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Neeland IJ, Arafah A, Bourges-Sevenier B, Dazard JE, Albar Z, Landskroner Z, Tashtish N, Eaton E, Friswold J, Porges J, Nennstiel M, Davies A, Rahmani S, Howard QS, Forrest K, Sullivan C, Greene L, Al-Kindi SG, Rajagopalan S. Second-year results from CINEMA: A novel, patient-centered, team-based intervention for patients with Type 2 diabetes or prediabetes at high cardiovascular risk. Am J Prev Cardiol 2024; 17:100630. [PMID: 38223296 PMCID: PMC10787236 DOI: 10.1016/j.ajpc.2023.100630] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 01/16/2024] Open
Abstract
Background The care for patients with type 2 diabetes mellitus (T2DM) necessitates a multidisciplinary team approach to reduce cardiovascular (CV) risk but implementation of effective integrated strategies has been limited. Methods and Results We report 2-year results from a patient-centered, team-based intervention called CINEMA at University Hospitals Cleveland Medical Center. Patients with T2DM or prediabetes at high-risk for CV events, including those with established atherosclerotic CVD, elevated coronary artery calcium score ≥100, chronic heart failure with reduced ejection fraction, chronic kidney disease (CKD) stages 2-4, and/or prevalent metabolic syndrome were included. From May 2020 through September 2022, 426 patients were enrolled in the CINEMA program. A total of 227 (54%) completed ≥1 follow-up visit after an initial baseline visit with median (IQR) follow-up time 4 [3], [4], [5], [6], [7] months with maximum follow-up time 19 months. Mean age was 60 years, 47 % were women, and 37 % were Black and 85% had prevalent T2DM, 48 % had established ASCVD, 29% had chronic HF, 27% had CKD and mean baseline 10-year ASCVD risk estimate was 25.1 %; baseline use of a SGLT2i or GLP-1RA was 21 % and 18 %, respectively. Patients had significant reductions from baseline in body weight (-5.5 lbs), body mass index (-0.9 kg/m2), systolic (-3.6 mmHg) and diastolic (-1.2 mmHg) blood pressure, Hb A1c (-0.5 %), total (-10.7 mg/dL) and low-density lipoprotein (-9.0 mg/dL) cholesterol, and triglycerides (-13.5 mg/dL) (p<0.05 for all). Absolute 10-year predicted ASCVD risk decreased by ∼2.4 % (p<0.001) with the intervention. In addition, rates of guideline-directed cardiometabolic medication prescriptions significantly increased during follow-up with the most substantive changes seen in rates of SGLT2i and GLP-1RA use which approximately tripled from baseline (21 % to 57 % for SGLT2i and 18 % to 65 % for GLP-1RA, p<0.001 for both). Conclusions The CINEMA program, an integrated, patient-centered, team-based intervention for patients with T2DM or prediabetes at high risk for cardiovascular disease has continued to demonstrate effectiveness with significant improvements in ASCVD risk factors and improved use of evidence-based therapies. Successful implementation and dissemination of this care delivery paradigm remains a key priority.
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Affiliation(s)
- Ian J. Neeland
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Ala’ Arafah
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
| | - Brendan Bourges-Sevenier
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Jean-Eudes Dazard
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
| | - Zainab Albar
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
| | - Zoe Landskroner
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Nour Tashtish
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Elke Eaton
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Janice Friswold
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Jodie Porges
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Matthew Nennstiel
- University Hospitals Health System, Cleveland, OH 44106, United States
| | - Amanda Davies
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Sara Rahmani
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Quiana S. Howard
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Katherine Forrest
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Claire Sullivan
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Lloyd Greene
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Sadeer G. Al-Kindi
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Sanjay Rajagopalan
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
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Rahmani S, Caminero A, Hann A, Galipeau HJ, Anderson RP, Chirdo F, Didar TF, Verdu EF. A7 OPPORTUNISTIC PATHOGEN MODULATION OF GLUTEN-REACTIVE CD4+ T CELL ACTIVATION BY DQ2-EXPRESSING ORGANOID MONOLAYERS. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991225 DOI: 10.1093/jcag/gwac036.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Bacteria have recently emerged as additional modulators of inflammation in CeD. We have shown that the elastase-like producing opportunistic pathogen, Pseudomonas (P) aeruginosa, partially metabolizes gluten into peptides that translocate the mucosal barrier and retain their immunogenicity. We previously demonstrated that organoid monolayers derived from DR3-DQ2 mice carrying the CeD risk gene HLA-DQ2 express MHC class II (HLA-DQ2) and co-stimulatory molecules under induced inflammatory conditions, priming the monolayers for gluten antigen presentation. Here we investigate the activation of human (h)CD4+ T cell co-cultured with DQ2 monolayers stimulated with gluten pre-digested, or not, by bacterial elastase. Purpose To investigate whether organoid monolayers expressing DQ2 activate T cell differentially in the presence of gluten metabolized by elastase-like producing Pseudomonas aeruginosa. Method Organoid monolayers were derived from the duodenum and proximal jejunum of gluten-sensitized DR3-DQ2 mice, following the gluten sensitization protocol previously described1. Monolayers were then stimulated with IFN-γ for 24h to induce MHC-II and co-stimulatory molecules expression. Splenic T-cell expressing hCD4 from gluten-sensitized DR3-DQ2-hCD4 mice were then co-cultured with monolayers in the presence of deamidated pepsin-trypsin-digested (DAPT)-gluten or Pseudomonas aeruginosa PA14 (WT)-digested DAPT-gluten. As a control, DAPT-gluten was incubated with a P. aeruginosa lasB mutant strain that lacks elastase-like activity (lasB△/△). Co-cultures stimulated with DAPT-gluten alone or WT-media were used as additional controls. Result(s) Increased hCD4+ T-cell proliferation was observed in co-cultures stimulated with WT-digested gluten compared with lasB△/△-digested gluten (p<0.0001), gluten alone (p=0.0002) or WT-media (p<0.0001). hCD4+ T cell co-cultured with organoid monolayers stimulated with WT-digested gluten, had an activated phenotype with increased expression of CD69, CD44 and CD25 versus those stimulated with gluten, lasB△/△-digested gluten, or WT-media. Increased levels of pro-inflammatory and T helper type 1 (Th1)-associated cytokines were detected in the supernatant of the co-cultures stimulated with WT-digested gluten, including IL-2, IFN-γ, IL-6, TNF-α, IL-1α, IL-β, and IL-15. Conclusion(s) Using a novel HLA-DQ2-expressing organoid monolayer, we demonstrate elastase-like producing P. aeruginosa, enhanced activation and proliferation of hCD4+ T cell through gluten metabolism. This in vitro model constitutes a relevant tool for studying microbial triggers and drivers of intestinal epithelial dysfunction in CeD. 1. Galipeau, H. J. et al. 1. Galipeau, H. J. et al. Sensitization to Gliadin Induces Moderate Enteropathy and Insulitis in Nonobese Diabetic-DQ8 Mice. J. Immunol.187, 4338–4346 (2011). Please acknowledge all funding agencies by checking the applicable boxes below CIHR, Other Please indicate your source of funding; Canadian Celiac Disease Association (CCA) Disclosure of Interest None Declared
