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Ong C, Huang Q, Kim I, Pohlmann J, Chatzidakis S, Brush B, Zhang Y, Du Y, Mallinger LA, Benjamin EJ, Dupuis J, Greer D, Smirnakis S, Trinquart L. Dynamic trajectories of life-threatening mass effect in patients with large middle cerebral artery stroke. Res Sq 2023:rs.3.rs-3594179. [PMID: 38045289 PMCID: PMC10690305 DOI: 10.21203/rs.3.rs-3594179/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Background Life-threatening, space-occupying mass effect due to cerebral edema and/or hemorrhagic transformation is an early complication of patients with middle cerebral artery ( MCA ) stroke. Little is known about longitudinal trajectories of laboratory and vital signs leading up to radiographic and clinical deterioration related to this mass effect. Methods We curated a granular retrospective dataset of 635 patients with large middle cerebral artery ( MCA ) stroke totaling 108,547 data points for repeated measurements of 10 covariates, and 40 time-independent covariates. We assessed longitudinal trajectories of the 10 longitudinal variables during the 72 hours preceding three outcomes representative of life-threatening mass effect: midline shift ( MLS ) \(\ge\)5mm, pineal gland shift ( PGS ) \(>\)4mm, and decompressive hemicraniectomy ( DHC ). We used a "backward looking" trajectory approach. Patients were aligned according to the time of outcome occurrence and the trajectory of each variable was assessed prior to that outcome by accounting for both cases and non-cases. Results Of 635 patients, 49% were female, and mean age was 69 years. Thirty five percent of patients had MLS \(\ge\)5mm, 24.1% had PGS \(>\)4mm, and DHC occurred in 10.7%. For the three outcomes of interest, backward-looking trajectories showed mild increases in white blood cell count (10 up to 11 K/UL within 72 hours), temperature (up to half a degree within 24 hours), and sodium (1-3 mEq/L within 24 hours) leading up to outcomes. We also observed a decrease in heart rate (75 - 65 beats per minute) 24 hours prior to DHC. Conclusions Univariable longitudinal profiling showed that temperature, white blood cell count, and sodium increase prior to radiographic and clinical indicators of space-occupying mass effect. These findings will inform development of multivariable dynamic risk models to aid prediction of life-threatening space-occupying mass effect.
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Patel M, Wilson A, Ong C. Double-lumen tubes and bronchial blockers. BJA Educ 2023; 23:416-424. [PMID: 37876764 PMCID: PMC10591134 DOI: 10.1016/j.bjae.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 06/02/2023] [Accepted: 07/04/2023] [Indexed: 10/26/2023] Open
Affiliation(s)
- M. Patel
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A. Wilson
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - C. Ong
- Guy's and St Thomas' NHS Foundation Trust, London, UK
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Wang C, Leng S, Tan R, Chai P, Fam J, Teo L, Chin C, Ong C, Baskaran L, Keng F, Low A, Chan M, Wong A, Chua T, Tan S, Lim S, Zhong L. 517 Computed Tomography Coronary Angiography Based Morphological Index Predicts Coronary Ischemia. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Toh VTR, Walsh M, Yap C, Yassa J, Young T, Agarwal N, Almoosawy SA, Bowen K, Bruce D, Connachan R, Cook A, Daniell A, Elliott M, Fung HKF, Irving A, Laurie S, Lee YJ, Lim ZX, Maddineni S, McClenaghan RE, Muthuganesan V, Ravichandran P, Roberts N, Shaji S, Solt S, Toshney E, Arnold C, Baker O, Belais F, Bojanic C, Byrne M, Chau CYC, De Soysa S, Eldridge M, Fairey M, Fearnhead N, Guéroult A, Ho JSY, Joshi K, Kadiyala N, Khalid S, Khan F, Kumar K, Lewis E, Magee J, Manetta-Jones D, Mann S, McKeown L, Mitrofan C, Mohamed T, Monnickendam A, Ng AYKC, Ortu A, Patel M, Pope T, Pressling S, Purohit K, Saji S, Shah Foridi J, Shah R, Siddiqui SS, Surman K, Utukuri M, Varghese A, Williams CYK, Yang JJ, Billson E, Cheah E, Holmes P, Hussain S, Murdock D, Nicholls A, Patel P, Ramana G, Saleki M, Spence H, Thomas D, Yu C, Abousamra M, Brown C, Conti I, Donnelly A, Durand M, French N, Goan R, O'Kane E, Rubinchik P, Gardiner H, Kempf B, Lai YL, Matthews H, Minford E, Rafferty C, Reid C, Sheridan N, Al Bahri T, Bhoombla N, Rao BM, Titu L, Chatha S, Field C, Gandhi T, Gulati R, Jha R, Jones Sam MT, Karim S, Patel R, Saunders M, Sharma K, Abid S, Heath E, Kurup D, Patel A, Ali M, Cresswell B, Felstead D, Jennings K, Kaluarachchi T, Lazzereschi L, Mayson H, Miah JE, Reinders B, Rosser A, Thomas C, Williams H, Al-Hamid Z, Alsadoun L, Chlubek M, Fernando P, Gaunt E, Gercek Y, Maniar R, Ma R, Matson M, Moore S, Morris A, Nagappan PG, Ratnayake M, Rockall L, Shallcross O, Sinha A, Tan KE, Virdee S, Wenlock R, Donnelly HA, Ghazal R, Hughes I, Liu X, McFadden M, Misbert E, Mogey P, O'Hara A, Peace C, Rainey C, Raja P, Salem M, Salmon J, Tan CH, Alves D, Bahl S, Baker C, Coulthurst J, Koysombat K, Linn T, Rai P, Sharma A, Shergill A, Ahmed M, Ahmed S, Belk LH, Choudhry H, Cummings D, Dixon Y, Dobinson C, Edwards J, Flint J, Franco Da Silva C, Gallie R, Gardener M, Glover T, Greasley M, Hatab A, Howells R, Hussey T, Khan A, Mann A, Morrison H, Ng A, Osmond R, Padmakumar N, Pervaiz F, Prince R, Qureshi A, Sawhney R, Sigurdson B, Stephenson L, Vora K, Zacken A, Cope P, Di Traglia R, Ferarrio I, Hackett N, Healicon R, Horseman L, Lam LI, Meerdink M, Menham D, Murphy R, Nimmo I, Ramaesh A, Rees J, Soame R, Dilaver N, Adebambo D, Brown E, Burt J, Foster K, Kaliyappan L, Knight P, Politis A, Richardson E, Townsend J, Abdi M, Ball M, Easby S, Gill N, Ho E, Iqbal H, Matthews M, Nubi S, Nwokocha JO, Okafor I, Perry G, Sinartio B, Vanukuru N, Walkley D, Welch T, Yates J, Yeshitila N, Bryans K, Campbell B, Gray C, Keys R, Macartney M, Chamberlain G, Khatri A, Kucheria A, Lee STP, Reese G, Roy choudhury J, Tan WYR, Teh JJ, Ting A, Kazi S, Kontovounisios C, Vutipongsatorn K, Amarnath T, Balasubramanian N, Bassett E, Gurung P, Lim J, Panjikkaran A, Sanalla A, Alkoot M, Bacigalupo V, Eardley N, Horton M, Hurry A, Isti C, Maskell P, Nursiah K, Punn G, Salih H, Epanomeritakis E, Foulkes A, Henderson R, Johnston E, McCullough H, McLarnon M, Morrison E, Cheung A, Cho SH, Eriksson F, Hedges J, Low Z, May C, Musto L, Nagi S, Nur S, Salau E, Shabbir S, Thomas MC, Uthayanan L, Vig S, Zaheer M, Zeng G, Ashcroft-Quinn S, Brown R, Hayes J, McConville R, French R, Gilliam A, Sheetal S, Shehzad MU, Bani W, Christie I, Franklyn J, Khan M, Russell J, Smolarek S, Varadarassou R, Ahmed SK, Narayanaswamy S, Sealy J, Shah M, Dodhia V, Manukyan A, O'Hare R, Orbell J, Chung I, Forenc K, Gupta A, Agarwal A, Al Dabbagh A, Bennewith R, Bottomley J, Chu TSM, Chu YYA, Doherty W, Evans B, Hainsworth P, Hosfield T, Li CH, McCullagh I, Mehta A, Thaker A, Thompson B, Virdi A, Walker H, Wilkins E, Dixon C, Hassan MR, Lotca N, Tong KS, Batchelor-Parry H, Chaudhari S, Harris T, Hooper J, Johnson C, Mulvihill C, Nayler J, Olutobi O, Piramanayagam B, Stones K, Sussman M, Weaver C, Alam F, Al Rawi M, Andrew F, Arrayeh A, Azizan N, Hassan A, Iqbal Z, John I, Jones M, Kalake O, Keast M, Nicholas J, Patil A, Powell K, Roberts P, Sabri A, Segue AK, Shah A, Shaik Mohamed SA, Shehadeh A, Shenoy S, Tong A, Upcott M, Vijayasingam D, Anarfi S, Dauncey J, Devindaran A, Havalda P, Komninos G, Mwendwa E, Norman C, Richards J, Urquhart A, Allan J, Cahya E, Hunt H, McWhirter C, Norton R, Roxburgh C, Tan JY, Ali Butt S, Hansdot S, Haq I, Mootien A, Sanchez I, Vainas T, Deliyannis E, Tan M, Vipond M, Chittoor Satish NN, Dattani A, De Carvalho L, Gaston-Grubb M, Karunanithy L, Lowe B, Pace C, Raju K, Roope J, Taylor C, Youssef H, Munro T, Thorn C, Wong KHF, Yunus A, Chawla S, Datta A, Dinesh AA, Field D, Georgi T, Gwozdz A, Hamstead E, Howard N, Isleyen N, Jackson N, Kingdon J, Sagoo KS, Schizas A, Yin L, Aung E, Aung YY, Franklin S, Han SM, Kim WC, Martin Segura A, Rossi M, Ross T, Tirimanna R, Wang B, Zakieh O, Ben-Arzi H, Flach A, Jackson E, Magers S, Olu abara C, Rogers E, Sugden K, Tan H, Veliah S, Walton U, Asif A, Bharwada Y, Bowley D, Broekhuizen A, Cooper L, Evans N, Girdlestone H, Ling C, Mann H, Mehmood N, Mulvenna CL, Rainer N, Trout I, Gujjuri R, Jeyaraman D, Leong E, Singh D, Smith E, Anderton J, Barabas M, Goyal S, Howard D, Joshi A, Mitchell D, Weatherby T, Badminton R, Bird R, Burtle D, Choi NY, Devalia K, Farr E, Fischer F, Fish J, Gunn F, Jacobs D, Johnston P, Kalakoutas A, Lau E, Loo YNAF, Louden H, Makariou N, Mohammadi K, Nayab Y, Ruhomaun S, Ryliskyte R, Saeed M, Shinde P, Sudul M, Theodoropoulou K, Valadao-Spoorenberg J, Vlachou F, Arshad SR, Janmohamed AM, Noor M, Oyerinde O, Saha A, Syed Y, Watkinson W, Ahmadi H, Akintunde A, Alsaady A, Bradley J, Brothwood D, Burton M, Higgs M, Hoyle C, Katsura C, Lathan R, Louani A, Mandalia R, Prihartadi AS, Qaddoura B, Sandland-Taylor L, Thadani S, Thompson A, Walshaw J, Teo S, Ali S, Bawa JH, Fox S, Gargan K, Haider SA, Hanna N, Hatoum A, Khan Z, Krzak AM, Li T, Pitt J, Tan GJS, Ullah Z, Wilson E, Cleaver J, Colman J, Copeland L, Coulson A, Davis P, Faisal H, Hassan F, Hughes JT, Jabr Y, Mahmoud Ali F, Nahaboo Solim ZN, Sangheli A, Shaya S, Thompson R, Cornwall H, De Andres Crespo M, Fay E, Findlay J, Groves E, 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Langhorne B, Lund J, Lutchman I, McGuinness R, Neary M, Pampapathi S, Pang E, Podbicanin S, Rai N, Redhouse White G, Sujith J, Thomas P, Walker I, Winterton R, Anderson P, Barrington M, Bhadra K, Clark G, Fowler G, Gibson C, Hudson S, Kaminskaite V, Lawday S, Longshaw A, MacKrill E, McLachlan F, Murdeshwar A, Nieuwoudt R, Parker P, Randall R, Rawlins E, Reeves SA, Rye D, Sirkis T, Sykes B, Ventress N, Wosinska N, Akram B, Burton L, Coombs A, Long R, Magowan D, Ong C, Sethi M, Williams G, Chan C, Chan LH, Fernando D, Gaba F, Khor Z, Les JW, Mak R, Moin S, Ng Kee Kwong KC, Paterson-Brown S, Tew YY, Bardon A, Burrell K, Coldwell C, Costa I, Dexter E, Hardy A, Khojani M, Mazurek J, Raymond T, Reddy V, Reynolds J, Soma A, Agiotakis S, Alsusa H, Desai N, Peristerakis I, Adcock A, Ayub H, Bennett T, Bibi F, Brenac S, Chapman T, Clarke G, Clark F, Galvin C, Gwyn-Jones A, Henry-Blake C, Kerner S, Kiandee M, Lovett A, Pilecka A, Ravindran R, Siddique H, Sikand T, Treadwell K, Akmal K, Apata A, Barton O, Broad G, Darling H, Dhuga Y, Emms L, Habib S, Jain R, Jeater J, Kan CYP, Kathiravelupillai A, Khatkar H, Kirmani S, Kulasabanathan K, Lacey H, Lal K, Manafa C, Mansoor M, McDonald S, Mittal A, Mustoe S, Nottrodt L, Oliver P, Papapetrou I, Pattinson F, Raja M, Reyhani H, Shahmiri A, Small O, Soni U, Aguirrezabala Armbruster B, Bunni J, Hakim MA, Hawkins-Hooker L, Howell KA, Hullait R, Jaskowska A, Ottewell L, Thomas-Jones I, Vasudev A, Clements B, Fenton J, Gill M, Haider S, Lim AJM, Maguire H, McMullan J, Nicoletti J, Samuel S, Unais MA, White N, Yao PC, Yow L, Boyle C, Brady R, Cheekoty P, Cheong J, Chew SJHL, Chow R, Ganewatta Kankanamge D, Mamer L, Mohammed B, Ng Chieng Hin J, Renji Chungath R, Royston A, Sharrad E, Sinclair R, Tingle S, Treherne K, Wyatt F, Maniarasu VS, Moug S, Appanna T, Bucknall T, Hussain F, Owen A, Parry M, Parry R, Sagua N, Spofforth K, Yuen ECT, Bosley N, Hardie W, Moore T, Regas C, Abdel-Khaleq S, Ali N, Bashiti H, Buxton-Hopley R, Constantinides M, D'Afflitto M, Deshpande A, Duque Golding J, Frisira E, Germani Batacchi M, Gomaa A, Hay D, Hutchison R, Iakovou A, Iakovou D, Ismail E, Jefferson S, Jones L, Khouli Y, Knowles C, Mason J, McCaughan R, Moffatt J, Morawala A, Nadir H, Neyroud F, Nikookam Y, Parmar A, Pinto L, Ramamoorthy R, Richards E, Thomson S, Trainer C, Valetopoulou A, Vassiliou A, Wantman A, Wilde S, Dickinson M, Rockall T, Senn D, Wcislo K, Zalmay P, Adelekan K, Allen K, Bajaj M, Gatumbu P, Hang S, Hashmi Y, Kaur T, Kawesha A, Kisiel