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Eid MM, Mostafa MR, Alabdouh A, Najim M, Mohamed S, Ziada AR, Takla A, Balmer-Swain M, Baibhav B, Al-Azizi KM, Goldsweig AM. Short duration of dual antiplatelet therapy following complex percutaneous coronary intervention: A systematic review and meta-analysis. Cardiovasc Revasc Med 2024; 61:8-15. [PMID: 37951758 DOI: 10.1016/j.carrev.2023.11.002] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION AND AIM The optimal composition and duration of antiplatelet therapy after complex percutaneous coronary intervention (PCI) remains unclear. We conducted a meta-analysis to compare 1-3 months of dual antiplatelet therapy (DAPT) followed by monotherapy vs. 12 months of DAPT. METHOD MEDLINE/PubMed, EMBASE, and Cochrane Central Register of Controlled Trials were queried for studies comparing 1-3 months of DAPT followed by monotherapy vs. 12 months of DAPT in the outcomes of complex PCI from inception through January 2023. Outcomes of interest included major bleeding, all-cause mortality, cardiovascular mortality, myocardial infarction (MI), stent thrombosis, target vessel revascularization, and stroke. RESULTS Compared to 12 months, 1-3 months of dual antiplatelet therapy had a weak association with less major bleeding (OR 0.67; 95 % CI, 0.44-1.00; p = 0.05; I2 = 28 %). There were no significant differences between the shorter and longer antiplatelet therapy in terms of all-cause mortality (OR 0.83; 95 % CI, 0.59-1.16; p = 0.21; I2 = 17 %), cardiovascular mortality (OR 0.87; 95 % CI, 0.53-0.42; p = 0.50; I2 = 0), MI (OR 0.97; 95 % CI, 0.69-1.35; p = 0.82; I2 = 32 %), stent thrombosis (OR 1.17, 95 % CI, 0.77-1.76; p = 0.38; I2 = 0 %), target vessel revascularization (OR 1.05, 95 % CI, 0.58-1.89; p = 0.82; I2 = 64 %), or stroke (OR 1.10, 95 % CI, 0.55-2.17; p = 0.37; I2 = 7 %);. CONCLUSION Among patients undergoing complex PCI, DAPT for 1-3 months may be associated with less major bleeding but similar rates of cardiovascular events (death, MI, stroke, stent thrombosis, and revascularization) compared to DAPT for 12 months.
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Affiliation(s)
| | | | - Ahmad Alabdouh
- Department of Medicine, University of Kentucky, Lexington, KY, USA
| | - Mostafa Najim
- Rochester Regional Health/Unity Hospital, Rochester, NY, USA
| | | | | | - Andrew Takla
- Rochester Regional Health/Unity Hospital, Rochester, NY, USA
| | | | | | - Karim M Al-Azizi
- Interventional Cardiology and Structural Heart Disease, Baylor Scott & White Health-The Heart Hospital Plano, USA
| | - Andrew M Goldsweig
- Department of Cardiovascular Medicine, Baystate Medical Center, Springfield, MA, USA; Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
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Mostafa MR, Eid MM, Awad AK, Takla A, Hassan AR, Katamesh BE, AlBarakat MM, Ziada AR, Mohamed S, Al-Azizi KM, Goldsweig AM. Safety and Efficacy of Cangrelor in Acute Coronary Syndromes: A Systematic Review and Network Meta-Analysis. Am J Cardiovasc Drugs 2024; 24:71-81. [PMID: 37995040 DOI: 10.1007/s40256-023-00616-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 11/24/2023]
Abstract
INTRODUCTION Cangrelor is a potent intravenous non-thienopyridine P2Y12 inhibitor. We conducted a network meta-analysis to study the efficacy and safety of cangrelor as compared with the oral P2Y12 inhibition, clopidogrel, or placebo in acute coronary syndromes. METHODS This meta-analysis followed the Cochrane collaboration guidelines and the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocols. Outcomes of interest included all-cause mortality, myocardial infarction, stent thrombosis, target vessel revascularization, major bleeding, minor bleeding, and the need for blood transfusion. RESULTS The analysis was comprised of 6 studies including 26,444 patients treated with cangrelor, clopidogrel, or placebo. There were no statistically significant differences in the incidence of all-cause mortality, myocardial infarction, stent thrombosis, target vessel revascularization, or major bleeding. Cangrelor was associated with a higher risk of minor bleeding than clopidogrel or placebo, with no difference in requiring blood transfusion. CONCLUSION Cangrelor has comparable outcomes to clopidogrel in patients with acute coronary syndromes and can be used as a reliable alternative in this population.
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Affiliation(s)
| | | | - Ahmed K Awad
- Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Andrew Takla
- Department of Medicine, Rochester General Hospital, Rochester, NY, USA
| | | | | | - Majd M AlBarakat
- Faculty of Medicine, Jordan University of Science and Technology, Amman, Jordan
| | | | | | - Karim M Al-Azizi
- Baylor Scott and White Health-The Heart Hospital, Plano, TX, USA
| | - Andrew M Goldsweig
- Department of Cardiovascular Medicine, Baystate Medical Center, Springfield, MA, USA
- Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE, USA
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Parker SG, Blake H, Zhao S, van Dellen J, Mohamed S, Albadry W, Akhtar H, Franczak B, Jakkalasaibaba R, Rothnie A, Thomas R. An established abdominal wall multidisciplinary team improves patient care and aids surgical decision making with complex ventral hernia patients. Ann R Coll Surg Engl 2024; 106:29-35. [PMID: 36927113 PMCID: PMC10757872 DOI: 10.1308/rcsann.2022.0167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2022] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION Abdominal wall reconstruction (AWR) is an emerging subspecialty within general surgery. The practice of multidisciplinary team (MDT) meetings to aid decision making and improve patient care has been demonstrated, with widespread acceptance. This study presents our initial experience of over 150 cases of complex hernia patients discussed in a newly established MDT setting. METHODS From February 2020 to July 2022 (30-month period), abdominal wall MDTs were held bimonthly. Key stakeholders included upper and lower gastrointestinal surgeons, a gastrointestinal specialist radiologist, a plastic surgeon, a high-risk anaesthetist and two junior doctors integrated into the AWR clinical team. Meetings were held online, where patient history, past medical and surgical history, hernia characteristics and up-to-date computed tomography scans were discussed. RESULTS Some 156 patients were discussed over 18 meetings within the above period. Ninety-five (61%) patients were recommended for surgery, and 61 (39%) patients were recommended for conservative management or referred elsewhere. Seventy-eight (82%) patients were directly waitlisted, whereas seventeen (18%) required preoperative optimisation: three (18%) for smoking cessation, eleven (65%) for weight-loss management and three (18%) for specialist diabetic assessment and management. In total, 92 (59%) patients (including operative and nonoperative management) have been discharged to primary care. DISCUSSION A multidisciplinary forum for complex abdominal wall patients is a safe process that facilitates decision making, promotes education and improves patient care. As the AWR subspecialty evolves, our view is that the "complex hernia MDT" will become commonplace. We present our experience and share advice for others planning to establish an AWR centre.
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Affiliation(s)
- SG Parker
- Croydon Health Services NHS Trust, UK
| | - H Blake
- Croydon Health Services NHS Trust, UK
| | - S Zhao
- Croydon Health Services NHS Trust, UK
| | | | - S Mohamed
- Croydon Health Services NHS Trust, UK
| | - W Albadry
- St George’s University Hospitals NHS Foundation Trust, UK
| | - H Akhtar
- Croydon Health Services NHS Trust, UK
| | | | | | - A Rothnie
- Croydon Health Services NHS Trust, UK
| | - R Thomas
- Croydon Health Services NHS Trust, UK
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Najim M, Reda Mostafa M, Eid MM, Alabdouh A, Awad AK, Elbanna M, Mohamed S, Alweis R, Al-Azizi KM, Mamas MA. Efficacy and safety of the new generation Watchman FLX device compared to the Watchman 2.5: a systematic review and meta-analysis. Am J Cardiovasc Dis 2023; 13:291-299. [PMID: 38026111 PMCID: PMC10658049] [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] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/31/2023] [Indexed: 12/01/2023]
Abstract
INTRODUCTION The first-generation Watchman 2.5 (W 2.5)TM presented several limitations, such as challenges in implantation within complex left atrial appendage (LAA) anatomies, higher incidence of peri-device leak, device recapture, and device-related thrombus (DRT). The newer generation Watchman FLX (W-FLX)TM was introduced with a modified design aiming to overcome these limitations. The purpose of this meta-analysis is to conduct a comparative assessment of the safety and efficacy of the W-FLX and 2.5 devices in clinical practice. METHOD The meta-analysis was conducted according to the preferred reporting items for systematic review and meta-analysis protocols (PRISMA). Studies were located through a search strategy utilizing PubMed, Cochrane, Google scholar and MEDLINE from inception to March 2023, with a primary objective to compare the safety and efficacy of the W-FLX and W 2.5 devices. After applying the selection criteria, five studies were included in this analysis. RESULTS The analysis included five studies comprising 54,727 patients. The W-FLX is associated with an increase in procedural success (OR 7.49 [95% CI 1.98-28.26, P = 0.02; I2 = 0%]), and a significant reduction in mortality (OR 0.52 [95% CI 0.51-0.54, P<0.01; I2 = 0%], major bleeding 0.57 [95% CI 0.51-0.64, P<0.01; I2 = 0%]), device embolism (OR 0.35 [95% CI 0.18-0.70, P = 0.02; I2 = 0%]), and pericardial effusion (OR 0.33 [95% CI 0.26-0.41, P<0.01; I2 = 0%]). The rates of DRT and stroke were similar between the two groups. CONCLUSION Compared to the W 2.5, the W-FLX was associated with a higher procedural success rate and significantly reduced adverse outcomes including mortality, major bleeding, device embolization, and pericardial effusion.
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Affiliation(s)
- Mostafa Najim
- Rochester Regional Health/Unity HospitalRochester, NY, USA
| | | | | | - Ahmad Alabdouh
- Department of Medicine, University of KentuckyLexington, KY, USA
| | - Ahmed K Awad
- Faculty of Medicine, Ain-Shams UniversityCairo, Egypt
| | | | | | - Richard Alweis
- Rochester Regional Health/Unity HospitalRochester, NY, USA
| | - Karim M Al-Azizi
- Department of Cardiology, Baylor Scott & White Health - The Heart HospitalPlano, TX, USA
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Keele UniversityKeele, UK
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Al-Dhaibani N, Omar H, Habshi A, El Meadawi A, Alidrisi M, Ali G, Mohamed S. A Novel Method for Intracavitary Cervical HDR Brachytherapy: Express Finger-Guided Implant Insertion at Simulation Table without Speculum, Cervical Dilatation, Sleeve, Anesthesia, or Sedation. Int J Radiat Oncol Biol Phys 2023; 117:e501-e502. [PMID: 37785577 DOI: 10.1016/j.ijrobp.2023.06.1747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Our purpose is to develop a fast, effective, and independent intracavitary brachytherapy implant insertion method that does not need sleeve insertion, anesthesia or conscious sedation, and that can be performed at the front edge of the simulation table (CT or MRI), using finger guidance without a need for speculum or cervical dilatation. MATERIALS/METHODS From February 2022 to January 2023, we treated 27 locally advanced cervical cancer patients. In the last week of EBRT, we assessed patients with MRI and pelvic exam to determine their eligibility: 89% (24 patients) met the two inclusion criteria for the express insertion which are: the ability to cover any residual disease with intracavitary brachytherapy, and the accessibility of cervix external os. Each patient had 3 HDR express insertions (8Gy x3). A total of 72 consecutive express implant insertions were performed. Each insertion is evaluated for the success of procedure, number of attempts, and time taken. Patients started on laxative 3 days prior to the procedure, and paracetamol & Ibuprofen taken at home 2 hours before the procedure. On arrival, patients used the bathroom, and IM/SC morphine given. Patients were prepared at the front edge of the simulation table and topical lidocaine applied to the cervix. The external os identified with the index finger of one hand which also guided the tandem insertion using the other hand. No cervical dilatation was used. CT simulation was performed to confirm adequate implant placement and to contour and plan CTV-HR and OARs as per GEC-ESTRO/ABS guidelines. RESULTS The success rate was 100% in all the 72 express insertions. >90% (66 insertions) were smooth and fast, i.e., completed in 1 attempt that took <20 minutes. <10% (6 insertions) were challenging but successful, in 2 patients: one patient had an acute anteverted uterus for which suprapubic abdominal pressure facilitated the procedure that took <3 attempts and completed in <40 minutes, the other patient had an acute retroverted uterus which was associated with the most challenging procedure that took >3 attempts and completed in >40 minutes. The success rate was not affected by the type of applicator used. 85% of our applications used multichannel tandem and cylinder, 10% used tandem and ovoids, and 5% used tandem and ring applicators. CONCLUSION Express finger-guided intracavitary brachytherapy implant insertion at the simulation table without speculum, cervical dilatation, sleeve, anesthesia, or sedation is fast, effective, and an independent method that can be used in most cervical cancer patients to complete their planned brachytherapy treatment regardless of limited resources. Practice and dissemination of this innovative method is important especially when operative rooms and anesthesia support are limited (e.g., epidemics and closures) and in centers lacking such support. Further studies are warranted to optimize the procedure and to highlight its significant medical and socioeconomic benefits.
