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Elhage KG, Kranyak A, Jin JQ, Haran K, Spencer RK, Smith PL, Davis MS, Hakimi M, Bhutani T, Liao W. Mendelian Randomization Studies in Atopic Dermatitis: A Systematic Review. J Invest Dermatol 2024; 144:1022-1037. [PMID: 37977498 DOI: 10.1016/j.jid.2023.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 10/17/2023] [Accepted: 10/22/2023] [Indexed: 11/19/2023]
Abstract
Prior studies have found associations between atopic dermatitis (AD) and comorbidities, including depression, obesity, asthma, and allergic rhinitis. Although observational studies often cannot establish robust causality between potential risk factors and AD, Mendelian randomization minimizes confounding when exploring causality by relying on random allelic assortment at birth. In this study, we systematically reviewed 30 Mendelian randomization studies in AD. Body mass index, gut microbial flora, the IL-18 signaling pathway, and gastroesophageal reflux disease were among the causal factors for AD, whereas AD was causal for several medical conditions, including heart failure, rheumatoid arthritis, and conjunctivitis. These insights may improve preventive counseling in AD.
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Affiliation(s)
- Kareem G Elhage
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Allison Kranyak
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Joy Q Jin
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA; School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Kathryn Haran
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Riley K Spencer
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Payton L Smith
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Mitchell S Davis
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Marwa Hakimi
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Tina Bhutani
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Wilson Liao
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA; Institute for Human Genetics, University of California San Francisco, San Francisco, California, USA.
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2
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Davis MS, Spencer RK, Johnson CE, Elhage KG, Jin JQ, Hakimi M, Bhutani T, Liao W. Risk of Cutaneous T Cell Lymphoma with Psoriasis Biologic Therapies. Dermatol Ther (Heidelb) 2024; 14:15-30. [PMID: 38043065 PMCID: PMC10828324 DOI: 10.1007/s13555-023-01074-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/13/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND The risk of developing cutaneous T cell lymphoma (CTCL) in patients using psoriasis biologics has not been well characterized. The goals of this review were to investigate the incidence of CTCL in patients with psoriasis receiving biologic therapy in clinical trials and psoriasis registries, and to review cases of CTCL and biologic use reported in scientific publications. METHODS The US National Library of Medicine clinical trials database (clinicaltrials.gov) was queried to identify phase 3 and 4 clinical trials of the 12 biologic agents currently FDA approved for psoriatic disease. The incidence of CTCL in these trials was examined and summarized. To examine the incidence of CTCL in psoriasis registries, a Medline search was conducted. Finally, we performed a systematic review of CTCL cases reported in the literature. RESULTS Only two cases of CTCL were reported in 35,801 subjects with psoriasis receiving a biologic agent in the active arm of 108 psoriasis phase 3 clinical trials. One of these CTCL cases was determined by the investigator to be CTCL misdiagnosed as psoriasis prior to randomization. No cases of CTCL were reported in 5440 subjects with psoriasis in 34 phase 4 clinical trials. Only one case of CTCL was identified in 34,111 registry subjects. In the literature, tumor necrosis factor (TNF) inhibitors had the highest number of reported cases of CTCL (34 cases), followed by interleukin (IL)-17 inhibitors (7 cases), and IL-12/23 inhibitors (6 cases). No cases of CTCL were found to be reported with IL-23 inhibitors. CONCLUSION Our findings indicate that the development of CTCL is rare in the setting of psoriasis biologic use. Of the limited number of cases of CTCL found, most were in the setting of TNF inhibitor use and no cases of CTCL were reported in the setting of IL-23 inhibitor use.
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Affiliation(s)
- Mitchell S Davis
- Department of Dermatology, University of California San Francisco, Floor 04, Room N426, 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA
| | - Riley K Spencer
- Department of Dermatology, University of California San Francisco, Floor 04, Room N426, 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA
| | - Chandler E Johnson
- Department of Dermatology, University of California San Francisco, Floor 04, Room N426, 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA
- Medical College of Georgia, Augusta, GA, USA
| | - Kareem G Elhage
- Department of Dermatology, University of California San Francisco, Floor 04, Room N426, 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA
| | - Joy Q Jin
- Department of Dermatology, University of California San Francisco, Floor 04, Room N426, 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Marwa Hakimi
- Department of Dermatology, University of California San Francisco, Floor 04, Room N426, 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA
| | - Tina Bhutani
- Department of Dermatology, University of California San Francisco, Floor 04, Room N426, 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA
| | - Wilson Liao
- Department of Dermatology, University of California San Francisco, Floor 04, Room N426, 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA.
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3
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Jung G, Breiding PS, Schmitz-Rixen T, Hakimi M. [Pelvic vein thrombosis : Current treatment options and importance of recanalization procedures]. Chirurgie (Heidelb) 2024; 95:87-98. [PMID: 37792045 DOI: 10.1007/s00104-023-01964-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/09/2023] [Indexed: 10/05/2023]
Abstract
Venous thrombosis is a frequent disorder. A distinction is made between an acute phase of the disease and a chronic manifestation, the postthrombotic syndrome. In particular, proximal venous thrombosis/pelvic vein thrombosis can cause a life-threatening pulmonary embolism during the acute phase of the disease. The postthrombotic syndrome is characterized by the remodeling of the affected venous section, which is often caused by inflammation. Locally, the typical clinical finding is caused by scarred stricture of the vein with restricted drainage and peripheral venous hypertension. Acute thrombosis should be primarily treated by therapeutic anticoagulation and compression therapy of the affected extremity. The duration of these measures depends on clinical presentation, cause (provoked, unprovoked) and risk factors for venous thrombosis/recurrent thrombosis. Venous revascularization procedures are important both in the acute phase of the disease and in the treatment of postthrombotic syndrome. The recanalization treatment is mostly carried out as an endovascular or hybrid intervention and venous bypass procedures are reserved for special situations.
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Affiliation(s)
- G Jung
- Klinik für Gefässchirurgie, Luzerner Kantonsspital, Spitalstr., 6000, Luzern 16, Schweiz.
| | - P S Breiding
- Radiologie, Sektion interventionelle Radiologie, Luzerner Kantonsspital, Spitalstr., 6000, Luzern 16, Schweiz
| | - T Schmitz-Rixen
- Deutsche Gesellschaft für Chirurgie, Luisenstr. 58-58, 10117, Berlin, Deutschland
| | - M Hakimi
- Klinik für Gefässchirurgie, Luzerner Kantonsspital, Spitalstr., 6000, Luzern 16, Schweiz
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4
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Yeroushalmi S, Chung M, Bartholomew E, Hakimi M, Koo J. Comparing the odds of reported depression in psoriasis patients on systemic therapy: a cross-sectional analysis of postmarketing data. J DERMATOL TREAT 2023; 34:2152272. [PMID: 36472387 DOI: 10.1080/09546634.2022.2152272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022]
Abstract
Patients with psoriasis are more likely to experience depression and suicidality compared to non-psoriatic patients, though systemic therapies have been shown to improve depressive symptoms. It is unclear whether or not biologic or oral agents are more effective at improving such depressive symptoms in psoriasis patients, however. We aimed to determine an estimate of the odds of incident depression in psoriasis patients on different systemic therapies by performing a cross-sectional analysis of postmarketing data. The reporting odds ratio (ROR) for 15 different systemic agents was calculated using reports from the Food and Drug Administration Adverse Events Reporting System (FAERS). After excluding brodalumab and apremilast due to high risk of reporting bias, we found oral agents were associated with a significantly higher ROR of depression compared to biologics (OR = 2.42, 95% confidence interval: 1.93-3.04). These results suggest biologics may be more effective at reducing incident depression than oral agents. Future controlled trials are needed to confirm these findings.
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Affiliation(s)
- Samuel Yeroushalmi
- The Department of Dermatology, The University of California, San Francisco, CA, USA
| | - Mimi Chung
- The Department of Dermatology, The University of California, San Francisco, CA, USA
| | - Erin Bartholomew
- The Department of Dermatology, The University of California, San Francisco, CA, USA
| | - Marwa Hakimi
- The Department of Dermatology, The University of California, San Francisco, CA, USA
| | - John Koo
- The Department of Dermatology, The University of California, San Francisco, CA, USA
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5
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Chung M, Liu J, Yeroushalmi S, Bartholomew E, Hakimi M, Gensler LS, Bhutani T, Liao W. The association of psoriasis with rheumatic diseases: A national cross-sectional study. J Am Acad Dermatol 2023; 89:1259-1261. [PMID: 37549791 DOI: 10.1016/j.jaad.2023.07.1021] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 05/23/2023] [Accepted: 07/17/2023] [Indexed: 08/09/2023]
Affiliation(s)
- Mimi Chung
- Department of Dermatology, University of California, San Francisco, California.
| | - Jared Liu
- Department of Dermatology, University of California, San Francisco, California
| | - Samuel Yeroushalmi
- Department of Dermatology, University of California, San Francisco, California
| | - Erin Bartholomew
- Department of Dermatology, University of California, San Francisco, California
| | - Marwa Hakimi
- Department of Dermatology, University of California, San Francisco, California
| | - Lianne S Gensler
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, California
| | - Tina Bhutani
- Department of Dermatology, University of California, San Francisco, California
| | - Wilson Liao
- Department of Dermatology, University of California, San Francisco, California
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Jin JQ, Cronin A, Roberts-Toler C, Yeroushalmi S, Hadeler E, Spencer RK, Elhage KG, Gondo G, Wallace EB, Reddy SM, Han G, Kaffenberger J, Davis MS, Hakimi M, Scher JU, Armstrong AW, Bhutani T, McLean RR, Liao W. Sociodemographic and clinical characteristics associated with multiple biologic failure in psoriasis: A 2015-2022 prospective cohort analysis of the CorEvitas psoriasis registry. J Am Acad Dermatol 2023; 89:974-983. [PMID: 37495173 DOI: 10.1016/j.jaad.2023.06.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/16/2023] [Accepted: 06/20/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Psoriasis patients with poor therapeutic response to multiple biologic agents are not well-characterized. OBJECTIVE To describe the characteristics associated with development of multiple biologic failure (MBF) versus good clinical response (GR) to the first biologic. METHODS This prospective cohort analysis evaluated patients in the multicenter CorEvitas Psoriasis Registry who initiated their first biologic between 2015 and 2020 and were followed for ≥24 months. Multivariable logistic regression identified sociodemographic, clinical, and patient-reported outcomes that differed between MBF (discontinued ≥2 biologics of different classes, each used for ≥90 days, due to inadequate efficacy) and GR (continued use of first biologic for ≥2 years) patients. RESULTS One thousand thirty-nine patients were analyzed (490 GR [47.2%], 65 MBF [6.3%]). Female sex, shorter psoriasis duration, earlier year of biologic initiation, prior nonbiologic systemic therapy use, history of hyperlipidemia, and Medicaid insurance were significantly associated with MBF, though the latter 2 variables exhibited wider confidence intervals, indicating a lower level of support. The first-to-second biologic sequence most observed with MBF was Tumor necrosis factor-α inhibitor to IL-17 inhibitor use. LIMITATIONS Biologic adherence between visits was not evaluated. CONCLUSION Approximately 6% of psoriasis patients met MBF criteria. The results identify characteristics associated with MBF that may distinguish patients warranting more frequent follow-up.