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Affiliation(s)
- S Rahmani
- Biomedical Engineering, Farncombe Family Digestive Health Research Institute
| | - A Caminero
- Farncombe Family Digestive Health Research Institute , McMaster University, Hamilton, Canada
| | - A Hann
- Farncombe Family Digestive Health Research Institute , McMaster University, Hamilton, Canada
| | - H J Galipeau
- Farncombe Family Digestive Health Research Institute , McMaster University, Hamilton, Canada
| | - R P Anderson
- Wesley Medical Research, The Wesley Hospital, Auchenflower, Australia
| | - F Chirdo
- Facultad de Ciencias Exactas, Universidad Nacional de La Plata, La Plata, Argentina
| | - T F Didar
- Biomedical Engineering , McMaster University, Hamilton, Canada
| | - E F Verdu
- Farncombe Family Digestive Health Research Institute , McMaster University, Hamilton, Canada
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Hann A, Santiago Badenas A, Galipeau HJ, Constante M, Libertucci J, Rahmani S, Jackson K, Rueda G, Rossi L, Ramachandran R, Ruf W, Caminero A, Bercik P, Verdu EF. A3 CROHN’S DISEASE PROTEOLYTIC MICROBIOTA ENHANCES INFLAMMATION THROUGH PAR2 PATHWAY IN GNOTOBIOTIC MICE. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991128 DOI: 10.1093/jcag/gwac036.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background An imbalance in host proteases has been implicated in inflammatory bowel disease (IBD). Recent evidence implicates microbial proteolytic activity (PA) in ulcerative colitis but whether it also plays a role in Crohn’s disease (CD) remains unclear. Purpose We therefore investigated the colitogenic potential and underlying pathways of proteolytic CD microbiota. Method Adult germ-free (GF) C57BL/6 mice were colonized with CD microbiota selected based on high (CD-HPA) or low fecal proteolytic activity (CD-LPA), and from healthy controls with LPA (HC-LPA), after which total fecal proteolytic, elastolytic and mucolytic activity were analyzed in the mice. Microbial community was assessed by 16S rRNA gene sequencing. Immune function and colonic injury were investigated by inflammatory gene expression (NanoString) and histology. Colitis severity and underlying pathways were investigated in C57BL/6, Nucleotide-binding Oligomerization Domain-2 knock-out (Nod2-/-), and Protease-Activated Receptor 2 (PAR2) cleavage resistant mice (R38E-PAR2) subjected to 2% dextran sodium sulfate in drinking water for 5 days followed by 2 days on water. Result(s) Colonization with HC-LPA or CD-LPA lowered baseline fecal proteolytic activity compared with GF mice, which was paralleled by lower acute inflammatory cell infiltrate. CD-HPA further increased proteolytic activity compared with GF mice. Fecal supernatants from CD-LPA or HC-LPA colonized mice had lower in vitro PAR2 cleavage compared to supernatants from GF and CD-HPA colonized mice. Several genes, such as Map kinases, Rhoa, Myd88, and Tollip, were increased in GF mice compared to colonized mice. 18 genes related to inflammation and barrier function (e.g., Mapk2k6, Tnf, Claudin1) were differentially expressed between CD-LPA and CD-HPA. CD-HPA mice had lower alpha diversity, distinct microbial profiles, and higher fecal proteolytic activity compared with CD-LPA. Abundance of several beneficial species (e.g., Akkermansia muciniphilia) was decreased while other taxa were increased (e.g., Hungattella hathewayi) in CD-HPA compared to CD-LPA. H. hathewayi as well as the serine protease K04772 were transcriptionally increased in fecal samples from CD-HPA colonized mice. C57BL/6 and Nod2-/- mice, but not R38E-PAR2 mice, colonized with CD-HPA developed earlier and more severe colitis compared with mice colonized with CD-LPA. Conclusion(s) CD proteolytic microbiota is proinflammatory through a PAR2 pathway. H. hathewayi correlates with the proinflammatory phenotype through the serine protease K04772 in this model. The results support a role of microbial PA in CD, which could constitute a biomarker for identifying patients who would benefit from anti-proteolytic therapies. Disclosure of Interest None Declared
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Affiliation(s)
| | | | | | | | | | | | - K Jackson
- Medicine,Chemical Engineering, McMaster University, Hamilton
| | | | | | - R Ramachandran
- Physiology and Pharmacology, Western University, London, Canada
| | - W Ruf
- Immunology and Microbiology, The Scripps Research Institute, La Jolla, United States,Center for Thrombosis and Hemostasis, Johannes Gutenberg University Medical Center, Mainz, Germany
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Santiago A, Hann A, Constante M, Rahmani S, Libertucci J, Jackson K, Rueda G, Rossi L, Rithwick R, Ruf W, Schertzer J, Caminero A, Bercik P, Galipeau HJ, Verdu EF. Crohn's disease proteolytic microbiota enhances inflammation through PAR2 pathway in gnotobiotic mice. Gut Microbes 2023; 15:2205425. [PMID: 37131291 PMCID: PMC10158566 DOI: 10.1080/19490976.2023.2205425] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
Emerging evidence implicates microbial proteolytic activity in ulcerative colitis (UC), but whether it also plays a role in Crohn's disease (CD) remains unclear. We investigated the effects of colonizing adult and neonatal germ-free C57BL/6 mice with CD microbiota, selected based on high (CD-HPA) or low fecal proteolytic activity (CD-LPA), or microbiota from healthy controls with LPA (HC-LPA) or HPA (HC-HPA). We then investigated colitogenic mechanisms in gnotobiotic C57BL/6, and in mice with impaired Nucleotide-binding Oligomerization Domain-2 (NOD2) and Protease-Activated Receptor 2 (PAR2) cleavage resistant mice (Nod2-/-; R38E-PAR2 respectively). At sacrifice, total fecal proteolytic, elastolytic, and mucolytic activity were analyzed. Microbial community and predicted function were assessed by 16S rRNA gene sequencing and PICRUSt2. Immune function and colonic injury were investigated by inflammatory gene expression (NanoString) and histology. Colonization with HC-LPA or CD-LPA lowered baseline fecal proteolytic activity in germ-free mice, which was paralleled by lower acute inflammatory cell infiltrate. CD-HPA further increased proteolytic activity compared with germ-free mice. CD-HPA mice had lower alpha diversity, distinct microbial profiles and higher fecal proteolytic activity compared with CD-LPA. C57BL/6 and Nod2-/- mice, but not R38E-PAR2, colonized with CD-HPA had higher colitis severity than those colonized with CD-LPA. Our results indicate that CD proteolytic microbiota is proinflammatory, increasing colitis severity through a PAR2 pathway.
