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Thomas HA, Singh N, Thomas AM, Masih S, Cherian JM, Varghese KG. Effect of protective coating agents on microleakage and flexural strength of glass ionomer cement and zirconomer. an in vitro study. Eur Arch Paediatr Dent 2024; 25:57-63. [PMID: 37991624 DOI: 10.1007/s40368-023-00853-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/25/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE The objective of this study was to assess the microleakage and flexural strength of glass ionomer cement (GIC) and modified GIC (Zirconomer) when coated with protective coating agents such as COAT-IT and G-COAT plus. METHODS Sixty tooth specimens were grouped into two groups based on the type of restorations (GIC (n = 30) and Zirconomer (n = 30)). The samples were further divided into three subgroups (n = 10) based on the protective coating agent (Petroleum jelly, G-COAT Plus, or COAT IT) applied. This study evaluated the microleakage at the occlusal and cervical margins of class V restoration after being subjected to dye penetration and sectioning. Each specimen was viewed under a 40 × microscope and was given scores based on the depth of dye penetration. They were statistically analyzed using the Kruskal-Wallis test and compared within the groups using the Mann- Whitney Test. In addition, flexural strength was assessed using standardized cuboid (25 × 2 × 2 mm) specimens of restorative materials with and without protective coating agents. The mean flexural strength data of all the subgroups were statistically evaluated using a one-way analysis of variance (ANOVA) and compared within the subgroups using the student t test. RESULTS A statistically significant difference was found when occlusal margin microleakage scores were evaluated with G-COAT Plus demonstrating the lowest occlusal margin microleakage when applied over GIC restoration. The increasing order of occlusal margin microleakage scores is as follows: GIC with G-COAT Plus, Zirconomer with COAT-IT, GIC with COAT-IT, GIC, Zirconomer with G-COAT Plus, and Zirconomer. However, the cervical margin microleakage scores revealed no significant difference. While flexural strength was found to be highest for the GIC group coated with G-COAT Plus, it was observed that there was a significant improvement in the flexural strength of both GIC and Zirconomer when coated with either of the protective coating agents. CONCLUSION Within the limitations of this in vitro study, it was observed that the application of protective coating agents can significantly reduce the potential microleakage and improve the flexural strength of the restorative material especially when zirconia-reinforced GIC is the restorative material.
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Affiliation(s)
- H A Thomas
- Department of Pedodontics and Preventive Dentistry, Christian Dental College, Ludhiana, Punjab, India.
| | - N Singh
- Department of Pedodontics and Preventive Dentistry, Christian Dental College, Ludhiana, Punjab, India
| | - A M Thomas
- Department of Pedodontics and Preventive Dentistry, Christian Dental College, Ludhiana, Punjab, India
| | - S Masih
- Department of Pedodontics and Preventive Dentistry, Christian Dental College, Ludhiana, Punjab, India
| | - J M Cherian
- Department of Pedodontics and Preventive Dentistry, Christian Dental College, Ludhiana, Punjab, India
| | - K G Varghese
- Department of Prosthodontics and Crown and Bridge, Christian Dental College, Ludhiana, Punjab, India
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Piana A, Basile G, Masih S, Bignante G, Uleri A, Gallioli A, Prudhomme T, Boissier R, Pecoraro A, Campi R, Di Dio M, Alba S, Breda A, Territo A. Kidney stones in renal transplant recipients: A systematic review. Actas Urol Esp 2024; 48:79-104. [PMID: 37574010 DOI: 10.1016/j.acuroe.2023.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 07/10/2023] [Indexed: 08/15/2023]
Abstract
INTRODUCTION Lithiasis in renal graft recipients might be a dangerous condition with a potential risk of organ function impairment. EVIDENCE ACQUISITION A systematic literature search was conducted through February 2023. The primary objective was to assess the incidence of lithiasis in kidney transplant (KT) recipients. The secondary objective was to assess the timing of stone formation, localization and composition of stones, possible treatment options, and the incidence of graft loss. EVIDENCE SYNTHESIS A total of 41 non-randomized studies comprising 699 patients met our inclusion criteria. The age at lithiasis diagnosis ranged between 29-53 years. Incidence of urolithiasis ranged from 0.1-6.3%, usually diagnosed after 12 months from KT. Most of the stones were diagnosed in the calyces or in the pelvis. Calcium oxalate composition was the most frequent. Different treatment strategies were considered, namely active surveillance, ureteroscopy, percutaneous/combined approach, or open surgery. 15.73% of patients were submitted to extracorporeal shock wave lithotripsy (ESWL), while 26.75% underwent endoscopic lithotripsy or stone extraction. 18.03% of patients underwent percutaneous nephrolithotomy whilst 3.14% to a combined approach. Surgical lithotomy was performed in 5.01% of the cases. Global stone-free rate was around 80%. CONCLUSIONS Lithiasis in kidney transplant is a rare condition usually diagnosed after one year after surgery and mostly located in the calyces and renal pelvis, more frequently of calcium oxalate composition. Each of the active treatments is associated with good results in terms of stone-free rate, thus the surgical technique should be chosen according to the patient's characteristics and surgeon preferences.
