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Moussiopoulou J, Handrack‐Bonnet M, Pross B, Pogarell O, Keeser D, Halle M, Falkai P, Scherr J, Hasan A, Roeh A. Comparative electroencephalography analysis: Marathon runners during tapering versus sedentary controls reveals no significant differences. Brain Behav 2024; 14:e3480. [PMID: 38680019 PMCID: PMC11056696 DOI: 10.1002/brb3.3480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 01/26/2024] [Accepted: 03/18/2024] [Indexed: 05/01/2024] Open
Abstract
INTRODUCTION Previous studies described various adaptive neuroplastic brain changes associated with physical activity (PA). EEG studies focused mostly on effects during or shortly after short bouts of exercise. This is the first study to investigate the capability of EEG to display PA-induced long-lasting plasticity in runners compared to a sedentary control group. METHODS Thirty trained runners and 30 age- and sex-matched sedentary controls (SC) were included as a subpopulation of the ReCaP (Running effects on Cognition and Plasticity) study. PA was measured with the International Physical Activity Questionnaire (IPAQ). Resting-state EEG of the runners was recorded in the tapering phase of the training for the Munich marathon 2017. Power spectrum analyses were conducted using standardized low-resolution electromagnetic tomography (sLORETA) and included the following frequency bands: delta: 1.5-6 Hz, theta: 6.5-8.0 Hz, alpha1: 8.5-10 Hz, alpha2: 10.5-12.0 Hz, beta1: 12.5-18.0 Hz, beta2: 18.5-21.0 Hz, beta3: 21.5-30.0 Hz, and total power (1.5-30 Hz). RESULTS PA (IPAQ) and BMI differed significantly between the groups. The other included demographic parameters were comparable. Statistical nonparametric mapping showed no significant power differences in EEG between the groups. DISCUSSION Heterogeneity in study protocols, especially in time intervals between exercise cessation and EEG recordings and juxtaposition of acute exercise-induced effects on EEG in previous studies, could be possible reasons for the differences in results. Future studies should record EEG at different time points after exercise cessation and in a broader spectrum of exercise intensities and forms to further explore the capability of EEG in displaying long-term exercise-induced plasticity.
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Affiliation(s)
- J. Moussiopoulou
- Department of Psychiatry and PsychotherapyLMU University Hospital, LMU MunichMunichGermany
| | - M. Handrack‐Bonnet
- Department of Psychiatry and PsychotherapyLMU University Hospital, LMU MunichMunichGermany
| | - B. Pross
- Department of Psychiatry and PsychotherapyLMU University Hospital, LMU MunichMunichGermany
- Medical Faculty, Department of Psychiatry, Psychotherapy and Psychosomatics, Bezirkskrankenhaus AugsburgUniversity of AugsburgAugsburgGermany
| | - O. Pogarell
- Department of Psychiatry and PsychotherapyLMU University Hospital, LMU MunichMunichGermany
| | - D. Keeser
- Department of Psychiatry and PsychotherapyLMU University Hospital, LMU MunichMunichGermany
| | - M. Halle
- Department of Prevention and Sports MedicineKlinikum rechts der Isar, Technische Universitaet MuenchenMunichGermany
- Partner Site Munich Heart AllianceDeutsches Zentrum für Herz‐ und Kreislauf‐Forschung (DZHK) e.V. (German Center for Cardiovascular Research)MunichGermany
| | - P. Falkai
- Department of Psychiatry and PsychotherapyLMU University Hospital, LMU MunichMunichGermany
| | - J. Scherr
- Department of Prevention and Sports MedicineKlinikum rechts der Isar, Technische Universitaet MuenchenMunichGermany
- University Center for Preventive and Sports Medicine, Balgrist University Hospital, University of ZurichZurichSwitzerland
| | - A. Hasan
- Medical Faculty, Department of Psychiatry, Psychotherapy and Psychosomatics, Bezirkskrankenhaus AugsburgUniversity of AugsburgAugsburgGermany
| | - A. Roeh
- Medical Faculty, Department of Psychiatry, Psychotherapy and Psychosomatics, Bezirkskrankenhaus AugsburgUniversity of AugsburgAugsburgGermany
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Alam MK, Hasan A, Paul M, Chowdhury MM, Kuryshi MSA, Islam SN, Akhter N, Sultana S, Chowdhury MST. Cardiovascular Risk Scoring of Hospitalized Chronic Kidney Disease Patients by Framingham Risk Score. Mymensingh Med J 2024; 33:174-182. [PMID: 38163790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Patients with chronic kidney disease (CKD) are more likely to have complications due to cardiovascular diseases (CVD). This cross sectional descriptive study was conducted in the Department of Medicine and Nephrology, Chittagong Medical College (CMC), Chittagong, Bangladesh from June to December, 2014 and was performed to estimate the risk of cardiovascular events according to Framingham's Risk Score of CKD patients. In this research, 100 patients who was diagnosed as CKD and admitted in the Chittagong Medical College Hospital were enrolled. Estimated glomerular filtration rate (eGFR) was calculated with the MDRD formula. Cardiovascular risk factors were analyzed by Framinghams criteria and after compilation data were analyzed by SPSS-18.0. Among 100 patients, most of patients were under 60 years of age where males (56.0%) were more than females (44.0%). Framingham Cardiovascular Risk Score revealed that most of the male were at high risk group compared to female. Regarding different components of lipid profile with Framingham risk score, higher risk group had high mean total cholesterol (212.17mg/dl) and also low mean HDL level (38.58mg/dl). Patient with different stages of CKD with cardiovascular risk showed stage 5 CKD was 80%, stage 4 was 15.0% and rest 5 was at stage 3 and most were in low risk group (56.0%). There were significant positive correlations found in between age and serum total cholesterol level with the cardiovascular risk scoring but not with HDL and eGFR. The predominant cardiovascular risk factors were age, male gender, smoking and high serum total cholesterol.
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Affiliation(s)
- M K Alam
- Dr Mohammad Khurshadul Alam, Medical Officer, National Institute of Cardiovascular Disease (NICVD), Dhaka, Bangladesh; E-mail:
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Staplin N, Haynes R, Judge PK, Wanner C, Green JB, Emberson J, Preiss D, Mayne KJ, Ng SYA, Sammons E, Zhu D, Hill M, Stevens W, Wallendszus K, Brenner S, Cheung AK, Liu ZH, Li J, Hooi LS, Liu WJ, Kadowaki T, Nangaku M, Levin A, Cherney D, Maggioni AP, Pontremoli R, Deo R, Goto S, Rossello X, Tuttle KR, Steubl D, Petrini M, Seidi S, Landray MJ, Baigent C, Herrington WG, Abat S, Abd Rahman R, Abdul Cader R, Abdul Hafidz MI, Abdul Wahab MZ, Abdullah NK, Abdul-Samad T, Abe M, Abraham N, Acheampong S, Achiri P, Acosta JA, Adeleke A, Adell V, Adewuyi-Dalton R, Adnan N, Africano A, Agharazii M, Aguilar F, Aguilera A, Ahmad M, Ahmad MK, Ahmad NA, Ahmad NH, Ahmad NI, Ahmad Miswan N, Ahmad Rosdi H, Ahmed I, Ahmed S, Ahmed S, Aiello J, Aitken A, AitSadi R, Aker S, Akimoto S, Akinfolarin A, Akram S, Alberici F, Albert C, Aldrich L, Alegata M, Alexander L, Alfaress S, Alhadj Ali M, Ali A, Ali A, Alicic R, Aliu A, Almaraz R, Almasarwah R, Almeida J, Aloisi A, Al-Rabadi L, Alscher D, Alvarez P, Al-Zeer B, Amat M, Ambrose C, Ammar H, An Y, Andriaccio L, Ansu K, Apostolidi A, Arai N, Araki H, Araki S, Arbi A, Arechiga O, Armstrong S, Arnold T, Aronoff S, Arriaga W, Arroyo J, Arteaga D, Asahara S, Asai A, Asai N, Asano S, Asawa M, Asmee MF, Aucella F, Augustin M, Avery A, Awad A, Awang IY, Awazawa M, Axler A, Ayub W, Azhari Z, Baccaro R, Badin C, Bagwell B, Bahlmann-Kroll E, Bahtar AZ, Baigent C, Bains D, Bajaj H, Baker R, Baldini E, Banas B, Banerjee D, Banno S, Bansal S, Barberi S, Barnes S, Barnini C, Barot C, Barrett K, Barrios R, Bartolomei Mecatti B, Barton I, Barton J, Basily W, Bavanandan S, Baxter A, Becker L, Beddhu S, Beige J, Beigh S, Bell S, Benck U, Beneat A, Bennett A, Bennett D, Benyon S, Berdeprado J, Bergler T, Bergner A, Berry M, Bevilacqua M, Bhairoo J, Bhandari S, Bhandary N, Bhatt A, Bhattarai M, Bhavsar M, Bian W, Bianchini F, Bianco S, Bilous R, Bilton J, Bilucaglia D, Bird C, Birudaraju D, Biscoveanu M, Blake C, Bleakley N, Bocchicchia K, Bodine S, Bodington R, Boedecker S, Bolduc M, Bolton S, Bond C, Boreky F, Boren K, Bouchi R, Bough L, Bovan D, Bowler C, Bowman L, Brar N, Braun C, Breach A, Breitenfeldt M, Brenner S, Brettschneider B, Brewer A, Brewer G, Brindle V, Brioni E, Brown C, Brown H, Brown L, Brown R, Brown S, Browne D, Bruce K, Brueckmann M, Brunskill N, Bryant M, Brzoska M, Bu Y, Buckman C, Budoff M, Bullen M, Burke A, Burnette S, Burston C, Busch M, Bushnell J, Butler S, Büttner C, Byrne C, Caamano A, Cadorna J, Cafiero C, Cagle M, Cai J, Calabrese K, Calvi C, Camilleri B, Camp S, Campbell D, Campbell R, Cao H, Capelli I, Caple M, Caplin B, Cardone A, Carle J, Carnall V, Caroppo M, Carr S, Carraro G, Carson M, Casares P, Castillo C, Castro C, Caudill B, Cejka V, Ceseri M, Cham L, Chamberlain A, Chambers J, Chan CBT, Chan JYM, Chan YC, Chang E, Chang E, Chant T, Chavagnon T, Chellamuthu P, Chen F, Chen J, Chen P, Chen TM, Chen Y, Chen Y, Cheng C, Cheng H, Cheng MC, Cherney D, Cheung AK, Ching CH, Chitalia N, Choksi R, Chukwu C, Chung K, Cianciolo G, Cipressa L, Clark S, Clarke H, Clarke R, Clarke S, Cleveland B, Cole E, Coles H, Condurache L, Connor A, Convery K, Cooper A, Cooper N, Cooper Z, Cooperman L, Cosgrove L, Coutts P, Cowley A, Craik R, Cui G, Cummins T, Dahl N, Dai H, Dajani L, D'Amelio A, Damian E, Damianik K, Danel L, Daniels C, Daniels T, Darbeau S, Darius H, Dasgupta T, Davies J, Davies L, Davis A, Davis J, Davis L, Dayanandan R, Dayi S, Dayrell R, De Nicola L, Debnath S, Deeb W, Degenhardt S, DeGoursey K, Delaney M, Deo R, DeRaad R, Derebail V, Dev D, Devaux M, Dhall P, Dhillon G, Dienes J, Dobre M, Doctolero E, Dodds V, Domingo D, Donaldson D, Donaldson P, Donhauser C, Donley V, Dorestin S, Dorey S, Doulton T, Draganova D, Draxlbauer K, Driver F, Du H, Dube F, Duck T, Dugal T, Dugas J, Dukka H, Dumann H, Durham W, Dursch M, Dykas R, Easow R, Eckrich E, Eden G, Edmerson E, Edwards H, Ee LW, Eguchi J, Ehrl Y, Eichstadt K, Eid W, Eilerman B, Ejima Y, Eldon H, Ellam T, Elliott L, Ellison R, Emberson J, Epp R, Er A, Espino-Obrero M, Estcourt S, Estienne L, Evans G, Evans J, Evans S, Fabbri G, Fajardo-Moser M, Falcone C, Fani F, Faria-Shayler P, Farnia F, Farrugia D, Fechter M, Fellowes D, Feng F, Fernandez J, Ferraro P, Field A, Fikry S, Finch J, Finn H, Fioretto P, Fish R, Fleischer A, Fleming-Brown D, Fletcher L, Flora R, Foellinger C, Foligno N, Forest S, Forghani Z, Forsyth K, Fottrell-Gould D, Fox P, Frankel A, Fraser D, Frazier R, Frederick K, Freking N, French H, Froment A, Fuchs B, Fuessl L, Fujii H, Fujimoto A, Fujita A, Fujita K, Fujita Y, Fukagawa M, Fukao Y, Fukasawa A, Fuller T, Funayama T, Fung E, Furukawa M, Furukawa Y, Furusho M, Gabel S, Gaidu J, Gaiser S, Gallo K, Galloway C, Gambaro G, Gan CC, Gangemi C, Gao M, Garcia K, Garcia M, Garofalo C, Garrity M, Garza A, Gasko S, Gavrila M, Gebeyehu B, Geddes A, Gentile G, George A, George J, Gesualdo L, Ghalli F, Ghanem A, Ghate T, Ghavampour S, Ghazi A, Gherman A, Giebeln-Hudnell U, Gill B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura S, Kiyosue A, Kiyota M, Klauser F, Klausmann G, Kmietschak W, Knapp K, Knight C, Knoppe A, Knott C, Kobayashi M, Kobayashi R, Kobayashi T, Koch M, Kodama S, Kodani N, Kogure E, Koizumi M, Kojima H, Kojo T, Kolhe N, Komaba H, Komiya T, Komori H, Kon SP, Kondo M, Kondo M, Kong W, Konishi M, Kono K, Koshino M, Kosugi T, Kothapalli B, Kozlowski T, Kraemer B, Kraemer-Guth A, Krappe J, Kraus D, Kriatselis C, Krieger C, Krish P, Kruger B, Ku Md Razi KR, Kuan Y, Kubota S, Kuhn S, Kumar P, Kume S, Kummer I, Kumuji R, Küpper A, Kuramae T, Kurian L, Kuribayashi C, Kurien R, Kuroda E, Kurose T, Kutschat A, Kuwabara N, Kuwata H, La Manna G, Lacey M, Lafferty K, LaFleur P, Lai V, Laity E, Lambert A, Landray MJ, Langlois M, Latif F, Latore E, Laundy E, Laurienti D, Lawson A, Lay M, Leal I, Leal I, Lee AK, Lee J, Lee KQ, Lee R, Lee SA, Lee YY, Lee-Barkey Y, Leonard N, Leoncini G, Leong CM, Lerario S, Leslie A, Levin A, Lewington A, Li J, Li N, Li X, Li Y, Liberti L, Liberti ME, Liew A, Liew YF, Lilavivat U, Lim SK, Lim YS, Limon E, Lin H, Lioudaki E, Liu H, Liu J, Liu L, Liu Q, Liu WJ, Liu X, Liu Z, Loader D, Lochhead H, Loh CL, Lorimer A, Loudermilk L, Loutan J, Low CK, Low CL, Low YM, Lozon Z, Lu Y, Lucci D, Ludwig U, Luker N, Lund D, Lustig R, Lyle S, Macdonald C, MacDougall I, Machicado R, MacLean D, Macleod P, Madera A, Madore F, Maeda K, Maegawa H, Maeno S, Mafham M, Magee J, Maggioni AP, Mah DY, Mahabadi V, Maiguma M, Makita Y, Makos G, Manco L, Mangiacapra R, Manley J, Mann P, Mano S, Marcotte G, Maris J, Mark P, Markau S, Markovic M, Marshall C, Martin M, Martinez C, Martinez S, Martins G, Maruyama K, Maruyama S, Marx K, Maselli A, Masengu A, Maskill A, Masumoto S, Masutani K, Matsumoto M, Matsunaga T, Matsuoka N, Matsushita M, Matthews M, Matthias