1
|
Alsulmi A, Shaker MH, Basely AM, Abdel-Messih MF, Sultan A, Ahmed MA. Engineering S-scheme Ag 2CO 3/g-c 3N 4 heterojunctions sonochemically to eradicate Rhodamine B dye under solar irradiation. RSC Adv 2023; 13:12229-12243. [PMID: 37091619 PMCID: PMC10113822 DOI: 10.1039/d3ra00173c] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/11/2023] [Indexed: 04/25/2023] Open
Abstract
The use of natural solar radiation is a low-cost significant technology for water pollution remediation and production of clean energy. In this work, S-scheme Ag2CO3/g-C3N4 heterojunctions were engineered for carefully eradicating Rhodamine B dye under natural sunlight irradiation. Solid thermal decomposition reactions generate g-C3N4 sheets by annealing urea at 520 °C. Ag2CO3 nanoparticles are directed and localized sonochemically to the active centers of g-C3N4 sheets. The physicochemical properties of the solid specimen were determined by PL, DRS, XRD, HRTEM, mapping, EDX, N2-adsorption-desorption isotherm and XPS analyses. As elucidated by HRTEM, PL and DRS analyses, 5 wt% of spherical Ag2CO3 nanoparticles deposited on the g-C3N4 sheet surface and nearly equidistant from each other elevate the electron-hole separation efficiency and broaden the absorption capacity of photocatalysts. Rhodamine B dye was degraded at a rate of 0.0141 min-1 by heterojunctions containing 5 wt% Ag2CO3 and 95 wt% g-C3N4, which is three-fold higher than that on pristine g-C3N4 nanosheets. Free radical scrubber experiments revealed the contribution of charge carriers and reactive oxygen species to the decomposition of RhB dye with a preferential role of positive holes and superoxide species. PL measurements of terephthalic acid and scrubber trapping experiments provide confirmatory evidence for charge diffusion via the S-scheme mechanism that accounts for the production of electron-hole pairs with strong redox power. This novel research work is contributory to manipulate the S-scheme heterojunction for efficient and low-cost wastewater treatment under natural solar irradiation.
Collapse
Affiliation(s)
- Ali Alsulmi
- Department of Chemistry, College of Science, King Saud University P.O.2455 Riyadh 11451 Saudi Arabia
| | - Mohamed H Shaker
- Chemistry Department, Faculty of Science, Ain Shams University Egypt
| | - Abanoob M Basely
- Chemistry Department, Faculty of Science, Ain Shams University Egypt
| | - M F Abdel-Messih
- Chemistry Department, Faculty of Science, Ain Shams University Egypt
| | - Ayman Sultan
- Department of Chemistry, University of York York YO10 5DD UK
| | - M A Ahmed
- Chemistry Department, Faculty of Science, Ain Shams University Egypt
| |
Collapse
|
2
|
Gunawardene MA, Lemoine M, Deneke T, Wakili R, Steven D, Schaeffer B, Rillig A, Nentwich K, Siebermair J, Filipovic K, Simu G, Riesinger L, Sultan A, Willems S, Metzner A. Pulsed field ablation for atrial fibrillation: acute procedural efficacy and safety of an initial German multicenter experience. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.473] [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: 11/13/2022] Open
Abstract
Abstract
Background
Pulsed field ablation (PFA) is a novel non-thermal energy source to conduct catheter ablation of atrial fibrillation (AF). However, real-world multi-center data regarding acute procedural efficacy and safety is sparse.
Purpose
To study acute procedural success and safety in patients undergoing PFA for catheter ablation of AF in a multicenter registry.
Methods
Consecutive paroxysmal and persistent AF patients undergoing PFA-based catheter ablation using a multispline catheter were enrolled. The cohort included first and repeat ablation procedures. Procedural parameters, acute success and in-hospital safety were evaluated. A follow-up of all patients was conducted.
Results
Five German centers enrolled a total of 154 patients undergoing PFA in this study. Mean age was 68±12 years, median CHA2DS2-VASc Score was 3 (Q1-Q3: 2–4).
Patients suffered from paroxysmal AF (n=55; 36%), persistent AF (n=93; 60%) and consecutive atrial tachycardias (AT) due to previous CA (n=6; 4%).
The median left atrial (LA) PFA and total procedure times were 33 (Q1-Q3: 24–53) and 90 (Q1-Q3: 73–116) minutes, respectively. Mean LA PFA fluoroscopy and total fluoroscopy times were 12.1±5.5 and 20.2±8.7 minutes. Of all 154 procedures, 130 (84%) were index ablation procedures with isolation of pulmonary veins (PVI) only and 24 (16%) were repeat procedures (including re-PVI and ablation of consecutive AT).
Acute PV reconnection following primary PVI and the initial set of PFA-applications was found in 20/130 (15%) patients, necessitating additional PFA ablation. Finally, successful PFA-guided PVI was achieved in all patients.
Additional PFA lesion sets (including LA posterior wall isolation, anterior ablation, mitral isthmus ablation) were applied in 17/154 (11%) patients.
Complications occurred in a total of 6/154 (3.8%) patients (including three groin site complications, two pericardial tamponades, one transient coronary spasm without sequela). The follow up data is still being assessed and will be provided by the time of the ESC 2022 meeting.
Conclusion
PFA performed in patients with atrial fibrillation demonstrates high acute procedural success rates and a favorable safety profile in this first real-world multicenter registry.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
| | - M Lemoine
- The University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - T Deneke
- Heart Center Bad Neustadt , Bad Neustadt a. d. Saale , Germany
| | - R Wakili
- University hospital Essen , Essen , Germany
| | - D Steven
- University of Cologne , Cologne , Germany
| | - B Schaeffer
- Asklepios Clinic St. Georg , Hamburg , Germany
| | - A Rillig
- The University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - K Nentwich
- Heart Center Bad Neustadt , Bad Neustadt a. d. Saale , Germany
| | | | | | - G Simu
- Heart Center Bad Neustadt , Bad Neustadt a. d. Saale , Germany
| | | | - A Sultan
- University of Cologne , Cologne , Germany
| | - S Willems
- Asklepios Clinic St. Georg , Hamburg , Germany
| | - A Metzner
- The University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| |
Collapse
|
3
|
Bou Khalil R, Risch N, Sleilaty G, Richa S, Seneque M, Lefebvre P, Sultan A, Avignon A, Maimoun L, Renard E, Courtet P, Guillaume S. Neutrophil-to-lymphocyte ratio (NLR) variations in relationship with childhood maltreatment in patients with anorexia nervosa: a retrospective cohort study. Eat Weight Disord 2022; 27:2201-2212. [PMID: 35128621 DOI: 10.1007/s40519-022-01372-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 01/20/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Anorexia nervosa (AN) is a serious mental illness. It is frequently accompanied by a history of childhood maltreatment (CM) that may constitute a specific ecophenotype in patients with eating disorders necessitating special assessment and management. This retrospective study tested whether in patients with AN, CM-related chronic stress may manifest through low-grade inflammation reflected by an increase in white blood cell ratios (neutrophil-to-lymphocyte ratio, NLR, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio). METHODS Participants (N = 206) were enrolled at an eating disorder daycare unit in Montpellier, France, from March 2013 and January 2020. CM was assessed using the childhood trauma questionnaire (CTQ). The Eating Disorder Examination Questionnaire (EDE-Q) and the MINI were used to assess AN severity and the other clinical characteristics, respectively. RESULTS NLR was higher in patients with AN and history of CM (p = 0.029) and in patients with AN and history of emotional abuse (p = 0.021), compared with patients with AN without history of CM. In multivariate analysis, emotional abuse (β = 0.17; p = 0.027) contributed significantly to NLR variability. CONCLUSION In patients with AN, NLR is a low-grade inflammation marker that is influenced by various sociodemographic, clinical and biological factors. It is more directly affected by some CM types, especially emotional abuse, than by the presence/absence of CM history. Future studies should focus on mediators between CM and increased inflammation, such as interoceptive awareness, emotional dysregulation, food addiction, and stress sensitization. LEVEL OF EVIDENCE III. Evidence obtained from well-designed cohort or case-control analytic studies.
Collapse
Affiliation(s)
- R Bou Khalil
- Department of Psychiatry, Saint Joseph University-Hôtel Dieu de France Hospital, Beirut, Lebanon. .,Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.
| | - N Risch
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295, Montpellier, France
| | - G Sleilaty
- Clinical Research Center and Department of Cardiac and Thoracic Surgery, Saint Joseph University-Hôtel Dieu de France Hospital, Beirut, Lebanon
| | - S Richa
- Department of Psychiatry, Saint Joseph University-Hôtel Dieu de France Hospital, Beirut, Lebanon
| | - M Seneque
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295, Montpellier, France
| | - P Lefebvre
- Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, University of Montpellier, Montpellier, France
| | - A Sultan
- University of Montpellier, PhyMedExp, INSERM, CNRS UMR, CHRU Montpellier, Montpellier, France
| | - A Avignon
- Desbrest Institute of Epidemiology and Public Health, Univ Montpellier, INSERM, CHU, Montpellier, France
| | - L Maimoun
- University of Montpellier, PhyMedExp, INSERM, CNRS UMR, CHRU Montpellier, Montpellier, France.,Département de Médecine Nucléaire, Hôpital Lapeyronie, CHU Montpellier, Montpellier, France
| | - E Renard
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,Department of Endocrinology, Diabetes, Nutrition, CHU Montpellier, Montpellier, France
| | - P Courtet
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295, Montpellier, France
| | - S Guillaume
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295, Montpellier, France
| |
Collapse
|
4
|
De Boysson H, Guittet L, Cerasuolo D, Morello R, Sultan A, Deshayes S, Aouba A. Incidences nationale et régionales de l’artérite à cellules géantes en France métropolitaine et d’Outre-mer. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
5
|
Van Den Bruck JH, Sultan A, Woermann J, Filipovic K, Erlhoefer S, Arica Z, Scheurlen C, Dittrich S, Schipper JH, Lueker J, Steven D. Modern technologies for radiofrequency pulmonary vein isolation. Comparison of radiofrequency balloon catheter with high power-short duration ablation in patients with paroxysmal atrial fibrillation. Europace 2022. [DOI: 10.1093/europace/euac053.233] [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: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Pulmonary vein isolation (PVI) is an established therapy for symptomatic atrial fibrillation (AF). Traditional point by point ablation can be time consuming requiring advanced training. Novel radiofrequency (RF) ablation techniques sought to facilitate PVI. Point by point ablation using high power short duration (HPSD) settings has already shown to be safe and effective whereas there is paucity of data using a novel multi-electrode balloon catheter (Heliostar™, Biosense Webster, CA, USA).
