1
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Youssef D, Kearney K. Planning Ahead: Can Diagnosing Congenital Heart Disease Earlier Improve Outcomes? Circ Cardiovasc Qual Outcomes 2023; 16:e010263. [PMID: 37539539 DOI: 10.1161/circoutcomes.123.010263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Affiliation(s)
- David Youssef
- Children's Hospital Westmead Clinical School, University of Sydney, Westmead, NSW, Australia (D.Y.)
- The School of Women's and Children's Health, University of New South Wales, Randwick, NSW Australia (D.Y.)
| | - Katherine Kearney
- St Vincent's Clinical School, University of New South Wales, Darlinghurst, NSW, Australia (K.K.)
- Victor Chang Cardiac Research Institute, Darlinghurst, NSW, Australia (K.K.)
- Department of Cardiology, Toronto General Hospital, Toronto, Ontario, Canada (K.K.)
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2
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Rossitto CP, Yudkoff C, Youssef D, Carrasquilla A, Carr MT, Oemke H, Tabani H, Hickman ZL, Kellner CP. Resection of Arteriovenous Malformation With Sonolucent Cranioplasty: 2-Dimensional Operative Video With 360° Virtual Reality Fly-Through. Oper Neurosurg (Hagerstown) 2023:01787389-990000000-00682. [PMID: 37083550 DOI: 10.1227/ons.0000000000000686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 01/22/2023] [Indexed: 04/22/2023] Open
Affiliation(s)
- Christina P Rossitto
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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3
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Youssef D, Wittig JH, Jackson S, Inati SK, Zaghloul KA. Neuronal spiking responses to direct electrical microstimulation in the human cortex. J Neurosci 2023:JNEUROSCI.1666-22.2023. [PMID: 37188513 DOI: 10.1523/jneurosci.1666-22.2023] [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] [Received: 09/01/2022] [Revised: 04/23/2023] [Accepted: 04/29/2023] [Indexed: 05/17/2023] Open
Abstract
Microstimulation can modulate the activity of individual neurons in order to affect behavior, but the effects of stimulation on neuronal spiking are complex and remain poorly understood. This is especially challenging in the human brain where the response properties of individual neurons are sparse and heterogenous. Here we use micro- electrode array (MEAs) in the human anterior temporal lobe in six participants (3 female) to examine the spiking responses of individual neurons to microstimulation delivered through multiple distinct stimulation sites. We demonstrate that individual neurons can be driven with excitation or inhibition using different stimulation sites, which suggests an approach for providing direct control of spiking activity at the single neuron level. Spiking responses are inhibitory in neurons that are close to the site of stimulation, while excitatory responses are more spatially distributed. Together, our data demonstrate that spiking responses of individual neurons can be reliably identified and manipulated in the human cortex.SIGNIFICANCE STATEMENT:One of the major limitations in our ability to interface directly with the human brain is that the effects of stimulation on the activity of individual neurons remains poorly understood. Here, Youssef et al. examine the spiking responses of neurons in the human temporal cortex in response to pulses of microstimulation. They find that individual neurons can either be excited or inhibited depending on the site of stimulation. These data suggest an approach for modulating the spiking activity of individual neurons in the human brain.
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Affiliation(s)
- David Youssef
- Surgical Neurology Branch, NINDS, National Institutes of Health, Bethesda, MD 20892, USA
| | - John H Wittig
- Surgical Neurology Branch, NINDS, National Institutes of Health, Bethesda, MD 20892, USA
| | - Samantha Jackson
- Surgical Neurology Branch, NINDS, National Institutes of Health, Bethesda, MD 20892, USA
| | - Sara K Inati
- Office of the Clinical Director, NINDS, National Institutes of Health, Bethesda, MD 20892, USA
| | - Kareem A Zaghloul
- Surgical Neurology Branch, NINDS, National Institutes of Health, Bethesda, MD 20892, USA
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Youssef D, Richards S, Sheppard C, Hornberger L, Pietrosanu M, Bates A. Preteen with Prenatal Agenesis of the Ductus Venosus Presenting with a Portosystemic Shunt and Severe Delayed-Onset Pulmonary Arterial Hypertension: A Rare Case Report. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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5
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Youssef D, Richards S, Sheppard C, Gerdung C, Pietrosanu M, Bates A. An Infant Presenting with Severe Pulmonary Hypertension Following Nitric Oxide Treatment: A Case Report. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Youssef D, Handler S, Richards S, Sheppard C, Smith J, Tillman K, Pietrosanu M, Kirkpatrick E, Bates A. Multicenter review of a tadalafil suspension formulation in infants and children with pulmonary hypertension: a north american experience. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.083] [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: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Pulmonary arterial hypertension (PAH) is a disease characterised by an increase in pulmonary vascular resistance and pulmonary artery pressure. Phosphodiesterase type 5 (PDE5) inhibitors, with sildenafil the earliest among them, are widely used in the management of pediatric PAH. There has more recently been a transition to once-daily tadalafil suspensions. Herein, we present a multicenter experience detailing safety, tolerability and haemodynamic data utilizing tadalafil suspension alone or in combination for the management of pediatric PAH.
Methods and materials
We performed a retrospective review of all infants and children at two North American paediatric PH centres between December 2013 and April 2022. We included all patients less than 9 years of age who were treated with a tadalafil suspension after an initial treatment with sildenafil. Demographic, clinical, imaging, and laboratory data were collected.
Results
Over the study period, 158 children were treated with tadalafil therapy: 41 (25.9%) had group 1 PAH, 81 (51.3%) had group 3 PH, and 33 (20.9%) had group 5 PH. The median initial dose of tadalafil was 1.0 mg/kg once daily with a median time to maximum dose of 1 day. The majority of patients required the suspension formulation due to an inability to take oral tablets or the need for nasogastric or nasojejunal feeding. We observed improvements in median echocardiographic parameters in the six months following initiation, namely, in RVFAC from 34.7% (Q1 = 31.0%, Q3 = 42.0%) to 37.0% (Q1 = 31.0%, Q3 = 44.0%) and in TAPSE from 1.0 (Q1 = 0.8, Q3 = 1.7) cm to 1.3 (Q1 = 1.0, Q3 = 1.7) cm. We observed median decreases in RVSp from 51.0 (Q1 = 35.0, Q3 = 69.0) mmHg to 37.0 (Q1 = 30.0, Q3 = 50.0) mmHg and in NT pro BNP levels from 439.0 (Q1 = 217.0, Q3 = 2051.0) ng/L to 313.0 (Q1 = 193.0, Q3 = 1110.0) ng/L. Tadalafil therapy was well tolerated over the six-month period: at baseline, only four patients (2.5%) reported gastrointestinal side effects, two (1.3%) reported adverse skin adverse effects (i.e., rash and flushing), and one (0.6%) reported adverse neurological effects. At six months, 150 patients (94.9%) reported no adverse effects.
Conclusion
Tadalafil, a long-acting PDE5 inhibitor, when administered in a suspension formulation, has a safe and tolerable adverse effect profile once patients are established on sildenafil therapy. Following 6 months of once daily tadalafil suspension, alone or in combination, showed a trend towards improvement in clinical parameters, echocardiographic measurements, and laboratory results for pediatric PAH. All patient adverse effects were managed with non pharmacological measures and there was good patient compliance.