A, Woodmass M, Adelowo T, Ahari D, Alhwaishel K, Atherton R, Clayton B, Cockroft A, Curtis Lopez C, Hilton M, Ismail N, Kouadria M, Lee L, MacConnachie A, Monks F, Mungroo S, Nikoletopoulou C, Pearce L, Sara X, Shahid A, Suresh G, Wilcha R, Atiyah A, Davies E, Dermanis A, Gibbons H, Hyde A, Lawson A, Lee C, Leung-Tack M, Li Saw Hee J, Mostafa O, Nair D, Pattani N, Plumbley-Jones J, Pufal K, Ramesh P, Sanghera J, Saram S, Scadding S, See S, Stringer H, Torrance A, Vardon H, Wyn-Griffiths F, Brew A, Kaur G, Soni D, Tickle A, Akbar Z, Appleyard T, Figg K, Jayawardena P, Johnson A, Kamran Siddiqui Z, Lacy-Colson J, Oatham R, Rowlands B, Sludden E, Turnbull C, Allin D, Ansar Z, Azeez Z, Dale VH, Garg J, Horner A, Jones S, Knight S, McGregor C, McKenna J, McLelland T, Packham-Smith A, Rowsell K, Spector-Hill I, Adeniken E, Baker J, Bartlett M, Chikomba L, Connell B, Deekonda P, Dhar M, Elmansouri A, Gamage K, Goodhew R, Hanna P, Knight J, Luca A, Maasoumi N, Mahamoud F, Manji S, Marwaha PK, Mason F, Oluboyede A, Pigott L, Razaq AM, Richardson M, Saddaoui I, Wijeyendram P, Yau S, Atkins W, Liang K, Miles N, Praveen B, Ashai S, Braganza J, Common J, Cundy A, Davies R, Guthrie J, Handa I, Iqbal M, Ismail R, Jones C, Jones I, Lee KS, Levene A, Okocha M, Olivier J, Smith A, Subramaniam E, Tandle S, Wang A, Watson A, Wilson C, Chan XHF, Khoo E, Montgomery C, Norris M, Pugalenthi PP, Common T, Cook E, Mistry H, Shinmar HS, Agarwal G, Bandyopadhyay S, Brazier B, Carroll L, Goede A, Harbourne A, Lakhani A, Lami M, Larwood J, Martin J, Merchant J, Pattenden S, Pradhan A, Raafat N, Rothwell E, Shammoon Y, Sudarshan R, Vickers E, Wingfield L, Ashworth I, Azizi S, Bhate R, Chowdhury T, Christou A, Davies L, Dwaraknath M, Farah Y, Garner J, Gureviciute E, Hart E, Jain A, Javid S, Kankam HK, Kaur Toor P, Kaz R, Kermali M, Khan I, Mattson A, McManus A, Murphy M, Nair K, Ngemoh D, Norton E, Olabiran A, Parry L, Payne T, Pillai K, Price S, Punjabi K, Raghunathan A, Ramwell A, Raza M, Ritehnia J, Simpson G, Smith W, Sodeinde S, Studd L, Subramaniam M, Thomas J, Towey S, Tsang E, Tuteja D, Vasani J, Vio M, Badran A, Adams J, Anthony Wilkinson J, Asvandi S, Austin T, Bald A, Bix E, Carrick M, Chander B, Chowdhury S, Cooper Drake B, Crosbie S, D Portela S, Francis D, Gallagher C, Gillespie R, Gravett H, Gupta P, Ilyas C, James G, Johny J, Jones A, Kinder F, MacLeod C, Macrow C, Maqsood-Shah A, Mather J, McCann L, McMahon R, Mitham E, Mohamed M, Munton E, Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa M, Lehmann J, Mangtani A, Narayan A, Nazarian S, Parmar C, Shah D, Shaw C, Zhao Z, Beck C, Caldwell S, Clements JM, French B, Kenny R, Kirk S, Lindsay J, McClung A, McLaughlin N, Watson S, Whiteside E, Alyacoubi S, Arumugam V, Beg R, Dawas K, Garg S, Lloyd ER, Mahfouz Y, Manobharath N, Moonesinghe R, Morka N, Patel K, Prashar J, Yip S, Adeeko ES, Ajekigbe F, Bhat A, Evans C, Farrugia A, Gurung C, Long T, Malik B, Manirajan S, Newport D, Rayer J, Ridha A, Ross E, Saran T, Sinker A, Waruingi D, Allen R, Al Sadek Y, Alves do Canto Brum H, Asharaf H, Ashman M, Balakumar V, Barrington J, Baskaran R, Berry A, Bhachoo H, Bilal A, Boaden L, Chia WL, Covell G, Crook D, Dadnam F, Davis L, De Berker H, Doyle C, Fox C, Gruffydd-Davies M, Hafouda Y, Hill A, Hubbard E, Hunter A, Inpadhas V, Jamshaid M, Jandu G, Jeyanthi M, Jones T, Kantor C, Kwak SY, Malik N, Matt R, McNulty P, Miles C, Mohomed A, Myat P, Niharika J, Nixon A, O'Reilly D, Parmar K, Pengelly S, Price L, Ramsden M, Turnor R, Wales E, Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Arandela K, Samudrala S, Abdalkader M, Anand P, Daneshmand A, Dasenbrock H, Nguyen T, Ong C, Takahashi C, Shulman J, Babi MA, Sivakumar S, Shah N, Jain S, Anand S, Nobleza COS, Shekhar S, Venkatasubramanian C, Salahuddin H, Taqi MA, Nour HA, Nofar JB, Cervantes-Arslanian AM. Reversible Cerebral Vasoconstriction Syndrome in Patients with Coronavirus Disease: A Multicenter Case Series. J Stroke Cerebrovasc Dis 2021; 30:106118. [PMID: 34560378 PMCID: PMC8445803 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106118] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/07/2021] [Accepted: 09/10/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVES RCVS (Reversible Cerebral Vasoconstrictive Syndrome) is a condition associated with vasoactive agents that alter endothelial function. There is growing evidence that endothelial inflammation contributes to cerebrovascular disease in patients with coronavirus disease 2019 (COVID-19). In our study, we describe the clinical features, risk factors, and outcomes of RCVS in a multicenter case series of patients with COVID-19. MATERIALS AND METHODS Multicenter retrospective case series. We collected clinical characteristics, imaging, and outcomes of patients with RCVS and COVID-19 identified at each participating site. RESULTS Ten patients were identified, 7 women, ages 21 - 62 years. Risk factors included use of vasoconstrictive agents in 7 and history of migraine in 2. Presenting symptoms included thunderclap headache in 5 patients with recurrent headaches in 4. Eight were hypertensive on arrival to the hospital. Symptoms of COVID-19 included fever in 2, respiratory symptoms in 8, and gastrointestinal symptoms in 1. One patient did not have systemic COVID-19 symptoms. MRI showed subarachnoid hemorrhage in 3 cases, intraparenchymal hemorrhage in 2, acute ischemic stroke in 4, FLAIR hyperintensities in 2, and no abnormalities in 1 case. Neurovascular imaging showed focal segment irregularity and narrowing concerning for vasospasm of the left MCA in 4 cases and diffuse, multifocal narrowing of the intracranial vasculature in 6 cases. Outcomes varied, with 2 deaths, 2 remaining in the ICU, and 6 surviving to discharge with modified Rankin scale (mRS) scores of 0 (n=3), 2 (n=2), and 3 (n=1). CONCLUSIONS Our series suggests that patients with COVID-19 may be at risk for RCVS, particularly in the setting of additional risk factors such as exposure to vasoactive agents. There was variability in the symptoms and severity of COVID-19, clinical characteristics, abnormalities on imaging, and mRS scores. However, a larger study is needed to validate a causal relationship between RCVS and COVID-19.
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Affiliation(s)
- Kristine Arandela
- Departments of Neurology, Boston University School of Medicine and Boston Medical Center, United States
| | - Shilpa Samudrala
- Departments of Neurology, Boston University School of Medicine and Boston Medical Center, United States
| | - Mohamad Abdalkader
- Departments of Radiology, Boston University School of Medicine and Boston Medical Center, United States
| | - Pria Anand
- Departments of Neurology, Boston University School of Medicine and Boston Medical Center, United States
| | - Ali Daneshmand
- Departments of Neurology, Boston University School of Medicine and Boston Medical Center, United States; Departments of Neurosurgery, Boston University School of Medicine and Boston Medical Center, United States
| | - Hormuzdiyar Dasenbrock
- Departments of Neurology, Boston University School of Medicine and Boston Medical Center, United States; Departments of Neurosurgery, Boston University School of Medicine and Boston Medical Center, United States
| | - Thanh Nguyen
- Departments of Neurology, Boston University School of Medicine and Boston Medical Center, United States; Departments of Radiology, Boston University School of Medicine and Boston Medical Center, United States
| | - Charlene Ong
- Departments of Neurology, Boston University School of Medicine and Boston Medical Center, United States; Departments of Neurosurgery, Boston University School of Medicine and Boston Medical Center, United States
| | - Courtney Takahashi
- Departments of Neurology, Boston University School of Medicine and Boston Medical Center, United States; Departments of Neurosurgery, Boston University School of Medicine and Boston Medical Center, United States
| | - Julie Shulman
- Departments of Neurology, Boston University School of Medicine and Boston Medical Center, United States
| | - Marc Alain Babi
- Departments of Neurology and Neurosurgery, University of Florida, United States
| | - Sanjeev Sivakumar
- Department of Neurology, University of South Carolina Greenville School of Medicine, United States
| | - Neel Shah
- Department of Neurology, University of South Carolina Greenville School of Medicine, United States
| | - Sandip Jain
- Department of Neurology, University of South Carolina Greenville School of Medicine, United States
| | - Samyuktha Anand
- Department of Neurology, Prisma Health-Upstate, United States
| | | | - Shashank Shekhar
- Departments Neurology and Neurosurgery, University of Mississippi Medical Center, United States
| | | | | | - Muhammad A Taqi
- Department of Neurology, Los Robles Medical Center, United States
| | | | - Justin B Nofar
- Department of Neurology, Henry Ford Health System, United States
| | - Anna M Cervantes-Arslanian
- Departments of Neurology, Boston University School of Medicine and Boston Medical Center, United States; Departments of Neurosurgery, Boston University School of Medicine and Boston Medical Center, United States; Departments of Medicine Infectious Diseases, Boston University School of Medicine and Boston Medical Center, United States.
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Ong C, Logarajah V, Phua KB. Paediatric gastroenterology in Singapore: historical aspects and recent advances. Singapore Med J 2021. [DOI: 10.11622/smedj.2021069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Paediatric gastroenterology in Singapore began in the 1970s. Led by Professor Phua Kong Boo and Professor Quak Seng Hock, paediatric gastroenterology has enjoyed significant strides in the areas of diagnostics, interventions, patient care and research. Several advances such as endoscopy, parenteral nutrition and liver transplantation are well established. The first paediatric small bowel transplant is anticipated in the next decade. Robust research activities have ensured the generation of local data on gastrointestinal disorders. One such research led to the discovery of the changing trends in the incidence of inflammatory bowel disease among the paediatric population in Singapore. The impact of the nation’s paediatric gastroenterology extends internationally, with the notable involvement of Professor Phua in developing the rotavirus vaccine trials and other ongoing collaborative work with international centres. This review explores the history of paediatric gastroenterology from its origins to its remarkable transformation over the decades as centres of excellence in the region.
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Takahashi CE, Virmani D, Chung DY, Ong C, Cervantes-Arslanian AM. Blunt and Penetrating Severe Traumatic Brain Injury. Neurol Clin 2021; 39:443-469. [PMID: 33896528 DOI: 10.1016/j.ncl.2021.02.009] [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] [Indexed: 12/09/2022]
Abstract
Severe traumatic brain injury is a common problem. Current practices focus on the importance of early resuscitation, transfer to high-volume centers, and provider expertise across multiple specialties. In the emergency department, patients should receive urgent intracranial imaging and consideration for tranexamic acid. Close observation in the intensive care unit environment helps identify problems, such as seizure, intracranial pressure crisis, and injury progression. In addition to traditional neurologic examination, patients benefit from use of intracranial monitors. Monitors gather physiologic data on intracranial and cerebral perfusion pressures to help guide therapy. Brain tissue oxygenation monitoring and cerebromicrodialysis show promise in studies.
