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Gjyriqi G, Gross A, Burns E, Gianos E, Sidhu M, Mathew R. Patterns of Statin Therapy Use and Associated Outcomes in Older Veterans Across Kidney Function. Am J Med 2024:S0002-9343(24)00173-6. [PMID: 38574795 DOI: 10.1016/j.amjmed.2024.03.016] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 03/05/2024] [Accepted: 03/09/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Despite significant morbidity and mortality related to atherosclerotic cardiovascular disease, to date, most major clinical trials studying the effects of statin therapy have excluded older adults. The objective of this analysis was to evaluate the effect of initiating statin therapy on incident dementia and mortality among individuals 75 years of age or older across the complete spectrum of kidney function. METHODS We conducted a retrospective cohort study of 640,191 VA health system patients who turned 75 years of age between 2000 and 2018. Patients on statin therapy received the medication for an average of 6.3 years (standard deviation 4.6 years). The primary outcome of interest included incident dementia diagnosis during the study period. The secondary outcome was all-cause mortality. Cox-proportional hazard analysis was used to evaluate the adjusted association of statin initiation with these outcomes. RESULTS There was a higher rate of incident dementia in the No Statin group (4.7%) versus the Statin group (3.2%). Additionally, we observed a 22% all-cause mortality benefit associated with statin therapy. We did not observe a treatment effect with respect to primary or secondary outcomes across varying levels of kidney function. CONCLUSION This large cohort study did not reveal an association between the initiation of statin therapy and incident dementia. A survival benefit was seen in statin users compared to non-users. Prospective studies in more diverse populations including older adults will be needed to verify these findings.
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Affiliation(s)
- Grenita Gjyriqi
- Zucker School of Medicine Hofstra Northwell, Manhasset, NY 11549, USA
| | - Adam Gross
- Albany Medical College, Albany, NY 12208, USA.
| | - Edith Burns
- Zucker School of Medicine Hofstra Northwell, Manhasset, NY 11549, USA
| | - Eugenia Gianos
- Zucker School of Medicine Hofstra Northwell, Manhasset, NY 11549, USA
| | - Mandeep Sidhu
- Division of Cardiology, Department of Medicine and Department of Medical Education, Albany Medical College, Albany Med Health System, Albany, NY 12208, USA
| | - Roy Mathew
- Department of Medicine, Loma Linda VA Health Care System, Loma Linda, CA 92357, USA.
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Weiss R, Knight BP, El-Chami M, Aasbo J, Hanon S, Sadhu A, Sidhu M, Brisben AJ, Carter N, Burke MC, Gold M. Impact of Age on Subcutaneous Implantable Cardioverter-Defibrillator in a Large Patient Cohort: Mid-Term Follow-Up. JACC Clin Electrophysiol 2023; 9:2132-2145. [PMID: 37676200 DOI: 10.1016/j.jacep.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 05/26/2023] [Accepted: 06/25/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND The subcutaneous implantable cardioverter-defibrillator (S-ICD) is an accepted alternative to transvenous (TV) ICD to provide defibrillation therapy to treat life-threatening ventricular tachyarrhythmias in high-risk patients. S-ICD outcomes by age group have not been reported. OBJECTIVES In this study, the authors sought to report S-ICD outcomes in different age groups in a multicenter S-ICD post-approval study (PAS) involving the largest cohort of patients ever reported. METHODS Patients were prospectively enrolled in the S-ICD PAS and stratified based on age: young, aged 15-34 years; adult, aged 35-69 years; and elderly, aged ≥70 years. Patient characteristics and clinical outcomes through 3 years of follow up after implantation were compared. RESULTS The S-ICD PAS enrolled 1,637 patients. Elderly patients were more likely to receive an S-ICD as a replacement of a TV-ICD (15.1% elderly vs 12.3% adult vs 7.4% young). Secondary prevention indication decreased with age (32.7% young vs 22.2% adult vs 20.5% elderly). Mortality rate was significantly higher in the elderly group (24.0% elderly vs 13.0% adult vs 7.4% young; P < 0.0001), whereas the complication rate did not differ significantly (12.3% young vs 11.3% adult vs 8.1% elderly). Rates of appropriate shock (12.7% young vs 13.0% adult vs 13.8% elderly) and inappropriate shock (7.8% young vs 9.1% adult vs 8.8% elderly) rates did not differ between groups (P = 0.96 and P = 0.98, respectively). CONCLUSIONS Implant complications and appropriate and inappropriate shock rates were similar among age groups. S-ICD for secondary prevention was more common in the young group. Replacing a TV-ICD for an S-ICD increases with age. (S-ICD System Post-Approval Study; NCT01736618).
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Affiliation(s)
- Raul Weiss
- Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
| | | | | | - Johan Aasbo
- Baptist Health Lexington, Lexington, Kentucky, USA
| | - Sam Hanon
- Mount Sinai-Beth Israel Medical Center, New York, New York, USA
| | - Ashish Sadhu
- Phoenix Cardiovascular Research Group, Phoenix, Arizona, USA
| | | | - Amy J Brisben
- Boston Scientific Corporation, Saint Paul, Minnesota, USA
| | - Nathan Carter
- Boston Scientific Corporation, Saint Paul, Minnesota, USA
| | | | - Michael Gold
- Medical University of South Carolina, Charleston, South Carolina, USA
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Sidhu M, Gokhroo G, Mulinti S, Patil MB, Murali M, Gupta V, Chaudhari S, Rayn K, Beriwal S. Pilot Study of Peer Review in Low Middle-Income Country (LMIC) through Cloud-Based Platform. Int J Radiat Oncol Biol Phys 2023; 117:e437. [PMID: 37785421 DOI: 10.1016/j.ijrobp.2023.06.1610] [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) Peer review is an essential step in clinical quality assurance and can impact patient safety and treatment outcomes. Most published data on peer review is from developed nations, with little data on peer review from low middle income countries (LMIC). Major challenges to peer review can include a lack of time, expertise and commitment from team members. With increasing access to advanced technology in LMIC, peer review is becoming more important to maintain quality and standard of care. We evaluated cloud-based e- peer review (Varian) in our network of hospitals in India with an aim to see feasibility and impact on care. MATERIALS/METHODS Four of 15 centers across India were selected for this pilot study. All team members were trained on the platform prior to implementation. New cases for the week treated with definitive intent were selected by the dosimetrist. The link to the cases were sent through email to reviewing physicians. Various aspects which were reviewed for each case were.1) Work up & staging (Documents were scanned and loaded).2) Treatment intent & prescription.3) Target contours.4) Normal Organ at risk contours.5) Dose- Volume -Histogram (DVH) with clinical goals attached. Cases were marked as "Not Appropriate", "Appropriate", "Appropriate with minor finding", "Represent with major revisions" as per volume and plan review. RESULTS Over a period of 2 months, a total of 80 cases underwent e-Peer Review at our network of hospitals prior to the start of treatment. Median turnover time (like from link sent to time to completion of review) was 48 (6-360) hours. Mean time taken by physician for review was 9 minutes (range 3 to15). 31.2% of cases were accepted without any changes, 51.9 % had a minor change and 16.9 % cases had major changes. Most frequent reason of major changes was contouring corrections 16.9%. 31% of major changes underwent recontouring and replanning before initiation of treatment. CONCLUSION Peer review was feasible in our network through this e-peer review system, with average turnover time and mean time taken for review of 48 hours & 9 min respectively. Peer review led to significant changes which could impact patient care delivery and outcome. The ability to review cases asynchronously via this cloud-based e-peer review system, helped to ease the burden of scheduling between treating and reviewing physician. We plan to implement this across the remaining centers in our network.
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Affiliation(s)
- M Sidhu
- American Oncology Institute- DMC Care Center, Ludhiana, India
| | - G Gokhroo
- American Oncology Institute, Hyderabad, CA, India
| | - S Mulinti
- American Oncology Institute, Hyderabad, India
| | - M B Patil
- American Oncology Institute, Nagpur, India
| | - M Murali
- American Oncology Institute, Calicut, India
| | - V Gupta
- American Oncology Institute, Hyderabad, India
| | - S Chaudhari
- American Oncology Institute, Hyderabad, India
| | - K Rayn
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - S Beriwal
- Allegheny Health Network Cancer Institute, Department of Radiation Oncology, Pittsburgh, PA
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Carey CN, Paquette M, Sahye-Pudaruth S, Dadvar A, Dinh D, Khodabandehlou K, Liang F, Mishra E, Sidhu M, Brown R, Tandon S, Wanyan J, Bazinet RP, Hanley AJ, Malik V, Sievenpiper JL, Jenkins DJ. The Environmental Sustainability of Plant-Based Dietary Patterns: A Scoping Review. J Nutr 2023; 153:857-869. [PMID: 36809853 DOI: 10.1016/j.tjnut.2023.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 01/28/2023] [Accepted: 02/02/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A large part of the existential threat associated with climate change is the result of current human feeding patterns. Over the last decade, research evaluating the diet-related environmental impacts of plant-based diets has emerged, and a synthesis of the available data is now due. OBJECTIVES The objectives of the study were as follows: 1) to compile and summarize the literature on diet-related environmental impacts of plant-based dietary patterns; 2) to assess the nature of the data on impacts of plant-based dietary patterns on both environmental parameters and health (e.g., if land use is reduced for a particular diet, is cancer risk also reduced?); and 3) to determine where sufficient data exist for meta-analyses, in addition to identifying gaps within the literature. METHODS Global peer-reviewed studies on the environmental impacts of plant-based diets were searched in Ovid MEDLINE, EMBASE, and Web of Science. After removing duplicates, the screening identified 1553 records. After 2 stages of independent review by 2 reviewers, 65 records met the inclusion criteria and were eligible to be used in synthesis. RESULTS Evidence suggests that plant-based diets may offer lower greenhouse gas emissions (GHGEs), land use, and biodiversity loss than offered by standard diets; however, the impact on water and energy use may depend on the types of plant-based foods consumed. Further, the studies were consistent in demonstrating that plant-based dietary patterns that reduce diet-related mortality also promote environmental sustainability. CONCLUSIONS Overall, there was agreement across the studies regarding the impact of plant-based dietary patterns on GHGE, land used, and biodiversity loss despite varied plant-based diets assessed.
