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Lamidi S, Coe PO, Bordeianou LG, Hart AL, Hind D, Lindsay JO, Lobo AJ, Myrelid P, Raine T, Sebastian S, Fearnhead NS, Lee MJ, Adams K, Almer S, Ananthakrishnan A, Bethune RM, Block M, Brown SR, Cirocco WC, Cooney R, Davies RJ, Atici SD, Dhar A, Din S, Drobne D, Espin‐Basany E, Evans JP, Fleshner PR, Folkesson J, Fraser A, Graf W, Hahnloser D, Hager J, Hancock L, Hanzel J, Hargest R, Hedin CRH, Hill J, Ihle C, Jongen J, Kader R, Karmiris K, Katsanos KH, Keller DS, Kopylov U, Koutrabakis IE, Lamb CA, Landerholm K, Lee GC, Litta F, Limdi JK, Lopes EW, Madoff RD, Martin ST, Martin‐Perez B, Michalopoulos G, Millan M, Münch A, Nakov R, Noor NM, Oresland T, Paquette IM, Pellino G, Perra T, Porcu A, Roslani AC, Samaan MA, Sebepos‐Rogers GM, Segal JP, de Silva SD, Söderholm AM, Spinelli A, Speight RA, Steinhagen RM, Stenström P, Tsimogiannis KE, Varma MG, Verma AM, Verstockt B, Warden C, Yassin NA, Zawadzki A, Carr P, Devlin B, Avery MSP, Gecse KB, Goren I, Hellström PM, Kotze PG, McWhirter D, Naik AS, Sammour T, Selinger CP, Stein SL, Torres J, Wexner SD, Younge LC. Development of a core descriptor set for Crohn's anal fistula. Colorectal Dis 2022; 25:695-706. [PMID: 36461766 DOI: 10.1111/codi.16440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/21/2022] [Accepted: 11/08/2022] [Indexed: 12/04/2022]
Abstract
AIM Crohn's anal fistula (CAF) is a complex condition, with no agreement on which patient characteristics should be routinely reported in studies. The aim of this study was to develop a core descriptor set of key patient characteristics for reporting in all CAF research. METHOD Candidate descriptors were generated from published literature and stakeholder suggestions. Colorectal surgeons, gastroenterologists and specialist nurses in inflammatory bowel disease took part in three rounds of an international modified Delphi process using nine-point Likert scales to rank the importance of descriptors. Feedback was provided between rounds to allow refinement of the next ratings. Patterns in descriptor voting were assessed using principal component analysis (PCA). Resulting PCA groups were used to organize items in rounds two and three. Consensus descriptors were submitted to a patient panel for feedback. Items meeting predetermined thresholds were included in the final set and ratified at the consensus meeting. RESULTS One hundred and thirty three respondents from 22 countries completed round one, of whom 67.0% completed round three. Ninety seven descriptors were rated across three rounds in 11 PCA-based groups. Forty descriptors were shortlisted. The consensus meeting ratified a core descriptor set of 37 descriptors within six domains: fistula anatomy, current disease activity and phenotype, risk factors, medical interventions for CAF, surgical interventions for CAF, and patient symptoms and impact on quality of life. CONCLUSION The core descriptor set proposed for all future CAF research reflects characteristics important to gastroenterologists and surgeons. This might aid transparent reporting in future studies.