S, Matvienko E, Maurer M, Maxwell P, Mayne KJ, Mazlan N, Mazlan SA, Mbuyisa A, McCafferty K, McCarroll F, McCarthy T, McClary-Wright C, McCray K, McDermott P, McDonald C, McDougall R, McHaffie E, McIntosh K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, Nakahara M, Nakamura J, Nakamura R, Nakamura T, Nakaoka M, Nakashima E, Nakata J, Nakata M, Nakatani S, Nakatsuka A, Nakayama Y, Nakhoul G, Nangaku M, Naverrete G, Navivala A, Nazeer I, Negrea L, Nethaji C, Newman E, Ng SYA, Ng TJ, Ngu LLS, Nimbkar T, Nishi H, Nishi M, Nishi S, Nishida Y, Nishiyama A, Niu J, Niu P, Nobili G, Nohara N, Nojima I, Nolan J, Nosseir H, Nozawa M, Nunn M, Nunokawa S, Oda M, Oe M, Oe Y, Ogane K, Ogawa W, Ogihara T, Oguchi G, Ohsugi M, Oishi K, Okada Y, Okajyo J, Okamoto S, Okamura K, Olufuwa O, Oluyombo R, Omata A, Omori Y, Ong LM, Ong YC, Onyema J, Oomatia A, Oommen A, Oremus R, Orimo Y, Ortalda V, Osaki Y, Osawa Y, Osmond Foster J, O'Sullivan A, Otani T, Othman N, Otomo S, O'Toole J, Owen L, Ozawa T, Padiyar A, Page N, Pajak S, Paliege A, Pandey A, Pandey R, Pariani H, Park J, Parrigon M, Passauer J, Patecki M, Patel M, Patel R, Patel T, Patel Z, Paul R, Paul R, Paulsen L, Pavone L, Peixoto A, Peji J, Peng BC, Peng K, Pennino L, Pereira E, Perez E, Pergola P, Pesce F, 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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, Nakahara M, Nakamura J, Nakamura R, Nakamura T, Nakaoka M, Nakashima E, Nakata J, Nakata M, Nakatani S, Nakatsuka A, Nakayama Y, Nakhoul G, Nangaku M, Naverrete G, Navivala A, Nazeer I, Negrea L, Nethaji C, Newman E, Ng SYA, Ng TJ, Ngu LLS, Nimbkar T, Nishi H, Nishi M, Nishi S, Nishida Y, Nishiyama A, Niu J, Niu P, Nobili G, Nohara N, Nojima I, Nolan J, Nosseir H, Nozawa M, Nunn M, Nunokawa S, Oda M, Oe M, Oe Y, Ogane K, Ogawa W, Ogihara T, Oguchi G, Ohsugi M, Oishi K, Okada Y, Okajyo J, Okamoto S, Okamura K, Olufuwa O, Oluyombo R, Omata A, Omori Y, Ong LM, Ong YC, Onyema J, Oomatia A, Oommen A, Oremus R, Orimo Y, Ortalda V, Osaki Y, Osawa Y, Osmond Foster J, O'Sullivan A, Otani T, Othman N, Otomo S, O'Toole J, Owen L, Ozawa T, Padiyar A, Page N, Pajak S, Paliege A, Pandey A, Pandey R, Pariani H, Park J, Parrigon M, Passauer J, Patecki M, Patel M, Patel R, Patel T, Patel Z, Paul R, Paul R, Paulsen L, Pavone L, Peixoto A, Peji J, Peng BC, Peng K, Pennino L, Pereira E, Perez E, Pergola P, Pesce F, Pessolano G, Petchey W, Petr EJ, Pfab T, Phelan P, Phillips R, Phillips T, Phipps M, Piccinni G, Pickett T, Pickworth S, Piemontese M, Pinto D, Piper J, Plummer-Morgan J, Poehler D, Polese L, Poma V, Pontremoli R, Postal A, Pötz C, Power A, Pradhan N, Pradhan R, Preiss D, Preiss E, Preston K, Prib N, Price L, Provenzano C, Pugay C, Pulido R, Putz F, Qiao Y, Quartagno R, Quashie-Akponeware M, Rabara R, Rabasa-Lhoret R, Radhakrishnan D, Radley M, Raff R, Raguwaran S, Rahbari-Oskoui F, Rahman M, Rahmat K, Ramadoss S, Ramanaidu S, Ramasamy S, Ramli R, Ramli S, Ramsey T, Rankin A, Rashidi A, Raymond L, Razali WAFA, Read K, Reiner H, Reisler A, Reith C, Renner J, Rettenmaier B, Richmond L, Rijos D, Rivera R, Rivers V, Robinson H, Rocco M, Rodriguez-Bachiller I, Rodriquez R, Roesch C, Roesch J, Rogers J, Rohnstock M, Rolfsmeier S, Roman M, Romo A, Rosati A, Rosenberg S, Ross T, Rossello X, Roura M, Roussel M, Rovner S, Roy S, Rucker S, Rump L, Ruocco M, Ruse S, Russo F, Russo M, Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Ganapathi A, Sarwar S, Hasan A, Lampert B, Henn M, Mokadam N, Emani S, Marschalk N, Whitson B. Use of Hepatitis C Positive Donor in HIV Positive Heart Transplant Recipient. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.663] [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: 04/05/2023] Open
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Tiwari A, Mehrotra M, Hasan A, Agarwal J, Singh GK. "HBV liver decompensation: Antiviral therapy for all". J Gastroenterol Hepatol 2023; 38:833-834. [PMID: 36999212 DOI: 10.1111/jgh.16187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 03/28/2023] [Indexed: 04/01/2023]
Affiliation(s)
- A Tiwari
- Department of Gastroenterology Regency Hospital Ltd, Kanpur, Uttar Pradesh, India, 208005
| | - M Mehrotra
- Department of Gastroenterology Regency Hospital Ltd, Kanpur, Uttar Pradesh, India, 208005
| | - A Hasan
- Department of Gastroenterology Regency Hospital Ltd, Kanpur, Uttar Pradesh, India, 208005
| | - J Agarwal
- Regency Hospital Ltd, Kanpur, Uttar Pradesh, India, 208005
| | - G K Singh
- Regency Hospital Ltd, Kanpur, Uttar Pradesh, India, 208005
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Shah PP, Hasan A, Winokur J, Braunstein R, Ritterband DC, Seedor JA, Cheela I. Impact of Donor, Recipient, and Graft Characteristics on Corneal Transplantation Outcomes. Clin Ophthalmol 2023; 17:633-640. [PMID: 36866241 PMCID: PMC9970880 DOI: 10.2147/opth.s399847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/09/2023] [Indexed: 02/25/2023] Open
Abstract
Purpose Although several donor, recipient, and graft characteristics have been studied in relation to corneal transplantation outcomes, no study to our knowledge has assessed the impact of donor cooling times on postoperative outcomes longitudinally. With only one corneal graft available for every 70 needed worldwide, this study seeks to identify any factors that could alleviate this shortage. Methods Patients undergoing corneal transplantation at the Manhattan Eye, Ear & Throat Hospital over a 2-year period were retrospectively studied. Study metrics included age, diabetic history, hypertensive history, endothelial cell density, death-to-preservation time (DTP), death-to-cooling time (DTC), and time-in-preservation (TIP). Postoperative transplantation outcomes, including best corrected visual acuity (BCVA) at 6- and 12-month follow-up visits, need for re-bubbling, and need for re-grafting, were assessed. Unadjusted univariate and adjusted multivariate binary logistic regressions were performed to determine the association of cooling and preservation parameters with corneal transplantation outcomes. Results Among 111 transplants, our adjusted model found that DTC ≥4 hours was associated with significantly worse BCVA, but only at 6-month postoperative follow-up (odds ratio [OR]: 0.234; 95% confidence interval [CI]: 0.073-0.747; p = 0.014). By 12-month follow-up, DTC >4 hours was no longer associated with BCVA in a statistically significant manner (OR: 0.472; 95% CI: 0.135-1.653; p = 0.240). A similar trend was found at a DTC cutoff of ≥3 hours. None of the other studied parameters, including DTP, TIP, donor age, or medical history were significantly correlated with transplantation outcomes. Conclusion Longer DTC or DTP did not have a statistically significant effect on corneal graft outcomes after one year, though short-term outcomes were improved in donor tissues with DTC below four hours. None of the other studied variables correlated with transplantation outcomes. Given the global shortage of corneal tissue, these findings should be considered when determining suitability for transplantation.
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Affiliation(s)
- Paras P Shah
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA,Correspondence: Paras P Shah, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY, 11549, USA, Email
| | - Aisha Hasan
- Department of Ophthalmology, Northwell Health/Manhattan Eye, Ear & Throat Hospital, New York, NY, USA
| | - Jules Winokur
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA,Department of Ophthalmology, Northwell Health/Manhattan Eye, Ear & Throat Hospital, New York, NY, USA
| | - Richard Braunstein
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA,Department of Ophthalmology, Northwell Health/Manhattan Eye, Ear & Throat Hospital, New York, NY, USA
| | - David C Ritterband
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA,Department of Ophthalmology, Northwell Health/Manhattan Eye, Ear & Throat Hospital, New York, NY, USA
| | - John A Seedor
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA,Department of Ophthalmology, Northwell Health/Manhattan Eye, Ear & Throat Hospital, New York, NY, USA
| | - Isha Cheela
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA,Department of Ophthalmology, Northwell Health/Manhattan Eye, Ear & Throat Hospital, New York, NY, USA
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Iqbal N, Hasan A, Razzaq S, Rashid FS. Effect of Body Mass Index on complications and success rates of percutaneous nephrolithotomy-A tertiary care hospital experience. Pak J Med Sci 2022; 38:2112-2117. [PMID: 36415255 PMCID: PMC9676566 DOI: 10.12669/pjms.38.8.3663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 08/04/2022] [Accepted: 08/28/2022] [Indexed: 11/06/2022] Open
Abstract
Background and Objectives: Urolithiasis is prevalent globally. Over time, innovation in endoscopic instruments and miniaturization has untangled the interventional strategy for carrying out remedial surgical procedures for renal stones. However, studies have been scarce as for sequelae of Percutaneous Nephrolithotomy (PCNL) in varying body mass index group patients in the developing world. We aimed to report success rates and complications in different BMI groups. Methods: This was a retrospective study wherein data of 359 patients was reviewed in charts. These patients went through PCNL at our department from July 2011 till September 2019. Three groups of patients were made in agreement with WHO BMI classification. Information concerning study variables was noted in designated and then processed in SPSS version 16 for the statistical computations. Results: On the whole, the mean age of patients was 44.6± 14.4 years. While the mean calculus size was 3.1± 1.4 cm. Moreover, the majority of stones in all the three groups belonged to Guy’s stone score 1 and 2 (see Table-I). The overall mean procedure time and inpatient stay were almost comparable in the obese group. The highest stone-free rate was observed in the normal weight group (77.69 %), however, stone-free status in overweight and obese groups was not comparatively too lower (p=0.74). Complication rates were being close among the three groups. Conclusion: PCNL can be ventured with safety and in an effectual manner for attaining stone treatment goals alike in obese and non-obese group patients.
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Affiliation(s)
- Nadeem Iqbal
- Nadeem Iqbal, Shifa International Hospital, Islamabad, Pakistan
- Correspondence: Dr. Nadeem Iqbal Department of Urology and Kidney Transplant. Pakistan Kidney Institute, Shifa International Hospital, Sector H-8/4, Islamabad, Pakistan.
| | - Aisha Hasan
- Aisha Hasan, Shifa College of Medicine, Islamabad, Pakistan
| | - Sajid Razzaq
- Sajid Razzaq, Sheikh Khalifa Bin Zayed Hospital/Poonch Medical College, Rawalakot, Azad Kashmir, Pakistan
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Reicherts P, Zerbini G, Halms T, Strasser M, Papazova I, Hasan A, Kunz M. COVID-19 related psychological burden and potential benefits of vaccination - Data from a repeated cross-sectional survey in healthcare workers. Psychiatry Research Communications 2022; 2:100054. [PMID: 35702354 PMCID: PMC9181270 DOI: 10.1016/j.psycom.2022.100054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/13/2022] [Accepted: 06/05/2022] [Indexed: 11/27/2022]
Abstract
The COVID-19 pandemic is impacting the psychological well-being, especially of health care workers, for more than two years now. Here, we followed-up on a survey we conducted at the very beginning of the pandemic, to determine potential changes in psychological strain experienced by health care workers one year later. Since our first survey in 2020, COVID-19 vaccines have been established, thus we assessed whether vaccination-status might modulate psychological burden of health care workers. We also collected data on resilience and sleep, as those might be related to successful coping. Between March and April 2021, nurses and physicians (N = 286) working at the University Hospital Augsburg - with high or low exposure to COVID-19 patients - took part in an online survey. We found that fully vaccinated personnel reported lower levels of anxiety, depression, stress and exhaustion suggesting the potential positive consequences of vaccination beyond the obvious protection against a COVID-19 infection. Nurses reported more depressive symptoms, anxiety, stress and exhaustion and lower levels of job fulfilment than physicians. Individuals with high exposure to COVID-19 patients reported higher exhaustion and depersonalization. Resilience and sleep quality were significantly correlated with psychological and work-related burden, suggesting their potential role as protective resources. In general, the comparison of the present data to the survey conducted in 2020 suggests an overall increase of psychological burden in health care workers. Despite these surely alarming findings, it should be noted that being vaccinated might come along with reduced psychological strain.