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Affiliation(s)
- A Piana
- Servicio de Urología, Hospital Romolo, Rocca di Neto, Italy; Departamento de Urología, Universidad de Turín, Turín, Italy.
| | - G Basile
- Unidad de Uro-oncología y Trasplante Renal, Servicio de Urología, Fundación Puigvert, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain
| | - S Masih
- Servicio de Urología, Centro Médico de la Universidad de Toledo, Toledo, OH, United States
| | - G Bignante
- Departamento de Urología, Universidad de Turín, Turín, Italy
| | - A Uleri
- Unidad de Uro-oncología y Trasplante Renal, Servicio de Urología, Fundación Puigvert, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain
| | - A Gallioli
- Unidad de Uro-oncología y Trasplante Renal, Servicio de Urología, Fundación Puigvert, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain
| | - T Prudhomme
- Servicio de Urología, Trasplante Renal y Andrología, Hospital Universitario de Rangueil, Toulouse, France
| | - R Boissier
- Servicio de Urología y Trasplante Renal, Hospital Universitario La Concepción, Marsella, France
| | - A Pecoraro
- Departmento de Medicina Experimental y Clínica, Universidad de Florencia, Florencia, Italy
| | - R Campi
- Departmento de Medicina Experimental y Clínica, Universidad de Florencia, Florencia, Italy
| | - M Di Dio
- Sección de Urología, Servicio de Cirugía, Hospital Annunziata, Cosenza, Italy
| | - S Alba
- Servicio de Urología, Hospital Romolo, Rocca di Neto, Italy
| | - A Breda
- Unidad de Uro-oncología y Trasplante Renal, Servicio de Urología, Fundación Puigvert, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain
| | - A Territo
- Unidad de Uro-oncología y Trasplante Renal, Servicio de Urología, Fundación Puigvert, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain
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Elbaz-Greener G, Qiu F, Masih S, Fang J, Austin PC, Cantor WJ, Dvir D, Asgar AW, Webb JG, Ko DT, Wijeysundera HC. Profiling Hospital Performance Based on Mortality After Transcatheter Aortic Valve Replacement in Ontario, Canada. Circ Cardiovasc Qual Outcomes 2018; 11:e004947. [PMID: 30562064 DOI: 10.1161/circoutcomes.118.004947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Public reporting of hospital-level outcomes is increasingly common as a means to target quality improvement strategies to ensure the delivery of optimal care. Despite the rapid dissemination of transcatheter aortic valve replacement (TAVR), there is a paucity of reliable case-mix adjustment models for hospital profiling in TAVR. Our objective was to develop and evaluate different models for calculating risk-standardized all-cause mortality rates (RSMRs) post-TAVR. METHODS AND RESULTS In this population-based study in Ontario, Canada, we identified all patients who underwent a TAVR procedure between April 1, 2012, and March 31, 2016. For each hospital, we calculated 30-day and 1-year RSMR, using 2-level hierarchical logistic regression models that accounted for patient-specific demographic and clinical characteristics, as well as the clustering of patients within the same hospital using a hospital-specific random effects. We classified each hospital into one of 3 groups: performing worse than expected, better than expected, or performing as expected, based on whether the 95% CI of the RSMR was above, below, or included the provincial average mortality rate, respectively. Our cohort consisted of 2129 TAVR procedures performed at 10 hospitals. The observed mortality was 7.0% at 30 days and 16.4% at 1 year, with a range of 4% to 10% and 8% to 22%, respectively, across hospitals. We developed case-mix adjustment models using 28 clinically relevant variables. Using 30-day and 1-year RSMR to profile each hospital, we found that all hospitals performed as expected, with 95% CI that included the provincial average. CONCLUSIONS We found no significant interhospital variation in RSMR among hospitals, suggesting that quality improvement efforts should be directed at aspects other than the variation in observed mortality.
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Affiliation(s)
- Gabby Elbaz-Greener
- Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada (G.E.-G., D.T.K., H.C.W.).,Cardiovascular Institute, Baruch Padeh Medical Center, Poriya, Israel (G.E.-G.)
| | - Feng Qiu
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (F.Q., S.M., J.F., P.C.A., D.T.K., H.C.W.)
| | - Shannon Masih
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (F.Q., S.M., J.F., P.C.A., D.T.K., H.C.W.).,Chronic Disease and Injury Prevention, Public Health, Region of Peel (S.M.)
| | - Jiming Fang
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (F.Q., S.M., J.F., P.C.A., D.T.K., H.C.W.)
| | - Peter C Austin
- Sunnybrook Research Institute, University of Toronto, Ontario, Canada (P.C.A., D.T.K., H.C.W.).,Institute for Health Policy Management and Evaluation, University of Toronto, Ontario, Canada (P.C.A., D.T.K., H.C.W.).,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (F.Q., S.M., J.F., P.C.A., D.T.K., H.C.W.)
| | - Warren J Cantor
- Division of Cardiology, Southlake Regional Health Centre, Newmarket, Ontario, Canada (W.J.C.)
| | - Danny Dvir
- Division of Cardiology, University of Washington, Seattle (D.D.)
| | - Anita W Asgar
- Institute for Cardiology, University of Montréal, Quebec, Canada (A.W.A.)
| | - John G Webb
- Center for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, Vancouver (J.G.W.)
| | - Dennis T Ko
- Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada (G.E.-G., D.T.K., H.C.W.).,Sunnybrook Research Institute, University of Toronto, Ontario, Canada (P.C.A., D.T.K., H.C.W.).,Institute for Health Policy Management and Evaluation, University of Toronto, Ontario, Canada (P.C.A., D.T.K., H.C.W.).,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (F.Q., S.M., J.F., P.C.A., D.T.K., H.C.W.)
| | - Harindra C Wijeysundera
- Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada (G.E.-G., D.T.K., H.C.W.).,Sunnybrook Research Institute, University of Toronto, Ontario, Canada (P.C.A., D.T.K., H.C.W.).,Institute for Health Policy Management and Evaluation, University of Toronto, Ontario, Canada (P.C.A., D.T.K., H.C.W.).,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (F.Q., S.M., J.F., P.C.A., D.T.K., H.C.W.)