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Affiliation(s)
- D Youssef
- Stollery Children's Hospital , Edmonton , Canada
| | - S Handler
- University of Wisconsin , Wisconsin , United States of America
| | - S Richards
- Stollery Children's Hospital , Edmonton , Canada
| | - C Sheppard
- Stollery Children's Hospital , Edmonton , Canada
| | - J Smith
- Stollery Children's Hospital , Edmonton , Canada
| | - K Tillman
- Stollery Children's Hospital , Edmonton , Canada
| | | | - E Kirkpatrick
- University of Wisconsin , Wisconsin , United States of America
| | - A Bates
- Stollery Children's Hospital , Edmonton , Canada
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Wittig J, Youssef D, Zaghloul K, Faturos N. Selective control of neuronal spiking activity in the human cortex using electrical microstimulation. Brain Stimul 2023. [DOI: 10.1016/j.brs.2023.01.061] [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: 02/17/2023] Open
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8
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Youssef D, Richards S, Lague S, Sheppard C, Smith J, Vorhies E, Hosking M, Pietrosanu M, Bates A. A Canadian, retrospective, multicenter experience with selexipag for a heterogeneous group of pediatric pulmonary hypertension patients. Front Pediatr 2023; 11:1055158. [PMID: 36925667 PMCID: PMC10011093 DOI: 10.3389/fped.2023.1055158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 02/13/2023] [Indexed: 03/18/2023] Open
Abstract
Introduction Selexipag, an oral nonprostanoid prostaglandin receptor agonist, has led to reduced morbidity and mortality in adults with pulmonary arterial hypertension (PAH). While the adult literature has been extrapolated to suggest selexipag as an oral treatment for severe pediatric pulmonary hypertension (PH), longitudinal, multicenter data on the benefits of selexipag in this population are lacking. The purpose of this study is to present a longitudinal, multicentre experience with selexipag in a relatively large cohort of pediatric PH patients and add to the existing selexipag literature. Materials and methods We performed a retrospective, multicenter review describing the clinical outcomes of pediatric PH patients receiving selexipag in addition to standard oral pulmonary vasodilator therapy across three Canadian centers between January 2005 and June 2021. Results Twenty-four pediatric patients (fifteen female) with a mean age of 9.7 (range 2.0-15.5) years were included. Of this cohort, eighteen (75.0%) were in group 1, one (4.2%) was in group 2, four (16.7%) were in group 3, and one (4.2%) was in group 4. Twenty-two (91.7%) patients were on dual PH therapy after six months. Dosing was targeted to achieve 20-30 mcg/kg/dose orally every twelve hours. Median dose after twelve months was 30 mcg/kg/dose. Twelve months following selexipag initiation, median decreases of 0.2 cm in tricuspid annular plane systolic excursion, 3.5 mmHg in right-ventricular systolic pressure, and 6.1 mmHg in mean pulmonary arterial pressure were observed; none of these changes were statistically significant. Three patients died, one clinically deteriorated and required admission to a pediatric intensive care unit, ten had gastrointestinal symptoms, and three had flushing. Conclusion Selexipag appears to be a safe and effective adjunctive therapy for pediatric PH patients and has a tolerable adverse effect profile aside from gastrointestinal disturbances. Additional prospective studies of changes in hemodynamics and functional classification over a longer period and with a larger sample are needed. Future research should aim to identify subgroups that stand to benefit from the addition of selexipag as well as optimal timing and dosing for the pediatric population.
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Affiliation(s)
- David Youssef
- Department of Pediatric Pulmonary Hypertension, Stollery Children's Hospital, Edmonton, AB, Canada
| | - Susan Richards
- Department of Pediatric Pulmonary Hypertension, Stollery Children's Hospital, Edmonton, AB, Canada
| | - Sabine Lague
- Department of Pediatrics, BC Children's Hospital, Vancouver, BC, Canada
| | - Catherine Sheppard
- Department of Pediatric Pulmonary Hypertension, Stollery Children's Hospital, Edmonton, AB, Canada
| | - Jenna Smith
- Department of Pharmacy, Stollery Children's Hospital, Edmonton, AB, Canada
| | - Erika Vorhies
- Department of Pediatric Cardiology, Alberta Children's Hospital, Calgary, AB, Canada
| | - Martin Hosking
- Department of Pediatric Cardiology, BC Children's Hospital, Vancouver, BC, Canada
| | - Matthew Pietrosanu
- Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, AB, Canada
| | - Angela Bates
- Department of Pediatric Pulmonary Hypertension, Stollery Children's Hospital, Edmonton, AB, Canada.,Division of Pediatric Critical Care, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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Youssef D, Abbas LA, Issa O, Youssef J, Hassan H. Integrating Health Belief model to determine factors associated with COVID-19 Vaccine Acceptance in Lebanon: Differences between health care workers and non-healthcare workers. Int J Infect Dis 2022. [PMCID: PMC8884826 DOI: 10.1016/j.ijid.2021.12.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Purpose Vaccine acceptance is critical to the success of immunization programs, especially for emerging infectious diseases. This study aims to assess the willingness to receive the COVID-19 vaccine, and the factors associated with this willingness among healthcare workers (HCWs) and non-healthcare workers in Lebanon. Methods & Materials A web-based cross-sectional survey was conducted among Lebanese adults aged 18 years and above during November 2020 among Lebanese adults from all Lebanese provinces using a snowball sampling technique. Data were collected using an anonymous Arabic questionnaire that included sociodemographic, health-related variables, intention to receive COVID-19 vaccine, and the Health Belief Model covariates. Multivariable logistic regression analyses were performed to identify the factors associated with the COVID-19 vaccine acceptance among the 2 groups. Results A total number of 2802 participants completed the survey. The overall intention to receive a COVID-19 vaccine among the Lebanese adult population was 51.5%. HCWs expressed a higher willingness of getting vaccinated against COVID-19 than non HCWs (65.8% vs. 47%, p< 0.001). The factors that are positively associated with the willingness to vaccinate among the general population, non HCWs and HCWs were: older age, being married, living in urban areas, receiving influenza vaccine for this season, higher perception of susceptibility and benefits, concerns related to availability and accessibility of vaccines and recommendation of vaccine from health authorities. However, the previous refusal of any vaccine, concerns about vaccine safety, and side effects impacted negatively this intention. Female gender, importance accounted to religiosity, and concerns about the reliability of the manufacturer were negatively associated with vaccine acceptance among non HCWs. Conversely, good knowledge, vaccine intake by the public, and self-motivation were positively associated with this willingness. Of note, these factors were not significantly associated with such willingness among HCWs. Conclusion To control COVID-19 effectively, efforts targeting modifiable factors driving COVID-19 vaccine acceptance are required to increase the acceptance rate among the Lebanese population.
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10
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Youssef D, Singh A, Ayer J, Turner C, Christoff A, Bromage J, Balit C, Numa A, Skinner JR. A multicentre survey of paediatric out-of-hospital cardiac arrest incidence, aetiology, and survival in New South Wales over an 11-year period. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehab849.038] [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
Funding Acknowledgements
Type of funding sources: None.
Introduction
Out-of-hospital cardiac arrest (OOHCA) is commonly associated with pulseless ventricular tachycardia and ventricular fibrillation (VT/VF) and cardiac aetiologies. One New South Wales (NSW) ambulance registry reported(1) cardiac aetiologies with a prevalence of 31% among OOHCA cases. Multicentre OOHCA data and NSW’s well-developed services for cardiac genetic predisposition screening motivate us to consider the following study of paediatric OOHCA in this state.
