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Teoh ZH, Roy J, Reiken J, Papitsas M, Byrne J, Monaghan MJ. Prevalence of moderate-to-severe TR suitable for percutaneous intervention in TTE patients. Echo Res Pract 2018; 5:ERP-18-0018.R2. [PMID: 30400052 PMCID: PMC6280247 DOI: 10.1530/erp-18-0018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 10/29/2018] [Indexed: 11/23/2022] Open
Abstract
Moderate-to-severe tricuspid regurgitation is associated with higher mortality and morbidity yet remains significantly undertreated. The reasons for this are complex but include a higher operative mortality for patients undergoing isolated tricuspid valve surgery. This study sought to determine the prevalence of patients with moderate-to-severe tricuspid regurgitation and identify those who could be potentially suitable for percutaneous tricuspid valve intervention by screening patients referred for transthoracic echocardiography (ECHO) at a tertiary center. Our results showed that the prevalence of moderate-to-severe tricuspid regurgitation in our total ECHO patient population was 2.8%. Of these, approximately 1 in 8 patients with moderate-to-severe tricuspid regurgitation would be potentially suitable for percutaneous intervention, and suggests a large, unmet clinical need in this population.
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Netley J, Roy J, Greenlee J, Hart S, Todt M, Statz B. Bivalirudin Anticoagulation Dosing Protocol for Extracorporeal Membrane Oxygenation: A Retrospective Review. THE JOURNAL OF EXTRA-CORPOREAL TECHNOLOGY 2018; 50:161-166. [PMID: 30250342 PMCID: PMC6146270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 04/06/2018] [Indexed: 06/08/2023]
Abstract
Anticoagulation with unfractionated heparin during extracorporeal membrane oxygenation (ECMO) is common, but alternative agents are being evaluated for safety and efficacy. The objective of this analysis was to assess if a comprehensive bivalirudin dosing and monitoring protocol effectively guides dose adjustments and monitoring of bivalirudin in patients during ECMO. Our analysis included 11 patients who received bivalirudin during ECMO therapy and had dosing managed using our hospital derived protocol. Patients treated over a 1-year period were included in this retrospective analysis. Clinical characteristics and changes in activated partial thromboplastin time (aPTT) were evaluated from medical records to determine the efficacy of the dosing protocol. ECMO was initiated for acute respiratory distress syndrome in eight (72.7%) patients and for cardiac arrest in three (27.3%) patients. A total of 178 protocol guided dose adjustments were made during the study. Among the dose adjustments, 56 (31.5%) attained the protocol predicted aPTT level change, 96 (53.9%) of the measured aPTT changes were less than predicted, and 26 (14.6%) of the measured aPTT changes were more than predicted. On average, patients were within their defined therapeutic aPTT target range 66.3% of the time. All patients reached their designated aPTT target range within the first 24 hours of therapy. Significant bleeding was documented in eight (72.7%) patients. No clinically evident thromboembolic events were identified in vivo while cannulated. This analysis suggests that bivalirudin can be managed using a dosing protocol to provide anticoagulation therapy to patients during ECMO and can provide foundational guidance for dose adjustment and monitoring for other institutions.
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Li DY, Busch A, Jin HH, Hofmann P, Boon RA, Pelisek J, Paloschi V, Roy J, Eckstein HH, Spin JM, Tsao PS, Maegdefessel L. P3199Long non-coding RNA H19 induces abdominal aortic aneurysms. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ahsan MS, Roy J, Shah MA, Arafat SY, Nahar JS, Mullick MI. Psychotic Symptoms in Dissociative (Conversion) Disorder in Two Tertiary Care Hospitals in Bangladesh. Mymensingh Med J 2018; 27:520-526. [PMID: 30141441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Dissociative (conversion) disorder (DCR) has a long and controversial history. Some authors wish to classify it with somatoform disorders separate from dissociative disorders; many researchers keep it with DCR. Symptoms pattern also varies in different cultures. This study used the criteria of International Classification of Diseases Tenth Edition (ICD-10). Study was aimed to see the presenting symptom profile of dissociative (conversion) disorder more focusing on psychotic symptoms in tertiary care hospital in Bangladesh. This cross sectional observation was carried out in two different tertiary care hospitals in Dhaka city with preformed pretested questionnaire. Data were collected from 100 consecutive patients from July 2005 to June 2006 and data were analyzed by Statistical Package of Social Science (SPSS) 16.0. Pattern of dissociative (conversion) disorder indicated that symptoms presentations are different in Bangladesh which is difficult to categorize using existing criteria of ICD-10. Among 100 consecutive patients diagnosed as dissociative (conversion) disorder 13 patients had psychotic symptoms. Psychotic presentation of conversion disorder often creates doubts among the clinicians. Careful history taking, identifying the underlying psychosocial stressors will help clinicians to diagnose them accurately. It should be noted that the pattern of presentation in South Asia may be different due to role of culture on symptoms presentation in this region.