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Affiliation(s)
- Courtney E Takahashi
- Department of Neurology, Boston Medical Center, 72 East Concord Street, Collamore, C-3, Boston, MA 02118, USA.
| | - Deepti Virmani
- Department of Neurology, Boston University School of Medicine and Boston Medical Center, 72 East Concord Street, Collamore, C-3, Boston, MA 02118, USA
| | - David Y Chung
- Department of Neurology, Boston University School of Medicine and Boston Medical Center, 72 East Concord Street, Collamore, C-3, Boston, MA 02118, USA; Division of Neurocritical Care, Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA; Neurovascular Research Unit, Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Charlene Ong
- Department of Neurology, Boston University School of Medicine and Boston Medical Center, 72 East Concord Street, Collamore, C-3, Boston, MA 02118, USA
| | - Anna M Cervantes-Arslanian
- Boston University School of Medicine and Boston Medical Center, 72 East Concord Street, Collamore, C-3, Boston, MA 02118, USA
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Nwajei F, Anand P, Abdalkader M, Andreu Arasa VC, Aparicio HJ, Behbahani S, Curiale G, Daneshmand A, Dasenbrock H, Mayo T, Mian A, Nguyen T, Ong C, Romero JR, Sakai O, Takahashi C, Cervantes-Arslanian AM. Cerebral Venous Sinus Thromboses in Patients with SARS-CoV-2 Infection: Three Cases and a Review of the Literature. J Stroke Cerebrovasc Dis 2020; 29:105412. [PMID: 33254367 PMCID: PMC7571902 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105412] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 09/18/2020] [Accepted: 10/13/2020] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Early studies suggest that acute cerebrovascular events may be common in patients with coronavirus disease 2019 (COVID-19) and may be associated with a high mortality rate. Most cerebrovascular events described have been ischemic strokes, but both intracerebral hemorrhage and rarely cerebral venous sinus thrombosis (CVST) have also been reported. The diagnosis of CVST can be elusive, with wide-ranging and nonspecific presenting symptoms that can include headache or altered sensorium alone. OBJECTIVE To describe the presentation, barriers to diagnosis, treatment, and outcome of CVST in patients with COVID-19. METHODS We abstracted data on all patients diagnosed with CVST and COVID-19 from March 1 to August 9, 2020 at Boston Medical Center. Subsequently, we reviewed the literature and extracted all published cases of CVST in patients with COVID-19 from January 1, 2020 through August 9, 2020 and included all studies with case descriptions. RESULTS We describe the clinical features and management of CVST in 3 women with COVID-19 who developed CVST days to months after initial COVID-19 symptoms. Two patients presented with encephalopathy and without focal neurologic deficits, while one presented with visual symptoms. All patients were treated with intravenous hydration and anticoagulation. None suffered hemorrhagic complications, and all were discharged home. We identified 12 other patients with CVST in the setting of COVID-19 via literature search. There was a female predominance (54.5%), most patients presented with altered sensorium (54.5%), and there was a high mortality rate (36.4%). CONCLUSIONS During this pandemic, clinicians should maintain a high index of suspicion for CVST in patients with a recent history of COVID-19 presenting with non-specific neurological symptoms such as headache to provide expedient management and prevent complications. The limited data suggests that CVST in COVID-19 is more prevalent in females and may be associated with high mortality.
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Affiliation(s)
- Felix Nwajei
- Department of Neurosurgery, Boston University Medical Center, Boston, Massachusetts, USA
| | - Pria Anand
- Department of Neurology, Boston University Medical Center, Boston, Massachusetts, USA
| | - Mohamad Abdalkader
- Department of Radiology, Boston University Medical Center, Boston, Massachusetts, USA
| | - Vanesa C Andreu Arasa
- Department of Radiology, Boston University Medical Center, Boston, Massachusetts, USA
| | - Hugo J Aparicio
- Department of Neurology, Boston University Medical Center, Boston, Massachusetts, USA
| | - Siavash Behbahani
- Department of Radiology, Boston University Medical Center, Boston, Massachusetts, USA
| | - Gioacchino Curiale
- Department of Neurology, Boston University Medical Center, Boston, Massachusetts, USA
| | - Ali Daneshmand
- Department of Neurosurgery, Boston University Medical Center, Boston, Massachusetts, USA; Department of Neurology, Boston University Medical Center, Boston, Massachusetts, USA
| | - Hormuzdiyar Dasenbrock
- Department of Neurosurgery, Boston University Medical Center, Boston, Massachusetts, USA
| | - Thomas Mayo
- Department of Neurology, Boston University Medical Center, Boston, Massachusetts, USA
| | - Asim Mian
- Department of Radiology, Boston University Medical Center, Boston, Massachusetts, USA
| | - Thanh Nguyen
- Department of Neurosurgery, Boston University Medical Center, Boston, Massachusetts, USA; Department of Neurology, Boston University Medical Center, Boston, Massachusetts, USA; Department of Radiology, Boston University Medical Center, Boston, Massachusetts, USA
| | - Charlene Ong
- Department of Neurosurgery, Boston University Medical Center, Boston, Massachusetts, USA; Department of Neurology, Boston University Medical Center, Boston, Massachusetts, USA
| | - J Rafael Romero
- Department of Neurology, Boston University Medical Center, Boston, Massachusetts, USA
| | - Osamu Sakai
- Department of Radiology, Boston University Medical Center, Boston, Massachusetts, USA
| | - Courtney Takahashi
- Department of Neurosurgery, Boston University Medical Center, Boston, Massachusetts, USA; Department of Neurology, Boston University Medical Center, Boston, Massachusetts, USA
| | - Anna M Cervantes-Arslanian
- Department of Neurosurgery, Boston University Medical Center, Boston, Massachusetts, USA; Department of Neurology, Boston University Medical Center, Boston, Massachusetts, USA; Department of Medicine, Boston University Medical Center, Boston, Massachusetts, USA.
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Anand P, Slama MCC, Kaku M, Ong C, Cervantes‐Arslanian AM, Zhou L, David WS, Guidon AC. Comment on
COVID
‐19 in patients with myasthenia gravis: Author response. Muscle Nerve 2020; 62:E87-E88. [DOI: 10.1002/mus.27062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/09/2020] [Accepted: 09/09/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Pria Anand
- Department of Neurology Boston University Medical Center Boston Massachusetts USA
| | - Michaël C. C. Slama
- Department of Neurology Massachusetts General Hospital Boston Massachusetts USA
- Department of Neurology Brigham and Women's Hospital Boston Massachusetts USA
| | - Michelle Kaku
- Department of Neurology Boston University Medical Center Boston Massachusetts USA
| | - Charlene Ong
- Department of Neurology Boston University Medical Center Boston Massachusetts USA
| | | | - Lan Zhou
- Department of Neurology Boston University Medical Center Boston Massachusetts USA
| | - William S. David
- Department of Neurology Massachusetts General Hospital Boston Massachusetts USA
| | - Amanda C. Guidon
- Department of Neurology Massachusetts General Hospital Boston Massachusetts USA
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Abstract
OBJECTIVES To describe the risk factors for and outcomes after myoclonus in a cohort of patients with coronavirus disease 2019. DESIGN Multicenter case series. SETTING Three tertiary care hospitals in Massachusetts, Georgia, and Virginia. PATIENTS Eight patients with clinical myoclonus in the setting of coronavirus disease 2019. INTERVENTIONS & MEASUREMENTS AND MAIN RESULTS Outcomes in patients with myoclonus were variable, with one patient who died during the study period and five who were successfully extubated cognitively intact and without focal neurologic deficits. In five cases, the myoclonus completely resolved within 2 days of onset, while in three cases, it persisted for 10 days or longer. Seven patients experienced significant metabolic derangements, hypoxemia, or exposure to sedating medications that may have contributed to the development of myoclonus. One patient presented with encephalopathy and developed prolonged myoclonus in the absence of clear systemic provoking factors. CONCLUSIONS Our findings suggest that myoclonus may be observed in severe acute respiratory syndrome coronavirus 2 infected patients, even in the absence of hypoxia. This association warrants further evaluation in larger cohorts to determine whether the presence of myoclonus may aid in the assessment of disease severity, neurologic involvement, or prognostication.
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Affiliation(s)
- Pria Anand
- Department of Neurology, Boston University Medical Center, Boston, MA
| | - Asma Zakaria
- Critical Care Medicine, INOVA Fairfax Medical Campus, Falls Church, VA
| | - Karima Benameur
- Department of Neurology, Emory University School of Medicine, Atlanta, GA
| | - Charlene Ong
- Department of Neurology, Boston University Medical Center, Boston, MA
| | - Maryann Putman
- Department of Neurology, Emory University School of Medicine, Atlanta, GA
| | - Sarah O'Shea
- Department of Neurology, Boston University Medical Center, Boston, MA
| | - David Greer
- Department of Neurology, Boston University Medical Center, Boston, MA
| | - Anna M Cervantes-Arslanian
- Department of Neurology, Boston University Medical Center, Boston, MA
- Department of Medicine (Infectious Diseases), Boston University Medical Center, Boston, MA
- Department of Neurosurgery, Boston University Medical Center, Boston, MA
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11
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Beijert M, Soubeyran P, El Badawy S, Specht L, Verschueren K, Ong C, Maazen R, Aurer I, Ta B, Neven A, Meulemans B, Fortpied C, Aleman B. OC-0374: Does low-dose TBI improve outcome in patients with early stage low grade NHL? (EORTC 20971-22997). Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00398-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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12
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Barra ME, Feske SK, Sylvester KW, Ong C, Culbreth SE, Krause P, Henderson GV, Rybak E. Fibrinogen Concentrate for the Treatment of Thrombolysis-Associated Hemorrhage in Adult Ischemic Stroke Patients. Clin Appl Thromb Hemost 2020; 26:1076029620951867. [PMID: 32946279 PMCID: PMC7502993 DOI: 10.1177/1076029620951867] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
In patients with ischemic stroke who receive systemic recombinant tissue plasminogen activator (rt-PA), the risk of secondary hemorrhage is 1-7%. Fibrinogen supplementation with cryoprecipitate is recommended in patients with rt-PA-associated symptomatic hemorrhage. We examined whether fibrinogen concentrate can be used safely in this setting. A single-center retrospective case series was performed in patients who received fibrinogen concentrate for post-rt-PA hemorrhage between January-2012 and December-2017. The primary outcome was the incidence of in-hospital thromboembolic events and infusion reactions. Secondary outcomes included incidence of clinically significant ICH expansion within 24-hours and patient serum fibrinogen response to fibrinogen concentrate therapy. Thromboembolic events occurred in 3 (12.5%) of 24 patients included in the analysis. No patients experienced infusion-related reactions. Five of 22 patients with ICH experienced clinically significant hemorrhage expansion. Hypofibrinogenemia was corrected in 87.5%(7/8) of patients with baseline hypofibrinogenemia, with a median increase in serum fibrinogen 166 mg/dL. Median fibrinogen increase in patients without baseline hypofibrinogenemia was 18 mg/dL. Fibrinogen concentrate is a safe potential therapeutic option to restore fibrinogen levels in acute ischemic stroke patients with thrombolysis-associated hemorrhage.
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Affiliation(s)
- Megan E. Barra
- Department of Pharmacy, Massachusetts General Hospital, Boston, MA, USA
- Megan E. Barra, Department of Pharmacy, Massachusetts General Hospital, Boston, MA, USA.
| | - Steven K. Feske
- Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA
| | | | - Charlene Ong
- Department of Neurology, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA
| | - Sarah E. Culbreth
- Department of Pharmacy, Brigham and Women’s Hospital, Boston, MA, USA
| | - Patricia Krause
- Department of Pharmacy, Brigham and Women’s Hospital, Boston, MA, USA
| | | | - Eva Rybak
- Department of Pharmacy, Brigham and Women’s Hospital, Boston, MA, USA
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13
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Ong C, Lucet JC, Bourigault C, Birgand G, Aho S, Lepelletier D. Staphylococcus aureus nasal decolonization before cardiac and orthopaedic surgeries: first descriptive survey in France. J Hosp Infect 2020; 106:332-334. [PMID: 32805310 DOI: 10.1016/j.jhin.2020.08.008] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/10/2020] [Indexed: 11/25/2022]
Abstract
The objective was to describe French hospital nasal screening and decolonization procedures before clean surgery procedures. Information for participants was sent to the French Society for Infection Control members in June 2018. Seventy hospitals participated in the survey; 40% (N = 28) declared having institutional decolonization procedures: 64% (N = 18) in orthopaedic and 56% (N = 15) in cardiac surgeries. All hospitals used mupirocin for nasal decolonization and body decolonization with chlorhexidine (N = 16) or povidone iodine (N = 10). This study is the first to be performed in France giving information in this field. Screening/decolonization procedures are heterogeneous and the evaluation of their clinical impact remains complex.
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Affiliation(s)
- C Ong
- Bacteriology and Infection Control Department, Nantes University Hospital, Nantes, France
| | - J-C Lucet
- Infection Control Unit UHLIN, Bichat Hospital, AP-HP Paris, Paris, France
| | - C Bourigault
- Bacteriology and Infection Control Department, Nantes University Hospital, Nantes, France
| | - G Birgand
- Centre for Infection Control and Prevention, Pays de la Loire, Nantes, France
| | - S Aho
- Epidemiology and Infection Control Department, Dijon University Hospital, Dijon, France
| | - D Lepelletier
- Bacteriology and Infection Control Department, Nantes University Hospital, Nantes, France; MiHAR lab, University of Nantes, Nantes, France.
