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Tan N, Li KC, Qian SY. [Application of systemic glucocorticoids in preventing upper airway obstruction after extubation in children]. Zhonghua Er Ke Za Zhi 2023; 61:1136-1139. [PMID: 38018053 DOI: 10.3760/cma.j.cn112140-20230814-00103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Affiliation(s)
- N Tan
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - K C Li
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - S Y Qian
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
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Li CY, Chen S, Qian WL, Yang L, Zheng Q, Chen AJ, Chen J, Huang K, Fang S, Wang P, Hu L, Liu XR, Zhao XQ, Tan N, Cai T. [Clinical observation on the efficacy and safety of dupilumab in the treatment of moderate to severe atopic dermatitis]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:1590-1595. [PMID: 37859375 DOI: 10.3760/cma.j.cn112150-20221103-01063] [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: 10/21/2023]
Abstract
To investigate the clinical efficacy and safety of dupilumab in the treatment of moderate to severe atopic dermatitis (AD) in China. A small sample self-controlled study before and after treatment was conducted to retrospective analysis patients with moderate to severe AD treated with dupilumab in the department of dermatology of the First Affiliated Hospital of Chongqing Medical University from July 2020 to March 2022. Dupilumab 600 mg was injected subcutaneously at week 0, and then 300 mg was injected subcutaneously every 2 weeks. The condition was evaluated by SCORAD(severity scoring of atopic dermatitis), NRS(numerical rating scale), DLQI(dermatology life quality index) and POEM(patient-oriented eczema measure). The improvement of SCORAD, NRS, DLQI and POEM was analyzed by paired t test and non-parametric paired Wilcoxon. The results showed that a total of 67 patients with moderate to severe AD received dupilumab treatment, of which 41 patients (the course of treatment was more than 6 weeks) had reduced the severity of skin lesions, improved quality of life and reduced pruritus. A total of 23 patients completed 16 weeks of treatment. At 4, 8, 12 and 16 weeks, SCORAD, NRS, DLQI and POEM decreased compared with the baseline, and the differences were statistically significant. SCORAD (50.13±15.19) at baseline, SCORAD (36.08±11.96)(t=6.049,P<0.001) at week 4,SCORAD (28.04±11.10)(t=10.471,P<0.001) at week 8, SCORAD (22.93±9.72)(t=12.428,P<0.001) at week 12, SCORAD (16.84±7.82)(t=14.609,P<0.001) at week 16, NRS 7(6,8) at baseline, NRS 4(3,5)(Z=-3.861,P<0.001) at week 4, NRS 2(1,4)(Z=-4.088,P<0.001) at week 8, NRS 1(0,2)(Z=-4.206,P<0.001) at week 12, NRS 2(0,2)(Z=-4.222,P<0.001) at week 16, DLQI (13.83±5.71) at baseline, DLQI (8.00±4.02)(t=6.325,P<0.001) at week 4, DLQI (5.61±3.50)(t=8.060,P<0.001) at week 8, DLQI (3.96±1.99)(t=8.717,P<0.001) at week 12, DLQI (2.70±1.89)(t=10.355,P<0.001) at week 16, POEM (18.04±6.41) at baseline, POEM (9.70±4.70)(t=7.031,P<0.001) at week 4, POEM (7.74±3.48)(t=8.806,P<0.001) at week 8, POEM (6.35±3.33)(t=10.474,P<0.001) at week 12, POEM (4.26±2.51)(t=11.996,P<0.001) at week 16. In the 16th week, 100%(23 patients), 91.3%(21 patients), 34.8%(8 patients) and 8.7%(2 patients) of 23 patients reached SCORAD30, SCORAD50, SCORAD70, and SCORAD90 statuses, respectively. There were 82.6%(19 patients), 95.7%(22 patients) and 95.7%(22 patients) of 23 patients with NRS, DLQI and POEM improved by≥4 points compared with baseline. Twelve patients with AD who continued to receive dupilumab after 16 weeks showed further improvement in skin lesions. The adverse events were conjunctivitis and injection site reaction. In conclusion, dupilumab is an effective and safe treatment for moderate and severe AD. However, the longer-term efficacy and safety require further studies involving larger sample sizes and a longer follow-up time.
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Affiliation(s)
- C Y Li
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University,Chongqing 400042, China
| | - S Chen
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University,Chongqing 400042, China
| | - W L Qian
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University,Chongqing 400042, China
| | - L Yang
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University,Chongqing 400042, China
| | - Q Zheng
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University,Chongqing 400042, China
| | - A J Chen
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University,Chongqing 400042, China
| | - J Chen
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University,Chongqing 400042, China
| | - K Huang
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University,Chongqing 400042, China
| | - S Fang
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University,Chongqing 400042, China
| | - P Wang
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University,Chongqing 400042, China
| | - L Hu
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University,Chongqing 400042, China
| | - X R Liu
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University,Chongqing 400042, China
| | - X Q Zhao
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University,Chongqing 400042, China
| | - N Tan
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University,Chongqing 400042, China
| | - T Cai
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University,Chongqing 400042, China
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Gohil B, Tan N, Jolly R, Yadav N, Jain S. 25 The efficacy of pre-operative multidisciplinary meetings for surgical management of strabismus. BMJ Open Ophthalmol 2023; 8:A9. [PMID: 37798004 DOI: 10.1136/bmjophth-2023-biposa.25] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
Informal discussion regarding surgical management plans between strabismus surgeons is common but this limits potentially valuable multi-disciplinary input and learning opportunities. We evaluate the effectiveness of virtual multidisciplinary meetings to provide a platform for discussion of pre-operative strabismus surgical cases.Weekly virtual MS Teams meetings are held on Monday mornings for one hour, attended by the three paediatric consultants, paediatric fellow, all trainees on the paediatric firm and orthoptists. The meetings are recorded and available for reference to the content and for those not present.Presentations for upcoming surgery cases are prepared and presented by the fellow, with discussion from participants regarding examination findings and surgical options. Cases are anonymised to allow multicentre collaboration. The agreed management plan is documented in the patient's medical notes, and outcomes of challenging cases are discussed.The management plan is formalised during the MDT. Where required, additional tests are arranged. There are opportunities for all participants to constructively challenge decisions. Trainees of all levels are actively engaged by presenting, listening to the rationale behind surgical plans, with the opportunity to ask and respond to questions.Patients are informed that their case has been presented in the MDT to obtain multiple opinions, which gives them additional confidence. Orthoptists can see the impact of the measurements they provide, and how differing tests can change management plans.This MDT has been a positive change to our surgical strabismus patient pathway. Knowledge and teamwork have been strengthened using this innovative virtual discussion method.
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Affiliation(s)
- B Gohil
- Royal Free London NHS Foundation Trust
| | - N Tan
- Royal Free London NHS Foundation Trust
| | - R Jolly
- Royal Free London NHS Foundation Trust
| | - N Yadav
- Royal Free London NHS Foundation Trust
| | - S Jain
- Royal Free London NHS Foundation Trust
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Tan N, Gao F, Mohammed RA, Lim ST, Abdul Aziz Z, Govindasamy S, Chao VTT, Ewe SH, Ho KW, Yap J. Safety and efficacy of cerebral embolic protection devices in transcatheter aortic valve implantation: a meta-analysis. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.097] [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: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Stroke during Transcatheter Aortic Valve implantation (TAVI) is not an uncommon complication with potential devastating consequences. With the extension of TAVI to the low-risk patient, stroke prevention takes on increasing importance. The use of cerebral embolic protection device (EPD) reveals conflicting data. This meta-analysis aims to evaluate the clinical efficacy and safety of EPDs.
Methods
A comprehensive literature search for all studies till May 2022 reporting clinical safety and efficacy outcomes of the only EPD approved for use by the Food and Drug Administration (FDA) was performed. Study outcomes were divided based on time period - overall (up to 30 days and in-hospital) and short (≤7 days). Primary outcome was stroke - major and minor. Secondary outcomes included transient ischaemic attack (TIA), mortality, acute kidney injury (AKI), major vascular and bleeding complications.
Results
A total of 12 studies involving 288531 patients were analysed, which included 3 randomised controlled trials (RCTs), 7 propensity-matched and 2 cohort studies. Regarding overall outcomes, significant differences were noted for mortality (OR 0.59 [0.42-0.84], p=0.0036) and major stroke (OR 0.40 [0.18-0.91], p=0.028) (Fig 1). No significant differences were noted for all stroke (p=0.058), minor stroke (p=0.32), TIA (p=0.49), AKI (p=0.17), major vascular complications (p=0.40) and major bleeding complications (p=0.11). There was significant heterogeneity across the studies for mortality (p=0.032) and all stroke (p=0.009). In the subgroup analysis of studies reporting ≤7 days outcomes (n=5), EPDs showed significantly lower rates of all stroke (0.33 [95% CI 0.19-0.56], p=<0.0001), major stroke (0.19 [0.08-0.48], p=0.0004) and major bleeding complications (OR 0.29 [0.10-0.79], p=0.016), but no significant differences for mortality (p=0.67) and minor stroke (p=0.070). There was no significant heterogeneity across the studies (all p>0.05)
Conclusions
In this meta-analysis including non-randomised studies, the use of EPDs was associated with lower mortality and major stroke rates, although significant heterogeneity was noted for the studies reporting mortality. Further ongoing larger scale RCTs will further clarify these results.