Purpose
We aimed to assess procedure characteristics, efficacy, and safety of the Heliostar™ RF-balloon catheter in direct comparison with the latest RF ablation technique.
Methods
All patients undergoing PVI using the Heliostar™ between September and November 2021 were included in this ongoing single center registry. Procedural data and outcome were assessed and compared with data from patients undergoing initial PVI for paroxysmal AF with the HPSD approach from our specifically designed database. A power setting of 70W/7s (70W/5s at posterior wall) was considered as HPSD.
Results
A total of 51 consecutive patients (61±16 years, 49% male) were included. Of those 13 patients undergoing RF-balloon and 38 patients HPSD ablation. Baseline parameters did not differ between groups. Acute PVI was achieved in all patients. For every RF-application with the RF-balloon all necessary criteria were met: Inflation index was between 0.9 and 1.0 and a minimum of 9/10 electrodes were within impedance range. A mean of 2.8±1.4 applications per vein (LSPV 3.2±2.9, LIPV 2.6±2.5, RSPV 2.8±2.0 and RIPV 1.8±0.8) were necessary to achieve durable isolation. The mean maximum esophageal temperature was 40.2±0.8°C. When comparing procedural parameters with HPSD no statistically significant difference was seen regarding procedure duration (Heliostar™ 111±28min and HPSD 100±25min; p=0.3) and left atrial dwell time (Heliostar™ 90±23min and HPSD 80±26min; p=0.08). Fluoroscopy time (Heliostar™ 17±4min and HPSD 13±5min; p=0.005) and dose (Heliostar™ 3961±1325mGy*cm2 vs. HPSD 3153±1833mGy*cm2; p=0.04) were higher in the Heliostar™ group. No major complication occurred in both groups. A three month follow up was available for 10 patients in the Heliostar™ and for 38 patients in the HPSD group. All 10 Heliostar™ patients and 79% of the HPSD patients were free from atrial arrhythmias at follow up.
Conclusion
The novel multi-electrode RF-balloon has shown to be safe and effective in the first clinical routine AF ablation procedures. The tendency towards longer LA dwell times, procedure durations and the significantly higher fluoroscopy exposition in comparison with the HPSD PVI can be attributed to the learning curve applying a new ablation system. More experience is needed in the future to determine the benefits of the novel RF-balloon.
Collapse
Affiliation(s)
| | - A Sultan
- Heart Center at the University of Cologne, Cologne, Germany
| | - J Woermann
- Heart Center at the University of Cologne, Cologne, Germany
| | - K Filipovic
- Heart Center at the University of Cologne, Cologne, Germany
| | - S Erlhoefer
- Heart Center at the University of Cologne, Cologne, Germany
| | - Z Arica
- Heart Center at the University of Cologne, Cologne, Germany
| | - C Scheurlen
- Heart Center at the University of Cologne, Cologne, Germany
| | - S Dittrich
- Heart Center at the University of Cologne, Cologne, Germany
| | - J-H Schipper
- Heart Center at the University of Cologne, Cologne, Germany
| | - J Lueker
- Heart Center at the University of Cologne, Cologne, Germany
| | - D Steven
- Heart Center at the University of Cologne, Cologne, Germany
| |
Collapse
|
6
|
Scheurlen C, Van Den Bruck JH, Dittrich S, Erlhoefer S, Filipovic K, Lueker J, Woermann J, Steven D, Sultan A. Procedural and outcome impact of obesity in cryoballoon versus radiofrequency pulmonary vein isolation in atrial fibrillation patients. Europace 2022. [DOI: 10.1093/europace/euac053.211] [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: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Cryoballoon-(CB)- and radiofrequency-(RF)-ablation are the most common techniques for pulmonary vein isolation (PVI) in patients (pts) with symptomatic atrial fibrillation (AF). An increasing number of pts undergoing PVI are obese.
Objective
To address the paucity of procedural differences and outcome data of CB- vs. RF-based PVI in relation to body mass index (BMI) of AF patients.
Methods
All pts undergoing de novo PVI between 01/2018-08/2019 at our university hospital were included in this retrospective analysis. Pts of each group (CB-PVI vs. RF-PVI) were subdivided based on their BMI: normal weight BMI <25kg/m², pre-obesity 25-30kg/m², obesity stage I 30-35kg/m² and severe obesity stage II ≥35kg/m². Hereafter, procedural characteristics and AF recurrence rate during follow-up were compared with regard the different BMI groups.
Results
A total of 526 pts (62% male, 65.3±11.2 years) underwent successful de novo PVI (320 CB and 206 RF). Especially in obese patients, differences in procedural characteristics were noted: A significantly increased contrast medium volume in CB group (all: CB 50 [40-80] vs. RF 20 [20-30], p<0.001; BMI≥35: CB 70 [54.5-102.5] ml vs. RF 20 [15-30] ml, p<0.001). In line with previous studies, the overall procedure time was significantly shorter with CB-PVI (CB 75 [60-100] vs. RF 120 [110-180], p<0.001). Also, as expected, lower fluoroscopy dose was detected in RF group (all: CB 392.4 [197.9-995.9] vs. RF 282.5 [139.8-507.2], p<0.001). The complication rate was equal throughout all BMI groups.
A 12-month follow up was available in 480 of 526 (91%) pts. Freedom from any arrhythmia was comparable between CB-PVI and RF-PVI (CB 77% vs. RF 75%, p=0.63). However, for obese pts a trend towards higher AF recurrence rate after RF- compared to CB-PVI was observed (BMI≥35: CB 24% vs. RF 50%, p=0.099).
Conclusion
For obese pts CB-PVI is similarly safe and effective as RF-PVI. The significantly shorter procedure time for CB-PVI may minimize potential obesity-related complications. However, the lower contrast medium quantity and fluoroscopy dose in RF-PVI must be considered. AF recurrence rates were comparable between CB-PVI und RF-PVI. Randomised trials are needed to evaluate the long-term freedom of AF recurrence in pts with higher BMI comparing CB- vs. RF-based PVI and possible obesity related complication.
Collapse
Affiliation(s)
- C Scheurlen
- Heart Center at the University of Cologne, Cologne, Germany
| | | | - S Dittrich
- Heart Center at the University of Cologne, Cologne, Germany
| | - S Erlhoefer
- Heart Center at the University of Cologne, Cologne, Germany
| | - K Filipovic
- Heart Center at the University of Cologne, Cologne, Germany
| | - J Lueker
- Heart Center at the University of Cologne, Cologne, Germany
| | - J Woermann
- Heart Center at the University of Cologne, Cologne, Germany
| | - D Steven
- Heart Center at the University of Cologne, Cologne, Germany
| | - A Sultan
- Heart Center at the University of Cologne, Cologne, Germany
| |
Collapse
|
7
|
Gawalko M, Hermans ANL, Van Der Velden RMJ, Betz K, Verhaert DVM, Pluymaekers NAHA, Vernooy K, Sultan A, Pison L, Manninger M, Duncker D, Evans S, Sohaib A, Linz D, Hendriks JM. Patient motivation and adherence to an on-demand app-based heart rate and rhythm monitoring infrastructure for atrial fibrillation management through teleconsultation. TeleCheck-AF project results. Europace 2022. [DOI: 10.1093/europace/euac053.587] [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: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
TeleCheck-AF is a mobile health (mHealth) infrastructure developed to provide remote management and comprehensive care to patients with atrial fibrillation (AF) during the Covid disease-19 pandemic lockdown within cardiology centers in Europe. TeleCheck-AF integrates an on-demand photoplethysmography-based heart rate/rhythm monitoring application supported a scheduled teleconsultation.
Purpose
The current sub-study of the TeleCheck-AF project aimed to provide the first real-world dataset on patient adherence and motivation to a standardized mHealth application integrated in remote AF management.
Methods
Patients were instructed to perform 60-second app-based heart rate/rhythm recordings three times daily and in case of symptoms for seven consecutive days prior to teleconsultation. Motivation was defined as number of days in which the expected number of measurements (≥three/day) were performed per number of days over the entire prescription period. Adherence was defined as number of performed measurements per number of expected measurements over the entire prescription period.
Results
Data from 990 consecutive patients with diagnosed AF (median age 64 [57-71] years, 39% female) from 10 centers that included the highest number of patients (≥25) were analyzed. Patients with both optimal motivation (100%) and adherence (≥100%) constituted 28% of the study population and had a lower percentage of recordings in sinus rhythm (90 [53-100%] vs 100 [64-100%], P<0.001) compared to others. Age and diabetes were predictors of both optimal motivation and adherence (odds ratio [OR] 1.02, 95% coincidence interval [95% CI] 1.01-1.04, P<0.001 and OR, 0.49, 95% CI 0.28-0.86, P=0.013, respectively). Patients with 100% motivation also had ≥100% adherence. Independent predictors for optimal adherence alone were age (OR 1.02, 95% CI 1.00-1.04, P=0.014), female sex (OR 1.70, 95% CI 1.29-2.23, P<0.001), previous AF ablation (OR 1.35, 95%CI 1.03-1.07, P=0.028).
Conclusion
In the TeleCheck-AF project, older age and diabetes were predictors of optimal patient motivation and adherence to app-based heart rate/rhythm monitoring. Therefore, physicians, nurses and allied health specialists involved in the management and care for patients with AF should not be discouraged to provide a mHealth infrastructure to elderly patients. Patient engagement improves mHealth adherence/motivation, hence, it is crucial to tailor the mHelath intervention to the needs and preferences of the patient.
