1
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Alghamdi AS, Alshibani A, Binhotan M, Alharbi M, Algarni SS, Alzahrani MM, Asiri AN, Alsulami FF, Ayoub K, Alabdali A. Shortening Door-to-Balloon Time: The Use of Ambulance versus Private Vehicle for Patients with ST-Segment Elevation Acute Myocardial Infarction. Open Access Emerg Med 2023; 15:457-463. [PMID: 38145227 PMCID: PMC10740716 DOI: 10.2147/oaem.s435446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 12/09/2023] [Indexed: 12/26/2023] Open
Abstract
Purpose Time is critical when dealing with acute myocardial infarction (AMI) patients in the Emergency Department (ED), as 90 min is crucial for overall health. Using non-EMS transportation for critical patients, such as patients with acute myocardial infarction, to a hospital might delay the rapid identification of the underlying medical disease and initiating definitive treatment. We aim to evaluate the association between the mode of transportation and the D2B time in patients presenting at the ED with AMI. Patients and Methods We conducted a retrospective cohort study with patients who presented at ED with AMI and underwent percutaneous coronary intervention (PCI). The participants were patients with confirmed AMI at the ED of King Abdullah Medical City (KAMC) from January 2019 to December 2019. Results In total, 162 AMI patients were enrolled in the study and divided based on the method of transportation. Less than half (n=65, 40.1%) were transported with an ambulance and 97 (59.9%) patients with a private car. The door-to-balloon (D2B) time for the ambulance group was 93.6±38.31 minutes, and the private car group was 93.8±30.88 minutes. Conclusion There was no statistical significance when comparing the D2B time between the private car group and the ambulance group (P = 0.1870). Finally, ambulance transport significantly shortened the time to first ED physician contact. However, it was not associated with shortened D2B time when compared to private vehicle transport.
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Affiliation(s)
- Abdulrhman Saleh Alghamdi
- Department of Emergency Medical Services, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Abdullah Alshibani
- Department of Emergency Medical Services, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Meshary Binhotan
- Department of Emergency Medical Services, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Meshal Alharbi
- Department of Emergency Medical Services, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Saleh S Algarni
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, 11481, Saudi Arabia
| | - Mohammed Musaed Alzahrani
- Department of Emergency Medical Services, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Abdulmalik Nasser Asiri
- Department of Emergency Medical Services, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Faisal Faleh Alsulami
- Department of Emergency Medical Services, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Kamal Ayoub
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Abdullah Alabdali
- Department of Emergency Medical Services, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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2
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Algethami A, Aldosary SF, Alhowaish TS, Ayoub K, Balgaith M, Ahmed A, Alzeer AM, Albarrak DA, Algublan AN, Alsayari OS, Alanazi FS, Almogairi A, Alamri H, Alotaiby M, Samargandy S, Alzahrani B, Alkhushail A, Alghamedi A. CRT-700.57 The Need for Coronary Access 10 Years After Transcatheter Aortic Valve Implantation (TAVI). JACC Cardiovasc Interv 2023. [DOI: 10.1016/j.jcin.2023.01.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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3
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Salahuddin T, Taj M, Ayoub K, Khan M. Effect of Coriolis and buoyancy forces on three-dimensional flow of chemically reactive tangent hyperbolic fluid subject to variable viscosity. ARAB J CHEM 2022. [DOI: 10.1016/j.arabjc.2022.104446] [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: 12/15/2022] Open
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4
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Alghamdi J, Alaamery M, Barhoumi T, Rashid M, Alajmi H, Aljasser N, Alhendi Y, Alkhalaf H, Alqahtani H, Algablan O, Alshaya AI, Tashkandi N, Massadeh S, Almuzzaini B, Ehaideb SN, Bosaeed M, Ayoub K, Yezli S, Khan A, Alaskar A, Bouchama A. Interferon-induced transmembrane protein-3 genetic variant rs12252 is associated with COVID-19 mortality. Genomics 2021; 113:1733-1741. [PMID: 33838280 PMCID: PMC8025598 DOI: 10.1016/j.ygeno.2021.04.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [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: 12/08/2020] [Revised: 03/08/2021] [Accepted: 04/04/2021] [Indexed: 01/04/2023]
