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Shah SH, Sheikh IS, Kakar N, Sumaira, Afzal S, Mehmood K, Rehman HU. In vivo analysis the effect of antibiotic growth promoters (AGPs), Oxytetracycline di-hydrate and Tylosin phosphate on the intestinal microflora in broiler chicken. BRAZ J BIOL 2024; 84:e258114. [DOI: 10.1590/1519-6984.258114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/24/2022] [Indexed: 11/21/2022] Open
Abstract
Abstract The study was aimed to analyse the effects of antibiotic growth promoters (AGPs), Oxytetracycline di-hydrate and Tylosin phosphate on the intestinal microflora in broiler chicken. The AGPs were provided in different concentrations solely or in combinations for 42 days of rearing. Faecal samples were collected from the intestine (duodenum, jejunum and caeca) of broiler chicken on 14th, 28th and 42nd days of trial. Samples were cultured on different selective medium and bacterial identification was performed by different biochemical and molecular diagnostic tools. Results showed a significant effect of AGPs on the growth of pathogenic microorganisms such as Escherichia coli and Clostridium perfringens in the intestine. Interestingly, an impaired growth was observed for both bacterium showing a significant effect (P<0.05) of AGPs on E. coli and C. perfringens on day 14th, 28th, and 42nd. This effect was observed solely and in combination while using AGPs. Data further showed that the effect was more prominent in combination and with an increase concentration of AGPs. Remarkably, no impairment was seen on the growth of L. reuteri at different sites of intestine and duration (14th, 28th, and 42nd days). The results showed that the use of AGPs in diet has no harmful effect on beneficial bacteria, however, an impaired growth was seen on the harmful bacteria. It is suggested that a combination of AGPs (OXY-1.0+TP-0.5) is economical and have no harmful effect on the broiler chicken. The use of AGPs in a recommended dose and for a specific period of time are safe to use in poultry both as growth promoter and for the prevention of diseases.
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Affiliation(s)
| | | | | | - Sumaira
- University of Balochistan, Pakistan
| | - S. Afzal
- University of Balochistan, Pakistan
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Tolba MM, Jabbar A, Afzal S, Mahmoud M, Zulfiqar F, El-Soudany I, Samir S, Wadan AHS, Ellakwa TE, Ellakwa DES. A promising RNA nanotechnology in clinical therapeutics: a future perspective narrative review. Future Sci OA 2023; 9:FSO883. [PMID: 37621841 PMCID: PMC10445585 DOI: 10.2144/fsoa-2023-0067] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/03/2023] [Indexed: 08/26/2023] Open
Abstract
Nanotechnology is the use of materials that have unique nanoscale properties. In recent years, nanotechnologies have shown promising results for human health, especially in cancer treatment. The self-assembly characteristic of RNA is a powerful bottom-up approach to the design and creation of nanostructures through interdisciplinary biological, chemical and physical techniques. The use of RNA nanotechnology in therapeutics is about to be realized. This review discusses different kinds of nano-based drug delivery systems and their characteristic features.
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Affiliation(s)
- Mahmoud M Tolba
- Pharmaceutical Division, Ministry of health & population, Faiyum, Egypt
| | - Abdul Jabbar
- Department of Veterinary Medicine, Faculty of Veterinary Science, University of Veterinary & Animal Sciences, Lahore Punjab, Pakistan
| | - Sadia Afzal
- Department of Botany, Faculty of Life Science, Women University Multan
| | | | - Farheen Zulfiqar
- Department of Food Science & Human Nutrition, University of Veterinary & Animal Sciences Lahore Punjab Pakistan
| | - Ingy El-Soudany
- Microbiology & Immunology Department, Faculty of Pharmacy, Pharos University in Alexandria, Alexandria, Egypt
| | - Salma Samir
- Genetics & Genetic engineering Department, Faculty of Agriculture, Benha University
| | | | - Takwa E Ellakwa
- Physical Chemistry, Faculty of Pharmacy, Egyptian Russian University, Egypt
| | - Doha El-Sayed Ellakwa
- Department of Biochemistry & Molecular Biology, Faculty of Pharmacy for Girls, Al-Azhar University, Cairo, Egypt
- Department of Biochemistry, Faculty of Pharmacy, Sinai University, Kantra Branch, Ismailia, Egypt
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Javed N, Iqbal E, Afzal S, Rehman B, Parvaiz M. Efficacy of pre-operative axillary ultrasonography in excluding nodal disease – can it replace sentinel lymph node biopsy in early stage breast cancer? Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01418-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Hasselbalch R, Strandkjaer N, Kristensen J, Joergensen N, Kock TO, Rye Ostrowski S, Vesterager Pedersen OB, Torp-Pedersen C, Bundgaard H, Bor V, Afzal S, Kamstrup P, Dahl M, Hilsted L, Iversen KI. The impact of age on the 99th percentile of cardiac troponin. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
The 99th percentile upper reference limit (URL) of cardiac troponin (cTn) is diagnostic cutoff for myocardial infarction (MI). Several factors are known to lead to an increase in cTn including sex, kidney function, left ventricular function and various comorbidities. Similarly, studies have shown that cTn concentration of patients increase with age. However, the impact of age on the concentration of cTn in healthy individuals is unclear as several studies of healthy populations showed little to no impact of age.
Purpose
To determine the effect of age on the URL of cTn for the Danish population.
Methods
We invited active and retired blood donors with the aim of including 250 participants of each sex in each of four age groups, <50, 50–60, 60–70 and >70 years, for a total of about 2000 participants. cTn levels were measured by 4 cTn assays (Siemens Atellica and Vista cTnI, Roche cTnT and Abbott Alinity cTnI). The age specific URL were calculated using the non-parametric method. Quantile regression for the 99th percentile was adjusted for sex and creatinine concentration.
Results
A total of 2287 participants were sampled in the study, of which 4 (0.2%) were excluded due to a history of heart disease and 7 (0.3%) were excluded due to insufficient plasma for screening biomarkers. The median age was 58.6 (IQR 48.2–69.7), and 52.6% were female. Figure 1 shows the distribution of cTn concentrations in age intervals. There was a significant increase in cTn with age for all assays (all p<0.001). After adjusting for sex and creatinine concentration, increasing age was only significantly associated with cTnT (0.40 ng/L increase per year, p=0.03). Figure 2 panel A shows the age specific URL for each assay, where we observed a significant difference for cTnT with the URL increasing from 15.8 ng/L (90% CI 12.4–33.9 ng/L) for participants <50 years to 37.6 ng/L (90% CI 34.6–41.5 ng/L) for participants >70 years. The proportion of participants with concentrations above the manufacturers URL increased with age for cTnT from 1.5% in participants <50 years to 25.6% for participants >70 years (p<0.001), figure 2 panel B. This changed little when removing participants with decreased kidney function (eGFR <60 mL/min/1.73 m2) as 24.3% of the remaining participants >70 years had a cTnT above the URL.
Conclusions
The concentration of cTn increased with age for all assays. This was clearest for cTnT in which the 99th percentiles of participants were significantly different for participants age >70 years of whom a quarter had cTnT levels above the level for myocardial injury according to the manufacturer's URL.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): HelsefondenMauritzen La Fountaine Foundation
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Affiliation(s)
- R Hasselbalch
- Herlev Hospital - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - N Strandkjaer
- Herlev Hospital - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - J Kristensen
- Herlev Hospital - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - N Joergensen
- Herlev Hospital - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - T O Kock
- Herlev Hospital - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - S Rye Ostrowski
- Rigshospitalet - Copenhagen University Hospital, Department of Clinical Immunology , Copenhagen , Denmark
| | | | - C Torp-Pedersen
- Hillerod Hospital, Department of Research , Hillerod , Denmark
| | - H Bundgaard
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - V Bor
- South West Jutland Hospital, Department of Clinical Biochemistry , Esbjerg , Denmark
| | - S Afzal
- Herlev Hospital, Department of Clinical Biochemistry , Herlev , Denmark
| | - P Kamstrup
- Herlev Hospital, Department of Clinical Biochemistry , Herlev , Denmark
| | - M Dahl
- Koge University Hospital, Department of Clinical Biochemistry , Koege , Denmark
| | - L Hilsted
- Rigshospitalet - Copenhagen University Hospital, Clinical Biochemistry , Copenhagen , Denmark
| | - K I Iversen
- Herlev Hospital - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
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Abid T, Jaffari SAZ, Muhammad Zohaib, Muhammad Jamil, Afzal S, Hashim Z. Oxidative stress and PON1 (T172A/L55M) polymorphism: potential risk factors for Osteoarthritis. J PAK MED ASSOC 2022. [DOI: 10.47391/jpma.3658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Objective: To investigate the role of oxidative stress in the progression of osteoarthritis with the genetic determinant of paraoxonase-1 enzyme L55M in osteoarthritis patients.
