1
|
Petit M, Dumont R, Huon JF, Sellal O, Feldman D. [Design, implementation and evaluation of an educational approach for patients with PICC line and midline]. Ann Pharm Fr 2023; 81:882-892. [PMID: 36796508 DOI: 10.1016/j.pharma.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 01/14/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023]
Abstract
OBJECTIVES Design the competency framework and an interview guide for patients with PICC line or midline. Develop a patient satisfaction evaluation questionnaire. METHODS A multidisciplinary team has developed a reference system for the skills of patients with PICC line or midline. The skills are classified in three categories: knowledge, know-how and attitudes. An interview guide was written in order to transmit the priority skills, determined beforehand, to the patient. A second multidisciplinary team designed a questionnaire to evaluate patient satisfaction. RESULTS The competency framework includes nine competencies: four, knowledge-based; three, know-how-based and two, attitude-based. Among these competencies, five were considered to be priorities. The interview guide is a tool that allows care professionals to transmit the priority skills to patients. The satisfaction questionnaire explores the information received by the patient, the passage through the interventional technical platform, the end of the management before the return home, and the overall satisfaction of the patients with the course of the device placement. Over a 6-month period, 276 patients responded with a high satisfaction rate. CONCLUSIONS The PICC line or midline patient's competency framework has made it possible to list all the skills that patients should acquire. The interview guide serves as a support for the care teams in the patient education process. This work could be used by other establishments to develop the educational process around these vascular access devices.
Collapse
Affiliation(s)
- M Petit
- Pharmacie, CHU de Nantes, Nantes Université, 44000 Nantes, France.
| | - R Dumont
- Unité d'accès vasculaire, CHU de Nantes, Nantes Université, 44000 Nantes, France
| | - J-F Huon
- Unité d'accès vasculaire, CHU de Nantes, Nantes Université, 44000 Nantes, France
| | - O Sellal
- Pharmacie, CHU de Nantes, Nantes Université, 44000 Nantes, France
| | - D Feldman
- Pharmacie, CHU de Nantes, Nantes Université, 44000 Nantes, France
| |
Collapse
|
2
|
Kalil R, Adejumo Y, Wong SC, Bergman G, Kim L, Feldman D, Singh H, Mick S, Iannacone E, Minutello R. TCT-402 One-Year Outcomes of Transcatheter Mitral Valve-in-Valve Replacement. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.1255] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
3
|
Wong SC, Minutello R, Bergman G, Mick S, Iannacone E, Feldman D, Kim L, Singh H, Reisman M. TCT-425 Perclose or Manta Post-TAVR (PROMPT) Study. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.1278] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
4
|
Narula N, Singh H, Krishnan U, Sciria C, Vohra A, Kim J, Lau C, Feldman D, Kim L, Friedman JL. A Challenging Case of Extensive Spontaneous Coronary Artery Dissection. JACC Case Rep 2020; 2:1437-1442. [PMID: 34316991 PMCID: PMC8302183 DOI: 10.1016/j.jaccas.2020.07.005] [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: 03/23/2020] [Revised: 07/07/2020] [Accepted: 07/07/2020] [Indexed: 11/24/2022]
Abstract
The detection of spontaneous coronary artery dissection (SCAD) causing myocardial infarction is integral in pursuing the appropriate management. Our case posed a diagnostic challenge, with Takotsubo cardiomyopathy and coronary embolism among the potential differential diagnoses upon the initial presentation. Extensive propagation of spontaneous coronary artery dissection subsequently resulted in a significant challenge to management requiring surgical revascularization. (Level of Difficulty: Intermediate.).