Abstract
Interferon-induced membrane proteins (IFITM) 3 gene variants are known risk factor for severe viral diseases. We examined whether IFITM3 variant may underlie the heterogeneous clinical outcomes of SARS-CoV-2 infection-induced COVID-19 in large Arab population. We genotyped 880 Saudi patients; 93.8% were PCR-confirmed SARS-CoV-2 infection, encompassing most COVID-19 phenotypes. Mortality at 90 days was 9.1%. IFITM3-SNP, rs12252-G allele was associated with hospital admission (OR = 1.65 [95% CI; 1.01-2.70], P = 0.04]) and mortality (OR = 2.2 [95% CI; 1.16-4.20], P = 0.01). Patients less than 60 years old had a lower survival probability if they harbor this allele (log-rank test P = 0.002). Plasma levels of IFNγ were significantly lower in a subset of patients with AG/GG genotypes than patients with AA genotype (P = 0.00016). Early identification of these individuals at higher risk of death may inform precision public health response.
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Affiliation(s)
- Jahad Alghamdi
- Saudi Biobank, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia,Corresponding author
| | - Manal Alaamery
- Developmental Medicine Department, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard- Health Affairs, Riyadh, Saudi Arabia,KACST-BWH Centre of Excellence for Biomedicine, Joint Centers of Excellence Program, King Abdulaziz City for Science and Technology (KACST), Riyadh, Saudi Arabia,King Abdulaziz City for Science and Technology (KACST), Saudi Human Genome Project (SHGP), Satellite Lab at King Abdulaziz Medical City (KAMC), Ministry of National Guard Health Affairs (MNG-HA), Riyadh, Saudi Arabia
| | - Tlili Barhoumi
- Core Facility and Research Platforms, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
| | - Mamoon Rashid
- Department of Bioinformatics, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
| | - Hala Alajmi
- Saudi Biobank, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
| | - Nasser Aljasser
- Saudi Biobank, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
| | - Yaseen Alhendi
- Saudi Biobank, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
| | - Hind Alkhalaf
- Saudi Biobank, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
| | - Hanadi Alqahtani
- Saudi Biobank, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
| | - Omer Algablan
- Saudi Biobank, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
| | - Abdulraham I. Alshaya
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
| | - Nabiha Tashkandi
- Nursing Services, Ministry of the National Guard - Health Affairs, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Salam Massadeh
- Developmental Medicine Department, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard- Health Affairs, Riyadh, Saudi Arabia,KACST-BWH Centre of Excellence for Biomedicine, Joint Centers of Excellence Program, King Abdulaziz City for Science and Technology (KACST), Riyadh, Saudi Arabia,King Abdulaziz City for Science and Technology (KACST), Saudi Human Genome Project (SHGP), Satellite Lab at King Abdulaziz Medical City (KAMC), Ministry of National Guard Health Affairs (MNG-HA), Riyadh, Saudi Arabia
| | - Bader Almuzzaini
- Medical Genomics Research Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
| | - Salleh N. Ehaideb
- Experimental Medicine Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
| | - Mohammad Bosaeed
- Department of Medicine, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia,College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Kamal Ayoub
- King Abdulaziz Cardiac Center, Ministry of the National Guard - Health Affairs, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Saber Yezli
- The Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - Anas Khan
- The Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia,College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Alaskar
- Oncology Department, Ministry of the National Guard - Health Affairs, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abderrezak Bouchama
- Experimental Medicine Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia,Corresponding author
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Alanezi A, Khan FM, Alotaibi T, Alhaddadi B, Alanazi F, Alqahtani M, Alsheri J, Masrahi A, Aljumah F, AlShamamry H, Alwasel Z, Balghith M, Ayoub K, Al Ghamdi A, Mahmud A. P.06 Comparison of Manual vs. Automated Haemodynamic Monitoring Systems in the Cardiac Catheterization Laboratory. Artery Res 2020. [DOI: 10.2991/artres.k.201209.020] [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: 11/01/2022] Open
