availability of transgenic flies may reveal mechanistic insight into gut-microbiota-brain interactions and the impact of its alteration on behaviors relevant to neurological disorders like ASD.
Collapse
Affiliation(s)
- Safa Salim
- Division of Biological and Biomedical Sciences (BBS), College of Health & Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Doha, 34110, Qatar
| | - Ayesha Banu
- Division of Biological and Biomedical Sciences (BBS), College of Health & Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Doha, 34110, Qatar
| | - Amira Alwa
- Division of Biological and Biomedical Sciences (BBS), College of Health & Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Doha, 34110, Qatar
| | - Swetha B M Gowda
- Division of Biological and Biomedical Sciences (BBS), College of Health & Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Doha, 34110, Qatar
| | - Farhan Mohammad
- Division of Biological and Biomedical Sciences (BBS), College of Health & Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Doha, 34110, Qatar.
| |
Collapse
|
14
|
Salim S, Vidal-Diez A, Machin M, Patterson BO, Onida S, Davies AH. O15 Venous Leg Ulceration: an assessment of associated lifestyle, sociodemographic and clinical factors using UK Biobank. Br J Surg 2021. [DOI: 10.1093/bjs/znab282.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
A number of factors have reportedly been associated with venous leg ulceration (VLU) however many of these remain disputed. UK Biobank (UKB) is an electronic dataset that provides in-depth detail on the lives of its participants. The aim of this research is to utilise UKB to understand factors associated with VLU.
Methods
Participants in the UKB with historical or active venous ulceration were identified and an age, sex and comorbidity matched control group was formed. A multivariate logistic regression was used to explore factors associated with VLU with significant factors expressed through odds ratios (OR). Mortality was investigated using a Kaplan Meier plot and log-rank test. Data analysis was preformed using R Studio Version 1.2.5033 and Python 3.8.10.
Results
Factors associated with VLU included; male gender, older age, deprivation (OR 1.27), obesity (OR 1.40), current smoking (OR 1.21), immoderate alcohol intake (OR 1.32), previous deep vein thrombosis (OR 3.07), depression and loneliness (OR 1.21). Biochemical factors associated with VLU included low haemoglobin concentrations (OR 1.50), low circulating lymphocyte percentages (OR 1.57), raised glycated haemoglobin (HbA1c) (OR 2.92), raised c-reactive protein (OR 1.41), raised cystatin C (OR 1.11) and low Vitamin D levels (OR 1.52). At a median follow up of 11.5 years, the mortality in VLU participants was 28%; significantly higher than in controls (P < 0.001).
Conclusion
Participants with VLU are comorbid with poorer physical, social and psychological wellbeing.
Collapse
Affiliation(s)
- Safa Salim
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Alberto Vidal-Diez
- London In Vitro Diagnostics Co-operative, National Institute for Health Research, UK
| | - Matthew Machin
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | | | - Sarah Onida
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Alun H Davies
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| |
Collapse
|
15
|
Tabernero J, Bekaii-Saab T, Safont Aguilera M, Cubillo A, Garcia-Carbonero R, Limon L, Rodríguez-Salas N, Tournigand C, Borg C, Raghav K, Finley G, Strickler J, Beier F, Salim S, Esser R, Liu E, Adrian S, López-López C. P-111 PERSPECTIVE: Tepotinib plus cetuximab in patients with RAS/BRAF wild-type left-sided metastatic colorectal cancer and acquired resistance to anti-EGFR antibody therapy due to MET amplification. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
16
|
Siddig S, Kaboush M, Dabora M, Gafer N, Khair Allah M, Zakaria S, Salim S, Edward J. Omission of radiation therapy after breast conserving surgery in older early breast cancer among Sudanese patients. Breast 2021. [DOI: 10.1016/s0960-9776(21)00117-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: 12/01/2022] Open
|
17
|
Salim S, Martin G, Bicknell C. Reply. J Vasc Surg 2021; 73:1115. [PMID: 33632504 DOI: 10.1016/j.jvs.2020.10.032] [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] [Received: 10/12/2020] [Accepted: 10/23/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Safa Salim
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Guy Martin
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Colin Bicknell
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| |
Collapse
|
18
|
Machin M, Salim S, Tan M, Onida S, Davies AH, Shalhoub J. Surgical and non-surgical approaches in the management of lower limb post-thrombotic syndrome. Expert Rev Cardiovasc Ther 2021; 19:191-200. [PMID: 33455484 DOI: 10.1080/14779072.2021.1876563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Introduction: Post-thrombotic syndrome (PTS) is a common lifelong condition affecting up to 50% of those suffering from deep vein thrombosis (DVT). PTS compromises function and quality of life with subsequent venous ulceration in up to 29% of those affected.Areas covered: A literature review of surgical and non-surgical approaches in the prevention and treatment of PTS was undertaken. Notable areas include the use of percutaneous endovenous interventions and the use of graduated compression stockings (GCS) after acute proximal DVT.Expert opinion: In patients with acute iliofemoral DVT, we think it is important to have a frank conversation with the patient about catheter-directed thrombolysis, aiming to reduce the severity of PTS experienced. We advocate ultrasound-accelerated thrombolysis with adjunctive procedures, such as deep venous stenting for proximal iliofemoral DVT. For patients with isolated femoral DVT, we believe that anticoagulation and GCS should be recommended. In patients with established PTS, we recommend GCS for symptomatic relief. We recommend that patients engage in regular exercise where possible with the prospect of gaining symptomatic relief. For those with severe PTS that has a significant effect on quality of life, we discuss the patient's case at a multi-disciplinary team meeting to plan for endovenous intervention.