Purpose
We present a multicentre, retrospective study summarizing the demographics, clinical characteristics, incidence, presenting rhythm, and survival-to-discharge status of paediatric OOHCA cases in NSW over an 11-year period. We also present and categorize diagnostic outcomes for patients presenting with VT/VF.
Methods
A retrospective case series of 298 patients admitted to one of three NSW PICUs (two in Sydney and one in Newcastle) under 18 years of age and presenting with OOHCA between January 2009 and December 2019.
Results
Out of 296 paediatric OOHCA patients that survived until PICU admission, 187 (63.2%) were male and 160 (54.1%) survived until hospital discharge. Of those surviving to discharge, 105 (65.6%) were male. Presenting rhythm was asystole or pulseless electrical activity in 240 patients (84.8%, aged 0–17 years, median age 2 years), VT/VF in 41 patients (14.5%, aged 0–16 years, median age 9 years), and complete heart block in 2 patients (0.7%, aged 4–4 years, median age 4 years). Survival was higher in the VT/VF group (82.9%) relative to the asystole and pulseless electrical activity group (50.0%). Of the 41 patients presenting with VT/VF, 13 (31.7%) had a predisposing cardiac condition (2 truncus arteriosus, 1 arrhythmogenic right ventricular cardiomyopathy, 1 double outlet right ventricle, 1 hypoplastic right ventricle, 1 left ventricular non-compaction, 2 asystolic syncope, 2 left ventricular intramyocardial fibroma, 1 familial dilated cardiomyopathy, and 2 undetermined cardiac conditions) and 20 (48.8%) had a genetic condition (9 catecholaminergic polymorphic ventricular tachycardia, 4 hypertrophic cardiomyopathies, 1 Nkx-2.5 mutation, 2 Long QT syndrome, 2 PPA2 mutation, 1 TANGO2 mutation, 1 supraventricular tachycardia). Toxins or trauma were involved in 4 (9.8%) cases, while no cause was determined in 4 (9.8%) other cases.
Conclusions
Overall, 54.1% of paediatric OOHCA patients admitted to PICU survived until hospital discharge, rising to 82.9% among those with VT/VF. Genetic conditions (48.8%), predominated by CPVT, were present in over one-third of VT/VF cases: this figure confirms the continued need for detailed cardiac/genetic assessment for paediatric OOHCA cases.
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Affiliation(s)
- D Youssef
- The Sydney Children"s Hospital Network Westmead campus, Heart Centre for Children, Sydney, Australia
| | - A Singh
- The Sydney Children"s Hospital Network Westmead campus, Heart Centre for Children, Sydney, Australia
| | - J Ayer
- The Sydney Children"s Hospital Network Westmead campus, Heart Centre for Children, Sydney, Australia
| | - C Turner
- The Sydney Children"s Hospital Network Westmead campus, Heart Centre for Children, Sydney, Australia
| | - A Christoff
- Sydney Children"s Hospital Network Intensive Care Unit, PICU, Sydney, Australia
| | - J Bromage
- John Hunter Hospital, Paediatric Intensive Care Unit, Sydney, Australia
| | - C Balit
- John Hunter Hospital, Paediatric Intensive Care Unit, Sydney, Australia
| | - A Numa
- The Sydney Children"s Hospital Network Randwick campus, Paediatric Intensive Care Unit, Sydney, Australia
| | - J R Skinner
- The Sydney Children"s Hospital Network Westmead campus, Heart Centre for Children, Sydney, Australia
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11
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Fong LS, Youssef D, Ayer J, Nicholson IA, Winlaw DS, Orr Y. Correlation of ventricular septal defect height and outcomes after complete atrioventricular septal defect repair. Interact Cardiovasc Thorac Surg 2021; 34:431-437. [PMID: 34633029 PMCID: PMC8860429 DOI: 10.1093/icvts/ivab263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 08/14/2021] [Accepted: 09/09/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES There are limited data available on the height of the ventricular component of the septal deficiency (VSD) in patients undergoing complete atrioventricular septal defect (CAVSD) repair. VSD height may influence optimal choice of repair strategy with potential consequences for long-term outcomes. We aimed to measure VSD height using 2-dimensional echocardiography and review its association with postoperative outcomes. METHODS We retrospectively reviewed the preoperative echocardiograms of 45 consecutive patients who underwent CAVSD repair between May 2010 and December 2015 at a single centre. VSD height and left ventricular length on the four-chamber view were measured. Demographic details and early and late outcomes including reoperation and long-term survival were studied. RESULTS Twenty patients underwent modified single-patch repair and 25 patients underwent double-patch repair of CAVSD. VSD height in the modified single-patch group ranged from 4.2 to 11.7 mm and in the double-patch group ranged from 5.1 to 14.9 mm. Nine patients had a deep ‘scoop’ with a VSD height of >10 mm, (7 double patch, 2 modified single patch). VSD height did not correlate with a specific Rastelli classification. There was no significant difference in the VSD height (P = 0.51) or the VSD height-to-left ventricular length ratio (P = 0.43) between the 2 repair groups. There was no 30-day mortality. Eight patients required reoperation; however, VSD height was not a significant predictor of reoperation (hazard ratio 0.95, 95% confidence interval 0.69–1.33; P = 0.08). CONCLUSIONS There was no correlation between VSD height and risk of reoperation after CAVSD repair. A deep ventricular scoop is uncommon in CAVSD patients.
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Affiliation(s)
- Laura S Fong
- The University of Sydney Children's Hospital at Westmead Clinical School, Sydney, NSW, Australia.,Heart Centre for Children, Children's Hospital at Westmead, Sydney, NSW, Australia
| | - David Youssef
- Heart Centre for Children, Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Julian Ayer
- The University of Sydney Children's Hospital at Westmead Clinical School, Sydney, NSW, Australia.,Heart Centre for Children, Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Ian A Nicholson
- Heart Centre for Children, Children's Hospital at Westmead, Sydney, NSW, Australia
| | - David S Winlaw
- The University of Sydney Children's Hospital at Westmead Clinical School, Sydney, NSW, Australia.,Heart Centre for Children, Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Yishay Orr
- The University of Sydney Children's Hospital at Westmead Clinical School, Sydney, NSW, Australia.,Heart Centre for Children, Children's Hospital at Westmead, Sydney, NSW, Australia
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Abstract
A 20-year-old woman presented with abdominal pain and MRI findings of intussusception of the distal small bowel with no identifiable lead point and no visualisation of the appendix. A diagnostic laparoscopy succeeded in manually reducing the intussusception but was unable to find any candidate lead point. Intraoperatively, hyperperistalsis was observed throughout the small bowel which seemed prone to transient intussusception. Incidental appendectomy revealed an uninflamed appendix with Enterobius vermicularis (pinworm) infestation, the most common parasite present in appendectomy specimens worldwide. Although intussusception in young adults is an uncommon occurrence, the unique nature of this case is amplified by the concurrent finding of E. vermicularis infection of the appendix in an adolescent in western Canada, a phenomenon normally observed in paediatric populations with higher incidence in tropical areas. Although the mechanism of intussusception in this patient remains unclear, it is hypothesised that E. vermicularis colonisation acted as an irritant stimulating intestinal hypercontractility with resulting intussusception. Successful medical eradication of the pinworm in this individual may prevent future recurrence.