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Godin R, Roy J, Gaudreault P, Paulin A, Forest G. 0861 Teen Sleep Patterns and Enjoyment in Sports. Sleep 2018. [DOI: 10.1093/sleep/zsy061.860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sweeting MJ, Ulug P, Roy J, Hultgren R, Indrakusuma R, Balm R, Thompson MM, Hinchliffe RJ, Thompson SG, Powell JT. Value of risk scores in the decision to palliate patients with ruptured abdominal aortic aneurysm. Br J Surg 2018; 105:1135-1144. [PMID: 30461007 PMCID: PMC6055637 DOI: 10.1002/bjs.10820] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 11/16/2017] [Accepted: 12/13/2017] [Indexed: 01/19/2023]
Abstract
Background The aim of this study was to develop a 48‐h mortality risk score, which included morphology data, for patients with ruptured abdominal aortic aneurysm presenting to an emergency department, and to assess its predictive accuracy and clinical effectiveness in triaging patients to immediate aneurysm repair, transfer or palliative care. Methods Data from patients in the IMPROVE (Immediate Management of the Patient With Ruptured Aneurysm: Open Versus Endovascular Repair) randomized trial were used to develop the risk score. Variables considered included age, sex, haemodynamic markers and aortic morphology. Backwards selection was used to identify relevant predictors. Predictive performance was assessed using calibration plots and the C‐statistic. Validation of the newly developed and other previously published scores was conducted in four external populations. The net benefit of treating patients based on a risk threshold compared with treating none was quantified. Results Data from 536 patients in the IMPROVE trial were included. The final variables retained were age, sex, haemoglobin level, serum creatinine level, systolic BP, aortic neck length and angle, and acute myocardial ischaemia. The discrimination of the score for 48‐h mortality in the IMPROVE data was reasonable (C‐statistic 0·710, 95 per cent c.i. 0·659 to 0·760), but varied in external populations (from 0·652 to 0·761). The new score outperformed other published risk scores in some, but not all, populations. An 8 (95 per cent c.i. 5 to 11) per cent improvement in the C‐statistic was estimated compared with using age alone. Conclusion The assessed risk scores did not have sufficient accuracy to enable potentially life‐saving decisions to be made regarding intervention. Focus should therefore shift to offering repair to more patients and reducing non‐intervention rates, while respecting the wishes of the patient and family. Not much help
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Roy J, Oger C, Fauconnier J, Farah C, Lee J, Bultel Ponce V, Vigor C, Lacampagne A, Galano J, Durand T, Le Guennec J. Metabolism of omegas 3: Which is responsible for cardioprotective effects? ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2018. [DOI: 10.1016/j.acvdsp.2018.02.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Fedorov A, Razuvaev A, Kox B, Ignatieva E, Roy J, Perisic Matic L, Hedin U, Kostareva A. P562Expression profiling of complicated and uncomplicated atherosclerotic plaques of the lower extremities. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ahsan MS, Mullick MS, Begum K, Arafat SM, Shah MA, Podder BR, Roy J. Substance Use among the Patients with First Episode Psychosis. Mymensingh Med J 2018; 27:313-320. [PMID: 29769496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Substance Use Disorder is a frequent problem in Bangladesh and many of these patients develop psychosis. Substance use can cause psychosis and it can modify the course of psychosis. This cross-sectional study was done to see the proportion of substance use in patients with First-Episode Psychosis (FEP) in two tertiary care hospitals in Dhaka, Bangladesh mentioned here as Bangabandhu Sheikh Mujib Medical University and Dhaka Medical College Hospital; from November 2007 March 2009. Fifty consecutive FEP patients were taken as subjects and 50 healthy attendants were recruited as control. Mean age of the patients was 27.24, male (62%) are more having first-episode psychosis than female (38%). Majority of the patients were unmarried (64%). Regarding occupation students were 34%, followed by unemployed 24% and service18%. In control group's occupation; service 34%, housewife 22%. Life time substance use was found double in patients with first-episode psychosis than control. Cannabis was found to be the most common substance causing psychosis. Among the lifetime substance users in fist-episode psychosis patients 77.78% were male where as, in control group 100% patients were male. However, the researcher did not find any of the first-episode psychosis patients taking current use of substance (abuse and /or dependence). The small size of the present study was only 50. Future prospective study is required having large sample size to see the outcome of substance use in first-episode psychosis.
