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Chen L, Wang L, Petrossian G, Robinson N, Chung W, Henry M, Mihalatos D, Bano R, Weber J, Khan J, Cohen DJ, Berke A, Ali Z, Khalique OK. Etiologies and Impact of Exclusion Rates for Transcatheter Mitral and Tricuspid Valve Structural Heart Clinical Trials at a High-Volume Quaternary Care Hospital. Am J Cardiol 2024; 218:102-112. [PMID: 38432332 DOI: 10.1016/j.amjcard.2024.02.035] [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: 09/20/2023] [Revised: 01/31/2024] [Accepted: 02/23/2024] [Indexed: 03/05/2024]
Abstract
There are various devices under clinical investigation for transcatheter mitral valve intervention and transcatheter tricuspid valve intervention (TTVI); however, the exclusion rates remain high. We aimed to investigate the exclusion rates for transcatheter mitral valve repair (TMVr), transcatheter mitral valve replacement (TMVR), transcatheter tricuspid valve repair (TTVr), and transcatheter tricuspid valve replacement (TTVR). There were 129 patients who were referred to St. Francis Hospital & Heart Center valve clinic and completed screening between January 2021 and July 2022. The causes for exclusion were classified into 4 categories: patient withdrawal, anatomic unsuitability, clinical criteria, and medical futility. In 129 patients, the exclusion rates for TMVr, TMVR, TTVr, and TTVR were 81%, 85%, 91%, and 87%, respectively. Patient withdrawal and medical futility were leading etiologies for exclusion, followed by anatomic unsuitability. TMVr had the highest rate of patient withdrawal (64%) and the lowest anatomic unsuitability (5%) because of short posterior leaflet length. Replacement interventions have a higher anatomic unsuitability (33%) than repair interventions (17%) (p = 0.04). Most exclusions of anatomic unsuitability were because of mitral stenosis or small annulus size for TMVR and large annulus size for TTVR. A total of 50% of exclusions from TTVr were because of the presence of pacemaker/defibrillator leads. In patients excluded from their respective trials, patients being referred for TMVr had the highest recurrent hospitalization and repair group had a higher mortality (p <0.01 and p = 0.01, respectively). In conclusion, the exclusion rates for transcatheter mitral valve intervention and TTVI trials remain high because of various reasons, limiting patient enrollment and treatment. This supports the need for further device improvement or exploring alternative means of therapy.
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Affiliation(s)
- Lu Chen
- DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, Roslyn, New York.
| | - Lin Wang
- DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, Roslyn, New York
| | - George Petrossian
- DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, Roslyn, New York
| | - Newell Robinson
- DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, Roslyn, New York
| | - William Chung
- DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, Roslyn, New York
| | - Matthew Henry
- DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, Roslyn, New York
| | - Dennis Mihalatos
- DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, Roslyn, New York
| | - Ruqiyya Bano
- Department of Nephrology and Hypertension, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
| | - Jonathan Weber
- DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, Roslyn, New York
| | - Jaffar Khan
- DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, Roslyn, New York
| | - David J Cohen
- DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, Roslyn, New York
| | - Andrew Berke
- DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, Roslyn, New York
| | - Ziad Ali
- DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, Roslyn, New York; New York Institute of Technology, Old Westbury, New York
| | - Omar K Khalique
- DeMatteis Cardiovascular Institute, St Francis Hospital & Heart Center, Roslyn, New York; New York Institute of Technology, Old Westbury, New York
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Araki M, Park SJ, Dauerman HL, Uemura S, Kim JS, Di Mario C, Johnson TW, Guagliumi G, Kastrati A, Joner M, Holm NR, Alfonso F, Wijns W, Adriaenssens T, Nef H, Rioufol G, Amabile N, Souteyrand G, Meneveau N, Gerbaud E, Opolski MP, Gonzalo N, Tearney GJ, Bouma B, Aguirre AD, Mintz GS, Stone GW, Bourantas CV, Räber L, Gili S, Mizuno K, Kimura S, Shinke T, Hong MK, Jang Y, Cho JM, Yan BP, Porto I, Niccoli G, Montone RA, Thondapu V, Papafaklis MI, Michalis LK, Reynolds H, Saw J, Libby P, Weisz G, Iannaccone M, Gori T, Toutouzas K, Yonetsu T, Minami Y, Takano M, Raffel OC, Kurihara O, Soeda T, Sugiyama T, Kim HO, Lee T, Higuma T, Nakajima A, Yamamoto E, Bryniarski KL, Di Vito L, Vergallo R, Fracassi F, Russo M, Seegers LM, McNulty I, Park S, Feldman M, Escaned J, Prati F, Arbustini E, Pinto FJ, Waksman R, Garcia-Garcia HM, Maehara A, Ali Z, Finn AV, Virmani R, Kini AS, Daemen J, Kume T, Hibi K, Tanaka A, Akasaka T, Kubo T, Yasuda S, Croce K, Granada JF, Lerman A, Prasad A, Regar E, Saito Y, Sankardas MA, Subban V, Weissman NJ, Chen Y, Yu B, Nicholls SJ, Barlis P, West NEJ, Arbab-Zadeh A, Ye JC, Dijkstra J, Lee H, Narula J, Crea F, Nakamura S, Kakuta T, Fujimoto J, Fuster V, Jang IK. Author Correction: Optical coherence tomography in coronary atherosclerosis assessment and intervention. Nat Rev Cardiol 2024; 21:348. [PMID: 38110566 DOI: 10.1038/s41569-023-00982-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Affiliation(s)
| | | | | | | | - Jung-Sun Kim
- Yonsei University College of Medicine, Seoul, South Korea
| | | | - Thomas W Johnson
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - Adnan Kastrati
- Technische Universität München and Munich Heart Alliance, Munich, Germany
| | | | | | | | - William Wijns
- National University of Ireland Galway and Saolta University Healthcare Group, Galway, Ireland
| | | | | | - Gilles Rioufol
- Hospices Civils de Lyon and Claude Bernard University, Lyon, France
| | | | | | | | | | | | - Nieves Gonzalo
- Hospital Clinico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain
| | | | - Brett Bouma
- Massachusetts General Hospital, Boston, MA, USA
| | | | - Gary S Mintz
- Cardiovascular Research Foundation, New York, NY, USA
| | - Gregg W Stone
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christos V Bourantas
- Barts Health NHS Trust, University College London and Queen Mary University London, London, UK
| | - Lorenz Räber
- Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | | | | | | | - Myeong-Ki Hong
- Yonsei University College of Medicine, Seoul, South Korea
| | - Yangsoo Jang
- Yonsei University College of Medicine, Seoul, South Korea
| | | | - Bryan P Yan
- Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Italo Porto
- University of Genoa, Genoa, Italy, San Martino Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy
| | | | - Rocco A Montone
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | | | | | - Harmony Reynolds
- New York University Grossman School of Medicine, New York, NY, USA
| | - Jacqueline Saw
- Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Peter Libby
- Brigham and Women's Hospital, Boston, MA, USA
| | - Giora Weisz
- New York Presbyterian Hospital, Columbia University Medical Center and Cardiovascular Research Foundation, New York, NY, USA
| | | | - Tommaso Gori
- Universitäts medizin Mainz and DZHK Rhein-Main, Mainz, Germany
| | | | | | | | | | | | - Osamu Kurihara
- Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | | | | | | | - Tetsumin Lee
- Japanese Red Cross Musashino Hospital, Tokyo, Japan
| | - Takumi Higuma
- Kawasaki Municipal Tama Hospital, St. Marianna University School of Medicine, Kanagawa, Japan
| | | | - Erika Yamamoto
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Krzysztof L Bryniarski
- Jagiellonian University Medical College, Institute of Cardiology, Department of Interventional Cardiology, John Paul II Hospital, Krakow, Poland
| | | | | | | | - Michele Russo
- Catholic University of the Sacred Heart, Rome, Italy
| | | | | | - Sangjoon Park
- Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Marc Feldman
- University of Texas Health, San Antonio, TX, USA
| | | | - Francesco Prati
- UniCamillus - Saint Camillus International University of Health Sciences, Rome, Italy
| | - Eloisa Arbustini
- IRCCS Foundation University Hospital Policlinico San Matteo, Pavia, Italy
| | - Fausto J Pinto
- Santa Maria University Hospital, CHULN Center of Cardiology of the University of Lisbon, Lisbon School of Medicine, Lisbon Academic Medical Center, Lisbon, Portugal
| | - Ron Waksman
- MedStar Washington Hospital Center, Washington, DC, USA
| | | | - Akiko Maehara
- Cardiovascular Research Foundation, New York, NY, USA
| | - Ziad Ali
- Cardiovascular Research Foundation, New York, NY, USA
| | | | | | | | - Joost Daemen
- Erasmus University Medical Centre, Rotterdam, Netherlands
| | | | - Kiyoshi Hibi
- Yokohama City University Medical Center, Kanagawa, Japan
| | | | | | | | - Satoshi Yasuda
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kevin Croce
- Brigham and Women's Hospital, Boston, MA, USA
| | | | | | | | | | | | | | | | | | - Yundai Chen
- Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Bo Yu
- The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | | | - Peter Barlis
- University of Melbourne, Melbourne, Victoria, Australia
| | | | | | - Jong Chul Ye
- Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | | | - Hang Lee
- Massachusetts General Hospital, Boston, MA, USA
| | - Jagat Narula
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Filippo Crea
- Catholic University of the Sacred Heart, Rome, Italy
| | | | | | - James Fujimoto
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | - Ik-Kyung Jang
- Massachusetts General Hospital, Boston, MA, USA.
- Kyung Hee University, Seoul, South Korea.
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Ohashi H, Mizukami T, Sonck J, Boussiet F, Ko B, Nørgaard BL, Mæng M, Jensen JM, Sakai K, Ando H, Amano T, Amabile N, Ali Z, De Bruyne B, Koo B, Otake H, Collet C. Intravascular Imaging Findings After PCI in Patients With Focal and Diffuse Coronary Artery Disease. J Am Heart Assoc 2024; 13:e032605. [PMID: 38390822 PMCID: PMC10944036 DOI: 10.1161/jaha.123.032605] [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: 09/10/2023] [Accepted: 01/17/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Following percutaneous coronary intervention (PCI), optical coherence tomography provides prognosis information. The pullback pressure gradient is a novel index that discriminates focal from diffuse coronary artery disease based on fractional flow reserve pullbacks. We sought to investigate the association between coronary artery disease patterns, defined by coronary physiology, and optical coherence tomography after stent implantation in stable patients undergoing PCI. METHODS AND RESULTS This multicenter, prospective, single-arm study was conducted in 5 countries (NCT03782688). Subjects underwent motorized fractional flow reserve pullbacks evaluation followed by optical coherence tomography-guided PCI. Post-PCI optical coherence tomography minimum stent area, stent expansion, and the presence of suboptimal findings such as incomplete stent apposition, stent edge dissection, and irregular tissue protrusion were compared between patients with focal versus diffuse disease. Overall, 102 patients (105 vessels) were included. Fractional flow reserve before PCI was 0.65±0.14, pullback pressure gradient was 0.66±0.14, and post-PCI fractional flow reserve was 0.88±0.06. The mean minimum stent area was 5.69±1.99 mm2 and was significantly larger in vessels with focal disease (6.18±2.12 mm2 versus 5.19±1.72 mm2, P=0.01). After PCI, incomplete stent apposition, stent edge dissection, and irregular tissue protrusion were observed in 27.6%, 10.5%, and 51.4% of the cases, respectively. Vessels with focal disease at baseline had a lower prevalence of incomplete stent apposition (11.3% versus 44.2%, P=0.002) and more irregular tissue protrusion (69.8% versus 32.7%, P<0.001). CONCLUSIONS Baseline coronary pathophysiological patterns are associated with suboptimal imaging findings after PCI. Patients with focal disease had larger minimum stent area and a higher incidence of tissue protrusion, whereas stent malapposition was more frequent in patients with diffuse disease.
