1
|
ElSherbiney M, Khawaja AH, Noureldin K, Issa M, Varma A. Single incision laparoscopy versus conventional multiport laparoscopy for colorectal surgery: a systematic review and meta-analysis. Ann R Coll Surg Engl 2023; 105:709-720. [PMID: 37843129 PMCID: PMC10618036 DOI: 10.1308/rcsann.2022.0132] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Indexed: 10/17/2023] Open
Abstract
INTRODUCTION There has been an increase in colorectal cancer resections worldwide and in the UK. Initially conducted as an open procedure, this was replaced with the conventional multiport technique. Laparoscopic colectomy became the standard surgical technique in 1991. With innovation in surgical technology, single incision laparoscopy (SIL) has attracted more attention as the possible next step in colorectal resection. The aim of this review was to compare outcomes between SIL and conventional laparoscopy (CL). METHODS A literature search was carried out in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. The PubMed®, MEDLINE®, Embase®, Google Scholar™ and Cochrane Library databases were used to extract randomised controlled trials (RCTs) published between January 2000 and May 2021. Statistical analysis was performed with RevMan software. RESULTS A total of 11 RCTs were extracted with 1,370 patients (686 SIL, 684 CL). There was no significant difference between SIL and CL for operative time (standardised mean difference [SMD]: 0.01, 95% confidence interval [CI]: -0.19 to 0.22, z=0.11, p=0.91), length of hospital stay (SMD: -0.10, 95% CI: 0.22 to 0.02, z=1.61, p=0.11) or overall complications (odds ratio [OR]: 0.99, 95% CI: 0.75 to 1.30, z=0.09, p=0.93). SIL had a shorter mean incision (SMD: -0.99, 95% CI: -1.35 to -0.62, z=5.25, p<0.00001). Patients undergoing SIL had a higher conversion rate to CL or an open approach (OR: 3.10, 95% CI: 0.95 to 10.14, z=1.87, p=0.06) but this just missed statistical significance. CONCLUSIONS SIL can be considered a safe alternative to CL if performed by experienced surgeons.
Collapse
Affiliation(s)
| | - A H Khawaja
- Nottingham University Hospitals NHS Trust, UK
| | - K Noureldin
- Wirral University Teaching Hospital NHS Foundation Trust, UK
| | - M Issa
- Dudley Group NHS Foundation Trust, UK
| | - A Varma
- United Lincolnshire Hospitals NHS Trust, UK
| |
Collapse
|
2
|
Dörner T, Tanaka Y, Mosca M, Bruce IN, Cardiel M, Morand EF, Petri MA, Silk M, Dickson C, Meszaros G, Issa M, Zhang L, Wallace DJ. POS0714 POOLED SAFETY ANALYSIS OF BARICITINIB IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: RESULTS FROM THREE RANDOMISED, DOUBLE-BLIND, PLACEBO-CONTROLLED, CLINICAL TRIALS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2375] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundBaricitinib (BARI), an oral selective inhibitor of Janus kinase 1 and 2 approved for the treatment of rheumatoid arthritis and atopic dermatitis, has been evaluated in clinical studies in patients with systemic lupus erythematosus (SLE).ObjectivesTo assess the safety profile of BARI in patients with SLE.MethodsPatients with SLE receiving stable background therapy were randomised 1:1:1 to BARI 2-mg, 4-mg, or placebo (PBO) once daily in one 24-week, phase 2 (NCT02708095) and two 52-week, phase 3, PBO controlled studies (NCT03616912 and NCT03616964).ResultsA total of 1,849 patients were included in this pooled analysis, representing 1,463.5 patient years of exposure (PYE). The incidence rates per 100 PYR at risk (IR/100 PYR) for serious adverse events (SAEs) were 9.5, 14.7, and 14.1 respectively for PBO, BARI 2-mg, and BARI 4-mg. There were no clinically meaningful differences between treatment groups for discontinuations due to AEs or death (Table 1).Table 1.Overview of safety measures of baricitinib in patients with SLESafety measurePBOBARI 2-mgBARI 4-mgPooled-BARIN=614N=621N=614N=1235PYE=488.1PYE=494.0PYE=481.4PYE=975.4n(%)n(%)n(%)n(%)PYRPYRPYRPYR[IR; 95%CI][IR; 95%CI][IR; 95%CI][IR; 95%CI]SAEs45 (7.3)70 (11.3)*65 (10.6)*135 (10.9)*473.2476.6461.9938.5[9.5; 6.9, 12.7][14.7; 11.5, 18.6][14.1; 10.9, 17.9][14.4; 12.1, 17.0]Discontinuation of study drug due to AE48 (7.8)58 (9.3)57 (9.3)115 (9.3)485.3492.3480.6973.0[9.9; 7.3, 13.1][11.8; 8.9, 15.2][11.9; 9.0, 15.4][11.8; 9.8, 14.2]Death4 (0.7)1 (0.2)4 (0.7)5 (0.4)488.2494.0481.5975.5[0.8; 0.2, 2.1][0.2; 0.0, 1.1][0.8; 0.2, 2.1][0.5; 0.2, 1.2]Serious infections12 (2.0)22 (3.5)28 (4.6)*50 (4.0)*484.3487.2472.5959.7[2.5; 1.3, 4.3][4.5; 2.8, 6.8][5.9; 3.9, 8.6][5.2; 3.9, 6.9]Herpes Zoster18 (2.9)17 (2.7)29 (4.7)46 (3.7)481.1486.5468.6955.1[3.7; 2.2, 5.9][3.5; 2.0, 5.6][6.2; 4.1, 8.9][4.8; 3.5, 6.4]VTEs#6 (1.2)3 (0.6)1 (0.2)4 (0.4)444.0450.2438.1888.3[1.4; 0.5, 2.9][0.7; 0.1, 1.9][0.2; 0.0, 1.3][0.5; 0.1, 1.2]MACE#01 (0.2)3 (0.6)4 (0.4)443.9450.1438.1888.3[0.0; NA, 0.8][0.2; 0.0, 1.2][0.7; 0.1, 2.0][0.5; 0.1, 1.2]Malignancy excluding NMSC2 (0.3)3 (0.5)2 (0.3)5 (0.4)488.0494.1481.4975.5[0.4; 0.0, 1.5][0.6; 0.1, 1.8][0.4; 0.1, 1.5][0.5; 0.2, 1.2]NMSC2 (0.3)000*486.7494.0481.4975.4[0.4; 0.0, 1.5][0.0; NA, 0.7][0.0; NA, 0.8][0.0; NA, 0.4]Data are n (%) patients PYR [IR; 95% CI]. #Phase 2 study data not included. AE=adverse event; CI=confidence interval; MACE=major adverse cardiac event; NMSC=non-melanoma skin cancers; VTE=venous thrombotic event (includes deep vein thrombosis and pulmonary embolism); IR=incidence rate (100 times the number of patients reporting an adverse event divided by the event-specific exposure to treatment); N=number of patients in the analysis population; n=number of patients in the specified category; PYE=patient-year of exposure; PYR=patient years at risk; SAE=serious adverse event. *p≤0.05 vs placebo.The IR/100 PYR for serious infections were 2.5, 4.5, and 5.9 respectively for PBO, BARI 2-mg, and BARI 4-mg. The risk of Herpes Zoster was higher in BARI 4-mg (4.7%) vs PBO (2.9%) (Table 1).The IR/100 PYR for positively adjudicated venous thrombotic events (VTEs) were 1.4, 0.7, and 0.2 respectively for PBO, BARI 2-mg, and BARI 4-mg. The IR/100 PYR for positively adjudicated major adverse cardiac event (MACE) was numerically higher in BARI 2-mg (0.2) and BARI 4-mg (0.7) vs PBO (0.0), however the pooled-BARI IR/PYR (0.5) was within the range of background disease (1). No increased risk for malignancies was observed.ConclusionThe safety profile of BARI in SLE patients was consistent with the known BARI safety profile. There was no increased risk of VTE in BARI treatment groups.References[1]Barbhaiya M, Feldman CH, et al. Arthritis Rheumatol. 2017;69(9):1823-31.Disclosure of InterestsThomas Dörner Speakers bureau: Eli Lilly and Company and Roche, Consultant of: AbbVie, Celgene, Eli Lilly and Company, Janssen, Novartis, Roche, Samsung and UCB, Grant/research support from: Chugai, Janssen, Novartis and Sanofi, Yoshiya Tanaka Speakers bureau: Gilead, Abbvie, Behringer-Ingelheim, Eli Lilly, Mitsubishi-Tanabe, Chugai, Amgen, YL Biologics, Eisai, Astellas, Bristol-Myers, Astra-Zeneca, Consultant of: Eli Lilly, Daiichi-Sankyo, Taisho, Ayumi, Sanofi, GSK, Abbvie, Grant/research support from: Asahi-Kasei, Abbvie, Chugai, Mitsubishi-Tanabe, Eisai, Takeda, Corrona, Daiichi-Sankyo, Kowa, Behringer-Ingelheim, Marta Mosca Speakers bureau: Eli Lilly, GSK, Astra Zeneca, Consultant of: Eli Lilly, GSK, Astra Zeneca, Ian N. Bruce Speakers bureau: GSK, Astra Zeneca, UCB, Consultant of: Eli Lilly, GSK, UCB, BMS, Merck Serono, Astra Zeneca, IL-TOO, Aurinia, Grant/research support from: GSK, Janssen, Mario Cardiel Speakers bureau: Eli Lilly, Pfizer, Abbvie, Consultant of: Eli Lilly, Pfizer, Grant/research support from: Pfizer, Gilead, Roche, Janssen, Eric F. Morand Speakers bureau: AstraZeneca, Eli Lilly, Novartis, Consultant of: Amgen, AstraZeneca, Asahi Kasei, Biogen, BristolMyersSquibb, Capella, Eli Lilly, EMD Serono, Genentech, GlaxoSmithKline, Janssen, Neovacs, Sanofi, Servier, UCB, Wolf, Grant/research support from: Janssen, AstraZeneca, BristolMyersSquibb, Eli Lilly, EMD Serono, GlaxoSmithKline, Michelle A Petri Consultant of: Eli Lilly, Grant/research support from: Eli Lilly, Maria Silk Shareholder of: Eli Lilly, Employee of: Eli Lilly, christina dickson Shareholder of: Eli Lilly, Employee of: Eli Lilly, Gabriella Meszaros Shareholder of: Eli Lilly, Employee of: Eli Lilly, Maher Issa Shareholder of: Eli Lilly, Employee of: Eli Lilly, Lu Zhang Shareholder of: Eli Lilly, Employee of: Eli Lilly, Daniel J. Wallace Consultant of: Amgen, Eli Lilly and Company, EMD Merck Serono and Pfizer
Collapse
|
3
|
Song C, Liu D, Liu S, Li D, Horecny I, Zhang X, Li P, Chen L, Miller M, Chowdhury R, Issa M, Shen R, Yan Y, Zhang F, Zhang L, Zhang L, Bai C, Feng J, Zhuang L, Zhang R, Li J, Wilkinson H, Liu J, Tao W. SHR1032, a novel STING agonist, stimulates anti-tumor immunity and directly induces AML apoptosis. Sci Rep 2022; 12:8579. [PMID: 35595822 PMCID: PMC9122897 DOI: 10.1038/s41598-022-12449-1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 05/04/2022] [Indexed: 11/09/2022] Open
Abstract
Stimulator of interferon genes (STING) activation induces type I interferons and pro-inflammatory cytokines which stimulate tumor antigen cross presentation and the adaptive immune responses against tumor. The first-generation of STING agonists, cyclic di-nucleotide (CDN), mimicked the endogenous STING ligand cyclic guanosine monophosphate adenosine monophosphate, and displayed limited clinical efficacy. Here we report the discovery of SHR1032, a novel small molecule non-CDN STING agonist. Compared to the clinical CDN STING agonist ADU-S100, SHR1032 has much higher activity in human cells with different STING haplotypes and robustly induces interferon β (IFNβ) production. When dosed intratumorally, SHR1032 induced strong anti-tumor effects in the MC38 murine syngeneic tumor model. Pharmacodynamic studies showed induction of IFNβ, tumor necrosis factor α (TNFα) and interleukin-6 (IL-6) in the tumors and, to a lower extent, in the plasma. More importantly, we found SHR1032 directly causes cell death in acute myeloid leukemia (AML) cells. In conclusion, our findings demonstrate that in addition to their established ability to boost anti-tumor immune responses, STING agonists can directly eradicate AML cells, and SHR1032 may present a new and promising therapeutic agent for cancer patients.