Collapse
Affiliation(s)
- M Gawalko
- Maastricht University Medical Centre (MUMC), Department of Cardiology, Maastricht, Netherlands (The)
| | - ANL Hermans
- Maastricht University Medical Centre (MUMC), Department of Cardiology, Maastricht, Netherlands (The)
| | - RMJ Van Der Velden
- Maastricht University Medical Centre (MUMC), Department of Cardiology, Maastricht, Netherlands (The)
| | - K Betz
- Maastricht University Medical Centre (MUMC), Department of Cardiology, Maastricht, Netherlands (The)
| | - DVM Verhaert
- Maastricht University Medical Centre (MUMC), Department of Cardiology, Maastricht, Netherlands (The)
| | - NAHA Pluymaekers
- Maastricht University Medical Centre (MUMC), Department of Cardiology, Maastricht, Netherlands (The)
| | - K Vernooy
- Maastricht University Medical Centre (MUMC), Department of Cardiology, Maastricht, Netherlands (The)
| | - A Sultan
- Heart Center at the University of Cologne, Department of Electrophysiology, Cologne, Germany
| | - L Pison
- Hospital Oost-Limburg (ZOL), Department of Cardiology, Genk, Belgium
| | - M Manninger
- Medical University of Graz, Department of Cardiology, Graz, Austria
| | - D Duncker
- Hannover Medical School, Department of Cardiology and Angiology, Hannover, Germany
| | - S Evans
- Qompium NV, Hasselt, Belgium
| | - A Sohaib
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - D Linz
- Maastricht University Medical Centre (MUMC), Department of Cardiology, Maastricht, Netherlands (The)
| | - JM Hendriks
- Maastricht University Medical Centre (MUMC), Department of Cardiology, Maastricht, Netherlands (The)
| |
Collapse
|
8
|
Filipovic K, Dittrich S, Scheurlen C, Arica Z, Erlhoefer S, Woermann J, Van Den Bruck JH, Sultan A, Steven D, Lueker J. Validation of seven risk scores in a prospective and independent cohort: the challenge of predicting recurrence after atrial fibrillation ablation. Europace 2022. [DOI: 10.1093/europace/euac053.191] [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: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Several predictive scores for atrial fibrillation (AF) recurrence after ablation have been developed, only some of these are validated in prospective cohorts. The predictive value of such scores has thus far been limited, and many have not been compared with one another.
Aims
We sought to compare the predictive value of seven previously described risk scores ((CHA2DS2 and CHA2DS2-VASC, HATCH, APPLE, CAAP-AF, BASE-AF2, MB-LATER) for prediction of AF recurrence risk at 12 months after AF ablation. Further, we aimed to identify additional variables to predict recurrences after AF ablation.
Methods
We analyzed data from of our prospective digital AF ablation registry to compare the previously published scores in an independent and prospective cohort (n=883, 50.8% with paroxysmal AF). Patients were undergoing de-novo ablation of AF received a pulmonary vein isolation (PVI) using radiofrequency (RF) ablation or cryoablation. Ablation procedures for recurrences of AF after initial PVI included re-isolation of the pulmonary veins by RF ablation, with additional substrate modification at the operators’ discretion.
Early recurrence and recurrence after ablation were defined as any AF or atrial tachycardia episode lasting ≥ 30 s in the first 3 months after ablation and from the end of the 3-month period to 12 months after ablation. Follow-up of patients was scheduled at regular intervals 3 and 12 months after ablation, and included Holter-ECG, 12-lead ECG and history. Outcome-relevant data from implanted cardiac devices (CIED), such as 2-chamber ICD and pacemakers, or implantable loop recorders were analyzed when available.
A predefined subgroup analysis was performed in the following subgroups: first procedure vs. redo procedure, paroxysmal vs. persistent AF, and RF ablation vs. cryoablation.
Results
The BASE-AF2 (AUC 0.630, p<0.001), MB-LATER (AUC 0.612, p<0.001) CAAP-AF (AUC 0.591, p<0.001), APPLE (AUC 0.591, p<0.001) and CHA2DS2-VASC (AUC 0.547, p=0.018) scores had a significant but modest predictive value for 12-month AF-recurrence. None of these scores was significantly superior. Other previously published scores had no predictive value. There was no difference in the predictive value for 12-month recurrence of AF between first procedure vs. redo procedure and RF ablation vs. cryoablation. Unlike other scores, MB-LATER showed better predictive value for paroxysmal vs. persistent AF (AUC 0.632 vs. 0.551, p=0.038). In the multivariate logistic regression, only age (p=0.006), number of prior electrical cardioversions (p<0.001) and early AF recurrence (p<0.001) were independent predictors of 12-month AF recurrence.
Conclusion
Despite numerous available scores, predicting recurrences after AF ablation remains challenging. New simple and robust predictors are needed, potentially based on diagnostic interventions, as well as novel genetic, functional and anatomic parameters.
Collapse
Affiliation(s)
- K Filipovic
- University of Cologne, Heart Center, Cologne, Germany
| | - S Dittrich
- University of Cologne, Heart Center, Cologne, Germany
| | - C Scheurlen
- University of Cologne, Heart Center, Cologne, Germany
| | - Z Arica
- University of Cologne, Heart Center, Cologne, Germany
| | - S Erlhoefer
- University of Cologne, Heart Center, Cologne, Germany
| | - J Woermann
- University of Cologne, Heart Center, Cologne, Germany
| | | | - A Sultan
- University of Cologne, Heart Center, Cologne, Germany
| | - D Steven
- University of Cologne, Heart Center, Cologne, Germany
| | - J Lueker
- University of Cologne, Heart Center, Cologne, Germany
| |
Collapse
|
9
|
Van Den Bruck JH, Woermann J, Sultan A, Filipovic K, Scheurlen C, Erlhoefer S, Arica Z, Dittrich S, Schipper J, Steven D, Lueker J. Impact of pacing output and cycle length on qrs morphology in ablation of premature ventricular contractions (PACE-MAP-Trial). Europace 2022. [DOI: 10.1093/europace/euac053.359] [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: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Pace mapping is an established technique to localize the origin of premature ventricular contractions (PVC). The QRS morphology induced by endocardial pacing is compared with a previously recorded template of the target arrhythmia. Based upon historic in-vitro models pacing at the arrhythmia’s coupling interval (CI) and stimulation threshold has become the gold standard in pace mapping.
Purpose
There is a paucity of data supporting pacing at the CI and stimulation threshold as the gold standard for pace mapping. In this prospective study, we sought to assess systematically the impact of variations of pacing output and cycle length on the resulting QRS morphology during pace mapping in the context of PVC ablation (NCT05061498).
Methods
All patients undergoing ablation of idiopathic PVC were prospectively enrolled in this study. Pace mapping was performed using four different parameter settings: (1) A predefined fixed burst at maximum output (10V/2ms), (2) fixed burst at stimulation threshold, (3) coupling interval at maximum output and (4) coupling interval at stimulation threshold. Pacing cycle length (PCL) of the fixed burst was defined as follows: for a CI ≤450ms = PCL of CI+100ms and for a CI ≥450 = PCL of CI-100ms. Using an automated waveform comparison algorithm, the resulting QRS complexes were matched with the clinical PVC, and with the gold standard. For every parameter setting the mean of the matching percentage of three QRS complexes entered the analysis.
Results
We report data of the first 22 consecutive patients (53±15 years, 64% female) enrolled in this ongoing study between May and November 2021. The pacing protocols were performed at 39 different sites: 5/39 epicardially via great cardiac vein, 15/39 in the RVOT 12/39 and 7/22 in the left ventricular cavity. When comparing the QRS morphologies resulting from the four different pace mapping settings with the clinical PVC, the univariate analysis revealed no difference between groups (p=0.9). Furthermore, there was no difference comparing the paced QRS morphologies at different output and cycle length to the gold standard of threshold pacing at coupling interval (p=0.9).
Conclusion
Variations of pacing output and stimulation cycle length during pace mapping does not affect QRS morphology during PVC ablation. Applying a modern automated waveform comparison tool, no advantage was observed when comparing with the gold standard. It is therefore reasonable to assume, that pace mapping can be performed using an easily applicable setting of a fixed burst at maximum pacing output.
Collapse
Affiliation(s)
| | - J Woermann
- Heart Center at the University of Cologne, Cologne, Germany
| | - A Sultan
- Heart Center at the University of Cologne, Cologne, Germany
| | - K Filipovic
- Heart Center at the University of Cologne, Cologne, Germany
| | - C Scheurlen
- Heart Center at the University of Cologne, Cologne, Germany
| | - S Erlhoefer
- Heart Center at the University of Cologne, Cologne, Germany
| | - Z Arica
- Heart Center at the University of Cologne, Cologne, Germany
| | - S Dittrich
- Heart Center at the University of Cologne, Cologne, Germany
| | - J Schipper
- Heart Center at the University of Cologne, Cologne, Germany
| | - D Steven
- Heart Center at the University of Cologne, Cologne, Germany
| | - J Lueker
- Heart Center at the University of Cologne, Cologne, Germany
| |
Collapse
|
10
|
Van Der Velden RMJ, Verhaert DVM, Hermans ANL, Gawalko M, Duncker D, Manninger M, Hemels M, Pisters R, Lodzinski P, Steven D, Sultan A, Crijns HJGM, Pluymaekers NAHA, Hendriks JM, Linz D. The photoplethysmography dictionary: practical guidance on signal interpretation and clinical scenarios from TeleCheck-AF. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0320] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
During the coronavirus disease 2019 (COVID-19) pandemic, numerous centres in Europe used on-demand photoplethysmography (PPG) technology to remotely assess heart rate and rhythm in conjunction with teleconsultations within the TeleCheck-AF project.
Purpose
To develop an educational structured stepwise practical guide on how to interpret PPG signals and to study typical clinical scenarios how on-demand PPG was used in the TeleCheck-AF project.
Methods
During an online conference, the structured stepwise practical guide on how to interpret PPG signals was discussed and further refined during an internal review process. We provide the number of respective PPG recordings and number of patients managed within a clinical scenario during the TeleCheck-AF project.
Results
To interpret PPG recordings, we introduce a structured stepwise practical guide and provide representative PPG recordings. In the TeleCheck-AF project, 2522 subjects collected 90.616 recordings. The majority of these recordings was classified by the PPG algorithm as sinus rhythm (57.6%), followed by atrial fibrillation (AF) (23.6%). In 9.7% of recordings the quality was too low to interpret. Other observed rhythms were tachycardia (1.4%), extra systoles (4.7%), bigeminy episodes (1.8%), trigeminy episodes (0.6%) and atrial flutter (0.2%). The most frequent clinical scenario where PPG technology was used in the TeleCheck-AF project was follow-up after AF ablation (1110 patients) followed by heart rate and rhythm assessment around (tele)consultation (966 patients), sometimes including remote PPG-guided adaption of rate or rhythm control. 275 patients were followed around cardioversion, either (semi-)acute or elective. Other possible scenarios are assessment of palpitations, assessment of symptom-rhythm correlation and monitoring during up-titration of heart failure medication.