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Affiliation(s)
- P Reicherts
- Department of Medical Psychology and Sociology, Medical Faculty, University of Augsburg, Germany
| | - G Zerbini
- Department of Medical Psychology and Sociology, Medical Faculty, University of Augsburg, Germany
| | - T Halms
- Department of Medical Psychology and Sociology, Medical Faculty, University of Augsburg, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Bezirkskrankenhaus, Augsburg, Germany
| | - M Strasser
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Bezirkskrankenhaus, Augsburg, Germany
| | - I Papazova
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Bezirkskrankenhaus, Augsburg, Germany
| | - A Hasan
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Bezirkskrankenhaus, Augsburg, Germany
| | - M Kunz
- Department of Medical Psychology and Sociology, Medical Faculty, University of Augsburg, Germany
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Generali T, Jansen K, Rybicka J, Nassar M, Hasan A, De Rita F. Collateral damage in single ventricle circulation: the unresolved challenge of heart transplantation for adult congenital heart disease. J Heart Lung Transplant 2022; 41:1530-1533. [DOI: 10.1016/j.healun.2022.06.014] [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] [Received: 03/24/2022] [Revised: 06/03/2022] [Accepted: 06/16/2022] [Indexed: 11/16/2022] Open
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Maurus I, Röll L, Keeser D, Schmitt A, Hasan A, Hirjak D, Meyer-Lindenberg A, Falkai P. Effects of Exercise in People with Severe Mental Illness and Recommendations for its Implementation as Add-on Therapy. Eur Psychiatry 2022. [PMCID: PMC9567411 DOI: 10.1192/j.eurpsy.2022.80] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
There are many reasons for people with (and without) severe mental illness to exercise regularly. In people with schizophrenia, major depression and bipolar disorder, it has already been shown that regular physical activity as an add-on therapy can improve quality of life and symptom severity. This is particularly important in domains that standard therapy is currently not able to treat sufficiently, such as cognitive deficits. Postulated underlying neurobiological effects include increased volume in hippocampal areas as demonstrated by data of a current clinical trial in people with schizophrenia. Furthermore, regular exercise is essential to counteract the increased cardiovascular morbidity and mortality of people with severe mental illness. However, most people with severe mental illness do not achieve the recommended amount of physical activity and the potential of exercise as an add-on therapy is currently not even close to being fully realized. On the one hand, it is important that mental health staff also considers the physical condition of patients with mental illnesses and counsels them on their health behavior. On the other hand, there is a need for individually adapted training programs delivered by qualified exercise professionals that incorporate motivational and adherence strategies. Examples of barriers and facilitators for the implementation of exercise as an add-on therapy are discussed on the basis of current local projects.
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Hasan A, Nasution Y. A compartmental epidemic model incorporating probable cases to model COVID-19 outbreak in regions with limited testing capacity. ISA Trans 2022; 124:157-163. [PMID: 33487398 PMCID: PMC7817488 DOI: 10.1016/j.isatra.2021.01.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 01/13/2021] [Accepted: 01/13/2021] [Indexed: 06/12/2023]
Abstract
We propose a new compartmental epidemic model taking into account people who have symptoms with no confirmatory laboratory testing (probable cases). We prove well-posedness of the model and provide an explicit expression for the basic reproduction number (R0). We use the model together with an extended Kalman filter (EKF) to estimate the time-varying effective reproduction number (Rt) of COVID-19 in West Java province in Indonesia and the state of Michigan in the USA, where laboratory testing capacities are limited. Based on our estimation, the value of Rt is higher when the probable cases are taken into account. This correction can be used by decision and policy makers when considering re-opening policy and evaluation of public measures.
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Affiliation(s)
- A Hasan
- Mærsk McKinney Møller Institute, University of Southern Denmark, Denmark.
| | - Y Nasution
- Department of Mathematics, University of Mulawarman, Indonesia
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Hasan A, Putri ERM, Susanto H, Nuraini N. Data-driven modeling and forecasting of COVID-19 outbreak for public policy making. ISA Trans 2022; 124:135-143. [PMID: 33487397 PMCID: PMC7816594 DOI: 10.1016/j.isatra.2021.01.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 01/11/2021] [Accepted: 01/13/2021] [Indexed: 06/12/2023]
Abstract
This paper presents a data-driven approach for COVID-19 modeling and forecasting, which can be used by public policy and decision makers to control the outbreak through Non-Pharmaceutical Interventions (NPI). First, we apply an extended Kalman filter (EKF) to a discrete-time stochastic augmented compartmental model to estimate the time-varying effective reproduction number (Rt). We use daily confirmed cases, active cases, recovered cases, deceased cases, Case-Fatality-Rate (CFR), and infectious time as inputs for the model. Furthermore, we define a Transmission Index (TI) as a ratio between the instantaneous and the maximum value of the effective reproduction number. The value of TI indicates the "effectiveness" of the disease transmission from a contact between a susceptible and an infectious individual in the presence of current measures, such as physical distancing and lock-down, relative to a normal condition. Based on the value of TI, we forecast different scenarios to see the effect of relaxing and tightening public measures. Case studies in three countries are provided to show the practicability of our approach.
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Affiliation(s)
- A Hasan
- Mærsk McKinney Møller Institute, University of Southern Denmark, Denmark.
| | - E R M Putri
- Department of Mathematics, Institut Teknologi Sepuluh Nopember, Indonesia
| | - H Susanto
- Department of Mathematics, Khalifa University, United Arab Emirates; Department of Mathematical Sciences, University of Essex, United Kingdom
| | - N Nuraini
- Department of Mathematics, Institut Teknologi Bandung, Indonesia
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Iqbal N, Iqbal S, Hasan A, Iqbal A, Blair KAA, Milstein DMJ, Akhter S. Outcome of tubeless percutaneous nephrolithotomy in elder patients: A single-center experience from a developing country. J Clin Transl Res 2022; 8:160-165. [PMID: 35475270 PMCID: PMC9036081] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 11/07/2022] [Accepted: 02/18/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Percutaneous nephrolithotomy (PCNL) has evolved as a standard procedure to treat large-sized renal stones. A nephrostomy tube is used frequently in this procedure; however, data regarding tubeless PCNL procedures in elder patients is scarce. AIM The aim of this study was to review the results and outcomes associated with tubeless PCNL procedures in the elderly population. MATERIALS AND METHODS A retrospective review of patients aged ≥60 years at our hospital that was treated for renal stones by PCNL procedure. The patients were separated into two groups: Group 1 underwent tubed PCNL procedures and Group 2 received tubeless PCNL procedures. Information regarding variables were recorded in specified pro forma and then processed in Statistical Package for the Social Sciences statistics analyses. Statistical tests were utilized for continuous and categorical variables and a P<0.05 was considered statistically significant. RESULTS 121 patients with a mean age of 65±5 years were included in the analysis. Mean stone size and body mass index were 3.4±1.5 cm and 26.2±4.3 kg/m2, respectively. Mean operative time was longer in tubed PCNL as compared to the tubeless group. Mean hospital stay was similar among the tubed and tubeless PCNL treated groups. Mean analgesic doses were significantly lower in the tubeless group. The overall stone-free rate was 89/121 patients (74%). CONCLUSION Tubeless PCNL can be safely undertaken in geriatric patients and has potential advantages associated with shorter operative times and reduced necessity for analgesia. RELEVANCE FOR PATIENTS Tubeless PCNL is considered advantageous as it can reduce post-operative pain and analgesia necessity; shorten hospitalization and lower cost in young patients. However, there is no clear evidence with reference to virtue of tubeless PCNL in the elderly age groups. This study will analyze and review results and outcomes associated with tubeless PCNL in a cohort of elderly patients.
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Affiliation(s)
- Nadeem Iqbal
- 1Department of Urology and Kidney Transplant, Shifa International Hospital, Islamabad, Pakistan,Corresponding author: Nadeem Iqbal Department of Urology and Kidney Transplant, Pakistan Kidney Institute, Shifa International Hospital Ltd. Pitras, Bukhari Road, Sector H-8/4, Islamabad, Pakistan. E-mail:
| | - Sajid Iqbal
- 2Department of Rehabilitation, Pakistan Navy PNS Hospital, Karachi, Pakistan
| | - Aisha Hasan
- 3Department of Biochemistry, Riphah International University, Rawalpindi, Pakistan
| | - Aimen Iqbal
- 4Department of Medicine, Bahria University Medical and Dental College, Karachi, Pakistan
| | - Keron A. A. Blair
- 5Department of Medicine, American International School of Medicine, Georgetown, Guyana
| | - Dan M. J. Milstein
- 6Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centre, Location: AMC, Amsterdam, Netherlands
| | - Saeed Akhter
- 1Department of Urology and Kidney Transplant, Shifa International Hospital, Islamabad, Pakistan
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Jannat K, Hasan A, Bondhon TA, Mahboob T, Paul AK, Jahan R, Nissapatorn V, Pereira ML, Wiart C, Rahmatullah M. Can Costus afer be used for co-treatment of COVID-19, its symptoms and comorbidities? A novel approach for combating the pandemic and implications for sub-Saharan Africa. Trop Biomed 2021; 38:540-551. [PMID: 35001920 DOI: 10.47665/tb.38.4.097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Despite the huge loss of lives and massive disruption of the world economy by the COVID -19 pandemic caused by SARS -CoV-2, scientists are yet to come out with an effective therapeutic against this viral disease . Several vaccines have obtained 'emergency approval ', but difficulties are being faced in the even distribution of vaccines amongst high- and low- income countries . On top of it, comorbidities associated with COVID -19 like diabetes, hypertension and malaria can seriously impede the treatment of the main disease, thus increasing the fatality rate . This is more so in the context of sub -Saharan African and south Asian countries . Our objective was to demonstrate that a single plant containing different phytoconstituents may be used for treatment of COVID -19 and comorbidities . Towards initial selection of a plant, existing scientific literature was scanned for reported relevant traditional uses, phytochemicals and pharmacological activities of a number of plants and their phytoconstituents pertaining to treatment of COVID-19 symptoms and comorbidities. Molecular docking studies were then performed with phytochemicals of the selected plant and SARS-CoV-2 components - Mpro, and spike protein receptor binding domain and hACE2 interface using AutoDock V ina. We showed that crude extracts of an indigenous African plant, Costus afer having traditional antidiabetic and antimalarial uses, has phytochemicals with high binding affinities for Mpro, and /or spike protein receptor binding domain and hACE2 interface; the various phytochemicals with predicted high binding energies include aferoside C, dibutyl phthalate, nerolidol, suginal, and ± -terpinene, making them potential therapeutics for COVID -19. The results suggest that crude extracts and phytochemicals of C. afer can function as a treatment modality for COVID -19 and comorbidities like especially diabetes and malaria .
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Affiliation(s)
- K Jannat
- Department of Biotechnology & Genetic Engineering, University of Development Alternative, Lalmatia, Dhaka, Bangladesh
| | - A Hasan
- Department of Biotechnology & Genetic Engineering, University of Development Alternative, Lalmatia, Dhaka, Bangladesh
| | - T A Bondhon
- Department of Biotechnology & Genetic Engineering, University of Development Alternative, Lalmatia, Dhaka, Bangladesh
| | - T Mahboob
- School of Allied Health Sciences, World Union for Herbal Drug Discovery (WUHeDD) and Research Excellence Center for Innovation and Health Products (RECIHP), Walailak University, Nakhon Si Thammarat, Thailand
| | - A K Paul
- Department of Biotechnology & Genetic Engineering, University of Development Alternative, Lalmatia, Dhaka, Bangladesh
| | - R Jahan
- Department of Biotechnology & Genetic Engineering, University of Development Alternative, Lalmatia, Dhaka, Bangladesh
| | - V Nissapatorn
- School of Allied Health Sciences, World Union for Herbal Drug Discovery (WUHeDD) and Research Excellence Center for Innovation and Health Products (RECIHP), Walailak University, Nakhon Si Thammarat, Thailand
| | - M L Pereira
- CICECO-Aveiro Institute of Materials & Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - C Wiart
- School of Pharmacy, University of Nottingham Malaysia Campus, Selangor, Malaysia
| | - M Rahmatullah
- Department of Biotechnology & Genetic Engineering, University of Development Alternative, Lalmatia, Dhaka, Bangladesh
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Paul AK, Jahan R, Bondhon TA, Jannat K, Hasan A, Rahmatullah M, Nissapatorn V, Pereira ML, Wiart C. Potential role of flavonoids against SARS-CoV-2 induced diarrhea. Trop Biomed 2021; 38:360-365. [PMID: 34508344 DOI: 10.47665/tb.38.3.079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
COVID-19, caused by the SARS-CoV-2 virus, can lead to massive inflammation in the gastrointestinal tract causing severe clinical symptoms. SARS-CoV-2 infects lungs after binding its spike proteins with alveolar angiotensin-converting enzyme 2 (ACE2), and it also triggers inflammation in the gastrointestinal tract. SARS-CoV-2 invades the gastrointestinal tract by interacting with Toll-like receptor-4 (TLR4) that induces the expression of ACE2. The influx of ACE2 facilitates cellular binding of more SARS-CoV-2 and causes massive gastrointestinal inflammation leading to diarrhea. Diarrhea prior to COVID-19 infection or COVID-19-induced diarrhea reportedly ends up in a poor prognosis for the patient. Flavonoids are part of traditional remedies for gastrointestinal disorders. Preclinical studies show that flavonoids can prevent infectious diarrhea. Recent studies show flavonoids can inhibit the multiplication of SARS-CoV-2. In combination with vitamin D, flavonoids possibly activate nuclear factor erythroid-derived-2-related factor 2 that downregulates ACE2 expression in cells. We suggest that flavonoids have the potential to prevent SARS-CoV-2 induced diarrhea.
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Affiliation(s)
- A K Paul
- Department of Biotechnology & Genetic Engineering, University of Development Alternative, Lalmatia, Dhaka-1207, Bangladesh.,School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Australia
| | - R Jahan
- Department of Biotechnology & Genetic Engineering, University of Development Alternative, Lalmatia, Dhaka-1207, Bangladesh
| | - T A Bondhon
- Department of Biotechnology & Genetic Engineering, University of Development Alternative, Lalmatia, Dhaka-1207, Bangladesh
| | - K Jannat
- Department of Biotechnology & Genetic Engineering, University of Development Alternative, Lalmatia, Dhaka-1207, Bangladesh
| | - A Hasan
- Department of Biotechnology & Genetic Engineering, University of Development Alternative, Lalmatia, Dhaka-1207, Bangladesh
| | - M Rahmatullah
- Department of Biotechnology & Genetic Engineering, University of Development Alternative, Lalmatia, Dhaka-1207, Bangladesh
| | - V Nissapatorn
- School of Allied Health Sciences, World Union for Herbal Drug Discovery (WUHeDD), and Research Excellence Center for Innovation and Health Products (RECIHP), Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - M L Pereira
- CICECO - Aveiro Institute of Materials and Department of Medical Sciences, University of Aveiro, Aveiro 3810, Portugal
| | - C Wiart
- School of Pharmacy, University of Nottingham Malaysia Campus, Semenyih 43500, Selangor Darul Ehsan, Malaysia
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Kumpf U, Stadler M, Plewnia C, Bajbouj M, Langguth B, Zwanzger P, Normann C, Keeser D, Schellhorn K, Egert-Schwender S, Berkes S, Palm U, Hasan A, Padberg F. Transcranial Direct Current Stimulation (tDCS) for major depression - Interim analysis of cloud supervised technical data from the DepressionDC trial. Brain Stimul 2021; 14:1234-1237. [PMID: 34391956 DOI: 10.1016/j.brs.2021.08.005] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/02/2021] [Accepted: 08/05/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) of prefrontal cortex regions has been reported to exert antidepressant effects, though large scale multicenter trials in major depressive disorder (MDD) supporting this notion are still lacking. Application of tDCS in multicenter settings, however, requires measurement, storage and evaluation of technical parameters of tDCS sessions not only for safety reasons but also for quality control. To address this issue, we conducted an interim analysis of supervised technical data across study centers in order to monitor technical quality of tDCS in an ongoing multicenter RCT in MDD (DepressionDC trial). METHODS Technical data of 818 active tDCS sessions were recorded, stored in a data cloud, and analysed without violating study blinding. Impedance, voltage and current were monitored continuously with one data point recorded every second of stimulation. RESULTS Variability of impedance was considerable (1,42 kΩ, to 8,23 kΩ), inter-individually and even more intra-individually, but did not significantly differ between the study centre in Munich and all other sites. CONCLUSION Measurement, centralized data storage via data cloud and remote supervision of technical parameters of tDCS are feasible and proposed for future RCTs on therapeutic tDCS in multiple settings.