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Affiliation(s)
- Hirofumi Ohashi
- Cardiovascular Center AalstOLV ClinicAalstBelgium
- Department of CardiologyAichi Medical UniversityAichiJapan
| | - Takuya Mizukami
- Cardiovascular Center AalstOLV ClinicAalstBelgium
- Division of Clinical Pharmacology, Department of PharmacologyShowa UniversityTokyoJapan
- Department of Cardiovascular MedicineGifu Heart CenterGifuJapan
| | - Jeroen Sonck
- Cardiovascular Center AalstOLV ClinicAalstBelgium
| | - Frederic Boussiet
- Cardiovascular Center AalstOLV ClinicAalstBelgium
- Department of CardiologyToulouse University HospitalToulouseFrance
| | - Brian Ko
- Monash Cardiovascular Research CentreMonash University and Monash Heart, Monash HealthClaytonVictoriaAustralia
| | | | - Michael Mæng
- Department of CardiologyAarhus University HospitalAarhusDenmark
| | | | - Koshiro Sakai
- Cardiovascular Center AalstOLV ClinicAalstBelgium
- Department of Medicine, Division of CardiologyShowa University School of MedicineTokyoJapan
| | - Hirohiko Ando
- Department of CardiologyAichi Medical UniversityAichiJapan
| | - Tetsuya Amano
- Department of CardiologyAichi Medical UniversityAichiJapan
| | - Nicolas Amabile
- Department of CardiologyInstitut Mutualiste MontsourisParisFrance
| | - Ziad Ali
- DeMatteis Cardiovascular InstituteSt. Francis Hospital & Heart CenterRoslynNY
| | - Bernard De Bruyne
- Cardiovascular Center AalstOLV ClinicAalstBelgium
- Department of CardiologyLausanne University HospitalLausanneSwitzerland
| | - Bon‐Kwon Koo
- Department of Internal Medicine and Cardiovascular CenterSeoul National University HospitalSeoulSouth Korea
| | - Hiromasa Otake
- Division of Cardiovascular Medicine, Department of Internal MedicineKobe University Graduate School of MedicineKobeJapan
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Visinoni ZM, Jurewitz DL, Kereiakes DJ, Shlofmitz R, Shlofmitz E, Ali Z, Hill J, Lee MS. Coronary intravascular lithotripsy for severe coronary artery calcification: The disrupt CAD I-IV trials. Cardiovasc Revasc Med 2024:S1553-8389(24)00076-9. [PMID: 38472025 DOI: 10.1016/j.carrev.2024.03.001] [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: 11/27/2023] [Revised: 02/14/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024]
Abstract
Coronary artery calcification (CAC) severity is associated with increased vessel inflammation, atherosclerosis, stent failure, and risk of percutaneous coronary intervention-related complications. Current modalities for CAC modification include atherectomy techniques (rotational, orbital, and laser) and balloon modification (cutting and scoring). However, these methods are limited by their risk of slow flow/no reflow, coronary dissection, perforation, and myocardial infarction. Intravascular lithotripsy (IVL) emits high-energy sonic waves that induce calcium fractures within a target lesion to improve vessel compliance for stent placement. Low rates of major cardiac adverse events (MACE) and high rates of procedural and angiographic success were observed with IVL in the Disrupt CAD I-IV trials. Optical coherence tomography sub-studies identified calcium fracture as the likely etiology of improved vessel compliance and increased luminal diameter post-IVL. Rates of MACE, procedural, and angiographic success were consistent across the Disrupt CAD trials, suggesting IVL is less operator-dependent compared to other calcium-modifying techniques. Coronary IVL offers interventional cardiologists a safe and effective method of severe CAC modification, while providing reproducible outcomes.
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Affiliation(s)
- Zachary M Visinoni
- Sutter Roseville Medical Center, Roseville, CA, United States of America
| | - Daniel L Jurewitz
- Sutter Roseville Medical Center, Roseville, CA, United States of America
| | - Dean J Kereiakes
- The Carl and Edyth Lindner Research Center at The Christ Hospital, Cincinnati, OH, United States of America
| | - Richard Shlofmitz
- St. Francis Hospital & Heart Center, Roslyn, NY, United States of America
| | - Evan Shlofmitz
- St. Francis Hospital & Heart Center, Roslyn, NY, United States of America
| | - Ziad Ali
- Cardiovascular Research Foundation, New York, NY, United States of America
| | - Jonathan Hill
- Royal Bromptom Hospital, London, England, United Kingdom of Great Britain and Northern Ireland
| | - Michael S Lee
- Innovative Medical Solutions, Beverly Hills, CA, United States of America.
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Atif M, Husnain HU, Rehman AU, Younas U, Rafique T, Khalid W, Ali Z, Nadeem M. Enhancement in the dielectric and magnetic properties of Ni 2+-Cu 2+ co-doped BaFe 11Cu 1-xNi xO 19 hexaferrites (0.0 ≤ x ≤ 1.0). RSC Adv 2024; 14:6883-6895. [PMID: 38410360 PMCID: PMC10895416 DOI: 10.1039/d3ra06684c] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 02/13/2024] [Indexed: 02/28/2024] Open
Abstract
Herein, Ni2+-Cu2+ co-doped barium hexaferrites (BaFe11Cu1-xNixO19, 0.0 ≤ x≤ 1.0 with an interval of 0.25) were successfully synthesized using a co-precipitation method. The formation of a magnetoplumbite structure with the P63/mmc space group was confirmed by Rietveld refinement of the obtained X-ray diffraction patterns. Microstructural investigations revealed grains in the shape of hexagonal plates, while co-doping resulted in a variation in the grain sizes of the prepared samples. X-ray photoelectron spectroscopy was performed to determine the valence state of iron in the prepared hexaferrites. Impedance spectroscopy analysis revealed that dielectric permittivity initially decreased with an increase in the co-dopant content up to x = 0.5 and then increased by two orders of magnitude for x = 1.0. Alternatively, resistive properties showed microstructural resistance values in the range 105-108 Ω, with the highest value obtained for the sample with x = 0.5. Furthermore, magnetic measurements indicated that all the prepared samples exhibited ferrimagnetic behaviour. Saturation magnetization and magnetic anisotropy values were found to be the highest for the sample with x = 1.0, which also had the lowest coercivity among the prepared samples. Herein, the observed variations in the obtained results can be explained by the variations in grain sizes and the Fe2+/Fe3+ ratio associated with the preferential occupation of co-dopants at octahedral sites. Based on our findings, the BaFe11Ni1O19 (x = 1.0) composition appears to be the most promising choice as a microwave absorption material among the prepared samples owing to the coexistence of high dielectric permittivity (>103 at 107 Hz) and saturation magnetization (73 emu g-1).
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Affiliation(s)
- M Atif
- Functional Materials Lab, Department of Physics, Air University PAF Complex E-9 Islamabad Pakistan
| | - H Ul Husnain
- Functional Materials Lab, Department of Physics, Air University PAF Complex E-9 Islamabad Pakistan
| | - Atta Ur Rehman
- Functional Materials Lab, Department of Physics, Air University PAF Complex E-9 Islamabad Pakistan
- Department of Physics, The University of Hong Kong Pokfulam Hong Kong
| | - U Younas
- Functional Materials Lab, Department of Physics, Air University PAF Complex E-9 Islamabad Pakistan
| | - T Rafique
- Functional Materials Lab, Department of Physics, Air University PAF Complex E-9 Islamabad Pakistan
| | - W Khalid
- Functional Materials Lab, Department of Physics, Air University PAF Complex E-9 Islamabad Pakistan
| | - Z Ali
- Functional Materials Lab, Department of Physics, Air University PAF Complex E-9 Islamabad Pakistan
| | - M Nadeem
- Polymer Composite Group, Physics Division, Directorate of Science, PINSTECH P.O. Nilore Islamabad Pakistan
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Romagnoli E, Burzotta F, Vergallo R, Gatto L, Biondi-Zoccai G, Ramazzotti V, Biccirè F, Budassi S, Trani C, Ali Z, Stone GW, Prati F. Clinical impact of OCT-derived suboptimal stent implantation parameters and definitions. Eur Heart J Cardiovasc Imaging 2023; 25:48-57. [PMID: 37463223 PMCID: PMC10735315 DOI: 10.1093/ehjci/jead172] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/09/2023] [Accepted: 06/25/2023] [Indexed: 07/20/2023] Open
Abstract
AIMS Despite growing evidence supporting the clinical utility of optical coherence tomography (OCT) guidance during percutaneous coronary interventions (PCIs), there is no common agreement as to the optimal stent implantation parameters that enhance clinical outcome. METHODS AND RESULTS We retrospectively examined the predictive accuracy of suboptimal stent implantation definitions proposed from the CLI-OPCI II, ILUMIEN-IV OPTIMAL PCI, and FORZA studies for the long-term risk of device-oriented cardiovascular events (DoCE) in the population of large all-comers CLI-OPCI project. A total of 1020 patients undergoing OCT-guided drug-eluting stent implantation in the CLI-OPCI registry with a median follow-up of 809 (quartiles 414-1376) days constituted the study population. According to CLI-OPCI II, ILUMIEN-IV OPTIMAL PCI, and FORZA criteria, the incidence of suboptimal stent implantation was 31.8%, 58.1%, and 57.8%, respectively. By multivariable Cox analysis, suboptimal stent implantation criteria from the CLI-OPCI II [hazard ratio 2.75 (95% confidence interval 1.88-4.02), P < 0.001] and ILUMIEN-IV OPTIMAL PCI [1.79 (1.18-2.71), P = 0.006] studies, but not FORZA trial [1.11 (0.75-1.63), P = 0.597], were predictive of DoCE. At long-term follow-up, stent edge disease with minimum lumen area <4.5 mm2 [8.17 (5.32-12.53), P < 0.001], stent edge dissection [2.38 (1.33-4.27), P = 0.004], and minimum stent area <4.5 mm2 [1.68 (1.13-2.51), P = 0.011] were the main OCT predictors of DoCE. CONCLUSION The clinical utility of OCT-guided PCI might depend on the metrics adopted to define suboptimal stent implantation. Uncovered disease at the stent border, stent edge dissection, and minimum stent area <4.5 mm2 were the strongest OCT associates of stent failure.
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Affiliation(s)
- Enrico Romagnoli
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Burzotta
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Rocco Vergallo
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Laura Gatto
- Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy
- Centro per la Lotta Contro L’Infarto—CLI Foundation, Rome, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- Mediterranea Cardiocentro, Napoli, Italy
| | | | - Flavio Biccirè
- Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy
- Centro per la Lotta Contro L’Infarto—CLI Foundation, Rome, Italy
| | - Simone Budassi
- Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy
- Centro per la Lotta Contro L’Infarto—CLI Foundation, Rome, Italy
| | - Carlo Trani
- Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Ziad Ali
- St Francis Hospital & Heart Center, Roslyn, NY, USA
- Cardiovascular Research Foundation, New York, NY, USA
| | - Gregg W Stone
- The Icahn School of Medicine at Mount Sinai, Mount Sinai Heart and the Cardiovascular Research Foundation, New York, NY, USA
| | - Francesco Prati
- Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy
- Centro per la Lotta Contro L’Infarto—CLI Foundation, Rome, Italy
- UniCamillus—Saint Camillus International University of Health Sciences, Rome, Italy
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7
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Quach D, Lyons NB, Nguyen K, Olavarria OA, Bernardi K, Neela N, Dhanani NH, Jackson A, Ali Z, Liang MK. Natural history of occult hernias in adults at a safety-net hospital. Hernia 2023; 27:1467-1472. [PMID: 36795186 DOI: 10.1007/s10029-023-02754-7] [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: 11/07/2022] [Accepted: 02/03/2023] [Indexed: 02/17/2023]
Abstract
PURPOSE Occult hernias, hernias seen on radiologic imaging but not felt on physical exam, are common. Despite their high prevalence, little is known about the natural history of this finding. Our aim was to determine and report on the natural history of patients with occult hernias including the impact on abdominal wall quality of life (AW-QOL), need for surgery, and risk of acute incarceration/strangulation. METHODS This was a prospective cohort study of patients who underwent a computed tomography (CT) abdomen/pelvis scan from 2016 to 2018. Primary outcome was change in AW-QOL using the modified Activities Assessment Scale (mAAS), a hernia-specific, validated survey (1 = poor, 100 = perfect). Secondary outcomes included elective and emergent hernia repairs. RESULTS A total of 131 (65.8%) patients with occult hernias completed follow-up with a median (IQR) of 15.4 (22.5) months. Nearly half of these patients (42.8%) experienced a decrease in their AW-QOL, 26.0% were unchanged, and 31.3% reported improvement. One-fourth of patients (27.5%) underwent abdominal surgery during the study period: 9.9% were abdominal procedures without hernia repair, 16.0% involved elective hernia repairs, and 1.5% were emergent hernia repairs. AW-QOL improved for patients who underwent hernia repair (+ 11.2 ± 39.7, p = 0.043) while those who did not undergo hernia repair experienced no change in AW-QOL (- 3.0 ± 35.1). CONCLUSION When untreated, patients with occult hernias on average experience no change in their AW-QOL. However, many patients experience improvement in AW-QOL after hernia repair. Additionally, occult hernias have a small but real risk of incarceration requiring emergent repair. Further research is needed to develop tailored treatment strategies.
