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Shah M, Borquez AA, Cortez D, McCanta A, De Filippo P, Whitehill R, Imundo J, Moore JP, Sherwin E, Howard T, Rosenthal E, Kertesz N, Chang P, Madan N, Kutalek S, Hammond B, Janson CM, Ramesh Iyer V, Williams MR. Transcatheter Leadless Pacing in Children: A PACES Collaborative Study in the Real-World Setting. Circ Arrhythm Electrophysiol 2023; 16:e011447. [PMID: 37039017 DOI: 10.1161/circep.122.011447] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
BACKGROUND Transcatheter Leadless Pacemakers (TLP) are a safe and effective option for adults with pacing indications. These devices may be an alternative in pediatric patients and patients with congenital heart disease for whom repeated sternotomies, thoracotomies, or transvenous systems are unfavorable. However, exemption of children from clinical trials has created uncertainty over the indications, efficacy, and safety of TLP in the pediatric population. The objectives of this study are to evaluate clinical indications, procedural characteristics, electrical performance, and outcomes of TLP implantation in children. METHODS Retrospective data were collected from patients enrolled in the Pediatric and Congenital Electrophysiology Society TLP registry involving 15 centers. Patients ≤21 years of age who underwent Micra (Medtronic Inc, Minneapolis, MN) TLP implantation and had follow-up of ≥1 week were included in the study. RESULTS The device was successfully implanted in 62 of 63 registry patients (98%) at a mean age of 15±4.1 years and included 20 (32%) patients with congenital heart disease. The mean body weight at TLP implantation was 55±19 kg and included 8 patients ≤8 years of age and ≤30 kg in weight. TLP was implanted by femoral (n=55, 87%) and internal jugular (n=8, 12.6%) venous approaches. During a mean follow-up period of 9.5±5.3 months, there were 10 (16%) complications including one cardiac perforation/pericardial effusion, one nonocclusive femoral venous thrombus, and one retrieval and replacement of TLP due to high thresholds. There were no deaths, TLP infections, or device embolizations. Electrical parameters, including capture thresholds, R wave sensing, and pacing impedances, remained stable. CONCLUSIONS Initial results from the Pediatric and Congenital Electrophysiology Society TLP registry demonstrated a high level of successful Micra device implants via femoral and internal venous jugular approaches with stable electrical parameters and infrequent major complications. Long-term prospective data are needed to confirm the reproducibility of these initial findings.
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Affiliation(s)
- Maully Shah
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Children's Hospital of Philadelphia (M.S., C.M.J., V.R.I.)
| | - Alejandro A Borquez
- Department of Pediatrics, University of California, Rady Children's Hospital, San Diego (A.A.B., M.R.W.)
| | - Daniel Cortez
- Department of Pediatrics, University of Minnesota, Minneapolis (D.C.)
- Department of Pediatrics, University of California, Davis, Sacramento (D.C)
| | - Anthony McCanta
- Department of Pediatrics, University of California, Children's Hospital of Orange County, Irvine (A.M.)
| | - Paolo De Filippo
- Cardiovascular Department, Ospedale Papa Giovanni XXIII Hospital, Bergamo, Italy (P.D.F.)
| | - Robert Whitehill
- Department of Pediatrics, Emory University, Children's Healthcare of Atlanta, GA (R.W.)
| | - Jason Imundo
- Department of Pediatrics, Penn State Health Children's Hospital, Hershey, PA (J.I.)
| | - Jeremy P Moore
- Department of Pediatrics, University of California, Los Angeles, Mattel Children's Hospital (J.P.M.)
| | - Elizabeth Sherwin
- Department of Pediatrics, George Washington University School of Medicine, Children's National Medical Center, DC (E.S.)
| | - Taylor Howard
- Department of Pediatrics, Baylor University, Texas Children's Hospital, Houston (T.H.)
| | - Eric Rosenthal
- Evelina Children's Hospital, Guys & St Thomas' NHS Trust, London, United Kingdom (E.R.)
| | - Naomi Kertesz
- Department of Pediatrics, Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus (N.K.)
| | - Philip Chang
- Department of Pediatrics, University of Florida, Shands Children's Hospital, Gainesville (P.C.)
| | - Nandini Madan
- Department of Pediatrics, Drexel University College of Medicine, St. Christopher's Hospital of Children (N.M.)
| | - Steven Kutalek
- Department of Medicine, Drexel University College of Medicine, Philadelphia, PA (S.K.)
| | - Benjamin Hammond
- Department of Pediatrics, Lerner College of Medicine, Cleveland Clinic, OH (B.H.)
| | - Christopher M Janson
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Children's Hospital of Philadelphia (M.S., C.M.J., V.R.I.)
| | - V Ramesh Iyer
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Children's Hospital of Philadelphia (M.S., C.M.J., V.R.I.)
| | - Matthew R Williams
- Department of Pediatrics, University of California, Rady Children's Hospital, San Diego (A.A.B., M.R.W.)
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Sherwin E, Deter R, Joudi N, Trepman P, Lee W, El-Sayed YY, Girsen AI, Datoc I, Hintz SR, Blumenfeld YJ. Individualized growth assessment in pregnancies complicated by fetal gastroschisis. J Matern Fetal Neonatal Med 2021; 35:6842-6852. [PMID: 34098833 DOI: 10.1080/14767058.2021.1926976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Prenatal ultrasound (US) has been shown to overestimate the incidence of suspected fetal growth restriction (FGR) in gastroschisis cases. This is largely because of altered sonographic abdominal circumference (AC) measurements when comparing gastroschisis cases with population nomograms. Individualized Growth Assessment (IGA) evaluates fetal growth using serial US measurements that allow consideration of the growth potential for a given case. Our goal was to assess the utility of IGA for distinguishing normal and pathological fetal growth in gastroschisis cases. STUDY DESIGN Pregnancies with prenatally diagnosed fetal gastroschisis were managed and delivered at a single academic medical center. US fetal biometry including head circumference (HC), abdominal circumference (AC), and femur diaphysis length (FDL), and neonatal measurements including birthweight and HC were collected and analyzed for 32 consecutive fetal gastroschisis cases with at least two 2nd and two 3rd trimester measurements. Second trimester growth velocities were compared to a group of 118 non-anomalous fetuses with normal neonatal growth outcomes. Gastroschisis cases were classified into groups based on fetal growth pathology score (FGPS9) patterns. Agreement between IGA (FGPS9) and serial conventional estimated fetal weight (EFW) measurements for determining growth pathology was evaluated. Neonatal size outcomes were compared between conventional birthweight classifications for determining small for gestational age (SGA) and IGA Growth Potential Realization Index (GPRI) for weight and head circumference measurements. RESULTS Fetal growth pathology score (FGPS9) measurements identified three in-utero growth patterns: no growth pathology, growth restriction and recovery, and progressive growth restriction. In the no growth pathology group (n = 19), there was 84% agreement between IGA and conventional methods in determining pathological growth in both the 3rd trimester and at birth. In the growth restriction and recovery group (n = 7), there was 71% agreement both in the 3rd trimester and at birth between IGA and conventional methods. In the progressive growth restriction group (n = 5), there was 100% agreement in the 3rd trimester and 60% agreement at birth between IGA and conventional methods. CONCLUSION We present the first study using IGA to evaluate normal and pathological fetal growth in prenatally diagnosed gastroschisis cases. IGA was able to delineate two 3rd trimester growth pathology patterns - one with persistent growth restriction and another with in-utero growth recovery. Further validation of these initial findings with larger cohorts is warranted.
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Affiliation(s)
- Elizabeth Sherwin
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
| | - Russell Deter
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
| | - Noor Joudi
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
| | - Paula Trepman
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
| | - Wesley Lee
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
| | - Yasser Y El-Sayed
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
| | - Anna I Girsen
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
| | - Imee Datoc
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
| | - Susan R Hintz
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Yair J Blumenfeld
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
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Howard MB, Basu S, Sherwin E, Cohen JS. Triple threat: New presentation with diabetic ketoacidosis, COVID-19, and cardiac arrhythmias. Am J Emerg Med 2021; 49:437.e5-437.e8. [PMID: 33895040 PMCID: PMC8053600 DOI: 10.1016/j.ajem.2021.04.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 03/10/2021] [Revised: 04/15/2021] [Accepted: 04/15/2021] [Indexed: 12/28/2022] Open
Abstract
Patients with diabetes have increased susceptibility to infection with Severe acute respiratory syndrome-coronavirus 2 and increased morbidity and mortality from Coronavirus disease 2019 (COVID-19) infection. Mortality from COVID-19 is sometimes caused by cardiac arrhythmias. Electrolyte disturbances in patients with diabetic ketoacidosis (DKA) can increase the risk of cardiac arrhythmias. Despite these correlations, little has been reported about the co-incidence of these three conditions: COVID-19, DKA and cardiac arrhythmias. In this case report we describe two children with COVID-19, new-onset DKA and cardiac arrhythmias. These cases emphasize the importance of close cardiac and electrolyte monitoring in patients with COVID-19 infection.