Collapse
Affiliation(s)
- M Machin
- Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College London, London, UK.,Imperial Vascular Unit, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - S Salim
- Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College London, London, UK.,Imperial Vascular Unit, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - M Tan
- Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College London, London, UK.,Imperial Vascular Unit, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - S Onida
- Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College London, London, UK.,Imperial Vascular Unit, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - A H Davies
- Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College London, London, UK
| | - J Shalhoub
- Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College London, London, UK.,Imperial Vascular Unit, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| |
Collapse
|
19
|
Gowda SBM, Salim S, Mohammad F. Anatomy and Neural Pathways Modulating Distinct Locomotor Behaviors in Drosophila Larva. Biology (Basel) 2021; 10:90. [PMID: 33504061 PMCID: PMC7910854 DOI: 10.3390/biology10020090] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/07/2020] [Accepted: 12/30/2020] [Indexed: 11/17/2022]
Abstract
The control of movements is a fundamental feature shared by all animals. At the most basic level, simple movements are generated by coordinated neural activity and muscle contraction patterns that are controlled by the central nervous system. How behavioral responses to various sensory inputs are processed and integrated by the downstream neural network to produce flexible and adaptive behaviors remains an intense area of investigation in many laboratories. Due to recent advances in experimental techniques, many fundamental neural pathways underlying animal movements have now been elucidated. For example, while the role of motor neurons in locomotion has been studied in great detail, the roles of interneurons in animal movements in both basic and noxious environments have only recently been realized. However, the genetic and transmitter identities of many of these interneurons remains unclear. In this review, we provide an overview of the underlying circuitry and neural pathways required by Drosophila larvae to produce successful movements. By improving our understanding of locomotor circuitry in model systems such as Drosophila, we will have a better understanding of how neural circuits in organisms with different bodies and brains lead to distinct locomotion types at the organism level. The understanding of genetic and physiological components of these movements types also provides directions to understand movements in higher organisms.
Collapse
Affiliation(s)
| | | | - Farhan Mohammad
- Division of Biological and Biomedical Sciences (BBS), College of Health & Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Doha 34110, Qatar; (S.B.M.G.); (S.S.)
| |
Collapse
|
20
|
Bhattacharyya GS, Walia M, Nandi M, Murli A, Salim S, Rajpurohit S, Shinde S, Aggarwal S, Parikh PM. Practical consensus recommendations for neo-adjuvant chemotherapy in triple negative breast cancer. South Asian J Cancer 2020; 7:156-158. [PMID: 29721485 PMCID: PMC5909296 DOI: 10.4103/sajc.sajc_126_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This manuscript provides a practical and easy to use consensus recommendation to community oncologists on how to use neoadjuvant chemotherapy in triple negative breast cancer patients.
Collapse
Affiliation(s)
- G S Bhattacharyya
- Department of Medical Oncology, Fortis Hospital, Kolkata, West Bengal, India
| | - M Walia
- Department of Medical Oncology, Max Hospital, New Delhi, India
| | - M Nandi
- Department of Medical Oncology, Jaypee Hospital, Noida, Uttar Pradesh, India
| | - A Murli
- Department of Medical Oncology, Sarvodaya Hospital, Faridabad, Haryana, India
| | - S Salim
- Department of Oncology, Hakim Sanaullah Cancer Center, Sopore, Jammu and Kashmir, India
| | - S Rajpurohit
- Department of Medical Oncology, RGCI, New Delhi, India
| | - S Shinde
- Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | - S Aggarwal
- Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | - P M Parikh
- Department of Oncology, Shalby Cancer and Research Institute, Mumbai, Maharashtra, India
| |
Collapse
|
21
|
Aggarwal S, Vaid A, Ramesh A, Parikh PM, Purohit S, Avasthi B, Gupta S, Ranjan S, Kaushal V, Salim S, Singh R, Minhas S, Doval D. Practical consensus recommendations on management of HR + ve early breast cancer with specific reference to genomic profiling. South Asian J Cancer 2020; 7:96-101. [PMID: 29721472 PMCID: PMC5909304 DOI: 10.4103/sajc.sajc_110_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Breast cancer is a heterogeneous disease and patients are managed clinically based on ER, PR, HER2 expression, and key risk factors. The use of gene expression assays for early stage disease is already common practice. These tests have found a place in risk stratifying the heterogeneous group of stage I–II breast cancers for recurrence, for predicting chemotherapy response, and for predicting breast cancer-related mortality. Most guidelines for hormone receptor (HR)–positive early breast cancer recommend addition of adjuvant chemotherapy for most women, leading to overtreatment, which causes considerable morbidity and cost. Expert oncologist discussed about strategies of gene expression assays and aid in chemotherapy recommendations for treatment of HR + ve EBC and the expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at this practical consensus recommendations for the benefit of community oncologists.
Collapse
Affiliation(s)
- S Aggarwal
- Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | - A Vaid
- Department of Medical Oncology, Medanata Hospital, Gurugram, Haryana, India
| | - A Ramesh
- Department of Medical Oncology, HCG Cancer Center, Chennai, Tamil Nadu, India.,Department of Medical Oncology, SMH Curie Cancer Center, New Delhi, India
| | - Purvish M Parikh
- Department of Oncology, Shalby Cancer and Research Institute, Mumbai, Maharashtra, India
| | - S Purohit
- Department of Medical Oncology, Artemis Hospital, Gurugram, Haryana, India
| | - B Avasthi
- Department or Radiation Oncology, Fortis Hospital, New Delhi, India
| | - S Gupta
- Department of Medical Oncology, Sarvodaya Hospital, Faridabad, Haryana, India
| | - S Ranjan
- Department of Medicine, INHS Sanjivani, Kochi, Kerala, India
| | - V Kaushal
- Department of Radiation Oncology, RCC, Rohtak, Haryana, India
| | - S Salim
- Department of Oncology, Hakim Sanaullah Cancer Center, Baramulla, Jammu and Kashmir, India
| | - R Singh
- Department of Medical Oncology, Army Hospital R and R, New Delhi, India
| | - S Minhas
- Department of Medical Oncology, Medanata Hospital, Gurugram, Haryana, India
| | - D Doval
- Department of Medical Oncology, Rajiv Gandhi Cancer Institute, New Delhi, India
| |
Collapse
|
22
|
Abstract
Venous leg ulceration (VLU) is a public health concern that is largely managed in community settings. The present study aimed to survey current VLU management in the community. A 14-question survey was distributed to primary care professionals, and 90 responses were received. Some 54% of respondents stated that they would assess ankle brachial pressure indices (ABPI) for those with VLU, while 25% reported that they would not. Additionally, 62% reported not organising duplex ultrasound scanning. Compression therapy was offered by 82% of respondents. When asked whether VLU patients were referred to specialist services in secondary or tertiary care, some 32% reported that they would. However, 57% reported that, if a study suggested that referral to specialist services was beneficial, they would change their practice. On the basis of the findings, the authors concluded that there is diversity in VLU diagnostic and treatment pathways. New, high-quality evidence may improve practice, but care delivery is influenced by local factors including time and resource distribution.