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Affiliation(s)
- U Kumpf
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University Munich, Nussbaumstr. 7, 80336, Munich, Germany.
| | - M Stadler
- Faculty of Psychology and Educational Sciences, Ludwig Maximilian University Munich, Germany
| | - C Plewnia
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - M Bajbouj
- Department of Psychiatry and Psychotherapy, Charité-Campus Benjamin Franklin, Berlin, Germany
| | - B Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - P Zwanzger
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University Munich, Nussbaumstr. 7, 80336, Munich, Germany; kbo-Inn-Salzach-Hospital, Wasserburg am Inn, Germany
| | - C Normann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine & Center for Basics in Neuomodulation NeuroModulBasics, University of Freiburg, Germany
| | - D Keeser
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University Munich, Germany; Department of Radiology, Ludwig Maximilian University Munich, Germany; Munich Center for Neurosciences (MCN) - Brain & Mind, Planegg-Martinsried, Germany
| | | | | | - S Berkes
- NeuroCare Group GmbH, Munich, Germany
| | - U Palm
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University Munich, Nussbaumstr. 7, 80336, Munich, Germany; Medicalpark Chiemseeblick, Bernau-Felden, Germany
| | - A Hasan
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, BKH Augsburg, Augsburg, Germany
| | - F Padberg
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University Munich, Germany
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Bondhon TA, Fatima A, Jannat K, Hasan A, Jahan R, Nissapatorn V, Wiart C, Pereira ML, Rahmatullah M. In silico screening of Allium cepa phytochemicals for their binding abilities to SARS and SARS-CoV-2 3C-like protease and COVID-19 human receptor ACE-2. Trop Biomed 2021; 38:214-221. [PMID: 34172713 DOI: 10.47665/tb.38.2.060] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Corona virus SARS-CoV-2-induced viral disease (COVID-19) is a zoonotic disease that was initially transmitted from animals to humans. The virus surfaced towards the end of December 2019 in Wuhan, China where earlier SARS (Severe Acute Respiratory Syndrome) had also surfaced in 2003. Unlike SARS, SARS-CoV-2 (a close relative of the SARS virus) created a pandemic, and as of February 24 2021, caused 112,778,672 infections and 2,499,252 deaths world-wide. Despite the best efforts of scientists, no drugs against COVID-19 are yet in sight; five vaccines have received emergency approval in various countries, but it would be a difficult task to vaccinate twice the world population of 8 billion. The objective of the present study was to evaluate through in silico screening a number of phytochemicals in Allium cepa (onion) regarding their ability to bind to the main protease of COVID-19 known as the 3C-like protease or 3CLpro, (PDB ID: 6LU7), 3CLpro of SARS (PDB ID: 3M3V), and human angiotensin converting enzyme-2 (ACE-2), [PDB ID: 1R42], which functions as a receptor for entry of the virus into humans. Molecular docking (blind docking, that is docking not only against any target pocket) were done with the help of AutoDockVina. It was observed that of the twenty-two phytochemicals screened, twelve showed good binding affinities to the main protease of SARS-CoV-2. Surprisingly, the compounds also demonstrated good binding affinities to ACE-2. It is therefore very likely that the binding affinities shown by these compounds against both 3CLpro and ACE-2 merit further study for their potential use as therapeutic agents.
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Affiliation(s)
- T A Bondhon
- Department of Biotechnology and Genetic Engineering, University of Development Alternative, Lalmatia, Dhaka-1207, Bangladesh
| | - A Fatima
- Quest International University Perak, Ipoh, Malaysia
| | - K Jannat
- Department of Biotechnology and Genetic Engineering, University of Development Alternative, Lalmatia, Dhaka-1207, Bangladesh
| | - A Hasan
- Department of Biotechnology and Genetic Engineering, University of Development Alternative, Lalmatia, Dhaka-1207, Bangladesh
| | - R Jahan
- Department of Biotechnology and Genetic Engineering, University of Development Alternative, Lalmatia, Dhaka-1207, Bangladesh
| | - V Nissapatorn
- chool of Allied Health Sciences, World Union for Herbal Drug Discovery (WUHeDD), and Research Excellence Center for Innovation and Health Products (RECIHP), Walailak University, Nakhon Si Thammarat, Thailand
| | - C Wiart
- School of Pharmacy, University of Nottingham Malaysia Campus, Selangor, Malaysia
| | - M L Pereira
- CICECO-Aveiro Institute of Materials and Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - M Rahmatullah
- Department of Biotechnology and Genetic Engineering, University of Development Alternative, Lalmatia, Dhaka-1207, Bangladesh
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Iqbal N, Hasan A, Singh G, Hassan MH, Nazar A, Khilan MH, Malik SI, Khawaja MA, Akhter S, Iqbal D, Khan F. Use Of Computed Tomography-Based Nomogram In Adult Age Patients To Predict Success Rates After Shock Wave Lithotripsy For Renal Stones: A Single Center Experience. J Ayub Med Coll Abbottabad 2021; 33:386-392. [PMID: 34487643] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND The Triple D score is a novel and easy to use nomogram to predict shock-wave lithotripsy (SWL) outcomes. It is based on Computed Tomography (CT scan) parameters including stone density, skin-to-stone distance, and stone volume. However, its use has not been validated much as studies are sparse regarding its use. Our aim was to validate and evaluate accuracy of the Triple D scoring system in predicting SWL success rates. METHODS It was a prospective study of 277 patients who had undergone SWL procedure for renal stones. They were evaluated by using non-contrast tomography, before undergoing SWL. CT scan-based parameters including distance of stone to skin (SSD), stone volume (SV), stone density was assessed. Computation of Cut off values was done with receiver operating characteristics analysis. Score was assigned on the basis of these cut-off values and success rate of SWL was determined. This score ranged from 0 (least favourable score) to 3 (most favourable score). RESULTS Stone-free status was attained in 160 patients (57.7%), and 117 (42.3%) patients were labelled to have failed the procedure. Differences between these two groups in terms of Stone volume, stone density and skin to stone distance were significant. Triple D scores of zero,1, 2, and 3 had stone-free rates of 3.6%, 52.56%, 53.3%, and 93.1% respectively (p-vaue<0.001). CONCLUSIONS Shock-wave lithotripsy outcomes can be predicted with use of Triple D score and hence, it's externally corroborated. It may help urologist in appropriate patient selection and hence decision making and patient counselling.
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Affiliation(s)
- Nadeem Iqbal
- Department of Urology, Shifa International Hospital Islamabad
| | - Aisha Hasan
- Riphah International University, Rawalpindi, Pakistan
| | - Gurdeep Singh
- Pakistan Kidney and Liver Institute and Research Center, Lahore, Pakistan
| | | | - Ahsan Nazar
- Department of Urology, Shifa International Hospital Islamabad, Pakistan
| | | | | | | | - Saeed Akhter
- Department of Urology, Shifa International Hospital Islamabad, Pakistan
| | - Daud Iqbal
- Department of Cardiology, Ayub Medical College, Abbottabad, Pakistan
| | - Faheemullah Khan
- 4Diagnostic Radiology, Aga Khan university Hospital, Karachi, Pakistan
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Schoenfeld AJ, Altan M, Owonikoko TK, D'Angelo S, Ladle BH, Noujaim J, He K, Liebner D, Sacher AG, Haanen JB, Yachnin J, Huang C, Van Tine BA, Hasan A, Faitg T, Butler E, Shalabi A, Attia S, Araujo DM. Abstract CT219: Master protocol to assess the safety and recommended Phase 2 dose of next generation NY-ESO-1-specific TCR T-cells in HLA-A*02 patients with synovial sarcoma and non-small cell lung cancer. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-ct219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Letetresgene autoleucel (lete-cel; GSK3377794) is an autologous T-cell therapy expressing a genetically modified T-cell receptor (TCR) to improve recognition of cancer cells expressing NY-ESO-1 and/or LAGE-1a. Next generation NY-ESO-1 TCR T-cell therapies, including GSK3901961 and GSK3845097, incorporate further genetic modifications to enhance anticancer activity. GSK3901961 co-expresses the CD8α chain to stabilize TCR-human leukocyte A (HLA) class I interactions on CD4+ T cells, enhancing T-cell persistence and increasing helper functions such as Type 1 T-helper anti-tumor responses. GSK3845097 co-expresses a dominant negative transforming growth factor-β (TGF-β) type II receptor to reduce TGF-β pathway activation and maintain T-cell proliferation, cytokine production, and cytotoxicity in the tumor microenvironment. A first-time-in-human master protocol (NCT04526509) will evaluate the safety, tolerability, and recommended Phase 2 dose (RP2D) of these two therapies and possible subsequent ones. Substudy 1 will assess GSK3901961 in patients with advanced non-small cell lung cancer (NSCLC) or synovial sarcoma (SS). Substudy 2 will assess GSK3845097 in patients with advanced SS.
Methods: Each substudy includes a dose confirmation stage to assess RP2D and a dose expansion stage. Table 1 lists eligibility criteria. Primary endpoints are safety (adverse events) and tolerability (dose-limiting toxicities). Secondary endpoints include investigator-assessed overall response rate, duration of response, and maximum expansion/persistence and phenotype of infiltrating transduced T cells. Exploratory endpoints include laboratory parameters, overall survival, and anti-GSK3901961 and anti-GSK3845097 titers for the respective substudies. The substudies are open and recruiting.
Funding: GSK (209012; NCT04526509)
Initial screening criteriaInclusion criteriaExclusion criteriaSubstudies 1 and 2 (SS and NSCLC)≥18 years of agePrior malignancy that is not in complete remission or clinically significant systemic illnessMeasurable disease per RECIST v1.1 criteriaPrevious treatment with genetically modified NY-ESO-1-specific T cells, NY-ESO-1 vaccine, or NY-ESO-1 targeting antibodyExpression of HLA-A*02:01, A*02:05, or A*02:06Prior gene therapy using an integrating vectorExpression of NY-ESO-1/LAGE-1a in tumor archival or fresh biopsyPrevious allogeneic hematopoietic stem cell transplant within the last 5 years or solid organ transplantSubstudies 1 and 2 (SS only)Histologically confirmed advanced (metastatic or unresectable) SS diagnosisCentral nervous system metastasesPresence of t(X;18) translocation(Allowed for NSCLC participants on a case-by-case basis)Received, completed, or intolerant to treatment with anthracycline or anthracycline with ifosfamide for advanced (metastatic or unresectable) disease and has progressedSubstudy 1 (NSCLC only)Histologically or cytologically confirmed Stage IV NSCLCReceived or failed ≥3 lines of systemic therapyReceiving or previously received ≥1 prior line(s) of standard of care treatment including programmed death receptor-1/programmed death ligand-1 checkpoint blockade therapy, and received or be intolerant to doublet taxane and platinum chemotherapyPresence of actionable genetic aberration (activation epithelial growth factor receptor, anaplastic lymphoma kinase/c-ros oncogene 1) per NCCN guidelines
Citation Format: Adam J. Schoenfeld, Mehmet Altan, Taofeek K. Owonikoko, Sandra D'Angelo, Brian H. Ladle, Jonathan Noujaim, Kai He, David Liebner, Adrian G. Sacher, John B.A.G. Haanen, Jeffrey Yachnin, Chao Huang, Brian A. Van Tine, Aisha Hasan, Thomas Faitg, Emily Butler, Aiman Shalabi, Steven Attia, Dejka M. Araujo. Master protocol to assess the safety and recommended Phase 2 dose of next generation NY-ESO-1-specific TCR T-cells in HLA-A*02 patients with synovial sarcoma and non-small cell lung cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr CT219.
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Affiliation(s)
| | | | | | | | | | - Jonathan Noujaim
- 5Institut D'Hématologie-Oncologie, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
| | - Kai He
- 6The Ohio State University, Columbus, OH
| | | | | | | | | | - Chao Huang
- 10University of Kansas Medical Center, Kansas City, KS
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Iqbal N, Hasan A, Malik HA, Khan R, Nazar A, Khawaja MA. A Comparison of Complications and Success Rates after PCNL in Younger and Elderly Patients. J Coll Physicians Surg Pak 2021; 30:1316-1320. [PMID: 33397060 DOI: 10.29271/jcpsp.2020.12.1316] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 09/30/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To compare the outcomes of percutaneous nephrolithotomy (PCNL) across younger and elderly, especially PCNL complications in terms of modified Clavian grading system. STUDY DESIGN Cros-sectional comparative study. PLACE AND DURATION OF STUDY Department of Urology, Shifa International Hospital, Islamabad, from 2010 till 2018 December at a tertiary care hospital. METHODOLOGY Patients who underwent unilateral PCNL were reviewed group 1 (younger, age < 60 years) had 594 patients; while group 2 (elderly, age >60 years) had 137 patents. Information regarding complication and success rate were recorded by residents in proforma and then processed for statistical computations. RESULTS There were total of 731 subjects. The mean age in group 1 was 39.7±11.2 years and that of group B was 65.66±4.55 years. The mean size for calculi in group 1 was 2.83±1.32 cm while in group 2 stone size reached 2.81±1.04 cm. A total of 174 (23.8%) complications and stone free rate of 81.8% (598/731) was recorded in this study. Overall when compared, no notable difference in complications, hospital duration and success rates was observed between the young and elderly age group. CONCLUSION Despite old age, the success rates and complications were not remarkably different from that of the younger subjects for prone PCNL. Key Words: Percutaneous nephrolithotomy, Geriatrics, Renal stone, Complications.