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6
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Abstract
Abstract
Current methods of analysis for ethylene oxide (EO) in medical devices include headspace and simulated-use extractions followed by gas chromatography with either a packed or a capillary column. The quantitation limits are about 0.5–1.0 μg/g for a packed column and about 0.1–0.2 μg/g for a capillary column. The current allowable levels of EO on medical devices sterilized with EO gas as outlined in International Organization for Standardization (ISO) 10993-7 may be significantly reduced from current levels by applying the ISO Draft International Standard 10993-17 method for establishing allowable limits. This may require EO test methods with detection and quantitation limits that are much lower than those of the currently available methods. This paper describes a new method that was developed for the determination of low-level EO by solid-phase microextraction using the direct-immersion method. Factors such as temperature and stirring were found to affect absorption efficiency and absorption time. A low extraction temperature (about 6°C) was found to be more efficient than room-temperature extraction. Stirring was found to reduce absorption time by about 50%. Under these conditions, detection and quantitation limits of 0.002 and 0.009 μg/g, respectively, were obtained by using a capillary column. As a result, this method makes compliance with lower EO limits feasible.
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Affiliation(s)
- Kamal Ayoub
- Tyco/Healthcare-Kendall, 2010 E. International Speedway Blvd, DeLand, FL 32724
| | - Leonard Harris
- Tyco/Healthcare-Kendall, 2010 E. International Speedway Blvd, DeLand, FL 32724
| | - Bill Thompson
- Tyco/Healthcare-Kendall, 2010 E. International Speedway Blvd, DeLand, FL 32724
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7
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Masri A, Altibi A, Erqou S, Zmaili M, Saleh A, Al-Adham R, Ayoub K, Barakat A, Jain S, Saba S, Adelstein E. P1025Wearable cardioverter-defibrillator therapy for the prevention of sudden cardiac death: a systematic review and meta-analysis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p1025] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Masri
- University of Pittsburgh, Heart and Vascular Institute, Pittsburgh, United States of America
| | - A Altibi
- University of Pittsburgh, Heart and Vascular Institute, Pittsburgh, United States of America
| | - S Erqou
- University of Pittsburgh, Heart and Vascular Institute, Pittsburgh, United States of America
| | - M Zmaili
- University of Pittsburgh, Heart and Vascular Institute, Pittsburgh, United States of America
| | - A Saleh
- University of Pittsburgh, Heart and Vascular Institute, Pittsburgh, United States of America
| | - R Al-Adham
- University of Arizona, Department of Medicine, Phoenix, United States of America
| | - K Ayoub
- University of Kentucky, Department of Medicine, Division of Cardiology, Lexington, United States of America
| | - A Barakat
- University of Pittsburgh, Heart and Vascular Institute, Pittsburgh, United States of America
| | - S Jain
- University of Pittsburgh, Heart and Vascular Institute, Pittsburgh, United States of America
| | - S Saba
- University of Pittsburgh, Heart and Vascular Institute, Pittsburgh, United States of America
| | - E Adelstein
- University of Pittsburgh, Heart and Vascular Institute, Pittsburgh, United States of America
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8
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Mahmud A, Allghamdi A, Balghith M, Ayoub K, Khan MF, AlChighouri S, AlMutairi F, AlZaibag M. P111 DISCREPANCY BETWEEN BRACHIAL AND INVASIVE INTRA-AORTIC PRESSURES IN PATIENTS UNDERGOING CARDIAC CATHETERIZATION. Artery Res 2018. [DOI: 10.1016/j.artres.2018.10.164] [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] Open
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9
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Mahmud A, Balghaith M, Ayoub K, Khan F, Sameer M, Thanoon B, Thawyee A, Al-Shabeeb A, Ghamdi A. P2111Age and gender related differences in invasive central pulsatile heamodynamics versus. non-invasive brachial pressures in a large arab population. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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10
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Saeed B, Salih A, Enriquez N, Ayoub K, Balghith M, Alghamdi A. 50. Primary PCI for STEMI patients at KACC: Has patient’s access and hospital outcome improved over the last 5 years? J Saudi Heart Assoc 2016. [DOI: 10.1016/j.jsha.2016.04.051] [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] Open