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14
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Anand P, Slama MCC, Kaku M, Ong C, Cervantes‐Arslanian AM, Zhou L, David WS, Guidon AC. COVID-19 in patients with myasthenia gravis. Muscle Nerve 2020; 62:254-258. [PMID: 32392389 PMCID: PMC7272991 DOI: 10.1002/mus.26918] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/03/2020] [Accepted: 05/07/2020] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) has rapidly become a global pandemic, but little is known about its potential impact on patients with myasthenia gravis (MG). METHODS We studied the clinical course of COVID-19 in five hospitalized patients with autoimmune MG (four with acetylcholine receptor antibodies, one with muscle-specific tyrosine kinase antibodies) between April 1, 2020-April 30-2020. RESULTS Two patients required intubation for hypoxemic respiratory failure, whereas one required significant supplemental oxygen. One patient with previously stable MG had myasthenic exacerbation. One patient treated with tocilizumab for COVID-19 was successfully extubated. Two patients were treated for MG with intravenous immunoglobulin without thromboembolic complications. DISCUSSION Our findings suggest that the clinical course and outcomes in patients with MG and COVID-19 are highly variable. Further large studies are needed to define best practices and determinants of outcomes in this unique population.
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Affiliation(s)
- Pria Anand
- Department of NeurologyBoston University Medical CenterBostonMassachusetts
| | - Michaël C. C. Slama
- Department of NeurologyMassachusetts General HospitalBostonMassachusetts
- Department of NeurologyBrigham and Women's HospitalBostonMassachusetts
| | - Michelle Kaku
- Department of NeurologyBoston University Medical CenterBostonMassachusetts
| | - Charlene Ong
- Department of NeurologyBoston University Medical CenterBostonMassachusetts
| | | | - Lan Zhou
- Department of NeurologyBoston University Medical CenterBostonMassachusetts
| | - William S. David
- Department of NeurologyMassachusetts General HospitalBostonMassachusetts
| | - Amanda C. Guidon
- Department of NeurologyMassachusetts General HospitalBostonMassachusetts
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15
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Abstract
The multidisciplinary team brief and effective clinical decision-making are critical to airway surgery. To illustrate this, we present the case of a 58-year-old female with papillary thyroid cancer invading the trachea. We describe a basic framework that was used to aid planning the management of this patient. Tracheal resection is a complex airway operation requiring the evaluation of airway obstruction risk, the formulation of strategies for complex airway management and lung ventilation during complete resection of the tracheal segment and a handover plan for safe tracheal extubation. We suggest that team performance is facilitated by a standardised structure for consideration of anticipated events and important decisions to be made before the operation. Furthermore, it can provide a platform to engage the team when unanticipated events occur and alternate plans have to be made in a time-critical manner.
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Affiliation(s)
- E Cervi
- Department of Anaesthesia Guy's and St. Thomas' NHS Foundation Trust London UK
| | - C Ong
- Department of Anaesthesia Guy's and St. Thomas' NHS Foundation Trust London UK
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16
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Ong C, Hutch M, Barra M, Kim A, Zafar S, Smirnakis S. Effects of Osmotic Therapy on Pupil Reactivity: Quantification Using Pupillometry in Critically Ill Neurologic Patients. Neurocrit Care 2020; 30:307-315. [PMID: 30298336 DOI: 10.1007/s12028-018-0620-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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] [Indexed: 12/22/2022]
Abstract
BACKGROUND Osmotic therapy is a critical component of medical management for cerebral edema. While up to 90% of neurointensivists report using these treatments, few quantitative clinical measurements guide optimal timing, dose, or administration frequency. Its use is frequently triggered by a qualitative assessment of neurologic deterioration and/or pupil size, and anecdotally appears to improve pupil asymmetry suggestive of uncal herniation. However, subjective pupil assessment has poor reliability, making it difficult to detect or track subtle changes. We hypothesized that osmotic therapy reproducibly improves quantitative pupil metrics. METHODS We included patients at two centers who had recorded quantitative pupil measurements within 2 h before and after either 20% mannitol or 23.4% hypertonic saline in the neurosciences intensive care unit. The primary outcome was the Neurologic Pupil Index (NPi), a composite metric ranging from 0 to 5 in which > 3 is considered normal. Secondary outcomes included pupil size, percent change, constriction and dilation velocity, and latency. Results were analyzed with Wilcoxon signed-rank tests, Chi-square and multi-level linear regression to control for other edema-reducing interventions. RESULTS Out of 72 admissions (403 paired pupil observations), NPi significantly differed within 2 h of osmotic therapy when controlling for other commonly used interventions in our whole cohort (β = 0.08, p = 0.0168). The effect was most pronounced (β = 0.57) in patients with abnormal NPi prior to intervention (p = 0.0235). CONCLUSIONS Pupil reactivity significantly improves after osmotic therapy in a heterogenous critically ill population when controlling for various other interventions. Future work is necessary to determine dose-dependent effects and clinical utility.
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Affiliation(s)
- C Ong
- Boston University School of Medicine, Boston, USA.
- Brigham and Women's Hospital, Boston, USA.
- Harvard Medical School, Boston, USA.
| | - M Hutch
- Boston University School of Medicine, Boston, USA
| | - M Barra
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, USA
| | - A Kim
- Brigham and Women's Hospital, Boston, USA
- Harvard Medical School, Boston, USA
| | - S Zafar
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, USA
| | - S Smirnakis
- Brigham and Women's Hospital, Boston, USA
- Harvard Medical School, Boston, USA
- Jamaica Plain VA Hospital, Boston, USA
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17
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Abstract
BACKGROUND Automated devices collecting quantitative measurements of pupil size and reactivity are increasingly used for critically ill patients with neurological disease. However, there are limited data on the effect of ambient light conditions on pupil metrics in these patients. To address this issue, we tested the range of pupil reactivity in healthy volunteers and critically ill patients in both bright and dark conditions. METHODS We measured quantitative pupil size and reactivity in seven healthy volunteers and seven critically ill patients with the Neuroptics-200 pupillometer in both bright and dark ambient lighting conditions. Bright conditions were created by overhead LED lighting in a room with ample natural light. Dark conditions consisted of a windowless room with no overhead light source. The primary outcome was the Neurological Pupil Index (NPi), a composite metric ranging from 0 to 5 in which > 3 is considered normal. Secondary outcomes included resting and constricted pupil size, change in pupil size, constriction velocity, dilation velocity, and latency. Results were analyzed with multi-level linear regression to account for both inter- and intra-subject variability. RESULTS Fourteen subjects underwent ten pupil readings each in bright and dark conditions, yielding 280 total measurements. In healthy subjects, median NPi in bright and dark conditions was 4.2 and 4.3, respectively. In critically ill subjects, median NPi was 2.85 and 3.3, respectively. Multi-level linear regression demonstrated significant differences in pupil size, pupil size change, constriction velocity, and dilation velocity in various light levels in healthy patients, but not NPi. In the critically ill, NPi and pupil size change were significantly affected. CONCLUSION Ambient light levels impact pupil parameters in both healthy and critically ill subjects. Changes in NPi under different light conditions are small and more consistent in healthy subjects, but significantly differ in the critically ill. Practitioners should standardize lighting conditions to maximize measurement reliability.
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Affiliation(s)
- C Ong
- Boston University School of Medicine, Boston, USA. .,Brigham and Women's Hospital, Boston, USA. .,Harvard Medial School, Boston, USA.
| | - M Hutch
- Brigham and Women's Hospital, Boston, USA.,Harvard Medial School, Boston, USA
| | - S Smirnakis
- Brigham and Women's Hospital, Boston, USA.,Harvard Medial School, Boston, USA.,Jamaica Plain VA Hospital, Boston, USA
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18
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Ong C, Weichard A, Thacker J, Nixon G, Davey M, Horne R. Gender differences in the effects of sleep disordered breathing in children on blood pressure, sleep, quality of life, executive function and behaviour. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.435] [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: 11/26/2022]
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19
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Huang D, Lim J, Binte Mohd Kahliab K, Tang T, Pang W, Laurensia Y, Cheah D, Tan S, Zhang X, Chow E, Lim S, Ong C. WHOLE GENOME SEQUENCING REVEALS POTENTIAL THERAPEUTIC STRATEGY FOR MEITL. Hematol Oncol 2019. [DOI: 10.1002/hon.18_2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- D. Huang
- CMR; National Cancer Centre; Singapore Singapore
| | - J. Lim
- CMR; National Cancer Centre; Singapore Singapore
| | | | - T. Tang
- DMO; National Cancer Centre; Singapore Singapore
| | - W. Pang
- CMR; National Cancer Centre; Singapore Singapore
| | - Y. Laurensia
- CMR; National Cancer Centre; Singapore Singapore
| | - D. Cheah
- CMR; National Cancer Centre; Singapore Singapore
| | - S. Tan
- Pathology; National University of Singapore; Singapore Singapore
| | - X. Zhang
- Pharmacology; Cancer Science Institute; Singapore Singapore
| | - E. Chow
- Pharmacology; Cancer Science Institute; Singapore Singapore
| | - S. Lim
- DMO; National Cancer Centre; Singapore Singapore
| | - C. Ong
- CMR; National Cancer Centre; Singapore Singapore
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20
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Lim J, Huang D, Tang T, Cai Q, Tan D, Laurensia Y, Chia B, Rou-Jun P, Pang W, Cheah D, Ng C, Hong H, Tan J, Feng L, Chen J, Han B, Guo Y, Goh Y, Rötzschke O, Cheng C, Au-Yeung R, Chan T, Ng S, Kwong Y, Hwang W, Chng W, Tousseyn T, Tan P, Teh B, Khor C, Rozen S, Bei J, Lin T, Lim S, Ong C. WHOLE-GENOME SEQUENCING REVEALS IMMUNOTHERAPEUTIC OPTIONS FOR NATURAL-KILLER/T CELL LYMPHOMA PATIENTS. Hematol Oncol 2019. [DOI: 10.1002/hon.19_2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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21
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Ong C. Response to “Letter to the Editor” by Couret et al. Neurocrit Care 2019; 30:494. [DOI: 10.1007/s12028-018-0665-y] [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: 10/27/2022]
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22
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Ong C, Daemen A, Merrick K, O'Brien T, Friedman L, Hatzivassiliou G. Abstract P5-04-26: Identification of preclinical mechanisms driving acquired resistance to endocrine therapy in estrogen-receptor positive (ER+) breast cancer cells. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-04-26] [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: 11/16/2022]
Abstract
Abstract
Estrogen Receptor positive (ER+) breast cancer accounts for the majority of breast cancer cases and standard of care for these tumors is treatment with endocrine therapy, including the blockade of estrogen production (i.e. aromatase inhibitors; AIs) as well as the use of antagonists of ER function, i.e. selective estrogen receptor modulators (SERMs, i.e. tamoxifen) and selective estrogen receptor degraders (SERDs, i.e. fulvestrant). Despite the initial dependency of ER+ breast tumors on estrogen and ER for their survival and proliferation, treatment in the metastatic setting invariably leads to therapeutic resistance. While mechanisms of resistance to AIs include mutations in the estrogen receptor gene ESR1, less is known about mechanisms of resistance to SERMs and SERDs, thus it is essential to further investigate the latter, in order to successfully treat relapsed patients. To pre-clinically model cell-autonomous acquired resistance to these agents, we used T47D, an ER+ and p53- estrogen-responsive cell line treated with increasing concentrations of the SERM/SERD hybrid (SSH) ER-targeting agent GDC-0810 over the period of several months during which individual clones with acquired resistance to GDC-0810 were selected. GDC-0810-resistant clones were cross-resistant to other endocrine agents, including SERMs (tamoxifen) and SERDs (fulvestrant), consistent with general loss of dependency on ER. Surprisingly, the cells also lost sensitivity to palbociclib, the latter likely linked to their loss of one copy of the retinoblastoma (Rb) tumor suppressor gene. Comprehensive genetic and phenotypic characterization of the resistant clones relative to the parental cells revealed multiple mutations and deletions in DNA repair and cell cycle genes, and associated defects in DNA repair and cell cycle checkpoints. Cell cycle, proteomic, and mRNA expression analysis of parental versus resistant clones at baseline and upon DNA damage, identified a distinct cell cycle profile in the GDC-0810-resistant clones, characterized by accumulation of cells in the mitotic phase. A broad chemical screen identified pharmacologic inhibitors of cell cycle regulators and chemotherapeutic drug classes that preferentially target the ER-independent, GDC-0810 resistant clones compared to the parental cells. Our work provides novel insights into mechanisms and biomarkers of acquired resistant to estrogen therapies in ER+ breast cancer and reveals the acquisition of actionable dependencies that may potentially be exploited in resistant tumors. Furthermore, our studies provide rationale for testing specific chemotherapy regimens upon endocrine resistance accompanied by cell cycle and DNA repair checkpoint dysfunction in ER+ breast cancer.
Citation Format: Ong C, Daemen A, Merrick K, O'Brien T, Friedman L, Hatzivassiliou G. Identification of preclinical mechanisms driving acquired resistance to endocrine therapy in estrogen-receptor positive (ER+) breast cancer cells [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-04-26.