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Affiliation(s)
- Collin Pryma
- Pathology and Laboratory Medicine, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - David Youssef
- Surgery, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - David Evans
- Surgery, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Hui-Min Yang
- Pathology and Laboratory Medicine, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
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13
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Youssef D, Flores MN, Ebrahim E, Eshak K, Westerink J, Chaudhuri D, Balakrishnan N, Mukerji A, Mondal T. Assessing the clinical significance of echocardiograms in determining treatment of patent ductus arteriosus in neonates. J Neonatal Perinatal Med 2020; 13:345-350. [PMID: 32925117 DOI: 10.3233/npm-170122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND To evaluate the utility of echocardiogram (ECHO) in detection and treatment of patent ductus arteriosus (PDA) and hemodynamically significant PDA (hsPDA) in preterm neonates. METHODS This was a retrospective case-control study of all preterm infants born or admitted to the level III Neonatal Intensive Care Unit in McMaster Children's Hospital from January 2009 to January 2013. These cases were further classified into the following sub-groups: group A) hsPDA confirmed on ECHO; and the control, group B) PDA (but not hemodynamically significant) confirmed on ECHO. Patients without an ECHO were excluded from all analyses. The primary outcome was incidence of treatment for PDA. RESULTS PDA treatment was administered in 83.3% and 11.2% of patients in groups A and B respectively (P < 0.05). Among patients with a hsPDA within group A, 17% did not receive treatment, while 11% of patients with non-hemodynamically significant PDA received treatment for the PDA. Within the cohort of patients who received treatment for a hsPDA, gestational age below 35 weeks as well as murmurs heard on auscultation were both found to be predictors of treatment. CONCLUSION While the ECHO remains the gold standard for detecting pathological PDA, there is evidence that other traditional clinical measures continue to guide clinical practice and treatment decisions. Further research is required to gain an understanding of how clinical measures and ECHO may be used in conjunction to optimize resource utilization.
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Affiliation(s)
- D Youssef
- Department of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - M N Flores
- Department of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - E Ebrahim
- Department of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - K Eshak
- Department of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - J Westerink
- Department of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - D Chaudhuri
- Department of Internal Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - N Balakrishnan
- Department of Mathematics and Statistics, McMaster University, Hamilton, Ontario, Canada
| | - A Mukerji
- Division of Neonatology, McMaster University, Hamilton, Ontario, Canada
| | - T Mondal
- Division of Pediatric Cardiology, McMaster University, Hamilton, Ontario, Canada
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14
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Gupta S, Xie M, Mohamedali M, Youssef D, Hannah-Shmouni F, Dorasamy P. An unexpected diagnosis of Graves’ disease in an 81-year-old female with altered mental status. Endocrine and Metabolic Science 2020. [DOI: 10.1016/j.endmts.2020.100055] [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: 10/24/2022] Open
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15
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Ebrahimi P, Youssef D, Salve G, Ayer J, Dehghani F, Fletcher DF, Winlaw DS. Evaluation of personalized right ventricle to pulmonary artery conduits using in silico design and computational analysis of flow. JTCVS Open 2020; 1:33-48. [PMID: 36003197 PMCID: PMC9390144 DOI: 10.1016/j.xjon.2020.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 11/09/2019] [Accepted: 02/03/2020] [Indexed: 11/28/2022]
Abstract
Objectives Right ventricle to pulmonary artery (RV-PA) conduits are required for the surgical management of pulmonary atresia with ventricular septal defect and truncus arteriosus. Bioengineered RV-PA connections may address some of the shortcomings of homografts and xenografts, such as lack of growth potential and structural deterioration and may be manufactured to accommodate patient-specific anatomy. The aim of this study was to develop a methodology for in silico patient-specific design and analysis of RV-PA conduits. Methods Cross-sectional imaging was obtained from patients with truncus arteriosus (n = 5) and pulmonary atresia with ventricular septal defect (n = 5) who underwent complete repair with a RV-PA conduit. Three-dimensional models of the heart were constructed by segmentation of the right ventricle, existing conduit, branch pulmonary arteries, and surrounding structures. A customized conduit design for each patient was proposed. Computational fluid dynamics analysis was performed and outputs, including wall shear stress and energy loss, were used to compare the performance of the existing conduits and the customized geometries. Results In this study, a methodology for patient-specific analysis of RV-PA conduit in silico was developed. The results of simulations for 10 patients showed between 23% and 56% decrease in the average wall shear stress and between 24% and 87% reduction in average power requirements in customized designs compared with the stenosed conduits, translating into better hemodynamic performance. Conclusions Creation of an optimal conduit for an individual patient can be achieved using surgeon-guided design and computational fluid dynamics analysis. Manufacture of personalized RV-PA conduits may obviate the need for surgical customization to accommodate existing materials and provide superior long-term outcomes.
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Affiliation(s)
- Pegah Ebrahimi
- School of Chemical and Biomolecular Engineering, The University of Sydney, Sydney, Australia
- Heart Centre for Children, The Children's Hospital at Westmead, Sydney, Australia
| | - David Youssef
- Heart Centre for Children, The Children's Hospital at Westmead, Sydney, Australia
| | - Gananjay Salve
- Heart Centre for Children, The Children's Hospital at Westmead, Sydney, Australia
| | - Julian Ayer
- Heart Centre for Children, The Children's Hospital at Westmead, Sydney, Australia
- Faculty of Medicine and Health, Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Fariba Dehghani
- School of Chemical and Biomolecular Engineering, The University of Sydney, Sydney, Australia
| | - David F. Fletcher
- School of Chemical and Biomolecular Engineering, The University of Sydney, Sydney, Australia
| | - David S. Winlaw
- School of Chemical and Biomolecular Engineering, The University of Sydney, Sydney, Australia
- Faculty of Medicine and Health, Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, Australia
- Address for reprints: David S. Winlaw, MBBS, MD, FRACS, Heart Centre for Children, The Children's Hospital at Westmead, Locked Bag 4001, Corner Hawkesbury Rd and Hainsworth St, Westmead, 2145, Sydney, Australia.