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Affiliation(s)
- N Al-Dhaibani
- King Abdullah Medical City Radiation Oncology Department, Makkah, Saudi Arabia
| | - H Omar
- King Abdullah Medical City Radiation Oncology Department, Makkah, Saudi Arabia
| | - A Habshi
- King Abdullah Medical City Radiation Oncology Department, Makkah, Saudi Arabia
| | - A El Meadawi
- King Abdullah Medical City Radiation Oncology Department, Makkah, Saudi Arabia
| | - M Alidrisi
- King Abdullah Medical City Radiation Oncology Department, Makkah, Saudi Arabia
| | - G Ali
- King Abdullah Medical City Radiation Oncology Department, Makkah, Saudi Arabia
| | - S Mohamed
- King Abdullah Medical City Radiation Oncology Department, Makkah, Saudi Arabia
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Mostafa MR, Eid MM, Abuelazm M, Al-Abdouh A, Najim M, Hassan AR, El-Sakka AA, Renjithal SLM, Malik MA, Mohamed S, Balmer-Swain M, Paul TK, Goldsweig AM. Meta-Analysis of the Outcomes of Peri-Device Leak After Left Atrial Appendage Closure. Am J Cardiol 2023; 204:325-332. [PMID: 37572568 DOI: 10.1016/j.amjcard.2023.07.102] [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: 02/21/2023] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 08/14/2023]
Abstract
Left atrial appendage closure (LAAC) reduces the risk of thromboembolic stroke in atrial fibrillation. Peri-device leak (PDL) after LAAC may affect the subsequent risk of thromboembolism. We conducted a systematic review and meta-analysis to evaluate the effect of PDL after LAAC. We searched PubMed/Medline, Embase, and Google Scholar for studies reporting outcomes of PDL after LAAC from inception through October 2022. The primary outcome was the composite of stroke, transient ischemic attack (TIA), or systemic embolism (SE). Secondary outcomes included all-cause and cardiovascular mortality, ischemic stroke, TIA, and device-related thrombus. Outcomes were pooled using random-effects models. We used I2 statistics to assess statistical heterogeneity; I2 >50% considered significant heterogeneity. This study included 54,279 patients from 11 studies (6 observational, 2 nonrandomized controlled trials [non-RCTs] primary results, 2 RCT post hoc analyses, and 1 analysis combining 2 RCTs data). PDL was associated with a significant increase in the composite outcome of stroke, TIA, or SE (odds ratio 1.63, 95% confidence interval 1.06 to 2.52, p = 0.03, I2 = 43%) as compared with cases with no PDL. There were no significant differences in all-cause or cardiovascular mortality, ischemic stroke, TIA, or device-related thrombus. In conclusion, PDL after LAAC is associated with an increased risk of thromboembolism (composite stroke, TIA, or SE) without impacting mortality.
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Affiliation(s)
- Mostafa Reda Mostafa
- Department of Medicine, Rochester Regional Health, Unity Hospital, Rochester, New York
| | - Mohamed Magdi Eid
- Department of Medicine, Rochester Regional Health, Unity Hospital, Rochester, New York
| | - Mohamed Abuelazm
- Department of Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ahmad Al-Abdouh
- Department of Medicine, University of Kentucky, Lexington, Kentucky
| | - Mostafa Najim
- Department of Medicine, Rochester Regional Health, Unity Hospital, Rochester, New York
| | - Abdul Rhman Hassan
- Department of Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Amro A El-Sakka
- Department of Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | | | - Muhammad Ahmed Malik
- Department of Medicine, Rochester Regional Health, Unity Hospital, Rochester, New York
| | - Sarah Mohamed
- Department of Medicine, Cairo University School of Medicine, Cairo, Egypt
| | - Mallory Balmer-Swain
- Department Cardiology, Rochester Regional Health, Unity Hospital, Rochester, New York
| | - Timir K Paul
- Department of Cardiovascular Medicine, University of Tennessee at Nashville, Ascension St. Thomas Hospital, Nashville, Tennessee
| | - Andrew M Goldsweig
- Department of Cardiovascular Medicine, Baystate Medical Center and University of Massachusetts-Baystate, Springfield, Massachusetts.
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Mohamed S, Reda Mostafa M, Magdi Eid M, AbdelQadir YH, Abdelghafar YA, Swed S, Jahshan B, El‐Radi WA. A case report of severe hyponatremia secondary to Paxlovid-induced SIADH. Clin Case Rep 2023; 11:e7860. [PMID: 37655131 PMCID: PMC10465720 DOI: 10.1002/ccr3.7860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 06/05/2023] [Accepted: 08/14/2023] [Indexed: 09/02/2023] Open
Abstract
Nirmatrelvir-ritonavir (Paxlovid) is a brand-new oral antiviral medication for treating mild to severe COVID-19. The Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for ritonavir-nirmatrelvir on December 22, 2021, to treat COVID-19. We describe a case of mild COVID-19 infection who developed severe hyponatremia following the administration of Paxlovid. Clinical and laboratory evaluations suggest SIADH, likely secondary to Paxlovid. The potential side effects of this medication still require further study.
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Affiliation(s)
| | | | - Mohamed Magdi Eid
- Department of MedicineRochester Regional/Unity HospitalRochesterNew YorkUSA
| | | | | | - Sarya Swed
- Faculty of MedicineAleppo UniversityAleppoSyria
| | - Bishara Jahshan
- Department of MedicineRochester Regional/Unity HospitalRochesterNew YorkUSA
| | - Waddah Abd El‐Radi
- Department of MedicineRochester Regional/Unity HospitalRochesterNew YorkUSA
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Mohamed AA, Alharbi M, Mohamed S. Pneumoperitoneum as a Complication of Mechanical Ventilation: A Case Report. Cureus 2023; 15:e41379. [PMID: 37546041 PMCID: PMC10400810 DOI: 10.7759/cureus.41379] [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] [Accepted: 07/04/2023] [Indexed: 08/08/2023] Open
Abstract
Pneumoperitoneum is defined as the presence of free air in the abdominal cavity. The most common cause of pneumoperitoneum is intestinal perforation, which usually requires surgical intervention. Nonsurgical pneumoperitoneum (NPS) is defined as the presence of free air in the abdominal cavity without visceral perforation by an intrathoracic route, which commonly occurs in patients on mechanical ventilation in intensive care units. NSP, when properly diagnosed, can be successfully treated conservatively without surgery, and intensivists and surgeons should be aware of this entity associated with mechanical ventilation to avoid unnecessary surgical intervention.
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Affiliation(s)
- Abbas A Mohamed
- General and Laparoscopic Surgery, King Salman Specialist Hospital, Hail, SAU
| | - Mohammed Alharbi
- Medical College, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Sarah Mohamed
- General Surgery, University Hospital of Wales, Cardiff, GBR
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Bertolaccini L, Mohamed S, Galetta D, Petrella F, Casiraghi M, Diotti C, Mazzella A, Iacono GL, Girelli L, Sedda G, de Marinis F, Spaggiari L. 92P Predictors, surrogate and patient-reported outcomes in neoadjuvant immunotherapy for lung cancer: A single-center retrospective study. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00347-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
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Renjihtlal SLM, Eid MM, Vyas C, Mohamed S, Shanmukhappa S, Renjith K, Mostafa MR, Baibhav B, Pillai N. Demographics and Trends of Hypertrophic Cardiomyopathy-Related Mortality in the US, 1999-2020. Curr Probl Cardiol 2023; 48:101681. [PMID: 36906160 DOI: 10.1016/j.cpcardiol.2023.101681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 03/02/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND There is limited data on the mortality trends of HCM in the US. OBJECTIVE To study the demographics and trends of mortality in patients with HCM. METHODS A retrospective cohort analysis was done with mortality data of patients with HCM listed as an underlying cause of death in the US Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database (CDC-WONDER) from January 1999 to December 2020. The analysis took place in February 2022. First, we measured HCM-related Age-Adjusted Mortality Rate (AAMR) per 100,000 US population stratified by sex, race, ethnicity, and geographic area. We then calculated the Annual Percentage Change (APC) for AAMR for each. RESULTS A total of 24,655 HCM-related deaths occurred between 1999 and 2020. The AAMR for HCM-related deaths declined from 0.5/100,000 patients in 1999 to 0.2 in 2020. The APC changes are as follows: -6.8 (95% CI: -11.8 to -1.5) from 2002-2009, -1.23 (95%CI -13.8 to 13.2) from 2009-2014, -6.71 (95%CI -46.2 to 61.7) from 2014-2017 and remained at 2.07 (95%CI -26.1 to 41.1) from 2017-2020. Men had consistently higher AAMR than women. Overall, AAMR in men was 0.4 (95% CI: 0.4-0.5), and in women was 0.3 (95% CI: 0.3-0.3). A similar trend was noticed in men and women over the years, starting from 1999 (AAMR men: 0.7 and women: 0.4) to 2020 (AAMR men: 0.3 and women: 0.2). AAMRs were highest among black or African American patients 0.6 (95% CI: 0.5-0.6), followed by Non-Hispanic and Hispanic white 0.3 (95% CI 0.3-0.3) and Asian or Pacific Islander 0.2 (95% CI 0.2-0.2). There was substantial variation in each region in the US. States such as California, Ohio, Michigan, Oregon, and Wyoming had the highest AAMR. Large metropolitan cities had higher AAMR than non-metropolitan cities. CONCLUSION During the study period from 1999 to 2020, HCM-related mortality steadily decreased. The highest AAMR was observed among men, black patients, and residents of metropolitan areas. States such as California, Ohio, Michigan, Oregon, and Wyoming had the highest AAMR.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Nisha Pillai
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
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11
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Ali F, Ali S, Mohamed S, Khan I, Khan I, Khan S, Khan F, Alfeel AH, Higazi H. Analysis of mitochondrial DNA mutations in Pakistani population diagnosed with cardiovascular diseases. BRAZ J BIOL 2023; 84:e266924. [PMID: 36856233 DOI: 10.1590/1519-6984.266924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/29/2022] [Indexed: 03/02/2023] Open
Abstract
Heart and blood vessel disorders, such as coronary heart disease, brain vessel disease, rheumatic heart disease, and others, are together referred to as cardiovascular disease (CVD). In this study, we sought to determine how mitochondrial Leucine Transfer RNA genes and CVDs are related (MT-L1 and MT-L2). From CVD patients in Peshawar, a total of 27 saliva samples were taken. Leu-tRNA genes expressed by mitochondria were amplified using polymerase chain reaction after DNA was removed. Ten samples were sent for sequencing after PCR and gene cleaning. We obtained all of the sequenced results, which were subsequently aligned and evaluated against the mitochondrial revised Cambridge Reference Sequence (rCRS). However, in our sequenced samples, Leu-tRNA MT-L1 and MT-L2 genes were determined to be unaltered. Thus, it is suggested that a large population be taken into account while screening for mutations in the mitochondrial encoded Leu-tRNA MT-L1 and MT-L2 genes of cardiac patients in areas of Pakistan. Additionally, it is recommended that patients with cardiac problems should also have other mitochondrial encoded genes checked for potential mutations. This could result in the identification of genetic markers that could be used for early CVD screening in Pakistan.