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Affiliation(s)
- D Quach
- Department of Surgery, HCA Healthcare Kingwood, University of Houston, Kingwood, TX, USA
| | - N B Lyons
- Department of Surgery, University of Miami Miller School of Medicine, 1800 NW 10th Ave, Miami, FL, 33136, USA.
| | - K Nguyen
- Department of Surgery, HCA Healthcare Kingwood, University of Houston, Kingwood, TX, USA
| | - O A Olavarria
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA
| | - K Bernardi
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA
| | - N Neela
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - N H Dhanani
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA
| | - A Jackson
- Department of Surgery, University of Miami Miller School of Medicine, 1800 NW 10th Ave, Miami, FL, 33136, USA
| | - Z Ali
- Department of Surgery, HCA Healthcare Kingwood, University of Houston, Kingwood, TX, USA
| | - M K Liang
- Department of Surgery, HCA Healthcare Kingwood, University of Houston, Kingwood, TX, USA
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8
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Munhoz D, Collet C, Mizukami T, Yong A, Leone AM, Eftekhari A, Ko B, da Costa BR, Berry C, Collison D, Perera D, Christiansen EH, Rivero F, Zimmermann FM, Ando H, Matsuo H, Nakayama M, Escaned J, Sonck J, Sakai K, Adjedj J, Desta L, van Nunen LX, West NEJ, Fournier S, Storozhenko T, Amano T, Engstrøm T, Johnson T, Shinke T, Biscaglia S, Fearon WF, Ali Z, De Bruyne B, Johnson NP. Rationale and design of the pullback pressure gradient (PPG) global registry. Am Heart J 2023; 265:170-179. [PMID: 37611857 DOI: 10.1016/j.ahj.2023.07.016] [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] [Received: 04/06/2023] [Revised: 06/20/2023] [Accepted: 07/08/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION Diffuse disease has been identified as one of the main reasons leading to low post-PCI fractional flow reserve (FFR) and residual angina after PCI. Coronary pressure pullbacks allow for the evaluation of hemodynamic coronary artery disease (CAD) patterns. The pullback pressure gradient (PPG) is a novel metric that quantifies the distribution and magnitude of pressure losses along the coronary artery in a focal-to-diffuse continuum. AIM The primary objective is to determine the predictive capacity of the PPG for post-PCI FFR. METHODS This prospective, large-scale, controlled, investigator-initiated, multicenter study is enrolling patients with at least 1 lesion in a major epicardial vessel with a distal FFR ≤ 0.80 intended to be treated by PCI. The study will include 982 subjects. A standardized physiological assessment will be performed pre-PCI, including the online calculation of PPG from FFR pullbacks performed manually. PPG quantifies the CAD pattern by combining several parameters from the FFR pullback curve. Post-PCI physiology will be recorded using a standardized protocol with FFR pullbacks. We hypothesize that PPG will predict optimal PCI results (post-PCI FFR ≥ 0.88) with an area under the ROC curve (AUC) ≥ 0.80. Secondary objectives include patient-reported and clinical outcomes in patients with focal vs. diffuse CAD defined by the PPG. Clinical follow-up will be collected for up to 36 months, and an independent clinical event committee will adjudicate events. RESULTS Recruitment is ongoing and is expected to be completed in the second half of 2023. CONCLUSION This international, large-scale, prospective study with pre-specified powered hypotheses will determine the ability of the preprocedural PPG index to predict optimal revascularization assessed by post-PCI FFR. In addition, it will evaluate the impact of PPG on treatment decisions and the predictive performance of PPG for angina relief and clinical outcomes.
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Affiliation(s)
- Daniel Munhoz
- Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium; Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Carlos Collet
- Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium
| | - Takuya Mizukami
- Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium; Division of Clinical Pharmacology, Department of Pharmacology, Showa University, Tokyo, Japan
| | - Andy Yong
- Concord Repatriation General Hospital, University of Sydney, New South Wales, Australia
| | - Antonio Maria Leone
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University School of Medicine, Rome, Italy; Center of Excellence in Cardiovascular Diagnostics and Therapeutic, Ospedale Fabenefratelli Isola Tiberina Gemelli Isola, Rome, Italy
| | - Ashkan Eftekhari
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Brian Ko
- Monash Cardiovascular Research Centre, Monash University and Monash Heart, Monash Health, Clayton, Victoria, Australia
| | - Bruno R da Costa
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, England; Clinical Epidemiology and Health Care Research, Institute of Health Policy and Management Evaluation (IHPME), University of Toronto, Toronto, Ontorio, Canada
| | - Colin Berry
- School Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Damien Collison
- School Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Divaka Perera
- School of Cardiovascular Medicine and Sciences, St Thomas' Hospital Campus, King's College London, London, UK
| | | | - Fernando Rivero
- Cardiac Department, Hospital Universitario de La Princesa, Madrid, Spain
| | | | - Hirohiko Ando
- Department of Cardiology, Aichi Medical University, Aichi, Japan
| | - Hitoshi Matsuo
- Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
| | | | - Javier Escaned
- Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos and Complutense University, Madrid, Spain
| | - Jeroen Sonck
- Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium
| | - Koshiro Sakai
- Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium; Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan
| | - Julien Adjedj
- Department of Cardiology, Arnault Tzanck Institute Saint Laurent du Var, France
| | - Liyew Desta
- Department of Cardiology, Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Lokien X van Nunen
- Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Stephane Fournier
- Department of Cardiology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Tatyana Storozhenko
- Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium; Department of Prevention and Treatment of Emergency Conditions, L.T. Malaya Therapy National Institute NAMSU, Kharkiv, Ukraine
| | - Tetsuya Amano
- Department of Cardiology, Aichi Medical University, Aichi, Japan
| | - Thomas Engstrøm
- Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Johnson
- University Hospitals Bristol & Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Toshiro Shinke
- Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan
| | - Simone Biscaglia
- Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara, Ferrara, Italy
| | - William F Fearon
- Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University School of Medicine and VA Palo Alto Health Care System, Palo Alto, CA
| | - Ziad Ali
- St Francis Hospital and Heart Center, Roslyn, NY
| | - Bernard De Bruyne
- Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium; Department of Cardiology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Nils P Johnson
- Weatherhead PET Center, Division of Cardiology, Department of Medicine, McGovern Medical School at UTHealth and Memorial Hermann Hospital, Houston, TX.
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Cartmell KB, Doherty EA, Gikaara N, Ali Z, Qanungo S, Melikam ES, Powell RA. Kenyan palliative care providers' and leaders' perceptions of palliative care research needs and support to facilitate rigorous research. BMC Palliat Care 2023; 22:135. [PMID: 37697339 PMCID: PMC10496291 DOI: 10.1186/s12904-023-01199-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 06/20/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Palliative care (PC) can reduce symptom distress and improve quality of life for patients and their families experiencing life-threatening illness. While the need for PC in Kenya is high, PC service delivery and research is limited. Qualitative research is needed to explore potential areas for PC research and support needed to enable that research. This insight is critical for informing a national PC research agenda and mobilizing limited resources for conducting rigorous PC research in Kenya. OBJECTIVES To explore perceptions of priority areas for PC research and support needed to facilitate rigorous research from the perspective of Kenyan PC providers and leaders. METHODS Focus groups (FGs) were conducted in November and December of 2018 using a semi-structured interview guide. FGs were audio-recorded, transcribed, and analyzed using a thematic content analysis approach. RESULTS Three FGs were conducted (n = 22 participants). Ten themes related to PC research emerged, including research on: 1) beliefs about death, disease, and treatment to inform PC; 2) awareness about PC, 3) integration of PC within the health system; 4) understanding caregiver experiences and needs; 5) community health volunteers (CHVs) and volunteer programs; 6) evaluation of costs and benefits of PC; 7) treatment approaches, including complementary and alternative medicine (CAM) and advanced diagnostics at end of life; 8) other suggestions for research, 9) populations in need of PC research; and 10) resources for enabling research. CONCLUSIONS Kenyan PC providers and leaders identified key areas requiring increased scientific inquiry and critical resources needed to enable this research. These findings can help to focus future PC research in Kenya and encourage funding agencies to prioritize the issues identified.
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Affiliation(s)
- K B Cartmell
- Department of Public Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, USA.
| | - E A Doherty
- Department of Public Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, USA
| | - N Gikaara
- Department of Medicine, Aga Khan University Hospital, Nairobi, Kenya
| | - Z Ali
- Kenyan Hospice and Palliative Care Association, Nairobi, Kenya
| | - S Qanungo
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - E S Melikam
- Department of Public Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, USA
| | - R A Powell
- Department of Primary Care and Public Health, Faculty of Medicine, Imperial College London, London, England
- Ethnicity and Health Unit, NIHR Applied Research Collaboration Northwest London, London, England
- MWAPO Health Development Group, Nairobi, Kenya
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10
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Bashar HAB, Saunders A, Alaour B, Gerontitis D, Hinton J, Karamanou D, Kechagioglou G, Olsen S, Onwordi E, Pope M, Zingale A, Nicholas Z, Golledge P, Escaned J, Ali Z, Curzen N. Systematic coronary physiology improves level of agreement in diagnostic coronary angiography. Open Heart 2023; 10:openhrt-2023-002258. [PMID: 37130658 PMCID: PMC10163596 DOI: 10.1136/openhrt-2023-002258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/29/2023] [Indexed: 05/04/2023] Open
Abstract
OBJECTIVE The training of interventional cardiologists (ICs), non-interventional cardiologists (NICs) and cardiac surgeons (CSs) differs, and this may be reflected in their interpretation of invasive coronary angiography (ICA) and management plan. Availability of systematic coronary physiology might result in more homogeneous interpretation and management strategy compared with ICA alone. METHODS 150 coronary angiograms from patients with stable chest pain were presented independently to three NICs, three ICs and three CSs. By consensus, each group graded (1) coronary disease severity and (2) management plan, using options: (a) optimal medical therapy alone, (b) percutaneous coronary intervention, (c) coronary artery bypass graft or (d) more investigation required. Each group was then provided with fractional flow reserve (FFR) from all major vessels and asked to repeat the analysis. RESULTS There was only 'fair' level of agreement of management plan among ICs, NICs and CSs (kappa 0.351, 95% CI 0.295-0.408, p<0.001) based on ICA alone (complete agreement in 35% of cases), which almost doubled to 'good' level (kappa 0.635, 95% CI 0.572-0.697, p<0.001) when comprehensive FFR was available (complete agreement in 66% of cases). Overall, the consensus management plan changed in 36.7%, 52% and 37.3% of cases for ICs, NICs and CSs, respectively, when FFR data were available. CONCLUSIONS Compared with ICA alone, the availability of systematic FFR of all major coronary arteries produced a significantly more concordant interpretation and more homogeneous management plan among IC, NIC and CS specialists. Comprehensive physiological assessment may be of value in routine care for Heart Team decision-making. TRIAL REGISTRATION NUMBER NCT01070771.
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Affiliation(s)
| | - Alec Saunders
- Wessex Cardiothoracic Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Bashir Alaour
- Cardiovascular Research, King's College London, Southampton, UK
| | | | - Jonathan Hinton
- Department of Cardiology, University Hospitals Dorset NHS Foundation Trust, Poole, UK
| | - Danai Karamanou
- Wessex Cardiothoracic Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Georgios Kechagioglou
- Wessex Cardiothoracic Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Sally Olsen
- Wessex Cardiothoracic Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Eunice Onwordi
- Wessex Cardiothoracic Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Michael Pope
- Wessex Cardiothoracic Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Anna Zingale
- Wessex Cardiothoracic Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Zoe Nicholas
- Wessex Cardiothoracic Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Javier Escaned
- Department of Cardiology, Hospital Clínico San Carlos, Madrid, Spain
| | - Ziad Ali
- Interventional & Structural Cardiology, St Francis Hospital Heart Centre, New York, New York, USA
| | - Nick Curzen
- Wessex Cardiothoracic Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Faculty of Medicine, University of Southampton, Southampton, UK
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11
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Karacsonyi J, Kostantinis S, Simsek B, Basir M, Megaly M, Ali Z, Kirtane A, McEntegart M, Brilakis ES, Alaswad K. Intravascular Imaging Use in Percutaneous Coronary Interventions of Chronic Total Occlusions. J Invasive Cardiol 2023; 35:E265-E268. [PMID: 37169391] [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] [Indexed: 05/13/2023]
Abstract
BACKGROUND Intravascular ultrasound (IVUS) can assist percutaneous coronary intervention (PCI) of chronic total occlusions (CTO). METHODS We analyzed 8,983 CTO PCIs performed in 8,771 patients between 2012 and 2022 at 39 centers. RESULTS Overall, IVUS was used in 44.5% of the cases, for crossing in 11.5% and for stent optimization in 33.1%. IVUS for stent optimization was used more often for complex lesions with higher prevalence of calcification (51.2% vs 34.3%; P<.001); was associated with lower air kerma radiation dose (1.78 [1.00, 3.09] vs 2.30 (1.35, 3.91) min, P<.001) and contrast volume (190 [138, 258] vs 220 [160, 300] ml, P<.001). Among cases with successful guidewire crossing, those that used IVUS for stent optimization had higher technical (99.3% vs 96.3%; P<.001) and procedural (96.1% vs 94.6%, P=.002) success rates and similar major adverse complication event rates (2.04% vs 1.62%; P=.176). The use of IVUS for stent optimization significantly increased over time. CONCLUSION In a contemporary, multicenter registry, IVUS was used in 44.5% and its use for stent optimization significantly increased over time. Cases where IVUS was used for stent optimization had higher technical and procedural success and similar risk of complications compared with cases where IVUS was not used for stent optimization.