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Affiliation(s)
- N Tan
- National Heart Centre Singapore, Department of Cardiology , Singapore , Singapore
| | - F Gao
- National Heart Centre Singapore, Department of Cardiology , Singapore , Singapore
| | - R A Mohammed
- National Heart Centre Singapore, Department of Cardiology , Singapore , Singapore
| | - S T Lim
- National Heart Centre Singapore, Department of Cardiology , Singapore , Singapore
| | - Z Abdul Aziz
- National Heart Centre Singapore, Department of Cardiothoracic Surgery , Singapore , Singapore
| | - S Govindasamy
- National Heart Centre Singapore, Department of Cardiothoracic Surgery , Singapore , Singapore
| | - V T T Chao
- National Heart Centre Singapore, Department of Cardiothoracic Surgery , Singapore , Singapore
| | - S H Ewe
- National Heart Centre Singapore, Department of Cardiology , Singapore , Singapore
| | - K W Ho
- National Heart Centre Singapore, Department of Cardiology , Singapore , Singapore
| | - J Yap
- National Heart Centre Singapore, Department of Cardiology , Singapore , Singapore
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Kang Q, Liu JX, Tan N, Chen HY, Pan JL, Han YF, Xu XY. [Diagnostic value of novel hepatic fibrosis markers in assessing cirrhosis in patients with chronic hepatitis C]. Zhonghua Gan Zang Bing Za Zhi 2023; 31:56-64. [PMID: 36948850 DOI: 10.3760/cma.j.cn501113-20220329-00149] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
Objective: To investigate the efficacy of chitinase-3-like protein 1 (CHI3L1) and Golgi protein 73 (GP73) in the diagnosis of cirrhosis and the dynamic changes of CHI3L1 and GP73 after HCV clearance in patients with chronic hepatitis C (CHC) treated with direct-acting antiviral drugs (DAAs). The comparison of continuous variables of normal distribution were statistically analyzed by ANOVA and t-test. The comparison of continuous variables of non-normal distribution were statistically analyzed by rank sum test. The categorical variables were statistically analyzed by Fisher's exact test and χ(2) test. Correlation analysis was performed using Spearman correlation analysis. Methods: Data of 105 patients with CHC diagnosed from January 2017 to December 2019 were collected. The receiver operating characteristic curve (ROC curve) was plotted to study the efficacy of serum CHI3L1 and GP73 for the diagnosis of cirrhosis. Friedman test was used to compare CHI3L1 and GP73 change characteristics. Results: The areas under the ROC curve for CHI3L1 and GP73 in the diagnosis of cirrhosis at baseline were 0.939 and 0.839, respectively. Serum levels of CHI3L1 and GP73 in the DAAs group decreased significantly at the end of treatment compared with baseline [123.79 (60.25, 178.80) ng/ml vs. 118.20 (47.68, 151.36) ng/ml, P = 0.001; 105.73 (85.05, 130.69) ng/ml vs. 95.52 (69.52, 118.97) ng/ml, P = 0.001]. Serum CHI3L1 and GP73 in the pegylated interferon combined with ribavirin (PR) group were significantly lower at the end of 24 weeks of treatment than the baseline [89.15 (39.15, 149.74) ng/ml vs. 69.98 (20.52, 71.96) ng/ml, P < 0.05; 85.07 (60.07, 121) ng/ml vs. 54.17 (29.17, 78.65) ng/ml, P < 0.05]. Conclusion: CHI3L1 and GP73 are sensitive serological markers that can be used to monitor the fibrosis prognosis in CHC patients during treatment and after obtaining a sustained virological response. Serum CHI3L1 and GP73 levels in the DAAs group decreased earlier than those in the PR group, and the serum CHI3L1 levels in the untreated group increased compared with the baseline at about two years of follow-up.
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Affiliation(s)
- Q Kang
- Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China
| | - J X Liu
- Department of Gastroenterology, Peking University First Hospital, Beijing 100034, China
| | - N Tan
- Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China
| | - H Y Chen
- Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China
| | - J L Pan
- Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China
| | - Y F Han
- Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China
| | - X Y Xu
- Department of Gastroenterology, Peking University First Hospital, Beijing 100034, China
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Patel R, Roachell B, Caino-Lores S, Ketron R, Leonard J, Tan N, Vahi K, Brown DA, Deelman E, Taufer M. Reproducibility of the First Image of a Black Hole in the Galaxy M87 from the Event Horizon Telescope (EHT) Collaboration. Comput Sci Eng 2023. [DOI: 10.1109/mcse.2023.3241105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- R. Patel
- University of Tennessee, Knoxville
| | | | | | | | | | - N. Tan
- University of Tennessee, Knoxville
| | - K. Vahi
- University of Southern California
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Liu G, Zheng YLC, Tan N, Wang LJ, Liu YC, Gao HM, Qian SY. [Application of initial anti-infectives and trends in children with septic shock]. Zhonghua Er Ke Za Zhi 2022; 60:1288-1294. [PMID: 36444432 DOI: 10.3760/cma.j.cn112140-20220511-00443] [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: 06/16/2023]
Abstract
Objective: To investigate the pathogen composition, initial anti-infectives and pathogen coverage, and trends over the last 5 years in children with septic shock in pediatric intensive care unit (PICU). Methods: The single-center retrospective study included 257 children with septic shock who were admitted to PICU of Beijing Children's Hospital, Capital Medical University from 2017 to 2021. The causitive pathogen composition, initial use of anti-infective drugs, pathogen coverage, and changes in recent years were analyzed. The children were divided into sufficient and insufficient coverage groups according to whether the pathogen were sufficiently covered by initial anti-infectives; community-and hospital-acquired groups; and with and without underlying disease groups. T test, rank-sum test and Chi-square test were used for comparison between the groups to investigate the differences in pathogen, treatment and prognosis. Results: A total of 257 septic shock children were included, with 162 males and 95 females, aged 36 (12, 117) months. The pathogen positive rate was 64.6% (166/257) and the in-hospital mortality was 27.6% (71/257). In the 208 pathogen-positive samples, bacteria was the most common (57.7%, 120/208) with G-negative bacteria predominating (55.8%, 67/120), followed by viruses (26.0%, 54/208). Nearly 99.2% (255/257) of the children were treated with antibacterial at the beginning, of whom 47.1% (121/257) were treated with carbapenems combined with vancomycin or linezolid. The proportion of 3 or more antibacterial combinations was higher in children with underlying diseases and hospital-acquired septic shock than in those without underlying disease or community-acquired septic shock (27.4% (49/179) vs. 14.1% (11/78), 29.4% (52/177) vs. 10.0% (8/80), χ2=5.35,11.56,all P<0.05). The proportion of initial combination of carbapenem and vancomycin or linezolid reduced from 52.5% (21/40) to 41.3% (19/46), and of adequate pathogen coverage increased from 40.0% (16/40) to 58.7% (27/46) in the last five years. Conclusions: The initial use of antibacterial drugs is common in children with septic shock in PICU, especially in those with hospital-acquired septic shock and underlying diseases. In recent years, antimicrobial combinations have decreased, but the pathogen coverage has improved, indicating that drug selection is more reasonable and accurate.
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Affiliation(s)
- G Liu
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Y L C Zheng
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - N Tan
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - L J Wang
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Y C Liu
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - H M Gao
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - S Y Qian
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
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Zhong Y, Anton A, Xie O, Tan N, Maleki S, Parente P, Spain L, Gibbs P, Tran B. 160MO Concomitant medication (conmed) interactions with novel hormonal agents (NHAs) in metastatic castration resistant prostate cancer (mCRPC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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Tan N, Zhu F, Ding Y, Xu WY, Zhang J. [Effects of nitroquine on the development of Plasmodium yoelii at different stages in Anopheles stephensi]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2022; 34:85-88. [PMID: 35266363 DOI: 10.16250/j.32.1374.2021279] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To investigate the effects of nitroquine on the development of different stages of Plasmodium yoelii in Anopheles stephensi. METHODS An. stephensi mosquitoes were fed with conventional sucrose water or sucrose water containing 100 μmol/L nitroquine one day prior to P. yoelii infection. Following starvation for 24 hours, mosquitoes were fed with the blood of Kunming mice infected with P. yoelii, and the number of oocysts was observed in the stomach of An. stephensi. After 6 days and 14 days of infection, the mosquitoes were starved for 24 hours, and then fed with conventional sucrose water or nitroquine treated sucrose water. The An. stephensi mosquitoes were starved for 24 hours 6 and 14 days post-infection with P. yoelii, and then fed with conventional sucrose water or nitroquine-containing sucrose water, the numbers of P. yoelii sporozoites were examined in the hemolymph and salivary glands of An. stephensi. RESULTS Following exposure to nitroquine-containing sucrose water one day prior to P. yoelii infections, the number of P. yoelii oocysts was significantly lower in the An. stephensi stomach on day 7 (119.2 ± 16.1 vs. 207.3 ± 21.8; t = 3.207, P < 0.05). After conventional sucrose water was ceased for 24 hours on day 6, and An. stephensi was fed with nitroquine-containing sucrose water, the number of P. yoelii sporozoites peaked in the hemolymph on day 14 in the nitroquine treatment group (952.3 ± 22.7) and on day 12 in the sucrose water treatment group (1 287.0 ± 39.0), and there was a significant difference in the number of sporozoites in the salivary glands between the nitroquine treatment group and the sucrose water treatment group (9 467.0 ± 1 304.0 vs. 10 533.0 ± 758.7; t = 0.707, P = 0.506) on day 17. After conventional sucrose water was ceased for 24 hours on day 14, and An. stephensi was fed with nitroquine-containing sucrose water, the number of sporozoites in the salivary glands was significantly greater in the nitroquine treatment group than in the sucrose water treatment group (21 900.0 ± 2 613.0 vs. 10 533.0 ± 732.3; t = 4.188, P < 0.05). CONCLUSIONS Nitroquine treatment exhibits diverse effects the development of different stages of P. yoelii, and nitroquine treatment may reduce the transmission of P. yoelii in uninfected An. stephensi.