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Oakes G, Tang J, Masih S, Qiu F, Fang J, Wijeysundera H, Woodward G. OUTCOMES FOLLOWING TRANSCATHETER AORTIC VALVE IMPLANTATION (TAVI) IN ONTARIO (2013-2016). Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.170] [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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Elbaz Greener G, Qiu F, Masih S, Fang J, Austin P, Cantor W, Dvir D, Asgar A, Webb J, Ko D, Wijeysundera H. PROFILING HOSPITAL PERFORMANCE BASED ON MORTALITY AFTER TRANS-CATHETER AORTIC VALVE REPLACEMENT IN ONTARIO, CANADA. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.207] [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: 10/28/2022] Open
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Elbaz-Greener G, Masih S, Fang J, Ko DT, Lauck SB, Webb JG, Nallamothu BK, Wijeysundera HC. Temporal Trends and Clinical Consequences of Wait Times for Transcatheter Aortic Valve Replacement. Circulation 2018; 138:483-493. [DOI: 10.1161/circulationaha.117.033432] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [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: 11/16/2022]
Abstract
Background:
Transcatheter aortic valve replacement (TAVR) represents a paradigm shift in the therapeutic options for patients with severe aortic stenosis. However, rapid and exponential growth in TAVR demand may overwhelm capacity, translating to inadequate access and prolonged wait times. Our objective was to evaluate temporal trends in TAVR wait times and the associated clinical consequences.
Methods:
In this population-based study in Ontario, Canada, we identified all TAVR referrals from April 1, 2010, to March 31, 2016. The primary outcome was the median total wait time from referral to procedure. Piecewise regression analyses were performed to assess temporal trends in TAVR wait times, before and after provincial reimbursement in September 2012. Clinical outcomes included all-cause death and heart failure hospitalizations while on the wait list.
Results:
The study cohort included 4461 referrals, of which 50% led to a TAVR, 39% were off-listed for other reasons, and 11% remained on the wait list at the conclusion of the study. For patients who underwent a TAVR, the estimated median wait time in the postreimbursement period stabilized at 80 days and has remained unchanged. The cumulative probability of wait-list mortality and heart failure hospitalization at 80 days was ≈2% and 12%, respectively, with a relatively constant increase in events with increased wait times.
Conclusions:
Postreimbursement wait time has remained unchanged for patients undergoing a TAVR procedure, suggesting the increase in capacity has kept pace with the increase in demand. The current wait time of almost 3 months is associated with important morbidity and mortality, suggesting a need for greater capacity and access.
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Affiliation(s)
- Gabby Elbaz-Greener
- Schulich Heart Centre, Division of Cardiology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada (G.E-G., D.T.K., H.C.W.)
| | - Shannon Masih
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (S.M., J.F., D.T.K., H.C.W.)
| | - Jiming Fang
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (S.M., J.F., D.T.K., H.C.W.)
| | - Dennis T. Ko
- Schulich Heart Centre, Division of Cardiology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada (G.E-G., D.T.K., H.C.W.)
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (S.M., J.F., D.T.K., H.C.W.)
- Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada (D.T.K., H.C.W.)
- Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (D.T.K., H.C.W.)
| | - Sandra B. Lauck
- Center for Heart Valve Innovation, St. Paul’s Hospital, University of British Columbia, Vancouver, Canada (S.B.L., J.G.W.)
| | - John G. Webb
- Center for Heart Valve Innovation, St. Paul’s Hospital, University of British Columbia, Vancouver, Canada (S.B.L., J.G.W.)
| | - Brahmajee K. Nallamothu
- Division of Cardiovascular Disease and Department of Internal Medicine, University of Michigan, Ann Arbor, MI (B.K.N.)
| | - Harindra C. Wijeysundera
- Schulich Heart Centre, Division of Cardiology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada (G.E-G., D.T.K., H.C.W.)
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (S.M., J.F., D.T.K., H.C.W.)
- Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada (D.T.K., H.C.W.)
- Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (D.T.K., H.C.W.)