Collapse
Key Words
- ACS, acute coronary syndrome
- CABG, coronary artery bypass graft
- CMR, cardiac magnetic resonance
- ECG, electrocardiogram
- LAD, left anterior descending artery
- LGE, late gadolinium enhancement
- LM, left main
- MI, myocardial infarction
- MINOCA, myocardial infarction with nonobstructive coronary arteries
- SCAD, spontaneous coronary artery dissection
- TTC, Takotsubo cardiomyopathy
- Takotsubo cardiomyopathy
- spontaneous coronary artery dissection
- women’s health
Collapse
Affiliation(s)
- Nupoor Narula
- Division of Cardiology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
| | - Harsimran Singh
- Division of Cardiology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
| | - Udhay Krishnan
- Division of Cardiology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
| | - Christopher Sciria
- Division of Cardiology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
| | - Adam Vohra
- Division of Cardiology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
| | - Jiwon Kim
- Division of Cardiology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
| | - Christopher Lau
- Department of Cardiothoracic Surgery, Weill Cornell Medical College, New York, New York
| | - Dmitriy Feldman
- Division of Cardiology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
| | - Luke Kim
- Division of Cardiology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
| | - Julie L. Friedman
- Division of Cardiology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
| |
Collapse
|
5
|
Sharma N, George S, Kalil R, Sharma P, Kim P, Goulbourne C, Kort S, Feldman D, Parikh P. PREDICTORS OF CALCIFIC AORTIC VALVE STENOSIS PROGRESSION AS MEASURED BY CHANGE IN PEAK VELOCITY: A META-ANALYSIS AND META-REGRESSION. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)32799-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
6
|
Giustina A, Adler RA, Binkley N, Bollerslev J, Bouillon R, Dawson-Hughes B, Ebeling PR, Feldman D, Formenti AM, Lazaretti-Castro M, Marcocci C, Rizzoli R, Sempos CT, Bilezikian JP. Consensus statement from 2 nd International Conference on Controversies in Vitamin D. Rev Endocr Metab Disord 2020; 21:89-116. [PMID: 32180081 PMCID: PMC7113202 DOI: 10.1007/s11154-019-09532-w] [Citation(s) in RCA: 146] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The 2nd International Conference on Controversies in Vitamin D was held in Monteriggioni (Siena), Italy, September 11-14, 2018. The aim of this meeting was to address ongoing controversies and timely topics in vitamin D research, to review available data related to these topics and controversies, to promote discussion to help resolve lingering issues and ultimately to suggest a research agenda to clarify areas of uncertainty. Several issues from the first conference, held in 2017, were revisited, such as assays used to determine serum 25-hydroxyvitamin D [25(OH)D] concentration, which remains a critical and controversial issue for defining vitamin D status. Definitions of vitamin D nutritional status (i.e. sufficiency, insufficiency and deficiency) were also revisited. New areas were reviewed, including vitamin D threshold values and how they should be defined in the context of specific diseases, sources of vitamin D and risk factors associated with vitamin D deficiency. Non-skeletal aspects related to vitamin D were also discussed, including the reproductive system, neurology, chronic kidney disease and falls. The therapeutic role of vitamin D and findings from recent clinical trials were also addressed. The topics were considered by 3 focus groups and divided into three main areas: 1) "Laboratory": assays and threshold values to define vitamin D status; 2) "Clinical": sources of vitamin D and risk factors and role of vitamin D in non-skeletal disease and 3) "Therapeutics": controversial issues on observational studies and recent randomized controlled trials. In this report, we present a summary of our findings.
Collapse
Affiliation(s)
- A Giustina
- Chair of Endocrinology, School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Endocrinology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - R A Adler
- McGuire Veterans Affairs Medical Center and Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - N Binkley
- Osteoporosis Clinical Research Program and Institute on Aging, University of Wisconsin-Madison, Madison, WI, USA
| | - J Bollerslev
- Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - R Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, Leuven, KU, Belgium
| | - B Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - P R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - D Feldman
- Department of Medicine, Endocrinology Division, Stanford University School of Medicine, Stanford, CA, USA
| | - A M Formenti
- Chair of Endocrinology, School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Endocrinology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Lazaretti-Castro
- Division of Endocrinology, Escola Paulista de Medicina - Universidade Federal de Sao Paulo (EPM-UNIFESP), Sao Paulo, Brazil
| | - C Marcocci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - R Rizzoli
- Divison of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - C T Sempos
- Vitamin D Standardization Program LLC, Havre de Grace, MD, USA
| | - J P Bilezikian
- Department of Medicine, Endocrinology Division, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
| |
Collapse
|
7
|
Sharma N, George S, Kalil R, Sharma P, Kim P, Goulbourne C, Kort S, Feldman D, Parikh P. PREDICTORS OF CALCIFIC AORTIC VALVE STENOSIS PROGRESSION AS MEASURED BY CHANGE IN MEAN PRESSURE GRADIENT: A META-ANALYSIS AND META-REGRESSION. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)32798-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
8
|
Venkatesh P, Evans AT, Maw AM, Pashun RA, Patel A, Kim L, Feldman D, Minutello R, Wong SC, Stribling JC, LaPar D, Holzer R, Ginns J, Bacha E, Singh HS. Predictors of Late Mortality in D-Transposition of the Great Arteries After Atrial Switch Repair: Systematic Review and Meta-Analysis. J Am Heart Assoc 2019; 8:e012932. [PMID: 31642369 PMCID: PMC6898856 DOI: 10.1161/jaha.119.012932] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background Existing data on predictors of late mortality and prevention of sudden cardiac death after atrial switch repair surgery for D‐transposition of the great arteries (D‐TGA) are heterogeneous and limited by statistical power. Methods and Results We conducted a systematic review and meta‐analysis of 29 observational studies, comprising 5035 patients, that reported mortality after atrial switch repair with a minimum follow‐up of 10 years. We also examined 4 additional studies comprising 105 patients who reported rates of implantable cardioverter‐defibrillator therapy in this population. Average survival dropped to 65% at 40 years after atrial switch repair, with sudden cardiac death accounting for 45% of all reported deaths. Mortality was significantly lower in cohorts that were more recent and operated on younger patients. Patient‐level risk factors for late mortality were history of supraventricular tachycardia (odds ratio [OR] 3.8, 95% CI 1.4–10.7), Mustard procedure compared with Senning (OR 2.9, 95% CI 1.9–4.5) and complex D‐TGA compared with simple D‐TGA (OR 4.4, 95% CI 2.2–8.8). Significant risk factors for sudden cardiac death were history of supraventricular tachycardia (OR 4.7, 95% CI 2.2–9.8), Mustard procedure (OR 2.2, 95% CI 1.1–4.1), and complex D‐TGA (OR 5.7, 95% CI 1.8–18.0). Out of a total 124 implantable cardioverter‐defibrillator discharges over 330 patient‐years in patients with implantable cardioverter‐defibrillators for primary prevention, only 8% were appropriate. Conclusions Patient‐level risk of both mortality and sudden cardiac death after atrial switch repair are significantly increased by history of supraventricular tachycardia, Mustard procedure, and complex D‐TGA. This knowledge may help refine current selection practices for primary prevention implantable cardioverter‐defibrillator implantation, given disproportionately high rates of inappropriate discharges.