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Affiliation(s)
| | - Sonali Basu
- Children's National Hospital, Washington, DC, United States; George Washington University School of Medicine and Health Sciences, United States
| | - Elizabeth Sherwin
- Children's National Hospital, Washington, DC, United States; George Washington University School of Medicine and Health Sciences, United States
| | - Joanna S Cohen
- Children's National Hospital, Washington, DC, United States; George Washington University School of Medicine and Health Sciences, United States.
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Sherwin E. Oncology team check. Br Dent J 2020; 229:762. [DOI: 10.1038/s41415-020-2519-1] [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] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Patterson E, Ryan PM, Wiley N, Carafa I, Sherwin E, Moloney G, Franciosi E, Mandal R, Wishart DS, Tuohy K, Ross RP, Cryan JF, Dinan TG, Stanton C. Gamma-aminobutyric acid-producing lactobacilli positively affect metabolism and depressive-like behaviour in a mouse model of metabolic syndrome. Sci Rep 2019; 9:16323. [PMID: 31704943 PMCID: PMC6841999 DOI: 10.1038/s41598-019-51781-x] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 09/20/2019] [Indexed: 12/22/2022] Open
Abstract
Metabolic and neuroactive metabolite production represents one of the mechanisms through which the gut microbiota can impact health. One such metabolite, gamma-aminobutyric acid (GABA), can modulate glucose homeostasis and alter behavioural patterns in the host. We previously demonstrated that oral administration of GABA-producing Lactobacillus brevis DPC6108 has the potential to increase levels of circulating insulin in healthy rats. Therefore, the objective of this study was to assess the efficacy of endogenous microbial GABA production in improving metabolic and behavioural outcomes in a mouse model of metabolic dysfunction. Diet-induced obese and metabolically dysfunctional mice received one of two GABA-producing strains, L. brevis DPC6108 or L. brevis DSM32386, daily for 12 weeks. After 8 and 10 weeks of intervention, the behavioural and metabolic profiles of the mice were respectively assessed. Intervention with both L. brevis strains attenuated several abnormalities associated with metabolic dysfunction, causing a reduction in the accumulation of mesenteric adipose tissue, increased insulin secretion following glucose challenge, improved plasma cholesterol clearance and reduced despair-like behaviour and basal corticosterone production during the forced swim test. Taken together, this exploratory dataset indicates that intervention with GABA-producing lactobacilli has the potential to improve metabolic and depressive- like behavioural abnormalities associated with metabolic syndrome in mice.
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Affiliation(s)
- E Patterson
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland
| | - P M Ryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland
| | - N Wiley
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland
| | - I Carafa
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland.,Department of Food Quality and Nutrition, Research and Innovation Centre-Fondazione Edmund Mach, San Michele all'Adige, Trento, Italy
| | - E Sherwin
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - G Moloney
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - E Franciosi
- Department of Food Quality and Nutrition, Research and Innovation Centre-Fondazione Edmund Mach, San Michele all'Adige, Trento, Italy
| | - R Mandal
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - D S Wishart
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada.,Department of Computing Science, University of Alberta, Edmonton, Alberta, Canada.,National Institute for Nanotechnology, Edmonton, Alberta, Canada
| | - K Tuohy
- Department of Food Quality and Nutrition, Research and Innovation Centre-Fondazione Edmund Mach, San Michele all'Adige, Trento, Italy
| | - R P Ross
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - J F Cryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - T G Dinan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork, Ireland
| | - C Stanton
- APC Microbiome Ireland, University College Cork, Cork, Ireland. .,Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland.
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6
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Velikova G, Williams LJ, Willis S, Dixon JM, Loncaster J, Hatton M, Clarke J, Kunkler IH, Russell NS, Alhasso A, Adamson D, Algurafi H, Allerton R, Anandadas C, Bahl A, Barraclough L, Barrett-Lee P, Barthakur U, Bedi C, Beresford M, Bishop J, Blackman G, Bliss P, Bloomfield D, Blunt M, Branson T, Brazil L, Brunt A, Chakrabarti A, Chittalie A, Churn M, Clarke J, Cleator S, Crellin P, Danwata F, De-Silva-Minor S, Dhadda A, Eicholz A, Fernando I, Forrest J, Fraser J, Geropantas K, Goodman A, Grieve R, Griffin M, Hadaki M, Hall A, Hatton M, Hicks J, Hignett S, Hogg M, Jyothirmayi R, Khan M, Kumar S, Lawton P, Lee D, Lewinski C, Lim C, Locke I, Loncaster J, Lumsden G, Lupton S, Magee B, Marshall J, Masinghe S, McGregor C, McLennan M, Memtsa P, Milanovic D, Misra V, Mithal N, Mukesh MB, Neal A, Needleman S, Persic M, Quigley M, Raj S, Riddle P, Ritchie D, Roberts F, Robson P, Roe H, Rolles M, Shah N, Sharma R, Sherwin E, Simmonds P, Skailles G, Skaria S, Soe W, Sripadam R, Stevens A, Stockdale A, Storey N, Storey N, Syndikus I, Thorp N, Thorp N, Upadhyay S, Varughese M, Walji N, Welch R, Wells T, Wolstenholme V, Wolstenholme V, Woodings P, Yuille F. Quality of life after postmastectomy radiotherapy in patients with intermediate-risk breast cancer (SUPREMO): 2-year follow-up results of a randomised controlled trial. Lancet Oncol 2018; 19:1516-1529. [DOI: 10.1016/s1470-2045(18)30515-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 06/29/2018] [Accepted: 07/02/2018] [Indexed: 11/12/2022]
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Tague L, Wiggs J, Li Q, McCarter R, Sherwin E, Weinberg J, Sable C. Comparison of Left Ventricular Hypertrophy by Electrocardiography and Echocardiography in Children Using Analytics Tool. Pediatr Cardiol 2018; 39:1378-1388. [PMID: 29774391 DOI: 10.1007/s00246-018-1907-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 01/17/2018] [Accepted: 05/08/2018] [Indexed: 12/16/2022]
Abstract
Left ventricular hypertrophy (LVH) is a common finding on pediatric electrocardiography (ECG) leading to many referrals for echocardiography (echo). This study utilizes a novel analytics tool that combines ECG and echo databases to evaluate ECG as a screening tool for LVH. SQL Server 2012 data warehouse incorporated ECG and echo databases for all patients from a single institution from 2006 to 2016. Customized queries identified patients 0-18 years old with LVH on ECG and an echo performed within 24 h. Using data visualization (Tableau) and analytic (Stata 14) software, ECG and echo findings were compared. Of 437,699 encounters, 4637 met inclusion criteria. ECG had high sensitivity (≥ 90%) but poor specificity (43%), and low positive predictive value (< 20%) for echo abnormalities. ECG performed only 11-22% better than chance (AROC = 0.50). 83% of subjects with LVH on ECG had normal left ventricle (LV) structure and size on echo. African-Americans with LVH were least likely to have an abnormal echo. There was a low correlation between V6R on ECG and echo-derived Z score of left ventricle diastolic diameter (r = 0.14) and LV mass index (r = 0.24). The data analytics client was able to mine a database of ECG and echo reports, comparing LVH by ECG and LV measurements and qualitative findings by echo, identifying an abnormal LV by echo in only 17% of cases with LVH on ECG. This novel tool is useful for rapid data mining for both clinical and research endeavors.
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Affiliation(s)
- Lauren Tague
- Division of Cardiology, Children's National Health System, Washington, DC, USA.