Collapse
Affiliation(s)
| | - Layla Bolton Saghdaoui
- Pre-doctoral Clinical Fellow/Clinical Research Nurse, Vascular Surgery Research Department, Imperial College Healthcare NHS Trust
| | - Safa Salim
- Clinical Research Fellow, Division of Surgery, Imperial College London
| | - Sarah Onida
- Clinical Lecturer, Faculty of Medicine, Department of Surgery and Cancer, Imperial College London
| | - Alun Huw Davies
- Professor of Vascular Surgery and Honorary Consultant, Imperial College Healthcare NHS Trust
| |
Collapse
|
23
|
Machin M, Salim S, Onida S, Davies AH. The less invasive paradox, why carotid artery stenting is not suitable for the high-risk patient. Ann Transl Med 2020; 8:1269. [PMID: 33178801 PMCID: PMC7607106 DOI: 10.21037/atm-19-4085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Carotid artery stenosis causes significant morbidity and mortality accounting for approximately 8% of all ischaemic strokes. Carotid artery stenting (CAS) offers an endovascular alternative to carotid endarterectomy (CEA), suggested as a viable option in those deemed high-risk for open CEA due to comorbidities or operative technical considerations. A number of large randomised-controlled trials (RCTs) and meta-analysis comparing CAS vs. CEA in unselected patient populations support the conclusion that CAS is associated with a higher risk of stroke and CEA is associated with a higher risk of myocardial infraction. Initial promise for CAS in high-risk patients was demonstrated by The Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy (SAPPHIRE) trial that reported CAS was non-inferior to CEA. However, there is evidence to suggest age-related adverse outcome in patients undergoing CAS. There is limited evidence to suggest that CEA could be suitable even in patients deemed high-risk for medical or technical reasons. Further contemporary research on the use of CAS and CEA in high-risk patients is required to re-evaluate current guidelines and high-risk criterion. It is common for a composite outcome of death, ipsilateral stroke and MI which should be questioned as subsequent quality of life is likely to differ after suffering a stroke in comparison to MI. This literature review will discuss the current evidence for CAS and CEA interventions in unselected populations and high-risk patients with carotid disease requiring intervention.
Collapse
Affiliation(s)
- Matthew Machin
- Academic Department of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.,Imperial Vascular Unit, Imperial Healthcare NHS Trust, London, UK
| | - Safa Salim
- Academic Department of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.,Imperial Vascular Unit, Imperial Healthcare NHS Trust, London, UK
| | - Sarah Onida
- Academic Department of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.,Imperial Vascular Unit, Imperial Healthcare NHS Trust, London, UK
| | - Alun Huw Davies
- Academic Department of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.,Imperial Vascular Unit, Imperial Healthcare NHS Trust, London, UK
| |
Collapse
|
24
|
Abstract
Background and Aims: Acute mesenteric venous thrombosis accounts for up to 20% of all patients with acute mesenteric ischemia in high-income countries. Acute mesenteric venous thrombosis is nowadays relatively more often diagnosed with intravenous contrast-enhanced computed tomography in the portal phase than at explorative laparotomy No high-quality comparative studies between anticoagulation alone, endovascular therapy, or surgery exists. The aim of the present systematic review was to offer a contemporary overview on management. Materials and Methods: Eleven relevant published original studies with series of at least ten patients were retrieved from a Pub Med search between 2015 and 2020 using the Medical Subject Heading term “mesenteric venous thrombosis.” Results: When MVT is diagnosed early, immediate anticoagulation with either unfractionated heparin or subcutaneous low-molecular-weight heparin should commence. Surgeons need to be aware of the importance to scrutinize the computed tomography images themselves for assessment of secondary intestinal abnormalities to mesenteric venous thrombosis and the risk of bowel resection and worse prognosis. Progression toward peritonitis is an indication for explorative laparotomy and assessment of bowel viability. Frank transmural small bowel necrosis should be resected and bowel anastomosis may be delayed for several days until second look. Meanwhile, intravenous full-dose unfractionated heparin should be given at the end of the first operation. Postoperative major intra-abdominal or gastrointestinal bleeding occurs rarely, but the heparin effect can instantaneously be reversed by protamine sulfate. Patients who do not improve during conservative therapy with anticoagulation alone but without developing peritonitis may be subjected to endovascular therapy in expert centers. When the patient’s intestinal function has recovered, with or without bowel resection, switch from parenteral unfractionated heparin or low-molecular-weight heparin therapy to oral anticoagulation can be performed. There is a trend that direct oral anticoagulants are increasingly used instead of vitamin K antagonists. Up to now, direct oral anticoagulants have been shown to be equally effective with the same rate of bleeding complications. Patients with no strong permanent trigger factor for mesenteric venous thrombosis such as intra-abdominal cancer should undergo blood screening for inherited and acquired thrombophilia. Conclusion: Early diagnosis with emergency computed tomography with intravenous contrast-enhancement and imaging in the portal phase and anticoagulation therapy is necessary to be able to have a succesful non-operative succesful course.
Collapse
Affiliation(s)
- S Acosta
- Department of Clinical Sciences, Lund University, Malmö, Sweden.,Vascular Center, Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden
| | - S Salim
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| |
Collapse
|
25
|
Salim S, Heatley F, Bolton L, Khatri A, Onida S, Davies AH. The management of venous leg ulceration post the EVRA (early venous reflux ablation) ulcer trial: Management of venous ulceration post EVRA. Phlebology 2020; 36:203-208. [PMID: 33103957 PMCID: PMC7941504 DOI: 10.1177/0268355520966893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objectives This survey study evaluates current management strategies for venous ulceration and the impacts of the EVRA trial results. Methods An online survey was disseminated to approximately 15000 clinicians, through 12 vascular societies in 2018. Survey themes included: referral times, treatment times and strategies, knowledge of the EVRA trial and service barriers to managing venous ulceration. Data analysis was performed using Microsoft Excel and SPSS. Results 664 responses were received from 78 countries. Respondents were predominantly European (55%) and North American (23%) vascular surgeons (74%). Responses varied between different countries. The median vascular clinic referral time was 6 weeks and time to be seen in clinic was 2 weeks. This was significantly higher in the UK (p ≤ 0.02). 77% of respondents performed surgical/endovenous interventions prior to ulcer healing, the median time to intervention was 4 weeks. 31% of participants changed their practice following EVRA. Frequently encountered barriers to implementing change were a lack of operating space/time (18%). Conclusion Venous ulcers are not managed as quickly as they should be. An evaluation of local resource requirements should be performed to improve service provision for venous ulceration. When interpreting the results of this survey consideration should be given to the response rate.
