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Mast M, Leong A, Korreman S, Lee G, Probst H, Scherer P, Tsang Y. ESTRO-ACROP guideline for positioning, immobilisation and setup verification for local and loco-regional photon breast cancer irradiation. Tech Innov Patient Support Radiat Oncol 2023; 28:100219. [PMID: 37745181 PMCID: PMC10511493 DOI: 10.1016/j.tipsro.2023.100219] [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] [Received: 09/10/2023] [Accepted: 09/10/2023] [Indexed: 09/26/2023] Open
Affiliation(s)
- M.E. Mast
- Department of Radiation Oncology, Haaglanden Medical Center, Leidschendam, The Netherlands
| | - A. Leong
- Department of Radiation Therapy, University of Otago, Wellington, New Zealand
- Bowen Icon Cancer Centre, Wellington, New Zealand
| | - S.S. Korreman
- Department of Clinical Medicine, Aarhus University, Denmark
- Department of Oncology, Aarhus University Hospital, Denmark
- Danish Center for Particle Therapy, Aarhus University Hospital, Denmark
| | - G. Lee
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - H. Probst
- Sheffield Hallam University, Sheffield, United Kingdom
| | - P. Scherer
- Department of Radiotherapy and Radio-Oncology, LKH Salzburg, Paracelsus Medical University Clinics, Salzburg, Austria
| | - Y. Tsang
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, Canada
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Lyons KS, Herity N, Lee G, Talbot C, McKeeman G. Assay interference as a cause of false positive troponin T elevation in emergency department patients. Int J Cardiol 2023; 389:131165. [PMID: 37423573 DOI: 10.1016/j.ijcard.2023.131165] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/30/2023] [Accepted: 07/06/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Troponin assays are used in the diagnosis of myocardial injury and may show elevated results for a variety of reasons. However it is increasingly recognised that cardiac troponin elevation may in some cases be due to assay interference. This is of significant importance as a misdiagnosis of myocardial injury may lead to unnecessary and potentially harmful investigation and treatment for patients. We sought to confirm the accuracy of cardiac high sensitivity troponin T (chsTnT) elevation in an unselected group of patients presenting to the emergency department, by using a second confirmatory cardiac high sensitivity troponin I (chsTnI) assay. METHODS We identified patients presenting to two local emergency departments over a five-day period who had chsTnT levels measured as part of routine clinical care. All samples with elevated chsTnT levels (above the 99% centile URL) were retested for chsTnI in order to confirm true myocardial injury. RESULTS A total of 74 samples from 54 patients were analysed for chsTnT and chsTnI. 7 samples (9.5%) had chsTnI levels < 5 ng/L suggesting assay interference as the cause of chsTnT elevation. CONCLUSIONS Assay interference leading to false positive troponin elevation may be more common than many physicians appreciate and can potentially lead to harmful investigation and treatment for patients. In cases where the diagnosis of myocardial injury is uncertain, a second alternative troponin assay should be performed to confirm true myocardial injury.
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Affiliation(s)
- K S Lyons
- Northern HSC Trust, Antrim Area Hospital, Bush Road, Antrim BT41 2RL, UK.
| | - N Herity
- Belfast HSC Trust, First Floor, West Wing, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, UK
| | - G Lee
- Department of Clinical Biochemistry & Diagnostic Endocrinology, Mater Misericordiae University Hospital and School of Medicine, University College Dublin, Ireland
| | - C Talbot
- Department of Clinical Biochemistry & Diagnostic Endocrinology, Mater Misericordiae University Hospital and School of Medicine, University College Dublin, Ireland
| | - G McKeeman
- Belfast HSC Trust, First Floor, West Wing, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, UK
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Lee G, Aitelli A, Niemierko A, Lamba N, Kim DW, Chapman PH, Curry W, Oh KS, Barker Ii FG, Shih HA. Adjuvant Radiotherapy in Atypical Meningioma: Are the Risks Worth the Benefit? Int J Radiat Oncol Biol Phys 2023; 117:e125. [PMID: 37784679 DOI: 10.1016/j.ijrobp.2023.06.918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Adjuvant radiotherapy (RT) improves progression-free survival (PFS) in atypical meningiomas. Herein, we assess whether the treatment-related acute and long-term toxicity of upfront RT in atypical meningioma patients versus surveillance merits the PFS benefit. MATERIALS/METHODS In our prior single institution retrospective study of 230 patients with resected intracranial atypical meningiomas between 2000-2015, adjuvant RT was associated with a significantly lower risk of progression/recurrence compared to surveillance (HR = 0.21 [95% CI 0.11-0.41]; p<0.01), with 36% of surveillance patients eventually requiring salvage RT. In the current study, the acute (≤6 months) and long term (>6 months) RT-related toxicities from the same patient cohort for those who received adjuvant RT (n = 51) were evaluated and compared to those who received salvage RT (n = 64) in the surveillance group. Additionally, overall treatment-related toxicity at time of last follow up was obtained for comparison between the adjuvant RT (n = 51) vs surveillance (n = 179) group. All toxicities were graded per CTCAE v5.0. Kaplan-Meier analysis was used to calculate the cumulative incidence of toxicities; Pearson's chi-squared and log-rank test were used for comparison. RESULTS Adjuvant RT as compared to salvage RT was generally associated with greater RT-related toxicities both in the acute (90% vs 69%, p = 0.006) and long term (57% vs 33%, p = 0.010). While there was no significant difference in grade 3-4 acute toxicities, long term grade 3-4 toxicities (including headache, seizure, vision loss, neuromotor deficit, and neurocognitive deficit) were present in 14% of adjuvant vs 3% of salvage RT group (p = 0.035). Radionecrosis occurred in 18% of adjuvant RT vs 8% of salvage RT group (p = 0.11). Between adjuvant RT vs surveillance groups, any-treatment related toxicity at last follow up was greater with adjuvant RT (31% vs 15%; p = 0.006), with trend towards greater grade 3-4 toxicities (including headache, vision loss, neuromotor deficit, neurocognitive deficit, and cerebral edema) as well (8% vs 3%; p = 0.101). Cumulative incidence of treatment-related neuromotor deficit (any grade) was significantly greater in the adjuvant RT vs surveillance group with 14% vs 2% at 10 years (p = 0.004). There was no difference in rate of cerebrovascular accident between adjuvant RT (6%) vs surveillance (4%) groups (p = 0.83). CONCLUSION Adjuvant RT for patients with atypical meningioma was associated with greater acute and long-term treatment toxicities. Potential RT-related toxicity and impact on quality-of-life should thus be carefully weighed against the tumor control benefit of RT in deciding the optimal use and timing of RT.