- Department of Cardiology, Children's National Health System, 111 Michigan Avenue NW, Suite WW3-200, Washington, DC, 20010, USA.
| | - Justin Wiggs
- Division of Cardiology, Children's National Health System, Washington, DC, USA
| | - Qianxi Li
- Philips Research North America, Cambridge, MA, USA
| | - Robert McCarter
- Division of Biostatistics and Study Methods, Children's National Health System, Washington, DC, USA
| | - Elizabeth Sherwin
- Division of Cardiology, Children's National Health System, Washington, DC, USA
| | - Jacqueline Weinberg
- Division of Cardiology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
| | - Craig Sable
- Division of Cardiology, Children's National Health System, Washington, DC, USA
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8
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Cunningham T, Uzun O, Morris R, Franciosi S, Wong A, Jeremiasen I, Sherwin E, Sanatani S. The Safety and Effectiveness of Flecainide in Children in the Current Era. Pediatr Cardiol 2017; 38:1633-1638. [PMID: 28840327 DOI: 10.1007/s00246-017-1707-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 04/28/2017] [Accepted: 08/09/2017] [Indexed: 01/24/2023]
Abstract
This retrospective study sought to determine the safety and effectiveness of flecainide in children with normal hearts and those with congenital heart disease (CHD) or cardiomyopathy (CMO). Baseline and follow-up data at two pediatric cardiology sites were queried (2000-2015); a total of 175 patients (20 with CHD and two with CMO) receiving flecainide were assessed. When comparing patients with CHD to those with normal hearts, patients with CHD were younger at diagnosis (median age 19 days; IQR 3-157.5 days vs normal heart patients median age 21 days; IQR 7-172 days, p = 0.4) and severe cardiac dysfunction was more prevalent (30% in CHD patients vs 8% in normal heart patients, p = 0.009). Treatment duration did not differ between the two groups (CHD patients median duration 52 weeks; IQR 27-91.5 weeks vs normal heart patients median duration 55 weeks; IQR 32-156 weeks, p = 0.5). Cardiac dysfunction resulting in flecainide discontinuation occurred in two patients (1%), one with CHD and one without. Three patients experienced proarrhythmia (2%) and there were no cardiac arrests during follow-up. There was one death in this cohort in a patient with severe CHD and an RSV infection (<1%). Arrhythmia control did not differ between the groups (90% in CHD patients vs 77% in normal heart patients, p = 0.2). Flecainide was well tolerated in this cohort, with fewer than 3% discontinuing medication due to flecainide-associated adverse events. Contrary to adult studies, there was no difference in the incidence of adverse events between patients with normal hearts and patients with CHD. Flecainide is a safe and effective antiarrhythmic medication, even for children with underlying CHD.
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Affiliation(s)
- Taylor Cunningham
- Children's Heart Centre, British Columbia's Children's Hospital, 1F9, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada
| | - Orhan Uzun
- Children's Heart Centre, British Columbia's Children's Hospital, 1F9, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.,Department of Pediatric Cardiology, Noah's Ark Children's Hospital for Wales, University Hospital of Wales, Cardiff, Wales, UK
| | - Rachel Morris
- Department of Pediatric Cardiology, Noah's Ark Children's Hospital for Wales, University Hospital of Wales, Cardiff, Wales, UK
| | - Sonia Franciosi
- Children's Heart Centre, British Columbia's Children's Hospital, 1F9, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada
| | - Amos Wong
- Department of Pediatric Cardiology, Noah's Ark Children's Hospital for Wales, University Hospital of Wales, Cardiff, Wales, UK
| | - Ida Jeremiasen
- Department of Pediatric Cardiology, Noah's Ark Children's Hospital for Wales, University Hospital of Wales, Cardiff, Wales, UK
| | - Elizabeth Sherwin
- Children's Heart Centre, British Columbia's Children's Hospital, 1F9, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.,Division of Cardiology, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.,Division of Cardiology, Department of Pediatrics, Children's National Health System, George Washington School of Medicine, Washington, DC, USA
| | - Shubhayan Sanatani
- Children's Heart Centre, British Columbia's Children's Hospital, 1F9, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada. .,Division of Cardiology, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
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9
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Swayne LA, Murphy NP, Asuri S, Chen L, Xu X, McIntosh S, Wang C, Lancione PJ, Roberts JD, Kerr C, Sanatani S, Sherwin E, Kline CF, Zhang M, Mohler PJ, Arbour LT. Novel Variant in the ANK2 Membrane-Binding Domain Is Associated With Ankyrin-B Syndrome and Structural Heart Disease in a First Nations Population With a High Rate of Long QT Syndrome. ACTA ACUST UNITED AC 2017; 10:CIRCGENETICS.116.001537. [PMID: 28196901 DOI: 10.1161/circgenetics.116.001537] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 06/09/2016] [Accepted: 11/21/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND Long QT syndrome confers susceptibility to ventricular arrhythmia, predisposing to syncope, seizures, and sudden death. While rare globally, long QT syndrome is ≈15× more common in First Nations of Northern British Columbia largely because of a known mutation in KCNQ1. However, 2 large multigenerational families were affected, but negative for the known mutation. METHODS AND RESULTS Long QT syndrome panel testing was carried out in the index case of each family, and clinical information was collected. Cascade genotyping was performed. Biochemical and myocyte-based assays were performed to evaluate the identified gene variant for loss-of-function activity. Index cases in these 2 families harbored a novel ANK2 c.1937C>T variant (p.S646F). An additional 16 carriers were identified, including 2 with structural heart disease: one with cardiomyopathy resulting in sudden death and the other with congenital heart disease. For all carriers of this variant, the average QTc was 475 ms (±40). Although ankyrin-B p.S646F is appropriately folded and expressed in bacteria, the mutant polypeptide displays reduced expression in cultured H9c2 cells and aberrant localization in primary cardiomyocytes. Furthermore, myocytes expressing ankyrin-B p.S646F lack normal membrane targeting of the ankyrin-binding partner, the Na/Ca exchanger. Thus, ankyrin-B p.S646F is a loss-of-function variant. CONCLUSIONS We identify the first disease-causing ANK2 variant localized to the membrane-binding domain resulting in reduced ankyrin-B expression and abnormal localization. Further study is warranted on the potential association of this variant with structural heart disease given the role of ANK2 in targeting and stabilization of key structural and signaling molecules in cardiac cells.
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Affiliation(s)
- Leigh Anne Swayne
- From the Division of Medical Sciences, University of Victoria, BC, Canada (L.A.S., L.C., X.X., L.T.A.); University of British Columbia Island Medical Program, Victoria, BC, Canada (L.A.S., L.T.A.); Department of Medical Genetics (S.A., S.M., L.T.A.), Division of Cardiology (C.K.), and Division of Cardiology, Department of Pediatrics, BC Children's Hospital (S.S., E.S.), University of British Columbia, Vancouver, BC, Canada; Division of Cardiovascular Medicine, Department of Internal Medicine, Dorothy M. Davis Heart and Lung Research Institute (N.P.M., P.J.L., C.F.K., P.J.M.) and Department of Physiology and Cell Biology (N.P.M., P.J.L., C.F.K., P.J.M.), The Ohio State University Wexner Medical Center, Columbus, OH; Division of Life Science, State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China (C.W., M.Z.); and Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, ON, Canada (J.D.R.)
| | - Nathaniel P Murphy
- From the Division of Medical Sciences, University of Victoria, BC, Canada (L.A.S., L.C., X.X., L.T.A.); University of British Columbia Island Medical Program, Victoria, BC, Canada (L.A.S., L.T.A.); Department of Medical Genetics (S.A., S.M., L.T.A.), Division of Cardiology (C.K.), and Division of Cardiology, Department of Pediatrics, BC Children's Hospital (S.S., E.S.), University of British Columbia, Vancouver, BC, Canada; Division of Cardiovascular Medicine, Department of Internal Medicine, Dorothy M. Davis Heart and Lung Research Institute (N.P.M., P.J.L., C.F.K., P.J.M.) and Department of Physiology and Cell Biology (N.P.M., P.J.L., C.F.K., P.J.M.), The Ohio State University Wexner Medical Center, Columbus, OH; Division of Life Science, State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China (C.W., M.Z.); and Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, ON, Canada (J.D.R.)
| | - Sirisha Asuri
- From the Division of Medical Sciences, University of Victoria, BC, Canada (L.A.S., L.C., X.X., L.T.A.); University of British Columbia Island Medical Program, Victoria, BC, Canada (L.A.S., L.T.A.); Department of Medical Genetics (S.A., S.M., L.T.A.), Division of Cardiology (C.K.), and Division of Cardiology, Department of Pediatrics, BC Children's Hospital (S.S., E.S.), University of British Columbia, Vancouver, BC, Canada; Division of Cardiovascular Medicine, Department of Internal Medicine, Dorothy M. Davis Heart and Lung Research Institute (N.P.M., P.J.L., C.F.K., P.J.M.) and Department of Physiology and Cell Biology (N.P.M., P.J.L., C.F.K., P.J.M.), The Ohio State University Wexner Medical Center, Columbus, OH; Division of Life Science, State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China (C.W., M.Z.); and Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, ON, Canada (J.D.R.)