Collapse
Affiliation(s)
- Safa Salim
- Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Francine Heatley
- Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Layla Bolton
- Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Amulya Khatri
- Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Sarah Onida
- Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Alun H Davies
- Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| |
Collapse
|
26
|
Machin M, Younan HC, Smith S, Salim S, Davies AH, Shalhoub J. Systematic review on the benefit of graduated compression stockings in the prevention of venous thromboembolism in low-risk surgical patients. Phlebology 2020; 36:184-193. [PMID: 33016226 PMCID: PMC7941500 DOI: 10.1177/0268355520958590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objectives The aim of this systematic review is to assess the performance of graduated compression stockings (GCS) in comparison to no venous thromboembolism (VTE) prophylaxis in the prevention of hospital-acquired thrombosis in low-risk surgical patients undergoing short-stay procedures. Methods Aligning with PRISMA guidelines, online databases MEDLINE and EMBASE, Cochrane Library® and trial registries were searched. Eligible articles reported the VTE rate in low-risk surgical patients either receiving GCS or no VTE prophylaxis. Results Narrative synthesis was performed on a single eligible article. The included study arm consisted of participants undergoing knee arthroscopy with the use of GCS alone reporting a total of 29 VTE events (4.4%), 16 of which were asymptomatic DVTs (2.4%). Conclusion There is a complete lack of evidence to support the use of GCS in the prevention of HAT for low-risk surgical patients. An adequately powered trial is required to provide level-IA evidence to support this practice.
Collapse
Affiliation(s)
- M Machin
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.,Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London, UK
| | - H C Younan
- School of Public Health, Imperial College London, London, UK
| | - S Smith
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Safa Salim
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - A H Davies
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.,Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London, UK
| | - J Shalhoub
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.,Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London, UK
| |
Collapse
|
27
|
Abstract
BACKGROUND The arteriovenous fistula is the modality of choice for long-term haemodialysis access. We describe the feasibility of routinely fashioning a brachiocephalic fistula utilising a 3 mm long arteriotomy in an attempt to reduce the incidence of symptomatic steal syndrome yet while maintaining satisfactory clinical outcomes. METHODS All patients who underwent brachiocephalic fistula formation using a routine 3 mm long arteriotomy within Hammersmith Hospital between January 2017 and March 2018 were included. Primary outcomes included primary failure, failure of maturation, secondary patency and steal syndrome. RESULTS Sixty-eight brachiocephalic arteriovenous fistula were fashioned utilising a 3 mm long arteriotomy during the study period. Mean age was 60.5 years with 59% having a history of diabetes mellitus. Mean followup was 368 days. Primary failure occurred in 10 (14.7%) patients. Cannulation was achieved in 67.3% of remaining fistula within 3-months, rising to 87.3% by 6-months. Primary patency at 6 and 12 months was 76% and 69%, respectively. Secondary patency at 6 and 12 months was 94% and 91%, respectively. Dialysis access steal syndrome was clinically apparent in three (4.4%) patients with all cases being managed conservatively. CONCLUSION A 3 mm long arteriotomy may be routinely utilised for brachiocephalic fistula creation in an attempt to limit the incidence of steal syndrome yet while maintaining clinical patency outcomes.
Collapse
Affiliation(s)
- Jeremy Crane
- West London Renal and Transplant Centre, Imperial College Healthcare NHS Trust, London, UK
| | - Safa Salim
- West London Renal and Transplant Centre, Imperial College Healthcare NHS Trust, London, UK
| | - Rowland Storey
- West London Renal and Transplant Centre, Imperial College Healthcare NHS Trust, London, UK
| |
Collapse
|
28
|
Abstract
Objective Determine standards of referral and management of patients with venous leg ulceration in primary care after the release of the EVRA (A Randomized Trial of Early Endovenous Ablation in Venous Ulceration) study results. Methods An online questionnaire was disseminated over four months to professionals working within primary care. Results The survey received 643 responses. Of respondents, 90 (14%) had heard of the EVRA trial and 51 (8%) were familiar with the results. Of those who answered the following questions, 410 (69.1%) stated that referral to a vascular specialist must be made by the General Practitioner and 13 (2.2%) reported that they would always refer patients for secondary care assessment before the publication of EVRA. Considering the EVRA results, 128 (29%) reported that they would change practice regarding referral and would experience no barriers and 198 (45%) reported that they would like to refer earlier but is not their decision. Barriers to changing practice included local referral policies, training and time restrictions, 266 (59%) had heard of the NICE guideline (CG168) and 194 (43%) were aware of the recommendations for referral to a vascular service within two weeks for patients with an open or healed ulcer. Conclusion There is a considerable variation in local referral pathways for venous leg ulceration, and despite clinicians wanting to refer promptly, many primary care professionals are unable to. Unfortunately, the EVRA study alone may not change the overall practice, and work is needed to overcome barriers faced by primary care professionals.