Method: The case control study was carried out at the University of Karachi from April to November 2020, and comprised blood samples of female osteoarthritis patients aged >50 years and healthy controls matched for age and gender. Oxidative stress was assessed by measuring lipid peroxidation product and protein carbonyl content. Activities of paraoxonase-1 paraoxonase and arylesterase were evaluated in the subjects. Protein expression of paraoxonase-1 was also analysed using western blot method. Paraoxonase-1 L55M (rs854560) polymorphism was determined using tetra-amplification-refractory mutation system polymerase chain reaction. Data was analysed using SPSS® Statistics 20.0.
Results: Of the 103 subjects, 50(48.5%) were patients and 53(51.5%) were controls. The overall age range was 50-70 years. The extent of malondialdehyde (p<0.001) and protein carbonyl content (p<0.05) were increased significantly in the patients compared to the controls. Activity of paraoxonase and arylesterase was found decreased (p<0.001) in patients compared to the controls. The prevalence of genotype MM was higher in the patients than the controls(p=0.001). L55M was more pronounced in patients suffering than the controls (p=0.01).
Conclusion: The elevated levels of malondialdehyde and cabonylated protein content might be associated with osteoarthritis progression. Decreased serum paraoxonase-1 activity with L55M was the major consequence of oxidative stress in female osteoarthritis patients.
Key Words: Osteoarthritis, Oxidative stress, Paraoxonase, Polymorphism.
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Simony S, Mortensen M, Langsted A, Afzal S, Kamstrup P, Nordestgaard B. Sex differences of lipoprotein(a) levels and associated risk of morbidity and mortality by age: The Copenhagen general population study. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Emanuelsson F, Afzal S, Nordestgaard B, Benn M. Risk of fragility fractures in individuals with diabetes. An observational and Mendelian randomization study. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Hodhody G, Lum JW, Afzal S, Mulgrew EV. The COVID CLAVICLE Study: A predictor of future trauma trends. JSES Int 2022; 6:362-367. [PMID: 35128502 PMCID: PMC8805908 DOI: 10.1016/j.jseint.2021.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Clavicle fractures are a common presentation to the emergency department after falls and sporting injuries. During 2020, the coronavirus disease 2019 (COVID-19) pandemic brought with it a long period of social isolation, resulting in a change of behavior patterns and, in return, the presentation of fractures to our local hospitals. The effects of this global pandemic on the presentation and management of clavicles were noted with particular interest to the change in mechanism and its future implications. Methods We performed a longitudinal observational study in 10 hospitals in the North West of England, reviewing all patients presenting with a clavicle fracture during 6 weeks in the first peak of COVID-19 pandemic and compared these with the same period in 2019. Collection points included the patient demographics, fracture characteristics, mechanism of injury, and management. Results A total of 427 clavicle fractures were assessed with lower numbers of patients presenting with a clavicle fracture during the COVID-2020 period (n = 177) compared with 2019 (n = 250). Cycling-related clavicle fractures increased 3-fold during the pandemic compared with the 2019 control group. We also noted an overall increase in clavicle fractures resulting from higher energy trauma as opposed to low energy or fragility fracture. We also found a faster time to surgery in the COVID cohort by 2.7 days on average when compared with 2019. Conclusions Government restrictions and the encouragement of social distancing led to behavioral changes with a vast increase in cyclists on the road. This created a significant rise in clavicle fractures related to this activity. This is likely to be further driven by the government pledge to double cyclists on the road by 2025 in the United Kingdom. We forecast that this increase in cyclists, a behavior change accelerated by the pandemic, is a reliable predictor for future trauma trends.
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Nawaz MF, Fatima R, Gul S, Rana N, Ahmad I, Naseer J, Afzal S, Yasin G, Asif M, Khan SH, Altaf M. Study of human knowledge and attitude toward urban birds in Faisalabad city, Pakistan. BRAZ J BIOL 2021; 83:e249229. [PMID: 34669801 DOI: 10.1590/1519-6984.249229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 05/11/2021] [Indexed: 11/22/2022] Open
Abstract
Birds are very valuable indicators of species richness and endemic patterns in a specified ecosystem, which eventually help the scientist to measure the environmental degradation. The aim of present study was to know human knowledge and attitude toward urban birds in Faisalabad city, Pakistan. The study conducted in four consecutive months: November 2019 to February 2020. Population of birds was noted from eight residential towns of Faisalabad city, data were collected through questionnaire. Faisalabad has a reasonably large population of birds and present data show that, there is a significant difference between favorite bird of residential areas and institutions. The pigeon received the most likeness in bird population among residential area residents, while the myna received the least. The most popular bird in Faisalabad institutions was the sparrow, while the least popular bird was the common myna. Bird adaptation percentage of residential areas and institutional areas of Faisalabad was the highest for parrot and sparrow respectively. People in residential areas and institutions, on the other hand, adapted least to common myna. It is concluded that people of the study area like birds and offered food and high population of birds are present in study area.
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Affiliation(s)
- M F Nawaz
- University of Agriculture, Department of Forestry and Range Management, Faisalabad, Pakistan
| | - R Fatima
- University of Agriculture, Department of Zoology, Wildlife and Fisheries, Faisalabad, Pakistan
| | - S Gul
- University of Karachi, Department of Botany, Karachi, Pakistan
| | - N Rana
- University of Agriculture, Department of Zoology, Wildlife and Fisheries, Faisalabad, Pakistan
| | - I Ahmad
- University of Agriculture, Department of Forestry and Range Management, Faisalabad, Pakistan
| | - J Naseer
- The Islamia University of Bahawalpur, Department of Forestry, Range and Wildlife Management, Bahawalpur, Pakistan
| | - S Afzal
- University of Sargodha, Department of Forestry, Range Management and Wildlife, Sargodha, Pakistan
| | - G Yasin
- The Islamia University of Bahawalpur, Department of Forestry, Range and Wildlife Management, Bahawalpur, Pakistan
| | - M Asif
- University of Agriculture, Department of Forestry and Range Management, Faisalabad, Pakistan
| | - S H Khan
- University of Agriculture, Department of Forestry and Range Management, Faisalabad, Pakistan
| | - M Altaf
- The Islamia University of Bahawalpur, Department of Forestry, Range and Wildlife Management, Bahawalpur, Pakistan
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Veulemans V, Maier O, Piayda K, Berning KL, Binneboessel S, Polzin A, Afzal S, Dannenberg L, Horn P, Jung C, Westenfeld R, Kelm M, Zeus T. Rapid pacing is an independent predictor for high implantation depth using self-expandable devices in TAVR. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Optimizing valve implantation depth (ID) plays a crucial role in minimizing conduction disturbances and achieving optimal functional integrity. Until now, the impact of intraprocedural fast (FP) or rapid ventricular pacing (RP) on the implantation depth has not been investigated.
Purpose
Therefore, we aimed to 1) evaluate the impact of different pacing maneuvers on ID, and 2) identify the independent predictors of deep ID.
Methods
562 TAVR patients with newer-generation self-expandable devices were retrospectively enrolled and further separated into patients undergoing TAVR under FP (n=331; 58.9%) and RP (n=231; 41.1%). The final ID was analyzed, and the underlying functional, anatomical, and procedural conditions were evaluated by univariate and multivariate analysis.
Results
The highest ID was reached under RP in severe aortic valve calcification and valve size 26 mm. Multivariate analysis identified left ventricular outflow (LVOT) calcification (OR 0.56 [0.37–0.85], p=0.006*), a bicuspid valve (OR 0.34 [0.11–1.0], p=0.049*), valve size 26 mm (OR 0.47 [0.28–0.81], p=0.006*), and RP (OR 0.57 [0.37–0.87], p=0.010*) as independent and highly preventable predictors for deep valve deployment. Independent risk factors for deep ID were the use of a 34 mm device (OR 1.96 [1.22–3.15], p=0.005*) and mild aortic valve calcification (OR 1.62 [0.01–2.61], p=0.046*). In a model of protective factors, ID was significantly reduced with the number of protective criteria (0–2 criteria: −5.6±2.6 mm vs. 3–5 criteria: −4.5±2.0 mm; p<0.0001*).
Conclusion
Data from this retrospective analysis indicate that RP is an independent predictor to reach a higher implantation depth using self-expandable devices.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- V Veulemans
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - O Maier
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - K Piayda
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - K L Berning
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - S Binneboessel
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - A Polzin
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - S Afzal
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - L Dannenberg
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - P Horn
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - C Jung
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - R Westenfeld
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - M Kelm
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - T Zeus
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
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Maier O, Afzal S, Piayda K, Polzin A, Westenfeld R, Jung C, Zeus T, Kelm M, Veulemans V. Electrocardiographic predictors of recovery from pacemaker dependency after transcatheter aortic valve implantation: a meta-analysis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Transcatheter aortic valve implantation (TAVI) is a well-established alternative to surgery for the treatment of patients with severe symptomatic aortic stenosis at high and intermediate surgical risk. The occurrence of electrical conduction disturbances with the need for permanent pacemaker (PPM) implantation remains one of the most frequent complications of the procedure. But PPM dependency after TAVI is often transient and conduction abnormalities may improve over time.