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Affiliation(s)
- C Ong
- Genentech, Inc, South San Francisco, CA
| | - A Daemen
- Genentech, Inc, South San Francisco, CA
| | - K Merrick
- Genentech, Inc, South San Francisco, CA
| | - T O'Brien
- Genentech, Inc, South San Francisco, CA
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Karpe AV, Dunn MS, Taylor MC, Nguyen T, Ong C, Karla T, Rockman S, Beale DJ. Nitrogen deprivation in Fusarium oxysporum promotes mycotoxin production via intermediates in the Krebs cycle and unreported methylmalonyl-CoA mutase activity. Metabolomics 2018; 14:160. [PMID: 30830469 DOI: 10.1007/s11306-018-1459-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 12/05/2018] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Fusarium oxysporum has a high affinity for lignin and cellulose-based substrates and is known to grow in a wide range of environments. It is these properties and its ability to produce mycotoxins that have contributed to its pathogenicity in cereal crops that can affect human and animal health when ingested. OBJECTIVES Identify the mechanisms of mycotoxin production and map the functional output of F. oxysporum under varying growth conditions. METHODS Liquid and gas-based chromatography coupled with mass spectrometry was used to identify and map the untargeted metabolic pathway of F. oxysporum grown using nitrogen limited and organic/inorganic nitrogen supplemented media. RESULTS Over 1300 metabolites were identified, relating to 42 metabolic pathways. Of these, 520 metabolites merged at pyruvate (glycolysis), succinate (Krebs cycle) and aspartate-glutamate metabolic pathways. CoA depletion at the growth stage triggered the initiation of fatty acid and branched amino acid degradation. This in turn activated propionyl CoA carnitine acetyltransferase enzymes, resulting in nitrogen preservation (urea, putrescine and organic acids end-products). CoA then transferred into the TCA cycle via previously unreported β-alanine and propionyl CoA metabolic pathways, the latter likely being a novel methylmalonyl-CoA mutase activity for F. oxysporum. CONCLUSIONS The lower supplementation of inorganic nitrogen compounds (≤ 50 mM) and the elimination of nitrates/organic nitrogen sources resulted in TCA autophagy events that boosted mycotoxin-based metabolism and decreased overall F. oxysporum growth. Such knowledge of functional mycotoxin production can be used to supplement agricultural crops and reduce the risk of mycotoxin contamination in human and animal food supplies.
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Affiliation(s)
- A V Karpe
- Land & Water, CSIRO, Ecosciences Precinct, Dutton Park, QLD, 4102, Australia
| | - M S Dunn
- Technical Development, Seqirus, 63 Poplar Road, Parkville, VIC, 3052, Australia
| | - M C Taylor
- Land & Water, CSIRO, Acton, ACT, 2601, Australia
| | - T Nguyen
- Technical Development, Seqirus, 63 Poplar Road, Parkville, VIC, 3052, Australia
| | - C Ong
- Technical Development, Seqirus, 63 Poplar Road, Parkville, VIC, 3052, Australia
| | - T Karla
- Technical Development, Seqirus, 63 Poplar Road, Parkville, VIC, 3052, Australia
| | - S Rockman
- Technical Development, Seqirus, 63 Poplar Road, Parkville, VIC, 3052, Australia
| | - D J Beale
- Land & Water, CSIRO, Ecosciences Precinct, Dutton Park, QLD, 4102, Australia.
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Koo J, Ong C, Han W. SUN-P103: Validation of Modified Nutrition Screening Tools for Childhood Cancer in a Tertiary Hospital in Singapore. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30524-1] [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] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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25
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Ong C, Lim C, Mok Y, Tan Z, Ang B, Tan T, Loh Y, Chan Y, Lee J. SUN-P019: Adequacy of Enteral Energy Intake is Associated with Mortality in Children on Extracorporeal Membrane Oxygenation. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30607-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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26
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Song T, Nairismagi M, Lim J, Nagarajan S, Pang J, Laurensia Y, Wijaya G, Jing T, Ong C. ONCOGENIC ACTIVATION OF STAT3 PATHWAY DRIVES PD-L1 EXPRESSION IN NATURAL KILLER/T CELL LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- T. Song
- Division of Medical Oncology; National Cancer Centre Singapore; Singapore Singapore
| | - M. Nairismagi
- Division of Medical Oncology; National Cancer Centre Singapore; Singapore Singapore
| | - J. Lim
- Division of Medical Oncology; National Cancer Centre Singapore; Singapore Singapore
| | - S. Nagarajan
- Division of Medical Oncology; National Cancer Centre Singapore; Singapore Singapore
| | - J.W. Pang
- Division of Medical Oncology; National Cancer Centre Singapore; Singapore Singapore
| | - Y. Laurensia
- Division of Medical Oncology; National Cancer Centre Singapore; Singapore Singapore
| | - G.C. Wijaya
- Division of Medical Oncology; National Cancer Centre Singapore; Singapore Singapore
| | - T. Jing
- Division of Medical Oncology; National Cancer Centre Singapore; Singapore Singapore
| | - C. Ong
- Division of Medical Oncology; National Cancer Centre Singapore; Singapore Singapore
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Muslem R, Ong C, Gilotra N, Sharma K, Houston B, Zehr K, Duquaine D, Whitman G, Caliskan K, Russell S, Tedford R. Prognostic Relevance of INTERMACS Defined Right Heart Failure After Left Ventricular Assists Device Implantation. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1204] [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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Velasquez T, Mackey G, Lusk J, Kyle UG, Fontenot T, Marshall P, Shekerdemian LS, Coss-Bu JA, Nishigaki A, Yatabe T, Tamura T, Yamashita K, Yokoyama M, Ruiz-Rodriguez JC, Encina B, Belmonte R, Troncoso I, Tormos P, Riveiro M, Baena J, Sanchez A, Bañeras J, Cordón J, Duran N, Ruiz A, Caballero J, Nuvials X, Riera J, Serra J, Rutten AMF, van Ieperen SNM, Der Kinderen EPHM, Van Logten T, Kovacikova L, Skrak P, Zahorec M, Kyle UG, Akcan-Arikan A, Silva JC, Mackey G, Lusk J, Goldsworthy M, Shekerdemian LS, Coss-Bu JA, Wood D, Harrison D, Parslow R, Davis P, Pappachan J, Goodwin S, Ramnarayan P, Chernyshuk S, Yemets H, Zhovnir V, Pulitano’ SM, De Rosa S, Mancino A, Villa G, Tosi F, Franchi P, Conti G, Patel B, Khine H, Shah A, Sung D, Singer L, Haghbin S, Inaloo S, Serati Z, Idei M, Nomura T, Yamamoto N, Sakai Y, Yoshida T, Matsuda Y, Yamaguchi Y, Takaki S, Yamaguchi O, Goto T, Longani N, Medar S, Abdel-Aal IR, El Adawy AS, Mohammed HMEH, Mohamed AN, Parry SM, Knight LD, Denehy L, De Morton N, Baldwin CE, Sani D, Kayambu G, da Silva VZM, Phongpagdi P, Puthucheary ZA, Granger CL, Rydingsward JE, Horkan CM, Christopher KB, Muscedere J, Scott SH, Saha T, Hamilton A, Petsikas D, Payne D, Boyd JG, Puthucheary ZA, McNelly AS, Rawal J, McWilliams D, Connolly B, McPhail MJ, Sidhu P, Rowlerson A, Moxham J, Harridge SD, Hart N, Montgomery HE, Jovaisa T, Thomas B, Jones C, Gupta D, Wijayatilake DS, Shum HP, King HS, Chan KC, Tang KB, Yan WW, Arias CC, Latorre J, De La Rica AS, Reeves E, Garrido EM, Feijoo AM, Gancedo CH, Tofiño AL, Rodríguez FG, Gemmell LK, Campbell R, Doherty P, MacKay A, Singh N, Atkins G, Vitaller S, Nagib H, Prieto J, Del Arco A, Zayas B, Gomez C, Tirumala S, Pasha SA, Kumari BK, Martinez-Lopez P, Snelson C, Puerto-Morlán A, Nuevo-Ortega P, Pujol LM, Dolset RA, González BS, Riera SQ, Álvarez JT, Quintana S, Martínez L, Algarte R, Aitken LM, Sánchez B, Trenado J, Tomas E, Brock N, Viegas E, Filipe E, Cottle D, Traynor T, Martínez MVT, Márquez MP, Rattray J, Gómez LC, Martínez NA, Muñoz JMM, Bellver BQ, Varea MM, Llorente MÁA, Calvo CP, Hillier SD, Faulds MC, Hendra H, Kenardy J, Lawrence N, Maekawa K, Hayakawa M, Ono Y, Kodate A, Sadamoto Y, Tominaga N, Mizugaki A, Murakami H, Yoshida T, Hull AM, Katabami K, Wada T, Sawamura A, Gando S, Silva S, Kerhuel L, Malagurski B, Citerio G, Chabanne R, Laureys S, Ullman A, Puybasset L, Nobile L, Pognuz ER, Rossetti AO, Verginella F, Gaspard N, Creteur J, Ben-Hamouda N, Oddo M, Taccone FS, Le Brocque R, Ono Y, Hayakawa M, Iijima H, Maekawa K, Kodate A, Sadamoto Y, Mizugaki A, Murakami H, Katabami K, Wada T, Mitchell M, Sawamura A, Gando S, Kodate A, Katabami K, Wada T, Ono Y, Maekawa K, Hayakawa M, Sawamura A, Gando S, Davis C, Andersen LW, Raymond T, Berg R, Nadkarni V, Grossestreuer A, Kurth T, Donnino M, Krüger A, Ostadal P, Janotka M, Macfarlane B, Vondrakova D, Kongpolprom N, Cholkraisuwat J, Pekkarinen PT, Ristagno G, Masson S, Latini R, Bendel S, Ala-Kokko T, Varpula T, Azevedo JC, Vaahersalo J, Hoppu S, Tiainen M, Mion MM, Plebani M, Pettilä V, Skrifvars M, Son Y, Kim KS, Suh GJ, Rocha LL, Kwon WY, Ko JI, Park MJ, Cavicchi FZ, Iesu E, Nobile L, Vincent JL, Creteur J, Taccone FS, Tanaka H, De Freitas FFM, Otani N, Ode S, Ishimatsu S, Martínez L, Algarte R, Sánchez B, Romero I, Martínez F, Quintana S, Trenado J, Cavalheiro AM, Vondrakova D, Ostadal P, Kruger A, Janotka M, Malek F, Neuzil P, Yeh YC, Chen YS, Wang CH, Huang CH, Lucinio NM, Chao A, Lee CT, Lai CH, Chan WS, Cheng YJ, Sun WZ, Kaese S, Horstmann C, Lebiedz P, Mourad M, Lobato MS, Gaudard P, Eliet J, Zeroual N, Colson P, Ostadal P, Mlcek M, Hrachovina M, Kruger A, Vondrakova D, Janotka M, Ebeling G, Mates M, Hala P, Kittnar O, Neuzil P, Jacky A, Rudiger A, Spahn DR, Bettex DA, Kara A, Akin S, Kraegpoeth A, Dos reis Miranda D, Struijs A, Caliskan K, van Thiel RJ, Dubois EA, de Wilde W, Zijlstra F, Gommers D, Ince C, Marca L, Laerkner E, Xini A, Mongkolpun W, Cordeiro CPR, Leite RT, Lheureux O, Bader A, Rincon L, Santacruz C, Preiser JC, Chao A, De Brito-Ashurst I, Chao AS, Chen YS, Kim W, Ahn C, Cho Y, Lim TH, Oh J, Choi KS, Jang BH, Ha JK, White C, Mecklenburg A, Stamm J, Soeffker G, Kubik M, Sydow K, Reichenspurner H, Kluge S, Braune S, Bergantino B, Ruberto F, Gregory S, Magnanimi E, Privato E, Zullino V, Bruno K, Pugliese F, Sales G, Girotto V, Vittone F, Brazzi L, Fritz C, Forni LG, Kimmoun A, Vanhuyse F, Trifan B, Orlowski S, Albuisson E, Tran N, Levy B, Chhor V, Joachim J, Follin A, Flowers E, Champigneulle B, Chatelon J, Fave G, Mantz J, Pirracchio R, Diaz DD, Villanova M, Aguirregabyria M, Andrade G, López L, Curtis A, Palencia E, John G, Cowan R, Hart R, Lake K, Litchfield K, Song JW, Lee YJ, Cho YJ, Choi S, Wood CA, Vermeir P, Vandijck D, Blot S, Mariman A, Verhaeghe R, Deveugele M, Vogelaers D, Chok L, Bachli EB, Bettex D, Siu K, Cottini SR, Keller E, Maggiorini M, Schuepbach R, Fiks T, Stiphout C, Grevelink M, Vaneker I, Ruijter A, Buise M, Venkatesan K, Spronk PE, Tena SA, Barrachina LG, Portillo