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Gaba P, Sabik JF, Murphy SA, Bellavia A, O'Gara PT, Smith PK, Serruys PW, Kappetein AP, Park SJ, Park DW, Christiansen EH, Holm NR, Nielsen PH, Sabatine MS, Stone GW, Bergmark BA. Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Left Main Disease With and Without Diabetes: Findings From a Pooled Analysis of 4 Randomized Clinical Trials. Circulation 2024; 149:1328-1338. [PMID: 38465592 DOI: 10.1161/circulationaha.123.065571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 02/20/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Diabetes may be associated with differential outcomes in patients undergoing left main coronary revascularization with percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). The aim of this study was to investigate outcomes in patients with left main disease with and without diabetes randomized to PCI versus CABG. METHODS Individual patient data were pooled from 4 trials (SYNTAX [Synergy Between PCI With Taxus and Cardiac Surgery], PRECOMBAT [Premier of Randomized Comparison of Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease], NOBLE [Nordic-Baltic-British Left Main Revascularisation Study], and EXCEL [Evaluation of XIENCE Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization]) that randomized patients with left main disease to PCI or CABG. Patients were considered suitable for either approach. Patients were categorized by diabetes status. Kaplan-Meier event rates, Cox model hazard ratios, and interactions were assessed. RESULTS Among 4393 patients, 1104 (25.1%) had diabetes. Patients with diabetes experienced higher rates of 5-year death (158/1104 [Kaplan-Meier rate, 14.7%] versus 297/3289 [9.3%]; P<0.001), spontaneous myocardial infarction (MI; 67/1104 [6.7%] versus 114/3289 [3.7%]; P<0.001), and repeat revascularization (189/1104 [18.5%] versus 410/3289 [13.2%]; P<0.001). Rates of all-cause mortality did not differ after PCI versus CABG in those with (84/563 [15.3%] versus 74/541 [14.1%]; hazard ratio, 1.11 [95% CI, 0.82-1.52]) or without (155/1634 [9.7%] versus 142/1655 [8.9%]; hazard ratio, 1.08 [95% CI, 0.86-1.36; PintHR=0.87) diabetes. Rates of stroke within 1 year were lower with PCI versus CABG in the entire population, with no heterogeneity based on diabetes status (PintHR=0.51). The 5-year rates of spontaneous MI and repeat coronary revascularization were higher after PCI regardless of diabetes status (spontaneous MI: 45/563 [8.9%] versus 22/541 [4.4%] in diabetes and 82/1634 [5.3%] versus 32/1655 [2.1%] in no diabetes, PintHR=0.47; repeat revascularization: 127/563 [24.5%] versus 62/541 [12.4%] in diabetes and 254/1634 [16.3%] versus 156/1655 [10.1%] in no diabetes, PintHR=0.18). For spontaneous MI and repeat revascularization, there were greater absolute risk differences beyond 1 year in patients with diabetes (4.9% and 9.9%) compared with those without (2.1% and 4.3%; PintARD=0.047 and 0.016). CONCLUSIONS In patients with left main disease considered equally suitable for PCI or CABG and with largely low to intermediate SYNTAX scores, diabetes was associated with higher rates of death and cardiovascular events through 5 years. Compared with CABG, PCI resulted in no difference in the risk of death and a lower risk of early stroke regardless of diabetes status, and a higher risk of spontaneous MI and repeat coronary revascularization, with larger late absolute excess risks in patients with diabetes. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifiers: NCT01205776, NCT0146651, NCT00422968, and NCT00114972.
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Affiliation(s)
- Prakriti Gaba
- TIMI Study Group, Brigham and Women's Hospital, Boston, MA (P.G., S.A.M., A.B., M.S.S., B.A.B.)
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (P.G., S.A.M., A.B., P.T.O., M.S.S., B.A.B.)
| | - Joseph F Sabik
- Department of Surgery, University Hospitals Cleveland Medical Center, OH (J.F.S.)
| | - Sabina A Murphy
- TIMI Study Group, Brigham and Women's Hospital, Boston, MA (P.G., S.A.M., A.B., M.S.S., B.A.B.)
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (P.G., S.A.M., A.B., P.T.O., M.S.S., B.A.B.)
| | - Andrea Bellavia
- TIMI Study Group, Brigham and Women's Hospital, Boston, MA (P.G., S.A.M., A.B., M.S.S., B.A.B.)
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (P.G., S.A.M., A.B., P.T.O., M.S.S., B.A.B.)
| | - Patrick T O'Gara
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (P.G., S.A.M., A.B., P.T.O., M.S.S., B.A.B.)
| | - Peter K Smith
- Duke University School of Medicine, Duke Clinical Research Institute, Durham, NC (P.K.S)
| | - Patrick W Serruys
- National Heart and Lung Institute, Imperial College London, UK (P.W.S.)
| | - A Pieter Kappetein
- Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands (A.P.K.)
| | - Seung-Jung Park
- Department of Cardiology, Asan Medical Center, Seoul, South Korea (S.-J.P., D.-W.P.,)
| | - Duk-Woo Park
- Department of Cardiology, Asan Medical Center, Seoul, South Korea (S.-J.P., D.-W.P.,)
| | - Evald H Christiansen
- Department of Cardiology, Aarhus, Aarhus University Hospital, Denmark (E.H.C., N.R.H., P.H.N.)
| | - Niels R Holm
- Department of Cardiology, Aarhus, Aarhus University Hospital, Denmark (E.H.C., N.R.H., P.H.N.)
| | - Per H Nielsen
- Department of Cardiology, Aarhus, Aarhus University Hospital, Denmark (E.H.C., N.R.H., P.H.N.)
| | - Marc S Sabatine
- TIMI Study Group, Brigham and Women's Hospital, Boston, MA (P.G., S.A.M., A.B., M.S.S., B.A.B.)
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (P.G., S.A.M., A.B., P.T.O., M.S.S., B.A.B.)
| | - Gregg W Stone
- The Zena and Michael A Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (G.W.S.)
| | - Brian A Bergmark
- TIMI Study Group, Brigham and Women's Hospital, Boston, MA (P.G., S.A.M., A.B., M.S.S., B.A.B.)
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (P.G., S.A.M., A.B., P.T.O., M.S.S., B.A.B.)
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Conti DM, Hellings PW, Smith PK, Scadding GK. A EUFOREA Comment In Reference to Cost-Effectiveness Analysis of Inferior Turbinate Reduction and Immunotherapy in Allergic Rhinitis. Laryngoscope 2024; 134:E12-E13. [PMID: 38153194 DOI: 10.1002/lary.31246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 12/29/2023]
Affiliation(s)
- Diego M Conti
- The European Forum for Research and Education in Allergy and Airway Diseases Scientific Expert Team Members, Brussels, Belgium
| | - Peter W Hellings
- Department of Otorhinolaryngology, And Laboratory of Allergy and Clinical Immunology, University of Leuven, Leuven, Belgium
- Upper Airways Disease Laboratory, University of Ghent, Ghent, Belgium
| | - Peter K Smith
- School of Medicine, Griffith University, Southport, Queensland, Australia
| | - Glenis K Scadding
- Department of Allergy & Rhinology, Royal National ENT Hospital, London, UK
- Division of Immunity and Infection, University College, London, UK
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Baroody FM, Gevaert P, Smith PK, Ziaie N, Bernstein JA. Nonallergic Rhinopathy: A Comprehensive Review of Classification, Diagnosis, and Treatment. J Allergy Clin Immunol Pract 2024:S2213-2198(24)00270-8. [PMID: 38467330 DOI: 10.1016/j.jaip.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 03/13/2024]
Abstract
Chronic nonallergic rhinitis syndromes encompass various conditions, of which vasomotor rhinitis is the most common form, representing approximately 80% of patients, also referred to as nonallergic rhinopathy (NAR), nasal hyperreactivity, neurogenic rhinitis, or idiopathic rhinitis. Expert panels have recommended replacing vasomotor rhinitis terminology because it is more descriptive of this condition that is characterized by symptoms triggered by chemical irritants and weather changes through chemosensors, mechanosensors, thermosensors, and/or osmosensors activated through different transient receptor potential calcium ion channels. Elucidating the specific role of transient receptor potential vanilloid 1, triggered by capsaicin, has been an important advancement in better understanding the pathophysiology of NAR because it has now been shown that downregulation of transient receptor potential vanilloid 1 receptors by several therapeutic compounds provides symptomatic relief for this condition. The classification of NAR is further complicated by its association with allergic rhinitis referred to as mixed rhinitis, which involves both immunoglobulin E-mediated and neurogenic mechanistic pathways. Comorbidities associated with NAR, including rhinosinusitis, headaches, asthma, chronic cough, and sleep disturbances, underscore the need for comprehensive management. Treatment options for NAR include environmental interventions, pharmacotherapy, and in refractory cases, surgical options, emphasizing the need for a tailored approach for each patient. Thus, it is extremely important to accurately diagnose NAR because inappropriate therapies lead to poor clinical outcomes and unnecessary health care and economic burdens for these patients. This review provides a comprehensive overview of NAR subtypes, focusing on classification, diagnosis, and treatment approaches for NAR.
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Affiliation(s)
- Fuad M Baroody
- Section of Otolaryngology-Head and Neck Surgery, University of Chicago Medicine, Chicago, Ill
| | - Philippe Gevaert
- Upper Airways Research Laboratory, Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Peter K Smith
- Department of Surgery-Otolaryngology-Head and Neck, School of Medicine, Griffith University, Southport, Queensland, Australia
| | - Navid Ziaie
- Department of Internal Medicine, Division of Rheumatology, Allergy and Immunology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Jonathan A Bernstein
- Department of Internal Medicine, Division of Rheumatology, Allergy and Immunology, University of Cincinnati College of Medicine, Cincinnati, Ohio.
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Willems RA, Smith PK, Culbert C, Purdy N, Hamilton J, Völlink T, Scheithauer H, Fiedler N, Brighi A, Menin D, Mameli C, Guarini A. Internet Use and Perceived Parental Involvement among Adolescents from Lower Socioeconomic Groups in Europe: An Exploration. Children (Basel) 2023; 10:1780. [PMID: 38002871 PMCID: PMC10670471 DOI: 10.3390/children10111780] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023]
Abstract
Internet usage is a salient developmental factor in adolescents' lives. Although relevant correlates of Internet use have been documented earlier, there is a lack of information on lower socioeconomic status groups. This is important, as these adolescents have increased risk of negative online experiences. The current survey aimed to explore Internet use and parental involvement amongst adolescents from areas of socio-economic disadvantage in 30 urban schools across five European countries. A total of 2594 students participated, of whom 90% were 14-16 years. Virtually all adolescents of socioeconomic disadvantage had Internet access, with 88.5% reporting spending more than two hours per day online, often on apps such as Instagram, Snapchat, and YouTube. Almost one-third of adolescents did not talk with their parents about their Internet use and almost two-thirds indicated that their parents were only a little or not interested in their Internet use. A consistent finding across countries was that girls more often talked with their parents about their Internet use and more often reported that their parents were interested in their Internet use than boys. The results suggest that parents have an important task in explicitly showing interest in their adolescents' Internet use, with special attention needed for boys.
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Affiliation(s)
- Roy A. Willems
- Department of Psychology, Open Universiteit, 6419 AT Heerlen, The Netherlands;
| | - Peter K. Smith
- Department of Psychology, Goldsmiths, University of London, London SE14 6NW, UK; (P.K.S.); (C.C.)
| | - Catherine Culbert
- Department of Psychology, Goldsmiths, University of London, London SE14 6NW, UK; (P.K.S.); (C.C.)
| | - Noel Purdy
- Centre for Research in Educational Underachievement, Stranmillis University College, Belfast BT9 5DY, UK;
| | - Jayne Hamilton
- School of Social Sciences, Education and Social Work, Queen’s University, Belfast BT7 1PS, UK;
| | - Trijntje Völlink
- Department of Psychology, Open Universiteit, 6419 AT Heerlen, The Netherlands;
| | - Herbert Scheithauer
- Department of Education and Psychology, Freie Universität Berlin, 14195 Berlin, Germany; (H.S.); (N.F.)
| | - Nora Fiedler
- Department of Education and Psychology, Freie Universität Berlin, 14195 Berlin, Germany; (H.S.); (N.F.)
| | - Antonella Brighi
- Faculty of Education, Free University of Bolzano, 39042 Bolzano, Italy;
| | - Damiano Menin
- Department of Humanities, University of Ferrara, 44121 Ferrara, Italy;
| | - Consuelo Mameli
- Department of Education Studies “Giovanni Maria Bertin”, University of Bologna, 40126 Bologna, Italy;
| | - Annalisa Guarini
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy;
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Bakaeen FG, Ruel M, Calhoon JH, Girardi LN, Guyton R, Hui D, Kelly RF, MacGillivray TE, Malaisrie SC, Moon MR, Sabik JF, Smith PK, Svensson LG, Szeto WY. STS/AATS-Endorsed Rebuttal to 2023 ACC/AHA Chronic Coronary Disease Guideline: A Missed Opportunity to Present Accurate and Comprehensive Revascularization Recommendations. Ann Thorac Surg 2023; 116:675-678. [PMID: 37530679 DOI: 10.1016/j.athoracsur.2023.02.007] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 02/05/2023] [Indexed: 08/03/2023]
Affiliation(s)
- Faisal G Bakaeen
- Coronary Center, Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.
| | - Marc Ruel
- Division of Cardiac Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - John H Calhoon
- Department of Cardiothoracic Surgery, University of Texas Health Science Center, San Antonio, Texas
| | - Leonard N Girardi
- Department of Cardiothoracic Surgery, NewYork-Presbyterian/Weil Cornell Medical Center, New York, New York
| | - Robert Guyton
- Cardiothoracic Surgery, The Emory Clinic, Inc, Atlanta, Georgia
| | - Dawn Hui
- Department of Cardiothoracic Surgery, University of Texas Health Science Center, San Antonio, Texas
| | - Rosemary F Kelly
- Division of Cardiothoracic Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Thomas E MacGillivray
- Department of Cardiac Surgery, MedStar Heart and Vascular Institute, Washington Hospital Center, Washington, DC
| | | | - Marc R Moon
- Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Texas
| | - Joseph F Sabik
- Department of Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Peter K Smith
- Department of Cardiothoracic Surgery, Duke University, Durham, North Carolina
| | - Lars G Svensson
- Coronary Center, Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Wilson Y Szeto
- Department of Cardiothoracic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
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6
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Bakaeen FG, Ruel M, Calhoon JH, Girardi LN, Guyton R, Hui D, Kelly RF, MacGillivray TE, Malaisrie SC, Moon MR, Sabik JF, Smith PK, Svensson LG, Szeto WY. STS/AATS-endorsed rebuttal to 2023 ACC/AHA Chronic Coronary Disease Guideline: A missed opportunity to present accurate and comprehensive revascularization recommendations. J Thorac Cardiovasc Surg 2023; 166:1115-1118. [PMID: 37530691 DOI: 10.1016/j.jtcvs.2023.03.001] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 02/05/2023] [Indexed: 08/03/2023]
Affiliation(s)
- Faisal G Bakaeen
- Coronary Center, Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.
| | - Marc Ruel
- Division of Cardiac Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - John H Calhoon
- Department of Cardiothoracic Surgery, University of Texas Health Science Center, San Antonio, Tex
| | - Leonard N Girardi
- Department of Cardiothoracic Surgery, NewYork-Presbyterian/Weil Cornell Medical Center, New York, NY
| | - Robert Guyton
- Cardiothoracic Surgery, The Emory Clinic, Inc, Atlanta, Ga
| | - Dawn Hui
- Department of Cardiothoracic Surgery, University of Texas Health Science Center, San Antonio, Tex
| | - Rosemary F Kelly
- Division of Cardiothoracic Surgery, University of Minnesota, Minneapolis, Minn
| | - Thomas E MacGillivray
- Department of Cardiac Surgery, MedStar Heart and Vascular Institute, Washington Hospital Center, Washington, DC
| | | | - Marc R Moon
- Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Tex
| | - Joseph F Sabik
- Department of Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Peter K Smith
- Department of Cardiothoracic Surgery, Duke University, Durham, NC
| | - Lars G Svensson
- Coronary Center, Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Wilson Y Szeto
- Department of Cardiothoracic Surgery, University of Pennsylvania, Philadelphia, Pa
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Scadding GK, Smith PK, Hellings PW. EUFOREA Comment on a Misleading Allergic Rhinitis Report [Letter]. Patient Prefer Adherence 2023; 17:1881-1883. [PMID: 37538315 PMCID: PMC10395507 DOI: 10.2147/ppa.s431247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/05/2023] Open
Affiliation(s)
- Glenis K Scadding
- Department of Allergy & Rhinology, Royal National ENT Hospital; Division of Immunity and Infection, University College, London, UK
| | - Peter K Smith
- Griffith University, School of Medicine, Southport, Queensland, 4215, Australia
| | - Peter W Hellings
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals, Leuven, Belgium
- Upper Airways Research Laboratory, Department of Head and Skin, Ghent University, Ghent, Belgium
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Gaba P, Christiansen EH, Nielsen PH, Murphy SA, O’Gara PT, Smith PK, Serruys PW, Kappetein AP, Park SJ, Park DW, Stone GW, Sabik JF, Sabatine MS, Holm NR, Bergmark BA. Percutaneous Coronary Intervention vs Coronary Artery Bypass Graft Surgery for Left Main Disease in Patients With and Without Acute Coronary Syndromes: A Pooled Analysis of 4 Randomized Clinical Trials. JAMA Cardiol 2023; 8:631-639. [PMID: 37256598 PMCID: PMC10233454 DOI: 10.1001/jamacardio.2023.1177] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/27/2023] [Indexed: 06/01/2023]
Abstract
Importance Patients with left main coronary artery disease presenting with an acute coronary syndrome (ACS) represent a high-risk and understudied subgroup of patients with atherosclerosis. Objective To assess clinical outcomes after PCI vs CABG in patients with left main disease with vs without ACS. Design, Setting, and Participants Data were pooled from 4 trials comparing PCI with drug-eluting stents vs CABG in patients with left main disease who were considered equally suitable candidates for either strategy (SYNTAX, PRECOMBAT, NOBLE, and EXCEL). Patients were categorized as presenting with or without ACS. Kaplan-Meier event rates through 5 years and Cox model hazard ratios were generated, and interactions were tested. Patients were enrolled in the individual trials from 2004 through 2015. Individual patient data from the trials were pooled and reconciled from 2020 to 2021, and the analyses pertaining to the ACS subgroup were performed from March 2022 through February 2023. Main Outcomes and Measures The primary outcome was death through 5 years. Secondary outcomes included cardiovascular death, spontaneous myocardial infarction (MI), procedural MI, stroke, and repeat revascularization. Results Among 4394 patients (median [IQR] age, 66 [59-73] years; 3371 [76.7%] male and 1022 [23.3%] female) randomized to receive PCI or CABG, 1466 (33%) had ACS. Patients with ACS were more likely to have diabetes, prior MI, left ventricular ejection fraction less than 50%, and higher SYNTAX scores. At 30 days, patients with ACS had higher all-cause death (hazard ratio [HR], 3.40; 95% CI, 1.81-6.37; P < .001) and cardiovascular death (HR, 3.21; 95% CI, 1.69-6.08; P < .001) compared with those without ACS. Patients with ACS also had higher rates of spontaneous MI (HR, 1.70; 95% CI, 1.25-2.31; P < .001) through 5 years. The rates of all-cause mortality through 5 years with PCI vs CABG were 10.9% vs 11.5% (HR, 0.93; 95% CI, 0.68-1.27) in patients with ACS and 11.3% vs 9.6% (HR, 1.19; 95% CI, 0.95-1.50) in patients without ACS (P = .22 for interaction). The risk of early stroke was lower with PCI vs CABG (ACS: HR, 0.39; 95% CI, 0.12-1.25; no ACS: HR, 0.35; 95% CI, 0.16-0.75), whereas the 5-year risks of spontaneous MI and repeat revascularization were higher with PCI vs CABG (spontaneous MI: ACS: HR, 1.74; 95% CI, 1.09-2.77; no ACS: HR, 3.03; 95% CI, 1.94-4.72; repeat revascularization: ACS: HR, 1.57; 95% CI, 1.19-2.09; no ACS: HR, 1.90; 95% CI, 1.54-2.33), regardless of ACS status. Conclusion and Relevance Among largely stable patients undergoing left main revascularization and with predominantly low to intermediate coronary anatomical complexity, those with ACS had higher rates of early death. Nonetheless, rates of all-cause mortality through 5 years were similar with PCI vs CABG in this high-risk subgroup. The relative advantages and disadvantages of PCI vs CABG in terms of early stroke and long-term spontaneous MI and repeat revascularization were consistent regardless of ACS status. Trial Registration ClinicalTrials.gov Identifiers: NCT00114972, NCT00422968, NCT01496651, NCT01205776.
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Affiliation(s)
- Prakriti Gaba
- Thrombolysis in Myocardial Infarction (TIMI) Study Group, Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Per H. Nielsen
- Department of Cardiology, Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Sabina A. Murphy
- Thrombolysis in Myocardial Infarction (TIMI) Study Group, Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Patrick T. O’Gara
- Thrombolysis in Myocardial Infarction (TIMI) Study Group, Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Deputy Editor, JAMA Cardiology
| | - Peter K. Smith
- Duke University School of Medicine, Duke Clinical Research Institute, Durham, North Carolina
| | - Patrick W. Serruys
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - A. Pieter Kappetein
- Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Seung-Jung Park
- Department of Cardiology, Asan Medical Center, Seoul, South Korea
| | - Duk-Woo Park
- Department of Cardiology, Asan Medical Center, Seoul, South Korea
| | - Gregg W. Stone
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joseph F. Sabik
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Marc S. Sabatine
- Thrombolysis in Myocardial Infarction (TIMI) Study Group, Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Deputy Editor, JAMA Cardiology
| | - Niels R. Holm
- Department of Cardiology, Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Brian A. Bergmark
- Thrombolysis in Myocardial Infarction (TIMI) Study Group, Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
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Du Preez S, Eaton-Fitch N, Smith PK, Marshall-Gradisnik S. Altered TRPM7-Dependent Calcium Influx in Natural Killer Cells of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients. Biomolecules 2023; 13:1039. [PMID: 37509075 PMCID: PMC10377690 DOI: 10.3390/biom13071039] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023] Open
Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a disabling multisystemic condition. The pathomechanism of ME/CFS remains unestablished; however, impaired natural killer (NK) cell cytotoxicity is a consistent feature of this condition. Calcium (Ca2+) is crucial for NK cell effector functions. Growing research recognises Ca2+ signalling dysregulation in ME/CFS patients and implicates transient receptor potential ion channel dysfunction. TRPM7 (melastatin) was recently considered in the pathoaetiology of ME/CFS as it participates in several Ca2+-dependent processes that are central to NK cell cytotoxicity which may be compromised in ME/CFS. TRPM7-dependent Ca2+ influx was assessed in NK cells isolated from n = 9 ME/CFS patients and n = 9 age- and sex-matched healthy controls (HCs) using live cell fluorescent imaging techniques. Slope (p < 0.05) was significantly reduced in ME/CFS patients compared with HCs following TRPM7 activation. Half-time of maximal response (p < 0.05) and amplitude (p < 0.001) were significantly reduced in the HCs compared with the ME/CFS patients following TRPM7 desensitisation. Findings from this investigation suggest that TRPM7-dependent Ca2+ influx is reduced with agonism and increased with antagonism in ME/CFS patients relative to the age- and sex-matched HCs. The outcomes reported here potentially reflect TRPM3 dysfunction identified in this condition suggesting that ME/CFS is a TRP ion channelopathy.