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Affiliation(s)
- Cassandra N Carey
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada.
| | - Melanie Paquette
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Sandhya Sahye-Pudaruth
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Abolfazl Dadvar
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Dorothy Dinh
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada
| | | | - Fred Liang
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Ekta Mishra
- McMaster University, Toronto, Ontario, Canada
| | - Mandeep Sidhu
- School of Global Health, York University, Toronto, Ontario, Canada
| | - Ramon Brown
- Department of Biology, Western University, Toronto, Ontario, Canada
| | - Shilpa Tandon
- Farncombe Family Digestive Health Research Institute, McMaster University, Toronto, Ontario, Canada
| | - Jessica Wanyan
- Department of Human Biology, University of Toronto, Toronto, Ontario, Canada
| | - Richard P Bazinet
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Anthony J Hanley
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Vasanti Malik
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - John L Sievenpiper
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - David Ja Jenkins
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada
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Srinivasan VJ, Akhtar S, Huppertz JW, Sidhu M, Coates A, Knudsen N. Prospective Cohort Study on the Impact of Early Versus Late Inpatient Palliative Care on Length of Stay and Cost of Care. Am J Hosp Palliat Care 2023:10499091231152609. [PMID: 36688285 DOI: 10.1177/10499091231152609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Aim: To evaluate the impact of early vs late palliative care on (1) length of stay (LOS) in the context of expected LOS measures and (2) total cost of care to the hospital for each patient. Methods: A prospective cohort study was performed at a single large academic medical center on patients who received an inpatient palliative care consultation. The two cohorts were early palliative care (within 3 days of admission) and late palliative care (after 3 days of admission). Comparisons were made between patients' actual LOS, expected LOS, and total hospital costs between both cohorts. Results: Compared to the late palliative care cohort (N = 126), patients who received early palliative care (N = 68) had a significantly shorter LOS (P < .001) and also performed better compared to CMS-Expected LOS standards (Observed/Expected 3.1 vs 1.5 respectively; P < .001). Early palliative care patients also saw an average decline of $1431 in total costs 1-day pre/post consult as opposed to a more modest $403 decline in the later palliative care cohort (P < .001). Similarly, patients who received early palliative care had a $5839 decline in aggregated total 3-day costs, as opposed to a $1478 decline in those who received late palliative care (P < .001). Conclusions: In the competitive and rapidly evolving healthcare system, the opportunity to suppress costs and lower patient LOS has increasing importance. Our study strongly supports the implementation of earlier palliative care intervention to assist hospitals in approaching LOS targets and reducing patient costs.
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Affiliation(s)
- Vamshek J Srinivasan
- 1092Albany Medical College, Albany, NY, USA.,University of Michigan Medicine, Ann Arbor, MI, USA
| | - Saad Akhtar
- 1092Albany Medical College, Albany, NY, USA.,Boston Medical Center, Boston, MA, USA
| | - John W Huppertz
- Clarkson University School of Business, Schenectady, NY, USA
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Malhi P, Bharti B, Sidhu M. Impact of school closures during the pandemic on screen time and behavior of children: Evidence from a developing country. Eur Psychiatry 2022. [PMCID: PMC9566917 DOI: 10.1192/j.eurpsy.2022.1768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Serious concerns regarding the indirect physical and mental health impact of the extended school closure measure to control the spread of the pandemic have been raised, however, the extent of the problem remains unquantified in India. Objectives To examine the impact of school closures on recreational screen time, emotional, and behavioral functioning of school-going children during the pandemic. Methods The survey utilized a Google form that was sent to parents of children (6-14 years) through emails and social media platforms. Parents were asked to report on the child’s duration of recreational screen time and whether the child’s overall behavioral functioning had changed since the school closures. The child’s emotional and behavioral functioning was assessed by the Strength and Difficulties Questionnaire (SDQ). The study was cleared by the Ethics committee. Results A total of 160 parents were recruited for the study. Overall, a little more one-fourth (28.1%) of the children’s behavior was reported to have worsened. The mean recreational screen time was 2.65 hours (SD=1.89). A significantly higher proportion of children whose behavior worsened after school closures, relative to those whose behavior improved or remained same, had scores in the abnormal range of functioning on three of the subscales of SDQ. Stepwise multiple regression analysis indicated that recreational screen time explained 2% of the variance in the total SDQ score (F=4.18. P=.04). Conclusions Increase in psychological services supporting healthy behaviors and anticipatory telehealth consultations for high-risk children and families is the need of the hour to foster psychological wellbeing during the pandemic. Disclosure No significant relationships.
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Pollard S, Anderson JC, Bah F, Mateus M, Sidhu M, Simmons D. Non-Lethal Blood Sampling of Fish in the lab and Field With Methods for Dried Blood Plasma Spot Omic Analyses. Front Genet 2022; 13:795348. [PMID: 35401689 PMCID: PMC8988233 DOI: 10.3389/fgene.2022.795348] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 12/24/2021] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
There is global acknowledgment that humane methods in animal research are a priority, but few environmental effects monitoring programs use nonlethal methods for fish. The goal of the present study was to determine the impacts of sampling small volumes of blood in larger-bodied fish on survival and healing. In addition to evaluating survival following blood sampling, we evaluated the utility of dried blood spots as an alternative for sample processing and storage in the field. In our approach, we housed 80 rainbow trout (Oncorhynchus mykiss) in our flow-through aquatic facility. We then anaesthetized using MS-222 and sampled 1 μl/g bw of blood via puncture of the caudal vasculature. We tested four different post-blood sampling treatments on the puncture wound: 1. application of liquid bandage; 2. a swab of betadine; 3. a swab of fish mucous; and 4. compared survival outcomes to a group where no post-treatment was performed (negative control). Overall, we observed 90% survival among all treatments, with the most effective approach being the negative control (100% survival). Based upon these results, we repeated the blood sampling with no-post treatment by housing 20 rainbow trout (not previously tested upon) in cages at a nearby creek and monitored survival for 2 weeks post sampling. The survival rate was 95% with full healing of the puncture site in all subjects. In addition to this, we tested the efficacy of dry blood spotting on proteomic, lipidomic and amino acid analysis as an alternative method for blood sample processing and storage. It was found that dried plasma spotting using parafilm in conjunction with a modified Bligh-Dyer extraction offered the best balance for good recovery of protein, lipid and amino acids relative to wet plasma and Noviplex dried plasma spot cards. In this article, we will present the detailed results of these combined studies and describe what we have determined to be the safest non-lethal blood sampling protocol.
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Affiliation(s)
- S Pollard
- Aquatic Omics Laboratory, Department of Biology, Ontario Tech University, Oshawa, ON, Canada
| | - J C Anderson
- Aquatic Omics Laboratory, Department of Biology, Ontario Tech University, Oshawa, ON, Canada
| | - F Bah
- Aquatic Omics Laboratory, Department of Biology, Ontario Tech University, Oshawa, ON, Canada
| | - M Mateus
- Aquatic Omics Laboratory, Department of Biology, Ontario Tech University, Oshawa, ON, Canada
| | - M Sidhu
- Aquatic Omics Laboratory, Department of Biology, Ontario Tech University, Oshawa, ON, Canada
| | - Dbd Simmons
- Aquatic Omics Laboratory, Department of Biology, Ontario Tech University, Oshawa, ON, Canada
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Shahidi NC, Vosko S, Gupta S, Whitfield A, Cronin O, O’Sullivan T, van Hattem W, Sidhu M, Tate D, Lee E, Burgess N, Williams S, Bourke M. A111 A RECTUM-SPECIFIC SELECTIVE RESECTION ALGORITHM OPTIMIZES ONCOLOGIC OUTCOMES FOR LARGE NON-PEDUNCULATED RECTAL POLYPS. J Can Assoc Gastroenterol 2022. [PMCID: PMC8859147 DOI: 10.1093/jcag/gwab049.110] [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: 11/14/2022] Open
Abstract
Background Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are complementary techniques for large (≥ 20mm) non-pedunculated rectal polyps (LNPRPs). A mechanism for appropriate technique selection has not been described. Aims To evaluate whether a selective resection algorithm using EMR and ESD, based on real-time optical evaluation, optimizes oncologic outcomes for LNPRPs Methods We evaluated the performance of a selective resection algorithm (SRA; 08/2017-04/2021) compared to a universal EMR algorithm (UEA; 07/2008-07/2017) for LNPRPs within a prospective observational study. In the SRA, LNPRPs with features of superficial submucosal invasive cancer (SMIC < 1000μm; S-SMIC; Kudo pit pattern Vi), or with an increased risk of SMIC (Paris 0-Is or 0-IIa+Is non-granular, 0-IIa+Is granular with a dominant nodule ≥ 10mm) underwent ESD. The remaining LNPRPs underwent EMR. Algorithm performance was evaluated by SMIC identified after EMR, curative oncologic resection (R0 resection, S-SMIC, absence of negative histologic features), technical success, adverse events, and recurrence at first surveillance colonoscopy. Results 480 LNPRPs were evaluated (290 UEA, 190 SRA). Median lesion size was 40mm (IQR 30-60mm). In the SRA, 103 (54.2%) and 87 (45.8%) LNPRPs underwent EMR and ESD, respectively. SMIC was identified in 56 (11.7%) LNPRPs. Significant differences in SMIC after EMR (SRA 1 (1.0%) vs. UEA 35 (12.1%); p = 0.001), curative oncologic resection (SRA 7 (33.3%) vs. UEA 2 (5.7%); p = 0.010), and recurrence (SRA 2 (1.6%) vs. UEA 40 (17.2%); p < 0.001) were identified. No significant differences in technical success or adverse events were identified (all p > 0.137). Among potentially curable malignant LNPRPs which underwent ESD, 100% (7/7) were cured. Conclusions A SRA optimizes oncologic outcomes for LNPRPs and mitigates the risk of piecemeal resection of cancers. Funding Agencies The Cancer Institute of New South Wales provided funding for a research nurse and data manager to assist with the administration of the study. Neal Shahidi was supported by the University of British Columbia Clinician Investigator Program. There was no influence from either institution regarding study design or conduct, data collection, management, analysis, interpretation, preparation, review, or approval of the manuscript.