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Affiliation(s)
- G Lee
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA
| | - A Aitelli
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA
| | - A Niemierko
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA
| | - N Lamba
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA
| | - D W Kim
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA
| | - P H Chapman
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA
| | - W Curry
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA
| | - K S Oh
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA
| | - F G Barker Ii
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA
| | - H A Shih
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA
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Lee G, Park S, Lee S, Song K, Kim Y, Chang W, Kim J, Park N, Kim J, Park S, Hwang I, Kim H, Kim I. Bioimpedance Analysis as a Screening Tool in Heart-Transplanted Patients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Park J, Jung W, Lee G, Kang D, Mog Shim Y, Kim H, Cho J, Shin D. PP01.29 Prevalence and Predictor of Significant Unmet Needs in Patients who were Surgically Resected for Non-Small Cell Lung Cancer. J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2022.09.055] [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: 01/30/2023]
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6
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Lee JH, Lee D, Lee HL, Lee G. Hysterectomy for uterine fibroids and stress urinary incontinence surgery: A nationwide cohort study. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00909-0] [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] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Christifano DN, Crawford SA, Lee G, Brown AR, Camargo JT, Kerling EH, Gajewski BJ, Valentine CJ, Gustafson KM, DeFranco EA, Carlson SE. Docosahexaenoic acid (DHA) intake estimated from a 7-question survey identifies pregnancies most likely to benefit from high-dose DHA supplementation. Clin Nutr ESPEN 2023; 53:93-99. [PMID: 36657936 PMCID: PMC9852746 DOI: 10.1016/j.clnesp.2022.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/17/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Two randomized trials found women with low blood docosahexaenoic acid (DHA; an omega 3 fatty acid) had fewer early preterm births (<34 weeks gestation) if they were assigned to high dose DHA supplementation, however, there is currently no capacity for clinicians who care for pregnancies to obtain a blood assessment of DHA. Determining a way to identify women with low DHA intake whose risk could be lowered by high dose DHA supplementation is desired. OBJECTIVE To determine if assessing DHA intake can identify pregnancies that benefit from high dose DHA supplementation. STUDY DESIGN This secondary analysis used birth data from 1310 pregnant women who completed a 7-question food frequency questionnaire (DHA-FFQ) at 16.8 ± 2.5 weeks gestation that is validated to assess DHA status. They were then randomly assigned to a standard (200 mg/day) or high dose (800 or 1000 mg/day) DHA supplement for the remainder of pregnancy. Bayesian logistic regressions were fitted for early preterm birth and preterm birth as a function of DHA intake and assigned DHA dose. RESULTS Participants who consumed less than 150 mg/day DHA prior to 20 weeks' gestation (n = 810/1310, 58.1%) had a lower Bayesian posterior probability (pp) of early preterm birth if they were assigned to high dose DHA supplementation (1.4% vs 3.9%, pp = 0.99). The effect on preterm birth (<37 weeks) was also significant (11.3% vs 14.8%, pp = 0.97). CONCLUSION The DHA-FFQ can identify pregnancies that will benefit most from high dose DHA supplementation and reduce the risk of preterm birth. The DHA-FFQ is low burden to providers and patients and could be easily implemented in obstetrical practice.
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Affiliation(s)
- D N Christifano
- The University of Kansas Medical Center, Department of Dietetics and Nutrition, Kansas City, KS, USA; The University of Kansas Medical Center, Hoglund Biomedical Imaging Center, Kansas City, KS, USA
| | - S A Crawford
- The University of Kansas Medical Center, Department of Dietetics and Nutrition, Kansas City, KS, USA
| | - G Lee
- The University of Kansas Medical Center, Department of Obstetrics and Gynecology, Kansas City, KS, USA
| | - A R Brown
- The University of Kansas Medical Center, Department of Biostatistics & Data Science, Kansas City, KS, USA
| | - J T Camargo
- The University of Kansas Medical Center, Department of Dietetics and Nutrition, Kansas City, KS, USA; The University of Kansas Medical Center, Department of Urology, Kansas City, KS, USA
| | - E H Kerling
- The University of Kansas Medical Center, Department of Dietetics and Nutrition, Kansas City, KS, USA
| | - B J Gajewski
- The University of Kansas Medical Center, Department of Biostatistics & Data Science, Kansas City, KS, USA
| | - C J Valentine
- Banner University Medical Center, The University of Arizona, Department of Pediatrics, Tucson, AZ, USA
| | - K M Gustafson
- The University of Kansas Medical Center, Hoglund Biomedical Imaging Center, Kansas City, KS, USA; The University of Kansas Medical Center, Department of Neurology, Kansas City, KS, USA
| | - E A DeFranco
- The University of Cincinnati, Department of Obstetrics and Gynecology, Cincinnati, OH, USA
| | - S E Carlson
- The University of Kansas Medical Center, Department of Dietetics and Nutrition, Kansas City, KS, USA.
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Dave R, Vickery B, Weselman B, Lee G. WHY DO GENERALISTS ORDER FOOD ALLERGEN IGE PANELS? A QUALITY IMPROVEMENT NEEDS ASSESSMENT. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.684] [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: 11/11/2022]
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Xu J, Chandrakasan S, Lee G. AN ATYPICAL PRESENTATION OF FAMILIAL MEDITERRANEAN FEVER. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.868] [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: 11/11/2022]
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Segan L, Canovas R, Nanayakkara S, Chieng D, Prabhu S, Ling LH, Voskoboinik A, Sugumar H, Lee G, Morton J, Kalman J, Kistler P. Development and validation of the HARMS2-AF lifestyle risk score to predict incident AF. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Lifestyle risk factors (RFs) are a modifiable target in atrial fibrillation (AF) management. However, the relative contribution of individual lifestyle RFs to AF incidence has not been described.
Purpose
Development and validation of a novel AF-lifestyle risk score to determine AF risk in the general population.
Methods
The UK Biobank (UKB) is a large prospective cohort with outcomes measured >10 years. In the UKB, we performed regression analysis of AF lifestyle RFs which were then evaluated in a multivariable model and a weighted score was developed. Next, the risk score was externally validated in the Framingham Heart Study (FHS) population. Kaplan-Meier estimates ascertained the 10-year risk of AF development.
Results
In the UKB, AF incidence was 5.3% among 302,926 participants, with a median time to AF 7.3 years (IQR 4.3–9.8). Hypertension, sleep apnoea, male sex, age, obesity (BMI>30 kg/m2), alcohol and smoking were predictive variables (all p<0.001); physical inactivity (OR 1.02,95% CI 0.97–1.10, p=0.3), diabetes (OR 0.98,95% CI 0.91–1.06, p=0.2) and BMI 27–30 kg/m2 (OR 1.02, 95% CI 0.97–1.07, p=0.424) were not significant. The HARMS2-AF score (Figure 1) had similar predictive performance (AUC=0.782, LogLoss 0.178, Brier Score 0.046) to the unweighted regression model (AUC 0.808) in the UKB. Validation in the FHS (AF incidence 6.7% of 7206 participants) maintained excellent predictive performance with an AUC of 0.747 (95% CI 0.724–0.769, Figure 2). A higher HARMS2-AF score (>5 points) was associated with a heightened 10-year AF risk (score 5–9: OR 9.35, score 10–14: OR 33.34).