| | - Lena Chen
- From the Division of Medical Sciences, University of Victoria, BC, Canada (L.A.S., L.C., X.X., L.T.A.); University of British Columbia Island Medical Program, Victoria, BC, Canada (L.A.S., L.T.A.); Department of Medical Genetics (S.A., S.M., L.T.A.), Division of Cardiology (C.K.), and Division of Cardiology, Department of Pediatrics, BC Children's Hospital (S.S., E.S.), University of British Columbia, Vancouver, BC, Canada; Division of Cardiovascular Medicine, Department of Internal Medicine, Dorothy M. Davis Heart and Lung Research Institute (N.P.M., P.J.L., C.F.K., P.J.M.) and Department of Physiology and Cell Biology (N.P.M., P.J.L., C.F.K., P.J.M.), The Ohio State University Wexner Medical Center, Columbus, OH; Division of Life Science, State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China (C.W., M.Z.); and Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, ON, Canada (J.D.R.)
| | - Xiaoxue Xu
- From the Division of Medical Sciences, University of Victoria, BC, Canada (L.A.S., L.C., X.X., L.T.A.); University of British Columbia Island Medical Program, Victoria, BC, Canada (L.A.S., L.T.A.); Department of Medical Genetics (S.A., S.M., L.T.A.), Division of Cardiology (C.K.), and Division of Cardiology, Department of Pediatrics, BC Children's Hospital (S.S., E.S.), University of British Columbia, Vancouver, BC, Canada; Division of Cardiovascular Medicine, Department of Internal Medicine, Dorothy M. Davis Heart and Lung Research Institute (N.P.M., P.J.L., C.F.K., P.J.M.) and Department of Physiology and Cell Biology (N.P.M., P.J.L., C.F.K., P.J.M.), The Ohio State University Wexner Medical Center, Columbus, OH; Division of Life Science, State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China (C.W., M.Z.); and Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, ON, Canada (J.D.R.)
| | - Sarah McIntosh
- From the Division of Medical Sciences, University of Victoria, BC, Canada (L.A.S., L.C., X.X., L.T.A.); University of British Columbia Island Medical Program, Victoria, BC, Canada (L.A.S., L.T.A.); Department of Medical Genetics (S.A., S.M., L.T.A.), Division of Cardiology (C.K.), and Division of Cardiology, Department of Pediatrics, BC Children's Hospital (S.S., E.S.), University of British Columbia, Vancouver, BC, Canada; Division of Cardiovascular Medicine, Department of Internal Medicine, Dorothy M. Davis Heart and Lung Research Institute (N.P.M., P.J.L., C.F.K., P.J.M.) and Department of Physiology and Cell Biology (N.P.M., P.J.L., C.F.K., P.J.M.), The Ohio State University Wexner Medical Center, Columbus, OH; Division of Life Science, State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China (C.W., M.Z.); and Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, ON, Canada (J.D.R.)
| | - Chao Wang
- From the Division of Medical Sciences, University of Victoria, BC, Canada (L.A.S., L.C., X.X., L.T.A.); University of British Columbia Island Medical Program, Victoria, BC, Canada (L.A.S., L.T.A.); Department of Medical Genetics (S.A., S.M., L.T.A.), Division of Cardiology (C.K.), and Division of Cardiology, Department of Pediatrics, BC Children's Hospital (S.S., E.S.), University of British Columbia, Vancouver, BC, Canada; Division of Cardiovascular Medicine, Department of Internal Medicine, Dorothy M. Davis Heart and Lung Research Institute (N.P.M., P.J.L., C.F.K., P.J.M.) and Department of Physiology and Cell Biology (N.P.M., P.J.L., C.F.K., P.J.M.), The Ohio State University Wexner Medical Center, Columbus, OH; Division of Life Science, State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China (C.W., M.Z.); and Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, ON, Canada (J.D.R.)
| | - Peter J Lancione
- From the Division of Medical Sciences, University of Victoria, BC, Canada (L.A.S., L.C., X.X., L.T.A.); University of British Columbia Island Medical Program, Victoria, BC, Canada (L.A.S., L.T.A.); Department of Medical Genetics (S.A., S.M., L.T.A.), Division of Cardiology (C.K.), and Division of Cardiology, Department of Pediatrics, BC Children's Hospital (S.S., E.S.), University of British Columbia, Vancouver, BC, Canada; Division of Cardiovascular Medicine, Department of Internal Medicine, Dorothy M. Davis Heart and Lung Research Institute (N.P.M., P.J.L., C.F.K., P.J.M.) and Department of Physiology and Cell Biology (N.P.M., P.J.L., C.F.K., P.J.M.), The Ohio State University Wexner Medical Center, Columbus, OH; Division of Life Science, State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China (C.W., M.Z.); and Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, ON, Canada (J.D.R.)
| | - Jason D Roberts
- From the Division of Medical Sciences, University of Victoria, BC, Canada (L.A.S., L.C., X.X., L.T.A.); University of British Columbia Island Medical Program, Victoria, BC, Canada (L.A.S., L.T.A.); Department of Medical Genetics (S.A., S.M., L.T.A.), Division of Cardiology (C.K.), and Division of Cardiology, Department of Pediatrics, BC Children's Hospital (S.S., E.S.), University of British Columbia, Vancouver, BC, Canada; Division of Cardiovascular Medicine, Department of Internal Medicine, Dorothy M. Davis Heart and Lung Research Institute (N.P.M., P.J.L., C.F.K., P.J.M.) and Department of Physiology and Cell Biology (N.P.M., P.J.L., C.F.K., P.J.M.), The Ohio State University Wexner Medical Center, Columbus, OH; Division of Life Science, State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China (C.W., M.Z.); and Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, ON, Canada (J.D.R.)
| | - Charles Kerr
- From the Division of Medical Sciences, University of Victoria, BC, Canada (L.A.S., L.C., X.X., L.T.A.); University of British Columbia Island Medical Program, Victoria, BC, Canada (L.A.S., L.T.A.); Department of Medical Genetics (S.A., S.M., L.T.A.), Division of Cardiology (C.K.), and Division of Cardiology, Department of Pediatrics, BC Children's Hospital (S.S., E.S.), University of British Columbia, Vancouver, BC, Canada; Division of Cardiovascular Medicine, Department of Internal Medicine, Dorothy M. Davis Heart and Lung Research Institute (N.P.M., P.J.L., C.F.K., P.J.M.) and Department of Physiology and Cell Biology (N.P.M., P.J.L., C.F.K., P.J.M.), The Ohio State University Wexner Medical Center, Columbus, OH; Division of Life Science, State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China (C.W., M.Z.); and Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, ON, Canada (J.D.R.)
| | - Shubhayan Sanatani
- From the Division of Medical Sciences, University of Victoria, BC, Canada (L.A.S., L.C., X.X., L.T.A.); University of British Columbia Island Medical Program, Victoria, BC, Canada (L.A.S., L.T.A.); Department of Medical Genetics (S.A., S.M., L.T.A.), Division of Cardiology (C.K.), and Division of Cardiology, Department of Pediatrics, BC Children's Hospital (S.S., E.S.), University of British Columbia, Vancouver, BC, Canada; Division of Cardiovascular Medicine, Department of Internal Medicine, Dorothy M. Davis Heart and Lung Research Institute (N.P.M., P.J.L., C.F.K., P.J.M.) and Department of Physiology and Cell Biology (N.P.M., P.J.L., C.F.K., P.J.M.), The Ohio State University Wexner Medical Center, Columbus, OH; Division of Life Science, State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China (C.W., M.Z.); and Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, ON, Canada (J.D.R.)
| | - Elizabeth Sherwin
- From the Division of Medical Sciences, University of Victoria, BC, Canada (L.A.S., L.C., X.X., L.T.A.); University of British Columbia Island Medical Program, Victoria, BC, Canada (L.A.S., L.T.A.); Department of Medical Genetics (S.A., S.M., L.T.A.), Division of Cardiology (C.K.), and Division of Cardiology, Department of Pediatrics, BC Children's Hospital (S.S., E.S.), University of British Columbia, Vancouver, BC, Canada; Division of Cardiovascular Medicine, Department of Internal Medicine, Dorothy M. Davis Heart and Lung Research Institute (N.P.M., P.J.L., C.F.K., P.J.M.) and Department of Physiology and Cell Biology (N.P.M., P.J.L., C.F.K., P.J.M.), The Ohio State University Wexner Medical Center, Columbus, OH; Division of Life Science, State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China (C.W., M.Z.); and Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, ON, Canada (J.D.R.)