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Affiliation(s)
- N C Shahidi
- Westmead Hospital, Department of Gastroenterology and Hepatology, Sydney, New South Wales, Australia
| | - S Vosko
- Westmead Hospital, Department of Gastroenterology and Hepatology, Sydney, New South Wales, Australia
| | - S Gupta
- Westmead Hospital, Department of Gastroenterology and Hepatology, Sydney, New South Wales, Australia
| | - A Whitfield
- Westmead Hospital, Department of Gastroenterology and Hepatology, Sydney, New South Wales, Australia
| | - O Cronin
- Westmead Hospital, Department of Gastroenterology and Hepatology, Sydney, New South Wales, Australia
| | - T O’Sullivan
- Westmead Hospital, Department of Gastroenterology and Hepatology, Sydney, New South Wales, Australia
| | - W van Hattem
- Westmead Hospital, Department of Gastroenterology and Hepatology, Sydney, New South Wales, Australia
| | - M Sidhu
- Westmead Hospital, Department of Gastroenterology and Hepatology, Sydney, New South Wales, Australia
| | - D Tate
- University Hospital of Ghent, Ghent, Belgium
| | - E Lee
- Westmead Hospital, Department of Gastroenterology and Hepatology, Sydney, New South Wales, Australia
| | - N Burgess
- Westmead Hospital, Department of Gastroenterology and Hepatology, Sydney, New South Wales, Australia
| | - S Williams
- Westmead Hospital, Department of Gastroenterology and Hepatology, Sydney, New South Wales, Australia
| | - M Bourke
- Westmead Hospital, Department of Gastroenterology and Hepatology, Sydney, New South Wales, Australia
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Sidhu M, Garza J, Raheem A, Dang T, Panchagnula N, Mahmood S, Tariq H, Oud L. 526: ASSOCIATION BETWEEN SYSTEMIC LUPUS ERYTHEMATOSUS AND SHORT-TERM MORTALITY IN SEPSIS. Crit Care Med 2022. [DOI: 10.1097/01.ccm.0000808428.46992.12] [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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Abstract
Women in medicine face barriers that hinder progress toward top leadership roles, and the industry remains plagued by the grand challenge of gender inequality. The purpose of this study was to explore how subtle and overt gender biases affect women physicians, physician leaders, researchers, and faculty working in academic health sciences environments and to further examine the association of these biases with workplace satisfaction. The study used a convergent mixed methods approach. Sampling from a list of medical schools in the United States, in conjunction with a list of each state's medical society, the authors analyzed the quantitative survey responses of 293 women in medicine. The authors conducted ordinary least squares multiple regression to assess the relationship of gender barriers on workplace satisfaction. Additionally, 132 of the 293 participants provided written open-ended responses that were explored using a qualitative content analysis methodology. The survey results showed that male culture, lack of sponsorship, lack of mentoring, and queen bee syndrome were associated with lower workplace satisfaction. The qualitative results provided illustrations of how participants experienced these biases. These results emphasize the obstacles that women face and highlight the detrimental nature of gender bias in medicine. The authors conclude by presenting concrete recommendations for managers endeavoring to improve the culture of gender equity and inclusivity.
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Hamdan A, Moeen Z, Tariq H, Olson O, Matute-Martinez C, Sidhu M, Mukkera S. An Interesting Case of Immunoglobulin G4-Related Retroperitoneal Fibrosis Treated With Rituximab. Cureus 2021; 13:e17940. [PMID: 34660129 PMCID: PMC8497182 DOI: 10.7759/cureus.17940] [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] [Accepted: 09/13/2021] [Indexed: 11/15/2022] Open
Abstract
Immunoglobulin G4-related disease (IgG4-RD) is a fibroinflammatory condition. Its common manifestations include type I autoimmune pancreatitis and retroperitoneal fibrosis (RPF). We present a rare case involving a 43-year-old female who presented with left lower quadrant (LLQ) pain. Imaging of the abdomen and pelvis revealed left hydroureteronephrosis to the level of an inflammatory process in the left adnexal region, possibly reflecting a tubo-ovarian abscess (TOA). The gynecologic evaluation concluded that the mass was unlikely of gynecologic sources. Transgluteal biopsy of the mass was highly suggestive of IgG4-RD. The patient received prednisone and rituximab (RTX), resulting in complete resolution of the mass, which was confirmed on repeat imaging. This case report provides a valuable addition to the literature to highlight that the diagnosis of IgG4-RD is based on the combination of characteristic clinical, serologic, radiologic, and histopathologic findings. Also, it underlines that the management of the disease is through glucocorticoids (GCs) as the first-line agent for remission induction in all patients with active, untreated IgG4-RD. RTX therapy is an effective treatment for IgG4-RD that is refractory to GCs. Recent studies have suggested that RTX monotherapy can be used to induce and maintain remission in patients with IgG4-RD.
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Affiliation(s)
- Ahmad Hamdan
- Internal Medicine, Texas Tech University Health Sciences Center School of Medicine at the Permian Basin, Odessa, USA
| | - Zunera Moeen
- Internal Medicine, Texas Tech University-Permian Basin, Odessa, USA
| | - Hina Tariq
- Internal Medicine, Islam Medical College, Sialkot, PAK
| | - Olga Olson
- Internal Medicine, Twin Cities Community Hospital, Templeton, USA
| | - Carlos Matute-Martinez
- Internal Medicine, Texas Tech University Health Sciences Center School of Medicine at the Permian Basin, Odessa, USA
| | - Mandeep Sidhu
- Internal Medicine, Texas Tech University Health Sciences Center, Odessa, USA
| | - Srikanth Mukkera
- Rheumatology, Texas Tech University Health Sciences Center, Odessa, USA
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Saghir N, Saghir R, Sidhu M, Okhiria T, Okhiria R, Husein R, Sforza M. 1051 The Effect of Ginger Oil on Postoperative Nausea and Vomiting (PONV) After Breast Augmentation Surgery. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.711] [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: 11/13/2022]
Abstract
Abstract
Aim
Postoperative nausea and vomiting (PONV) is one of the commonest complaints following general anaesthetic. Poorly controlled due to its multifactorial nature most current antiemetics are not effective and have an undesirable side effect profile. As such we have studied the effect of Ginger (Zingiber Officinale), a relatively inert yet powerful antiemetic and its properties in managing PONV.
Method
A double-blind (surgeon/anaesthetist), randomised, placebo-controlled, single-centre study was carried out in a homogenous 30 female patient cohort undergoing breast augmentation surgery. Participants were randomly allocated to have 3 drops of either Ginger oil (110mg Zingiber officinale) or a simple control oil on the laryngeal mask before insertion. PONV and visual analogue scales (VAS) were used as outcome measures and were plotted against the dose of morphine used in the patient.
Results
Multivariate analysis of variance (MANOVA) was conducted on the data. Using Pillai’s trace, there was a significant effect of ginger on PONV/VAS, V = 0.87, F(3,16)=34.78, P < 0.001. Separate univariate ANOVAs showed: PONV Mean=1.70, PONVSD=0.48 compared with no ginger treatment plan group; PONV Mean=4.20, PONVSD=0.79. VAS Mean= 5.0, VASSD=1.63 for the ginger treatment plan group; and VAS Mean=5.9, VASSD=2.33 for the no ginger treatment plan group.
Conclusions
This study has found that ginger has an important role in preventing postoperative vomiting, reducing postoperative nausea, and is useful in breast augmentation. We have demonstrated a novel application of ginger oil during induction of anaesthesia and have provided evidence of its use in opioid-induced PONV.
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Affiliation(s)
- N Saghir
- Royal Preston Hospital, Manchester, United Kingdom
| | - R Saghir
- Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom
| | - M Sidhu
- Imperial College School of Medicine, London, United Kingdom
| | - T Okhiria
- Imperial College School of Medicine, London, United Kingdom
| | - R Okhiria
- Manchester Medical School, Manchester, United Kingdom
| | - R Husein
- Royal Free Hospital, London, United Kingdom
| | - M Sforza
- SESA and UNFESO universities, Rio De Janeiro, United Kingdom
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Saghir R, Saghir N, Okhiria R, Okhiria T, Sidhu M, Husein R, Sforza M. 1039 Assessing the Efficacy of The Modified S-PECS Anaesthetic Block in Patients Undergoing Breast Augmentation Surgery – A Randomised Double-Blind Control Trial. Br J Surg 2021. [DOI: 10.1093/bjs/znab258.024] [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: 11/14/2022]
Abstract
Abstract
Aim
Postoperative acute on chronic pain following breast surgery is a common complication which needs resolving to allow for improved patient outcomes. Previously thoracic epidurals and paravertebral blocks (PVB) have been the gold standard administered intra-operatively. However, more recently the introduction of the Pectoral nerve block (PECS and PECS-2 blocks) has looked promising to control the pain more effectively, but further robust analysis is required to prove its efficacy. The authors aim to study the efficacy of a new block S-PECS that comprises a serratus anterior and a PECS-2 block associated.