Conclusions
The HARMS2-AF score is a novel lifestyle risk score which may help identify individuals at risk of AF and assists in general population screening.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- L Segan
- The Alfred Hospital , Melbourne , Australia
| | - R Canovas
- Baker Heart and Diabetes Institute , Melbourne , Australia
| | | | - D Chieng
- The Alfred Hospital , Melbourne , Australia
| | - S Prabhu
- The Alfred Hospital , Melbourne , Australia
| | - L H Ling
- The Alfred Hospital , Melbourne , Australia
| | | | - H Sugumar
- The Alfred Hospital , Melbourne , Australia
| | - G Lee
- Royal Melbourne Hospital, Department of Cardiology , Melbourne , Australia
| | - J Morton
- Royal Melbourne Hospital, Department of Cardiology , Melbourne , Australia
| | - J Kalman
- Royal Melbourne Hospital, Department of Cardiology , Melbourne , Australia
| | - P Kistler
- The Alfred Hospital , Melbourne , Australia
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Chieng D, Sugumar H, Segan L, Al-Kaisey A, Hawson J, Prabhu S, Voskoboinik A, Morton JB, Lee G, Mariani J, La Gerche A, Kistler PM, Kalman JM, Kaye DM, Ling LH. Catheter ablation in atrial fibrillation and heart failure with preserved ejection fraction improves peak pulmonary capillary wedge pressure, exercise capacity and quality of life: RCT STALL HFpEF. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Atrial fibrillation (AF) frequently accompanies heart failure with preserved ejection fraction (HFpEF). AF exacerbates HFpEF through adverse haemodynamic effects. In turn, HFpEF promotes AF through adverse left atrial remodelling. Observational data suggest sinus rhythm restoration improves outcomes in patients with AF and HFpEF. However, there are no randomised data examining the effects of rhythm control with catheter-based AF ablation on HFpEF outcomes.
Purpose
To compare the effects of AF ablation versus usual medical therapy on markers of HFpEF severity, including exercise haemodynamics, natriuretic peptide levels and patient symptoms.
Methods
Patients with symptomatic AF and HFpEF underwent exercise right heart catheterization (RHC) and cardiopulmonary exercise testing (CPET). HFpEF diagnosis was based on left ventricular ejection fraction (LVEF) ≥50%, elevated natriuretic peptide and echocardiographic diastolic impairment. HFpEF was confirmed on exercise RHC based on peak exercise pulmonary capillary wedge pressure (PCWP) of ≥25mmHg. Patients were randomised to AF ablation versus medical therapy, with investigations repeated at 6 months. The primary outcome was change in PCWP on follow-up.
Results
31 patients aged 66.1±7.5 years were randomized to AF ablation (16) versus medical therapy (15), with 51.6% female and 80.6% persistent AF. Baseline characteristics were comparable across groups. Paired analyses of ablation cohort showed significant reductions in peak PCWP (29.6±3.7 vs 25.9±4.6 mmHg, p<0.01), PCWP indexed for workload (39.0±57.9 vs 33.0±50.5 mmHg/W/kg, p<0.01), and BNP (146.2±80.5 vs 82.2±75.4 pg/mL, p=0.01); and increased resting cardiac output (4.6±0.9 vs 5.6±1.2 L/min, p=0.01), peak cardiac output (9.6±4.2 vs 10.4±3.7 L/min, p=0.02), peak (30s averaged) VO2 (1875.1±759.2 vs 2193.7±878.1 mL/min, p<0.01), peak absolute VO2 (1937.3±739.3 vs 2216.3±861.9 mL/min, p<0.01), peak (30s averaged) relative VO2 (19.4±5.9 vs 22.9±7.4 ml/kg/min) and peak workload (162.0±81.1 vs 184.4±83.4 W, p<0.01). Quality of life scores improved: AFEQT (45.3±20.9 vs 75±20.7, p<0.01) and MLHF (53±23.3 vs 17.5±22.8, p<0.01). Reversal of HFpEF by PCWP criteria occurred in 31.2% following AF ablation, and 50% among those free from arrhythmia recurrence. In the medical arm, there were no significant differences in RHC, CPET, and natriuretic peptide outcomes on follow-up versus baseline. Repeated measures mixed ANOVA testing showed significant time-randomisation interaction on peak VO2, absolute peak VO2, peak relative VO2, AFEQT/ MLHF scores, suggesting that significant improvements in these parameters were related to AF ablation.
Conclusion
In patients with concomitant AF and HFpEF, AF ablation improves invasive exercise haemodynamic parameters, increases exercise capacity, and enhances quality of life. Successful AF ablation may reverse the clinical syndrome of HFpEF in a subset of cases.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Chieng
- Baker Heart and Diabetes Institute , Melbourne , Australia
| | - H Sugumar
- Baker Heart and Diabetes Institute , Melbourne , Australia
| | - L Segan
- Baker Heart and Diabetes Institute , Melbourne , Australia
| | - A Al-Kaisey
- Royal Melbourne Hospital, Cardiology , Melbourne , Australia
| | - J Hawson
- Royal Melbourne Hospital, Cardiology , Melbourne , Australia
| | - S Prabhu
- Baker Heart and Diabetes Institute , Melbourne , Australia
| | - A Voskoboinik
- Baker Heart and Diabetes Institute , Melbourne , Australia
| | - J B Morton
- Royal Melbourne Hospital, Cardiology , Melbourne , Australia
| | - G Lee
- Royal Melbourne Hospital, Cardiology , Melbourne , Australia
| | - J Mariani
- The Alfred Hospital , Melbourne , Australia
| | - A La Gerche
- Baker Heart and Diabetes Institute , Melbourne , Australia
| | - P M Kistler
- Baker Heart and Diabetes Institute , Melbourne , Australia
| | - J M Kalman
- Royal Melbourne Hospital, Cardiology , Melbourne , Australia
| | - D M Kaye
- Baker Heart and Diabetes Institute , Melbourne , Australia
| | - L H Ling
- Baker Heart and Diabetes Institute , Melbourne , Australia
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Segan L, Nanayakkara S, Spear E, Shirwaiker A, Chieng D, Sugumar H, Ling LH, Prabhu S, Lee G, Morton J, Kalman J, Voskoboinik A, Kistler P. Clinical risk prediction for left atrial appendage thrombus among patients with atrial fibrillation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Exclusion of left atrial appendage thrombus (LAAT) by transoesophageal echocardiography (TOE) is recommended in patients with inadequate anticoagulation prior to direct cardioversion (DCR) or catheter ablation for atrial fibrillation/flutter (AF/AFL). LAAT risk factors in this population remain poorly defined.
Purpose
Determine LAAT predictors in AF/AFL patients undergoing pre-procedural TOE.
Methods
We evaluated available clinical and transthoracic echocardiographic (TTE) parameters in AF/AFL patients undergoing TOE between 1999–2022 in our institution in Melbourne, Australia. Regression analysis identified predictors of LAAT, which were applied to a weighted score developed in the derivation cohort (70%) and validated in the remaining 30%.
Results
Of 627 patients (age 62±12 years, 27% female, AF 84%,AFL 16%, left ventricular ejection fraction (LVEF) 44±20%), 24% had LAAT and 13.8% dense spontaneous echo contrast precluding DCR. Anticoagulation was NOAC 56.5%, warfarin 32.1% and none in 11.4%. In the LAAT cohort, thrombus resolution occurred in 39% on serial transoesophageal imaging with a median time to resolution of 131 days (IQR 54–398).