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Affiliation(s)
- Stanley Du Preez
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute, Griffith University, Gold Coast 4215, Australia
- Consortium Health International for Myalgic Encephalomyelitis, Menzies Health Institute Queensland, Griffith University, Gold Coast 4215, Australia
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast 4215, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast 4215, Australia
| | - Natalie Eaton-Fitch
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute, Griffith University, Gold Coast 4215, Australia
- Consortium Health International for Myalgic Encephalomyelitis, Menzies Health Institute Queensland, Griffith University, Gold Coast 4215, Australia
| | - Peter K Smith
- School of Medicine and Dentistry, Griffith University, Gold Coast 4215, Australia
- Queensland Allergy Services, Gold Coast 4215, Australia
| | - Sonya Marshall-Gradisnik
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute, Griffith University, Gold Coast 4215, Australia
- Consortium Health International for Myalgic Encephalomyelitis, Menzies Health Institute Queensland, Griffith University, Gold Coast 4215, Australia
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10
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Carney AS, Smith PK. Current Understanding of the Role of Eosinophils in CRSwNP and Implications for Treatment with Mepolizumab and Benralizumab. Am J Rhinol Allergy 2023; 37:175-181. [PMID: 36848284 DOI: 10.1177/19458924221149270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
BACKGROUND International consensus statements now subdivide chronic rhinosinusitis (CRS) into several phenotypes and endotypes, including the presence of polyps (CRSwNP) and eosinophilia (eCRSwNP). Biological treatments aimed at blocking eosinophilic inflammation in CRSwNP via interleukin 5 (IL5) or the interleukin 5 receptor (IL5R) have demonstrated limited efficacy thus far. OBJECTIVE To review the pathophysiology of eCRSwNP, the evidence for mepolizumab (anti-IL5) and benralizumab (anti-IL5R) in CRSwNP, and to highlight areas for future research and therapeutic intervention. METHODS Primary and secondary literature search. RESULTS Clinical trials on mepolizumab and benralizumab in CRSwNP are limited and restricted by trial design which prevents direct comparison with other interventions, including surgery. Both agents would appear to provide some benefit in reducing nasal polyp size but limited clinical patient benefit. Molecular biological research highlights that eCRSwNP can occur in the absence of IL5 and that other cells/cytokines play an important part in the disease's pathophysiology. CONCLUSION Blockade of IL5/IL5R alone would appear to provide limited "real life" clinical benefit in patients with CRSwNP due to the complexities of the pathophysiology of the condition. Therapy aimed at several simultaneous cytokine targets has logic but well-designed trials are unlikely to be forthcoming in the short term due to the financial cost and commercial conflicts of interest.
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Affiliation(s)
- A Simon Carney
- College of Medicine and Public Health, 1065Flinders University, Adelaide, South Australia, Australia
| | - Peter K Smith
- School of Medicine and Dentistry, Griffith University, Southport, Queensland, Australia
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11
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Venter C, Smith PK, Fleischer DM. Food allergy prevention: Where are we in 2023? Asia Pac Allergy 2023; 13:15-27. [PMID: 37389093 PMCID: PMC10166243 DOI: 10.5415/apallergy.0000000000000001] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 02/22/2023] [Indexed: 07/01/2023] Open
Abstract
Food allergy prevention involves recommendations to the maternal diet during pregnancy and breast feeding, early life feeding and introduction of solid foods. Pregnant and breastfeeding women are not recommended to exclude any food allergens from their diet, but data are lacking to support active consumption of food allergens for prevention of food allergy. Breastfeeding is recommended for the many health benefits to the mother and child but has not shown any association with reduction in childhood food allergies. There is currently no recommendation regarding the use of any infant formula for allergy prevention, including the use of partially or extensively hydrolyzed formulas. Once the introduction of solid food commences, based on randomized controlled trials, it is advised to actively introduce peanuts and egg early into the infant diet and continue with consumption of these. Although there are limited data with respect to other major food allergens and whether early introduction may prevent allergy development, there is no need to delay the introduction of these allergens into the infant diet. Interpreting food allergen consumption in the context of cultural food practices has not been studied, but it makes sense to introduce the infant to family foods by 1 year of age. Consumption of foods typical of the Western diet and foods high in advanced glycation end products may be associated with an increase in food allergies. Similarly, intake of micronutrients, such as vitamin D and omega-3 fatty acids in both the maternal and infant diet, needs further clarification in the context of food allergy prevention.
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Affiliation(s)
- Carina Venter
- Section of Allergy and Immunology, Department of Pediatrics, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA
| | - Peter K. Smith
- Qld Allergy Services, Southport, QLD, Australia
- Department of Clinical Medicine, Griffith University, Southport, QLD, Australia
| | - David M. Fleischer
- Section of Allergy and Immunology, Department of Pediatrics, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA
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12
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Jawitz OK, Vekstein AM, Young R, Vemulapalli S, Zwischenberger BA, Thibault DP, O'Brien S, Shahian DM, Badhwar V, Thourani VH, Jacobs JP, Smith PK. Comparing Consumer-Directed Hospital Rankings With STS Adult Cardiac Surgery Database Outcomes. Ann Thorac Surg 2023; 115:533-540. [PMID: 35932793 DOI: 10.1016/j.athoracsur.2022.06.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 06/15/2022] [Accepted: 06/27/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Public interest in stratifying hospital performance has led to the proliferation of commercial, consumer-oriented hospital rankings. In cardiac surgery, little is known about how these rankings correlate with clinical registry quality ratings. METHODS The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database was queried for isolated coronary artery bypass grafting or coronary artery bypass grafting/valve patients at hospitals among the top 100 U.S. News & World Report (USNWR) Cardiology & Heart Surgery rankings from 2016 to 2020. Hospitals were grouped into deciles by risk-adjusted observed/expected (O/E) ratios for morbidity and mortality using the STS 2018 risk models. Agreement between STS Adult Cardiac Surgery Database and USNWR ranked deciles was calculated by Bowker symmetry test. The association between each center's annual change in STS O/E ratio and change in USNWR ranking was modeled in repeated measures regression analysis. RESULTS Inclusion criteria were met by 524 393 patients from 149 hospitals that ranked in USNWR top 100 at least once during the study period. There was no agreement between USNWR ranking and STS major morbidity and mortality O/E ratio (P > .50 for all years). Analysis of patients undergoing surgery at the 65 hospitals that were consistently ranked in the top 100 during the study period demonstrated no association between annual change in hospital ranking and change in O/E ratio (P all > .3). CONCLUSIONS There was no agreement between annual USNWR hospital ranking and corresponding risk-adjusted STS morbidity or mortality. Furthermore, annual changes in USNWR rankings could not be accounted for using clinical outcomes. These findings suggest that factors unrelated to key surgical outcomes may be driving consumer-directed rankings.
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Affiliation(s)
- Oliver K Jawitz
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Duke University, Durham, North Carolina; Department of Medicine, Duke Clinical Research Institute, Duke University, Durham, North Carolina.
| | - Andrew M Vekstein
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Duke University, Durham, North Carolina; Department of Medicine, Duke Clinical Research Institute, Duke University, Durham, North Carolina
| | - Rebecca Young
- Department of Medicine, Duke Clinical Research Institute, Duke University, Durham, North Carolina
| | - Sreekanth Vemulapalli
- Department of Medicine, Duke Clinical Research Institute, Duke University, Durham, North Carolina; Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina
| | - Brittany A Zwischenberger
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Duke University, Durham, North Carolina; Department of Medicine, Duke Clinical Research Institute, Duke University, Durham, North Carolina
| | - Dylan P Thibault
- Department of Medicine, Duke Clinical Research Institute, Duke University, Durham, North Carolina
| | - Sean O'Brien
- Department of Medicine, Duke Clinical Research Institute, Duke University, Durham, North Carolina
| | - David M Shahian
- Division of Cardiac Surgery, Department of Surgery, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Vinay Badhwar
- Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia
| | - Vinod H Thourani
- Department of Cardiovascular Surgery, Piedmont Heart Institute, Atlanta, Georgia
| | - Jeffrey P Jacobs
- Division of Cardiovascular Surgery, Department of Surgery, University of Florida Health, Gainesville, Florida
| | - Peter K Smith
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Duke University, Durham, North Carolina
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13
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Bowdish ME, Barkauskas CE, Overbey JR, Gottlieb RL, Osman K, Duggal A, Marks ME, Hupf J, Fernandes E, Leshnower BG, Golob JL, Iribarne A, Rassias AJ, Moquete EG, O’Sullivan K, Chang HL, Williams JB, Parnia S, Patel NC, Desai ND, Vekstein AM, Hollister BA, Possemato T, Romero C, Hou PC, Burke E, Hayes J, Grossman F, Itescu S, Gillinov M, Pagani FD, O’Gara PT, Mack MJ, Smith PK, Bagiella E, Moskowitz AJ, Gelijns AC. A Randomized Trial of Mesenchymal Stromal Cells for Moderate to Severe Acute Respiratory Distress Syndrome from COVID-19. Am J Respir Crit Care Med 2023; 207:261-270. [PMID: 36099435 PMCID: PMC9896641 DOI: 10.1164/rccm.202201-0157oc] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Rationale: There are limited therapeutic options for patients with coronavirus disease (COVID-19)-related acute respiratory distress syndrome with inflammation-mediated lung injury. Mesenchymal stromal cells offer promise as immunomodulatory agents. Objectives: Evaluation of efficacy and safety of allogeneic mesenchymal cells in mechanically-ventilated patients with moderate or severe COVID-19-induced respiratory failure. Methods: Patients were randomized to two infusions of 2 million cells/kg or sham infusions, in addition to the standard of care. We hypothesized that cell therapy would be superior to sham control for the primary endpoint of 30-day mortality. The key secondary endpoint was ventilator-free survival within 60 days, accounting for deaths and withdrawals in a ranked analysis. Measurements and Main Results: At the third interim analysis, the data and safety monitoring board recommended that the trial halt enrollment as the prespecified mortality reduction from 40% to 23% was unlikely to be achieved (n = 222 out of planned 300). Thirty-day mortality was 37.5% (42/112) in cell recipients versus 42.7% (47/110) in control patients (relative risk [RR], 0.88; 95% confidence interval, 0.64-1.21; P = 0.43). There were no significant differences in days alive off ventilation within 60 days (median rank, 117.3 [interquartile range, 60.0-169.5] in cell patients and 102.0 [interquartile range, 54.0-162.5] in control subjects; higher is better). Resolution or improvement of acute respiratory distress syndrome at 30 days was observed in 51/104 (49.0%) cell recipients and 46/106 (43.4%) control patients (odds ratio, 1.36; 95% confidence interval, 0.57-3.21). There were no infusion-related toxicities and overall serious adverse events over 30 days were similar. Conclusions: Mesenchymal cells, while safe, did not improve 30-day survival or 60-day ventilator-free days in patients with moderate and/or severe COVID-19-related acute respiratory distress syndrome.
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Affiliation(s)
- Michael E. Bowdish
- Department of Surgery and Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
| | | | | | | | - Keren Osman
- The Tisch Cancer Institute, Icahn School of Medicine, New York, New York
| | | | | | | | | | | | | | - Alexander Iribarne
- Section of Cardiac Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Athos J. Rassias
- Section of Cardiac Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | | | | | | | - Judson B. Williams
- Cardiovascular Surgery, WakeMed Health and Hospitals, Raleigh, North Carolina
| | - Sam Parnia
- Department of Medicine, New York University Grossman School of Medicine, New York, New York
| | - Nirav C. Patel
- Department of Cardiothoracic Surgery, Northwell Health, Manhasset, New York
| | - Nimesh D. Desai
- Cardiac Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Andrew M. Vekstein
- Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University, Durham, North Carolina
| | - Beth A. Hollister
- Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University, Durham, North Carolina
| | - Tammie Possemato
- Department of Surgery and Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Christian Romero
- Department of Surgery and Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Peter C. Hou
- Division of Emergency Critical Care Medicine, Department of Emergency Medicine and
| | | | | | | | | | - Marc Gillinov
- Department of Thoracic & Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio
| | | | - Patrick T. O’Gara
- Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts; and
| | - Michael J. Mack
- Cardiac and Thoracic Surgery, Baylor Scott & White Health, Dallas, Texas
| | - Peter K. Smith
- Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University, Durham, North Carolina
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14
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Venter C, Meyer RW, Greenhawt M, Pali-Schöll I, Nwaru B, Roduit C, Untersmayr E, Adel-Patient K, Agache I, Agostoni C, Akdis CA, Feeney M, Hoffmann-Sommergruber K, Lunjani N, Grimshaw K, Reese I, Smith PK, Sokolowska M, Vassilopoulou E, Vlieg-Boerstra B, Amara S, Walter J, O'Mahony L. Role of dietary fiber in promoting immune health-An EAACI position paper. Allergy 2022; 77:3185-3198. [PMID: 35801383 DOI: 10.1111/all.15430] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 06/27/2022] [Accepted: 07/04/2022] [Indexed: 01/28/2023]
Abstract
Microbial metabolism of specific dietary components, such as fiber, contributes to the sophisticated inter-kingdom dialogue in the gut that maintains a stable environment with important beneficial physiological, metabolic, and immunological effects on the host. Historical changes in fiber intake may be contributing to the increase of allergic and hypersensitivity disorders as fiber-derived metabolites are evolutionarily hardwired into the molecular circuitry governing immune cell decision-making processes. In this review, we highlight the importance of fiber as a dietary ingredient, its effects on the microbiome, its effects on immune regulation, the importance of appropriate timing of intervention to target any potential window of opportunity, and potential mechanisms for dietary fibers in the prevention and management of allergic diseases. In addition, we review the human studies examining fiber or prebiotic interventions on asthma and respiratory outcomes, allergic rhinitis, atopic dermatitis, and overall risk of atopic disorders. While exposures, interventions, and outcomes were too heterogeneous for meta-analysis, there is significant potential for using fiber in targeted manipulations of the gut microbiome and its metabolic functions in promoting immune health.
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Affiliation(s)
- Carina Venter
- Section of Allergy and Immunology, University of Colorado School of Medicine, Aurora, Colorado, USA.,Children's Hospital Colorado, Aurora, Colorado, USA
| | | | - Matthew Greenhawt
- Section of Allergy and Immunology, University of Colorado School of Medicine, Aurora, Colorado, USA.,Children's Hospital Colorado, Aurora, Colorado, USA
| | - Isabella Pali-Schöll
- Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna, Vienna, Austria
| | - Bright Nwaru
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Caroline Roduit
- University Children's Hospital Zurich, Zurich, Switzerland.,Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland
| | - Eva Untersmayr
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Karine Adel-Patient
- Université Paris-Saclay, CEA, INRAE, UMR MTS/SPI/Laboratoire d'Immuno-Allergie Alimentaire (LIAA), INRA, CEA, Université Paris Saclay, Gif sur Yvette Cedex, France
| | | | - Carlo Agostoni
- Pediatric Unit, De Marchi Clinic, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy.,Dipartimento di Scienze Cliniche e di Comunita, Universita' degli Studi, Milan, Italy
| | - Cezmi A Akdis
- Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland.,Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Mary Feeney
- Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy, King's College London, London, UK.,Guy's & St Thomas' Hospital, London, UK
| | - Karin Hoffmann-Sommergruber
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Nonhlanhla Lunjani
- APC Microbiome Ireland, National University of Ireland, Cork, Ireland.,University of Cape Town, Cape Town, South Africa
| | - Kate Grimshaw
- Dietetic Department, Salford Royal NHS Foundation Trust, Salford, UK
| | - Imke Reese
- Private Practice for Dietary Advice and Nutrition Therapy, Munich, Germany
| | - Peter K Smith
- School of Medicine, Griffith University, Southport, Australia
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Emilia Vassilopoulou
- Department of Nutritonal Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Berber Vlieg-Boerstra
- OLVG, Department of Paediatrics, Amsterdam, the Netherlands.,Rijnstate Hospital, Department of Paediatrics, Arnhem, The Netherlands
| | - Shriya Amara
- Undergraduate, University College Los Angeles, Los Angeles, California, USA
| | - Jens Walter
- APC Microbiome Ireland, National University of Ireland, Cork, Ireland.,Department of Medicine, National University of Ireland, Cork, Ireland.,School of Microbiology, National University of Ireland, Cork, Ireland
| | - Liam O'Mahony
- APC Microbiome Ireland, National University of Ireland, Cork, Ireland.,Department of Medicine, National University of Ireland, Cork, Ireland.,School of Microbiology, National University of Ireland, Cork, Ireland
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15
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Barkauskas C, Mylonakis E, Poulakou G, Young BE, Vock DM, Siegel L, Engen N, Grandits G, Mosaly NR, Vekstein AM, Rogers R, Shehadeh F, Kaczynski M, Mylona EK, Syrigos KN, Rapti V, Lye DC, Hui DS, Leither L, Knowlton KU, Jain MK, Marines-Price R, Osuji A, Overcash JS, Kalomenidis I, Barmparessou Z, Waters M, Zepeda K, Chen P, Torbati S, Kiweewa F, Sebudde N, Almasri E, Hughes A, Bhagani SR, Rodger A, Sandkovsky U, Gottlieb RL, Nnakelu E, Trautner B, Menon V, Lutaakome J, Matthay M, Robinson P, Protopapas K, Koulouris N, Kimuli I, Baduashvili A, Braun DL, Günthard HF, Ramachandruni S, Kidega R, Kim K, Hatlen TJ, Phillips AN, Murray DD, Jensen TO, Padilla ML, Accardi EX, Shaw-Saliba K, Dewar RL, Teitelbaum M, Natarajan V, Laverdure S, Highbarger HC, Rehman MT, Vogel S, Vallée D, Crew P, Atri N, Schechner AJ, Pett S, Hudson F, Badrock J, Touloumi G, Brown SM, Self WH, North CM, Ginde AA, Chang CC, Kelleher A, Nagy-Agren S, Vasudeva S, Looney D, Nguyen HH, Sánchez A, Weintrob AC, Grund B, Sharma S, Reilly CS, Paredes R, Bednarska A, Gerry NP, Babiker AG, Davey VJ, Gelijns AC, Higgs ES, Kan V, Matthews G, Argyraki K, Lourida P, Bakakos P, Vlachakos V, Balis E, Zakynthinos S, Sigala I, Gianniou N, Dima E, Magkouta S, Thompson BT, Synolaki E, Konstanta S, Vlachou M, Stathopoulou P, Panagopoulos P, Petrakis V, Papazoglou D, Tompaidou E, Isaakidou E, Leontis K, Legenne P, Nitsotolis T, Athanasiou K, Myrodia M, Kyriakoulis K, Trontzas I, Arfara-Melanini M, Kolonia V, Kityo C, Mugerwa H, Lukaakome J, Chandra R, Nsereko C, Lubega G, Kibirige M, Nakahima W, Wangi D, Aguti E, Generous L, Massa R, Nalaki M, Magala F, Lane HC, Nabaggala PK, Kityo C, Mugerwa H, Faith OD, Florence A, Emmanuel O, Beacham MP, Geoffrey A, Nakiboneka D, Apiyo P, Neaton JD, Kiweewa F, Kirenga B, Kimuli I, Atukunda A, Muttamba W, Remmy K, Segawa I, Pheona N, Kigere D, Mbabazi QL, Lundgren JD, Boersalino L, Nyakoolo G, Kiweewa F, Fred A, Alupo A, Ebong D, Monday E, Nalubwama RN, Kainja M, Ambrose M, Barkauskas C, Kwehayo V, Nalubega MG, Ongoli A, Obbo S, Alaba J, Magombe G, Tino H, Obonya E, Lutaakome J, Kitonsa J, Mylonakis E, Onyango M, Naboth T, Naluyinda H, Nanyunja R, Irene M, Jane B, Wimfred K, Leonar S, Deus T, Babra N, Poulakou G, Taire P, Lutaakone J, Nabankema E, Ogavu J, Mugerwa O, Okoth I, Mwebaze R, Mugabi T, Makhoba A, Arikiriza P, Young BE, Theresa N, Nakayima H, Frank K, Ramgi P, Pereira K, Osinusi A, Cao H, Stumpp M, Goncalves S, Ramanathan K, Vock DM, Baseler B, Holley HP, Jankelevich S, Adams A, Becker N, Dolney S, Hissey D, Simpson S, Kim MH, Beeler J, Siegel L, Harmon L, Asomah M, Jato Y, Stottlemyer A, Tang O, Vanderpuye S, Yeon L, Buehn M, Eccard-Koons V, Frary S, Engen N, MacDonald L, Cash J, Hoopengardner L, Linton J, Schaffhauser M, Nelson M, Spinelli-Nadzam M, Proffitt C, Lee C, Engel T, Grandits G, Fontaine L, Osborne C, Hohn M, Galcik M, Thompson D, Chang W, Sherman BT, Rupert AW, Baseler M, Lallemand P, Mosaly NR, Imamichi T, Paudel S, Cook K, Haupt K, Highbarger J, Hazen A, Badralmaa Y, Smith K, Patel B, Kubernac R, Vekstein AM, Hoover ML, Brown C, DuChateau N, Ellis S, Flosi A, Fox L, Johnson L, Nelson R, Stojanovic J, Treagus A, Rogers R, Wenner C, Williams R, Shehadeh F, Kaczynski M, Mylona EK, Syrigos KN, Rapti V, Lye DC, Hui DS, Leither L, Knowlton KU, Jain MK, Marines-Price R, Osuji A, Overcash JS, Kalomenidis I, Barmparessou Z, Waters M, Zepeda K, Chen P, Torbati S, Kiweewa F, Sebudde N, Almasri E, Hughes A, Bhagani SR, Rodger A, Sandkovsky U, Gottlieb RL, Nnakelu E, Trautner B, Menon V, Lutaakome J, Matthay M, Robinson P, Protopapas K, Koulouris N, Kimuli I, Baduashvili A, Braun DL, Günthard HF, Ramachandruni S, Kidega R, Kim K, Hatlen TJ, Phillips AN, Murray DD, Jensen TO, Padilla ML, Accardi EX, Shaw-Saliba K, Dewar RL, Teitelbaum M, Natarajan V, Laverdure S, Highbarger HC, Rehman MT, Vogel S, Vallée D, Crew P, Atri N, Schechner AJ, Pett S, Hudson F, Badrock J, Touloumi G, Brown SM, Self WH, North CM, Ginde AA, Chang CC, Kelleher A, Nagy-Agren S, Vasudeva S, Looney D, Nguyen HH, Sánchez A, Weintrob AC, Grund B, Sharma S, Reilly CS, Paredes R, Bednarska A, Gerry NP, Babiker AG, Davey VJ, Gelijns AC, Higgs ES, Kan V, Matthews G, Thompson BT, Legenne P, Chandra R, Lane HC, Neaton JD, Lundgren JD, Sahner D, Tierney J, Herpin BR, Smolskis MC, McKay LA, Cahill K, Sardana R, Raim SS, Hensely L, Lorenzo J, Mock R, Zuckerman J, Miller M, Chung L, Kang N, Adam SJ, Read S, Draghia-Akli R, Carlsen A, Carter A, Denning E, DuChene A, Eckroth K, Frase A, Gandits G, Harrison M, Kaiser P, Koopmeiners J, Meger S, Murray T, Quan K, Quan SF, Thompson G, Walski J, Wentworth D, Moskowitz AJ, Bagiella E, Moquete E, O’Sullivan K, Marks ME, Kinzel E, Burris S, Bedoya G, Gupta L, Overbey JR, Padillia ML, Santos M, Gillinov MA, Miller MA, Taddei-Peters WC, Fenton K, Mack M, Berhe M, Haley C, Dishner E, Bettacchi C, Golden K, Duhaime E, Ryan M, Burris S, Tallmadge C, Estrada L, Jones F, Villa S, Wang S, Robert R, Coleman T, Clariday L, Baker R, Hurutado-Rodriguez M, Iram N, Fresnedo M, Davis A, Leonard K, Ramierez N, Thammavong J, Duque K, Turner E, Fisher T, Robinson D, Ransom D, Maldonado N, Lusk E, Killian A, Palacious A, Solis E, Jerrow J, Watts M, Whitacre H, Cothran E, Smith PK, Ko ER, Dreyer GR, Stafford N, Brooks M, Der T, Witte M, Gamarallage R, Franzone J, Ivey N, Lumsden RH, Mourad A, Holland TL, Motta M, Lane K, McGowan LM, Stout J, Aloor H, Bragg KM, Toledo B, McLendon-Arvik B, Bussadori B, Hollister BA, Griffin M, Giangiacomo DM, Rodriguez V, Parrino PE, Spindel S, Bansal A, Baumgarten K, Hand J, Vonderhaar D, Nossaman B, Laudun S, Ames D, Broussard S, Hernandez N, Isaac G, Dinh H, Zheng Y, Tran S, McDaniel H, Crovetto N, Perin E, Costello B, Manian P, Sohail MR, Postalian A, Hinsu P, Watson C, Chen J, Fink M, Sturgis L, Kim W, Mahon K, Parenti J, Kappenman C, Knight A, Sturek JM, Barros A, Enfield KB, Kadl A, Green CJ, Simon RM, Fox A, Thornton K, Adams A, Traverse JH, Rhame F, Huelster J, Kethireddy R, Salamanca J, Majeski C, Skelton P, Zarambo M, Sarafolean A, Oldmixon C, Ringwood N, Muzikansky A, Morse R, Brower RG, Reineck LA, Aggarwal NR, Bienstock K, Steingrub JH, Hou PK, Steingrub JS, Tidswell MA, Kozikowski LA, Kardos C, DeSouza L, Romain S, Talmor D, Shapiro N, Andromidas K, Banner-Goodspeed V, Bolstad M, Boyle KL, Cabrera P, deVilla A, Ellis JC, Grafals A, Hayes S, Higgins C, Kurt L, Kurtzman