Collapse
Affiliation(s)
- Chunying Song
- Eternity Bioscience Inc., 6 Cedarbrook Drive, Cranbury, NJ, 08512, USA.
| | - Dong Liu
- Eternity Bioscience Inc., 6 Cedarbrook Drive, Cranbury, NJ, 08512, USA
| | - Suxing Liu
- Eternity Bioscience Inc., 6 Cedarbrook Drive, Cranbury, NJ, 08512, USA
| | - Di Li
- Eternity Bioscience Inc., 6 Cedarbrook Drive, Cranbury, NJ, 08512, USA
| | - Ivana Horecny
- Eternity Bioscience Inc., 6 Cedarbrook Drive, Cranbury, NJ, 08512, USA
| | - Xinzhu Zhang
- Eternity Bioscience Inc., 6 Cedarbrook Drive, Cranbury, NJ, 08512, USA
| | - Puhui Li
- Eternity Bioscience Inc., 6 Cedarbrook Drive, Cranbury, NJ, 08512, USA
| | - Lei Chen
- Eternity Bioscience Inc., 6 Cedarbrook Drive, Cranbury, NJ, 08512, USA
| | - Matthew Miller
- Eternity Bioscience Inc., 6 Cedarbrook Drive, Cranbury, NJ, 08512, USA
| | | | - Mena Issa
- Eternity Bioscience Inc., 6 Cedarbrook Drive, Cranbury, NJ, 08512, USA
| | - Ru Shen
- Eternity Bioscience Inc., 6 Cedarbrook Drive, Cranbury, NJ, 08512, USA
| | - Yinfa Yan
- Eternity Bioscience Inc., 6 Cedarbrook Drive, Cranbury, NJ, 08512, USA
| | - Fengqi Zhang
- Eternity Bioscience Inc., 6 Cedarbrook Drive, Cranbury, NJ, 08512, USA
| | - Lei Zhang
- Shanghai Hengrui Pharmaceutical Co. Ltd., 279 Wenjing Road, Shanghai, 200245, China
| | - Limin Zhang
- Shanghai Hengrui Pharmaceutical Co. Ltd., 279 Wenjing Road, Shanghai, 200245, China
| | - Chang Bai
- Shanghai Hengrui Pharmaceutical Co. Ltd., 279 Wenjing Road, Shanghai, 200245, China
| | - Jun Feng
- Shanghai Hengrui Pharmaceutical Co. Ltd., 279 Wenjing Road, Shanghai, 200245, China
| | - Linghang Zhuang
- Eternity Bioscience Inc., 6 Cedarbrook Drive, Cranbury, NJ, 08512, USA
| | - Rumin Zhang
- Eternity Bioscience Inc., 6 Cedarbrook Drive, Cranbury, NJ, 08512, USA
| | - Jing Li
- Eternity Bioscience Inc., 6 Cedarbrook Drive, Cranbury, NJ, 08512, USA
| | - Hilary Wilkinson
- Eternity Bioscience Inc., 6 Cedarbrook Drive, Cranbury, NJ, 08512, USA
| | - Jian Liu
- Eternity Bioscience Inc., 6 Cedarbrook Drive, Cranbury, NJ, 08512, USA
| | - Weikang Tao
- Shanghai Hengrui Pharmaceutical Co. Ltd., 279 Wenjing Road, Shanghai, 200245, China
| |
Collapse
|
4
|
Zhou Y, Li X, Shen R, Wang X, Zhang F, Liu S, Li D, Liu J, Li P, Yan Y, Dong P, Zhang Z, Wu H, Zhuang L, Chowdhury R, Miller M, Issa M, Mao Y, Chen H, Feng J, Li J, Bai C, He F, Tao W. Novel Small Molecule Tyrosine Kinase 2 Pseudokinase Ligands Block Cytokine-Induced TYK2-Mediated Signaling Pathways. Front Immunol 2022; 13:884399. [PMID: 35693820 PMCID: PMC9186491 DOI: 10.3389/fimmu.2022.884399] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 04/22/2022] [Indexed: 11/15/2022] Open
Abstract
A member of the Janus kinase (JAK) family, Tyrosine Kinase 2 (TYK2), is crucial in mediating various cytokine-signaling pathways such as interleukin-23 (IL23), interleukin-12 (IL12) and type I Interferons (IFN) which contribute to autoimmune disorders (e.g., psoriasis, lupus, and inflammatory bowel disease). Thus, TYK2 represents an attractive target to develop small-molecule therapeutics for the treatment of cytokine-driven inflammatory diseases. Selective inhibition of TYK2 over other JAK isoforms is critical to achieve a favorable therapeutic index in the development of TYK2 inhibitors. However, designing small molecule inhibitors to target the adenosine triphosphate (ATP) binding site of TYK2 kinase has been challenging due to the substantial structural homology of the JAK family catalytic domains. Here, we employed an approach to target the JAK homology 2 (JH2) pseudokinase regulatory domain of the TYK2 protein. We developed a series of small-molecule TYK2 pseudokinase ligands, which suppress the TYK2 catalytic activity through allosteric regulation. The TYK2 pseudokinase-binding small molecules in this study simultaneously achieve high affinity-binding for the TYK2 JH2 domain while also affording significantly reduced affinity for the TYK2 JAK homology 1 (JH1) kinase domain. These TYK2 JH2 selective molecules, although possessing little effect on suppressing the catalytic activity of the isolated TYK2 JH1 catalytic domain in the kinase assays, can still significantly block the TYK2-mediated receptor-stimulated pathways by binding to the TYK2 JH2 domain and allosterically regulating the TYK2 JH1 kinase. These compounds are potent towards human T-cell lines and primary immune cells as well as in human whole-blood specimens. Moreover, TYK2 JH2-binding ligands exhibit remarkable selectivity of TYK2 over JAK isoforms not only biochemically but also in a panel of receptor-stimulated JAK1/JAK2/JAK3-driven cellular functional assays. In addition, the TYK2 JH2-targeting ligands also demonstrate high selectivity in a multi-kinase screening panel. The data in the current study underscores that the TYK2 JH2 pseudokinase is a promising therapeutic target for achieving a high degree of biological selectivity. Meanwhile, targeting the JH2 domain represents an appealing strategy for the development of clinically well-tolerated TYK2 inhibitors that would have superior efficacy and a favorable safety profile compared to the existing Janus kinase inhibitors against autoimmune diseases.