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Affiliation(s)
- N Tan
- Department of Pathogenic Biology, School of Basic Medical Sciences, Army Medical University, Chongqing 400038, China
| | - F Zhu
- Department of Pathogenic Biology, School of Basic Medical Sciences, Army Medical University, Chongqing 400038, China
| | - Y Ding
- Department of Pathogenic Biology, School of Basic Medical Sciences, Army Medical University, Chongqing 400038, China
| | - W Y Xu
- Department of Pathogenic Biology, School of Basic Medical Sciences, Army Medical University, Chongqing 400038, China
| | - J Zhang
- Department of Pathogenic Biology, School of Basic Medical Sciences, Army Medical University, Chongqing 400038, China
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Li Q, Lu X, Chen W, Huang H, Chen S, Chen W, Shi S, Liang G, Huang Z, Deng J, Guo W, Su S, Tan N, Chen J, Liu J, Liu Y, Xie N. Malnutrition Increases the Risk of Left Ventricular Remodeling. J Nutr Health Aging 2022; 26:1094-1100. [PMID: 36519773 DOI: 10.1007/s12603-022-1862-0] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Malnutrition is associated with increased incidence of heart failure (HF). Left ventricular (LV) remodeling is one of the most important processes in the occurrence and evolution of HF. However, the association between nutritional status and LV remodeling is not well known. The study aimed to investigate the association between malnutrition and LV remodeling. DESIGN The study was a retrospective observation study. SETTING AND PARTICIPANTS We included patients from the registry of Cardiorenal Improvement study from January 2007 to December 2018 at Guangdong Provincial People's Hospital. MEASUREMENTS The primary endpoint was LV remodeling, defined as an absolute decrease in LV ejection fraction ≥10% after discharge compared with baseline. Nutritional status was assessed by the Controlling Nutritional Status (CONUT) score. Eligible patients were divided into absent-mild malnutrition group (CONUT score ≤4) and moderate-severe malnutrition group (CONUT score >4). Univariable and multivariable logistic regression was performed to verify the association between malnutrition and left ventricular remodeling. RESULTS A total of 7,217 patients (mean age 61.3±10.5 years, 71.7% male) were included in the final analysis, among which 712 (9.9%) had LV remodeling. The incidence of LV remodeling in moderate-severe malnutrition group was significantly higher than that in absent-mild malnutrition group (12.9% vs. 9.5%, p=0.002). In multivariable logistic regression, moderate-severe malnutrition group was significantly associated with 1.69-fold increased risk of LV remodeling after adjusting confounders (OR: 1.69, CI: 1.32-2.16). Similar results were observed in subgroup stratified by age, gender, and coronary artery disease. CONCLUSION Nearly one eighth of patients were classified as moderate-severe malnutrition, 12% of whom had LV remodeling. Moderate-severe malnutrition was associated with 69% increased risk of LV remodeling. Further studies are needed to prospectively evaluate the nutrition-oriented managements on outcomes in LV remodeling.
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Affiliation(s)
- Q Li
- Nianjin Xie, MD; Yong Liu, MD, PhD, FACC; Jin Liu, MD, Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China, Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong, Academy of Medical Sciences, Guangzhou, 510080, China, Tel: (+86) 02083827812-10528/Fax: (+86) 02083851483, E-mail: ; ;
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Wang B, Liu J, Chen SQ, Luo QH, Liu Y, Tan N. Association between baseline ldl-c and prognosis among patients with coronary artery disease and advanced kidney disease. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2909] [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
Background
Lower low-density lipoprotein cholesterol (LDL-C) is significantly associated with improved prognosis in patients with coronary artery disease (CAD). However, LDL-C reduction does not decrease all-cause mortality among CAD patients when renal function impairs. There are currently no studies examining the association of low baseline LDL-C concentration (<1.8 mmol/L) with mortality among patients with CAD and advanced kidney disease (AKD). We aimed to evaluate prognostic value of low baseline LDL-C level for all-cause death in these patients.
Methods
In this observational study, 803 CAD patients complicated with AKD (eGFR <30 mL/min/1.73 m 2) were enrolled between January 2008 to December 2018. Patients were divided into two groups (LDL-C <1.8 mmol/L, n=138; LDL-C ≥1.8 mmol/L, n=665). We used Kaplan-Meier methods and Cox regression analyses to assess the association between baseline low LDL-C levels and long-term all-cause mortality.
Results
Among 803 participants (mean age 67.4 years; 68.5% male), there were 315 incidents of all-cause death during a median follow-up of 2.7 years. Kaplan–Meier analysis showed that low LDL-C levels were associated with worse prognosis. After adjusting for full 24 confounders (e.g., age, diabetes, heart failure, and dialysis, etc.), multivariate Cox regression analysis revealed that lower LDL-C level (<1.8mmol/L) was significantly associated with higher risk of all-cause death (adjusted HR, 1.38; 95% CI, 1.01–1.89).
Conclusions
Our data demonstrated that among patients with CAD and AKD, a lower baseline LDLC level (<1.8mmol/L) did not present a higher survival rate but was related to a worse prognosis, suggesting a cautiousness of too low LDL-C levels among patients with CAD and AKD.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): This study was supported by the National Natural Science Foundation of China (Grant No. 81670339 and Grant No. 81970311), Cardiovascular Research Foundation Project of the Chinese Medical Doctor Association (SCRFCMDA201216) and Beijing Lisheng Cardiovascular Health Foundation (LHJJ20141751).
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Affiliation(s)
- B Wang
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
| | - J Liu
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
| | - S Q Chen
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
| | - Q H Luo
- Guangdong Pharmaceutical University, Guangzhou, China
| | - Y Liu
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
| | - N Tan
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
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12
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Wang B, Liu J, Chen SQ, Zhou ZQ, Tan N, Liu Y. Malnutrition affects cholesterol paradox in coronary artery disease: a 41,229 Chinese cohort study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1098] [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
Background
Several studies found that baseline low LDL-C concentration was associated with poor prognosis in patients with acute coronary syndrome (ACS), which was called “cholesterol paradox”. Low LDL-C concentration may reflect underlying malnutrition, which was strongly associated with increased mortality. We objected to investigate the cholesterol paradox in patients with CAD and the effects of malnutrition.
Method
A total of 41,229 CAD patients admitted to Guangdong Provincial People's Hospital in China were included in this study from January 2007 to December 2018, and divided into two groups (LDL-C <1.8 mmol/L, n=4,863; LDL-C ≥1.8 mmol/L, n=36,366). We used Kaplan-Meier method and Cox regression analyses to assess the association between LDL-C levels and long-term all-cause mortality and the effect of malnutrition.
Result
In this real-world cohort (mean age 62.94 years; 74.94% male), there were 5257 incidents of all-cause death during a median follow-up of 5.20 years [Inter-quartile range (IQR): 3.05–7.78 years]. Kaplan–Meier analysis showed that low LDL-C levels were associated with worse prognosis. After adjusting for baseline confounders (e.g., age, sex and comorbidities, etc.), multivariate Cox regression analysis revealed that low LDL-C level (<1.8mmol/L) was not significantly associated with all-cause mortality (adjusted HR, 1.04; 95% CI, 0.96–1.24). After adjustment of nutritional status, risk of all-cause mortality of patients with low LDL-C level decreased (adjusted HR, 0.90; 95% CI, 0.83–0.98). In the final multivariate Cox model, low LDL-C level was related to better prognosis (adjusted HR, 0.91; 95% CI, 0.84–0.99).
Conclusion
Our results demonstrate that the cholesterol paradox persisted in CAD patients, but disappeared after accounting for the effects of malnutrition.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): the National Natural Science Foundation of China (Grant No. 81670339 and Grant No. 81970311), Cardiovascular Research Foundation Project of the Chinese Medical Doctor Association (SCRFCMDA201216)
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Affiliation(s)
- B Wang
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
| | - J Liu
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
| | - S Q Chen
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
| | - Z Q Zhou
- Guangdong Pharmaceutical University, Guangzhou, China
| | - N Tan
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
| | - Y Liu
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
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13
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Li Q, Chen SQ, Huang HZ, Liu LW, Chen WH, Zhou JH, Tan N, Liu J, Liu Y. Association between recovered acute kidney injury within 48hours and mortality in patients following coronary angiography: a cohort study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The association of recovered acute kidney injury (AKI) with mortality was controversial. Our study aims to investigate the impact of recovered AKI on mortality in patients following coronary angiography (CAG).
Methods
Our study retrospectively enrolled 3,970 patients with pre-operative serum p creatinine (Scr) and twice measurements within 48hours after procedure. Recovered AKI defined as the diagnosis of AKI (Scr >0.3 mg/dL or >50% from the baseline level) on day 1 when Scr failed to meet the criteria for AKI on the day 2. Maintained AKI was defined as AKI not meeting the definition for recovered AKI. The primary outcome was 1-year all-cause mortality. Multivariable logistic regression was used to assess the association between recovered AKI and 1-year mortality.
Results
Among 3,970 participants, 861 (21.7%) occurred AKI, of whom 128 (14.9%) was recovered AKI and 733 (85.1%) was maintained AKI. 312 (7.9%) patients died within 1-year after admission. After multivariable analysis, recovered AKI was not associated with higher 1-year mortality (adjusted odds ratio [aOR], 1.37; CI, 0.68–2.51) compared without AKI. Among AKI patients, Recovered AKI was associated with a 52% lower 1-year mortality compared with maintained AKI. Additionally, maintained AKI was significantly associated with higher 1-year mortality (aOR, 2.67; CI, 2.05–3.47).
Conclusions
Our data suggested that recovered AKI within 48h was a common subtype of AKI following CAG, without increasing mortality. More attention need to be paid to the patients suffering from maintained AKI following CAG.