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Affiliation(s)
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- Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield, UK
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Sorsdahl K, Stein DJ, Pasche S, Jacobs Y, Kader R, Odlaug B, Richter S, Myers B, Grant JE. A novel brief treatment for methamphetamine use disorders in South Africa: a randomised feasibility trial. Addict Sci Clin Pract 2021; 16:3. [PMID: 33413631 PMCID: PMC7791768 DOI: 10.1186/s13722-020-00209-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 12/12/2020] [Indexed: 11/22/2022] Open
Abstract
Background Effective brief treatments for methamphetamine use disorders (MAUD) are urgently needed to complement longer more intensive treatments in low and middle income countries, including South Africa. To address this gap, the purpose of this randomised feasibility trial was to determine the feasibility of delivering a six-session blended imaginal desensitisation, plus motivational interviewing (IDMI) intervention for adults with a MAUD. Methods We enrolled 60 adults with a MAUD and randomly assigned them 1:1 to the IDMI intervention delivered by clinical psychologists and a control group who we referred to usual care. Feasibility measures, such as rates of recruitment, consent to participate in the trial and retention, were calculated. Follow-up interviews were conducted at 6 weeks and 3 months post-enrollment. Results Over 9 months, 278 potential particiants initiated contact. Following initial screening 78 (28%) met inclusion criteria, and 60 (77%) were randomised. Thirteen of the 30 participants assigned to the treatment group completed the intervention. Both psychologists were highly adherent to the intervention, obtaining a fidelity rating of 91%. In total, 39 (65%) participants completed the 6-week follow-up and 40 (67%) completed the 3-month follow-up. The intervention shows potential effectiveness in the intention-to-treat analysis where frequency of methamphetamine use was significantly lower in the treatment than in the control group at both the 6 week and 3-month endpoints. No adverse outcomes were reported. Conclusions This feasibility trial suggests that the locally adapted IDMI intervention is an acceptable and safe intervention as a brief treatment for MAUD in South Africa. Modifications to the study design should be considered in a fully powered, definitive controlled trial to assess this potentially effective intervention. Trial registration The trial is registered with the Pan African Clinical Trials Registry (Trial ID: PACTR201310000589295)
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Affiliation(s)
- K Sorsdahl
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry & Mental Health, University of Cape Town, 46 Sawkins Rd., Cape Town, 7700, South Africa.
| | - D J Stein
- Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa.,South African Medical Research Council Unit on Risk & Resilience in Mental Disorders, Cape Town, South Africa
| | - S Pasche
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Y Jacobs
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry & Mental Health, University of Cape Town, 46 Sawkins Rd., Cape Town, 7700, South Africa.,Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - R Kader
- Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa
| | - B Odlaug
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
| | - S Richter
- Professional Data Analysts, Minneapolis, United States
| | - B Myers
- Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa.,Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - J E Grant
- Department of Psychiatry & Behavioural Neuroscience, University of Chicago, Chicago, United States
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Kader R, Aljubran S, Barnes C. THE RELATIONSHIP OF MOLDS SPECIFIC IGE TO TOTAL IGE AND AGE IN MIDWEST PEDIATRIC POPULATION. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kader R, Mattsson G, Pournaras A, Magnusson P. P1031Inappropriate shocks and complications requiring surgery in patients with implantable cardioverter defibrillators. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p1031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- R Kader
- Uppsala University, Centre for Research and Development, Uppsala University/Region Gävleborg, SE-801 87, Gävle, Sweden
| | - G Mattsson
- Uppsala University, Centre for Research and Development, Uppsala University/Region Gävleborg, SE-801 87, Gävle, Sweden
| | - A Pournaras
- Uppsala University, Centre for Research and Development, Uppsala University/Region Gävleborg, SE-801 87, Gävle, Sweden
| | - P Magnusson
- Uppsala University, Centre for Research and Development, Uppsala University/Region Gävleborg, SE-801 87, Gävle, Sweden
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Mattsson G, Kader R, Pournaras A, Magnusson P. P1032Appropriate therapy in primary prevention implantable cardioverter defibrillator patients with ischemic and non-ischemic cardiomyopathy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p1032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- G Mattsson
- Uppsala University, Centre for Research and Development, Uppsala University/Region Gävleborg, SE-801 87, Gävle, Sweden
| | - R Kader