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Mshaik R, Tchatchat L, Roy J, Guihot A, Vessiers E, Barbelivien A, Fassot C, Loufrani L, Custaud M, Henrion D. The angiotensin II type 2 receptor promotes perivascular adipose tissue-dependent dilation in type 2 diabetic female mice and contraction in healthy mice. ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2018. [DOI: 10.1016/j.acvdsp.2018.02.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Azzalini L, Karatasakis A, Spratt JC, Tajti P, Riley RF, Ybarra LF, Schumacher SP, Benincasa S, Bellini B, Candilio L, Mitomo S, Henriksen P, Hidalgo F, Timmers L, Kraaijeveld AO, Agostoni P, Roy J, Ramsay DR, Weaver JC, Knaapen P, Nap A, Starcevic B, Ojeda S, Pan M, Alaswad K, Lombardi WL, Carlino M, Brilakis ES, Colombo A, Rinfret S, Mashayekhi K. Subadventitial stenting around occluded stents: A bailout technique to recanalize in-stent chronic total occlusions. Catheter Cardiovasc Interv 2018; 92:466-476. [DOI: 10.1002/ccd.27472] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 11/14/2017] [Accepted: 11/26/2017] [Indexed: 11/11/2022]
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Naylor AR, Ricco JB, de Borst GJ, Debus S, de Haro J, Halliday A, Hamilton G, Kakisis J, Kakkos S, Lepidi S, Markus HS, McCabe DJ, Roy J, Sillesen H, van den Berg JC, Vermassen F, Kolh P, Chakfe N, Hinchliffe RJ, Koncar I, Lindholt JS, Vega de Ceniga M, Verzini F, Archie J, Bellmunt S, Chaudhuri A, Koelemay M, Lindahl AK, Padberg F, Venermo M. Editor's Choice - Management of Atherosclerotic Carotid and Vertebral Artery Disease: 2017 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2018; 55:3-81. [PMID: 28851594 DOI: 10.1016/j.ejvs.2017.06.021] [Citation(s) in RCA: 789] [Impact Index Per Article: 131.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Isbister J, Chen D, Youssef G, Roy J. Rapid Resolution of a Large Recurrent Left Ventricular Thrombus Using Apixaban. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Roy J, Hill J, Spratt JC. The “side-BASE technique”: Combined side branch anchor balloon and balloon assisted sub-intimal entry to resolve ambiguous proximal cap chronic total occlusions. Catheter Cardiovasc Interv 2017; 92:E15-E19. [DOI: 10.1002/ccd.27422] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 10/04/2017] [Accepted: 10/30/2017] [Indexed: 12/26/2022]
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Azzalini L, Karatasakis A, Spratt J, Tajti P, Ybarra L, Benincasa S, Bellini B, Candilio L, Hidalgo F, Timmers L, Kraaijeveld A, Agostoni P, Roy J, Ramsay D, Weaver J, Knaapen P, Starcevic B, Ojeda S, Pan M, Alaswad K, Lombardi W, Rinfret S, Carlino M, Brilakis E, Colombo A, Mashayekhi K. TCT-24 Subadventitial Crossing and Crushing to Recanalize In-stent Chronic Total Occlusions: A Multicenter Registry. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lindley RI, Anderson CS, Billot L, Forster A, Hackett ML, Harvey LA, Jan S, Li Q, Liu H, Langhorne P, Maulik PK, Murthy GVS, Walker MF, Pandian JD, Alim M, Felix C, Syrigapu A, Tugnawat DK, Verma SJ, Shamanna BR, Hankey G, Thrift A, Bernhardt J, Mehndiratta MM, Jeyaseelan L, Donnelly P, Byrne D, Steley S, Santhosh V, Chilappagari S, Mysore J, Roy J, Padma MV, John L, Aaron S, Borah NC, Vijaya P, Kaul S, Khurana D, Sylaja PN, Halprashanth DS, Madhusudhan BK, Nambiar V, Sureshbabu S, Khanna MC, Narang GS, Chakraborty D, Chakraborty SS, Biswas B, Kaura S, Koundal H, Singh P, Andrias A, Thambu DS, Ramya I, George J, Prabhakar AT, Kirubakaran