Purpose
We performed a meta-analysis to summarize available studies that reported the incidence of new PPM after TAVI and investigated the rate and possible predictors of recovery from PPM dependency during follow-up.
Methods
The authors conducted a literature search in PubMed and MEDLINE databases from January of 2012 until February of 2021. Eleven observational studies (n=6794) met inclusion criteria for the final analysis. The effect size was estimated using a random-effects model with 95% confidence interval (CI).
Results
PPM implantation was performed in 902 patients after TAVI (13.3%), mostly due to high degree atrioventricular (AV) block (81.3%). A follow-up of 683 patients was performed after a median period of 139 days. 322 of the patients examined during follow-up (48.6%) showed recovery from PPM dependency. Regarding secondary endpoints' analysis of relative risk (RR) and mean difference (MD) predictors of PPM recovery during follow-up were female sex (RR 1.37; 95% CI 1.10–1.71; p=0.006), preexisting coronary artery disease (RR 1.12; 95% CI 0.99–1.27; p=0.08) and reduced left ventricular ejection fraction (MD −2.08%; 95% CI 0.23–3.93%; p=0.03). ECG predictors for long-term PPM dependency after TAVI appeared to be preexisting right bundle branch block (RBBB) (RR 1.84; 95% CI 1.38–2.45; p<0.0001), bifascicular block (RR 4.41; 95% CI 1.64–11.86; p=0.003) and prolonged QRS duration (MD 8.69 ms; 95% CI 0.11–17.28 ms; p=0.05). While postprocedural complete heart block was highly predictive for long-term PPM dependency after TAVI (RR 1.35; 95% CI 0.97–1.89; p<0.0001), patients with recovery of PPM dependency showed more indications other than complete heart block for PPM implantation like lower degree AV block or sick sinus syndrome (RR 2.28; 95% CI 1.53–3.38; p<0.0001). Especially postprocedural AV block grade I (RR 1.73; 95% CI 0.96–3.14; p=0.07) and new left bundle branch block (LBBB) (RR 1.94; 95% CI 1.22–3.08; p=0.005) turned out to be predictors of PPM recovery during follow-up.
Conclusion
This structured meta-analysis proved new PPM implantation in 13.3% of patients following TAVI with half of the cases (48.6%) recovering from PPM dependency during follow-up. Therefore, it should be considered to carefully reassess the indication for PPM rather than to immediately implant PPM after TAVI, especially regarding postprocedural ECG predictors for early pacemaker recovery (lower degree AV block, postprocedural LBBB).
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- O Maier
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - S Afzal
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - K Piayda
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - A Polzin
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - R Westenfeld
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - C Jung
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - T Zeus
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - M Kelm
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - V Veulemans
- University Hospital Duesseldorf, Duesseldorf, Germany
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Gul F, Ahmad B, Afzal S, Ullah A, Khan S, Aman K, Khan MT, Hadi F, Kiran K, Zahra M, Maqbool T, Mohsin U, Nadeem T, Javed MA, Ali Q, Ahmad L. Comparative analysis of various sources of selenium on the growth performance and antioxidant status in broilers under heat stress. BRAZ J BIOL 2021; 83:e251004. [PMID: 34614126 DOI: 10.1590/1519-6984.251004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 05/18/2021] [Indexed: 11/22/2022] Open
Abstract
The supplementation of Selenium-enriched probiotics is effective in reducing oxidative stress and maintaining meat quality stability in broiler chicken especially under heat stress. An experimental study was conducted to perform Comparative analysis of Selenium yeast with inorganic Se in broilers under heat stress. A total of 120 broilers chicks of one day were assigned to 4 groups each consisting 30 chicks fed on same basal diet but different selenium sources. The basal diet of group D1 was not supplemented with Se source (Negative control), group D2 basal diet was supplemented with inorganic selenium (Sodium selenite 0.22mg/Kg starter phase and 0.15mg/Kg finisher phase), group D3 basal diet was supplemented with commercially available organic selenium (Seleno-methionine 0.22mg/Kg starter phase and 0.15mg/Kg finisher phase) and group D4 basal diet was supplemented with self-developed organic selenium (Se-enriched yeast 0.22mg/Kg starter phase and 0.15mg/Kg finisher phase). The performance parameters i.e. feed intake (FI), live body weight (BW) and FCR were not significantly (p>0.05) effected by selenium supplementation in the starter phase but were significantly (p<0.05) effected in the finisher phase. Selenium supplementation significantly (p<0.05) effected serum Se level in different supplemented groups. Higher serum Se value (58.20±0.06) was recorded in D4 group. Similarly significantly lower selenium value was recorded for D4 and higher was recorded for D1 (11.36±0.08). However lower serum Paraoxonase (PON) value was recorded for D4 (13.24±0.01) and higher for D1 (13.33±0.03). Comparatively self-developed Se enriched yeast increased the Se accumulation and improved antioxidant system. Glutathione peroxidase (GPx) was found higher in D4 (12.333±0.03) followed by D3, D2 and D1 respectively. Whereas superoxide dismutase (SOD) was significantly lower (p<0.05) in D4 (0.1437±0.003) followed by D3 (0.1457±0.002). Selenium supplementation increased the bird's survival rate. Birds fed on Se enriched yeast showed higher Se deposition and better antioxidant capacity as compared to other sources of selenium. Se-enriched yeast displayed an improved result on Se deposition in tissues, and oxidative capacity, meat tenderness and immune response level as compared to other sources of selenium.
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Affiliation(s)
- F Gul
- University of Peshawar, Center of Biotechnology and Microbiology, Peshawar, Pakistan
| | - B Ahmad
- University of Peshawar, Center of Biotechnology and Microbiology, Peshawar, Pakistan
| | - S Afzal
- University of Peshawar, Center of Biotechnology and Microbiology, Peshawar, Pakistan
| | - A Ullah
- University of Peshawar, Center of Biotechnology and Microbiology, Peshawar, Pakistan
| | - S Khan
- Bacha Khan University, Institute of Microbiology and Biotechnology, Charsada, Pakistan
| | - K Aman
- Abasyn University Peshawar, Department of Microbiology, Peshawar, Pakistan
| | - M T Khan
- The University of Lahore, Institute of Molecular Biology and Biotechnology, Lahore, Pakistan
| | - F Hadi
- The University of Lahore, Institute of Molecular Biology and Biotechnology, Lahore, Pakistan
| | - K Kiran
- The University of Lahore, Institute of Molecular Biology and Biotechnology, Lahore, Pakistan
| | - M Zahra
- The University of Lahore, Institute of Molecular Biology and Biotechnology, Lahore, Pakistan
| | - T Maqbool
- The University of Lahore, Institute of Molecular Biology and Biotechnology, Lahore, Pakistan
| | - U Mohsin
- The University of Lahore, Institute of Molecular Biology and Biotechnology, Lahore, Pakistan
| | - T Nadeem
- University of the Punjab Lahore, Centre of Excellence in Molecular Biology, Lahore, Pakistan
| | - M A Javed
- University of the Punjab Lahore, Department of Plant Breeding and Genetics, Lahore, Pakistan
| | - Q Ali
- The University of Lahore, Institute of Molecular Biology and Biotechnology, Lahore, Pakistan.,University of the Punjab Lahore, Department of Plant Breeding and Genetics, Lahore, Pakistan
| | - L Ahmad
- Khybar Medical College Peshawar, Department of Medicine, Khyber Pakhtunkhwa, Peshawar, Pakistan
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Johansen M, Vedel-Krogh S, Nielsen S, Afzal S, Smith GD, Nordestgaard B. Per particle triglyceride-rich lipoproteins imply higher myocardial infarction risk than low-density lipoproteins: Copenhagen general population study. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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14
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Nordestgaard L, Christoffersen M, Afzal S, Nordestgaard B, Tybjærg-Hansen A, Frikke-Schmidt R. Genetic variation in ABCA1 and risk of all-cause dementia, age-related macular degeneration, and ischemic heart disease. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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15
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Afzal S, Ahmad HI, Jabbar A, Tolba MM, AbouZid S, Irm N, Zulfiqar F, Iqbal MZ, Ahmad S, Aslam Z. Use of Medicinal Plants for Respiratory Diseases in Bahawalpur, Pakistan. Biomed Res Int 2021; 2021:5578914. [PMID: 33884265 PMCID: PMC8041525 DOI: 10.1155/2021/5578914] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 01/29/2021] [Revised: 03/14/2021] [Accepted: 03/20/2021] [Indexed: 12/22/2022]
Abstract
The most common ethnomedicinal plants being effective in respiratory disorders were studied for the first time in Bahawalpur District. The herbal medication represents a low-cost treatment for the local community. There is a need for documenting the traditional uses of plants for further investigation of bioactive compounds. Using a qualitative approach, the ethnobotanical data was collected from the district of Bahawalpur, Pakistan, from February 2018 to February 2020 through semistructured interviews with the local people and traditional healers. The quantitative analysis included use value, informant consensus factor, family importance value, and relative frequency citation. A total of 20 indigenous plants belonging to 17 families were documented from 185 informants. These plants were claimed to be used for the treatment of 10 respiratory ailments. The plant habit, part of the plant used, and mode of preparation were standardized for authentication. The herbs are the most used life form (55%), while trees and shrubs are also used. Leaves dominate with high use value (47.62%) followed by fruit, stem, flower, and other parts of plants. For the preparation of traditional remedies, decoction (76.19%) and extract (71.43%) are common preparation methods. However, other methods of paste infusion, powder juice, and ash are used to a lower extent. The plants with higher use value are Glycyrrhiza glabra, Acacia arabica, and Mentha piperita; these have significant potential therapeutic activity for respiratory disease. The ethnomedicinal importance of plants against respiratory diseases used by the local population (traditional healers) is the commercial availability of the herbal product. It is a first-time study in this area to fill the gap between traditional practices and synthetic medicine to screen out the phytochemical and pharmacological properties of plants that have a highly futuristic use value to develop antibiotic drug with least side effects by using sustainable methods.