- Uppsala University, Centre for Research and Development, Uppsala University/Region Gävleborg, SE-801 87, Gävle, Sweden
| | - A Pournaras
- Uppsala University, Centre for Research and Development, Uppsala University/Region Gävleborg, SE-801 87, Gävle, Sweden
| | - P Magnusson
- Uppsala University, Centre for Research and Development, Uppsala University/Region Gävleborg, SE-801 87, Gävle, Sweden
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Pournaras A, Kader R, Mattsson G, Magnusson P. P5785Causes of death and mortality in patients with implantable cardioverter defibrillators with and without cardiac resynchronization therapy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Pournaras
- Uppsala University, Centre for Research and Development, Uppsala University/Region Gävleborg, SE-801 87, Gävle, Sweden
| | - R Kader
- Uppsala University, Centre for Research and Development, Uppsala University/Region Gävleborg, SE-801 87, Gävle, Sweden
| | - G Mattsson
- Uppsala University, Centre for Research and Development, Uppsala University/Region Gävleborg, SE-801 87, Gävle, Sweden
| | - P Magnusson
- Uppsala University, Centre for Research and Development, Uppsala University/Region Gävleborg, SE-801 87, Gävle, Sweden
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Mohannad N, Kader R. AB1150 Effect of Interferon Alpha Therapy on Chronic Hepatitis C Patients with Croglobulinaemia (Clinical & Laboratory):. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pizarro C, Zhou H, Kader R, Kalff J, Nickenig G, Skowasch D. [Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) in a 67-year-old patient with chronic coughing]. Dtsch Med Wochenschr 2014; 139:1245-8. [PMID: 24866961 DOI: 10.1055/s-0034-1370073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
HISTORY AND CLINICAL FINDINGS A 67-year-old woman with a history of chronic obstructive pulmonary disease and breast cancer developed an increase in size and number of pulmonary nodules that had previously been stable over the course of 9 years. INVESTIGATIONS Thoracic computed tomography revealed a well-defined pulmonary lesion with a diameter of 1,1 × 1,1 cm, accompanied by multiple bilateral pulmonary nodules with a maximum size of 5 mm. Thoracoscopic resection of the major nodule was extended to a completive resection of an adjacent lung area that operatively showed a macroscopically noticeable hypervascularity. Histopathological examination assigned the larger lesion to a typical carcinoid; the additionally resected hypervascular lung parenchyma confirmed an accumulation of hyperplastic neuroendocrine cells in terms of a diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH). TREATMENT AND COURSE Since histological examination showed an entirely resected neuroendocrine tumor classified as typical carcinoid, and considering DIPNECH to be a preinvasive lesion, the therapeutic management consisted of serial imaging by computed tomography. During the last two years, no progression of either the pulmonary lesions or of the obstructive disease was observed. CONCLUSION DIPNECH is a rare, primary pulmonary process with proliferation of hyperplastic neuroendocrine cells, affecting principally middle-aged, non-smoking women. It is considered to be a precursor lesion to pulmonary carcinoid tumors. Given its only minor risk of invasive metastatic spread, serial imaging for timely detection of progressing lesions and optimizing of concomitant obstructive pulmonary disease are the preferred treatment approaches.
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Affiliation(s)
- C Pizarro
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn
| | - H Zhou
- Institut für Pathologie, Universitätsklinikum Bonn
| | - R Kader
- Medizinisches Versorgungszentrum Venusberg GmbH, Bonn
| | - J Kalff
- Klinik und Poliklinik für Allgemein-, Viszeral-, Thorax-, Gefäßchirurgie, Universitätsklinikum Bonn
| | - G Nickenig
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn
| | - D Skowasch
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn
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Kader R, Seedat S, Govender R, Koch JR, Parry CD. Hazardous and harmful use of alcohol and/or other drugs and health status among South African patients attending HIV clinics. AIDS Behav 2014; 18:525-34. [PMID: 23921585 DOI: 10.1007/s10461-013-0587-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
There is growing recognition of the influence of substance use, particularly alcohol use, on HIV disease progression. This study investigated how hazardous/harmful use of alcohol and drugs impacts the health status of 1503 patients attending HIV clinics. Of the sample, 37 % indicated hazardous/harmful drinking and 13 % indicated a drug problem. Hazardous/harmful use of alcohol and drugs was significantly related to health status, with participants using substances more likely to have TB-positive status (χ(2) = 4.30, p < 0.05), less likely to be on ARVs (χ(2) = 9.87, p < 0.05) and having lower CD4 counts (t = 4.01, p < 0.05). Structural equation modelling confirmed the centrality of hazardous/harmful use of alcohol as a direct and indirect determinant of disease progression. Based on these findings it is recommended that patients attending HIV clinics be routinely screened for problematic alcohol and/or drug use, with strong emphasis on ensuring ARV adherence in those with problematic alcohol use.