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Affiliation(s)
- Nadeem Iqbal
- Department of Urology and Kidney Transplant, Pakistan Kidney Institute, Shifa International Hospital, Islamabad, Pakistan
| | - Aisha Hasan
- Department of Urology and Kidney Transplant, Pakistan Kidney Institute, Shifa International Hospital, Islamabad, Pakistan
| | - Hajra Arshad Malik
- Department of Urology and Kidney Transplant, Pakistan Kidney Institute, Shifa International Hospital, Islamabad, Pakistan
| | - Rabiyya Khan
- Department of Urology and Kidney Transplant, Pakistan Kidney Institute, Shifa International Hospital, Islamabad, Pakistan
| | - Ahsan Nazar
- Department of Urology and Kidney Transplant, Pakistan Kidney Institute, Shifa International Hospital, Islamabad, Pakistan
| | - Muhammad Athar Khawaja
- Department of Urology and Kidney Transplant, Pakistan Kidney Institute, Shifa International Hospital, Islamabad, Pakistan
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Deng X, Hasan A, Elsharkawy S, Tejeda-Montes E, Tarakina N, Greco G, Nikulina E, Stormonth-Darling J, Convery N, Rodriguez-Cabello J, Boyde A, Gadegaard N, Pugno N, Al-Jawad M, Mata A. Topographically guided hierarchical mineralization. Mater Today Bio 2021; 11:100119. [PMID: 34286238 PMCID: PMC8273417 DOI: 10.1016/j.mtbio.2021.100119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 05/29/2021] [Accepted: 06/02/2021] [Indexed: 12/24/2022] Open
Abstract
Material platforms based on interaction between organic and inorganic phases offer enormous potential to develop materials that can recreate the structural and functional properties of biological systems. However, the capability of organic-mediated mineralizing strategies to guide mineralization with spatial control remains a major limitation. Here, we report on the integration of a protein-based mineralizing matrix with surface topographies to grow spatially guided mineralized structures. We reveal how well-defined geometrical spaces defined within the organic matrix by the surface topographies can trigger subtle changes in single nanocrystal co-alignment, which are then translated to drastic changes in mineralization at the microscale and macroscale. Furthermore, through systematic modifications of the surface topographies, we demonstrate the possibility of selectively guiding the growth of hierarchically mineralized structures. We foresee that the capacity to direct the anisotropic growth of such structures would have important implications in the design of biomineralizing synthetic materials to repair or regenerate hard tissues.
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Affiliation(s)
- X. Deng
- School of Engineering and Materials Science, Queen Mary University of London, London, E1 4NS, UK
- Institute of Bioengineering, Queen Mary University of London, London, E1 4NS, UK
| | - A. Hasan
- School of Pharmacy, University of Nottingham, Nottingham, NG7 2RD, UK
- Department of Chemical and Environmental Engineering, University of Nottingham, Nottingham, NG7 2RD, UK
- Biodiscovery Institute, University of Nottingham, Nottingham, NG7 2RD, UK
| | - S. Elsharkawy
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, SE1 9RT, UK
| | | | - N.V. Tarakina
- Max Planck Institute of Colloids and Interfaces, Potsdam-Golm Science Park, Am Mühlenberg 1 OT Golm, Potsdam, 14476, Germany
| | - G. Greco
- Laboratory of Bio-Inspired, Bionic, Nano, Meta, Materials & Mechanics, Department of Civil, Environmental and Mechanical Engineering, University of Trento, Trento, 38122, Italy
| | - E. Nikulina
- CIC nanoGUNE BRTA, Tolosa Hiribidea, 76, Donostia – San Sebastian, E-20018, Spain
| | | | - N. Convery
- James Watt School of Engineering, University of Glasgow, Glasgow, G12 8QQ, UK
| | | | - A. Boyde
- Oral Bioengineering, Queen Mary University of London, London, E1 4NS, UK
| | - N. Gadegaard
- James Watt School of Engineering, University of Glasgow, Glasgow, G12 8QQ, UK
| | - N.M. Pugno
- School of Engineering and Materials Science, Queen Mary University of London, London, E1 4NS, UK
- Laboratory of Bio-Inspired, Bionic, Nano, Meta, Materials & Mechanics, Department of Civil, Environmental and Mechanical Engineering, University of Trento, Trento, 38122, Italy
| | - M. Al-Jawad
- School of Dentistry, University of Leeds, Leeds, LS2 9JT, UK
| | - A. Mata
- School of Engineering and Materials Science, Queen Mary University of London, London, E1 4NS, UK
- Institute of Bioengineering, Queen Mary University of London, London, E1 4NS, UK
- School of Pharmacy, University of Nottingham, Nottingham, NG7 2RD, UK
- Department of Chemical and Environmental Engineering, University of Nottingham, Nottingham, NG7 2RD, UK
- Biodiscovery Institute, University of Nottingham, Nottingham, NG7 2RD, UK
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Generali T, Jansen K, Steedman R, De Rita F, Viganò G, McParlin D, Hermuzi A, Crossland D, O'Sullivan J, Coats L, Hasan A, Nassar MS. Contemporary Ross procedure outcomes: medium- to long-term results in 214 patients. Eur J Cardiothorac Surg 2021; 60:1112-1121. [PMID: 33969415 DOI: 10.1093/ejcts/ezab193] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 01/18/2021] [Accepted: 02/22/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Our goal was to present 2 decades of our experience with the Ross procedure and its sequential modifications, adopted since 2010, to improve the reoperation rate. METHODS We performed a single-centre, retrospective review of database information and medical notes about the implantation technique: the freestanding root. We compared era 1 (1997-2009) and era 2 (2010-2019). RESULTS Between 1997 and 2019, a total of 214 Ross procedures were performed (71% men, median age 24 years) [interquartile range (IQR) 15-38]. Of these, 87% had various forms of congenital-dysplastic aortic valves. The median cross-clamping and bypass times were 173 (IQR 148-202) and 202 (IQR 182-244) min. The median postoperative stay was 6 days (2-77). Thirty-day mortality was 0.5%. The median follow-up time was 8.2 years (IQR 3.9-13.2). Survival at 10 and 20 years was 97% and 95%; freedom from greater than moderate aortic regurgitation or aortic valve intervention was 91% and 80%; and 93% of the patients were in New York Heart Association functional class I. Twenty (21%) patients operated on during era 1 and 6 (9%) during era 2 underwent autograft reoperations. The median follow-up time was 14.3 (IQR 11.5-17.4) and 4.8 (IQR 2.5-7) years. Freedom from autograft reoperation was 87% and 69% at 10 and 20 years, with no significant difference between eras. Freedom from homograft reoperation was 96% and 76% at 10 and 20 years. The presence of aortic regurgitation, infective endocarditis and era 1 were predictors of autograft reoperation. Male gender and era 1 were predictors of neoaortic root dilatation. CONCLUSIONS The contemporary modified Ross procedure continues to deliver excellent results and should remain part of the strategy to treat children and young adults requiring aortic valve replacement.
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Affiliation(s)
- T Generali
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - K Jansen
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Congenital Heart Disease Research Group, Population Health Science Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - R Steedman
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - F De Rita
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - G Viganò
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - D McParlin
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - A Hermuzi
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - D Crossland
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Congenital Heart Disease Research Group, Population Health Science Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - J O'Sullivan
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Congenital Heart Disease Research Group, Population Health Science Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - L Coats
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Congenital Heart Disease Research Group, Population Health Science Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - A Hasan
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - M S Nassar
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Congenital Heart Disease Research Group, Population Health Science Institute, Newcastle University, Newcastle Upon Tyne, UK
- Cardiothoracic Unit, Alexandria University, Alexandria, Egypt
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Gonzalez Fernandez O, De Rita F, Coats L, Crossland D, Nassar M, Hermuzi A, Santos Lopez B, Woods A, Robinson-Smith N, Petit T, Seller N, O´Sullivan J, McDiarmid A, Schueler S, Hasan A, MacGowan G, Jansen K. Ventricular Assist Devices in Adults with Failing Systemic Right Ventricle: The Importance of Concomitant Tricuspid Valve Replacement. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.321] [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: 10/21/2022] Open
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25
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Fernandez OG, De Rita F, Hasan A, Schueler S, MacGowan G, Jansen K. HVAD Decommission in a Failing Mustard: Making Virtue out of Necessity. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.2110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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26
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Kaka Y, Ganapathi A, Emani S, Kahwash R, Hasan A, Franco V, Haas G, Vallakati A, Henn M, Benza R, Mokadam N, Whitson B, Lampert B. The Waiting Game: Waitlist Times and Outcomes for Highly Sensitized Patients in the New Heart Transplant Allocation System. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1775] [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: 11/29/2022] Open
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27
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Iqbal N, Iqbal S, Hasan A, Majeed M, Iqbal D, Shahzad M, Khan F, Khawaja MA, Akhter S. Outcomes Of Percutaneous Nephrolithotomy In Elder Age Patients-Single Center Experience. J Ayub Med Coll Abbottabad 2021; 33:217-221. [PMID: 34137532] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Urolithiasis is a prevailing ailment affecting all age groups across global population. In modern innovative industry endoscopic instruments alterations and miniaturization has simplified the interventional strategy for undertaking these procedures for renal stones. However, there has been paucity of studies regarding outcomes of Percutaneous Nephrolithotomy (PCNL) in elder age group. We aimed to report success rates and complications in elder age group. METHODS This was a retrospective review of the charts for subjects that underwent unilateral PCNL from 2012 till 2018 November at a tertiary care hospital at capital of Pakistan. Patients of age ≥60 years were chosen for this study. PCNL procedures were done in prone position. We implemented the Guy stone scoring (stone complexity) to forecast the net results of PCNL. Information regarding variables were recorded in specified proforma and then processed in SPSS version 16 for the statistical computations. RESULTS On the whole 79 patients were incorporated for this study. Most common presenting complaint in clinic was flank pain followed by haematuria and fever respectively. Mean age in this analysis was calculated as 63.36±5.19 years. Mean size for calculi was 449±163mm2. One patient underwent transfusion after surgery while only 2.5% of these patients had sepsis (post PCNL procedure). Stone free rate was significantly affected by Guys stone score (GSS). CONCLUSIONS PCNL can be undertaken safely and effectually for achieving treatment goals even in elder subjects. Stone free rates are higher in lower Guys stone score as compared to the higher scores.
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Affiliation(s)
- Nadeem Iqbal
- Department of Urology and Kidney Transplant, Shifa International Hospital Islamabad,Pakistan
| | - Sajid Iqbal
- Department of Rehabilitation, Pakistan Navy PNS Hospital, Karachi, Pakistan
| | - Aisha Hasan
- Riphah International University, Rawalpindi, Pakistan
| | - Mehr Majeed
- Department of Urology and Kidney Transplant, Shifa International Hospital Islamabad, Pakistan
| | - Daud Iqbal
- Department of Cardiology, Ayub Teaching Hospital, Abbottabad, Pakistan
| | | | | | - Muhammad Athar Khawaja
- Department of Urology and Kidney Transplant, Shifa International Hospital Islamabad, Pakistan
| | - Saeed Akhter
- Department of Urology and Kidney Transplant, Shifa International Hospital Islamabad, Pakistan
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28
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Iqbal N, Hasan A, Nazar A, Iqbal S, Hassan MH, Gill BS, Khan R, Akhter S, Suarez-Ibarrola R. Role of Stone Heterogeneity Index in Determining Success of Shock Wave Lithotripsy in Urinary Calculi. J Clin Transl Res 2021; 7:241-247. [PMID: 34104827 PMCID: PMC8177853] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 10/24/2020] [Accepted: 01/28/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Various stone factors can affect the outcome of shock wave lithotripsy (SWL). A novel factor called the stone heterogeneity index (SHI) may have an impact on stone free rates. The objective of this study was to assess the role of SHI in SWL outcomes. METHODS Patients' medical records were reviewed for the collection of data variables. They were subjected to SWL, using an electromagnetic lithotripter machine (Storz Modulith SLX-MX). Computation of mean stone density (mean value of the Hounsfield units) and SHI was accomplished by generating elliptical regions of interest on the computed tomography (CT) scan images. Grouping was performed on the basis of stone free and failure outcomes. Relevant statistical tests were applied for continuous and categorical variables. P ≤ 0.05 was considered statistically significant. RESULTS Overall, 385 subjects were included having a mean age of 38.4 ± 14.7 years. The cohort comprised 276 (71.7%) males and 109 (28.3%) female patients. A total of 234 (60.8%) patients were rendered successful (stone free after one session) while 151 (39.2%) of the patients were declared to have failed the SWL procedure. Stone length, stone density, and SHI values were 13.7 ± 7.6 mm, 935 ± 404, and 201 ± 107, respectively. The stone density, SHI, and stone length were significantly different between the two groups (p-values of 0.001, 0.02, and 0.04, respectively). CONCLUSIONS SHI can be a helpful CT scan-based parameter to assess stone fragility. It can help clinicians in the judicious selection of patients before implementing SWL procedure. RELEVANCE FOR PATIENTS Non-contrast CT-based stone parameters have been found to be effective for predictions of outcomes. SHI can be a helping tool to better predict SWL success rates when treating the renal stones.
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Affiliation(s)
- Nadeem Iqbal
- 1Department of Urology and Kidney Transplant, Pakistan Kidney Institute, Shifa International Hospital, Islamabad, Pakistan,
Corresponding author: Nadeem Iqbal Department of Urology and Kidney Transplant, Pakistan Kidney Institute,, Shifa International Hospital, Sector H-8/4, Islamabad, Pakistan E-mail:
| | - Aisha Hasan
- 2Riphah International University, Rawalpindi, Pakistan
| | - Ahsan Nazar
- 1Department of Urology and Kidney Transplant, Pakistan Kidney Institute, Shifa International Hospital, Islamabad, Pakistan
| | - Sajid Iqbal
- 3Department of Rehabilitation, Pakistan Navy PNS Hospital, Karachi, Pakistan
| | - Mohammad Haroon Hassan
- 1Department of Urology and Kidney Transplant, Pakistan Kidney Institute, Shifa International Hospital, Islamabad, Pakistan
| | - Behzad Saeed Gill
- 1Department of Urology and Kidney Transplant, Pakistan Kidney Institute, Shifa International Hospital, Islamabad, Pakistan
| | - Rabiyya Khan
- 1Department of Urology and Kidney Transplant, Pakistan Kidney Institute, Shifa International Hospital, Islamabad, Pakistan
| | - Saeed Akhter
- 1Department of Urology and Kidney Transplant, Pakistan Kidney Institute, Shifa International Hospital, Islamabad, Pakistan
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Altan M, Govindan R, Schoenfeld A, Noujaim J, Sacher A, Haanen J, Huang C, Hasan A, Faitg T, Butler E, Shalabi A, Owonikoko T. P14.19 CD8α-Enhanced NY-ESO-1-Specific TCR T Cells (GSK3901961) in HLA-A*02 Patients with NSCLC: Master Protocol Substudy 1. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.525] [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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30
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Hasan A, Quintero-Estades JA, Nataneli N. A Woman With Intraocular Inflammation After Descemet Membrane Endothelial Keratoplasty. JAMA Ophthalmol 2021; 138:1000-1001. [PMID: 32729891 DOI: 10.1001/jamaophthalmol.2020.1337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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31
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Jahan S, Rahim A, Afzal M, Naveed AK, Ayub S, Hasan A. Association of single nucleotide polymorphism of transforming growth factor β1 (T29C) in breast cancer patients: a case control study in Rawalpindi. J PAK MED ASSOC 2021; 70:390-393. [PMID: 32207412 DOI: 10.5455/jpma.296490] [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: 11/03/2022]
Abstract
OBJECTIVE To determine the association of single nucleotide polymorphism in three CC, TT and TC genotypes of transforming growth factor β1 T29C in breast cancer patients. METHODS The case-control study was conducted from April 2017 to April 2018 at the Islamic International Medical College, Rawalpindi, Pakistan, in collaboration with Nuclear Oncology Medicine and Radiotherapy Institute and Holy Family Hospital, Rawalpindi. Using convenience sampling, breast cancer cases and healthy controls were enrolled. All investigations were done using standardized laboratory protocols. The outcomes were determined in terms of association of single nucleotide polymorphism of transforming growth factor β1with breast cancer. Data was analysed using SPSS 21. RESULTS Of the 150 subjects, 80(53.3%) were cases and 70(47.7%) were healthy controls. Among the cases, the most frequent genotype was CC 38(47.5%) followed by TC 26(32.5%) and TT 16(20%). Among the controls, the corrsesponding values were 50(71.42%), 13(18.5%) and 7(10%). Transforming growth factor β1 TC genotype was strongly associated with the increased risk of developing breast cancer (odds ratio: 3.79). CONCLUSIONS The incidence of breast cancer was markedly lower among women with CC genotype compared to those with CT or TT genotypes.