Conclusion
We introduce a newly developed structured stepwise practical guide on PPG signal interpretation developed based on presented experiences from TeleCheck-AF. The present clinical scenarios for the use of on-demand PPG technology derived from the TeleCheck-AF project will help to implement PPG technology in the management of arrhythmia patients.
Funding Acknowledgement
Type of funding sources: None. TeleCheck-AF clinical scenariosClassification of PPG recordings
Collapse
Affiliation(s)
- R M J Van Der Velden
- Maastricht University Medical Centre (MUMC), Cardiology, Maastricht, Netherlands (The)
| | - D V M Verhaert
- Radboud University Medical Center, Cardiology, Nijmegen, Netherlands (The)
| | - A N L Hermans
- Maastricht University Medical Centre (MUMC), Cardiology, Maastricht, Netherlands (The)
| | - M Gawalko
- Maastricht University Medical Centre (MUMC), Cardiology, Maastricht, Netherlands (The)
| | - D Duncker
- Hannover Heart Center, Cardiology, Hannover, Germany
| | - M Manninger
- Medical University of Graz, Cardiology, Graz, Austria
| | - M Hemels
- Rijnstate Hospital, Cardiology, Arnhem, Netherlands (The)
| | - R Pisters
- Rijnstate Hospital, Cardiology, Arnhem, Netherlands (The)
| | - P Lodzinski
- Medical University of Warsaw, Cardiology, Warsaw, Poland
| | - D Steven
- University hospital Köln, Electrophysiology, Cologne, Germany
| | - A Sultan
- University hospital Köln, Electrophysiology, Cologne, Germany
| | - H J G M Crijns
- Maastricht University Medical Centre (MUMC), Cardiology, Maastricht, Netherlands (The)
| | - N A H A Pluymaekers
- Maastricht University Medical Centre (MUMC), Cardiology, Maastricht, Netherlands (The)
| | - J M Hendriks
- Royal Adelaide Hospital, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - D Linz
- Maastricht University Medical Centre (MUMC), Cardiology, Maastricht, Netherlands (The)
| | | |
Collapse
|
11
|
Ullah A, Qamash T, Khan FA, Sultan A, Ahmad S, Abbas M, Khattak MAK, Begum N, Din SU, Jamil J, Kalsoom. Characterization of a Coliphage AS1 isolated from sewage effluent in Pakistan. BRAZ J BIOL 2021; 82:e240943. [PMID: 34259715 DOI: 10.1590/1519-6984.240943] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 12/14/2020] [Indexed: 01/21/2023] Open
Abstract
The emergence of multi-drug resistant (MDR) bacterial strains, which are posing a global health threat has developed the interest of scientists to use bacteriophages instead of conventional antibiotics therapy. In light of an increased interest in the use of phage as a bacterial control agent, the study aimed to isolate and characterize lytic phages from sewage effluent. During the current study, bacteriophage AS1 was isolated from sewage effluent against E.coli S2. The lytic activity of phageAS1 was limited to E.coli S2 strain showing monovalent behavior. The calculated phage titer was 3.5×109 pfu/ml. PhageAS1 was stable at a wide range of pH and temperature. The maximum stability was recorded at 37ºC and pH 7.0, while showing its normal lytic activity at temperature 60ºC and from pH 5.0 to11.0 respectively. At temperature 70ºC, phage activity was somewhat reduced whereas, further increase in temperature and decrease or increase in pH completely inactivated the phage. From the current study, it was concluded that waste water is a best source for finding bacteriophages against multi-drug resistant bacterial strains and can be used as bacterial control agent.
Collapse
Affiliation(s)
- A Ullah
- University of Swabi, Department of Microbiology, Swabi, KP, Pakistan
| | - T Qamash
- University of Swabi, Department of Microbiology, Swabi, KP, Pakistan
| | - F A Khan
- University of Okara, Department of Microbiology and Molecular Genetics, Okara, Pakistan
| | - A Sultan
- University of Swabi, Department of Microbiology, Swabi, KP, Pakistan
| | - S Ahmad
- University of Swabi, Department of Microbiology, Swabi, KP, Pakistan
| | - M Abbas
- Abdul Wali Khan University, Department of Pharmacy, Mardan, KP, Pakistan
| | - M A K Khattak
- University of Swabi, Department of Microbiology, Swabi, KP, Pakistan
| | - N Begum
- University of Swabi, Department of Microbiology, Swabi, KP, Pakistan
| | - S U Din
- Quaid E Azam University, Department of Microbiology, Islamabad, Pakistan
| | - J Jamil
- University of Swabi, Department of Microbiology, Swabi, KP, Pakistan
| | - Kalsoom
- University of Swabi, Department of Microbiology, Swabi, KP, Pakistan
| |
Collapse
|
12
|
Berger M, Castille E, Gau A, Rivière S, Vanessa S, Taieb G, Sultan A, Guilpain P, Maria A. Diagnostiquer un lupus, ce n’est pas une mince affaire ! Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
13
|
Zedda AM, Rillo M, Sultan A, Ramanna H, Deisenhofer I, Richter S, Mccready J, Muller D, Senatore G, Venkataraman R, Lo M, Day JD, Chung FP, Tao C, Di Cori A. Comparison of geographic workflow preferences with real-time dynamic regional mapping data during catheter ablation. Europace 2021. [DOI: 10.1093/europace/euab116.070] [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: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
The clinical benefit of multielectrode high-density (HD) mapping during catheter ablation has been an area of active research. One advantage of HD mapping is improved sensitivity which can lead to better visualization and substrate delineation during the procedure. In addition to the advantages offered by the multielectrode grid mapping catheter (HD Grid), a novel software enable the display of beat-to-beat, dynamic regional mapping data from the current location of HD Grid in real-time (LiveView). The optimal settings and workflows to incorporate the dynamic data into routine ablation procedures have not been explored.
Purpose
To examine the common settings and workflow patterns among operators from different geographies when using dynamic mapping.
Methods
Observational procedural data including procedure time, total RF time, workflow preference, and fluoroscopy time, were prospectively collected from operators across Europe, the U.S., and Asia Pacific countries from May to September 2020. Cases from both catheter ablation of atrial and ventricular arrhythmias were included in the analysis.
Results
A total of 754 cases were collected (428, 133, and 193 cases from Europe, the U.S., and the Asia Pacific region, respectively). The most commonly reported indication across all three geographies was de novo paroxysmal atrial fibrillation (223/754, 30.0%). A steerable sheath was more frequently used with the mapping catheter in Europe and U.S. compared to Asia Pacific countries. Contrary to cases from the U.S. and Asia Pacific countries where the double transseptal approach was the preferred technique for left atrial procedures (78.8% and 55.3%, respectively), the single transseptal approach was more commonly observed in European cases (233/428, 54.4%). Visualization of real-time mapping data after creation of traditional full-chamber maps were commonly observed in all three geographies. Regardless of geography, the CS catheter was commonly used a reference electrode; and the most common map appearance settings for interior projection, exterior projection, and interpolation was 7, 7, and 7 respectively. Voltage cutoff of 0.1 mV, range from 0.01 to 1.5 mV, was most frequently observed for delineating scar in atrial arrhythmia cases analyzed in this dataset.
Conclusions
While there is a geographical difference in ablation workflow, common settings and patterns can be observed in all three regions. This data suggests that minimal workflow changes are required to incorporate the use of dynamic data into routine procedures. Adaptation of LiveView can help improve procedure efficiency and efficacy by reducing the need for full chamber maps, identifying areas that were under ablated, and confirming ablation endpoints. Further control study examining procedure efficiency and efficacy associated with dynamic mapping may be warranted.
Collapse
Affiliation(s)
- AM Zedda
- Herzzentrum Dresden, Dresden, Germany
| | - M Rillo
- Casa di cura Villa Verde, Taranto, Italy
| | - A Sultan
- Heart Center University of Cologne , Cologne, Germany
| | - H Ramanna
- Haga Ziekenhuis, Den Haag, Netherlands (The)
| | | | - S Richter
- Heart Center - University of Leipzig, Leipzig, Germany
| | - J Mccready
- Royal Sussex County Hospital, Brighton, United Kingdom of Great Britain & Northern Ireland
| | - D Muller
- Klinikum Reinkenheide, Bremerhaven, Germany
| | | | - R Venkataraman
- Houston Methodist The Woodlands, Houston, United States of America
| | - M Lo
- Arkansas Heart Hospital, Little Rock, United States of America
| | - JD Day
- Intermountain Medical Center, Salt Lake City, United States of America
| | - FP Chung
- Taipei Veterans General Hospital, Taipei, Taiwan
| | - C Tao
- Abbott, Minneapolis, United States of America
| | | |
Collapse
|
14
|
Linz D, Pluymaekers N, Duncker D, Manninger M, Van Der Velden R, Hermans A, Verhaert D, Hemels M, Sultan A, Gupta D, Heidbuchel H, Sohaib A, Svennberg E, Crijns H, Hendriks J. The TeleCheck-AF project on remote app-based management of atrial fibrillation during the COVID-19 pandemic: Patient experiences. Europace 2021. [PMCID: PMC8194565 DOI: 10.1093/europace/euab116.521] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Funding Acknowledgements OnBehalf Aims Methods Results Conclusions
Collapse
Affiliation(s)
- D Linz
- Maastricht University Medical Centre (MUMC), Maastricht, Netherlands (The)
| | - N Pluymaekers
- Maastricht University Medical Centre (MUMC), Maastricht, Netherlands (The)
| | - D Duncker
- Hannover Medical School, Cardiology, Hannover, Germany
| | - M Manninger
- Medical University of Graz, Cardiology, Graz, Austria
| | - R Van Der Velden
- Maastricht University Medical Centre (MUMC), Maastricht, Netherlands (The)
| | - A Hermans
- Maastricht University Medical Centre (MUMC), Maastricht, Netherlands (The)
| | - D Verhaert
- Maastricht University Medical Centre (MUMC), Maastricht, Netherlands (The)
| | - M Hemels
- Rijnstate Hospital, Arnhem, Netherlands (The)
| | - A Sultan
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - D Gupta
- Liverpool Heart and Chest Hospital, Liverpool, United Kingdom of Great Britain & Northern Ireland
| | | | - A Sohaib
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - E Svennberg
- Karolinska University Hospital, Stockholm, Sweden
| | - H Crijns
- Maastricht University Medical Centre (MUMC), Maastricht, Netherlands (The)
| | - J Hendriks
- Flinders Medical Centre and Flinders University, Adelaide, Australia
| |
Collapse
|
15
|
Di Cori A, Rillo M, Sultan A, Ramanna H, Deisenhofer I, Richter S, Mccready J, Muller D, Senatore G, Tao C, Zedda AM. Workflows and clinical utilization of dynamic mapping data in radiofrequency catheter ablation of cardiac arrhythmias. Europace 2021. [DOI: 10.1093/europace/euab116.069] [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: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Previous publications suggest that the use of high-density (HD) mapping leads to better substrate visualization and may lead to improved procedural outcomes. A novel dynamic mapping software, utilizes the HD grid mapping catheter (HD Grid) to display beat-to-beat, dynamic regional mapping data (LiveView). Incorporation of real-time dynamic mapping data into routine mapping/ablation workflows may further enhance the clinical benefits of HD mapping during radiofrequency (RF) catheter ablation procedures.