Diabetes (p=0.004), prior stroke (p=0.009), coronary disease (p=0.015), renal impairment (p<0.001) and CHADS2VASc >2 (73% vs. 55%, p<0.001) were higher in the LAAT cohort. Age (p=0.093), gender (p=0.689), BMI (p=0.828), anticoagulant type (p=0.316) and diabetes (p=0.107) were not univariate predictors, whereas anticoagulation duration (<30 days), creatinine and TTE markers of remodeling (LVEF, LAVI, RVSP and TAPSE) were independent predictors on univariate and multivariate regression; CHADS2VASc was not significant after adjustment (p=0.090). The weighted risk model included continuous (age, creatinine, LVEF, LAVI, TAPSE and RVSP) and categorical (anticoagulation duration) variables with excellent predictive performance: AUC 0.872 (95% CI 0.798–0.946), PPV 91%, NPV 70% and accuracy 80%.
Conclusion
A novel LAAT risk model comprising clinical and echocardiographic parameters enhances risk prediction over CHADS2VASc in AF/AFL and may guide the need for pre-procedural TOE imaging.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- L Segan
- The Alfred Hospital , Melbourne , Australia
| | | | - E Spear
- Monash Health, General Medicine , Melbourne , Australia
| | | | - D Chieng
- The Alfred Hospital , Melbourne , Australia
| | - H Sugumar
- The Alfred Hospital , Melbourne , Australia
| | - L H Ling
- The Alfred Hospital , Melbourne , Australia
| | - S Prabhu
- The Alfred Hospital , Melbourne , Australia
| | - G Lee
- Royal Melbourne Hospital, Department of Cardiology , Melbourne , Australia
| | - J Morton
- Royal Melbourne Hospital, Department of Cardiology , Melbourne , Australia
| | - J Kalman
- Royal Melbourne Hospital, Department of Cardiology , Melbourne , Australia
| | | | - P Kistler
- The Alfred Hospital , Melbourne , Australia
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Lee G, Durante A, Vellone E, Dellafiore F, Cagginelli G, Khan M, Baker EE, Khatib R. Patients and healthcare professionals views on injectables for cardiovascular disease. Eur Heart J 2022. [PMCID: PMC9619637 DOI: 10.1093/eurheartj/ehac544.2757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction Injectable medicines are increasingly used to manage risk factors for cardiovascular (CV) events, such as PCSK-9 inhibitors in dyslipidaemia and GLP-1 agonists in diabetes. However, there is a paucity of data around the administrative and clinical practicalities when using these injectables, and limited information on patient and healthcare professionals' perceptions. Purpose To identify the facilitators and barriers on the use of injectable therapies with CV benefits by undertaking interviews with patients, caregivers and healthcare professionals (HCPs). Methods Interviews were conducted via telephone and using MS Teams due to Covid-19 restrictions in the United Kingdom (London and Leeds) and Italy (Rome and Milan) in 2021. Coding was undertaken using NVivo and thematic analysis performed. Results A total of 56 patients were interviewed: 30 in the U.K. (mean age 66 yrs, 60% male) and 26 patients in Italy (mean age 63 yrs, 80% male) and 11 caregivers (mean age 59 yrs, 73% female). A total of 38 HCPs were interviewed, 19 in each country and composed of physicians (n=18), pharmacists (n=10), nurses (n=9) and pharmacy technician (n=1). Three distinct themes were identified: (i) Organisational and governance issues - relating to prescribing restrictions and availability of the drugs locally (PCSK9i are initiated and supplied from hospitals) and lack of communication between hospital and primary care setting; (ii) Clinical issues around HCPs' skills and experience - including: lack of experience with these injectables, lack of time to provide education to patients and caregivers, therapeutic inertia (HCPs not adopting a change in practice despite the evidence or due to bureaucratic restrictions) as well as lack of knowledge on long-term effects, and finally (iii) Patient-related issues - relating to behaviours and beliefs such as reluctance about using injectable therapies, and lack of education about these injectables in terms of indications/clinical benefits for use. Despite some differences in the prescribing of these injectables in the two countries, the analysis captured similar facilitators and barriers. Facilitators included prior use of injectables (e.g. insulin), and the ability to reach a clinical target of lower cholesterol by having just a “one shot”. HCPs stated that access to rapid pathology tests would aid uptake of injectables with CV benefit as well as having educational tools on these injectables in practice. Conclusion This qualitative study identified barriers to initiation, continuation, and adherence with injectable therapies with CV benefits but also highlighted areas where changes can be made especially around education and support for patients and HCPs. Funding Acknowledgement Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): ACNAP education grant. Sponsored by Amgem and Novo Nordisk
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Affiliation(s)
- G Lee
- King's College London , London , United Kingdom
| | - A Durante
- University of Rome Tor Vergata, Nursing , Rome , Italy
| | - E Vellone
- University of Rome Tor Vergata, Nursing , Rome , Italy
| | | | - G Cagginelli
- University of Rome Tor Vergata, Nursing , Rome , Italy
| | - M Khan
- Leeds Teaching Hospitals NHS Trust, Pharmacy , Leeds , United Kingdom
| | - E E Baker
- King's College London , London , United Kingdom
| | - R Khatib
- Leeds Teaching Hospitals NHS Trust, Pharmacy , Leeds , United Kingdom
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14
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Lee G, Malik A, Vervoort D, Tam D, Marquis-Gravel G, Gaudino M, Fremes S. PERCUTANEOUS CORONARY INTERVENTION VERSUS CORONARY ARTERY BYPASS GRAFTING FOR PATIENTS WITH LEFT VENTRICULAR SYSTOLIC DYSFUNCTION: A META-ANALYSIS OF KAPLAN-MEIER DERIVED INDIVIDUAL PATIENT DATA. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.194] [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: 11/02/2022] Open
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15
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Sieger J, Brümmer F, Ahn H, Lee G, Kim S, Schill RO. Reduced ageing in the frozen state in the tardigrade
Milnesium inceptum
(Eutardigrada: Apochela). J Zool (1987) 2022. [DOI: 10.1111/jzo.13018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J. Sieger
- Institute of Biomaterials and Biomolecular Systems, University of Stuttgart Stuttgart Germany
| | - F. Brümmer
- Institute of Biomaterials and Biomolecular Systems, University of Stuttgart Stuttgart Germany
| | - H. Ahn
- Department of Life Sciences Pohang University of Science and Technology Pohang South Korea
| | - G. Lee
- Department of Life Sciences Pohang University of Science and Technology Pohang South Korea
| | - S. Kim
- Department of Life Sciences Pohang University of Science and Technology Pohang South Korea
| | - R. O. Schill
- Institute of Biomaterials and Biomolecular Systems, University of Stuttgart Stuttgart Germany
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16
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Acharya M, Lee D, Maharjan A, Yang S, Seo S, Kang H, Sin J, Lee G, Yu Y, Park J, Lee G, Kim C, Kim H, Heo Y. P10-04 Development of alternative test method for immunotoxicity prediction on chemical substances through profiling of cytokines production from THP-1 cell line. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Kim M, Park S, Kim YH, Lee G. EP07.01-015 Multimodality Imaging for Characterization, Classification, and Staging of Malignant Pleural Mesothelioma, Focusing on MR Imaging. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.547] [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: 10/14/2022]
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18
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Krymova E, Béjar B, Thanou D, Sun T, Manetti E, Lee G, Namigai K, Choirat C, Flahault A, Obozinski G. Trend estimation and short-term forecasting of COVID-19 cases and deaths worldwide. Proc Natl Acad Sci U S A 2022; 119:e2112656119. [PMID: 35921436 PMCID: PMC9371653 DOI: 10.1073/pnas.2112656119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 06/06/2022] [Indexed: 02/05/2023] Open
Abstract
Since the beginning of the COVID-19 pandemic, many dashboards have emerged as useful tools to monitor its evolution, inform the public, and assist governments in decision-making. Here, we present a globally applicable method, integrated in a daily updated dashboard that provides an estimate of the trend in the evolution of the number of cases and deaths from reported data of more than 200 countries and territories, as well as 7-d forecasts. One of the significant difficulties in managing a quickly propagating epidemic is that the details of the dynamic needed to forecast its evolution are obscured by the delays in the identification of cases and deaths and by irregular reporting. Our forecasting methodology substantially relies on estimating the underlying trend in the observed time series using robust seasonal trend decomposition techniques. This allows us to obtain forecasts with simple yet effective extrapolation methods in linear or log scale. We present the results of an assessment of our forecasting methodology and discuss its application to the production of global and regional risk maps.