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11
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Alzahrani S, Almalah M, El-Metwally A, Ayoub K, Nasser T, Amjed A. 72. Addressing barriers for conducting/participating in clinical trials among cardiologists. J Saudi Heart Assoc 2016. [DOI: 10.1016/j.jsha.2016.04.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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12
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Alghamdi A, Tamimi O, Balgaith M, Bannan A, Ayoub K. Cardiac catheterization laboratory, organization, and metrics. Eur Heart J Suppl 2014; 16:B75-B75. [DOI: 10.1093/eurheartj/suu006] [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: 08/02/2023]
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13
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Jmaiel A, Saileek AA, Omran A, Ayoub K. Paradoxical embolism resulted in acute myocardial infarction in a patient with congenital heart disease. J Saudi Heart Assoc 2013. [DOI: 10.1016/j.jsha.2013.03.022] [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: 10/27/2022] Open
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14
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Alghamdi AM, Balgaith M, Ayoub K, Saeed B, Sailik A, Alzaibag M. Improvement in door-to-balloon time at King Abdulaziz Cardiac Center: Are we achieving the goal? J Saudi Heart Assoc 2013. [DOI: 10.1016/j.jsha.2013.03.051] [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] Open
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15
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Balghith M, Alghamdi A, Ayoub K, Saeed B. Drug eluted balloon has the potential to treat in-stent restenosis and small vessels disease. J Saudi Heart Assoc 2012. [DOI: 10.1016/j.jsha.2012.06.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Abstract
We present a case of a young male with severe pulmonary stenosis, hypoplastic right ventricle, and atrial septal defect. Acute embolic myocardial infarction, followed by cardiac arrest, occurred during hospitalization after Glenn operation. The therapeutic challenges are discussed. Insufficient anticoagulation therapy during the postoperative period was a possible contributing factor leading to embolic myocardial infarction.
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Affiliation(s)
- Abdelrahman Jamiel
- Cardiac Sciences, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, KSA,Address for correspondence: Abdelrahman Jamiel, Cardiac Sciences (code 1413), King Abdulaziz Medical City, National Guard Health Affairs Riyadh, 11426,KSA. E-mail:
| | - Ahmed Alsaileek
- Cardiac Sciences, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, KSA
| | - Kamal Ayoub
- Cardiac Sciences, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, KSA
| | - Ahmad Omran
- Cardiac Sciences, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, KSA
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17
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Balghith M, Alghamdi A, Ayoub K, Aziz M, Saleh A, Algahtani M. SHA 065. Stent thrombosis is a major concern in clinical practice, a single Saudi center experience. J Saudi Heart Assoc 2011. [DOI: 10.1016/j.jsha.2011.02.066] [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] Open
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18
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Cutts S, Datta A, Ayoub K, Rahman H, Lawrence T. Early failure modalities in hip resurfacing? Hip Int 2005; 15:155-158. [PMID: 28224600 DOI: 10.1177/112070000501500305] [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: 02/04/2023]
Abstract
Between 1996 and 2002, we treated 60 patients (65 hips) by hip resurfacing. The notes and radiographs of these cases were studied retrospectively and the modalities of failure identified. At a mean follow-up of 51 months, 14 of these cases (22%) required revision surgery. One patient had died from unrelated causes and one was lost to follow-up. At the time of primary surgery, the mean age of the patients in our series was 55 years. The commonest mechanism of failure in our series was fractured neck of femur (six cases). Four of these occurred in females over the age of 60. None of the fractured necks of femur were associated with trauma. There were four cases of loose acetabular components and one case of progressive AVN (avascular necrosis). Two patients required revision surgery for ongoing hip pain and one required a twostage revision for early deep infection. (Hip International 2005; 15: 155-8).