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Affiliation(s)
- F Ali
- Dalian Medical University, Department of Cell Biology, Dalian, Liaoning, China
| | - S Ali
- Gulf Medical University, College of Health Sciences, Department of Medical Laboratory Sciences, Ajman, United Arab Emirates
| | - S Mohamed
- Gulf Medical University, College of Health Sciences, Department of Medical Laboratory Sciences, Ajman, United Arab Emirates
| | - I Khan
- Lanzhou University, School of Life Sciences, Department of Microbiology, Lanzhou, Gansu, China
| | - I Khan
- Khyber Medical University, Department of Microbiology, Peshawar, Pakistan
| | - S Khan
- Center for Reproductive Medicine, Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - F Khan
- Pir Mehr Ali Shah Arid Agriculture University, Department of Zoology, Rawalpindi, Pakistan
| | - A H Alfeel
- Gulf Medical University, College of Health Sciences, Department of Medical Laboratory Sciences, Ajman, United Arab Emirates
| | - H Higazi
- Gulf Medical University, College of Health Sciences, Department of Medical Laboratory Sciences, Ajman, United Arab Emirates
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Eid MM, Rivera LC, Mohamed S, Salar T, Mostafa MR, Najim M, Malik MA, Renjithal SLM. ORGANIZING PNEUMONIA: AN UNUSUAL SEQUELA OF COVID-19 INFECTION. Eur J Case Rep Intern Med 2023; 10:003787. [PMID: 36970163 PMCID: PMC10035623 DOI: 10.12890/2023_003787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 01/31/2023] [Indexed: 02/18/2023] Open
Abstract
Organizing pneumonia (OP) is a form of interstitial lung disease that develops in response to acute lung injury. SARS-CoV-2 causes a wide range of lung and extrapulmonary disease, but there are few data suggesting an association between COVID-19 and OP. We describe a patient with COVID-19 pneumonia who developed severe progressive OP with significant morbidity.
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Affiliation(s)
| | | | | | - Tooba Salar
- Rochester Regional Health/Unity Hospital, Rochester, New York, USA
| | | | - Mostafa Najim
- Rochester Regional Health/Unity Hospital, Rochester, New York, USA
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Hoo YY, Mazlan-Kepli W, Habizal NH, Ismail MI, Wong YP, Rosnan NH, Mohamed S, Abd Ghani AR, Mohd Yusof H, Abdullah Ramaiah AR, Selvaraj K, Abd Malek AM, Abdul Ghapar AK. Antithrombotics prescription pattern and clinical outcomes in atrial fibrillation patients with type 2 diabetes mellitus. Eur Heart J 2023; 44. [DOI: 10.1093/eurheartj/ehac779.118] [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: 09/01/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Atrial fibrillation (AF) and Diabetes mellitus (DM) often coexist. As DM is considered while calculating the thromboembolic risk for AF patients, little is known about the prescription pattern of antithrombotic therapies in patients with AF and DM and their clinical outcomes.
Purpose
In this subsidiary study, we examined the prescription patterns of antithrombotic therapies and clinical outcomes of AF patients with type 2 DM.
Methods
We analyzed data from a single-center cohort of patients with a primary diagnosis of AF in a tertiary cardiac referral hospital in Malaysia from 1st January 2018 to 31st December 2020. Patients' clinical data and information related to antithrombotic therapy were traced through electronic Hospital Information system. A data collection form was used for data collection. The primary endpoint of the study was a composite cardiovascular (CV) event which consists of all-cause mortality, acute coronary syndrome (ACS), ischemic stroke and transient ischemic attack (TIA). The safety endpoint of the study was a bleeding event, defined as hemoglobin drop more than 2 g/dl, blood transfusion and bleeding at critical area.
Results
Of the 1006 AF patients (59.2% male; mean age 64.2 (12.1) years), 400 (39.8%) had a history of DM. Of these, 45.8% (n=183) were using warfarin; 46.5% (n=159) used direct oral anticoagulant (DOAC), 54.0% (n=216) used a single antiplatelet, 11.5% (n=46) used a double antiplatelet, 8.0% (n=32) used triple therapy which consists of two antiplatelet agents with one anticoagulant. The use of single antiplatelet agent (54.0% vs 46.4%, p=0.018) and double antiplatelet agents (11.5% vs 7.1%, p=0.016) was significantly associated with AF with DM patients, whereas there was no association between anticoagulant use and AF patients with or without DM (85.5% vs 82.5%, p=0.209). There was no association in composite CV events between AF patients with or without DM (12.0% vs 10.4%, p=0.427). The proportion of subjects who reported having bleeding events were also did not differ by the presence of AF patients with or without DM. (4.5% vs 2.8%, p=0.151).
Conclusion
Diabetes was associated with increased use of antiplatelet agents; however, DM was not associated with increased risk of composite CV events and bleeding events in patients with concurrent AF. The lack of an association between diabetes and CV risk contrasts with previous research, which could be due to improved diabetes treatment in this cohort of patients with relatively low fasting sugar readings. Further study on the degree of blood glucose as measured by glycosylated hemoglobin (HbA1c) is needed to confirm the finding.
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Affiliation(s)
- Y Y Hoo
- Hospital Serdang , Kajang , Malaysia
| | - W Mazlan-Kepli
- University of Malaya , Wilayah Persekutuan Kuala Lumpur , Malaysia
| | | | | | - Y P Wong
- Hospital Serdang , Kajang , Malaysia
| | | | - S Mohamed
- Hospital Serdang , Kajang , Malaysia
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Mazlan-Kepli W, Mohamed S, Nik-Ismail N, Nagarajah J. Anticoagulation control in Malaysia: Reports of time in therapeutic range, bleeding, and thromboembolic complications. Int J Cardiol 2022. [DOI: 10.1016/j.ijcard.2022.10.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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15
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Mohamed S, Mazlan-Kepli W, Nik-Ismail N, Nagarajah J. Evaluation of anticoagulation control in elderly patients. Int J Cardiol 2022. [DOI: 10.1016/j.ijcard.2022.10.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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16
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Mohamed AA, Alharbi M, Alrashidi I, Mohamed S. Cecal Volvulus a Rare Cause of Intestinal Obstruction. A Case Report. Cureus 2022; 14:e30560. [DOI: 10.7759/cureus.30560] [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] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
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17
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Magdi M, Mostafa MR, Abusnina W, Al-abdouh A, Doss R, Mohamed S, Ekpo CP, Alweis R, Baibhav B. A systematic review and meta-analysis of the prevalence of transthyretin amyloidosis in heart failure with preserved ejection fraction. Am J Cardiovasc Dis 2022; 12:102-111. [PMID: 35873185 PMCID: PMC9301026] [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] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/02/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Heart failure with preserved ejection fraction is a complex clinical syndrome marked by different phenotypes and related comorbidities. Transthyretin amyloidosis is an underestimated phenotype. We aim to evaluate the prevalence of transthyretin amyloidosis in heart failure with preserved ejection fraction. METHODS This meta-analysis was conducted according to PRISMA guidelines. A search strategy was designed to utilize PubMed/Medline, EMBASE, and Google scholar to locate studies whose primary objective was to analyze the prevalence of transthyretin amyloidosis in heart failure preserved ejection fraction. RESULTS Of 271 studies initially identified, 5 studies comprising 670 patients were included in the final analysis. The prevalence of transthyretin amyloidosis was 11%. Patients with transthyretin amyloid cardiomyopathy were more likely to be males (RR 1.38; 95% CI 1.09 to 1.75; P<0.01; I2=37%), and more likely to have low voltage criteria on ECG (RR 2.98; 95% CI 1.03 to 8.58; P=0.04; I2=75%) compared with transthyretin negative group. They also have higher SMD of age (SMD 0.73; 95% CI 0.48 to 0.97; P<0.01; I2=0%), and NT-proBNP (SMD 0.48; 95% CI 0.02 to 0.93; P=0.04; I2=36%) compared with transthyretin negative group. On reported echocardiogram, they have higher SMD of mass index (SMD 0.77; 95% CI 0.27 to 1.27; P<0.01; I2=65%), posterior wall thickness (SMD 0.92; 95% CI 0.62 to 1.21; P<0.01; I2=0%), and septal wall thickness (SMD 1.49; 95% CI 0.65 to 2.32; P<0.01; I2=87%) compared with transthyretin negative group. CONCLUSION Transthyretin amyloidosis affects 11% of HFpEF patients. Therefore, screening HFpEF patients at risk of cardiac amyloidosis is warranted.
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Affiliation(s)
- Mohamed Magdi
- Department of Internal Medicine, Rochester Regional HealthNY, USA
| | | | - Waiel Abusnina
- Department of Cardiology, Creighton University School of MedicineNE, USA
| | | | - Ramy Doss
- Department of Internal Medicine, Baylor University Medical CenterDallas, Texas
| | - Sarah Mohamed
- Department of Ophthalmology, Cairo UniversityCairo, Egypt
| | | | - Richard Alweis
- Department of Internal Medicine, Rochester Regional HealthNY, USA
| | - Bipul Baibhav
- Department of Cardiology, Rochester General HospitalNY, USA
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Mohamed S, Lilja-Fischer J, Hjørringgaard Madsen M, Eriksen J. PO-1120 The potential value of MRI in response evaluation after primary (C-)RT for head and neck cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03084-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Mohamed S, Patel AJ, Mazhar K, Osman A, Balacumaraswami L, Ridley P. Native pulmonary valve endocarditis requiring pulmonary valve replacement in adulthood: a case series. J Surg Case Rep 2022; 2022:rjac137. [PMID: 35444791 PMCID: PMC9015772 DOI: 10.1093/jscr/rjac137] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Native pulmonary valve endocarditis is a rare phenomenon as native valve endocarditis tends to typically affect the left sided heart valves. However, the right-sided heart valves can be affected in patients with a history of intravenous drug use, whereby the tricuspid valve is most commonly affected. We present two cases who were diagnosed with native pulmonary valve endocarditis in the absence of congenital heart disease. In the first case, the native pulmonary valve endocarditis was probably a derivative of compounding factors of an enlarged underlying pulmonary artery and staphylococcal bacteraemia. In the second case, a common causal organism of native valve endocarditis following dental treatment and the resultant echocardiography findings was of significant interest. In summary, native pulmonary valve endocarditis is relatively rare complication in the adult population, especially in the absence of congenital heart disease.
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Affiliation(s)
- S Mohamed
- Department of Cardiothoracic Surgery, Royal Stoke University Hospital, Stoke on Trent, UK
| | - A J Patel
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK
| | - K Mazhar
- Department of Cardiothoracic Surgery, Royal Stoke University Hospital, Stoke on Trent, UK
| | - A Osman
- Department of Cardiothoracic Surgery, Royal Stoke University Hospital, Stoke on Trent, UK
| | - L Balacumaraswami
- Department of Cardiothoracic Surgery, Royal Stoke University Hospital, Stoke on Trent, UK
| | - P Ridley
- Department of Cardiothoracic Surgery, Royal Stoke University Hospital, Stoke on Trent, UK
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Mohamed S, Attia A, Mahmoud T, Salama A. Assessment of the Protective Effect of the Humoral Immune Response against Major Moraxella catarrhalis Surface Antigens on Otitis Media Manifestation in Egyptian Children. Int J Infect Dis 2022. [DOI: 10.1016/j.ijid.2021.12.216] [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: 10/19/2022] Open
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21
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Dagra A, Barpujari A, Bauer SZ, Olowofela BO, Mohamed S, McGrath K, Robinson C, Robicsek S, Snyder A, Lucke-Wold B. Epigenetics of Neurotrauma. Neurology (Chic) 2022; 2:42-47. [PMID: 36507115 PMCID: PMC9732507] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Epigenetic changes have been linked to a host of disease states. Besides the physiological function of epigenetic changes in regulating cellular function, recent data indicates that key changes in epigenetic activity also play an important pathophysiologic role following neurotrauma specifically. Such manifestations occur through the activation or silencing of different genes. Histone methylation has emerged as a critical component of this process and can be selectively modulated after injury. Pre-clinical studies have resulted in key discoveries regarding specific methylation sites of interest. This focused review highlights some of these early findings and their relationship to clinical outcomes. These findings suggest areas of future investigation and discovery in the quest to develop ideal biomarkers and methods to utilize them in developing therapeutic interventions.