P, Anbalagan P, Ghose M, Bordoloi K, Gohain P, Reddy NM, Reddy KV, Rao TNM, Alladi S, Jalapu VRR, Manchireddy K, Rajan A, Mehta S, Katoch C, Das B, Jangir A, Kaur T, Sreedharan S, Sivasambath S, Dinesh S, Shibi BS, Thangaraj A, Karunanithi A, Sulaiman SMS, Dehingia K, Das K, Nandini C, Thomas NJ, Dhanya TS, Thomas N, Krishna R, Aneesh V, Krishna R, Khullar S, Thouman S, Sebastian I. Family-led rehabilitation after stroke in India (ATTEND): a randomised controlled trial. Lancet 2017; 390:588-599. [PMID: 28666682 DOI: 10.1016/s0140-6736(17)31447-2] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 03/17/2017] [Accepted: 04/04/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Most people with stroke in India have no access to organised rehabilitation services. The effectiveness of training family members to provide stroke rehabilitation is uncertain. Our primary objective was to determine whether family-led stroke rehabilitation, initiated in hospital and continued at home, would be superior to usual care in a low-resource setting. METHODS The Family-led Rehabilitation after Stroke in India (ATTEND) trial was a prospectively randomised open trial with blinded endpoint done across 14 hospitals in India. Patients aged 18 years or older who had had a stroke within the past month, had residual disability and reasonable expectation of survival, and who had an informal family-nominated caregiver were randomly assigned to intervention or usual care by site coordinators using a secure web-based system with minimisation by site and stroke severity. The family members of participants in the intervention group received additional structured rehabilitation training-including information provision, joint goal setting, carer training, and task-specific training-that was started in hospital and continued at home for up to 2 months. The primary outcome was death or dependency at 6 months, defined by scores 3-6 on the modified Rankin scale (range, 0 [no symptoms] to 6 [death]) as assessed by masked observers. Analyses were by intention to treat. This trial is registered with Clinical Trials Registry-India (CTRI/2013/04/003557), Australian New Zealand Clinical Trials Registry (ACTRN12613000078752), and Universal Trial Number (U1111-1138-6707). FINDINGS Between Jan 13, 2014, and Feb 12, 2016, 1250 patients were randomly assigned to intervention (n=623) or control (n=627) groups. 33 patients were lost to follow-up (14 intervention, 19 control) and five patients withdrew (two intervention, three control). At 6 months, 285 (47%) of 607 patients in the intervention group and 287 (47%) of 605 controls were dead or dependent (odds ratio 0·98, 95% CI 0·78-1·23, p=0·87). 72 (12%) patients in the intervention group and 86 (14%) in the control group died (p=0·27), and we observed no difference in rehospitalisation (89 [14%]patients in the intervention group vs 82 [13%] in the control group; p=0·56). We also found no difference in total non-fatal events (112 events in 82 [13%] intervention patients vs 110 events in 79 [13%] control patients; p=0·80). INTERPRETATION Although task shifting is an attractive solution for health-care sustainability, our results do not support investment in new stroke rehabilitation services that shift tasks to family caregivers, unless new evidence emerges. A future avenue of research should be to investigate the effects of task shifting to health-care assistants or team-based community care. FUNDING The National Health and Medical Research Council of Australia.