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Affiliation(s)
- Ekaterina Krymova
- Swiss Data Science Center, École Polytechnique Fédérale de Lausanne and Eidgenössische Technische Hochschule Zürich, 1015 Lausanne, Switzerland
| | - Benjamín Béjar
- Swiss Data Science Center, École Polytechnique Fédérale de Lausanne and Eidgenössische Technische Hochschule Zürich, 1015 Lausanne, Switzerland
| | - Dorina Thanou
- Center for Intelligent Systems, École Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland
| | - Tao Sun
- Swiss Data Science Center, École Polytechnique Fédérale de Lausanne and Eidgenössische Technische Hochschule Zürich, 1015 Lausanne, Switzerland
| | - Elisa Manetti
- Institute of Global Health, Faculty of Medicine, University of Geneva, 1202 Geneva, Switzerland
| | - Gavin Lee
- Swiss Data Science Center, École Polytechnique Fédérale de Lausanne and Eidgenössische Technische Hochschule Zürich, 1015 Lausanne, Switzerland
| | - Kristen Namigai
- Institute of Global Health, Faculty of Medicine, University of Geneva, 1202 Geneva, Switzerland
| | - Christine Choirat
- Swiss Data Science Center, École Polytechnique Fédérale de Lausanne and Eidgenössische Technische Hochschule Zürich, 1015 Lausanne, Switzerland
| | - Antoine Flahault
- Institute of Global Health, Faculty of Medicine, University of Geneva, 1202 Geneva, Switzerland
| | - Guillaume Obozinski
- Swiss Data Science Center, École Polytechnique Fédérale de Lausanne and Eidgenössische Technische Hochschule Zürich, 1015 Lausanne, Switzerland
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19
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Wieser J, Chen A, Lee G, Baughman L, Pope E, Franco A, Verhave B, Johnson B, Love T, Beck L, Ryan Wolf J. 388 Impact of crisaborole & tacrolimus 0.03% on patient-reported outcomes and caregiver burden in children with atopic dermatitis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.397] [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]
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20
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Kumar V, Lee G, Yoo J, Ro HS, Lee KW. An attention mechanism-based LSTM network for cancer kinase activity prediction. SAR QSAR Environ Res 2022; 33:631-647. [PMID: 36062308 DOI: 10.1080/1062936x.2022.2109062] [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] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 07/30/2022] [Indexed: 06/15/2023]
Abstract
Despite the endeavours and achievements made in treating cancers during the past decades, resistance to available kinase drugs continues to be a major problem in cancer therapies. Thus, it is highly desirable to develop computational models that can predict the bioactivity of a compound against cancer kinases. Here, we present a Long Short-Term Memory (LSTM) framework for predicting the activities of lead molecules against seven different kinases. A total of 14,907 compounds from the ChEMBL database were selected for model building. Two different molecular representations, namely, 2D descriptors and MACCS fingerprints were subjected to the LSTM method for the training process. We also successfully integrated an attention mechanism into our model, which helped us to interpret the contribution of chemical features on kinase activity. The attention mechanism extracted the significant chemical moieties more effectively by taking them into consideration during the activity prediction. The recorded accuracies in the test sets for both 2D descriptors and MACCS fingerprints-based models were 0.81 and 0.78, respectively. The receiver operating characteristic curve (ROC)-area under the curve (AUC) score for both models was in the range of 0.8-0.99. The proposed framework can be a good starting point for the development of new cancer kinase drugs.
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Affiliation(s)
- V Kumar
- Department of Bio & Medical Big Data (BK21 Four Program), Division of Life Sciences, Research Institute of Life Sciences, Gyeongsang National University, Jinju, Korea
| | - G Lee
- Division of Applied Life Science (BK21 Program), ABC-RLRC, PMBBRC, Gyeongsang National University, Jinju, Korea
| | - J Yoo
- Division of Applied Life Science (BK21 Program), Research Institute of Life Sciences, Gyeongsang National University, Jinju, Korea
| | - H S Ro
- Department of Bio & Medical Big Data (BK21 Four Program), Division of Life Sciences, Research Institute of Life Sciences, Gyeongsang National University, Jinju, Korea
| | - K W Lee
- Department of Bio & Medical Big Data (BK21 Four Program), Division of Life Sciences, Research Institute of Life Sciences, Gyeongsang National University, Jinju, Korea
- ANGEL i-Drug Design (AiDD), Jinju, Korea
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21
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22
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Christifano DN, Crawford SA, Lee G, Gajewski BJ, Carlson SE. Utility of a 7- question online screener for DHA intake. Prostaglandins Leukot Essent Fatty Acids 2022; 177:102399. [PMID: 35063885 PMCID: PMC8825685 DOI: 10.1016/j.plefa.2022.102399] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/06/2022] [Accepted: 01/06/2022] [Indexed: 02/03/2023]
Abstract
The secondary analyses of two large, recently completed randomized clinical trials of DHA supplementation in pregnancy found that women with a low baseline DHA status benefited from randomization to a higher dose (800 vs 0 and 1000 vs 200 mg/day DHA). To obtain DHA status, it is necessary to obtain a blood sample and conduct an analysis using gas chromatography (GC) or GC-mass spectrometry (GCMS), both barriers to clinics where pregnant women receive advice on nutrition. Participants consuming less than 150 mg/day of DHA at baseline in our recent trial had a lower risk of early preterm birth and preterm birth when assigned to 1000 vs 200 m/day DHA. DHA intake was determined using a 7-question food frequency questionnaire administered by a trained nutritionist. Because the need for trained personnel to administer the questionnaire would be a barrier to implementing this finding in clinical management of pregnancy, the goal of this study was to determine if an online version of the questionnaire could be validly completed without assistance.