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Affiliation(s)
- A Dagra
- College of Medicine, University of Florida, USA
| | - A Barpujari
- College of Liberal Arts and Sciences, University of Florida, USA
| | - SZ Bauer
- College of Medicine, University of Nevada, USA
| | | | - S Mohamed
- College of Medicine, University of Florida, USA
| | - K McGrath
- College of Medicine, University of Florida, USA
| | - C Robinson
- Departments of Neurology and Neuroscience, McKnight Brain Institute, University of Florida, USA
- Department of Neuroscience, Center for Translational Research in Neurodegenerative Disease, and Brain Injury Rehabilitation and Neuroresilience Center, University of Florida, USA
| | - S Robicsek
- Department of Anesthesiology, University of Florida, USA
| | - A Snyder
- Department of Neuropsychology, University of Florida, USA
| | - B Lucke-Wold
- Department of Neurosurgery, University of Florida, USA
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Mohamed S, Doweidar H, Kamal H, Moustafa Y, Abdelghany M. Effect of Ag-doping on the thermal features of hydroxyapatite. Egypt J Chem 2021. [DOI: 10.21608/ejchem.2021.99125.4612] [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: 10/19/2022]
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23
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Magdi M, Renjithal SLM, Mubasher M, Mostafa MR, lathwal Y, Mukuntharaj P, Mohamed S, Alweis R, Tan BEX, Baibhav B. The WATCHMAN device and post-implantation anticoagulation management. A review of key studies and the risk of device-related thrombosis. Am J Cardiovasc Dis 2021; 11:714-722. [PMID: 35116184 PMCID: PMC8784674] [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] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/06/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Ischemic stroke is a devastating complication of atrial fibrillation (Afib). Anticoagulation is the gold standard to prevent stroke and systemic embolization. However, many patients have a contraindication to oral anticoagulation. The WATCHMAN device, which closes the left atrial appendage, is non-inferior to warfarin to prevent embolic events in clinical trials. Post-procedural anticoagulation is needed to avoid device-related thrombosis. The use of anticoagulants after WATCHMAN implantation in patients with high bleeding risks has been a source of debate. OBJECTIVE This article summarizes the current evidence on anticoagulation following the implantation of the WATCHMAN device, focusing on patients who have an absolute contraindication to oral anticoagulation. OBSERVATION The WATCHMAN device is efficacious and safe in preventing stroke and systemic embolization. Warfarin and aspirin are given for 45 days after implantation. If TEE at 45 days shows minimal residual peri-device flow (≤ 5mm) and no device-related thrombus, warfarin is stopped. This is followed by aspirin and clopidogrel for six months, then aspirin indefinitely. Antithrombotic therapy with aspirin and clopidogrel for six months followed by daily aspirin indefinitely may be feasible for patients with an absolute contraindication to OAC. DOACs are more convenient to use than warfarin, and limited evidence suggests that they are not inferior following implantation of the device. CONCLUSION Following the WATCHMAN implantation, the most often utilized regimen is warfarin followed by antiplatelet treatment. In cases where there is a high risk of bleeding, antiplatelets alone may be sufficient. More research is needed to tailor the existing antithrombotic regimen to the needs of patients.
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Affiliation(s)
- Mohamed Magdi
- Department of Internal Medicine, Unity Hospital of Rochester, Rochester Regional HealthRochester, New York 14618, USA
| | | | - Mahmood Mubasher
- Department of Internal Medicine, Unity Hospital of Rochester, Rochester Regional HealthRochester, New York 14618, USA
| | - Mostafa Reda Mostafa
- Department of Internal Medicine, Unity Hospital of Rochester, Rochester Regional HealthRochester, New York 14618, USA
| | - Yashdeep lathwal
- Department of Internal Medicine, Unity Hospital of Rochester, Rochester Regional HealthRochester, New York 14618, USA
| | - Pradeeksha Mukuntharaj
- Department of Internal Medicine, Unity Hospital of Rochester, Rochester Regional HealthRochester, New York 14618, USA
| | - Sarah Mohamed
- Department of Internal Medicine, Unity Hospital of Rochester, Rochester Regional HealthRochester, New York 14618, USA
| | - Richard Alweis
- Department of Internal Medicine, Unity Hospital of Rochester, Rochester Regional HealthRochester, New York 14618, USA
| | - Bryan E-Xin Tan
- Department of Cardiology, Rochester General Hospital, Rochester Regional HealthRochester, New York 14618, USA
| | - Bipul Baibhav
- Department of Cardiology, Rochester General Hospital, Rochester Regional HealthRochester, New York 14618, USA
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Abu El-Leel O, Mohamed S, Sukar N, Abd EL-Aziz M. Influence of Jasmine oil and Methyl Jasmonate on Gene Expression and Menthol Production in Mentha. Scientific Journal of Agricultural Sciences 2021; 0:0-0. [DOI: 10.21608/sjas.2021.79508.1108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Sulieman I, Mohamed S, Elmoghazy W, Alaboudy A, Khalaf H, Elaffandi A. The value of diffusion-weighted imaging in diagnosing gallbladder malignancy: performance of a new parameter. Clin Radiol 2021; 76:709.e7-709.e12. [PMID: 34119303 DOI: 10.1016/j.crad.2021.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 05/12/2021] [Indexed: 02/07/2023]
Abstract
AIM To assess the value of the ratio of signal intensities at high and low b-values (b800/b0 ratio) during diffusion-weighted imaging (DWI) for gallbladder cancer diagnosis. MATERIALS AND METHODS All patients presenting with suspicious gallbladder lesions between January 2011 and December 2016 who underwent DWI and histopathological diagnoses of the lesions were assessed. RESULTS Thirty-two patients (24 men, eight women) were identified. Eighteen patients had benign gallbladder lesions while 14 had malignant lesions. The mean apparent diffusion coefficient (ADC) value was 1.62 (±0.57)×10-3 mm2/s for benign cases and 1.27 (±0.39)×10-3 mm2/s for malignant cases; this difference was not significant (p=0.0773). The mean b800/b0 ratio was 0.31 (±0.19) for benign cases and 0.48 (±0.13) for malignant cases; this difference was significant (p=0.007). The ROC curve for b800/b0 had an AUC of 0.782 (95% confidence interval [CI]: 0.616-0.947) with a sensitivity and specificity of 85.7% and 72.2%, respectively, at a cut-off point of 0.33. CONCLUSION The b800/b0 ratio can help differentiate benign and malignant gallbladder lesions and may be more reliable than ADC values in quantitative DWI assessments.
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Affiliation(s)
- I Sulieman
- Department of Surgery, Division of Organ Transplant, Hamad General Hospital, PO Box 3050, Doha, Qatar.
| | - S Mohamed
- Department of Radiology, Hamad General Hospital, PO Box 3050, Doha, Qatar; Department of Diagnostic Radiology, National Cancer Institute, Cairo University, Egypt
| | - W Elmoghazy
- Department of Surgery, Division of Organ Transplant, Hamad General Hospital, PO Box 3050, Doha, Qatar; Department of Surgery, Sohag University, Sohag, Egypt
| | - A Alaboudy
- Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Sohag University, Sohag 82-524, Egypt
| | - H Khalaf
- Department of Surgery, Division of Organ Transplant, Hamad General Hospital, PO Box 3050, Doha, Qatar; Department of Surgery, College of Medicine, Qatar University, Qatar
| | - A Elaffandi
- Department of Surgery, Division of Organ Transplant, Hamad General Hospital, PO Box 3050, Doha, Qatar; Department of Surgical Oncology, National Cancer Institute, Cairo University, Egypt
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Elhassan ABE, Mohamed S, Ali A, Elbathani M, Abdallah O, Mohamed A, Ibrahim A, Salman M, Elni M, Elhassa M, Elkhidi I, Abuzie A. 388 Detection of Cytomegalovirus Infection in Infants with Biliary Atresia: A Meta-analysis. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.268] [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: 11/13/2022]
Abstract
Abstract
Introduction
Biliary atresia (BA) is the most common indication of liver transplantation in children. Several reports attributed BA to both prenatal and perinatal aetiologies, including a viral infection-induced auto-immune response that targets the bile ducts. Cytomegalovirus (CMV) remains the most common virus being linked to BA. This meta-analysis estimates to what extent CMV infection is detected in patients with BA.
Method
This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases of MEDLINE/PubMed, WHO-Virtual Health Library (VHL), ScienceDirect, and Google Scholar were used for the systematic search. Random effects model was used to estimate the pooled prevalence estimate with the corresponding 95% confidence interval (CI) using StatsDirect statistical software.
Results
A total of 13 studies (covering 419 patients) that fulfilled the eligibility criteria were included in the meta-analysis. The pooled overall prevalence of CMV infection in patients with BA was 24.5% (95% CI 11.9 %– 33.9%).
Conclusions
The available data demonstrate that the detection of CMV infection is common in infants with BA. There is still a need for large studies with appropriate controls to examine various aspects of the association between CMV infection and BA.
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Affiliation(s)
- A B E Elhassan
- University of Khartoum, Khartoum, Sudan
- Oxford University Hospital, Oxford, United Kingdom
| | - S Mohamed
- University of Khartoum, Khartoum, Sudan
| | - A Ali
- University of Khartoum, Khartoum, Sudan
| | | | | | - A Mohamed
- University of Khartoum, Khartoum, Sudan
| | - A Ibrahim
- University of Khartoum, Khartoum, Sudan
| | - M Salman
- University of Khartoum, Khartoum, Sudan
| | - M Elni
- University of Khartoum, Khartoum, Sudan
| | - M Elhassa
- University of Khartoum, Khartoum, Sudan
| | - I Elkhidi
- University of Khartoum, Khartoum, Sudan
| | - A Abuzie
- University of Khartoum, Khartoum, Sudan
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Mohamed S, Mazhar K, Patel AJ, Jeeji R, Ridley P, Balacumaraswami L. Off-pump external pericardial patch repair for post-infarct left ventricular free wall rupture: a case series. J Surg Case Rep 2021; 2021:rjab073. [PMID: 33758654 PMCID: PMC7963454 DOI: 10.1093/jscr/rjab073] [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] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/09/2021] [Indexed: 11/17/2022] Open
Abstract
We describe an off-pump surgical approach to this challenging condition supported by our results from a case series, which would add to existing literature in the management of this life-threatening complication. We identified seven patients who underwent surgical intervention for left ventricular (LV) free wall rupture at our institution. They were all diagnosed to have cardiac tamponade secondary to free wall rupture of the LV in the presence of acute myocardial infarction. The surgical technique comprised of utilizing an external pericardial patch which was secured using surgical biological glues (fibrin-based sealants or gelatin hydrogels). The 30-day mortality, 1-year survival and 2-year survival were 57, 42 and 42%, respectively. Advanced age, female gender and use of cardiopulmonary bypass were characteristics that were not significantly associated with survival. We advocate the use of an off-pump external pericardial patch repair strategy as a ‘bridge to recovery’ in this extremely high-risk group of patients.