Collapse
Affiliation(s)
- Francine Heatley
- Imperial Health Care NHS Trust, Imperial College London, London, UK
| | | | - Safa Salim
- Imperial Health Care NHS Trust, Imperial College London, London, UK
| | - Sarah Onida
- Imperial Health Care NHS Trust, Imperial College London, London, UK
| | - Manj S Gohel
- Addenbrookes Hospital, Imperial College, Cambridge, London, UK
| | - Alun H Davies
- Imperial Health Care NHS Trust, Imperial College London, London, UK
| |
Collapse
|
29
|
Tan M, Salim S, Beshr M, Guni A, Onida S, Lane T, Davies AH. A methodologic assessment of lymphedema clinical practice guidelines. J Vasc Surg Venous Lymphat Disord 2020; 8:1111-1118.e3. [PMID: 32454237 DOI: 10.1016/j.jvsv.2020.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 05/14/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The objective of this review was to determine the methodologic quality of current lymphedema clinical practice guidelines (CPGs) to assist health care professionals in selecting accessible, high-quality guidance and to identify areas for improvement in future CPGs. METHODS MEDLINE, Embase, online CPG databases, and reference lists of included guidelines were searched up to January 31, 2020. Full-text CPGs reporting on evidence-based recommendations in lymphedema diagnosis or management in English were included. CPGs based on expert consensus, CPG summaries, or CPGs that were not freely available were excluded. Two reviewers identified eligible CPGs, extracted data, and assessed their quality independently using the Appraisal of Guidelines for Research and Evaluation II instrument. Significant scoring discrepancies were discussed with a third reviewer. An overall scaled quality score of ≥80% was the threshold to recommend guideline use. RESULTS Six relevant CPGs were identified. One was subsequently excluded as its full text could not be obtained. Overall, there was very good inter-reviewer reliability of scores with intraclass correlation coefficient of 0.952 (95% confidence interval, 0.921-0.974). No single CPG scored highest in all domains, with methodologic heterogeneity observed. Poor performance was noted in domain 5 (mean scaled score, 23.8% ± 17.1%) and domain 6 (22.9% ± 26.7%). No CPG achieved an overall scaled quality score of ≥80%, with the top CPG scoring 79.2%. CONCLUSIONS According to the defined threshold, no lymphedema CPG was considered adequate for use in clinical practice. All current lymphedema CPGs have areas for improvement with elements of methodologic quality lacking, particularly with respect to rigor of development. A structured approach, guided by the use of CPG creation tools and checklists such as the Appraisal of Guidelines for Research and Evaluation II instrument, should help CPG development groups in improving the quality of future CPGs. This is of particular importance in a complex, multidisciplinary condition such as lymphedema.
Collapse
Affiliation(s)
- Matthew Tan
- Department of Surgery and Cancer, Imperial College London, Charing Cross Hospital, London, United Kingdom
| | - Safa Salim
- Department of Surgery and Cancer, Imperial College London, Charing Cross Hospital, London, United Kingdom
| | - Mostafa Beshr
- Department of Surgery and Cancer, Imperial College London, Charing Cross Hospital, London, United Kingdom
| | - Ahmad Guni
- Department of Surgery and Cancer, Imperial College London, Charing Cross Hospital, London, United Kingdom
| | - Sarah Onida
- Department of Surgery and Cancer, Imperial College London, Charing Cross Hospital, London, United Kingdom
| | - Tristan Lane
- Department of Surgery and Cancer, Imperial College London, Charing Cross Hospital, London, United Kingdom
| | - Alun H Davies
- Department of Surgery and Cancer, Imperial College London, Charing Cross Hospital, London, United Kingdom.
| |
Collapse
|
30
|
Gupta V, Salim S, Hmila I, Vaikath NN, Sudhakaran IP, Ghanem SS, Majbour NK, Abdulla SA, Emara MM, Abdesselem HB, Lukacsovich T, Erskine D, El-Agnaf OMA. Fibrillar form of α-synuclein-specific scFv antibody inhibits α-synuclein seeds induced aggregation and toxicity. Sci Rep 2020; 10:8137. [PMID: 32424162 PMCID: PMC7235225 DOI: 10.1038/s41598-020-65035-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 04/24/2020] [Indexed: 12/21/2022] Open
Abstract
Synucleinopathies including Parkinson's disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA) are characterized by pathological accumulation of α-synuclein (α-syn). Amongst the various approaches attempting to tackle the pathological features of synucleinopathies, antibody-based immunotherapy holds much promise. However, the large size of antibodies and corresponding difficulty in crossing the blood-brain barrier has limited development in this area. To overcome this issue, we engineered single-chain variable fragments (scFvs) against fibrillar α-syn, a putative disease-relevant form of α-syn. The purified scFvs showed specific activity towards α-syn fibrils and oligomers in comparison to monomers and recognized intracellular inclusions in human post-mortem brain tissue of Lewy body disease cases, but not aged controls. In vitro studies indicated scFvs inhibit the seeding of α-syn aggregation in a time-dependent manner, decreased α-syn seed-induced toxicity in a cell model of PD, and reduced the production of insoluble α-syn phosphorylated at Ser-129 (pS129-α-syn). These results suggest that our α-syn fibril-specific scFvs recognize α-syn pathology and can inhibit the aggregation of α-syn in vitro and prevent seeding-dependent toxicity. Therefore, the scFvs described here have considerable potential to be utilized towards immunotherapy in synucleinopathies and may also have applications in ante-mortem imaging modalities.
Collapse
Affiliation(s)
- Vijay Gupta
- Neurological Disorder Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha, Qatar
| | - Safa Salim
- Neurological Disorder Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha, Qatar
| | - Issam Hmila
- Neurological Disorder Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha, Qatar
| | - Nishant N Vaikath
- Neurological Disorder Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha, Qatar
| | - Indulekha P Sudhakaran
- Neurological Disorder Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha, Qatar
| | - Simona S Ghanem
- Neurological Disorder Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha, Qatar
| | - Nour K Majbour
- Neurological Disorder Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha, Qatar
| | - Sara A Abdulla
- Neurological Disorder Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha, Qatar
| | - Mohamed M Emara
- Basic Medical Sciences Department, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Houari B Abdesselem
- Neurological Disorder Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha, Qatar
| | | | - Daniel Erskine
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Omar M A El-Agnaf
- Neurological Disorder Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha, Qatar.