Purpose
To examine the clinical utility and common workflows when dynamic mapping data was used during RF ablation procedures among operators with various experience levels.
Methods
Observational procedural data including procedure time, total RF time, and workflow preference were prospectively collected in catheter ablation cases utilizing LiveView from May to September 2020. Mapping and ablation strategies were determined at the operator’s discretion. Total percentage exceed 100% when multiple usage were reported.
Results
A total of 428 cases were collected from over 25 operators in 11 European countries. LiveView was used in a variety of cases including atrial fibrillation (paroxysmal and persistent), atrial flutter (typical and atypical), and VT (ischemic, non-ischemic, and idiopathic). Visualization of real-time mapping data from the current location of the HD Grid was commonly used after creation of traditional full-chamber maps (319/428, 74.5%). While operators in over 55% of the cases indicated that the use of dynamic display during mapping helped identify areas that were under ablated (238/428, 55.6%), using LiveView did not affect the lesion delivery strategies in those regions. LiveView was also used as a primary method for confirmation of pulmonary vein isolation (PVI) in 213 cases (49.8%). The most common reported usage of LiveView among the 428 cases analyzed was PVI confirmation/gap identification (75.2%), ablation line gap identification (41.1)%, and identification of breakthrough activation (23.6%)
Conclusions
This initial analysis demonstrated the diverse clinical utilization of LiveView dynamic display during RF catheter ablation procedures, including atrial and ventricular arrhythmias. Without causing significant changes to normal workflow, dynamic display of regional signals allows for rapid identification of ablation targets. When used during RF delivery, real-time assessment of regional activation patterns helped improve outcomes by rapidly identifying critical ablation location and ensuring successful lesion delivery. A further study that examines the impact of dynamic display on procedure efficacy may be warranted.
Collapse
Affiliation(s)
| | - M Rillo
- Casa di cura Villa Verde, Taranto, Italy
| | - A Sultan
- Heart Center University of Cologne , Cologne, Germany
| | - H Ramanna
- Haga Ziekenhuis, Den Haag, Netherlands (The)
| | | | - S Richter
- Heart Center - University of Leipzig, Leipzig, Germany
| | - J Mccready
- Royal Sussex County Hospital, Brighton, United Kingdom of Great Britain & Northern Ireland
| | - D Muller
- Klinikum Reinkenheide, Bremerhaven, Germany
| | | | - C Tao
- Abbott, Minneapolis, United States of America
| | - AM Zedda
- Herzzentrum Dresden, Dresden, Germany
| |
Collapse
|
16
|
Maire A, Chapet N, Mathieu B, Audurier Y, Breuker C, De Barry G, Jalabert A, Leclercq F, Pasquié J, Sultan A, Roubille F, Castet-Nicolas A. ESC 2019 guidelines for the management of type 2 diabetes mellitus: Evaluation of the application for patients admitted in a cardiology unit. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.351] [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: 10/22/2022]
|
17
|
Al-Herz A, Sultan A, Almahmeed A, Saleh K, Al-Awadhi A, Al-Kandari W, Hasan E, Ghanem A, Hussain M, Ali Y, Nahar E, Alenizi A, Hayat S, Abutiban F, Aledei A, Al-Qadhi A, Alhajeri H, Behbehani H, Alhadhood N, Alsaber A. AB0176 RISK OF ANTI-CITRULLINATED PEPTIDE ANTIBODIES AND RHEUMATOID FACTOR IN MALE SMOKERS: DATA FROM KUWAIT REGISTRY FOR RHEUMATIC DISEASES (KRRD). Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6388] [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: 11/03/2022]
Abstract
Background:Smoking has been proposed to be associated with the development of anti-citrullinated peptide antibodies (ACPA) in rheumatoid arthritis (RA) patients.Objectives:To study the relationship between smoking and ACPA as well as smoking and RF in patients with RA in Kuwait Registry for Rheumatic Diseases (KRRD).Methods:Data on RA patients were extracted from KRRD from four major hospitals from February 2013 through December 2019. As females rarely smoke in Kuwait with a smoking prevalence of 3% in female RA patients in KRRD, females were excluded from the study population to reach the minimum statistical percentage needed to perform chi square test and assess the association between smoking and other variables. Statistical tests were applied where appropriate. Logistic regression was conducted to adjust for possible confounders including age, disease duration, comorbidities, family history of a rheumatic disease, ANA, treatment agents and disease activity and quality of life assessment tools.Results:A total of 863 RA male patients were studied with a mean age of 53.9±12.5 years and a mean disease duration 7.3±5.5 years. 652 (75.6%) had positive RF and 624 (72.3%) had positive ACPA. 431 (50%) had at least one comorbidity. 640 (74.2%) were on conventional disease modifying agents (cDMARD’s) and 223 (25.8%) were on biologic therapy. 183 (21.2%) were smokers. After adjustment of other factors, logistic regression showed that smokers were significantly different than non-smokers in terms of a positive ACPA (β=-1.051,p<0.001, odds=4.019) and a positive RF (β=-0.804,p=0.019, odds=2.517).Conclusion:Smokers have a higher risk of expressing a positive RF and a positive ACPA in a male population. Smoking should be considered as a possible risk factor for RA and efforts should be done to educate the population to cease smoking to possibly lower that risk.References:[1]Benowitz, N.L., 2009. Pharmacology of nicotine: addiction, smoking-induced disease, and therapeutics. Annual review of pharmacology and toxicology, 49, pp.57-71.[2]Firestein, G.S., 2003. Evolving concepts of rheumatoid arthritis. Nature, 423(6937), p.356.[3]Heliövaara, M., Aho, K., Aromaa, A., Knekt, P. and Reunanen, A., 1993. Smoking and risk of rheumatoid arthritis. The Journal of rheumatology, 20(11), pp.1830-1835.[4]Hoy, K. W., 2009. Quantitative Research in Education: A Primer. SAGE. pp. 69-86.[5]Kerlan-Candon, S., Combe, B., Vincent, R., Clot, J., Pinet, V. and Eliaou, J.F., 2001. HLA-DRB1 gene transcripts in rheumatoid arthritis. Clinical & Experimental Immunology, 124(1), pp.142-149.[6]Kuada, J., 2012. Research Methodology: A Project Guide for University Students. Samfundslitteratur. pp. 45-56.[7]Kumar, R., 2010. Research Methodology: A Step-by-Step Guide for Beginners. SAGE. pp. 148-159.[8]Masdottir, B., Jonsson, T., Manfreðsdóttir, V., Víkingsson, A., Brekkan, Á. and Valdimarsson, H., 2000. Smoking, rheumatoid factor isotypes and severity of rheumatoid arthritis. Rheumatology, 39(11), pp.1202-1205.[9]Neuman, W., 2009. Understanding research. Boston: Pearson. pp. 230- 255.Disclosure of Interests:None declared
Collapse
|
18
|
Juneja A, Sultan A, Iqbal S. Exploring the presence of dental anomalies as a consequence of treatment of malignancy: A case report. J Oral Biol Craniofac Res 2020; 10:135-137. [PMID: 32322476 DOI: 10.1016/j.jobcr.2020.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 03/31/2020] [Accepted: 04/04/2020] [Indexed: 10/24/2022] Open
Abstract
Simultaneous presentation of tuberculosis (TB) and lymphoma in a young child is indeed a very rare entity. Malignancy such as Hodgkin's disease (HD) most commonly causes suppression of the cell-mediated immunity, which makes the individual, especially children, more prone to tuberculous infection. One of the non-life threatening complications in these young cancer survivors is the associated dental anomalies. These can seriously impair the quality of life of teenagers and young adults. Higher incidence of caries, discoloration of teeth or even early loss of teeth requiring dental prosthesis, can be associated with the use of cytostatic drugs. These drugs can also disturb odontogenesis, resulting in the absence of tooth buds, microdontia, dilacerations or shortening of tooth roots. Some of the anticancer drugs, including busulfan, cyclophosphamide, doxorubicin etc. May particularly play a significant role in the development of dental anomalies. This paper is a short review and case report of an 11 year old child having oligodontia and secondary dental complications caused as a side effect of treatment of Hodgkin's lymphoma with Tuberculous Lymphadenitis.