Method
In this study we performed a prospective, single-centre randomised controlled double-blind group trial in 30 female patients undergoing breast augmentation surgery with silicone breast implants and the S-PECS block. Divided into groups of 15, the S-PECS group received local anaesthetics with the no-PECS control group receiving a saline injection. All participants were followed up at recovery (REC), 4, 6 and 12 (4H, 6H and 12H) hourly postoperatively.
Results
Our results showed that the pain score in the S-PECS group was significantly less than the no-PECS group across all time points REC, 4H, 6H and 12H. Furthermore, the patients that received the S-PECS block were 74% less likely to request pain medications compared to the no-PECS group (p < 0.05).
Conclusions
Overall, the modified S-PECS block is an effective, efficient, and safe method of controlling pain in patients undergoing breast augmentation surgery with additional applications yet to be explored.
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Affiliation(s)
- R Saghir
- Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom
| | - N Saghir
- Royal Preston Hospital, Manchester, United Kingdom
| | - R Okhiria
- Manchester Medical School, Manchester, United Kingdom
| | - T Okhiria
- Imperial College School of Medicine, London, United Kingdom
| | - M Sidhu
- Imperial College School of Medicine, London, United Kingdom
| | - R Husein
- Royal Free Hospital, London, United Kingdom
| | - M Sforza
- SESA and UNFESO universities, Rio De Janeiro, Brazil
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14
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Saghir R, Saghir N, Okhiria T, Sidhu M, Okhiria R, Husein R, Sforza M. 1058 DVT And Abdominoplasty: A Holistic 8-Point Protocol-Based Approach to Prevent DVT. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.712] [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: 11/13/2022]
Abstract
Abstract
Aim
Plastic surgery as a speciality is afflicted with one of the highest incidence rates of thromboembolic events, with abdominoplasty procedures known to assimilate the greatest rates of Deep Vein Thrombosis (DVT).
Method
A total of 1078 abdominoplasty patients were enrolled onto an 8-point prophylaxis protocol with an inclusive holistic approach over a 7- year period. A 4-week smoking, HRT and COC cessation period was imposed on all patients and a maximum BMI score of 40 was required of all preoperative patients. Participants were administered with compression stockings, flowtrons and enoxaparin. Individuals with a DVT history were also required to be 1-year treatment free prior to surgery. Furthermore, the protocol necessitated post-operative deambulation of fit patients within 4 hours.
Results
Between 2008 and 2013, no incidence of DVT was recorded in all 1078 abdominoplasty surgery patients, indicating the potential for this protocol to lead to a significantly lower incidence than any previously published methodology. Due to the zero-incidence rate of DVT, different hypotheses of DVT proportions were tested to find out the rates that could be statistically consistent with our sample, thereby providing conservative incidence rate estimates.
Conclusions
This 8-point DVT prophylaxis protocol is the first non-criteria based inclusive protocol aimed at preventing abdominoplasty-associated DVT. As a result, not a single incident of DVT was recorded over the seven-year period of this study. We therefore believe that a holistic and procedure-specific approach to prophylaxis can drastically reduce the occurrence of DVT in abdominoplasty surgery
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Affiliation(s)
- R Saghir
- Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom
| | - N Saghir
- Royal Preston Hospital, Manchester, United Kingdom
| | - T Okhiria
- Imperial College School of Medicine, London, United Kingdom
| | - M Sidhu
- Imperial College School of Medicine, London, United Kingdom
| | - R Okhiria
- Manchester Medical School, Manchester, United Kingdom
| | - R Husein
- Royal Free Hospital, London, United Kingdom
| | - M Sforza
- SESA and UNFESO universities, Rio De Janeiro, Brazil
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15
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Lopez-Sendon JL, Cyr DD, Mark DB, Bangalore S, Huang Z, White HD, Alexander KP, Li J, Nair RG, Demkow M, Peteiro J, Wander GS, Demchenko EA, Gamma R, Gadkari M, Poh KK, Nageh T, Stone PH, Keltai M, Sidhu M, Newman JD, Boden WE, Reynolds HR, Chaitman BR, Hochman JS, Maron DJ, O'Brien SM. Effects of initial invasive vs. initial conservative treatment strategies on recurrent and total cardiovascular events in the ISCHEMIA trial. Eur Heart J 2021; 43:148-149. [PMID: 34514494 DOI: 10.1093/eurheartj/ehab509] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/26/2021] [Accepted: 08/16/2021] [Indexed: 12/24/2022] Open
Abstract
AIMS The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial prespecified an analysis to determine whether accounting for recurrent cardiovascular events in addition to first events modified understanding of the treatment effects. METHODS AND RESULTS Patients with stable coronary artery disease (CAD) and moderate or severe ischaemia on stress testing were randomized to either initial invasive (INV) or initial conservative (CON) management. The primary outcome was a composite of cardiovascular death, myocardial infarction (MI), and hospitalization for unstable angina, heart failure, or cardiac arrest. The Ghosh-Lin method was used to estimate mean cumulative incidence of total events with death as a competing risk. The 5179 ISCHEMIA patients experienced 670 index events (318 INV, 352 CON) and 203 recurrent events (102 INV, 101 CON). A single primary event was observed in 9.8% of INV and 10.8% of CON patients while ≥2 primary events were observed in 2.5% and 2.8%, respectively. Patients with recurrent events were older; had more frequent hypertension, diabetes, prior MI, or cerebrovascular disease; and had more multivessel CAD. The average number of primary endpoint events per 100 patients over 4 years was 18.2 in INV [95% confidence interval (CI) 15.8-20.9] and 19.7 in CON (95% CI 17.5-22.2), difference -1.5 (95% CI -5.0 to 2.0, P = 0.398). Comparable results were obtained when all-cause death was substituted for cardiovascular death and when stroke was added as an event. CONCLUSIONS In stable CAD patients with moderate or severe myocardial ischaemia enrolled in ISCHEMIA, an initial INV treatment strategy did not prevent either net recurrent events or net total events more effectively than an initial CON strategy. CLINICAL TRIAL REGISTRATION ISCHEMIA ClinicalTrials.gov number, NCT01471522, https://clinicaltrials.gov/ct2/show/NCT01471522.
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Affiliation(s)
- Jose L Lopez-Sendon
- Cardiology department, Hospital Universitario La Paz, Idipaz, UAM, CIBER-CV, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Derek D Cyr
- Duke Clinical Research Institute and Duke University, 300 W. Morgan Street, Durham, NC, USA
| | - Daniel B Mark
- Duke Clinical Research Institute and Duke University, 300 W. Morgan Street, Durham, NC, USA
| | - Sripal Bangalore
- NYU Grossman School of Medicine, 530 First Avenue, New York, NY, USA
| | - Zhen Huang
- Duke Clinical Research Institute and Duke University, 300 W. Morgan Street, Durham, NC, USA
| | - Harvey D White
- Auckland City Hospital Green Lane Cardiovascular Services and University of Auckland, 2 Park Road, Grafton, Auckland 1023, New Zealand
| | - Karen P Alexander
- Duke Clinical Research Institute and Duke University, 300 W. Morgan Street, Durham, NC, USA
| | - Jianghao Li
- Duke Clinical Research Institute and Duke University, 300 W. Morgan Street, Durham, NC, USA
| | - Rajesh Goplan Nair
- Government Medical College, 48/584, Subhag Sastrinagar, Thiruvananthapuram, Kerala 695002, India
| | - Marcin Demkow
- Department of Coronary and Structural Heart Diseases, National Institute of Cardiology, Alpejska 42, Warsaw 04-628, Poland
| | - Jesus Peteiro
- CHUAC, Universidad de A Coruña, CIBER-CV, As Xubias, 84, A Coruna 15006, Spain
| | - Gurpreet S Wander
- Dayanand Medical College & Hospital, Civil Lines, Tagore Nagar, Ludhiana, Punjab 141001, India
| | - Elena A Demchenko
- Almazov National Medical Research Centre, Ulitsa Akkuratova, 2, Saint-Petersburg 197341, Russia
| | - Reto Gamma
- Broomfield Hospital, Court Rd, Broomfield, Chelmsford CM1 7ET, UK
| | - Milind Gadkari
- Kem Hospital Maharashtra, 489, Mudaliar Rd, Rasta Peth, Pune, Maharashtra 411011, India
| | - Kian Keong Poh
- National University Heart Center Singapore, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, Singapore
| | - Thuraia Nageh
- Southend University Hospital, Prittlewell Chase, Westcliff-on-Sea, Southend-on-Sea, Westcliff-on-Sea SS0 0RY, Southend, England, UK
| | - Peter H Stone
- Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA
| | - Matyas Keltai
- Semmelweis University, Budapest, Üllői út 26, 1085 Hungary
| | - Mandeep Sidhu
- Albany Medical College, 47 New Scotland Avenue, Physicians Pavilion, 2nd Floor, Albany, NY 12208, USA
| | - Jonathan D Newman
- NYU Grossman School of Medicine, 530 First Avenue, New York, NY, USA
| | - William E Boden
- VA New England Healthcare System, Boston University School of Medicine, 150 South Huntington Avenue, Boston, MA, USA
| | | | - Bernard R Chaitman
- St Louis University School of Medicine Center for Comprehensive Cardiovascular Care, 1034 S. Brentwood Blvd., Suite 1120, St. Louis, MO, USA
| | - Judith S Hochman
- NYU Grossman School of Medicine, 530 First Avenue, New York, NY, USA
| | - David J Maron
- Department of Medicine, Stanford University, 300 Pasteur Drive, Falk CVRC 265, Stanford, CA 94305-5406, USA
| | - Sean M O'Brien
- Duke Clinical Research Institute and Duke University, 300 W. Morgan Street, Durham, NC, USA
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16
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Abuown A, Ellis T, Miller J, Davidson R, Kachwala Q, Medeiros M, Mejia K, Manoraj S, Sidhu M, Whittington AM, Pattani S. COVID-19 vaccination intent among London healthcare workers. Occup Med (Lond) 2021; 71:211-214. [PMID: 34002797 PMCID: PMC8194640 DOI: 10.1093/occmed/kqab057] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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] [Indexed: 12/30/2022] Open
Abstract
Background The 10-month timeline from conception to regulatory approval of the Pfizer–BioNTech vaccine against SARS-CoV-2 is unprecedented in modern medicine. However, the climate of the pandemic has also seen anti-vaccination sentiments flourish. Aims To determine the intent to accept COVID-19 vaccination among healthcare workers at a London Hospital Trust and examine variation in uptake between demographic groups. Methods We conducted a cross-sectional survey open to staff working at the trust. Staff rated on a five-point scale the likelihood of them accepting COVID-19 vaccination. Results We received 514 responses, representing 16% of the workforce. About 59% of staff intended to seek vaccination, 24% to reject and 17% were unsure. There was significantly reduced intended uptake in females, younger age groups, healthcare assistants, nurses, staff of black ethnic backgrounds and those who rejected influenza vaccination. Safety was the dominant concern. Conclusions Our study finds COVID-19 vaccinate hesitancy is prevalent among healthcare workers at a London Hospital Trust. It is particularly concerning that hesitancy was highest amongst groups most exposed to COVID-19 and most at risk of severe disease. Reasons behind disparities in uptake must be addressed to protect staff and prevent deepening inequalities within the healthcare workforce.