| |
Collapse
|
31
|
Salim S, Locci R, Martin G, Gibbs R, Jenkins M, Hamady M, Riga C, Bicknell C. Short- and long-term outcomes of treatment strategies for isolated penetrating aortic ulcers (PAUs). Eur J Vasc Endovasc Surg 2020. [DOI: 10.1016/j.ejvs.2019.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
32
|
Abstract
BACKGROUND The treatment of distal (below the knee) deep vein thrombosis (DVT) is not clearly established. Distal DVT can either be treated with anticoagulation, or monitored with close follow-up to detect progression to the proximal veins (above the knee), which requires anticoagulation. Proponents of this monitoring strategy base their decision to withhold anticoagulation on the fact that progression is rare and most people can be spared from potential bleeding and other adverse effects of anticoagulation. OBJECTIVES To assess the effects of different treatment interventions for people with distal (below the knee) deep vein thrombosis (DVT). SEARCH METHODS The Cochrane Vascular Information Specialist searched the Cochrane Vascular Specialised Register, CENTRAL, MEDLINE, Embase and CINAHL databases and World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov trials registers to 12 February 2019. We also undertook reference checking to identify additional studies. SELECTION CRITERIA Randomised controlled trials (RCTs) for the treatment of distal DVT. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials and extracted data. We resolved disagreements by discussion. Primary outcomes of interest were recurrence of venous thromboembolism (VTE), DVT and major bleeding and follow up ranged from three months to two years. We performed fixed-effect model meta-analyses with risk ratio (RRs) and 95% confidence intervals (CIs). We assessed the certainty of the evidence using GRADE. MAIN RESULTS We identified eight RCTs reporting on 1239 participants. Five trials randomised participants to anticoagulation for up to three months versus no anticoagulation. Three trials compared anticoagulation treatment for different time periods. Anticoagulant compared to no intervention or placebo for distal DVT treatment Anticoagulation with a vitamin K antagonist (VKA) reduced the risk of recurrent VTE during follow-up compared with participants receiving no anticoagulation (RR 0.34, 95% CI 0.15 to 0.77; 5 studies, 496 participants; I2 = 3%; high-certainty evidence), and reduced the risk of recurrence of DVT (RR 0.25, 95% CI 0.10 to 0.67; 5 studies, 496 participants; I2 = 0%; high-certainty evidence). There was no clear effect on risk of pulmonary embolism (PE) (RR 0.81, 95% CI 0.18 to 3.59; 4 studies, 480 participants; I2 = 0%; low-certainty evidence). There was little to no difference in major bleeding with anticoagulation compared to placebo (RR 0.76, 95% CI 0.13 to 4.62; 4 studies, 480 participants; I2 = 26%; low-certainty evidence). There was an increase in clinically relevant non-major bleeding events in the group treated with anticoagulants (RR 3.34, 95% CI 1.07 to 10.46; 2 studies, 322 participants; I2 = 0%; high-certainty evidence). There was one death, not related to PE or major bleeding, in the anticoagulation group. Anticoagulation for three months or more compared to anticoagulation for six weeks for distal DVT treatment Three RCTs of 736 participants compared three or more months of anticoagulation with six weeks of anticoagulation. Anticoagulation with a VKA for three months or more reduced the incidence of recurrent VTE to 5.8% compared with 13.9% in participants treated for six weeks (RR 0.42, 95% CI 0.26 to 0.68; 3 studies, 736 participants; I2 = 50%; high-certainty evidence). The risk for recurrence of DVT was also reduced (RR 0.32, 95% CI 0.16 to 0.64; 2 studies, 389 participants; I2 = 48%; high-certainty evidence), but there was probably little or no difference in PE (RR 1.05, 95% CI 0.19 to 5.88; 2 studies, 389 participants; I2 = 0%; low-certainty evidence). There was no clear difference in major bleeding events (RR 3.42, 95% CI 0.36 to 32.35; 2 studies, 389 participants; I2 = 0%; low-certainty evidence) or clinically relevant non-major bleeding events (RR 1.76, 95% CI 0.90 to 3.42; 2 studies, 389 participants; I2 = 1%; low-certainty evidence) between three months or more of treatment and six weeks of treatment. There were no reports for overall mortality or PE and major bleeding-related deaths. AUTHORS' CONCLUSIONS Our review found a benefit for people with distal DVT treated with anticoagulation therapy using VKA with little or no difference in major bleeding events although there was an increase in clinically relevant non-major bleeding when compared to no intervention or placebo. The small number of participants in this meta-analysis and strength of evidence prompts a call for more research regarding the treatment of distal DVT. RCTs comparing different treatments and different treatment periods with placebo or compression therapy, are required.
Collapse
Affiliation(s)
- George Kirkilesis
- University of Patras Medical SchoolDepartment of Vascular SurgeryHippocrates Ave, RioPatrasAchaiaGreece26504
| | - Stavros K Kakkos
- University of Patras Medical SchoolDepartment of Vascular SurgeryHippocrates Ave, RioPatrasAchaiaGreece26504
| | - Colin Bicknell
- Imperial College LondonDepartment of Vascular SurgeryLondonUK
| | - Safa Salim
- Imperial College Healthcare NHS TrustTransplant DepartmentLondonUK
| | - Kyriaki Kakavia
- National and Kapodistrian University of AthensDepartment of Surgery, Laiko HospitalAthensGreece
| | | |
Collapse
|
33
|
Abstract
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects of different treatment interventions for people with distal (below the knee) deep vein thrombosis (DVT).
Collapse
Affiliation(s)
- George Kirkilesis
- University of Patras Medical SchoolDepartment of Vascular SurgeryHippocrates Ave, RioPatrasGreece26504
| | - Stavros K Kakkos
- University of Patras Medical SchoolDepartment of Vascular SurgeryHippocrates Ave, RioPatrasGreece26504
| | - Colin Bicknell
- Imperial College LondonDepartment of Vascular SurgeryLondonUK
| | - Safa Salim
- Imperial College Healthcare NHS TrustTransplant DepartmentLondonUK
| | - Kyriaki Kakavia
- National and Kapodistrian University of AthensDepartment of Surgery, Laiko HospitalAthensGreece
| |
Collapse
|
34
|
Fayyad M, Salim S, Majbour N, Erskine D, Stoops E, Mollenhauer B, El-Agnaf OMA. Parkinson's disease biomarkers based on α-synuclein. J Neurochem 2019; 150:626-636. [PMID: 31265130 DOI: 10.1111/jnc.14809] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/05/2019] [Accepted: 06/26/2019] [Indexed: 12/20/2022]
Abstract
Parkinson's disease is the second most common neurodegenerative disorder after Alzheimer's disease and is estimated to affect approximately 1-4% of individuals aged over 60 years old. Although considerable efforts have been invested into developing disease-modifying therapies for Parkinson's disease, such efforts have been confounded by the difficulty in accurately diagnosing Parkinson's disease during life to enable accurate patient stratification for clinical trialling of candidate therapeutics. Therefore, the search for effective biomarkers that can be accurately evaluated during life with non-invasive means is a pressing issue in the field. Since the discovery of α-synuclein (α-syn) as a protein linked to a familial form of Parkinson's disease, later identified as the major protein component of the neuropathological hallmark of idiopathic Parkinson's disease, considerable interest has focused on this protein and its distinct conformers. We describe here the progress that has been made in the area of Parkinson's disease biomarker discovery with a focus on α-synuclein. In particular, we highlight the novel assays that have been employed and the increasing complexity in evaluating α-synuclein with regard to the considerable diversity of conformers that exist in the biofluids and peripheral tissues under disease conditions. "This article is part of the Special Issue Synuclein."