JHR, Aznar GP, Campos LM, Sellés MDF, Tomás MA, Muncharaz AB, Skinner L, Muhammad JBH, Monsalvo S, Olavarria E, Stümpfle R, Na SJ, Park J, Chung CR, Park CM, Suh GY, Yang JH, Witter T, Ng L, Brousseau C, Butler MB, Erdogan M, Dougall PCM, Green RS, Abbott TEF, Torrance HDT, Cron N, Vaid N, Emmanuel J, Seet E, Siddiqui SS, Prabu N, Chaudhari HK, Patil VP, Divatia JV, Solanki S, Kulkarni AP, Gutierrez LAR, Bader A, Brasseur A, Baptista N, Lheureux O, Vincent JL, Creteur J, Taccone FS, Hempel D, Stauffert N, Recker F, Schröder T, Reusch S, Schleifer J, Escoval A, Breitkreutz R, Sjövall F, Perner A, Møller MH, Moraes RB, Borges FK, Guillen JAV, Zabaletta WJC, Ruiz-Ramos J, Ramirez P, Tomas E, Marqués-Miñana MR, Villarreal E, Gordon M, Sosa M, Concha P, Castellanos A, Menendez R, Ramírez CS, Santana MC, Balcázar LC, Agrawal R, Escalada SH, Viera MAH, Vázquez CFL, Díaz JJD, Campelo FA, Monroy NS, Santana PS, Santana SR, Gutiérrez-Pizarraya A, Garnacho-Montero J, 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Zakynthinos S, Pertuz EDD, Sánchez MJG, Sanz ER, Hualde JB, Hernández AA, Ramirez JR, Takahashi H, Kazutoshi F, Okada Y, Oobayashi W, Routsi C, Naito T, Baidya DK, Maitra S, Anand RK, Ray BR, Arora MK, Ruffini C, Rota L, Corona A, Sesana G, Atchade E, Ravasi S, Catena E, Naumann DN, Mellis C, Husheer SL, Bishop J, Midwinter MJ, Hutchings S, Corradi F, Brusasco C, Houzé S, Manca T, Ramelli A, Lattuada M, Nicolini F, Gherli T, Vezzani A, Young A, Carmona AF, Santiago AI, Guillamon LN, Jean-Baptiste S, Delgado MJG, Delgado-Amaya M, Curiel-Balsera E, Rivera-Romero L, Castillo-Lorente E, Carrero-Gómez F, Aguayo-DeHoyos E, Healey AJ, Cameron C, Jiao L, Thabut G, Stümpfle R, Pérez A, Martin S, del Moral OL, Toval S, Rico J, Aldecoa C, Oguzhan K, Demirkiran O, Kirman M, Genève C, Bozbay S, Kosuk ME, Asyralyyeva G, Dilek M, Duzgun M, Telli S, Aydin M, Yilmazer F, Hodgson LE, Dimitrov BD, Tanaka S, Stubbs C, Forni LG, Venn R, Vedage D, Shawaf S, Naran P, Sirisena N, Kinnear J, Dimitrov BD, 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J, Roesthuis L, van der Hoeven JG, Wang H, Heunks LMA, Chen GQ, Sun XM, He X, Yang YL, Shi ZH, Xu M, Zhou JX, Pereira SM, Tucci MR, Su L, Tonelotto BFF, Simoes CM, Morais CCA, Pompeo MS, Kay FU, Amato MBP, Vieira JE, Suzuki S, Mihara Y, Hikasa Y, Qiu H, Okahara S, Morimatsu H, Kwon HM, Moon YJ, Lee SH, Jung KW, Shin WJ, Jun IG, Song JG, Hwang GS, Li R, Lee S, Moon YJ, Kwon HM, Jung K, Shin WJ, Jun IG, Song JG, Hwang GS, Ramelli A, Manca T, Jaffal K, Corradi F, Brusasco C, Nicolini F, Gherli T, Brianti R, Fanzaghi P, Vezzani A, Tudor BA, Klaus DA, Lebherz-Eichinger D, Rouzé A, Lechner C, Schwarz C, Bodingbauer M, Seemann R, Kaczirek K, Fleischmann E, Roth GA, Krenn CG, Malyshev A, Sergey S, Poissy J, Yamaguchi Y, Nomura T, Yoshitake E, Idei M, Yoshida T, Takaki S, Yamaguchi O, Kaneko M, Goto T, Tencé N, Sendid B, Zaien I, Wolf M, Trouiller P, Jacobs FM, Kelly JM, Veigas P, Hollands S, Min A, Rizoli S, Robles CMC, Nseir S, de Oca Sandoval MAM, Tarabrin O, Gavrychenko D, Mazurenko G, 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Moffatt S, Erb J, Ilan R, Messenger D, Ball I, Boyd JG, Harrison M, Ridi S, Muscedere J, Andrade AH, Mignot T, Costa RC, Souza VA, Gonzalez V, Amorim V, Rolla F, Filho CACA, Miranda R, Atchasiri S, Buranavanich P, Wathanawatthu T, Houzé S, Suwanpasu S, Bureau C, Rolland-Debord C, Poitou T, Clavel M, Perbet S, Terzi N, Kouatchet A, Similowski T, Demoule A, Jean-Baptiste S, Diaz P, Nunes J, Escórcio S, Silva G, Chaves S, Jardim M, Câmara M, Fernandes N, Duarte R, Jardim JJ, Thabut G, Pereira CA, Nóbrega JJ, Chen CM, Lai CC, Cheng KC, Chou W, Lee SJ, Cha YS, Lee WY, Onodera M, Lortat-Jacob B, Nakataki E, Oto J, Imanaka H, Nishimura M, Khadjibaev A, Sabirov D, Rosstalnaya A, Akalaev R, Parpibaev F, Antonucci E, Tanaka S, Rossini P, Gandolfi S, Montini E, Orlando S, van Nes M, Karachi F, Hanekom S, Andrade AH, Pereira UV, Filho CACA, Augustin P, Costa RC, Parkin MSW, Moore M, Andrade AH, Costa RC, Carvalho KVS, Filho CACA, Min HJ, Kim HJ, Lee DS, Desmard M, Choi YY, Lee EY, Song I, Kim DJ, 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González JCM, Hadley JS, Yang JS, Chiang CH, Hung WT, Huang WC, Cheng CC, Lin KC, Lin SC, Chiou KR, Wann SR, Lin KL, Millar M, Kang PL, Mar GY, Liu CP, Zhou JC, Choi YJ, Yoon SZ, Gordillo-Brenes A, Fernandez-Zamora MD, Perez-Borrero L, Arias-Verdu MD, Hall D, Aguilar-Alonso E, Herruzo-Aviles A, Garcia-Delgado M, Hinojosa-Perez R, Curiel-Balsera E, Rivera-Fernandez R, Lesmes SPG, Rosario LEDLC, Hernández AA, Herrera ANG, Hewitt H, Sanz ER, Sánchez MJG, Hualde JB, Pascual OA, León JPT, Irazabal JMG, Pérez AG, Fernández PA, Amor LL, Albaiceta GM, Yasuda H, Lesmes SPG, Rosario LEDLC, Hernández AA, Sanz ER, Sánchez MJG, Calvo SA, Herrera ANG, Hualde JB, Pascual OA, León JPT, Sanui M, Corona A, Ruffini C, Spazzadeschi A, Marrazzo F, Gandola A, Sciurti R, Savi C, Catena E, Ke MW, Cheng CC, Komuro T, Huang WC, Chiang CH, Hung WT, Lin KC, Lin SC, Wann SR, Chiou KR, Tseng CJ, Kang PL, Mar GY, Kawano S, Liu CP, Bertini P, De Sanctis F, Guarracino F, Bertini P, Baldassarri R, Guarracino F, Buitinck SH, van der Voort PHJ, Oto J, Andoh K, Nakataki E, Tsunano Y, Izawa M, Tane N, Onodera M, Nishimura M, Ghosh S, Gupta A, De Gasperi A, Mazza E, Yamamoto H, Limuti R, Prosperi M, Bissenova N, Yergaliyeva A, Talan L, Yılmaz G, Güven G, Yoruk F, Altıntas ND, Mukherjee DN, Noda E, Agarwal LK, Mandal K, Palomar M, Balsera B, Vallverdu M, Martinez M, Garcia M, Castellana D, Lopez R, Barcenilla F, Hatakeyama J, Kaminsky GE, Carreño R, Escribá A, Fuentes M, Gálvez V, Del Olmo R, Nieto B, Vaquerizo C, Alvarez J, De la Torre MA, Saitou N, Torres E, Bogossian E, Nouer SA, Salgado DR, Brugger SC, Jiménez GJ, Torner MM, Vidal MV, Garrido BB, Casals XN, Okamoto H, Gaite FB, Cabello JT, Martínez MP, Doganci M, Izdes S, Besevli SG, Alkan A, Kayaaslan B, Ramírez CS, Balcázar LC, Kobayashi A, Santana MC, Viera MAH, Escalada SH, Vázquez CFL, Penichet SMM, Campelo FA, López MADLC, Santana PS, Santana SR, Repessé X, Takei T, Artiguenave M, Paktoris-Papine S, Espinasse F, Dinh A, El Sayed F, Charron C, Géri G, Vieillard-Baron A, Marmanidou K, Oikonomou M, Matsukubo S, Nouris C, Dimitroulakis K, Soilemezi E, Matamis D, Ferré A, Guillot M, Teboul JL, Lichtenstein D, Mézière G, Richard C, Rotzel HB, Monnet X, Pham T, Beduneau G, Schortgen F, Piquilloud L, Zogheib E, Jonas M, Grelon F, Runge I, Terzi N, Lázaro AS, Grangé S, Barberet G, Guitard PG, Frat JP, Constan A, Chrétien JM, Mancebo J, Mercat A, Richard JCM, Brochard L, Prada DA, Prīdāne S, Sabeļņikovs O, Mojoli F, Orlando A, Bianchi I, Torriglia F, Bianzina S, Pozzi M, Iotti GA, Braschi A, Gimillo MR, Beduneau G, Pham T, Schortgen F, Piquilloud L, Zogheib E, Jonas M, Grelon F, Runge I, Terzi N, Grangé S, Barinas OD, Barberet G, Guitard PG, Frat JP, Constan A, Chrétien JM, Mancebo J, Mercat A, Richard JCM, Brochard L, Kondili E, Cortes MLB, Psarologakis C, Kokkini S, Amargianitakis V, Babalis D, Chytas A, Chouvarda I, Vaporidi K, Georgopoulos D, Trapp O, Kalenka A, Franco JF, Mojoli F, Orlando A, Bianchi I, Torriglia F, Bianzina S, Pozzi M, Iotti GA, Braschi A, Lozano JAB, Sánchez PC, Roca JMS, Francioni JEB, Ferrón FR, Simón JMS, Spadaro S, Karbing DS, Gioia A, Moro F, Corte FD, Mauri T, Volta CA, Carratalá A, Rees SE, Petrova MV, Mohan R, Butrov AV, Beeharry SD, Vatsik MV, Sakieva FI, Gobert F, Yonis H, Tapponnier R, Gonçalves B, Fernandez R, Labaune MA, Burle JF, Barbier J, Vincent B, Cleyet M, Richard JC, Guérin C, Shinotsuka CR, Creteur J, Turon R, Taccone FS, Törnblom S, Nisula S, Vaara S, Poukkanen M, Andersson S, Pettilä V, Pesonen E, Xie Z, Liao X, Mendes A, Kang Y, Zhang J, Kubota K, Egi M, Mizobuchi S, Hegazy S, El-Keraie A, El Sayed E, El Hamid MA, Rodrigues NJ, Miranda F, Pereira M, Godinho I, Gameiro J, Neves M, Gouveia J, e Silva ZC, Lopes JA, Mckinlay J, Kostalas M, Kooner G, Mata PJ, Dudas G, Horton A, Kerr C, Karanjia N, Creagh-Brown B, Forni L, Yamazaki A, Ganuza MS, Molina JAM, Martinez FH, Cavalcanti D, Freile MTC, Fernandez NG, Travieso PM, Bandert A, Frithiof R, Lipcsey M, Smekal D, Schlaepfer P, Durovray JD, Plouhinec V, Melo N, Chiappa C, Bellomo R, Schneider AG, Mitchell S, Durrant J, Street H, Dunthorne E, Shears J, Caballero CH, Hutchison R, Lacerda P, Schwarze S, Ghabina S, Thompson E, Prowle JR, Kirwan CJ, Gonzalez CA, Pinto JL, Orozco V, Patiño JA, Garcia PK, Kurtz P, Contreras KM, Rodriguez P, Echeverri JE, Righy C, Rosario LEDLC, Lesmes SPG, Romero JCG, Herrera ANG, Pertuz EDD, Sánchez MJG, Sanz ER, Hualde JB, Hernández AA, Irazabal JMG, Spatenkova V, Bradac O, Suchomel P, Urli T, Lazzeri EH, Aspide R, Zanello M, Perez-Borrero L, Garcia-Alvarez JM, Arias-Verdu MD, Aguilar-Alonso E, Rivera-Fernandez R, Mora-Ordoñez J, De La Fuente-Martos C, Castillo-Lorente E, Guerrero-Lopez F, Lesmes SPG, Rosario LEDLC, Pertuz EDD, Hernández AA, Romero JCG, Sánchez MJG, Herrera ANG, Ramírez JR, Sanz ER, Hualde JB, León JPT, Navarro-Guillamón L, Cordovilla-Guardia S, Iglesias-Santiago A, Guerrero-López F, Fernández-Mondéjar E, Vidal A, Perez M, Juez A, Arias N, Colino L, Perez JL, Pérez H, Calpe P, Alcala MA, Robaglia D, Perez C, Lan SK, Cunha MM, Moreira T, Santos F, Lafuente E, Fernandes MJ, Silva JG, Rosario LEDLC, Lesmes SPG, Herrera ANG, Romero JCG, Pertuz EDD, Sánchez MJG, Sanz ER, Echeverría JGA, Hernández AA, Hualde JB, Podlepich V, Sokolova E, Alexandrova E, Lapteva K, Kurtz P, Shuinotsuka C, Rabello L, Vianna G, Reis A, Cairus C, Salluh J, Bozza F, Torres JCB, Araujo NJF, García-Olivares P, Keough E, Dalorzo M, Tang LK, De Sousa I, Díaz M, Marcos-Zambrano LJ, Guerrero JE, Gomez SEZ, Lopez GDH, Cuellar AIV, Nieto ORP, Gonzalez JAC, Bhasin D, Rai S, Singh H, Gupta O, Bhattal MK, Sampley S, Sekhri K, Nandha R, Aliaga FA, Olivares F, Appiani F, Farias P, Alberto F, Hernández A, Pons S, Sonneville R, Bouadma L, Neuville M, Mariotte E, Radjou A, Lebut J, Chemam S, Voiriot G, Dilly MP, Mourvillier B, Dorent R, Nataf P, Wolff M, Timsit JF, Ediboglu O, Ataman S, Ozkarakas H, Kirakli C, Vakalos A, Avramidis V, Obukhova O, Kurmukov IA, Kashiya S, Golovnya E, Baikova VN, Ageeva T, Haritydi T, Kulaga EV, Rios-Toro JJ, Perez-Borrero L, Aguilar-Alonso E, Arias-Verdu MD, Garcia-Alvarez JM, Lopez-Caler C, De La Fuente-Martos C, Rodriguez-Fernandez S, Sanchez-Orézzoli MG, Martin-Gallardo F, Nikhilesh J, Joshi V, Villarreal E, Ruiz J, Gordon M, Quinza A, Gimenez J, Piñol M, Castellanos A, Ramirez P, Jeon YD, Jeong WY, Kim MH, Jeong IY, Ahn MY, Ahn JY, Han SH, Choi JY, Song YG, Kim JM, Ku NS, Shah H, Kellner F, Rezai F, Mistry N, Yodice P, Ovnanian V, Fless K, Handler E, Alejos RM, Romeu JDM, Antón DG, Quinart A, Martí AT, Llaurado-Serra M, Lobo-Civico A, Ventura-Rosado A, Piñol-Tena A, Pi-Guerrero M, Paños-Espinosa C, Peralvo-Bernat