Funding Acknowledgement
Type of funding sources: None. Association of AKI and mortalitySubgroups analysis
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Affiliation(s)
- Q Li
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Department of Cardiology, Guangzhou, China
| | - S Q Chen
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Department of Cardiology, Guangzhou, China
| | - H Z Huang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Department of Cardiology, Guangzhou, China
| | - L W Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Department of Cardiology, Guangzhou, China
| | - W H Chen
- Longyan First Affiliated Hospital of Fujian Medical University, Department of Cardiology, Longyan, China
| | - J H Zhou
- Guangdong Pharmaceutical University, Guangzhou, China
| | - N Tan
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Department of Cardiology, Guangzhou, China
| | - J Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Department of Cardiology, Guangzhou, China
| | - Y Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Department of Cardiology, Guangzhou, China
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14
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Liu H, Yuan HF, Xu D, Chen KJ, Tan N, Zheng QJ. Circular RNA circ_0000034 upregulates STX17 level to promote human retinoblastoma development via inhibiting miR-361-3p. Eur Rev Med Pharmacol Sci 2021; 24:12080-12092. [PMID: 33336726 DOI: 10.26355/eurrev_202012_23997] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Retinoblastoma (RB) is a common intraocular tumor of infancy and childhood. Circular RNAs (circRNAs) are related to the development of RB. The purpose of this research was to reveal the functional mechanism of circRNA circ_0000034 in RB. MATERIALS AND METHODS Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR) and Western blot were applied to determine the levels of genes. MTT assay and flow cytometry were employed to assess cell proliferation and apoptosis rate, respectively. Furthermore, cell migratory and invasive abilities were measured using the transwell assay. Mouse xenograft was conducted to analyze the effect of circ_0000034 on tumor growth in vivo. Besides, the interaction between miR-361-3p and circ_0000034 or syntaxin 17 (STX17) was predicted by starBase, and then, confirmed by the Dual-Luciferase reporter assay and RNA immunoprecipitation (RIP) assay. RESULTS The levels of circ_0000034 and STX17 were increased and miR-361-3p level was decreased in RB tissues and cells. Circ_0000034 knockdown suppressed cell proliferation, migration, invasion, autophagy, and tumor growth, and induced apoptosis in RB. Circ_0000034 targeted miR-361-3p and miR-361-3p bound to STX17. Circ_0000034 overexpression and miR-361-3p knockdown reversed the effect of miR-361-3p upregulation and STX17 depletion on the growth of RB cells, respectively. Besides, circ_0000034 elevated STX17 level by repressing miR-361-3p expression. CONCLUSIONS We demonstrated that circ_0000034 knockdown suppressed the development of RB by the modulation of miR-361-3p/STX17 axis. Our findings provided a theoretical basis for the treatment of RB.
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Affiliation(s)
- H Liu
- Department of Ophthalmology, Daping Hospital, Army Medical Center of PLA, Chongqing, China.
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15
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Zhang Y, Li Y, Liu J, Wei X, Tan N, Zhang J, Wang W, Wang Y. Association of Vitamin D or Calcium Supplementation with Cardiovascular Outcomes and Mortality: A Meta-Analysis with Trial Sequential Analysis. J Nutr Health Aging 2021; 25:263-270. [PMID: 33491043 DOI: 10.1007/s12603-020-1551-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 01/08/2023]
Abstract
BACKGROUND To exploring the role of vitamin D or calcium supplementation in reducing all-cause mortality and cardiovascular outcomes. METHODS The search was restricted to systematic reviews or meta-analyses published from January 1, 2010, to July 7, 2019. An additional search was performed to identify recently published randomized controlled trials (from January 1, 2015, to July 7, 2019). Homogeneous results from different studies were pooled using Revman 5.3 software. RESULTS Twenty-three studies involving 89,251 participants were ultimately included in this meta-analysis. No associations were observed between the supplementation and composite cardiovascular outcomes, consisting of all-cause mortality, cardiovascular mortality, myocardial infarction, and other MACEs. CONCLUSIONS Whether used alone or in combination, vitamin D and calcium supplementation do not exert meaningful effects on all-cause mortality, cardiovascular mortality, MACEs or MI among community-dwelling adults.
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Affiliation(s)
- Y Zhang
- Yong Wang, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Bei San Huan Dong Lu 11, Chao Yang district, Beijing 100029, P.R. China,
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16
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Sanmartí M, Meyer AC, Jaen A, Robertson K, Tan N, Mapesi H, Samson L, Ndaki R, Battegay M, Tanner M, Weisser M, Dalmau D, Letang E. HIV-associated neurocognitive impairment in stable people living with HIV on ART in rural Tanzania. HIV Med 2020; 22:102-112. [PMID: 33190352 DOI: 10.1111/hiv.12979] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Few studies have assessed cognitive impairment among healthy people living with HIV (PLWH) who are stable on antiretroviral treatment (ART) in sub-Saharan Africa. METHODS We conducted a cross-sectional study among a random sample of stable adult PLWH from rural Tanzania on ART for more than 1 year and without immunological failure or pre-existing neurological disease. We evaluated the prevalence and risk factors for neurocognitive impairment (NCI), assessed through neuropsychological tests, functional and depression questionnaires and defined as a mean Z-score ≤ -1 in two or more cognitive domains. RESULTS Among 243 participants [median age = 44.3 years (interquartile range: 36-52] and 71% female] we found a rate of NCI of 19.3% (95% confidence interval: 14.8-24.8%). Memory and psychomotor domains demonstrated the highest impairment. Independent predictors of NCI were age and self-reported alcohol use. Other classical risk factors were not associated with HIV-associated NCI. CONCLUSION Despite effective ART roll-out, NCI remained a prevalent condition in this healthy rural Tanzanian population of PLWH on ART. Age and alcohol use were key risk factors.
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Affiliation(s)
- M Sanmartí
- Infectious Diseases & HIV Service, Hospital Universitari MutuaTerrassa, Terrassa, Spain.,University of Barcelona, Catalonia, Barcelona, Spain.,Fundació per la Docència i Recerca MútuaTerrassa, Terrassa, Catalonia, Spain.,Infectious Diseases Department, Parc Sanitari Sant Joan de Déu - Hospital Sant Boi, Sant Boi Ll, Catalonia, Spain
| | - A C Meyer
- United States Army Medical Research and Material Command, Fort Detrick, MD, USA.,Neurology Department, Yale University, New Haven, CT, United States
| | - A Jaen
- Fundació per la Docència i Recerca MútuaTerrassa, Terrassa, Catalonia, Spain.,Spanish HIV/AIDS Research Network of Excellence (RIS), Madrid, Spain
| | - K Robertson
- AIDS Neurological Center Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
| | - N Tan
- Department of Engineering, Stanford University, Stanford, CA, USA
| | - H Mapesi
- Ifakara branch, Ifakara Health Institute, Ifakara, Tanzania.,Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - L Samson
- Ifakara branch, Ifakara Health Institute, Ifakara, Tanzania.,St Francis Referral Hospital, Ifakara, Tanzania
| | - R Ndaki
- Ifakara branch, Ifakara Health Institute, Ifakara, Tanzania.,St Francis Referral Hospital, Ifakara, Tanzania
| | - M Battegay
- Department of Infectious Diseases, University Hospital Basel, Basel, Switzerland.,Division of Infectious Diseases and Hospital Epidemiology, University of Basel, Basel, Switzerland
| | - M Tanner
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - M Weisser
- Ifakara branch, Ifakara Health Institute, Ifakara, Tanzania.,Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - D Dalmau
- Infectious Diseases & HIV Service, Hospital Universitari MutuaTerrassa, Terrassa, Spain.,University of Barcelona, Catalonia, Barcelona, Spain.,Fundació per la Docència i Recerca MútuaTerrassa, Terrassa, Catalonia, Spain.,Spanish HIV/AIDS Research Network of Excellence (RIS), Madrid, Spain
| | - E Letang
- Ifakara branch, Ifakara Health Institute, Ifakara, Tanzania.,Swiss Tropical and Public Health Institute, Basel, Switzerland.,ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Catalonia, Spain.,Department of Infectious Diseases, Hospital del Mar, Hospital del Mar Research Institute (IMIM), Barcelona, Catalonia, Spain
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17
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Fan H, Liu Y, Chen P, Jiang L, Wei X, Guo W, Zeng L, Tan N, Chen J, He P. Association of baseline hemoglobin A1c levels with bleeding in patients with non-ST-segment elevation acute coronary syndrome underwent percutaneous coronary intervention. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The association between baseline hemoglobin A1c (HbA1c) levels before the percutaneous coronary intervention and bleeding is unclear in patients with non-ST-segment elevation acute coronary syndrome.
Purpose
To investigate the association between baseline HbA1c levels before the percutaneous coronary intervention and bleeding in patients with non-ST-segment elevation acute coronary syndrome.
Methods
This observational cohort study enrolled 6,283 consecutive patients with non-ST-segment elevation acute coronary syndrome, from 1 January 2010 to 31 December 2014. Based on baseline HbA1c levels, the patients were divided into the HbA1c <7% group (n=4,740) and the HbA1c ≥7% group (n=1,543). The primary outcomes are major bleeding events (BARC grades 3–5) and all-cause death during follow-up.
Results
Of the patients who were enrolled, 4,705 (74.9%) were male and 2,143 (34.1%) had a history of diabetes mellitus, with a mean (SD) age of 64.13 (10.32) years. Median follow-up duration was 3.21 years. Compared with HbA1c <7% patients, the risk of major bleeding events and all-cause was both higher in HbA1c ≥7% patients (major bleeding: adjusted hazard ratio, 1.62; 95% confidence interval, 1.04–2.53; P=0.032; all-cause death: adjusted hazard ratio, 1.26; 95% confidence interval, 1.03–1.55; P=0.027). The result of the subgroups analyses was consistent with the primary analyses.
Conclusions
Higher baseline HbA1c levels before percutaneous coronary intervention was associated with an increase in bleeding risk in non-ST-elevation acute coronary syndrome patients. This study suggests that the HbA1c levels should be taken into account for the prolonged antithrombotic strategies of non-ST-elevation acute coronary syndrome patients.
Figure 1. Kaplan-Meier Analysis for Outcomes
Funding Acknowledgement
Type of funding source: Other. Main funding source(s): Science and Technology Planning Project of Guangzhou City (201707010002)
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Affiliation(s)
- H.L Fan
- School of Medicine, South China University of Technology, Guangzhou, China
| | - Y.H Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Department of Cardiology, Guangzhou, China
| | - P.Y Chen
- Guangdong Provincial People's Hospital's Nanhai Hospital, Department of Cardiology, Guangzhou, China
| | - L Jiang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Department of Cardiology, Guangzhou, China
| | - X.B Wei
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Department of Cardiology, Guangzhou, China
| | - W Guo
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Department of Cardiology, Guangzhou, China
| | - L.H Zeng
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - N Tan
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Department of Cardiology, Guangzhou, China
| | - J.Y Chen
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Department of Cardiology, Guangzhou, China
| | - P.C He
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Department of Cardiology, Guangzhou, China
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18
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Guo Z, Lei L, Liu J, Song F, He Y, Chen S, Sun G, Liu B, Liu L, Chen G, Xue Y, Huang H, Liu Y, Tan N, Chen J. Effects of targeted hydration on risk of major adverse renal and cardiac events: a systematic review and meta-analysis of randomized controlled trials. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1423] [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
Background
Inconsistent results have been published that have evaluated the preventive effect of targeted hydration in major adverse renal and cardiac events among patients exposed to contrast agents.