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Affiliation(s)
- Joy Q Jin
- School of Medicine, University of California San Francisco, San Francisco, California; Department of Dermatology, University of California San Francisco, San Francisco, California
| | | | | | - Samuel Yeroushalmi
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Edward Hadeler
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Riley K Spencer
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Kareem G Elhage
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | | | | | - Soumya M Reddy
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, NYU Langone Medical Center, New York, New York
| | - George Han
- Department of Dermatology, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York
| | - Jessica Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Mitchell S Davis
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Marwa Hakimi
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Jose U Scher
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, NYU Langone Medical Center, New York, New York
| | - April W Armstrong
- Department of Dermatology, University of Southern California, Los Angeles, California
| | - Tina Bhutani
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | | | - Wilson Liao
- Department of Dermatology, University of California San Francisco, San Francisco, California.
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7
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Spencer RK, Jin JQ, Elhage KG, Davis MS, Hakimi M, Gondo G, Liao W, Bhutani T. Association Between Poor Sleep and Myocardial Infarction in Patients with Psoriasis: Findings from a Cross-Sectional Study with the National Psoriasis Foundation. Dermatol Ther (Heidelb) 2023; 13:2903-2909. [PMID: 37798556 PMCID: PMC10613158 DOI: 10.1007/s13555-023-01045-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/15/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Poor sleep quality occurs in patients with psoriasis at rates nearly twice that of the general population. Chronic sleep impairment is an independent risk factor for the development of cardiovascular disease. Here, we examine the association between sleep quantity and history of myocardial infarction in patients with psoriasis. METHODS This observational, cross-sectional study utilized data from the 2020 National Psoriasis Foundation Annual Survey. Effect estimates were obtained using a multivariate logistic regression model, which controlled for prespecified covariates. RESULTS Based on data from 1405 individuals with psoriasis, our analysis demonstrated a significant association between sleep quantity and history of myocardial infarction: odds ratio (OR) 0.67 [95% confidence interval (CI) 0.49-0.92], p = 0.012. The association was not significantly influenced by psoriasis severity (OR 1.01, [95% CI 0.99-1.03], p = 0.38), comorbid psoriatic arthritis (OR 1.06, [95% CI 0.48-2.38], p = 0.88), sleep apnea, or other traditional risk factors for myocardial infarction. CONCLUSION Our analyses indicate an association between sleep quantity and history of myocardial infarction in patients with psoriasis. For each hour increase in average nightly sleep, patients with psoriasis have a 33% decrease in the odds of having a history of myocardial infarction. The chief limitation of this study is its cross-sectional design limiting ascertainment of causality.
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Affiliation(s)
- Riley K Spencer
- Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA.
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA.
| | - Joy Q Jin
- Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Kareem G Elhage
- Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Mitchell S Davis
- Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Marwa Hakimi
- Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - George Gondo
- National Psoriasis Foundation, Portland, OR, USA
| | - Wilson Liao
- Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Tina Bhutani
- Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
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8
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Bartholomew E, Chung BY, Davis M, Yeroushalmi S, Chung M, Hakimi M, Bhutani T, Liao W. Rapid Remission of Sunburn-Induced Guttate Psoriasis with Guselkumab. Dermatol Ther (Heidelb) 2023; 13:2473-2478. [PMID: 37676470 PMCID: PMC10539232 DOI: 10.1007/s13555-023-01013-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/11/2023] [Indexed: 09/08/2023] Open
Abstract
Guselkumab is an anti-interleukin-23 monoclonal antibody that is approved for plaque psoriasis and psoriatic arthritis. We present a case of a 28-year-old female patient with acute onset of guttate psoriasis after a blistering sunburn. She had no personal or family history of psoriasis or chronic inflammatory skin disease. The guttate psoriasis was refractory to topical treatment. After the first dose of guselkumab (100 mg subcutaneous injection), the patient experienced near-clearance of her guttate psoriasis, with continued improvement and drug-free remission 8 months after cessation of treatment. Dermatologists could consider guselkumab as a treatment option for patients with guttate psoriasis. Future studies should examine the potential for guselkumab to induce drug-free remissions in guttate psoriasis.
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Affiliation(s)
- Erin Bartholomew
- Department of Dermatology, The University of California, San Francisco (UCSF), 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA
| | - Bo-Young Chung
- Department of Dermatology, The University of California, San Francisco (UCSF), 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Republic of Korea
| | - Mitchell Davis
- Department of Dermatology, The University of California, San Francisco (UCSF), 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA
| | - Samuel Yeroushalmi
- Department of Dermatology, The University of California, San Francisco (UCSF), 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA
| | - Mimi Chung
- Department of Dermatology, The University of California, San Francisco (UCSF), 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA
| | - Marwa Hakimi
- Department of Dermatology, The University of California, San Francisco (UCSF), 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA
| | - Tina Bhutani
- Department of Dermatology, The University of California, San Francisco (UCSF), 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA
| | - Wilson Liao
- Department of Dermatology, The University of California, San Francisco (UCSF), 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA.
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Jin JQ, Hong J, Elhage KG, Braun M, Spencer RK, Chung M, Yeroushalmi S, Hadeler E, Mosca M, Bartholomew E, Hakimi M, Davis MS, Thibodeaux Q, Wu D, Kahlon A, Dhaliwal P, Mathes EF, Dhaliwal N, Bhutani T, Liao W. Development of SkinTracker, an integrated dermatology mobile app and web portal enabling remote clinical research studies. Front Digit Health 2023; 5:1228503. [PMID: 37744686 PMCID: PMC10516539 DOI: 10.3389/fdgth.2023.1228503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/25/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction In-person dermatology clinical research studies often face recruitment and participation challenges due to travel-, time-, and cost-associated barriers. Studies incorporating virtual/asynchronous formats can potentially enhance research subject participation and satisfaction, but few mobile health tools are available to enable remote study conduct. We developed SkinTracker, a patient-facing mobile app and researcher-facing web platform, that enables longitudinal collection of skin photos, patient reported outcomes, and biometric health and environmental data. Methods Eight design thinking sessions including dermatologists, clinical research staff, software engineers, and graphic designers were held to create the components of SkinTracker. Following iterative prototyping, SkinTracker was piloted across six adult and four pediatric subjects with atopic dermatitis (AD) of varying severity levels to test and provide feedback on SkinTracker for six months. Results The SkinTracker app enables collection of informed consent for study participation, baseline medical history, standardized skin photographs, patient-reported outcomes (e.g., Patient Oriented Eczema Measure (POEM), Pruritus Numerical Rating Scale (NRS), Dermatology Life Quality Index (DLQI)), medication use, adverse events, voice diary to document qualitative experiences, chat function for communication with research team, environmental and biometric data such as exercise and sleep metrics through integration with an Apple Watch. The researcher web portal allows for management and visualization of subject enrollment, skin photographs for examination and severity scoring, survey completion, and other patient modules. The pilot study requested that subjects complete surveys and photographs on a weekly to monthly basis via the SkinTracker app. Afterwards, participants rated their experience in a 7-item user experience survey covering app function, design, and desire for participation in future studies using SkinTracker. Almost all subjects agreed or strongly agreed that SkinTracker enabled more convenient participation in skin research studies compared to an in-person format. Discussion To our knowledge, SkinTracker is one of the first integrated app- and web-based platforms allowing collection and management of data commonly obtained in clinical research studies. SkinTracker enables detailed, frequent capture of data that may better reflect the fluctuating course of conditions such as AD, and can be modularly customized for different skin conditions to improve dermatologic research participation and patient access.
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Affiliation(s)
- Joy Q. Jin
- School of Medicine, University of California, San Francisco, San Francisco, CA, United States
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States
| | - Julie Hong
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States
| | - Kareem G. Elhage
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States
| | - Mitchell Braun
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States
| | - Riley K. Spencer
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States
| | - Mimi Chung
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States
| | - Samuel Yeroushalmi
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States
| | - Edward Hadeler
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States
| | - Megan Mosca
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States
| | - Erin Bartholomew
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States
| | - Marwa Hakimi
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States
| | - Mitchell S. Davis
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States
| | - Quinn Thibodeaux
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States
| | - David Wu
- School of Medicine, University of California, San Francisco, San Francisco, CA, United States
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States
| | | | | | - Erin F. Mathes
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States
| | | | - Tina Bhutani
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States
| | - Wilson Liao
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States
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10
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Jin JQ, Elhage KG, Spencer RK, Davis MS, Hakimi M, Bhutani T, Liao W. Ethnoracial disparities in alopecia areata clinical trials: a cross-sectional study with proposed recommendations. Arch Dermatol Res 2023; 315:2191-2194. [PMID: 37253862 DOI: 10.1007/s00403-023-02651-0] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 04/30/2023] [Accepted: 05/17/2023] [Indexed: 06/01/2023]
Affiliation(s)
- Joy Q Jin
- School of Medicine, University of California at San Francisco, San Francisco, CA, USA.