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Affiliation(s)
- A Abuown
- London North West University Healthcare, London, UK
| | - T Ellis
- Barts and the London, London, UK
| | - J Miller
- Royal Free London NHS Foundation Trust, London, UK
| | | | | | | | - K Mejia
- Imperial College London, London, UK
| | | | - M Sidhu
- Imperial College London, London, UK
| | | | - S Pattani
- London North West University Healthcare, London, UK
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17
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Kretov E, Huang Z, Sidhu M, O'Brien S, Fleg J, Prokhorikhin A, Mathew R, Maron D, Hochman J, Bangalore S. ASSOCIATION OF BMI ON WITH CLINICAL OUTCOMES IN PATIENTS WITH CORONARY DISEASE AND ADVANCED CHRONIC KIDNEY DISEASE: INSIGHTS FROM THE ISCHEMIA-CKD TRIAL. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)01456-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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18
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Mathew R, Sidhu M, Farkouh M, Rihal C, Lennon R, El-Hajjar M, Yager N, Abdul-Nour K, Weitz S, O'Cochlain D, Levisay J, Murthy V, Graham J, Dzavik V, Marzo K, So D, Goodman S, Pereira N. GENOTYPE-GUIDED P2Y12 INHIBITION FOLLOWING PCI BENEFITS CYP2C19 LOSS OF FUNCTION PATIENTS WITH NORMAL RENAL FUNCTION COMPARED TO THOSE WITH CHRONIC KIDNEY DISEASE. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)01389-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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19
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Brueske B, Sidhu M, Anavekar N, Brenes-Salazar J, Barsness G, Jentzer J. BRADEN SKIN SCORE SUB-DOMAINS PREDICT MORTALITY AMONG CARDIAC INTENSIVE CARE PATIENTS. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02047-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Briguori C, Mavromatis K, Huang Z, Mathew R, Hickson L, Lau WL, Ye Z, Mathew A, Mahajan S, Wheeler D, Claes K, Chen G, Nolasco F, Fleg J, Sidhu M, Chertow G, Hochman J, Maron D, Bangalore S. DIALYSIS INITIATION IN PATIENTS WITH STABLE ISCHEMIC HEART DISEASE AND SEVERE CHRONIC KIDNEY DISEASE IN THE ISCHEMIA-CKD TRIAL. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)01369-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Chaitman B, Kunichoff D, Alexander K, Pracon R, Bainey K, Mathew A, Acharya A, Lopes R, Fleg J, Sidhu M, Rockhold F, Maron D, Hochman J, Bangalore S. MYOCARDIAL INFARCTION RATES BY DEFINITION, TYPE, AND TREATMENT IN THE ISCHEMIA-CKD TRIAL. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)01391-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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22
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Pereira NL, Farkouh ME, So D, Lennon R, Geller N, Mathew V, Bell M, Bae JH, Jeong MH, Chavez I, Gordon P, Abbott JD, Cagin C, Baudhuin L, Fu YP, Goodman SG, Hasan A, Iturriaga E, Lerman A, Sidhu M, Tanguay JF, Wang L, Weinshilboum R, Welsh R, Rosenberg Y, Bailey K, Rihal C. Effect of Genotype-Guided Oral P2Y12 Inhibitor Selection vs Conventional Clopidogrel Therapy on Ischemic Outcomes After Percutaneous Coronary Intervention: The TAILOR-PCI Randomized Clinical Trial. JAMA 2020; 324:761-771. [PMID: 32840598 PMCID: PMC7448831 DOI: 10.1001/jama.2020.12443] [Citation(s) in RCA: 215] [Impact Index Per Article: 53.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE After percutaneous coronary intervention (PCI), patients with CYP2C19*2 or *3 loss-of-function (LOF) variants treated with clopidogrel have increased risk of ischemic events. Whether genotype-guided selection of oral P2Y12 inhibitor therapy improves ischemic outcomes is unknown. OBJECTIVE To determine the effect of a genotype-guided oral P2Y12 inhibitor strategy on ischemic outcomes in CYP2C19 LOF carriers after PCI. DESIGN, SETTING, AND PARTICIPANTS Open-label randomized clinical trial of 5302 patients undergoing PCI for acute coronary syndromes (ACS) or stable coronary artery disease (CAD). Patients were enrolled at 40 centers in the US, Canada, South Korea, and Mexico from May 2013 through October 2018; final date of follow-up was October 2019. INTERVENTIONS Patients randomized to the genotype-guided group (n = 2652) underwent point-of-care genotyping. CYP2C19 LOF carriers were prescribed ticagrelor and noncarriers clopidogrel. Patients randomized to the conventional group (n = 2650) were prescribed clopidogrel and underwent genotyping after 12 months. MAIN OUTCOMES AND MEASURES The primary end point was a composite of cardiovascular death, myocardial infarction, stroke, stent thrombosis, and severe recurrent ischemia at 12 months. A secondary end point was major or minor bleeding at 12 months. The primary analysis was in patients with CYP2C19 LOF variants, and secondary analysis included all randomized patients. The trial had 85% power to detect a minimum hazard ratio of 0.50. RESULTS Among 5302 patients randomized (median age, 62 years; 25% women), 82% had ACS and 18% had stable CAD; 94% completed the trial. Of 1849 with CYP2C19 LOF variants, 764 of 903 (85%) assigned to genotype-guided therapy received ticagrelor, and 932 of 946 (99%) assigned to conventional therapy received clopidogrel. The primary end point occurred in 35 of 903 CYP2C19 LOF carriers (4.0%) in the genotype-guided therapy group and 54 of 946 (5.9%) in the conventional therapy group at 12 months (hazard ratio [HR], 0.66 [95% CI, 0.43-1.02]; P = .06). None of the 11 prespecified secondary end points showed significant differences, including major or minor bleeding in CYP2C19 LOF carriers in the genotype-guided group (1.9%) vs the conventional therapy group (1.6%) at 12 months (HR, 1.22 [95% CI, 0.60-2.51]; P = .58). Among all randomized patients, the primary end point occurred in 113 of 2641 (4.4%) in the genotype-guided group and 135 of 2635 (5.3%) in the conventional group (HR, 0.84 [95% CI, 0.65-1.07]; P = .16). CONCLUSIONS AND RELEVANCE Among CYP2C19 LOF carriers with ACS and stable CAD undergoing PCI, genotype-guided selection of an oral P2Y12 inhibitor, compared with conventional clopidogrel therapy without point-of-care genotyping, resulted in no statistically significant difference in a composite end point of cardiovascular death, myocardial infarction, stroke, stent thrombosis, and severe recurrent ischemia based on the prespecified analysis plan and the treatment effect that the study was powered to detect at 12 months. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01742117.