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Affiliation(s)
- Alba Santiago
- Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Canada
| | - Amber Hann
- Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Canada
| | - Marco Constante
- Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Canada
| | - Sara Rahmani
- Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Canada
- School of Biomedical Engineering, McMaster University, Ontario, Canada
| | - Josie Libertucci
- Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Canada
| | - Kyle Jackson
- Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Canada
- Department of Chemical Engineering, McMaster University, Ontario, Canada
| | - Gaston Rueda
- Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Canada
| | - Laura Rossi
- Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Canada
| | - Ramachandran Rithwick
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada
| | - Wolfram Ruf
- Center for Thrombosis and Hemostasis, Johannes Gutenberg University Medical Center, Mainz, Germany
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | - Jon Schertzer
- Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Canada
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Alberto Caminero
- Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Canada
| | - Premysl Bercik
- Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Canada
| | - Heather Jean Galipeau
- Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Canada
| | - Elena Francisca Verdu
- Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Canada
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Torkington J, Harries R, O'Connell S, Knight L, Islam S, Bashir N, Watkins A, Fegan G, Cornish J, Rees B, Cole H, Jarvis H, Jones S, Russell I, Bosanquet D, Cleves A, Sewell B, Farr A, Zbrzyzna N, Fiera N, Ellis-Owen R, Hilton Z, Parry C, Bradbury A, Wall P, Hill J, Winter D, Cocks K, Harris D, Hilton J, Vakis S, Hanratty D, Rajagopal R, Akbar F, Ben-Sassi A, Francis N, Jones L, Williamson M, Lindsey I, West R, Smart C, Ziprin P, Agarwal T, Faulkner G, Pinkney T, Vimalachandran D, Lawes D, Faiz O, Nisar P, Smart N, Wilson T, Myers A, Lund J, Smolarek S, Acheson A, Horwood J, Ansell J, Phillips S, Davies M, Davies L, Bird S, Palmer N, Williams M, Galanopoulos G, Rao PD, Jones D, Barnett R, Tate S, Wheat J, Patel N, Rahmani S, Toynton E, Smith L, Reeves N, Kealaher E, Williams G, Sekaran C, Evans M, Beynon J, Egan R, Qasem E, Khot U, Ather S, Mummigati P, Taylor G, Williamson J, Lim J, Powell A, Nageswaran H, Williams A, Padmanabhan J, Phillips K, Ford T, Edwards J, Varney N, Hicks L, Greenway C, Chesters K, Jones H, Blake P, Brown C, Roche L, Jones D, Feeney M, Shah P, Rutter C, McGrath C, Curtis N, Pippard L, Perry J, Allison J, Ockrim J, Dalton R, Allison A, Rendell J, Howard L, Beesley K, Dennison G, Burton J, Bowen G, Duberley S, Richards L, Giles J, Katebe J, Dalton S, Wood J, Courtney E, Hompes R, Poole A, Ward S, Wilkinson L, Hardstaff L, Bogden M, Al-Rashedy M, Fensom C, Lunt N, McCurrie M, Peacock R, Malik K, Burns H, Townley B, Hill P, Sadat M, Khan U, Wignall C, Murati D, Dhanaratne M, Quaid S, Gurram S, Smith D, Harris P, Pollard J, DiBenedetto G, Chadwick J, Hull R, Bach S, Morton D, Hollier K, Hardy V, Ghods M, Tyrrell D, Ashraf S, Glasbey J, Ashraf M, Garner S, Whitehouse A, Yeung D, Mohamed SN, Wilkin R, Suggett N, Lee C, Bagul A, McNeill C, Eardley N, Mahapatra R, Gabriel C, Datt P, Mahmud S, Daniels I, McDermott F, Nodolsk M, Park L, Scott H, Trickett J, Bearn P, Trivedi P, Frost V, Gray C, Croft M, Beral D, Osborne J, Pugh R, Herdman G, George R, Howell AM, Al-Shahaby S, Narendrakumar B, Mohsen Y, Ijaz S, Nasseri M, Herrod P, Brear T, Reilly JJ, Sohal A, Otieno C, Lai W, Coleman M, Platt E, Patrick A, Pitman C, Balasubramanya S, Dickson E, Warman R, Newton C, Tani S, Simpson J, Banerjee A, Siddika A, Campion D, Humes D, Randhawa N, Saunders J, Bharathan B, Hay O. Incisional hernia following colorectal cancer surgery according to suture technique: Hughes Abdominal Repair Randomized Trial (HART). Br J Surg 2022; 109:943-950. [PMID: 35979802 PMCID: PMC10364691 DOI: 10.1093/bjs/znac198] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/09/2022] [Accepted: 05/13/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Incisional hernias cause morbidity and may require further surgery. HART (Hughes Abdominal Repair Trial) assessed the effect of an alternative suture method on the incidence of incisional hernia following colorectal cancer surgery. METHODS A pragmatic multicentre single-blind RCT allocated patients undergoing midline incision for colorectal cancer to either Hughes closure (double far-near-near-far sutures of 1 nylon suture at 2-cm intervals along the fascia combined with conventional mass closure) or the surgeon's standard closure. The primary outcome was the incidence of incisional hernia at 1 year assessed by clinical examination. An intention-to-treat analysis was performed. RESULTS Between August 2014 and February 2018, 802 patients were randomized to either Hughes closure (401) or the standard mass closure group (401). At 1 year after surgery, 672 patients (83.7 per cent) were included in the primary outcome analysis; 50 of 339 patients (14.8 per cent) in the Hughes group and 57 of 333 (17.1 per cent) in the standard closure group had incisional hernia (OR 0.84, 95 per cent c.i. 0.55 to 1.27; P = 0.402). At 2 years, 78 patients (28.7 per cent) in the Hughes repair group and 84 (31.8 per cent) in the standard closure group had incisional hernia (OR 0.86, 0.59 to 1.25; P = 0.429). Adverse events were similar in the two groups, apart from the rate of surgical-site infection, which was higher in the Hughes group (13.2 versus 7.7 per cent; OR 1.82, 1.14 to 2.91; P = 0.011). CONCLUSION The incidence of incisional hernia after colorectal cancer surgery is high. There was no statistical difference in incidence between Hughes closure and mass closure at 1 or 2 years. REGISTRATION NUMBER ISRCTN25616490 (http://www.controlled-trials.com).
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Neeland IJ, Al-Kindi SG, Tashtish N, Eaton E, Friswold J, Rahmani S, White-Solaru KT, Rashid I, Berg D, Rana M, Sullivan C, Hatipoglu B, Pronovost P, Rajagopalan S. Lessons Learned From a Patient-Centered, Team-Based Intervention for Patients With Type 2 Diabetes at High Cardiovascular Risk: Year 1 Results From the CINEMA Program. J Am Heart Assoc 2022; 11:e024482. [PMID: 35904203 PMCID: PMC9375496 DOI: 10.1161/jaha.120.024482] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background The care for patients with type 2 diabetes necessitates a multidisciplinary team approach to reduce cardiovascular risk, but implementation of effective integrated strategies has been limited. Methods and Results We conceptualized and initiated a patient‐centered, team‐based intervention called Center for Integrated and Novel Approaches in Vascular‐Metabolic Disease (CINEMA) at University Hospitals Cleveland Medical Center. Patients with type 2 diabetes at high risk for cardiovascular events, including those with established atherosclerotic cardiovascular disease, elevated coronary artery calcium score >100, chronic heart failure with reduced ejection fraction, and/or chronic kidney disease stages 2 to 4 were included. Herein, we present the year 1 results for the program. From May 2020 through August 2021, there were 417 referrals. Among 206 eligible patients, 113 (55%) completed a baseline and ≥1 follow‐up visit through December 2021, with mean (SD) time of 105 (34) days between baseline and first follow‐up visits. Mean age was 59 years, with 49% women and 37% Black patients. Patients had significant reductions from baseline in glycosylated hemoglobin (−10.8%), total cholesterol (−7.9%), low‐density lipoprotein cholesterol (−13.5%), systolic blood pressure (−4.0%), and body mass index (−2.7%) (P≤0.001 for all). In addition, among the 129 (63%) eligible patients not on sodium‐glucose cotransporter 2 inhibitor or glucagon‐like peptide‐1 receptor agonist at baseline, 81% were prescribed evidence‐based therapy with sodium‐glucose cotransporter 2 inhibitor (n=66 [51%]) and/or glucagon‐like peptide‐1 receptor agonist (n=67 [52%]) to reduce the risk of cardiovascular disease in the initial 3‐month follow‐up period. Conclusions A team‐based, patient‐centered approach to high‐risk disease management appears to be a promising paradigm for care delivery associated with greater use of evidence‐based therapies and improved control of multiple cardiovascular risk factors.