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA.
| | - Kareem G Elhage
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA
| | - Riley K Spencer
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA
| | - Mitchell S Davis
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA
| | - Marwa Hakimi
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA
| | - Tina Bhutani
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA
| | - Wilson Liao
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA
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Elhage KG, Davis MS, Hakimi M, Spencer RK, Jin JQ, Yeroushalmi S, Chung M, Bartholomew E, Bhutani T, Liao W. Ethnoracial representation in hidradenitis suppurativa clinical trials. Arch Dermatol Res 2023; 315:1793-1796. [PMID: 36509944 DOI: 10.1007/s00403-022-02510-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/16/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is an inflammatory skin disorder characterized by recurring painful and suppurating lesions, with the disease disproportionately affecting black populations in the United States. Ethnoracial representation in clinical trials is vital to ensuring results are generalizable. The purpose of this study is to examine whether ethnic or racial disparities exist in HS clinical trials. METHODS The US National Library of Medicine clinical trials database (clinicaltrials.gov) was queried to identify HS clinical trials. Trials that did not present ethnic or racial data on either the website or publication were not considered. RESULTS A total of 57 HS trials were identified. Of these, 23 trials, containing 2530 patients, included racial or ethnic data (Table 1). White patients made up 76.1% (1435/1886) of the study population, followed by Blacks or African Americans (13.7% (238/1732)), Hispanics or Latinos (7.2% (20/279), Asians (2.6% (26/1016)), American Indians or Alaska Natives (1.3% (14/1051)), and Native Hawaiians or Other Pacific Islanders (0.4% (4/926)). DISCUSSION Our results establish a significant lack of minority ethnoracial representation in HS clinical trials. Since HS prevalence is highest among Blacks or African Americans, it is imperative that future clinical trials are conducted with a larger proportion of this population. Furthermore, clinical trials that did not report racial or ethnic information were conducted in countries with predominantly White populations, which likely skewed the results of this study and caused underreporting of these patients.
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Affiliation(s)
- Kareem G Elhage
- Department of Dermatology, University of California, San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA.
| | - Mitchell S Davis
- Department of Dermatology, University of California, San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Marwa Hakimi
- Department of Dermatology, University of California, San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Riley K Spencer
- Department of Dermatology, University of California, San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Joy Q Jin
- Department of Dermatology, University of California, San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Samuel Yeroushalmi
- Department of Dermatology, University of California, San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Mimi Chung
- Department of Dermatology, University of California, San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Erin Bartholomew
- Department of Dermatology, University of California, San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Tina Bhutani
- Department of Dermatology, University of California, San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Wilson Liao
- Department of Dermatology, University of California, San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
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12
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Spencer RK, Jin JQ, Elhage KG, Davis MS, Hakimi M, Bhutani T, Liao W. Comparative efficacy of biologics and oral agents in palmoplantar psoriasis and palmoplantar pustulosis: A systematic review and network meta-analysis of randomized clinical trials. J Am Acad Dermatol 2023:S0190-9622(23)00746-6. [PMID: 37121476 DOI: 10.1016/j.jaad.2023.04.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/12/2023] [Accepted: 04/16/2023] [Indexed: 05/02/2023]
Affiliation(s)
- Riley K Spencer
- Department of Dermatology, University of California San Francisco, San Francisco, CA; Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ
| | - Joy Q Jin
- Department of Dermatology, University of California San Francisco, San Francisco, CA; School of Medicine, University of California San Francisco, San Francisco, CA
| | - Kareem G Elhage
- Department of Dermatology, University of California San Francisco, San Francisco, CA
| | - Mitchell S Davis
- Department of Dermatology, University of California San Francisco, San Francisco, CA
| | - Marwa Hakimi
- Department of Dermatology, University of California San Francisco, San Francisco, CA
| | - Tina Bhutani
- Department of Dermatology, University of California San Francisco, San Francisco, CA
| | - Wilson Liao
- Department of Dermatology, University of California San Francisco, San Francisco, CA.
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13
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Hakimi M, North JP, Taylor MA, Hailer A, Liu Y, Kim E, Morehead K, Shinkai K, Bhutani T, Cheng JB, Cho RJ. Transcriptomics aids differentiation of IL-23 overactivity in a patient with atypical skin and joint disease. Lancet 2023; 401:1381. [PMID: 37087172 DOI: 10.1016/s0140-6736(23)00455-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 01/30/2023] [Accepted: 02/28/2023] [Indexed: 04/24/2023]
Affiliation(s)
- Marwa Hakimi
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Jeffrey P North
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Mark A Taylor
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Ashley Hailer
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Yale Liu
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Esther Kim
- Division of Plastic and Reconstructive Surgery, University of California, San Francisco, CA, USA
| | - Kerstin Morehead
- Department of Rheumatology, University of California, San Francisco, CA, USA
| | - Kanade Shinkai
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Tina Bhutani
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Jeffrey B Cheng
- Department of Dermatology, University of California, San Francisco, CA, USA; Department of Dermatology, Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Raymond J Cho
- Department of Dermatology, University of California, San Francisco, CA, USA.
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14
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Bang AS, Hakimi M, Tahir P, Bhutani T, Leslie KS. Biologic Therapies in HIV/AIDS Patients with Inflammatory Diseases: A Systematic Review of the Literature. AIDS Patient Care STDS 2023; 37:215-242. [PMID: 37083445 DOI: 10.1089/apc.2022.0197] [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: 04/22/2023] Open
Abstract
Biologic therapies have been increasingly developed and used for the treatment of severe inflammatory diseases. However, the safety and efficacy profile of biologic drugs in patients with HIV is not well established as this patient population is historically excluded from clinical trials. We review the available evidence of biologic use in people with HIV. We conducted a systematic review of the literature up to June 29, 2022 and included studies that treated patients with HIV who have inflammatory disease using biologic drugs. Clinical data regarding safety and efficacy were abstracted into tables. One hundred twelve studies were included, and 179 patients were included in our study. Nearly all classes of biologics drugs had a favorable safety profile with minimal or minor adverse events. Anti-CD-20 inhibitors and TNF-alpha inhibitors were associated with opportunistic infections. Transient increase in HIV viral load was noted with use of some agents such as TNF-alpha inhibitors. The quality of evidence is low, restricted to case reports and retrospective reviews. However, the safety profile of biologics observed in these patients with HIV was overall favorable.
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Affiliation(s)
- Alexander S Bang
- Department of Dermatology, Weill Cornell Medicine, New York, New York, USA
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Dermatology, Stanford Medicine, Redwood City, California, USA
| | - Marwa Hakimi
- Department of Dermatology and University of California San Francisco, San Francisco, California, USA
| | - Peggy Tahir
- UCSF Library, University of California San Francisco, San Francisco, California, USA
| | - Tina Bhutani
- Department of Dermatology and University of California San Francisco, San Francisco, California, USA
| | - Kieron S Leslie
- Department of Dermatology and University of California San Francisco, San Francisco, California, USA
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15
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Chung M, Hakimi M, Yeroushalmi S, Bartholomew E, Bhutani T. Improvement of psoriasis after initiation of antiviral therapy for hepatitis B. Dermatol Online J 2023; 29. [PMID: 37220297 DOI: 10.5070/d329260781] [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: 04/24/2023] [Accepted: 04/24/2023] [Indexed: 05/25/2023] Open
Affiliation(s)
- Mimi Chung
- Department of Dermatology, University of California San Francisco, California, USA
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16
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Spencer RK, Elhage KG, Jin JQ, Davis MS, Hakimi M, Bhutani T, Chang H, Liao W. Living with Psoriasis Vulgaris and Multi-Treatment Failure: A Patient and Dermatologist Perspective. Dermatol Ther (Heidelb) 2023; 13:857-866. [PMID: 36913122 DOI: 10.1007/s13555-023-00907-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 02/15/2023] [Indexed: 03/14/2023] Open
Abstract
Psoriasis vulgaris is a systemic, chronic inflammatory disease affecting 2-3% of the population. Recent advances in the understanding of the pathophysiology of psoriatic disease have facilitated the development of novel therapeutic options with improved safety and efficacy. This article is coauthored by a patient with a lifelong history of psoriasis who experienced multiple treatment failures. He details his diagnosis and treatment experiences, as well as the physical, mental, and social ramifications of his skin condition. He then goes on to elaborate how evolutions in the treatment of psoriatic disease have impacted his life. This case is then discussed from the perspective of a dermatologist specializing in inflammatory skin disorders. We highlight the clinical features of psoriasis, its medical and psychosocial comorbidities, and the current landscape of psoriatic disease treatments.
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Affiliation(s)
- Riley K Spencer
- Department of Dermatology, University of California San Francisco, Floor 04, Room N426, 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA.,Midwestern University, Arizona College of Osteopathic Medicine, Glendale, AZ, USA
| | - Kareem G Elhage
- Department of Dermatology, University of California San Francisco, Floor 04, Room N426, 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA
| | - Joy Q Jin
- Department of Dermatology, University of California San Francisco, Floor 04, Room N426, 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA.,School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Mitchell S Davis
- Department of Dermatology, University of California San Francisco, Floor 04, Room N426, 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA
| | - Marwa Hakimi
- Department of Dermatology, University of California San Francisco, Floor 04, Room N426, 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA
| | - Tina Bhutani
- Department of Dermatology, University of California San Francisco, Floor 04, Room N426, 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA
| | | | - Wilson Liao
- Department of Dermatology, University of California San Francisco, Floor 04, Room N426, 2340 Sutter Street, Box 0808, San Francisco, CA, 94115, USA.