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Aljabbary T, Qiu F, Masih S, Fang J, Elbaz-Greener G, Austin PC, Rodés-Cabau J, Ko DT, Singh S, Wijeysundera HC. Association of Clinical and Economic Outcomes With Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement. JAMA Netw Open 2018; 1:e180088. [PMID: 30646053 PMCID: PMC6324315 DOI: 10.1001/jamanetworkopen.2018.0088] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
IMPORTANCE The literature is inconsistent regarding the impact of permanent pacemaker implantation after transcatheter aortic valve replacement. OBJECTIVE To evaluate clinical and economic outcomes in patients who required permanent pacemaker implantation during the index hospitalization after transcatheter aortic valve replacement. DESIGN, SETTING, AND PARTICIPANTS This retrospective, population-based cohort study using data from a multicenter registry included patients who underwent a transcatheter aortic valve replacement procedure from April 1, 2010, to March 31, 2015, in Ontario, Canada, with follow-up to March 31, 2017. Patients who had a previously implanted permanent pacemaker or who died during the index hospitalization were excluded. Inverse probability of treatment weighting using the propensity score was used to adjust for baseline differences between the pacemaker and nonpacemaker groups. EXPOSURES Patients received a permanent pacemaker during the index hospitalization after transcatheter aortic valve replacement. MAIN OUTCOMES AND MEASURES All-cause mortality, readmission, readmission for heart failure, emergency department visits, and cumulative 1-year health care costs. RESULTS The study cohort consisted of 1263 patients (mean [SD] age, 82.3 [7.2] years; 595 [47.1%] female; 137 [10.8%] rural), of whom 186 (14.7%) required permanent pacemaker insertion during the index hospitalization after transcatheter aortic valve replacement. Mean follow-up was 990 days. After propensity score weighting, over the entire follow-up period, pacemaker implantation was associated with significantly higher all-cause mortality (43.9% vs 31.7%; hazard ratio [HR], 1.40; 95% CI, 1.01-1.94; P = .04), all-cause readmission (80.9% vs 70.6%; HR, 1.28; 95% CI, 1.15-1.43; P < .001), and emergency department visits (95.5% vs 87.3%; HR, 1.28; 95% CI, 1.08-1.52; P = .004). Pacemaker implantation was also associated with significantly greater readmission for heart failure (33.9% vs 19.1%; HR, 1.90; 95% CI, 1.53-2.36; P < .001). There were no statistically significant differences between groups in adjusted cumulative health care costs 1 year after discharge. CONCLUSIONS AND RELEVANCE New permanent pacemaker implantation after transcatheter aortic valve replacement was associated with significantly greater morbidity and mortality at long-term follow-up. However, this did not translate to a difference in cumulative health care costs after hospital discharge.
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Affiliation(s)
- Talal Aljabbary
- Institute for Clinical Evaluation Sciences, Toronto, Ontario, Canada
- Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Feng Qiu
- Institute for Clinical Evaluation Sciences, Toronto, Ontario, Canada
| | - Shannon Masih
- Institute for Clinical Evaluation Sciences, Toronto, Ontario, Canada
| | - Jiming Fang
- Institute for Clinical Evaluation Sciences, Toronto, Ontario, Canada
| | - Gabby Elbaz-Greener
- Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Peter C Austin
- Institute for Clinical Evaluation Sciences, Toronto, Ontario, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Josep Rodés-Cabau
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Dennis T Ko
- Institute for Clinical Evaluation Sciences, Toronto, Ontario, Canada
- Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Sheldon Singh
- Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Harindra C Wijeysundera
- Institute for Clinical Evaluation Sciences, Toronto, Ontario, Canada
- Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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Greener GE, Masih S, Fang J, Roifman I, Wijeysundera HC. Abstract 165: Temporal Trends in FFR Utilization in Patients Undergoing Coronary Angiography: A Population Based Study. Circ Cardiovasc Qual Outcomes 2018. [DOI: 10.1161/circoutcomes.11.suppl_1.165] [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: 11/16/2022]
Abstract
Background:
Invasive fractional flow reserve (FFR) has emerged as an important tool to identify a subset of patients in whom coronary revascularization may be beneficial. Our objective was to evaluate temporal trends in FFR utilization.
Methods:
In this population-based study, we identified all coronary angiograms in the CorHealth Ontario Cardiac Registry between January 1
st
, 2010 to December 31
st
, 2015. The primary and secondary outcomes were the age-sex adjusted monthly rate of FFR per 100,000 population and per 100 angiograms respectively. Piecewise regression analysis was used to evaluate the temporal trends in FFR utilization, for the entire cohort, and then stratified by indication (stable coronary disease (SCAD) versus acute coronary syndrome (ACS)).
Results:
The study cohort included 379,688 angiograms, of which 122,571 were for SCAD (32%), and 134,769 were for ACS (35%). FFR was performed in 3.2% of all angiograms (4.6% in SCAD; 2.7% in ACS). Monthly age-sex adjusted FFR utilization rates increased significantly over the study period, from 0.4 to 2.1 per 1000,000 people/month. The monthly FFR utilization rate per 100 angiograms increased from 1.3 to 4.8 per 100 angiograms/month; however, the proportion of positive FFR results was relatively constant at 27%. There was a more dramatic increase in the use of FFR in the SCAD (1.4 to 7.5 per 100 angiograms/month) compared to the ACS population (1.3 to 3.4 per 100 angiograms/month).
Conclusions:
Over time, there was a 5-fold increase in the use of FFR in patients across Ontario, which was predominantly driven by use in patients with SCAD. Case selection for FFR use was relatively unchanged with approximately a quarter of FFR cases being positive over time.
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Affiliation(s)
| | - Shannon Masih
- Institute for Clinical Evaluative Sciences, Toronto, Canada
| | - Jiming Fang
- Institute for Clinical Evaluative Sciences, Toronto, Canada
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Elbaz -Greener G, Masih S, Fang J, Ko DT, Lauck SB, Webb JG, Nallamothu BK, Wijeysundera HC. Abstract 179: Temporal Trends and Clinical Consequences of Wait-Times for Trans-Catheter Aortic Valve Replacement: A Population Based Study. Circ Cardiovasc Qual Outcomes 2018. [DOI: 10.1161/circoutcomes.11.suppl_1.179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Trans-catheter aortic valve replacement (TAVR) represents a paradigm shift in the therapeutic options for patients with severe aortic stenosis. However, rapid and exponential growth in TAVR demand may overwhelm capacity, translating to inadequate access and prolonged wait-times. Our objective was to evaluate temporal trends in TAVR wait-times and the associated clinical consequences.