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Affiliation(s)
- Naveen L. Pereira
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Michael E. Farkouh
- Peter Munk Cardiac Centre and Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, Ontario, Canada
| | - Derek So
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Ryan Lennon
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Nancy Geller
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Verghese Mathew
- Department of Medicine, Loyola University, Maywood, Illinois
| | - Malcolm Bell
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Jang-Ho Bae
- Department of Internal Medicine, Division of Cardiology, Konyang University, Seo-gu, Taejon, South Korea
| | - Myung Ho Jeong
- Heart Research Center, Chonnam National University, Gwangju, South Korea
| | - Ivan Chavez
- Department of Cardiology, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota
| | - Paul Gordon
- Division of Cardiology, The Miriam Hospital, Providence, Rhode Island
| | - J. Dawn Abbott
- Division of Cardiology, Rhode Island Hospital, Providence, Rhode Island
| | - Charles Cagin
- Mayo Clinic Health System—La Crosse, La Crosse, Wisconsin
| | - Linnea Baudhuin
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Yi-Ping Fu
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Shaun G. Goodman
- St Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
- Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta
| | - Ahmed Hasan
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Erin Iturriaga
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Amir Lerman
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Mandeep Sidhu
- Division of Cardiology, Department of Medicine, Albany Medical Center and Albany Medical College, Albany, New York
| | | | - Liewei Wang
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota
| | - Richard Weinshilboum
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota
| | - Robert Welsh
- Department of Medicine, Mazankowski Alberta Heart Institute and University of Alberta, Edmonton, Alberta, Canada
| | - Yves Rosenberg
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Kent Bailey
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Charanjit Rihal
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
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23
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Jentzer JC, Breen T, Sidhu M, Barsness GW, Kashani K. Epidemiology and outcomes of acute kidney injury in cardiac intensive care unit patients. J Crit Care 2020; 60:127-134. [PMID: 32799182 DOI: 10.1016/j.jcrc.2020.07.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/29/2020] [Accepted: 07/31/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE To describe the epidemiology and outcomes of acute kidney injury (AKI) among contemporary non-surgical cardiac intensive care unit (CICU) patients. MATERIALS AND METHODS We reviewed adult non-surgical CICU patients admitted from 2007 to 2015. The highest AKI stage during hospitalization was defined using modified Kidney Disease: Improving Global Outcomes (KDIGO) criteria, based on changes in serum creatinine. Hospital and 5-year mortality were examined using logistic regression and Cox proportional-hazards models, respectively. RESULTS We included 9311 patients with a mean age of 67.5 years, including 37% females. AKI was present in 51%: stage 1 AKI in 34%, stage 2 AKI in 9%, and stage 3 AKI in 8%. Hospital mortality was associated with AKI stage (adjusted OR for each AKI stage 1.17, 95% CI 1.04-1.31, p = 0.007). Five-year mortality was incrementally associated with AKI stage (adjusted HR per AKI stage 1.13, 95% CI 1.08-1.18; p < 0.001), particularly post-discharge mortality among hospital survivors (adjusted HR per AKI stage 1.20, 95% CI 1.15-1.25, p < 0.001). Patients with stage 3 AKI (especially requiring dialysis) had the highest adjusted hospital and five-year mortality. CONCLUSION AKI severity is incrementally associated with higher short-term and long-term mortality in CICU patients, especially severe AKI requiring dialysis.
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Affiliation(s)
- Jacob C Jentzer
- Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States of America; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States of America.
| | - Thomas Breen
- Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States of America.
| | - Mandeep Sidhu
- Division of Cardiology, Department of Medicine, Albany Medical Center, 43 New Scotland Ave, Albany, NY 12208, United States of America.
| | - Gregory W Barsness
- Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States of America.
| | - Kianoush Kashani
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States of America; Division of Nephrology & Hypertension, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States of America.
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Piccini JP, Xu H, Cox M, Matsouaka RA, Fonarow GC, Butler J, Curtis AB, Desai N, Fang M, McCabe PJ, Page II RL, Turakhia M, Russo AM, Knight BP, Sidhu M, Hurwitz JL, Ellenbogen KA, Lewis WR. Adherence to Guideline-Directed Stroke Prevention Therapy for Atrial Fibrillation Is Achievable. Circulation 2019; 139:1497-1506. [DOI: 10.1161/circulationaha.118.035909] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [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: 11/16/2022]
Affiliation(s)
- Jonathan P. Piccini
- Duke Clinical Research Institute and Duke University Medical Center, Durham, NC (J.P.P., H.X., M.C., R.A.M.)
| | - Haolin Xu
- Duke Clinical Research Institute and Duke University Medical Center, Durham, NC (J.P.P., H.X., M.C., R.A.M.)
| | - Margueritte Cox
- Duke Clinical Research Institute and Duke University Medical Center, Durham, NC (J.P.P., H.X., M.C., R.A.M.)
| | - Roland A. Matsouaka
- Duke Clinical Research Institute and Duke University Medical Center, Durham, NC (J.P.P., H.X., M.C., R.A.M.)
| | - Gregg C. Fonarow
- Ronald Reagan-UCLA Medical Center, University of California, Los Angeles (G.C.F.)
| | - Javed Butler
- Stony Brook University School of Medicine, NY (J.B.)
| | | | | | | | | | | | - Mintu Turakhia
- VA Palo Alto Health Care System and Stanford University School of Medicine, CA (M.T.)
| | | | - Bradley P. Knight
- Feinberg School of Medicine, Northwestern University, Chicago, IL (B.P.K.)
| | | | | | | | - William R. Lewis
- MetroHealth System Campus, Case Western Reserve University, Cleveland, OH (W.R.L.)
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25
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Torosoff M, Breen T, Balulad S, Padala S, Lyubarova R, Tan H, Sidhu M. Resolution of sinus bradycardia, high-grade heart block, and left ventricular systolic dysfunction with rituximab therapy in Henoch-Schonlein purpura. Intern Med J 2018; 48:868-871. [PMID: 29984516 DOI: 10.1111/imj.13948] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 10/26/2017] [Accepted: 10/28/2017] [Indexed: 01/23/2023]
Abstract
Henoch-Schonlein purpura (HSP) is a rare, typically self-limited, multi-organ vasculitis. Cardiac involvement with HSP carries high morbidity and mortality, thus requiring early aggressive immunosuppressive therapy. We report a case of HSP complicated with acute systolic left ventricular (LV) dysfunction, symptomatic sinus bradycardia and high-grade atrio-ventricular (AV) heart block. Cyclophosphamide, a commonly used agent in HSP, was contraindicated due to the patient's presentation with acute renal failure. Treatment with monoclonal antibody rituximab and corticosteroids was initiated with an improvement in and resolution of LV systolic dysfunction, sinus bradycardia and AV block. We believe this is the first published report on rituximab treatment in HSP with cardiac involvement manifesting with severe LV systolic dysfunction, sinus bradycardia and high-grade AV block.
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Affiliation(s)
| | | | | | - Santosh Padala
- Virginia Commonwealth University Medical Center, Richmond, Virginia, USA
| | | | - Henry Tan
- Albany Medical Center, Albany, New York, USA
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26
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Sidhu M, Brady L, Vladutiu GD, Tarnopolsky MA. Novel heterozygous mutations in the PGAM2 gene with negative exercise testing. Mol Genet Metab Rep 2018; 17:53-55. [PMID: 30310767 PMCID: PMC6178239 DOI: 10.1016/j.ymgmr.2018.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 09/26/2018] [Accepted: 09/27/2018] [Indexed: 12/17/2022] Open
Abstract
Pathogenic variants in the PGAM2 gene are associated with glycogen storage disease type X (GSDX) and is characterized by exercise induced muscle cramping, weakness, myoglobinuria, and often tubular aggregates in skeletal muscle. We report here a patient diagnosed with GSDX at 52 years of age with a normal increase in post-exercise lactate with both anaerobic and aerobic exercise. Genetic testing found two novel PGAM2 variants (c.426C > A, p.Tyr142Ter and c.533delG, p.Gly178Alafs*31).
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Affiliation(s)
- M Sidhu
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - L Brady
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - G D Vladutiu
- Departments of Pediatrics, Neurology, and Pathology & Anatomical Sciences, University at Buffalo, Buffalo, NY 14214, USA
| | - M A Tarnopolsky
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
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27
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Weiss R, Aasbo J, Hanon S, Sadhu A, Sidhu M, Burke M. P2931Impact of age at implant on subcutaneous implantable cardioverter defibrillator outcomes. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2931] [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: 11/13/2022] Open
Affiliation(s)
- R Weiss
- The Ohio State University, Columbus, United States of America
| | - J Aasbo
- The Toledo Hospital, Toledo, United States of America
| | - S Hanon
- Beth Israel Medical Center, New York, United States of America
| | - A Sadhu
- Phoenix Cardiovascular Research Group, Phoenix, United States of America
| | - M Sidhu
- Albany Medical Center, Albany, United States of America
| | - M Burke
- CorVita Science Foundation, Chicago, United States of America
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28
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Wang SC, Schulman-Marcus J, Fantauzzi J, Bevington T, Sayegh A, Lee E, Ata A, Kambam M, Sidhu M, Lyubarova R. Colon cancer laterality is associated with atherosclerosis and coronary artery disease. J Gastrointest Oncol 2018; 10:30-36. [PMID: 30788156 DOI: 10.21037/jgo.2018.09.18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Primary right-sided colon cancer (RCC) is associated with a higher mortality than left-sided colon cancer (LCC), but the etiology of this phenomenon remains unclear. We sought to study whether cancer laterality is associated with the prevalence of clinical coronary artery disease, calcific atherosclerosis as measured by computed tomography (CT), and cardiovascular risk factors. Methods We conducted a single center retrospective study of 546 participants who had previously been diagnosed with colon cancer between January 2005 and December 2014. The presence of coronary and aortic calcifications was assessed by CT in 486 of these patients. We examined the prevalence of clinical cardiovascular disease (CAD) (prior myocardial infarction or revascularization), comorbidities, coronary and aortic calcification in patients with RCC (n=261) and LCC (n=285). Logistic regression analysis was performed to assess the likelihood of clinical CAD and calcific atherosclerosis by cancer laterality. Results Compared to patients with LCC, patients with RCC were more likely to have hypertension, hyperlipidemia, hypothyroidism and clinical CAD. In the patients with available CT scans, RCC was associated with higher prevalence of coronary, thoracic, and abdominal calcifications than LCC. On univariate and multivariate analyses, RCC was associated with higher likelihood of clinical CAD (adjusted risk ratio 2.15, 95% CI, 1.37-3.38, P=0.001) as well as radiological evidence of calcific atherosclerosis compared to LCC. Conclusions we found that both clinical CAD and vascular calcifications are prevalent in patients with colon cancer, and are independently increased in patients with RCC compared to LCC.