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17
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Spencer RK, Elhage KG, Jin JQ, Davis MS, Hakimi M, Bhutani T, Liao W. Apremilast in Palmoplantar Psoriasis and Palmoplantar Pustulosis: A Systematic Review and Meta-analysis. Dermatol Ther (Heidelb) 2023; 13:437-451. [PMID: 36609960 PMCID: PMC9884725 DOI: 10.1007/s13555-022-00877-w] [Citation(s) in RCA: 3] [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: 10/24/2022] [Accepted: 12/07/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND This review's goals were to investigate apremilast's efficacy versus placebo in palmoplantar psoriasis (PP) and palmoplantar pustulosis (PPP), and apremilast's efficacy versus methotrexate in PP. METHODS A literature search was conducted in PubMed, clinicaltrials.gov, and Embase in July 2022. Publications investigating subjects with PP or PPP, treated with apremilast, which reported palmoplantar-specific outcomes were used. Exclusion criteria included cases of drug-induced PP/PPP, case studies, non-English texts, omission of palmoplantar-specific outcomes, and incomplete publications. Studies were assessed for risk of bias using Cochrane Review Manager application and CASP checklist. Primary endpoints were a 50% improvement of the Palmoplantar Psoriasis/Pustulosis Area and Severity Index (PPPASI 50) and improvement of the Palmoplantar Physician Global Assessment (PPPGA) to 0 or 1 in patients with baseline PPPGA ≥ 3. RESULTS Seventeen original studies including five placebo-controlled randomized clinical trials (RCTs), one phase II clinical trial, two randomized methotrexate comparative trials, six cohort studies, and three case series were analyzed, totaling 1117 participants. Meta-analysis of four placebo-controlled RCTs investigating PP found apremilast treatment to be superior to placebo in achieving a PPPGA of 0/1 (baseline PPPGA of ≥ 3) after 16 weeks of treatment (n = 244; OR = 2.69 [1.39-5.22]). Apremilast was superior to placebo in achieving PPPASI 50 at week 16 in the only placebo-controlled RCT of PPP (78.3 vs. 40.9%) [P = 0.0003]. Apremilast was comparable to methotrexate in achieving PPPASI 50 at week 16 in PP (59.5 vs. 64.3%; n = 84; [P = 0.65]). Non-randomized studies generally showed marked improvement in PPPASI, PPPGA, and DLQI scores following apremilast treatment. DISCUSSION Apremilast treatment in PP and PPP resulted in significant improvement in objective, palmoplantar-specific clinical parameters versus placebo, and comparable efficacy with methotrexate in PP. Limitations in interpreting these results include variations in palmoplantar-specific metrics used and risk of bias of included studies.
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Affiliation(s)
- Riley K Spencer
- Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA.
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, USA.
| | - Kareem G Elhage
- Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Joy Q Jin
- Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Mitchell S Davis
- Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Marwa Hakimi
- Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Tina Bhutani
- Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Wilson Liao
- Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
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18
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Mosca M, Hadeler E, Hong J, Hakimi M, Bhutani T, Liao W. A cross-sectional study of ethnic and racial disparities in pediatric atopic dermatitis clinical trials. J Am Acad Dermatol 2023; 88:453-455. [PMID: 35690166 DOI: 10.1016/j.jaad.2022.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 05/23/2022] [Accepted: 06/02/2022] [Indexed: 01/17/2023]
Affiliation(s)
- Megan Mosca
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, California.
| | - Edward Hadeler
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, California
| | - Julie Hong
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, California
| | - Marwa Hakimi
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, California
| | - Tina Bhutani
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, California
| | - Wilson Liao
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, California
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19
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Jin JQ, Wu D, Spencer R, Elhage KG, Liu J, Davis M, Hakimi M, Kumar S, Huang ZM, Bhutani T, Liao W. Biologic insights from single-cell studies of psoriasis and psoriatic arthritis. Expert Opin Biol Ther 2022; 22:1449-1461. [PMID: 36317702 DOI: 10.1080/14712598.2022.2142465] [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: 11/05/2022]
Abstract
INTRODUCTION Psoriasis (PSO) and psoriatic arthritis (PSA) represent a large burden of global inflammatory disease, but sustained treatment response and early diagnosis remain challenging. Both conditions arise from complex immune cell dysregulation. Single-cell techniques, including single-cell RNA sequencing (scRNA-seq), have revolutionized our understanding of pathogenesis by illuminating heterogeneous cell populations and their interactions. AREAS COVERED We discuss the transcriptional profiles and cellular interactions unique to PSO/PSA affecting T cells, myeloid cells, keratinocytes, innate lymphoid cells, and stromal cells. We also review advances, limitations, and future challenges associated with single-cell studies. EXPERT OPINION Following analyses of 22 single-cell studies, several themes emerged. A small subpopulation of cells can have a large impact on disease pathogenesis. Multiple cell types identified via scRNA-seq play supporting roles in PSO pathogenesis, contrary to the traditional paradigm focusing on IL-23/IL-17 signaling among dendritic cells and T cells. Immune cell states are dynamic, with psoriatic subpopulations aberrantly re-activating and differentiating into inflammatory phenotypes depending on surrounding signaling cues. Comparison of circulating immune cells with resident skin/joint cells has uncovered specific T cell clonotypes associated with the disease. Finally, machine learning models demonstrate great promise in identifying biomarkers to diagnose clinically ambiguous rashes and PSA at earlier stages.
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Affiliation(s)
- Joy Q Jin
- Department of Medicine, UCSF School of Medicine, San Francisco, CA, USA.,Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA
| | - David Wu
- Department of Medicine, UCSF School of Medicine, San Francisco, CA, USA.,Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA
| | - Riley Spencer
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA
| | - Kareem G Elhage
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA
| | - Jared Liu
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA
| | - Mitchell Davis
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA
| | - Marwa Hakimi
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA
| | - Sugandh Kumar
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA
| | - Zhi-Ming Huang
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA
| | - Tina Bhutani
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA
| | - Wilson Liao
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA.,Institute for Human Genetics, University of California at San Francisco, San Francisco, CA, USA
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20
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Hassani H, Khosravi M, Hakimi M. Synthesis of Aldehydes and Ketones via Oxidation of Alcohols with Hydrogen Peroxide in Aqueous Acetonitrile in the Presence of Potassium Heptamolybdate Tetrahydrate Catalyst. Russ J Org Chem 2022. [DOI: 10.1134/s1070428022120181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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21
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Chung M, Yeroushalmi S, Hakimi M, Bartholomew E, Hong J, Hadeler E, Mosca M, Dhaliwal P, Liao W. 35168 SkinTracker: A novel smartphone app enabling remote clinical research in dermatology. J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.848] [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: 10/14/2022]
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22
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Chung M, Yeroushalmi S, Hakimi M, Bartholomew E, Liao W, Bhutani T. A critical review of halobetasol propionate foam (0.05%) as a treatment option for adolescent plaque psoriasis. Expert Rev Clin Immunol 2022; 18:997-1003. [PMID: 35930002 DOI: 10.1080/1744666x.2022.2110071] [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: 11/04/2022]
Abstract
INTRODUCTION Halobetasol propionate foam has been established as an efficacious and easy-to-use topical treatment for adults with plaque psoriasis. Its recent approval in the United States expanded its use to adolescents from ages 12 to 17 years old. AREAS COVERED : We briefly summarize the chemistry of halobetasol and review clinical trials involving halobetasol propionate 0.05% foam to evaluate its efficacy and safety profile with a specific focus on adolescents with plaque psoriasis. EXPERT OPINION Halobetasol propionate 0.05% foam is an effective and cosmetically elegant superpotent topical corticosteroid, with a tolerable safety profile in adolescents. The use of this foam offers another option to address patient-specific needs and preferences, adding to the toolbox of currently available treatments for adolescent psoriasis.
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Affiliation(s)
- Mimi Chung
- Department of Dermatology, University of California, San Francisco
| | | | - Marwa Hakimi
- Department of Dermatology, University of California, San Francisco
| | - Erin Bartholomew
- Department of Dermatology, University of California, San Francisco
| | - Wilson Liao
- Department of Dermatology, University of California, San Francisco
| | - Tina Bhutani
- Department of Dermatology, University of California, San Francisco
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23
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Lynn M, Iftekhar N, Mumby P, Hakimi M, Adam W. A Multidisciplinary Approach to the Treatment of Sexual Dysfunction in Couples. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.05.017] [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: 12/01/2022]
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24
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Yeroushalmi S, Chung M, Bartholomew E, Hakimi M, Koo J. Examining Worldwide Postmarketing Suicides from Biologics Used for Psoriasis with a Focus on Brodalumab: A Cross-sectional Analysis Using the FDA Adverse Event Reporting System (FAERS). JAAD Int 2022; 9:119-121. [PMID: 36248199 PMCID: PMC9563208 DOI: 10.1016/j.jdin.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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25
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Yeroushalmi S, Hakimi M, Chung M, Bartholomew E, Bhutani T, Liao W. Psoriasis and Exercise: A Review. Psoriasis (Auckl) 2022; 12:189-197. [PMID: 35813078 PMCID: PMC9258800 DOI: 10.2147/ptt.s349791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/11/2022] [Indexed: 12/20/2022] Open
Abstract
Psoriasis is a prevalent inflammatory skin disorder that is associated with a number of comorbidities including cardiovascular disease and metabolic syndrome. Exercise can influence the outcomes of chronic inflammatory diseases, and the presence of these diseases can also influence physical activity in afflicted patients. We reviewed the available literature published on exercise in psoriasis patients and aimed to explore physical activity levels, barriers to exercise, physical fitness, exercise as a prevention strategy as well as a treatment modality. Overall, patients with moderate to severe psoriasis are more sedentary than the general population and experience barriers to exercise secondary to their skin disease. Moderate to vigorous exercise may be an independent preventative factor in reducing the incident risk of developing psoriasis and the utilization of exercise as a weight loss strategy may improve disease severity especially in overweight patients. Expert panels agree that exercise can be beneficial as an adjunct treatment in patients with psoriasis who are overweight; however, more randomized clinical trials are needed to establish these links.