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Youssef D, Britton P, Mohammad S, Mervis J, Gnanaapa G, Yusoff S. 647 A Rare Case Report of Complete Heart Block and Transient Parkinsonism in a Child Secondary to Mycoplasma Pneumoniae With Normal Magnetic Resonance Imaging (MRI). Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.654] [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]
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Youssef D, Singh A, Ayer J, Skinner J, Turner C, Christoff A. 648 A Single Centre Experience of the Incidence and Rhythm Characteristics of Paediatric Out of Hospital Cardiac Arrest Survivors Over a 11-Year Period. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.655] [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]
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Carrillo-Martin I, Molony K, Reddy K, Youssef D, Gonzalez-Estrada A. P031 A case of cefepime IgE-mediated reaction with negative skin testing. should current concentrations be reconsidered? Ann Allergy Asthma Immunol 2017. [DOI: 10.1016/j.anai.2017.08.100] [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]
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Shen L, Youssef D, Abu-Abed S, Malhotra SK, Atkinson K, Vikis E, Melich G, MacKenzie S. Cytomegalovirus duodenitis associated with life-threatening duodenal hemorrhage in an immunocompetent patient: A case report. Int J Surg Case Rep 2017; 33:102-106. [PMID: 28292662 PMCID: PMC5348597 DOI: 10.1016/j.ijscr.2017.02.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 02/18/2017] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Cytomegalovirus (CMV) is known to be opportunistic in immunocompromised patients. However, there have been emerging cases of severe CMV infections found in immunocompetent patients. Gastrointestinal (GI) CMV disease is the most common manifestation affecting immunocompetent patients, with duodenal involvement being exceedingly rare. Presented is a case of an immunocompetent patient with life-threatening bleeding caused by CMV duodenitis, requiring surgical intervention. PRESENTATION OF CASE A 60-year-old male with history of disseminated Methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia and aortic valve infective endocarditis, presented with life-threatening upper GI hemorrhage. Endoscopy revealed ulcerations, with associated generalized mucosal bleeding in the duodenum. After repeated endoscopic therapies and failed interventional-radiology arterial embolization, the patient required a duodenectomy and associated total pancreatectomy, to control the duodenal hemorrhage. Pathologic review of the surgical specimen demonstrated CMV duodenitis. Systemic ganciclovir was utilized postoperatively. DISCUSSION GI CMV infections should be on the differential diagnosis of immunocompetent patients presenting with uncontrollable GI bleeding, especially in critically ill patients due to transiently suppressed immunity. Endoscopic and histopathological examinations are often required for diagnosis. Ganciclovir is first-line treatment. Surgical intervention may be considered if there is recurrent bleeding and CMV duodenitis is suspected because of high potential for bleeding-associated mortality. CONCLUSION Presented is a rare case of life-threatening GI hemorrhage caused by CMV duodenitis in an immunocompetent patient. The patient failed endoscopic and interventional-radiology treatment options, and ultimately stabilized after surgical intervention.
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Affiliation(s)
- Lucy Shen
- Department of General Surgery, Royal Columbian Hospital, University of British Columbia, New Westminster, BC, Canada.
| | - David Youssef
- Department of General Surgery, Royal Columbian Hospital, University of British Columbia, New Westminster, BC, Canada
| | - Suzan Abu-Abed
- Department of Pathology, Royal Columbian Hospital, University of British Columbia, New Westminster, BC, Canada
| | - Sangita K Malhotra
- Department of Infectious Diseases, Royal Columbian Hospital, University of British Columbia, New Westminster, BC, Canada
| | - Kenneth Atkinson
- Department of Gastroenterology, Royal Columbian Hospital, University of British Columbia, New Westminster, BC, Canada
| | - Elena Vikis
- Department of General Surgery, Royal Columbian Hospital, University of British Columbia, New Westminster, BC, Canada
| | - George Melich
- Department of General Surgery, Royal Columbian Hospital, University of British Columbia, New Westminster, BC, Canada
| | - Shawn MacKenzie
- Department of General Surgery, Royal Columbian Hospital, University of British Columbia, New Westminster, BC, Canada
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Youssef D, Vasani S, Hodge R. Simple perioperative interventions can minimise the risk of pharyngocutaneous fistula following total laryngectomy – Experience at a single tertiary institution. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.080] [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: 10/20/2022]
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Zaccardi F, Webb DR, Htike ZZ, Youssef D, Khunti K, Davies MJ. Efficacy and safety of sodium-glucose co-transporter-2 inhibitors in type 2 diabetes mellitus: systematic review and network meta-analysis. Diabetes Obes Metab 2016; 18:783-94. [PMID: 27059700 DOI: 10.1111/dom.12670] [Citation(s) in RCA: 311] [Impact Index Per Article: 38.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 03/24/2016] [Accepted: 03/31/2016] [Indexed: 12/13/2022]
Abstract
AIM To assess the comparative efficacy and safety of sodium-glucose co-transporter-2 (SGLT2) inhibitors in adults with type 2 diabetes. METHODS We electronically searched randomized controlled trials (≥24 weeks) including canagliflozin, dapagliflozin or empagliflozin that were published up to 3 November 2015. Data were collected on cardiometabolic and safety outcomes and synthesized using network meta-analyses. RESULTS A total of 38 trials (23 997 participants) were included. Compared with placebo, all SGLT2 inhibitors reduced glycated haemoglobin (HbA1c), fasting plasma glucose (FPG), body weight and blood pressure, and slightly increased HDL cholesterol. Canagliflozin 300 mg reduced HbA1c, FPG and systolic blood pressure and increased LDL cholesterol to a greater extent compared with other inhibitors at any dose. At their highest doses, canagliflozin 300 mg reduced: HbA1c by 0.2% [95% confidence interval (CI) 0.1-0.3] versus both dapagliflozin 10 mg and empagliflozin 25 mg; FPG by 0.6 mmol/l (95% CI 0.3-0.9) and 0.5 mmol/l (95% CI 0.1-0.8) versus dapagliflozin and empagliflozin, respectively; and systolic blood pressure by 2 mmHg (95% CI 1.0-3.0) versus dapagliflozin; and increased LDL cholesterol by 0.13 mmol/l (95% CI 0.03-0.23) and 0.15 mmol/l (95% CI 0.06-0.23) versus dapagliflozin and empagliflozin, respectively. The highest doses of inhibitors had similar effects on body weight reduction. Canagliflozin 300 and 100 mg increased the risk of hypoglycaemia versus placebo, dapagliflozin 10 mg and empagliflozin 10 mg [odds ratios (ORs) 1.4-1.6]. Dapagliflozin 10 mg increased the risk of urinary tract infection versus placebo and empagliflozin 25 mg (ORs 1.4). All inhibitors similarly increased the risk of genital infection (ORs 4-6 versus placebo). CONCLUSIONS Although they increase the risk of genital infection, SGLT2 inhibitors are effective in improving cardiometabolic markers in type 2 diabetes, with canagliflozin 300 mg performing better in this respect than other inhibitors. Further studies will clarify whether these differences are likely to translate into differing long-term outcomes.