N, Redman K, Rosseto E, Scaffidi D, Shapiro N, Talmor D, Filbin MR, Hibbert KA, Parry B, Margolin J, Hillis B, Hamer R, Jones AE, Galbraith J, Nandi U, Hendey G, Matthay MA, Kangelaris K, Ashktorab K, Gropper R, Agrawal A, Almasri E, Fayed M, Hubel KA, Garcia RL, Lim GW, Chang SY, Hendey G, Lin MY, Vargas J, Sihota H, Beutler R, Rogers AJ, Wilson JG, Vojnik R, Perez C, McDowell JH, Albertson T, Hardy E, Harper R, Moss MA, Ginde AA, Chauhan L, Douin DJ, Martinez F, Finck LL, Bastman J, Hyzy RC, Park PK, Hyzy RC, Park PK, Nelson K, McSparron JI, Co IN, Wang BR, Jimenez J, Sullins B, Olbrich N, Gong MN, Richardson LD, Gong MN, Nair R, Lopez B, Amosu O, Tzehaie H, Nkemdirim W, Boujid S, Mosier JM, Hypes C, Campbell ES, Bixby B, Gilson B, Lopez A, Hite RD, Terndrup TE, Wiedemann HP, Hudock K, Tanzeem H, More H, Martinkovic J, Sellers S, Houston J, Burns M, Hough CL, Robinson BH, Hough CL, Khan A, Krol OF, Mills E, Kinjal M, Briceno G, Reddy R, Hubel K, Parimon T, Caudill A, Mattison B, Jackman SE, Chen PE, Bayoumi E, Ojukwu C, Fine D, Weissberg G, Isip K, Choi-Kuaea Y, Mehdikhani S, Dar TB, Augustin NBF, Tran D, Dukov JE, O’Mahony DS, Wilson DM, Wallick JA, Duven AM, Fletcher DD, Files DC, Miller C, Gibbs KW, Flores LS, LaRose ME, Landreth LD, Palacios DR, Parks L, Hicks M, Goodwin AJ, Kilb EF, Lematty CT, Patti K, Bledsoe J, Brown S, Lanspa M, Pelton I, Armbruster BP, Montgomery Q, Kumar N, Fergus M, Imel K, Palmer G, Webb B, Klippel C, Jensen H, Duckworth S, Gray A, Burke T, Knox D, Lumpkin J, Aston VT, Rice TW, Self WH, Rice TW, Casey JD, Johnson J, 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Vjecha MJ, Osuji A, Agbor BTA, Petersen T, Kamel D, Hansen L, Garcia A, Cha C, Mozaffari A, Hernandez R, Jain MK, Agbor BTA, Petersen T, Kamel D, Hansen L, Garcia A, Kim M, DellaValle N, Gonzales S, Somboonwit C, Oxner A, Guerra L, Tran T, Pinto A, Anderson B, Zepeda-Gutierrez A, Martin D, Temblador C, Cuenca A, Guerrero M, Daar E, Correa R, Hartnell G, Wortmann G, Doshi S, Moriarty T, Gonzales M, Garman K, Baker JV, Frosch A, Goldsmith R, Jibrell H, Lo M, Klaphake J, Mackedanz S, Ngo L, Garcia-Myers K, Kunisaki KM, Hassler M, Walquist M, Augenbraun M, Dehovitz J, Abassi M, Leuck AM, Rao V, Biswas K, Harrington C, Garcia A, Bremer T, Burke T, Koker B, Davis-Karim A, Pittman D, Vasudeva SS, Pandit L, Hines-Munson C, Van J, Dillon L, Wang Y, Ochalek T, Caldwell E, Humerickhouse E, Boone D, McGraw W, Mehta SR, Johns ST, John MS, Raceles J, Sear E, Funk S, Cesarini R, Fang M, Nicalo K, Drake W, Jones B, Holtman T, Maniar A, Johnson EA, Nguyen L, Tran MT, Barrett TW, Johnston T, Huggins JT, Beiko TY, Hughes HY, McManigle WC, Tanner NT, Washburn RG, Ardelt M, Tuohy PA, Mixson JL, Hinton CG, Thornley N, Allen H, Elam S, Boatman B, Baber BJ, Ryant R, Roller B, Nguyen C, Mikail AM, Hansen M, Lichtenberger P, Baracco G, Ramos C, Bjork L, Sueiro M, Tien P, Freasier H, Buck T, Nekach H, Holodniy M, Chary A, Lu K, Peters T, Lopez J, Tan SY, Lee RH, Asghar A, Isip TKK, Le K, Nguyen T, Wong S, Raben D, Aagaard B, Nielsen CB, Krapp K, Nykjær BR, Olsson C, Kanne KL, Grevsen AL, Joensen ZM, Bruun T, Bojesen A, Woldbye F, Normand NE, Benfield T, Clausen CL, Hovmand N, Israelsen SB, Iversen K, Leding C, Pedersen KB, Thorlacius-Ussing L, Tinggaard M, Tingsgard S, Jensen JUS, Overgaard R, Rastoder E, Heerfordt C, Hedsund C, Ronn CP, Kamstrup PT, Hogsberg DS, Bergsoe C, Ostergaard L, Staerke NB, Yehdego Y, Sondergaard A, Johansen IS, Holden IK, Lindvig SO, Helleberg M, Gerstoft J, Kirk O, Bruun T, Jensen TO, Madsen BL, Pedersen TI, Harboe ZB, Roge BT, Hansen TM, Glesner MK, Lofberg SV, Nielsen AD, Nielsen H, Thisted RK, Petersen KT, Juhl MR, Podlekareva D, Johnsen S, Wiese L, Knudsen LS, Expósito M, Badillo J, Martínez A, Abad E, Chamorro A, Mateu L, España S, Lucero MC, Santos JR, Lladós G, Lopez C, Carabias L, Fernández-Cruz E, Di Natale M, Padure S, Gomez J, Ausin C, Cervilla E, Balastegui H, Sainz CR, Lopez P, Escobar M, Balerdi L, Legarda A, Roldan M, Letona L, Muñoz J, Arribas JR, Sánchez RM, Díaz-Pollán B, Stewart SM, Garcia I, Borobia A, Estrada V, Cabello N, Nuñez-Orantos M, Sagastagoitia I, Homen J, Orviz E, Montalvá AS, Espinosa-Pereiro J, Bosch-Nicolau P, Salvador F, Morales-Rull JL, Pena AMM, Acosta C, Solé-Felip C, West E, M’Rabeth-Bensalah K, Eichinger ML, Grüttner-Durmaz M, Grube C, Zink V, Goes J, Tsertsvadze T, Abutidze A, Chkhartishvili N, Metchurtchlishvili R, Endeladze M, Paciorek M, Bursa D, Krogulec D, Pulik P, Ignatowska A, Fishchuk R, Kobrynska O, Levandovska K, Kirieieva I, Kuziuk M, Polizzotto M, Carey C, Dharan NJ, Hough S, Virachit S, Davidson S, Bice DJ, Ognenovska K, Cabrera G, Flynn R, Chia PY, Lee TH, Lin RJ, Ong SW, Puah SH, Yeo TW, Ongko J, Yeo HP, Kwaghe V, Zaiyad H, Idoko G, Uche B, Selvamuthu P, Kumarasamy N, Beulah FE, Govindarajan N, Mariyappan K, Losso MH, Abela C, Moretto R, Belloc CG, Ludueña J, Amar J, Losso MH, Toibaro J, Macias LM, Fernandez L, Frare PS, Chaio SR, Pachioli V, Timpano SM, Sanchez MDL, Sierra MDP, Stanek V, Belloso W, Cilenti FL, Valentini RN, Stryjewski ME, Locatelli N, Riera MCS, Salgado C, Baeck IM, Di Castelnuovo V, Zarza SM, Parmar MK, Goodman AL, Gregory A, Goodall K, Harris N, Wyncoll J, Luntiel A, Patterson C, Morales J, Witele E, Preston A, Nandani A, Price D, Nell J, Patel B, Hays C, Jones G, Davidson J, Pantazis N, Gioukari V, Souliou T, Antoniadou A, Kavatha D, Grigoropoulou S, Tziolos R, Oikonomopoulo C, Moschopoulos C, Tzimopoulos K, Koromilias A. Efficacy and Safety of Ensovibep for Adults Hospitalized With COVID-19 : A Randomized Controlled Trial. Ann Intern Med 2022; 175:1266-1274. [PMID: 35939810 PMCID: PMC9384272 DOI: 10.7326/m22-1503] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Ensovibep (MP0420) is a designed ankyrin repeat protein, a novel class of engineered proteins, under investigation as a treatment of SARS-CoV-2 infection. OBJECTIVE To investigate if ensovibep, in addition to remdesivir and other standard care, improves clinical outcomes among patients hospitalized with COVID-19 compared with standard care alone. DESIGN Double-blind, randomized, placebo-controlled, clinical trial. (ClinicalTrials.gov: NCT04501978). SETTING Multinational, multicenter trial. PARTICIPANTS Adults hospitalized with COVID-19. INTERVENTION Intravenous ensovibep, 600 mg, or placebo. MEASUREMENTS Ensovibep was assessed for early futility on the basis of pulmonary ordinal scores at day 5. The primary outcome was time to sustained recovery through day 90, defined as 14 consecutive days at home or place of usual residence after hospital discharge. A composite safety outcome that included death, serious adverse events, end-organ disease, and serious infections was assessed through day 90. RESULTS An independent data and safety monitoring board recommended that enrollment be halted for early futility after 485 patients were randomly assigned and received an infusion of ensovibep (n = 247) or placebo (n = 238). The odds ratio (OR) for a more favorable pulmonary outcome in the ensovibep (vs. placebo) group at day 5 was 0.93 (95% CI, 0.67 to 1.30; P = 0.68; OR > 1 would favor ensovibep). The 90-day cumulative incidence of sustained recovery was 82% for ensovibep and 80% for placebo (subhazard ratio [sHR], 1.06 [CI, 0.88 to 1.28]; sHR > 1 would favor ensovibep). The primary composite safety outcome at day 90 occurred in 78 ensovibep participants (32%) and 70 placebo participants (29%) (HR, 1.07 [CI, 0.77 to 1.47]; HR < 1 would favor ensovibep). LIMITATION The trial was prematurely stopped because of futility, limiting power for the primary outcome. CONCLUSION Compared with placebo, ensovibep did not improve clinical outcomes for hospitalized participants with COVID-19 receiving standard care, including remdesivir; no safety concerns were identified. PRIMARY FUNDING SOURCE National Institutes of Health.
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Affiliation(s)
| | - Christina Barkauskas
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Duke Health, Durham, North Carolina
| | - Eleftherios Mylonakis
- Division of Infectious Diseases, Rhode Island Hospital and The Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Garyfallia Poulakou
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | | | - David M Vock
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Lianne Siegel
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Nicole Engen
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Greg Grandits
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | | | | | - Ralph Rogers
- Division of Infectious Diseases, Rhode Island Hospital and The Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Fadi Shehadeh
- Division of Infectious Diseases, Rhode Island Hospital and The Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Matthew Kaczynski
- Division of Infectious Diseases, Rhode Island Hospital and The Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Evangelia K Mylona
- Division of Infectious Diseases, Rhode Island Hospital and The Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Konstantinos N Syrigos
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - Vasiliki Rapti
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - David C Lye
- National Centre for Infectious Diseases, Tan Tock Seng Hospital, Lee Kong Chian School of Medicine, Singapore
| | - Diong Shiau Hui
- National Centre for Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | - Lindsay Leither
- Division of Pulmonary and Critical Care, Department of Medicine, Intermountain Medical Center, Salt Lake City, Utah
| | - Kirk U Knowlton
- Cardiovascular Department, Intermountain Medical Center, Salt Lake City, Utah
| | - Mamta K Jain
- UT Southwestern Medical Center and Parkland Health and Hospital Systems, Dallas, Texas
| | - Rubria Marines-Price
- UT Southwestern Medical Center and Parkland Health and Hospital Systems, Dallas, Texas
| | - Alice Osuji
- UT Southwestern Medical Center and Parkland Health and Hospital Systems, Dallas, Texas
| | | | - Ioannis Kalomenidis
- 1st Department of Critical Care and Pulmonary Medicine, Medical School, National and Kapodistrian University of Athens, Evaggelismos General Hospital, Athens, Greece
| | - Zafeiria Barmparessou
- 1st Department of Critical Care and Pulmonary Medicine, Medical School, National and Kapodistrian University of Athens, Evaggelismos General Hospital, Athens, Greece
| | | | | | - Peter Chen
- Cedars-Sinai Medical Center, Los Angeles, California
| | - Sam Torbati
- Cedars-Sinai Medical Center, Los Angeles, California
| | | | | | - Eyad Almasri
- University of California, San Francisco-Fresno, Fresno, California
| | - Alyssa Hughes
- University of California, San Francisco-Fresno, Fresno, California
| | | | | | | | | | | | - Barbara Trautner
- Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas
| | - Vidya Menon
- NYC Health + Hospitals/Lincoln, Bronx, New York
| | - Joseph Lutaakome
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Michael Matthay
- University of California, San Francisco, Medical Center, Fresno, California
| | - Philip Robinson
- Hoag Memorial Hospital Presbyterian, Newport Beach, California
| | - Konstantinos Protopapas
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece
| | - Nikolaos Koulouris
- 1st Respiratory Medicine Department, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - Ivan Kimuli
- Makerere University Lung Institute, Kampala, Uganda
| | - Amiran Baduashvili
- Division of Hospital Medicine, University of Colorado Hospital - Anschutz Medical Campus, Aurora, Colorado
| | - Dominique L Braun
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Huldrych F Günthard
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | | | | | - Kami Kim
- Division of Infectious Diseases, University of South Florida and Global Emerging Diseases Institute, Tampa General Hospital, Tampa, Florida
| | - Timothy J Hatlen
- Lundquist Institute for Biomedical Innovation, Torrance, California
| | | | - Daniel D Murray
- CHIP Center of Excellence for Health, Immunity, and Infections and Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Tomas O Jensen
- CHIP Center of Excellence for Health, Immunity, and Infections and Department of Infectious Diseases, Rigshospitalet, Copenhagen, and Department of Pulmonary and Infectious Diseases, North Zealand University Hospital, Hillerod, Denmark
| | | | - Evan X Accardi
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Katy Shaw-Saliba
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland
| | - Robin L Dewar
- Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | | | - Ven Natarajan
- Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Sylvain Laverdure
- Laboratory of Human Retrovirology and Immunoinformatics, National Institutes of Health, Frederick, Maryland
| | | | - M Tauseef Rehman
- Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Susan Vogel
- Office of Clinical Research Policy and Regulatory Operations, National Institutes of Health, Bethesda, Maryland
| | - David Vallée
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Page Crew
- Collaborative Clinical Research Branch, National Institutes of Health, Bethesda, Maryland
| | - Negin Atri
- Office of Clinical Research Policy and Regulatory Operations, National Institutes of Health, Bethesda, Maryland
| | | | - Sarah Pett
- The Medical Research Council Clinical Trials Unit at University College London, London, England
| | - Fleur Hudson
- The Medical Research Council Clinical Trials Unit at University College London, London, England
| | - Jonathan Badrock
- The Medical Research Council Clinical Trials Unit at University College London, London, England
| | - Giota Touloumi
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Samuel M Brown
- Division of Pulmonary and Critical Care Medicine, Intermountain Medical Center, and Department of Internal Medicine, University of Utah, Murray, Utah
| | - Wesley H Self
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Crystal M North
- Division of Pulmonary and Critical Care, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Adit A Ginde
- University of Colorado School of Medicine, Aurora, Colorado
| | - Christina C Chang
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Anthony Kelleher
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | | | | | - David Looney
- The Veterans Medical Research Foundation, San Diego, California
| | - Hien H Nguyen
- Veterans Affairs Northern California Health Care System, Sacramento, California
| | | | - Amy C Weintrob
- Infectious Diseases Section, Washington Veterans Affairs Medical Center, Washington, DC
| | - Birgit Grund
- School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Shweta Sharma
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Cavan S Reilly
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Roger Paredes
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Agnieszka Bednarska
- Wojewódzki Szpital Zakaźny w Warszawie, Medical University of Warsaw, Warsaw, Poland
| | - Norman P Gerry
- Advanced Biomedical Laboratories, Cinnaminson, New Jersey
| | - Abdel G Babiker
- The Medical Research Council Clinical Trials Unit at University College London, London, England
| | | | - Annetine C Gelijns
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Elizabeth S Higgs
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland
| | - Virginia Kan
- Infectious Diseases Section, Veterans Affairs Medical Center, Washington, DC
| | - Gail Matthews
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - K. Argyraki
- Sotiria General, Medical School, National & Kapodistrian University of Athens
| | - P. Lourida
- Sotiria General Hospital, Medical School, National & Kapodistrian University of Athens
| | - P. Bakakos
- Sotiria General Hospital, Medical School, National & Kapodistrian University of Athens
| | - V. Vlachakos
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - E. Balis
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - S. Zakynthinos
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - I. Sigala
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - N. Gianniou
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - E. Dima
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - S. Magkouta
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - B Taylor Thompson
- Division of Pulmonary and Critical Care, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - E. Synolaki
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - S. Konstanta
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - M. Vlachou
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - P. Stathopoulou
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - P. Panagopoulos
- Alexandroupolis General Hospital, Medical School, Democritus University of Thrace
| | - V. Petrakis
- Alexandroupolis General Hospital, Medical School, Democritus University of Thrace
| | - D. Papazoglou
- Alexandroupolis General Hospital, Medical School, Democritus University of Thrace
| | - E. Tompaidou
- Alexandroupolis General Hospital, Medical School, Democritus University of Thrace
| | - E. Isaakidou
- Alexandroupolis General Hospital, Medical School, Democritus University of Thrace
| | - K. Leontis
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | | | - T. Nitsotolis
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - K. Athanasiou
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - M.D. Myrodia
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - K. Kyriakoulis
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - I. Trontzas
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - M. Arfara-Melanini
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - V. Kolonia
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - Cissy Kityo
- Uganda SCC, JCRC/MRC/UVRI Uganda Research Unit
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - H Clifford Lane
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland
| | | | | | | | | | | | | | | | | | | | | | - James D Neaton
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | | | | | | | | | | | | | | | | | | | | | - Jens D Lundgren
- CHIP Center of Excellence for Health, Immunity, and Infections and Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | | | | | | | | | | | | | | | | | | | | | - Christina Barkauskas
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Duke Health, Durham, North Carolina
| | | | | | | | | | | | | | | | | | | | | | - Eleftherios Mylonakis
- Division of Infectious Diseases, Rhode Island Hospital and The Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | | | | | | | | | | | | | | | | | | | | | - Garyfallia Poulakou
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Patrícia Ramgi
- CISPOC: Centro de Investigaçäo e Treino em Saúde da Polana Caniço, Maputo, Mozambique
| | - Kássia Pereira
- CISPOC: Centro de Investigaçäo e Treino em Saúde da Polana Caniço, Maputo, Mozambique
| | | | - Huyen Cao
- Gilead Sciences, Foster City, California
| | | | | | | | - David M. Vock
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | | | | | | | - Amy Adams
- Leidos Biomedical Research, Frederick, Maryland
| | | | | | | | | | - Mi Ha Kim
- Leidos Biomedical Research, Frederick, Maryland
| | - Joy Beeler
- Leidos Biomedical Research, Frederick, Maryland
| | - Lianne Siegel
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Liam Harmon
- Leidos Biomedical Research, Frederick, Maryland
| | | | - Yvonne Jato
- Leidos Biomedical Research, Frederick, Maryland
| | | | - Olivia Tang
- Leidos Biomedical Research, Frederick, Maryland
| | | | | | - Molly Buehn
- Leidos Biomedical Research, Frederick, Maryland
| | | | - Sadie Frary
- Leidos Biomedical Research, Frederick, Maryland
| | - Nicole Engen
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | | | | | | | | | | | | | | | | | | | | | - Greg Grandits
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | | | | | - Matt Hohn
- Leidos Biomedical Research, Frederick, Maryland
| | | | | | - Weizhong Chang
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Brad T. Sherman
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Adam W. Rupert
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Michael Baseler
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Perrine Lallemand
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | | | - Tom Imamichi
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Sharada Paudel
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Kyndal Cook
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Kendra Haupt
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Jeroen Highbarger
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Allison Hazen
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Yunden Badralmaa
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Kenneth Smith
- Advanced Biomedical Laboratories, Cinnaminson, New Jersey
| | - Bhakti Patel
- Advanced Biomedical Laboratories, Cinnaminson, New Jersey
| | | | | | | | | | | | | | | | | | | | | | | | | | - Ralph Rogers
- Division of Infectious Diseases, Rhode Island Hospital and The Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | | | | | - Fadi Shehadeh
- Division of Infectious Diseases, Rhode Island Hospital and The Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Matthew Kaczynski
- Division of Infectious Diseases, Rhode Island Hospital and The Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Evangelia K. Mylona
- Division of Infectious Diseases, Rhode Island Hospital and The Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Konstantinos N. Syrigos
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - Vasiliki Rapti
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - David C. Lye
- National Centre for Infectious Diseases, Tan Tock Seng Hospital, Lee Kong Chian School of Medicine, Singapore
| | - Diong Shiau Hui
- National Centre for Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | - Lindsay Leither
- Division of Pulmonary and Critical Care, Department of Medicine, Intermountain Medical Center, Salt Lake City, Utah
| | - Kirk U. Knowlton
- Cardiovascular Department, Intermountain Medical Center, Salt Lake City, Utah
| | - Mamta K. Jain
- UT Southwestern Medical Center and Parkland Health and Hospital Systems, Dallas, Texas
| | - Rubria Marines-Price
- UT Southwestern Medical Center and Parkland Health and Hospital Systems, Dallas, Texas
| | - Alice Osuji
- UT Southwestern Medical Center and Parkland Health and Hospital Systems, Dallas, Texas
| | | | - Ioannis Kalomenidis
- 1st Department of Critical Care and Pulmonary Medicine, Medical School, National and Kapodistrian University of Athens, Evaggelismos General Hospital, Athens, Greece
| | - Zafeiria Barmparessou
- 1st Department of Critical Care and Pulmonary Medicine, Medical School, National and Kapodistrian University of Athens, Evaggelismos General Hospital, Athens, Greece
| | | | | | - Peter Chen
- Cedars-Sinai Medical Center, Los Angeles, California
| | - Sam Torbati
- Cedars-Sinai Medical Center, Los Angeles, California
| | | | | | - Eyad Almasri
- University of California, San Francisco–Fresno, Fresno, California
| | - Alyssa Hughes
- University of California, San Francisco–Fresno, Fresno, California
| | | | | | | | | | | | - Barbara Trautner
- Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas
| | - Vidya Menon
- NYC Health + Hospitals/Lincoln, Bronx, New York
| | - Joseph Lutaakome
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Michael Matthay
- University of California, San Francisco, Medical Center, Fresno, California
| | - Philip Robinson
- Hoag Memorial Hospital Presbyterian, Newport Beach, California
| | - Konstantinos Protopapas
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece
| | - Nikolaos Koulouris
- 1st Respiratory Medicine Department, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - Ivan Kimuli
- Makerere University Lung Institute, Kampala, Uganda
| | - Amiran Baduashvili
- Division of Hospital Medicine, University of Colorado Hospital - Anschutz Medical Campus, Aurora, Colorado
| | - Dominique L. Braun
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Huldrych F. Günthard
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | | | | | - Kami Kim
- Division of Infectious Diseases, University of South Florida and Global Emerging Diseases Institute, Tampa General Hospital, Tampa, Florida
| | | | | | - Daniel D. Murray
- CHIP Center of Excellence for Health, Immunity, and Infections and Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Tomas O. Jensen
- CHIP Center of Excellence for Health, Immunity, and Infections and Department of Infectious Diseases, Rigshospitalet, Copenhagen, and Department of Pulmonary and Infectious Diseases, North Zealand University Hospital, Hillerod, Denmark
| | | | | | - Katy Shaw-Saliba
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland
| | - Robin L. Dewar
- Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | | | - Ven Natarajan
- Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Sylvain Laverdure
- Laboratory of Human Retrovirology and Immunoinformatics, National Institutes of Health, Frederick, Maryland
| | | | - M. Tauseef Rehman
- Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Susan Vogel
- Office of Clinical Research Policy and Regulatory Operations, National Institutes of Health, Bethesda, Maryland
| | - David Vallée
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Page Crew
- Collaborative Clinical Research Branch, National Institutes of Health, Bethesda, Maryland
| | - Negin Atri
- Office of Clinical Research Policy and Regulatory Operations, National Institutes of Health, Bethesda, Maryland
| | | | - Sarah Pett
- The Medical Research Council Clinical Trials Unit at University College London, London, England
| | - Fleur Hudson
- The Medical Research Council Clinical Trials Unit at University College London, London, England
| | - Jonathan Badrock
- The Medical Research Council Clinical Trials Unit at University College London, London, England