| | - Crystal F Kline
- From the Division of Medical Sciences, University of Victoria, BC, Canada (L.A.S., L.C., X.X., L.T.A.); University of British Columbia Island Medical Program, Victoria, BC, Canada (L.A.S., L.T.A.); Department of Medical Genetics (S.A., S.M., L.T.A.), Division of Cardiology (C.K.), and Division of Cardiology, Department of Pediatrics, BC Children's Hospital (S.S., E.S.), University of British Columbia, Vancouver, BC, Canada; Division of Cardiovascular Medicine, Department of Internal Medicine, Dorothy M. Davis Heart and Lung Research Institute (N.P.M., P.J.L., C.F.K., P.J.M.) and Department of Physiology and Cell Biology (N.P.M., P.J.L., C.F.K., P.J.M.), The Ohio State University Wexner Medical Center, Columbus, OH; Division of Life Science, State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China (C.W., M.Z.); and Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, ON, Canada (J.D.R.)
| | - Mingjie Zhang
- From the Division of Medical Sciences, University of Victoria, BC, Canada (L.A.S., L.C., X.X., L.T.A.); University of British Columbia Island Medical Program, Victoria, BC, Canada (L.A.S., L.T.A.); Department of Medical Genetics (S.A., S.M., L.T.A.), Division of Cardiology (C.K.), and Division of Cardiology, Department of Pediatrics, BC Children's Hospital (S.S., E.S.), University of British Columbia, Vancouver, BC, Canada; Division of Cardiovascular Medicine, Department of Internal Medicine, Dorothy M. Davis Heart and Lung Research Institute (N.P.M., P.J.L., C.F.K., P.J.M.) and Department of Physiology and Cell Biology (N.P.M., P.J.L., C.F.K., P.J.M.), The Ohio State University Wexner Medical Center, Columbus, OH; Division of Life Science, State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China (C.W., M.Z.); and Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, ON, Canada (J.D.R.)
| | - Peter J Mohler
- From the Division of Medical Sciences, University of Victoria, BC, Canada (L.A.S., L.C., X.X., L.T.A.); University of British Columbia Island Medical Program, Victoria, BC, Canada (L.A.S., L.T.A.); Department of Medical Genetics (S.A., S.M., L.T.A.), Division of Cardiology (C.K.), and Division of Cardiology, Department of Pediatrics, BC Children's Hospital (S.S., E.S.), University of British Columbia, Vancouver, BC, Canada; Division of Cardiovascular Medicine, Department of Internal Medicine, Dorothy M. Davis Heart and Lung Research Institute (N.P.M., P.J.L., C.F.K., P.J.M.) and Department of Physiology and Cell Biology (N.P.M., P.J.L., C.F.K., P.J.M.), The Ohio State University Wexner Medical Center, Columbus, OH; Division of Life Science, State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China (C.W., M.Z.); and Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, ON, Canada (J.D.R.)
| | - Laura T Arbour
- From the Division of Medical Sciences, University of Victoria, BC, Canada (L.A.S., L.C., X.X., L.T.A.); University of British Columbia Island Medical Program, Victoria, BC, Canada (L.A.S., L.T.A.); Department of Medical Genetics (S.A., S.M., L.T.A.), Division of Cardiology (C.K.), and Division of Cardiology, Department of Pediatrics, BC Children's Hospital (S.S., E.S.), University of British Columbia, Vancouver, BC, Canada; Division of Cardiovascular Medicine, Department of Internal Medicine, Dorothy M. Davis Heart and Lung Research Institute (N.P.M., P.J.L., C.F.K., P.J.M.) and Department of Physiology and Cell Biology (N.P.M., P.J.L., C.F.K., P.J.M.), The Ohio State University Wexner Medical Center, Columbus, OH; Division of Life Science, State Key Laboratory of Molecular Neuroscience, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China (C.W., M.Z.); and Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, ON, Canada (J.D.R.).
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Gligorov J, Ataseven B, Verrill M, De Laurentiis M, Jung K, Azim H, Al-Sakaff N, Lauer S, Shing M, Pivot X, Koroveshi D, Bouzid K, Casalnuovo M, Cascallar D, Korbenfeld EP, Bastick P, Beith J, Colosimo M, Friedlander M, Ganju V, Green M, Patterson K, Redfern A, Richardson G, Ceric T, Gordana K, Beato CA, Ferrari M, Hegg R, Helena V, Ismael GF, Lessa AE, Mano M, Morelle A, Nogueira JA, Timcheva K, Tomova A, Tsakova M, Zlatareva-Petrova A, Asselah J, Assi H, Brezden-Masley C, Chia S, Freedman O, Harb M, Joy AA, Kulkarni S, Prady C, Gaete AAA, Matamala L, Torres R, Yanez E, Franco S, Urrego M, Gugić D, Vrbanec D, Melichar B, Prausová J, Vyzula R, Pilarte RG, León MI, Muñoz R, Ramos G, Azeem HA, Aziz AA, El Zawahry H, Osegueda FR, Alexandre J, Artignan X, Barletta H, Beguier E, Berdah JF, Marty CB, Bollet M, Bourgeois H, Bressac C, Burki F, Campone M, Coeffic D, Cojocarasu OZ, Dagada C, Dalenc F, Del Piano F, Desauw C, Desmoulins I, Dohollou N, Egreteau J, Ferrero JM, Foa C, Garidi R, Gasnault L, Gligorov J, Guardiola E, Hamizi S, Jarcau R, Jacquin JP, Jaubert D, Jolimoy G, Mineur HL, Largillier R, Leduc B, Martin P, Melis A, Monge J, Moullet I, Mousseau M, Nguyen S, Orfeuvre H, Petit T, Pivot X, Priou F, Bach IS, Simon H, Stefani L, Uwer L, Youssef A, Aktas B, von der Assen A, Augustin D, Balser C, Bauer LE, Bechtner C, Beyer G, Brucker C, Bückner U, Busch S, Christensen B, Deryal M, Farrokh A, Faust E, Friedrichs K, Graf H, Griesshammer M, Grischke EM, Hänle C, Heider A, Henschen S, Hesse T, Jackisch C, Kisro J, Köhler A, Kuemmel S, Lampe D, Lantzsch T, Latos K, Lex B, Liedtke C, Luedders D, Maintz C, Müller V, Overkamp F, Park-Simon TW, Paul M, Prechtl A, Ringsdorf U, Runnebaum I, Ruth S, Salat C, Scheffen I, Schilling J, Schmatloch S, Schmidt M, Schneeweiss A, Schrader I, Seipelt G, Simon E, Stefek A, Stickeler E, Thill M, Tio J, Tuczek A, Warm M, Weigel M, Wischnik A, Wojcinski S, Ziegler-Löhr K, Aravantinos G, Ardavanis A, Fountzilas G, Gogas H, Kakolyris S, Mavroudis D, Papadimitriou C, Papandreou C, Papazisis K, Castro H, Hernandez-Monroy CE, Ngan R, Yeo W, Bittner N, Boer K, Csejtei A, Horvath Z, Kocsis J, Mangel LC, Mezei K, Nagy Z, Szanto J, Atmakusuma D, Fadjari H, Kurnianda D, Prayogo N, Tanggo EH, Coate L, Hennessy B, Kelly C, Martin M, Nasim S, O'Connor M, Aieta M, Allegrini G, Amadori D, Bidoli P, Biti G, Bordonaro R, Bottini A, Carterni G, Cavanna L, Cazzaniga M, Cognetti F, Contu A, Cruciani G, Donadio M, Falcone A, Farci D, Forcignanò RC, Frassoldati A, Gaion F, Gamucci T, Giotta F, de Laurentiis M, Livi L, Lorusso V, Maiello E, Marchetti P, Mariani G, Mion M, Moscetti L, Musolino A, Pazzola A, Pedrazzoli P, Pigi A, de Placido S, Caremoli ER, Santoro A, Tienghi A, Ahn JS, Jung KH, Lee KS, Lee SH, Seo JH, Sohn JH, Cesas A, Juozaityte E, Cheah NLC, Chong FLT, Devi BC, Phua V, Teoh D, Ching LW, Yusof M, Corona J, Dominguez A, Mendoza RLG, Hernandez CA, Ramiro AJ, Santos JM, Espinosa PM, Villarreal Garza CM, Errihani H, Bakker S, van den Berkmortel F, Blaisse R, Huinink DTB, van den Bosch J, Braun J, Dercksen M, Droogendijk H, Erdkamp F, Haringhuizen A, de Jongh F, Kok T, Los M, Madretsma S, Terwogt JMM, van der Padt A, van Rossum-Schornagel QC, Smilde T, de Valk B, van der Velden A, van Warmerdam L, van de Wouw A, North R, Kersten C, Mjaaland I, Wist E, Aziz Z, Masood N, Rashid K, Shah M, Alcedo JC, Aleman D, Neciosup S, Reategui R, Valdiviezo N, Vera L, Fernando G, Roque F, Strebel HM, Krzemieniecki K, Litwiniuk M, Mruk A, Pienkowski T, Sawrycki P, Slomian G, Tomczak P, Afonso N, Cardoso F, Damasceno M, Nave M, Badulescu F, Ciule L, Curescu