Methods:
In this population-based study in Ontario, Canada, we identified all TAVR referrals from April 1, 2010 to March 31, 2016. The primary outcome was the median total wait-time from referral to procedure. Piecewise regression analyses were performed to assess temporal trends in TAVI wait-times, before and after provincial reimbursement in September 2012. Clinical outcomes included all-cause death and heart failure hospitalizations while on the wait-list.
Results:
The study cohort included 4,461 referrals, of which 50% led to a TAVR, 39% were off-listed for other reasons and 11% remained on the wait-list at the conclusion of the study. For patients who underwent a TAVR, the estimated median wait-time in the post-reimbursement period stabilized at 82-84 days, and has remained unchanged since September 2012. The cumulative probability of wait-list mortality and heart failure hospitalization was 4.3% and 14.7% respectively, with a relatively constant increase in events with increased wait-times.
Conclusion:
Post-reimbursement wait-time has remained unchanged for patients undergoing a TAVR procedure, suggesting the increase in capacity has kept pace with the increase in demand. The current wait-time of almost 3 months is associated with important morbidity and mortality, suggesting a need for greater capacity and access.
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Affiliation(s)
| | - Shannon Masih
- Institute for Clinical Evaluative Sciences, Toronto, Canada
| | - Jiming Fang
- Institute for Clinical Evaluative Sciences, Toronto, Canada
| | - Dennis T Ko
- Sunnybrook Health Science Cntr, Toronto, Canada
| | - Sandra B Lauck
- Cntr for Heart Valve Innovation, St. Paul’s Hosp, Univ of British Columbia, Vancouver, Canada
| | - John G Webb
- Cntr for Heart Valve Innovation, St. Paul’s Hosp, Univ of British Columbia, Vancouver, Canada
| | - Brahmajee K Nallamothu
- Div of Cardiovascular Disease and the Dept of Internal Medicine at the Univ of Michigan, Michigan, MI
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Oxner A, Elbaz-Greener G, Qui F, Masih S, Zivkovic N, Alnasser S, Cheema AN, Wijeysundera HC. Variations in Use of Optimal Medical Therapy in Patients With Nonobstructive Coronary Artery Disease: A Population-Based Study. J Am Heart Assoc 2017; 6:JAHA.117.007526. [PMID: 29151028 PMCID: PMC5721803 DOI: 10.1161/jaha.117.007526] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND There is a paucity of data on the need for optimal medical therapy (OMT) in nonobstructive coronary artery disease . We sought to understand if there was variation in the use of OMT between hospitals for patients with nonobstructive coronary artery disease, the factors associated with such variation, and its clinical consequences. METHODS AND RESULTS Using a population-level clinical registry in Ontario, Canada, we identified all patients >66 years undergoing coronary angiography for the indication of stable angina, who had nonobstructive coronary artery disease between November 1, 2010, and October 31, 2013. Hierarchical multivariable logistic models were developed to identify the factors associated with OMT use, with median odds ratio used to quantify the degree of variation between hospitals not explained by the modeled risk factors. Clinical outcomes of interest were all-cause mortality and rehospitalization, with follow-up until March 31, 2015. Our cohort consisted of 5413 patients, of whom 2554 (47.2%) were receiving OMT within 1 year. There was a 2-fold variation in OMT across hospitals (30.4%-61.8%). The variation between hospitals was fully explained by preangiography medication use (median odds ratio of 1.21 in the null model and 1.03 in the full model). There was no difference in risk-adjusted mortality (hazard ratio, 0.94; 95% confidence interval, 0.76-1.16); however, patients receiving OMT had a lower risk of all-cause hospital readmission (hazard ratio, 0.89; 95% confidence interval, 0.84-0.95). CONCLUSIONS There is wide variation in the use of OMT in patients with nonobstructive coronary artery disease, the major driver of which is differences in baseline medication use.
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Affiliation(s)
- Adam Oxner
- Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Gabby Elbaz-Greener
- Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Feng Qui
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Shannon Masih
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Nevena Zivkovic
- Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Sami Alnasser
- Division of Cardiology, St Michael's Hospital, Toronto, Ontario, Canada
| | - Asim N Cheema
- Division of Cardiology, St Michael's Hospital, Toronto, Ontario, Canada
| | - Harindra C Wijeysundera
- Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada .,Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.,Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
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11
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Szpakowski N, Qiu F, Masih S, Kurdyak P, Wijeysundera HC. Economic Impact of Subsequent Depression in Patients With a New Diagnosis of Stable Angina: A Population-Based Study. J Am Heart Assoc 2017; 6:JAHA.117.006911. [PMID: 29021276 PMCID: PMC5721880 DOI: 10.1161/jaha.117.006911] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Depression is strongly linked to increased morbidity and mortality in patients with chronic stable angina; however, its associated healthcare costs have been less well studied. Our objective was to identify the characteristics of chronic stable patients found to have depression and to determine the impact of an occurrence of depression on healthcare costs within 1 year of a diagnosis of stable angina. Methods and Results In this population‐based study conducted in Ontario, Canada, we identified patients diagnosed with stable angina based on angiogram between October 1, 2008, and September 30, 2013. Depression was ascertained by physician billing codes and hospital admission diagnostic codes contained within administrative databases. The primary outcome was cumulative mean 1‐year healthcare costs following index angiogram. Generalized linear models were developed with a logarithmic link and γ distribution to determine predictors of cost. Our cohort included 22 917 patients with chronic stable angina. Patients with depression had significantly higher mean 1‐year healthcare costs ($32 072±$41 963) than patients without depression ($23 021±$25 741). After adjustment for baseline comorbidities, depression was found to be a significant independent predictor of cost, with a cost ratio of 1.33 (95% confidence interval, 1.29–1.37). Higher costs in depressed patients were seen in all healthcare sectors, including acute and ambulatory care. Conclusions Depression is an important driver of healthcare costs in patients following a diagnosis of chronic stable angina. Further research is needed to understand whether improvements in the approach to diagnosis and treatment of depression will translate to reduced expenditures in this population.