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Affiliation(s)
- Samuel Yeroushalmi
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Marwa Hakimi
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Mimi Chung
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Erin Bartholomew
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Tina Bhutani
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Wilson Liao
- Department of Dermatology, University of California, San Francisco, CA, USA
- Correspondence: Wilson Liao, Email
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26
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Chung M, Bartholomew E, Yeroushalmi S, Hakimi M, Bhutani T, Liao W. Dietary Intervention and Supplements in the Management of Psoriasis: Current Perspectives. Psoriasis (Auckl) 2022; 12:151-176. [PMID: 35769285 PMCID: PMC9234314 DOI: 10.2147/ptt.s328581] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/08/2022] [Indexed: 11/27/2022] Open
Abstract
Nutrition is a complex topic encompassing diet and a variety of supplements including vitamins, fish oil, herbal products, and probiotics. Patients with psoriasis display high interest in understanding the potential impact of nutritional modifications on their psoriasis. In this review, we examine the evidence for nutritional interventions in psoriasis and summarize important concepts. We found that certain diets, such as low-calorie diets for obese patients, gluten-free diets for patients with comorbid celiac disease, and the Mediterranean diet, may have benefits for psoriasis patients. Supplements in general do not show strong evidence of benefit, though more studies are required given the heterogeneity of these trials. Finally, the gut microbiome has drawn considerable interest in recent years, with specific probiotics showing promising results for psoriasis patients and warranting further exploration.
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Affiliation(s)
- Mimi Chung
- The University of California, San Francisco, Department of Dermatology, San Francisco, CA, USA
- Correspondence: Mimi Chung, 515 Spruce Street, San Francisco, CA, 94118, USA, Tel +415-944-7618, Email
| | - Erin Bartholomew
- The University of California, San Francisco, Department of Dermatology, San Francisco, CA, USA
| | - Samuel Yeroushalmi
- The University of California, San Francisco, Department of Dermatology, San Francisco, CA, USA
| | - Marwa Hakimi
- The University of California, San Francisco, Department of Dermatology, San Francisco, CA, USA
| | - Tina Bhutani
- The University of California, San Francisco, Department of Dermatology, San Francisco, CA, USA
| | - Wilson Liao
- The University of California, San Francisco, Department of Dermatology, San Francisco, CA, USA
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Liu J, Kumar S, Hong J, Huang ZM, Paez D, Castillo M, Calvo M, Chang HW, Cummins DD, Chung M, Yeroushalmi S, Bartholomew E, Hakimi M, Ye CJ, Bhutani T, Matloubian M, Gensler LS, Liao W. Combined Single Cell Transcriptome and Surface Epitope Profiling Identifies Potential Biomarkers of Psoriatic Arthritis and Facilitates Diagnosis via Machine Learning. Front Immunol 2022; 13:835760. [PMID: 35309349 PMCID: PMC8924042 DOI: 10.3389/fimmu.2022.835760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
Early diagnosis of psoriatic arthritis (PSA) is important for successful therapeutic intervention but currently remains challenging due, in part, to the scarcity of non-invasive biomarkers. In this study, we performed single cell profiling of transcriptome and cell surface protein expression to compare the peripheral blood immunocyte populations of individuals with PSA, individuals with cutaneous psoriasis (PSO) alone, and healthy individuals. We identified genes and proteins differentially expressed between PSA, PSO, and healthy subjects across 30 immune cell types and observed that some cell types, as well as specific phenotypic subsets of cells, differed in abundance between these cohorts. Cell type-specific gene and protein expression differences between PSA, PSO, and healthy groups, along with 200 previously published genetic risk factors for PSA, were further used to perform machine learning classification, with the best models achieving AUROC ≥ 0.87 when either classifying subjects among the three groups or specifically distinguishing PSA from PSO. Our findings thus expand the repertoire of gene, protein, and cellular biomarkers relevant to PSA and demonstrate the utility of machine learning-based diagnostics for this disease.
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Affiliation(s)
- Jared Liu
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, United States
| | - Sugandh Kumar
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, United States
| | - Julie Hong
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, United States
| | - Zhi-Ming Huang
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, United States
| | - Diana Paez
- Division of Rheumatology, Department of Medicine, University of California at San Francisco, San Francisco, CA, United States
| | - Maria Castillo
- Division of Rheumatology, Department of Medicine, University of California at San Francisco, San Francisco, CA, United States
| | - Maria Calvo
- Division of Rheumatology, Department of Medicine, University of California at San Francisco, San Francisco, CA, United States
| | - Hsin-Wen Chang
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, United States
| | - Daniel D. Cummins
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, United States
| | - Mimi Chung
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, United States
| | - Samuel Yeroushalmi
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, United States
| | - Erin Bartholomew
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, United States
| | - Marwa Hakimi
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, United States
| | - Chun Jimmie Ye
- Division of Rheumatology, Department of Medicine, University of California at San Francisco, San Francisco, CA, United States
- Institute for Human Genetics, University of California at San Francisco, San Francisco, CA, United States
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, United States
- Institute of Computational Health Sciences, University of California at San Francisco, San Francisco, CA, United States
- Parker Institute for Cancer Immunotherapy, San Francisco, CA, United States
- Chan Zuckerberg Biohub, San Francisco, CA, United States
| | - Tina Bhutani
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, United States
| | - Mehrdad Matloubian
- Division of Rheumatology, Department of Medicine, University of California at San Francisco, San Francisco, CA, United States
- Rosalind Russell/Ephraim P Engleman Rheumatology Research Center, University of California at San Francisco, San Francisco, CA, United States
| | - Lianne S. Gensler
- Division of Rheumatology, Department of Medicine, University of California at San Francisco, San Francisco, CA, United States
| | - Wilson Liao
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, United States
- Institute for Human Genetics, University of California at San Francisco, San Francisco, CA, United States
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Mosca M, Hong J, Hadeler E, Hakimi M, Liao W, Bhutani T. The Role of IL-17 Cytokines in Psoriasis. Immunotargets Ther 2021; 10:409-418. [PMID: 34853779 PMCID: PMC8627853 DOI: 10.2147/itt.s240891] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/22/2021] [Indexed: 12/18/2022] Open
Abstract
Psoriasis is a chronic inflammatory skin condition associated with immune dysregulation. The immunologic cascade mediated by the interleukin (IL)-17 pathway plays a critically important role in the pathogenesis of psoriasis. The IL-17 effectors (IL-17A, IL-17C, IL-17E, and IL17F) act on keratinocytes, endothelial cells, and immune cells to stimulate epidermal hyperplasia and the pro-inflammatory feed-forward cycle seen within plaque psoriasis. The IL-17 pathway is also hypothesized to modulate the inflammatory responses linking comorbid systemic diseases with psoriasis. Furthermore, the robust clinical response seen with current and emerging therapies targeting IL-17 emphasizes the importance of the IL-17 cytokines in the pathogenesis of psoriasis.
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Affiliation(s)
- Megan Mosca
- Psoriasis and Skin Treatment Center, Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Julie Hong
- Psoriasis and Skin Treatment Center, Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Edward Hadeler
- Psoriasis and Skin Treatment Center, Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Marwa Hakimi
- Psoriasis and Skin Treatment Center, Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Wilson Liao
- Psoriasis and Skin Treatment Center, Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Tina Bhutani
- Psoriasis and Skin Treatment Center, Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
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Burkart P, Bossard M, Moccetti F, Hess S, Jeyarasa M, Madanchi M, Cioffi G, Seiler T, Wolfrum M, Hakimi M, Seelos R, Toggweiler S, Attinger-Toller A, Kobza R, Cuculi F. Utility and safety of the MANTA device for access site closure after removal of the mechanical hemodynamic support device Impella on the intensive care unit. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The percutaneously implanted hemodynamic mechanical support devices Impella are commonly used in patients at risk for or with cardiogenic shock (CS). Impella removal after hemodynamic stabilization on the intensive care unit (ICU) remains a major challenge and is prone to high rates of bleeding and vascular complications.
Purpose
It is unknown if the use of the novel large-bore access closure device MANTA® is safe and facilitates access management compared to manual compression.
Methods
Between January 2017 and December 2020, 172 CS patients were treated with an Impella® device at our centre. Of those, in 89 patients the Impella® was removed on the ICU and access site management occurred with either MANTA® device or manual compression. The criteria for MANTA® 14 french device deployment included: (i) femoral artery Diameter >6mm and (ii) absence of significant peripheral arterial disease (PAD). Bleeding and vascular access site complications were assessed and adjudicated according to the Valve Academic Research Consortium-2 (VARC-2) criteria.
Results
Among the 89 included patients, Impella® removal was performed using the MANTA® device in 31 cases and manual compression in 58 cases. Mean age was 66±11 years, and 50 (56.2%) patients had a CS classified as Society for Cardiovascular Angiography and Interventions (SCAI) D or higher due to myocardial infarction. Median support time was 40 (IQR 24; 69) hours. Baseline characteristics are displayed in Table 1. Immediate haemostasis was more frequently achieved by MANTA® device compared to manual compression (p=0.034). Moreover, we observed significantly less overall (2 (6.5%) vs. 22 (37.9%), p=0.001) and minor bleedings (1 (3.2%) vs. 15 (25.9%), p=0.006) with the MANTA® device when compared to manual compression. Of note, there were no significant differences in vascular complications between the two groups (Table 2).
Conclusions
In patients requiring Impella® support and residing on ICU, the MANTA® device, compared to standard of care manual compression, seems to be a safe and effective option for access site management, especially with regards to the reduction of bleeding events. However, physicians should carefully assess the vascular anatomy and degree of calcification prior to deployment of the MANTA® device. Nevertheless, more prospective data is necessary for evaluating the optimal access closure among CS patients treated with a percutaneously implanted Impella® device.