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Affiliation(s)
- Sadia Afzal
- Department of Botany, Faculty of Life Science, Women University Multan, Punjab, Pakistan
| | - Hafiz Ishfaq Ahmad
- Department of Animal Breeding and Genetics, University of Veterinary and Animal Science, Ravi Campus Pattoki Punjab, Pakistan
| | - Abdul Jabbar
- Department of Clinical Medicine, Faculty of Veterinary Science, University of Veterinary and Animal Sciences, Lahore Punjab, Pakistan
| | - Mahmoud M. Tolba
- Pharmaceutical Division, Ministry of Health and Population, Faiyum, Egypt
| | - Sameh AbouZid
- Department of Pharmacognosy, Faculty of Pharmacy, Heliopolis University for Sustainable Development, Egypt
| | - Nimra Irm
- Department of Animal Breeding and Genetics, University of Veterinary and Animal Science, Ravi Campus Pattoki Punjab, Pakistan
| | - Farheen Zulfiqar
- Department of Food Science and Human Nutrition, Faculty of Biosciences, University of Veterinary and Animal Sciences, Lahore Punjab, Pakistan
| | - Muhammad Zahid Iqbal
- Department of Clinical Medicine, Faculty of Veterinary Science, University of Veterinary and Animal Sciences, Lahore Punjab, Pakistan
| | - Shoaib Ahmad
- Faisalabad Medical University, Faisalabad, Pakistan
- Punjab Medical College, Faisalabad, Pakistan
| | - Zubair Aslam
- Department of Agronomy, University of Agriculture, Faisalabad, Pakistan
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Arain F, Tohid A, Arain H, Afzal S, Tauheed M, Tauheed M, Zeshan M, Azeem W. Role of digital health in improving physical and mental well-being during COVID-19 pandemic. Eur Psychiatry 2021. [PMCID: PMC9528473 DOI: 10.1192/j.eurpsy.2021.740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionDue to the COVID-19 pandemic, there is a steep rise in the acceptance of telemedicine and digital health, including increased interest in pursuing mental health treatment through telepsychiatry. Digital health helps following social distancing measures and increases the health outcomes.ObjectivesTo see the role of digital health in improving physical and mental well-being during COVID-19 PandemicMethods
This study is a part of a large global project where 240 people inquired advice on phone app during COVID-19-Pandemic. Later on, a short study was conducted on the same population through survey to evaluate the effectiveness of digital health/tele-mental health. We also searched PubMed, Google Scholar, PsychInfo, and Medline for words “Digital Health, Tele-mental health, COVID-19-Pandemic”. Reviewed 40 articles and included 3 in this review1,4,5.Results
We received a total of 98 responses. 65.6% people reported that online health resources are helpful in relieving pandemic-induced anxiety/stress, 66.2% reported to continue online health services after pandemic, 37.7% noted that digital health saves times in waiting areas, 46% reported lack of physical interaction with doctor as a disadvantage of digital health, and 40.3% reported comfort in using tele-mental health. Our literature review has shown barriers like privacy concerns and technological issues1. Provision of tele-psychiatry is safe and effective in continuity of mental health care.4,5Conclusions
There has been an increased inclination towards digital health during any disaster. During COVID-19-Pandemic, digital health has increased access to mental health care and reduced risk of infection. The drawbacks include poor patient-doctor relationship, reimbursement concerns, and lack of confidentiality.
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Nordestgaard L, Lauridsen B, Christoffersen M, Afzal S, Nordestgaard B, Frikke-Schmidt R, Tybjærg-Hansen A. Genetic inhibition of CETP and risk of dementia, age-related macular degeneration and cardiovascular mortality. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.028] [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: 10/22/2022]
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18
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Maier O, Bosbach G, Hellhammer K, Afzal S, Piayda K, Zeus T, Jung C, Westenfeld R, Polzin A, Kelm M, Veulemans V. Stroke after transcatheter aortic valve implantation: new insights into risk prediction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2600] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Stroke is still a feared complication following transcatheter aortic valve implantation (TAVI), associated with increased mortality and severe impact on patients' daily living. Despite technological development and knowledge improvement, cerebrovascular events (CVE) are still not predictable so far and simple risk scores are lacking.
Purpose
This study aimed to evaluate different preprocedural factors that may favour stroke after TAVI, especially regarding severity of aortic calcification.
Methods
From May 2011 to January 2018 a total of 1365 patients underwent TAVI with a balloon-expandable (n=442, 32.4%) or self-expandable (n=923, 67.6%) device at our institution. All patients underwent multi-slice computed tomography (MSCT) before TAVI. To obtain the significant factors for stroke risk prediction we performed multivariate regression analysis and selected the optimal cut-off values according to the maximum Youden index for dichotomization of the risk score items. Finally, we used receiver operating characteristics (ROC) analysis and areas under the ROC curves (AUC) to validate our risk score in comparison to other existing models.
Results
60 of 1365 patients (4.4%) had new neurological impairment after TAVI during hospital stay (mean 11.2±6.7 days). We performed propensity score matching (1:10) to balance baseline characteristics between patients with and without stroke following TAVI, resulting in 56 patients with in-hospital stroke and 521 patients without. Preprocedural factors associated with stroke turned out to be history of prior stroke (OR 1.94; 95% CI 0.85–4.43; p=0.114), aortic valve area ≥0.545 cm2 (OR 3.11; 95% CI 1.16–8.34; p=0.024), atrioventricular angle ≥48.5° (OR 2.32; 95% CI 1.20–4.49; p=0.013), RCC Agatston Score ≥447.2 AU (OR 1.8; 95% CI 0.94–3.44; p=0.077), LVOT Agatston Score ≥262.4 AU (OR 2.01; 95% CI 1.08–3.75; p=0.028) and ascending thoracic aorta Agatston Score ≥116.4 AU (OR 2.21; 95% CI 1.17–4.17; p=0.015). ROC analysis showed that our risk model had an AUC of 0.73 (95% CI 0.66–0.80; p<0.001), a sensitivity of 70.6%, a specificity of 69.0%, a positive predictive value of 19.5% and a high negative predictive value of 95.7%. Our risk model appeared to be the best for stroke prediction after TAVI compared to other risk scores used in literature before like EuroSCORE II (AUC 0.50; 95% CI 0.43–0.58; p=0.950) or CHA2DS2-VASc Score (AUC 0.62; 95% CI 0.55–0.70; p=0.004).
Conclusion
Especially aortic root calcium volume assessed by MSCT predicts CVE after TAVI and could be integrated into a six items risk model for preprocedural prediction of stroke after TAVI. This model could guide us in identifying those patients who are most likely to benefit from transcatheter cerebral embolic protection devices.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- O Maier
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - G Bosbach
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - K Hellhammer
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - S Afzal
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - K Piayda
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - T Zeus
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - C Jung
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - R Westenfeld
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - A Polzin
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - M Kelm
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - V Veulemans
- University Hospital Duesseldorf, Duesseldorf, Germany
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Piayda K, Wimmer A, Sievert H, Hellhammer K, Afzal S, Veulemans V, Jung C, Kelm M, Zeus T. Use and success evaluation of percutaneous aortic balloon valvuloplasty in different hemodynamic entities of severe aortic stenosis in the TAVR era. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In the era of transcatheter aortic valve replacement (TAVR), there is renewed interest in percutaneous balloon aortic valvuloplasty (BAV), which may qualify as the primary treatment option of choice in special clinical situations. Success of BAV is commonly defined as a significant mean pressure gradient reduction after the procedure.
Purpose
To evaluate the correlation of the mean pressure gradient reduction and increase in the aortic valve area (AVA) in different flow and gradient patterns of severe aortic stenosis (AS).
Methods
Consecutive patients from 01/2010 to 03/2018 undergoing BAV were divided into normal-flow high-gradient (NFHG), low-flow low-gradient (LFLG) and paradoxical low-flow low-gradient (pLFLG) AS. Baseline characteristics, hemodynamic and clinical information were collected and compared. Additionally, the clinical pathway of patients (BAV as a stand-alone procedure or BAV as a bridge to aortic valve replacement) was followed-up.