| | - Giota Touloumi
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Samuel M. Brown
- Division of Pulmonary and Critical Care Medicine, Intermountain Medical Center, and Department of Internal Medicine, University of Utah, Murray, Utah
| | - Wesley H. Self
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Crystal M. North
- Division of Pulmonary and Critical Care, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Adit A. Ginde
- University of Colorado School of Medicine, Aurora, Colorado
| | - Christina C. Chang
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Anthony Kelleher
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | | | | | - David Looney
- The Veterans Medical Research Foundation, San Diego, California
| | - Hien H. Nguyen
- Veterans Affairs Northern California Health Care System, Sacramento, California
| | | | - Amy C. Weintrob
- Infectious Diseases Section, Washington Veterans Affairs Medical Center, Washington, DC
| | - Birgit Grund
- School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Shweta Sharma
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Cavan S. Reilly
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Roger Paredes
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Agnieszka Bednarska
- Wojewódzki Szpital Zakaźny w Warszawie, Medical University of Warsaw, Warsaw, Poland
| | | | - Abdel G. Babiker
- The Medical Research Council Clinical Trials Unit at University College London, London, England
| | | | - Annetine C. Gelijns
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Elizabeth S. Higgs
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland
| | - Virginia Kan
- Infectious Diseases Section, Veterans Affairs Medical Center, Washington, DC
| | - Gail Matthews
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - B. Taylor Thompson
- Division of Pulmonary and Critical Care, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | - H. Clifford Lane
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland
| | - James D. Neaton
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Jens D. Lundgren
- CHIP Center of Excellence for Health, Immunity, and Infections and Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - David Sahner
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - John Tierney
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Betsey R. Herpin
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Mary C. Smolskis
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Laura A. McKay
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Kelly Cahill
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Ratna Sardana
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Sharon Segal Raim
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Lisa Hensely
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Joshua Lorenzo
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Rebecca Mock
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Judith Zuckerman
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Mark Miller
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Lucy Chung
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Nayon Kang
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Stacey J. Adam
- Foundation for the National Institutes of Health, The Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) and Operation Warp Speed
| | - Sarah Read
- Foundation for the National Institutes of Health, The Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) and Operation Warp Speed
| | - Ruxandra Draghia-Akli
- Foundation for the National Institutes of Health, The Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) and Operation Warp Speed
| | - Amy Carlsen
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Anita Carter
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Eileen Denning
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Alain DuChene
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Kate Eckroth
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Alex Frase
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Greg Gandits
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Merrie Harrison
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Payton Kaiser
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Joseph Koopmeiners
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Sue Meger
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Thomas Murray
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Kien Quan
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Siu Fun Quan
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Greg Thompson
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Jamie Walski
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Deborah Wentworth
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Alan J. Moskowitz
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Emilia Bagiella
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Ellen Moquete
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Karen O’Sullivan
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Mary E. Marks
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Emily Kinzel
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Sarah Burris
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Gabriela Bedoya
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Lola Gupta
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Jessica R. Overbey
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Maria L. Padillia
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Milerva Santos
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Amy Adams
- University of Virginia Health Systems
| | | | | | | | | | | | | | | | | | | | - Cathryn Oldmixon
- Prevention and Early Treatment of Acute Lung Injury (PETAL) ICC, Massachusetts General Hospital, Boston, Massachusetts
| | - Nancy Ringwood
- Prevention and Early Treatment of Acute Lung Injury (PETAL) ICC, Massachusetts General Hospital, Boston, Massachusetts
| | - Ariela Muzikansky
- Prevention and Early Treatment of Acute Lung Injury (PETAL) ICC, Massachusetts General Hospital, Boston, Massachusetts
| | - Richard Morse
- Prevention and Early Treatment of Acute Lung Injury (PETAL) ICC, Massachusetts General Hospital, Boston, Massachusetts
| | - Roy G. Brower
- PETAL Steering Committee Chair, Johns Hopkins University
| | | | | | | | - Jay H. Steingrub
- ALIGNE Site Coordinating Center (SCC) Lead Investigators, Baystate Medical Center
| | - Peter K. Hou
- ALIGNE Site Coordinating Center (SCC) Lead Investigators, Brigham and Women's Hospital
| | | | | | | | | | | | | | - Daniel Talmor
- Boston SCC Lead Investigators, Beth Israel Deaconess Medical Center
| | - Nathan Shapiro
- Boston SCC Lead Investigators, Beth Israel Deaconess Medical Center
| | | | | | | | | | | | | | | | | | | | | | - Lisa Kurt
- Beth Israel Deaconess Medical Center
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Gregory Hendey
- California SCC Lead Investigators, David Geffen School of Medicine at UCLA
| | - Michael A. Matthay
- University of California San Francisco, University of San Francisco Mount Zion
| | - Kirsten Kangelaris
- University of California San Francisco, University of San Francisco Mount Zion
| | - Kimia Ashktorab
- University of California San Francisco, University of San Francisco Mount Zion
| | - Rachel Gropper
- University of California San Francisco, University of San Francisco Mount Zion
| | - Anika Agrawal
- University of California San Francisco, University of San Francisco Mount Zion
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marc A. Moss
- Colorado SCC Lead Investigators, University of Colorado Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Michelle N. Gong
- Montefiore-Sinai SCC Lead Investigators: Montefiore Medical Center
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Catherine L. Hough
- Pacific Northwest SCC Lead Investigators, Oregon Health & Science University
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Todd W. Rice
- Vanderbilt SCC Lead Investigators, Vanderbilt University Medical Center
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jim Wong
- Carilion Roanoke Memorial Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Laura Popielski
- INSIGHT Washington ICC, Veterans Affairs (VA) Medical Center, Washington, DC
| | - Amy Kambo
- INSIGHT Washington ICC, Veterans Affairs (VA) Medical Center, Washington, DC
| | - Kimberley Viens
- INSIGHT Washington ICC, Veterans Affairs (VA) Medical Center, Washington, DC
| | - Melissa Turner
- INSIGHT Washington ICC, Veterans Affairs (VA) Medical Center, Washington, DC
| | - Michael J. Vjecha
- INSIGHT Washington ICC, Veterans Affairs (VA) Medical Center, Washington, DC
| | | | | | | | | | | | | | | | | | | | - Mamta K. Jain
- University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Tianna Petersen
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Dena Kamel
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Laura Hansen
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Angie Garcia
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Mina Kim
- University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Sonia Gonzales
- University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Asa Oxner
- University of South Florida, Tampa General Hospital
| | - Lucy Guerra
- University of South Florida, Tampa General Hospital
| | - Thanh Tran
- University of South Florida, Tampa General Hospital
| | | | | | | | | | | | - Avon Cuenca
- Lundquist Institute for Biomedical Innovation
| | | | - Eric Daar
- Lundquist Institute for Biomedical Innovation
| | | | | | | | | | | | | | | | - Jason V. Baker
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota
| | - Anne Frosch
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota
| | | | - Hodan Jibrell
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota
| | - Melanie Lo
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota
| | | | - Shari Mackedanz
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota
| | - Linh Ngo
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota
| | | | | | | | | | | | | | | | | | | | | | | | | | - Tammy Bremer
- INSIGHT US Department of Veterans Affairs (VA) ICC
| | - Tara Burke
- INSIGHT US Department of Veterans Affairs (VA) ICC
| | | | | | | | | | | | | | - John Van
- Michael E. DeBakey VA Medical Center, Houston, Texas
| | - Laura Dillon
- Michael E. DeBakey VA Medical Center, Houston, Texas
| | - Yiqun Wang
- Michael E. DeBakey VA Medical Center, Houston, Texas
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Kan Lu
- Veterans Affairs Palo Alto Health Care System
| | | | | | | | | | | | | | | | | | | | - Dorthe Raben
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Bitten Aagaard
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte B. Nielsen
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Katharina Krapp
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Bente Rosdahl Nykjær
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Christina Olsson
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Katja Lisa Kanne
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anne Louise Grevsen
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Zillah Maria Joensen
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Tina Bruun
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ane Bojesen
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Frederik Woldbye
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Nick E. Normand
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Benfield
- Denmark Copenhagen University Hospital - Amager and Hvidovre, Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases
| | - Clara Lundetoft Clausen
- Denmark Copenhagen University Hospital - Amager and Hvidovre, Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases
| | - Nichlas Hovmand
- Denmark Copenhagen University Hospital - Amager and Hvidovre, Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases
| | - Simone Bastrup Israelsen
- Denmark Copenhagen University Hospital - Amager and Hvidovre, Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases
| | - Katrine Iversen
- Denmark Copenhagen University Hospital - Amager and Hvidovre, Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases
| | - Caecilie Leding
- Denmark Copenhagen University Hospital - Amager and Hvidovre, Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases
| | - Karen Brorup Pedersen
- Denmark Copenhagen University Hospital - Amager and Hvidovre, Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases
| | - Louise Thorlacius-Ussing
- Denmark Copenhagen University Hospital - Amager and Hvidovre, Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases
| | - Michaela Tinggaard
- Denmark Copenhagen University Hospital - Amager and Hvidovre, Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases
| | - Sandra Tingsgard
- Denmark Copenhagen University Hospital - Amager and Hvidovre, Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases
| | | | - Rikke Overgaard
- Herlev-Gentofte Hospital, Respiratory Medicine Section, Department of Internal Medicine
| | - Ema Rastoder
- Herlev-Gentofte Hospital, Respiratory Medicine Section, Department of Internal Medicine
| | - Christian Heerfordt
- Herlev-Gentofte Hospital, Respiratory Medicine Section, Department of Internal Medicine
| | - Caroline Hedsund
- Herlev-Gentofte Hospital, Respiratory Medicine Section, Department of Internal Medicine
| | | | | | | | - Christina Bergsoe
- Herlev-Gentofte Hospital, Respiratory Medicine Section, Department of Internal Medicine
| | | | | | | | | | | | - Inge K. Holden
- Odense University Hospital, Department of Infectious Diseases
| | | | - Marie Helleberg
- Dept. of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital
| | - Jan Gerstoft
- Dept. of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital
| | - Ole Kirk
- Dept. of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital
| | - Tina Bruun
- Dept. of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital
| | | | | | | | | | | | | | | | | | | | - Henrik Nielsen
- Aalborg University Hospital, Department of Infectious Diseases
| | | | | | | | - Daria Podlekareva
- Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Stine Johnsen
- Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Lothar Wiese
- Department of Infectious Diseases, Zealand University Hospital Roskilde and Department of Internal Medicine, Zealand University Hospital Koge
| | - Lene Surland Knudsen
- Department of Infectious Diseases, Zealand University Hospital Roskilde and Department of Internal Medicine, Zealand University Hospital Koge
| | - Maria Expósito
- Spain INSIGHT SCC Spain, Hospital Universitari Germans Trias i Pujol, Badalona
| | - José Badillo
- Spain INSIGHT SCC Spain, Hospital Universitari Germans Trias i Pujol, Badalona
| | - Ana Martínez
- Spain INSIGHT SCC Spain, Hospital Universitari Germans Trias i Pujol, Badalona
| | - Elena Abad
- Spain INSIGHT SCC Spain, Hospital Universitari Germans Trias i Pujol, Badalona
| | - Ana Chamorro
- Spain INSIGHT SCC Spain, Hospital Universitari Germans Trias i Pujol, Badalona
| | - Lourdes Mateu
- Hospital Universitari Germans Trias i Pujol, Badalona
| | - Sergio España
- Hospital Universitari Germans Trias i Pujol, Badalona
| | | | | | - Gemma Lladós
- Hospital Universitari Germans Trias i Pujol, Badalona
| | | | | | | | | | - Sergiu Padure
- Hospital General Universitario Gregorio Marañón, Madrid
| | - Jimena Gomez
- Hospital General Universitario Gregorio Marañón, Madrid
| | | | - Eva Cervilla
- Hospital General Universitario Gregorio Marañón, Madrid
| | | | | | - Paco Lopez
- Hospital General Universitario Gregorio Marañón, Madrid
| | | | - Leire Balerdi
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona
| | - Almudena Legarda
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona
| | - Montserrat Roldan
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona
| | - Laura Letona
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona
| | - José Muñoz
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona
| | | | | | | | | | | | | | | | | | | | | | | | - E. Orviz
- Hospital Clínico San Carlos, Madrid
| | | | | | | | | | | | | | - Cristina Acosta
- Internal Medicine Department, University Hospital Arnau de Vilanova, Lleida
| | | | - Emily West
- Switzerland Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Khadija M’Rabeth-Bensalah
- Switzerland Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Mareile L. Eichinger
- Switzerland Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Manuela Grüttner-Durmaz
- Switzerland Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Christina Grube
- Switzerland Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Veronika Zink
- Switzerland Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Josefine Goes
- Switzerland Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Tengiz Tsertsvadze
- Georgia SCC, Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia
| | - Akaki Abutidze
- Georgia SCC, Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia
| | - Nikoloz Chkhartishvili
- Georgia SCC, Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia
| | - Revaz Metchurtchlishvili
- Georgia SCC, Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia
| | - Marina Endeladze
- Georgia SCC, Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia
| | | | | | | | - Piotr Pulik
- Poland SCC, Wojewodzki Szpital Zakazny Warsaw
| | | | - Roman Fishchuk
- Ukraine Central City Clinical Hospital of Ivano-Frankivsk City, Ukraine
| | - Olena Kobrynska
- Ukraine Central City Clinical Hospital of Ivano-Frankivsk City, Ukraine
| | | | - Ivanna Kirieieva
- Ukraine Central City Clinical Hospital of Ivano-Frankivsk City, Ukraine
| | - Mykhailo Kuziuk
- Ukraine Central City Clinical Hospital of Ivano-Frankivsk City, Ukraine
| | - Mark Polizzotto
- INSIGHT Sydney ICC, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Catherine Carey
- INSIGHT Sydney ICC, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Nila J. Dharan
- INSIGHT Sydney ICC, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Sally Hough
- INSIGHT Sydney ICC, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Sophie Virachit
- INSIGHT Sydney ICC, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Sarah Davidson
- INSIGHT Sydney ICC, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Daniel J. Bice
- INSIGHT Sydney ICC, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Katherine Ognenovska
- INSIGHT Sydney ICC, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Gesalit Cabrera
- INSIGHT Sydney ICC, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Ruth Flynn
- INSIGHT Sydney ICC, The Kirby Institute, University of New South Wales, Sydney, Australia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marcelo H. Losso
- INSIGHT SCC Argentina, Coordinación en Investigación Clínica Académica en Latinoamérica
| | - Cecilia Abela
- INSIGHT SCC Argentina, Coordinación en Investigación Clínica Académica en Latinoamérica
| | - Renzo Moretto
- INSIGHT SCC Argentina, Coordinación en Investigación Clínica Académica en Latinoamérica
| | - Carlos G. Belloc
- INSIGHT SCC Argentina, Coordinación en Investigación Clínica Académica en Latinoamérica
| | - Jael Ludueña
- INSIGHT SCC Argentina, Coordinación en Investigación Clínica Académica en Latinoamérica
| | - Josefina Amar
- INSIGHT SCC Argentina, Coordinación en Investigación Clínica Académica en Latinoamérica
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Clara Salgado
- Centro de Educacion Medica e Investigaciones Clinicas, Buenos Aires
| | - Ines M. Baeck
- Centro de Educacion Medica e Investigaciones Clinicas, Buenos Aires
| | | | - Stella M. Zarza
- Centro de Educacion Medica e Investigaciones Clinicas, Buenos Aires
| | - Mahesh K.B. Parmar
- INSIGHT London ICC, MRC Clinical Trials Unit at UC, London, United Kingdom
| | - Anna L. Goodman
- INSIGHT London ICC, MRC Clinical Trials Unit at UC, London, United Kingdom
| | - Adam Gregory
- INSIGHT London ICC, MRC Clinical Trials Unit at UC, London, United Kingdom
| | - Katharine Goodall
- INSIGHT London ICC, MRC Clinical Trials Unit at UC, London, United Kingdom
| | - Nicola Harris
- INSIGHT London ICC, MRC Clinical Trials Unit at UC, London, United Kingdom
| | - James Wyncoll
- INSIGHT London ICC, MRC Clinical Trials Unit at UC, London, United Kingdom
| | | | | | | | - E. Witele
- United Kingdom SCC: Royal Free Hospital
| | | | | | | | | | | | | | | | | | - Nikos Pantazis
- Greece SCC, Medical School, National & Kapodistrian University of Athens
| | - Vicky Gioukari
- Greece SCC, Medical School, National & Kapodistrian University of Athens
| | - Tania Souliou
- Greece SCC, Medical School, National & Kapodistrian University of Athens
| | - A. Antoniadou
- Attikon University General Hospital, Medical School, National & Kapodistrian University of Athens
| | - D. Kavatha
- Attikon University General Hospital, Medical School, National & Kapodistrian University of Athens
| | - S. Grigoropoulou
- Attikon University General Hospital, Medical School, National & Kapodistrian University of Athens
| | - R.N. Tziolos
- Attikon University General Hospital, Medical School, National & Kapodistrian University of Athens
| | - C. Oikonomopoulo
- Attikon University General Hospital, Medical School, National & Kapodistrian University of Athens
| | - C. Moschopoulos
- Attikon University General Hospital, Medical School, National & Kapodistrian University of Athens
| | - K. Tzimopoulos
- Sotiria General Hospital, Medical School, National & Kapodistrian University of Athens
| | - A. Koromilias
- Sotiria General Hospital, Medical School, National & Kapodistrian University of Athens
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Smith PK, Lesslar O, Price DB. Correspondence to "Differentiation of COVID-19 signs and symptoms from allergic rhinitis and common cold: An ARIA-EAACI-GA2LEN consensus". Allergy 2022; 77:2571-2573. [PMID: 35932253 PMCID: PMC9537924 DOI: 10.1111/all.15281] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 03/01/2022] [Accepted: 03/07/2022] [Indexed: 12/26/2022]
Affiliation(s)
- Peter K Smith
- Griffith University, Southport, Qld, Australia.,Observational and Pragmatic Research Institute, Singapore City, Singapore
| | | | - David B Price
- Griffith University, Southport, Qld, Australia.,Division of Applied Health Sciences, Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK
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Mameli C, Menabò L, Brighi A, Menin D, Culbert C, Hamilton J, Scheithauer H, Smith PK, Völlink T, Willems RA, Purdy N, Guarini A. Stay Safe and Strong: Characteristics, Roles and Emotions of Student-Produced Comics Related to Cyberbullying. IJERPH 2022; 19:ijerph19148776. [PMID: 35886631 PMCID: PMC9324025 DOI: 10.3390/ijerph19148776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/14/2022] [Accepted: 07/16/2022] [Indexed: 02/01/2023]
Abstract
The present study aimed at giving voice to students from disadvantaged socio-economic backgrounds using a co-participatory approach. Participants were 59 adolescents (52.5% males) aged between 14 and 16 from five European countries who created ten comics to illustrate cyberbullying for a broader audience of peers. We analyzed texts and images according to four primary themes: cyberbullying episodes (types, platforms, co-occurrence with bullying), coping strategies, characters (roles, gender, and group membership), and emotions. The content analysis showed that online denigration on social media platforms was widely represented and that cyberbullying co-existed with bullying. Social strategies were frequently combined with passive and confrontational coping, up to suicide. All roles (cyberbully, cybervictim, bystander, reinforcer, defender) were portrayed among the 154 characters identified, even if victims and defenders appeared in the vignettes more often. Males, females, peers, and adults were represented in all roles. Among the 87 emotions detected, sadness was the most frequently expressed, followed by joy, surprise, anger, and fear. Emotions, mainly represented by drawings or drawings with text, were most often represented in association with cybervictims. The results are discussed in terms of their methodological and practical implications, as they emphasize the importance of valorizing young peoples’ voices in research and interventions against cyberbullying.
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Affiliation(s)
- Consuelo Mameli
- Department of Education Studies “Giovanni Maria Bertin”, University of Bologna, 40126 Bologna, Italy
- Correspondence: (C.M.); (A.G.)
| | - Laura Menabò
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy;
| | - Antonella Brighi
- Faculty of Education, Free University of Bolzano, 39042 Bolzano, Italy;
| | - Damiano Menin
- Department of Humanities, University of Ferrara, 44121 Ferrara, Italy;
| | - Catherine Culbert
- Department of Psychology, Goldsmiths, University of London, London SE14 6NW, UK; (C.C.); (P.K.S.)
| | - Jayne Hamilton
- School of Social Sciences, Education and Social Work, Queen’s University, Belfast BT7 1PS, UK;
| | - Herbert Scheithauer
- Department of Education and Psychology, Freie Universität Berlin, 14195 Berlin, Germany;
| | - Peter K. Smith
- Department of Psychology, Goldsmiths, University of London, London SE14 6NW, UK; (C.C.); (P.K.S.)
| | - Trijntje Völlink
- Department of Psychology, Open University of the Netherlands, 6419 AT Heerlen, The Netherlands; (T.V.); (R.A.W.)
| | - Roy A. Willems
- Department of Psychology, Open University of the Netherlands, 6419 AT Heerlen, The Netherlands; (T.V.); (R.A.W.)
| | - Noel Purdy
- Centre for Research in Educational Underachievement, Stranmillis University College, Belfast BT9 5DY, UK;
| | - Annalisa Guarini
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy;
- Correspondence: (C.M.); (A.G.)