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Affiliation(s)
- S Mohamed
- Department of Cardiothoracic Surgery, Royal Stoke University Hospital, Stoke-On-Trent, UK
| | - K Mazhar
- Department of Cardiothoracic Surgery, Royal Stoke University Hospital, Stoke-On-Trent, UK
| | - A J Patel
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - R Jeeji
- Department of Cardiothoracic Surgery, Royal Stoke University Hospital, Stoke-On-Trent, UK
| | - P Ridley
- Department of Cardiothoracic Surgery, Royal Stoke University Hospital, Stoke-On-Trent, UK
| | - L Balacumaraswami
- Department of Cardiothoracic Surgery, Royal Stoke University Hospital, Stoke-On-Trent, UK
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Mohamed S, Mohamed A. Simple measures. Br Dent J 2020; 229:702-703. [DOI: 10.1038/s41415-020-2467-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Aktuerk D, Ali J, Badran A, Balmforth D, Bleetman D, Brown C, Suelo-Calanao R, Cartwright J, Casey L, Chiwera L, Fudulu D, Garner M, Gradinariu G, Harky A, Hussain A, Hutton S, Kew E, Loubani M, Mani K, Martin J, Rochon M, Moawad N, Mohamed S, Muretti M, Murphy G, Olivieri G, Paglinawan I, Quijano-Campos J, Rizzo V, Robertson S, Rogers L, Roman M, Salmon K, Sanders J, Talukder S, Tanner J, Vaja R, Zientara A, Green S, Miles R, Lamagni T, Harrington P. National survey of variations in practice in the prevention of surgical site infections in adult cardiac surgery, United Kingdom and Republic of Ireland. J Hosp Infect 2020; 106:812-819. [DOI: 10.1016/j.jhin.2020.09.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 09/11/2020] [Indexed: 11/25/2022]
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Mohamed S, Osman A, Patel A, Mazhar K, Srinivasan L, Balacumaraswami L. Delayed cardiac tamponade following blunt chest trauma due to disruption of fourth costal cartilage with posterior dislocation. Trauma Case Rep 2020; 29:100340. [PMID: 32793793 PMCID: PMC7415922 DOI: 10.1016/j.tcr.2020.100340] [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] [Accepted: 07/27/2020] [Indexed: 11/20/2022] Open
Abstract
Cardiac tamponade is a recognised sequelae of non-penetrating and penetrating chest trauma. Delayed cardiac tamponade has been described following blunt chest trauma. We present a 29 year-old gentleman who had initially presented to peripheral district general hospital following direct blunt chest wall trauma. His initial trauma CT demonstrated a small mediastinal haematoma and large left haemopneumothorax and disruption/dislocation of the costal cartilage. He initially underwent a thoracoscopic procedure uneventfully. He then had worsening chest radiograph appearances with enlarging cardiac contours. Transthoracic echocardiography confirmed cardiac tamponade. He underwent creation of a pericardial window and excision of the protruding fourth costal cartilage.
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Affiliation(s)
- S Mohamed
- Department of Cardiothoracic Surgery, Royal Stoke University Hospital, Stoke On Trent, United Kingdom
| | - A Osman
- Department of Cardiothoracic Surgery, Royal Stoke University Hospital, Stoke On Trent, United Kingdom
| | - A Patel
- Department of Cardiothoracic Surgery, Royal Stoke University Hospital, Stoke On Trent, United Kingdom.,Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT, United Kingdom
| | - K Mazhar
- Department of Cardiothoracic Surgery, Royal Stoke University Hospital, Stoke On Trent, United Kingdom
| | - L Srinivasan
- Department of Cardiothoracic Surgery, Royal Stoke University Hospital, Stoke On Trent, United Kingdom
| | - L Balacumaraswami
- Department of Cardiothoracic Surgery, Royal Stoke University Hospital, Stoke On Trent, United Kingdom
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Campagne J, Kurt S, Moulinet T, Mohamed S, Deibener-Kaminsky J, Jaussaud R. Une couleur inhabituelle. Rev Med Interne 2020; 42:61-62. [PMID: 32709435 PMCID: PMC7374124 DOI: 10.1016/j.revmed.2020.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 05/21/2020] [Indexed: 11/24/2022]
Affiliation(s)
- J Campagne
- Département de Médecine Interne et Immunologie Clinique, Centre Hospitalo-Universitaire de Nancy, Hôpitaux de Brabois, Rue du Morvan, 54511 Vandœuvre-Lès-, Nancy Cedex., France
| | - S Kurt
- Service d'Hépato-Gastro-Entérologie, Centre Hospitalo-Universitaire de Nancy, Hôpitaux de Brabois, Rue du Morvan, 54511 Vandœuvre-Lès-, Nancy Cedex., France
| | - T Moulinet
- Département de Médecine Interne et Immunologie Clinique, Centre Hospitalo-Universitaire de Nancy, Hôpitaux de Brabois, Rue du Morvan, 54511 Vandœuvre-Lès-, Nancy Cedex., France.
| | - S Mohamed
- Département de Médecine Interne et Immunologie Clinique, Centre Hospitalo-Universitaire de Nancy, Hôpitaux de Brabois, Rue du Morvan, 54511 Vandœuvre-Lès-, Nancy Cedex., France
| | - J Deibener-Kaminsky
- Département de Médecine Interne et Immunologie Clinique, Centre Hospitalo-Universitaire de Nancy, Hôpitaux de Brabois, Rue du Morvan, 54511 Vandœuvre-Lès-, Nancy Cedex., France
| | - R Jaussaud
- Département de Médecine Interne et Immunologie Clinique, Centre Hospitalo-Universitaire de Nancy, Hôpitaux de Brabois, Rue du Morvan, 54511 Vandœuvre-Lès-, Nancy Cedex., France
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Nagy M, Lynch M, Kamal S, Mohamed S, Hadad A, Abouelnaga S, Aquilante CL. Assessment of healthcare professionals' knowledge, attitudes, and perceived challenges of clinical pharmacogenetic testing in Egypt. Per Med 2020; 17:251-260. [PMID: 32589096 DOI: 10.2217/pme-2019-0163] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Aim: We evaluated healthcare practitioners' perspectives regarding clinical pharmacogenetics in Cairo, Egypt. Materials & methods: We administered a paper-based survey to pharmacists and physicians practicing at Children's Cancer Hospital Egypt. The survey assessed practitioners' knowledge, attitudes, and perspectives about pharmacogenetic testing. Results: The study included 184 respondents (67.9% pharmacists; 32.1% physicians. Overall, the pharmacogenetic knowledge was low (mean = 41.7%) but attitudes toward pharmacogenetic testing and its potential clinical application were generally positive. Pharmacists responded more favorably than physicians to statements attributing the responsibility of applying pharmacogenetics in the clinical setting to their profession. However, several challenges were identified; the most common being: lack of pharmacogenetic knowledge and skill, lack of pharmacogenetic testing devices, and limited funding. Conclusion: Future efforts to promote pharmacogenetic implementation should focus on foundational education, practical training, and exploration of potential funding sources.
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Affiliation(s)
- Mohamed Nagy
- Children's Cancer Hospital Egypt, 57357, Cairo, Egypt
| | - Meghan Lynch
- Department of Pharmaceutical Sciences, University of Colorado Skaggs School of Pharmacy & Pharmaceutical Sciences, Aurora, CO 80045, USA
| | - Sherif Kamal
- Children's Cancer Hospital Egypt, 57357, Cairo, Egypt
| | - Sarah Mohamed
- Children's Cancer Hospital Egypt, 57357, Cairo, Egypt
| | - Alaa Hadad
- Children's Cancer Hospital Egypt, 57357, Cairo, Egypt
| | | | - Christina L Aquilante
- Department of Pharmaceutical Sciences, University of Colorado Skaggs School of Pharmacy & Pharmaceutical Sciences, Aurora, CO 80045, USA
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Kerstens F, Mohamed S, Visman I, Turkstra F, Swearingen C, Yazici Y. AB0536 EFFECT OF HYDROXYCHLOROQUINE TREATMENT IN MUCOCUTANEOUS MANIFESTATIONS IN PATIENTS WITH BEHÇET’S SYNDROME. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Behçet syndrome (BS) is a rare multisystemic vasculitis, most commonly seen in regions along the ancient Silk Road. It runs a relapsing and remitting course. Mucocutaneous disease, consisting of oral ulcers, genital ulcers and skin lesions is often reported. EULAR recommendations advise colchicine and topical agents for the treatment of these lesions.1Not all patients respond adequately, thus, it is important to explore alternative treatment options.Objectives:To study the efficacy of hydroxychloroquine (HCQ) 400 mg daily in patients with mucocutaneous BS.Methods:Data on all patients who presented at the outpatient Behçet clinic in New York were recorded. Patients with a first prescription with HCQ and a follow-up of 3 months (range: 2.75-41.2 months) were included. Patient reported outcomes BSAS and RAPID3 were used to evaluate the effect of HCQ. Results of all patients and of International Study Group (ISG) positive patients were analyzed separately using Wilcoxon rank tests.Results:We included 94 patients with a first prescription of HCQ. 72 patients (76.6%) fulfilled ISG criteria. Mean age was 36.1 years (SD 12.5), 76 patients (80.9%) were female and 11 patients (11.7%) were from Silk Road countries.Mean duration until follow-up was 6.5 months (SD 5.7). Median BSAS scores in ISG+ patients at baseline did not differ significantly from ISG- patients, except for skin lesions (5.0 in ISG+ vs. 0.5 in ISG- p=0.005). BSAS scores at follow-up did not differ significantly (ISG+ vs. ISG-).Median BSAS scores were significantly lower at follow-up compared to baseline for oral ulcers (p=0.010), skin lesions (p=0.018) and overall activity (p=0.019). Regarding genital ulcers there was no significant result, due to only 37 patients reporting complaints of genital ulcers. Performing these analyses in ISG+ patients only did not change these results, except for BSAS overall activity, which lost significance (p=0.057).RAPID3 scores were not statistically different between baseline and follow-up (9.67 vs. 8.75, p=0.145), nor were its separate components function (p=0.67 vs. 0.67, 0.713), pain (4.0 vs. 4.0, p=0.157) and patient global (5.0 vs. 4.5, p=0.095).The majority of patients used prednisone at baseline (58.5%) and at follow-up (57.4%). In 15 patients, prednisone was stopped at follow up, in 13 patients it was started.Table 1.Median BSAS scores of patients treated with HCQ.Baseline(median, IQR)Follow-up 3 months(median, IQR)P-valuesAll patients (n=94)Oral ulcers5.0 (2.00-7.88)3.0 (1.00-6.00)0.010Genital ulcers0.0 (0.00-3.88)0.0 (0.00-3.00)0.371Skin lesions5.0 (1.25-7.00)2.5 (0.00-7.00)0.018Overall activity5.5 (4.00-8.00)5.0 (2.00-7.25)0.019ISG+ patients (n=72)Oral ulcers5.25 (2.00-7.63)3.25 (1.00-6.00)0.007Genital ulcers0.5 (0.00-4.00)0.0 (0.00-3.00)0.684Skin lesions5.0 (2.00-7.13)3.0 (0.00-7.00)0.015Overall activity6.0 (4.00-8.00)5.0 (2.00-7.50)0.057Conclusion:HCQ improves median BSAS scores for oral ulcers, skin lesions and overall activity at 3 months follow-up compared to baseline. These results were similar in ISG+ patients (except for overall activity). Additional research is needed to assess the effect of HCQ in more patients and over multiple time points.References:[1]Hatemi G et al. 2018 update of the EULAR recommendations for the management of Behçet’s syndrome. Ann Rheum Dis 2019;77:808-818Disclosure of Interests:Floor Kerstens: None declared, Shreen Mohamed: None declared, Ingrid Visman: None declared, Franktien Turkstra: None declared, Christopher Swearingen: None declared, Yusuf Yazici Consultant of: BMS, Celgene Corporation, Genentech, Sanofi – consultant, Consultant of: BMS, Celgene Corporation, Genentech, Sanofi – consultant
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Mohamed S, Kunz M, Casey S, Katsiyiannis W, Abdelhadi R, Storey K, Berg A, Schmidt C, Sengupta J. P1077Late gadolinium enhancement with cardiac magnetic resonance imaging demonstrates left ventricular involvement is under-recognized in arrhythmogenic right ventricular cardiomyopathy. Europace 2020. [DOI: 10.1093/europace/euaa162.138] [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] Open
Abstract
Abstract
Funding Acknowledgements
The study is partially funded by Medtronic and the Minneapolis Heart Institute Foundation.