S, Eniu A, Filip D, Grecea D, Jinga DC, Lungulescu D, Oprean CM, Stanculeanu DL, Turdean M, Dvornichenko V, Emelyanov S, Lichinitser M, Manikhas A, Sakaeva D, Shirinkin V, Stroyakovskiy D, Abulkhair O, Zekri J, Filipovic S, Kovcin V, Nedovic J, Pesic J, Vasovic S, Ng R, Bystricky B, Leskova J, Mardiak J, Mišurová E, Wagnerova M, Takač I, Demetriou GS, Dreosti L, Govender P, Jordaan JP, Veersamy P, Romero JLA, Lopez NB, Arias CC, Chacon J, Aramburo AF, Morales LAF, Garcia M, Estevez LG, Garcia-Palomo Perez A, Garcia Saenz JA, Garcia Sanchis L, Cubells LG, Cortijo LG, Santiago SG, De Aranguiz BHF, Mañas JJI, Gallego PJ, Cussac AL, Ferrandiz CL, Garrido ML, Alvarez PL, Vega JML, Del Prado PM, Jañez NM, Murillo SM, Rosales AM, Jaso LM, Fernandez IP, Martorell AP, Carrion RP, Simon SP, Alcibar AP, Lorenzo JP, Garcia VQ, Asensio TRYC, Maicas MDT, Villanueva Silva MJ, Killander F, Svensson JH, Fehr M, Hauser N, Müller A, Pagani O, Passmann-Kegel H, Popescu R, Rabaglio M, Rauch D, Schlatter C, Zaman K, Chang TW, Huang CS, Wang HC, Yu JC, Bandidwattanawong C, Maneechavakajorn J, Seetalarom K, Dejthevaporn T(S, Somwangprasert A, Vongsaisuwon M, Akbulut H, Altundag K, Arican A, Bozcuk H, Eralp Y, Idris M, Isikdogan A, Senol CH, Sevinc A, Uygun K, Yucel E, Yucel I, Yumuk F, Shparyk Y, Voitko N, Jaloudi M, Adams J, Agrawal R, Ahmed S, Alhasso A, Allerton R, Anwar S, Archer C, Ashford R, Barraclough L, Bertelli G, Bishop J, Branson T, Butt M, Chakrabarti A, Chakraborti P, Churn M, Crowley C, Davis R, Dhadda A, Eldeeb H, Fraser J, Hall J, Hickish T, Hogg M, Howe T, Joffe J, Kelleher M, Kelly S, Kendall A, Kristeleit H, Lumsden G, Macmillan C, MacPherson I, Malik Z, Mithal N, Neal A, Panwar U, Proctor A, Proctor SJ, Raj S, Rehman S, Sandri I, Scatchard K, Sherwin E, Sims E, Singer J, Smith S, Tahir S, Taylor W, Tsalic M, Verrill M, Wardley A, Waters S, Wheatley D, Wright K, Yuille F, Alonso I, Artagaveytia N, Rodriguez R, Arbona E, Garcia Y, Lion L, Marcano D, Van Thuan T. Safety and tolerability of subcutaneous trastuzumab for the adjuvant treatment of human epidermal growth factor receptor 2-positive early breast cancer: SafeHer phase III study's primary analysis of 2573 patients. Eur J Cancer 2017. [DOI: 10.1016/j.ejca.2017.05.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kato H, Escudero C, Sherwin E, Hosking M, Gandhi SK. Jellyfish-Like Accessory Mitral Valve Tissue Causing Near-Collapse in a Young Child. World J Pediatr Congenit Heart Surg 2016; 9:251-253. [PMID: 27881808 DOI: 10.1177/2150135116668335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Accessory mitral valve tissue (AMVT) causing left ventricular outflow tract obstruction (LVOTO) is rare. We report a case of AMVT causing severe LVOTO resulting in acutely progressive symptoms of near-collapse. Urgent surgical resection eliminated the patient's life-threatening symptoms. AMVT should be considered among potential LVOTO diagnoses, and early surgical intervention may be required.
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Affiliation(s)
- Hideyuki Kato
- 1 Division of Cardiovascular and Thoracic Surgery, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Carolina Escudero
- 2 Division of Cardiology, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Elizabeth Sherwin
- 2 Division of Cardiology, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Martin Hosking
- 2 Division of Cardiology, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Sanjiv K Gandhi
- 1 Division of Cardiovascular and Thoracic Surgery, BC Children's Hospital, Vancouver, British Columbia, Canada
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Padfield GJ, Escudero CA, DeSouza AM, Steinberg C, Gibbs K, Puyat JH, Lam PY, Sanatani S, Sherwin E, Potts JE, Sandor G, Krahn AD. Characterization of Myocardial Repolarization Reserve in Adolescent Females With Anorexia Nervosa. Circulation 2016; 133:557-65. [PMID: 26769740 DOI: 10.1161/circulationaha.115.016697] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 12/29/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Patients with anorexia nervosa exhibit abnormal myocardial repolarization and are susceptible to sudden cardiac death. Exercise testing is useful in unmasking QT prolongation in disorders associated with abnormal repolarization. We characterized QT adaptation during exercise in anorexia. METHODS AND RESULTS Sixty-one adolescent female patients with anorexia nervosa and 45 age- and sex-matched healthy volunteers performed symptom-limited cycle ergometry during 12-lead ECG monitoring. Changes in the QT interval during exercise were measured, and QT/RR-interval slopes were determined by using mixed-effects regression modeling. Patients had significantly lower body mass index than controls; however, resting heart rates and QT/QTc intervals were similar at baseline. Patients had shorter exercise times (13.7±4.5 versus 20.6±4.5 minutes; P<0.001) and lower peak heart rates (159±20 versus 184±9 beats/min; P<0.001). The mean QTc intervals were longer at peak exercise in patients (442±29 versus 422±19 ms; P<0.001). During submaximal exertion at comparable heart rates (114±6 versus 115±11 beats/min; P=0.54), the QTc interval had prolonged significantly more in patients than controls (37±28 versus 24±25 ms; P<0.016). The RR/QT slope, best described by a curvilinear relationship, was more gradual in patients than in controls (13.4; 95% confidence interval, 12.8-13.9 versus 15.8; 95% confidence interval, 15.3-16.4 ms QT change per 10% change in RR interval; P<0.001) and steepest in patients within the highest body mass index tertile versus the lowest (13.9; 95% confidence interval, 12.9-14.9 versus 12.3; 95% confidence interval, 11.3-13.3; P=0.026). CONCLUSIONS Despite the absence of manifest QT prolongation, adolescent anorexic females have impaired repolarization reserve in comparison with healthy controls. Further study may identify impaired QT dynamics as a risk factor for arrhythmias in anorexia nervosa.
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Affiliation(s)
- Gareth J Padfield
- From Heart Rhythm Services, Division of Cardiology, University of British Columbia, Vancouver, Canada (G.J.P., C.S., K.G., A.D.K.); British Columbia Children's Hospital, Vancouver, Canada (C.A.E., A.M.D., P.Y.L., S.S., E.S., J.E.P., G.S.); and Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, Canada (J.H.P.)
| | - Carolina A Escudero
- From Heart Rhythm Services, Division of Cardiology, University of British Columbia, Vancouver, Canada (G.J.P., C.S., K.G., A.D.K.); British Columbia Children's Hospital, Vancouver, Canada (C.A.E., A.M.D., P.Y.L., S.S., E.S., J.E.P., G.S.); and Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, Canada (J.H.P.)
| | - Astrid M DeSouza
- From Heart Rhythm Services, Division of Cardiology, University of British Columbia, Vancouver, Canada (G.J.P., C.S., K.G., A.D.K.); British Columbia Children's Hospital, Vancouver, Canada (C.A.E., A.M.D., P.Y.L., S.S., E.S., J.E.P., G.S.); and Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, Canada (J.H.P.)
| | - Christian Steinberg
- From Heart Rhythm Services, Division of Cardiology, University of British Columbia, Vancouver, Canada (G.J.P., C.S., K.G., A.D.K.); British Columbia Children's Hospital, Vancouver, Canada (C.A.E., A.M.D., P.Y.L., S.S., E.S., J.E.P., G.S.); and Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, Canada (J.H.P.)