Collapse
Affiliation(s)
- Prashanth Venkatesh
- Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY
| | - Arthur T Evans
- Division of Hospital Medicine Weill Cornell Medicine New York Presbyterian Hospital New York NY
| | - Anna M Maw
- Division of Hospital Medicine Weill Cornell Medicine New York Presbyterian Hospital New York NY
| | - Raymond A Pashun
- Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY
| | - Agam Patel
- Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY
| | - Luke Kim
- Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY
| | - Dmitriy Feldman
- Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY
| | - Robert Minutello
- Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY
| | - S Chiu Wong
- Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY
| | - Judy C Stribling
- Weill Cornell Medicine Samuel J. Wood Library Myra Mahon Patient Resource Center New York NY
| | - Damian LaPar
- Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY
| | - Ralf Holzer
- Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY
| | - Jonathan Ginns
- Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY
| | - Emile Bacha
- Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY
| | - Harsimran S Singh
- Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY
| |
Collapse
|
9
|
Gillessen S, Collette L, Daugaard G, de Wit R, Tryakin A, Albany C, Stahl O, Fizazi K, Gietema J, De Giorgi U, Hansen A, Feldman D, Cafferty F, Tandstad T, Garcia del Muro X, Huddart R, Sweeney C, Heng D, Sauve N, Beyer J. Redefining the IGCCCG classification in advanced non-seminoma. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
10
|
Sandau K, Lee C, Garberich R, Weaver C, Joseph S, Hall S, Carey S, Cowger J, Chaudhry S, Schroeder S, Hoffman R, Feldman D, Conway G, Birati E, Soni M, Marble J, Kunz M, Storey K, Faulkner K, Eckman P. Relationship of Spiritual Wellbeing and Depressive Symptoms for Patients with a Left-Ventricular Assist Device (LVAD). J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.759] [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: 11/24/2022] Open
|
11
|
Sandau K, Lee C, Faulkner K, Eckman P, Garberich R, Pozehl B, Jurgens C, Weaver C, Joseph S, Hall S, Carey S, Cowger J, Chaudhry S, Schroeder S, Hoffman R, Feldman D, Conway G, Birati E, Soni M, Marble J, Kunz M, Storey K, Hoglund B. Validity and Reliability of the Quality of Life with a Left Ventricular Assist Device (QOLVAD) Questionnaire. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.649] [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: 10/27/2022] Open
|
12
|
Lam M, Kolte D, Kennedy K, Naidu S, Feldman D, Chu A, Aronow H. INCIDENCE, TIMING, AND PREDICTORS OF PERMANENT PACEMAKER PLACEMENT FOLLOWING ALCOHOL SEPTAL ABLATION FOR HYPERTROPHIC CARDIOMYOPATHY. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)31782-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
13
|
Lu D, Steitieh D, Chae J, Cheung J, Feldman D, Kim L. MID-TERM OUTCOMES AFTER PERCUTANEOUS CORONARY INTERVENTION IN PATIENTS WITH CIRRHOSIS. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)31903-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
14
|
Casey D, Pitter K, Imber B, Parhar P, Chan T, Beal K, Yamada Y, Feldman D, Yang T. High-Dose Radiation Therapy is Needed for Intracranial Control and Long-Term Survival in Patients with Non-Seminomatous Germ Cell Tumor Brain Metastases. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.791] [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]
|
15
|
Vierecke J, Feldman D. The Utility of a Wireless Implantable Hemodynamic Monitoring System in Advanced Heart Failure Patients Needing Left Ventricular Mechanical Circulatory Support. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.190] [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: 10/17/2022] Open
|
16
|
Bhardwaj B, Spertus J, Kennedy K, Jones S, Safley D, Tsai T, Aronow H, Vora A, Pokharel Y, Attaran RR, Feldman D, Salisbury A. TCT-59 Prevalence, predictors and outcomes of bleeding complications in peripheral vascular interventions for lower extremities: Insights from the NCDR PVI registry. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
17
|
Voudris K, Feldman D, Minutello R, Kim L, Charitakis K, Singh H, Bergman G, Salemi A, Wong SC. TCT-439 Trans-Apical Aortic Valve Replacement in Patients with History of Coronary Artery Bypass Grafting Surgery: An Analysis of the National Inpatient Sample Database. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.545] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