Background/Introduction: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is characterized by replacement of the myocardium with fibrous and fatty tissue that may lead to an increased risk of ventricular arrhythmias and heart failure. Although left ventricular (LV) and biventricular forms have been identified post-mortem resulting in the increased use of the term arrhythmogenic cardiomyopathy, there is only inclusion of right ventricular wall motion abnormalities in the taskforce diagnostic criteria.
Purpose
The aim of our study was to examine the utility of cardiac magnetic resonance (CMR) imaging in characterizing LV or biventricular involvement with late gadolinium enhancement (LGE) in a large cohort of patients with suspected ARVC.
Methods
Retrospective, single-institution, chart review of 76 patients diagnosed with ARVC between January 2009 and July 2019. Data collection and analysis included baseline demographics and parameters specific to diagnosis (definite, borderline, or possible) and risk stratification of ARVC based on 2019 modified taskforce criteria, as well as detailed CMR evaluation.
Results
Of the 76 patients with ARVC, 66 (87%) had at least one CMR with gadolinium administered. In that subset of patients, 27 (41%) had LGE. Of those with LGE, LV involvement was identified in 23 (85%) patients. The pattern of LGE was not localized to one myocardial region but demonstrated variable LV enhancement patterns including anterior, inferior, lateral, septal, basal, mid, apical, and from the sub-epicardium into the mid-myocardium.
Conclusions
Left ventricular involvement reflected by LGE was identified in a high percentage of patients with suspected ARVC, and there was significant variation in the pattern of distribution in terms of region and depth of myocardial involvement. While post-mortem examination of patients with ARVC demonstrates a high prevalence of left ventricular involvement, this study shows that CMR can consistently detect late gadolinium enhancement, and ARVC should be considered in the differential diagnosis for biventricular cardiomyopathy. The identification of variable locations of LGE within the LV suggests there is more than one phenotype, and this imaging modality may help to clarify the implications of left ventricular involvement in disease progression.
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Affiliation(s)
- S Mohamed
- Minneapolis Heart Institute Foundation, Minneapolis, United States of America
| | - M Kunz
- Minneapolis Heart Institute Foundation, Minneapolis, United States of America
| | - S Casey
- Minneapolis Heart Institute Foundation, Minneapolis, United States of America
| | - W Katsiyiannis
- Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, United States of America
| | - R Abdelhadi
- Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, United States of America
| | - K Storey
- Minneapolis Heart Institute Foundation, Minneapolis, United States of America
| | - A Berg
- Children"s Minnesota, Minneapolis, United States of America
| | - C Schmidt
- Minneapolis Heart Institute Foundation, Minneapolis, United States of America
| | - J Sengupta
- Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, United States of America
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Kari J, Alhasan K, Albanna A, Mohamed S, Böckenhauer D, El-Desoky S. SAT-406 Rituximab versus Cyclophosphamide as First Sparing Agent in Childhood Frequently relapsing and Steroid Dependent Nephrotic Syndrome. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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El-Sabagh HA, Mohamed S, Amin AM. Efficiency of Radiolabeled Silver Nanoflowers as Theranostic Agent. Radiochemistry 2020. [DOI: 10.1134/s1066362220020101] [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: 11/23/2022]
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Al Shehadat M, Khalifa E, Mohamed S, Ghareep A, Gomaa M, Alkuwari M, Helmy S. P836 Long-term survival of a rare case of pseudoaneurysm of the mitral-aortic intervalvular fibrosa as a complication of endocarditis of a bicuspid aortic valve. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
This is a case report of a rare condition of pseudoaneurysm of the mitral-aortic intervalvular fibrosa (P-MAIVF).
Case presentation
The patient was a 42-year-old Filipino gentleman. He first presented to us in 2014, for routine echocardiographic examination as a part of a preoperative assessment for a non-cardiac surgery. Patient was asymptomatic and had a history of bicuspid aortic valve, which was complicated by endocarditis in 2006, and was treated with antibiotics.
Echocardiography findings: Transthoracic echocardiography (TTE) showed a bicuspid aortic valve of no hemodynamic significance . A P-MAIVF was noted by Transesophageal echocardiography as a cavity expanding posteriorly into the left atrium from the left ventricular outflow tract, with a narrow neck at the junction of the aortic posterior cusp and the anterior mitral leaflet (Figure A). The cavity showed the characteristic expansion during ventricular systole, and collapse in diastole. Color flow showed the flow through the neck in systole and emptying during diastole (Figures C,D). There was mild mitral incompetence and no fistula was detected. Diagnosis was confirmed by cardiac magnetic resonance (Figure B).
Follow up
Because of the known complications of this condition, some of which are potentially fatal (such as rupture into the pericardium and tamponade), he was offered a surgical repair, which he had refused. Alternative conservative follow-up strategy was implemented and we had the opportunity to follow him for more than 5 years. During these years he was asymptomatic and uncomplicated. There was no change in the size of the pseudoaneurysm or its flow pattern.
Conclusion
This report demonstrates a rare case of P-MAIF as a complication of bicuspid aortic valve endocarditis and a long-term patient survival of a potentially fatal condition without corrective surgery.
Abstract P836 Figures A,B,C,D
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Affiliation(s)
- M Al Shehadat
- Hamad Medical Corporation Heart Hospital, Doha, Qatar
| | - E Khalifa
- Hamad Medical Corporation Heart Hospital, Doha, Qatar
| | - S Mohamed
- Hamad Medical Corporation Heart Hospital, Doha, Qatar
| | - A Ghareep
- Hamad Medical Corporation Heart Hospital, Doha, Qatar
| | - M Gomaa
- Hamad Medical Corporation Heart Hospital, Doha, Qatar
| | - M Alkuwari
- Hamad Medical Corporation Heart Hospital, Doha, Qatar
| | - S Helmy
- Hamad Medical Corporation Heart Hospital, Doha, Qatar
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Ocheke IE, Mohamed S, Okpe ES, Bode-Thomas F, McCullouch MI. Microalbuminuria risks and glomerular filtration in children with sickle cell anaemia in Nigeria. Ital J Pediatr 2019; 45:143. [PMID: 31718702 PMCID: PMC6852760 DOI: 10.1186/s13052-019-0720-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 09/21/2019] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Evidence of kidney damage is observed in children with sickle cell anaemia (SCA) and this continues through adulthood with progression to severe functional impairment in some. One of the earliest features of kidney damage associated with SCA is microalbuminuria. Our objective was to determine the risk factors of microalbuminuria in these children and its relationship with estimated glomerular filtration rate. METHODS This was a cross-sectional and comparative study involving three hundred and twenty three children with SCA in steady state and equal numbers of apparently healthy age and sex matched haemoglobin AA (HbAA) control, aged 6 months to 18 years. They were consecutively recruited over a 6 month period. RESULT Microalbuminuria was present in 26% of the study subjects compared with 1.85% of control P = 0.001). Anaemia and high estimated glomerular filtration rate (eGFR) showed strong positive correlation with microalbuminuria (OR = 3.19, CI 0.953-1.116, p = 0.003 and OR = 1.7, CI 1.042-1.066, p = 0.001 respectively). Similarly, eGFR was higher in subjects with SCA than in controls and as well as in those with microalbuminuria compared with those who do not (p = < 0.01). CONCLUSIONS The two most important risk factors for microalbuminuria were anaemia and high eGFR. Age category was associated more with microalbuminuria than just age as a variable. Glomerular filtration rate was higher in children with microalbuminuria than those who do not and it was also higher in children with SCA than in control.
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Affiliation(s)
- I E Ocheke
- Department of Paediatrics, Jos University Teaching Hospital, Jos, PMB 2076, Nigeria.
| | - S Mohamed
- Department of Paediatrics, Jos University Teaching Hospital, Jos, PMB 2076, Nigeria
| | - E S Okpe
- Department of Paediatrics, Jos University Teaching Hospital, Jos, PMB 2076, Nigeria
| | - F Bode-Thomas
- Department of Paediatrics, Jos University Teaching Hospital, Jos, PMB 2076, Nigeria
| | - M I McCullouch
- Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
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Samson O, Muhihi A, Mohamed S, Ameh S, Ochimana C, Oluwasanu B, Bolarinwa AO, Sewankambo N, Danaei G. P1946Hypertension prevalence, awareness, treatment and control and 10-year estimated CVD risk in East and West Africa: pooled analysis of data from 4 African countries. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Though the prevalence of hypertension is rising in Sub-Saharan Africa, few studies have characterized the epidemiology and management of hypertension across many heterogeneous communities. We assessed prevalence, awareness, treatment and control of hypertension and estimated the 10-year cardiovascular risk across six sites in East and West Africa.
Methods
Between June and August 2018, we conducted household-based surveys in 6 rural, semi-urban and urban settings in Kenya, Nigeria, Tanzania and Uganda to enroll community-dwelling adults (aged >18 years) collect data including age, gender, smoking, anthropometric measures, health insurance, utilization of health care facilities. We defined hypertension as systolic blood pressure of at least 140 mm Hg, or diastolic blood pressure of at least 90 mm Hg, or self-reported antihypertensive medication use. We used country specific Globorisk prediction equations to estimate 10-year CVD risk.
Results
A total 3,150 participants with a mean age of 40 years (SD 15), 61% of whom were women, 8% had ever smoked, and 33% were overweight/obese. About 23.7% (95% CI 22.2, 25.2) of the entire sample had hypertension, of whom 60.6% (56.8, 64.3) were diagnosed. Among diagnosed, 61.7% (57.2, 66.1) were taking antihypertensives, and 27.7% (22.7, 33.1) had controlled BP. The prevalence of hypertension was 38.6% in Ikire-Nigeria, 25.1% Ukonga-Tanzania, 23.3% in Oyo-Nigeria, 21.6% in Okpok-Nigeria, 20.4% in Soroti-Uganda, and 9.7% in Viwandani-Kenya. The overall median estimated 10-yr CVD risk was low 4.6% IQR (2.3, 9.6) and 8.6% had 10-yr CVD risk >10%. (Figure 1)
Conclusion
Among African adults aged >18 years, nearly a quarter have hypertension, three in 5 being treated, and fewer than three in ten had BP under control. The low number of people in control is ubiquitous in all sites and warrants greater prevention strategies, better screening and more effective and affordable treatment options than what is currently available.