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12
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Salisbury AC, Grantham JA, Brown WM, Ballard WL, Allen KB, Kirtane AJ, Argenziano M, Yeh RW, Khabbaz K, Lasala J, Kachroo P, Karmpaliotis D, Moses J, Lombardi WL, Nugent K, Ali Z, Gosch KL, Spertus JA, Kandzari DE. Outcomes of Medical Therapy Plus PCI for Multivessel or Left Main CAD Ineligible for Surgery. JACC Cardiovasc Interv 2023; 16:261-273. [PMID: 36792252 DOI: 10.1016/j.jcin.2023.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/09/2022] [Accepted: 01/02/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Percutaneous coronary intervention (PCI) is increasingly used to revascularize patients ineligible for CABG, but few studies describe these patients and their outcomes. OBJECTIVES This study sought to describe characteristics, utility of risk prediction, and outcomes of patients with left main or multivessel coronary artery disease ineligible for coronary bypass grafting (CABG). METHODS Patients with complex coronary artery disease ineligible for CABG were enrolled in a prospective registry of medical therapy + PCI. Angiograms were evaluated by an independent core laboratory. Observed-to-expected 30-day mortality ratios were calculated using The Society for Thoracic Surgeons (STS) and EuroSCORE (European System for Cardiac Operative Risk Evaluation) II scores, surgeon-estimated 30-day mortality, and the National Cardiovascular Data Registry (NCDR) CathPCI model. Health status was assessed at baseline, 1 month, and 6 months. RESULTS A total of 726 patients were enrolled from 22 programs. The mean SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score was 32.4 ± 12.2 before and 15.0 ± 11.7 after PCI. All-cause mortality was 5.6% at 30 days and 12.3% at 6 months. Observed-to-expected mortality ratios were 1.06 (95% CI: 0.71-1.36) with The Society for Thoracic Surgeons score, 0.99 (95% CI: 0.71-1.27) with the EuroSCORE II, 0.59 (95% CI: 0.42-0.77) using cardiac surgeons' estimates, and 4.46 (95% CI: 2.35-7.99) using the NCDR CathPCI score. Health status improved significantly from baseline to 6 months: SAQ summary score (65.9 ± 22.5 vs 86.5 ± 15.1; P < 0.0001), Kansas City Cardiomyopathy Questionnaire summary score (54.1 ± 27.2 vs 82.6 ± 19.7; P < 0.0001). CONCLUSIONS Patients ineligible for CABG who undergo PCI have complex clinical profiles and high disease burden. Following PCI, short-term mortality is considerably lower than surgeons' estimates, similar to surgical risk model predictions but is over 4-fold higher than estimated by the NCDR CathPCI model. Patients' health status improved significantly through 6 months.
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Affiliation(s)
- Adam C Salisbury
- Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA; University of Missouri-Kansas City, Kansas City, Missouri, USA.
| | - J Aaron Grantham
- Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA; University of Missouri-Kansas City, Kansas City, Missouri, USA
| | | | | | - Keith B Allen
- Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA; University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Ajay J Kirtane
- Columbia University Irving Medical Center/NewYork-Presbyterian Hospital and the Cardiovascular Research Foundation, New York, New York, USA
| | - Michael Argenziano
- Columbia University Irving Medical Center/NewYork-Presbyterian Hospital and the Cardiovascular Research Foundation, New York, New York, USA
| | - Robert W Yeh
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Kamal Khabbaz
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - John Lasala
- Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Puja Kachroo
- Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Dimitri Karmpaliotis
- Columbia University Irving Medical Center/NewYork-Presbyterian Hospital and the Cardiovascular Research Foundation, New York, New York, USA
| | - Jeffrey Moses
- Columbia University Irving Medical Center/NewYork-Presbyterian Hospital and the Cardiovascular Research Foundation, New York, New York, USA
| | | | - Karen Nugent
- Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA
| | - Ziad Ali
- Columbia University Irving Medical Center/NewYork-Presbyterian Hospital and the Cardiovascular Research Foundation, New York, New York, USA
| | - Kensey L Gosch
- Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA
| | - John A Spertus
- Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA; University of Missouri-Kansas City, Kansas City, Missouri, USA
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Younas U, Atif M, Anjum A, Nadeem M, Ali T, Shaheen R, Khalid W, Ali Z. Fabrication of La 3+ doped Ba 1-x La x TiO 3 ceramics with improved dielectric and ferroelectric properties using a composite-hydroxide-mediated method. RSC Adv 2023; 13:5293-5306. [PMID: 36777949 PMCID: PMC9912143 DOI: 10.1039/d2ra06640h] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/05/2023] [Indexed: 02/12/2023] Open
Abstract
Lanthanum (La3+) doped Ba1-x La x TiO3 (x = 0.0, 0.0025, 0.005, 0.0075) ceramics were synthesized by the composite-hydroxide-mediated method. Rietveld refinement of the XRD patterns confirmed the formation of a perovskite crystal structure that transforms from tetragonal to pseudo-cubic with La3+ doping content (x). Scanning electron microscopy displayed a dense and homogeneous microstructure with reduced grain size on La3+ doping. The frequency and temperature-dependent dielectric measurements showed an improvement in the dielectric permittivity, a decrease in the ferroelectric-paraelectric transition temperature, and an increase in the dielectric diffusivity with increasing La3+ doping content. Complex impedance analysis indicated the semiconducting behavior with a positive temperature coefficient of resistance effect, which could be explained in terms of a charge compensation mechanism in the donor doped BaTiO3. The ferroelectric hysteresis loops revealed that these ceramics are ferroelectric in nature, while an improvement in the energy storage density and energy storage efficiency was observed for the doped samples due to reduced grain size on La3+ doping. Here, the sample with x = 0.005 has a high dielectric permittivity, a low dielectric tangent loss, and the highest energy storage efficiency. This makes this composition interesting for energy storage applications.
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Affiliation(s)
- U. Younas
- Functional Materials Lab, Department of Physics, Air UniversityPAF Complex E-9IslamabadPakistan
| | - M. Atif
- Functional Materials Lab, Department of Physics, Air UniversityPAF Complex E-9IslamabadPakistan
| | - A. Anjum
- Functional Materials Lab, Department of Physics, Air UniversityPAF Complex E-9IslamabadPakistan
| | - M. Nadeem
- Polymer Composite Group, Directorate of SciencePINSTECHIslamabadPakistan
| | - T. Ali
- Physics Division, Directorate of SciencePINSTECHIslamabadPakistan
| | - R. Shaheen
- Physics Division, Directorate of SciencePINSTECHIslamabadPakistan
| | - W. Khalid
- Functional Materials Lab, Department of Physics, Air UniversityPAF Complex E-9IslamabadPakistan
| | - Z. Ali
- Functional Materials Lab, Department of Physics, Air UniversityPAF Complex E-9IslamabadPakistan
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14
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Karacsonyi J, Alaswad K, Krestyaninov O, Karmpaliotis D, Kirtane A, Ali Z, McEntegart M, Masoumi A, Poomipanit P, Jaffer FA, Khatri J, Choi J, Patel M, Koutouzis M, Tsiafoutis I, Gorgulu S, Sheikh AM, Elbarouni B, Jaber W, ElGuindy A, Yeh R, Kostantinis S, Simsek B, Rangan B, Mastrodemos OC, Vemmou E, Nikolakopoulos I, Ungi I, Rafeh NA, Goktekin O, Burke MN, Brilakis ES, Sandoval Y. Single vs. multiple operators for chronic total occlusion percutaneous coronary interventions: From the PROGRESS-CTO Registry. Catheter Cardiovasc Interv 2023; 101:543-552. [PMID: 36695421 DOI: 10.1002/ccd.30564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/31/2022] [Accepted: 01/11/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND There is limited data on the impact of a second attending operator on chronic total occlusion (CTO) percutaneous coronary intervention (PCI) outcomes. METHODS We analyzed the association between multiple operators (MOs) (>1 attending operator) and procedural outcomes of 9296 CTO PCIs performed between 2012 and 2021 at 37 centers. RESULTS CTO PCI was performed by a single operator (SO) in 85% of the cases and by MOs in 15%. Mean patient age was 64.4 ± 10 years and 81% were men. SO cases were more complex with higher Japan-CTO (2.38 ± 1.29 vs. 2.28 ± 1.20, p = 0.005) and Prospective Global Registry for the Study of Chronic Total Occlusion Intervention scores (1.13 ± 1.01 vs. 0.97 ± 0.93, p < 0.001) compared with MO cases. Procedural time (131 [87, 181] vs. 112 [72, 167] min, p < 0.001), fluoroscopy time (49 [31, 76] vs. 42 [25, 68] min, p < 0.001), air kerma radiation dose (2.32 vs. 2.10, p < 0.001), and contrast volume (230 vs. 210, p < 0.001) were higher in MO cases. Cases performed by MOs and SO had similar technical (86% vs. 86%, p = 0.9) and procedural success rates (84% vs. 85%, p = 0.7), as well as major adverse complication event rates (MACE 2.17% vs. 2.42%, p = 0.6). On multivariable analyses, MOs were not associated with higher technical success or lower MACE rates. CONCLUSION In a contemporary, multicenter registry, 15% of CTO PCI cases were performed by multiple operators. Despite being more complex, SO cases had lower procedural and fluoroscopy times, and similar technical and procedural success and risk of complications compared with MO cases.
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Affiliation(s)
- Judit Karacsonyi
- Minneapolis Heart Institute, Abbott Northwestern Hospital and Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | | | | | - Dimitri Karmpaliotis
- Morristown Medical Center, Gagnon Cardiovascular Institute, Morristown, New Jersey, USA
| | | | - Ziad Ali
- St. Francis Hospital and Heart Center, Roslyn, New York, USA
| | | | - Amirali Masoumi
- Morristown Medical Center, Gagnon Cardiovascular Institute, Morristown, New Jersey, USA
| | - Paul Poomipanit
- Harrington Heart and Vascular Institute, University Hospitals, Case Western Reserve University, Cleveland, Ohio, USA
| | - Farouc A Jaffer
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jaikirshan Khatri
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - James Choi
- Baylor Heart and Vascular Hospital, Baylor University Medical Center, Dallas, Texas, USA
| | - Mitul Patel
- Division of Cardiovascular Medicine, University of California San Diego, La Jolla, California, USA
| | - Michalis Koutouzis
- 2nd Department of Cardiology, Red Cross Hospital of Athens, Athens, Greece
| | | | - Sevket Gorgulu
- Department of Cardiology, Biruni University Medical School, Istanbul, Turkey
| | | | - Basem Elbarouni
- Department of Internal Medicine, Section of Cardiology, St. Boniface General Hospital, Winnipeg, Manitoba, Canada
| | - Wissam Jaber
- Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Ahmed ElGuindy
- Aswan Heart Centre, Magdi Yacoub Foundation, Aswan, Egypt
| | - Robert Yeh
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Spyridon Kostantinis
- Minneapolis Heart Institute, Abbott Northwestern Hospital and Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | - Bahadir Simsek
- Minneapolis Heart Institute, Abbott Northwestern Hospital and Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | - Bavana Rangan
- Minneapolis Heart Institute, Abbott Northwestern Hospital and Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | - Olga C Mastrodemos
- Minneapolis Heart Institute, Abbott Northwestern Hospital and Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | - Evangelia Vemmou
- Minneapolis Heart Institute, Abbott Northwestern Hospital and Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | - Ilias Nikolakopoulos
- Minneapolis Heart Institute, Abbott Northwestern Hospital and Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | - Imre Ungi
- Division of Invasive Cardiology, Department of Internal Medicine and Cardiology Center, University of Szeged, Szeged, Hungary
| | | | - Omer Goktekin
- Department of Cardiology, Memorial Bahcelievler Hospital, Istanbul, Turkey
| | - M Nicholas Burke
- Minneapolis Heart Institute, Abbott Northwestern Hospital and Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | - Emmanouil S Brilakis
- Minneapolis Heart Institute, Abbott Northwestern Hospital and Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | - Yader Sandoval
- Minneapolis Heart Institute, Abbott Northwestern Hospital and Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
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15
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Ali Z, Umer M, Noordin S. Thirty-Day Morbidity and Mortality After Total Knee Replacement in a Tertiary Care Hospital in Pakistan. Cureus 2023; 15:e35409. [PMID: 36987473 PMCID: PMC10040218 DOI: 10.7759/cureus.35409] [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] [Accepted: 02/24/2023] [Indexed: 03/30/2023] Open
Abstract
Background Total knee arthroplasty has become very popular globally as a safe surgical modality for relieving pain and improving functional outcomes in patients who fail to respond to conservative treatments; however, it may be associated with postoperative complications. The aim of this study is to determine the incidence of postoperative complications occurring within the first 30 days after total knee replacement (TKR). Materials and methods This is a prospective cross-sectional study. All consecutive patients who underwent primary unilateral or bilateral total knee arthroplasty between November 2020 and July 2021 were included in the study. Patients were followed for a period of 30 days, and postoperative complications (if any) were documented. Continuous variables were expressed as means ± standard deviations. Categorical variables were expressed as frequency and percentages, and chi-square test was used to compare the qualitative variables. Univariate and multiple logistic regression analyses were done to analyze the magnitude of associations of the complication with other predictor variables keeping a level of significance of <0.05. Results The overall complication rate within the 30-day window was 7.0%. Postoperative surgical site infections (SSI) were noted in three patients (2.6%). Thromboembolic complications were seen in only one patient (0.9%). One patient (0.9%) was readmitted within the one-month period after initial discharge, and one patient (0.9%) expired within 12 hours postoperatively. Conclusion TKR renders satisfactory results with a low incidence of complications in general; however, wound infections, thromboembolic complications, and cardiovascular complications do occur postoperatively. Male gender, obesity, and bilateral TKRs remain the notable risk factors for the development of complications post-procedure.