Collapse
Affiliation(s)
- Yu Zhou
- R & D Center, Eternity Bioscience Inc., Cranbury, NJ, United States
- *Correspondence: Yu Zhou, ; Xin Li,
| | - Xin Li
- R & D Center, Shanghai Hengrui Pharmaceutical Co. Ltd., Shanghai, China
- *Correspondence: Yu Zhou, ; Xin Li,
| | - Ru Shen
- R & D Center, Eternity Bioscience Inc., Cranbury, NJ, United States
| | - Xiangzhu Wang
- R & D Center, Eternity Bioscience Inc., Cranbury, NJ, United States
| | - Fan Zhang
- R & D Center, Eternity Bioscience Inc., Cranbury, NJ, United States
| | - Suxing Liu
- R & D Center, Eternity Bioscience Inc., Cranbury, NJ, United States
| | - Di Li
- R & D Center, Eternity Bioscience Inc., Cranbury, NJ, United States
| | - Jian Liu
- R & D Center, Eternity Bioscience Inc., Cranbury, NJ, United States
| | - Puhui Li
- R & D Center, Eternity Bioscience Inc., Cranbury, NJ, United States
| | - Yinfa Yan
- R & D Center, Eternity Bioscience Inc., Cranbury, NJ, United States
| | - Ping Dong
- R & D Center, Shanghai Hengrui Pharmaceutical Co. Ltd., Shanghai, China
| | - Zhigao Zhang
- R & D Center, Shanghai Hengrui Pharmaceutical Co. Ltd., Shanghai, China
| | - Heping Wu
- R & D Center, Eternity Bioscience Inc., Cranbury, NJ, United States
| | - Linghang Zhuang
- R & D Center, Eternity Bioscience Inc., Cranbury, NJ, United States
| | | | - Matthew Miller
- R & D Center, Eternity Bioscience Inc., Cranbury, NJ, United States
| | - Mena Issa
- R & D Center, Eternity Bioscience Inc., Cranbury, NJ, United States
| | - Yuchang Mao
- R & D Center, Shanghai Hengrui Pharmaceutical Co. Ltd., Shanghai, China
| | - Hongli Chen
- R & D Center, Shanghai Hengrui Pharmaceutical Co. Ltd., Shanghai, China
| | - Jun Feng
- R & D Center, Shanghai Hengrui Pharmaceutical Co. Ltd., Shanghai, China
| | - Jing Li
- R & D Center, Eternity Bioscience Inc., Cranbury, NJ, United States
| | - Chang Bai
- R & D Center, Shanghai Hengrui Pharmaceutical Co. Ltd., Shanghai, China
| | - Feng He
- R & D Center, Shanghai Hengrui Pharmaceutical Co. Ltd., Shanghai, China
| | - Weikang Tao
- R & D Center, Shanghai Hengrui Pharmaceutical Co. Ltd., Shanghai, China
| |
Collapse
|
5
|
Issa M, Dunne SS, Dunne CP. Hand hygiene practices for prevention of health care-associated infections associated with admitted infectious patients in the emergency department: a systematic review. Ir J Med Sci 2022; 192:871-899. [PMID: 35435564 PMCID: PMC10066077 DOI: 10.1007/s11845-022-03004-y] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/01/2022] [Indexed: 11/24/2022]
Abstract
Abstract
Background
In most high-income countries, emergency departments (ED) represent the principal point of access forcer by critically ill or injured patients. Unlike inpatient units, ED healthcare workers (ED HCWs) have demonstrated relative lack of adherence to hand hygiene (HH) guidelines, commonly citing frequency of intervention and high rates of admission, which reflect severity of cases encountered.
Aim
Assessment of studies on hand hygiene compliance (HHC) by ED HCWs conducted between 2010 and 2020, seeking to estimate HHC rates and intervention strategies utilised to improve HHC in EDs.
Methods
Searches conducted in Web of Science, EBSCO HOST (CINHAL & Medline), PubMed, Embase, and Cochrane for full studies published between 2010 and 2020 on the topic of HHC in the ED.
Results
One hundred twenty-nine eligible articles were identified of which 79 were excluded. Fifty-one underwent full-text screening before 20 studies were deemed relevant. Of the eligible studies, fifteen (75%) had, as the primary outcome, HHC according to the WHO-recommended 5-moments. Twelve studies (60%) implemented multimodal or single intervention strategies. Eight studies were ambiguous regarding the nature of the approach adopted. In the nine observational studies where HHC was documented, an overall post-intervention median HHC rate of 45% (range 8–89.7%).
Conclusion
Multimodal approaches appear to have enhanced HHC moderately among ED HCWs. Elevated complexity associated with critically ill patients, and ED overcrowding, are contributing factors to relatively low compliance rates observed. Strategies to improve HHC rates may need to acknowledge, and cater for, the context of an unpredictable environment.
Collapse
Affiliation(s)
- M Issa
- School of Medicine, University of Limerick, Master's in Public Health Programme, Limerick, Ireland
| | - S S Dunne
- Centre for Interventions in Infection, Inflammation & Immunity (4I) and School of Medicine, University of Limerick, Limerick, Ireland
| | - C P Dunne
- Centre for Interventions in Infection, Inflammation & Immunity (4I) and School of Medicine, University of Limerick, Limerick, Ireland.
| |
Collapse
|
6
|
Issa M, Noureldin K, Jones L. 42 The Accuracy of the Multi-Slice Detector CT scan (MDCT) in Staging Borderline Respectable Periampullary Carcinoma. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aim
Assess MDCT accuracy in staging cancers periampullary cancers.
Method
Periampullary malignancies are highly aggressive with poor outcomes. Surgery is the only curative option. It is crucial to define the patients who can advantage from a Whipple’s resection and who can avoid. RCT investigated randomly 28 patients over 15 months. The patients were sub-divided into 2 groups. Group A, we relied mainly on the MDCT for preoperative staging, while in Group B staging laparoscopy was added before the abdominal exploration. Sensitivity of the MDCT and its accuracy were 100% in defining the signs of irresectability. For borderline staging, the accuracy of the scan was 62.5% and 71%, in groups A and B. The Overall accuracy of MDCT was 75%. It decreased to 68.1% for borderline lesions. The addition of staging laparoscopy to the diagnostic work up, increased the accuracy to 92.5%. The camera test was able to see occult findings which were missed in the images. Liver Mets and malignant peritoneal fluid were localized in 18% and 9% respectively. 3 cases in group A and one in group B underwent unnecessary laparotomy. Thus, the false negative incidences were 21% and 7% in group A and B, with overall incidence 14.2%.
Conclusion
MDCT is highly sensitive and specific with high stage periampullary cancers. These parameters drop in border tumours with reduced accuracy in detecting the degree of vascular abutment and distant-occult findings. Addition of other adjuncts to decrease the rate of un-indicated laparotomy.
Collapse
Affiliation(s)
- M. Issa
- Prince Charles Hospital, Merther Tydfil, Wales, United Kingdom
| | - K. Noureldin
- Prince Charles Hospital, Merther Tydfil, Wales, United Kingdom
| | - L. Jones
- Southend University Hospital, Westcliff on Sea, Essex, United Kingdom
| |
Collapse
|
7
|
Noureldin K, Ayantunda A, Issa M, Jones L. 52 Evaluating the Outcomes of Anal Squamous Cell Carcinoma with Curative Intent- a 10-Year Experience. Br J Surg 2022. [DOI: 10.1093/bjs/znac040.006] [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
Background
Our 10-year experience in treating anal squamous cell carcinoma (ASCC) with curative intent.
Method
Clinical and pathological data were analysed between January 2011 and December 2019. All patients underwent the standard workup and treated accordingly. Patients were followed up according to the network protocol. The outcome measures were clinicopathological characteristics, treatment modalities, response, recurrence, disease-free and overall survival.
Results
117 patients followed up over the 10-year. 26 patients treated palliatively, 11 patients with adenocarcinoma, 1 melanoma, 1 Paget disease and 1 carcinoid tumour were excluded. Median age was 65 (38–90) years with male to female ratio of 1:1.9. 3 patients were HIV+ve and 52% of the patients had AIN of varying degree of dysplasia. AJCC stages were I (16), II (18), IIIA (19), IIIB (9) and IV (15). 88.3%% of the patients had radical chemoradiotherapy while 9 patients with tumour ≤2cm underwent wide local excision. 81.8% of the patients treated with radical chemoradiotherapy had complete response while (5/77) had partial response.4 patients with incomplete response underwent salvage APER. Recurrence rate was 13%.
The overall mean survival time was 99.82 (95% CI 88.87–110.77) months with 5-year survival rate 78.0%. Overall recurrence rate was 13.0%. Mean disease-free survival time in 77 patients was 111.82 (95% CI 102.38–121;26) months. 75.3% of the patients were alive at the end of the study with an overall mortality rate was 24.7% and disease-specific mortality was 15.6%.
Conclusions
Recurrent anal SCC occurred in 1 in 10 after radical chemo-radiotherapy with disease-specific mortality of 26%.
Collapse
Affiliation(s)
- K. Noureldin
- Prince Charles Hospital, Merthyr Tydfil,Wales, United Kingdom
| | - A. Ayantunda
- Southend University hospital, Southend on sea, Essex, United Kingdom
| | - M. Issa
- Prince Charles Hospital, Merthyr Tydfil,Wales, United Kingdom
| | - L. Jones
- Southend University hospital, Southend on sea, Essex, United Kingdom
| |
Collapse
|
8
|
Issa M, Nair D, David B, Banks J, Lewis E, Monk C, Griffin A, Guy R. 127 Optimum Treatment for Sigmoid Volvulus Remains Elusive but Surgery May Provide Considerable Benefit: Results of a 5-Year Audit. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.071] [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
Background
Sigmoid volvulus is a surgical emergency and patients are often elderly with significant comorbidities. Whilst endoscopic decompression is easy and effective in the short-term, recurrence and repeated admissions are common with surgery generally being reserved for non-resolution or complications. Consensus an optimum management is lacking.
Method
A retrospective audit of all patients admitted with sigmoid volvulus to a DGH General Surgery service between 01/01/2015-20/10/2020 was undertaken. Patient demographics, comorbidities, clinical findings, investigations, and treatment were recorded.
Results
Sixty-three patients were identified (median age 71.5 years; 58.7% male]. Some 50.8% had more than one previous presentation (range 1–6), 19% presented after 3 days of symptoms and 3.2% presented with perforation. Plain radiography and CT scanning was undertaken in 90.5% and 54%, respectively.