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Affiliation(s)
- Ian J Neeland
- Division of Cardiovascular Medicine University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center Cleveland OH.,University Hospitals Health System Cleveland OH.,Case Western Reserve University School of Medicine Cleveland OH
| | - Sadeer G Al-Kindi
- Division of Cardiovascular Medicine University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center Cleveland OH.,University Hospitals Health System Cleveland OH.,Case Western Reserve University School of Medicine Cleveland OH
| | - Nour Tashtish
- Division of Cardiovascular Medicine University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center Cleveland OH.,University Hospitals Health System Cleveland OH.,Case Western Reserve University School of Medicine Cleveland OH
| | - Elke Eaton
- Division of Cardiovascular Medicine University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center Cleveland OH.,University Hospitals Health System Cleveland OH.,Case Western Reserve University School of Medicine Cleveland OH
| | - Janice Friswold
- Division of Cardiovascular Medicine University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center Cleveland OH.,University Hospitals Health System Cleveland OH.,Case Western Reserve University School of Medicine Cleveland OH
| | - Sara Rahmani
- Division of Cardiovascular Medicine University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center Cleveland OH.,University Hospitals Health System Cleveland OH.,Case Western Reserve University School of Medicine Cleveland OH
| | - Khendi T White-Solaru
- Division of Cardiovascular Medicine University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center Cleveland OH.,University Hospitals Health System Cleveland OH.,Case Western Reserve University School of Medicine Cleveland OH
| | - Imran Rashid
- Division of Cardiovascular Medicine University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center Cleveland OH.,University Hospitals Health System Cleveland OH.,Case Western Reserve University School of Medicine Cleveland OH
| | - Diamond Berg
- Case Western Reserve University School of Medicine Cleveland OH
| | - Mariam Rana
- University Hospitals Health System Cleveland OH.,Case Western Reserve University School of Medicine Cleveland OH
| | - Claire Sullivan
- Division of Cardiovascular Medicine University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center Cleveland OH.,University Hospitals Health System Cleveland OH.,Case Western Reserve University School of Medicine Cleveland OH
| | - Betul Hatipoglu
- Division of Cardiovascular Medicine University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center Cleveland OH.,Center for Diabetes and Obesity University Hospitals Cleveland Medical Center Cleveland OH.,University Hospitals Health System Cleveland OH.,Case Western Reserve University School of Medicine Cleveland OH
| | - Peter Pronovost
- University Hospitals Health System Cleveland OH.,Case Western Reserve University School of Medicine Cleveland OH
| | - Sanjay Rajagopalan
- Division of Cardiovascular Medicine University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center Cleveland OH.,University Hospitals Health System Cleveland OH.,Case Western Reserve University School of Medicine Cleveland OH
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Rahmani S, Hann A, Galipeau HJ, Chirdo FG, Didar T, Verdu E. A5 GLUTEN-SPECIFIC T CELL ACTIVATION BY MHC CLASS II EXPRESSING ORGANOID MONOLAYERS. J Can Assoc Gastroenterol 2022. [PMCID: PMC8859341 DOI: 10.1093/jcag/gwab049.004] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
NOT PUBLISHED AT AUTHOR’S REQUEST Funding Agencies: CIHR
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Affiliation(s)
- S Rahmani
- McMaster University, Hamilton, ON, Canada
| | - A Hann
- McMaster University, Hamilton, ON, Canada
| | - H J Galipeau
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - F G Chirdo
- Universidad Nacional de la Plata, La Plata, Argentina
| | - T Didar
- McMaster University, Hamilton, ON, Canada
| | - E Verdu
- McMaster University, Hamilton, ON, Canada
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8
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Villegas M, Alonso-Cantu C, Rahmani S, Wilson D, Hosseinidoust Z, Didar TF. Antibiotic-Impregnated Liquid-Infused Coatings Suppress the Formation of Methicillin-Resistant Staphylococcus aureus Biofilms. ACS Appl Mater Interfaces 2021; 13:27774-27783. [PMID: 34115463 DOI: 10.1021/acsami.0c19355] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Medical device-associated infections are an ongoing problem. Once an implant is infected, bacteria create a complex community on the surface known as a biofilm, protecting the bacterial cells against antibiotics and the immune system. To prevent biofilm formation, several coatings have been engineered to hinder bacterial adhesion or viability. In recent years, liquid-infused surfaces (LISs) have been shown to be effective in repelling bacteria due to the presence of a tethered liquid interface. However, local lubricant loss or temporary local displacement can lead to bacteria penetrating the lubrication layer, which can then attach to the surface, proliferate, and form a biofilm. Biofilm formation on biomedical devices can subsequently disrupt the chemistry tethering the slippery liquid interface, causing the LIS coating to fail completely. To address this concern, we developed a "fail-proof" multifunctional coating through the combination of a LIS with tethered antibiotics. The coatings were tested on a medical-grade stainless steel using contact angle, sliding angle, and Fourier transform infrared spectroscopy. The results confirm the presence of antibiotics while maintaining a stable and slippery liquid interface. The antibiotic liquid-infused surface significantly reduced biofilm formation (97% reduction compared to the control) and was tested against two strains of Staphylococcus aureus, including a methicillin-resistant strain. We also demonstrated that antibiotics remain active and reduce bacteria proliferation after subsequent coating modifications. This multifunctional approach can be applied to other biomaterials and provide not only a fail-safe but a fail-proof strategy for preventing bacteria-associated infections.
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Affiliation(s)
| | | | | | - David Wilson
- Department of Surgery, Juravinski Hospital, 711 Concession Street, Hamilton, ON L8V 1C3, Canada
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9
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Sanati A, Rahmani S, Nikoo A, Malayeri M, Busse O, Weigand J. Comparative study of an acidic deep eutectic solvent and an ionic liquid as chemical agents for enhanced oil recovery. J Mol Liq 2021. [DOI: 10.1016/j.molliq.2021.115527] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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10
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Kasapgil E, Badv M, Cantú CA, Rahmani S, Erbil HY, Anac Sakir I, Weitz JI, Hosseini-Doust Z, Didar TF. Polysiloxane Nanofilaments Infused with Silicone Oil Prevent Bacterial Adhesion and Suppress Thrombosis on Intranasal Splints. ACS Biomater Sci Eng 2021; 7:541-552. [PMID: 33470781 DOI: 10.1021/acsbiomaterials.0c01487] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Like all biofluid-contacting medical devices, intranasal splints are highly prone to bacterial adhesion and clot formation. Despite their widespread use and the numerous complications associated with infected splints, limited success has been achieved in advancing their safety and surface biocompatibility, and, to date, no surface-coating strategy has been proposed to simultaneously enhance the antithrombogenicity and bacterial repellency of intranasal splints. Herein, we report an efficient, highly stable lubricant-infused coating for intranasal splints to render their surfaces antithrombogenic and repellent toward bacterial cells. Lubricant-infused intranasal splints were prepared by creating superhydrophobic polysiloxane nanofilament (PSnF) coatings using surface-initiated polymerization of n-propyltrichlorosilane (n-PTCS) and further infiltrating them with a silicone oil lubricant. Compared with commercially available intranasal splints, lubricant-infused, PSnF-coated splints significantly attenuated plasma and blood clot formation and prevented bacterial adhesion and biofilm formation for up to 7 days, the typical duration for which intranasal splints are kept. We further demonstrated that the performance of our engineered biointerface is independent of the underlying substrate and could be used to enhance the hemocompatibility and repellency properties of other medical implants such as medical-grade catheters.