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Affiliation(s)
- F Zaccardi
- Diabetes Research Centre, University of Leicester, Leicester, UK
- Diabetes Research Center, Leicester Diabetes Centre, UHL NHS Trust, Leicester, UK
| | - D R Webb
- Diabetes Research Centre, University of Leicester, Leicester, UK
- Diabetes Research Center, Leicester Diabetes Centre, UHL NHS Trust, Leicester, UK
| | - Z Z Htike
- Diabetes Research Centre, University of Leicester, Leicester, UK
- Diabetes Research Center, Leicester Diabetes Centre, UHL NHS Trust, Leicester, UK
| | - D Youssef
- Diabetes Research Centre, University of Leicester, Leicester, UK
- Diabetes Research Center, Leicester Diabetes Centre, UHL NHS Trust, Leicester, UK
| | - K Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
- Diabetes Research Center, Leicester Diabetes Centre, UHL NHS Trust, Leicester, UK
| | - M J Davies
- Diabetes Research Centre, University of Leicester, Leicester, UK
- Diabetes Research Center, Leicester Diabetes Centre, UHL NHS Trust, Leicester, UK
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Zargar H, Espiritu PN, Fairey AS, Mertens LS, Dinney CP, Mir MC, Krabbe LM, Cookson MS, Jacobsen NE, Gandhi NM, Griffin J, Montgomery JS, Vasdev N, Yu EY, Youssef D, Xylinas E, Campain NJ, Kassouf W, Dall'Era MA, Seah JA, Ercole CE, Horenblas S, Sridhar SS, McGrath JS, Aning J, Shariat SF, Wright JL, Thorpe AC, Morgan TM, Holzbeierlein JM, Bivalacqua TJ, North S, Barocas DA, Lotan Y, Garcia JA, Stephenson AJ, Shah JB, van Rhijn BW, Daneshmand S, Spiess PE, Black PC. Multicenter assessment of neoadjuvant chemotherapy for muscle-invasive bladder cancer. Eur Urol 2014; 67:241-9. [PMID: 25257030 DOI: 10.1016/j.eururo.2014.09.007] [Citation(s) in RCA: 204] [Impact Index Per Article: 20.4] [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: 04/21/2014] [Accepted: 09/06/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND The efficacy of neoadjuvant chemotherapy (NAC) for muscle-invasive bladder cancer (BCa) was established primarily with methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC), with complete response rates (pT0) as high as 38%. However, because of the comparable efficacy with better tolerability of gemcitabine and cisplatin (GC) in patients with metastatic disease, GC has become the most commonly used regimen in the neoadjuvant setting. OBJECTIVE We aimed to assess real-world pathologic response rates to NAC with different regimens in a large, multicenter cohort. DESIGN, SETTING, AND PARTICIPANTS Data were collected retrospectively at 19 centers on patients with clinical cT2-4aN0M0 urothelial carcinoma of the bladder who received at least three cycles of NAC, followed by radical cystectomy (RC), between 2000 and 2013. INTERVENTION NAC and RC. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The primary outcome was pathologic stage at cystectomy. Univariable and multivariable analyses were used to determine factors predictive of pT0N0 and ≤pT1N0 stages. RESULTS AND LIMITATIONS Data were collected on 935 patients who met inclusion criteria. GC was used in the majority of the patients (n=602; 64.4%), followed by MVAC (n=183; 19.6%) and other regimens (n=144; 15.4%). The rates of pT0N0 and ≤pT1N0 pathologic response were 22.7% and 40.8%, respectively. The rate of pT0N0 disease for patients receiving GC was 23.9%, compared with 24.5% for MVAC (p=0.2). There was no difference between MVAC and GC in pT0N0 on multivariable analysis (odds ratio: 0.89 [95% confidence interval, 0.61-1.34]; p=0.6). CONCLUSIONS Response rates to NAC were lower than those reported in prospective randomized trials, and we did not discern a difference between MVAC and GC. Without any evidence from randomized prospective trials, the best NAC regimen for invasive BCa remains to be determined. PATIENT SUMMARY There was no apparent difference in the response rates to the two most common presurgical chemotherapy regimens for patients with bladder cancer.
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Affiliation(s)
- Homayoun Zargar
- Vancouver Prostate Centre, Vancouver, British Columbia, Canada
| | - Patrick N Espiritu
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Adrian S Fairey
- USC/Norris Comprehensive Cancer Center, Institute of Urology, University of Southern California, Los Angeles, CA, USA; University of Alberta, Edmonton, Alberta, Canada
| | - Laura S Mertens
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Colin P Dinney
- Department of Urology, MD Anderson Cancer Center, Houston, TX, USA
| | - Maria C Mir
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Laura-Maria Krabbe
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Michael S Cookson
- Department of Urology, University of Oklahoma College of Medicine, Oklahoma City, OK, USA
| | | | - Nilay M Gandhi
- Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Joshua Griffin
- Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA
| | | | - Nikhil Vasdev
- Department of Urology, Freeman Hospital, Newcastle Upon Tyne, UK
| | - Evan Y Yu
- Department of Medicine, Division of Oncology, University of Washington School of Medicine and Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - David Youssef
- Vancouver Prostate Centre, Vancouver, British Columbia, Canada
| | - Evanguelos Xylinas
- Department of Urology, Weill Cornell Medical College, Presbyterian Hospital, New York, NY, USA
| | - Nicholas J Campain
- Department of Surgery, Exeter Surgical Health Services Research Unit, Royal Devon and Exeter NHS Trust, Exeter, UK
| | - Wassim Kassouf
- Department of Surgery (Division of Urology), McGill University Health Center, Montreal, Quebec, Canada
| | - Marc A Dall'Era
- Department of Urology, University of California at Davis, Davis Medical Center, Sacramento, CA, USA
| | - Jo-An Seah
- Princess Margaret Hospital, Toronto, Ontario, Canada
| | - Cesar E Ercole
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Simon Horenblas
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | | | - John S McGrath
- Department of Surgery, Exeter Surgical Health Services Research Unit, Royal Devon and Exeter NHS Trust, Exeter, UK
| | - Jonathan Aning
- Department of Urology, Freeman Hospital, Newcastle Upon Tyne, UK; Department of Surgery, Exeter Surgical Health Services Research Unit, Royal Devon and Exeter NHS Trust, Exeter, UK
| | - Shahrokh F Shariat
- Department of Urology, Weill Cornell Medical College, Presbyterian Hospital, New York, NY, USA; Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Jonathan L Wright
- Department of Medicine, Division of Oncology, University of Washington School of Medicine and Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Andrew C Thorpe
- Department of Urology, Freeman Hospital, Newcastle Upon Tyne, UK
| | - Todd M Morgan
- Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Jeff M Holzbeierlein
- Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Trinity J Bivalacqua
- Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Scott North
- Cross Cancer Institute, Edmonton, Alberta, Canada
| | - Daniel A Barocas
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yair Lotan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jorge A Garcia
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Andrew J Stephenson
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jay B Shah
- Department of Urology, MD Anderson Cancer Center, Houston, TX, USA
| | - Bas W van Rhijn
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Siamak Daneshmand
- USC/Norris Comprehensive Cancer Center, Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Philippe E Spiess
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Peter C Black
- Vancouver Prostate Centre, Vancouver, British Columbia, Canada.
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Zargar H, Fairey AS, Mertens L, Espiritu PN, Dinney CP, Krabbe LM, Cookson MS, Jacobsen NE, Montgomery JS, Gandhi N, Griffin J, Yu EY, Vasdev N, Campain NJ, Xylinas E, Horenblas S, Youssef D, Kassouf W, Shariat SF, Aning JJ, Wright JL, Thorpe AC, Holzbeierlein JM, Bivalacqua TJ, Morgan TM, North S, Barocas DA, Lotan Y, Shah JB, Spiess PE, van Rhijn B, Daneshmand S, Black P. MP55-08 PATHOLOGIC RESPONSE TO NEOADJUVANT CHEMOTHERAPY IN A MULTICENTRE COHORT OF PATIENTS WITH MUSCLE INVASIVE BLADDER CANCER. J Urol 2014. [DOI: 10.1016/j.juro.2014.02.1556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Besson M, Matthey A, Youssef D, Vuillemier P, Curatolo M, Dayer P, Zeilhofer H, Desmeules J. PP273—Effect of the gabaa ligands clobazam and clonazepam on the modulation of pain transmission in humans: A pk-pd study. Clin Ther 2013. [DOI: 10.1016/j.clinthera.2013.07.301] [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]
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Hoag NA, Afshar K, Youssef D, Masterson JST, Murphy J, Macneily AE. Cystic intratesticular lesions in pediatric patients. J Pediatr Surg 2013; 48:1773-7. [PMID: 23932621 DOI: 10.1016/j.jpedsurg.2012.10.049] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 08/24/2012] [Revised: 09/26/2012] [Accepted: 10/22/2012] [Indexed: 10/26/2022]
Abstract
BACKGROUND/PURPOSE Intratesticular cysts are a rare clinical entity in the pediatric population. Recently, testes sparing surgery has been recommended. We share our experience with the management of pediatric testicular cysts. METHODS A retrospective review of all pediatric patients referred for intratesticular cysts was conducted at a single pediatric institution from 2002 to 2010. Charts were evaluated for patient demographics, diagnosis, and management. RESULTS Seven patients were identified and included in this series. After partial orchiectomy, the final diagnosis in three patients was epidermoid cyst. Three further patients were diagnosed as mature cystic teratoma, with two of these demonstrating adjacent intra-tubular germ cell neoplasia (ITGCN). One cyst in the series underwent spontaneous resolution after eight months. CONCLUSION All of the cystic lesions in our case series were benign with one undergoing complete resolution. The remainder became smaller and developed a solid component prompting surgery. The pre-pubertal findings of ITGCN in two patients raise a dilemma regarding the optimal long-term management for these patients. Initial conservative observation is an option for the majority of pre-pubertal cystic testicular lesions until such time that testis sparing surgery is deemed technically feasible. Testes sparing surgery should be advocated in those patients undergoing surgical management.