Endoscopic detorsion was performed in 77.77% and repeated in the same admission for 33.3% of cases. Flatus tubes and rigid sigmoidoscopy was used in 47.6% with a 59.6% success rate. Seventeen patients (27%) underwent sigmoid resection, 14 having open surgery and 3 laparoscopic. Primary anastomosis was undertaken in 64.7% (11 patients), with only one anastomotic leak; the remaining 6 patients had a colostomy. The re-admission rate was 30.1% (19% non-operated patients, 11.1% operated patients).
Conclusions
Most patients with sigmoid volvulus are managed non-operatively with endoscopic detorsion which may be associated with a considerable healthcare burden and high readmission rates. Selective resection can be associated with low morbidity and good outcomes. Clinicians could reasonably adopt a lower threshold for surgical intervention, particularly for recurrent volvulus.
Collapse
Affiliation(s)
- M. Issa
- Prince Charles Hospital, Myrther Tydfil, United Kingdom
| | - D. Nair
- Arrowe Park Hospital, Wirral, United Kingdom
| | - B. David
- Arrowe Park Hospital, Wirral, United Kingdom
| | - J. Banks
- Arrowe Park Hospital, Wirral, United Kingdom
| | - E. Lewis
- Arrowe Park Hospital, Wirral, United Kingdom
| | - C. Monk
- Arrowe Park Hospital, Wirral, United Kingdom
| | - A. Griffin
- Arrowe Park Hospital, Wirral, United Kingdom
| | - R. Guy
- Arrowe Park Hospital, Wirral, United Kingdom
| |
Collapse
|
9
|
Issa M, Ahmad S, Vijayagopal K, Freeborn S, Omolokun O, Griffine A, Wilson J, Magee C. 302 Metastatic: Benign Lymph Node Ratio (LNR) and Lymph Node Yield (LNY) as Predictors of Survival in Resected Colorectal Cancer (CRC). Br J Surg 2022. [DOI: 10.1093/bjs/znac039.198] [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
Background
Lymphadenectomy is central to tumor prognosis. 12 LNY during CRC resection is a standard of good oncological resection, but 30–50 percent of resections do not achieve this. LNR was suggested to be a more accurate predictive factor.
Aim
To examine the prognostic significance of LNY and LNR on survival in patients with non-metastatic CRC.
Method
A retrospective study on patients with CRC treated at a DGH from January 2015 to February 2017. Outcome measures were Disease-Free (DFS) and Overall Survival (OS).
Results
265 cases were identified. The mean age was (71.4±11.3) years with a median follow-up of 56 (range 0–72) months. Median LNY was 18 (range 0–66) nodes. 74.9% of the cases have> 12 LNY and only 25.1% of the cases have < 12 LN yielded in the specimen; however, 76.4% have LNR of 0-<0.25. Increasing LNR was associated with poorer OS and
DFS (p-value 0.0001). An LNR of (0.75–1) was associated with a very poor prognosis (p-value 0.0001); it showed 30 and 33 months less in median OS and DFS retrospectively than LNR
(0-<0.25). LNY did not show any statistically significant predictive factor in survival.
Multivariate analysis showed OS and DFS are affected (R2 = 27.3% and 26.1% retrospectively) mainly by LNR. It did not show statistical significance with the other variables, including TNM, LNY, and Dukes' stages.
Conclusions
Increasing LNR was a marker of poor survival; however, LNY was not a statistically significant predictive factor. LNR is better in predicting survival than TNM and Dukes' staging.
Collapse
Affiliation(s)
- M. Issa
- Prince Charles Hospital, Myrther Tydfil, United Kingdom
| | - S. Ahmad
- Arrowe Park Hospital, Wirral, United Kingdom
| | | | - S. Freeborn
- Arrowe Park Hospital, Wirral, United Kingdom
| | - O. Omolokun
- Arrowe Park Hospital, Wirral, United Kingdom
| | - A. Griffine
- Arrowe Park Hospital, Wirral, United Kingdom
| | - J. Wilson
- Arrowe Park Hospital, Wirral, United Kingdom
| | - C. Magee
- Arrowe Park Hospital, Wirral, United Kingdom
| |
Collapse
|
10
|
Yuvaraj J, Cameron W, Andrews J, Lin A, Nerlekar N, Nicholls SJ, Hamilton G, Issa M, Che ZC, Lim E, Wong DTL. Vascular inflammation in patients with obstructive sleep apnoea and coronary artery disease shown on coronary computed tomography angiography attenuation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehab849.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Obstructive sleep apnoea (OSA) is associated with increased plaque burden in coronary artery disease (CAD), but the role of vascular inflammation in this relationship is unclear. Coronary computed tomography angiography (CTA) enables surrogate assessment of systemic inflammation via subcutaneous adipose tissue attenuation (ScAT-a), and of coronary inflammation via epicardial adipose tissue volume and attenuation (EAT-v and EAT-a) and pericoronary adipose tissue attenuation (PCAT-a).
Purpose
To investigate whether vascular inflammation is increased in patients with severe OSA and high plaque burden.
Methods
Patients with clinically indicated polysomnography and coronary CTA were included. Severe OSA was classified as apnoea/hypopnoea index (AHI) >30. High plaque burden was defined as a CT-Leaman score (CT-LeSc) >8.3. Patients with both severe OSA and high plaque burden were defined as ‘Group 1’, all other patients were classified as ‘Group 2’. ScAT-a, EAT-a, EAT-v and PCAT-a were assessed on semi-automated software.
Results
A total of 91 patients were studied (59.3 ± 11.1 years). Severe OSA was associated with high plaque burden (p = 0.02). AHI correlated with CT-LeSc (r = 0.24, p = 0.023). Group 1 had lower EAT-a and PCAT-a compared to Group 2 (EAT-a: -87.6 vs. -84.0 HU, p = 0.01; PCAT-a: -90.4 vs. -83.4 HU, p < 0.01). However, among patients without high plaque burden, EAT-a was increased in patients with severe OSA versus mild-moderate OSA (-80.3 vs. -84.0 HU, p = 0.020). On multivariable analysis, EAT-a independently associated with severe OSA and high plaque burden (p < 0.02), and PCAT-a associated with severe OSA and high plaque burden, and hypertension (all p < 0.01).
Conclusions
EAT attenuation is decreased in patients with severe OSA and high plaque burden but increased in patients with severe OSA and low plaque burden. These divergent results suggest coronary inflammation may be increased in OSA independent of CAD, but larger studies are required to validate these findings.
Collapse
Affiliation(s)
- J Yuvaraj
- Monash Heart, Monash Cardiovascular Research Centre, Melbourne, Australia
| | - W Cameron
- Monash Heart, Monash Cardiovascular Research Centre, Melbourne, Australia
| | - J Andrews
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - A Lin
- Monash Heart, Monash Cardiovascular Research Centre, Melbourne, Australia
| | - N Nerlekar
- Monash Heart, Monash Cardiovascular Research Centre, Melbourne, Australia
| | - S J Nicholls
- Monash Heart, Monash Cardiovascular Research Centre, Melbourne, Australia
| | - G Hamilton
- Monash Health, Department of Lung and Sleep Medicine, Melbourne, Australia
| | - M Issa
- Monash Heart, Monash Cardiovascular Research Centre, Melbourne, Australia
| | - Z C Che
- Monash Heart, Monash Cardiovascular Research Centre, Melbourne, Australia
| | - E Lim
- Monash Heart, Monash Cardiovascular Research Centre, Melbourne, Australia
| | - D T L Wong
- Monash Heart, Monash Cardiovascular Research Centre, Melbourne, Australia
| |
Collapse
|
11
|
Arej N, Mechleb N, Issa M, Cherfan G, Tomey K, Abdelmassih Y, Khoueir Z. Combining spectral domain optical coherence tomography of retinal nerve fiber layer and noncontact tonometry in mass glaucoma screening during the World Glaucoma Week. J Fr Ophtalmol 2022; 45:384-391. [DOI: 10.1016/j.jfo.2021.11.010] [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] [Received: 08/06/2021] [Revised: 10/28/2021] [Accepted: 11/02/2021] [Indexed: 11/30/2022]
|
12
|
Dibs K, Mladkova N, DiCostanzo D, Baliga S, Gamez M, Jhawar S, Mitchell D, Ewing A, Issa M, Karivedu V, Palmer J, Bhateja P, Laliottis G, Konieczkowski D, Grecula J, Old M, Rocco J, Bonomi M, Blakaj D. Brachial Plexus Tolerance to High-Dose Radiation in the Re-Irradiation Setting. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.814] [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: 11/17/2022]
|
13
|
David B, Issa M, Gallucci A. 1073 Synchronous Cholecystitis and Appendicitis: A Case Report Highlighting Learning Points on Medical Imaging and Consent. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.357] [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
Laparoscopic appendicectomy and laparoscopic cholecystectomy are separately two of the most common emergency surgical procedures carried out in the UK. Only a small number of synchronous presentations of acute appendicitis and acute cholecystitis have been reported in surgical literature and this rare co-existent pathology gives rise to several valuable learning points with regards to laparoscopy, medical imaging interpretation and the consent process.
Our case report involves a 58-year-old female patient presenting with both RUQ and RIF pain and positive Murphy’s sign on clinical examination. US scan demonstrated several gallstones within a thin-walled gallbladder. Subsequent CT scan reported acute appendicitis which was treated definitively with laparoscopic surgery. Intraoperatively a perforated gangrenous gallbladder containing multiple calculi was discovered, and the decision was made to perform a double procedure of laparoscopic appendicectomy and cholecystectomy. Histopathology confirmed synchronous pathology of appendicitis with faecolith and calculus cholecystitis.
This case demonstrates the importance of considering multiple pathologies when assessing a patient with ambiguous and migratory abdominal pain. It reinforces the importance of diagnostic laparoscopy to rule out multiple pathologies. This acts as a cautionary case against over-reliance on medical imaging and reminds surgeons of their obligation to maintain competence in CT interpretation plus correlation of imaging with clinical assessment of the patient. Readers should also be reminded that the consent process for surgical interventions should be undertaken meticulously in patients with ambiguous abdominal pain.