18
|
Schram AM, Reales D, Galle J, Cambria R, Durany R, Feldman D, Sherman E, Rosenberg J, D’Andrea G, Baxi S, Janjigian Y, Tap W, Dickler M, Baselga J, Taylor BS, Chakravarty D, Gao J, Schultz N, Solit DB, Berger MF, Hyman DM. Oncologist use and perception of large panel next-generation tumor sequencing. Ann Oncol 2017; 28:2298-2304. [PMID: 28911072 PMCID: PMC5834089 DOI: 10.1093/annonc/mdx294] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Genomic profiling is increasingly incorporated into oncology research and the clinical care of cancer patients. We sought to determine physician perception and use of enterprise-scale clinical sequencing at our center, including whether testing changed management and the reasoning behind this decision-making. PATIENTS AND METHODS All physicians who consented patients to MSK-IMPACT, a next-generation hybridization capture assay, in tumor types where molecular profiling is not routinely performed were asked to complete a questionnaire for each patient. Physician determination of genomic 'actionability' was compared to an expertly curated knowledgebase of somatic variants. Reported management decisions were compared to chart review. RESULTS Responses were received from 146 physicians pertaining to 1932 patients diagnosed with 1 of 49 cancer types. Physicians indicated that sequencing altered management in 21% (331/1593) of patients in need of a treatment change. Among those in whom treatment was not altered, physicians indicated the presence of an actionable alteration in 55% (805/1474), however, only 45% (362/805) of these cases had a genomic variant annotated as actionable by expert curators. Further evaluation of these patients revealed that 66% (291/443) had a variant in a gene associated with biologic but not clinical evidence of actionability or a variant of unknown significance in a gene with at least one known actionable alteration. Of the cases annotated as actionable by experts, physicians identified an actionable alteration in 81% (362/445). In total, 13% (245/1932) of patients were enrolled to a genomically matched trial. CONCLUSION Although physician and expert assessment differed, clinicians demonstrate substantial awareness of the genes associated with potential actionability and report using this knowledge to inform management in one in five patients. CLINICAL TRIAL NUMBER NCT01775072.
Collapse
Affiliation(s)
- A. M. Schram
- Department of Medicine, Division of Solid Tumor Oncology
| | | | - J. Galle
- Clinical Research Administration
| | | | - R. Durany
- Josie Robertson Surgical Center, MSKCC, New York
| | - D. Feldman
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
| | - E. Sherman
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
| | - J. Rosenberg
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
| | - G. D’Andrea
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
| | - S. Baxi
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
| | - Y. Janjigian
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
| | - W. Tap
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
| | - M. Dickler
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
| | - J. Baselga
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
- Human Oncology and Pathogenesis Program
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology
| | - B. S. Taylor
- Human Oncology and Pathogenesis Program
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology
- Department of Epidemiology and Biostatistics
| | - D. Chakravarty
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology
| | - J. Gao
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology
| | - N. Schultz
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology
- Department of Epidemiology and Biostatistics
| | - D. B. Solit
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
- Human Oncology and Pathogenesis Program
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology
| | - M. F. Berger
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology
- Department of Pathology, MSKCC, New York, USA
| | - D. M. Hyman
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
| |
Collapse
|
19
|
Wong SC, Yeo I, Kim L, Feldman D, Singh H, Minutello R, Bergman J. THE INFLUENCE OF GENDER ON IN-HOSPITAL CLINICAL OUTCOMES IN HISPANICS FOLLOWING SURGICAL AND TRANSCATHETER AORTIC VALVE REPLACEMENT. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)34597-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