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Affiliation(s)
- Ziad Ali
- Department of Orthopaedic Surgery, The Aga Khan University Hospital, Karachi, PAK
| | - Masood Umer
- Department of Orthopaedic Surgery, The Aga Khan University Hospital, Karachi, PAK
| | - Shahryar Noordin
- Department of Orthopaedic Surgery, The Aga Khan University Hospital, Karachi, PAK
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16
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Araki M, Park SJ, Dauerman HL, Uemura S, Kim JS, Di Mario C, Johnson TW, Guagliumi G, Kastrati A, Joner M, Holm NR, Alfonso F, Wijns W, Adriaenssens T, Nef H, Rioufol G, Amabile N, Souteyrand G, Meneveau N, Gerbaud E, Opolski MP, Gonzalo N, Tearney GJ, Bouma B, Aguirre AD, Mintz GS, Stone GW, Bourantas CV, Räber L, Gili S, Mizuno K, Kimura S, Shinke T, Hong MK, Jang Y, Cho JM, Yan BP, Porto I, Niccoli G, Montone RA, Thondapu V, Papafaklis MI, Michalis LK, Reynolds H, Saw J, Libby P, Weisz G, Iannaccone M, Gori T, Toutouzas K, Yonetsu T, Minami Y, Takano M, Raffel OC, Kurihara O, Soeda T, Sugiyama T, Kim HO, Lee T, Higuma T, Nakajima A, Yamamoto E, Bryniarski KL, Di Vito L, Vergallo R, Fracassi F, Russo M, Seegers LM, McNulty I, Park S, Feldman M, Escaned J, Prati F, Arbustini E, Pinto FJ, Waksman R, Garcia-Garcia HM, Maehara A, Ali Z, Finn AV, Virmani R, Kini AS, Daemen J, Kume T, Hibi K, Tanaka A, Akasaka T, Kubo T, Yasuda S, Croce K, Granada JF, Lerman A, Prasad A, Regar E, Saito Y, Sankardas MA, Subban V, Weissman NJ, Chen Y, Yu B, Nicholls SJ, Barlis P, West NEJ, Arbab-Zadeh A, Ye JC, Dijkstra J, Lee H, Narula J, Crea F, Nakamura S, Kakuta T, Fujimoto J, Fuster V, Jang IK. Optical coherence tomography in coronary atherosclerosis assessment and intervention. Nat Rev Cardiol 2022; 19:684-703. [PMID: 35449407 PMCID: PMC9982688 DOI: 10.1038/s41569-022-00687-9] [Citation(s) in RCA: 93] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/03/2022] [Indexed: 02/07/2023]
Abstract
Since optical coherence tomography (OCT) was first performed in humans two decades ago, this imaging modality has been widely adopted in research on coronary atherosclerosis and adopted clinically for the optimization of percutaneous coronary intervention. In the past 10 years, substantial advances have been made in the understanding of in vivo vascular biology using OCT. Identification by OCT of culprit plaque pathology could potentially lead to a major shift in the management of patients with acute coronary syndromes. Detection by OCT of healed coronary plaque has been important in our understanding of the mechanisms involved in plaque destabilization and healing with the rapid progression of atherosclerosis. Accurate detection by OCT of sequelae from percutaneous coronary interventions that might be missed by angiography could improve clinical outcomes. In addition, OCT has become an essential diagnostic modality for myocardial infarction with non-obstructive coronary arteries. Insight into neoatherosclerosis from OCT could improve our understanding of the mechanisms of very late stent thrombosis. The appropriate use of OCT depends on accurate interpretation and understanding of the clinical significance of OCT findings. In this Review, we summarize the state of the art in cardiac OCT and facilitate the uniform use of this modality in coronary atherosclerosis. Contributions have been made by clinicians and investigators worldwide with extensive experience in OCT, with the aim that this document will serve as a standard reference for future research and clinical application.
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Affiliation(s)
| | | | | | | | - Jung-Sun Kim
- Yonsei University College of Medicine, Seoul, South Korea
| | | | - Thomas W Johnson
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - Adnan Kastrati
- Technische Universität München and Munich Heart Alliance, Munich, Germany
| | | | | | | | - William Wijns
- National University of Ireland Galway and Saolta University Healthcare Group, Galway, Ireland
| | | | | | - Gilles Rioufol
- Hospices Civils de Lyon and Claude Bernard University, Lyon, France
| | | | | | | | | | | | - Nieves Gonzalo
- Hospital Clinico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain
| | | | - Brett Bouma
- Massachusetts General Hospital, Boston, MA, USA
| | | | - Gary S Mintz
- Cardiovascular Research Foundation, New York, NY, USA
| | - Gregg W Stone
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christos V Bourantas
- Barts Health NHS Trust, University College London and Queen Mary University London, London, UK
| | - Lorenz Räber
- Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | | | | | | | - Myeong-Ki Hong
- Yonsei University College of Medicine, Seoul, South Korea
| | - Yangsoo Jang
- Yonsei University College of Medicine, Seoul, South Korea
| | | | - Bryan P Yan
- Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Italo Porto
- University of Genoa, Genoa, Italy, San Martino Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy
| | | | - Rocco A Montone
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | | | | | - Harmony Reynolds
- New York University Grossman School of Medicine, New York, NY, USA
| | - Jacqueline Saw
- Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Peter Libby
- Brigham and Women's Hospital, Boston, MA, USA
| | - Giora Weisz
- New York Presbyterian Hospital, Columbia University Medical Center and Cardiovascular Research Foundation, New York, NY, USA
| | | | - Tommaso Gori
- Universitäts medizin Mainz and DZHK Rhein-Main, Mainz, Germany
| | | | | | | | | | | | - Osamu Kurihara
- Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | | | | | | | - Tetsumin Lee
- Japanese Red Cross Musashino Hospital, Tokyo, Japan
| | - Takumi Higuma
- Kawasaki Municipal Tama Hospital, St. Marianna University School of Medicine, Kanagawa, Japan
| | | | - Erika Yamamoto
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Krzysztof L Bryniarski
- Jagiellonian University Medical College, Institute of Cardiology, Department of Interventional Cardiology, John Paul II Hospital, Krakow, Poland
| | | | | | | | - Michele Russo
- Catholic University of the Sacred Heart, Rome, Italy
| | | | | | - Sangjoon Park
- Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Marc Feldman
- University of Texas Health, San Antonio, TX, USA
| | | | - Francesco Prati
- UniCamillus - Saint Camillus International University of Health Sciences, Rome, Italy
| | - Eloisa Arbustini
- IRCCS Foundation University Hospital Policlinico San Matteo, Pavia, Italy
| | - Fausto J Pinto
- Santa Maria University Hospital, CHULN Center of Cardiology of the University of Lisbon, Lisbon School of Medicine, Lisbon Academic Medical Center, Lisbon, Portugal
| | - Ron Waksman
- MedStar Washington Hospital Center, Washington, DC, USA
| | | | - Akiko Maehara
- Cardiovascular Research Foundation, New York, NY, USA
| | - Ziad Ali
- Cardiovascular Research Foundation, New York, NY, USA
| | | | | | | | - Joost Daemen
- Erasmus University Medical Centre, Rotterdam, Netherlands
| | | | - Kiyoshi Hibi
- Yokohama City University Medical Center, Kanagawa, Japan
| | | | | | | | - Satoshi Yasuda
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kevin Croce
- Brigham and Women's Hospital, Boston, MA, USA
| | | | | | | | | | | | | | | | | | - Yundai Chen
- Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Bo Yu
- The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | | | - Peter Barlis
- University of Melbourne, Melbourne, Victoria, Australia
| | | | | | - Jong Chul Ye
- Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | | | - Hang Lee
- Massachusetts General Hospital, Boston, MA, USA
| | - Jagat Narula
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Filippo Crea
- Catholic University of the Sacred Heart, Rome, Italy
| | | | | | - James Fujimoto
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | - Ik-Kyung Jang
- Massachusetts General Hospital, Boston, MA, USA.
- Kyung Hee University, Seoul, South Korea.
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17
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Sato T, Yamamoto K, Matsumura M, Moses J, Thomas S, Cohen D, Mintz G, Shlofmitz R, Jeremias A, Ali Z, Maehara A. TCT-285 Prevalence and Anatomical Factors to Be Associated With Stent Underexpansion in Non-Severely Calcified Lesions. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.335] [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: 10/14/2022]
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18
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Sato T, Matsumura M, Yamamoto K, Moses J, Thomas S, Cohen D, Mintz G, Shlofmitz R, Ali Z, Maehara A. TCT-270 Impact of Eruptive- Versus Nodular-Calcified Nodule Morphology on Acute and Long-Term Outcomes After Stenting. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.318] [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: 11/30/2022]
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19
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Ali Z, Egeberg A, Thyssen JP, Ulrik CS, Thomsen SF. Adults with concomitant atopic dermatitis and asthma have more frequent urgent health care utilization and less frequent scheduled follow-up visits than adults with atopic dermatitis or asthma only: A nationwide cohort study. J Eur Acad Dermatol Venereol 2022; 36:2406-2413. [PMID: 35796157 DOI: 10.1111/jdv.18415] [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: 12/21/2021] [Accepted: 06/15/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) and asthma often co-occur in the same patient, and health care utilization is related to disease severity of these diseases. OBJECTIVE To investigate differences in healthcare utilization in adults with concomitant AD and asthma compared to patients with asthma or AD only. METHODS All Danish adults with a hospital-diagnosis of AD, asthma or concomitant AD and asthma recorded in national registries were included. Health care utilization data were obtained in 3-month intervals from two year prior to index date (the date of the first hospital diagnosis), and to five years after. RESULTS A total of 12,409 patients with AD were included (11,590 with AD only and 819 with concomitant AD and asthma), and 65,539 with asthma only. Adults with concomitant AD and asthma had higher risk of hospitalization for AD (OR 1.38, 95% CI (1.15-1.67), p=0.001) and asthma (OR 1.16, 95% CI (1.00-1.35), p=0.047) compared to patients with only AD and asthma, respectively. These patients also had fewer visits in outpatient clinics for AD (OR 0.10, 95% CI (0.08-0.12), p<0.001) and asthma (OR 0.34, 95% CI (0.29-0.39), P<0.001) compared to patients with only AD or asthma. Outpatient clinic visits for rhinitis were more frequent among patients with concomitant AD and asthma compared to patients with only AD or asthma. CONCLUSION Adults with concomitant AD and asthma had different patterns of healthcare utilization compared to adults with AD or asthma alone, suggesting that improvements in management and monitoring may reduce unscheduled health care visits, and lower healthcare costs.
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Affiliation(s)
- Z Ali
- Department of Dermato-Venereology and Wound Healing Centre, Copenhagen University Hospital Bispebjerg, Denmark
| | - A Egeberg
- Department of Dermato-Venereology and Wound Healing Centre, Copenhagen University Hospital Bispebjerg, Denmark
| | - J P Thyssen
- Department of Dermato-Venereology and Wound Healing Centre, Copenhagen University Hospital Bispebjerg, Denmark
| | - C S Ulrik
- Department of Respiratory Medicine, Copenhagen University Hospital Hvidovre, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - S F Thomsen
- Department of Dermato-Venereology and Wound Healing Centre, Copenhagen University Hospital Bispebjerg, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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Goldfarb J, Dominguez-Sulca D, Chowdhury E, Ali Z, Khalique O. 509 Cardiovascular Computed Tomography And FFRCTIn The United States Medicare Population From 2013-2020. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.120] [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: 11/30/2022]
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21
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Ali Z, El-Mallakh RS. Suicidal Depression in Ancient Egypt. Arch Suicide Res 2022; 26:1607-1623. [PMID: 33502962 DOI: 10.1080/13811118.2021.1878079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the oldest record of a depressed individual contemplating suicide. METHOD A directed review of ancient Egyptology literature of translations and discussion regarding a papyrus that is approximately 4,000 years old. RESULTS The content of the document is consistent with a man going through a severe depression and is contemplating suicide. However, this does not appear to be a suicide note, but more of an ancient example of 'journaling' or working through the thoughts of suicide and its possible consequences to the man's eternal life in the afterworld. CONCLUSIONS Presentation of depression, the reasons for considering suicide, and the process by which an individual works through those thoughts have not varied significantly over the past 4,000 years.
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22
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Ali Z, Vasavan T, Meeladah G, Eliza W, Getreu N, O’Neill H. P-738 Impact of limited reproductive health awareness on PCOS diagnosis timelines and the need for improved patient education. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.684] [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
Study question
Does the lack of awareness of Polycystic ovary syndrome (PCOS) symptoms contribute to a delay in diagnosis?
Summary answer
Limited awareness regarding reproductive health symptoms can negatively impact help-seeking behaviour, delaying diagnostic timelines.
What is known already
PCOS is a common endocrine condition estimated to affect up to 20% of women worldwide. Frequently observed symptoms include oligomenorrhea or amenorrhea, clinical features of hyperandrogenism, metabolic dysfunction, infertility and poor mental health.
Despite its prevalence and the debilitating impact of symptoms on quality of life, it takes an average of two years and over three clinical consultations to diagnose. Delayed diagnosis may be influenced by a lack of standardised screening guidelines, poor understanding of how PCOS manifests in ethnic minorities and hesitancy from the general public to seek help for their reproductive health symptoms.
Study design, size, duration
A cross-sectional study investigating the barriers to diagnosis of PCOS.
Participants aged 18 or older with an existing or suspected diagnosis of PCOS were invited to complete an online survey across five days in January 2022.
The survey assessed general demographic information, the influence of symptoms on their daily life and their experiences with receiving a diagnosis.
Of the 200 responses, 143 responses were analysed and 99 were included in the results.
Participants/materials, setting, methods
Participants were aged between 18 - 45 and provided informed consent after reading a patient information leaflet detailing the background of the study.
75 (52.44%) participants were UK-based, while 68 (47.55%) were based abroad.
Ethical approval of all study-related documents was given by the Hertility Health Research Ethics Committee.
The online survey was presented on Typeform and disseminated via the social media platforms Instagram, Twitter and LinkedIn.
Descriptive statistics are presented.