Collapse
Affiliation(s)
- B David
- Wirral University Teaching Hospitals, Liverpool, United Kingdom
| | - M Issa
- Wirral University Teaching Hospitals, Liverpool, United Kingdom
| | - A Gallucci
- Wirral University Teaching Hospitals, Liverpool, United Kingdom
| |
Collapse
|
14
|
Vijayagopal KA, Issa M, Fok M, Javed MS. 833 An Interesting Association Between Recurrent Acute Pancreatitis and Myotonic Dystrophy, A Case Report. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.328] [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
Myotonic Dystrophy(MD) is an autosomal dominant genetic condition affecting the musculoskeletal system. Recurrent acute pancreatitis(RAP) is a frequent presentation in the emergency surgical scenario with two or more episodes of established acute pancreatitis separated by a minimum of 3 month periods. We report here a case of a patient presenting with a background of Myotonic Dystrophy with a third episode of RAP. Diagnostic work up led to the discovery of microlithiasis as a possible cause of pancreatitis in our patient. Literature review reports two other case reports detailing a potential association between MD and pancreatitis at the time of writing. This could be due to disturbances of the pancreatobiliary system, resulting from the sphincter of Oddi dysfunction (SOD) and gallbladder myotonia as MD affects the smooth and striated muscle of the gastrointestinal tract. In our case report, we highlight the importance of understanding how MD is a rare cause for a common surgical emergency presentation clinicians should be aware of.
Collapse
Affiliation(s)
| | - M Issa
- Wirral University Teaching Hospital, Wirral, United Kingdom
| | - M Fok
- Wirral University Teaching Hospital, Wirral, United Kingdom
| | - M S Javed
- Wirral University Teaching Hospital, Wirral, United Kingdom
| |
Collapse
|
15
|
Issa M, Sommereux LA, Osuji J, Meredith R, Muhammed MH, Guy R. 645 An EGS-Led Service for Acute Appendicitis Enhances Surgical Training Whilst Improving Outcomes for Patients: Results of A 6-Month Audit. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
Appendicitis is common &treatment by appendectomy is usually undertaken. Variations in diagnostics &imaging are accompanied by high negative appendectomy rates (NAR) of around 20%. This study evaluated the outcomes of appendectomy in a dedicated Surgical Emergency Unit.
Method
All patients undergoing emergency appendectomy between 1stSept 2019&29thFeb 2020 were identified. Demographics, clinical findings, pre-operative investigations, intra-operative findings &post-operative outcomes were recorded.
Results
There were 192 patients (102 [53.1%] female;90 [46.9%] male). Median age was 36 years(range 8-80)with 25 below 14.Some 58.3% underwent imaging (ultrasound 33.5%; CT 32.5%).
Laparoscopic appendectomy (LA) was performed in 84.4% of cases with 11.4% open; conversion from laparoscopic to open was only 4.2%. Some 56% paediatric patients had open appendectomy & 44% laparoscopic with no conversions. Trainees were the sole or first operators in 63% of cases.
NAR was just 5.7%. Some 21(10.9%) patients were readmitted within 30 days of which 8 had a collection; all were treated conservatively.
Conclusions
Accurate clinical diagnosis & selective use of imaging in a dedicated EGS unit optimizes outcomes for appendectomy with low NAR & low complication rates. Appendectomy is effectively undertaken by trainees. LA is safely performed in children.
Collapse
Affiliation(s)
- M Issa
- Wirral University Teaching Hospital, Wirral, United Kingdom
| | - L A Sommereux
- Wirral University Teaching Hospital, Wirral, United Kingdom
| | - J Osuji
- Wirral University Teaching Hospital, Wirral, United Kingdom
| | - R Meredith
- Wirral University Teaching Hospital, Wirral, United Kingdom
| | - M H Muhammed
- Wirral University Teaching Hospital, Wirral, United Kingdom
| | - R Guy
- Wirral University Teaching Hospital, Wirral, United Kingdom
| |
Collapse
|
16
|
Yuvaraj J, Cameron W, Andrews J, Lin A, Nerlekar N, Nicholls S, Hamilton G, Wong D, Issa M, Che Z, Lim E. Association of Coronary Inflammation With Obstructive Sleep Apnoea and Coronary Artery Disease: Insights From Computed Tomography Coronary Angiography (CTCA). Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
17
|
Bieber T, Thyssen JP, Reich K, Simpson EL, Katoh N, Torrelo A, De Bruin-Weller M, Thaci D, Bissonnette R, Gooderham M, Weisman J, Nunes F, Brinker D, Issa M, Holzwarth K, Gamalo M, Riedl E, Janes J. Pooled safety analysis of baricitinib in adult patients with atopic dermatitis from 8 randomized clinical trials. J Eur Acad Dermatol Venereol 2020; 35:476-485. [PMID: 32926462 DOI: 10.1111/jdv.16948] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 09/07/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Janus kinase (JAK) inhibition is a new mode of action in atopic dermatitis (AD); clarity about drug class safety considerations in the context of AD is important. Baricitinib, an oral, reversible, selective inhibitor of JAK1/JAK2, is in late-stage development for adult patients with moderate-to-severe AD. OBJECTIVE To report pooled safety data for baricitinib in patients with moderate-to-severe AD in the clinical development program including long-term extension (LTE) studies. METHODS This analysis included patient-level safety data from six double-blinded, randomized, placebo-controlled studies (one phase 2 and five phase 3), one double-blinded, randomized, LTE study and one open-label LTE study, reported in three data sets: placebo-controlled, 2-mg - 4-mg extended and All-bari AD. Safety outcomes include treatment-emergent adverse events, adverse events of special interest and abnormal laboratory changes. Proportions of patients with events and incidence rates were calculated. RESULTS Data were collected for 2531 patients who were given baricitinib for 2247 patient-years (median duration 310 days). The frequency of serious infections, opportunistic infections and conjunctival disorders was low and similar between treatment groups in the placebo-controlled period. The most common serious infections were eczema herpeticum [n = 11, incidence rates (IR) = 0.5], cellulitis (n = 6, IR = 0.3) and pneumonia (n = 3, IR = 0.1). There were four opportunistic infections (IR = 0.2). No malignancies, gastrointestinal perforations, positively adjudicated cardiovascular events or tuberculosis were reported in the placebo-controlled period in baricitinib-treated patients. Frequency of herpes simplex was higher in the 4-mg group (6.1%) vs. the 2-mg (3.6%) and placebo group (2.7%); IRs in the extended data set (2-mg IR = 9.6; 4-mg IR = 14.5) were lower vs. the placebo-controlled data set (2-mg IR = 12.4; 4-mg IR = 21.3). In the All-bari AD data set, there were two positively adjudicated major adverse cardiovascular events (2-mg group): two venous thrombosis events (4-mg group) and one death. CONCLUSION This integrated safety analysis in patients with moderate-to-severe AD confirms the established safety profile of baricitinib.
Collapse
Affiliation(s)
- T Bieber
- University Hospital of Bonn, Bonn, Germany
| | - J P Thyssen
- Department of Dermatology and Allergy, Herlev-Gentofte Hospital University of Copenhagen, Copenhagen, Denmark
| | - K Reich
- University Med Cen Hamburg-Eppendorf, Hamburg, Germany
| | - E L Simpson
- Oregon Health & Science University, Portland, OR, USA
| | - N Katoh
- Department of Dermatology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - A Torrelo
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | | | - D Thaci
- Comprehensive Center for Inflammation Medicine, University Hospital Schleswig Holstein, Luebeck, Germany
| | | | - M Gooderham
- SKiN Centre for Dermatology, Peterborough, ON, Canada
| | - J Weisman
- Medical Dermatology Specialists, Atlanta, GA, USA
| | - F Nunes
- Eli Lilly and Company, Indianapolis, IN, USA
| | - D Brinker
- Eli Lilly and Company, Indianapolis, IN, USA
| | - M Issa
- Eli Lilly and Company, Indianapolis, IN, USA
| | - K Holzwarth
- Eli Lilly and Company, Indianapolis, IN, USA
| | - M Gamalo
- Eli Lilly and Company, Indianapolis, IN, USA
| | - E Riedl
- Eli Lilly and Company, Indianapolis, IN, USA
| | - J Janes
- Eli Lilly and Company, Indianapolis, IN, USA
| |
Collapse
|
18
|
Issa M, Schultz T, Xu M, Bhateja P, Karivedu V, Dibs K, Old M, Kang S, Gamez M, Grecula J, Jhawar S, Mitchell D, Seim N, Agrawal A, Ozer E, Baliga S, Carrau R, Rocco J, Blakaj D, Bonomi M. 948P Pre-treatment characteristics and long-term outcomes of recurrent-metastatic head and neck cancer patients treated with immune checkpoint inhibitors. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
19
|
Hamdan R, Fakih S, Mohammad M, Charif F, Abdallah H, Safa S, Al Ali F, Issa M, Damen B, El Zein A, Younes M, Rabah A, Saab M. The Lebanese left ventricular assist device experience, a success story despite the odds. J Cardiothorac Surg 2020; 15:192. [PMID: 32723392 PMCID: PMC7388207 DOI: 10.1186/s13019-020-01235-7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 07/20/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND AIM Heart failure is still a leading cause of mortality and morbidity. Assist devices are reserved for advanced heart failure patients with no other therapeutic options. We aim in this paper to describe the characteristics and outcome of Lebanese left ventricular assist device (LVAD) patients. RESULTS From 2010 till December 2019, 78 patients were implanted with assist devices at the Beirut cardiac Institute, 82 pumps were used. To the most recent follow up after 10 years, 26 patients died (34%). 24 patients of 35 (68%) survived more than 5 years. Seven patients only (9%) died during one month of surgery. One year mortality was 19% (15 patients). The leading cause of early mortality was infection, whereas cerebrovascular accidents CVA were the leading cause of late mortality. Pump thrombosis occurred in 12% of the cases. The most serious long term complication was haemorrhagic CVA. Only seven patients (9%) received heart transplantation, with a mean time on support prior to transplantation of 1303 ± 213 days. CONCLUSION In this manuscript we reported the characteristics and outcome of the largest population of LVAD patients in Lebanon. The survival rate was 81% at one year. These findings were comparable to the international registries except for rates of heart transplantation. More efforts should be made to encourage organ donation in Lebanon.