20
|
Ullal A, Kampaktsis P, Swaminathan R, Wong SC, Minutello R, Feldman D, Bergman G, Kim L, Singh H, Okin P. BASELINE ABSENCE OF ELECTROCARDIOGRAPHIC LEFT VENTRICULAR HYPERTROPHY IS ASSOCIATED WITH INCREASED MORTALITY AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)34432-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
21
|
Tong CWC, Madhur M, Rzeszut A, Valente AM, Hira R, Leung S, Bubor Y, Feldman D, Abudayyeh I, Turner M, Spatz E, Gopinathannair R, Freeman A. STATUS OF EARLY CAREER ACADEMIC CARDIOLOGY: A GLOBAL PERSPECTIVE. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)35921-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
22
|
Marmagkiolis K, Mustapha J, Montero-Baker M, Charitakis K, Iliescu C, Feldman D, Cilingiroglu M. SAFETY AND EFFICACY OF TRANSPEDAL ACCESS FOR THE MANAGEMENT OF COMPLEX PERIPHERAL ARTERIAL DISEASE. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)34393-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
23
|
Voudris KV, Devereux RB, Feldman D, Minutello R, Kim L, Singh H, Bergman G, Salemi A, Wong SC. PERIPROCEDURAL BLOOD TRANSFUSIONS IN PATIENTS UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)34681-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
24
|
Yeo I, Kim L, Singh H, Feldman D, Minutello R, Bergman G, Wong SC. IN-HOSPITAL CLINICAL OUTCOMES FOLLOWING CONCOMITANT CORONARY ARTERY BYPASS GRAFT AND HEART VALVE SURGERY IN WOMEN. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)35382-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
25
|
Wong SC, Yeo I, Kim L, Singh H, Minutello R, Bergman J, Feldman D. THE IMPACT OF GENDER ON IN-HOSPITAL CLINICAL OUTCOMES FOLLOWING ISOLATED MITRAL OR AORTIC HEART VALVE SURGERY. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)35329-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
26
|
Voudris K, Devereux R, Feldman D, Minutello R, Kim L, Singh H, Bergman G, Salemi A, Wong SC. CRT-800.19 Outcomes of Intra Aortic Balloon Pump use in Surgical and Transcatheter Aortic Valve Replacement. JACC Cardiovasc Interv 2017. [DOI: 10.1016/j.jcin.2016.12.226] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
27
|
Yu HA, Sima C, Feldman D, Liu LL, Vaitheesvaran B, Cross J, Rudin CM, Kris MG, Pao W, Michor F, Riely GJ. Phase 1 study of twice weekly pulse dose and daily low-dose erlotinib as initial treatment for patients with EGFR-mutant lung cancers. Ann Oncol 2017; 28:278-284. [PMID: 28073786 PMCID: PMC5834093 DOI: 10.1093/annonc/mdw556] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Patients with EGFR-mutant lung cancers treated with EGFR tyrosine kinase inhibitors (TKIs) develop clinical resistance, most commonly with acquisition of EGFR T790M. Evolutionary modeling suggests that a schedule of twice weekly pulse and daily low-dose erlotinib may delay emergence of EGFR T790M. Pulse dose erlotinib has superior central nervous system (CNS) penetration and may result in superior CNS disease control. Methods We evaluated toxicity, pharmacokinetics, and efficacy of twice weekly pulse and daily low-dose erlotinib. We assessed six escalating pulse doses of erlotinib. Results We enrolled 34 patients; 11 patients (32%) had brain metastases at study entry. We observed 3 dose-limiting toxicities in dose escalation: transaminitis, mucositis, and rash. The MTD was erlotinib 1200 mg days 1-2 and 50 mg days 3-7 weekly. The most frequent toxicities (any grade) were rash, diarrhea, nausea, fatigue, and mucositis. 1 complete and 24 partial responses were observed (74%, 95% CI 60-84%). Median progression-free survival was 9.9 months (95% CI 5.8-15.4 months). No patient had progression of an untreated CNS metastasis or developed a new CNS lesion while on study (0%, 95% CI 0-13%). Of the 18 patients with biopsies at progression, EGFR T790M was identified in 78% (95% CI 54-91%). Conclusion This is the first clinical implementation of an anti-cancer TKI regimen combining pulse and daily low-dose administration. This evolutionary modeling-based dosing schedule was well-tolerated but did not improve progression-free survival or prevent emergence of EGFR T790M, likely due to insufficient peak serum concentrations of erlotinib. This dosing schedule prevented progression of untreated or any new central nervous system metastases in all patients.