Collapse
Affiliation(s)
- Muneera Fayyad
- Neurological Disorder Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha, Qatar.,College of Health and Life Sciences, Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha, Qatar
| | - Safa Salim
- Neurological Disorder Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha, Qatar.,College of Health and Life Sciences, Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha, Qatar
| | - Nour Majbour
- Neurological Disorder Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha, Qatar
| | - Daniel Erskine
- Institute of Neuroscience, Ageing Research Laboratories Newcastle University, Newcastle upon Tyne, UK
| | | | | | - Omar M A El-Agnaf
- Neurological Disorder Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha, Qatar.,College of Health and Life Sciences, Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha, Qatar
| |
Collapse
|
35
|
Affiliation(s)
- Matthew Machin
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Safa Salim
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Sarah Onida
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Alun H Davies
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| |
Collapse
|
36
|
Kachouchi A, Salim S, Berghalout M, Adali I, Manoudi F, Asri F. Le profil des patients âgés marocains hospitalisés en psychiatrie. Encephale 2018; 44:571. [DOI: 10.1016/j.encep.2018.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 05/26/2018] [Accepted: 05/28/2018] [Indexed: 10/28/2022]
|
37
|
Kachouchi A, Sebbani M, Salim S, Adali I, Manoudi F, Amine M, Asri F. Facteurs de risque de passage à l’acte d’homicide chez des patients marocains atteints de schizophrénie. Encephale 2018; 44:409-414. [DOI: 10.1016/j.encep.2017.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 07/03/2017] [Accepted: 07/05/2017] [Indexed: 10/18/2022]
|
38
|
Salim S, Zarrouk M, Elf J, Gottsäter A, Ekberg O, Acosta S. Improved Prognosis and Low Failure Rate with Anticoagulation as First-Line Therapy in Mesenteric Venous Thrombosis. World J Surg 2018; 42:3803-3811. [PMID: 29777267 PMCID: PMC6182753 DOI: 10.1007/s00268-018-4667-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Monotherapy with anticoagulation has been considered as first-line therapy in patients with mesenteric venous thrombosis (MVT). The aim of this study was to evaluate outcome, prognostic factors, and failure rate of anticoagulation as monotherapy, and to identify when bowel resection was needed. METHODS Retrospective study of consecutive patients with MVT diagnosed between 2000 and 2015. RESULTS The overall incidence rate of MVT was 1.3/100,000 person-years. Among 120 patients, seven died due to autopsy-verified MVT without bowel resection and 15 underwent immediate bowel resection without prior anticoagulation therapy. The remaining 98 patients received anticoagulation monotherapy, whereof 83 (85%) were treated successfully. Fifteen patients failed on anticoagulation monotherapy, of whom seven underwent bowel resection and eight endovascular therapy. Endovascular therapy was followed by bowel resection in three patients. Two late bowel resections were performed due to intestinal stricture. The 30-day mortality rate was 19.0% in the former (2000-2007) and 3.2% in the latter (2008-2015) part of the study period (p = 0.006). Age ≥75 years (OR 12.4, 95% CI [2.5-60.3]), management during the former as opposed to the latter time period (OR 8.4, 95% CI [1.3-54.7]), and renal insufficiency at admission (OR 8.0, 95% CI [1.2-51.6]) were independently associated with increased mortality in multivariable analysis. CONCLUSIONS Short-term prognosis in patients with MVT has improved. Contemporary data show that monotherapy with anticoagulation is an effective first choice in MVT patients.
Collapse
Affiliation(s)
- S Salim
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Vascular Centre, Department of Cardio-Thoracic and Vascular Surgery, Skåne University Hospital, 205 02, Malmö, Sweden
| | - M Zarrouk
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Vascular Centre, Department of Cardio-Thoracic and Vascular Surgery, Skåne University Hospital, 205 02, Malmö, Sweden
| | - J Elf
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Vascular Centre, Department of Cardio-Thoracic and Vascular Surgery, Skåne University Hospital, 205 02, Malmö, Sweden
| | - A Gottsäter
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Vascular Centre, Department of Cardio-Thoracic and Vascular Surgery, Skåne University Hospital, 205 02, Malmö, Sweden
| | - O Ekberg
- Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö, Sweden
| | - S Acosta
- Department of Clinical Sciences, Lund University, Malmö, Sweden.
- Vascular Centre, Department of Cardio-Thoracic and Vascular Surgery, Skåne University Hospital, 205 02, Malmö, Sweden.
| |
Collapse
|
39
|
Salim S, Hassam B. Dermoscopie des lymphomes cutanés B primitifs : une nouvelle série. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.03.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
40
|
Salim S, El Gaitibi F, Meziane M, Ismaili N, Bnezekri L, Senouci K, Hassam B. Ulcère de Marjolin : une complication redoutable des séquelles de brûlures. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.03.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
41
|
Atrooz F, Salim S. 0021 Early Life Sleep Deprivation By Enhancing Neuronal Expression Of MKP1 Causes Later Life Behavioral Deficits In Rats. Sleep 2018. [DOI: 10.1093/sleep/zsy061.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- F Atrooz
- University of Houston, Houston, TX
| | - S Salim
- University of Houston, Houston, TX
| |
Collapse
|
42
|
Parikh PM, Wadhwa J, Minhas S, Gupta A, Mittal S, Ranjan S, Mehta P, Singh R, Kataria SP, Salim S, Ahmed M, Aggarwal S. Practical consensus recommendation on when to do BRCA testing. South Asian J Cancer 2018; 7:106-109. [PMID: 29721474 PMCID: PMC5909285 DOI: 10.4103/sajc.sajc_112_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BRCA-mutation associated breast cancer and to future cancer risks and sensitivity to systemic therapies. Now that rapid genetic testing for BRCA1 and BRCA2 mutations is available, BRCA mutation status can be considered when making treatment and prevention decisions for BRCA testing, BRCA mutation carriers with breast cancer. Expert group used data from published literature, practical experience, and opinion of a large group of academic oncologists, to arrive at practical consensus recommendations for use by the community oncologists.