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Affiliation(s)
- D N Christifano
- The University of Kansas Medical Center, Department of Dietetics and Nutrition, Kansas City, KS, USA; The University of Kansas Medical Center, Hoglund Biomedical Imaging Center, Kansas City, KS, USA
| | - S A Crawford
- The University of Kansas Medical Center, Department of Dietetics and Nutrition, Kansas City, KS, USA
| | - G Lee
- The University of Kansas Medical Center, Department of Obstetrics and Gynecology, Kansas City, KS, USA
| | - B J Gajewski
- The University of Kansas Medical Center, Department of Biostatistics & Data Science, Kansas City, KS, USA
| | - S E Carlson
- The University of Kansas Medical Center, Department of Dietetics and Nutrition, Kansas City, KS, USA.
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23
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Al-Kaisey A, Parameswaran R, Anderson R, Chieng D, Hawson J, Voskoboinik A, Sugumar H, Wong G, West D, Azzopardi S, Joseph S, McLellan A, Ling L, Bryant C, Finch S, Sanders P, Lee G, Kistler P, Kalman J. Randomised Evaluation of the Impact of Catheter Ablation on Cognitive Function in Atrial Fibrillation. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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24
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Segan L, Chieng D, Lee G, Sugumar H, Voskoboinik A, Ling L, Morton J, Kalman J, Kistler P, Prabhu S. The Impact of Atrial Scarring on AF Recurrence and LV Recovery in AF-Mediated Cardiomyopathy. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.024] [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: 10/16/2022]
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25
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Chieng D, Segan L, Sugumar H, Al-Kaisey A, Hawson J, Moore B, Nam M, Voskoboinik A, Prabhu S, Ling L, Ng J, Brown G, Lee G, Morton J, Debinski H, Kalman J, Kistler P. High Power Short Duration (HPSD) is Safe and Improves Outcomes for Atrial Fibrillation Ablation vs Lower Power Longer Duration (LPLD): A Prospective Multi-Centre Randomised Controlled Study (Hi-Lo HEAT trial). Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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Chieng D, Canovas R, Segan L, Sugumar H, Voskoboinik A, Prabhu S, Ling L, Lee G, Morton J, Kaye D, Kalman J, Kistler P. Effects of Habitual Coffee Consumption on Incident Cardiovascular Disease, Arrhythmia, and Mortality: Long Term Outcomes From the UK Biobank. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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27
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Chieng D, Kistler P, Canovas R, Kaye D, Morton J, Lee G, Ling L, Prabhu S, Voskoboinik A, Sugumar H, Segan L, Kalman J. Regular Coffee Intake Is Safe and Associated With Improved Mortality in Prevalent Cardiovascular Disease and /or Arrhythmia. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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28
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Segan L, Canovas R, Nanayakkara S, Chieng D, Prabhu S, Sugumar H, Voskoboinik A, Ling L, Morton J, Lee G, Kalman J, Kistler P. Development and Validation of the HARMS2-AF Lifestyle Risk Score to Predict Incident AF. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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29
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Chieng D, Sugumar H, Segan L, Tan C, Vizi D, Al-Kaisey A, Hawson J, Prabhu S, Voskoboinik A, Morton J, Lee G, Mariani J, Le Gerche A, Kistler P, Kalman J, Kaye D, Ling L. Catheter Ablation in Atrial Fibrillation and Heart Failure With Preserved Ejection Fraction Improves Peak Pulmonary Capillary Wedge Pressure, Exercise Capacity and Quality of Life. A Prospective Randomised Controlled Trial (RCT-STALL HFpEF). Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.021] [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]
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30
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Segan L, Canovas R, Nanayakkara S, Chieng D, Prabhu S, Ling L, Voskoboinik A, Sugumar H, Lee G, Morton J, Kalman J, Kistler P. Development of an AF Lifestyle Score for Risk Prediction in Incident AF. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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31
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Kim D, Lee G, Chapman P, Bussiere M, Daartz J, Loeffler J, Shih H. Two-Fraction Proton Beam Stereotactic Radiosurgery for Cerebral Arteriovenous Malformations. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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32
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Lee G, Vollmer D, Han X. A Phytocannabinoid Formula Containing Palmitoylethanolamide, Acmella Oleracea Extract, and Bovine Colostrum Filtrate Inhibited Cytokine and Chemokine Production in Human Peripheral Blood Mononuclear Cells Stimulated Ex Vivo. CURR TOP NUTRACEUT R 2021. [DOI: 10.37290/ctnr2641-452x.20:438-446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
A phytocannabinoid formula containing copaiba essential oil, palmitoylethanolamide, Sichuan pepper extract, Acmella oleracea extract, cruciferous vegetable extracts blend, and bovine colostrum filtrate was tested for its ex vivo effect on inhibiting stimulated cytokine release in human peripheral blood mononuclear cells. Effects of the phytocannabinoid formula on the peripheral blood mononuclear cells viability were measured by alamarBlue™ to confirm no obvious cytotoxicity. The phytocannabinoid formula was compared to reference compounds for its ability to inhibit both the phytohemagglutinin-stimulated release of the cytokines from T-cells and the lipopolysaccharide-stimulated release of the cytokines from macrophages/monocytes in human peripheral blood mononuclear cells. The T cell cytokine responses measured were those of interleukins (interleukin-1β, interleukin-2, interleukin-4, interleukin-5, interleukin-6, interleukin-8, interleukin-10, and interleukin-13) and interferon-gamma, interferon gamma-induced protein 10, macrophage inflammatory protein-1α, and tumor necrosis factor-α. The macrophage and monocyte cytokine responses measured were of interleukin-1β, interleukin-6, interleukin-8, macrophage inflammatory protein-1α, and tumor necrosis factor-α. For the phytohemagglutinin-stimulated T cell production of cytokines, the peripheral blood mononuclear cells treated with the Phytocannabinoid formula at 2 μg/mL and 20 μg/mL showed significant inhibition of interleukin-2, interleukin-6, interleukin-5, interleukin-8, interleukin-10, interleukin-13, and interferon gamma-induced protein 10 production. The phytocannabinoid formula also significantly reduced the macrophage/monocyte production of interleukin-1β and interleukin-6. Results from the present study showed that the phytocannabinoid formula inhibited cytokines and chemokines production in ex vivo stimulated human peripheral blood mononuclear cells, suggesting a potential immunomodulatory effect.
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Affiliation(s)
- G. Lee
- 4Life Research USA, LLC, 9850 S 300 W, Sandy, UT 84070 USA
| | - D. Vollmer
- 4Life Research USA, LLC, 9850 S 300 W, Sandy, UT 84070 USA
| | - X. Han
- 4Life Research USA, LLC, 9850 S 300 W, Sandy, UT 84070 USA
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Lee G, Clough O, McLean E, Campioni-Norman D. 1552 'The Modified Cappuccini Audit Tool: Patient Safety in the Operating Theatre'. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aim
To assess our trust over a period of two weeks with regard to safe supervision of surgical and anaesthetic trainees within the operating theatre using the Cappuccini audit tool.