Collapse
Affiliation(s)
- H. A. Yu
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York
- Weill Cornell Medical College, New York
| | - C. Sima
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York
| | - D. Feldman
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York
| | - L. L. Liu
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - B. Vaitheesvaran
- Donald B. and Catherine C. Marron Cancer Metabolism Center, Sloan Kettering Institute, Sloan Kettering Cancer Center, New York
| | - J. Cross
- Donald B. and Catherine C. Marron Cancer Metabolism Center, Sloan Kettering Institute, Sloan Kettering Cancer Center, New York
| | - C. M. Rudin
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York
- Weill Cornell Medical College, New York
| | - M. G. Kris
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York
- Weill Cornell Medical College, New York
| | - W. Pao
- Department of Medicine, Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - F. Michor
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - G. J. Riely
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York
- Weill Cornell Medical College, New York
| |
Collapse
|
28
|
Wong SC, Voudris K, Bergman G, Minutello R, Devereux R, Swaminathan R, Singh H, Feldman D, Kim L, Salemi A. TCT-709 Trans-apical Transcatheter Aortic Valve Replacement in Patients with History of Coronary Artery Bypass Grafting: An Analysis from the National Inpatient Sample Database. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.122] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
29
|
Voudris K, Devereux R, Feldman D, Minutello R, Kim L, Swaminathan R, Singh H, Bergman G, Salemi A, Wong SC. TCT-745 In-Hospital Clinical Outcomes Post Transcatheter Aortic Valve Replacement (TAVR) in Patients with History of Non-Cardiac Transplantation: Insights from the National Inpatient Sample (NIS) Database. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.158] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
30
|
Kim L, Minutello R, Feldman D, Swaminathan R, Bergman G, Singh H, Wong SC. TCT-700 Impact of Gender on Procedural Outcomes Following Surgical and Transcatheter Aortic Valve Replacement in the United States. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.113] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
31
|
Goyal P, Paul T, Almarzooq ZI, Swaminathan R, Feldman D, Peterson J, Karas M, Sobol I, Horn E, Kim L. CHARACTERIZATION AND IMPACT OF COMORBIDITY AMONG GENDER AND RACIAL SUBGROUPS HOSPITALIZED WITH HEART FAILURE WITH PRESERVED EJECTION FRACTION. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)31464-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
32
|
Walsh B, Clayton L, Feldman D. 103 Does Video-Assisted Laryngoscopy Improve Outcomes in Cardiac Arrest Patients Who Are Intubated Out-of-Hospital? Ann Emerg Med 2015. [DOI: 10.1016/j.annemergmed.2015.07.135] [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: 10/23/2022]
|
33
|
Barzilay S, Feldman D, Snir A, Apter A, Carli V, Hoven CW, Wasserman C, Sarchiapone M, Wasserman D. The interpersonal theory of suicide and adolescent suicidal behavior. J Affect Disord 2015; 183:68-74. [PMID: 26001665 DOI: 10.1016/j.jad.2015.04.047] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [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: 01/15/2015] [Revised: 04/25/2015] [Accepted: 04/27/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Joiner's interpersonal theory of suicide (IPTS) proposes that suicide results from the combination of a perception of burdening others, social alienation, and the capability for self-harm. The theory gained some empirical support, however the overall model has yet to be tested. This study aimed to test the main predictions of IPTS in a large community sample of Israeli adolescents. METHOD 1196 Israeli Jewish and Arab high-school pupils participating in the SEYLE project completed a self-report questionnaire measuring perceived burdensomeness, thwarted belongingness, health risk behaviors, and non-suicidal self-injury (risk variables), and suicidal ideation and suicide attempts (outcome measures). The data were tested in cross-sectional regression models. RESULTS Consistent with IPTS, perceived burdensomeness was found to interact with thwarted belongingness, predicting suicidal ideation. Depression mediated most of the effect of thwarted belongingness and perceived burdensomeness on suicidal ideation. Acquired capability for self-harm, as measured by health risk behaviors and direct non-suicidal self-injurious behaviors, predicted suicide attempt. However, this mechanism operated independently from ideation rather than in interaction with it, at variance with IPTS-based predictions. LIMITATIONS The cross-sectional design precludes conclusions about causality and directionality. Proxy measures were used to test the interpersonal theory constructs. CONCLUSION The findings support some of the IPTS predictions but not all, and imply two separate pathways for suicidal behavior in adolescents: one related to internalizing psychopathology and the other to self-harm behaviors. This conceptualization has clinical implications for the differential identification of adolescents at risk for suicidal behavior and for the development of prevention strategies.
Collapse
Affiliation(s)
- S Barzilay
- Feinberg Child Study Centre, Schneider Children's Medical Center, Petach Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Psychology, Bar Ilan University, Ramat Gan, Israel.