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Affiliation(s)
- Nathan A Hoag
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada.
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Shi H, Wen J, LI Z, Elsayed M, Kamal K, LI Z, Wen J, Shi H, El Shal A, Youssef D, Caubet C, Lacroix C, Benjamin B, Bandin F, Bascands JL, Monsarrat B, Decramer S, Schanstra J, Laetitia DB, Ulinski T, Aoun B, Ozdemir K, Dincel N, Sozeri B, Mir S, Dincel N, Berdeli A, Mir S, Akyigit F, Mizerska-Wasiak M, Panczyk-Tomaszewska M, Szymanik-Grzelak H, Roszkowska-Blaim M, Jamin A, Dehoux L, Monteiro RC, Deschenes G, Bouts A, Davin JC, Dorresteijn E, Schreuder M, Lilien M, Oosterveld M, Kramer S, Gruppen M, Pintos-Morell G, Ramaswami U, Parini R, Rohrbach M, Kalkum G, Beck M, Carter M, Antwi S, Callegari J, Kotanko P, Levin NW, Rumjon A, Macdougall IC, Turner C, Booth CJ, Goldsmith D, Sinha MD, Camilla R, Camilla R, Loiacono E, Donadio ME, Conrieri M, Bianciotto M, Bosetti FM, Peruzzi L, Conti G, Bitto A, Amore A, Coppo R, Mizerska-Wasiak M, Roszkowska-Blaim M, Maldyk J, Chou HH, Chiou YY, Bochniewska V, Jobs K, Jung A, Fallahzadeh Abarghooei MH, Zare J, Sedighi Goorabi V, Derakhshan A, Basiratnia M, Fallahzadeh Abarghooei MA, Hosseini Al-Hashemi G, Fallahzadeh Abarghooei F, Kluska-Jozwiak A, Soltysiak J, Lipkowska K, Silska M, Fichna P, Skowronska B, Stankiewicz W, Ostalska-Nowicka D, Zachwieja J, Girisgen L, Sonmez F, Yenisey C, Kis E, Cseprekal O, Kerti A, Szabo A, Salvi P, Benetos A, Tulassay T, Reusz G, Makulska I, Szczepanska M, Drozdz D, Zwolnska D, Sozeri B, Berdeli A, Mir S, Tolstova E, Anis L, Ulinski T, Alber B, Edouard B, Gerard C, Seni K, Dunia Julienne Hadiza T, Christian S, Benoit T, Francois B, Adama L, Rosenberg A, Munro J, Murray K, Wainstein B, Ziegler J, Singh-Grewal D, Boros C, Adib N, Elliot E, Fahy R, Mackie F, Kainer G, Polak-Jonkisz D, Zwolinska D, Laszki-Szczachor K, Zwolinska D, Janocha A, Rusiecki L, Sobieszczanska M, Garzotto F, Ricci Z, Clementi A, Cena R, Kim JC, Zanella M, Ronco C, Polak-Jonkisz D, Zwolinska D, Purzyc L, Zwolinska D, Makulska I, Szczepanska M, Peco-Antic A, Kotur-Stevuljevic J, Paripovic D, Scekic G, Milosevski-Lomic G, Bogicevic D, Spasojevic-Dimitrijeva B, Hassan R, El-Husseini A, Sobh M, Ghoneim M, Harambat J, Bonthuis M, Van Stralen KJ, Ariceta G, Battelino N, Jahnukainen T, Sandes AR, Combe C, Jager KJ, Verrina E, Schaefer F, Espindola R, Bacchetta J, Cochat P, Stefanis C, Leroy S, Leroy S, Fernandez-Lopez A, Nikfar R, Romanello C, Bouissou F, Gervaix A, Gurgoze M, Bressan S, Smolkin V, Tuerlinkx D, Stefanidis C, Vaos G, Leblond P, Gungor F, Gendrel D, Chalumeau M, Rumjon A, Macdougall IC, Turner C, Rawlins D, Booth CJ, Simpson JM, Sinha MD, Arnaud G, Arnaud G, Anne M, Stephanie T, Flavio B, Veronique FB, Stephane D, Mumford L, Marks S, Ahmad N, Maxwell H, Tizard J, Vidal E, Amigoni A, Varagnolo M, Benetti E, Ghirardo G, Brugnolaro V, Murer L, Aoun B, Christine G, Alber B, Ulinski T, Aoun B, Decramer S, Bandin F, Ulinski T, Degi A, Degi A, Kerti A, Kis E, Cseprekal O, Szabo AJ, Reusz GS, Ghirardo G, Vidoni A, Vidal E, Benetti E, Ramondo G, Miotto D, Murer L. Paediatric nephrology. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs250] [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
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Youssef D, Bailey B, El-Abbassi A, Vannoy M, Manning T, Moorman JP, Peiris AN. Healthcare costs of methicillin resistant Staphylococcus aureus and Pseudomonas aeruginosa infections in veterans: role of vitamin D deficiency. Eur J Clin Microbiol Infect Dis 2011; 31:281-6. [PMID: 21695580 DOI: 10.1007/s10096-011-1308-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Accepted: 05/23/2011] [Indexed: 01/28/2023]
Abstract
Methicillin resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (P. aeruginosa) infections are frequently associated with hospitalization and increased healthcare costs. Vitamin D deficiency may contribute to increased costs for patients with these infections and there is evidence that vitamin D may have an antimicrobial role. To evaluate the role of vitamin D deficiency in the costs incurred with these infections, we studied the relationship of serum 25(OH)D levels to healthcare costs in veterans in the southeastern United States. Patients with both infections were vitamin D deficient to a similar extent and so were combined for further analysis. Vitamin D deficient patients had higher costs and service utilization than those who were not vitamin D deficient. Those with vitamin D deficiency had higher inpatient costs compared to the non-deficient group, and this difference was across most categories except for the number of inpatient hospitalizations or total number of days as an inpatient. Vitamin D deficiency was not significantly related to outpatient cost or service utilization parameters. We conclude that vitamin D deficiency is intimately linked to adverse healthcare costs in veterans with MRSA and P. aeruginosa infections. Vitamin D status should be assayed in patients with these infections.