Collapse
Affiliation(s)
- A Juneja
- Dept of Pediatric and Preventive Dentistry, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - A Sultan
- Dept of Pediatric and Preventive Dentistry, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - S Iqbal
- Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| |
Collapse
|
19
|
Richardson DA, Sritangos P, James AD, Sultan A, Bruce JIE. Metabolic regulation of calcium pumps in pancreatic cancer: role of phosphofructokinase-fructose-bisphosphatase-3 (PFKFB3). Cancer Metab 2020; 8:2. [PMID: 32266066 PMCID: PMC7114799 DOI: 10.1186/s40170-020-0210-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 01/12/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND High glycolytic rate is a hallmark of cancer (Warburg effect). Glycolytic ATP is required for fuelling plasma membrane calcium ATPases (PMCAs), responsible for extrusion of cytosolic calcium, in pancreatic ductal adenocarcinoma (PDAC). Phosphofructokinase-fructose-bisphosphatase-3 (PFKFB3) is a glycolytic driver that activates key rate-limiting enzyme Phosphofructokinase-1; we investigated whether PFKFB3 is required for PMCA function in PDAC cells. METHODS PDAC cell-lines, MIA PaCa-2, BxPC-3, PANC1 and non-cancerous human pancreatic stellate cells (HPSCs) were used. Cell growth, death and metabolism were assessed using sulforhodamine-B/tetrazolium-based assays, poly-ADP-ribose-polymerase (PARP1) cleavage and seahorse XF analysis, respectively. ATP was measured using a luciferase-based assay, membrane proteins were isolated using a kit and intracellular calcium concentration and PMCA activity were measured using Fura-2 fluorescence imaging. RESULTS PFKFB3 was highly expressed in PDAC cells but not HPSCs. In MIA PaCa-2, a pool of PFKFB3 was identified at the plasma membrane. PFKFB3 inhibitor, PFK15, caused reduced cell growth and PMCA activity, leading to calcium overload and apoptosis in PDAC cells. PFK15 reduced glycolysis but had no effect on steady-state ATP concentration in MIA PaCa-2. CONCLUSIONS PFKFB3 is important for maintaining PMCA function in PDAC, independently of cytosolic ATP levels and may be involved in providing a localised ATP supply at the plasma membrane.
Collapse
Affiliation(s)
- D. A. Richardson
- Division of Cancer Sciences, School of Medical Sciences, University Of Manchester, Michael Smith Building, Oxford Road, Manchester, M13 9PT UK
| | - P. Sritangos
- Division of Cancer Sciences, School of Medical Sciences, University Of Manchester, Michael Smith Building, Oxford Road, Manchester, M13 9PT UK
| | - A. D. James
- Department of Biology, University of York, Heslington, York, UK
| | - A. Sultan
- Division of Cancer Sciences, School of Medical Sciences, University Of Manchester, Michael Smith Building, Oxford Road, Manchester, M13 9PT UK
| | - J. I. E. Bruce
- Division of Cancer Sciences, School of Medical Sciences, University Of Manchester, Michael Smith Building, Oxford Road, Manchester, M13 9PT UK
| |
Collapse
|
20
|
Sultan A, Juneja A, Bhaskar S. Co-morbidity of down syndrome with autism spectrum disorder: Dental implications. J Oral Biol Craniofac Res 2020; 10:146-148. [PMID: 32489813 DOI: 10.1016/j.jobcr.2020.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 11/27/2022] Open
Abstract
Over the past several years, numerous studies have emerged documenting the high incidence (1-11%) of comorbidity of autism spectrum disorders (ASD) in Down syndrome (DS). While children with these health issues are reported to be more cognitively impaired presenting significantly lower IQ scores, they also demonstrate differences in social and expressive language skills when compared to their coequals with DS only. More than that subjects with DS and ASD comorbidity exhibit atypical behaviour manifested by stereotypic anxiety and social withdrawal when compared to DS alone. This article provides a brief understanding of this challenging concurrence along with a case report of a 12-year-old male patient with ASD-DS condition reporting with multiple missing teeth (Oligodontia).
Collapse
Affiliation(s)
- A Sultan
- Department of Pediatric and Preventive Dentistry, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - A Juneja
- Department of Pediatric and Preventive Dentistry, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - S Bhaskar
- Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| |
Collapse
|
21
|
De Boysson H, Dumont A, Deshayes S, Audemard-Verger A, Boutemy J, Martin Silva N, Maigné G, Sultan A, Aouba A. Intégration des différentes formes cliniques et radiologiques dans les critères de classification de l’artérite à cellules géantes : proposition à partir d’une cohorte prospective monocentrique. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
22
|
Thein K, Jahan N, Tun A, Sultan A, Swarup S, Mogollon-Duffo F, Yendala R, Quirch M, Htut T, D’Cunha N, Rehman S, Hardwicke F, Awasthi S, Tijani L. MA03.07 First-Line Atezolizumab Chemoimmunotherapy in Advanced Non-Squamous NSCLC Patients Harboring EGFR/ALK Genetic Alterations. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
23
|
Thein K, Mogollon-Duffo F, Swarup S, Sultan A, Yendala R, Jahan N, Quirch M, Ball S, Htut TW, D’Cunha N, Rehman S, Hardwicke F, Awasthi S, Tijani L. Combination therapy with checkpoint inhibitors for first-line treatment of advanced renal cell carcinoma: A systematic review and meta-analysis of randomized controlled trials. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.054] [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: 11/14/2022] Open
|
24
|
Htut TW, Swarup S, Sultan A, Mogollon-Duffo F, Meda S, Arevalo M, Adhikari N, Naing P, Hlaing P, Myat YM, Hardwicke F, D’Cunha N, Tijani L, Thein K. Treatment-related adverse events and tolerability in patients with advanced renal cell carcinoma treated with first-line combination therapy with checkpoint inhibitors. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz253.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
25
|
Thein K, Jahan N, Sultan A, Swarup S, Tun A, Yendala R, Ball S, Hlaing P, Htut T, Rehman S, D’Cunha N, Hardwicke F, Tijani L, Awasthi S. P1.04-78 Efficacy of Checkpoint Inhibitors in Combination with Chemotherapy for First-Line Treatment of Advanced Non-Squamous NSCLC. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.981] [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: 10/25/2022]
|
26
|
Jahan N, Thein K, Sultan A, Swarup S, Mogollon-Duffo F, Adhikari N, Arevalo M, Htut T, Naing T, D’Cunha N, Rehman S, Hardwicke F, Tijani L. P2.04-46 Tolerability and Treatment-Related Adverse Events of Upfront Pembrolizumab Combination Regimens in Advanced NSCLC Patients. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1551] [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]
|
27
|
d’Cunha R, D’Cunha P, Swarup S, Sultan A, Mogollon-Duffo F, Jahan N, Win Htut T, Wongsaengsak S, Adhikari N, Mon A, Hlaing P, Tun A, D’Cunha N, Thein K. Treatment-related adverse events and tolerability in patients with advanced non-squamous non-small cell lung cancer treated with first-line checkpoint inhibitors in combination with chemotherapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz265.033] [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: 11/14/2022] Open
|
28
|
Swarup S, Thein K, Sultan A, Jahan N, Quirch M, Meda S, Htut T, Adhikari N, Hlaing P, Dash A, Tun A, Rehman S, Hardwicke F, Tijani L. P1.01-78 Treatment-Related Adverse Events in Patients with Advanced NSCLC Treated with First-Line Atezolizumab Chemoimmunotherapy. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.793] [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]
|
29
|
Sultan A, Thein K, Swarup S, Jahan N, Tun A, Meda S, Arevalo M, Naing T, Htut T, D’Cunha N, Awasthi S, Rehman S, Tijani L, Hardwicke F. P2.04-09 Immune-Related Adverse Events in Advanced Non-Squamous NSCLC Patients Treated with Upfront Checkpoint Inhibitors Combination. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1514] [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]
|
30
|
Jahan N, Swarup S, Sultan A, Naing T, Mogollon-Duffo F, Ball S, Tun A, Htut T, Dash A, D’Cunha N, Hardwicke F, Awasthi S, Tijani L, Thein K. EP1.01-10 Pembrolizumab in Combination with Chemotherapy as First-Line Treatment of Advanced Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
31
|
Shaheen MA, Xiao W, Aziz M, Karim A, Saleem M, Mustaqeem M, Mehmood T, Tahir MN, Sultan A, Simair A, Lu C. Synthesis and Antibacterial Evaluation of Cu(II), Co(II), and Mn(II) Complexes with Schiff Bases Derived from 5-Aminosalicylic Acid and o-Vanillin. RUSS J GEN CHEM+ 2019. [DOI: 10.1134/s1070363219080231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
32
|
Igboeli P, Walker W, McHugh A, Sultan A, Al-Hendy A. Burden of Uterine Fibroids: An African Perspective, A Call for Action and Opportunity for Intervention. ACTA ACUST UNITED AC 2019; 2:287-294. [PMID: 32647835 PMCID: PMC7344264 DOI: 10.18314/cogo.v2i1.1701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Black women carry the burden of uterine fibroids, (AKA uterine leiomyomas), at a much higher rate than their racial counterparts. Thus, increasing awareness and discovering a solution to an endemic problem that plagues Sub-Saharan Africa is of critical importance, not only for the region itself, but also for the medical community globally. A collaborative, patient oriented, cost effective, and culturally sensitive approach must be at the forefront of this endeavor. While the exact pathogenesis of uterine fibroid development remains elusive, the racial disparity is well documented. Moreover, in the developed world, women are able to seek treatment through surgical and non-surgical means; however, sub-Saharan regions face their own challenges that, if not addressed, can ultimately extinguish the lives of many suffering women. Unfortunately, the literature is scarce on how to prevent fibroid development, which may be critical for women who do not have access to effective interventions. Recent research from our group and others has shown that vitamin D deficiency plays an important role in fibroid development and may be a preventable risk factor. Daily vitamin D supplementation is a low cost, effective intervention that could be implemented throughout the Sub-Saharan region. Similarly, education and increased awareness as to the nature and symptoms of uterine fibroids could improve the quality of life, remove negative social stigma, and reduce morbidity and mortality rates in women who seek medical care with advanced uterine fibroids.