Main results and the role of chance
Of the 143 participants, 99 (69.2%) reported a PCOS diagnosis. Anxiety (71.4%), irregular menstrual cycles (69.4%) and weight-related concerns (64.3%) were the most commonly reported symptoms.
Despite the majority reporting that their symptoms impacted daily life (80.8%), mental health (82.8%), and educational or work performance (70.7%), only 10.2% had sought medical help immediately while 75.5% waited for up to 2 years.
Not realising their symptoms required medical help (73.2%), lack of information regarding routes to care (18.3%) and stigma from family members (18.3%) were the most common reasons why medical help was not sought immediately.
Following clinical consultations, 54.7% of participants were not satisfied with the information provided to manage their diagnosis. Although mental health-related symptoms were most frequently reported (75.5%), only 4.8% reported that management strategies for mental health were referenced in their consultations.
Of the 93.2% of those looking for extra information online, only 52.3% used official websites such as the National Health Service (NHS) website. Many participants also chose to use social media sources such as Instagram and Tik Tok for information (52.3%) and support (59.3%).
Limitations, reasons for caution
Although there was a global uptake, the study needs to be carried out on a larger scale with an emphasis on minority ethnicities.
Recall bias could have also impacted findings as the participants were required to provide details on their entire diagnosis experience.
Wider implications of the findings
It is evident that limited awareness regarding reproductive health can delay the diagnosis of PCOS.
Due to unsatisfactory management by healthcare providers, patients heavily rely on unregulated channels such as social media to obtain reproductive health information, highlighting the need for better Sex and Fertility Education programs and improved accessibility.
Trial registration number
NA
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Affiliation(s)
- Z Ali
- Hertility Health Limited, Research and Development , London, United Kingdom
| | - T Vasavan
- Hertility Health Limited, Research and Development , London, United Kingdom
| | - G Meeladah
- Hertility Health Limited, Research and Development , London, United Kingdom
- University College London, EGA Institute for Women's Health , London, United Kingdom
| | - W Eliza
- Hertility Health Limited, Research and Development , London, United Kingdom
| | - N Getreu
- Hertility Health Limited, Research and Development , London, United Kingdom
- University College London, EGA Institute for Women's Health , London, United Kingdom
| | - H O’Neill
- Hertility Health Limited, Research and Development , London, United Kingdom
- University College London, EGA Institute for Women's Health , London, United Kingdom
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23
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Rehman AU, Atif M, Younas M, Rafique T, Wahab H, Ul-Hamid A, Iqbal N, Ali Z, Khalid W, Nadeem M. Unusual semiconductor-metal-semiconductor transitions in magnetite Fe 3O 4 nanoparticles. RSC Adv 2022; 12:12344-12354. [PMID: 35480359 PMCID: PMC9036052 DOI: 10.1039/d2ra00530a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/19/2022] [Indexed: 01/14/2023] Open
Abstract
Magnetite (Fe3O4) nanoparticles were successfully prepared by a co-precipitation method. Rietveld refinement on the X-ray diffraction pattern confirmed the development of a single-phase cubic spinel structure with space group Fd3̄m. However, 57Fe Mössbauer spectroscopy suggested the presence of Fe3+ and Fe2.5+ (mixed Fe3+ and Fe2+) ions at the tetrahedral and octahedral sites of the inverse spinel structure, respectively. Impedance spectroscopy measurements showed a discontinues variation in the temperature dependence of the sample's resistive behavior, indicating the appearance of semiconductor–metal–semiconductor like transitions between the temperature range of 293 and 373 K. A similar dual transition was also observed from the dielectric and conductivity measurements around the same temperature regions. The observed unusual transition is explained in term of the competitive effects among the hopping of localized/delocalized and short-range/long-range charge carriers present in the sample. Moreover, the prepared sample exhibits colossal dielectric permittivity (∼106), reduced tangent loss (∼0.2) and moderate conductivity (>10−6 S cm−1) values, making Fe3O4 nanoparticles a potential candidate for electromagnetic absorbing materials. Herein, we report the existence of a novel semiconductor–metal–semiconductor type transition in Fe3O4 nanoparticles by employing impedance spectroscopy techniques.![]()
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Affiliation(s)
- Atta Ur Rehman
- Functional Materials Lab, Department of Physics, Air University PAF Complex E-9 Islamabad Pakistan
| | - M Atif
- Functional Materials Lab, Department of Physics, Air University PAF Complex E-9 Islamabad Pakistan
| | - M Younas
- Polymer Composite Group, Physics Division, Directorate of Science, PINSTECH P.O. Nilore Islamabad Pakistan
| | - T Rafique
- Functional Materials Lab, Department of Physics, Air University PAF Complex E-9 Islamabad Pakistan
| | - H Wahab
- Polymer Composite Group, Physics Division, Directorate of Science, PINSTECH P.O. Nilore Islamabad Pakistan
| | - A Ul-Hamid
- Core Research Facilities, King Fahd University of Petroleum & Minerals Dhahran 31261 Saudi Arabia
| | - N Iqbal
- US-Pakistan Centre for Advanced Studies in Energy (USPCAS-E), NUST H-12 Islamabad 44000 Pakistan
| | - Z Ali
- Functional Materials Lab, Department of Physics, Air University PAF Complex E-9 Islamabad Pakistan
| | - W Khalid
- Functional Materials Lab, Department of Physics, Air University PAF Complex E-9 Islamabad Pakistan
| | - M Nadeem
- Polymer Composite Group, Physics Division, Directorate of Science, PINSTECH P.O. Nilore Islamabad Pakistan
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Coffey N, Ali Z, Grau J. Imipramine-Induced Cutaneous and Iris Hyperpigmentation. Prim Care Companion CNS Disord 2022; 24. [DOI: 10.4088/pcc.21r03161] [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] Open
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25
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Bergmark B, Osborn EA, Ali Z, Gupta A, Kolli KK, Prillinger J, West NE, Hasegawa J, Croce KJ, Secemsky EA. ASSOCIATION BETWEEN INTRACORONARY IMAGING USE DURING PCI AND SUBSEQUENT CLINICAL OUTCOMES IN A REAL-WORLD U.S. MEDICARE CLAIMS DATABASE. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01629-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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EMILIA E, Ali Z, Effendi I, Suhaimi N, Slamet S, Syahrir M, Indrajaya T, Saleh M, Kartika H, Fathurrachman A. POS-167 THE ASSOCIATION BETWEEN URINARY TISSUE INHIBITOR METALLOPROTEINASE 2*INSULIN-LIKE GROWTH FACTOR BINDING PROTEIN 7 AND HEMODIALYSIS IN ACUTE KIDNEY INJURY AT Dr. MOHAMMAD HOESIN HOSPITAL PALEMBANG. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.182] [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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27
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KARTIKA H, Emilia E, Ali Z, Effendi I, Novadian N, Suprapti S, Fathurrachman A, Mulia D. POS-070 THE ASSOCIATION BETWEEN GLOMERULUS FILTRATION RATE AND URINARY TISSUE INHIBITOR METALLOPROTEINASE 2*INSULIN LIKE GROWTH FACTOR BINDING PROTEIN 7 IN ACUTE KIDNEY INJURY AT RSMH PALEMBANG. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.079] [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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28
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Strange J, Ali Z, Holland M, Gaillemin O. Improving and Sustaining the Quality of Discharge Summaries. Acute Med 2022; 21:139-145. [PMID: 36427212 DOI: 10.52964/amja.0913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
High quality discharge information communication has been linked to a reduction in the incidence of adverse events, decreasing the risk of prescription errors and lost follow up. In this paper we describe how our trust-wide quality improvement project, led by acute physicians, successfully improved discharge documentation. We demonstrate how we identified obstacles to continued success, and the interventions we implemented. We recommend how discharge summary quality can be optimised through training of junior doctors, recruitment of local champions, and use of novel methods to preserve engagement, such as gamification.
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Affiliation(s)
- J Strange
- BSc(Hons), MB ChB(Hons); ACCS CT1; Salford Care Organisation, Northern Care Alliance
| | - Z Ali
- BA (Hons) MB BChir; FY2; Salford Care Organisation, Northern Care Alliance, Stott Lane, Salford M6 8HD
| | - M Holland
- MB, BS, MEd, FRCP, FHEA; Associate TIRI Professor, Department of Clinical and Biomedical Sciences, Faculty of Health and Wellbeing, University of Bolton. ORCHID ID 0000-0001-8336-5336
| | - O Gaillemin
- MB ChB, PGDip, MRCP; Consultant Physician in Acute Medicine, Salford Care Organisation, Northern Care Alliance
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Aljulayfi I, O'Toole S, Healy M, Sumaidaa S, Ali Z, Bartlett D, Austin R. The interplay of saliva, erosion and attrition on enamel and dentine. Saudi Dent J 2022; 34:232-236. [PMID: 35935719 PMCID: PMC9346941 DOI: 10.1016/j.sdentj.2022.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 01/07/2022] [Accepted: 01/25/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose This investigation aimed to compare the protective role of saliva against erosion and attrition challenges. Method Polished enamel and dentine samples (n = 160) were prepared and randomly assigned to either the saliva or saliva-free group (n = 40 enamel and n = 40 dentine/group). Within each subgroup, they were allocated to four subgroups: negative control (deionized water exposure 10 min), erosion (0.3% citric acid 10 min), attrition (120 S of 300 g force), or combined erosion/attrition (0.3% citric acid 10 min then 120 S of 300 g force). Experimental cycles were repeated three times. Data analysis was performed using SPSS. Results The mean and standard deviation (SD) of step heights produced by the attrition and erosion/attrition groups in enamel in the saliva-free group were 5.6 µm (2.4) and 13.4 µm (2.8), respectively, while they were 2.4 µm (3.8) and 12.9 µm (3.5) in the saliva group, with no significant difference between the saliva and saliva-free groups. For dentine, the corresponding step heights were 25.2 µm (5.5) and 35.9 µm (7.9) for the saliva-free group, but 21.8 µm (5.3) and 27.3 µm (6.4) for the saliva group (p < 0.001). Conclusion There was a trend that saliva decreased wear, but this was only statistically significant for erosion/attrition dentine wear.
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Affiliation(s)
- I. Aljulayfi
- Centre for Clinical Oral and Translational Sciences, King’s College London, Guy’s Hospital, London SE1 9RT, United Kingdom
- Prince Sattam bin Abdulaziz University, College of Dentistry, Alkharj, Saudi Arabia
- Corresponding author at: Prince Sattam bin Abdulaziz University, College of Dentistry, Alkharj, 16245, Saudi Arabia.
| | - S. O'Toole
- Centre for Clinical Oral and Translational Sciences, King’s College London, Guy’s Hospital, London SE1 9RT, United Kingdom
| | - M. Healy
- Centre for Clinical Oral and Translational Sciences, King’s College London, Guy’s Hospital, London SE1 9RT, United Kingdom
| | - S. Sumaidaa
- Centre for Clinical Oral and Translational Sciences, King’s College London, Guy’s Hospital, London SE1 9RT, United Kingdom
| | - Z. Ali
- Centre for Clinical Oral and Translational Sciences, King’s College London, Guy’s Hospital, London SE1 9RT, United Kingdom
| | - D. Bartlett
- Centre for Clinical Oral and Translational Sciences, King’s College London, Guy’s Hospital, London SE1 9RT, United Kingdom
| | - R. Austin
- Centre for Clinical Oral and Translational Sciences, King’s College London, Guy’s Hospital, London SE1 9RT, United Kingdom
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Ali Z, Egeberg A, Thyssen JP, Sørensen JA, Vestergaard C, Thomsen SF. No association between omalizumab use and risk of cancer: a nationwide registry-based cohort study. Br J Dermatol 2021; 186:746-748. [PMID: 34878656 DOI: 10.1111/bjd.20941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/18/2021] [Accepted: 11/30/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Z Ali
- Department of Dermato-Venereology and Wound Healing Centre, Copenhagen University Hospital Bispebjerg, Denmark
| | - A Egeberg
- Department of Dermato-Venereology and Wound Healing Centre, Copenhagen University Hospital Bispebjerg, Denmark
| | - J P Thyssen
- Department of Dermato-Venereology and Wound Healing Centre, Copenhagen University Hospital Bispebjerg, Denmark
| | - J A Sørensen
- Department of Dermato-Venereology and Wound Healing Centre, Copenhagen University Hospital Bispebjerg, Denmark
| | - C Vestergaard
- The Department of Dermatology and Venereology, Aarhus University Hospital, Aarhus, Denmark
| | - S F Thomsen
- Department of Dermato-Venereology and Wound Healing Centre, Copenhagen University Hospital Bispebjerg, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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Rehan I, Gondal M, Aldakheel R, Rehan K, Sultana S, Almessiere M, Ali Z. Development of laser induced breakdown spectroscopy technique to study irrigation water quality impact on nutrients and toxic elements distribution in cultivated soil. Saudi J Biol Sci 2021; 28:6876-6883. [PMID: 34866988 PMCID: PMC8626308 DOI: 10.1016/j.sjbs.2021.07.064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/22/2021] [Accepted: 07/24/2021] [Indexed: 11/18/2022] Open
Abstract
This study is focused mainly on impact of irrigation water quality in cultivated soil on distribution of essentials nutrients (Al, Mg, Ca, Fe, S, Si, Na, P, and K) and relatively toxic metals (As, Ba, Cr, Cu, Ti, Sn, Mn, Ni, and Zn) using an elegant Laser induced breakdown spectroscopy (LIBS) technique. A pulsed Nd:YAG laser operating at 1064 nm in conjunction with suitable detector was applied to record soil emission spectra. The abundance of these elements were evaluated via standard calibration curve Laser Induced Breakdown Spectroscopy (CC-LIBS) and calibration free Laser Induced Breakdown Spectroscopy (CF-LIBS) approaches. Quantitative analyses were accomplished under conjecture of local thermodynamic equilibrium (L.T.E) and optically thin plasma. The average electron temperatures were estimated by Boltzmann plot method for cultivated soil samples in 7800 to 9300 K range. The electron number density was ~ 1.11 × 1017 cm − 3 to 1.60 × 1017 cm − 3. Prior to application on soil samples, the experimental setup was optimized at the following parameters: pulsed energy = 60 mJpulse-1, sample to lens distance of 9.0 cm, and the gate delay of 3.5 μs. It is noteworthy that nutritional elements content of cultivated soils were found strongly dependent upon the irrigation water quality. The cultivated soil from industrial area was found rich of toxins while the cultivated land using tube well water contains toxins in least amount. Our LIBS findings were also validated by comparing its results with contents measured using a standard inductively coupled plasma optical emission spectroscopy (ICP-OES) method and both were found in excellent agreement. The present study could be highly beneficial for agricultural applications and for farmers to produce safe food products and higher crops yield.