M, Marine-Vidal J, Gonzalez-Engroba R, Montesinos-Cerro N, Treso-Geira M, Valeiras-Valero A, Martinez-Reyes L, Sandiumenge A, Jimenez-Herrera MF, Helyar S, Riozzi P, Noon A, Hallows G, Cotton H, Keep J, Hopkins PA, Taggu A, Renuka S, Sampath S, Rood PJT, Frenzel T, Verhage R, Bonn M, Pickkers P, van der Hoeven JG, van den Boogaard M, Corradi F, Melnyk L, Moggia F, Pienovi R, Adriano G, Brusasco C, Mariotti L, Lattuada M, Bloomer MJ, Coombs M, Ranse K, Endacott R, Maertens B, Blot K, Blot S, Amerongen MPVN, van der Heiden ES, Twisk JWR, Girbes ARJ, Spijkstra JJ, Riozzi P, Helyar S, Cotton H, Hallows G, Noon A, Bell C, Peters K, Feehan A, Keep J, Hopkins PA, Churchill K, Hawkins K, Brook R, Paver N, Endacott R, Maistry N, van Wijk A, Rouw N, van Galen T, Evelein-Brugman S, Taggu A, Krishna B, Sampath S, Putzu A, Fang M, Berto MB, Belletti A, Cassina T, Cabrini L, Mistry M, Alhamdi Y, Welters I, Abrams ST, Toh CH, Han HS, Gil EM, Lee DS, Park CM, Winder-Rhodes S, Lotay R, Doyle J, Ke MW, Huang WC, Chiang CH, Hung WT, Cheng CC, Lin KC, Lin SC, Chiou KR, Wann SR, Shu CW, Kang PL, Mar GY, Liu CP, Dubó S, Aquevedo A, Jibaja M, Berrutti D, Labra C, Lagos R, García MF, Ramirez V, Tobar M, Picoita F, Peláez C, Carpio D, Alegría L, Hidalgo C, Godoy K, Bakker J, Hernández G, Sadamoto Y, Katabami K, Wada T, Ono Y, Maekawa K, Hayakawa M, Sawamura A, Gando S, Marin-Mateos H, Perez-Vela JL, Garcia-Gigorro R, Peiretti MAC, Lopez-Gude MJ, Chacon-Alves S, Renes-Carreño E, Montejo-González JC, Parlevliet KL, Touw HRW, Beerepoot M, Boer C, Elbers PWG, Tuinman PR, Abdelmonem SA, Helmy TA, El Sayed I, Ghazal S, Akhlagh SH, Masjedi M, Hozhabri K, Kamali E, Zýková I, Paldusová B, Sedlák P, Morman D, Youn AM, Ohta Y, Sakuma M, Bates D, Morimoto T, Su PL, Chang WY, Lin WC, Chen CW, Facchin F, Zarantonello F, Panciera G, De Cassai A, Venrdramin A, Ballin A, Tonetti T, Persona P, Ori C, Del Sorbo L, Rossi S, Vergani G, Cressoni M, Chiumello D, Chiurazzi C, Brioni M, Algieri I, Tonetti T, Guanziroli M, Colombo A, Tomic I, Colombo A, Crimella F, Carlesso E, Gasparovic V, Gattinoni L, Neto AS, Schmidt M, Pham T, Combes A, de Abreu MG, Pelosi P, Schultz MJ, Katira BH, Engelberts D, Giesinger RE, Ackerley C, Yoshida T, Zabini D, Otulakowski G, Post M, Kuebler WM, McNamara PJ, Kavanagh BP, Pirracchio R, Rigon MR, Carone M, Chevret S, Annane D, Eladawy S, El-Hamamsy M, Bazan N, Elgendy M, De Pascale G, Vallecoccia MS, Cutuli SL, Di Gravio V, Pennisi MA, Conti G, Antonelli M, Andreis DT, Khaliq W, Singer M, Hartmann J, Harm S, Carmona SA, Almudevar PM, Abellán AN, Ramos JV, Pérez LP, Valbuena BL, Sanz NM, Simón IF, Arrigo M, Feliot E, Deye N, Cariou A, Guidet B, Jaber S, Leone M, Resche-Rigon M, Baron AV, Legrand M, Gayat E, Mebazaa A, Balik M, Kolnikova I, Maly M, Waldauf P, Tavazzi G, Kristof J, Herpain A, Su F, Post E, Taccone F, Vincent JL, Creteur J, Lee C, Hatib F, Jian Z, Buddi S, Cannesson M, Fileković S, Turel M, Knafelj R, Gorjup V, Stanić R, Gradišek P, Cerović O, Mirković T, Noč M, Tirkkonen J, Hellevuo H, Olkkola KT, Hoppu S, Lin KC, Hung WT, Chiang CC, Huang WC, Juan WC, Lin SC, Cheng CC, Lin PH, Fong KY, Hou DS, Kang PL, Wann SR, Chen YS, Mar GY, Liu CP, Paul M, Bougouin W, Geri G, Dumas F, Champigneulle B, Legriel S, Charpentier J, Mira JP, Sandroni C, Cariou A, Zimmerman J, Sullivan E, Noursadeghi M, Fox B, Sampson D, McHugh L, Yager T, Cermelli S, Seldon T, Bhide S, Brandon RA, Brandon RB, Zwaag J, Beunders R, Pickkers P, Kox M, Gul F, Arslantas MK, Genc D, Zibandah N, Topcu L, Akkoc T, Cinel I, Greco E, Lauretta MP, Andreis DT, Singer M, Garcia IP, Cordero M, Martin AD, Pallás TA, Montero JG, Rey JR, Malo LR, Montoya AAT, Martinez ADCA, Ayala LYD, Zepeda EM, Granillo JF, Sanchez JA, Alejo GC, Cabrera AR, Montenegro AP, Pham T, Beduneau G, Schortgen F, Piquilloud L, Zogheib E, Jonas M, Grelon F, Runge I, Terzi N, Grangé S, Barberet G, Guitard PG, Frat JP, Constan A, Chrétien JM, Mancebo J, Mercat A, Richard JCM, Brochard L, Soilemezi E, Koco E, Savvidou S, Nouris C, Matamis D, Di Mussi R, Spadaro S, Volta CA, Mariani M, Colaprico A, Antonio C, Bruno F, Grasso S, Rodriguez A, Martín-Loeches I, Díaz E, Masclans JR, Gordo F, Solé-Violán J, Bodí M, Avilés-Jurado FX, Trefler S, Magret M, Reyes LF, Marín-Corral J, Yebenes JC, Esteban A, Anzueto A, Aliberti S, Restrepo MI, Larsson JS, Redfors B, Ricksten SE, Haines R, Powell-Tuck J, Leonard H, Ostermann M, Berthelsen RE, Itenov TS, Perner A, Jensen JU, Ibsen M, Jensen AEK, Bestle MH, Bucknall T, Dixon J, Boa F, MacPhee I, Philips BJ, Doyle J, Saadat F, Samuels T, Huddart S, McCormick B, DeBrunnar R, Preece J, Swart M, Peden C, Richardson S, Forni L, Kalfon P, Baumstarck K, Estagnasie P, Geantot MA, Berric A, Simon G, Floccard B, Signouret T, Boucekine M, Fromentin M, Nyunga M, Sossou A, Venot M, Robert R, Follin A, Renault A, Garrouste M, Collange O, Levrat Q, Villard I, Thévenin D, Pottecher J, Patrigeon RG, Revel N, Vigne C, Mimoz O, Auquier P, Pawar S, Jacques T, Deshpande K, Pusapati R, Wood B, Pulham RA, Wray J, Brown K, Pierce C, Nadel S, Ramnarayan P, Azevedo JR, Montenegro WS, Rodrigues DP, Sousa SC, Araujo VF, Leitao AL, Prazeres PH, Mendonca AV, Paula MP, Das Neves A, Loudet CI, Busico M, Vazquez D, Villalba D, Lischinsky A, Veronesi M, Emmerich M, Descotte E, Juliarena A, Bisso MC, Grando M, Tapia A, Camargo M, Ulla DV, Corzo L, dos Santos HP, Ramos A, Doglia JA, Estenssoro E, Carbonara M, Magnoni S, Donald CLM, Shimony JS, Conte V, Triulzi F, Stretti F, Macrì M, Snyder AZ, Stocchetti N, Brody DL, Podlepich V, Shimanskiy V, Savin I, Lapteva K, Chumaev A, Tjepkema-Cloostermans MC, Hofmeijer J, Beishuizen A, Hom H, Blans MJ, van Putten MJAM, Longhi L, Frigeni B, Curinga M, Mingone D, Beretta S, Patruno A, Gandini L, Vargiolu A, Ferri F, Ceriani R, Rottoli MR, Lorini L, Citerio G, Pifferi S, Battistini M, Cordolcini V, Agarossi A, Di Rosso R, Ortolano F, Stocchetti N, Lourido CM, Cabrera JLS, Santana JDM, Alzola LM, del Rosario CG, Pérez HR, Torrent RL, Eslami S, Dalhuisen A, Fiks T, Schultz MJ, Hanna AA, Spronk PE, Wood M, Maslove D. ESICM LIVES 2016: part three. Intensive Care Med Exp 2016. [PMCID: PMC5042925 DOI: 10.1186/s40635-016-0100-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Affiliation(s)
| | - C Ong
- Guy's and St. Thomas' Hospitals, London, UK
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Raussen T, Siriri D, Ong C. Trapping Water, Producing Wood and Improving Yields Through Rotational Woodlots on Degraded Parts of Bench Terraces in Uganda. ACTA ACUST UNITED AC 2015. [DOI: 10.4314/eaafj.v65i1.1760] [Citation(s) in RCA: 3] [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] [Indexed: 11/17/2022]
Affiliation(s)
- T Raussen
- International Centre for Research in Agroforestry (ICRAF) PO Box 311, Kabale, Uganda
| | - D Siriri
- International Centre for Research in Agroforestry (ICRAF) PO Box 311, Kabale, Uganda
| | - C Ong
- International Centre for Research in Agroforestry (ICRAF) PO Box 311, Kabale, Uganda
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Dineen R, Avula S, Chambers T, Dutta M, Macarthur D, Harave S, Ong C, Mallucci C, Kumar R, Pizer B, Walker D. OP10DEVELOPMENT OF A POTENTIAL PRE-OPERATIVE RISK STRATIFICATION TOOL OF CEREBELLAR MUTISM SYNDROME IN CHILDREN WITH POSTERIOR FOSSA TUMOUR. Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov283.10] [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: 11/13/2022] Open
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Halasa R, Brown A, Ong C, Beckett R, Shah S, Patel D, Phillips K, McNinch D, Jones J. 337 Then and Now: Psychosocial Emergencies in the Elderly. Ann Emerg Med 2015. [DOI: 10.1016/j.annemergmed.2015.07.373] [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: 11/16/2022]
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Affiliation(s)
- Charlene Ong
- From the Department of Neurology and Ophthalmology, Washington University in St. Louis, MO.
| | - Kevin Patel
- From the Department of Neurology and Ophthalmology, Washington University in St. Louis, MO
| | - Erik Musiek
- From the Department of Neurology and Ophthalmology, Washington University in St. Louis, MO
| | - Gregory Van Stavern
- From the Department of Neurology and Ophthalmology, Washington University in St. Louis, MO
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Ong C, Seet E, Koh KF, Kumar CM. Knowledge and perception of a sample of Singapore anaesthetists towards controlled drug security and abuse. Anaesth Intensive Care 2014; 42:675-677. [PMID: 25233188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Tong HJ, Khong J, Ong C, Ng A, Lin Y, Ng JJ, Hong CHL. Children's and parents' attitudes towards dentists' appearance, child dental experience and their relationship with dental anxiety. Eur Arch Paediatr Dent 2014; 15:377-84. [PMID: 24840104 DOI: 10.1007/s40368-014-0126-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 03/21/2014] [Indexed: 10/25/2022]
Abstract
AIM To evaluate child and parental attitudes towards dentists' appearance, subsequently related to a child's dental experience and their association with child's anxiety levels. METHODS 402 parent-child pairs were surveyed using interviewer-administered questionnaires at the School Dental Service, Health Promotion Board, Singapore. Standardised pictures of models with different attires, ages, genders and ethnicities were shown to the parent-child pairs. Information on each child's dental experience was obtained. Parental proxy was used to evaluate the children's dental fear levels based on the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). RESULTS Personal protective equipment (PPE) was the attire of choice for both parents and children, followed by the paediatric coat. Formal and informal attire was least preferred by children and parents, respectively. Parents preferred female dentists to treat their child, whereas children preferred a dentist of the same gender (p < 0.001). Parent's and child's preferences for the child's dentist's appearance were shown to be significantly different (p < 0.001). CFSS-DS scores were also significantly associated with the number of previous dental visits (p = 0.002) as well as a history of extractions (p = 0.02), but not with child's demographics, dmft or preference for dentist's appearance (p > 0.05). CONCLUSION Regardless of child anxiety levels, the PPE followed by paediatric coats were preferred over other choices of dentists' attire. Children tended to choose a dentist who was of a younger age, and of the same gender and ethnicity as themselves. Parents tended to choose younger, female dentists of the same ethnicity as themselves. Subjective experience of extractions, as well as multiple dental visits appeared to play a more significant role in the development of dental fear than dental caries experience per se.