Collapse
Affiliation(s)
- Purvish M. Parikh
- Department of Oncology, Shalby Cancer and Research Institute, Mumbai, Maharashtra, India
| | - J. Wadhwa
- Department of Medical Oncology, Medanta Hospital, Gurugram, Haryana, India
| | - S. Minhas
- Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | - A. Gupta
- Department of Radiation Oncology, Safdarjung Hospital, New Delhi, India
| | - S. Mittal
- Department of Medical Oncology, Action Balajee Cancer Center, New Delhi, India
| | - S. Ranjan
- Department of Medicine, INHS Sanjivani, Kochi, Kerala, India
| | - P. Mehta
- Department of Medical Oncology, Asian Institute of Medical Sciences, Faridabad, Haryana, India
| | - R. Singh
- Department of Medical Oncology, Artemis Hospital, Gurugram, Haryana, India
| | - S. P. Kataria
- Department of Medical Oncology, Safdarjung Hospital, New Delhi, India
| | - S. Salim
- Department of Oncology, Hakim Sanaullah Cancer Center, Baramulla, Jammu and Kashmir, India
| | - M. Ahmed
- Department of Radiation Oncology, Jolly Grant Himalayan Institute, Dehradoon, Uttarakhand, India
| | - S. Aggarwal
- Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| |
Collapse
|
43
|
Salim S, Ekberg O, Elf J, Zarrouk M, Gottsäter A, Acosta S. Clinical implications of CT findings in mesenteric venous thrombosis at admission. Emerg Radiol 2018; 25:407-413. [DOI: 10.1007/s10140-018-1601-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 03/16/2018] [Indexed: 02/07/2023]
|
44
|
Salim S, Bouhelab J, Khalaayoune M, Hassam B. Kératose séborrhéique en transformation bowénoïde : quand la bénignité se mêle à l’atypie. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
45
|
Salim S, Meziane M, Hassam B. Dermoscopie du psoriasis unguéal : étude prospective analytique à propos de 30 cas. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
46
|
Atrooz F, Liu H, Salim S. 0046 IMPACT OF EARLY LIFE SLEEP DISTURBANCE ON BEHAVIORAL PARAMETERS IN RATS: POTENTIAL ROLE OF OXIDATIVE STRESS MECHANISMS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.045] [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: 11/14/2022] Open
|
47
|
Zarrouk M, Salim S, Elf J, Gottsäter A, Acosta S. Testing for thrombophilia in mesenteric venous thrombosis - Retrospective original study and systematic review. Best Pract Res Clin Gastroenterol 2017; 31:39-48. [PMID: 28395787 DOI: 10.1016/j.bpg.2016.11.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 11/02/2016] [Accepted: 11/07/2016] [Indexed: 01/31/2023]
Abstract
The aim was to perform a local study of risk factors and thrombophilia in mesenteric venous thrombosis (MVT), and to review the literature concerning thrombophilia testing in MVT. Patients hospitalized for surgical or medical treatment of MVT at our center 2000-2015. A systematic review of observational studies was performed. In the local study, the most frequently identified risk factor was Factor V Leiden mutation. The systematic review included 14 original studies. The highest pooled percentage of any inherited thrombophilic factor were: Factor V Leiden mutation 9% (CI 2.9-16.1), prothrombin gene mutation 7% (CI 2.7-11.8). The highest pooled percentage of acquired thrombophilic factors were JAK2 V617F mutation 14% (CI -1.9-28.1). The wide range of frequency of inherited and acquired thrombophilic factors in different populations indicates the necessity to relate these factors to background population based data in order to estimate their overrepresentation in MVT. There is a need to develop guidelines for when and how thrombophilia testing should be performed in MVT.
Collapse
Affiliation(s)
- M Zarrouk
- Lund University, Department of Vascular Diseases, Skåne University Hospital, S-205 02 Malmö, Sweden.
| | - S Salim
- Lund University, Department of Vascular Diseases, Skåne University Hospital, S-205 02 Malmö, Sweden.
| | - J Elf
- Lund University, Department of Vascular Diseases, Skåne University Hospital, S-205 02 Malmö, Sweden.
| | - A Gottsäter
- Lund University, Department of Vascular Diseases, Skåne University Hospital, S-205 02 Malmö, Sweden.
| | - S Acosta
- Lund University, Department of Vascular Diseases, Skåne University Hospital, S-205 02 Malmö, Sweden.
| |
Collapse
|
48
|
Mayyas E, Vance S, Brown S, Liu J, Kim J, Zhen S, Devpura S, Ajlouni M, Salim S, Chetty I, Movsas B. WE-AB-207B-12: Prospective Study of the Relationship Between Dose-Volume Clinical Toxicity and Patient Reported Outcomes in Lung Cancer Patients Treated with SBRT. Med Phys 2016. [DOI: 10.1118/1.4957793] [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: 11/07/2022] Open
|
49
|
Affiliation(s)
- S Salim
- Department of Obstetrics and Gynaecology, Royal Bournemouth and Christchurch Hospitals , Bournemouth , UK
| | | | | |
Collapse
|
50
|
Salim S, Gilissen L, Rinzema A, Vermuë MH, Wijffels RH. Modeling microalgal flocculation and sedimentation. Bioresour Technol 2013; 144:602-607. [PMID: 23899573 DOI: 10.1016/j.biortech.2013.07.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [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: 06/02/2013] [Revised: 07/02/2013] [Accepted: 07/05/2013] [Indexed: 06/02/2023]
Abstract
In this study, a combined flocculation and sedimentation model is developed. The model predicts the time needed to reach a desired concentration of microalgal suspension in a sedimentation tank. The concentration of the particles as function of the time and the position in the tank is described. The model was validated with experimental data for Ettlia texensis. The concentration changes measured in time at different heights in the sedimentation vessel corresponded well with model predictions. The model predicts that it takes 25 h to reach a final concentration of 5.2 gDW L(-1), when the initial concentration is 0.26 gDW L(-1) and the tank height is 1m. This example illustrates the use of this model for the design of the settling tank needed for pre-concentration of microalgal biomass before further dewatering.
Collapse
Affiliation(s)
- S Salim
- Bioprocess Engineering, AlgaePARC, Wageningen University, Wageningen, The Netherlands.
| | | | | | | | | |
Collapse
|