Collapse
Affiliation(s)
- R Hamdan
- Cardiology department, Beirut Cardiac Institute, Beirut, Lebanon.
| | - S Fakih
- Cardiology fellow, Cardiology department, Beirut Cardiac Institute, Beirut, Lebanon
| | - M Mohammad
- Lebanese Society of Cardiology, Cardiology department, Bahman Hospital, Beirut, Lebanon
| | - F Charif
- Critical care unit, Beirut Cardiac Institute, Beirut, Lebanon
| | - H Abdallah
- Cockrell school of engineering, University of Texas, Austin, TX, USA
| | - S Safa
- Cardiology fellow, Cardiology department, Beirut Cardiac Institute, Beirut, Lebanon
| | - F Al Ali
- Cardiac surgeon, Cardiac Surgery department, Beirut Cardiac Institute, Beirut, Lebanon
| | - M Issa
- Cardiac Surgery department, Beirut Cardiac Institute, Beirut, Lebanon
| | - B Damen
- Cardiac Surgery department, Beirut Cardiac Institute, Beirut, Lebanon
| | - A El Zein
- Cardiac Surgery department, Beirut Cardiac Institute, Beirut, Lebanon
| | - M Younes
- Cardiology department, Beirut Cardiac Institute, Beirut, Lebanon
| | - A Rabah
- Cardiac Surgery department, Beirut Cardiac Institute, Beirut, Lebanon
| | - M Saab
- Cardiac Surgery department, Beirut Cardiac Institute, Beirut, Lebanon
| |
Collapse
|
20
|
Bonomi M, Bhateja P, Issa M, Klamer B, Pan X, Blakaj A, Karivedu V, Mousa L, Mitchell D, Gamez M, Kang S, Seim NB, Old M, Carrau R, Rocco J, Blakaj D. A predictive survival model for patients with head and neck squamous cell carcinoma treated with immune check point inhibitors. Oral Oncol 2020; 110:104900. [PMID: 32702630 DOI: 10.1016/j.oraloncology.2020.104900] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 07/04/2020] [Accepted: 07/07/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND ICIs have expanded treatment options for HNSCC. A minority of the patients respond to these expensive treatments. PATIENTS AND METHODS This is a single institutional retrospective review on 121 unresectable or metastatic HNSCC patients treated with ICIs. We predicted that inflammatory markers available through routine blood work, in addition to clinical characteristics may divide patients into groups more or less likely to respond to these agents. Here we develop and internally validate our nomogram to predict survival in patients treated with ICIs.
Collapse
Affiliation(s)
- M Bonomi
- Division of Medical Oncology, Ohio State University, Columbus, United States.
| | - P Bhateja
- Division of Medical Oncology, Ohio State University, Columbus, United States
| | - M Issa
- Division of Medical Oncology, Ohio State University, Columbus, United States
| | - B Klamer
- Department of Biomedical Informatics, Ohio State University, Columbus, United States
| | - X Pan
- Department of Biomedical Informatics, Ohio State University, Columbus, United States
| | - A Blakaj
- Division of Radiation Oncology, Yale University, New Haven, United States
| | - V Karivedu
- Division of Medical Oncology, Ohio State University, Columbus, United States
| | - L Mousa
- Division of Medical Oncology, Ohio State University, Columbus, United States
| | - D Mitchell
- Division of Radiation Oncology, Ohio State University, Columbus, United States
| | - M Gamez
- Division of Radiation Oncology, Ohio State University, Columbus, United States
| | - S Kang
- Division of Otolaryngology, Ohio State University, Columbus, United States
| | - Nolan B Seim
- Division of Otolaryngology, Ohio State University, Columbus, United States
| | - M Old
- Division of Otolaryngology, Ohio State University, Columbus, United States
| | - R Carrau
- Division of Otolaryngology, Ohio State University, Columbus, United States
| | - J Rocco
- Division of Otolaryngology, Ohio State University, Columbus, United States
| | - D Blakaj
- Division of Radiation Oncology, Ohio State University, Columbus, United States
| |
Collapse
|
21
|
Geraghty L, Hoffman S, Schultz T, Porter K, Issa M, Rupert R, Bhateja P, Old M, Rocco J, Blakaj D, Bonomi M. Weekly Versus Tri-Weekly Paclitaxel and Carboplatin in Combination with Cetuximab in Recurrent/Metastatic Head and Neck Cancer Patients: a Toxicity Analysis. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
22
|
Yoon G, Estañ M, Fernandez-Nuñez E, Zak M, Esteban M, Donkervoort S, Hawkins C, Caparros-Martin J, Saade D, Hu Y, Bolduc V, Chao K, Otaify G, Temtamy S, Aglan M, Issa M, Bönnemann C, Lapunzina P, Ruiz-Perez V. NEW GENES AND DISEASES. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
23
|
Mousa L, Issa M, Klamer B, Pan J, Old M, Kang S, Agrawal A, Ozer E, Carrau R, Bhateja P, Rupert R, Jhawar S, Mitchell D, Gamez M, Rocco J, Blakaj D, Bonomi M. A nomogram based prognostic score to predict overall survival (OS) in recurrent-metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) patients (pts) treated with immune checkpoint inhibitors (ICI). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.054] [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: 11/13/2022] Open
|
24
|
Issa M, Mousa L, Blakaj D, Klamer B, Pan J, Old M, Kang S, Rupert R, Mitchell D, Ozer E, Agrawal A, Bhateja P, Gamez M, Miller E, Jhawar S, Carrau R, Rocco J, Bonomi M. Treatment outcomes of head and neck cancer patients 70 years and older receiving different chemo-radiation combinations. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.018] [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: 11/14/2022] Open
|
25
|
Abstract
We report two siblings who had jejunal atresia which we believe to be familial. The parents of these siblings were first cousins. The first child had jejunal atresia with mesenteric agenesis and ‘apple-peel’ configuration; the second child had jejunal atresia with a V-shaped mesenteric defect. Other reported cases of familial atresia of the small intestine are reviewed.
Collapse
|
26
|
Bah A, Lateur GM, Kouevidjin BT, Bassinga JYS, Issa M, Jaafar A, Beaudouin E. Chronic anterior shoulder instability with significant Hill-Sachs lesion: Arthroscopic Bankart with remplissage versus open Latarjet procedure. Orthop Traumatol Surg Res 2018; 104:17-22. [PMID: 29248765 DOI: 10.1016/j.otsr.2017.11.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 11/10/2017] [Accepted: 11/16/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND The objective of this study was to compare short-term shoulder stability after arthroscopic Bankart repair with remplissage versus the open Latarjet procedure in patients who had chronic anterior shoulder instability with a significant Hill-Sachs lesion. HYPOTHESIS The dislocation recurrence rate is higher after Bankart repair with remplissage than after open Latarjet. PATIENTS AND METHODS An observational non-randomised retrospective cohort study was conducted at two surgical centres in patients treated for chronic anterior shoulder instability with a significant Hill-Sachs defect between January 2009 and July 2014. The study compared 43 patients managed by arthroscopic Bankart repair and remplissage and 43 patients managed with open Latarjet. The two groups were matched on age at surgery and on follow-up duration. All patients were evaluated by independent observers based on a questionnaire including recurrences, range of motion, and functional outcomes (Shoulder Subjective Value [SSV], Walch-Duplay score, and Rowe score). RESULTS Mean follow-up was 47.3 months (range, 24-67 months). The recurrence rate at last follow-up was not significantly different between the two groups (9.3% versus 11.2%; P=0.67). The Bankart group had significantly greater loss of external rotation and a significantly higher proportion of patients with residual pain (21% versus 9%, P=0.023). The SSV, Walch-Duplay score, and Rowe score values were similar between groups. DISCUSSION In patients who had chronic anterior shoulder instability with a significant Hill-Sachs lesion, arthroscopic Bankart repair with remplissage and open Latarjet were reliable and safe procedures associated with low and similar recurrence rates. However, loss of external rotation and residual pain were significantly more common with the combined Bankart-remplissage procedure. LEVEL OF EVIDENCE III; comparative retrospective study.