| | - D Feldman
- Feinberg Child Study Centre, Schneider Children's Medical Center, Petach Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Psychology, Bar Ilan University, Ramat Gan, Israel
| | - A Snir
- Feinberg Child Study Centre, Schneider Children's Medical Center, Petach Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Psychology, Bar Ilan University, Ramat Gan, Israel
| | - A Apter
- Feinberg Child Study Centre, Schneider Children's Medical Center, Petach Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - V Carli
- National Center for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
| | - C W Hoven
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - C Wasserman
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA; Department of Health Sciences, University of Molise, Campobasso, Italy
| | - M Sarchiapone
- Department of Health Sciences, University of Molise, Campobasso, Italy; National Institute for Health, Migration and Poverty (NIHMP), Rome, Italy "d'Annunzio University" Foundation, Chieti, Italy
| | - D Wasserman
- National Center for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
| |
Collapse
|
34
|
Voudris K, Chanin J, Feldman D, Charitakis K. Novel Inflammatory Biomarkers in Coronary Artery Disease: Potential Therapeutic Approaches. Curr Med Chem 2015; 22:2680-9. [DOI: 10.2174/0929867322666150420124427] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Revised: 01/27/2015] [Accepted: 04/16/2015] [Indexed: 11/22/2022]
|
35
|
Widdifield J, Moura C, Wang Y, Abrahamowicz M, Beauchamp ME, Paterson M, Huang A, Boire G, Fortin P, Bessette L, Bombardier C, Hanly J, Feldman D, Bernatsky S. OP0020 The Influence of Drug Exposures on Joint Surgeries in Rheumatoid Arthritis Patients: Cross-Provincial Comparisons. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
36
|
Chanin J, Feldman D, Swaminathan R, Minutello R, Jones J, Xu S, Bergman G, Kaple R, Ghosh B, Alaref S, Singh H, Wong SC, Kim L. OUTCOMES IN PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING BASED ON HOSPITAL VOLUME, 2007-2011. J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)61657-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
37
|
Voudris K, Avgerinos DV, Feldman D, Charitakis K. Hybrid Coronary Revascularization: Present Indications and Future Perspective. Curr Treat Options Cardio Med 2015; 17:364. [DOI: 10.1007/s11936-015-0364-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
38
|
Kobashigawa JA, Johnson M, Rogers J, Vega JD, Colvin-Adams M, Edwards L, Meyer D, Luu M, Reinsmoen N, Dipchand AI, Feldman D, Kormos R, Mancini D, Webber S. Report from a forum on US heart allocation policy. Am J Transplant 2015; 15:55-63. [PMID: 25534656 DOI: 10.1111/ajt.13033] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 07/23/2014] [Accepted: 08/03/2014] [Indexed: 01/25/2023]
Abstract
Since the latest revision in US heart allocation policy (2006), the landscape and volume of transplant waitlists have changed considerably. Advances in mechanical circulatory support (MCS) prolong survival, but Status 1A mortality remains high. Several patient subgroups may be disadvantaged by current listing criteria and geographical disparity remains in waitlist time. This forum on US heart allocation policy was organized to discuss these issues and highlight concepts for consideration in the policy development process. A 25-question survey on heart allocation policy was conducted. Among attendees/respondents were 84 participants with clinical/published experience in heart transplant representing 51 US transplant centers, and OPTN/UNOS and SRTR representatives. The survey results and forum discussions demonstrated very strong interest in change to a further-tiered system, accounting for disadvantaged subgroups and lowering use of exceptions. However, a heart allocation score is not yet viable due to the long-term viability of variables (used in the score) in an ever-developing field. There is strong interest in more refined prioritization of patients with MCS complications, highly sensitized patients and those with severe arrhythmias or restrictive physiology. There is also strong interest in distribution by geographic boundaries modified according to population. Differences of opinion exist between small and large centers.
Collapse
|
39
|
Snelder N, Ploeger BA, Luttringer O, Rigel DF, Webb RL, Feldman D, Fu F, Beil M, Jin L, Stanski DR, Danhof M. PKPD modelling of the interrelationship between mean arterial BP, cardiac output and total peripheral resistance in conscious rats. Br J Pharmacol 2014; 169:1510-24. [PMID: 23849040 DOI: 10.1111/bph.12190] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [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: 10/03/2012] [Revised: 02/01/2013] [Accepted: 03/05/2013] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND PURPOSE The homeostatic control of arterial BP is well understood with changes in BP resulting from changes in cardiac output (CO) and/or total peripheral resistance (TPR). A mechanism-based and quantitative analysis of drug effects on this interrelationship could provide a basis for the prediction of drug effects on BP. Hence, we aimed to develop a mechanism-based pharmacokinetic-pharmacodynamic (PKPD) model in rats that could be used to characterize the effects of cardiovascular drugs with different mechanisms of action (MoA) on the interrelationship between BP, CO and TPR. EXPERIMENTAL APPROACH The cardiovascular effects of six drugs with diverse MoA, (amlodipine, fasudil, enalapril, propranolol, hydrochlorothiazide and prazosin) were characterized in spontaneously hypertensive rats. The rats were chronically instrumented with ascending aortic flow probes and/or aortic catheters/radiotransmitters for continuous recording of CO and/or BP. Data were analysed in conjunction with independent information on the time course of drug concentration using a mechanism-based PKPD modelling approach. KEY RESULTS By simultaneous analysis of the effects of six different compounds, the dynamics of the interrelationship between BP, CO and TPR were quantified. System-specific parameters could be distinguished from drug-specific parameters indicating that the model developed is drug-independent. CONCLUSIONS AND IMPLICATIONS A system-specific model characterizing the interrelationship between BP, CO and TPR was obtained, which can be used to quantify and predict the cardiovascular effects of a drug and to elucidate the MoA for novel compounds. Ultimately, the proposed PKPD model could be used to predict the effects of a particular drug on BP in humans based on preclinical data.