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18
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Hancock KL, Bosnic-Anticevich S, Blakey JD, Hew M, Chung LP, Cvetkovski B, Claxton S, Del Fante P, Denton E, Doan J, Ranasinghe K, Morgan L, Sharma A, Smith PK, Stewart D, Thompson PJ, Wiseman R, Upham JW, Yan KY, Carter V, Dhillon K, Heraud F, Le T, Vella R, Price D. Characterisation of the Australian Adult Population Living with Asthma: Severe - Exacerbation Frequency, Long-Term OCS Use and Adverse Effects. Pragmat Obs Res 2022; 13:43-58. [PMID: 35818499 PMCID: PMC9270906 DOI: 10.2147/por.s360044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/21/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Asthma poses a significant burden for the Australian population. Understanding severe exacerbation rates, and steroid-related burden for adults diagnosed with asthma stands to offer insights into how this could be reduced. Methods Electronic medical records (EMR) and questionnaires from the Optimum Patient Care Research Database Australia (OPCRDA) were utilised retrospectively. OPCRDA is a real-world database with >800,000 medical records from Australian primary care practices. Outcomes were severe asthma exacerbations in Australian adults, over a 12-month period, stratified by Global Initiative for Asthma (GINA) treatment intensity steps, and steroid associated comorbidities. Results Of the 7868 adults treated for asthma, 19% experienced at least one severe exacerbation in the last 12-months. Severe exacerbation frequency increased with treatment intensity (≥1 severe exacerbation GINA 1 13%; GINA 4 23%; GINA 5a 33% and GINA 5b 28%). Questionnaire participants reported higher rates of severe exacerbations than suggested from their EMR (32% vs 23%) especially in steps 1, 4 and 5. Patients repeatedly exposed to steroids had an increased risk of osteoporosis (OR 1.95, 95% CI 1.43–2.66) and sleep apnoea (OR 1.78, 95% CI 1.30–2.46). Conclusion The Australian population living with GINA 1, 4, 5a and 5b asthma have high severe exacerbation rates and steroid-related burden, especially when compared to other first world countries, with these patients needing alternative strategies or possibly specialist assessment to better manage their condition.
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Affiliation(s)
| | - Sinthia Bosnic-Anticevich
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
- Woolcock Institute of Medical Research, Glebe, MSW, 2037, Australia
- Sydney Local Health District, Camperdown, NSW, 2050, Australia
| | - John D Blakey
- Respiratory Medicine, Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, WA, 6009, Australia
- Curtin University Medical School, Bentley, Western Australia, 6102, Australia
| | - Mark Hew
- Allergy, Asthma & Clinical Immunology, Alfred Health, Melbourne, VIC, 3004, Australia
- Public Health and Preventive Medicine, Monash University, Victoria, 3800, Australia
| | - Li Ping Chung
- Fiona Stanley Hospital, 11 Robin Warren Dr, Murdoch, WA, 6150, Australia
| | | | - Scott Claxton
- Genesis Care Sleep and Respiratory, Joondalup, WA, 6027, Australia
| | | | - Eve Denton
- Allergy, Asthma & Clinical Immunology, Alfred Health, Melbourne, VIC, 3004, Australia
- Public Health and Preventive Medicine, Monash University, Victoria, 3800, Australia
| | - Joe Doan
- HealthPlus Medical Centre, Kogarah, NSW, 2217, Australia
| | - Kanchanamala Ranasinghe
- School of Medicine, Griffith University, Nathan, QLD, Australia
- Cannon Hill Family Doctors, Cannon Hill, QLD, 4170, Australia
| | - Lucy Morgan
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
- Department of Thoracic Medicine, Concord Hospital, Sydney, NSW, Australia
- Australian School of Advanced Medicine, Macquarie University, Sydney, NSW, Australia
| | - Anita Sharma
- Platinum Medical Centre, Chermside, QLD, 4032, Australia
| | | | - Deb Stewart
- Adjunct Lecturer, School of Medicine, University of Tasmania, Churchill Ave, Hobart, TAS, 7005, Australia
| | - Philip J Thompson
- The Lung Health Clinic, Hollywood Medical Centre, Nedlands, 6009, Australia
- The University of Western Australia, Perth, Western Australia, 6009, Australia
- Curtin University, Bentley, Western Australia, 6102, Australia
| | | | - John W Upham
- Diamantina Institute & PA-Southside Clinical Unit, the University of Queensland, Woolloongabba, QLD, 4102, Australia
| | - Kwok Y Yan
- Department of Respiratory Medicine, W, Camperdown, NSW, 2050, Australia
| | | | | | - Florian Heraud
- Optimum Patient Care Australia, Brisbane, QLD, 4000, Australia
| | - Thao Le
- Optimum Patient Care, Cambridgeshire, CB24 3BA, UK
| | - Rebecca Vella
- Optimum Patient Care Australia, Brisbane, QLD, 4000, Australia
| | - David Price
- Optimum Patient Care, Cambridgeshire, CB24 3BA, UK
- Optimum Patient Care Australia, Brisbane, QLD, 4000, Australia
- Observational and Pragmatic Research Institute, Midview City, 573969, Singapore
- Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, AB25 2ZD, UK
- Correspondence: David Price, Optimum Patient Care Australia, 320 Adelaide St, Brisbane, QLD, 4000, Australia, Tel +4 05 764 842, Email
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Rouadi PW, Idriss SA, Bousquet J, Laidlaw TM, Azar CR, Al-Ahmad MS, Yañez A, Al-Nesf MAY, Nsouli TM, Bahna SL, Abou-Jaoude E, Zaitoun FH, Hadi UM, Hellings PW, Scadding GK, Smith PK, Morais-Almeida M, Maximiliano Gómez R, Gonzalez Diaz SN, Klimek L, Juvelekian GS, Riachy MA, Canonica GW, Peden D, Wong GW, Sublett J, Bernstein JA, Wang L, Tanno LK, Chikhladze M, Levin M, Chang YS, Martin BL, Caraballo L, Custovic A, Ortego-Martell JA, Lesslar OJ, Jensen-Jarolim E, Ebisawa M, Fiocchi A, Ansotegui IJ. WAO-ARIA consensus on chronic cough - Part III: Management strategies in primary and cough-specialty care. Updates in COVID-19. World Allergy Organ J 2022; 15:100649. [PMID: 35600836 PMCID: PMC9117692 DOI: 10.1016/j.waojou.2022.100649] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 11/18/2022] Open
Abstract
Background Chronic cough management necessitates a clear integrated care pathway approach. Primary care physicians initially encounter the majority of chronic cough patients, yet their role in proper management can prove challenging due to limited access to advanced diagnostic testing. A multidisciplinary approach involving otolaryngologists and chest physicians, allergists, and gastroenterologists, among others, is central to the optimal diagnosis and treatment of conditions which underly or worsen cough. These include infectious and inflammatory, upper and lower airway pathologies, or gastro-esophageal reflux. Despite the wide armamentarium of ancillary testing conducted in cough multidisciplinary care, such management can improve cough but seldom resolves it completely. This can be due partly to the limited data on the role of tests (eg, spirometry, exhaled nitric oxide), as well as classical pharmacotherapy conducted in multidisciplinary specialties for chronic cough. Other important factors include presence of multiple concomitant cough trigger mechanisms and the central neuronal complexity of chronic cough. Subsequent management conducted by cough specialists aims at control of cough refractory to prior interventions and includes cough-specific behavioral counseling and pharmacotherapy with neuromodulators, among others. Preliminary data on the role of neuromodulators in a proof-of-concept manner are encouraging but lack strong evidence on efficacy and safety. Objectives The World Allergy Organization (WAO)/Allergic Rhinitis and its Impact on Asthma (ARIA) Joint Committee on Chronic Cough reviewed the recent literature on management of chronic cough in primary, multidisciplinary, and cough-specialty care. Knowledge gaps in diagnostic testing, classical and neuromodulator pharmacotherapy, in addition to behavioral therapy of chronic cough were also analyzed. Outcomes This third part of the WAO/ARIA consensus on chronic cough suggests a management algorithm of chronic cough in an integrated care pathway approach. Insights into the inherent limitations of multidisciplinary cough diagnostic testing, efficacy and safety of currently available antitussive pharmacotherapy, or the recently recognized behavioral therapy, can significantly improve the standards of care in patients with chronic cough.
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Affiliation(s)
- Philip W. Rouadi
- Department of Otolaryngology – Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon
- Ear, Nose and Throat Department, Dar Al Shifa Hospital, Hawally, Kuwait
| | - Samar A. Idriss
- Department of Otolaryngology – Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon
- Department of Audiology and Otoneurological Evaluation, Edouard Herriot Hospital, Lyon, France
| | - Jean Bousquet
- Hospital Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Dermatology and Allergy, Comprehensive Allergy Center, Berlin Institute of Health, Berlin, Germany
- Macvia France, Montpellier France
- Université Montpellier, Montpellier, France
| | - Tanya M. Laidlaw
- Department of Medicine, Harvard Medical School, Division of Allergy and Clinical Immunology, Brigham and Women's Hospital Boston, Massachusetts, USA
| | - Cecilio R. Azar
- Department of Gastroenterology, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
- Department of Gastroenterology, Middle East Institute of Health (MEIH), Beirut, Lebanon
- Department of Gastroenterology, Clemenceau Medical Center (CMC), Beirut, Lebanon
| | - Mona S. Al-Ahmad
- Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait
| | - Anahi Yañez
- INAER - Investigaciones en Alergia y Enfermedades Respiratorias, Buenos Aires, Argentina
| | - Maryam Ali Y. Al-Nesf
- Allergy and Immunology Section, Department of Medicine, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
| | | | - Sami L. Bahna
- Allergy & Immunology Section, Louisiana State University Health Sciences Center, Shreveport, LA, USA
| | | | - Fares H. Zaitoun
- Department of Allergy Otolaryngology, LAU-RIZK Medical Center, Beirut, Lebanon
| | - Usamah M. Hadi
- Clinical Professor Department of Otolaryngology Head and Neck Surgery, American University of Beirut, Lebanon
| | - Peter W. Hellings
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Allergy and Clinical Immunology, Leuven, Belgium
- University Hospitals Leuven, Department of Otorhinolaryngology, Leuven, Belgium
- University Hospital Ghent, Department of Otorhinolaryngology, Laboratory of Upper Airways Research, Ghent, Belgium
- Academic Medical Center, University of Amsterdam, Department of Otorhinolaryngology, Amsterdam, the Netherlands
| | | | - Peter K. Smith
- Clinical Medicine Griffith University, Southport Qld, 4215, Australia
| | | | | | - Sandra N. Gonzalez Diaz
- Universidad Autónoma de Nuevo León, Hospital Universitario and Facultad de Medicina, Monterrey, Nuevo León, Mexico
| | - Ludger Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - Georges S. Juvelekian
- Department of Pulmonary, Critical Care and Sleep Medicine at Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Moussa A. Riachy
- Department of Pulmonary and Critical Care, Hôtel-Dieu de France university Hospital, Beirut, Lebanon
| | - Giorgio Walter Canonica
- Humanitas University & Personalized Medicine Asthma & Allergy Clinic-Humanitas Research Hospital-IRCCS-Milano Italy
| | - David Peden
- UNC Center for Environmental Medicine, Asthma, and Lung Biology, Division of Allergy, Immunology and Rheumatology, Department of Pediatrics UNC School of Medicine, USA
| | - Gary W.K. Wong
- Department of Pediatrics, Chinese University of Hong Kong, Hong Kong, China
| | - James Sublett
- Department of Pediatrics, Section of Allergy and Immunology, University of Louisville School of Medicine, 9800 Shelbyville Rd, Louisville, KY, USA
| | - Jonathan A. Bernstein
- University of Cincinnati College of Medicine, Department of Internal Medicine, Division of Immunology/Allergy Section, Cincinnati, OH, USA
| | - Lianglu Wang
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, 100730, China
| | - Luciana K. Tanno
- Université Montpellier, Montpellier, France
- Desbrest Institute of Epidemiology and Public Health, UMR UA-11, INSERM University of Montpellier, Montpellier, France
- WHO Collaborating Centre on Scientific Classification Support, Montpellier, France
| | - Manana Chikhladze
- Medical Faculty at Akaki Tsereteli State University, National Institute of Allergy, Asthma & Clinical Immunology, KuTaisi, Tskaltubo, Georgia
| | - Michael Levin
- Division of Paediatric Allergology, Department of Paediatrics, University of Cape Town, South Africa
| | - Yoon-Seok Chang
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Bryan L. Martin
- Department of Otolaryngology, Division of Allergy & Immunology, The Ohio State University, Columbus, OH, USA
| | - Luis Caraballo
- Institute for Immunological Research, University of Cartagena. Cartagena de Indias, Colombia
| | - Adnan Custovic
- National Heart and Lund Institute, Imperial College London, UK
| | | | | | - Erika Jensen-Jarolim
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University Vienna, Austria
- The interuniversity Messerli Research Institute, Medical University Vienna and University of Veterinary Medicine, Vienna, Austria
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - Alessandro Fiocchi
- Translational Pediatric Research Area, Allergic Diseases Research Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Holy See
| | - Ignacio J. Ansotegui
- Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain
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20
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Lesslar OJL, Smith PK. Itch Beyond the Skin-Mucosal Itch. Front Allergy 2022; 2:700368. [PMID: 35386995 PMCID: PMC8974814 DOI: 10.3389/falgy.2021.700368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 09/07/2021] [Indexed: 11/13/2022] Open
Abstract
Itch is a nociceptive sensation linked with reflexes and cognitive motor actions. We traditionally think of itch as a sensation of the skin related to allergy, an insect sting or interestingly, anxiety and frustration. Less understood and considered are the physiological processes involved in the itching sensation that occurs at mucosal and junctional dermal sites, which is extraordinary as from an evolutionary point of view these sites serve important guardian roles, rich in sensory nerves and inflammatory cells. Despite itch being an ancient reflex and evolutionarily conserved phenomenon, better clinical understanding of the nuances between sites of itch sensation may lead to improved clinical outcomes. This review invites readers to appreciate itch beyond the skin by highlighting several specific itch patterns-nasal, oral, auricular, vulvovaginal, anal, and perineal itch-the pathophysiological mechanisms that underlie them, the clinical patterns these may cause, and some unique treatments.
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Affiliation(s)
- Olivia J Ly Lesslar
- LifeSpan Medicine, Los Angeles, CA, United States.,Cingulum Health, Sydney, NSW, Australia
| | - Peter K Smith
- Clinical Medicine, Griffith University, Southport, QLD, Australia
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21
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Venter C, Smith PK, Arshad H. Dietary strategies for the prevention of asthma in children. Curr Opin Allergy Clin Immunol 2022; 22:123-131. [PMID: 35197434 DOI: 10.1097/aci.0000000000000805] [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: 11/25/2022]
Abstract
PURPOSE OF REVIEW This review summarizes information relating to dietary intake during pregnancy, lactation and early life that may prevent childhood asthma. This review also summarizes how future studies may be improved. RECENT FINDINGS Recent findings from observational studies suggest that eating according to certain dietary patterns during pregnancy, such as the dietary inflammatory index, Mediterranean diet and Maternal diet index, may reduce asthma and or wheeze in the child. Vitamin D supplementation with higher doses than recommended during pregnancy may be associated with reduced early transient childhood wheezing in the offspring. Higher levels of omega-3 fatty acids in breast milk may be protective against childhood asthma. Breastfeeding infants has been shown to offer many benefits to mother and child but a direct relationship between breastfeeding and the development of asthma has not been established. During childhood, infants and children may need to reduce their intake of advanced glycation end products, increase their food intake according to the traditional Mediterranean diet and increase the diversity of foods eaten. SUMMARY Current evidence provides limited suggestions regarding dietary changes for preventing early transient childhood wheezing. In order to harmonize methods for future data collection and reporting, it is important to harmonize relevant definitions and other important factors. The aim of the considerations described here is to enable a better comparison of future studies and provide better guidance to patients and families.
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Affiliation(s)
- Carina Venter
- Section of Allergy & Immunology, Department of Pediatrics, Children's Hospital Colorado, Denver, Aurora, Colorado, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Peter K Smith
- Griffith University Department of Clinical Medicine
- Qld Allergy Services, Southport, Queensland, Australia
| | - Hasan Arshad
- University of Southampton, Southampton
- The David Hide Asthma and Allergy Center, Isle of Wight, UK
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22
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Watts AM, West NP, Smith PK, Zhang P, Cripps AW, Cox AJ. Nasal immune gene expression in response to azelastine and fluticasone propionate combination or monotherapy. Immun Inflamm Dis 2022; 10:e571. [PMID: 34813682 PMCID: PMC8926499 DOI: 10.1002/iid3.571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/28/2021] [Accepted: 11/13/2021] [Indexed: 11/30/2022] Open
Abstract
Background The combination of the antihistamine azelastine (AZE) with the corticosteroid fluticasone propionate (FP) in a single spray, has been reported to be significantly more effective at reducing allergic rhinitis (AR) symptoms than treatment with either corticosteroid or antihistamine monotherapy. However, the biological basis for enhanced symptom relief is not known. This study aimed to compare gene expression profiles (760 immune genes, performed with the NanoString nCounter) from peripheral blood and nasal brushing/lavage lysate samples in response to nasal spray treatment. Methods Moderate/severe persistent dust mite AR sufferers received either AZE (125 μg/spray) nasal spray (n = 16), FP (50 μg/spray) nasal spray (n = 14) or combination spray AZE/FP (125 μg AZE and 50 μg FP/spray) (n = 14) for 7 days, twice daily. Self‐reported symptom questionnaires were completed daily for the study duration. Gene expression analysis (760 immune genes) was performed with the NanoString nCounter on purified RNA from peripheral blood and nasal brushing/lavage lysate samples. Results In nasal samples, 206 genes were significantly differentially expressed following FP treatment; 182 genes downregulated (−2.57 to −0.45 Log2 fold change [FC]), 24 genes upregulated (0.49–1.40 Log2 FC). In response to AZE/FP, only 16 genes were significantly differentially expressed; 10 genes downregulated (−1.53 to −0.58 Log2 FC), six genes upregulated (1.07–1.62 Log2 FC). Following AZE treatment only five genes were significantly differentially expressed; one gene downregulated (−1.68 Log2 FC), four genes upregulated (0.59–1.19 Log2 FC). Immune gene changes in peripheral blood samples following treatment were minimal. AR symptoms improved under all treatments, but improvements were less pronounced following AZE treatment. Conclusion AZE/FP, FP, and AZE had diverse effects on immune gene expression profiles in nasal mucosa samples. The moderate number of genes modulated by AZE/FP indicates alternative pathways in reducing AR symptoms whilst avoiding extensive local immune suppression. Antihistamine, steroid and combination nasal sprays elicit distinct gene expression profiles in nasal mucosa samples. Modest mucosal gene expression changes were noted for combination therapy compared with a steroid‐only formulation.
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Affiliation(s)
- Annabelle M. Watts
- School of Medical Science Griffith University Southport Queensland Australia
| | - Nicholas P. West
- School of Medical Science Griffith University Southport Queensland Australia
- Menzies Health Institute of Queensland Griffith University Southport Queensland Australia
| | - Peter K. Smith
- Queensland Allergy Services Clinic Southport Queensland Australia
| | - Ping Zhang
- Menzies Health Institute of Queensland Griffith University Southport Queensland Australia
| | - Allan W. Cripps
- Menzies Health Institute of Queensland Griffith University Southport Queensland Australia
- School of Medicine Griffith University Southport Queensland Australia
| | - Amanda J. Cox
- School of Medical Science Griffith University Southport Queensland Australia
- Menzies Health Institute of Queensland Griffith University Southport Queensland Australia
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23
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Nery M, Smith PK, Lang M, Vertommen T, Stirling A. Editorial: Safeguarding in sports. Front Psychol 2022; 13:1096118. [PMID: 36950531 PMCID: PMC10027007 DOI: 10.3389/fpsyg.2022.1096118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 11/30/2022] [Indexed: 03/08/2023] Open
Affiliation(s)
- Miguel Nery
- Faculdade e Ciências Sociais e Tecnologia, Universidade Europeia, Lisboa, Portugal
- *Correspondence: Miguel Nery
| | - Peter K. Smith
- Unit for School and Family Studies, Department of Psychology, Goldsmiths, University of London, London, United Kingdom
| | - Melanie Lang
- Department of History, Geography and Social Sciences, Edge Hill University, Ormskirk, United Kingdom
| | - Tine Vertommen
- Prevention and Empowerment Lab, People and Well-being Research Unit, Thomas More University of Applied Sciences, Antwerp, Belgium
- Social Epidemiology and Health Policy (SEHPO), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Ashley Stirling
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
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24
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Sabatine MS, Bergmark BA, Murphy SA, O'Gara PT, Smith PK, Serruys PW, Kappetein AP, Park SJ, Park DW, Christiansen EH, Holm NR, Nielsen PH, Stone GW, Sabik JF, Braunwald E. Percutaneous coronary intervention with drug-eluting stents versus coronary artery bypass grafting in left main coronary artery disease: an individual patient data meta-analysis. Lancet 2021; 398:2247-2257. [PMID: 34793745 DOI: 10.1016/s0140-6736(21)02334-5] [Citation(s) in RCA: 97] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/11/2021] [Accepted: 10/14/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND The optimal revascularisation strategy for patients with left main coronary artery disease is uncertain. We therefore aimed to evaluate long-term outcomes for patients treated with percutaneous coronary intervention (PCI) with drug-eluting stents versus coronary artery bypass grafting (CABG). METHODS In this individual patient data meta-analysis, we searched MEDLINE, Embase, and the Cochrane database using the search terms "left main", "percutaneous coronary intervention" or "stent", and "coronary artery bypass graft*" to identify randomised controlled trials (RCTs) published in English between database inception and Aug 31, 2021, comparing PCI with drug-eluting stents with CABG in patients with left main coronary artery disease that had at least 5 years of patient follow-up for all-cause mortality. Two authors (MSS and BAB) identified studies meeting the criteria. The primary endpoint was 5-year all-cause mortality. Secondary endpoints were cardiovascular death, spontaneous myocardial infarction, procedural myocardial infarction, stroke, and repeat revascularisation. We used a one-stage approach; event rates were calculated by use of the Kaplan-Meier method and treatment group comparisons were made by use of a Cox frailty model, with trial as a random effect. In Bayesian analyses, the probabilities of absolute risk differences in the primary endpoint between PCI and CABG being more than 0·0%, and at least 1·0%, 2·5%, or 5·0%, were calculated. FINDINGS Our literature search yielded 1599 results, of which four RCTs-SYNTAX, PRECOMBAT, NOBLE, and EXCEL-meeting our inclusion criteria were included in our meta-analysis. 4394 patients, with a median SYNTAX score of 25·0 (IQR 18·0-31·0), were randomly assigned to PCI (n=2197) or CABG (n=2197). The Kaplan-Meier estimate of 5-year all-cause death was 11·2% (95% CI 9·9-12·6) with PCI and 10·2% (9·0-11·6) with CABG (hazard ratio 1·10, 95% CI 0·91-1·32; p=0·33), resulting in a non-statistically significant absolute risk difference of 0·9% (95% CI -0·9 to 2·8). In Bayesian analyses, there was an 85·7% probability that death at 5 years was greater with PCI than with CABG; this difference was more likely than not less than 1·0% (<0·2% per year). The numerical difference in mortality was comprised more of non-cardiovascular than cardiovascular death. Spontaneous myocardial infarction (6·2%, 95% CI 5·2-7·3 vs 2·6%, 2·0-3·4; hazard ratio [HR] 2·35, 95% CI 1·71-3·23; p<0·0001) and repeat revascularisation (18·3%, 16·7-20·0 vs 10·7%, 9·4-12·1; HR 1·78, 1·51-2·10; p<0·0001) were more common with PCI than with CABG. Differences in procedural myocardial infarction between strategies depended on the definition used. Overall, there was no difference in the risk of stroke between PCI (2·7%, 2·0-3·5) and CABG (3·1%, 2·4-3·9; HR 0·84, 0·59-1·21; p=0·36), but the risk was lower with PCI in the first year after randomisation (HR 0·37, 0·19-0·69). INTERPRETATION Among patients with left main coronary artery disease and, largely, low or intermediate coronary anatomical complexity, there was no statistically significant difference in 5-year all-cause death between PCI and CABG, although a Bayesian approach suggested a difference probably exists (more likely than not <0·2% per year) favouring CABG. There were trade-offs in terms of the risk of myocardial infarction, stroke, and revascularisation. A heart team approach to communicate expected outcome differences might be useful to assist patients in reaching a treatment decision. FUNDING No external funding.