Results
One-hundred-fifty-six patients were grouped into NFHG (n=68, 43.5%), LFLG (n=68, 43.5%) and pLFLG (n=20, 12.8%) AS. Underlying reasons for BAV and not TAVR/SAVR as the primary treatment option are displayed in Figure 1. Spearman correlation revealed that the mean pressure gradient reduction had a moderate correlation with the increase in the AVA in patients with NFHG AS (r: 0.529, p<0.001) but showed no association in patients with LFLG (r: 0.145, p=0.239) and pLFLG (r: 0.030, p=0.889) AS. Underlying reasons for patients to undergo BAV and not TAVR/SAVR varied between groups, however cardiogenic shock or refractory heart failure (overall 46.8%) were the most common ones. After the procedure, independent of the hemodynamic AS entity, patients showed a functional improvement, represented by substantially lower NYHA class levels (p<0.001), lower NT-pro BNP levels (p=0.003) and a numerical but non-significant improvement in other echocardiographic parameters like the left ventricular ejection fraction (p=0.163) and tricuspid annular plane systolic excursion (TAPSE, p=0.066). An unplanned cardiac re-admission due to heart failure was necessary in 23.7% patients. Less than half of the patients (44.2%) received BAV as a bridge to TAVR/SAVR (median time to bridge 64 days). Survival was significantly increased in patients having BAV as a staged procedure (log-rank p<0.001).
Conclusion
In daily clinical practice, the mean pressure gradient reduction might be an adequate surrogate of BAV success in patients with NFHG AS but is not suitable for patients with other hemodynamic entities of AS. In those patients, TTE should be directly performed in the catheter laboratory to correctly assess the increase of the AVA. BAV as a staged procedure in selected clinical scenarios increases survival and is a considerable option in all flow states of severe AS. (NCT04053192)
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Piayda
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - A Wimmer
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - H Sievert
- CardioVascular Center Frankfurt, Frankfurt, Germany
| | - K Hellhammer
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - S Afzal
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - V Veulemans
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - C Jung
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - M Kelm
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - T Zeus
- University Hospital Duesseldorf, Duesseldorf, Germany
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Piayda K, Hellhammer K, Veulemans V, Afzal S, Heidari H, Jung C, Kelm M, Zeus T. Performance of the Corevalve Evolut R and PRO in severely calcified anatomies: a propensity-score matched analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The Corevalve Evolut R and PRO belong to the newer generation of self-expandable valves and are increasingly used to treat patients with severe aortic stenosis. Over the years, technical advancements and increasing experience with the procedure itself are responsible for excellent clinical and hemodynamic results. Patients with severely calcified native aortic valve anatomies still pose a special task to the implanting team since the risk for intraprocedural complications might be increased.
Purpose
To evaluate the hemodynamic and clinical performance of the CoreValve Evolut R and PRO in patients with severely calcified native aortic valve anatomies.
Methods
Baseline characteristics, imaging data and procedural outcome of patients undergoing transfemoral transcatheter aortic valve implantation with the CoreValve Evolut R and PRO from 09/2015 to 03/2018 were prospectively collected. Patients underwent high-resolution multisclice computed tomography (MSCT). A pre-specific threshold of 600 Hounsfield units was set to account for the hyperdensity of the applied contrast medium and to enable comparability with MSCT thresholds, derived by non-contrast enhanced MSCT scans. Patients were divided by the extent of calcification into a severely calcified anatomy group (men >2062AU, woman >1377AU) or a not severely calcified anatomy group (men <2062AU, woman <1377AU). Propensity score matching with the variables log EuroSCORE, LVOT calcium load and the cover index in a 1:2 fashion was performed and clinical and hemodynamic results in accordance with VARC II were collected.
Results
Ninety-eight patients with severely calcified anatomies (SC) could be identified and were matched with 196 patients with lower calcified (LC) anatomies. Patients with severely calcified anatomies were older (SC: 83.1 years vs. LC: 80.3 years, p<0.001) and had a smaller aortic valve area (SC: 0.63cm2 vs. LC: 0.70cm2, p=0.028). The mean implantation depth did not differ (SC 5.4mm±2.4 vs. LC: 5.1±2.2, p=0.554). Pre-dilatation was more often performed in the SC group (SC: 30.6% vs. LC: 15.8%, p=0.003) and the stroke/TIA rate did not differ (SC: 5.1% vs. LC: 3.5%, p=0.532). In SC patients, a permanent pacemaker implantation was significantly more often needed (SC: 28.5% vs. LC:7.6%, p<0.001). The mean pressure gradient after the procedure was effectively reduced (SC: 7.1mmHg±3.9 vs. LC: 7.8±3.7mmHg, p=0.477). No aortic regurgitation (AR) was more often present in patients with SC anatomies (SC: 72.5% vs. LC: 85.2%, p=0.011). The aortic regurgitation index numerically differed between groups without reaching statistical significance (SC: 24.1±7.1 vs. LC: 27.3±6.7, p=0.067).
Conclusion
The CoreValve Evolut R and PRO show a good clinical safety profile and excellent hemodynamic results even in patients with severely calcified anatomies. In those patients, a permanent pacemaker implantation was more often necessary.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Piayda
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - K Hellhammer
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - V Veulemans
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - S Afzal
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - H Heidari
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - C Jung
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - M Kelm
- University Hospital Duesseldorf, Duesseldorf, Germany
| | - T Zeus
- University Hospital Duesseldorf, Duesseldorf, Germany
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Khanum N, Rehman B, Parvaiz M, Chuadhary M, Javed N, Khan A, Afzal S, Naheed R, Mohsin J. Size discrepancy of residual tumor between post chemotherapy sonography and on post excision histopathology after Neo adjuvant chemotherapy and its impact on 5 years disease free survival. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30632-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Choudhury H, Cheng X, Afzal S, Prakash A, Tatarchuk B, Elbashir N. Understanding the deactivation process of a microfibrous entrapped cobalt catalyst in supercritical fluid Fischer-Tropsch Synthesis. Catal Today 2020. [DOI: 10.1016/j.cattod.2019.01.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
Purpose
The purpose of this paper is to determine the factors influencing the adoption of new information systems (IS) in organizations. Based on the institutional theory, this research proposes that organizations may induce their employees to adopt new IS by creating three types of institutional pressure: coercive, normative and mimetic. It is further argued that the effects of these three institutional pressures on employees’ new IS usage depend on their cultural orientations.
Design/methodology/approach
Model testing relies on data collected from 370 banking sector employees during the implementation of a new “customer relationship management” system. The hypothesized model was tested by using the structural equation modeling technique in MPlus 7.0.
Findings
The findings of this research reveal that institutional pressures (coercive, normative and mimetic) have positive effects on employees’ attitudes to using the new IS, which, in turn, positively influences their IS usage. In addition, collectivism strengthens the positive effect of coercive and normative forces on attitudes to using the new IS. Conversely, collectivism weakens the effect of the mimetic force on employees’ attitudes to using the new IS.
Originality/value
This research is among pioneering studies that explain the effect of institutional pressures (coercive, normative and mimetic) on employees’ IS usage. It is the first study of its nature that demonstrates that each of the three institutional pressures has differential effects on employees with highly collectivist orientations in comparison with employees with low collectivist orientations.
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Veulemans V, Hellhammer K, Maier O, Klein K, Afzal S, Piayda K, Jung C, Westenfeld R, Kelm M, Zeus T. P3742Transcatheter aortic valve implantation in large annuli: incidence and predictors of specific adverse events with the largest self-expanding device. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The recently released largest self-expanding transcatheter aortic valve device (STHV-34) is characterized by good results but nevertheless demands an experienced team for the implantation in large annuli.
Purpose
Looking at multi slice computed tomography (MSCT) and procedural data, we tried to identify characteristics that could explain intraprocedural VARC-2 and valve specific non-VARC-2 events.
Methods
We performed a single center retrospective analysis in 80 patients treated with STHV-34. STHV-34 patients were separated into subjects without events (NE, n=43, 54%) and the following adverse events: resheathing/-capture processes (RS/C, n=19, 24%), valve dislodgments (VD, n=21; 26%), infolding (IF, n=6, 8%) and complete dislocation with bail-out valve-in-valve implantation (ViV, n=3, 4%). Events were further categorized in non-VARC-2 and VARC-2. The analysis sought for underlying anatomical conditions and defined risk factors by multivariate analysis.
Results
Primary device success was reached in 96% and immediate postprocedural absence of moderate-to-severe aortic regurgitation was 100%. We identified specific anatomical conditions predisposing for non-VARC-2 and VARC-2 events: RS/C: annular calcium load<1600 AU (OR 47 [CI 1.4–216], p=0.0004). IF: peripheral kinking (RR 5.0 [CI 1.0–24], p=0.0478) and previous RS/C maneuvers (83%). ViV: annular ellipticity index (NS 1.2±0.1 vs. ViV 1.4±0.1, p=0.0049), aortic angulation (AA) angle (NS 54.0±7.0° vs. ViV 61.7±1.5°, p=0.0240) and LVOT-AO angle (NS 149.1±18.9° vs. ViV 130.3±3.5°, p=0.0470).