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Affiliation(s)
- H J Tong
- Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, National University of Singapore, 11 Lower Kent Ridge Road, Singapore, 119083, Republic of Singapore,
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Mogilevkina I, Jani P, Aboutanos M, Bedada A, Ajuzieogu O, Nasir A, Muchemwa F, Bekele A, Holmer H, Ddungu R, Singh K, Ingabire J, Swaroop M, Ogundele J, Ajiko M, Bush C, Ajuzieogu O, Malemo K, Pemberton J, Livingston M, Nagengast E, Skelton T, Nsereko E, Razek T, Hackenberg B, Twagirumugabe T, Elobu A, Ajuzieogu O, Allen Ingabire JC, Wandwi W, Mwizerwa O, Abdur-Rahman L, Makama J, Ademola S, Ogundele J, Abdur-Rahman L, Lymburner E, Esau D, Bos C, Bos C, Rothstein D, Nikolaou S, Rajkumar S, Westerholm J, Culp A, Baison G, Ong C, Knapp G, Klimovytskyiy F, Prudnikov Y, Jayaraman S, Mata L, Mora F, Ordóñez C, Pino L, Quiodettis M, Morales. C, Hsiao M, Bakanisi B, Motsumi J, Azzie. G, Achi J, Amucheazi A, Ikeani. C, Abdur-Rahman L, Oyedepo O, Arowona L, Alonge D, Rufai Z, Adeniran J, Abraham M, Olatinwo. A, Tadesse A, Gillies R, Meara J, Liljestrand J, Oyerinde K, Hagander. L, Namuddu R, Nakonde I, Mukasa. R, Marbaniang D, Byiringiro J, Calland J, Petrose R, Jayaraman S, Ntakiyiruta. G, Schuetz S, Iss N, Laguna M, Shapiro M, Gallardo. J, Ifesanya A, Riviello E, Irakiza J, Mvukiyehe J, Maine R, Kim W, Manirakiza F, Reshamwalla S, Mwumvaneza T, Kymanaywa P, Ntakiyiruta G, Kiviri W, Finlayson S, Berry W, Twagirumugabe. T, Amucheazi A, Achi J, Ezike H, Salmon M, Salmon C, Mutendi M, Reynolds. T, Frankfurter C, Cameron B, Poenaru D, D’Cruz J, Pemberton J, Ozgediz D, Poenaru. D, Caterson E, Magee W, Hatcher K, Ramos M, Campbell. A, Nshimyumuremyi I, Livingston P, Zolpys L, Mukwesi C, Uwineza. B, Evans. F, Marquis C, Linois-Davidson C, Ramos M, Campbell A, Resch S, Finlayson S, Howaldt H, Caterson. E, Irakiza J, Mvukiyehe J, Maine R, Bush C, Riviello E, Kim W, Manirakiza F, Reshamwalla S, Mwumvaneza T, Kymanaywa P, Ntakiyiruta G, Kiviri W, Finlayson S, Berry. W, Amucheazi A, Achi J, Ikeani. C, Ssebufu R, Kyamanywa P, Bayisenga J, Bikoroti J, Mazimpaka. D, Mpoki U, Muleshe S, Zwane. S, Calland J, Byiringiro J, Ntakiyiruta. G, Nasir A, Adeniran J, Bamigbola K, Irribhogbe P, Ameh. E, Olawoye O, Iyun A, Micheal A, Oluwatosin. O, Adebayo R, Abdulraheem N, Nasir A, Adeniran. J, Cameron B, Ho P, Blair G, Duffy D, O’Hara N, Ajiko M, Kapoor. V, Westerholm. J, Westerholm. J, Baron E, Herard P, Lassalle X, Teicher. C, Maraka J, Asige E, Owori F, Obaikol. R, Maine R, Nsengiyumva E, Ntakiyiruta G, Mubiligi J, Riviello R, Havugimana. J, Chavarri A, Meara J, Pyda J, Shulman L, Damuse R, Pierre. J, Hoogerboord M, Ernest A, Gesase. A. Abstracts of the 13th Bethune Round Table Conference on International Surgery. May 10-11, 2013. Vancouver, British Columbia, Canada. Can J Surg 2013; 56:S44-52. [PMID: 23883512 DOI: 10.1503/cjs.015713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Ong C, Lim JZZ, Ng CT, Li JJ, Yung LYL, Bay BH. Silver nanoparticles in cancer: therapeutic efficacy and toxicity. Curr Med Chem 2013; 20:772-781. [PMID: 23298139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 12/21/2012] [Accepted: 12/22/2012] [Indexed: 06/01/2023]
Abstract
In recent years, there has been escalating interest in the biomedical applications of nanoparticles (NPs). In particular, silver nanoparticles (AgNPs) are increasingly being investigated as tools for novel cancer therapeutics, capitalizing on their unique properties to enhance potential therapeutic efficacy. However, questions as to are we able to contain or control the toxicity effects of AgNPs, and how much do we know about the toxicological profile of AgNPs which are commonly used in emerging nanotechnology-based applications, still remain. Hence, serious considerations have to be given to the hazards and risks of toxicity associated with the use of AgNPs. This review focuses on the current applications of AgNPs, their known effects and toxicity, as well as the potential of harnessing them for use in cancer therapy.
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Affiliation(s)
- C Ong
- Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597
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Carbone V, Kim H, Huang JX, Baker MA, Ong C, Cooper MA, Li J, Rockman S, Velkov T. Molecular characterization of the receptor binding structure-activity relationships of influenza B virus hemagglutinin. Acta Virol 2013; 57:313-332. [PMID: 24020757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Selectivity of α2,6-linked human-like receptors by B hemagglutinin (HA) is yet to be fully understood. This study integrates binding data with structure-recognition models to examine the impact of regional-specific sequence variations within the receptor-binding pocket on selectivity and structure activity relationships (SAR). The receptor-binding selectivity of influenza B HAs corresponding to either B/Victoria/2/1987 or the B/Yamagata/16/88 lineages was examined using surface plasmon resonance, solid-phase ELISA and gel-capture assays. Our SAR data showed that the presence of asialyl sugar units is the main determinant of receptor preference of α2,6 versus α2,3 receptor binding. Changes to the type of sialyl-glycan linkage present on receptors exhibit only a minor effect upon binding affinity. Homology-based structural models revealed that structural properties within the HA pocket, such as a glyco-conjugate at Asn194 on the 190-helix, sterically interfere with binding to avian receptor analogs by blocking the exit path of the asialyl sugars. Similarly, naturally occurring substitutions in the C-terminal region of the 190-helix and near the N-terminal end of the 140-loop narrows the horizontal borders of the binding pocket, which restricts access of the avian receptor analog LSTa. This study helps bridge the gap between ligand structure and receptor recognition for influenza B HA; and provides a consensus SAR model for the binding of human and avian receptor analogs to influenza B HA.
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MESH Headings
- Amino Acid Sequence
- Animals
- Binding Sites
- Chick Embryo
- Chickens
- Hemagglutinin Glycoproteins, Influenza Virus/chemistry
- Hemagglutinin Glycoproteins, Influenza Virus/genetics
- Hemagglutinin Glycoproteins, Influenza Virus/metabolism
- Humans
- Influenza B virus/chemistry
- Influenza B virus/genetics
- Influenza B virus/metabolism
- Influenza in Birds/genetics
- Influenza in Birds/metabolism
- Influenza in Birds/virology
- Influenza, Human/genetics
- Influenza, Human/metabolism
- Influenza, Human/virology
- Models, Molecular
- Molecular Sequence Data
- Protein Structure, Secondary
- Receptors, Virus/chemistry
- Receptors, Virus/genetics
- Receptors, Virus/metabolism
- Structure-Activity Relationship
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Abstract
BACKGROUND Periodic epileptiform discharges (PEDs) are a frequent finding in comatose patients undergoing continuous EEG (cEEG) monitoring, but their clinical significance is unclear. PET and SPECT studies indicate that PEDs can be associated with focal hypermetabolism and hyperemia, suggesting that in some cases this pattern may be ictal and potentially harmful. We hypothesized that frequent PED activity in comatose patients is associated with reduced likelihood of recovery of consciousness. METHODS We identified all comatose patients treated in the Columbia neuro-ICU between June 2008 and August 2009 who underwent ten or more consecutive days of video cEEG monitoring (N = 67), and classified them into three groups: those with (1) prolonged PEDs (five or more consecutive days), (2) intermittent PEDs (at least one but fewer than five consecutive days), and (3) no PEDs. Outcome at discharge was assessed by the Glasgow Outcome Scale and classified as dead (GOS 1), vegetative (GOS 2), and command-following (GOS 3-5). RESULTS Mean age was 56 years, mean admission Glasgow Coma Scale score was seven, and the median duration of cEEG monitoring was 18 (range 10-111) days. The most common diagnoses were hypoxic-ischemic encephalopathy (18%), subarachnoid hemorrhage (16%), epilepsy (15%), encephalitis (15%), metabolic encephalopathy (13%), and intracerebral hemorrhage (12%). 37% of patients (N = 25) had prolonged PEDs, 31% (N = 21) had intermittent PEDs, and 31% (N = 21) had no PEDs. Prolonged PEDs were associated with the presence of SIRPIDS (P = 0.009), electrographic seizures (P = 0.019), and number of AEDs administered (P < 0.0001). However, the presence of intermittent or prolonged PED activity had no impact on mortality (31% overall) or recovery of consciousness (command-following) at the time of discharge (36% overall). CONCLUSION Persistent spontaneous PED activity in comatose patients is associated with SIRPIDs and electrographic seizures, but has no impact on the likelihood of survival or recovery of consciousness.
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Affiliation(s)
- Charlene Ong
- Department of Neurology, University of Washington in St. Louis, 660 S. Euclid Avenue, St. Louis, MO 63110, USA.
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Abstract
BACKGROUND The clinical impression of Australian physicians is that systemic lupus erythematosus (SLE) is more prevalent and more severe in Asian patients than in their Caucasian counterparts. The presence and severity of lupus nephritis is a major determinant of prognosis in SLE, and largely determines disease impact. AIM To analyse the relationships between ethnicity and the prevalence and severity of lupus nephritis (LN) in patients attending a tertiary referral centre (The Royal Melbourne Hospital (RMH)). METHODS The ethnicity of all known patients with biopsy-proven LN was determined according to three definitions of ethnicity - ancestry, country of origin and primary language spoken. The prevalence of Asian ethnicity in the LN cohort was analysed across severity class, and was compared with the prevalences of Asian ethnicity in the general population within the hospital's geographic area, and with that in the relevant RMH cohorts of inpatients and outpatients, over the same time period. RESULTS Within this single tertiary centre, Asian patients were disproportionately represented in both the systemic lupus erythematosus (SLE) and the LN patient groups, although the distribution of histological severity of LN was not significantly different from Caucasian patients. CONCLUSION This study supports the common clinical impression that SLE is more common and more severe in the Asian-Australian population. Asian patients with SLE were more commonly diagnosed with LN. However, the spectrum of histological severity of LN was similar in Asian and Caucasian patients.
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Affiliation(s)
- C Ong
- Department of Nephrology, The Royal Melbourne Hospital, and Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
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Ong C, Barnes S, Senanayake S. Actinomyces turicensis infection mimicking ovarian tumour. Singapore Med J 2012; 53:e9-e11. [PMID: 22252197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This case report explores an unusual presentation of a commensal organism, Actinomyces, which mimicked a presentation of ovarian cancer. A 73-year-old woman presented to a tertiary level hospital with persistent left iliac fossa abdominal pain, anorexia and fever lasting over one week, with a three-month history of bright rectal bleeding. Imaging was suggestive of malignancy. Fine needle aspiration of an enlarged lymph node was non-diagnostic. Blood cultures taken at presentation became positive after two days for Gram-positive rods, which were most likely Actinomyces. The patient was treated with penicillin 1.8 g four hourly with rapid improvement. Actinomycosis is frequently misdiagnosed as malignancy initially due to its relatively indolent course. Lesions often resolve with antibiotics, without the need for surgical intervention.
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Affiliation(s)
- C Ong
- Department of Infectious Diseases, The Canberra Hospital, Australia
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van Dieren E, Richards H, Helle P, Ong C, Sommer R, Koch S. 1238 poster CTV2PTV MARGINS WHEN APPLYING A PRIORI SETUP CORRECTIONS FOR HEAD AND NECK CANCER TREATMENT. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71360-3] [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]
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Ong C, Palma D, Verbakel W, Slotman B, Senan S. Stereotactic Body Radiotherapy (SBRT) for Stage I Lung Cancer >80 cm3: Correlation of Early Toxicity with Planning Parameters. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Ikka L, Boujan F, Boyer P, Modreanu A, Jahn C, Ong C, Habashy M, Kehrli P, Beaujeux R. Paralysie oculomotrice du III compliquant à distance un anévrysme de l’artère communicante postérieure embolisé. J Neuroradiol 2010. [DOI: 10.1016/j.neurad.2010.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ikka L, Boujan F, Boyer P, Habashy M, Ong C, Modreanu A, Jahn C, Kehrli P, Wolff V, Beaujeux R. Fistule artérioveineuses durale intracrânienne de type III avec œdème parenchymateux : à propos de deux cas embolisés à l’Onyx®. J Neuroradiol 2010. [DOI: 10.1016/j.neurad.2010.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Verbakel W, Senan S, Ong C, Cuijpers J, Slotman B, Lagerwaard F. Rapid Delivery of Stereotactic Radiotherapy for Peripheral Lung Tumors using Volumetric Intensity Modulated Arcs. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.279] [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: 11/25/2022]
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Ong C, Lam D, Ong M, Parkinson R, Wenderoth J. 001 The use of nitinol vascular plug for major craniocervical parent artery occlusion: an initial experience. J Neurointerv Surg 2009. [DOI: 10.1136/jnis.2009.000869a] [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: 11/03/2022]
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