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Affiliation(s)
- Esra Kasapgil
- Department of Materials Science and Engineering, Gebze Technical University, TR-41400 Gebze, Kocaeli, Turkey.,School of Biomedical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8
| | - Maryam Badv
- School of Biomedical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8.,Department of Mechanical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8
| | - Claudia Alonso Cantú
- Department of Chemical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8
| | - Sara Rahmani
- School of Biomedical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8
| | - H Yildirim Erbil
- Department of Chemical Engineering, Gebze Technical University, TR-41400 Gebze, Kocaeli, Turkey
| | - Ilke Anac Sakir
- Department of Materials Science and Engineering, Gebze Technical University, TR-41400 Gebze, Kocaeli, Turkey
| | - Jeffrey I Weitz
- School of Biomedical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8.,Department of Medicine, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8.,Department of Biochemistry and Biomedical Sciences, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8.,Thrombosis & Atherosclerosis Research Institute (TaARI), 237 Barton Street East, Hamilton, Ontario, Canada L8L 2X2
| | - Zeinab Hosseini-Doust
- School of Biomedical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8.,Department of Chemical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8.,Institute for Infectious Disease Research (IIDR), McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8
| | - Tohid F Didar
- School of Biomedical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8.,Department of Mechanical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8.,Institute for Infectious Disease Research (IIDR), McMaster University, 1280 Main St W, Hamilton, Ontario, Canada L8S 4L8
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11
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Rahmani S, Sadrzadeh S. SUCCESSFUL TREATMENT OF AN UNUSUAL CASE OF SUICIDE BY SHARP FORCE. Chest 2020. [DOI: 10.1016/j.chest.2020.05.128] [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: 11/30/2022] Open
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12
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Joyce K, Rahmani S, Rochev Y. Quasi-isothermal modulated DSC as a valuable characterisation method for soft tissue biomaterial crosslinking reactions. Bioact Mater 2020; 5:428-434. [PMID: 32258832 PMCID: PMC7125324 DOI: 10.1016/j.bioactmat.2020.03.002] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/04/2020] [Accepted: 03/05/2020] [Indexed: 11/03/2022] Open
Abstract
Glutaraldehyde (Glut) is an extensively used sterilant and fixative for the crosslinking of natural soft tissue biomaterials like bovine pericardium (BP) to provide stability and is required for its application in vivo. There is plenty of debate around the reaction mechanism of Glut with natural biomaterials. Differential scanning calorimetry (DSC) is a commonly used technique that is typically used to measure the thermal profile of polymers. However, a variation known as quasi-isothermal modulated differential scanning calorimetry (QiMDSC) has been utilised for the analysis of polymorphic transformations in both the pharmaceutical and food industries. This communication will address QiMDSC as a method for analysing soft tissue biomaterials and their crosslinking mechanisms and how it can be applied to other biomaterial applications.
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Affiliation(s)
- K Joyce
- Centre for Research in Medical Devices (CÚRAM), Biomedical Sciences, National University of Ireland Galway (NUIG), Newcastle Road, Galway, Ireland.,Boston Scientific Limited, Ballybrit Business Park, Galway, Ireland
| | - S Rahmani
- Boston Scientific Limited, Ballybrit Business Park, Galway, Ireland
| | - Y Rochev
- National University of Ireland, Galway, University Road, Galway, Ireland.,Institute for Regenerative Medicine, Sechenov University, 8-2 Trubetskaya St., Moscow, 119991, Russia
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13
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Rahmani S, Galipeau HJ, Su H, Chirdo FG, Didar TF, Verdu E. A200 HUMANIZED CELIAC-PRONE EPITHELIUM IN VITRO EXPRESS MHC-II AND CO-STIMULATORY MOLECULES NECESSARY FOR GLUTEN PEPTIDE PRESENTATION. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The role intestinal epithelial cells (IECs) play in the breakdown of tolerance to gluten at an early stage in celiac disease (CeD) is unclear. Epithelial stress is a feature of CeD, and although the triggers are largely unknown, it is accompanied by expression of several markers that could be involved in initiation of inflammatory responses. IECs have been shown to express MHC class II (MHC-II) molecules and participate in antigen presentation in several models. Whether IECs can participate in gluten peptide presentation, the major environmental trigger in celiac disease, is unknown. To study this, a model expressing human MHC-II, HLA DQ8 or HLA-DQ2, would be required.
Aims
To develop organoid monolayers from transgenic mice expressing human celiac risk genes: HLA-DQ8 and -DQ2. To investigate conditions leading to the induction of epithelial MHC-II and its main co-stimulatory molecules, CD80, CD86 and CD40, that could enable early gluten peptide presentation.
Methods
In order to show pathophysiological significance of the model, we used two approaches, either induction of inflammation in vivo through gluten sensitization, or direct stimulation of the monolayers using pro-inflammatory cytokines relevant in CeD, such as IFNγ. Mice were sensitized with Pepsin-Trypsin digested gliadin and cholera toxin (CT) once a week for 3 weeks, followed by a challenge phase in which they only received gliadin. Control mice received CT only. We then developed organoid monolayers from the duodenum followed by stimulation with 10 ng/ml IFNγ. Finally, markers necessary for gluten peptide presentation, the expression of MHC-II and its co-stimulatory molecules, were evaluated using flow cytometry.
Results
Both in vivo gluten sensitization and in vitro stimulation of the organoid derived monolayer with IFNγ induced a proinflammatory response, that independently primed the epithelium to express MHC-II molecules (p =0.02 and <0.0001, respectively). When in vivo sensitization and in vitro IFNγ stimulation were combined, epithelial MHC-II expression was further upregulated (p <0.0001). Lastly, only the combination of gluten sensitization and in vitro IFNγ induced expression of MHC-II co-stimulatory molecules, which are necessary for antigen presentation.
Conclusions
Our findings support that gluten induced-inflammation in vivo as well as independent stimuli that release IFNγ enhance the capacity of the IECs to express MHC-II molecules. However, co-stimulatory molecules are only expressed by the epithelium when both gluten tolerance is broken by in vivo sensitization and the organoid monolayers is further exposed to IFNγ. The results support the hypothesis that the epithelium participates in gluten peptide presentation and that this pathway is stimulated by both gluten-dependent and independent inflammation.
Funding Agencies
CIHRSupported by CIHR and a Farncombe Family Grant to EFV and TFD.