Conclusion
We confirm high procedural success for the largest currently available STHV-34. The incidence of intraprocedural non-VARC-2 and VARC-2 events are associated with anatomical characteristics that may influence valve selection and implantation strategy.
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Affiliation(s)
- V Veulemans
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - K Hellhammer
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - O Maier
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - K Klein
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - S Afzal
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - K Piayda
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - C Jung
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - R Westenfeld
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - M Kelm
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - T Zeus
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
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25
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Hellhammer K, Piayda K, Veulemans V, Afzal S, Hennig I, Makosch M, Polzin A, Kelm M, Zeus T. P5583Micro-movement during transcatheter aortic valve implantation with a contemporary self-expandable prosthesis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Precise positioning of the prosthesis is a crucial step during transcatheter aortic valve implantation. In some cases, contemporary self-expandable prostheses show micro-movement (MM) during the final phase of release.
Purpose
We aimed to establish a definition for MM, evaluated the incidence of MM using the CoreValve Evolut RTM, investigated potential risk factors for MM and the associated clinical outcomes.
Methods
MM was defined as movement of the prosthesis of at least 1.5 mm from its position directly before release compared to its final position. Patients were grouped according to the occurrence (+MM) or absence (-MM) of MM. Baseline characteristics, imaging data and outcome parameters in accordance with the updated valve academic research consortium (VARC-2) criteria were retrospectively analyzed.
Results
We identified 258 eligible patients. MM occurred in 31.8% (n=82) of cases with a mean magnitude of 2.8±2.2 mm in relation to the left coronary cusp and 3.0±2.1 mm to the non-coronary cusp. Clinical and hemodynamic outcomes were similar in both groups. The mean pressure gradient was effectively reduced after TAVI (-MM vs. +MM: 7±3.4 mmHg vs. 8±3.9 mmHg, p=0.326) with consistency over a follow-up period of at least three months (-MM vs. +MM: 6.7±3.7 mmHg vs. 7.9±8.4 mmHg, p=0.168). At three months follow-up most of the patients presented with no aortic regurgitation (-MM vs. +MM: 64% vs. 67.9%, p=0.569). Mild aortic regurgitation was observed in 34.2% of the -MM group and in 29.5% of the +MD group (p=0.414). Moderate aortic regurgitation occurred in 1.9% of all patients with no differences between groups (-MM vs. +MM: 1.9% vs. 2.6%, p=0.662). Patients with MM presented with a more symmetric calcification pattern (-MM vs. +MM: 27.3% vs. 40.2%; p=0.037) and a larger aortic valve area (-MM vs. +MM: 0.6 cm2 ± 0.3 vs. 0.7 cm2 ± 0.2; p=0.014), which was found to be a potential risk factor for the occurrence of MM in a multivariate regression analysis (OR 3.5; 95% CI: 1.1–10.9; p=0.032)
Conclusion
MM occurred in nearly one third of patients and did not affect clinical and hemodynamic outcome. A larger aortic valve area was the only independent risk factor for the occurrence of MM.
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Affiliation(s)
- K Hellhammer
- Medical Faculty, Heinrich-Heine-University, Division of Cardiology, Pulmunology and Vascular Medicine, Düsseldorf, Germany
| | - K Piayda
- Medical Faculty, Heinrich-Heine-University, Division of Cardiology, Pulmunology and Vascular Medicine, Düsseldorf, Germany
| | - V Veulemans
- Medical Faculty, Heinrich-Heine-University, Division of Cardiology, Pulmunology and Vascular Medicine, Düsseldorf, Germany
| | - S Afzal
- Medical Faculty, Heinrich-Heine-University, Division of Cardiology, Pulmunology and Vascular Medicine, Düsseldorf, Germany
| | - I Hennig
- Medical Faculty, Heinrich-Heine-University, Division of Cardiology, Pulmunology and Vascular Medicine, Düsseldorf, Germany
| | - M Makosch
- Medical Faculty, Heinrich-Heine-University, Division of Cardiology, Pulmunology and Vascular Medicine, Düsseldorf, Germany
| | - A Polzin
- Medical Faculty, Heinrich-Heine-University, Division of Cardiology, Pulmunology and Vascular Medicine, Düsseldorf, Germany
| | - M Kelm
- Medical Faculty, Heinrich-Heine-University, Division of Cardiology, Pulmunology and Vascular Medicine, Düsseldorf, Germany
| | - T Zeus
- Medical Faculty, Heinrich-Heine-University, Division of Cardiology, Pulmunology and Vascular Medicine, Düsseldorf, Germany
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26
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Afzal S, Veulemans V, Hellhammer K, Piayda K, Nijhof N, Polzin A, Kelm M, Zeus T. P2467Fusion imaging (Anatomical Intelligence) enables automated left atrial appendage sizing in real-time a single center pilot study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and purpose
Percutaneous left atrial appendage occlusion (LAAO) depicts an alternative treatment for patients with atrial fibrillation who are deemed for long-term oral anticoagulation therapy. In order to perform a successful LAAO accurate sizing of left atrial appendage (ostium, landing zone and depth) for device selection is essential. Echo-Fluoro fusion imaging in real-time offers with its latest prototype a patient-specific segmented automated 3D heart model and sizing of left atrial appendage (LAA). We therefore aimed to evaluate the automated segmented LAA sizing by comparing to 2D transesophageal (TOE) and MSCT measurements as gold standard.
Methods
We studied prospectively data of 8 consecutive patients who were admitted to our clinic for left atrial appendage closure. MSCT was performed preprocedural and analyzed with commercially available 3mensio software (Pie medical imaging). 2D TOE measurements and automated segmentation of the LAA and sizing were performed during the procedure by a highly experienced team of periinterventional cardiac imaging specialist and structural heart disease interventionalist who were blinded to the prior MSCT analysis. Dimension of ostium, landing zone (10 mm into the LAA parallel to the ostial plane at the level of the left circumflex for Amplatzer device) and depth (perpendicular to the ostial plane) were obtained in different TOE views according to instructions for use of Amulet Occluder. In order to generate an automated 3 D heart model, a high-quality 3D TOE image of the LAA volume and surrounding structures was acquired. After successful ECG-gated segmentation a 3 D heart model was generated. Automated LAA sizing followed in real-time. All measurements were taken into consideration before device selection. A Kruskal Wallis test was used to compare mean ranks of independent samples. A concordance analysis according to Kendall W was carried out to investigate reliability.
Results
The mean age of the patients was 82,6±4.15 years and half of the patients were female. All procedures were conducted successfully. The mean values of ostium and landing zone were comparable in TOE, automated sizing and MSCT sizing (ostium: 23,78±2,15 mm vs 25,71±5,25 mm vs 27,35±3,3 mm; (p=0,175); landing zone 22,13±3,18 mm vs 23,57±3,31 mm vs 24,00±3,51 mm; (p=0,377)). Furthermore, a significant concordance between the measurements was shown (ostium W= 0,991; p=0.045, landing zone W=0,835, p=0.014).
Conclusion
Automated LAA sizing acquired by fusion imaging may be an elegant real-time alternative for precise LAA Occluder device selection and needs to be investigated further.
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Affiliation(s)
- S Afzal
- Division of Cardiology, Pulmunology and Vascular Medicine, Medical Faculty, Heinrich-Heine-Universit, Duesseldorf, Germany
| | - V Veulemans
- Division of Cardiology, Pulmunology and Vascular Medicine, Medical Faculty, Heinrich-Heine-Universit, Duesseldorf, Germany
| | - K Hellhammer
- Division of Cardiology, Pulmunology and Vascular Medicine, Medical Faculty, Heinrich-Heine-Universit, Duesseldorf, Germany
| | - K Piayda
- Division of Cardiology, Pulmunology and Vascular Medicine, Medical Faculty, Heinrich-Heine-Universit, Duesseldorf, Germany
| | - N Nijhof
- Philips Healthcare, Best, Netherlands, Best, Netherlands (The)
| | - A Polzin
- Division of Cardiology, Pulmunology and Vascular Medicine, Medical Faculty, Heinrich-Heine-Universit, Duesseldorf, Germany
| | - M Kelm
- Division of Cardiology, Pulmunology and Vascular Medicine, Medical Faculty, Heinrich-Heine-Universit, Duesseldorf, Germany
| | - T Zeus
- Division of Cardiology, Pulmunology and Vascular Medicine, Medical Faculty, Heinrich-Heine-Universit, Duesseldorf, Germany
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Veulemans V, Hellhammer K, Afzal S, Maier O, Westenfeld R, Jung C, Kelm M, Zeus T, Polzin A. P2274Single-center experience with different regimes of antiplatelet therapy and oral anticoagulation in transcatheter aortic valve replacement. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Antithrombotic therapy in transcatheter aortic valve replacement (TAVR) is highly controversial. Dual antiplatelet therapy (DAPT) for 3–6 months with aspirin and clopidogrel is the current recommendation. Whereas in patients with indication for OAC several regimes were described, ranging from OAC monotherapy to dual and even triple therapy. Besides vitamin K antagonists (VKA), non-Vitamin K oral anticoagulants (NOAC) are frequently used in TAVR patients with indication for permanent OAC.