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Affiliation(s)
- Natalie Szpakowski
- Schulich Heart Centre, Division of Cardiology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Feng Qiu
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Shannon Masih
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Paul Kurdyak
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry and Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Harindra C Wijeysundera
- Schulich Heart Centre, Division of Cardiology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada .,Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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12
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Visentin CE, Masih S, Plumptre L, Malysheva O, Nielsen DE, Sohn KJ, Ly A, Lausman AY, Berger H, Croxford R, El-Sohemy A, Caudill MA, O'Connor DL, Kim YI. Maternal Choline Status, but Not Fetal Genotype, Influences Cord Plasma Choline Metabolite Concentrations. J Nutr 2015; 145:1491-7. [PMID: 25972528 DOI: 10.3945/jn.115.211136] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 04/16/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Choline deficiency during pregnancy can lead to adverse birth outcomes, including impaired neurodevelopment and birth defects. Genetic variants of choline and one-carbon metabolism may also influence birth outcomes by altering plasma choline concentrations. The effects of maternal ad libitum choline intake during pregnancy and fetal genetic variants on maternal and cord concentrations of choline and its metabolites are unknown. OBJECTIVES This prospective study sought to assess the effect of 1) maternal dietary choline intake on maternal and cord plasma concentrations of choline and its metabolites, and 2) fetal genetic polymorphisms on cord plasma concentrations. METHODS The dietary choline intake of 368 pregnant Canadian women was assessed in early (0-16 wk) and late (23-37 wk) pregnancy with the use of a food frequency questionnaire. Plasma concentrations of free choline and its metabolites were measured in maternal samples at recruitment and delivery, and in the cord blood. Ten fetal genetic variants in choline and one-carbon metabolism were assessed for their association with cord plasma concentrations of free choline and its metabolites. RESULTS Mean maternal plasma free choline, dimethylglycine, and trimethylamine N-oxide (TMAO) concentrations increased during pregnancy by 49%, 17%, and 13%, respectively (P < 0.005), whereas betaine concentrations decreased by 21% (P < 0.005). Cord plasma concentrations of free choline, betaine, dimethylglycine, and TMAO were 3.2, 2.0, 1.3, and 0.88 times corresponding maternal concentrations at delivery, respectively (all P < 0.005). Maternal plasma concentrations of betaine, dimethylglycine, and TMAO (r(2) = 0.19-0.51; P < 0.0001) at delivery were moderately strong, whereas maternal concentrations of free choline were not significant (r(2) = 0.12; P = 0.06), predictors of cord plasma concentrations of these metabolites. Neither maternal dietary intake nor fetal genetic variants predicted maternal or cord plasma concentrations of choline and its metabolites. CONCLUSION These data collectively indicate that maternal choline status, but not fetal genotype, influences cord plasma concentrations of choline metabolites. This trial was registered at clinicaltrials.gov as NCT02244684.
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Affiliation(s)
- Carly E Visentin
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada; Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Canada
| | - Shannon Masih
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada; Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Canada
| | - Lesley Plumptre
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada; Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Canada
| | - Olga Malysheva
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY; and
| | - Daiva E Nielsen
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada
| | - Kyoung-Jin Sohn
- Departments of Medicine and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Canada
| | - Anna Ly
- Departments of Medicine and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Canada
| | - Andrea Y Lausman
- Obstetrics and Gynecology, St. Michael's Hospital and University of Toronto, Toronto, Canada
| | - Howard Berger
- Obstetrics and Gynecology, St. Michael's Hospital and University of Toronto, Toronto, Canada
| | | | - Ahmed El-Sohemy
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada
| | - Marie A Caudill
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY; and
| | - Deborah L O'Connor
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada; Research Institute, the Hospital for Sick Children, Toronto, Canada
| | - Young-In Kim
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada; Departments of Medicine and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Canada;
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Kim D, Plumptre L, Masih S, Visentin C, Sohn K, Ly A, Lausman A, Berger H, Croxford R, O'Connor D, Kim Y. Maternal intake of vitamin B6 and maternal and cord plasma levels of pyridoxal 5' phosphate in a cohort of Canadian pregnant women and newborn infants. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.919.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | | | | | - Anna Ly
- MedicineUniversity of TorontoCanada
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Plumptre L, Tammen S, Masih S, Visentin C, Ly A, Sohn K, Lausman A, Croxford R, Berger H, Choi S, O'Connor D, Kim Y. Effects of Maternal Blood Levels of One‐carbon Nutrients on Global DNA Methylation and Demethylation in Cord Blood Lymphocytes. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.749.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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15