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Claveau JS, LeBlanc R, Ahmad I, Ferreira J, Pistono AA, Bambace N, Bernard L, Cohen S, Delisle JS, Kiss T, Lachance S, Roy J. Cerebral adenovirus endotheliitis presenting as posterior reversible encephalopathy syndrome after allogeneic stem cell transplantation. Bone Marrow Transplant 2017; 52:1457-1459. [PMID: 28692025 DOI: 10.1038/bmt.2017.154] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Tomaszewski KA, Vikse J, Henry BM, Roy J, Pękala PA, Svensen M, Guay D, Saganiak K, Walocha JA. The variable origin of the lateral circumflex femoral artery: a meta-analysis and proposal for a new classification system. Folia Morphol (Warsz) 2017; 76:157-167. [DOI: 10.5603/fm.a2016.0056] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 07/01/2016] [Accepted: 07/01/2016] [Indexed: 11/25/2022]
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Pion-Massicotte J, Chicoine M, Chevrier É, Roy J, Savard P, Godbout R. 0069 DEVELOPMENT AND VALIDATION OF AN ALGORITHM FOR THE STUDY OF SLEEP USING A BIOMETRIC SHIRT IN YOUNG HEALTHY ADULTS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Roy J, Michaud F, Green-Demers I, Forest G. 0957 SLEEP PATTERNS OF STUDENTS IN A SPORT STUDIES PROGRAM. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Thiant S, Moutuou MM, Laflamme P, Sidi Boumedine R, Leboeuf DM, Busque L, Roy J, Guimond M. Imatinib mesylate inhibits STAT5 phosphorylation in response to IL-7 and promotes T cell lymphopenia in chronic myelogenous leukemia patients. Blood Cancer J 2017; 7:e551. [PMID: 28387753 PMCID: PMC5436073 DOI: 10.1038/bcj.2017.29] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 01/19/2017] [Indexed: 02/07/2023] Open
Abstract
Imatinib mesylate (IM) therapy has been shown to induce lower T cell counts in chronic myelogenous leukemia (CML) patients and an interference of IM with T cell receptor (TCR) signaling has been invoked to explain this observation. However, IL-7 and TCR signaling are both essential for lymphocyte survival. This study was undertaken to determine whether IM interferes with IL-7 or TCR signaling to explain lower T cell counts in patients. At diagnosis, CML patients have typically lower CD4+ counts in their blood, yet CD8+ counts are normal or even increased in some. Following the initiation of IM treatment, CD4+ counts were further diminished and CD8+ T lymphocytes were dramatically decreased. In vitro studies confirmed IM interference with TCR signaling through the inhibition of ERK phosphorylation and we showed a similar effect on IL-7 signaling and STAT5 phosphorylation (STAT5-p). Importantly however, using an in vivo mouse model, we demonstrated that IM impaired T cell survival through the inhibition of IL-7 and STAT5-p but not TCR signaling which remained unaffected during IM therapy. Thus, off-target inhibitory effects of IM on IL-7 and STAT5-p explain how T cell lymphopenia occurs in patients treated with IM.