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Affiliation(s)
- S Cutts
- Solihull Hospital, Birmingham - UK
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19
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Ayoub K, Harris L, Thompson B. Determination of low-level residual ethylene oxide by using solid-phase microextraction and gas chromatography. J AOAC Int 2002; 85:1205-9. [PMID: 12477181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Current methods of analysis for ethylene oxide (EO) in medical devices include headspace and simulated-use extractions followed by gas chromatography with either a packed or a capillary column. The quantitation limits are about 0.5-1.0 microg/g for a packed column and about 0.1-0.2 microg/g for a capillary column. The current allowable levels of EO on medical devices sterilized with EO gas as outlined in International Organization for Standardization (ISO) 10993-7 may be significantly reduced from current levels by applying the ISO Draft International Standard 10993-17 method for establishing allowable limits. This may require EO test methods with detection and quantitation limits that are much lower than those of the currently available methods. This paper describes a new method that was developed for the determination of low-level EO by solid-phase microextraction using the direct-immersion method. Factors such as temperature and stirring were found to affect absorption efficiency and absorption time. A low extraction temperature (about 6 degrees C) was found to be more efficient than room-temperature extraction. Stirring was found to reduce absorption time by about 50%. Under these conditions, detection and quantitation limits of 0.002 and 0.009 microg/g, respectively, were obtained by using a capillary column. As a result, this method makes compliance with lower EO limits feasible.
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Affiliation(s)
- Kamal Ayoub
- Tyco/Healthcare-Kendall, DeLand, FL 32724, USA.
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20
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Fiorenza F, Abudu A, Grimer RJ, Carter SR, Tillman RM, Ayoub K, Mangham DC, Davies AM. Risk factors for survival and local control in chondrosarcoma of bone. ACTA ACUST UNITED AC 2002. [DOI: 10.1302/0301-620x.84b1.0840093] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We studied 153 patients with non-metastatic chondrosarcoma of bone to determine the risk factors for survival and local tumour control. The minimum follow-up was for five years; 52 patients had axial and 101 appendicular tumours. Surgical treatment was by amputation in 27 and limb-preserving surgery in 126. The cumulative rate of survival of all patients, at 10 and 15 years, was 70% and 63%, respectively; 40 patients developed a local recurrence between 3 and 87 months after surgery and 49 developed metastases. Local recurrence was associated with poor survival in patients with concomitant metastases but not in those without. On multivariate analysis independent risk factors for rates of survival include extracompartmental spread, development of local recurrence and high histological grade. Independent risk factors for local recurrence include inadequate surgical margins and tumour size greater than 10 cm. Location within the body, the type of surgery and the duration of symptoms are of no prognostic significance. Surgical excision with an oncologically wide margin provides the best prospect both for cure and local control in these patients.