Methods
Online databases were searched up to October, 2019, for randomized controlled trials (RCTs). The primary outcome was the incidence of contrast-induced acute kidney injury (CI-AKI), and the secondary outcomes were all-cause in-hospital mortality, all-cause long-term mortality, requirement for dialysis, acute pulmonary edema and stroke/transient ischemic attack (TIA).
Results
9 high quality trials were identified including 2424 patients. Overall, compared with general hydration, targeted hydration significantly reduced the incidence of CI-AKI by 58% (RR 0.42; 95% CI: 0.33–0.54, p<0.01), the requirement for dialysis by 68% (RR 0.32, 95% CI: 0.17–0.62, p<0.01) and the all-cause long-term mortality by 55% (RR 0.45; 95% CI: 0.26–0.76, p<0.01). The effect on all-cause in-hospital mortality was not statistically significant. The effect on acute pulmonary edema and stroke/TIA also showed no difference between two groups (RR: 0.54, 95% CI: 0.28–1.03, p=0.18; RR: 0.61, 95% CI: 0.14–2.61, p=0.49, respectively). Trial sequential analysis confirmed that an additional 3900 study participants would need to be recruited to demonstrate a statistically significant improvement for all-cause in-hospital mortality.
Conclusions
Targeted hydration likely reduces the incidence of CI-AKI, dialysis and all-cause long-term mortality in patients exposed to contrast agents. However, further independent high-quality RCTs should elucidate the effectiveness and safety of this prophylactic strategy in interventional cardiology.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- Z Guo
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
| | - L Lei
- Southern Medical University, Cardiology, Guangzhou, China
| | - J Liu
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
| | - F Song
- Guangdong Provincial People's Hospital, Emergency and Critical Care Medicine, Guangzhou, China
| | - Y He
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
| | - S Chen
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
| | - G Sun
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
| | - B Liu
- South China University of Technology, Cardiology, Guangzhou, China
| | - L Liu
- Southern Medical University, Cardiology, Guangzhou, China
| | - G Chen
- South China University of Technology, Cardiology, Guangzhou, China
| | - Y Xue
- People's Hospital of Guangxi Zhuang Autonomous Region, Cardiology, Nanning, China
| | - H Huang
- Sichuan Provincial People's Hospital, Cardiology, Chengdu, China
| | - Y Liu
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
| | - N Tan
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
| | - J Chen
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
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19
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Liu L, Liu Y, Chen S, Chung E, Lei L, He Y, Lun Z, Chen L, Zhang H, Zhuang X, Song F, Sun G, Chen G, Chen J, Tan N. Global risk factors of contrast-induced acute kidney injury: systematic review and meta-analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2448] [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
Background
Administration of iodinated contrast is common but may be associated with contrast-induced acute kidney injury (CI-AKI), particularly in at-risk patients. There is no recent systematic review of potentially modifiable risk factors.
Methods
We searched MEDLINE, Embase and the Cochrane Database of Systematic Reviews (to 30 th June 2019) for observational studies assessing risk factors associated with CI-AKI. Twelve potentially modifiable risk factors were finally included in this thematic review and meta-analysis. Random or fixed meta-analysis was performed to derive the adjusted odds ratio (aOR), and the population attributable risk (PAR) was calculated for each risk factor globally and by region.
Findings
We included 157 studies (2,297,863 participants). The global incidence of CI-AKI was 5.4%. The potentially modifiable risk factors included high contrast volume (PAR 33%), eight cardiovascular risk factors (diuretic use, multivessel coronary artery disease, acute coronary syndrome, hypertension, hypotension, heart failure, reduced left ventricular ejection fraction and intra-aortic balloon pump use) (combined PAR 76.2%) and three noncardiovascular risk factors (renal dysfunction, diabetes mellitus and anaemia) (combined PAR 47.4%) with geographical differences.
Bubble chart of the 12 risk factors
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): National Science Foundation of China
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Affiliation(s)
- L Liu
- Guangdong General Hospital Guangdong Cardiovascular Institute, Guangzhou, China
| | - Y Liu
- Guangdong General Hospital Guangdong Cardiovascular Institute, Guangzhou, China
| | - S Chen
- Guangdong General Hospital Guangdong Cardiovascular Institute, Guangzhou, China
| | | | - L Lei
- Guangdong General Hospital Guangdong Cardiovascular Institute, Guangzhou, China
| | - Y He
- Guangdong General Hospital Guangdong Cardiovascular Institute, Guangzhou, China
| | - Z Lun
- Guangdong General Hospital Guangdong Cardiovascular Institute, Guangzhou, China
| | - L Chen
- Guangdong General Hospital Guangdong Cardiovascular Institute, Guangzhou, China
| | - H Zhang
- First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - X Zhuang
- First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - F Song
- Guangdong General Hospital Guangdong Cardiovascular Institute, Guangzhou, China
| | - G Sun
- Guangdong General Hospital Guangdong Cardiovascular Institute, Guangzhou, China
| | - G Chen
- Guangdong General Hospital Guangdong Cardiovascular Institute, Guangzhou, China
| | - J.Y Chen
- Guangdong General Hospital Guangdong Cardiovascular Institute, Guangzhou, China
| | - N Tan
- Guangdong General Hospital Guangdong Cardiovascular Institute, Guangzhou, China
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20
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Liu Y, Wang L, Dai Y, Zeng L, Fan H, Duan C, Tan N, Chen J, He P. Validation and comparison of six risk scores for post acute myocardial infarction infection. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2912] [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
Background
Various risk scores have been proven to predict outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). However, few of them were validated and compared the difference of the prediction of infection during hospitalization in such patients.
Aim
We aimed to validate and compare the discriminatory value of different risk scores for predicting infection.
Methods
Patients who were diagnosed with STEMI treated with PCI were enrolled from January 2010 to May 2018. The six risk scores included the Age, Serum Creatinine (SCr), or Glomerular Filtration Rate, and Ejection Fraction (ACEF or AGEF) score, Canada Acute Coronary Syndrome Risk Score (CACS score), CHADS2 score, Global Registry for Acute Coronary Events (GRACE) score and Mehran score. The primary end point was infection during hospitalization. The secondary endpoint was major adverse clinical events including all cause death, stroke and any bleeding. The prognostic accuracy of the six scores was assessed using the c statistic for discrimination and the Hosmer-Lemeshow test for calibration.
Results
A total of 2260 eligible patients were enrolled (62.32±12.36 year, 81.3% of males). A significant gradient of risk with respect to infection and in hospital major adverse clinical events (MACE) was observed with increasing all six risk scores. Other than the CHADS2 score (AUC: 0.682; 95% CI, 0.652–0.712), other five risk scores showed the good discrimination for predicting infection, with the GRACE score being the best (AUC: 0.791; 95% CI, 0.765–0.817). In addition, all risk scores showed best calibration for infection, but good calibration for CACS risk score (calibration slope: 0.77, 95% CI: 0.18–1.35) (Figure 1). Furthermore, each score showed a best discrimination for in hospital MACE, with AUCs ranging from 0.761 to 0.786, other than CACS risk score and CHADS2 risk score with AUC of 0.700 and 0.696, respectively. All risk scores showed best calibration for in hospital MACE.
Conclusions
In patients with STEMI undergoing PCI, these risk scores (ACEF, AGEF, CACS, GRACE and Mehran) showed good discrimination and calibration to predict infection and MACE. The CACS score was recommended for clinical use as its clinical variables were simple and practical.
Figure 1
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): National Science Foundation for Young Scientists of China
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Affiliation(s)
- Y.H Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangzhou, China
| | - L.T Wang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Y.N Dai
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangzhou, China
| | - L.H Zeng
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangzhou, China
| | - H.L Fan
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangzhou, China
| | - C.Y Duan
- Southern Medical University, Biostatistics, Guangzhou, China
| | - N Tan
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangzhou, China
| | - J.Y Chen
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangzhou, China
| | - P.C He
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangzhou, China
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21
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Chen P, Liu Y, Duan C, Fan H, Zeng L, Guo W, Jiang L, Xue W, He W, Tao S, Guo Z, Chen J, Tan N, He P. The effect of in-hospital high-dose vs. low-dose intensive statin in patients with non-ST segment elevation acute coronary syndrome. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3335] [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
Background
Statins remain a standard treatment for acute coronary syndrome (ACS) patients. We aimed to determine the association between different dosages of in-hospital statins and the prognoses among patients receiving percutaneous coronary intervention (PCI).
Methods
NSTE-ACS patients were retrospectively enrolled from January 2010 to December 2014 from five centres in China. Patients receiving either atorvastatin or rosuvastatin during their hospitalizations were included. All the patients were categorized into high-dose statin group (40mg atorvastatin or 20mg rosuvastatin) or low-dose statin group (20mg atorvastatin or 10mg rosuvastatin). In-hospital events and long-term all-cause death was recorded.
Results
Of the 7,008 patients included in the study, 5,248 received low-dose intensive statin (mean age: 64.28±10.39; female: 25.2%), and 1,760 received high-dose intensive statin (mean age: 63.68±10.59; female: 23.1%). There was no significant difference in in-hospital all-cause death between the two groups (adjusted OR, 1.27; P=0.665). All-cause death was similar between the two groups during the long-term follow-up period (30-day: adjusted HR, 1.28; P=0.571; 3-year: adjusted HR, 0.83; P=0.082). However, there was a robust association between the high-dose statin and the reduction in in-hospital dialysis (adjusted OR, 0.11; P=0.030).
Conclusions
The in-hospital high-dose intensive statin is not associated with lower risks of in-hospital or follow-up all-cause death in NSTE-ACS patients undergoing PCI. Considering the robust beneficial effect of in-hospital dialysis, an individualized high-dose intensive statin can be rational in specified populations.