Collapse
Affiliation(s)
- P Igboeli
- University of Nigeria Teaching Hospital, Department of Obstetrics and Gynaecology, Enugu, Nigeria.,Department of Obstetrics and Gynecology, Augusta University, Augusta, GA 30912, USA.,Department of Obstetrics and Gynecology, University of Illinois, Chicago, Illinois, USA
| | - W Walker
- Department of Obstetrics and Gynecology, Augusta University, Augusta, GA 30912, USA
| | - A McHugh
- Department of Obstetrics and Gynecology, University of Illinois, Chicago, Illinois, USA
| | - A Sultan
- Xavier University School of Medicine, Oranjestad, Aruba
| | - A Al-Hendy
- Department of Obstetrics and Gynecology, University of Illinois, Chicago, Illinois, USA
| |
Collapse
|
33
|
Dumont A, Lecannuet A, Boutemy J, Maigné G, Martin-Silva N, Sultan A, Planchard G, Aouba A, De Boysson H. Caractéristiques et évolution des atteintes ophtalmologiques dans l’Artérite à Cellules Géantes : une étude cas-témoin. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.018] [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: 11/17/2022]
|
34
|
Rivet V, Maria A, Rivière S, Radjiv G, Suzon B, Henneton P, Rullier P, Konaté A, Schiffmann A, Sultan A, Le Quellec A, Guilpain P. Description de l’état nutritionnel chez 120 patients atteints de sclérodermie systémique suivis au CHRU de Montpellier. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.065] [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: 10/26/2022]
|
35
|
Volløyhaug I, Taithongchai A, Van Gruting I, Sultan A, Thakar R. Levator ani muscle morphology and function in women with obstetric anal sphincter injury. Ultrasound Obstet Gynecol 2019; 53:410-416. [PMID: 30207014 DOI: 10.1002/uog.20115] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 07/19/2018] [Accepted: 08/28/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To estimate the prevalence of, and explore the risk factors for, levator ani muscle (LAM) injury in women with clinically diagnosed obstetric anal sphincter injury (OASI). The secondary aim was to assess the association between LAM injury and pelvic floor muscle contraction, anal incontinence (AI) and urinary incontinence (UI) in women with OASI. METHODS This was a cross-sectional study of 250 women with OASI, recruited between 2013 and 2015 from a tertiary referral center at Croydon University Hospital, UK. AI symptoms were assessed using the modified St Mark's incontinence score and UI was assessed using the International Consultation on Incontinence modular Questionnaire for Urinary Incontinence - Short Form. All participants underwent three/four-dimensional transperineal ultrasound at rest and on maximum pelvic floor muscle contraction. Major LAM injury was defined as a unilateral or bilateral defect in all three central slices on tomographic ultrasound imaging. Muscle contraction was assessed using the modified Oxford scale (MOS) and measured on ultrasound as the proportional change in the anteroposterior (AP) levator hiatal diameter between rest and contraction. Multivariable logistic regression analysis was used to study risk factors for LAM injury. Differences in contraction and AI and UI symptoms between women with intact and those with injured LAM were studied using multivariable ANCOVA and the Mann-Whitney U-test. RESULTS Of the 248 women with OASI for whom ultrasound volumes of adequate quality were available, 29.4% were found to have major LAM injury. The prevalence of LAM injury was 23.6% after normal vaginal delivery and 40.2% after operative vaginal delivery (adjusted odds ratio, 4.1 (95% CI, 1.4-11.9); P = 0.01). LAM injury was associated with weaker pelvic floor muscle contraction, with an adjusted mean difference for proportional change in AP diameter of 5.0 (95% CI, 3.0-6.9) and MOS of 0.6 (95% CI, 0.3-0.9) (P < 0.001 for both). AI and UI symptom scores were similar between women with intact and those with injured LAM. CONCLUSIONS Operative vaginal delivery was a risk factor for LAM injury in women with OASI. LAM injury was associated with weaker pelvic floor muscle contraction. Special attention is recommended for women with OASI and LAM injury, as they are at high risk for future pelvic floor disorders. The benefits of implementation of an intensive, focused and structured pelvic floor rehabilitation program need to be evaluated in these women. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
Collapse
Affiliation(s)
- I Volløyhaug
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Obstetrics and Gynaecology, Trondheim University Hospital, Trondheim, Norway
| | - A Taithongchai
- Obstetrics and Gynaecology, Croydon University Hospital, Croydon, UK
| | - I Van Gruting
- Obstetrics and Gynaecology, Croydon University Hospital, Croydon, UK
| | - A Sultan
- Obstetrics and Gynaecology, Croydon University Hospital, Croydon, UK
| | - R Thakar
- Obstetrics and Gynaecology, Croydon University Hospital, Croydon, UK
| |
Collapse
|
36
|
Thein KZ, Swarup S, Sultan A, Tijani L, D'Cunha N, Hardwicke FT, Awasthi S, Jones C. Abstract P4-16-06: Incidence of interstitial lung disease in patients with HER2-positive advanced breast cancer treated with everolimus and trastuzumab: A combined analysis of two phase 3 randomized controlled trials. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-16-06] [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: The human epidermal growth factor receptor 2 (HER2) protein is overexpressed in approximately one fourth of breast tumors. Trastuzumab resistance has been demonstrated via aberrant PI3K/AKT/mTOR signaling due to PTEN loss. To circumvent this resistance mechanism, everolimus, an oral mTOR inhibitor, has been employed in treatment of HER2-positive advanced breast cancer (ABC). Lung toxicity due to everolimus is well established and has been reported with trastuzumab. Yet, the incidence of interstitial lung disease (ILD), when everolimus was added to trastuzumab, has never been reported. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to determine the incidence of ILD in patients with HER2-positive ABC treated with both everolimus and trastuzumab.
Methods: We systematically conducted a comprehensive literature search using MEDLINE, EMBASE databases and meeting abstracts through January 2018. Phase 3 RCTs that mention ILD as an adverse effect were incorporated in the analysis. The primary meta- analytic approach was a fixed effects model using the Mantel-Haenszel (MH) method. It was used to calculate the estimated pooled risk ratio (RR), and risk difference (RD) with 95% confidence interval (CI).
Results: A total of 1272 patients with HER-2 positive ABC from two phase 3 RCTs were eligible. Studies compared everolimus + paclitaxel + trastuzumab vs paclitaxel + trastuzumab and everolimus + vinorelbine + trastuzumab vs vinorelbine + trastuzumab. The initial dose of everolimus in BOLERO-1 was 10mg per day and in BOLERO-3, 5mg per day was used. The median relative dose intensity of everolimus was reduced to 0.54 in BOLERO-1 due to toxicity related dose reductions and dose interruptions. The randomization ratio of everolimus to placebo was 2 to 1 in BOLERO-1 and 1 to 1 in BOLERO-3. Everolimus was utilized in trastuzumab-resistant ABC after prior taxane therapy in the BOLERO-3 study (n= 562) and as first-line treatment in the BOLERO-1 study (n= 710). The I2 statistic for heterogeneity was 0, and the heterogeneity X2 (Cochran's Q) was 1 (P= 0), suggesting homogeneity among RCT. The incidence of all-grade ILD was 31 (4.122%) in the everolimus group vs 3 (0.577%) in control group and of high-grade ILD was 11 (1.463%) in everolimus arm vs 0 (0%) in the control arm. The pooled RR for all-grade ILD was significant at 7.258 (95% CI: 2.130 – 24.733, p = 0.002) and the absolute RD was 0.035 (95% CI: 0.019 – 0.050, P < 0.001). The pooled RR for high-grade ILD was noted at 7.930 (95% CI: 0.997 – 63.044, p = 0.050) and the absolute RD was 0.014 (95% CI: 0.004 – 0.024, P = 0.004).
Conclusions: Approximately 0.46 and 0.61% of patients on trastuzumab alone have been reported to develop ILD in previous studies. Our study showed that the addition of reduced dose of everolimus to trastuzumab, significantly contributed a higher incidence in all grades of ILD with a relative risk of 7.93 for grade 3 and 4 ILD. More randomized trials are required to determine the definitive incidence and actual relation of ILD as well as the optimal dose of everolimus, when combined with trastuzumab or other chemotherapy.
Citation Format: Thein KZ, Swarup S, Sultan A, Tijani L, D'Cunha N, Hardwicke FT, Awasthi S, Jones C. Incidence of interstitial lung disease in patients with HER2-positive advanced breast cancer treated with everolimus and trastuzumab: A combined analysis of two phase 3 randomized controlled trials [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-16-06.
Collapse
Affiliation(s)
- KZ Thein
- Texas Tech University Health Sciences Center, Lubbock, TX
| | - S Swarup
- Texas Tech University Health Sciences Center, Lubbock, TX
| | - A Sultan
- Texas Tech University Health Sciences Center, Lubbock, TX
| | - L Tijani
- Texas Tech University Health Sciences Center, Lubbock, TX
| | - N D'Cunha
- Texas Tech University Health Sciences Center, Lubbock, TX
| | - FT Hardwicke
- Texas Tech University Health Sciences Center, Lubbock, TX
| | - S Awasthi
- Texas Tech University Health Sciences Center, Lubbock, TX
| | - C Jones
- Texas Tech University Health Sciences Center, Lubbock, TX
| |
Collapse
|
37
|
Arosi I, Salarbux T, Lindsay T, Ward J, Curethers S, Sultan A. PO061 Impact of COPD on Short-term Mortality of Patients Hospitalised For Treatment of Acute Heart Failure. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.088] [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: 11/15/2022] Open
|
38
|
Arosi I, Salarbux T, Lindsay T, Ward J, Curethers S, Vijayenthiran H, Sammour R, Sultan A. PO062 HFpEF Vs. HFrEF: Six Month Retrospective Re-admission and Mortality Analysis. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.089] [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: 10/28/2022] Open
|
39
|
Ismail A, Sultan A, Thein K, Swarup S, Nugent K, Graham S, Tijani L, Hardwicke F. P3.CR-03 Pulmonary Spindle Cell Neoplasm - Neoadjuvant Treatment and Response. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1982] [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: 10/28/2022]
|
40
|
Thein K, Sultan A, Zaw M, Han M, Yu N, Igid H, Jones C, D'Cunha N, Awasthi S, Hardwicke F. Risk of health-related quality of life events and pulmonary toxicities in recurrent ovarian cancer patients treated with poly adenosine diphosphate ribose polymerase (PARP) inhibitors maintenance. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy300.077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
41
|
Thein K, Sultan A, Zaw M, Han M, Yendala R, Zin M, Awasthi S, D'Cunha N, Hardwicke F, Jones C. Risk of secondary hematological malignancies and hematological toxicities in recurrent ovarian cancer patients treated with poly adenosine diphosphate ribose polymerase (PARP) inhibitors maintenance. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy285.169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
42
|
Thein K, Sultan A, Zaw M, Han M, Hein A, Aung H, Awasthi S, Jones C, Hardwicke F, D'Cunha N. A systematic review and meta- analysis of randomized controlled trials to evaluate the risk of gastrointestinal and hepatic toxicities in patients with recurrent ovarian cancer treated with poly adenosine diphosphate ribose polymerase inhibitors maintenance. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy285.176] [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: 11/14/2022] Open
|
43
|
Swarup S, Thein K, Ball S, Quirch M, Vorakunthada Y, Sultan A, Hardwicke F, Tijani L, Awasthi S. P3.01-93 Osimertinib-Related Hematological and Pulmonary Toxicities in Advanced NSCLC Patients: Combined Analysis of Phase III Trials. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1653] [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: 10/28/2022]
|
44
|
De Boysson H, Liozon E, Ly K, Dumont A, Delmas C, Sultan A, Bienvenu B, Aouba A. Impact de la présentation clinique initiale et de l’imagerie des gros vaisseaux sur les complications cardiovasculaires précoces et tardives dans l’artérite à cellules géantes. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
45
|
Khan S, Khan RU, Alam W, Sultan A. Evaluating the nutritive profile of three insect meals and their effects to replace soya bean in broiler diet. J Anim Physiol Anim Nutr (Berl) 2018; 102:e662-e668. [PMID: 29098730 DOI: 10.1111/jpn.12809] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Accepted: 08/08/2017] [Indexed: 11/26/2022]
Abstract
This study was conducted to evaluate the comparative effect of maggot meal, silkworm meal and mealworm as dietary protein source on the production performance and some aspects of meat quality in broilers. In this regard, maggot meal was reared on chicken offal and poultry waste. Silkworm meal was obtained from silk industry, while mealworm was developed through beetles rearing. A total of 120-day-old broiler chicks were randomly divided into four groups where soya bean meal (M0) was replaced with maggot meal (M1), silkworm meal (M2) and mealworm (M3) respectively. Each group was further divided into three replicates. The study was carried out for a period of 5 weeks. Diets containing mealworm significantly reduced overall feed consumption and resulted into higher weight gain (p < .05). Lowest feed conversion ratio (FCR) was recorded for birds fed with mealworm diet (p < .05). Tenderness and juiciness of meat were higher (p < .05) in M3 compared to the control and other treatments. Mortality did not vary between the control and the treated groups. Therefore, it is concluded that insect meal is rich in essential nutrients and could be successfully used in broiler ration without compromising acceptability. In the light of this study, mealworm is the best choice in broiler ration, in comparison with maggot and silkworm.