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Affiliation(s)
- Stephani C Wang
- Department of Medicine, Albany Medical Center, Albany, NY, USA
| | | | - John Fantauzzi
- Department of Radiology, Albany Medical Center, Albany, NY, USA
| | | | - Anthony Sayegh
- Department of Radiology, Albany Medical Center, Albany, NY, USA
| | - Edward Lee
- Division of Colorectal Surgery, Department of Surgery, Albany Medical Center, Albany, NY, USA
| | - Ashar Ata
- Division of Colorectal Surgery, Department of Surgery, Albany Medical Center, Albany, NY, USA
| | | | - Mandeep Sidhu
- Division of Cardiology, Department of Medicine, Albany Medical Center, Albany, NY, USA
| | - Radmila Lyubarova
- Division of Cardiology, Department of Medicine, Albany Medical Center, Albany, NY, USA
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29
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Sharma N, Sidhu M, Simpson D. Removal Notice for ‘A “cough induced” pelvic fracture as the first sign of a malignant neoplasm’ [International Journal of Surgery Case Reports, Volume 11 (2015) Pages 75–77]. Int J Surg Case Rep 2018; 45:146. [DOI: 10.1016/j.ijscr.2017.12.022] [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: 10/18/2022] Open
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30
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Volodarskiy A, Kumar S, Pracon R, Sidhu M, Kretov E, Mazurek T, Bockeria O, Kaul U, Bangalore S. Drug-Eluting vs Bare-Metal Stents in Patients With Chronic Kidney Disease and Coronary Artery Disease: Insights From a Systematic Review and Meta-Analysis. J Invasive Cardiol 2018; 30:10-17. [PMID: 28915510] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Most drug-eluting stent (DES) trials have excluded patients with chronic kidney disease (CKD). The efficacy of DES implantation in patients with CKD is therefore not known. OBJECTIVES To evaluate the outcomes with DES vs bare-metal stent (BMS) implantation in patients with CKD. METHODS AND RESULTS MEDLINE, EMBASE, and CENTRAL were searched for studies including at least 100 patients with CKD (estimated glomerular filtration rate ≤60 mL/min/1.73 m² or on dialysis) treated with DES or BMS and followed for at least 1 month and reporting outcomes of all-cause mortality, cardiovascular (CV) mortality, myocardial infarction (MI), target-vessel revascularization (TVR), and stent thrombosis (ST). Thirty-one studies (5 randomized) with 91,817 participants (49,081 DES and 42,736 BMS) fulfilled the inclusion criteria. DES was associated with lower all-cause mortality (relative risk [RR], 0.77; 95% confidence interval [CI], 0.71-0.84), CV mortality (RR, 0.51; 95% CI, 0.38-0.70), MI (RR, 0.90; 95% CI, 0.86-0.95), TVR (RR, 0.61; 95% CI, 0.47-0.80), and numerically lower ST (RR, 0.75; 95% CI, 0.55-1.01) when compared with BMS. Analysis by study type (RCTs vs non-RCTs) showed similar results for most outcomes (Pinteraction>.05) except all-cause mortality, where there was no difference between DES vs BMS in RCTs (Pinteraction=.04). The effects were greater with 2nd-generation DES vs BMS (for example, ST: RR, 0.38; 95% CI, 0.20-0.72). CONCLUSIONS In patients with CKD, the available evidence, largely from observational studies, suggests significantly fewer events with DES vs BMS with even a lower ST rate with 2nd-generation DES. These findings should be tested in large, randomized trials.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Sripal Bangalore
- Cardiovascular Outcomes Group, Cardiovascular Clinical Research Center, Associate Professor of Medicine, New York University School of Medicine, The Leon H. Charney Division of Cardiology, New York, NY 10016 USA.
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31
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Sidhu M, Brady L, Tarnopolsky M, Ronen GM. Clinical Manifestations Associated With the N-Terminal-Acetyltransferase NAA10 Gene Mutation in a Girl: Ogden Syndrome. Pediatr Neurol 2017; 76:82-85. [PMID: 28967461 DOI: 10.1016/j.pediatrneurol.2017.07.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 05/04/2017] [Revised: 07/10/2017] [Accepted: 07/13/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Ogden syndrome is a rare X-linked disorder caused by pathogenic variants in the NAA10 gene. This syndrome, reported in just over 20 children, has been associated with dysmorphic features, failure to thrive, developmental impairments, hypotonia, and cardiac arrhythmias. PATIENT DESCRIPTION We describe a 14-year-old girl who presented in infancy with hypotonia, global developmental delay, and dysmorphic features. She later developed autism spectrum disorder, epileptic encephalopathy, extrapyramidal signs, early morning lethargy with hypersomnolence, and hypertension with left ventricular hypertrophy. Magnetic resonance imaging showed a thin corpus callosum and progressive white matter loss. Whole exome sequencing identified a de novo pathogenic variant in the NAA10 gene (c.247C>T, p.R83C). Much of her early presentation was in keeping with what has been previously described with Ogden syndrome. CONCLUSIONS We have identified additional evolving neurological impairments in this, to date, oldest documented girl with Ogden syndrome. We recommend screening patients with Ogden syndrome for these newly identified features of early life trajectories to guide management.
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Affiliation(s)
- Mandeep Sidhu
- Division of Pediatric Neurology, McMaster University, Hamilton, Ontario, Canada
| | - Lauren Brady
- Department of Pathology (Genetics), McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Mark Tarnopolsky
- Departments of Pediatrics and Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Gabriel M Ronen
- Division of Pediatric Neurology, McMaster University, Hamilton, Ontario, Canada.
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Affiliation(s)
- Sharda Sidhu
- Department of Human Genetics, Guru Nanak Dev University , Amritsar 143 005, Punjab, India
| | - Avneet Kaur
- Department of Human Genetics, Guru Nanak Dev University , Amritsar 143 005, Punjab, India
| | - Mandeep Sidhu
- Department of Human Genetics, Guru Nanak Dev University , Amritsar 143 005, Punjab, India
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33
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Rezaee ME, Nichols EL, Sidhu M, Brown JR. Combined Post- and Precapillary Pulmonary Hypertension in Patients With Heart Failure. Clin Cardiol 2016; 39:658-664. [PMID: 27768231 DOI: 10.1002/clc.22579] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 06/22/2016] [Accepted: 06/27/2016] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Pulmonary hypertension (PH) is a well-recognized complication of left ventricular heart failure (HF). HYPOTHESIS Differences exist in demographic, clinical, hemodynamic, and survival characteristics of patients with left ventricular HF who have combined postcapillary and precapillary PH (CpcPH), isolated postcapillary PH, or no PH. METHODS A secondary data analysis was conducted using a large prospective database of patients undergoing right heart catheterization from 1994 to 2012. One-year mortality postcatheterization was assessed between PH groups using Kaplan-Meier and log-rank techniques, as well as a multivariate Cox proportional hazards model adjusted for age, sex, diabetes, chronic kidney disease, atrial fibrillation, and chronic obstructive pulmonary disease. Mortality rates were calculated for each group as deaths per 100 person-years. RESULTS Of the 724 patients identified, 29.4% (n = 213) had no evidence of PH, 63.1% (n = 457) had isolated postcapillary PH, and 7.5% (n = 54) had CpcPH. Compared with no PH, there was an increased mortality rate within 1 year for CpcPH patients (crude hazard ratio: 5.22, 95% confidence interval: 2.06-13.22), but not for isolated postcapillary PH patients (crude hazard ratio: 2.12, 95% confidence interval: 0.99-4.57). Adjusted analyses revealed similar results. Mortality rates per 100 person-years were 3.9, 8.4, and 21.0 for no PH, isolated postcapillary PH, and CpcPH patients, respectively. CONCLUSIONS Heart failure patients with CpcPH are associated with increased death rate 1 year post-cardiac catheterization, compared with patients without PH. They are a high-risk PH group and should be evaluated and diagnosed earlier in the disease state.