Univariate and multivariate analyses
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): The Science and Technology Planning Project of Guangzhou City athe China Youth Research Funding
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Affiliation(s)
- P Chen
- Guangdong General Hospital's Nanhai Hospital, cardiology, Foshan, China
| | - Y Liu
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
| | - C Duan
- Southern Medical University, Biostatistics, guangzhou, China
| | - H Fan
- South China University of Technology, guangzhou, China
| | - L Zeng
- The Second School of Clinical Medicine, Southern Medical University, guangzhou, China
| | - W Guo
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
| | - L Jiang
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
| | - W Xue
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
| | - W He
- Guangdong General Hospital's Nanhai Hospital, cardiology, Foshan, China
| | - S Tao
- Guangdong General Hospital's Nanhai Hospital, cardiology, Foshan, China
| | - Z Guo
- Guangdong General Hospital's Nanhai Hospital, cardiology, Foshan, China
| | - J Chen
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
| | - N Tan
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
| | - P He
- Guangdong Provincial Cardiovascular Institute, Guangzhou, China
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22
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Shalmon T, Hamad F, Jimenez-Juan L, Kirpalani A, Urzua Fresno C, Folador L, Tan N, Singh S, Ge Y, Dorian P, Wong K, Deva D, Yan A. COMPARATIVE PROGNOSTIC SIGNIFICANCE OF DIFFERENT METHODS OF SCAR QUANTIFICATION IN PATIENTS RECEIVING IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS. Can J Cardiol 2020. [DOI: 10.1016/j.cjca.2020.07.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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23
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Tan N, Holmes NE, Chua KY, Stewardson AJ, Trubiano JA. Long-term impacts of antibiotic allergy testing on patient perceptions and antibiotic utilization. JAC Antimicrob Resist 2019; 1:dlz058. [PMID: 34222932 PMCID: PMC8210220 DOI: 10.1093/jacamr/dlz058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 05/27/2019] [Revised: 08/14/2019] [Accepted: 09/01/2019] [Indexed: 12/17/2022] Open
Abstract
Objectives To define the long-term impacts of antibiotic allergy testing (AAT) on patient allergy perception and antibiotic utilization. Methods Patients were identified from a prospective AAT database as having completed testing during a 15 month period beginning January 2017. Patients were contacted for a follow-up survey at least 12 months post-AAT. For those contacted, baseline demographics, antibiotic allergy label (AAL) history, age-adjusted Charlson comorbidity index, infection history, antibiotic de-labelling (≥1 AAL removed following AAT) and antibiotic usage for 12 months prior to testing (pre-AAT) and 12 months following testing (post-AAT) were recorded for each patient. Results From the follow-up survey of 112 patients post-AAT, 95.2% (59/62) of patients with complete AAL removal expressed willingness to use ‘de-labelled’ antibiotics and 91.9% (57/62) were adherent to allergy label modification. Comparing antibiotic utilization 12 months pre-AAT versus 12 months post-AAT, AAT was associated with a significant increase in preferred antibiotic therapy [adjusted odds ratio (aOR) 3.29, 95% CI 1.56–6.92] and reduction in restricted antibiotic utilization (aOR 0.42, 95% CI 0.19–0.93). Conclusions An antimicrobial stewardship (AMS)-led AAT programme was safe and effective in the long term in the promotion of preferred and narrow-spectrum antibiotic usage, and favourable patient perception towards the AAT testing results was identified. This study further supports the routine incorporation of AAT into AMS programmes, confirming safety and durability of testing impacts on patients as well as increasing preferred antibiotic utilization.
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Affiliation(s)
- N Tan
- Department of Infectious Diseases and Centre for Antibiotic Allergy and Research, Austin Hospital, VIC, Melbourne, Australia
| | - N E Holmes
- Department of Infectious Diseases and Centre for Antibiotic Allergy and Research, Austin Hospital, VIC, Melbourne, Australia
| | - K Y Chua
- Department of Infectious Diseases and Centre for Antibiotic Allergy and Research, Austin Hospital, VIC, Melbourne, Australia
| | - A J Stewardson
- Department of Infectious Diseases, Alfred Health and Central Clinical School, Monash University, VIC, Melbourne, Australia
| | - J A Trubiano
- Department of Infectious Diseases and Centre for Antibiotic Allergy and Research, Austin Hospital, VIC, Melbourne, Australia.,Department of Medicine, University of Melbourne, VIC, Melbourne, Australia.,The National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, VIC, Melbourne, Australia
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24
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Yang XR, Wu XP, Li CF, Tan N, Huang JJ, Zhang SY, Zheng H. [Mesothelial/monocytic incidental cardiac excrescences: report of a case]. Zhonghua Bing Li Xue Za Zhi 2019; 48:818-820. [PMID: 31594052 DOI: 10.3760/cma.j.issn.0529-5807.2019.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- X R Yang
- Department of Pathology, Affiliated Hospital of Zunyi Medical University, Guizhou Province, Zunyi 563000, China
| | - X P Wu
- Department of Ultrasound, Affiliated Hospital of Zunyi Medical University, Guizhou Province, Zunyi 563000, China
| | - C F Li
- Department of Pathology, Affiliated Hospital of Zunyi Medical University, Guizhou Province, Zunyi 563000, China
| | - N Tan
- Department of Pathology, Affiliated Hospital of Zunyi Medical University, Guizhou Province, Zunyi 563000, China
| | - J J Huang
- Department of Pathology, Affiliated Hospital of Zunyi Medical University, Guizhou Province, Zunyi 563000, China
| | - S Y Zhang
- Department of Pathology, Affiliated Hospital of Zunyi Medical University, Guizhou Province, Zunyi 563000, China
| | - H Zheng
- Department of Pathology, Affiliated Hospital of Zunyi Medical University, Guizhou Province, Zunyi 563000, China
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25
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Tan N, Allan K, Lin S, Lebovic G, Angaran P, Dorian P. CANADIAN TRENDS IN UTILIZATION OF CARDIAC INTERVENTIONS FOLLOWING OUT-OF-HOSPITAL CARDIAC ARREST: EVIDENCE FOR SUBSTANTIAL UNDERUSE. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.565] [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] Open
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26
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Coyle P, Tan N, Jonas N. Sleep disordered breathing and dysphonia in a pediatric patient - Laryngeal amyloidosis as an unusual diagnosis. Int J Pediatr Otorhinolaryngol 2019; 122:44-46. [PMID: 30959336 DOI: 10.1016/j.ijporl.2019.03.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/21/2019] [Accepted: 03/22/2019] [Indexed: 11/30/2022]
Abstract
Primary laryngeal amyloidosis is an uncommon condition, and cases in the pediatric population are even rarer. We present a case of a nine year old female patient who presented with sleep disordered breathing and dysphonia to our outpatient clinic. The patient underwent Microlaryngoscopy and Bronchoscopy for diagnosis which identified a large soft tissue mass in the supraglottis. After Histological diagnosis was made, she had subtotal debridement of the mass and has maintained a good exercise tolerance with no airway compromise.
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Affiliation(s)
- P Coyle
- Department of Pediatric ENT, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - N Tan
- Department of Pediatric ENT, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - N Jonas
- Department of Pediatric ENT, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK.
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Wei XB, Liu YH, Huang JL, Chen XL, Yu DQ, Tan N, Chen JY, He PC. Prediabetes and diabetes are both risk factors for adverse outcomes in infective endocarditis. Diabet Med 2018; 35:1499-1507. [PMID: 29908070 DOI: 10.1111/dme.13761] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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] [Accepted: 06/13/2018] [Indexed: 12/23/2022]
Abstract
AIM Diabetes is a risk factor in infective endocarditis. However, few studies have focused on the prognostic value of prediabetes in infective endocarditis. This analysis aimed to explore the relationship between prediabetes and outcomes for people with infective endocarditis. METHODS Diabetes and prediabetes definitions were based on the American Diabetes Association 2014 criteria. A total of 866 people who had been consecutively diagnosed with infective endocarditis between January 2009 and July 2015 were included in the analysis. They were divided into three groups: normoglycaemia (n = 469), prediabetes (n = 246) and diabetes (n = 151). Univariate and multivariate analyses were used to identify risk factors for adverse outcomes. RESULTS Overall in-hospital mortality was 8.5% (74 of 866), and differed significantly among the normoglycaemia, prediabetes and diabetes groups (3.4%, 12.6% and 17.9%, respectively; P < 0.001). Compared with the normoglycaemia group, the adjusted odds ratio for in-hospital death was 2.42 [95% confidence interval (CI) 1.11-5.31; P = 0.027) for prediabetes and 3.39 (95% CI 1.48-7.80; P = 0.004) for diabetes. The cumulative long-term death rate was significantly higher in the prediabetes or diabetes groups than in the normoglycaemia group (log-rank = 34.82; P < 0.001). CONCLUSION In addition to diabetes, prediabetes was also associated with a higher risk of in-hospital and long-term mortality among people with infective endocarditis. Therefore, attention should be paid to this population.
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Affiliation(s)
- X-B Wei
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Y-H Liu
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - J-L Huang
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - X-L Chen
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - D-Q Yu
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - N Tan
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - J-Y Chen
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - P-C He
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Department of Cardiology, Second People's Hospital of Nanhai District, Guangdong General Hospital's Nanhai Hospital, Foshan, China
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Tan N, Acheson J, Ali N. Giant cell arteritis in patients of Indian Subcontinental descent in the UK. Eye (Lond) 2018; 33:459-463. [PMID: 30315264 DOI: 10.1038/s41433-018-0220-2] [Citation(s) in RCA: 4] [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] [Received: 02/12/2018] [Revised: 07/30/2018] [Accepted: 08/30/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND GCA in the Indian Subcontinent (ISC) is rare. Our centre in London, UK, serves an ethnically diverse population, including a significant population of patients of ISC descent. We hypothesise that patients of ISC descent are no less likely than others to present with symptoms suggestive of GCA and therefore to undergo temporal artery biopsy (TAB). METHOD A retrospective audit of all TABs performed at our institution over an 8 year period, to identify ethnicity (white, black, ISC, other, unknown) and biopsy result. We compared the proportion of all patients of ISC descent attending the ED to the proportion of ISC patients undergoing TAB. We compared the proportion of positive TABs among ISC patients with positive TABs among white patients. We also compared the proportion of TAB in ISC patients with all non-ISC ethnicities combined. RESULTS The proportion of patients undergoing TAB who were of ISC descent (16.3% of 92) was comparable to the proportion of A&E attendances made up by ISC patients [p = 0.1339]. 3.8% (1/26) of positive biopsies were among patients of ISC descent. White patients were significantly more likely to have a positive biopsy than patients of ISC ethnicity (33% of 61 white patients vs. 7% of 15 ISC [p = 0.0456]), as were patients of non-ISC ethnicity (32.5% of 77 non-ISC patients vs. 7% of 15 ISC patients [p = 0.0464]). DISCUSSION At our centre, biopsy proven GCA occurs in patients of ISC descent, but rarely. Full investigation for GCA continues to be appropriate where it is suspected, regardless of ethnicity.