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Affiliation(s)
- F. Fiorenza
- Oncology Service, The Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham B31 2AP, UK
| | - A. Abudu
- Oncology Service, The Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham B31 2AP, UK
| | - R. J. Grimer
- Oncology Service, The Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham B31 2AP, UK
| | - S. R. Carter
- Oncology Service, The Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham B31 2AP, UK
| | - R. M. Tillman
- Oncology Service, The Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham B31 2AP, UK
| | - K. Ayoub
- Oncology Service, The Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham B31 2AP, UK
| | - D. C. Mangham
- Oncology Service, The Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham B31 2AP, UK
| | - A. M. Davies
- Oncology Service, The Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham B31 2AP, UK
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Fiorenza F, Abudu A, Grimer RJ, Carter SR, Tillman RM, Ayoub K, Mangham DC, Davies AM. Risk factors for survival and local control in chondrosarcoma of bone. J Bone Joint Surg Br 2002; 84:93-9. [PMID: 11837841 DOI: 10.1302/0301-620x.84b1.11942] [Citation(s) in RCA: 179] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We studied 153 patients with non-metastatic chondrosarcoma of bone to determine the risk factors for survival and local tumour control. The minimum follow-up was for five years; 52 patients had axial and 101 appendicular tumours. Surgical treatment was by amputation in 27 and limb-preserving surgery in 126. The cumulative rate of survival of all patients, at 10 and 15 years, was 70% and 63%, respectively; 40 patients developed a local recurrence between 3 and 87 months after surgery and 49 developed metastases. Local recurrence was associated with poor survival in patients with concomitant metastases but not in those without. On multivariate analysis independent risk factors for rates of survival include extracompartmental spread, development of local recurrence and high histological grade. Independent risk factors for local recurrence include inadequate surgical margins and tumour size greater than 10 cm. Location within the body, the type of surgery and the duration of symptoms are of no prognostic significance. Surgical excision with an oncologically wide margin provides the best prospect both for cure and local control in these patients.
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Affiliation(s)
- F Fiorenza
- Royal Orthopaedic Hospital, Northfield, Birmingham, England, UK
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Mitchell AD, Ayoub K, Mangham DC, Grimer RJ, Carter SR, Tillman RM. Experience in the treatment of dedifferentiated chondrosarcoma. J Bone Joint Surg Br 2000; 82:55-61. [PMID: 10697315 DOI: 10.1302/0301-620x.82b1.9020] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Dedifferentiated chondrosarcoma is a rare, highly malignant variant of chondrosarcoma in which a high-grade spindle-cell sarcoma coexists with a lower-grade chondroid tumour. We have reviewed our experience with this neoplasm in 22 patients, all of whom were treated using modern oncological principles of planned resection and chemotherapy. Despite this the median survival was under nine months and only 18% were alive at five years. Those patients who received chemotherapy, and in whom wide margins of excision were achieved at operation, did best. It is essential to have an accurate preoperative diagnosis in order to plan treatment which may offer a better prospect of cure.
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Affiliation(s)
- A D Mitchell
- Royal Orthopaedic Hospital Oncology, Service, Woodlands, Northfield, Birmingham, UK
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Abstract
Dedifferentiated chondrosarcoma is a rare, highly malignant variant of chondrosarcoma in which a high-grade spindle-cell sarcoma coexists with a lower-grade chondroid tumour. We have reviewed our experience with this neoplasm in 22 patients, all of whom were treated using modern oncological principles of planned resection and chemotherapy. Despite this the median survival was under nine months and only 18% were alive at five years. Those patients who received chemotherapy, and in whom wide margins of excision were achieved at operation, did best. It is essential to have an accurate preoperative diagnosis in order to plan treatment which may offer a better prospect of cure.
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Affiliation(s)
- A. D. Mitchell
- Royal Orthopaedic Hospital Oncology Service, Woodlands, Northfield, Birmingham B31 2AP, UK
| | - K. Ayoub
- Royal Orthopaedic Hospital Oncology Service, Woodlands, Northfield, Birmingham B31 2AP, UK
| | - D. C. Mangham
- Royal Orthopaedic Hospital Oncology Service, Woodlands, Northfield, Birmingham B31 2AP, UK
| | - R. J. Grimer
- Royal Orthopaedic Hospital Oncology Service, Woodlands, Northfield, Birmingham B31 2AP, UK
| | - S. R. Carter
- Royal Orthopaedic Hospital Oncology Service, Woodlands, Northfield, Birmingham B31 2AP, UK
| | - R. M. Tillman
- Royal Orthopaedic Hospital Oncology Service, Woodlands, Northfield, Birmingham B31 2AP, UK
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