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Affiliation(s)
- Saira Jahan
- Islamic International Medical College, Rawalpindi, Pakistan
| | - Amena Rahim
- Islamic International Medical College, Rawalpindi, Pakistan
| | - Muhammad Afzal
- Islamic International Medical College, Rawalpindi, Pakistan
| | | | - Saddaf Ayub
- Islamic International Medical College, Rawalpindi, Pakistan
| | - Aisha Hasan
- Islamic International Medical College, Rawalpindi, Pakistan
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Martinez SA, Hasan A, Beebe LA, Cheney MK. Smoking Behaviors of General Educational Development (GED) Recipients. Subst Use Misuse 2021; 56:1707-1714. [PMID: 34253161 DOI: 10.1080/10826084.2021.1949614] [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: 10/20/2022]
Abstract
OBJECTIVE Cigarette smoking is inversely associated with education, and despite this gradient effect, individuals with a General Educational Development (GED) diploma, obtained through a high school equivalency test, have the highest smoking prevalence. Considered the high school equivalency credential, it is unclear why individuals with a GED have a substantially higher smoking prevalence compared to high school graduates and dropouts. We conducted a qualitative study to understand life experiences, tobacco use patterns, and perceptions of tobacco among GED smokers and attitudes and behaviors around smoking cessation. METHODS We recruited 40 GED smokers aged 18 to 35 years and conducted surveys and semi-structured individual interviews. Transcripts were independently coded, then coding differences were resolved and reviewed by a third team member. We independently determined themes within and between codes and met to determine final themes. RESULTS GED recipients had many early life experiences and characteristics that made them highly vulnerable to tobacco dependence. With perceived high cognitive abilities, GED smokers were knowledgeable of many evidence-based smoking cessation strategies and were aware of health risks. Health risks and the financial burden of smoking were motivation to quit. The majority were uninterested or lacked confidence that nicotine replacement therapy, medications, counseling, or the quitline could help them quit. Nearly all were enthusiastic and confident that financial incentives had the potential to help them quit. CONCLUSIONS Research is needed to determine whether financial incentives could improve smoking cessation outcomes in this unique population with an unequal burden of smoking.
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Affiliation(s)
- S A Martinez
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma, USA
| | - A Hasan
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma, USA
| | - L A Beebe
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma, USA
| | - M K Cheney
- Department of Health and Exercise Science, University of Oklahoma, Norman, Oklahoma, USA
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Putri R, Lubis M, Andasuryani, Hasan A, Santosa, Arlius F. Energy audit of rice production in West Sumatra province, Indonesia. Food Res 2020. [DOI: 10.26656/fr.2017.4(s6).019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Audit energy is an appropriate method to determine the energy consumption expended in
each agricultural cultivation activity, thereby reducing the wasteful use of energy. Energy
consumption in rice cultivations consists of humans, fuel, machinery, seed, fertilizer and
pesticides. The objective of the study was to analyze the total energy consumptions in the
form of an energy audit activity on lowland rice cultivation in West Sumatera Indonesia. It
is important to do, because of much energy input excessed, but less on productivity. So,
by using analysis energy expenditure, productivity can be optimized with fixed input
energy the costs could be minimized. Energy inputs were measured during all operating
activities in rice cultivation (seeding, tillage, planting, fertilizing, spraying, weeding and
harvesting). Energy input analysis based on energy sources used was divided into six
parameters, namely: engine energy, fuel, humans, seeds, chemicals (pesticides) and
fertilizer energy. The result showed the average of the total energy inputs in this study was
16,816,612 MJ/ha distributed to human, fuel, machinery, seeds, fertilizers and pesticides
energy respectively 216.39; 890.75; 60.02; 983.29; 14,207.54; and 458.60 MJ/ha.
Production costs incurred in rice cultivation activities in this study were IDR 13,107,562/
ha. Finally, the rice yield prediction model based on the input energy are Y1 = 4786.56 –
28.29X1 + 36.23X2 - 24.73X3 - 8.43X4 + 0.06X5 - 0.80X6 and Y2 = 3605.11 + 5.44X2. The
data of total energy were needed as a recommendation for the government to balance
energy input and output on rice cultivations.
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Wagner E, McMahon L, Falkai P, Hasan A, Siskind D. Impact of smoking behavior on clozapine blood levels - a systematic review and meta-analysis. Acta Psychiatr Scand 2020; 142:456-466. [PMID: 32869278 DOI: 10.1111/acps.13228] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [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] [Received: 06/04/2020] [Revised: 08/14/2020] [Accepted: 08/19/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Tobacco smoking significantly impacts clozapine blood levels and has substantial implications on individual efficacy and safety outcomes. By investigating differences in clozapine blood levels in smoking and non-smoking patients on clozapine, we aim to provide guidance for clinicians how to adjust clozapine levels for patients on clozapine who change their smoking habits. METHODS We conducted a meta-analysis on clozapine blood levels, norclozapine levels, norclozapine/clozapine ratios, and concentration to dose (C/D) ratios in smokers and non-smokers on clozapine. Data were meta-analyzed using a random-effects model with sensitivity analyses on dose, ethnic origin, and study quality. RESULTS Data from 23 studies were included in this meta-analysis with 21 investigating differences between clozapine blood levels of smokers and non-smokers. In total, data from 7125 samples were included for the primary outcome (clozapine blood levels in ng/ml) in this meta-analysis. A meta-analysis of all between-subject studies (N = 16) found that clozapine blood levels were significantly lower in smokers compared with non-smokers (Standard Mean Difference (SMD) -0.39, 95% confidence interval (CI) -0.55 to -0.22, P < 0.001, I2 = 80%). With regard to the secondary outcome, C/D ratios (N = 16 studies) were significantly lower in the smoker group (n = 645) compared with the non-smoker group (n = 813; SMD -0.70, 95%CI -0.84 to -0.56, P < 0.00001, I2 = 17%). CONCLUSION Smoking behavior and any change in smoking behavior is associated with a substantial effect on clozapine blood levels. Reductions of clozapine dose of 30% are recommended when a patient on clozapine stops smoking. Reductions should be informed by clozapine steady-state trough levels and a close clinical risk-benefit evaluation.
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Affiliation(s)
- E Wagner
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - L McMahon
- School of Medicine, University of Queensland, Brisbane, Australia
| | - P Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - A Hasan
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - D Siskind
- School of Medicine, University of Queensland, Brisbane, Australia.,Metro South Addiction and Mental Health Service, Brisbane, Australia
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35
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Roeh A, Lembeck M, Papazova I, Pross B, Hansbauer M, Schoenfeld J, Haller B, Halle M, Falkai P, Scherr J, Hasan A. Marathon running improves mood and negative affect. J Psychiatr Res 2020; 130:254-259. [PMID: 32854076 DOI: 10.1016/j.jpsychires.2020.08.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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] [Received: 03/13/2020] [Revised: 06/13/2020] [Accepted: 08/09/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Physical activity has beneficial effects on depression, as well as on other mental and somatic diseases. The amount of recommended exercise is still under discussion. We investigated whether marathon runners (MA) exhibit less or more depressive symptoms and negative affects compared to sedentary controls (SC) and how their mood changes in the context of marathon training and marathon running. METHODS We included 100 amateur marathon runners and 46 age- and gender matched sedentary controls in the ReCaP (Running effects on Cognition and Plasticity) study. Questionnaires contained Beck Depression Inventory (BDI), Hamilton Depression Scale (HAMD), Oxford Happiness Questionnaire (OHQ), Visual Analogue Scale (VAS), Positive And Negative Affect Schedule (PANAS), Global Assessment of Functioning (GAF). SC were evaluated one time at baseline, MA six times during the six months study period. RESULTS Compared to SC, marathon runners (281.80 ± 131.44 running min/week) exhibited less depressive symptoms, more positive affects (PANAS-PA) and a higher level of functioning (GAF). Within the marathon group, negative affect (PANAS-NA) decreased and general mood states (VAS) further improved throughout the study period with a maximum 24 h after the marathon. DISCUSSION MA had less depressive symptoms and a higher level of functioning compared to SC. Higher amounts than the recommended duration of 150 min/week aerobic training (WHO/ACSM) and the participation in a marathon seem to even further improve negative affect. These findings give new insight into the relationship between exercise and mood parameters. They can be implemented in future preventive strategies for depressive symptoms.
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Affiliation(s)
- A Roeh
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Nußbaumstraße 7, 80336, Munich, Germany.
| | - M Lembeck
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Nußbaumstraße 7, 80336, Munich, Germany
| | - I Papazova
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Nußbaumstraße 7, 80336, Munich, Germany
| | - B Pross
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Nußbaumstraße 7, 80336, Munich, Germany
| | - M Hansbauer
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Nußbaumstraße 7, 80336, Munich, Germany
| | - J Schoenfeld
- Department of Prevention and Sports Medicine, Klinikum rechts der Isar, Technische Universitaet Muenchen, Georg-Brauchle-Ring 56, D-80992, Munich, Germany; Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - B Haller
- Institute of Medical Informatics, Statistics and Epidemiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - M Halle
- Department of Prevention and Sports Medicine, Klinikum rechts der Isar, Technische Universitaet Muenchen, Georg-Brauchle-Ring 56, D-80992, Munich, Germany; Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - P Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Nußbaumstraße 7, 80336, Munich, Germany
| | - J Scherr
- Department of Prevention and Sports Medicine, Klinikum rechts der Isar, Technische Universitaet Muenchen, Georg-Brauchle-Ring 56, D-80992, Munich, Germany; University Center for Preventive and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - A Hasan
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Nußbaumstraße 7, 80336, Munich, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, University of Augsburg, Augsburg, Germany
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Iqbal N, Hasan A, Saghir S, Iqbal S, Saif UB, Choudhry AM, Choudhry AM, Gill BS, Hussain I, Iqbal D, Khan F, Akhter S. Laparoscopic Orchiopexy For Management Of Bilateral Non-Palpable Testes. J Ayub Med Coll Abbottabad 2020; 32:445-449. [PMID: 33225641] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Despite numerous clinical studies regarding the management of unilateral impalpable testes by laparoscopy, there is a paucity of such studies regarding the management of bilateral 'non-palpable' testes. We shared the outcome of the laparoscopic management of bilateral 'non-palpable' testes in terms of successful orchiopexy and complications in children. METHODS A total of 22 children underwent bilateral diagnostic laparoscopy for undescended testes who presented to our department from January 2010 till March 2018. We did chart review for variables such as the age of children, operative time, hospital stay, single-stage or 2 stage procedure, and operative complications. Preoperatively history and physical examination were done along with baseline investigations and Ultrasound abdomen and scrotum before surgery for general anaesthesia fitness. They were managed by single or two steps laparoscopic orchiopexy according to suitability for each case. RESULTS We performed bilateral laparoscopic orchidopexies in 22 children having a mean age of 4.1±1.98 years (49.2 months) Mean operative time for single setting bilateral single-stage orchiopexy was 136±32 minutes. Out of twenty-two children with bilateral impalpable testes, 12 boys (54.5%) were managed with a single-stage Bilateral Laparoscopic technique while the other 10 (45.45%) were managed in 2 staged laparoscopic intervention using Fowler-Stephens technique. Testicular atrophy was seen in 2/44 testes (4.54%). While 1 /44 (2.27%) testis had ascended to the inguinal region requiring redo surgery. CONCLUSIONS Laparoscopic management of bilateral 'non-palpable' testes in a single or double setting is a safe and effective method of bringing testes down to the scrotum. It has no major morbidities.
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Affiliation(s)
- Nadeem Iqbal
- Shifa International hospital Islamabad, Pakistan
| | - Aisha Hasan
- Riphah International University, Rawalpindi, Pakistan
| | | | - Sidra Iqbal
- Ayub Teaching Hospital, Abbottabad, Pakistan
| | | | | | | | | | - Ijaz Hussain
- Shifa International hospital Islamabad, Pakistan
| | - Daud Iqbal
- Department of Operative Dentistry, Armed Forces Institute of Dentistry, Rawalpindi, Pakistan
| | | | - Saeed Akhter
- Shifa International hospital Islamabad, Pakistan
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Prockop S, Doubrovina E, Suser S, Heller G, Barker J, Dahi P, Perales MA, Papadopoulos E, Sauter C, Castro-Malaspina H, Boulad F, Curran KJ, Giralt S, Gyurkocza B, Hsu KC, Jakubowski A, Hanash AM, Kernan NA, Kobos R, Koehne G, Landau H, Ponce D, Spitzer B, Young JW, Behr G, Dunphy M, Haque S, Teruya-Feldstein J, Arcila M, Moung C, Hsu S, Hasan A, O'Reilly RJ. Off-the-shelf EBV-specific T cell immunotherapy for rituximab-refractory EBV-associated lymphoma following transplantation. J Clin Invest 2020; 130:733-747. [PMID: 31689242 DOI: 10.1172/jci121127] [Citation(s) in RCA: 143] [Impact Index Per Article: 35.8] [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: 03/16/2018] [Accepted: 10/22/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUNDAdoptive transfer of donor-derived EBV-specific cytotoxic T-lymphocytes (EBV-CTLs) can eradicate EBV-associated lymphomas (EBV-PTLD) after transplantation of hematopoietic cell (HCT) or solid organ (SOT) but is unavailable for most patients.METHODSWe developed a third-party, allogeneic, off-the-shelf bank of 330 GMP-grade EBV-CTL lines from specifically consented healthy HCT donors. We treated 46 recipients of HCT (n = 33) or SOT (n = 13) with established EBV-PTLD, who had failed rituximab therapy, with third-party EBV-CTLs. Treatment cycles consisted of 3 weekly infusions of EBV-CTLs and 3 weeks of observation.RESULTSEBV-CTLs did not induce significant toxicities. One patient developed grade I skin graft-versus-host disease. Complete remission (CR) or sustained partial remission (PR) was achieved in 68% of HCT recipients and 54% of SOT recipients. For patients who achieved CR/PR or stable disease after cycle 1, one year overall survival was 88.9% and 81.8%, respectively. In addition, 3 of 5 recipients with POD after a first cycle who received EBV-CTLs from a different donor achieved CR or durable PR (60%) and survived longer than 1 year. Maximal responses were achieved after a median of 2 cycles.CONCLUSIONThird-party EBV-CTLs of defined HLA restriction provide safe, immediately accessible treatment for EBV-PTLD. Secondary treatment with EBV-CTLs restricted by a different HLA allele (switch therapy) can also induce remissions if initial EBV-CTLs are ineffective. These results suggest a promising potential therapy for patients with rituximab-refractory EBV-associated lymphoma after transplantation.TRIAL REGISTRATIONPhase II protocols (NCT01498484 and NCT00002663) were approved by the Institutional Review Board at Memorial Sloan Kettering Cancer Center, the FDA, and the National Marrow Donor Program.FUNDINGThis work was supported by NIH grants CA23766 and R21CA162002, the Aubrey Fund, the Claire Tow Foundation, the Major Family Foundation, the Max Cure Foundation, the Richard "Rick" J. Eisemann Pediatric Research Fund, the Banbury Foundation, the Edith Robertson Foundation, and the Larry Smead Foundation. Atara Biotherapeutics licensed the bank of third-party EBV-CTLs from Memorial Sloan Kettering Cancer Center in June 2015.