| | - Karen Gibbs
- From Heart Rhythm Services, Division of Cardiology, University of British Columbia, Vancouver, Canada (G.J.P., C.S., K.G., A.D.K.); British Columbia Children's Hospital, Vancouver, Canada (C.A.E., A.M.D., P.Y.L., S.S., E.S., J.E.P., G.S.); and Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, Canada (J.H.P.)
| | - Joseph H Puyat
- From Heart Rhythm Services, Division of Cardiology, University of British Columbia, Vancouver, Canada (G.J.P., C.S., K.G., A.D.K.); British Columbia Children's Hospital, Vancouver, Canada (C.A.E., A.M.D., P.Y.L., S.S., E.S., J.E.P., G.S.); and Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, Canada (J.H.P.)
| | - Pei Yoong Lam
- From Heart Rhythm Services, Division of Cardiology, University of British Columbia, Vancouver, Canada (G.J.P., C.S., K.G., A.D.K.); British Columbia Children's Hospital, Vancouver, Canada (C.A.E., A.M.D., P.Y.L., S.S., E.S., J.E.P., G.S.); and Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, Canada (J.H.P.)
| | - Shubhayan Sanatani
- From Heart Rhythm Services, Division of Cardiology, University of British Columbia, Vancouver, Canada (G.J.P., C.S., K.G., A.D.K.); British Columbia Children's Hospital, Vancouver, Canada (C.A.E., A.M.D., P.Y.L., S.S., E.S., J.E.P., G.S.); and Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, Canada (J.H.P.)
| | - Elizabeth Sherwin
- From Heart Rhythm Services, Division of Cardiology, University of British Columbia, Vancouver, Canada (G.J.P., C.S., K.G., A.D.K.); British Columbia Children's Hospital, Vancouver, Canada (C.A.E., A.M.D., P.Y.L., S.S., E.S., J.E.P., G.S.); and Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, Canada (J.H.P.)
| | - James E Potts
- From Heart Rhythm Services, Division of Cardiology, University of British Columbia, Vancouver, Canada (G.J.P., C.S., K.G., A.D.K.); British Columbia Children's Hospital, Vancouver, Canada (C.A.E., A.M.D., P.Y.L., S.S., E.S., J.E.P., G.S.); and Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, Canada (J.H.P.)
| | - George Sandor
- From Heart Rhythm Services, Division of Cardiology, University of British Columbia, Vancouver, Canada (G.J.P., C.S., K.G., A.D.K.); British Columbia Children's Hospital, Vancouver, Canada (C.A.E., A.M.D., P.Y.L., S.S., E.S., J.E.P., G.S.); and Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, Canada (J.H.P.)
| | - Andrew D Krahn
- From Heart Rhythm Services, Division of Cardiology, University of British Columbia, Vancouver, Canada (G.J.P., C.S., K.G., A.D.K.); British Columbia Children's Hospital, Vancouver, Canada (C.A.E., A.M.D., P.Y.L., S.S., E.S., J.E.P., G.S.); and Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, Canada (J.H.P.).
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Roston TM, AlAhmari L, Krahn AD, Sherwin E, Sanatani S. Choking-induced cardiac arrest unmasks a diagnosis of catecholaminergic polymorphic ventricular tachycardia. HeartRhythm Case Rep 2015; 1:494-497. [PMID: 28491614 PMCID: PMC5419722 DOI: 10.1016/j.hrcr.2015.08.007] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
| | | | | | | | - Shubhayan Sanatani
- King Saud University, Riyadh, Saudi Arabia
- Address reprint requests and correspondence: Shubhayan Sanatani, Head, Division of Cardiology, Children’s Heart Centre, 1F9, British Columbia’s Children’s Hospital, 4480 Oak St, Vancouver, BC V6H 3V4, Canada
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14
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Armstrong K, De Souza A, Sneddon P, Potts J, Claydon V, Sherwin E, Sanatani S. DOES AN 8-WEEK LOWER BODY EXERCISE PROGRAM IMPROVE QUALITY OF LIFE IN TEENAGERS WITH DYSAUTONOMIA? Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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15
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Sheffield BS, Yip S, Ruchelli ED, Dunham CP, Sherwin E, Brooks PA, Sur A, Singh A, Human DG, Patel MS, Lee AF. Fatal congenital hypertrophic cardiomyopathy and a pancreatic nodule morphologically identical to focal lesion of congenital hyperinsulinism in an infant with costello syndrome: case report and review of the literature. Pediatr Dev Pathol 2015; 18:237-44. [PMID: 25668678 DOI: 10.2350/14-07-1525-cr.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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] [Indexed: 01/02/2023]
Abstract
Costello syndrome is characterized by constitutional mutations in the proto-oncogene HRAS, causing dysmorphic features, multiple cardiac problems, intellectual disability, and an increased risk of neoplasia. We report a male infant with dysmorphic features, born prematurely at 32 weeks, who, during his 3-month life span, had an unusually severe and ultimately fatal manifestation of hypertrophic cardiomyopathy and hyperinsulinemic hypoglycemia. Molecular studies in this patient demonstrated the uncommon Q22K mutation in the HRAS gene, diagnostic of Costello syndrome. The major autopsy findings revealed hypertrophic cardiomyopathy, congenital myopathy, and a 1.4-cm pancreatic nodule that was positive for insulin expression and morphologically identical to a focal lesion of congenital hyperinsulinism. Sequencing of KCNJ11 and ABCC8, the 2 most commonly mutated genes in focal lesion of congenital hyperinsulinism, revealed no mutations. While hyperinsulinism is a recognized feature of RASopathies, a focal proliferation of endocrine cells similar to a focal lesion of hyperinsulinism is a novel pathologic finding in Costello syndrome.
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Affiliation(s)
- Brandon S. Sheffield
- Faculty of Medicine, University of British Columbia, 4480 Oak Street, Room 2H47, Vancouver, BC, Canada
- Division of Anatomical Pathology, Children's and Women's Health Centre of British Columbia, and Department of Pathology and Laboratory Medicine, University of British Columbia, 4480 Oak Street, Room 2H47, Vancouver, BC V6H3V4, Canada
| | - Stephen Yip
- Faculty of Medicine, University of British Columbia, 4480 Oak Street, Room 2H47, Vancouver, BC, Canada
- Centre for Translational and Applied Genomics, British Columbia Cancer Agency, 600 West 10th Avenue, Vancouver, BC V6H3V4, Canada
| | - Eduardo D. Ruchelli
- Division of Anatomical Pathology, The Children's Hospital of Philadelphia. 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - Christopher P. Dunham
- Faculty of Medicine, University of British Columbia, 4480 Oak Street, Room 2H47, Vancouver, BC, Canada
- Division of Anatomical Pathology, Children's and Women's Health Centre of British Columbia, and Department of Pathology and Laboratory Medicine, University of British Columbia, 4480 Oak Street, Room 2H47, Vancouver, BC V6H3V4, Canada
| | - Elizabeth Sherwin
- Faculty of Medicine, University of British Columbia, 4480 Oak Street, Room 2H47, Vancouver, BC, Canada
- Division of Pediatric Cardiology, Children's and Women's Health Centre of British Columbia, 4480 Oak Street, Room 1C50, Vancouver, BC V6H3V4, Canada
| | - Paul A. Brooks
- Faculty of Medicine, University of British Columbia, 4480 Oak Street, Room 2H47, Vancouver, BC, Canada
- Division of Pediatric Cardiology, Children's and Women's Health Centre of British Columbia, 4480 Oak Street, Room 1C50, Vancouver, BC V6H3V4, Canada
| | - Amitava Sur
- Faculty of Medicine, University of British Columbia, 4480 Oak Street, Room 2H47, Vancouver, BC, Canada
- Department of Neonatal Perinatal Medicine, Children's and Women's Health Centre of British Columbia, 4480 Oak Street, Vancouver, BC V6H3V4, Canada
| | - Avash Singh
- Faculty of Medicine, University of British Columbia, 4480 Oak Street, Room 2H47, Vancouver, BC, Canada
- Department of Neonatal Perinatal Medicine, Children's and Women's Health Centre of British Columbia, 4480 Oak Street, Vancouver, BC V6H3V4, Canada
| | - Derek G. Human
- Faculty of Medicine, University of British Columbia, 4480 Oak Street, Room 2H47, Vancouver, BC, Canada
- Division of Pediatric Cardiology, Children's and Women's Health Centre of British Columbia, 4480 Oak Street, Room 1C50, Vancouver, BC V6H3V4, Canada
| | - Millan S. Patel
- Faculty of Medicine, University of British Columbia, 4480 Oak Street, Room 2H47, Vancouver, BC, Canada
- Department of Medical Genetics and Child and Family Research Institute, Children's and Women's Health Centre of British Columbia, 4480 Oak Street, Room C234, Vancouver, BC V6H3V4, Canada
| | - Anna F. Lee
- Faculty of Medicine, University of British Columbia, 4480 Oak Street, Room 2H47, Vancouver, BC, Canada
- Division of Anatomical Pathology, Children's and Women's Health Centre of British Columbia, and Department of Pathology and Laboratory Medicine, University of British Columbia, 4480 Oak Street, Room 2H47, Vancouver, BC V6H3V4, Canada
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16
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Armstrong K, De Souza AM, Sneddon P, Potts JE, Claydon V, Sherwin E, Sanatani S. Does An 8-week Lower Body Exercise Program Improve Quality Of Life In Teenagers With Dysautonomia? Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000479201.75816.1c] [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: 11/21/2022]
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17
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Hathaway J, Gibbs K, Bennett M, Chakrabarti S, Kerr C, Leather R, Lehman A, Sherwin E, Sanatani S, Arbour L, Krahn A. THE BC INHERITED ARRHYTHMIA PROGRAM: A MULTIDISCIPLINARY APPROACH TO FAMILIES AT RISK FOR SUDDEN DEATH. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.741] [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: 10/24/2022] Open
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18
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Sherwin E. The removal of teeth with forceps. Br Dent J 2012. [DOI: 10.1038/sj.bdj.2012.658] [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: 11/09/2022]
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19
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Sherwin E, Whiteneck G, Corrigan J, Bedell G, Brown M, Abreu B, Depompei R, Gordon W, Kreutzer J. Domains of a TBI minimal data set: Community reintegration phase. Brain Inj 2009; 20:383-9. [PMID: 16716984 DOI: 10.1080/02699050600663097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Efforts to establish a minimal data set for the period of community integration after traumatic brain injury (TBI) have been the focus of a working group of leading researchers, clinicians and advocates attending the Galveston Brain Injury Symposium in 2001 and 2002. The purpose of the data set is to increase the consistency and interpretability of TBI research and programme evaluation by providing a common set of measures to document key aspects of community integration. It is intended to be sensitive to intervention, comprehensive, reflect satisfaction and outcome and promote future treatment/therapy. In deciding on the components of a minimal data set, the tri-partite model of outcomes was adopted (initially employed in psychotherapy, adapted to TBI) which focuses on the needs of the individual, society and the health provider. Scales are recommended for the respective components of the model.