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Affiliation(s)
- R Kader
- Alcohol and Drug Abuse Research Unit, Medical Research Council, P.O. Box 19070, Tygerberg, Cape Town, 7505, South Africa,
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Plüddemann A, Dada S, Parry CDH, Kader R, Parker JS, Temmingh H, Van Heerden S, De Clercq C, Lewis I. Monitoring the prevalence of methamphetamine-related presentations at psychiatric hospitals in Cape Town, South Africa. ACTA ACUST UNITED AC 2013; 16:45-9. [DOI: 10.4314/ajpsy.v16i1.8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 03/26/2012] [Indexed: 11/17/2022]
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Kader R, Seedat S, Koch JR, Parry CD. A preliminary investigation of the AUDIT and DUDIT in comparison to biomarkers for alcohol and drug use among HIV-infected clinic attendees in Cape Town, South Africa. ACTA ACUST UNITED AC 2013; 15:346-51. [PMID: 23044889 DOI: 10.4314/ajpsy.v15i5.43] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Accepted: 08/16/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVE There is growing concern about the effect of substance use on HIV treatment outcomes. The study objectives included: (i) evaluating whether the use of validated questionnaires (AUDIT and DUDIT) provide useful and consistent information of alcohol and drug consumption when compared with the use of biomarkers of alcohol in (urine and hair) and drugs in (urine) and (ii) assessing the feasibility of using self-report measures compared with urine and hair tests. METHOD Participants were HIV positive patients attending an HIV community health clinic in Kraaifontein, Cape Town. Hair and urine samples were collected and analysed for alcohol, in Fatty Acid Ethyl Esters (FAEE) and in Ethyl Glucuronide and (EtG), and drugs. Biological markers were compared with self-report measures of alcohol and drug consumption in terms of sensitivity, specificity. Forty-three participants completed the self-report measures, while 30 provided hair and urine samples. RESULTS On the AUDIT, 18 (41.9%) participants screened positive for harmful and hazardous drinking and 13 (30.2%) participants on the DUDIT screened positive for having a drug-related problem. Two of 30 participants (7%) tested positive for alcohol abuse on FAEE analysis. For EtG, 6 of 24 (25%) participants tested positive for alcohol abuse. On hair drug analysis, all 30 participants tested negative for cannabis, amphetamines, opiates, cocaine, PCP and methaqualone. On the urinalysis, 1 of 30 participants tested positive for cannabis and everyone tested negative for all other drugs included in the screening. CONCLUSION Substance use among patients attending HIV clinics appears to be a problem, especially alcohol. Self-report measures seem to be a more cost effective option for screening of alcohol and drug abuse in resource poor settings.
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Affiliation(s)
- R Kader
- Alcohol & Drug Abuse Research Unit, Medical Research Council, Tygerberg, Cape Town, South Africa.
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Born M, Axmann C, Kader R, von Falkenhausen M, Manka C, Willinek WA, Schild H. [Is the renal excretion of orally applied diatrizoate (Gastrografin) a reliable marker of gastrointestinal perforation or dehiscence of a gastrointestinal anastomosis?]. ROFO-FORTSCHR RONTG 2004; 176:1617-23. [PMID: 15497080 DOI: 10.1055/s-2004-813489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 10/26/2022]
Abstract
PURPOSE Renal excretion of orally or rectally applied Gastrografin is reported to be a reliable indicator of a perforation or a postoperative anastomotic dehiscence of the GI-tract. The study was conducted to determine whether increased attenuation of the urine measured by CT after oral or rectal application of Gastrografin can give reliable evidence of any leakage from the gastrointestinal tract. MATERIALS AND METHODS Urine samples of 33 patients, who underwent a Gastrografin-enhanced fluoroscopic examination of the esophagus or the GI-tract for different clinical reasons, were examined by CT. The samples had been taken immediately before and 60 to 90 minutes after application of 100 ml Gastrografin. The results were compared with those of 5 healthy volunteers, who took urine samples before, 30, 60, 90, and 120 minutes after drinking 100 ml of Gastrografin. RESULTS Maximal attenuation of the volunteers' urine samples was achieved 60 to 90 minutes after Gastrografin application with a mean of 50 Hounsfield units (HU), SD = 17 HU. The urine of three patients with radiologically proven fistula or dehiscence of a GI-tract anastomosis had no relevant increase in attenuation. Three other cases without any clinical or radiological evidence of an anastomotic leak had a substantial increase in the attenuation of the urine probes (87, 110, and 290 HU, respectively). CONCLUSION The CT-measured urine samples as evidence of renal excretion of orally or rectally applied Gastrografin are not reliable for the detection of leaks from the GI-tract.
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Affiliation(s)
- M Born
- Radiologische Universitätsklinik Bonn.
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