Collapse
Affiliation(s)
- N Snelder
- Division of Pharmacology, Leiden Academic Centre for Drug Research, Leiden, The Netherlands
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Kamran S, Chen Y, Wolden S, Feldman D, Sklar C, Yasui Y, Robison L, Stovall M, Neglia J, Oeffinger K. Risk of Testicular Cancer Following Childhood Cancer Testicular Radiation. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1458] [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: 11/24/2022]
|
41
|
Burmester G, Rubbert-Roth A, Cantagrel A, Hall S, Leszczynski P, Feldman D, Rangaraj M, Roane G, Ludivico C, Mysler E, Bennett M, Rowell L, Bao M. FRI0316 The Efficacy and Safety of Subcutaneous Tocilizumab versus Intravenous Tocilizumab in Combination with Traditional DMARDS in Patients with RA at Week 97 (SUMMACTA). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1347] [Citation(s) in RCA: 1] [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: 11/03/2022]
|
42
|
Moura C, Abrahamowicz M, Beauchamp ME, Lacaille D, Wang Y, Bombardier C, Widdifield J, Hanly J, Boire G, Feldman D, Maksymowych W, Peschken C, Barnabe C, Edworthy S, Fortin P, Bessette L, Behlouli H, Bernatsky S. THU0120 Is Early DMARD Use Associated with Less Joint Replacement Surgery? an Analysis of 5,199 Incident Rheumatoid Arthritis (RA) Patients. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3061] [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: 11/04/2022]
|
43
|
Sandoval Y, Sun B, Louis L, Samara M, Feldman D, Chavez I, Cabuay B, Zimbwa P, Bennett M, Hryniewicz K. Percutaneous Insertion of Veno-Arterial Extracorporeal Membrane Oxygenation Circuit in the Catherization Laboratory for Refractory Cardiogenic Shock Is Safe and Associated with Excellent Outcomes. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
44
|
Yang D, Haider M, Kim L, Swaminathan R, Charitakis K, Shah A, Kaple R, Minutello R, Singh H, Bergman G, Wong SC, Feldman D. IMPACT OF LONG-TERM STATIN THERAPY ON POST-PROCEDURAL CONTRAST-INDUCED NEPHROPATHY IN PATIENTS UNDERGOING NON-EMERGENCY PERCUTANEOUS CORONARY INTERVENTION. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)60219-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
45
|
Kaple RK, Haider MA, Schoenfeld MS, Pawar S, Kampaktsis P, Wilson S, Kim L, Feldman D, Swaminathan R, Bergman G, Minutello R, Devereux R, Salemi A, Krieger K, Horn E, Singh H, Wong SC, Lin F. RIGHT VENTRICULAR STROKE WORK INDEX AS PROGNOSTIC INDICATOR FOR POST-PROCEDURAL MORBIDITY AND 1-YEAR MORTALITY IN PATIENTS UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)60910-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
46
|
Kim L, Yang D, Swaminathan R, Lee MK, Okin P, Minutello R, Sun X, Charitakis K, Wong SC, Bergman G, Singh H, Allareddy V, Feldman D. COMPARISON OF TRENDS AND OUTCOMES OF CAROTID ARTERY STENTING AND ENDARTERECTOMY: AN ANALYSIS OF THE NATIONWIDE INPATIENT SAMPLE (2001-2010). J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)62055-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
47
|
Kim L, Wong SC, Yang D, Feldman D, Swaminathan R, Sun X, Lee MK, Charitakis K, Shah A, Bergman G, Singh H, Minutello R. EARLY U.S. EXPERIENCE OF TRANSFEMORAL TRASCATHTER AORTIC VALVE REPLACEMENT FROM THE NATIONAL INPATIENT SAMPLE REGISTRY. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)61930-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
48
|
Kaple RK, Pawar S, Schoenfeld MS, Haider MA, Kampaktsis P, Baduashvili A, Wilson S, Kim L, Swaminathan R, Feldman D, Singh H, Bergman G, Minutello R, Devereux R, Salemi A, Krieger K, Horn E, Wong SC, Lin F. IMPACT OF ETIOLOGY OF PULMONARY HYPERTENSION ON POST-PROCEDURAL MANAGEMENT AND OUTCOMES IN PATIENTS UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)61477-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
49
|
|
50
|
Burmester GR, Rubbert-Roth A, Cantagrel A, Hall S, Leszczynski P, Feldman D, Rangaraj MJ, Roane G, Ludivico C, Mysler E, Rowell L, Vranic I. SAT0105 Summacta: A Randomized, Double-Blind, Parallel Group Study of the Safety and Efficacy Of Tocilizumab SC Versus Tocilizumab IV, in Combination with Traditional Dmards in Patients With Moderate to Severe Ra. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-eular.1831] [Citation(s) in RCA: 1] [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: 11/03/2022]
|