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Affiliation(s)
- O Samson
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - A Muhihi
- Management and Development for Health, Research, Dar es Salaam, Tanzania, United Republic of
| | - S Mohamed
- African Population and Health Research Center, Health and Systems for Health, Nairobi, Kenya
| | - S Ameh
- University of Calabar, Community Medicine, Calabar, Nigeria
| | - C Ochimana
- Federal Capital Territory, Abuja, Nigeria
| | | | - A O Bolarinwa
- University of Ilorin, Epidemiology and Community Health, Ilorin, Nigeria
| | - N Sewankambo
- Makerere University College of Health Sciences, Kampala, Uganda
| | - G Danaei
- Harvard TH Chan School of Public Health, Global Health and Population, Boston, United States of America
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Fennell D, Hudka M, Darlison L, Lord K, Bzura A, Dzialo J, Pritchard C, Harber J, Takata T, Popat S, Krebs M, Nolan L, Greystoke A, Richards C, Wells-Jordan P, Branson A, Gaba A, Bhundia V, Scotland M, Mohamed S, Dawson A, Poille C, Cowley C, Walter H, King A, Thomas A. P2.06-02 Mesothelioma Stratified Therapy (MiST): A Phase IIA Umbrella Trial for Accelerating the Development of Precision Medicines. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1620] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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El-Azız NA, Mohamed S, Kamel E, Elgohary G. Feasibility of the Arabic version of distress thermometer for Egyptian patients with solid cancers and hematological malignancies. Leuk Res 2019. [DOI: 10.1016/s0145-2126(19)30266-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sutton PA, Bourdon-Pierre R, Smith C, Appleton N, Lightfoot T, Gabriel C, Richards B, Mohamed S, Mason-Whitehead E, Hulbert-Williams NJ, Vimalachandran D. Evaluating unmet needs in patients undergoing surgery for colorectal cancer: a patient reported outcome measures study. Colorectal Dis 2019; 21:797-804. [PMID: 30828949 DOI: 10.1111/codi.14599] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 02/19/2019] [Indexed: 12/20/2022]
Abstract
AIM Patient reported outcome measures (PROMs) are self-reported measures of patients' health status or health-related quality of life at a single point in time. We aimed to evaluate the use of a colorectal PROM and conducted a focus group to further explore this and other unmet needs in our patient population treated surgically for colorectal cancer. METHOD A multidisciplinary research group consisting of colorectal surgeons, nurse specialists, psychologists, sociologists and patient representatives devised a composite tool of new and existing outcome measures which was piloted in our local population (n = 35). Participants were subsequently invited to attend a semi-structured focus group during which the PROM was reviewed and an unmet needs analysis was performed. Thematic analysis of focus group transcripts was undertaken for emergent themes. RESULTS Initial consensus was for a tool including the EQ-5D, Functional Assessment of Cancer Therapy - Colorectal (FACT-C), the distress thermometer, a validated measure of stigma, an unmet needs analysis, and questions assessing the psychological impact of cancer. Median and interquartile range values suggested that all metrics were discriminatory with the exception of FACT-C. All participants agreed that the tool was acceptable and reflected the current state of their health and emotions. Thematic analysis of focus group transcripts identified four major themes: physical symptoms, emotional response, information provision and coping mechanisms. CONCLUSION Through expert consensus, local piloting and patient focus groups we have evaluated a novel PROM for colorectal cancer. Furthermore, through our direct engagement with patients we have identified several unmet needs which we are currently exploring within the clinical service.
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Affiliation(s)
- P A Sutton
- Department of Surgery, Countess of Chester Hospital, Chester, UK
| | - R Bourdon-Pierre
- Department of Surgery, Countess of Chester Hospital, Chester, UK
| | - C Smith
- Department of Surgery, Countess of Chester Hospital, Chester, UK
| | - N Appleton
- Department of Surgery, Countess of Chester Hospital, Chester, UK
| | - T Lightfoot
- Department of Surgery, Countess of Chester Hospital, Chester, UK
| | - C Gabriel
- Department of Surgery, Countess of Chester Hospital, Chester, UK
| | - B Richards
- Department of Surgery, Countess of Chester Hospital, Chester, UK
| | - S Mohamed
- Department of Surgery, Countess of Chester Hospital, Chester, UK
| | | | | | - D Vimalachandran
- Department of Surgery, Countess of Chester Hospital, Chester, UK
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Moulinet T, Campagne J, Mohamed S, Deibener-Kaminsky J, Guesdon H, Gomez E, Jaussaud R. La Maladie de Duchenne au féminin. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Guichard S, Moulinet T, Clement-Filliatre L, Dor A, Sauvage A, Dziebowski L, Ziegler C, Deibener-Kaminsky J, Mohamed S, Campagne J, Feugier P, Jaussaud R. Polychondrite atrophiante et lymphoproliferation IgM : association fortuite ou syndrome paranéoplasique ? Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.157] [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: 10/26/2022]
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Hipp J, Mohamed S, Pott J, Sick O, Makowiec F, Hopt UT, Fichtner-Feigl S, Wittel UA. Management and outcomes of intraductal papillary mucinous neoplasms. BJS Open 2019; 3:490-499. [PMID: 31388641 PMCID: PMC6677100 DOI: 10.1002/bjs5.50156] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 09/11/2018] [Accepted: 01/29/2019] [Indexed: 12/11/2022] Open
Abstract
Background This study evaluated the outcome and survival of patients with radiologically suspected intraductal papillary mucinous neoplasms (IPMNs). Methods IPMN management was reviewed according to Fukuoka risk factors and IPMN localization, differentiating main‐duct (MD), mixed‐type (MT) and branch‐duct (BD) IPMNs. Perioperative results were compared with those of patients undergoing resection of pancreatic ductal adenocarcinoma (PDAC) over the same interval (2010–2014). Overall (OS) and disease‐specific (DSS) survival rates were calculated and subgroups compared. Results Of 142 patients with IPMNs, 26 had MD‐IPMN, eight had MT‐IPMN and 108 had BD‐IPMN. Some 74 per cent of patients with MD‐ and MT‐IPMN were managed by primary resection, whereas this was used in only 27·8 per cent of those with BD‐IPMN. The risk of secondary resection and malignant transformation for BD‐IPMNs smaller than 20 mm was 8 and 2 per cent respectively during follow‐up. Pancreatic head resection of IPMNs was associated with an increased risk of postoperative pancreatic fistula grade B/C compared with resection of PDAC (12 of 33 (36 per cent) versus 41 of 221 (18·6 per cent) respectively; P = 0·010), and greater morbidity and mortality (Clavien–Dindo grade III: 15 of 33 (45 per cent) versus 56 of 221 (25·3 per cent) respectively; grade IV: 1 (3 per cent) versus 7 (3·2 per cent); grade V: 2 (6 per cent) versus 2 (0·9 per cent); P = 0·008). Five‐year OS and DSS rates in patients with MD‐IPMN were worse than those for MT‐ and BD‐IPMN (OS: 44, 86 and 97·4 per cent respectively, P < 0·001; DSS: 60, 100 and 98·6 per cent; P < 0·001). Patients with invasive IPMN had worse OS and DSS rates than those with non‐invasive dysplasia (OS: IPMN‐carcinoma (10 patients) 33 per cent, high‐grade dysplasia 100 per cent, intermediate‐grade dysplasia 63 per cent, low grade‐dysplasia 100 per cent, P < 0·001; DSS: IPMN‐carcinoma 43 per cent, all grades of dysplasia 100 per cent, P < 0·001). Patients with high‐risk stigmata had poorer survival than those without risk factors (OS: high‐risk stigmata (35 patients) 55 per cent, worrisome features (31) 95 per cent, no risk factors (76) 100 per cent, P < 0·001; DSS: 71, 100 and 100 per cent respectively, P < 0·001). Conclusion The risk of malignant transformation was very low for BD‐IPMNs, but the development of high‐risk stigmata was associated with disease‐specific mortality. Patients with IPMN had greater morbidity after resection than those having resection of PDAC.
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Affiliation(s)
- J Hipp
- Department of General and Visceral Surgery, Medical Centre and Faculty of Medicine University of Freiburg Freiburg Germany
| | - S Mohamed
- Department of General and Visceral Surgery, Medical Centre and Faculty of Medicine University of Freiburg Freiburg Germany
| | - J Pott
- Department of General and Visceral Surgery, Medical Centre and Faculty of Medicine University of Freiburg Freiburg Germany
| | - O Sick
- Department of General and Visceral Surgery, Medical Centre and Faculty of Medicine University of Freiburg Freiburg Germany
| | - F Makowiec
- Department of General and Visceral Surgery, Medical Centre and Faculty of Medicine University of Freiburg Freiburg Germany
| | - U T Hopt
- Department of General and Visceral Surgery, Medical Centre and Faculty of Medicine University of Freiburg Freiburg Germany
| | - S Fichtner-Feigl
- Department of General and Visceral Surgery, Medical Centre and Faculty of Medicine University of Freiburg Freiburg Germany
| | - U A Wittel
- Department of General and Visceral Surgery, Medical Centre and Faculty of Medicine University of Freiburg Freiburg Germany
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Schön T, Matuschek E, Mohamed S, Utukuri M, Heysell S, Alffenaar JW, Shin S, Martinez E, Sintchenko V, Maurer FP, Keller PM, Kahlmeter G, Köser CU. Standards for MIC testing that apply to the majority of bacterial pathogens should also be enforced for Mycobacterium tuberculosis complex. Clin Microbiol Infect 2019; 25:403-405. [PMID: 30771527 DOI: 10.1016/j.cmi.2019.01.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 01/25/2019] [Accepted: 01/26/2019] [Indexed: 11/25/2022]
Affiliation(s)
- T Schön
- Department of Infectious Diseases and Clinical Microbiology, Kalmar County Hospital, Kalmar, Sweden; Department of Clinical and Experimental Medicine, Division of Medical Microbiology, Linköping University, Linköping, Sweden
| | - E Matuschek
- EUCAST Development Laboratory, Växjö, Sweden
| | - S Mohamed
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, VA, USA
| | - M Utukuri
- School of Clinical Medicine, University of Cambridge, UK
| | - S Heysell
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, VA, USA
| | - J-W Alffenaar
- Faculty of Medicine and Health, School of Pharmacy and Westmead Hospital, University of Sydney, Sydney, NSW, Australia
| | - S Shin
- Korean Institute of Tuberculosis, Cheongju, Republic of Korea
| | - E Martinez
- Centenary Institute and Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, NSW, Australia; NSW Mycobacterium Reference Laboratory, Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research-Pathology West, Sydney, NSW, Australia; Centre for Infectious Diseases and Microbiology-Public Health, Westmead Hospital, Western Sydney Local Health District, Sydney, NSW, Australia
| | - V Sintchenko
- Centenary Institute and Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, NSW, Australia; NSW Mycobacterium Reference Laboratory, Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research-Pathology West, Sydney, NSW, Australia; Centre for Infectious Diseases and Microbiology-Public Health, Westmead Hospital, Western Sydney Local Health District, Sydney, NSW, Australia
| | - F P Maurer
- National and Supranational Reference Centre for Mycobacteria, Research Centre Borstel, Borstel, Germany
| | - P M Keller
- Institute for Infectious Diseases, University of Berne, Berne, Switzerland
| | - G Kahlmeter
- EUCAST Development Laboratory, Växjö, Sweden
| | - C U Köser
- Department of Genetics, University of Cambridge, UK.