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Visentin C, Masih S, Plumptre L, Schroder T, Sohn K, Ly A, Nielsen D, Lausman A, Berger H, Croxford R, Lamers Y, O'Connor D, Kim Y. Vitamin B12 Status in a Cohort of Canadian Pregnant Women and Newborn Infants. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.134.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | | | | | - Anna Ly
- Fac. of Med. Univ. of TorontoCanada
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16
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Barzilay E, Moon A, Plumptre L, Masih S, Visentin C, Ly A, Sohn KJ, Lausman A, Croxford R, O’Connor DL, Kim YI, Berger H. 638: Gestational diabetes and the folate-methionine cycle. Am J Obstet Gynecol 2015. [DOI: 10.1016/j.ajog.2014.10.844] [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: 11/29/2022]
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17
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Franklin S, Masih S, Thomas AM. An in-vitro assessment of erosive potential of a calcium-fortified fruit juice. Eur Arch Paediatr Dent 2014; 15:407-11. [PMID: 24986231 DOI: 10.1007/s40368-014-0130-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 05/06/2014] [Indexed: 12/01/2022]
Abstract
AIM To evaluate and compare the in vitro pH, buffer capacity and calcium loss from tooth enamel before and after calcium fortification of a packaged fruit juice. METHODS An approved brand of packaged mixed fruit juice was selected as a test drink on the basis of a pilot questionnaire. The test drink was fortified with 1,000 mg/l (0.1% w/v) of calcium citrate malate to obtain two test groups: Group 1: original beverage (serving as control) and Group 2: calcium-fortified drink. The pH and buffering capacity for the test drinks were measured before and after calcium fortification; 90 prepared enamel samples were divided and immersed into three test subgroups: (1) buffer solution pH 7 (positive control), (2) original fruit juice (negative control) and (3) calcium-fortified fruit juice for 3 min. Calcium loss from the enamel of immersed teeth was measured as a quantitative estimate of tooth mineral loss. RESULTS After calcium fortification of the fruit juice the mean pH raised from 3.4 to 4.0 (p = 0.029), the mean buffer capacity decreased from 9.73 to 9.16 (p < 0.001) and the mean calcium loss from enamel specimens decreased from 3.5 to 0.26 mg/dl (p < 0.001). STATISTICS To compare the change in mean pH and buffering capacity between the subject groups, t test was used, and to compare the calcium loss from enamel specimens, among the three subgroups, ANOVA was used. CONCLUSION Calcium fortification of packaged fruit juice in vitro, improves its pH and buffering capacity. Consequently, the fortified juice causes significantly less mineral loss from human enamel. Fortifying juice with calcium may exert a significant protective potential against dental erosion particularly due to frequent exposure of acidic drinks.
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Affiliation(s)
- S Franklin
- Department of Pediatric and Preventive Dentistry, Christian Dental College, Ludhiana, 141008, Punjab, India,
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18
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Masih S, Plumptre L, Ly A, Sohn K, Berger H, Lausman A, Croxford R, O'Connor D, Kim Y. Vitamin B
12
: dietary intake, supplement use and serum concentrations in a cohort of Canadian pregnant women and in umbilical cord blood (135.7). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.135.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Shannon Masih
- St. Michael's HospitalTORONTOONCanada
- Nutritional SciencesUniversity of TORONTOTorontoONCanada
| | - Lesley Plumptre
- St. Michael's HospitalTORONTOONCanada
- Nutritional SciencesUniversity of TORONTOTorontoONCanada
| | - Anna Ly
- St. Michael's HospitalTORONTOONCanada
- Nutritional SciencesUniversity of TORONTOTorontoONCanada
| | - Kyoung‐Jin Sohn
- St. Michael's HospitalTORONTOONCanada
- Nutritional SciencesUniversity of TORONTOTorontoONCanada
| | - Howard Berger
- St. Michael's HospitalTORONTOONCanada
- Nutritional SciencesUniversity of TORONTOTorontoONCanada
| | - Andrea Lausman
- St. Michael's HospitalTORONTOONCanada
- Nutritional SciencesUniversity of TORONTOTorontoONCanada
| | - Ruth Croxford
- Nutritional SciencesUniversity of TORONTOTorontoONCanada
| | - Deborah O'Connor
- The Hospital for Sick ChildrenTORONTOONCanada
- Nutritional SciencesUniversity of TORONTOTorontoONCanada
| | - Young‐In Kim
- St. Michael's HospitalTORONTOONCanada
- Nutritional SciencesUniversity of TORONTOTorontoONCanada
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Visentin C, Masih S, Plumptre L, Malysheva O, Sohn K, Ly A, Lausman A, Berger H, Croxford R, Caudill M, O'Connor D, Kim Y. Dietary intake and blood levels of choline in a cohort of Canadian pregnant women and newborn infants (827.9). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.827.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Carly Visentin
- St. Michael's HospitalTORONTOONCanada
- University of TORONTOTorontoONCanada
| | - Shannon Masih
- St. Michael's HospitalTORONTOONCanada
- University of TORONTOTorontoONCanada
| | - Lesley Plumptre
- St. Michael's HospitalTORONTOONCanada
- University of TORONTOTorontoONCanada
| | | | - Kyoung‐Jin Sohn
- St. Michael's HospitalTORONTOONCanada
- University of TORONTOTorontoONCanada
| | - Anna Ly
- St. Michael's HospitalTORONTOONCanada
- University of TORONTOTorontoONCanada
| | | | | | - Ruth Croxford
- Inst. of Clinical Evaluative SciencesTORONTOONCanada
| | | | | | - Young‐In Kim
- St. Michael's HospitalTORONTOONCanada
- University of TORONTOTorontoONCanada
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20
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Masih S, Plumptre L, Ly A, Berger H, Lausman AY, Croxford R, O'Connor DL, Kim Y. Intakes, sources and blood levels of folate in Canadian pregnant women in the post‐fortification era. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.246.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Shannon Masih