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Affiliation(s)
- N Tan
- Moorfields Eye Hospital, London, UK.
| | - J Acheson
- National Hospital for Neurology and Neurosurgery, London, UK
| | - N Ali
- Moorfields Eye Hospital, London, UK
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Gong I, Tan N, Ali S, Lebovic G, Mamdani M, Goodman S, Ko D, Laupacis A, Yan A. TEMPORAL TRENDS OF WOMEN REPRESENTATION IN MAJOR CARDIOVASCULAR RANDOMIZED CLINICAL TRIALS. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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30
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Zhang W, Tan N, Hou D, Lin YW, Yan XM, Gao Y, He DX, Jiang M, Wang J. Preparation, adsorption and recognition properties of uranyl ion-imprinted marine facultative fungus mainly modified by phytic acid and tetraethyl silicate. J Radioanal Nucl Chem 2018. [DOI: 10.1007/s10967-018-5937-7] [Citation(s) in RCA: 3] [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: 11/28/2022]
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31
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Iqbal R, Seixas A, Chery K, Tan N, Sanchez L, Jean-Louis G. 0579 Feasibility and Accuracy of Home-Based Sleep Studies among Blacks at Risk for Sleep Apnea: A Scoping Review. Sleep 2018. [DOI: 10.1093/sleep/zsy061.578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- R Iqbal
- New York University School of Medicine, New York, NY
| | - A Seixas
- New York University School of Medicine, New York, NY
| | - K Chery
- New York University School of Medicine, New York, NY
| | - N Tan
- NYU Langone Health, NY, NY
| | | | - G Jean-Louis
- New York University School of Medicine, New York, NY
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Low T, Chan S, Wai S, Zhou A, Kyu K, Lee K, Ching A, Comer S, Tan N, Thong E, Nang T, Dutta M, Lam C. The Women’s Heart Health Programme: A Pilot Trial Of Sex-Specific Cardiovascular Management. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.01.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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33
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Zem GC, Chimayan A, Aleksanyan V, Gordon J, Gomez F, Seyedroudbari A, Chang J, Botello T, Tan N, Arefin D, Tobar D, Khachekian A, Gama L, Durodola E, Batty J, Plascencia C, Barillas L, Roverud A, Kreuz S, Sarkisyan L, Lee F, Munoz J, Reque L, Abed V, Kinog L, Oppenheimer SB. A kinetic assay for non‐automated drug screening. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.531.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - A Chimayan
- California State University NorthridgeNorthridgeCA
| | - V Aleksanyan
- California State University NorthridgeNorthridgeCA
| | - J Gordon
- California State University NorthridgeNorthridgeCA
| | - F Gomez
- California State University NorthridgeNorthridgeCA
| | | | - J Chang
- California State University NorthridgeNorthridgeCA
| | - T Botello
- California State University NorthridgeNorthridgeCA
| | - N Tan
- California State University NorthridgeNorthridgeCA
| | - D Arefin
- California State University NorthridgeNorthridgeCA
| | - D Tobar
- California State University NorthridgeNorthridgeCA
| | - A Khachekian
- California State University NorthridgeNorthridgeCA
| | - L Gama
- California State University NorthridgeNorthridgeCA
| | - E Durodola
- California State University NorthridgeNorthridgeCA
| | - J Batty
- California State University NorthridgeNorthridgeCA
| | - C Plascencia
- California State University NorthridgeNorthridgeCA
| | - L Barillas
- California State University NorthridgeNorthridgeCA
| | - A Roverud
- California State University NorthridgeNorthridgeCA
| | - S Kreuz
- California State University NorthridgeNorthridgeCA
| | - L Sarkisyan
- California State University NorthridgeNorthridgeCA
| | - F Lee
- California State University NorthridgeNorthridgeCA
| | - J Munoz
- California State University NorthridgeNorthridgeCA
| | - L Reque
- California State University NorthridgeNorthridgeCA
| | - V Abed
- California State University NorthridgeNorthridgeCA
| | - L Kinog
- California State University NorthridgeNorthridgeCA
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Seman M, Tan N, Karanatsios B, Simons K, Long C, Cox N, Neil C. Comparison of Measures of Rehospitalisation Burden in Heart Failure with Reduced versus Preserved Ejection Fraction. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.101] [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]
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35
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Tan N, Ali S, Lebovic G, Mamdani M, Laupacis A, Yan A. TEMPORAL TRENDS IN USE OF COMPOSITE ENDPOINTS IN MAJOR CARDIOVASCULAR RANDOMIZED CLINICAL TRIALS. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.206] [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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36
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Gulsoy Toplan G, Tan N, Bilgin M, Gulec M, Tan E. Antibacterial activities of Teucrium kotschyanum from Turkey. Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- G Gulsoy Toplan
- Department of Pharmacognosy, Faculty of Pharmacy, Istanbul University, Istanbul, ISTANBUL, Turkey
| | - N Tan
- Department of Pharmacognosy, Faculty of Pharmacy, Istanbul University, Istanbul, ISTANBUL, Turkey
| | - M Bilgin
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Istanbul Yeni Yuzy? l University, ISTANBUL, Turkey
| | - M Gulec
- Department of Pharmacognosy, Faculty of Pharmacy, Istanbul University, Istanbul, ISTANBUL, Turkey
| | - E Tan
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Istanbul Yeni Yuzy? l University, ISTANBUL, Turkey
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Tan N, Wu C, Jain S. A comparative study of adjustable and non-adjustable sutures in primary horizontal muscle surgery in children. Eye (Lond) 2017; 31:1746-1747. [PMID: 28776590 DOI: 10.1038/eye.2017.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- N Tan
- Department of Ophthalmology, Royal Free Hampstead NHS Trust, London, UK
| | - C Wu
- Whittington Health NHS Trust, London, UK
| | - S Jain
- Department of Ophthalmology, Royal Free Hampstead NHS Trust, London, UK.,University College London Medical School, London, UK
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Naksuk N, Yogeswaran V, Tan N, Lekhakul A, El-Harasis M, Gaba P, Kella D, Kapa S, McLeod C. P6412Right ventricular dysfunction is a major predictor of sudden cardiac death in patients with acute cardiac illness. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6412] [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: 11/14/2022] Open
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39
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Liu Y, Liu YH, Bei WJ, Wang K, Cui TT, Li HL, Wu DX, Chen SQ, Tan N, Chen JY. A dual-label time-resolved fluorescence immunoassay for the simultaneous determination of cystatin C and β2-microglobulin in urine. Br J Biomed Sci 2017; 74:193-197. [PMID: 28730872 DOI: 10.1080/09674845.2017.1334740] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Y Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Key Laboratory of Coronary Disease, Guangdong General Hospital, Guangzhou, China
| | - YH Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Key Laboratory of Coronary Disease, Guangdong General Hospital, Guangzhou, China
| | - WJ Bei
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Key Laboratory of Coronary Disease, Guangdong General Hospital, Guangzhou, China
| | - K Wang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Key Laboratory of Coronary Disease, Guangdong General Hospital, Guangzhou, China
| | - TT Cui
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Key Laboratory of Coronary Disease, Guangdong General Hospital, Guangzhou, China
| | - HL Li
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Key Laboratory of Coronary Disease, Guangdong General Hospital, Guangzhou, China
| | - DX Wu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Key Laboratory of Coronary Disease, Guangdong General Hospital, Guangzhou, China
| | - SQ Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Key Laboratory of Coronary Disease, Guangdong General Hospital, Guangzhou, China
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health and Tropical Medicine Southern Medical University, Guangzhou, China
- Department of Biostatistics, South China College of Cardiovascular Research, Guangdong Society of Interventional Cardiology, Guangzhou, China
| | - N Tan
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Key Laboratory of Coronary Disease, Guangdong General Hospital, Guangzhou, China
| | - JY Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Key Laboratory of Coronary Disease, Guangdong General Hospital, Guangzhou, China
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Malhotra R, Bautista M, Tan N, Tang W, Tay S, Tan A, Pouliot A, Vaillancourt R. ADD A LANGUAGE! ADD A PICTURE!—IMPROVING PRESCRIPTION MEDICATION LABELS FOR ELDERLY SINGAPOREANS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- R. Malhotra
- Health Services and Systems Research (HSSR), and Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore, Singapore,
| | - M.C. Bautista
- Health Services and Systems Research (HSSR), and Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore, Singapore,
| | - N. Tan
- SingHealth Polyclinics, Singapore, Singapore,
| | - W. Tang
- National Healthcare Group Polyclinics, Singapore, Singapore,
| | - S. Tay
- SingHealth Polyclinics, Singapore, Singapore,
| | - A. Tan
- National Healthcare Group HQ, Regional Health, Singapore, Singapore,
| | - A. Pouliot
- Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - R. Vaillancourt
- Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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Richards S, Seixas A, Chung D, Nunes J, Grandner M, Zizi F, Tan N, Jean-Louis G. 1150 SLEEP IMPACTS QUALITY OF LIFE AND NEUROCOGNITIVE CHARACTERISTICS OF BLACK AND HISPANIC STROKE SURVIVORS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.1149] [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
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Shi Y, Tan N, Zhang N, Xiong L, Peng S, Lin J, Chen M, Xiao Y. Predictors of proton pump inhibitor failure in non-erosive reflux disease: A study with impedance-pH monitoring and high-resolution manometry. Neurogastroenterol Motil 2016; 28:674-9. [PMID: 26768192 DOI: 10.1111/nmo.12763] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 11/27/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Approximately one-third of gastroesophageal reflux disease (GERD) patients have symptoms resistant to proton pump inhibitor (PPI). We used the high-resolution manometry (HRM) and multichannel intraluminal impedance-pH (MII-pH) monitoring to investigate potential predictors of PPI failure in non-erosive reflux disease (NERD) patients. METHODS One hundred and seventeen NERD patients were included, within which there were 44 PPI failure patients. The symptomatic questionnaire GerdQ, HRM and 24-hour MII-pH monitoring were performed before PPI therapy. PPI failure was defined as persistent reflux symptoms for more than 1 day during the last week on esomeprazole (20 mg twice daily) for continuous 4 weeks. The predictors for PPI failure were investigated by multivariable logistic regression analysis. KEY RESULTS Proton pump inhibitor failure patients had lower body mass index (BMI) and more concomitant functional dyspepsia (FD) symptoms. PPI failure patients had a higher percentage of type I esophagogastric junction (EGJ) morphology (p = 0.005), increased EGJ augmentation (p = 0.000), higher prevalence of esophageal motility disorders (p = 0.005) and a higher ratio of negative symptom index (SI, p = 0.000). Multivariable regression analysis showed that concomitance of FD symptoms, EGJ augmentation and negative SI were independent risk factors for PPI failure in NERD. CONCLUSIONS & INFERENCES Approximately half of PPI failure patients were found to have esophageal motility disorders in HRM. The independent risk factors for PPI failure in NERD were concomitant FD symptoms, increased EGJ augmentation and negative SI.