Purpose
We therefore aimed to evaluated different antithrombotic regimes and their impact on outcome.
Methods
We performed a single center retrospective analysis in 1160 patients treated by transfemoral approach (TF TAVR). Primary endpoints were 30-day mortality, stroke and bleeding according to VARC-2 criteria. Secondary endpoint was all-cause mortality at 1 year.
Results
In 1160 patients with TF TAVR, a broad range of regimes occurred in clinical practice. The majority of patients were on DAPT (637 patients, 55.0%), followed by VKA + clopidogrel (186 patients, 16%). Other patients received OAC mono (98 patients; 9%), triple therapy (93 patients; 8%), NOAC mono (31 patients; 3%), single antiplatelet therapy (SAPT, 40 patients; 4%) or NOAC + clopidogrel (31 patients, 3%).
All-cause mortality 30 days after TF TAVR differed between the regimens. (SAPT/OAC+SAPT/N-OAC+DAPT 0.0% vs DAPT 3.6% vs OAC 10.2% vs. NOAC 1.3% vs NOAC+SAPT 0.3%; pANOVA<0.0001). Severe bleeding events were comparable (SAPT 5.0% vs DAPT 2.4% vs OAC 7.1% vs NOAC 1.3% vs OAC+SAPT 3.2% vs NOAC+SAPT 0.0% vs. N-OAC+SDPT 4.3%; pANOVA=0.15). Stroke rates were comparable in all subcohorts as well (SAPT 5.0% vs DAPT 3.0% vs OAC 7.1% vs NOAC 2.7% vs OAC+SAPT 1.6% vs NOAC+SAPT 0.0% vs. N-OAC+DAPT 1.1%; pANOVA=0.13). Only 2 hemorrhagic strokes (5.6%) appeared under DAPT and OAC mono respectively, whereas all others were of thromboembolic origin (94.4%). Surprisingly, all-cause mortality at one-year after TF TAVR was higher in OAC patients compared to all other used regimes (logrankoverallp=0.0012).
Conclusion
Data from our retrospective analysis indicate that a variety of different antithrombotic regimes occur even in a single centre analysis. All-cause mortality was enhanced in patients with oral anticoagulation. Therefore, clinical trials need to investigate if this is only explained by additional atrial fibrillation.
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Affiliation(s)
- V Veulemans
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - K Hellhammer
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - S Afzal
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - O Maier
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - R Westenfeld
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - C Jung
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - M Kelm
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - T Zeus
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
| | - A Polzin
- University Hospital Düsseldorf, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Düsseldorf, Germany
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28
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Maier O, Hellhammer K, Boenner F, Afzal S, Spieker M, Zeus T, Horn P, Westenfeld R, Kelm M, Veulemans V. P1857Risk calculator for prediction of iatrogenic atrial septal defect persistence following percutaneous mitral valve repair. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The rising number of new percutaneous interventions for left-sided heart disease leads to increased occurrence of iatrogenic atrial septal defect (iASD). The percutaneous mitral valve repair (PMVR) for severe, symptomatic mitral regurgitation (MR) also requires intraprocedural puncture of the interatrial septum. In some cases iASD is persisting and becomes haemodynamically relevant with enhanced right heart overload due to significant left-to-right-shunting.
Purpose
This study aimed to evaluate pre- and periprocedural factors that may favour persistence and haemodynamic relevance of iASD in patients after PMVR.
Methods
In 2015, 75 consecutive patients with severe MR (age 74.8±10.5y) and following PMVR were enrolled. After 12 months, 57 patients completed their follow up (FU) including clinical conditions, transthoracic echocardiography (TTE), and cardiovascular magnetic resonance (CMR) whenever feasible. We evaluated the impact of comorbidities as well as intraprocedural, haemodynamic and functional characteristics that may favour persistence of iASD by multivariate analysis. Haemodynamic relevance of iASD was defined as right heart overload with predominantly significant enlargement of the right atrium (RA), impairment of right heart function as defined by fractional area shortening (FAC), and ratio of pulmonary to systemic blood flow (Qp/Qs>1) when available.
Results
18 out of 57 patients (32%) showed a persistent iASD (+iASD), being associated with a specific combination of comorbidities as well as pre-procedural and periprocedural factors that can be summarised by a multifactorial iASD risk calculator (+iASD vs. -iASD: 6.3±2.9 vs. 3.9±2.7; p=0.0058). 11 iASD (61%) became haemodynamically relevant (+hd iASD) with a significant right heart overload (RA area +hd iASD vs. -hd iASD: baseline 23.1±4.1 vs. 23.2±4.3; FU 30.7±6.3 vs. 20.1±4.6; p<0.0001), reduced RV function (FAC +hd iASD vs. -hd iASD: baseline 41.0±10.3 vs. 29.9±7.2; FU 25.3±7.2 vs. 29.1±13.2; p<0.0156) and left-to-right shunting (Qp/Qs -iASD vs. +hd iASD vs. -hd iASD: 1.0±0.3 vs. 1.7±0.4 vs. 0.8±0.1 L/min; p=0.0011).
Conclusion
This study shows for the first time, that persistence of iASD can be predicted by pre- and periprocedural factors using a risk calculator that may additionally guide careful follow up imaging and therapeutic action after PMVR to avoid development of progressive heart failure.
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Affiliation(s)
- O Maier
- University Hospital Dusseldorf, Dusseldorf, Germany
| | - K Hellhammer
- University Hospital Dusseldorf, Dusseldorf, Germany
| | - F Boenner
- University Hospital Dusseldorf, Dusseldorf, Germany
| | - S Afzal
- University Hospital Dusseldorf, Dusseldorf, Germany
| | - M Spieker
- University Hospital Dusseldorf, Dusseldorf, Germany
| | - T Zeus
- University Hospital Dusseldorf, Dusseldorf, Germany
| | - P Horn
- University Hospital Dusseldorf, Dusseldorf, Germany
| | - R Westenfeld
- University Hospital Dusseldorf, Dusseldorf, Germany
| | - M Kelm
- University Hospital Dusseldorf, Dusseldorf, Germany
| | - V Veulemans
- University Hospital Dusseldorf, Dusseldorf, Germany
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29
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Afzal S, Schulz PS, Veulemans VV, Kleinebrecht LK, Balzer JB, Westenfeld RW, Horn PH, Rassaf TR, Polzin AP, Nijhof NN, Kelm MK, Zeus TZ, Hellhammer KH. P1756Safety and efficacy of real-time fusion of echocardiography and fluoroscopy during MitraClip implantation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S Afzal
- Division of Cardiology, Pulmunology and Vascular Medicine, Medical Faculty, Heinrich-Heine-Universit, Duesseldorf, Germany
| | - P S Schulz
- Division of Cardiology, Pulmunology and Vascular Medicine, Medical Faculty, Heinrich-Heine-Universit, Duesseldorf, Germany
| | - V V Veulemans
- Division of Cardiology, Pulmunology and Vascular Medicine, Medical Faculty, Heinrich-Heine-Universit, Duesseldorf, Germany
| | - L K Kleinebrecht
- Division of Cardiology, Pulmunology and Vascular Medicine, Medical Faculty, Heinrich-Heine-Universit, Duesseldorf, Germany
| | - J B Balzer
- Uhlandpraxen, Uhlandstr. 9, 40225 Düsseldorf, Duesseldorf, Germany
| | - R W Westenfeld
- Division of Cardiology, Pulmunology and Vascular Medicine, Medical Faculty, Heinrich-Heine-Universit, Duesseldorf, Germany
| | - P H Horn
- Division of Cardiology, Pulmunology and Vascular Medicine, Medical Faculty, Heinrich-Heine-Universit, Duesseldorf, Germany
| | - T R Rassaf
- University Hospital Essen, Department of Cardiology, Westgerman Heart- and Vascular Centre, Essen, Essen, Germany
| | - A P Polzin
- Division of Cardiology, Pulmunology and Vascular Medicine, Medical Faculty, Heinrich-Heine-Universit, Duesseldorf, Germany
| | - N N Nijhof
- Philips Healthcare, Best, Netherlands, Best, Netherlands
| | - M K Kelm
- CARID, Cardiovascular Research Institute Düsseldorf, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - T Z Zeus
- Division of Cardiology, Pulmunology and Vascular Medicine, Medical Faculty, Heinrich-Heine-Universit, Duesseldorf, Germany
| | - K H Hellhammer
- Division of Cardiology, Pulmunology and Vascular Medicine, Medical Faculty, Heinrich-Heine-Universit, Duesseldorf, Germany
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30
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Winsløw U, Nordestgaard B, Afzal S. 血浆中25-羟基维生素D水平偏高,且罹患非黑色素瘤皮肤癌的风险较高:97,849名受试者参加的一项孟德尔随机化研究. Br J Dermatol 2018. [DOI: 10.1111/bjd.16762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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31
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Winsløw U, Nordestgaard B, Afzal S. High plasma 25-hydroxyvitamin D and high risk of nonmelanoma skin cancer: a Mendelian randomization study of 97 849 individuals. Br J Dermatol 2018. [DOI: 10.1111/bjd.16750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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32
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Ilyas K, Qureshi SW, Afzal S, Gul R, Yar M, Kaleem M, Khan AS. Microwave-assisted synthesis and evaluation of type 1 collagen-apatite composites for dental tissue regeneration. J Biomater Appl 2018; 33:103-115. [PMID: 29720018 DOI: 10.1177/0885328218773220] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 11/17/2022]
Abstract
The aim was to develop an economical and biocompatible collagen-based bioactive composite for tooth regeneration. Acid-soluble collagen was extracted and purified from fish scales. The design was innovated to molecularly tailor the surface charge sites of the nano-apatite providing chemical bonds with the collagen matrix via microwave irradiation technique. The obtained collagen was identified by sodium dodecyl sulfate polyacrylamide gel electrophoresis analysis. The composites were characterized by Fourier transform infrared spectroscopy, thermogravimetric analysis/differential scanning calorimetry, and scanning electron microscopy. MC3T3-E1 cell lines were used to assess the biological effects of these materials by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetra zolium bromide (MTT) assay. Indirect contact test was performed by extracting representative elutes in cell culture media and sulforhodamine B analysis was performed. Chorioallantoic membrane assay was conducted to define the new vessels formation behavior. The purity of collagen extracts was determined and showed two α-chains, i.e. the characteristic of type I collagen. Fourier transform infrared spectroscopy showed the characteristic peaks for amide I, I, III, and phosphate for collagen and composites. Scanning electron microscopy images showed three-dimensional mesh of collagen/apatite nano-fibers. Nontoxic behavior of composites was observed and there were graded and dose-related effects on experimental compounds. The angiogenesis and vessels formation behavior were observed in bioactive collagen composite. The obtained composites have potential to be used for tooth structure regeneration.