Funding Acknowledgement
Type of funding sources: None. Table 1. Baseline demographicsTable 2. Outcomes
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Affiliation(s)
- P Burkart
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | - M Bossard
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | - F Moccetti
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | - S Hess
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | - M Jeyarasa
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | - M Madanchi
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | - G Cioffi
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | - T Seiler
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | - M Wolfrum
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | - M Hakimi
- Luzerner Kantonsspital, Vascular surgery, Luzern, Switzerland
| | - R Seelos
- Luzerner Kantonsspital, Vascular surgery, Luzern, Switzerland
| | - S Toggweiler
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | | | - R Kobza
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | - F Cuculi
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
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Mosca M, Hong J, Hadeler E, Hakimi M, Brownstone N, Bhutani T, Liao W. A cross-sectional study of ethnoracial representation in pediatric plaque psoriasis clinical trials. J Am Acad Dermatol 2021; 86:442-444. [PMID: 34624415 DOI: 10.1016/j.jaad.2021.09.060] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/05/2021] [Accepted: 09/24/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Megan Mosca
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, California.
| | - Julie Hong
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, California
| | - Edward Hadeler
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, California
| | - Marwa Hakimi
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, California
| | - Nicholas Brownstone
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, California
| | - Tina Bhutani
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, California
| | - Wilson Liao
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, California
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Hadeler E, Hong J, Mosca M, Hakimi M, Brownstone N, Bhutani T, Liao W. Perspectives on the Future Development of Mobile Applications for Dermatology Clinical Research. Dermatol Ther (Heidelb) 2021; 11:1451-1456. [PMID: 34491532 PMCID: PMC8422374 DOI: 10.1007/s13555-021-00604-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Indexed: 12/17/2022] Open
Abstract
The COVID-19 pandemic significantly impacted clinical research in dermatology and practices around the country transitioned to teledermatology amid physical distancing requirements. Despite their growing use in teledermatology and clinical care, dermatology applications have not been studied extensively in the research space. The use of mobile applications has the potential to improve the experience of study subjects and physicians and increase the pool of individuals willing to participate in research beyond the pandemic. We discuss the various pros and cons of mobile apps, as well as the necessary components they require to successfully conduct research.
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Affiliation(s)
- Edward Hadeler
- Department of Dermatology, University of California, San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA.
| | - Julie Hong
- Department of Dermatology, University of California, San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Megan Mosca
- Department of Dermatology, University of California, San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Marwa Hakimi
- Department of Dermatology, University of California, San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Nicholas Brownstone
- Department of Dermatology, University of California, San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Tina Bhutani
- Department of Dermatology, University of California, San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Wilson Liao
- Department of Dermatology, University of California, San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
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32
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Mosca M, Hong J, Hadeler E, Hakimi M, Brownstone N, Liao W, Bhutani T. Psoriasis and Cardiometabolic Comorbidities: An Evaluation of the Impact of Systemic Treatments in Randomized Clinical Trials. Dermatol Ther (Heidelb) 2021; 11:1497-1520. [PMID: 34505985 PMCID: PMC8484473 DOI: 10.1007/s13555-021-00590-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/06/2021] [Indexed: 02/07/2023] Open
Abstract
The association between psoriasis, metabolic syndrome, and cardiovascular disease is well established. The shared pathways between psoriasis, metabolic syndrome, and atherosclerosis suggest that treatments targeting the inflammatory pathways of psoriasis may also be beneficial in the treatment of associated cardiometabolic comorbidities. This paper reviews the most recent data regarding the impact of systemic psoriasis treatments on comorbid cardiovascular and metabolic disease. Data from randomized clinical trials with systemic and biologic agents are presented. Overall, studies demonstrate beneficial effects on several cardiometabolic markers and risk factors in psoriasis patients; however, longer randomized controlled trials to characterize the direct benefit for cardiovascular outcomes are needed.
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Affiliation(s)
- Megan Mosca
- Department of Dermatology, University of California San Francisco, Psoriasis and Skin Treatment Center, 515 Spruce Street, San Francisco, CA, 94118, USA.
| | - Julie Hong
- Department of Dermatology, University of California San Francisco, Psoriasis and Skin Treatment Center, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Edward Hadeler
- Department of Dermatology, University of California San Francisco, Psoriasis and Skin Treatment Center, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Marwa Hakimi
- Department of Dermatology, University of California San Francisco, Psoriasis and Skin Treatment Center, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Nicholas Brownstone
- Department of Dermatology, University of California San Francisco, Psoriasis and Skin Treatment Center, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Wilson Liao
- Department of Dermatology, University of California San Francisco, Psoriasis and Skin Treatment Center, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Tina Bhutani
- Department of Dermatology, University of California San Francisco, Psoriasis and Skin Treatment Center, 515 Spruce Street, San Francisco, CA, 94118, USA
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Iftekhar N, Lynn M, Hakimi M, Wuest M, Walsh S, Mumby P. 080 Patient Reported Satisfaction Rating After Attending a Multidisciplinary Psychoeducational Sexual Wellness Program. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.316] [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: 10/23/2022]
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Laun R, Tanner S, Grassmann JP, Schneppendahl J, Wild M, Hakimi M, Windolf J, Jungbluth P. Primary cemented bipolar radial head prostheses for acute elbow injuries with comminuted radial head fractures: mid-term results of 37 patients. Musculoskelet Surg 2019; 103:91-97. [PMID: 30515741 DOI: 10.1007/s12306-018-0576-2] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 11/30/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Radial head arthroplasty represents a widely accepted treatment for elbow injuries with non-reconstructible radial head fractures. The aim of this retrospective multicenter study was to assess mid-term results of patients with clearly defined elbow injuries including type III fractures of the radial head according to Mason's classification type III after primary arthroplasty using a cemented bipolar design. MATERIALS AND METHODS In 45 cases a primary cemented bipolar arthroplasty of the radial head was implanted for elbow injuries combined with an acute Mason type III radial head fracture. In all patients associated fractures were detected with preoperative CT scans and ligamentous injuries were evaluated and both were addressed intraoperatively based on a standardized algorithm. Patients with associated injuries other than coronoid fractures and collateral ligament tears were excluded from this study to obtain a more homogenous sample. Clinical and radiological assessment was performed on thirty-seven patients at an average of 5.6 years postoperatively. RESULTS DASH Score, functional rating index of Broberg and Morrey, Mayo Elbow Performance Score, and Mayo Modified Wrist Score confirmed good-to-excellent results in most of the patients. Compared to the unaffected arm range of motion and grip strength were slightly reduced. No elbow instability or loosening of the prosthesis, and minor degenerative changes were detected in a few cases. CONCLUSION Primary cemented bipolar arthroplasty for type III fractures according to Mason's classification in an elbow injury pattern only including associated coronoid fractures and/or ligamentous tears resulted in good-to-excellent mid-term results. These results suggest that primary bipolar radial head arthroplasty combined with distinct treatment of all associated injuries provides good functional outcomes concerning range of motion, elbow stability, and strength in this cohort. However, the associated injuries may influence clinical and radiological outcome and need to be detected, classified, and treated carefully.
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Affiliation(s)
- R Laun
- Department of Trauma, Orthopedics and Handsurgery, Vivantes Klinikum Neukölln, Rudower Straße 48, 12351, Berlin, Germany
| | - S Tanner
- Department of Trauma and Handsurgery, Heinrich Heine University Hospital Duesseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
| | - J-P Grassmann
- Department of Trauma and Handsurgery, Heinrich Heine University Hospital Duesseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - J Schneppendahl
- Department of Trauma and Handsurgery, Heinrich Heine University Hospital Duesseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - M Wild
- Department of Trauma, Orthopedics and Handsurgery, Klinikum Darmstadt, Grafenstr. 9, 64283, Darmstadt, Germany
| | - M Hakimi
- Department of Trauma, Orthopedics and Handsurgery, Vivantes Klinikum Am Urban, Dieffenbachstraße 1, 10967, Berlin, Germany
| | - J Windolf
- Department of Trauma and Handsurgery, Heinrich Heine University Hospital Duesseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - P Jungbluth
- Department of Trauma and Handsurgery, Heinrich Heine University Hospital Duesseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
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Abstract
Aims The aim of this retrospective multicentre study was to evaluate mid-term results of the operative treatment of Monteggia-like lesions and to determine the prognostic factors that influence the clinical and radiological outcome. Patients and Methods A total of 46 patients (27 women and 19 men), with a mean age of 57.7 years (18 to 84) who had sustained a Monteggia-like lesion were followed up clinically and radiologically after surgical treatment. The Mayo Modified Wrist Score (MMWS), Mayo Elbow Performance Score (MEPS), Broberg and Morrey Score, and Disabilities of the Arm, Shoulder and Hand (DASH) score were used for evaluation at a mean of 65 months (27 to 111) postoperatively. All ulnar fractures were stabilized using a proximally contoured or precontoured locking compression plate. Mason type I fractures of the radial head were treated conservatively, type II fractures were treated with reconstruction, and type III fractures with arthroplasty. All Morrey type II and III fractures of the coronoid process was stabilized using lag screws. Results Good results were found for the MMWS, with a mean of 88.4 (40 to 100). There were 29 excellent results (63%), nine good (20%), seven satisfactory (15%), and one poor (2%). Excellent results were obtained for the MEPS, with a mean of 90.7 (70 to 100): 31 excellent results (68%), 13 good (28%), and two fair (4%). Good results were also found for the functional rating index of Broberg and Morrey, with a mean score of 86.6 (57 to 100). There were 16 excellent results (35%), 22 good (48%), six fair (13%), and two poor (4%). The mean DASH score was 15.1 (0 to 55.8). Two patients had delayed wound healing; four patients had nonunion requiring bone grafting. One patient had asymptomatic loosening of the radial head prosthesis. Conclusion Monteggia-like lesions are rare. With correct identification, classification, and understanding using CT scans followed by appropriate surgical treatment that addresses all components of the injury, good to excellent mid-term results can be achieved. Cite this article: Bone Joint J 2018;100-B:212–18.
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Affiliation(s)
- P. Jungbluth
- Heinrich Heine University Hospital Düsseldorf, Moorenstr.
5, 40225 Düsseldorf, Germany
| | - S. Tanner
- Heinrich Heine University Hospital Düsseldorf, Moorenstr.
5, 40225 Düsseldorf, Germany
| | - J. Schneppendahl
- Heinrich Heine University Hospital Düsseldorf, Moorenstr.
5, 40225 Düsseldorf, Germany
| | - J-P. Grassmann
- Heinrich Heine University Hospital Düsseldorf, Moorenstr.
5, 40225 Düsseldorf, Germany
| | - M. Wild
- Klinikum Darmstadt, Grafenstr.
9, 64283 Darmstadt, Germany
| | - M. Hakimi
- Vivantes Klinikum Am Urban, Dieffenbachstraße
1, 10967 Berlin, Germany
| | - J. Windolf
- Heinrich Heine University Hospital Düsseldorf, Moorenstr.