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Affiliation(s)
- I. Rehan
- Department of Physics, Islamia College University, Peshawar 25120, Pakistan
| | - M.A. Gondal
- Physics Department, IRC-Hydrogen and Energy Storage, K.A.CARE Energy Research and Innovation Center, King Fahd University of Petroleum and Minerals, P.O. Box 5047, Dhahran 31261, Saudi Arabia
| | - R.K. Aldakheel
- Department of Physics, College of Science, Imam Abdulrahman Bin Faisal University, Dammam P.O. Box 1982, Saudi Arabia
- Department of Biophysics, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam P.O. Box 1982, Saudi Arabia
| | - K. Rehan
- CAS Key Laboratory of Microscale Magnetic, University of Science and Technology of China, Hefei, Anhui, 230026, PR China
| | - S. Sultana
- Department of Chemistry, Islamia College University, Peshawar 25120, Pakistan
| | - M.A. Almessiere
- Department of Physics, College of Science, Imam Abdulrahman Bin Faisal University, Dammam P.O. Box 1982, Saudi Arabia
- Department of Biophysics, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam P.O. Box 1982, Saudi Arabia
- Corresponding author at: Department of Physics, College of Science, Imam Abdulrahman Bin Faisal University, Dammam P.O. Box 1982, Saudi Arabia.
| | - Z. Ali
- Nano science and catalysis division, National center for Physics, Islamabad Pakistan
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Sreenivasan J, Malik AH, Jurkoshek K, Khan M, Parambath SP, Ali Z, Naidu S, Michos E, Cooper H. TCT-31 Frailty Adjusted Risk Score for Outcomes in Type 2 Myocardial Infarction. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.036] [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: 10/19/2022]
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Lundy E, Shlofmitz E, Jeremias A, Abou-Eid G, Porter C, Thomas S, Maehara A, Pappas T, Mei N, Scheiner J, Robinson N, Ali Z, Shlofmitz R. TCT-307 Intraoperative Optical Coherence Tomography of the Saphenous Vein Conduit in Patients Undergoing Coronary Artery Bypass Surgery. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.1160] [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: 10/20/2022]
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Yamamoto K, Sato T, Matsumura M, Fall K, Kirtane A, Nazif T, Sethi S, Parikh S, Vahl T, Ali Z, Karmpaliotis D, Rabbani L, Leon M, Moses J, Mintz G, Maehara A. TCT-85 Mechanisms of In-Stent Restenosis in the Ostial Right Coronary Artery. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.935] [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: 10/19/2022]
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Shlofmitz E, Matsumura M, Maehara A, Moses J, Petrossian G, Abittan M, Kirtane A, Berke A, Pappas T, Chung W, Porter C, Thomas S, Glodan C, Ben-Yehuda O, Cohen D, Kereiakes D, Shlofmitz R, Ali Z, Jeremias A. TCT-273 Impact of Shockwave Intravascular Lithotripsy Induced Calcium Fracture for Treatment of Stent Underexpansion Mediated In-Stent Restenosis. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.1126] [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: 11/30/2022]
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Madhavan M, Galougahi KK, Redfors B, Ahmad Y, Prasad M, Genereux P, Maehara A, Zhou Z, Ben-Yehuda O, von Birgelen C, Smits P, Mehran R, Ali Z, Serruys P, Kirtane A, Leon M, Stone G. TCT-119 Association Among Degree of Coronary Artery Calcification, Clinical Presentation, and Adverse Clinical Outcomes After PCI: A Patient-Level Pooled Analysis of 11 Randomized Trials. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.969] [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: 11/15/2022]
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Yamamoto K, Sato T, Matsumura M, Fall K, Kirtane A, Nazif T, Sethi S, Parikh S, Vahl T, Ali Z, Karmpaliotis D, Rabbani L, Leon M, Moses J, Mintz G, Maehara A. TCT-282 IVUS Assessment of De Novo Ostial RCA Lesion Morphology. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.1135] [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: 10/20/2022]
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Ali Z, Hill J, Saito S, Gonzalo N, Di Mario C, Riley R, Honton B, Maehara A, Matsumura M, Kereiakes D, Stone G, Shlofmitz R. TCT-120 Optical Coherence Tomography Characterization of Shockwave Intravascular Lithotripsy for Treatment of Calcified Coronary Lesions: Patient-Level Pooled Analysis of the Disrupt CAD OCT Substudies. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Demola P, Di Mario C, Torguson R, Ten Cate T, Bambagioni G, Ali Z, Skinner W, Artis A, Zhang C, Garcia-Garcia HM, Doros G, Mintz GS, Waksman R. Greater plaque burden and cholesterol content may explain an increased incidence of non-culprit events in diabetic patients: a Lipid-Rich Plaque substudy. Eur Heart J Cardiovasc Imaging 2021; 23:1098-1107. [PMID: 34568945 DOI: 10.1093/ehjci/jeab161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/22/2021] [Indexed: 11/14/2022] Open
Abstract
AIMS Diabetes mellitus (DM) is associated with increased cardiovascular morbidity and mortality. The multicentre, prospective Lipid-Rich Plaque trial (LRP) examined non-culprit (NC) non-obstructive coronary segments with a combined near-infrared spectroscopy (NIRS)-intravascular ultrasound (IVUS) catheter. This study assessed the differences in NC plaque characteristics and their influence on major adverse cardiac events (MACE) in diabetic and non-diabetic patients. METHODS AND RESULTS Patients with known DM status were divided into no diabetes, diabetes not treated with insulin (non-ITDM), and insulin-treated diabetes (ITDM). The association between presence and type of DM and NC-MACE was assessed at both the patient and coronary segment levels by Cox proportional regression modelling. Out of 1552 patients enrolled, 1266 who had their diabetes status recorded were followed through 24 months. Female sex, hypertension, chronic kidney disease, peripheral vascular disease, and high body mass index were significantly more frequent in diabetic patients. The ITDM group had more diseased vessels, at least one NC segment with a maxLCBI4 mm ≥400 in 46.2% of patients, and maxLCBI4 mm ≥400 in nearly one out of six Ware segments (15.2%, 125/824 segments). The average maxLCBI4 mm significantly increased from non-diabetic patients (NoDM) to non-insulin-treated diabetic patients (non-ITDM) to insulin-treated diabetic patients (ITDM; 137.7 ± 161.9, 154.8 ± 173.6, 182.9 ± 193.2, P < 0.001, respectively). In patients assigned to follow-up (692 ± 129 days), ITDM doubled the incidence of NC-MACE compared with the absence of diabetes (15.7% vs. 6.9%, P = 0.0008). The presence of maxLCBI4 mm>400 further increased the NC-MACE rate to 21.6% (Kaplan-Meier estimate). CONCLUSION Cholesterol-rich NC plaques detected by NIRS-IVUS were significantly more frequent in diabetic patients, especially those who were insulin-treated, and were associated with an increased NC-MACE during follow-up.
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Affiliation(s)
- Pierluigi Demola
- Department of Clinical and Experimental Medicine, Structural Interventional Cardiology, Careggi University Hospital, Largo Brambilla 3, 50139 Florence, Italy
| | - Carlo Di Mario
- Department of Clinical and Experimental Medicine, Structural Interventional Cardiology, Careggi University Hospital, Largo Brambilla 3, 50139 Florence, Italy
| | - Rebecca Torguson
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tim Ten Cate
- Cardiology Department, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Gabriele Bambagioni
- Department of Clinical and Experimental Medicine, Structural Interventional Cardiology, Careggi University Hospital, Largo Brambilla 3, 50139 Florence, Italy
| | - Ziad Ali
- St. Francis Hospital-The Heart Center, Roslyn, NY, USA
| | - William Skinner
- Cardiovascular Department, Central Baptist Hospital, Lexington, KY, USA
| | - Andre Artis
- Cardiovascular Department, Methodist Hospital, Merrillville, IN, USA
| | - Cheng Zhang
- Cardiovascular Department, MedStar Washington Hospital Center, Washington, DC, USA
| | | | - Gheorghe Doros
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Gary S Mintz
- Cardiovascular Department, MedStar Washington Hospital Center, Washington, DC, USA
| | - Ron Waksman
- Cardiovascular Department, MedStar Washington Hospital Center, Washington, DC, USA
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Banerjee S, Leary A, Lheureux S, Stewart J, Attygalle A, Vroobel K, Gill S, Ali Z, Tai J, Toms C, Natrajan R, Lord C, Porta N, Bliss J. 815TiP ENGOT/GYN1/NCRI: ATR inhibitor in combination with olaparib in gynaecological cancers with ARID1A loss or no loss (ATARI). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Bambagioni G, Di Mario C, Torguson R, Demola P, Ali Z, Singh V, Skinner W, Artis A, Cate TT, Zhang C, Garcia-Garcia HM, Doros G, Mintz GS, Waksman R. Lipid-rich plaques detected by near-infrared spectroscopy predict coronary events irrespective of age: A Lipid Rich Plaque sub-study. Atherosclerosis 2021; 334:17-22. [PMID: 34455112 DOI: 10.1016/j.atherosclerosis.2021.08.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 07/27/2021] [Accepted: 08/11/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS In this Lipid Rich Plaque (LRP) sub-study, 1551 patients undergoing coronary angiography for acute coronary syndromes or stable angina were examined with near-infrared spectroscopy (NIRS) and intravascular ultrasound (IVUS). We aimed to assess the correlation of patient age with the presence of high-risk plaques, defined as maximum 4-mm Lipid Core Burden Index (maxLCBI4mm) >400 and plaque burden >70%, and 2-year incidence of non-culprit major adverse cardiovascular events (NC-MACE). METHODS The study population was divided into four groups according to age: <50 years (122), 50-64 years (700), 65-74 years (502), and ≥75 years (227). The primary outcome was NC-MACE from index procedure to event or the end of the study. Cox regression and mixed-effects Cox regression models were used to assess the effect of age on the association between LCBI and NC-MACE at the patient and plaque levels. RESULTS Average maxLCBI4mm and percentage of patients with at least one segment with maxLCBI4mm > 400 were similar across the four age groups at both the patient and coronary segment levels. Having at least one segment with maxLCBI4mm > 400 was strongly associated with NC-MACE, and that association did not differ significantly across age subgroups. Although less common (prevalence of 0.8%-1.3%), a similar trend toward greater NC-MACE rates was seen in patients with plaque burden >70% at the maximum LCBI site across age subgroups. CONCLUSIONS Lipid-rich plaques were as frequent in older as in younger patients and predicted a higher incidence of NC-MACE over 2-year follow-up irrespective of age.
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Affiliation(s)
- Gabriele Bambagioni
- Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
| | - Carlo Di Mario
- Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy.
| | - Rebecca Torguson
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Pierluigi Demola
- Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
| | - Ziad Ali
- St Francis Hospital & Heart Center, Roslyn, NY, USA; Cardiovascular Research Foundation, New York, NY, USA
| | | | | | | | - Tim Ten Cate
- Radboud University Medical Center, Nijmegen, Netherlands
| | - Cheng Zhang
- MedStar Washington Hospital Center, Washington, DC, USA
| | | | | | - Gary S Mintz
- MedStar Washington Hospital Center, Washington, DC, USA
| | - Ron Waksman
- MedStar Washington Hospital Center, Washington, DC, USA
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Matthews R, Ali Z. Comorbid mental health issues in patients with pemphigus vulgaris and pemphigus foliaceus. Clin Exp Dermatol 2021; 47:24-29. [PMID: 34459019 DOI: 10.1111/ced.14916] [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: 04/05/2021] [Revised: 08/02/2021] [Accepted: 08/26/2021] [Indexed: 10/20/2022]
Abstract
The term 'pemphigus' refers to chronic autoimmune skin disorders that cause blistering erosions on the skin and oral mucosa. The two major clinical forms are pemphigus vulgaris and pemphigus foliaceus. Although rare, they confer a stark symptomatic burden upon patients that significantly impacts daily life. Comorbid mental health issues are not routinely screened for in patients with pemphigus, and current UK guidance provides no formal provision for the identification and treatment of psychological issues. This review is the first of its kind, to our knowledge, to systematically examine the available evidence on mental health issues in pemphigus. Published work suggests that the incidence of anxiety and depression is much higher in patients with pemphigus compared with both the general population and with patients having other chronic skin disorders. Disease severity appears to be closely linked to mental health, with worsening of pemphigus associated with deteriorations in psychological wellbeing. Corticosteroids, which are associated with depression in chronic use, are the current first-line therapy for pemphigus and have been identified as a potential confounder and independent risk factor for mental health comorbidity in pemphigus. Current evidence is unclear whether a bidirectional relationship exists between mental health and pemphigus severity, and more thorough research is required to develop understanding of this issue. In conclusion, we have identified a high incidence of mental health comorbidity in pemphigus, and recommend routine screening of patients with pemphigus for mental health issues and signposting toward mental health services as an initial measure to address this.