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Affiliation(s)
- D Youssef
- Department of Internal Medicine, Division of Infectious Diseases, East Tennessee State University, Johnson City, TN, USA.
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Takahashi K, Shibasaki A, Hirose T, Kaneko K, Nakamura M, Ohba K, Kato I, Totsune K, Zumrutdal A, Calayoglu R, Mescigil P, Kutlay S, Sengul S, Erturk S, Ibrahim M, Ahmed T, Awadalla A, El Naggar A, Yokoyama T, Onodera Y, Shimonaka Y, Sasaki Y, Kuragano T, Furuta M, Kida A, Kitamura R, Yahiro M, Otaki T, Hasuike Y, Nonoguchi H, Nishihara F, Nakanishi T, Sedlackova T, Racek J, Trefil L, Eiselt J, Kielberger L, Malanova L, Youssef D, Tawfeek D, Desoki T, Khalifa N, Takasawa K, Takaeda C, Higuchi M, Maeda T, Tomosugi N, Bratescu LO, Barsan L, Garneata L, Stanciu A, Lipan M, Stancu SH, Mircescu G, Zager P, Paine S, Myers O, Chang JH, Jung JY, Lee HH, Chung W, Kim S, Tutal E, Erkmen Uyar M, Sezer S, Bal Z, Wabel P, Machek P, Moissl U, Chamney P, Jirka T, Moissl U, Wabel P, Chamney P, Wieskotten S, Amato C, Mari F, Korol L, Dudar I, Van Wyck D, Goykhman I, Weldon J, Krishnan M, Nissenson A, Kinugasa E, Sanaka T, Mochizuki T, Kuno T, Kojima K, Kobayashi S, Satoh M, Noiri E, Kusano E, Owada S, Shimada N, Nakao K, Nakazawa R, Nishimura H, Tomo T, Shigematsu T, Maeda T, Rottembourg J, Guerin A, Diaconita M, Dumont JC, Dansaert A, Chailimpamontree W, Gojaseni P, Pajareya T, Chittinandana A, Bachmakov I, Meissner R, Benkenstein C, Migliori M, Bernabini G, Beati S, Paoletti S, De Pietro S, Ferrandello FP, Panichi V, Senol E, Ersoy A, Erdinc S, Sarandol E, Mikami S, Hamano T, Iba O, Inoue T, Toki M, Takamitsu Y, Mikami H, Fujii M. Anaemia in CKD 5D. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.56] [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
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Youssef D, Pankajakshan D, Agrawal D. Calcitriol Increases the Expression of CCR3, LL-37, TGF-β1, and IL-5R in Human Blood Eosinophils. J Allergy Clin Immunol 2010. [DOI: 10.1016/j.jaci.2009.12.421] [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: 11/16/2022]
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O'Connor MD, Kardel MD, Iosfina I, Youssef D, Lu M, Li MM, Vercauteren S, Nagy A, Eaves CJ. Alkaline phosphatase-positive colony formation is a sensitive, specific, and quantitative indicator of undifferentiated human embryonic stem cells. Stem Cells 2008; 26:1109-16. [PMID: 18276800 DOI: 10.1634/stemcells.2007-0801] [Citation(s) in RCA: 124] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Human embryonic stem cells (hESCs) can be maintained in vitro as immortal pluripotent cells but remain responsive to many differentiation-inducing signals. Investigation of the initial critical events involved in differentiation induction would be greatly facilitated if a specific, robust, and quantitative assay for pluripotent hESCs with self-renewal potential were available. Here we describe the results of a series of experiments to determine whether the formation of adherent alkaline phosphatase-positive (AP(+)) colonies under conditions optimized for propagating undifferentiated hESCs would meet this need. The findings can be summarized as follows. (a) Most colonies obtained under these conditions consist of >or=30 AP(+) cells that coexpress OCT4, NANOG, SSEA3, SSEA4, TRA-1-60, and TRA-1-81. (b) Most such colonies are derived from SSEA3(+) cells. (c) Primary colonies contain cells that produce secondary colonies of the same composition, including cells that initiate multilineage differentiation in embryoid bodies (EBs). (d) Colony formation is independent of plating density or the colony-forming cell (CFC) content of the test population over a wide range of cell concentrations. (e) CFC frequencies decrease when differentiation is induced by exposure either to retinoic acid or to conditions that stimulate EB formation. Interestingly, this loss of AP(+) clonogenic potential also occurs more rapidly than the loss of SSEA3 or OCT4 expression. The CFC assay thus provides a simple, reliable, broadly applicable, and highly specific functional assay for quantifying undifferentiated hESCs with self-renewal potential. Its use under standardized assay conditions should enhance future elucidation of the mechanisms that regulate hESC propagation and their early differentiation.
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Affiliation(s)
- Michael D O'Connor
- Terry Fox Laboratory, 675 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L3.
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Mattern G, Weckert E, Youssef D, Frahm AW. Absolute Configuration of Chlorojanerin, a Chlorine-Containing Guaianolide from Centaurea scoparia. Acta Crystallogr C 1996. [DOI: 10.1107/s0108270196000741] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Youssef D, Frahm AW. Constituents of the Egyptian Centaurea scoparia. III. Phenolic constituents of the aerial parts. Planta Med 1995; 61:570-3. [PMID: 17238113 DOI: 10.1055/s-2006-959378] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The ethanolic extract of the aerial parts of Centaurea scoparia Sieb. (Asteraceae) afforded five polyoxygenated flavones apigenin, luteolin, salvigenin, cirsimaritin, and hispidulin, the two lignans (-)-matairesinol and (-)-arctigenin together with omega-hydroxypropioguaiacone and vanillin. The structure elucidations of the isolated compounds are based on spectroscopic methods including 1D- and 2D-NMR spectra. Some proton and carbon signals are revised or newly reported.
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Abstract
Aerial parts of CENTAUREA SCOPARIA Sieb. afforded a new chlorinated guaianolide with an unusual isobutyl structural feature, diain ( 1), together with three known guaianolides, janerin ( 2), cynaropicrin ( 3), and deacylcynaropicrin ( 4). Structural assignments of the isolated compounds are based on spectroscopic methods including 1D- and 2D-NMR spectroscopy as well as mass spectroscopy. New and revised (1)H- and (13)C-NMR data are reported.
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Affiliation(s)
- D Youssef
- Pharmazeutisches Institut der Universität, Hermann-Herder-Str. 9, D-79104 Freiburg, Federal Republic of Germany
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Abstract
A new chlorine-containing guaianolide, chloroscoparin, was isolated from the ethanol extract of the aerial parts of CENTAUREA SCOPARIA Sieb. together with three known chlorine-containing guaianolides. The structures of the isolated compounds were elucidated by spectroscopic methods including (1)H-NMR-, 2D (1)H- (1)H COSY-, (13)C-NMR-, APT-, DEPT-, HETCOR-, long-range-HETCOR-, 2D INADEQUATE-, and mass spectra. The relative configuration was determined by 2D-NOESY studies. New NMR data for the known compounds are reported.
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Affiliation(s)
- D Youssef
- Pharmazeutisches Institut der Universitát, Hermann-Herder-Str. 9, D-79104 Freiburg i.Br., Federal Republic of Germany
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