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Letournel H, Campagne J, Moulinet T, Corriger J, Mohamed S, Deibener-Kaminsky J, Bursztejn A, Jaussaud R. Mastocytose cutanée ou systémique indolente associée à des manifestations auto-immunes : Étude sur 40 cas. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.10.232] [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]
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Tetu P, Allayous C, Oriano B, Dalle S, Mortier L, Leccia MT, Guillot B, Dalac S, Dutriaux C, Lacour JP, Saiag P, Descamps V, De Quatrebarbes J, Stoebner P, Legoupil D, Beylot-Barry M, Lesimple T, Aubin F, Dréno B, Mohamed S, Ballon A, Porcher R, Lebbé C. Impact de la radiothérapie cérébrale concomitante chez les patients présentant un mélanome avancé avec métastases cérébrales. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.020] [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]
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Kluyts HL, le Manach Y, Munlemvo DM, Madzimbamuto F, Basenero A, Coulibaly Y, Rakotoarison S, Gobin V, Samateh AL, Chaibou MS, Omigbodun AO, Amanor-Boadu SD, Tumukunde J, Madiba TE, Pearse RM, Biccard BM, Abbas N, Abdelatif AI, Abdoulaye T, Abd-rouf A, Abduljalil A, Abdulrahman A, Abdurazig S, Abokris A, Abozaid W, Abugassa S, Abuhdema F, Abujanah S, Abusamra R, Abushnaf A, Abusnina S, Abuzalout T, Ackermann H, Adamu Y, Addanfour A, Adeleke D, Adigun T, Adisa A, Adjignon SV, Adu-Aryee N, Afolabi B, Agaba A, Agaba P, Aghadi K, Agilla H, Ahmed B, Ahmed EZ, Ahmed AJ, Ahmed M, Ahossi R, Aji S, Akanyun S, Akhideno I, Akhter M, Akinyemi O, Akkari M, Akodjenou J, AL Samateh A, al Shams E, Alagbe-Briggs O, Alakkari E, Alalem R, Alashhab M, Alatise O, Alatresh A, Alayeb Alayeb M, Albakosh B, Albert F, Alberts A, Aldarrat A, Alfari A, Alfetore A, Algbali M, Algddar A, Algedar H, Alghafoud I, Alghazali A, Alhajj M, Alhendery Alhendery A, Alhoty F, Ali A, Ali Y, Ali A, Alioune BS, Alkassem M, Alkchr M, Alkesa T, Alkilani A, Alkobty Alkobty F, Allaye T, Alleesaib S, Alli A, Allopi K, Allorto N, Almajbery A, Almesmary R, Almisslati S, Almoraid F, Alobeidi H, Swaleh A, Swayeb E, Szpytko A, Taiwo N, Tarhuni A, Tarloff D, Tchaou B, Tchegnonsi C, Tchoupa M, Teeka M, Alomami M, Thakoor B, Theunissen M, Thomas B, Thomas M, Thotharam A, Tobiko O, Torborg A, Tshisekedi S, Tshisola S, Tshitangano R, Alphonsus CS, Tshivhula F, Tshuma H, Tumukunde J, Tun M, Udo I, Uhuebor D, Umeh K, Usenbo A, Uwiteyimbabazi J, Van der Merwe D, Alqawi O, van der Merwe F, van der Walt J, van Dyk D, Van Dyk J, van Niekerk J, van Wyk S, van Zyl H, Veerasamy B, Venter P, Vermeulen A, Alraheem A, Villarreal R, Visser J, Visser L, Voigt M, von Rahden RP, Wafa A, Wafula A, Wambugu P, Waryoba P, Waweru E, Alsabri S, Weideman M, Wise RD, Wynne E, Yahya A, Yahya A, Yahya R, Yakubu Y, Yanga J, Yangazov Y, Yousef O, Alsayed A, Yousef G, Youssouf C, Yunus A, Yusuf A, Zeiton A, Zentuti H, Zepharine H, Zerihun A, Zhou S, Zidan A, Alsellabi B, Zimogo Zié S, Zinyemba C, Zo A, Zomahoun L, Zoobei N, Zoumenou E, Zubia N, Al-Serksi M, Alshareef M, Altagazi A, Aluvale J, Alwahedi H, Alzahra E, Alzarouk M, Al-Zubaidy K, Amadou M, Amadou M, Amanor-Boadu SD, Amer AA, Amisi B, Amuthenu M, Anabah T, Anani F, Anderson P, Andriamampionona A, Andrianina L, Anele A, Angelin R, Anjar N, Antùnez O, Antwi-Kusi A, Anyanwu L, Aribi A, Arowolo O, Arrey O, Ashebir DZ, Assefa S, Assoum G, Athanse V, Athombo J, Atiku M, Atito-Narh E, Atomabe A, Attia A, Aungraheeta M, Aurélia D, Ayandipo O, Ayebale A, Azzaidey H, Babajee N, Badi H, Badianga E, Baghni R, Bahta M, Bai M, Baitchu Y, Baloyi A, Bamuza K, Bamuza M, Bangure L, Bankole O, Barongo M, Barow M, Basenero A, Bashiya L, Basson C, Bechan S, Belhaj S, Ben Mansour M, Benali D, Benamour A, Berhe A, Bertie J, Bester J, Bester M, Bezuidenhout J, Bhagwan K, Bhagwandass D, Bhat K, Bhuiyan M, Biccard BM, Bigirimana F, Bikuelo C, Bilby B, Bingidimi S, Bischof K, Bishop DG, Bitta C, Bittaye M, Biyase T, Blake C, Blignaut E, Blignaut F, BN Tanjong B, Bogoslovskiy A, Boloko P, Boodhun S, Bori I, Boufas F, Brand M, Brouckaert NT, Bruwer J, Buccimazza I, Bula Bula I, Bulamba F, Businge B, Bwambale Y, Cacala S, Cadersa M, Cairns C, Carlos F, Casey M, Castro A, Chabayanzara N, Chaibou M, Chaibva T, Chakafa N, Chalo C, Changfoot C, Chari M, Chelbi L, Chibanda J, Chifamba H, Chikh N, Chikumba E, Chimberengwa P, Chirengwa J, Chitungo F, Chiwanga M, Chokoe M, Chokwe T, Chrirangi B, Christian M, Church B, Cisekedi J, Clegg-Lamptey J, Cloete E, Coltman M, Conradie W, Constance N, Coulibaly Y, Cronje L, Da Silva M, Daddy H, Dahim L, Daliri D, Dambaki M, Dasrath A, Davids J, Davies GL, De Lange J, de Wet J, Dedekind B, Degaulle M, Dehal V, Deka P, Delinikaytis S, Desalu I, Dewanou H, Deye MM, Dhege C, Diale B, Dibwe D, Diedericks B, Dippenaar J, Dippenaar L, Diyoyo M, Djessouho E, Dlamini S, Dodiyi-Manuel A, Dokolwana B, Domoyyeri D, Drummond LW, du Plessis D, du Plessis W, du Preez L, Dube K, Dube N, Dullab K, Duvenhage R, Echem R, Edaigbini S, Egote A, Ehouni A, Ekwen G, Ekwunife N, El Hensheri M, Elfaghi I, Elfagieh M, Elfallah S, Elfiky M, Elgelany S, Elghallal A, Elghandouri M, Elghazal Z, Elghobashy A, Elharati F, Elkhogia AM, Elkhwildi R, Ellis S, Elmadani L, Elmadany H, Elmehdawi H, Elmgadmi A, Eloi H, Elrafifi D, Elsaadi G, Elsaity R, Elshikhy A, Eltaguri M, Elwerfelli A, Elyasir I, Elzoway A, Elzufri A, Enendu E, Enicker B, Enwerem E, Esayas R, Eshtiwi M, Eshwehdi A, Esterhuizen J, Esterhuizen TM, Etuk E, Eurayet O, Eyelade O, Fanjandrainy R, Fanou L, Farina Z, Fawzy M, Feituri A, Fernandes N, Ford L, Forget P, François T, Freeman T, Freeman Y, Gacii V, Gadi B, Gagara M, Gakenia A, Gallou P, Gama G, Gamal M, Gandy Y, Ganesh A, Gangaly D, Garcia M, Gatheru A, Gaya S, Gbéhadé O, Gerbel G, Ghnain A, Gigabhoy R, Giles D, Girmaye G, Gitau S, Githae B, Gitta S, Gobin V, Goga R, Gomati A, Gonzalez M, Gopall J, Gordon CS, Gorelyk O, Gova M, Govender K, Govender P, Govender S, Govindasamy V, Green-Harris J, Greenwood M, Grey-Johnson S, Grobbelaar M, Groenewald M, Grünewald K, Guegni A, Guenane M, Gueye S, Guezo M, Gunguwo T, Gweder M, Gwila M, Habimana L, Hadecon R, Hadia E, Hamadi L, Hammouda M, Hampton M, Hanta R, Hardcastle TC, Hariniaina J, Hariparsad S, Harissou A, Harrichandparsad R, Hasan S, Hashmi H, Hayes M, Hdud A, Hebli S, Heerah H, Hersi S, Hery A, Hewitt-Smith A, Hlako T, Hodges S, Hodgson RE, Hokoma M, Holder H, Holford E, Horugavye E, Houston C, Hove M, Hugo D, Human C, Hurri H, Huwidi O, Ibrahim A, Ibrahim T, Idowu O, Igaga I, Igenge J, Ihezie O, Ikandi K, Ike I, Ikuku J, Ilbarasi M, Ilunga I, Ilunga J, Imbangu N, Imessaoudene Z, Imposo D, Iraya A, Isaacs M, Isiguzo M, Issoufou A, Izquirdo P, Jaber A, Jaganath U, Jallow C, Jamabo S, Jamal Z, Janneh L, Jannetjies M, Jasim I, Jaworska MA, Jay Narain S, Jermi K, Jimoh R, Jithoo S, Johnson M, Joomye S, Judicael R, Judicaël M, Juwid A, Jwambi L, Kabango R, Kabangu J, 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Roos J, Rorke NF, Roura H, Rousseau F, Rousseau N, Royas L, Roytowski D, Rungan D, Rwehumbiza S, Ryabchiy B, Ryndine V, Saaiman C, Sabwa H, Sadat S, Saed S, Salaheddin E, Salaou H, Saleh M, Salisu-Kabara H, Doles Sama H, Samateh AL, Sam-Awortwi W, Samuel N, Sanduku D, Sani CM, Sanyang L, Sarah H, Sarkin-Pawa A, Sathiram R, Saurombe T, Schutte H, Sebei M, Sedekounou M, Segooa M, Semenya E, Semo B, Sendagire C, Senoga S, Senusi F, Serdyn T, Seshibe M, Shah G, Shamamba R, Shambare C, Shangase T, Shanin S, Shefren I, Sheshe A, Shittu O, Shkirban A, Sholadoye T, Shubba A, Sigcu N, Sihope S, Sikazwe D, Sikombe B, Simaga Abdoul K, Simo W, Singata K, Singh A, Singh S, Singh U, Sinoamadi V, Sipuka N, Sithole N, Sitima S, Skinner DL, Skinner G, Smith O, Smits C, Sofia M, Sogoba G, Sohoub A, Sookun S, Sosinska O, Souhe R, Souley G, Souleymane T, Spicer J, Spijkerman S, Steinhaus H, Steyn A, Steyn G, Steyn H, Stoltenkamp HL, Stroyer S. The ASOS Surgical Risk Calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications. Br J Anaesth 2018; 121:1357-1363. [PMID: 30442264 DOI: 10.1016/j.bja.2018.08.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 07/19/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. The objective of this study was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications. METHODS ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was constructed with a multivariable logistic regression model for the outcome of in-hospital mortality and severe postoperative complications. The following preoperative risk factors were entered into the model; age, sex, smoking status, ASA physical status, preoperative chronic comorbid conditions, indication for surgery, urgency, severity, and type of surgery. RESULTS The model was derived from 8799 patients from 168 African hospitals. The composite outcome of severe postoperative complications and death occurred in 423/8799 (4.8%) patients. The ASOS Surgical Risk Calculator includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.805 and good calibration with c-statistic corrected for optimism of 0.784. CONCLUSIONS This simple preoperative risk calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance. CLINICAL TRIAL REGISTRATION NCT03044899.
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Affiliation(s)
- H-L Kluyts
- Department of Anaesthesiology, Sefako Makgatho Health Sciences University, Pretoria, Gauteng, South Africa
| | - Y le Manach
- Department of Anesthesia, Michael DeGroote School of Medicine, Faculty of Health Sciences, McMaster University and Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Perioperative Medicine and Surgical Research Unit, Hamilton, ON, Canada; Department of Clinical Epidemiology and Biostatistics, Michael DeGroote School of Medicine, Faculty of Health Sciences, McMaster University and Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Perioperative Medicine and Surgical Research Unit, Hamilton, ON, Canada
| | - D M Munlemvo
- University Hospital of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - F Madzimbamuto
- Department of Anaesthesia and Critical Care Medicine, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - A Basenero
- Ministry of Health and Social Services Namibia, Windhoek, Namibia
| | - Y Coulibaly
- Department, Faculté de médicine de Bamako, Bamako, Mali
| | | | - V Gobin
- Ministry of Health and Quality of Life, Jawaharlal Nehru Hospital, Rose Belle, Grand Port, Mauritius
| | - A L Samateh
- Department of Surgery, Edward Francis Small Teaching Hospital, Banjul, Gambia
| | - M S Chaibou
- Department of Anesthesiology, Intensive Care and Emergency, National Hospital of Niamey, Niamey, Niger
| | - A O Omigbodun
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - S D Amanor-Boadu
- Department of Anaesthesia, University College Hospital, Ibadan, Oyo State, Nigeria
| | - J Tumukunde
- Makerere University, Makerere, Kampala, Uganda
| | - T E Madiba
- Department of Surgery, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - R M Pearse
- Intensive Care Medicine, Queen Mary University of London, London, UK
| | - B M Biccard
- Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, Observatory, Western Cape, South Africa.
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Marnai R, Revuz S, Moulinet T, Deibener-Kaminsky J, Mohamed S, Angioi-Duprez K, Jaussaud R. Choriorétinopathie de Birdshot : une série rétrospective française monocentrique de 10 patients. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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