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Affiliation(s)
- R Matthews
- Department of Post-Graduate Medical Education, Royal Blackburn Teaching Hospital, East Lancashire Hospital Trust, Blackburn, UK
| | - Z Ali
- Department of Post-Graduate Medical Education, Salford Royal Foundation Trust, Salford, Manchester, UK
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Ali Z, Joergensen KM, Vestergaard C, Andersen AD, Alexaki M, Eiken AL, Manole I, Thomsen SF, Deleuran M, Zibert JR. Effective clinical study recruitment of patients with atopic dermatitis through social media. J Eur Acad Dermatol Venereol 2021; 35:e922-e923. [PMID: 34370350 DOI: 10.1111/jdv.17587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/30/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Z Ali
- Department of Dermato-Venereology and Wound Healing Centre, Copenhagen University Hospital Bispebjerg, Denmark
| | | | - C Vestergaard
- Department of Dermatology and Venereology, Aarhus University Hospital, Aarhus, Denmark
| | | | | | | | | | - S F Thomsen
- Department of Dermato-Venereology and Wound Healing Centre, Copenhagen University Hospital Bispebjerg, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - M Deleuran
- Department of Dermatology and Venereology, Aarhus University Hospital, Aarhus, Denmark
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Lima J, Ali Z, Banerjee S. Immunotherapy and Systemic Therapy in Metastatic/Recurrent Endometrial and Cervical Cancers. Clin Oncol (R Coll Radiol) 2021; 33:608-615. [PMID: 34312021 DOI: 10.1016/j.clon.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/21/2021] [Accepted: 07/02/2021] [Indexed: 10/20/2022]
Abstract
Despite advances in the treatment of gynaecological malignancies, both recurrent endometrial and cervical cancers when not amenable to localised therapy (surgery or radiotherapy), remain incurable with limited prognosis and effective treatment options. Chemotherapy remains the standard of care for women with metastatic endometrial or cervical cancers. The addition of bevacizumab to first-line chemotherapy for metastatic cervical cancer patients represents a significant step forward in improving survival. More recently, immunotherapeutic strategies targeting the PD-1/-L1 pathway have shown clinical activity in both endometrial and cervical cancers. The increased understanding of the molecular biology of these cancers is shaping target-specific treatments. Here we summarise current treatment options and results from clinical trials of immunotherapy and other targeted therapies that have already changed, or have the potential to change, clinical practice in metastatic/recurrent endometrial and cervical cancer.
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Affiliation(s)
- J Lima
- The Gynaecology Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Z Ali
- The Gynaecology Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - S Banerjee
- The Gynaecology Unit, The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK.
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Xing R, Mustapha O, Ali T, Rehman M, Zaidi SS, Baseer A, Batool S, Mukhtiar M, Shafique S, Malik M, Sohail S, Ali Z, Zahid F, Zeb A, Shah F, Yousaf A, Din F. Development, Characterization, and Evaluation of SLN-Loaded Thermoresponsive Hydrogel System of Topotecan as Biological Macromolecule for Colorectal Delivery. Biomed Res Int 2021; 2021:9968602. [PMID: 34285920 PMCID: PMC8275402 DOI: 10.1155/2021/9968602] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/21/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Chemotherapeutic drugs cause severe toxicities if administered unprotected, without proper targeting, and controlled release. In this study, we developed topotecan- (TPT-) loaded solid lipid nanoparticles (SLNs) for their chemotherapeutic effect against colorectal cancer. The TPT-SLNs were further incorporated into a thermoresponsive hydrogel system (TRHS) (TPT-SLNs-TRHS) to ensure control release and reduce toxicity of the drug. Microemulsion technique and cold method were, respectively, used to develop TPT-SLNs and TPT-SLNs-TRHS. Particle size, polydispersive index (PDI), and incorporation efficiency (IE) of the TPT-SLNs were determined. Similarly, gelation time, gel strength, and bioadhesive force studies of the TPT-SLNs-TRHS were performed. Additionally, in vitro release and pharmacokinetic and antitumour evaluations of the formulation were done. RESULTS TPT-SLNs have uniformly distributed particles with mean size in nanorange (174 nm) and IE of ~90%. TPT-SLNs-TRHS demonstrated suitable gelation properties upon administration into the rat's rectum. Moreover, drug release was exhibited in a control manner over an extended period of time for the incorporated TPT. Pharmacokinetic studies showed enhanced bioavailability of the TPT with improved plasma concentration and AUC. Further, it showed significantly enhanced antitumour effect in tumour-bearing mice as compared to the test formulations. CONCLUSION It can be concluded that SLNs incorporated in TRHS could be a potential source of the antitumour drug delivery with better control of the drug release and no toxicity.
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Affiliation(s)
- R. Xing
- Department of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
- Beijing Key Laboratory of Bio-characteristic Profiling for Evaluation of Rational Drug Use, Beijing 100038, China
| | - O. Mustapha
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, DOW University of Health Sciences, 74200 Karachi, Pakistan
| | - T. Ali
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, DOW University of Health Sciences, 74200 Karachi, Pakistan
| | - M. Rehman
- HE.J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Pakistan
| | - S. S. Zaidi
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, DOW University of Health Sciences, 74200 Karachi, Pakistan
| | - A. Baseer
- Department of Pharmacy, Abasyn University Peshawar, KPK, Pakistan
| | - S. Batool
- Nanomedicine Research Group, Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - M. Mukhtiar
- Department of Pharmacy, Faculty of Medical and Health Sciences, University of Poonch Rawalakot, AJK, Pakistan
| | - S. Shafique
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, DOW University of Health Sciences, 74200 Karachi, Pakistan
| | - M. Malik
- Nanomedicine Research Group, Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - S. Sohail
- Nanomedicine Research Group, Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Z. Ali
- Nanomedicine Research Group, Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - F. Zahid
- Nanomedicine Research Group, Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - A. Zeb
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Sector G-7/4, Islamabad 44000, Pakistan
| | - F. Shah
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Sector G-7/4, Islamabad 44000, Pakistan
| | - A. Yousaf
- Department of Pharmacy, COMSATS University Islamabad, Lahore Campus, Lahore 54000, Pakistan
| | - F. Din
- Nanomedicine Research Group, Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
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Demola P, Di Mario C, Turguson R, Bambagioni G, ten Cate T, Ali Z, Singh V, Artis A, Skinner W, Garcia-Garcia H, Mintz GS, Doros G, Waksman R. Greater Plaque Volume and Cholesterol Content Explain an Increased Incidence of Non-Culprit Events in Diabetic Patients: A Lipid Rich Plaque Substudy. Cardiovascular Revascularization Medicine 2021. [DOI: 10.1016/j.carrev.2021.06.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ali Z, Karimi Galougahi K, Mintz GS, Maehara A, Shlofmitz R, Mattesini A. Intracoronary optical coherence tomography: state of the art and future directions. EUROINTERVENTION 2021; 17:e105-e123. [PMID: 34110288 PMCID: PMC9725016 DOI: 10.4244/eij-d-21-00089] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [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: 11/23/2022]
Abstract
Optical coherence tomography (OCT) has been increasingly utilised to guide percutaneous coronary intervention (PCI). Despite the diagnostic utility of OCT, facilitated by its high resolution, the impact of intracoronary OCT on clinical practice has thus far been limited. Difficulty in transitioning from intravascular ultrasound (IVUS), complex image interpretation, lack of a standardised algorithm for PCI guidance, and paucity of data from prospective clinical trials have contributed to the modest adoption. Herein, we provide a comprehensive up-do-date overview on the utility of OCT in coronary artery disease, including technical details, device set-up, simplified OCT image interpretation, recognition of the imaging artefacts, and an algorithmic approach for using OCT in PCI guidance. We discuss the utility of OCT in acute coronary syndromes, provide a summary of the clinical trial data, list the work in progress, and discuss the future directions.
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Affiliation(s)
- Ziad Ali
- St. Francis Hospital and Heart Center 100 Port Washington Blvd., Roslyn, NY 11576, USA
| | | | - Gary S. Mintz
- Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA
| | - Akiko Maehara
- Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA,Center for Interventional Vascular Therapy, Division of Cardiology, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, USA
| | - Richard Shlofmitz
- DeMatteis Cardiovascular Institute, St. Francis Hospital & Heart Center, Roslyn, NY, USA
| | - Alessio Mattesini
- Structural Interventional Cardiology Unit, Careggi University Hospital, Florence, Italy
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Sanders BJ, Ali Z. Oral Baclofen Withdrawal Resulting in Hyperactive Delirium: A Case Report. Cureus 2021; 13:e14979. [PMID: 34123673 PMCID: PMC8194372 DOI: 10.7759/cureus.14979] [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] [Indexed: 11/05/2022] Open
Abstract
Baclofen is used in the treatment of muscle spasms by acting as an agonist GABAB receptors. Limited case reports describing baclofen withdrawal-induced delirium have largely been demonstrated to occur upon cessation of intrathecal baclofen administration. Fewer reports have characterized the presentation from oral baclofen withdrawal. We describe a case of a patient, MM, who presented with hyperactive delirium with various, associated, behavioral, perceptual, cognitive, and movement disturbances following abrupt withdrawal of oral baclofen. Symptomatic management of occurring during the withdrawal state with antipsychotics and benzodiazepines has been reported previously. Similarly, MM's perceptual and behavioral disturbances were managed with antipsychotics during her admission. However, addressing the underlying cause by reinstating and slowly tapering off baclofen has also been demonstrated to be an effective, targeted approach.
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Affiliation(s)
| | - Ziad Ali
- Psychiatry, University of Kentucky, Bowling Green, USA
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Fisher R, Hadjittofi C, Ali Z, Antonas P, Parekh K, Seraj S, Thomas L, Uddin A, Lovett B. 755 Elective Surgery in the COVID-19 Pandemic: Outcomes of 100 Consecutive Cases. Br J Surg 2021. [PMCID: PMC8135925 DOI: 10.1093/bjs/znab134.083] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Introduction The COVID-19 pandemic halted elective surgical activity. Basildon University Hospital established an elective Green Zone for COVID-19 swab negative patients who isolated for 14 days. This study reviewed the outcomes of the first 100 patients. Method A single-centre study was performed. Demographic and perioperative electronic data were supplemented with telephone follow-up for the first 100 Green Zone patients and analysed in Microsoft Excel. Results One hundred Green Zone patients underwent surgery between 21/05/2020 and 16/06/2020. The median age was 55 (14-88) years. 52% were female. Their operations were performed by General Surgery (39%), Gynaecology (17%), Vascular Surgery (14%), Oral Surgery (12%), ENT (9%), Urology (8%), and Pain Management (1%). Preoperatively, 100% had a negative SARS-CoV-2 swab and one had CT evidence of mild resolving COVID-19. Two patients had postoperative SARS-CoV-2 swabs, both negative. Median length of stay was 0 (0-7) days. 84% responded to telephone follow-up at a median 25 (13-54) postoperative days, 69% of whom were asymptomatic There were no 30-day major complications (>Clavien-Dindo IIIa) or 90-day mortality. Conclusions Elective surgery can be safe during the COVID-19 pandemic, with appropriate measures in place. This has significant implications in the context of an ever-expanding NHS waiting list during a pandemic of uncertain duration.
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Affiliation(s)
- R Fisher
- Basildon University Hospital, Basildon, United Kingdom
| | - C Hadjittofi
- Basildon University Hospital, Basildon, United Kingdom
| | - Z Ali
- Basildon University Hospital, Basildon, United Kingdom
| | - P Antonas
- Basildon University Hospital, Basildon, United Kingdom
| | - K Parekh
- Basildon University Hospital, Basildon, United Kingdom
| | - S Seraj
- Basildon University Hospital, Basildon, United Kingdom
| | - L Thomas
- Basildon University Hospital, Basildon, United Kingdom
| | - A Uddin
- Basildon University Hospital, Basildon, United Kingdom
| | - B Lovett
- Basildon University Hospital, Basildon, United Kingdom
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50
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Windecker S, Kedhi E, Latib A, Kandzari D, Kirtane A, Mehran R, Price M, Abizaid A, Simon D, Worthley S, Zaman A, Wetzels G, Lung TH, Marx S, Ali Z, Stone G. FINAL TWO-YEAR RESULTS FROM THE RANDOMIZED ONYX ONE TRIAL IN HIGH BLEEDING RISK PATIENTS TREATED WITH 1-MONTH DAPT. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02258-0] [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: 10/21/2022]
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