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Affiliation(s)
- Susan Prockop
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Division of Pediatric Hematology/Oncology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York, USA
| | - Ekaterina Doubrovina
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Center for Immune Cellular Therapy
| | - Stephanie Suser
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Juliet Barker
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Parastoo Dahi
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Miguel A Perales
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Esperanza Papadopoulos
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Craig Sauter
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Hugo Castro-Malaspina
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Farid Boulad
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Division of Pediatric Hematology/Oncology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York, USA
| | - Kevin J Curran
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Division of Pediatric Hematology/Oncology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York, USA
| | - Sergio Giralt
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Boglarka Gyurkocza
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Katharine C Hsu
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Ann Jakubowski
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Alan M Hanash
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Nancy A Kernan
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Division of Pediatric Hematology/Oncology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York, USA
| | - Rachel Kobos
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Jansen Pharmaceuticals, Raritan, New Jersey, USA
| | - Guenther Koehne
- Miami Cancer Institute, Baptist Health South Florida, Miami, Florida, USA
| | - Heather Landau
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Doris Ponce
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Barbara Spitzer
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Division of Pediatric Hematology/Oncology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York, USA
| | - James W Young
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Gerald Behr
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Mark Dunphy
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Sofia Haque
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Julie Teruya-Feldstein
- Department of Pathology, Icahn School of Medicine, Mount Sinai Health System, New York, New York, USA
| | - Maria Arcila
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Christine Moung
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Susan Hsu
- American Red Cross, Philadelphia, Pennsylvania, USA
| | - Aisha Hasan
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,GlaxoSmithKline, Oncology, Collegeville, Pennsylvania, USA
| | - Richard J O'Reilly
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Division of Pediatric Hematology/Oncology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York, USA
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O'Reilly RJ, Prockop S, Hasan A, Doubrovina E. Therapeutic advantages provided by banked virus-specific T-cells of defined HLA-restriction. Bone Marrow Transplant 2020; 54:759-764. [PMID: 31431697 DOI: 10.1038/s41409-019-0614-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We have developed banks of EBV and CMV-specific T-cell lines generated from healthy seropositive third party donors and characterized them as to their HLA type, virus specificity, lack of alloreactivity, and HLA restriction. We here summarize results of studies employing these immediately accessible, broadly-applicable third party virus-specific T-cells for adoptive therapy of EBV lymphomas and CMV infections in allo-HCT recipients. We describe the characteristics contributing to their safety. We also discuss several distinctive advantages of banked third party virus-specific T-cells selected on the basis of their HLA restriction, particularly in the treatment of Rituximab-non-responsive EBV+ lymphomas and drug refractory CMV infections complicating HLA non-identical transplants.
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Affiliation(s)
- Richard J O'Reilly
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Susan Prockop
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Aisha Hasan
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ekaterina Doubrovina
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Masood B, Iqbal W, Iqbal N, Hussain I, Haq AU, Rehman U, Haroon A, Khan F, Iqbal D, Hasan A. Incidental Findings Of Polypoid Cystitis In A 6-Year Old Child Without Any History Of Lower Urinary Tract Symptoms And Previous Urinary Catheterization. J Ayub Med Coll Abbottabad 2020; 32:410-412. [PMID: 32829562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A 6-year-old boy presented to ER with acute pain in right iliac fossa without any history of lower urinary tract symptoms, haematuria and urinary catheterization. Ultrasound showed loculated cystic area in pelvis with non-visualized appendix. A CT scan abdomen and pelvis revealed loculated, multi-septated cystic lesion in right hemipelvis thought to be a collection from possible appendicular inflammation / perforation. The laboratory findings revealed raised CRP and normal urine routine examination and culture. Exploratory laparotomy revealed cystic urinary bladder growth involving dome with normal appendix, partial cystectomy was done. Histopathology confirmed polypoid cystitis with no evidence of malignancy. This is a very rare presentation of polypoidal cystitis, not previously reported in literature.
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Affiliation(s)
- Basit Masood
- Department of Urology, Shifa International Hospital Islamabad, Pakistan
| | - Waqas Iqbal
- Department of Urology, Shifa International Hospital Islamabad, Pakistan
| | - Nadeem Iqbal
- Department of Urology, Shifa International Hospital Islamabad, Pakistan
| | - Ijaz Hussain
- Department of Urology, Shifa International Hospital Islamabad, Pakistan
| | - Anwar Ul Haq
- Department of Urology, Shifa International Hospital Islamabad,Pakistan
| | - Usama Rehman
- Department of Urology, Shifa International Hospital Islamabad, Pakistan
| | - Asna Haroon
- Department of Urology, Shifa International Hospital Islamabad,Pakistan
| | - Faheemullah Khan
- Department of Radiology, Hyatabad Medical Complex, Peshawar, Pakistan
| | - Daud Iqbal
- Department of Cardiology, Ayub Teaching Hospital, Abbottabad, Pakistan
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Montag C, Brandt L, Lehmann A, De Millas W, Falkai P, Gaebel W, Hasan A, Hellmich M, Janssen B, Juckel G, Karow A, Klosterkötter J, Lambert M, Maier W, Müller H, Pützfeld V, Schneider F, Stützer H, Wobrock T, Vernaleken IB, Wagner M, Heinz A, Bechdolf A, Gallinat J. Cognitive and emotional empathy in individuals at clinical high risk of psychosis. Acta Psychiatr Scand 2020; 142:40-51. [PMID: 32339254 DOI: 10.1111/acps.13178] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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] [Accepted: 04/22/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Impairments of social cognition are considered core features of schizophrenia and are established predictors of social functioning. However, affective aspects of social cognition including empathy have far less been studied than its cognitive dimensions. The role of empathy in the development of schizophrenia remains largely elusive. METHODS Emotional and cognitive empathy were investigated in large sample of 120 individuals at Clinical High Risk of Psychosis (CHR-P) and compared with 50 patients with schizophrenia and 50 healthy controls. A behavioral empathy assessment, the Multifaceted Empathy Test, was implemented, and associations of empathy with cognition, social functioning, and symptoms were determined. RESULTS Our findings demonstrated significant reductions of emotional empathy in individuals at CHR-P, while cognitive empathy appeared intact. Only individuals with schizophrenia showed significantly reduced scores of cognitive empathy compared to healthy controls and individuals at CHR-P. Individuals at CHR-P were characterized by significantly lower scores of emotional empathy and unspecific arousal for both positive and negative affective valences compared to matched healthy controls and patients with schizophrenia. Results also indicated a correlation of lower scores of emotional empathy and arousal with higher scores of prodromal symptoms. CONCLUSION Findings suggest that the tendency to 'feel with' an interaction partner is reduced in individuals at CHR-P. Altered emotional reactivity may represent an additional, early vulnerability marker, even if cognitive mentalizing is grossly unimpaired in the prodromal stage. Different mechanisms might contribute to reductions of cognitive and emotional empathy in different stages of non-affective psychotic disorders and should be further explored.
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Affiliation(s)
- C Montag
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany
| | - L Brandt
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany
| | - A Lehmann
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany
| | - W De Millas
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Vivantes Wenckebach-Klinikum, Berlin, Germany
| | - P Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - W Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - A Hasan
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - M Hellmich
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, Cologne, Germany.,Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - B Janssen
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.,LVR-Klinik Langenfeld, Langenfeld, Germany
| | - G Juckel
- Department of Psychiatry, Psychotherapy, and Preventive Medicine, Ruhr University Bochum, Bochum, Germany
| | - A Karow
- Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - J Klosterkötter
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - M Lambert
- Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - W Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.,Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany.,DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany
| | - H Müller
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - V Pützfeld
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - F Schneider
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.,Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH Aachen, Aachen, Germany
| | - H Stützer
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - T Wobrock
- Department of Psychiatry and Psychotherapy, Georg-August-University Goettingen, Goettingen, Germany.,Department of Psychiatry and Psychotherapy, County Hospitals Darmstadt-Dieburg, Groß-Umstadt, Germany
| | - I B Vernaleken
- Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH Aachen, Aachen, Germany
| | - M Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.,Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany.,DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany
| | - A Heinz
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany
| | - A Bechdolf
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany.,Faculty of Medicine, University Hospital Cologne, Cologne, Germany.,ORYGEN, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - J Gallinat
- Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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41
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Jahan S, Rahim A, Afzal M, Naveed AK, Ayub S, Hasan A. Response to Comments on Jahan et al (JPMA 70: 390-393; 2020) Association of single nucleotide polymorphism of transforming growth factor β1 (T29C) in breast cancer patients: A case control study in Rawalpindi. J PAK MED ASSOC 2020; 70:1296. [PMID: 32799300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Saira Jahan
- Islamic International Medical College, Rawalpindi, Pakistan
| | - Amena Rahim
- Islamic International Medical College, Rawalpindi, Pakistan
| | - Muhammad Afzal
- Islamic International Medical College, Rawalpindi, Pakistan
| | | | - Saddaf Ayub
- Islamic International Medical College, Rawalpindi, Pakistan
| | - Aisha Hasan
- Islamic International Medical College, Rawalpindi, Pakistan
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Hasan A, Rodríguez N, Wong L. Transport and concentration of wealth: Modeling an amenities-based-theory. Chaos 2020; 30:053110. [PMID: 32491913 DOI: 10.1063/5.0003767] [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] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 04/16/2020] [Indexed: 06/11/2023]
Abstract
We derive a reaction-advection-diffusion equation based framework for analyzing the movement of wealth in urban environments. Gentrification is a core issue that affects many urban areas, and the dynamics of such are not fully understood. To understand the process using a few physically relevant variables, we develop an approach to model the interplay between local amenities and wealth from existing analyses of factors influencing gentrification. We conduct a linear stability analysis on model parameters that results in spatially homogeneous solutions and determine directions for parameter changes to induce instabilities. From these parameters, we determine quantities that lead to the formation of areas of wealth and amenity concentration in the long term on bounded and unbounded domains. We present a global bifurcation result in two dimensions, leading to the existence and stability of non-constant equilibrium solutions, which represents solutions with wealth and amenity hotspots. Finally, we present a theory for discerning the one-dimensional pattern formation in the transition between stability and instability and verify numerically through a weakly nonlinear analysis. The analysis provides a promising framework for further verification using publicly available geospatial data on the relevant variables.
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Affiliation(s)
- A Hasan
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Room 1427, Fitzpatrick Center (FCIEMAS), 101 Science Drive Campus, Box 90281 Durham, North Carolina 27708-0281, USA
| | - N Rodríguez
- Department of Applied Mathematics, University of Colorado, Boulder, 11 Engineering Dr., Boulder, Colorado 80309, USA
| | - L Wong
- Department of Applied Mathematics, University of Colorado, Boulder, 11 Engineering Dr., Boulder, Colorado 80309, USA
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Behera RR, Das A, Hasan A, Pamu D, Pandey LM, Sankar MR. Effect of TiO 2 addition on adhesion and biological behavior of BCP-TiO 2 composite films deposited by magnetron sputtering. Mater Sci Eng C Mater Biol Appl 2020; 114:111033. [PMID: 32994014 DOI: 10.1016/j.msec.2020.111033] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/20/2020] [Accepted: 04/28/2020] [Indexed: 12/14/2022]
Abstract
The present investigation focuses on the deposition of biphasic calcium phosphate (BCP) and titania (TiO2) composite films on Ti-6Al-4V substrates using radio frequency (RF) magnetron sputtering. Three different compositions such as 100% BCP, 25% TiO2-75% BCP and 50% TiO2-50% BCP films were fabricated, and the physical, mechanical and biological behaviors of the films were analyzed. Post deposition, the films were annealed at 700 °C for 2 h to induce the crystallinity and to study its effect on different properties. The wettability was found to be 95°(±3°) for 100% BCP, 73°(±2°) for 25% TiO2-75% BCP and 35°(±1°) for 50% TiO2-50% BCP films, indicating improvement in wettability with an increase of TiO2 weight percent in the composite films. The value of critical load (Lc2) for 100 BCP film improved from 8.7 N to 14.8 N (25 TiO2-BCP) and >19 N (50 TiO2-BCP film), indicating improvement in bonding strength with TiO2 addition. The fetal bovine serum (FBS) adsorption decreased from 7.11 ± 0.25 to 4.42 ± 0.17 μg/cm2 with TiO2 weight percent from 0 to 50%. Cell adhesion and proliferation significantly improved in 100% BCP, 25% TiO2-75% BCP and 50% TiO2-50% BCP films as compared to uncoated Ti-6Al-4V. The maximum cell proliferation was found on the surface of 50% TiO2-50% BCP film (210.1 ± 6.5%) after 6 days of incubation. However, after annealing all the films exhibited less cell adhesion and cytocompatibility presumably due to change in composition. Globular apatite structure was observed on all modified surfaces after 7 days immersion in simulated body fluid (SBF); however, the growth rate was higher for 50 TiO2-BCP films. All these results revealed that the addition of TiO2 in BCP film (without annealing) is advantageous for improving the bonding strength as well as the bioactivity of implants, which can be used for long-term dental and orthopedic applications.
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Affiliation(s)
- R R Behera
- Department of Mechanical Engineering, Indian Institute of Technology Guwahati, Assam 781039, India; School of Mechanical Engineering, Kalinga Institute of Industrial Technology, Bhubaneswar, Odisha 751024, India.
| | - A Das
- Department of Physics, Indian Institute of Technology Guwahati, Assam 781039, India.
| | - A Hasan
- Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Assam 781039, India.
| | - D Pamu
- Department of Physics, Indian Institute of Technology Guwahati, Assam 781039, India.
| | - L M Pandey
- Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Assam 781039, India.
| | - M R Sankar
- Department of Mechanical Engineering, Indian Institute of Technology Guwahati, Assam 781039, India; Department of Mechanical Engineering, Indian Institute of Technology Tirupati, Andhra Pradesh 517506, India.