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Affiliation(s)
- Y Shi
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China.,Department of Gastroenterology, Shanxi Cancer Hospital, Taiyuan, Shanxi Province, China
| | - N Tan
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - N Zhang
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - L Xiong
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - S Peng
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - J Lin
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - M Chen
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Y Xiao
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
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Munjal K, Belachew A, Tan N, Morrison J, Kong C, Drake A, Chapin H, Redlener M, Ming K, Ngai G, Fierstein J, Richardson L. 136 Retrospective Application of a Low Acuity Emergency Medical Services Triage Protocol to Identify Patients Appropriate for Urgent Care. Ann Emerg Med 2015. [DOI: 10.1016/j.annemergmed.2015.07.168] [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: 11/28/2022]
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Hou D, Chen F, Yang SK, Yan XM, Long W, Zhang W, Jia XH, Tan N. Study on uranium(VI) biosorption of marine-derived fungus treated by cetyltrimethyl ammonium bromide. J Radioanal Nucl Chem 2015. [DOI: 10.1007/s10967-015-4303-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Liu Y, Liu YH, Chen JY, Tan N, Li HL, Luo JF, Chen ZJ, Yu DQ, Li G, Huang WH, Xie NJ, He PC, Yang JQ, Duan CY, Chen SQ, Chen PY. Renal function-adjusted safe contrast volume to prevent contrast-induced nephropathy and poor long-term outcomes in patients with chronic total occlusions undergoing cardiac catheterization. Eur Heart J Suppl 2015. [DOI: 10.1093/eurheartj/suv027] [Citation(s) in RCA: 3] [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: 12/21/2022]
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Liu Y, Liu YH, Tan N, Chen JY, Zhou YL, Duan CY, Li HL, Chen PY. Novel risk scoring for pre-procedural prediction of contrast-induced nephropathy and poor long-term outcomes among patients with chronic total occlusion undergoing percutaneous coronary intervention. Eur Heart J Suppl 2015. [DOI: 10.1093/eurheartj/suv042] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Liu YH, Liu Y, Chen JY, Tan N. ASSA14-12-05 The ratio of contrast volume to creatinine clearance predicts contrast-induced nephropathy and long-term outcomes in patients with chronic total occlusions undergoing cardiac catheterization. Heart 2015. [DOI: 10.1136/heartjnl-2014-307109.94] [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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Wang J, Tan N, Xiao Y, Chen J, Chen B, Ma Z, Zhang D, Chen M, Cui Y. Safety and efficacy of the modified peroral endoscopic myotomy with shorter myotomy for achalasia patients: a prospective study. Dis Esophagus 2014; 28:720-7. [PMID: 25214469 DOI: 10.1111/dote.12280] [Citation(s) in RCA: 43] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Peroral endoscopic myotomy (POEM) has been developed as a minimally invasive endoscopic treatment for achalasia for years. However, the optimal length of submucosal tunnel and myotomy of muscle bundles during procedure of POEM has not yet been determined, so we aim to assess safety and efficacy of modified POEM with shorter myotomy of muscle bundles in achalasia patients. Consecutive achalasia patients had been performed modified POEM with shorter myotomy, and assessed by symptoms, high-resolution manometry, and barium swallow examinations before and 3 months after POEM for safety and efficacy evaluation. Modified POEM with shorter submucosal tunnel (mean length 6.8 cm) and endoscopic myotomy of muscle bundles (total mean length 5.4 cm) were completed in 46 consecutive achalasia patients. During the 3-month follow up in all cases, significant improvement of symptoms (a significant drop in the Eckardt score 8.4 ± 3.2 vs. 2.7 ± 1.9; P < 0.001), decreased lower esophageal sphincter pressure (39.4 ± 10.1 vs. 24.4 ± 9.1 mmHg; P < 0.001) and integrated relaxation pressure (38.6 ± 10.4 vs. 25.7 ± 9.6 mmHg; P < 0.01), and a drop in height of esophagus barium-contrast column (5.4 ± 3.1 vs. 2.6 ± 1.8 cm; P < 0.001) were observed. The frequencies of adverse events were lower in those under endotracheal anesthesia and CO2 insufflations compared with intravenous anesthesia and air insufflations. Only three patients were found to have gastroesophageal reflux disease on follow up. Modified POEM with shorter myotomy under endotracheal anesthesia and CO2 insufflations shows its good safety and excellent short-term efficacy in the treatment of achalasia. But further studies are warranted to assess the long-term efficacy.
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Affiliation(s)
- J Wang
- Department of Gastroenterology and Hepatology, and Endoscopy Center, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - N Tan
- Department of Gastroenterology and Hepatology, and Endoscopy Center, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Y Xiao
- Department of Gastroenterology and Hepatology, and Endoscopy Center, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - J Chen
- Department of Gastroenterology and Hepatology, and Endoscopy Center, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - B Chen
- Department of Gastroenterology and Hepatology, and Endoscopy Center, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Z Ma
- Digestive Department, Shantou Central Hospital, Shantou, Guangdong, China
| | - D Zhang
- Digestive Department, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | - M Chen
- Department of Gastroenterology and Hepatology, and Endoscopy Center, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Y Cui
- Department of Gastroenterology and Hepatology, and Endoscopy Center, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
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Tan N, van Os J. [The schizophrenia spectrum and other psychotic disorders in the DSM-5]. Tijdschr Psychiatr 2014; 56:167-172. [PMID: 24643825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND This article discusses changes made in the diagnostic criteria for psychotic disorders in the transition from DSM-IV to DSM-5. AIM To review and evaluate the changes incorporated in the DSM-5 criteria for psychotic disorders. METHOD Relevant documents and proceedings were reviewed on the basis of personal experience in the APA working group on psychotic disorders. RESULTS The chapter on the 'schizophrenia spectrum and other psychotic disorders' in DSM-5 introduces a conceptual psychosis continuum, in which the level, number and duration of psychotic signs and symptoms are used to differentiate between various forms of psychotic disorders. The chapter includes only a few marginal adjustments, aimed at simplifying usage and measurement-based treatment. The DSM-5 Committee also aspired for harmonization with the ICD. The Committee was in favor of a new name for schizophrenia, but referred the matter to the WHO. The empirical basis for 'attentuated psychosis syndrome' was found to be insufficient for the syndrome to be included as a diagnosis. The most important changes in the criteria for schizophrenia are the elimination of the classic subtypes, the clarification of cross-sectional and longitudinal course specifiers, the elimination of special status of Schneiderian first-rank symptoms, and the clarification and better delineation of schizophrenia in terms of: a) the relationship between schizophrenia and schizoaffective disorders and b) the relationship between schizophrenia and catatonia. In schizoaffective disorder, the perspective shifts from an episode diagnosis in DSM-IV to a life course for the illness in DSM-5. Although the committee gave serious consideration to the inclusion of trans-diagnostic dimensions, these have not been included; a factor that precludes more personalised diagnoses, at least for the time being. CONCLUSION The limitations of the classic system of categorical diagnosis are widely acknowledged and serious consideration has been given to the abolition of this type of diagnosis or at least to the possibility of enriching it with a transdiagnostic focus on dimensions of psychopathology. These steps have not been taken in DSM-5 - for the consensus committees this is evidently still a bridge too far.
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Yang SK, Tan N, Yan XM, Chen F, Long W, Lin YC. Thorium(IV) removal from aqueous medium by citric acid treated mangrove endophytic fungus Fusarium sp. #ZZF51. Mar Pollut Bull 2013; 74:213-219. [PMID: 23871201 DOI: 10.1016/j.marpolbul.2013.06.055] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2013] [Revised: 06/23/2013] [Accepted: 06/26/2013] [Indexed: 06/02/2023]
Abstract
Thorium(IV) biosorption is investigated by citric acid treated mangrove endophytic fungus Fussarium sp. #ZZF51 (CA-ZZF51) from South China Sea. The biosorption process was optimized at pH 4.5, equilibrium time 90 min, initial thorium(IV) concentration 50 mg L(-1) and adsorbent dose 0.6 g L(-1) with 90.87% of removal efficiency and 75.47 mg g(-1) of adsorption capacity, which is obviously greater than that (11.35 mg g(-1)) of the untreated fungus Fussarium sp. #ZZF51 for thorium(IV) biosorption under the condition of optimization. The experimental data are analyzed by using isotherm and kinetic models. Kinetic data follow the pseudo-second-order model and equilibrium data agree very well with the Langmuir model. In addition, FTIR analysis indicates that hydroxyl, amino, and carbonyl groups act as the important roles in the adsorption process.
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Affiliation(s)
- S K Yang
- School of Chemistry and Chemical Engineering, University of South China, Hengyang, Hunan 421001, China.
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