5, 40225 Düsseldorf, Germany
| | - R. Laun
- Vivantes Klinikum Neukölln, Rudower
Straße 48, 12351 Berlin, Germany
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Naseem H, Chatterji S, Tsang K, Hakimi M, Chytas A, Alshryda S. Treatment of stable slipped capital femoral epiphysis: systematic review and exploratory patient level analysis. J Orthop Traumatol 2017; 18:379-394. [PMID: 28831651 PMCID: PMC5685987 DOI: 10.1007/s10195-017-0469-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 07/13/2017] [Indexed: 01/29/2023] Open
Abstract
Background Several aspects of slipped capital femoral epiphysis (SCFE) treatment remain controversial. Loder’s work has been instrumental in changing our understanding and approach to the management of the condition when he introduced the concept of “slip instability” and showed that avascular necrosis (AVN) developed in 47% of unstable slips but none of the stable slips. As the two types of SCFE behave differently in terms of presentation, progress and complications, we approached them as two different conditions to highlight these differences. This paper focuses on treatments of stable SCFE. Materials and methods An extensive literature search was carried out from multiple databases. One thousand six hundred and twenty-three citations were screened. Three hundred and sixteen full publications were obtained for further scrutiny. Fifty-eight studies (2262 hips) were included in the review. These studies evaluated 6 interventions. AVN was chosen as a surrogate for bad outcome. Secondary outcomes were chondrolysis (CL), femoro-acetabular impingement (FAI), osteoarthritis (OA) and patients’ reported outcomes. The latter were pooled when they met our predefined criteria. Results The type of surgical intervention was an important risk factor. Pinning in situ (PIS) was associated with the lowest AVN rate (1.4%). Moreover, the CL, FAI and OA rates were relatively low in patients who underwent PIS. These were not translated into high patient satisfaction rates among these patients, with only 47% reporting an “excellent” outcome. In contrast, 87% of patients who underwent Ganz surgical dislocation reported an “excellent” outcome. The Ganz surgical dislocation was associated with an AVN rate of 3.3%; double that observed in pinning in situ. Conclusion Pinning in situ is the best treatment for mild and moderate stable slip. Ganz surgical dislocation gives higher patient satisfaction for severe stable slip but the risk of AVN is doubled compared with pinning in situ. Devices that allow continued growth may be better than standard screws. Level of evidence Level III.
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Affiliation(s)
- H Naseem
- Royal Manchester Children's Hospital, Central Manchester Hospitals Foundation Trust, Oxford Road, Manchester, UK
| | - S Chatterji
- Royal Manchester Children's Hospital, Central Manchester Hospitals Foundation Trust, Oxford Road, Manchester, UK
| | - K Tsang
- University Hospitals of North Midlands, Royal Stoke Hospital, Stoke-on-Trent, UK
| | - M Hakimi
- Royal Manchester Children's Hospital, Central Manchester Hospitals Foundation Trust, Oxford Road, Manchester, UK
| | - A Chytas
- Royal Manchester Children's Hospital, Central Manchester Hospitals Foundation Trust, Oxford Road, Manchester, UK
| | - S Alshryda
- Royal Manchester Children's Hospital, Central Manchester Hospitals Foundation Trust, Oxford Road, Manchester, UK.
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Wiryo H, Hakimi M, Wahab AS, Soeparto P. Association between early feeding of banana (Musa paradisiaca) and vomiting or abdominal distention in neonates. PI 2016. [DOI: 10.14238/pi44.2.2004.41-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective To assess the relationship between banana given asearly solid food feeding and symptoms of intestinal obstruction (SIO)such as vomiting and abdominal distention among neonates.Methods A longitudinal cohort study was done in 1993 at a ruralcommunity of West Lombok District on Lombok Island, West NusaTenggara Province, Indonesia. There were 3420 neonates whowere followed up by interviewing their mothers until 28 days afterdelivery. The main outcome measure was the occurrence of SIO.Results Compared to infants who were not given solid food, therelative risk (RR) of SIO for infants given food other than bananaas early solid food feeding was 1.87 (95%CI 0.48;8.24), while forinfants given banana only as early solid food feeding, the RR was9.15 (95%CI 1.96;42.58). After the adjustments of birth weight, co-lostrum, and breast feeding, the odds ratio of SIO for infants givenbanana was 2.99 (95%CI 2.65;5.14).Conclusion Banana as early solid food for neonates feeding isan important risk factor for the occurrence of SIO
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Wiryo H, Hakimi M, Wahab AS, Soeparto P. Association between the absence of colostrum feeding and symptoms of intestinal obstruction or neonatal necrotizing enterocolitis. PI 2016. [DOI: 10.14238/pi44.1.2004.7-11] [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: 12/01/2022] Open
Abstract
Objective To assess the relationship between withholding colos-trum and symptoms of intestinal obstruction (SIO) or neonatal ne-crotizing enterocolitis (NNEC).Methods This was a longitudinal cohort study in four subdistrictsin West Lombok involving mothers and live newborns. Motherswere interviewed about prenatal care, delivery process, and prac-tice of colostrum feedings. Neonates were followed everyday for28 days by field assistants for signs of intestinal obstruction orNNEC. We used X 2 test to analyze the association between theabsence of colostrum feeding and the occurence of SIO and stu-dent t test to compare the average of colostrum feeding betweenthe SIO and the non-SIO group.Results 3420 live newborns between 1993-1994 were observed.1900 mothers gave colostrum while 1520 did not. The incidence ofSIO was 1.8%. There was a significant association between theabsence of colostrum feeding and the occurence of the SIO (RR1.816; 95%CI 1.08-3.06; p=0.028). No infants with NNEC weregiven colostrum.Conclusion The absence of colostrum feeding is an importantrisk factor for the occurence of SIO and NNEC in neonates
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Lestari ED, Hartini TNS, Hakimi M, Surjono A. Nutritional status and nutrient intake from complementary foods among breastfed children in Purworejo District, Central Java, Indonesia. PI 2016. [DOI: 10.14238/pi45.1.2005.31-9] [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: 12/01/2022] Open
Abstract
Background The growth rate of Indonesian infants beyond sixmonths of age declines compared with that of the internationalreference population.Objective This study aimed to describe the pattern of nutritionalstatus among breastfed children and their intake of energy, pro-tein, and zinc from complementary foods in Purworejo District, Cen-tral Java, Indonesia.Methods The study was a cross sectional survey drawing breastfedchildren under 24 months old from a well-defined population. Chil-dren with a history of prematurity or low birth weight were excluded.Anthropometrical measurements were collected. Intake of comple-mentary food was assessed using 24-hour recall. Analysis of nu-tritional intake was only performed in 11-23 month-old children.Results Of 577 children enrolled, the prevalence of underweight,stunting, and wasting were 8.1%, 8.8%, and 4.6%, respectively.The prevalence of undernutrition increased with age. There wasno association between frequency of breastfeeding during 24 hoursin the second year of life and the nutritional status. The averageintake of energy, protein, and zinc from complementary foods wasvery low i.e., 30%, 45%, and 5% of the Indonesian recommendeddietary allowance (RDA), respectively.Conclusion The prevalence of undernutrition in breastfed chil-dren increases with age. The breastfed children beyond 11 monthsof age in Purworejo District need sufficient density of nutrients fromcomplementary foods.
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Ramzi R, Soenarto Y, Sunartini S, Hakimi M. Prognostic factors of refractory epilepsy in children. PI 2016. [DOI: 10.14238/pi48.5.2008.269-73] [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: 12/01/2022] Open
Abstract
Background Epilepsy is one of the most common pediatricneurological disorders. Twenty percent of patients will developrefractory epilepsy. Early identification of refractory epilepsy willbe helpful to conduct adequate counseling and selecting patientswho need more intensive investigation and treatment.Objective To identify the clinical characteristics and other factorsthat are related to refractory epilepsy in children.Methods We conducted a case control study in patients of two to18 years old with epilepsy that admitted to Dr. Sardjito Hospital.There were 4 7 children with refractory epilepsy compared with122 subjects who have been one year free of seizure.Results Strong association had been noted between refractoryand several clinical factors: early onset of seizure, high initialseizure frequency, neonatal asphyxia, symptomatic etiology, statusepilepticus, abnormal neurodevelopmental status, and earlybreakthrough seizures after treatment initiation. On multivariateanalysis, more than 20 seizures prior to treatment initiation (OR3.40, 95% CI 1.03 to 11.3), and more than three seizures in thesubsequent six month after treatment initiation (OR 16.02, 95%CI 4.98 to 51.5) were independent prognostic factors related torefractory epilepsy.Conclusion Children who present high frequency seizures atonset and more than 3 breakthrough seizures subsequent to sixmonth after treatment have risks of developing refractory epilepsy.
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Wiryo H, Hakimi M. Implementation of Health Education, Based on Ethnographic Study, to Increase the Colostrum and Decrease Early Solid Food Feeding. Health Educ Behav 2016; 32:102-12. [PMID: 15642757 DOI: 10.1177/1090198104269514] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Traditionally, mothers provide banana to their neonates as well as discharge their colostrum prior to breastfeeding, increasing the risk of perinatal morbidity and mortality. Health education modules, based on ethnographic study, to discourage these detrimental practices were developed for use by community leaders. Two thousand six hundred and seventy neonates were followed from birth to 28 days. Overall, neonatal banana feeding decreased 18.3% and colostrum feeding increased 32.8%. Religious leaders, who had strong community influence, had the highest health module execution. Moreover, their influence on the communitywas important. Overall, the use of ethnographic study data to identify specific cues to action of individuals in a community, such as community religious leaders, is an effective and appropriate method for reducing the detrimental customs of both early solid-food feeding of banana and colostrum discharge prior to breast-feeding, positively affecting community perinatal morbidity and mortality.
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Affiliation(s)
- Hananto Wiryo
- Department of Pediatrics, Mataram General Hospital, SMF AnakRSU Mataram, Jl. Pejanggik No. 6, Mataram, Nusa Tenggara Barat, Indonesia.