Method
Between 7th of December 2020 and 18th December 2020 the anaesthetic and surgical team were approached and if there was a trainee present, they were asked a set of questions as follows:
If the supervisor is present in theatre no further action would be taken. If the supervisor was not present the volunteer would attempt to contact the supervisor by the method given by the trainee, and they were asked several questions:
Results
146 trainees were identified during our period. Of these the supervisor was present in 93% of cases. Of those not present 90% were contactable by phone, the other 10% were contactable by the trainee themselves. All trainees were happy to answer the questions was explained and all consultants were happy to be contacted. The average time to attend when not present was 2 minutes and 36 seconds.
Conclusions
We have shown the Cappuccini audit tool to be effective in determining safe supervision and found it in general to be well received within surgery and anaesthetics. We found our trust to have safe supervision in the operating theatre.
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Affiliation(s)
- G Lee
- Imperial College NHS Trust, London, United Kingdom
| | - O Clough
- Imperial College NHS Trust, London, United Kingdom
| | - El McLean
- Imperial College NHS Trust, London, United Kingdom
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Clough O, Lee G, Walker J. 423 Patient Perspective on the Use of the Independent Sector to Maintain Elective NHS Services During the COVID-19 Pandemic. Br J Surg 2021. [PMCID: PMC8524587 DOI: 10.1093/bjs/znab259.459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
COVID-19 resulted in the suspension of planned treatments for patients worldwide leaving millions suffering the physical and mental effects of delay. Reports indicate that when services have been re-established, patients have been afraid to take up appointments. Hospitals put processes in place to counter this, notably separating emergency and elective patient cohorts. Most notably seen by the co-operation between the NHS and independent private healthcare providers in March 2020 at the height of the pandemic. We undertook a study to ascertain the perceptions of NHS patients who underwent elective treatment at independent ‘cold’ sites during the COVID-19 pandemic.
Method
A cross-sectional study with structured telephone interviews of patients who had planned elective treatments at ‘cold’ independent hospitals between March and September 2020. 1150 patients were identified, and a 20% sample formed a 230 patient study group, with 158 (70%) agreeing to participate.
Results
30% of patients delayed their treatment due to COVID related concerns, with 76% of these only accepting treatment because this was at a ‘cold’ site. 46% of patients perceived treatment at a ‘cold’ site as the most important factor contributing to their safety. 153 patients (97%) supported the paid arrangement between the NHS and the independent sector to provide separate ‘cold’ sites for elective treatments.
Discussion
Safely restarting elective services to allow important planned treatments to take place, as was the pandemic continues, is a priority. Our study indicates that physical separation of patient pathways impacted most on patient confidence, and that the use of ‘cold’ sites is a viable option.
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Affiliation(s)
- O Clough
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - G Lee
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - J Walker
- Imperial College Healthcare NHS Trust, London, United Kingdom
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Ahn B, Yoon S, Lee G, Kim H, Jang S, Hwang H. MA14.05 Clinicopathologic and Genomic Significances of the Amount of High-Grade Histologic Components in Lung Adenocarcinoma. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Park J, Park I, Hwang J, Bae W, Lee G, Kim L, Choi Y, Jung H, Kim M, Hong S, Lee H, Yu E, Lee A, Park Y, Chae Y. P21.02 Real-World Concordance Between Tumor Mutational Burden From Blood and Tissue in Lung Cancer and Other Cancers. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lim S, Kim DW, Jung J, Lee G, Ryou JH, Kang SU, Lee YH, Shin HJ, Yum S, Yim E, Lee SY, Ahn J. 1365TiP A phase I/II, open-label study of BBT-176, a triple mutation targeting EGFR TKI, in patients with NSCLC who progressed after prior EGFR TKI therapy. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Choi Y, Bang Y, Park M, Lee G, Shin SY, Kim S. CN7 Prediction of onset timing of breakthrough pain using deep learning model. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Lee G, Liang JW, Zhang Q, Huang T, Choirat C, Parmigani G, Braun D. Multi-syndrome, multi-gene risk modeling for individuals with a family history of cancer with the novel R package PanelPRO. eLife 2021; 10:68699. [PMID: 34406119 PMCID: PMC8478415 DOI: 10.7554/elife.68699] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 08/16/2021] [Indexed: 01/01/2023] Open
Abstract
Identifying individuals who are at high risk of cancer due to inherited germline mutations is critical for effective implementation of personalized prevention strategies. Most existing models focus on a few specific syndromes; however, recent evidence from multi-gene panel testing shows that many syndromes are overlapping, motivating the development of models that incorporate family history on several cancers and predict mutations for a comprehensive panel of genes. We present PanelPRO, a new, open-source R package providing a fast, flexible back-end for multi-gene, multi-cancer risk modeling with pedigree data. It includes a customizable database with default parameter values estimated from published studies and allows users to select any combinations of genes and cancers for their models, including well-established single syndrome BayesMendel models (BRCAPRO and MMRPRO). This leads to more accurate risk predictions and ultimately has a high impact on prevention strategies for cancer and clinical decision making. The package is available for download for research purposes at https://projects.iq.harvard.edu/bayesmendel/panelpro.