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Affiliation(s)
- Marc S Sabatine
- Thrombolysis in Myocardial Infarction Study Group, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Brian A Bergmark
- Thrombolysis in Myocardial Infarction Study Group, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Sabina A Murphy
- Thrombolysis in Myocardial Infarction Study Group, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Patrick T O'Gara
- Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Peter K Smith
- Department of Surgery (Cardiothoracic), Duke University School of Medicine, Duke Clinical Research Institute, Durham, NC, USA
| | - Patrick W Serruys
- Department of Cardiology, National University of Ireland Galway, Galway, Ireland; National Heart and Lung Institute, Imperial College London, London, UK
| | - A Pieter Kappetein
- Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands; Medtronic, Maastricht, Netherlands
| | - Seung-Jung Park
- Department of Cardiology, Asan Medical Center, Seoul, South Korea
| | - Duk-Woo Park
- Department of Cardiology, Asan Medical Center, Seoul, South Korea
| | | | - Niels R Holm
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Per H Nielsen
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Gregg W Stone
- The Zena and Michael A Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Cardiovascular Research Foundation, New York, NY, USA
| | - Joseph F Sabik
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Eugene Braunwald
- Thrombolysis in Myocardial Infarction Study Group, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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25
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Rouadi PW, Idriss SA, Bousquet J, Laidlaw TM, Azar CR, Sulaiman AL-Ahmad M, Yáñez A, AL-Nesf MAY, Nsouli TM, Bahna SL, Abou-Jaoude E, Zaitoun FH, Hadi UM, Hellings PW, Scadding GK, Smith PK, Morais-Almeida M, Gómez RM, González Díaz SN, Klimek L, Juvelekian GS, Riachy MA, Canonica GW, Peden D, Wong GW, Sublett J, Bernstein JA, Wang L, Tanno LK, Chikhladze M, Levin M, Chang YS, Martin BL, Caraballo L, Custovic A, Ortega-Martell JA, Jensen-Jarolim E, Ebisawa M, Fiocchi A, Ansotegui IJ. WAO-ARIA consensus on chronic cough - Part 1: Role of TRP channels in neurogenic inflammation of cough neuronal pathways. World Allergy Organ J 2021; 14:100617. [PMID: 34934475 PMCID: PMC8654622 DOI: 10.1016/j.waojou.2021.100617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/09/2021] [Accepted: 09/14/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cough features a complex peripheral and central neuronal network. The function of the chemosensitive and stretch (afferent) cough receptors is well described but partly understood. It is speculated that chronic cough reflects a neurogenic inflammation of the cough reflex, which becomes hypersensitive. This is mediated by neuromediators, cytokines, inflammatory cells, and a differential expression of neuronal (chemo/stretch) receptors, such as transient receptor potential (TRP) and purinergic P2X ion channels; yet the overall interaction of these mediators in neurogenic inflammation of cough pathways remains unclear. OBJECTIVES The World Allergy Organization/Allergic Rhinitis and its Impact on Asthma (WAO/ARIA) Joint Committee on Chronic Cough reviewed the current literature on neuroanatomy and pathophysiology of chronic cough. The role of TRP ion channels in pathogenic mechanisms of the hypersensitive cough reflex was also examined. OUTCOMES Chemoreceptors are better studied in cough neuronal pathways compared to stretch receptors, likely due to their anatomical overabundance in the respiratory tract, but also their distinctive functional properties. Central pathways are important in suppressive mechanisms and behavioral/affective aspects of chronic cough. Current evidence strongly suggests neurogenic inflammation induces a hypersensitive cough reflex marked by increased expression of neuromediators, mast cells, and eosinophils, among others. TRP ion channels, mainly TRP V1/A1, are important in the pathogenesis of chronic cough due to their role in mediating chemosensitivity to various endogenous and exogenous triggers, as well as a crosstalk between neurogenic and inflammatory pathways in cough-associated airways diseases.
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Affiliation(s)
- Philip W. Rouadi
- Department of Otolaryngology - Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon
| | - Samar A. Idriss
- Department of Otolaryngology - Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon
- Department of Audiology and Otoneurological Evaluation, Edouard Herriot Hospital, Lyon, France
| | - Jean Bousquet
- Hospital Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Dermatology and Allergy, Comprehensive Allergy Center, Berlin Institute of Health, Berlin, Germany
- Macvia France, Montpellier France
- Université Montpellier, Montpellier, France
| | - Tanya M. Laidlaw
- Department of Medicine, Harvard Medical School, Division of Allergy and Clinical Immunology, Brigham and Women's Hospital Boston, MA, USA
| | - Cecilio R. Azar
- Department of Gastroenterology, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
- Department of Gastroenterology, Middle East Institute of Health (MEIH), Beirut, Lebanon
- Department of Gastroenterology, Clemenceau Medical Center (CMC), Beirut, Lebanon
| | | | - Anahí Yáñez
- INAER - Investigaciones en Alergia y Enfermedades Respiratorias, Buenos Aires, Argentina
| | - Maryam Ali Y. AL-Nesf
- Allergy and Immunology Section, Department of Medicine, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
| | | | - Sami L. Bahna
- Allergy & Immunology Section, Louisiana State University Health Sciences Center, Shreveport, LA, USA
| | | | - Fares H. Zaitoun
- Department of Allergy Otolaryngology, LAU-RIZK Medical Center, Beirut, Lebanon
| | - Usamah M. Hadi
- Clinical Professor Department of Otolaryngology Head and Neck Surgery, American University of Beirut, Lebanon
| | - Peter W. Hellings
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Allergy and Clinical Immunology, Leuven, Belgium
- University Hospitals Leuven, Department of Otorhinolaryngology, Leuven, Belgium
- University Hospital Ghent, Department of Otorhinolaryngology, Laboratory of Upper Airways Research, Ghent, Belgium
- Academic Medical Center, University of Amsterdam, Department of Otorhinolaryngology, Amsterdam, the Netherlands
| | | | - Peter K. Smith
- Clinical Medicine Griffith University, Southport Qld, 4215, Australia
| | | | | | - Sandra N. González Díaz
- Universidad Autónoma de Nuevo León, Hospital Universitario and Facultad de Medicina, Monterrey, Nuevo León, Mexico
| | - Ludger Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - Georges S. Juvelekian
- Department of Pulmonary, Critical Care and Sleep Medicine at Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Moussa A. Riachy
- Department of Pulmonary and Critical Care, Hôtel-Dieu de France University Hospital, Beirut, Lebanon
| | - Giorgio Walter Canonica
- Humanitas University, Personalized Medicine Asthma & Allergy Clinic-Humanitas Research Hospital-IRCCS-Milano Italy
| | - David Peden
- UNC Center for Environmental Medicine, Asthma, and Lung Biology, Division of Allergy, Immunology and Rheumatology, Department of Pediatrics UNS School of Medicine, USA
| | - Gary W.K. Wong
- Department of Pediatrics, Chinese University of Hong Kong, Hong Kong, China
| | - James Sublett
- Department of Pediatrics, Section of Allergy and Immunology, University of Louisville School of Medicine, 9800 Shelbyville Rd, Louisville, KY, USA
| | - Jonathan A. Bernstein
- University of Cincinnati College of Medicine, Department of Internal Medicine, Division of Immunology/Allergy Section, Cincinnati
| | - Lianglu Wang
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing 100730, China
| | - Luciana Kase Tanno
- Université Montpellier, Montpellier, France
- Desbrest Institute of Epidemiology and Public Health, UMR UA-11, INSERM University of Montpellier, Montpellier, France
- WHO Collaborating Centre on Scientific Classification Support, Montpellier, France
| | - Manana Chikhladze
- Medical Faculty at Akaki Tsereteli State University, National Institute of Allergy, Asthma & Clinical Immunology, KuTaisi, Tskaltubo, Georgia
| | - Michael Levin
- Division of Paediatric Allergology, Department of Paediatrics, University of Cape Town, South Africa
| | - Yoon-Seok Chang
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Bryan L. Martin
- Department of Otolaryngology, Division of Allergy & Immunology, The Ohio State University, Columbus, OH, USA
| | - Luis Caraballo
- Institute for Immunological Research, University of Cartagena. Cartagena de Indias, Colombia
| | - Adnan Custovic
- National Heart and Lund Institute, Imperial College London, UK
| | | | - Erika Jensen-Jarolim
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University Vienna, Austria
- The Interuniversity Messerli Research Institute, Medical University Vienna and Univ, of Veterinary Medicine Vienna, Austria
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology,National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - Alessandro Fiocchi
- Translational Pediatric Research Area, Allergic Diseases Research Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Holy See
| | - Ignacio J. Ansotegui
- Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain
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26
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Rouadi PW, Idriss SA, Bousquet J, Laidlaw TM, Azar CR, Al-Ahmad MS, Yañez A, Al-Nesf MAY, Nsouli TM, Bahna SL, Abou-Jaoude E, Zaitoun FH, Hadi UM, Hellings PW, Scadding GK, Smith PK, Morais-Almeida M, Gómez RM, Gonzalez Diaz SN, Klimek L, Juvelekian GS, Riachy MA, Canonica GW, Peden D, Wong GW, Sublett J, Bernstein JA, Wang L, Tanno LK, Chikhladze M, Levin M, Chang YS, Martin BL, Caraballo L, Custovic A, Ortega-Martell JA, Jensen-Jarolim E, Ebisawa M, Fiocchi A, Ansotegui IJ. WAO-ARIA consensus on chronic cough - Part II: Phenotypes and mechanisms of abnormal cough presentation - Updates in COVID-19. World Allergy Organ J 2021; 14:100618. [PMID: 34963794 PMCID: PMC8666560 DOI: 10.1016/j.waojou.2021.100618] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 10/30/2021] [Accepted: 11/12/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Chronic cough can be triggered by respiratory and non-respiratory tract illnesses originating mainly from the upper and lower airways, and the GI tract (ie, reflux). Recent findings suggest it can also be a prominent feature in obstructive sleep apnea (OSA), laryngeal hyperresponsiveness, and COVID-19. The classification of chronic cough is constantly updated but lacks clear definition. Epidemiological data on the prevalence of chronic cough are informative but highly variable. The underlying mechanism of chronic cough is a neurogenic inflammation of the cough reflex which becomes hypersensitive, thus the term hypersensitive cough reflex (HCR). A current challenge is to decipher how various infectious and inflammatory airway diseases and esophageal reflux, among others, modulate HCR. OBJECTIVES The World Allergy Organization/Allergic Rhinitis and its Impact on Asthma (WAO/ARIA) Joint Committee on Chronic Cough reviewed the current literature on classification, epidemiology, presenting features, and mechanistic pathways of chronic cough in airway- and reflux-related cough phenotypes, OSA, and COVID-19. The interplay of cough reflex sensitivity with other pathogenic mechanisms inherent to airway and reflux-related inflammatory conditions was also analyzed. OUTCOMES Currently, it is difficult to clearly ascertain true prevalence rates in epidemiological studies of chronic cough phenotypes. This is likely due to lack of standardized objective measures needed for cough classification and frequent coexistence of multi-organ cough origins. Notwithstanding, we emphasize the important role of HCR as a mechanistic trigger in airway- and reflux-related cough phenotypes. Other concomitant mechanisms can also modulate HCR, including type2/Th1/Th2 inflammation, presence or absence of deep inspiration-bronchoprotective reflex (lower airways), tissue remodeling, and likely cough plasticity, among others.
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Affiliation(s)
- Philip W. Rouadi
- Department of Otolaryngology - Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon
| | - Samar A. Idriss
- Department of Otolaryngology - Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon
- Department of Audiology and Otoneurological Evaluation, Edouard Herriot Hospital, Lyon, France
| | - Jean Bousquet
- Hospital Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Dermatology and Allergy, Comprehensive Allergy Center, Berlin Institute of Health, Berlin, Germany
- Macvia France, Montpellier France
- Université Montpellier, France, Montpellier, France
| | - Tanya M. Laidlaw
- Department of Medicine, Harvard Medical School, Division of Allergy and Clinical Immunology, Brigham and Women's Hospital Boston, MA, USA
| | - Cecilio R. Azar
- Department of Gastroenterology, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
- Department of Gastroenterology, Middle East Institute of Health (MEIH), Beirut, Lebanon
- Department of Gastroenterology, Clemenceau Medical Center (CMC), Beirut, Lebanon
| | - Mona S. Al-Ahmad
- Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait
| | - Anahi Yañez
- INAER - Investigaciones en Alergia y Enfermedades Respiratorias, Buenos Aires, Argentina
| | - Maryam Ali Y. Al-Nesf
- Allergy and Immunology Section, Department of Medicine, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
| | | | - Sami L. Bahna
- Allergy & Immunology Section, Louisiana State University Health Sciences Center, Shreveport, LA, USA
| | | | - Fares H. Zaitoun
- Department of Allergy Otolaryngology, LAU-RIZK Medical Center, Beirut, Lebanon
| | - Usamah M. Hadi
- Clinical Professor Department of Otolaryngology Head and Neck Surgery, American University of Beirut, Lebanon
| | - Peter W. Hellings
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Allergy and Clinical Immunology, Leuven, Belgium
- University Hospitals Leuven, Department of Otorhinolaryngology, Leuven, Belgium
- University Hospital Ghent, Department of Otorhinolaryngology, Laboratory of Upper Airways Research, Ghent, Belgium
- Academic Medical Center, University of Amsterdam, Department of Otorhinolaryngology, Amsterdam, the Netherlands
| | | | - Peter K. Smith
- Clinical Medicine Griffith University, Southport Qld, 4215, Australia
| | | | | | - Sandra N. Gonzalez Diaz
- Universidad Autónoma de Nuevo León, Hospital Universitario and Facultad de Medicina, Monterrey, NL, Mexico
| | - Ludger Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - Georges S. Juvelekian
- Department of Pulmonary, Critical Care and Sleep Medicine at Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Moussa A. Riachy
- Department of Pulmonary and Critical Care, Hôtel-Dieu de France University Hospital, Beirut, Lebanon
| | - Giorgio Walter Canonica
- Humanitas University & Personalized Medicine Asthma & Allergy Clinic-Humanitas Research Hospital-IRCCS-Milano Italy
| | - David Peden
- UNC Center for Environmental Medicine, Asthma, and Lung Biology, Division of Allergy, Immunology and Rheumatology, Department of Pediatrics UNS School of Medicine, USA
| | - Gary W.K. Wong
- Department of Pediatrics, Chinese University of Hong Kong, Hong Kong, China
| | - James Sublett
- Department of Pediatrics, Section of Allergy and Immunology, University of Louisville School of Medicine, Shelbyville Rd, Louisville, KY, 9800, USA
| | - Jonathan A. Bernstein
- University of Cincinnati College of Medicine, Department of Internal Medicine, Division of Immunology/Allergy Section, Cincinnati, USA
| | - Lianglu Wang
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, 100730, China
| | - Luciana K. Tanno
- Université Montpellier, France, Montpellier, France
- Desbrest Institute of Epidemiology and Public Health, UMR UA-11, INSERM University of Montpellier, Montpellier, France
- WHO Collaborating Centre on Scientific Classification Support, Montpellier, France
| | - Manana Chikhladze
- Medical Faculty at Akaki Tsereteli State University, National Institute of Allergy, Asthma & Clinical Immunology, KuTaisi, Tskaltubo, Georgia
| | - Michael Levin
- Division of Paediatric Allergology, Department of Paediatrics, University of Cape Town, South Africa
| | - Yoon-Seok Chang
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Bryan L. Martin
- Department of Otolaryngology, Division of Allergy & Immunology, The Ohio State University, Columbus, OH, USA
| | - Luis Caraballo
- Institute for Immunological Research, University of Cartagena. Cartagena de Indias, Colombia
| | - Adnan Custovic
- National Heart and Lund Institute, Imperial College London, UK
| | | | - Erika Jensen-Jarolim
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University Vienna, Austria
- The interuniversity Messerli Research Institute, Medical University Vienna and Univ, of Veterinary Medicine Vienna, Austria
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - Alessandro Fiocchi
- Translational Pediatric Research Area, Allergic Diseases Research Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Holy See
| | - Ignacio J. Ansotegui
- Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain
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Watts AM, West NP, Smith PK, Cripps AW, Cox AJ. Adult allergic rhinitis sufferers have unique nasal mucosal and peripheral blood immune gene expression profiles: A case-control study. Immun Inflamm Dis 2021; 10:78-92. [PMID: 34637606 PMCID: PMC8669689 DOI: 10.1002/iid3.545] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/26/2021] [Accepted: 09/29/2021] [Indexed: 11/16/2022]
Abstract
Background Allergic rhinitis (AR) is a complex disease involving both mucosal and systemic immune compartments. Greater understanding of the immune networks underpinning AR pathophysiology may assist with further refining disease‐specific biomarkers. Objective To compare immune gene expression profiles in nasal mucosa and peripheral blood samples between adults with AR and controls without AR. Methods This cross‐sectional study included 45 adults with moderate‐severe and persistent AR (37.6 ± 12.8 years; mean ± SD) and 24 adults without AR (36.6 ± 10.2). Gene expression analysis was performed using the NanoString nCounter PanCancer Immune profiling panel (n = 730 immune genes) in combination with the panel plus probe set (n = 30 allergy‐related genes) with purified RNA from peripheral blood and cell lysates prepared from combined nasal lavage and nasal brushing. Results One hundred and thirteen genes were significantly differentially expressed in peripheral blood samples between groups (p < .05). In contrast, 14 genes were differentially expressed in nasal lysate samples between groups (p < .05). Upregulation of allergy‐related genes in nasal mucosa samples in the AR group was observed. Namely, chemokines CCL17 and CCL26 are involved in the chemotaxis of key effector cells and TPSAB1 encodes tryptase, an inflammatory mediator released from activated mast cells and basophils. Six differentially expressed genes (DEGs) were in common between the nasal mucosa and blood samples. In addition, counts of specific DEGs in nasal mucosa samples were positively correlated with eosinophil and dust mite‐specific immunoglobulin E (IgE) counts in blood. Conclusions and Clinical Relevance Distinct gene expression profiles in blood and nasal mucosa samples were observed between AR sufferers and controls. The results of this study also provide evidence for a close interaction between the local site and systemic immunity. The genes identified in this study contribute to the current knowledge of AR pathophysiology and may serve as biomarkers to evaluate the effectiveness of treatment regimens, or as targets for drug discovery.
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Affiliation(s)
- Annabelle M Watts
- Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia.,School of Medical Science, Griffith University, Southport, Queensland, Australia
| | - Nicholas P West
- Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia.,School of Medical Science, Griffith University, Southport, Queensland, Australia
| | - Peter K Smith
- School of Medicine, Griffith University, Southport, Queensland, Australia.,Queensland Allergy Services Clinic, Southport, Queensland, Australia
| | - Allan W Cripps
- Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia.,School of Medicine, Griffith University, Southport, Queensland, Australia
| | - Amanda J Cox
- Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia.,School of Medical Science, Griffith University, Southport, Queensland, Australia
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28
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Knight T, Smith PK, Soutter V, Oswald E, Venter C. Is the low pH of infant and toddler foods a concern? Pediatr Allergy Immunol 2021; 32:1103-1106. [PMID: 33190325 DOI: 10.1111/pai.13414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 11/02/2020] [Accepted: 11/09/2020] [Indexed: 11/26/2022]
Affiliation(s)
| | - Peter K Smith
- Qld Allergy Services, Southport, Qld, Australia.,Department of Clinical Medicine, Griffith University, Southport, Qld, Australia
| | - Velencia Soutter
- Qld Allergy Services, Southport, Qld, Australia.,Allergy Unit, RPAH, Camperdown, NSW, Australia
| | - Emma Oswald
- Qld Allergy Services, Southport, Qld, Australia
| | - Carina Venter
- Children's Hospital Colorado, Denver, CO, USA.,University of Colorado, Denver, CO, USA
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29
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Golpanian RS, Aickara DJ, Bellodi Schmidt F, Smith PK, Yosipovitch G. Hydrolysed formula, delayed food introduction and fatty acids for atopic dermatitis prevention in infancy. Acta Paediatr 2021; 110:1784-1787. [PMID: 33378091 DOI: 10.1111/apa.15742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/08/2020] [Accepted: 12/28/2020] [Indexed: 01/03/2023]
Abstract
AIM The role of nutrition in preventing atopic diseases including atopic dermatitis has recently gained interest in the medical community. Caregivers of infants and children at an increased risk for developing atopic dermatitis often employ exclusion diets or other measures in hopes of preventing the development of this burdensome disease. This paper reviews the current literature in regard to the role of preventative dietary measures in the context of atopic dermatitis, with a special focus on the topics of hydrolysed formula, early vs. delayed introduction of certain foods and fatty acid supplementation. METHODS Literature pertaining to preventative dietary measures for infants at risk for atopic dermatitis was reviewed. RESULTS Analysis of the literature suggests that hydrolysed formula should not be routinely offered to infants for prevention of atopic dermatitis. Formulas utilised should contain concentrations of polyunsaturated fatty acids similar to that in breast milk. Finally, infant caregivers should not delay or restrict introduction of food, which can be more harmful than helpful to the patient. CONCLUSION Recommendations to caretakers providing for infants at risk for atopic dermatitis should include infant consumption of breast milk and avoid delayed introduction of foods.
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Affiliation(s)
- Rachel Shireen Golpanian
- Department of Dermatology and Cutaneous Surgery, and Itch Center University of Miami Miller School of Medicine Miami FL USA
| | - Divya J. Aickara
- Department of Dermatology and Cutaneous Surgery, and Itch Center University of Miami Miller School of Medicine Miami FL USA
| | - Fernanda Bellodi Schmidt
- Department of Dermatology and Cutaneous Surgery, and Itch Center University of Miami Miller School of Medicine Miami FL USA
| | - Peter K. Smith
- Clinical Medicine Griffith University Southport Qld Australia
| | - Gil Yosipovitch
- Department of Dermatology and Cutaneous Surgery, and Itch Center University of Miami Miller School of Medicine Miami FL USA
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30
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Baker AW, Maziarz EK, Lewis SS, Stout JE, Anderson DJ, Smith PK, Schroder JN, Daneshmand MA, Alexander BD, Wallace RJ, Sexton DJ, Wolfe CR. Invasive Mycobacterium abscessus Complex Infection After Cardiac Surgery: Epidemiology, Management, and Clinical Outcomes. Clin Infect Dis 2021; 72:1232-1240. [PMID: 32133489 DOI: 10.1093/cid/ciaa215] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 02/28/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND We recently mitigated a clonal outbreak of hospital-acquired Mycobacterium abscessus complex (MABC), which included a large cluster of adult patients who developed invasive infection after exposure to heater-cooler units during cardiac surgery. Recent studies have detailed Mycobacterium chimaera infections acquired during cardiac surgery; however, little is known about the epidemiology and clinical courses of cardiac surgery patients with invasive MABC infection. METHODS We retrospectively collected clinical data on all patients who underwent cardiac surgery at our hospital and subsequently had positive cultures for MABC from 2013 through 2016. Patients with ventricular assist devices or heart transplants were excluded. We analyzed patient characteristics, antimicrobial therapy, surgical interventions, and clinical outcomes. RESULTS Ten cardiac surgery patients developed invasive, extrapulmonary infection from M. abscessus subspecies abscessus in an outbreak setting. Median time from presumed inoculation in the operating room to first positive culture was 53 days (interquartile range [IQR], 38-139 days). Disseminated infection was common, and the most frequent culture-positive sites were mediastinum (n = 7) and blood (n = 7). Patients received a median of 24 weeks (IQR, 5-33 weeks) of combination antimicrobial therapy that included multiple intravenous agents. Six patients required antibiotic changes due to adverse events attributed to amikacin, linezolid, or tigecycline. Eight patients underwent surgical management, and 6 patients required multiple sternal debridements. Eight patients died within 2 years of diagnosis, including 4 deaths directly attributable to MABC infection. CONCLUSIONS Despite aggressive medical and surgical management, invasive MABC infection after cardiac surgery caused substantial morbidity and mortality. New treatment strategies are needed, and compliance with infection prevention guidelines remains critical.