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Affiliation(s)
- S Rahmani
- McMaster University, School of Biomedical Engineering, Farncombe Family Digestive Health Research Institute, Hamilton, ON, Canada
| | - H J Galipeau
- McMaster University, Farncombe Family Digestive Health Research Institute, Hamilton, ON, Canada
| | - H Su
- McMaster University, Department of Mechanical Engineering, School of Biomedical Engineering, Hamilton, ON, Canada
| | - F G Chirdo
- Instituto de Estudios Inmunologicos y Fisiopatologicos - IIFP (UNLP-CONICET). Facultad de Ciencias Exactas, Universidad Nacional de La Plata, La Plata, Argentina
| | - T F Didar
- McMaster University, Department of Mechanical Engineering, School of Biomedical Engineering, Hamilton, ON, Canada
| | - E Verdu
- McMaster University, Farncombe Family Digestive Health Research Institute, Hamilton, ON, Canada
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14
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Joyce K, Rochev Y, Rahmani S. Assessment of the uniaxial experimental parameters utilised for the mechanical testing of bovine pericardium. J Mech Behav Biomed Mater 2019; 96:27-37. [DOI: 10.1016/j.jmbbm.2019.04.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 04/09/2019] [Accepted: 04/13/2019] [Indexed: 11/26/2022]
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15
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Rahmani S, Vahedi F, Galipeau HJ, Su H, Chirdo FG, Didar TF, Verdu E. A48 NOVEL INTESTINAL ORGANOID-DERIVED MONOLAYERS TO MODEL CELIAC EPITHELIUM IN VITRO. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.047] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S Rahmani
- McMaster University, Hamilton, ON, Canada
| | - F Vahedi
- McMaster University, Hamilton, ON, Canada
| | | | - H Su
- McMaster University, Hamilton, ON, Canada
| | - F G Chirdo
- National University of La Plata, La Plata, Buenos Aires, Argentina
| | - T F Didar
- McMaster University, Hamilton, ON, Canada
| | - E Verdu
- McMaster University, Hamilton, ON, Canada
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16
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Rahmani S, Mogharizadeh L, Attar F, Rezayat SM, Mousavi SE, Falahati M. Probing the interaction of silver nanoparticles with tau protein and neuroblastoma cell line as nervous system models. J Biomol Struct Dyn 2017; 36:4057-4071. [PMID: 29173031 DOI: 10.1080/07391102.2017.1407673] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Interestingly pharmaceutical sciences are using nanoparticles (NPs) to design and develop nanomaterials-based drugs. However, up to recently, it has not been well realized that NPs themselves may impose risks to the biological systems. In this study, the interaction of silver nanoparticles (AgNPs) with tau protein and SH-SY5Y neuroblastoma cell line, as potential nervous system models, was examined with a range of techniques including intrinsic fluorescence spectroscopy, circular dichroism (CD) spectroscopy, 3-(4,5-dimethylthiazol-2-Yl)-2,5-diphenyltetrazolium bromide (MTT) assay, and acridine orange/ethidium bromide (AO/EB) dual staining method. Fluorescence study showed that AgNPs with a diameter of around 10-20 nm spontaneously form a static complex with tau protein via hydrogen bonds and van der Waals interactions. CD experiment revealed that AgNPs did not change the random coil structure of tau protein. Moreover, AgNPs showed to induce SH-SY5Y neuroblastoma cell mortality through fragmentation of DNA which is a key feature of apoptosis. In conclusion, AgNPs may induce slight changes on the tau protein structure. Also, the concentration of AgNPs is the main factor which influences their cytotoxicity. Since, all adverse effects of NPs are not well detected, so probably additional more specific testing would be needed.
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Affiliation(s)
- Sara Rahmani
- a Faculty of Advance Science and Technology, Department of Cell and Molecular Biology , Islamic Azad University, Pharmaceutical Sciences Branch (IAUPS) , Tehran , Iran
| | - Leila Mogharizadeh
- b Department of Cell and Molecular Biology , Islamic Azad University, Central Tehran Branch , Tehran , Iran
| | - Farnoosh Attar
- c Department of Biology, Faculty of Food Industry & Agriculture , Standard Research Institute (SRI) , Karaj , Iran
| | - Seyed Mahdi Rezayat
- d Department of Pharmacology, School of Medicine , Tehran University of Medical Sciences , Tehran , Iran.,e Department of Medical Nanotechnology, School of Advanced Technologies in Medicine , Tehran University of Medical Sciences , Tehran , Iran
| | - Seyyedeh Elaheh Mousavi
- d Department of Pharmacology, School of Medicine , Tehran University of Medical Sciences , Tehran , Iran
| | - Mojtaba Falahati
- f Faculty of Advance Science and Technology, Department of Nanotechnology , Islamic Azad University, Pharmaceutical Sciences Branch (IAUPS) , Tehran , Iran
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17
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Shafer KM, Janssen L, Carrick-Ranson G, Rahmani S, Palmer D, Fujimoto N, Livingston S, Matulevicius SA, Forbess LW, Brickner B, Levine BD. Cardiovascular response to exercise training in the systemic right ventricle of adults with transposition of the great arteries. J Physiol 2016; 593:2447-58. [PMID: 25809342 DOI: 10.1113/jp270280] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 03/09/2015] [Indexed: 12/25/2022] Open
Abstract
KEY POINTS Patients with transposition of the great arteries (TGA) and systemic right ventricles have premature congestive heart failure; there is also a growing concern that athletes who perform extraordinary endurance exercise may injure the right ventricle. Therefore we felt it essential to determine whether exercise training might injure a systemic right ventricle which is loaded with every heartbeat. Previous studies have shown that short term exercise training is feasible in TGA patients, but its effect on ventricular function is unclear. We demonstrate that systemic right ventricular function is preserved (and may be improved) in TGA patients with exercise training programmes that are typical of recreational and sports participation, with no evidence of injury on biomarker assessment. Stroke volume reserve during exercise correlates with exercise training response in our TGA patients, identifying this as a marker of a systemic right ventricle (SRV) that may most tolerate (and possibly even be improved by) exercise training. ABSTRACT We aimed to assess the haemodynamic effects of exercise training in transposition of the great arteries (TGA) patients with systemic right ventricles (SRVs). TGA patients have limited exercise tolerance and early mortality due to systemic (right) ventricular failure. Whether exercise training enhances or injures the SRV is unclear. Fourteen asymptomatic patients (34 ± 10 years) with TGA and SRV were enrolled in a 12 week exercise training programme (moderate and high-intensity workouts). Controls were matched on age, gender, BMI and physical activity. Exercise testing pre- and post- training included: (a) submaximal and peak; (b) prolonged (60 min) submaximal endurance and (c) high-intensity intervals. Oxygen uptake (V̇O2; Douglas bag technique), cardiac output (Q̇c, foreign-gas rebreathing), ventricular function (echocardiography and cardiac MRI) and serum biomarkers were assessed. TGA patients had lower peak V̇O2, Q̇c, and stroke volume (SV), a blunted Q̇c/V̇O2 slope, and diminished SV response to exercise (SV increase from rest: TGA = 15.2%, controls = 68.9%, P < 0.001) compared with controls. After training, TGA patients increased peak V̇O2 by 6 ± 8.5%, similar to controls (interaction P = 0.24). The magnitude of SV reserve on initial testing correlated with Q̇c training response (r = 0.58, P = 0.047), though overall, no change in peak Q̇c was observed. High-sensitivity troponin T (hs-TnT) and N-terminal prohormone of brain naturetic peptide (NT pro-BNP) were low and did not change with acute exercise or after training. Our data show that TGA patients with SRVs in this study safely participated in exercise training and improved peak V̇O2. Neither prolonged submaximal exercise, nor high-intensity intervals, nor short-term exercise training seem to injure the systemic right ventricle.