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Maurus I, Mantel C, Keller-Varady K, Schmitt A, Lembeck M, Röh A, Papazova I, Falkai P, Schneider-Axmann T, Hasan A, Malchow B. Resistance training in patients with schizophrenia: Concept and proof of principle trial. J Psychiatr Res 2020; 120:72-82. [PMID: 31634752 DOI: 10.1016/j.jpsychires.2019.09.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 05/28/2019] [Revised: 09/20/2019] [Accepted: 09/25/2019] [Indexed: 12/16/2022]
Abstract
Resistance training has been shown to contribute to the prevention and management of cardiovascular diseases, which is why it can help reducing morbidity and mortality in schizophrenia patients. Moreover, positive effects on different schizophrenia symptom domains have been proposed. However, a specific resistance training tailored to the needs of schizophrenia patients and its evaluation is still lacking. The objective in this proof of principle trial was to evaluate the feasibility and efficacy of a newly developed 12-week resistance program according to current recommendations of the WHO and the American College of Sports Medicine. We employed a single blind, parallel assignment clinical trial design with participants randomized to attend either a resistance training including three 50min units per week or a balance and tone program as control condition. The primary outcome was the impact on health-related difficulties assessed with the World Health Organization Disability Assessment Schedule (WHO-DAS). Secondary outcome parameters included the level of functioning, schizophrenia symptoms, selected cognitive parameters as well as risk factors for cardiovascular diseases. In our proof of principle trial, we could not find significant time or group effects of resistance training on the WHO-DAS. However, we could observe significant positive effects on the level of functioning assessed with the Global Assessment of Functioning Scale (GAF) over the course of time, which were more pronounced in the intervention group. Our findings indicated that patients with schizophrenia could safely participate in resistance training with relevant improvements in their level of functioning. Well-powered replication trials are needed to provide more efficacy data.
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Affiliation(s)
- I Maurus
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
| | - C Mantel
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - K Keller-Varady
- Hannover Medical School, Institute of Sports Medicine, Hannover, Germany
| | - A Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of Sao Paulo, São Paulo, Brazil
| | - M Lembeck
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - A Röh
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - I Papazova
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - P Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - T Schneider-Axmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - A Hasan
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - B Malchow
- Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany
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Hina S, Hasan A, Iqbal N, Shabbir MU, Sheikh AAE. Malakoplakia of the Urinary Bladder and Unilateral Ureter. J Coll Physicians Surg Pak 2019; 29:582-584. [PMID: 31133162 DOI: 10.29271/jcpsp.2019.06.582] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 11/12/2018] [Indexed: 11/11/2022]
Abstract
Malakoplakia is an unusual acquired granulomatous disease that can affect many systems including urogenital tract. It presents a huge diagnostic challenge as it can mimic malignancy. We report a 55-year diabetic woman who presented with history of macroscopic hematuria and right flank pain. On investigations, ultrasound of kidney, ureter and bladder (KUB) showed right hydronephroureter, and CT KUB showed right moderate hydronephroureter and right ureteric stone. Endoscopic examination revealed multiple white plaques involving urinary bladder and right ureter. The diagnosis of malakoplakia was based on microscopic findings that are specific for its diagnosis.
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Affiliation(s)
- Saddaf Hina
- Department of Urology, PIMS, Islamabad, Pakistan
| | - Aisha Hasan
- Department of Urology, Shifa College of Medicine, Shifa International Hospital, Islamabad, Pakistan
| | - Nadeem Iqbal
- Department of Urology, Shifa College of Medicine, Shifa International Hospital, Islamabad, Pakistan
| | - Muhammad Usman Shabbir
- Department of Urology, Shifa College of Medicine, Shifa International Hospital, Islamabad, Pakistan
| | - Abdul Ahad Ehsan Sheikh
- Department of Urology, Shifa College of Medicine, Shifa International Hospital, Islamabad, Pakistan
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Cardoso B, Heads-Baister A, Johnson A, Wake J, Chila T, Simpson E, Hasan A, O'sullivan J, Reinhardt Z, Khushnood A. P3440Can pre-operative echocardiography predict RV failure post-LVAD implantation in children? Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0314] [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: 11/12/2022] Open
Abstract
Abstract
Background
One of the most frequent complications of left ventricular assist device (LVAD) implantation is the development of right ventricular (RV) failure, which occurs in 10%-40% of patients. It is, therefore, essential to identify which LVAD candidates are at risk for RV failure and will require additional RV mechanical support with a biventricular assist device (BiVAD). However, the echocardiographic assessment of the RV is challenging due to its complex geometry and marked load dependence of its function indices. To our knowledge, there is no published evidence regarding which specific RV echocardiographic parameters should inform this decision in the paediatric population.
Aims
We sought to determine which pre-operative RV echocardiographic parameters best correlate with the need for a BiVAD, as opposed to LVAD alone, in a paediatric population undergoing VAD insertion at a tertiary care institution.
Methods
Retrospective review of the pre-operative echocardiograms of children (<18 years) with dilated cardiomyopathy undergoing elective VAD implantation at our institution, from November 2007 to December 2018. Preoperative quantitative and qualitative RV echocardiographic parameters described in the literature to be associated with RV failure after LVAD implantation in adults were collected. Moreover, qualitative RV function was independently assessed by three echocardiographers, blinded to the outcome of the patients.
Results
89 patients were included, 39 (43.8%) males, median age = 1.7 years (IQR = 6.9), median weight = 11.6 kg (IQR = 13.8). 49 (55.1%) patients had an LVAD implanted, whereas 40 (44.9%) were deemed to need biventricular support. 45 (50.6%) patients received an EXCOR Berlin Heart, 16 (18%) a HeartWare HVAD and 28 (31.4%) a Levitronix Centrimag device. Requirement of BiVAD support was significantly more common in patients with moderate to severe RV impairment, as per expert assessment (OR = 2.864; 95% CI: 1.188–6.903, p=0.018), and tricuspid regurgitation > grade III (OR = 3.154; 95% CI: 1.124–8.850, p=0.025). All the other parameters collected – tricuspid annular plane systolic excursion (TAPSE), tricuspid regurgitant jet velocity, tricuspid regurgitation duration corrected for heart rate, RV tissue Doppler indices, RV fractional area change, and RV/LV diameter ratio– were not significantly different among groups.
Conclusions
In our paediatric population, expert assessment of RV function and degree of tricuspid regurgitation were strong predictors of RV failure among patients undergoing LVAD implantation, allowing for pre-emptive RVAD implantation and improving patient outcomes.
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Affiliation(s)
- B Cardoso
- Freeman Hospital, Paediatric Cardiology department, Newcastle upon Tyne, United Kingdom
| | - A Heads-Baister
- Freeman Hospital, Paediatric Cardiology department, Newcastle upon Tyne, United Kingdom
| | - A Johnson
- Freeman Hospital, Paediatric Cardiology department, Newcastle upon Tyne, United Kingdom
| | - J Wake
- Freeman Hospital, Paediatric Cardiology department, Newcastle upon Tyne, United Kingdom
| | - T Chila
- Freeman Hospital, Paediatric Cardiac Intensive Care department, Newcastle upon Tyne, United Kingdom
| | - E Simpson
- Freeman Hospital, Paediatric Cardiac Intensive Care department, Newcastle upon Tyne, United Kingdom
| | - A Hasan
- Freeman Hospital, Cardiothoracic Surgery department, Newcastle upon Tyne, United Kingdom
| | - J O'sullivan
- Freeman Hospital, Paediatric Cardiology department, Newcastle upon Tyne, United Kingdom
| | - Z Reinhardt
- Freeman Hospital, Paediatric Cardiology department, Newcastle upon Tyne, United Kingdom
| | - A Khushnood
- Freeman Hospital, Paediatric Cardiology department, Newcastle upon Tyne, United Kingdom
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Steiner J, Prüß H, Köhler S, Hasan A, Falkai P. [Autoimmune encephalitis with psychotic symptoms : Diagnostics, warning signs and practical approach]. Nervenarzt 2019. [PMID: 29523913 DOI: 10.1007/s00115-018-0499-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Despite intensive research, a precise cause of schizophrenic and schizoaffective disorders has not yet been identified. Therefore, psychiatric diagnoses are still made based on clinical ICD-10/DSM‑5 criteria and not on any objective markers; however, various causes or pathophysiological processes may ultimately lead to similar symptoms. An important task for the future of psychiatry is to identify disease subtypes with a distinct pathophysiology to develop more specific and causally acting therapies. A new diagnostic entity has become established in clinical neurology and psychiatry in recent years: autoimmune encephalitis with psychotic symptoms caused by specific antineuronal antibodies has been identified as a rare but potentially treatable cause of psychotic disorders; however, these inflammatory brain diseases are not reliably detected by routine psychiatric diagnostics. Therefore, this qualitative review is intended to provide structured support for clinical practice, which, guided by clinical warning signals, enables a rapid and reliable diagnosis as well as the initiation of immunotherapy. In the case of psychiatric symptoms, the additional onset of focal neurological signs, disturbances of consciousness and orientation, autonomic instability or epileptic seizures and electroencephalograph (EEG) abnormalities should always be followed by a more specific cerebrospinal fluid analysis with determination of antineuronal autoantibodies. Although the scientific evidence indicates that only a small subgroup of patients is affected, the swift and correct diagnosis is of high therapeutic and prognostic relevance for the affected individuals.
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Affiliation(s)
- J Steiner
- Klinik für Psychiatrie und Psychotherapie, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland. .,Center for Behavioral Brain Sciences, Magdeburg, Deutschland.
| | - H Prüß
- Experimentelle Neurologie und Klinik für Neurologie, Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Deutschland.,Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) Berlin, Berlin, Deutschland
| | - S Köhler
- Klinik für Psychiatrie und Psychotherapie, Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - A Hasan
- Klinik für Psychiatrie und Psychotherapie, Ludwig Maximilians-Universität München, München, Deutschland
| | - P Falkai
- Klinik für Psychiatrie und Psychotherapie, Ludwig Maximilians-Universität München, München, Deutschland
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Andruszkow J, Hartleben B, Schlué J, Ritz T, Knüchel R, Hasan A, Petersen C, Madadi-Sanjani O. [Staging of liver fibrosis in biliary atresia : Comparison of Chevallier and Ishak score as well as automated evaluation]. Pathologe 2019; 40:85-92. [PMID: 30617605 DOI: 10.1007/s00292-018-0558-z] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Biliary atresia (BA) is a rare disease of the newborn, resulting in liver cirrhosis due to obliterative cholangiopathy. Liver biopsies are commonly performed in order to confirm the diagnosis and in order to stage fibrosis. OBJECTIVES The present study intended to analyze two established scores for evaluating liver fibrosis focusing on the interobserver variability as well as the prognostic reliability towards the time of liver transplantation. MATERIALS AND METHODS Liver biopsies of BA patients between 2012 and 2015 were evaluated retrospectively by two pathologists at the Hannover Medical School (MHH) and the RWTH Aachen University Hospital. Fibrosis was measured using Ishak and Chevallier scores. Furthermore, a computerized automatically algorithm-based analyzation (ABAA) was performed. Results were evaluated towards the time point of liver transplantation and hepatoportoenterostomy (HPE). RESULTS Overall, 34 liver biopsies were analyzed. The Ishak score showed a remarkable interobserver variability (ΚW = 0.68) while the Chevallier score was proven to have a poor interobserver variability (Fleiss' Κappa = -0.01). However, both scores were correlated positively, as was the ABAA (p < 0.001). Regarding prognostic reliability, ROC analyses of the Ishak score revealed the best validity towards an early liver transplantation within 12 months (AUC 0.813, p = 0.011). In addition, an increased Ishak score ≥4 reduced the survival time with the native liver (hazard ratio 6.6 [95% CI 1.9-23.3]). CONCLUSIONS The Ishak score was revealed to have the best interobserver variability as well as prognostic validity towards an early liver transplantation in BA patients. Due to its easy applicability, the Ishak score was proven superior in comparison to the Chevallier score and ABAA. Therefore, use of the Ishak score is recommended in daily clinical routine for analyzing liver biopsies in BA patients.
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Affiliation(s)
- J Andruszkow
- Institut für Pathologie, Uniklinik RWTH Aachen, Aachen, Deutschland.
| | - B Hartleben
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - J Schlué
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - T Ritz
- Institut für Pathologie, Uniklinik RWTH Aachen, Aachen, Deutschland
| | - R Knüchel
- Institut für Pathologie, Uniklinik RWTH Aachen, Aachen, Deutschland
| | - A Hasan
- Zentrum für Kinderchirurgie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - C Petersen
- Zentrum für Kinderchirurgie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - O Madadi-Sanjani
- Zentrum für Kinderchirurgie, Medizinische Hochschule Hannover, Hannover, Deutschland
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Hasan A, Rahim A, Afzal M, Naveed A, Ayub S, Jahan S. Serum Albumin and C3 Complement Levels in Endometriosis. J Coll Physicians Surg Pak 2019; 29:702-705. [DOI: 10.29271/jcpsp.2019.08.702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 04/08/2019] [Indexed: 11/11/2022]
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Roeh A, Bunse T, Lembeck M, Handrack M, Pross B, Schoenfeld J, Keeser D, Ertl-Wagner B, Pogarell O, Halle M, Falkai P, Hasan A, Scherr J. Running effects on cognition and plasticity (ReCaP): study protocol of a longitudinal examination of multimodal adaptations of marathon running. Res Sports Med 2019; 28:241-255. [PMID: 31345073 DOI: 10.1080/15438627.2019.1647205] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Regular moderate physical activity (PA) has been linked to beneficial adaptations in various somatic diseases (e.g. cancer, endocrinological disorders) and a reduction in all-cause mortality from several cardiovascular and neuropsychiatric diseases. This study was designed to investigate acute and prolonged exercise-induced cardio- and neurophysiological responses in endurance runners competing in the Munich Marathon. ReCaP (Running effects on Cognition and Plasticity) is a multimodal and longitudinal experimental study. This study included 100 participants (20-60 years). Six laboratory visits were included during the 3-month period before and the 3-month period after the Munich marathon. The multimodal assessment included laboratory measurements, cardiac and cranial imaging (MRI scans, ultrasound/echocardiography) and neurophysiological methods (EEG and TMS/tDCS), and vessel-analysis (e.g. retinal vessels and wave-reflection analyses) and neurocognitive measurements. The ReCaP study was designed to examine novel exercise-induced cardio- and neurophysiological responses to marathon running at the behavioral, functional and morphological levels. This study will expand our understanding of exercise-induced adaptations and will lead to more individually tailored therapeutic options.
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Affiliation(s)
- A Roeh
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - T Bunse
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - M Lembeck
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - M Handrack
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - B Pross
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - J Schoenfeld
- Department of Prevention and Sports Medicine, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany
| | - D Keeser
- Department of Clinical Radiology, Ludwig-Maximilians-University, Munich, Germany
| | - B Ertl-Wagner
- Department of Clinical Radiology, Ludwig-Maximilians-University, Munich, Germany
| | - O Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - M Halle
- Department of Prevention and Sports Medicine, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner site Munich, Munich Heart Alliance, Munich, Germany
| | - P Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - A Hasan
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - J Scherr
- Department of Prevention and Sports Medicine, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany
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