Collapse
Affiliation(s)
- A Bah
- Secrétariat d'orthopédie, centre hospitalier métropole Savoie-de-Chambéry, 7, square Massalez, 73000 Chambéry, France.
| | - G M Lateur
- Sports orthopaedic surgery and traumatology, Grenoble university hospital, hôpital Sud, Grenoble, France
| | - B T Kouevidjin
- Secrétariat d'orthopédie, centre hospitalier métropole Savoie-de-Chambéry, 7, square Massalez, 73000 Chambéry, France
| | - J Y S Bassinga
- Orthopaedic and trauma surgery 1, Mohammed V de Rabat military training hospital, avenue des Forces-Armées-Royales, Hay Riad, 10100 Rabat, Morocco
| | - M Issa
- Secrétariat d'orthopédie, centre hospitalier métropole Savoie-de-Chambéry, 7, square Massalez, 73000 Chambéry, France
| | - A Jaafar
- Orthopaedic and trauma surgery 1, Mohammed V de Rabat military training hospital, avenue des Forces-Armées-Royales, Hay Riad, 10100 Rabat, Morocco
| | - E Beaudouin
- Secrétariat d'orthopédie, centre hospitalier métropole Savoie-de-Chambéry, 7, square Massalez, 73000 Chambéry, France
| |
Collapse
|
27
|
A. I, Lokma M, Issa M. Economic Threshold, Injury Levels and Food Preference of Glassy Clover Snail, Monacha cartusiana (Muller) Infesting Strawberry Plants at Ismailia Governorate, Egypt. Egyptian Academic Journal of Biological Sciences, H Botany 2017. [DOI: 10.21608/eajbsh.2017.16763] [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: 10/28/2022] Open
|
28
|
Grema M, Traoré A, Issa M, Hamani M, Abdou M, Fernández I, Soudré A, Álvarez I, Sanou M, Tamboura H, Alhassane Y, Goyache F. Morphological assessment of Niger Kuri cattle using multivariate methods. S AFR J ANIM SCI 2017. [DOI: 10.4314/sajas.v47i4.9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
29
|
Saab M, Issa M, Samy W, El-Maradny H. Alternative approaches in formulating floating hollow tablets via sublimation technique; a platform tailored drug release profile. Pharmazie 2016; 71:701-708. [PMID: 29441998 DOI: 10.1691/ph.2016.5186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
The aim of this study was to formulate floating hollow tablets of salbutamol sulphate with a platform tailored drug release profile to attain a controllable drug release. Eight formulations (F1-F8) were prepared using sublimation technique. L-menthol was directly compressed as sublimable core followed by compression coating of hydroxypropylmethyl cellulose (HPMC-K15M) or polyethylene oxide (PEO-WSR301) as release retarding polymer coat. Tablets were then subjected to heat to allow sublimation of the core. The effect of polymer type and that of different drug coat/core distribution on swelling and drug release profile was studied. FTIR and DSC revealed the absence of any drug-excipients interaction. Tablets showed a hollow morphology, resulting in low density tablets that floated for over 24 hours without lag time. Moreover, different drug coat/core distribution resulted in controllable release profiles. Based on these results, an optimum drug release behavior was recorded for HPMC-based hollow tablets consisting of 2:1 drug coat/core distribution ratio (F4), revealing a zero order drug release for over 14 hours. Furthermore, F4 showed no changes in drug content, floating properties and drug release profile upon exposure to accelerated stability conditions.
Collapse
|
30
|
Tanaka Y, Fleischmann R, Schiff M, Takeuchi T, Keystone E, Weinblatt M, Zuckerman S, Issa M, Thanabalasundrum S, Augendre-Ferrante B, de Bono S, Schlichting D, Rooney T, Macias W, Taylor P. THU0209 Characterization of Changes in Lymphocyte Subsets in Baricitinib-Treated Patients with Rheumatoid Arthritis in A Phase 3 Study (RA-BEAM): Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1513] [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]
|
31
|
Takeuchi T, Genovese M, Xie L, Issa M, Pinto Correia A, Rooney T, Emoto K, Smolen J. OP0228 Baricitinib Dose Step-Down Following Disease Control in Patients with Rheumatoid Arthritis:. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
32
|
Emery P, McInnes I, Genovese MC, Smolen JS, Kremer J, Dougados M, Schlichting DE, Rooney T, Issa M, de Bono S, Macias WL, Rogai V, Zuckerman SH, Taylor PC. A7.16 Characterisation of changes in lymphocyte subsets in baricitinib-treated patients with rheumatoid arthritis in two phase 3 studies. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-209124.147] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
33
|
Siddo S, Moula N, Hamadou I, Issa M, Marichatou H, Leroy P, Antoine-Moussiaux N. Breeding criteria and willingness to pay for improved Azawak zebu sires in Niger. Arch Anim Breed 2015. [DOI: 10.5194/aab-58-251-2015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Abstract. In Niger, the growth in local demand for milk and meat makes it necessary to consider genetic improvement of the indigenous cattle. At the Toukounous breeding station, the Azawak zebu has undergone over 50 years of line breeding for milk and meat production traits. To understand the adoption potential of improved Azawak sires in Niger, this study proposes to estimate the values that cattle keepers ascribe to different breeding criteria. In a first participatory stage, the breeding criteria used by cattle keepers were first listed and their relative importance was semi-quantified in three different production zones: pastoral, rural sedentary and peri-urban sedentary. The willingness to pay (WTP) for chosen breeding criteria have then been estimated through stated preference methods with 150 breeders. From participatory surveys, the most important attributes in sire choice were reproductive performance, feeding requirements and docility. The criteria considered for conjoint analysis (CA) were feeding requirements, docility, meat or dairy type, reproductive performance, coat color and tail length. The WTP was EUR 149 for low feed requirements, EUR 139 for docility and EUR 132 for a long tail. The meat and dairy type of the sire were less important in the decision-making.
Collapse
|
34
|
Abdou H, Marichatou H, Beckers JF, Dufrasne I, Issa M, Hornick JL. Effect of bovine colostrum intake on growth, reproductive parameters and survival in red kids. J Anim Physiol Anim Nutr (Berl) 2014; 98:845-52. [PMID: 25356485 DOI: 10.1111/jpn.12143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this study is to evaluate the efficacy of frozen Azawak colostrum supplementation on body weight (BW), average daily gain (ADG), reproductive parameters (mean age at first parturition, fertility, fecundity, prolificacy) and mortality rate among red kids. The study was conducted at the goat farm secondary centre of Maradi in Niger from September 2010 to September 2011. The control animals (n = 20) were left with their mother, while the treatment animals (n = 20) received in addition 50 ml/animal/day of bovine colostrum at birth and 15 ml/animal/day from d2 to d15. Weight was measured weekly from birth to d365. Mortalities were also recorded over the same period. For reproductive parameters, observations began at weaning (d197). Growth rate was higher (p < 0.001) in supplemented animal, and the treatment effects on ADG were observed up to 150 day after the end of supplementation. A similar long-lasting trend was also observed in relation to the mortality rate (25% for ColG vs. 55% for ConG; p = 0.05). The age at first kidding tended to be lower in the treated group (13.8 ± 0.7 vs. 14.1 ± 0.8 month; p < 0.1). In conclusion, mild bovine colostrum supplementation induces a long-lasting positive impact on growth rate and to a lower extent on reproduction parameters and survival rate.
Collapse
|
35
|
Teleb M, Noufal M, Sattar A, Wazni W, Issa M, Asif K, Gheith A, Castonguay A, Zaidat O. E-069 Validation of a New Modified Capillary Index Score Angiographic Real Time Assessment of Dead vs Salvable Tissue. J Neurointerv Surg 2014. [DOI: 10.1136/neurintsurg-2014-011343.136] [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]
|
36
|
Sattar A, Asif K, Teleb M, Castonguay A, Issa M, Zaidat O. E-011 TICI Quantified: Automated Cerebral Revascularization Grading in Acute Ischemic Stroke. J Neurointerv Surg 2014. [DOI: 10.1136/neurintsurg-2014-011343.78] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
37
|
Maalouf G, Bachour F, Hlais S, Maalouf NM, Yazbeck P, Yaghi Y, Yaghi K, El Hage R, Issa M. Epidemiology of hip fractures in Lebanon: a nationwide survey. Orthop Traumatol Surg Res 2013; 99:675-80. [PMID: 24007698 DOI: 10.1016/j.otsr.2013.04.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [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: 10/11/2012] [Revised: 03/26/2013] [Accepted: 04/02/2013] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Hip fractures are a reliable indicator of osteoporosis. Despite their importance, few studies have assessed their epidemiology in Lebanon and the Middle East. HYPOTHESES Hip fracture incidence rates in Lebanon approximate those of Northern countries, and show the same characteristics, particularly the exponential increase with age, higher incidence in women, and a recent trend of rate leveling in women but not in men. MATERIALS AND METHODS A national database of hip fracture cases admitted to hospitals in Lebanon in 2007 was created. Crude and age-adjusted incidence rates were calculated at 5-year intervals for individuals over age 50. These rates were also standardized to the 2000 United States population, and compared to those of other countries. Projected incidence rates in Lebanon in 2020 and 2050 were also calculated. RESULTS A total of 1199 patients were included in the study. The crude annual incidence rate in individuals over 50 was 147 per 100,000 individuals, 132 per 100,000 males and 160 per 100,000 females, with a female-to-male ratio of 1.2. The age-standardized annual incidence rates (per 100,000) were 180 in males and 256 in females. Assuming unchanged healthcare parameters, the projected crude incidence rates for people over 50 are expected to reach 174 and 284 per 100,000 in 2020 and 2050 respectively. CONCLUSIONS Lebanese hip fracture rates are lower than Northern countries, but show many similar characteristics such as an exponential increase with age, a higher incidence in women, and clues of a leveling of rates in women but not in men. Numbers are expected to increase substantially in the coming decades. LEVEL OF EVIDENCE Level IV. Epidemiological study.