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Affiliation(s)
- K M Shafer
- Boston Children's Hospital, Department of Cardiology, Boston, MA, USA.,University of Texas Southwestern Medical Center, Dallas, TX, USA.,Institute for Exercise and Environmental Medicine, Dallas, TX, USA
| | - L Janssen
- Institute for Exercise and Environmental Medicine, Dallas, TX, USA.,Radboud University Nijmegen Medical Centre (RUNMC), Department of Physiology, Nijmegen, The Netherlands
| | - G Carrick-Ranson
- University of Texas Southwestern Medical Center, Dallas, TX, USA.,Institute for Exercise and Environmental Medicine, Dallas, TX, USA
| | - S Rahmani
- Institute for Exercise and Environmental Medicine, Dallas, TX, USA
| | - D Palmer
- Institute for Exercise and Environmental Medicine, Dallas, TX, USA
| | - N Fujimoto
- Institute for Exercise and Environmental Medicine, Dallas, TX, USA
| | - S Livingston
- Institute for Exercise and Environmental Medicine, Dallas, TX, USA
| | - S A Matulevicius
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - L W Forbess
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - B Brickner
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - B D Levine
- University of Texas Southwestern Medical Center, Dallas, TX, USA.,Institute for Exercise and Environmental Medicine, Dallas, TX, USA
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18
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Rahmani S, Grewal IS, Nabovati A, Doyle MG, Roche-Nagle G, Tse LW. Increasing angulation decreases measured aortic stent graft pullout forces. J Vasc Surg 2016; 63:493-9. [DOI: 10.1016/j.jvs.2014.06.115] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 06/14/2014] [Indexed: 11/17/2022]
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19
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20
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Samhkaniyan E, Mahdavi A, Mohamadpour S, Rahmani S. The effectiveness of mindfulness-based cognitive therapy on quality of life and loneliness of women with HIV. J Med Life 2015; 8:107-113. [PMID: 28316716 PMCID: PMC5319288] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
Objective: The present study investigated the performance of Mindfulness according to the Cognitive approach on the Quality of Life and Loneliness of women with HIV. Methods: This research is a semi-experimental with pretest-posttest and check team, which was conducted in winter, 2014. In this research, 24 positive HIV women in Tehran were selected by volunteers sampling method and were stochastically related to either the control team (n = 12) or the MBCT groups (n = 12) and, the World Health Organization quality of life survey and the University of California Los Angeles loneliness scale were administrated as pretest. The MBCT team got eight sessions of mindfulness according to the cognitive theory and the check team got no intervention. At the end, the post-test was administrated to two groups and, covariance method was used for data analysis by SPSS-20 software. Findings: The results of the present study indicated that there were clear variations among the test groups check group and MBCT (p < 0.001). Therefore, Mindfulness-based Cognitive theory increased the mean quality of life and decreased loneliness. Conclusion: The findings indicated that the Mindfulness-based Cognitive therapy increased the quality of life and decreased loneliness in positive HIV women. Therefore, in order to modify the quality of life and loneliness in these cases, attention to these variables during clinical trials with the goal of an appropriate intervention, will be beneficial.
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Affiliation(s)
- E Samhkaniyan
- PhD of Student Health Psychology, department of education and psychology, Islamic Azad University, Karaj, Iran
| | - A Mahdavi
- Master of Clinical Psychology, department of education and psychology, Islamic Azad University,
Science and Research Branch, Ahvaz, Iran
| | - S Mohamadpour
- Master of Clinical Psychology, Social Determinants of Health Research Center,
Lorestan University of Medical Sciences, Khorramabad, Iran
| | - S Rahmani
- PhD of Student Health Psychology, Azad University Islamic, Karaj, Iran.
Behavioral Sciences Research Center of Shahid Beheshti University of Medical Sciences
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21
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Sabzianpoor B, Ghazanfari Amrai M, Jalali Farahani M, Soheila R, Mahdavi A, Rahmani S. The impact of teaching psychological welfare on marital satisfaction and self-efficacy in nurses. J Med Life 2015; 8:307-312. [PMID: 28316749 PMCID: PMC5319253] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Objective: Proper psychological interventions for enhancing public health and mental welfare in nurses are of great importance. This study intended to explore the influence of the teaching psychological welfare on marital satisfaction and self-efficacy in nurses of Imam Khomeini hospital. Methodology: The method of the present study was semi-experimental with a pre-test post-test design and a control group. Hence, 24 nurses were selected from Imam Khomeini hospital, by using convenience sampling, and they were divided into two groups: experiment and monitoring. By using a 47-questions marital satisfaction questionnaire and a 17-questions general self-efficacy questionnaire, both groups were pre-tested. Then the test group, received lessons on psychological welfare within ten sessions, but the control group received no interventions. Afterwards, both groups were post-tested, and the data collected were analyzed by using descriptive and inferential statistics methods through SPSS software. Findings: Findings showed that teaching psychological welfare significantly increased marital satisfaction and self-efficacy in nurses (p < 0.001). Conclusion: From this research, it was concluded that teaching psychological welfare is an effective strategy for those with risky jobs like nurses, because it is highly efficient, especially when it is performed in groups, because it is cheap, and because it is acceptable by different working people.
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Affiliation(s)
- B Sabzianpoor
- Psychometric Psychology, Islamic Azad University, Central Tehran Branch, Iran
| | - M Ghazanfari Amrai
- General Psychology, Islamic Azad University, Science and Research Branch, Semnan, Iran
| | | | - R Soheila
- Clinical Psychology, Islamic Azad University, Chaloos Branch, Iran
| | - A Mahdavi
- Department of Psychology, Faculty of Psychology and Educational Sciences, University of Payame Noor, Tehran, Iran
| | - S Rahmani
- Student Health Psychology, Islamic Azad University, Karaj Branch, Iran
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22
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Jalali M, Rahmani S, Joyce AD, Cartledge JJ, Lewis MH, Ahmad N. Laparoscopic donor nephrectomy: an increasingly common cause for testicular pain and swelling. Ann R Coll Surg Engl 2012; 94:407-10. [PMID: 22943330 PMCID: PMC3954321 DOI: 10.1308/003588412x13171221592177] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Laparoscopic donor nephrectomy (LDN) is now a well established method for kidney procurement from living donors. In our centre, LDN is currently offered only to donors suitable for a left nephrectomy. The aim of this study was to investigate the incidence of testicular pain and swelling following LDN. METHODS A total of 25 left-sided LDN male patients were assessed in a prospective structured interview together with a control cohort of 25 male patients who had undergone left-sided open donor nephrectomy (ODN). RESULTS Data were collected on testicular pain, swelling, numbness, urinary symptoms and sexual dysfunction from all 50 patients (100% response rate). Of the 25 LDN patients, 11 (44%) experienced ipsilateral testicular pain and/or swelling. In most instances, pain was of immediate onset, mild to moderate in severity, lasted for a few days to several weeks and was associated with testicular swelling (10 of 11 cases). However, testicular pain and/or swelling were not apparent in ODN patients, with only 2 of 25 (8%) experiencing mild testicular pain, 1 of whom also had swelling. CONCLUSIONS Testicular pain and swelling following LDN is a common problem. It is underreported in the literature and should be included in the differential diagnoses of testicular pain and swelling. Further investigation is required to confirm our findings.
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Affiliation(s)
- M Jalali
- Leeds Teaching Hospitals NHS Trust, UK
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Mohammadinia M, Rahmani S, Eslami G, Ghassemi-Broumand M, Aghazadh Amiri M, Aghaie G, Tabatabaee SM, Taheri S, Behgozin A. Contact lens disinfecting solutions antibacterial efficacy: comparison between clinical isolates and the standard ISO ATCC strains of Pseudomonas aeruginosa and Staphylococcus aureus. Eye (Lond) 2011; 26:327-30. [PMID: 22094301 DOI: 10.1038/eye.2011.284] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To evaluate the disinfectant properties of the three multipurpose contact lens disinfecting solutions available in Iran, against clinical isolates and the standard ISO ATCC strains of Pseudomonas aeruginosa and Staphylococcus aureus, based on the international organization for standardization (ISO) 14729 guidelines. METHODS Three multipurpose solutions that were tested were ReNu Multiplus, Solo Care Aqua and All-Clean Soft. The test solutions were challenged with clinical isolates and the standard strains of P. aeruginosa(ATCC 9027) and S. aureus(ATCC 6538), based on the ISO Stand-alone procedure for disinfecting products. Solutions were sampled for surviving microorganisms at manufacturer's minimum recommended disinfection time. The number of viable organisms was determined and log reductions calculated. RESULTS All of the three test solutions in this study provided a reduction greater than the required mean 3.0 logarithmic reduction against the recommended standard ATCC strains of P. aeruginosa and S. aureus. Antibacterial effectiveness of Solo Care Aqua and All-Clean Soft against clinical isolates of P. aeruginosa and S. aureus were acceptable based on ISO 14729 Stand-alone test. ReNu MultiPlus showed a minimum acceptable efficacy against the clinical isolate of S. aureus, but did not reduce the clinical isolate by the same amount. CONCLUSIONS Although the contact lens disinfecting solutions meet/exceed the ISO 14729 Stand-alone primary acceptance criteria for standard strains of P. aeruginosa and S. aureus, their efficacy may be insufficient against clinical isolates of these organisms.