Collapse
Affiliation(s)
- S Khan
- Department of Poultry Science, Faculty of Animal Husbandry and Veterinary Sciences, The University of Agriculture, Peshawar, Pakistan
| | - R U Khan
- Department of Animal Health, Faculty of Animal Husbandry and Veterinary Sciences, The University of Agriculture, Peshawar, Pakistan
| | - W Alam
- Department of Poultry Science, Faculty of Animal Husbandry and Veterinary Sciences, The University of Agriculture, Peshawar, Pakistan
| | - A Sultan
- Department of Poultry Science, Faculty of Animal Husbandry and Veterinary Sciences, The University of Agriculture, Peshawar, Pakistan
| |
Collapse
|
46
|
Khan M, Chand N, Khan S, Khan RU, Sultan A. Utilizing the House Fly (Musca Domestica) Larva as an Alternative to Soybean Meal in Broiler Ration During the Starter Phase. ACTA ACUST UNITED AC 2018. [DOI: 10.1590/1806-9061-2017-0529] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- M Khan
- The University of Agriculture Peshawar, Pakistan
| | - N Chand
- The University of Agriculture Peshawar, Pakistan
| | - S Khan
- The University of Agriculture Peshawar, Pakistan
| | - RU Khan
- The University of Agriculture Peshawar, Pakistan
| | - A Sultan
- The University of Agriculture Peshawar, Pakistan
| |
Collapse
|
47
|
Heeger CH, Bellmann B, Fink T, Mathew S, Reissmann B, Lemes C, Maurer T, Santoro F, Sultan A, Plenge T, Ouyang F, Kuck KH, Metzner A, Steven D, Rillig A. P286Safety and long-term clinical success of pulmonary vein isolation utilizing the second generation cryoballoon in patients over 75 years of age: A multicenter study. Europace 2018. [DOI: 10.1093/europace/euy015.098] [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] Open
Affiliation(s)
- C H Heeger
- University of Luebeck, Medical clinic II, Luebeck, Germany
| | - B Bellmann
- University of Cologne, Cardiology, Cologne, Germany
| | - T Fink
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - S Mathew
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - B Reissmann
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - C Lemes
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - T Maurer
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - F Santoro
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - A Sultan
- University of Cologne, Cardiology, Cologne, Germany
| | - T Plenge
- University of Cologne, Cardiology, Cologne, Germany
| | - F Ouyang
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - K H Kuck
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - A Metzner
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - D Steven
- University of Cologne, Cardiology, Cologne, Germany
| | - A Rillig
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| |
Collapse
|
48
|
Heeger CH, Bellmann B, Fink T, Mathew S, Reissmann B, Lemes C, Maurer T, Santoro F, Sultan A, Plenge T, Ouyang F, Kuck KH, Metzner A, Steven D, Rillig A. P284Long-term clinical success of pulmonary vein isolation utilizing the second generation cryoballoon in patients with persistent atrial fibrillation: A multicenter study. Europace 2018. [DOI: 10.1093/europace/euy015.096] [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: 11/13/2022] Open
Affiliation(s)
- C H Heeger
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - B Bellmann
- University of Cologne, Cardiology, Cologne, Germany
| | - T Fink
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - S Mathew
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - B Reissmann
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - C Lemes
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - T Maurer
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - F Santoro
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - A Sultan
- University of Cologne, Cardiology, Cologne, Germany
| | - T Plenge
- University of Cologne, Cardiology, Cologne, Germany
| | - F Ouyang
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - K H Kuck
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - A Metzner
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - D Steven
- University of Cologne, Cardiology, Cologne, Germany
| | - A Rillig
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| |
Collapse
|
49
|
Filipovic K, Bellmann B, Lüker J, Steven D, Sultan A. External electrical cardioversion of persistent atrial fibrillation in a patient with a Micra™ Transcatheter Pacing System. Indian Pacing Electrophysiol J 2017; 18:44-46. [PMID: 29269168 PMCID: PMC5840851 DOI: 10.1016/j.ipej.2017.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 12/14/2017] [Indexed: 11/16/2022] Open
Abstract
We report a case of a 85-year old woman with a preexisting Transcatheter Pacing System (TPS) (Micra™ VR, Fa. Medtronic, Inc., Minneapolis, MN, USA) undergoing several external electrical cardioversions (CV) for symptomatic persistent atrial fibrillation (persAF). Due to bradycardia in the setting of atrial fibrillation a right apical TPS implantation was performed earlier. Four weeks prior to presentation at our facility an unsuccessful CV with a maximum biphasic energy level of 360J was performed, after which amiodarone was initiated. At the time of presentation three shocks with 100 J, 200 J and 360 J were delivered without sustained restoration of a stable sinus rhythm. Patches were in an anterior-posterior position. No complications and no significant changes in device parameters in comparison to the pre-acquired values were observed. To our knowledge, this is the first case report of an external CV in a patient with a TPS. External CV in patients with a preexisting TPS seems to be safe and feasible.
Collapse
Affiliation(s)
- K Filipovic
- University of Cologne, Heart Center, Department of Electrophysiology, Germany.
| | - B Bellmann
- University of Cologne, Heart Center, Department of Electrophysiology, Germany
| | - J Lüker
- University of Cologne, Heart Center, Department of Electrophysiology, Germany
| | - D Steven
- University of Cologne, Heart Center, Department of Electrophysiology, Germany
| | - A Sultan
- University of Cologne, Heart Center, Department of Electrophysiology, Germany
| |
Collapse
|
50
|
Breuker C, Macioce V, Mura T, Audurier Y, Boegner C, Jalabert A, Villiet M, Castet-Nicolas A, Avignon A, Sultan A. Medication errors at hospital admission and discharge in Type 1 and 2 diabetes. Diabet Med 2017; 34:1742-1746. [PMID: 29048753 DOI: 10.1111/dme.13531] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2017] [Indexed: 11/28/2022]
Abstract
AIMS To assess the prevalence and characteristics of medication errors at hospital admission and discharge in people with Type 1 and Type 2 diabetes, and identify potential risk factors for these errors. METHODS This prospective observational study included all people with Type 1 (n = 163) and Type 2 diabetes (n = 508) admitted to the Diabetology-Department of the University Hospital of Montpellier, France, between 2013 and 2015. Pharmacists conducted medication reconciliation within 24 h of admission and at hospital discharge. Medication history collected from different sources (patient/family interviews, prescriptions/medical records, contact with community pharmacies/general practitioners/nurses) was compared with admission and discharge prescriptions to detect unintentional discrepancies in medication indicating involuntary medication changes. Medication errors were defined as unintentional medication discrepancies corrected by physicians. Risk factors for medication errors and serious errors (i.e. errors that may cause harm) were assessed using logistic regression. RESULTS A total of 322 medication errors were identified and were mainly omissions. Prevalence of medication errors in Type 1 and Type 2 diabetes was 21.5% and 22.2% respectively at admission, and 9.0% and 12.2% at discharge. After adjusting for age and number of treatments, people with Type 1 diabetes had nearly a twofold higher odds of having medication errors (odds ratio (OR) 1.72, 95% confidence interval (CI) 1.02-2.94) and serious errors (OR 2.17, 95% CI 1.02-4.76) at admission compared with those with Type 2 diabetes. CONCLUSIONS Medication reconciliation identified medication errors in one third of individuals. Clinical pharmacists should focus on poly-medicated individuals, but also on other high-risk people, for example, those with Type 1 diabetes.
Collapse
Affiliation(s)
- C Breuker
- Clinical Pharmacy Department, University Hospital of Montpellier, France
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS, UMR 9214, France
| | - V Macioce
- Clinical Research and Epidemiology Unit, France
| | - T Mura
- Clinical Research and Epidemiology Unit, France
| | - Y Audurier
- Clinical Pharmacy Department, University Hospital of Montpellier, France
| | - C Boegner
- Endocrinology-Diabetology-Nutrition Department, University Hospital of Montpellier, France
| | - A Jalabert
- Clinical Pharmacy Department, University Hospital of Montpellier, France
| | - M Villiet
- Clinical Pharmacy Department, University Hospital of Montpellier, France
| | - A Castet-Nicolas
- Clinical Pharmacy Department, University Hospital of Montpellier, France
- IRCM, University of Montpellier, INSERM U1194, France
| | - A Avignon
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS, UMR 9214, France
- Endocrinology-Diabetology-Nutrition Department, University Hospital of Montpellier, France
| | - A Sultan
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS, UMR 9214, France
- Endocrinology-Diabetology-Nutrition Department, University Hospital of Montpellier, France
| |
Collapse
|