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Affiliation(s)
- Michael E Rezaee
- Internal Medicine, Oakland University William Beaumont School of Medicine, Rochester, Michigan.,The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Lebanon, New Hampshire
| | - Elizabeth L Nichols
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Lebanon, New Hampshire
| | - Mandeep Sidhu
- Division of Cardiology, Albany Medical Center, Albany, New York
| | - Jeremiah R Brown
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Lebanon, New Hampshire.,Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.,Department of Community and Family Medicine, Lebanon, New Hampshire
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34
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Friedman M, Hwang MS, Yalamanchali S, Pott T, Sidhu M, Joseph NJ. Provent therapy for obstructive sleep apnea: Impact of nasal obstruction. Laryngoscope 2015; 126:254-9. [DOI: 10.1002/lary.25312] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/15/2015] [Accepted: 03/16/2015] [Indexed: 11/08/2022]
Affiliation(s)
- Michael Friedman
- Section of Sleep Surgery (m.f.), Rush University Medical Center; Chicago Illinois U.S.A
- Advanced Center for Specialty Care (m.f., m.s.h., s.y., t.p., m.s., n.j.j.), Advocate Illinois Masonic Medical Center; Chicago Illinois U.S.A
| | - Michelle S Hwang
- Advanced Center for Specialty Care (m.f., m.s.h., s.y., t.p., m.s., n.j.j.), Advocate Illinois Masonic Medical Center; Chicago Illinois U.S.A
| | - Sreeya Yalamanchali
- Advanced Center for Specialty Care (m.f., m.s.h., s.y., t.p., m.s., n.j.j.), Advocate Illinois Masonic Medical Center; Chicago Illinois U.S.A
| | - Thomas Pott
- Advanced Center for Specialty Care (m.f., m.s.h., s.y., t.p., m.s., n.j.j.), Advocate Illinois Masonic Medical Center; Chicago Illinois U.S.A
| | - Mandeep Sidhu
- Advanced Center for Specialty Care (m.f., m.s.h., s.y., t.p., m.s., n.j.j.), Advocate Illinois Masonic Medical Center; Chicago Illinois U.S.A
| | - Ninos J. Joseph
- Advanced Center for Specialty Care (m.f., m.s.h., s.y., t.p., m.s., n.j.j.), Advocate Illinois Masonic Medical Center; Chicago Illinois U.S.A
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35
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Sidhu M, Daley A, Jolly K. A randomised controlled trial of a text supported weight maintenance programme. Lighten Up Plus. Appetite 2015. [DOI: 10.1016/j.appet.2014.12.130] [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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36
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Sharma N, Sidhu M, Simpson D. TEMPORARY REMOVAL: A "cough induced" pelvic fracture as the first sign of a malignant neoplasm. Int J Surg Case Rep 2015; 11:75-77. [PMID: 25938706 DOI: 10.1016/j.ijscr.2015.02.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 01/19/2015] [Accepted: 02/17/2015] [Indexed: 11/25/2022] Open
Abstract
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated.
The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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Affiliation(s)
- N Sharma
- Specialty registrar CT3, Royal Stoke NHS Trusts, UK.
| | - M Sidhu
- Specialty registrar CT2, Sandwell Hospital, UK.
| | - D Simpson
- Royal Wolverhampton NHS Trusts, New Cross Hospital, Wolverhampton, UK.
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37
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Dogra M, Dogra A, Sidhu M, Kotwal U. Seroprevalence of coinfections among blood donors in tertiary health care centre of Jammu region. Indian J Med Microbiol 2015; 33:181-2. [DOI: 10.4103/0255-0857.148425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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38
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Jain V, Joshi N, Sidhu M, Kalicinsky C, Pun T. Penicillin allergies: referral and management practices of anesthesiologists. Allergy Asthma Clin Immunol 2014. [PMCID: PMC4304046 DOI: 10.1186/1710-1492-10-s2-a20] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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39
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Mandal P, Chalmers J, Sidhu M, Davidson D, Rossi A, Hill A. S16 A Randomised Controlled Trial Of Atorvastatin As A Stable Treatment In Bronchiectasis. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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40
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Sidhu M, Gulati A, Hawkins P, Cooper S. P70 Improved Lung Cancer Referral Rates And Early Diagnosis In A District General Hospital. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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41
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Tongbram V, Sengupta N, Gaudig M, Sidhu M, Exuzides A, Colby C, Sanden SV, McGovern A. Comparative Effectiveness of Treatments for Relapsed or Refractory Mantle Cell Lymphoma (R/R MCL), Using Matching Adjusted Indirect Comparison. Value Health 2014; 17:A614-A615. [PMID: 27202151 DOI: 10.1016/j.jval.2014.08.2163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - N Sengupta
- Janssen Pharmaceuticals, Inc, Raritan, NJ, USA
| | - M Gaudig
- Janssen Pharmaceuticals, Inc, Neuss, Germany
| | - M Sidhu
- ICON Plc, Morristown, NJ, USA
| | | | - C Colby
- ICON plc, San Francisco, CA, USA
| | - S V Sanden
- Janssen Pharmaceuticals, Inc., Beerse, Belgium
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42
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Gillani SMR, Holland MR, Sidhu M, Singh BM. A case control study of use of the Failed Access Score for determination of failed access to structured diabetes care: the WICKED project. Practical Diabetes 2014. [DOI: 10.1002/pdi.1843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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43
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Hagstrom E, Roe M, Hafley G, Neely M, Sidhu M, Brown E, Prabhakaran D, White H, Armstrong P, Fox K, Ohman EM, Boden W. ASSOCIATION BETWEEN VERY LOW LEVELS OF BASELINE HIGH-DENSITY LIPOPROTEIN CHOLESTEROL AND INCREASED LONG-TERM MORTALITY IN MEDICALLY MANAGED ACUTE CORONARY SYNDROME PATIENTS. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)60067-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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44
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Granina E, Padala S, Seedhom A, Sidhu M, Torosoff M, Boden W. DYSLIPIDEMIC THERAPY AND PLATELET REACTIVITY IN OPTIMALLY TREATED STABLE ISCHEMIC HEART DISEASE PATIENTS UNDERGOING ELECTIVE PERCUTANEOUS CORONARY INTERVENTION. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)61617-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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45
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Jeffrey BS, Newman JD, Gregoire J, Senior R, Demkow M, Phaneuf D, Vertes A, Escobedo J, Kedev S, Mortara A, Dauber IM, Monti L, Devlin G, Cha J, Stone P, Reynolds HR, Johnston N, Gajos G, Mavromatis K, Lopez-Sendon JL, Sidhu M, Boden WE, Orso F, Maron DJ, Hochman JS. GEOGRAPHICAL VARIATION IN ISCHEMIA SEVERITY IN PATIENTS REFERRED FOR STRESS IMAGING STUDIES: SCREENING DATA FROM THE ISCHEMIA TRIAL. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)61232-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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46
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Padala S, Sidhu M, Hartigan P, Teo K, Spertus J, Maron D, Mancini GJ, Sedlis S, Chaitman B, Heller G, Weintraub W, Boden W. BASELINE EXERCISE CAPACITY AND IMPROVEMENT IN QUALITY OF LIFE IN PATIENTS WITH STABLE ISCHEMIC HEART DISEASE: A POST HOC ANALYSIS OF THE COURAGE TRIAL. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)61644-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Padala S, Sidhu M, Hartigan P, Teo K, Spertus J, Maron D, Mancini GBJ, Sedlis S, Chaitman B, Heller G, Weintraub W, Boden W. BASELINE EXERCISE CAPACITY AND CARDIOVASCULAR OUTCOMES IN PATIENTS WITH STABLE ISCHEMIC HEART DISEASE: A POST HOC ANALYSIS OF THE COURAGE TRIAL. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)61577-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Minsinger KD, Kassis HM, Block CA, Sidhu M, Brown JR. Meta-analysis of the effect of automated contrast injection devices versus manual injection and contrast volume on risk of contrast-induced nephropathy. Am J Cardiol 2014; 113:49-53. [PMID: 24188890 DOI: 10.1016/j.amjcard.2013.08.040] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 08/28/2013] [Accepted: 08/28/2013] [Indexed: 01/01/2023]
Abstract
Contrast-sparing devices have been slowly adopted into routine patient care. Randomized trial evidence of automated contrast injectors (ACIs) has not been analyzed to evaluate the true reduction in contrast volume during coronary angiography and intervention. It has been thought that reducing the amount of contrast exposure will result in a simultaneous reduction in the risk of contrast-induced nephropathy (CIN). Therefore, we sought to synthesize published evidence on contrast-sparing devices, contrast volume, and the incidence of CIN. We searched Medline, the Cochrane Library, and Clinicaltrials.gov. The search criteria included ACIs versus manual injection, contrast media volume, and the incidence of CIN. Data were extracted by 2 independent reviewers. The weighted mean difference of contrast volume was calculated using random effects models in RevMan, version 5.4.1, software to derive a summary estimate. A total of 79,694 patients from 10 studies were included (ACI arm, n = 20,099; manual injection arm, n = 59,595). On average, ACIs reduced contrast volume delivery by 45 ml/case (p <0.001, 95% confidence interval -54 to -35). The CIN incidence was significantly reduced by 15%, with an odds ratio of 0.85 (p <0.001, 95% confidence interval 0.78 to 0.93) for those using ACIs compared with manual injection. In conclusion, the use of ACIs in angiography significantly reduces the volume of contrast delivered to the patient and the incidence of CIN.
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Sidhu M, Footitt D, Donaldson I, Hughes S, Wuppalapati S, Emsley HCA. Intact neurological outcome after neurointerventional treatment for intracranial venous thrombosis with straight sinus involvement. BMJ Case Rep 2013; 2013:bcr-2013-010242. [PMID: 24000208 DOI: 10.1136/bcr-2013-010242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The role of neurointerventional treatment, including local thrombolysis, for intracranial venous thrombosis (ICVT) currently remains uncertain. We describe a case of postpartum ICVT involving the straight sinus, with rapid neurological deterioration and progressive thrombosis, despite anticoagulation. She underwent multimodality neurointerventional treatment involving attempted mechanical clot disruption, microcatheter suction, intrathrombus thrombolysis and microballoon disruption and clot retrieval. The patient achieved a full clinical recovery, with radiological evidence of recanalisation at follow-up.
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Affiliation(s)
- M Sidhu
- Department of Clinical and Experimental Epilepsy, UCL/Institute of Neurology, London, UK
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Cleary R, Stretton J, Winston G, Symms M, Sidhu M, Thompson P, Koepp M, Duncan J, Foong J. TEMPORAL LOBE EPILEPSY & AFFECTIVE DISORDERS: THE ROLE OF THE SUBGENUAL PREFRONTAL CORTEX. Journal of Neurology, Neurosurgery & Psychiatry 2013. [DOI: 10.1136/jnnp-2013-306103.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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