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Affiliation(s)
- Arthur W Baker
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA.,Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina, USA
| | - Eileen K Maziarz
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA
| | - Sarah S Lewis
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA.,Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina, USA
| | - Jason E Stout
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA
| | - Deverick J Anderson
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA.,Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina, USA
| | - Peter K Smith
- Division of Cardiovascular and Thoracic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jacob N Schroder
- Division of Cardiovascular and Thoracic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Mani A Daneshmand
- Division of Cardiovascular and Thoracic Surgery, Duke University School of Medicine, Durham, North Carolina, USA.,Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Barbara D Alexander
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA.,Duke University Clinical Microbiology Laboratory, Durham, North Carolina, USA
| | - Richard J Wallace
- Mycobacteria/Nocardia Research Laboratory, Department of Microbiology, University of Texas Health Science Center, Tyler, Texas, USA
| | - Daniel J Sexton
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA.,Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina, USA
| | - Cameron R Wolfe
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA
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31
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Bertrand PB, Overbey JR, Zeng X, Levine RA, Ailawadi G, Acker MA, Smith PK, Thourani VH, Bagiella E, Miller MA, Gupta L, Mack MJ, Gillinov AM, Giustino G, Moskowitz AJ, Gelijns AC, Bowdish ME, O'Gara PT, Gammie JS, Hung J. Progression of Tricuspid Regurgitation After Surgery for Ischemic Mitral Regurgitation. J Am Coll Cardiol 2021; 77:713-724. [PMID: 33573741 DOI: 10.1016/j.jacc.2020.11.066] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/13/2020] [Accepted: 11/20/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Whether to repair nonsevere tricuspid regurgitation (TR) during surgery for ischemic mitral valve regurgitation (IMR) remains uncertain. OBJECTIVES The goal of this study was to investigate the incidence, predictors, and clinical significance of TR progression and presence of ≥moderate TR after IMR surgery. METHODS Patients (n = 492) with untreated nonsevere TR within 2 prospectively randomized IMR trials were included. Key outcomes were TR progression (either progression by ≥2 grades, surgery for TR, or severe TR at 2 years) and presence of ≥moderate TR at 2 years. RESULTS Patients' mean age was 66 ± 10 years (67% male), and TR distribution was 60% ≤trace, 31% mild, and 9% moderate. Among 2-year survivors, TR progression occurred in 20 (6%) of 325 patients. Baseline tricuspid annular diameter (TAD) was not predictive of TR progression. At 2 years, 37 (11%) of 323 patients had ≥moderate TR. Baseline TR grade, indexed TAD, and surgical ablation for atrial fibrillation were independent predictors of ≥moderate TR. However, TAD alone had poor discrimination (area under the curve, ≤0.65). Presence of ≥moderate TR at 2 years was higher in patients with MR recurrence (20% vs. 9%; p = 0.02) and a permanent pacemaker/defibrillator (19% vs. 9%; p = 0.01). Clinical event rates (composite of ≥1 New York Heart Association functional class increase, heart failure hospitalization, mitral valve surgery, and stroke) were higher in patients with TR progression (55% vs. 23%; p = 0.003) and ≥moderate TR at 2 years (38% vs. 22%; p = 0.04). CONCLUSIONS After IMR surgery, progression of unrepaired nonsevere TR is uncommon. Baseline TAD is not predictive of TR progression and is poorly discriminative of ≥moderate TR at 2 years. TR progression and presence of ≥moderate TR are associated with clinical events. (Comparing the Effectiveness of a Mitral Valve Repair Procedure in Combination With Coronary Artery Bypass Grafting [CABG] Versus CABG Alone in People With Moderate Ischemic Mitral Regurgitation, NCT00806988; Comparing the Effectiveness of Repairing Versus Replacing the Heart's Mitral Valve in People With Severe Chronic Ischemic Mitral Regurgitation, NCT00807040).
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Affiliation(s)
- Philippe B Bertrand
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jessica R Overbey
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Xin Zeng
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Robert A Levine
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Gorav Ailawadi
- Section of Adult Cardiac Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Michael A Acker
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Peter K Smith
- Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Vinod H Thourani
- Cardiothoracic Surgery, Piedmont Heart Institute, Atlanta, Georgia, USA
| | - Emilia Bagiella
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Marissa A Miller
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Lopa Gupta
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michael J Mack
- Cardiothoracic Surgery, Baylor Research Institute, Baylor Scott & White Health, Plano, Texas, USA
| | - A Marc Gillinov
- Department of Thoracic & Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio, USA
| | - Gennaro Giustino
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Alan J Moskowitz
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Annetine C Gelijns
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
| | - Michael E Bowdish
- Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Patrick T O'Gara
- Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - James S Gammie
- Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Judy Hung
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA
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32
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Monks CP, Smith PK, Kucaba K. Peer Victimisation in Early Childhood; Observations of Participant Roles and Sex Differences. Int J Environ Res Public Health 2021; 18:ijerph18020415. [PMID: 33430281 PMCID: PMC7825670 DOI: 10.3390/ijerph18020415] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/22/2020] [Accepted: 01/05/2021] [Indexed: 12/02/2022]
Abstract
During middle childhood and adolescence, victimisation appears to be a group process involving different participant roles. However, peer reports with younger children (four to six years old) have failed to identify the participant roles of assistant (to the bully) reinforcers or defenders with much reliability. This may be because peer victimisation is a more dyadic process among younger children (behavioural reality), or because of limitations in young children’s cognitive capacity to identify these behaviours (cognitive limitations). The findings of an observational study which examined the group nature of peer victimisation among young children are presented. Observations were made of 56 children aged four and five years using time sampling during free play at school (totalling 43.5 h of observation). Records were made of their behaviour when an onlooker witnessed aggression by others, and also of others’ behaviour when they were being aggressive or being victimised. Although children other than the aggressor and target were present in nearly two thirds of the episodes of peer victimisation observed, few exhibited behavioural responses in line with the assistant, reinforcer or defender roles. This supports the behavioural reality rather than the cognitive limitations explanation. Sex differences were observed in types of aggression displayed by children, with boys more likely than girls to be physically aggressive. Children were less likely to be aggressive to other-sex peers and were most likely to be victimised by children of the same sex as them. There were also sex differences in children’s onlooker behaviour. The implications for our understanding of the development of peer victimisation and bullying in children are discussed.
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Affiliation(s)
- Claire P. Monks
- School of Human Sciences, Institute for Lifecourse Development, University of Greenwich, London SE10 9LS, UK;
- Correspondence: ; Tel.: +44-20-8331-9584
| | - Peter K. Smith
- Department of Psychology, Goldsmiths, University of London, London SE14 6NW, UK;
| | - Kat Kucaba
- School of Human Sciences, Institute for Lifecourse Development, University of Greenwich, London SE10 9LS, UK;
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33
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Samara M, Massarwi AA, El-Asam A, Hammuda S, Smith PK, Morsi H. The Mediating Role of Bullying and Victimisation on the Relationship Between Problematic Internet Use and Substance Abuse Among Adolescents in the UK: The Parent-Child Relationship as a Moderator. Front Psychiatry 2021; 12:493385. [PMID: 34777028 PMCID: PMC8581192 DOI: 10.3389/fpsyt.2021.493385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 07/09/2021] [Indexed: 11/29/2022] Open
Abstract
Over the last decade, research into the negative effects of problematic internet use has greatly increased. The current study adopted a mediation-moderation model in exploring the relationship between problematic internet use and substance abuse (drinking, drug use, and smoking tobacco cigarettes) among 1,613 adolescents (aged 10-16) in the UK. The findings of the study revealed a significant positive correlation between problematic internet use and substance abuse, which is mediated by traditional and cyber bullying and victimisation. Furthermore, the parent-child relationship was found to be a protective factor that moderated the correlation between problematic internet use and substance abuse and the correlation between problematic internet use and traditional bullying. The study emphasises the critical need to reduce problematic internet use among adolescents as a risk factor for involvement in bullying as perpetrators and victims, in addition to substance abuse. Furthermore, the findings of the study highlight the importance of a good parent-child relationship as a protective factor among adolescents. In light of the findings of the study, interventions for reducing problematic internet use taking into account bullying and the parent-child relationship are needed among adolescents.
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Affiliation(s)
- Muthanna Samara
- Department of Psychology, Kingston University London, Kingston upon Thames, United Kingdom
| | - Adeem Ahmad Massarwi
- Department of Psychology, Kingston University London, Kingston upon Thames, United Kingdom.,Department of Social Work, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Aiman El-Asam
- Department of Psychology, Kingston University London, Kingston upon Thames, United Kingdom
| | - Sara Hammuda
- Department of Psychology, Kingston University London, Kingston upon Thames, United Kingdom
| | - Peter K Smith
- Department of Psychology, Goldsmiths University of London, London, United Kingdom
| | - Hisham Morsi
- National Centre for Cancer Care and Research (NCCCR), Hamad Medical Corporation (HMC), Doha, Qatar
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34
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Giustino G, Overbey J, Taylor D, Ailawadi G, Kirkwood K, DeRose J, Gillinov MA, Dagenais F, Mayer ML, Moskowitz A, Bagiella E, Miller M, Grayburn P, Smith PK, Gelijns A, O'Gara P, Acker M, Lala A, Hung J. Sex-Based Differences in Outcomes After Mitral Valve Surgery for Severe Ischemic Mitral Regurgitation: From the Cardiothoracic Surgical Trials Network. JACC Heart Fail 2020; 7:481-490. [PMID: 31146872 DOI: 10.1016/j.jchf.2019.03.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/17/2019] [Accepted: 03/05/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVES This study investigated sex-based differences in outcomes after mitral valve (MV) surgery for severe ischemic mitral regurgitation (SIMR). BACKGROUND Whether differences in outcomes exist between men and women after surgery for SIMR remains unknown. METHODS Patients enrolled in a randomized trial comparing MV replacement versus MV repair for SIMR were included and followed for 2 years. Endpoints for this analysis included all-cause mortality, major adverse cardiovascular and cerebrovascular events (MACCE) (defined as the composite of death, stroke, hospitalization for heart failure, worsening New York Heart Association functional class or MV re-operation), quality of life (QOL), functional status, and percentage of change in left ventricular end-systolic volume index (LVESVI) from baseline through 2 years. RESULTS Of 251 patients enrolled in the trial, 96 (38.2%) were women. Compared with men, women had smaller LV volumes and effective regurgitant orifice areas (EROA) but greater EROA/left ventricular (LV) end-diastolic volume ratios. At 2 years, women had higher rates of all-cause mortality (27.1% vs. 17.4%, respectively; adjusted hazard ratio [adjHR]: 1.85; 95% confidence interval [CI]: 1.05 to 3.26; p = 0.03) and of MACCE (49.0% vs. 38.1%, respectively; adjHR: 1.58; 95% CI: 1.06 to 2.37; p = 0.02). Women also reported worse QOL and functional status at 2 years. There were no significant differences in the percentage of change over 2 years in LVESVI between women and men (adjβ: -10.4; 95% CI: -23.4 to 2.6; p = 0.12). CONCLUSIONS Women with SIMR displayed different echocardiographic features and experienced higher mortality and worse QOL after MV surgery than men. There were no significant differences in the degree of reverse LV remodeling between sexes. (Comparing the Effectiveness of Repairing Versus Replacing the Heart's Mitral Valve in People With Severe Chronic Ischemic Mitral Regurgitation [Severe Ischemic Mitral Regurgitation]; NCT00807040).
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Affiliation(s)
- Gennaro Giustino
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jessica Overbey
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Doris Taylor
- Department of Regenerative Medicine Research, Texas Heart Institute, Houston, Texas
| | - Gorav Ailawadi
- Division of Thoracic and Cardiovascular Surgery, University of Virginia, Charlottesville, Virginia
| | - Katherine Kirkwood
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joseph DeRose
- Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Marc A Gillinov
- Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - François Dagenais
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Mary-Lou Mayer
- Department of Surgery, Division of Cardiovascular Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Alan Moskowitz
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Emilia Bagiella
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Marissa Miller
- National Heart, Lung, and Blood Institute of the National Institutes of Health, Bethesda, Maryland
| | - Paul Grayburn
- Division of Cardiology, Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas
| | - Peter K Smith
- Division of Cardiothoracic Surgery, Department of Surgery, Duke University, Durham, North Carolina
| | - Annetine Gelijns
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Patrick O'Gara
- Division of Cardiology, Brigham and Women's' Hospital, Boston, Massachusetts
| | - Michael Acker
- Department of Surgery, Division of Cardiovascular Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Anuradha Lala
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Judy Hung
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts
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Sittichai R, Smith PK. Information Technology Use and Cyberbullying Behavior in South Thailand: A Test of the Goldilocks Hypothesis. Int J Environ Res Public Health 2020; 17:ijerph17197122. [PMID: 33003331 PMCID: PMC7578973 DOI: 10.3390/ijerph17197122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/11/2020] [Accepted: 09/15/2020] [Indexed: 11/16/2022]
Abstract
There has been concern about the effects of high levels of internet use on the mental well-being of young people. This has generally been phrased in terms of a displacement hypothesis, that the extent of internet use and mental well-being are directly proportional. This linear model has been contrasted with a Goldilocks Hypothesis, proposed by Przybylski and Weinstein. This supposes that moderate levels of internet use may be the least harmful, conforming to a curvilinear relationship. Here these hypotheses were tested on a sample of 1140 adolescents (42% boys, 58% girls) aged 12-18 years, in 12 schools from Southern Thailand. We first report levels of internet use, and of cybervictimization, taken as one important aspect of mental well-being. We then assess the relationship of four factors of internet use (frequency, time spent, number of places accessed, number of activities) with (a) being a victim of cyberbullying, and (b) being a frequent victim; taking these as indicators of mental well-being. For (a) there was limited evidence of a Goldilocks effect on two out of four measures. For (b) the evidence did support a Goldilocks effect for all four measures, but these were under-powered analyses and the findings did not reach statistical significance. If substantiated on larger samples, a curvilinear relationship between aspects of internet use and cyberbullying would suggest a 'safe zone' for adolescent internet use, bringing its benefits while minimizing risks of cyberbullying. In the future, similar research should use larger sample sizes or longitudinal measures when exploring nonlinear trends and include other aspects of mental well-being.
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Affiliation(s)
- Ruthaychonnee Sittichai
- Information Management Program, Kids and Youth Development Research Unit, Research Center for Educational Innovations and Teaching and Learning Excellence, Faculty of Humanities and Social Sciences, Prince of Songkla University, Pattani 94000, Thailand
- Correspondence:
| | - Peter K. Smith
- Department of Psychology, Goldsmiths University of London, London SE14 6NW, UK;
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Watts AM, West NP, Zhang P, Smith PK, Cripps AW, Cox AJ. The Gut Microbiome of Adults with Allergic Rhinitis Is Characterised by Reduced Diversity and an Altered Abundance of Key Microbial Taxa Compared to Controls. Int Arch Allergy Immunol 2020; 182:94-105. [PMID: 32971520 DOI: 10.1159/000510536] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/29/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Unique gut microbial colonisation patterns are associated with the onset of allergic disease in infants; however, there is insufficient evidence to determine if aberrant microbial composition patterns persist in adult allergic rhinitis (AR) sufferers. OBJECTIVE To compare the gut microbiome composition between adult AR sufferers and controls. METHODS Gut microbial composition in stool samples was compared between 57 adult AR sufferers (39.06 ± 13.29 years) and 23 controls (CG; 36.55 ± 10.51 years) via next-generation sequencing of the V3-V4 hypervariable regions of the 16S rRNA gene. Taxonomic classification and identity assignment was performed using a reference-based approach with the NCBI database of 16S rRNA gene sequences. RESULTS Species richness determined via the Shannon index was significantly reduced in the AR cohort compared to the CG (4.35 ± 0.59 in AR vs. 4.65 ± 0.55 in CG, p = 0.037); trends for reductions in operational taxonomic unit (OTU) counts, inverse Simpson, and CHAO1 diversity indices were also noted. Bacteroidetes (p = 0.014) was significantly more abundant in the AR group than in the CG. In contrast, the Firmicutes phylum was significantly less abundant in the AR group than in the CG (p = 0.006). An increased abundance of Parabacteroides (p = 0.008) and a reduced abundance of Oxalobacter (p = 0.001) and Clostridiales (p = 0.005) were also observed in the AR cohort compared to the CG. CONCLUSION Adult AR sufferers have a distinct gut microbiome profile, marked by a reduced microbial diversity and altered abundance of certain microbes compared to controls. The results of this study provide evidence that unique gut microbial patterns occur in AR sufferers in adulthood and warrant further examination in the form of mechanistic studies.
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Affiliation(s)
- Annabelle M Watts
- School of Medical Science, Griffith University, Southport, Queensland, Australia
| | - Nicholas P West
- School of Medical Science, Griffith University, Southport, Queensland, Australia.,Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia
| | - Ping Zhang
- Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia
| | - Peter K Smith
- School of Medicine, Griffith University, Southport, Queensland, Australia.,Queensland Allergy Services, Southport, Queensland, Australia
| | - Allan W Cripps
- Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia, .,School of Medicine, Griffith University, Southport, Queensland, Australia,
| | - Amanda J Cox
- School of Medical Science, Griffith University, Southport, Queensland, Australia.,Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia
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Anand J, Doberne J, Wojnarski CM, Smith PK, Zwischenberger BA. Coronary Anastomosis Simulation: Directed Interventions to Optimize Success. Ann Thorac Surg 2020; 111:2072-2077. [PMID: 32891660 DOI: 10.1016/j.athoracsur.2020.06.099] [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] [Received: 01/28/2020] [Revised: 06/11/2020] [Accepted: 06/23/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The role of simulation-based training in coronary artery bypass grafting remains undefined. Barriers to simulator use include clinical and personal obligations, insufficient materials, and lack of mentorship. The purpose of this study was to implement a longitudinal, residency-wide coronary anastomosis simulation curriculum. METHODS A prospective observational study was conducted from 2018 to 2019 at a single academic center. All residents of the Thoracic Surgery training program participated. Each participant was provided a low-fidelity coronary anastomosis simulator, high-quality instruments, and faculty mentor. Formal assessments were held quarterly, and residents were encouraged to practice alone and with their mentor. Baseline and follow-up metrics were compared with simple descriptive statistics. RESULTS Seventeen residents and 12 faculty participated in the study. Residents demonstrated increased use of the simulator, with 21% participating in independent practice at baseline and 82% in the fourth quarter (P = .02). The median score on the Thoracic Surgery Directors Association Vessel Anastomosis Assessment improved from 42 out of 65 at baseline to 54 out of 65 in the fourth quarter (P = .04), and mean anastomosis time was reduced by 5 minutes 6 seconds (P = .02). Over 12 months, junior residents demonstrated a mean reduction in anastomosis time of 6 minutes 36 seconds, and senior residents decreased anastomosis time by 3 minutes 6 seconds (P = .02). CONCLUSIONS Providing residents with a low-fidelity coronary anastomosis trainer with high-quality instruments and a faculty mentor improved rates of independent practice, Thoracic Surgery Directors Association assessment scores, and anastomosis time. Our next step is validating the coronary simulator curriculum by measuring improvement of resident performance in the operating room.
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Affiliation(s)
- Jatin Anand
- Duke University Medical Center, Department of Surgery, Division of Cardiovascular and Thoracic Surgery, Durham, North Carolina
| | - Julie Doberne
- Duke University Medical Center, Department of Surgery, Division of Cardiovascular and Thoracic Surgery, Durham, North Carolina
| | - Charles M Wojnarski
- Duke University Medical Center, Department of Surgery, Division of Cardiovascular and Thoracic Surgery, Durham, North Carolina
| | - Peter K Smith
- Duke University Medical Center, Department of Surgery, Division of Cardiovascular and Thoracic Surgery, Durham, North Carolina
| | - Brittany A Zwischenberger
- Duke University Medical Center, Department of Surgery, Division of Cardiovascular and Thoracic Surgery, Durham, North Carolina.
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Jawitz OK, Gulack BC, Brennan JM, Thibault DP, Wang A, O'Brien SM, Schroder JN, Gaca JG, Smith PK. Association of postoperative complications and outcomes following coronary artery bypass grafting. Am Heart J 2020; 222:220-228. [PMID: 32105988 DOI: 10.1016/j.ahj.2020.02.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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] [Received: 12/14/2019] [Accepted: 02/06/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND The long-term effects of postoperative complications following coronary artery bypass grafting (CABG) are unknown. METHODS Medicare-linked records from the Society of Thoracic Surgeons Adult Cardiac Surgery Database were queried for isolated CABG records from 2007 through 2012. Unadjusted and adjusted associations between individual postoperative complications and both mortality and all-cause rehospitalization were evaluated to 7 years using Cox proportional-hazards models and cumulative incidence functions. Because of nonproportional hazards, associations are presented as early (0 to 90 days) and late (90 days to 7 years). RESULTS Of the 294,533 isolated CABG patients who had records linked to Medicare for long-term follow-up (median age, 73 years; 30% female), 120,721 (41%) experienced at least 1 of the complications of interest, including new-onset atrial fibrillation (30.0%), prolonged ventilation (12.3%), renal failure (4.5%), reoperation (3.5%), stroke (1.9%), and sternal wound infection (0.4%). Each of the 6 postoperative complications was associated with a significantly increased risk of mortality and rehospitalization to 7 years despite adjustment for baseline characteristics and the presence of multiple complications. Although the predominant effect of postoperative complications was observed in the first 90 days, the increased risk-adjusted hazard for death and rehospitalization continued through 7 years. CONCLUSIONS Postoperative complications are associated with an increased risk of both early and late mortality and all-cause rehospitalization, particularly during the "value" window within 90 days of CABG. These findings underscore the need to develop avoidance strategies as well as cost-adjustment methods for each of these complications.
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Affiliation(s)
- Oliver K Jawitz
- Department of Surgery, Duke University Medical Center, Durham, NC; Duke Clinical Research Institute, Durham, NC.
| | - Brian C Gulack
- Department of Surgery, Duke University Medical Center, Durham, NC
| | - J Matthew Brennan
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | | | - Alice Wang
- Department of Surgery, Duke University Medical Center, Durham, NC
| | | | - Jacob N Schroder
- Department of Surgery, Duke University Medical Center, Durham, NC
| | - Jeffrey G Gaca
- Department of Surgery, Duke University Medical Center, Durham, NC
| | - Peter K Smith
- Department of Surgery, Duke University Medical Center, Durham, NC
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Bertrand PB, Raymond SS, Smith PK, Thourani V, Ailawadi G, Bagiella E, Voisine P, Zeng X, Nagata Y, Levine RA, Gelijns A, Miller M, Moskowitz A, Taddei-Peters W, Moquete E, O’Gara PT, Alexander JH, Gammie JS, Yerokun B, DeRose J, Overbey J, Hung J. EFFECT OF LONGITUDINAL STRAIN ON CLINICAL AND ECHOCARDIOGRAPHIC OUTCOMES AFTER CARDIAC SURGERY FOR MODERATE ISCHEMIC MITRAL REGURGITATION. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)32757-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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40
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Smith JD, Schneider BH, Smith PK, Ananiadou K. The Effectiveness of Whole-School Antibullying Programs: A Synthesis of Evaluation Research. School Psychology Review 2019. [DOI: 10.1080/02796015.2004.12086267] [Citation(s) in RCA: 125] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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41
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Afilalo J, Sharma A, Zhang S, Brennan JM, Edwards FH, Mack MJ, McClurken JB, Cleveland JC, Smith PK, Shahian DM, Peterson ED, Alexander KP. Gait Speed and 1-Year Mortality Following Cardiac Surgery: A Landmark Analysis From the Society of Thoracic Surgeons Adult Cardiac Surgery Database. J Am Heart Assoc 2019; 7:e010139. [PMID: 30571598 PMCID: PMC6405557 DOI: 10.1161/jaha.118.010139] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background In older adults undergoing cardiac surgery, prediction of downstream risk is critical. Our objective was to determine the association of 5‐m gait speed with 1‐year mortality and repeat hospitalization following cardiac surgery. Methods and Results In this prospective cohort of patients undergoing cardiac surgery at centers participating in the Society of Thoracic Surgeons Database with gait speed recorded, we examined all‐cause mortality using a landmark analysis at 0 to 30, 30 to 365, and >365 days, as well as repeat hospitalization. The cohort consisted of 8287 patients (median age, 74 years; 32% females). At 1 year, survival was 90% in the slow (<0.83 m/s), 95% in the middle (0.83–1.00 m/s), and 97% in the fast (>1.00 m/s) gait speed tertiles, and risk of hospitalization was 45%, 33%, and 27%, respectively (both P<0.0001). After adjustment, gait speed remained predictive of mortality (hazard ratio, 2.16 per 0.1‐m/s decrease in gait speed; 95% confidence interval, 1.59–2.93) and rehospitalization (hazard ratio, 1.71 per 0.1‐m/s decrease in gait speed; 95% confidence interval, 1.45–2.0). In a landmark analysis, the effect of slow gait speed on mortality was most marked from 30 to 365 days after surgery, where each decline in 0.1 m/s of gait speed conferred a 2‐fold increased risk of mortality. Conclusions Gait speed is a simple tool to screen for frailty and identify older adults at risk for adverse events in the early and midterm postoperative periods.