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Affiliation(s)
- E Sherwin
- University of Arkansas at Little Rock, AR 72204-1099, USA.
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20
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Williams MV, Burnet NG, Sherwin E, Kestelman R, Geater AR, Thomas SJ, Wilson CB. A radiotherapy technique to improve dose homogeneity around bone prostheses. Sarcoma 2008; 8:37-42. [PMID: 18521392 PMCID: PMC2395598 DOI: 10.1080/13577140410001679248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Purpose. Following limb conserving surgery for bone or soft tissue sarcoma, patients may require post-operative radiotherapy to minimise the risk of local recurrence. In such circumstances the metal prosthesis reduces the dose in its shadow by approximately 10% when using opposed fields. We describe a technique to boost the underdosed area to overcome this problem.Patients or subjects. Seven sequential patients presenting between 1995 and 2001 had their treatment individualised because they had metal prosthesis in the treatment volume.Methods. To improve the target dose homogeneity we used a custom-made keyhole cutout to boost the area in the shadow of the prosthesis. The degree of attenuation caused by the metal prosthesis was estimated and a boost dose calculated. Exit thermoluminescent dosimetry (TLD) was used to confirm the estimates made.Results and discussion. Variation between patients was seen, demonstrating the need for exit TLD to individualise the treatment plan. The use of a boost field provides a method to overcome under-dosage in the shadow of a metal prosthesis. It improves dose homogeneity throughout the target volume and ensures adequate dose intensity around the prosthesis, the site most at risk of local recurrence.
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Affiliation(s)
- M V Williams
- Oncology Centre Addenbrooke's Hospital Hills Road Cambridge CB2 2QQ UK
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21
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James H, Gulliford S, MacKenzie C, Le Vay J, Sherwin E, Smith S, Hardy V, Poynter A. 379 Applications of IMRT for breast related progressive disease. Radiother Oncol 2005. [DOI: 10.1016/s0167-8140(05)81355-6] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Gulliford S, James H, MacKenzie C, Le Vay J, Sherwin E, Smith S, Perry R, Poynter A. 224 Dosimetric implications of intentional skin dose with IMRT. Radiother Oncol 2005. [DOI: 10.1016/s0167-8140(05)81201-0] [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: 10/23/2022]
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23
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Greve KW, Sherwin E, Stanford MS, Mathias C, Love J, Ramzinski P. Personality and neurocognitive correlates of impulsive aggression in long-term survivors of severe traumatic brain injury. Brain Inj 2001; 15:255-62. [PMID: 11260773 DOI: 10.1080/026990501300005695] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.8] [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: 10/17/2022]
Abstract
This study addresses a common outcome of severe traumatic brain injury (TBI), disinhibited aggressive behaviour. This behaviour has been classified in aggression literature as 'impulsive aggression' (IA). The purpose was to: (1) characterize those TBI patients who are likely to be an aggression risk, and (2) determine if TBI patients with IA demonstrate personality style and neurocognitive performance similar to that seen in other IA groups. Participants were 45 survivors of severe TBI (26 of whom had persisting problems with IA), who were clients of a residential brain injury treatment facility. IA participants had a higher incidence of pre-morbid aggressive behaviour, were younger, had a shorter tenure in the programine, and were more impulsive, irritable, and antisocial than the non-aggressive control participants. Unlike past research, no neurocognitive differences were found. The results are discussed in terms of the conceptualization, identification, and treatment of persisting IA in severe TBI.
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Affiliation(s)
- K W Greve
- Department of Psychology, University of New Orleans, LA 70148, USA.
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Abstract
Diarrhoeal disease is a major cause of death in children in the developing world. In developing countries a quarter of infant and childhood mortality is related to diarrhoea. The World Health Organization started the Diarrhoeal Disease Control Programme (CDD) in 1980 with the objective to decrease diarrhoeal mortality and morbidity among young children in developing countries. The aim of this study was to measure the prevalence and incidence of diarrhoeal diseases among young children and to assess the quality of home case management of diarrhoeal cases. Particular emphasis was put on the assessment of drug use during diarrhoea. The survey included also the assessment of breast feeding practices. Geographically the survey was limited to two governorates, Dakahlia and Gharbia, in lower Egypt, which have the largest population (7.12 million) and were thought to be representative of lower Egypt. The total sample size was 11032. Seasonally adjusted diarrhoea incidence was 3.6 episodes per child under five years of age per year. This means a minimum estimate of 30 million cases annually in Egypt. Although the majority of the caretakers knew of Oral Rehydration Salts (ORS), only 22% of cases with diarrhoea in the last 24 h received ORS. 54% of cases had received drugs, and many of the children with diarrhoea received more than one drug. The source of drug prescription was most often a private doctor and the use of drugs was common among government doctors and health workers. The high proportion of cases treated with drugs, other than ORS, is the major problem in diarrhoeal home case management in Egypt. The message of ORS has penetrated into the general population well, but the practices of health professionals have not changed. To improve the situation further, training of health workers in correct case management is needed. Paediatric forms of symptomatic antidiarrhoeal drugs should also be withdrawn from the market.
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Affiliation(s)
- P Jousilahti
- Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland
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Abstract
A simplified, single-step shake test has been performed on gastric aspirate samples from 85 preterm infants and a control group of 214 term infants. Respiratory symptoms were seen in 25 of 30 preterm infants with a negative or intermediate test, but in only 2 of 55 infants with a positive test (P less than 0-001). No infant with a positive test developed respiratory distress syndrome (RDS) while RDS developed in 66% of those preterm infants with a negative test. False-negative results were not seen in the preterm group. The gastric aspirate shake test had better sensitivity and selectivity in prediction of clinical outcome than did the amniotic fluid lecithin/sphingomyelin ratio in 37 preterm infants in whom both results were available. Serial shake tests were performed on samples from a number of infants with RDS and the results were seen to change in parallel with clinical recovery. This and other observations suggest that the result of the gastric aspirate shake test depends more upon direct swallowing of fetal lung liquid than on swallowing of amniotic fluid.
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Pratt RAW, Sherwin E, Weston GJ. 89. The isotopic exchange reaction of carbonato-cis-diammine-(ethylenediamine)cobalt(III) ion and carbonate ion in aqueous solution. ACTA ACUST UNITED AC 1962. [DOI: 10.1039/jr9620000476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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