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Schmitz-Rixen T, Keese M, Hakimi M, Peters A, Böckler D, Nelson K, Grundmann RT. Ruptured abdominal aortic aneurysm—epidemiology, predisposing factors, and biology. Langenbecks Arch Surg 2016; 401:275-88. [DOI: 10.1007/s00423-016-1401-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 03/04/2016] [Indexed: 12/19/2022]
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Sheikholeslami-Vatani D, Siahkouhian M, Hakimi M, Ali-Mohammadi M. The effect of concurrent training order on hormonal responses and body composition in obese men. Sci Sports 2015. [DOI: 10.1016/j.scispo.2015.06.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [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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Dewi FST, Stenlund H, Hakimi M, Weinehall L. AN INCREASE IN RISK FACTORS FOR CARDIOVASCULAR DISEASE IN YOGYAKARTA, INDONESIA: A COMPARISON OF TWO CROSS-SECTIONAL SURVEYS. Southeast Asian J Trop Med Public Health 2015; 46:775-785. [PMID: 26867398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This paper aims to describe changes in risk factors for cardiovascular disease (CVD) over a five year period in urban Indonesia. In 2004 (n = 3,205) and 2009 (n = 2,467) we conducted cross-sectional surveys of residents in Yogjakarta City, Indonesia evaluating risk factors for CVD. Smoking habits, fruit and vegetable intake, physical activity, blood pressure, weight, and height were recorded. The results of these 2 surveys conducted 5 years apart were then compared. The risk for having a CVD event was also calculated. Behavioral CVD risk factors were more common among men. The predicted risk of having a CVD event increased from 8.4% to 11.3% among men between 2004 and 2009. Effective measures need to be taken to change these behaviors among men in Yogyakarta, Indonesia.
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Grassmann JP, Schneppendahl J, Hakimi AR, Herten M, Betsch M, Lögters TT, Thelen S, Sager M, Wild M, Windolf J, Jungbluth P, Hakimi M. Hyperbaric oxygen therapy improves angiogenesis and bone formation in critical sized diaphyseal defects. J Orthop Res 2015; 33:513-20. [PMID: 25640997 DOI: 10.1002/jor.22805] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [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: 03/31/2014] [Accepted: 12/03/2014] [Indexed: 02/04/2023]
Abstract
Besides the use of autologous bone grafting several osteoconductive and osteoinductive methods have been reported to improve bone healing. However, persistent non-union occurs in a considerable number of cases and compromised angiogenesis is suspected to impede bone regeneration. Hyperbaric oxygen therapy (HBO) improves angiogenesis. This study evaluates the effects of HBO on bone defects treated with autologous bone grafting in a bone defect model in rabbits. Twenty-four New-Zealand White Rabbits were subjected to a unilateral critical sized diaphyseal radius bone defect and treated with autologous cancellous bone transplantation. The study groups were exposed to an additional HBO treatment regimen. Bone regeneration was evaluated radiologically and histologically at 3 and 6 weeks, angiogenesis was assessed by immunohistochemistry at three and six weeks. The additional administration of HBO resulted in a significantly increased new bone formation and angiogenesis compared to the sole treatment with autologous bone grafting. These results were apparent after three and six weeks of treatment. The addition of HBO therapy to autologous bone grafts leads to significantly improved bone regeneration. The increase in angiogenesis observed could play a crucial role for the results observed.
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Affiliation(s)
- J P Grassmann
- Heinrich Heine University Hospital D, uesseldorf, Department of Trauma and Hand Surgery, Moorenstrasse 5, D-40225 Duesseldorf, Germany
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Grassmann JP, Schneppendahl J, Sager M, Hakimi AR, Herten M, Loegters TT, Wild M, Hakimi M, Windolf J, Jungbluth P. The effect of bone marrow concentrate and hyperbaric oxygen therapy on bone repair. J Mater Sci Mater Med 2015; 26:5331. [PMID: 25577213 DOI: 10.1007/s10856-014-5331-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 07/27/2014] [Indexed: 06/04/2023]
Abstract
Neoangiogenesis represents an essential part of bone regeneration. Therefore the improvement of neovascularization is the subject of various research approaches. In addition autologous mesenchymal stem cells concentrate in combination with bone substitute materials have been shown to support bone regeneration. In a rabbit model we examined the proposed synergistic effect of hyperbaric oxygen therapy (HBOT) and bone marrow concentrate (BMC) with porous calcium phosphate granules (CPG) on neoangiogenesis and osseous consolidation of a critical- size defect. The animal groups treated with HBOT showed a significantly higher microvessel density (MVD) by immunhistochemistry. Furthermore HBOT groups presented a significantly larger amount of new bone formation histomorphometrically as well as radiologically. We conclude that the increase in perfusion as a result of increased angiogenesis may play a key role in the effects of HBOT and consequently promotes bone healing.
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Affiliation(s)
- J P Grassmann
- Department of Trauma and Handsurgery, Heinrich Heine University Hospital Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
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Gehrmann SV, Kaufmann RA, Grassmann JP, Lögters T, Schädel-Höpfner M, Hakimi M, Windolf J. Fracture-dislocations of the carpometacarpal joints of the ring and little finger. J Hand Surg Eur Vol 2015; 40:84-7. [PMID: 25538072 DOI: 10.1177/1753193414562706] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We report the functional and radiographic results of 16 patients with fracture-dislocations of the ring and little finger carpometacarpal joints and 23 cases with fracture-dislocations of only the little finger carpometacarpal joint treated between 2006 and 2012. The above two cohort populations of patients were treated with either open reduction and pin fixation or closed reduction and pin fixation. These patients were followed for a mean of 13 months (range 9 to 48). The DASH scores for patients with fracture-dislocations of the ring and little finger carpometacarpal joints were 6.0 and of the little finger carpometacarpal joint 7.2. We found no functional differences in term of DASH scores after treatment between patients with fracture-dislocations of only the little finger carpometacarpal joint and both the ring and little finger carpometacarpal joints.
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Affiliation(s)
- S V Gehrmann
- Department of Trauma and Hand Surgery, Heinrich-Heine Universität, Düsseldorf, Germany
| | - R A Kaufmann
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, USA
| | - J P Grassmann
- Department of Trauma and Hand Surgery, Heinrich-Heine Universität, Düsseldorf, Germany
| | - T Lögters
- Department of Trauma and Hand Surgery, Heinrich-Heine Universität, Düsseldorf, Germany
| | - M Schädel-Höpfner
- Department of Trauma and Hand Surgery, Heinrich-Heine Universität, Düsseldorf, Germany
| | - M Hakimi
- Department of Trauma and Hand Surgery, Heinrich-Heine Universität, Düsseldorf, Germany
| | - J Windolf
- Department of Trauma and Hand Surgery, Heinrich-Heine Universität, Düsseldorf, Germany
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Abstract
The Essex-Lopresti injury (ELI) of the forearm is a rare and serious condition which is often overlooked, leading to a poor outcome. The purpose of this retrospective case study was to establish whether early surgery can give good medium-term results. From a group of 295 patients with a fracture of the radial head, 12 patients were diagnosed with ELI on MRI which confirmed injury to the interosseous membrane (IOM) and ligament (IOL). They were treated by reduction and temporary Kirschner (K)-wire stabilisation of the distal radioulnar joint (DRUJ). In addition, eight patients had a radial head replacement, and two a radial head reconstruction. All patients were examined clinically and radiologically 59 months (25 to 90) after surgery when the mean Mayo Modified Wrist Score (MMWS) was 88.4 (78 to 94), the mean Mayo Elbow Performance Scores (MEPS) 86.7 (77 to 95) and the mean disabilities of arm, shoulder and hand (DASH) score 20.5 (16 to 31): all of these indicate a good outcome. In case of a high index of suspicion for ELI in patients with a radial head fracture, we recommend the following: confirmation of IOM and IOL injury with an early MRI scan; early surgery with reduction and temporary K-wire stabilisation of the DRUJ; preservation of the radial head if at all possible or replacement if not, and functional bracing in supination. This will increase the prospect of a good result, and avoid the complications of a missed diagnosis and the difficulties of late treatment.
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Affiliation(s)
- J P Grassmann
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - M Hakimi
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - S V Gehrmann
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - M Betsch
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - P Kröpil
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - M Wild
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - J Windolf
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - P Jungbluth
- University Hospital Duesseldorf, Department of Trauma and Hand surgery, Moorenstrasse 5, Duesseldorf, 40225, Germany
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Böckler D, Peters A, Pfeiffer S, Kovacs B, Geisbüsch P, Bischoff M, Müller-Eschner M, Hakimi M. Nellix® Endovascular Aneurysm Sealing (EVAS) – eine neue Technologie zur endovaskulären Ausschaltung infrarenaler Aortenaneurysmen. Zentralbl Chir 2014. [DOI: 10.1055/s-0034-1383254] [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: 10/24/2022]
Affiliation(s)
- D. Böckler
- Klinik für Gefäßchirurgie und Endovasculäre Chirurgie, Universitätsklinik Heidelberg, Deutschland
| | - A. Peters
- Klinik für Gefäßchirurgie und Endovasculäre Chirurgie, Universitätsklinik Heidelberg, Deutschland
| | - S. Pfeiffer
- Klinik für Gefäßchirurgie und Endovasculäre Chirurgie, Universitätsklinik Heidelberg, Deutschland
| | - B. Kovacs
- Klinik für Gefäßchirurgie und Endovasculäre Chirurgie, Universitätsklinik Heidelberg, Deutschland
| | - P. Geisbüsch
- Klinik für Gefäßchirurgie und Endovasculäre Chirurgie, Universitätsklinik Heidelberg, Deutschland
| | - M. Bischoff
- Klinik für Gefäßchirurgie und Endovasculäre Chirurgie, Universitätsklinik Heidelberg, Deutschland
| | - M. Müller-Eschner
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinik, Heidelberg, Deutschland
| | - M. Hakimi
- Klinik für Gefäßchirurgie und Endovasculäre Chirurgie, Universitätsklinik Heidelberg, Deutschland
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