Collapse
Affiliation(s)
- G Maalouf
- Musculoskeletal Department, Bellevue University Medical Center, Faculty of Medicine, Saint-Joseph University, Mansourieh, Lebanon
| | | | | | | | | | | | | | | | | |
Collapse
|
38
|
|
39
|
Sweis R, Malaiyandi D, Issa M, Jani V, Taqi M, Zaidat O. Correlation between ECASS Defined Intracranial Bleed and 90 Days Outcome after Endovascular Treatment for Acute Stroke (P05.264). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
40
|
Roukos S, Issa M. Ablation par radiofréquence d’un ostéome ostéoïde du poignet : à propos de deux cas. ACTA ACUST UNITED AC 2011; 30:356-9. [DOI: 10.1016/j.main.2011.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Revised: 05/26/2011] [Accepted: 08/07/2011] [Indexed: 11/16/2022]
|
41
|
Cerda A, Genvigir F, Rohde C, Issa M, Cavalli S, Bertolami M, Hirata M, Hirata R. 201 ATORVASTATIN AND HORMONE REPLACEMENT THERAPY AFFECT EXPRESSION OF GENES REGULATING THE REVERSE CHOLESTEROL TRANSPORT IN MONONUCLEAR CELLS FROM POSTMENOPAUSAL WOMEN. ATHEROSCLEROSIS SUPP 2011. [DOI: 10.1016/s1567-5688(11)70202-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
42
|
Makni N, Toumi I, Puech P, Issa M, Colot O, Mordon S, Betrouni N. A non rigid registration and deformation algorithm for ultrasound & MR images to guide prostate cancer therapies. Annu Int Conf IEEE Eng Med Biol Soc 2011; 2010:3711-4. [PMID: 21097051 DOI: 10.1109/iembs.2010.5627656] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Multimodality image registration is a critical issue in image-guided cancer ablation techniques. Focal therapies of prostate cancer are usually monitored using ultrasound imaging, while the dose planning is performed on MRI. In this study, a new multimodality images registration and deformation method, based on the Thin Plate Splines -Rigid Point Matching (TPS-RPM) algorithm, is introduced. The Method combines non-rigid mapping and interpolation to deform the images. Preliminary results obtained on phantom and clinical images showed that the registration is accurate and robust against landmarks initialization.
Collapse
Affiliation(s)
- N Makni
- Inserm, U703 research unit. THAIS. Institut Hippocrate, 152 rue du Docteur Yersin 59120 Loos CHRU de Lille France.
| | | | | | | | | | | | | |
Collapse
|
43
|
Issa M, Mahzoul H, Brillard A, Brilhac JF. Catalytic Carbon Oxidation in The Presence of Cerium Oxide: Experimental Study and Modeling of The Effect of Oxygen Concentration. Chem Eng Technol 2009. [DOI: 10.1002/ceat.200800509] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
44
|
Jazieh AR, Komrokji R, Gupta A, Patil S, Flora D, Knapp M, Issa M, Abdel Karim N. Phase II trial of thalidomide, irinotecan and gemcitabine in chemonaive patients with advanced non-small cell lung cancer. Cancer Invest 2009; 27:932-6. [PMID: 19832041 DOI: 10.3109/07357900801944856] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [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
This study aim was to determine the efficacy and safety of the combination of Gemcitabine 1000 mg/m(2) day 1 & 8 and Irinotecan 100 mg/m(2) day 1 & 8 with escalating dose of thalidomide in chemonaive patients with advanced non-small cell lung cancer. Among the 20 patients who met eligibility criteria and received treatment, two patients (10%) experienced partial response and 14 (70%) experienced stable disease. The median time to disease progression was 4 months (95% CI: 2.8-6.6). The 1 year and 2 year survival rates were 36% and 27%, respectively. This combination is active in advanced NSCLC with manageable toxicity profile.
Collapse
Affiliation(s)
- A R Jazieh
- University of Cincinnati, Cincinnati, OH, USA.
| | | | | | | | | | | | | | | |
Collapse
|
45
|
Issa M, Petit C, Mahzoul H, Aboukaïs A, Brilhac JF. EPR and SEM Characterizations of the Contact Between Carbon Black and Cerium Oxide. Top Catal 2009. [DOI: 10.1007/s11244-009-9395-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
46
|
El Shenouf A, Issa M, Abd Elfata M, Elabd N. Urine Level of Interleukin-8 as a Non-Invasive Marker for Diagnosis of Vesicoureteral Reflux in Children. J of Medical Sciences 2009. [DOI: 10.3923/jms.2009.133.139] [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: 11/15/2022] Open
|
47
|
Jazieh AR, Komrokji R, Gupta A, Patil S, Flora D, Knapp M, Issa M, Karim NA. Phase II Trial of Thalidomide, Irinotecan and Gemcitabine in Chemonaive Patients with Advanced Non-Small Cell Lung Cancer. Cancer Invest 2009. [DOI: 10.1080/07357900801944856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
48
|
Watts DC, Issa M, Ibrahim A, Wakiaga J, Al-Samadani K, Al-Azraqi M, Silikas N. Edge strength of resin-composite margins. Dent Mater 2007; 24:129-33. [PMID: 17580089 DOI: 10.1016/j.dental.2007.04.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2007] [Accepted: 04/30/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Marginal integrity is a major clinical problem in restorative dentistry. The aim of this study was to evaluate the applicability of an edge strength measurement device in an in vitro test to determine the force required to fracture flakes of material by a Vickers indentation at progressively increasing distances from an interface edge of bulk material. METHODS Five representative resin-composites were investigated. Fourteen disks of specimens (12mm diameter x 2.5mm thick) were prepared for each material. These were divided into seven sub-groups corresponding to different edge-distances (0.4, 0.5, 0.6, 0.7, 0.8, 0.9 and 1.0mm). An edge strength measurement device (CK10) (Engineering Systems, Nottingham, UK) was used. The mode of the failure of each specimen was examined under the integral microscope of the CK10. RESULTS The force (N)-to-fracture at a distance of 0.5mm from the edge was defined as the edge strength. The highest failure force (edge strength) was observed for Tetric Ceram (174.2N) and the lowest for Filtek Supreme (enamel) (87.0N). Correlations between the failure-forces to fracture materials with edge-distance were regression analyzed giving coefficients (r) ranging from 0.94 (p=0.02) to 0.99 (p=0.01). Two modes of failure were observed: chipping and--generally at greater distances--cracking. SIGNIFICANCE Edge strength is a definable and potentially useful parameter to characterize this aspect of clinically related behavior. A standardized distance of 0.5mm from the specimen's edge, when chipping failure prevails, is suitable and convenient as a reference point.
Collapse
Affiliation(s)
- D C Watts
- Biomaterials Research Group, School of Dentistry and Photon Science Institute, The University of Manchester, Higher Cambridge Street, Manchester, UK.
| | | | | | | | | | | | | |
Collapse
|
49
|
Gerstein HC, Yale JF, Harris SB, Issa M, Stewart JA, Dempsey E. A randomized trial of adding insulin glargine vs. avoidance of insulin in people with Type 2 diabetes on either no oral glucose-lowering agents or submaximal doses of metformin and/or sulphonylureas. The Canadian INSIGHT (Implementing New Strategies with Insulin Glargine for Hyperglycaemia Treatment) Study. Diabet Med 2006; 23:736-42. [PMID: 16842477 DOI: 10.1111/j.1464-5491.2006.01881.x] [Citation(s) in RCA: 170] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
AIMS Insulin is generally withheld until people with Type 2 diabetes are unresponsive to other therapies. However, its potential advantages suggest that it could be added earlier to achieve glycaemic goals; this possibility was tested in a clinical trial. METHODS Consenting adults aged 18-80 years with Type 2 diabetes for at least 6 months, HbA1c of 7.5-11%, and on 0, 1 or 2 oral agents, were randomized to one of two therapeutic approaches for 24 weeks: evening insulin glargine plus self-titration by 1 unit/day if the fasting plasma glucose (FPG) was > 5.5 mmol/l; or conventional therapy with physician adjustment of oral glucose-lowering agents if capillary FPG levels were > 5.5 mmol/l. The primary outcome was the first achievement of two consecutive HbA1c levels <or= 6.5%. RESULTS Two hundred and six participants were allocated to glargine and 199 to oral agents. Compared with control subjects, participants receiving glargine: (i) were 1.68 times more likely to achieve two consecutive HbA1c levels <or= 6.5% (95% CI 1.00-2.83; P = 0.049); (ii) reduced their HbA1c by 1.55 vs. 1.25% (P = 0.005), achieving adjusted means of 7.0 vs. 7.2% (P = 0.0007); (iii) had lower FPG (P = 0.0001), non-high-density lipoprotein (HDL) cholesterol (P = 0.02) and triglycerides (P = 0.02); (iv) had greater increases in treatment satisfaction (P = 0.045); and (v) had a 1.9-kg greater increase in weight (P < 0.0001). No differences in hypoglycaemia were noted. CONCLUSIONS Adding insulin glargine is more likely to achieve a lower HbA(1c) level than conventional therapy with oral agents.
Collapse
Affiliation(s)
- H C Gerstein
- Division of Endocrinology and Metabolism and the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Ontario, Canada.
| | | | | | | | | | | |
Collapse
|
50
|
Nicolas P, Ait M'barek N, Al-Awaidy S, Al Busaidy S, Sulaiman N, Issa M, Mahjour J, Mölling P, Caugant DA, Olcén P, Santamaria M. Pharyngeal carriage of serogroup W135 Neisseria meningitidis in Hajjees and their family contacts in Morocco, Oman and Sudan. APMIS 2005; 113:182-6. [PMID: 15799761 DOI: 10.1111/j.1600-0463.2005.apm1130305.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In 2000 the global outbreak that began in Saudi Arabia was caused by a W135:2a:P1.5,2 strain of Neisseria meningitidis belonging to the ET-37 complex and to ST-11. There was concern that introduction of this epidemic clone (EC) might lead to a wave of outbreaks in the African meningitis belt. The WHO therefore initiated studies of meningococcal carriage among pilgrims and their family contacts in Morocco, Oman and Sudan, 3 to 12 months after the Hajj 2000. In Morocco, 1186 persons were swabbed 3 times. Ninety-five meningococcal strains were isolated from 2.7% of the specimens. Pulsed-field gel electrophoresis showed that 32 (33.6%) were identical with the EC. In Sudan, 5 strains identical with the EC were obtained after sampling 285 persons. In Oman, among 18 meningococcal strains isolated from 399 subjects, 11 (61.1%) belonged to the EC. The important pharyngeal carriage of W135 (EC) and its role in the 2001-2002 outbreaks in Burkina Faso argues for the necessity of reinforcing surveillance, and adapting and planning responses in Africa and the Middle East using the most appropriate vaccine.
Collapse
Affiliation(s)
- P Nicolas
- WHO Collaborating Centre for Reference and Research on Meningococci, 13998 Marseilles, France.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|