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Affiliation(s)
- Gavin Lee
- Swiss Data Science Center, ETH Zürich and EPFL, Lausanne, Switzerland
| | - Jane W Liang
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, United States.,Department of Data Sciences, Dana-Farber Cancer Institute, Boston, United States
| | - Qing Zhang
- Broad Institute of MIT and Harvard, Cambridge, United States
| | - Theodore Huang
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, United States.,Department of Data Sciences, Dana-Farber Cancer Institute, Boston, United States
| | - Christine Choirat
- Swiss Data Science Center, ETH Zürich and EPFL, Lausanne, Switzerland
| | - Giovanni Parmigani
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, United States.,Department of Data Sciences, Dana-Farber Cancer Institute, Boston, United States
| | - Danielle Braun
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, United States.,Department of Data Sciences, Dana-Farber Cancer Institute, Boston, United States
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Lee G, Meyer AJ, Kizito S, Katamba A, Davis JL, Armstrong-Hough M. Predictors of evaluation in child contacts of TB patients. Int J Tuberc Lung Dis 2021; 24:847-849. [PMID: 32912391 DOI: 10.5588/ijtld.20.0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- G Lee
- Department of Infectious Diseases, Children´s Hospital of Philadelphia, Philadelphia, PA, Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - A J Meyer
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA, Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala
| | - S Kizito
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala
| | - A Katamba
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Clinical Epidemiology and Biostatistics Unit, Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - J L Davis
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA, Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Pulmonary, Critical Care, and Sleep Medicine Section, Yale School of Medicine, New Haven, CT
| | - M Armstrong-Hough
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Department of Social and Behavioral Sciences and Department of Epidemiology, School of Global Public Health, New York University, New York, NY, USA, ,
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Hwang H, Lee G, Jang S. P35.02 Lung Adenocarcinoma with Oncogenic SMARCA4 Mutation: Possible Target of Cancer Immunotherapy. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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42
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Yao J, Soon H, Wong J, Fogarty S, Aggarwal A, Lee G, Kalman J, McLellan A. An Atypical Presentation of Takotsubo Cardiomyopathy Causing Torsades de Pointes. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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43
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Al-kaisey A, Parameswaran R, Anderson R, Hawson J, Chieng D, Sugumar H, Nam M, Tonchev I, Watts T, McLellan A, Kistler P, Lee G, Kalman J. Left and Right Atrial Septal Phase Mapping of Persistent Atrial Fibrillation: Marked Electrical Dissociation and Heterogeneous Activation Patterns. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kistler P, Chieng D, Tonchev I, Sugumar H, McLellan A, Prabhu S, Voskoboinik A, Schwartz L, Parameswaran R, Anderson R, Al-Kaisey A, Ling L, Lee G, Kalman J. P-wave Morphology in Focal Atrial Tachycardia: An Updated 2021 Algorithm to Predict Site of Origin. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.158] [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] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chieng D, Sugumar H, Kaye D, Azzopardi S, Vizi D, Rossi E, Voskoboinik A, Prabhu S, Ling L, Lee G, Kalman J, Kistler P. Prone and Supine 12 Lead Electrocardiography Comparisons: Utility of the Prone ECG for the Detection of Cardiac Conditions in Patients Requiring Prone Ventilation with COVID-19. Heart Lung Circ 2021. [PMCID: PMC8324102 DOI: 10.1016/j.hlc.2021.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Yun JM, Choi S, Kim K, Kim SM, Son JS, Lee G, Jeong SM, Park SY, Kim YY, Park SM. All-cause mortality, cardiovascular mortality, and incidence of cardiovascular disease according to a screening program of cardiovascular risk in South Korea among young adults: a nationwide cohort study. Public Health 2020; 190:23-29. [PMID: 33338899 DOI: 10.1016/j.puhe.2020.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 08/03/2020] [Accepted: 10/29/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES We aimed to determine whether there are any differences in all-cause and cause-specific mortality with cardiovascular disease (CVD) risk between health screening attenders and non-attenders among young adults. STUDY DESIGN We performed a retrospective cohort study using claim data from the Korean National Health Insurance Service database. METHODS Individuals aged 20-39 years who had received health screening at least once between 2002 and 2005 were classified as attenders, and the others were classified as non-attenders. After propensity score matching according to attendance of health screening, 2,060,409 attenders and 2,060,409 non-attenders were included. We estimated adjusted hazard ratios (HRs) and 95% confidence interval (CI) for all-cause mortality, cause-specific mortality, and hospitalization of CVD from 2006 to 2015. RESULTS Survival from all-cause mortality was greater among attenders than among non-attenders (log rank P < 0.001). Similarly, death from CVD (log rank P = 0.007) and CVD events (log rank P < 0.001) were less likely among attenders. The risk for all-cause mortality in attenders was significantly lower than that in non-attenders (HR = 0.83, 95% CI = 0.81 to 0.84). The risk for CVD mortality (HR = 0.80, 95% CI = 0.73 to 0.87) and hospitalization of CVD (HR = 0.92, 95% CI = 0.91 to 0.94) were lower in attenders. In stratified analyses, the risk for all-cause and cause-specific mortalities was lower among attenders regardless of insurance type. CONCLUSIONS Among young adults, the risk for all-cause mortality, CVD mortality, and hospitalization of CVD were lower for those who underwent health screenings. Future studies that evaluate the cost-effectiveness of health screening with additional consideration of psychosocial aspects are needed.
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Affiliation(s)
- J M Yun
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - S Choi
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea
| | - K Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea
| | - S M Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea
| | - J S Son
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - G Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - S-M Jeong
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - S Y Park
- Big Data Steering Department, National Health Insurance Service, Wonju, South Korea
| | - Y-Y Kim
- Big Data Steering Department, National Health Insurance Service, Wonju, South Korea
| | - S M Park
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea.
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Igbinosa I, Lee K, Oakeson A, Riley E, Melchor S, Birdsong J, Tran L, Weng Y, Collins W, Abir G, Bianco Y, He Z, Desai M, Mathew R, Lee G, Ahuja N, Lyell D, Gibbs R, Aziz N. Health disparities among pregnant women with sars-cov-2 infection at a university medical center in northern California. Am J Obstet Gynecol 2020. [PMCID: PMC7683952 DOI: 10.1016/j.ajog.2020.08.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lee G, Scuffell J, Galea JT, Shin SS, Magill E, Jaramillo E, Sweetland AC. Impact of mental disorders on active TB treatment outcomes: a systematic review and meta-analysis. Int J Tuberc Lung Dis 2020; 24:1279-1284. [PMID: 33317672 PMCID: PMC7740071 DOI: 10.5588/ijtld.20.0458] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND: Comorbid mental disorders in patients with TB may exacerbate TB treatment outcomes. We systematically reviewed current evidence on the association between mental disorders and TB outcomes.METHODS: We searched eight databases for studies published from 1990 to 2018 that compared TB treatment outcomes among patients with and without mental disorders. We excluded studies that did not systematically assess mental disorders and studies limited to substance use. We extracted study and patient characteristics and effect measures and performed a meta-analysis using random-effects models to calculate summary odds ratios (ORs) with 95% confidence intervals (CIs).RESULTS: Of 7687 studies identified, 10 were included in the systematic review and nine in the meta-analysis. Measurement of mental disorders and TB outcomes were heterogeneous across studies. The pooled association between mental disorders and any poor outcome, loss to follow-up, and non-adherence were OR 2.13 (95%CI 0.85-5.37), 1.90 (95%CI 0.33-10.91), and 1.60 (95%CI 0.81-3.02), respectively. High statistical heterogeneity was present.CONCLUSION: Our review suggests that mental disorders in TB patients increase the risk of poor TB outcomes, but pooled estimates were imprecise due to small number of eligible studies. Integration of psychological and TB services might improve TB outcomes and progress towards TB elimination.
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Affiliation(s)
- G Lee
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | - J Scuffell
- School of Population Health and Environmental Sciences, King´s College London, London, UK
| | - J T Galea
- School of Social Work, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, College of Public Health, University of South Florida, Tampa, FL
| | - S S Shin
- Sue & Bill Gross School of Nursing, University of California at Irvine, Irvine, CA
| | - E Magill
- Department of Psychiatry, Columbia Vagelos College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY, USA
| | - E Jaramillo
- Global Tuberculosis Programme, World Health Organization, Geneva, Switzerland
| | - A C Sweetland
- Department of Psychiatry, Columbia Vagelos College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY, USA
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Kim D, Clark J, Lee G, Hong T, Li G, Roeland E, Keane F, Eyler C, Drapek L, Ryan D, Allen J, Berger D, Mullen J, Klempner S, Wo J. Total Neoadjuvant Therapy versus Neoadjuvant Chemoradiotherapy in the Management of Gastric Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1836] [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]
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Nawaz S, Lee G, Tison K, Kobrynski L. M272 STAT1 GAIN-OF-FUNCTION MUTATION IN A PATIENT WITH MULTIFOCAL ENTEROCOLITIS, SLE, AND FAMILY HISTORY OF CMC. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.300] [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]
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