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Affiliation(s)
- M Mohammadinia
- Department of Optometry, Shahid Beheshti University of Medical Science, Tehran, Iran
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24
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25
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Nael E, Pemberton P, Hwang M, Rahmani S, Raghavan V. What are the predictive factors of positive resection margin in infiltrating lobular carcinoma treated by breast conserving surgery? Eur J Surg Oncol 2009. [DOI: 10.1016/j.ejso.2009.07.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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26
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Ben Abdelaziz A, Harrabi I, Rahmani S, Ghedira A, Gaha K, Ghannem H. [Attitudes of general practitioners to pharmaceutical sales representatives in Sousse]. East Mediterr Health J 2003; 9:1075-83. [PMID: 16450540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The therapeutic knowledge of physicians is the corner stone to the rational use of medicines; however information about medicines is generally obtained from the pharmaceutical industry via their sales representatives (reps). We aimed to identify general practitioners' (GPs) attitudes to pharmaceutical reps and the information they provide. We surveyed 140 GPs using a self-administered questionnaire. The response rate was 78% (72 GPs from the public sector and 68 from the private sector). About 10% of the GPs said they received daily visits from pharmaceutical reps; 84% of GPs considered them an efficient source of information and 31% said they might change their therapeutic prescribing following visits from these reps. Because of their positive perception of pharmaceutical reps, GPs are susceptible to the information they provide. Controlling the validity of the therapeutic information imparted by the pharmaceutical industry is thus a fundamental component of the programme for the rational use of medicines.
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Affiliation(s)
- A Ben Abdelaziz
- Department of Community Medicine, Faculty of Medicine Ibn El Jazzar, Sousse, Tunisia
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27
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Ben Abdel Aziz A, Harrabi I, Rahmani S, Ghedira A, Gaha K, Ghannem H. [Attitudes of general practitioners to pharmaceutical sales representatives in Sousse]. East Mediterr Health J 2003. [DOI: 10.26719/2003.9.5-6.1075] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The therapeutic knowledge of physicians is the corner stone to the rational use of medicines; however information about medicines is generally obtained from the pharmaceutical industry via their sales representatives [reps]. We aimed to identify general practitioners’ [GPs] attitudes to pharmaceutical reps and the information they provide. We surveyed 140 GPs using a self-administered questionnaire. The response rate was 78% [72 GPs from the public sector and 68 from the private sector]. About 10% of the GPs said they received daily visits from pharmaceutical reps; 84% of GPs considered them an efficient source of information and 31% said they might change their therapeutic prescribing following visits from these reps. Because of their positive perception of pharmaceutical reps, GPs are susceptible to the information they provide. Controlling the validity of the therapeutic information imparted by the pharmaceutical industry is thus a fundamental component of the programme for the rational use of medicines
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28
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Ben Abdelaziz A, Harrabi I, Rahmani S, Gaha R, Ghannem H. [Circulation of pharmaceutical information among general practitioners in the region of Sousse (Tunisia)]. Therapie 2002; 57:229-35. [PMID: 12422532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
The general practitioner plays an essential role in the rational strategy of drug-use by the quality of his prescription which translates the validity and the relevance of his pharmaceutical information. The objective of this work is to study the different means of pharmaceutical information used by general practitioners in the region of Sousse (Tunisia). We conducted a transversal, descriptive, exhaustive survey of 140 general practitioners in private (68) and public (72) practice during 1999. Data were collected through a questionnaire. This study, with a participation rate of 78%, showed that pharmaceutical dictionaries are the major source of information for 86% of general practitioners, that medical delegates have a positive image for 84% of them and that 36% of general practitioners do not subscribe to any medical journal. Thus, general practitioners are exposed to relatively unreliable pharmaceutical information coming generally from the pharmaceutical industry.
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Affiliation(s)
- A Ben Abdelaziz
- Service d'Epidémiologie et de Statistiques Médicales, Centre Hospitalo-Universitaire Farhat Hached de Sousse, Sousse, Tunisie.
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Dalal I, Binson I, Reifen R, Amitai Z, Shohat T, Rahmani S, Levine A, Ballin A, Somekh E. Food allergy is a matter of geography after all: sesame as a major cause of severe IgE-mediated food allergic reactions among infants and young children in Israel. Allergy 2002; 57:362-5. [PMID: 11906370 DOI: 10.1034/j.1398-9995.2002.1s3412.x] [Citation(s) in RCA: 211] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To determine the prevalence, importance, and the order of frequency of IgE-mediated food allergens among infants and young children in Israel. STUDY DESIGN AND PATIENTS In a cross-sectional study, the prevalence of IgE-mediated food allergy was investigated in 9070 infants and young children (0-2 years) who were followed-up at 23 Family Health Centers (FHCs) in central Israel. Patients with suspected IgE-mediated food allergic reactions, were recruited for further evaluation (detailed questionnaire and skin-prick test (SPT)). RESULTS We identified 150 out of 9070 (1.7%) patients with suspected IgE-mediated food allergy. Among them, 102/150 (67%) [59 males, 43 females; mean age 10.3 months] completed a detailed questionnaire and underwent SPT. Evaluation revealed 131 positive SPTs in 78/102 (76.5%) patients. Twenty-seven positive SPTs in 18 patients were considered clinically irrelevant based on previous consumption of the relevant foods without clinical symptoms. Thus, there were 104 relevant positive SPTs in 78 patients. The overall prevalence of clinically relevant IgE-mediated food allergic reactions among these patients is estimated to be 1.2% (104/9070). The most common food allergens were egg, cow's milk, and sesame. Anaphylaxis was the presenting symptom in 14/78 (18%) including six sesame-induced cases. A history of other atopic diseases was reported in 27 (35%) patients. In addition, 22 (28%) had a history of atopy in first-degree family members. CONCLUSIONS We found sesame to be a major cause of IgE-mediated food allergy in Israel. In fact, it is second only to cow's milk as a cause of anaphylaxis. We recommend that testing for food allergens be tailored to each community based on local experience and should include sesame in appropriate populations.
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Affiliation(s)
- I Dalal
- Pediatric Allergy and Clinical Immunology Unit, Department of Pediatrics, E. Wolfson Medical Center, Israel
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Gargouri HK, Chéour M, Ben Ahmed N, Rahmani S, Kraiem A. [Subretinal neovascularization in angioid streaks]. Tunis Med 2001; 79:161-4. [PMID: 11471445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Angoid streaks are linear crack-line dehiscences of Bruch's membrane. Choroidal neovascularization is the most serious complication of angioid streaks. The authors try to determine the incidence of neovascular macular degeneration in angioid streaks, their detection and treatment. A retrospective study of 26 eyes of 13 patients with angioid streaks was performed, 6 of whom had macular complications and 3 had subretinal neovascular membranes. Indocyanine green angiography is an adjunctive diagnostic tool in the detection of subretinal neovascular membranes in angioid streaks. Laser photocoagulation of choroidal neovascularization in angioid streaks may end the choroidal neovascularization and help stabilize visual acuity.
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Affiliation(s)
- H K Gargouri
- Service Ophtalmologie, Hôpital Habib Thameur, Tunis
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