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Affiliation(s)
- Jonathan Afilalo
- 1 Division of Cardiology & Centre for Clinical Epidemiology Jewish General Hospital McGill University Montreal Quebec Canada
| | - Abhinav Sharma
- 2 Duke Centre for Clinical Research Institute Durham NC.,3 Divisions of Cardiology Duke University Medical Center Durham NC
| | - Shuaiqi Zhang
- 2 Duke Centre for Clinical Research Institute Durham NC
| | - J Matthew Brennan
- 2 Duke Centre for Clinical Research Institute Durham NC.,3 Divisions of Cardiology Duke University Medical Center Durham NC
| | - Fred H Edwards
- 5 Division of Cardiac Surgery University of Florida Jacksonville FL
| | - Michael J Mack
- 6 Division of Cardiac Surgery The Heart Hospital Baylor Plano Plano TX
| | - James B McClurken
- 7 Cardiothoracic Surgery Reif Cardiovascular Institute, Doylestown Hospital Doylestown PA
| | | | - Peter K Smith
- 4 Divisions of Cardiac Surgery Duke University Medical Center Durham NC
| | - David M Shahian
- 9 Department of Surgery Massachusetts General Hospital Boston MA
| | - Eric D Peterson
- 2 Duke Centre for Clinical Research Institute Durham NC.,3 Divisions of Cardiology Duke University Medical Center Durham NC
| | - Karen P Alexander
- 2 Duke Centre for Clinical Research Institute Durham NC.,3 Divisions of Cardiology Duke University Medical Center Durham NC
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42
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Williams JB, Shah AA, Zhang S, Jung SH, Yerokun B, Vemulapalli S, Smith PK, Gammie JS, Gaca JG. Impact of Microbiological Organism Type on Surgically Managed Endocarditis. Ann Thorac Surg 2019; 108:1325-1329. [DOI: 10.1016/j.athoracsur.2019.04.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 03/21/2019] [Accepted: 04/07/2019] [Indexed: 12/14/2022]
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43
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Wang A, Li Z, Rymer JA, Kosinski AS, Yerokun B, Cox ML, Gulack BC, Sherwood MW, Lopes RD, Inohara T, Thourani V, Kirtane AJ, Holmes D, Hughes GC, Harrison JK, Smith PK, Vemulapalli S. Relation of Postdischarge Care Fragmentation and Outcomes in Transcatheter Aortic Valve Implantation from the STS/ACC TVT Registry. Am J Cardiol 2019; 124:912-919. [PMID: 31375245 DOI: 10.1016/j.amjcard.2019.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 06/03/2019] [Accepted: 06/10/2019] [Indexed: 11/15/2022]
Abstract
Fragmented care following elective surgery has been associated with poor outcomes. The association between fragmented care and outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) is unknown. We examined patients who underwent TAVI from 2011 to 2015 at 374 sites in the STS/ACC TVT Registry, linked to Center for Medicare and Medicaid Services claims data. Fragmented care was defined as at least one readmission to a site other than the implanting TAVI center within 90 days after discharge, whereas continuous care was defined as readmission to the same implanting center. We compared adjusted 1-year outcomes, including stroke, bleeding, heart failure, mortality, and all-cause readmission in patients who received fragmented versus continuous care. Among 8,927 patients who received a TAVI between 2011 and 2015, 27.4% were readmitted within 90 days of discharge. Most patients received fragmented care (57.0%). Compared with the continuous care group, the fragmented care group was more likely to have severe chronic lung disease, cerebrovascular disease, and heart failure. States that had lower TAVI volume per Center for Medicare and Medicaid Services population had greater fragmentation. Patients living > 30 minutes from their TAVI center had an increased risk of fragmented care 1.07 (confidence interval [CI] 1.06 to 1.09, p < 0.001). After adjustment for comorbidities and procedural complications, fragmented care was associated with increased 1-year mortality (hazards ratio 1.18, CI 1.04 to 1.35, p = 0.010) and all-cause readmission (hazards ratio 1.08, CI 1.00 to 1.16, p = 0.051. In conclusion, fragmented readmission following TAVI is common, and is associated with increased 1-year mortality and readmission. Efforts to improve coordination of care may improve these outcomes and optimize long-term benefits yielded from TAVI.
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Affiliation(s)
- Alice Wang
- Department of General Surgery, Duke University Medical Center, Durham, North Carolina
| | - Zhuokai Li
- Duke Clinical Research Institute, Durham, North Carolina
| | | | - Andrzej S Kosinski
- Duke Clinical Research Institute, Durham, North Carolina; Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina
| | - Babatunde Yerokun
- Department of General Surgery, Duke University Medical Center, Durham, North Carolina
| | - Morgan L Cox
- Department of General Surgery, Duke University Medical Center, Durham, North Carolina
| | - Brian C Gulack
- Department of General Surgery, Duke University Medical Center, Durham, North Carolina
| | - Matthew W Sherwood
- Department of Medicine, Division of Cardiology, Duke University Medical Center, Durham, North Carolina
| | - Renato D Lopes
- Department of Medicine, Division of Cardiology, Duke University Medical Center, Durham, North Carolina
| | - Taku Inohara
- Duke Clinical Research Institute, Durham, North Carolina
| | - Vinod Thourani
- Department of Surgery, Division of Cardiothoracic Surgery, Emory University Hospital, Atlanta, Georgia
| | - Ajay J Kirtane
- Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York
| | - David Holmes
- Department of Medicine, Division of Cardiology, Mayo Clinic, Rochester, Minnesota
| | - G Chad Hughes
- Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, North Carolina
| | - J Kevin Harrison
- Department of Medicine, Division of Cardiology, Duke University Medical Center, Durham, North Carolina
| | - Peter K Smith
- Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, North Carolina
| | - Sreekanth Vemulapalli
- Department of Medicine, Division of Cardiology, Duke University Medical Center, Durham, North Carolina; Duke Clinical Research Institute, Durham, North Carolina.
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Smith PK. Physician Time For Joint Replacement. Health Aff (Millwood) 2019; 38:1596. [DOI: 10.1377/hlthaff.2019.00965] [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: 11/05/2022]
Affiliation(s)
- Peter K. Smith
- Chair, AMA/Specialty Society RVS Update Committee Chicago, Illinois
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45
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Bouabdallaoui N, Stevens SR, Doenst T, Petrie MC, Al-Attar N, Ali IS, Ambrosy AP, Barton AK, Cartier R, Cherniavsky A, Demondion P, Desvigne-Nickens P, Favaloro RR, Gradinac S, Heinisch P, Jain A, Jasinski M, Jouan J, Kalil RAK, Menicanti L, Michler RE, Rao V, Smith PK, Zembala M, Velazquez EJ, Al-Khalidi HR, Rouleau JL. Society of Thoracic Surgeons Risk Score and EuroSCORE-2 Appropriately Assess 30-Day Postoperative Mortality in the STICH Trial and a Contemporary Cohort of Patients With Left Ventricular Dysfunction Undergoing Surgical Revascularization. Circ Heart Fail 2019; 11:e005531. [PMID: 30571194 DOI: 10.1161/circheartfailure.118.005531] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The STICH trial (Surgical Treatment for Ischemic Heart Failure) demonstrated a survival benefit of coronary artery bypass grafting in patients with ischemic cardiomyopathy and left ventricular dysfunction. The Society of Thoracic Surgeons (STS) risk score and the EuroSCORE-2 (ES2) are used for risk assessment in cardiac surgery, with little information available about their accuracy in patients with left ventricular dysfunction. We assessed the ability of the STS score and ES2 to evaluate 30-day postoperative mortality risk in STICH and a contemporary cohort (CC) of patients with a left ventricle ejection fraction ≤35% undergoing coronary artery bypass grafting outside of a trial setting. METHODS AND RESULTS The STS and ES2 scores were calculated for 814 STICH patients and 1246 consecutive patients in a CC. There were marked variations in 30-day postoperative mortality risk from 1 patient to another. The STS scores consistently calculated lower risk scores than ES2 (1.5 versus 2.9 for the CC and 0.9 versus 2.4 for the STICH cohort), and underestimated postoperative mortality risk. The STS and ES2 scores had moderately good C statistics: CC (0.727, 95% CI: 0.650-0.803 for STS, and 0.707, 95% CI: 0.620-0.795 for ES2); STICH (0.744, 95% CI: 0.677-0.812, for STS and 0.736, 95% CI: 0.665-0.808 for ES2). Despite the CC patients having higher STS and ES2 scores than STICH patients, mortality (3.5%) was lower than that of STICH (4.8%), suggesting a possible decrease in postoperative mortality over the past decade. CONCLUSIONS The 30-day postoperative mortality risk of coronary artery bypass grafting in patients with left ventricular dysfunction varies markedly. Both the STS and ES2 score are effective in evaluating risk, although the STS score tend to underestimate risk. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT00023595.
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Affiliation(s)
- Nadia Bouabdallaoui
- Departments of Medicine, ontreal Heart Institute, University of Montreal, Canada (N.B., J.L.R.)
| | - Susanna R Stevens
- M. Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC. (S.R.S.)
| | - Torsten Doenst
- Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich-Schiller-University Jena, Germany (T.D., P.H.)
| | - Mark C Petrie
- Department of Cardiology, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (M.C.P.)
- Department of Cardiology, Golden Jubilee National Hospital, Glasgow, United Kingdom (M.C.P., N.A.-A, A.K.B.)
| | - Nawwar Al-Attar
- Department of Cardiology, Golden Jubilee National Hospital, Glasgow, United Kingdom (M.C.P., N.A.-A, A.K.B.)
| | - Imtiaz S Ali
- Section of Cardiac Surgery, Department of Cardiac Sciences, Libin CV Institute, University of Calgary, Canada (I.S.A.)
| | - Andrew P Ambrosy
- Department of Medicine, Duke University School of Medicine, Durham, NC. (A.P.A., E.J.V.)
| | - Anna K Barton
- Department of Cardiology, Golden Jubilee National Hospital, Glasgow, United Kingdom (M.C.P., N.A.-A, A.K.B.)
| | - Raymond Cartier
- Cardiac Surgery, ontreal Heart Institute, University of Montreal, Canada (R.C.)
| | | | - Pierre Demondion
- Department of Cardiac Surgery, La Pitié Salpêtrière, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie-Paris 6, France (P.D.)
| | | | - Robert R Favaloro
- Department of Cardiac Surgery, University Hospital Favaloro Foundation, Buenos Aires, Argentina (R.R.F.)
| | - Sinisa Gradinac
- Dedinje Cardiovascular Institute, University of Belgrade School of Medicine, Serbia (S.G.)
| | - Petra Heinisch
- Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich-Schiller-University Jena, Germany (T.D., P.H.)
| | - Anil Jain
- Department of Cardiac Surgery, SAL Hospital and Medical Institute, Ahmedabad, India (A.J.)
| | - Marek Jasinski
- Department of Cardiac Surgery, Wroclaw Medical University, Poland (M.J.)
| | - Jerome Jouan
- Department of Cardiovascular Surgery, Georges Pompidou European Hospital and University Paris-Descartes, Sorbonne Paris-Cité, France (J.J.)
| | - Renato A K Kalil
- Postgraduate Program, Instituto de Cardiologia/FUC and UFCSPA, Porto Alegre, Brazil (R.A.K.K.)
| | - Lorenzo Menicanti
- Department of Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (L.M.)
| | - Robert E Michler
- Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, New York City, NY (R.E.M.)
| | - Vivek Rao
- Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto General Institute, University Health Network, University of Toronto, Canada (V.R.)
| | - Peter K Smith
- Department of Surgery, Duke University School of Medicine, Durham, NC. (P.K.S.)
| | - Marian Zembala
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Poland Medical University of Silesia in Katowice, Poland (M.Z.)
| | - Eric J Velazquez
- Department of Medicine, Duke University School of Medicine, Durham, NC. (A.P.A., E.J.V.)
| | - Hussein R Al-Khalidi
- Departments of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC. (H.R.A.-K.)
| | - Jean L Rouleau
- Departments of Medicine, ontreal Heart Institute, University of Montreal, Canada (N.B., J.L.R.)
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Iribarne A, Pan S, McCullough JN, Mathew JP, Hung J, Zeng X, Voisine P, O'Gara PT, Sledz NM, Gelijns AC, Taddei-Peters WC, Messé SR, Moskowitz AJ, Thourani VH, Argenziano M, Groh MA, Giustino G, Overbey JR, DiMaio JM, Smith PK. Impact of Aortic Atherosclerosis Burden on Outcomes of Surgical Aortic Valve Replacement. Ann Thorac Surg 2019; 109:465-471. [PMID: 31400333 DOI: 10.1016/j.athoracsur.2019.06.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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] [Received: 02/07/2019] [Revised: 06/04/2019] [Accepted: 06/10/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Epiaortic ultrasound detects and localizes ascending aortic atherosclerosis. In this analysis we investigated the association between epiaortic ultrasound-based atheroma grade during surgical aortic valve replacement (SAVR) and perioperative adverse outcomes. METHODS SAVR patients in a randomized trial of 2 embolic protection devices underwent a protocol-defined 5-view epiaortic ultrasound read at a core laboratory. Aortic atherosclerosis was quantified with the Katz atheroma grade, and patients were categorized as mild (grade I-II) or moderate/severe (grade III-V). Multivariable logistic regression was used to estimate associations between atheroma grade and adverse outcomes, including death, clinically apparent stroke, cerebral infarction on diffusion-weighted magnetic resonance imaging, delirium, and acute kidney injury (AKI) by 7 and 30 days. RESULTS Precannulation epiaortic ultrasound data were available for 326 of 383 randomized patients (85.1%). Of these, 106 (32.5%) had moderate/severe Katz atheroma grade at any segment of the ascending aorta. Although differences in the composite of death, stroke, or cerebral infarction on diffusion-weighted magnetic resonance imaging by 7 days were not statistically significant, moderate/severe atheroma grade was associated with a greater risk of AKI by 7 days (adjusted odds ratio, 2.63; 95% confidence interval, 1.24-5.58; P = .01). At 30 days, patients with moderate/severe atheroma grade had a greater risk of death, stroke, or AKI (adjusted odds ratio, 1.97; 95% confidence interval, 1.04-3.71; P = .04). CONCLUSIONS Moderate/severe aortic atherosclerosis was associated with an increased risk of adverse events after SAVR. Epiaortic ultrasound may serve as a useful adjunct for identifying patients who may benefit from strategies to reduce atheroembolic complications during SAVR.
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Affiliation(s)
- Alexander Iribarne
- Section of Cardiac Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Stephanie Pan
- Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jock N McCullough
- Section of Cardiac Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Joseph P Mathew
- Division of Cardiothoracic Anesthesiology, Duke University Medical Center, Durham, North Carolina
| | - Judy Hung
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Xin Zeng
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Pierre Voisine
- Institut Universitaire de Cardiologie et Pneumologie de Québec, Québec, Québec, Canada
| | - Patrick T O'Gara
- Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Nancy M Sledz
- Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Annetine C Gelijns
- Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Wendy C Taddei-Peters
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Steven R Messé
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alan J Moskowitz
- Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Vinod H Thourani
- Department of Cardiac Surgery, MedStar Heart and Vascular Institute, Washington, DC
| | - Michael Argenziano
- Division of Cardiothoracic Surgery, Department of Surgery, New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York
| | - Mark A Groh
- Cardiovascular and Thoracic Surgery, Mission Health and Hospitals, Asheville, North Carolina
| | - Gennaro Giustino
- Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jessica R Overbey
- Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - J Michael DiMaio
- Department of Cardiothoracic Surgery, The Heart Hospital Baylor Plano, Baylor Scott & White Health, Plano, Texas
| | - Peter K Smith
- Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
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Ferket BS, Thourani VH, Voisine P, Hohmann SF, Chang HL, Smith PK, Michler RE, Ailawadi G, Perrault LP, Miller MA, O'Sullivan K, Mick SL, Bagiella E, Acker MA, Moquete E, Hung JW, Overbey JR, Lala A, Iraola M, Gammie JS, Gelijns AC, O'Gara PT, Moskowitz AJ. Cost-effectiveness of coronary artery bypass grafting plus mitral valve repair versus coronary artery bypass grafting alone for moderate ischemic mitral regurgitation. J Thorac Cardiovasc Surg 2019; 159:2230-2240.e15. [PMID: 31375378 DOI: 10.1016/j.jtcvs.2019.06.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 05/23/2019] [Accepted: 06/16/2019] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The Cardiothoracic Surgical Trials Network reported that left ventricular reverse remodeling at 2 years did not differ between patients with moderate ischemic mitral regurgitation randomized to coronary artery bypass grafting plus mitral valve repair (n = 150) or coronary artery bypass grafting alone (n = 151). To address health resource use implications, we compared costs and quality-adjusted survival. METHODS We used individual patient data from the Cardiothoracic Surgical Trials Network trial on survival, hospitalizations, quality of life, and US hospitalization costs to estimate cumulative costs and quality-adjusted life years. A microsimulation model was developed to extrapolate to 10 years. Bootstrap and deterministic sensitivity analyses were performed to address uncertainty. RESULTS In-hospital costs were $59,745 for coronary artery bypass grafting plus mitral valve repair versus $51,326 for coronary artery bypass grafting alone (difference $8419; 95% uncertainty interval, 2259-18,757). Two-year costs were $81,263 versus $67,341 (difference 13,922 [2370 to 28,888]), and quality-adjusted life years were 1.35 versus 1.30 (difference 0.05; -0.04 to 0.14), resulting in an incremental cost-effectiveness ratio of $308,343/quality-adjusted life year for coronary artery bypass grafting plus mitral valve repair. At 10 years, its costs remained higher ($107,733 vs $88,583, difference 19,150 [-3866 to 56,826]) and quality-adjusted life years showed no difference (-0.92 to 0.87), with 5.08 versus 5.08. The likelihood that coronary artery bypass grafting plus mitral valve repair would be considered cost-effective at 10 years based on a cost-effectiveness threshold of $100K/quality-adjusted life year did not exceed 37%. Only when this procedure reduces the death rate by a relative 5% will the incremental cost-effectiveness ratio fall below $100K/quality-adjusted life year. CONCLUSIONS The addition of mitral valve repair to coronary artery bypass grafting for patients with moderate ischemic mitral regurgitation is unlikely to be cost-effective. Only if late mortality benefits can be demonstrated will it meet commonly used cost-effectiveness criteria.
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Affiliation(s)
- Bart S Ferket
- International Center for Health Outcomes and Innovation Research, the Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Vinod H Thourani
- Department of Cardiac Surgery, MedStar Heart & Vascular Institute, Washington, DC; Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Ga
| | - Pierre Voisine
- Institut Universitaire de Cardiologie et Pneumonologie de Québec, Hôpital Laval, Québec, Quebec, Canada
| | | | - Helena L Chang
- International Center for Health Outcomes and Innovation Research, the Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Peter K Smith
- Department of Surgery, Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, NC
| | - Robert E Michler
- Department of Cardiothoracic and Vascular Surgery, Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY
| | - Gorav Ailawadi
- Division of Thoracic and Cardiovascular Surgery, University of Virginia School of Medicine, Charlottesville, Va
| | - Louis P Perrault
- Montréal Heart Institute, University of Montréal, Montréal, Quebec, Canada
| | - Marissa A Miller
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Md
| | - Karen O'Sullivan
- International Center for Health Outcomes and Innovation Research, the Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Stephanie L Mick
- Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Emilia Bagiella
- International Center for Health Outcomes and Innovation Research, the Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Michael A Acker
- Department of Surgery, Division of Cardiovascular Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pa
| | - Ellen Moquete
- International Center for Health Outcomes and Innovation Research, the Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Judy W Hung
- Division of Cardiology, Massachusetts General Hospital, Boston, Mass
| | - Jessica R Overbey
- International Center for Health Outcomes and Innovation Research, the Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Anuradha Lala
- International Center for Health Outcomes and Innovation Research, the Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Margaret Iraola
- Cardiovascular Services, Suburban Hospital of Johns Hopkins Medicine, Bethesda, Md
| | - James S Gammie
- Department of Surgery, Division of Cardiac Surgery, University of Maryland Medical Center, Baltimore, Md
| | - Annetine C Gelijns
- International Center for Health Outcomes and Innovation Research, the Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Patrick T O'Gara
- Cardiovascular Division, Brigham and Women's Hospital, Boston, Mass
| | - Alan J Moskowitz
- International Center for Health Outcomes and Innovation Research, the Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
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Smith PK, Bauman S, Wong D. Challenges and Opportunities of Anti-Bullying Intervention Programs. Int J Environ Res Public Health 2019; 16:ijerph16101810. [PMID: 31121808 PMCID: PMC6572570 DOI: 10.3390/ijerph16101810] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 05/14/2019] [Indexed: 11/16/2022]
Abstract
Over recent decades, bullying, and the more recent version of cyberbullying, have come to be recognized as important social and public health issues, generating an increasing volume of publications [...].
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Affiliation(s)
- Peter K Smith
- Department of Psychology, Goldsmiths, University of London, London SE14 6NW, UK.
| | - Sheri Bauman
- Department of Disability and Psychoeducational Studies, University of Arizona, Tucson, AZ 85721, USA.
| | - Dennis Wong
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China.
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49
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Williams JB, McConnell G, Allender JE, Woltz P, Kane K, Smith PK, Engelman DT, Bradford WT. One-year results from the first US-based enhanced recovery after cardiac surgery (ERAS Cardiac) program. J Thorac Cardiovasc Surg 2019; 157:1881-1888. [DOI: 10.1016/j.jtcvs.2018.10.164] [Citation(s) in RCA: 114] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 10/25/2018] [Accepted: 10/28/2018] [Indexed: 12/27/2022]
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50
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Smith PK, Berkkun F. How prevalent is contextual information in research on school bullying? Scand J Psychol 2019; 61:17-21. [PMID: 31006893 DOI: 10.1111/sjop.12537] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 03/11/2019] [Indexed: 11/30/2022]
Abstract
Empirical articles on school bullying need to give contextual details of the study, including on participants (number, age, gender), the country in which data was gathered, and the year in which it was gathered. We argue that these are important aspects of information, and that country and year of data collection cannot be inferred unambiguously unless they are explicitly stated. We report an analysis of contextual information on a sample of 201 articles, from 1976 to 2015, on school bullying. The great majority of studies gave information on number and age of participants, and most on gender balance. Most also gave explicit information on the country in which data was gathered. However only about one quarter of articles gave information on the date (year) in which data was gathered. For those that did, the average gap from data gathering to publication was 4 years, with a range of 1 to 11 years. We argue that the date of data collection is an important historical aspect, as many societal changes, even over a period of a few years, can impact on prevalence and nature of bullying. We recommend that besides participant and country information, year of data collection is routinely given in empirical articles on school bullying.
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Affiliation(s)
- Peter K Smith
- Department of Psychology, Goldsmiths, University of London, UK
| | - Fethi Berkkun
- Department of Psychology, Goldsmiths, University of London, UK
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