- University of TorontoTorontoONCanada
- St. Michael's HospitalTorontoONCanada
| | - Lesley Plumptre
- University of TorontoTorontoONCanada
- St. Michael's HospitalTorontoONCanada
| | - Anna Ly
- St. Michael's HospitalTorontoONCanada
| | | | | | | | - Deborah L. O'Connor
- University of TorontoTorontoONCanada
- The Hospital for Sick ChildrenTorontoONCanada
| | - Young‐in Kim
- University of TorontoTorontoONCanada
- St. Michael's HospitalTorontoONCanada
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Plumptre L, Masih S, Ly A, Aufreiter S, Croxford R, Lausman AY, Berger H, O'Connor DL, Kim Y. Detectable levels of unmetabolized folic acid in Canadian pregnant women. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.1077.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Lesley Plumptre
- University of TorontoTorontoONCanada
- St. Michael's HospitalTorontoONCanada
| | - Shannon Masih
- University of TorontoTorontoONCanada
- St. Michael's HospitalTorontoONCanada
| | - Anna Ly
- St. Michael's HospitalTorontoONCanada
| | | | | | | | | | - Deborah L O'Connor
- University of TorontoTorontoONCanada
- The Hospital for Sick ChildrenTorontoONCanada
| | - Young‐In Kim
- University of TorontoTorontoONCanada
- St. Michael's HospitalTorontoONCanada
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Abstract
This article presents a case of bilateral unerupted supernumerary teeth in the mandibular premolar region. Surgical removal of the right-sided supernumerary tooth had to be carried out as it was impeding the eruption of the mandibular first premolar. However, its supernumerary antimere, lay dormant.
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Affiliation(s)
- S Masih
- Department of Pediatric and Preventive Dentistry, Christian Dental College, CMC, Ludhiana, Punjab, India
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Kao K, Hong S, Taylor C, Nouvong A, Masih S, Perell K, Fang M. Laterally Wedged Shoe Inserts as An Intervention for Medial Knee Osteoarthritis. J Investig Med 2006. [DOI: 10.1177/108155890605401s185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- K.C. Kao
- VA Greater Los Angeles Healthcare System, Los Angeles, CA
- David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - S. Hong
- VA Greater Los Angeles Healthcare System, Los Angeles, CA
- David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - C.E. Taylor
- VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - A. Nouvong
- VA Greater Los Angeles Healthcare System, Los Angeles, CA
- David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - S. Masih
- VA Greater Los Angeles Healthcare System, Los Angeles, CA
- David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - K.L. Perell
- VA Greater Los Angeles Healthcare System, Los Angeles, CA
- Department of Kinesiology and Health Science, California Sate University, Fullerton, CA
| | - M.A. Fang
- VA Greater Los Angeles Healthcare System, Los Angeles, CA
- David Geffen School of Medicine at UCLA, Los Angeles, CA
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Kao KC, Hong S, Taylor CE, Nouvong A, Masih S, Perell KL, Fang MA. 302 LATERALLY WEDGED SHOE INSERTS AS AN INTERVENTION FOR MEDIAL KNEE OSTEOARTHRITIS. J Investig Med 2006. [DOI: 10.2310/6650.2005.x0004.301] [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: 11/18/2022]
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Abstract
We present a rare case of a non-calcified pilomatricoma in a 67-year-old man. This tumor was extremely large in size, and its location, in the lower extremity, was very unusual. The clinical, radiographic, and histopathological features are described in detail. The role of magnetic resonance imaging (MRI) in the diagnosis of this entity is discussed. Definite internal reticulations and septations were observed. A possible explanation for this observation is that the high signal intensity reticulations may represent edematous stroma surrounding basaloid cells.
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Affiliation(s)
- S Masih
- West Los Angeles V.A. Medical Center, Department of Radiology, 114, 11301 Wilshire Blvd, Los Angeles, CA 90073, USA
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Abstract
Using radiographs and diagrams, this article reviews the most commonly used axes and angles of the foot, including: longitudinal axis of the rearfoot, collum tali axis, talocalcaneal angle, cuboid abduction angle, longitudinal axis of the lesser tarsus, lesser tarsus angle, talonavicular angle, longitudinal axis of the metatarsus, forefoot adductus angle, metatarsus adductus angle, first intermetatarsal angle, hallux valgus angle, proximal and distal articular set angles, and hallux interphalangeal angle, plane of support, collum tali axis, talar declination angle, calcaneal inclination axis, lateral talocalcaneal angle, first metatarsal declination axis and calcaneal inclination angle.
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Affiliation(s)
- A Gentili
- West-Los Angeles Veteran Administration Medical Center, CA 90073, USA
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Masih S, Bakhda RK, Collins JD. Pelvic fused kidneys: magnetic resonance imaging and intravenous pyelogram correlation. J Natl Med Assoc 1988; 80:925-7. [PMID: 3246706 PMCID: PMC2625714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This is a case presentation of pelvic fused kidneys as demonstrated by intravenous pyelogram and magnetic resonance imaging (MRI). The authors wish to stress the importance of anatomical imaging with MRI in the coronal plane. No reconstruction is required as with computerized tomography.
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Grossman I, von Phul R, Fitzgerald JP, Masih S, Turner F, Kurohara SS, George F. Proceedings: The early lymphatic spread of manifest prostatic adenocarcinoma. Am J Roentgenol Radium Ther Nucl Med 1974; 120:673-7. [PMID: 4856263 DOI: 10.2214/ajr.120.3.673] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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