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Farah C, Branquinho R, Roy J, Garcia G, Aimond F, Le Guennec J, Saúde Guimarães D, Guimaraes A, Mosqueira V, De Lana M, Richard S. Biodegradable polymeric nanocapsules prevent cardiotoxicity of antitrypanosomal lychnopholide. ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2017. [DOI: 10.1016/s1878-6480(17)30431-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Roy J, Nag DC. Antibiotic Susceptibility Pattern of Bacteria Isolated From Various Specimens of Patients with Hematological Malignancy. Mymensingh Med J 2017; 26:388-394. [PMID: 28588177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Infection is a life threatening complication in patients with hematological malignancy. So, proper treatment of infection with suitable antibiotic is very important in these patients. The aim of this study was to determine the antibiotic susceptibility of bacteria isolated from various specimens of patients with hematological malignancy, so that, an appropriate regimen of empiric antibiotic treatment can be established for these patients. This observational study was done in the Department of Microbiology and Immunology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from March 2012 to August 2012. Forty (40) diagnosed patients of hematological malignancies who were admitted in the Department of Hematology and Paediatric Hemato-oncology, BSMMU with symptoms of sepsis &/ or urinary tract infection (UTI) or respiratory tract infection (RTI) were enrolled in this study. Blood, throat swab and urine were collected from each patient and sputum was collected from four patients. Susceptibility pattern of Gram positive bacteria to antibiotics was satisfactory. But Gram negative bacteria were resistant to commonly used antibiotics. Enterobacteriaceae group of organisms were found completely resistant to Ceftriaxone & Aztreonam. The best drugs for them were Imipenem, Amikacin & Netilmicin. P. aeruginosa & Acinetobacter spp. were completely resistant to several antibiotics including Cephalosporines & Ciprofloxacin. The best drug for them was Imipenem, Netilmicin & combination of Tazobactam & Piperacilin.
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Roy J, Rees D, Ramsay D, Weaver J. Late Double-Barrel Lumen Following Successful CTO-PCI Using the Crossboss Stingray System. THE JOURNAL OF INVASIVE CARDIOLOGY 2017; 29:E28-E29. [PMID: 28145879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
There remains limited randomized controlled trials on long-term clinical outcomes after chronic total occlusion percutaneous coronary intervention (CTO-PCI). New techniques involving dissection of the subintimal space and reentry into the true lumen increase success rates in CTO-PCI. However, their longer-term safety and efficacy remain unknown and poorly studied. We present a case of double-lumen formation seen at 1 year post CTO-PCI using subintimal dissection reentry with late restoration of major side branches.
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Al-Ajlan FS, Demchuk AM, Aviv RI, Rodriguez-Luna D, Molina C, Silva Y, Dzialowski I, Czlonkowska A A, Boulanger JM, Lum C, Gubitz G, Padma V, Roy J, Kase CS, Hill MD, Dowlatshahi D. Abstract WP372: The Acute ICH Growth Score: Simple and Accurate Predictor of Hematoma Expansion in Patients with Acute Intracerebral Hemorrhage. Stroke 2017. [DOI: 10.1161/str.48.suppl_1.wp372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose:
Acute intracerebral hemorrhage (ICH) hematoma expansion predicts high mortality and morbidity, occurring in a third of patients presenting with this condition. Recent studies correlated ultra-early hematoma growth and hematoma morphologic appearance with ICH expansion. Our purpose was to develop simple and clinically useful score that would predict ICH hematoma expansion accurately.
Methods:
This cohort included patients with primary or anticoagulation-associated ICH patients presenting <6 hours post ictus prospectively enrolled in the PREDICT study. Patients underwent baseline CT, CT angiography and 24-hour CT for hematoma expansion analysis. A risk score model was developed for predicting hematoma expansion (> 6 ml or > 33%). A 7-point acute ICH growth score was based on ultra-early hematoma growth > 5 mL/hour (yes=1), irregular morphology (yes=1), density heterogeneity (yes=1), presence of fluid-blood levels (yes=1), spot sign (yes=1), and use of anticoagulation (yes=2). Discrimination of the expansion score was assessed.
Results:
We retrospectively studied 301 primary or anticoagulation-associated intracerebral hemorrhage patients. The 7-point acute ICH growth score demonstrated good discrimination for hematoma expansion>6 mL or 33% (area under the curve of 0.76). Median and significant HE are shown in the table below (p<0.001).
Conclusions:
In a multicenter prospective study, the ICH expansion score demonstrate good correlation with hematoma expansion, and included recently reported variables such as morphology and ultraearly growth.
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