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Affiliation(s)
- Kanwal Ilyas
- 1 COMSATS Institute of Information Technology-Lahore Campus, Lahore, Pakistan
| | - Saba W Qureshi
- 2 Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Sadia Afzal
- 1 COMSATS Institute of Information Technology-Lahore Campus, Lahore, Pakistan
| | | | - Muhammad Yar
- 1 COMSATS Institute of Information Technology-Lahore Campus, Lahore, Pakistan
| | - Muhammad Kaleem
- 2 Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Abdul S Khan
- 4 Imam Abdulrahman Bin Faisal University College of Dentistry, Dammam, Saudi Arabia
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33
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Winsløw U, Nordestgaard B, Afzal S. High plasma 25-hydroxyvitamin D and high risk of nonmelanoma skin cancer: a Mendelian randomization study of 97 849 individuals. Br J Dermatol 2018; 178:1388-1395. [DOI: 10.1111/bjd.16127] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2017] [Indexed: 11/28/2022]
Affiliation(s)
- U.C. Winsløw
- Department of Clinical Biochemistry and the Copenhagen General Population Study; Herlev and Gentofte Hospital; Copenhagen University Hospital; Denmark
- Faculty of Health and Medical Sciences; University of Copenhagen; Denmark
| | - B.G. Nordestgaard
- Department of Clinical Biochemistry and the Copenhagen General Population Study; Herlev and Gentofte Hospital; Copenhagen University Hospital; Denmark
- Faculty of Health and Medical Sciences; University of Copenhagen; Denmark
| | - S. Afzal
- Department of Clinical Biochemistry and the Copenhagen General Population Study; Herlev and Gentofte Hospital; Copenhagen University Hospital; Denmark
- Faculty of Health and Medical Sciences; University of Copenhagen; Denmark
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34
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Kobylecki CJ, Wium-Andersen MK, Afzal S, Nordestgaard BG. Response. Acta Psychiatr Scand 2018; 137:80. [PMID: 29090736 DOI: 10.1111/acps.12831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- C J Kobylecki
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
| | - M K Wium-Andersen
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
| | - S Afzal
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
| | - B G Nordestgaard
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark.,The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, Denmark
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Wium-Andersen MK, Kobylecki CJ, Afzal S, Nordestgaard BG. Association between the antioxidant uric acid and depression and antidepressant medication use in 96 989 individuals. Acta Psychiatr Scand 2017; 136:424-433. [PMID: 28845530 DOI: 10.1111/acps.12793] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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] [Accepted: 07/31/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE In the last decade, several studies have suggested that depression is accompanied by increased oxidative stress and decreased antioxidant defenses. We tested the hypothesis that high levels of the antioxidant uric acid are associated with lower risk of hospitalization with depression and use of prescription antidepressant medication. METHOD We examined plasma levels of the antioxidant uric acid in 96 989 individuals from two independent cohort studies. Logistic regression and Cox proportional hazards regression models were multivariable adjusted for age, gender, alcohol, smoking, income, body mass index, C-reactive protein, hemoglobin, triglycerides, cardiovascular disease, diabetes, and intake of meat and vegetables. Results were performed separately in each study and combined in a meta-analysis. RESULTS In both studies, high uric acid was associated with lower risk of hospitalization as in-patient or out-patient with depression and antidepressant medication use. A doubling in uric acid was associated with an effect estimate of 0.57 (95% CI 0.49-0.65) and 0.77 (0.73-0.81) for hospitalization with depression and antidepressant medication use. The association was consistent across strata of all covariates. Results were attenuated in Cox regression analyses with less statistical power. CONCLUSION High plasma levels of uric acid were associated with low risk of depression hospitalization and antidepressant medication use.
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Affiliation(s)
- M K Wium-Andersen
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
| | - C J Kobylecki
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
| | - S Afzal
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
| | - B G Nordestgaard
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark.,The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, Denmark
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Afzal S, Begum N, Zhao H, Fang Z, Lou L, Cai Q. Influence of endophytic root bacteria on the growth, cadmium tolerance and uptake of switchgrass (Panicum virgatumL.). J Appl Microbiol 2017; 123:498-510. [DOI: 10.1111/jam.13505] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 06/01/2017] [Accepted: 06/01/2017] [Indexed: 11/30/2022]
Affiliation(s)
- S. Afzal
- College of Life Sciences; Nanjing Agricultural University; Nanjing China
- Girls Degree College no.1; Gomal University; Dera Ismail Khan Pakistan
| | - N. Begum
- College of Life Sciences; Nanjing Agricultural University; Nanjing China
| | - H. Zhao
- College of Life Sciences; Nanjing Agricultural University; Nanjing China
| | - Z. Fang
- College of Life Sciences; Nanjing Agricultural University; Nanjing China
| | - L. Lou
- College of Life Sciences; Nanjing Agricultural University; Nanjing China
| | - Q. Cai
- College of Life Sciences; Nanjing Agricultural University; Nanjing China
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Afzal S, Veulemans V, Balzer J, Rassaf T, Hellhammer K, Polzin A, Kelm M, Zeus T. Safety and efficacy of transseptal puncture guided by real-time fusion of echocardiography and fluoroscopy. Neth Heart J 2016; 25:131-136. [PMID: 27966185 PMCID: PMC5260626 DOI: 10.1007/s12471-016-0937-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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
Aims Visual guidance through echocardiography and fluoroscopy is crucial for a successful transseptal puncture (TSP) in a prespecified region of the fossa ovalis. The novel EchoNavigator system Release II (EchoNav II, Philips Healthcare, Andover, Massachusetts, USA) enables the real-time fusion of fluoroscopic and echocardiographic images. We evaluated this new imaging method in respect to safety and efficacy of TSP during MitraClip implantation and left atrial appendage closure. Methods Forty-four patients before (−EchoNav) and 44 patients after (+EchoNav) the introduction of real-time fusion were included in our retrospective, single-centre study. The primary endpoint was the occurrence of adverse events due to TSP. Secondary endpoints were successful puncture at the prespecified region and time until TSP (min). Results In both groups TSP was performed successfully in the prespecified region and no adverse events occurred during or due to the accomplishment of TSP. Time until TSP was significantly reduced in the +EchoNav group in comparison with the EchoNav group (18.48 ± 5.62 min vs. 23.20 ± 9.61 min, p = 0.006). Conclusions Real-time fusion of echocardiography and fluoroscopy proved to be as safe and successful as standard best practice for TSP. Moreover, efficacy was improved through significant reduction of time until TSP.
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Affiliation(s)
- S Afzal
- Division of Cardiology, Pneumology, and Vascular Medicine, Department of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany.
| | - V Veulemans
- Division of Cardiology, Pneumology, and Vascular Medicine, Department of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - J Balzer
- Division of Cardiology, Pneumology, and Vascular Medicine, Department of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - T Rassaf
- Department of Cardiology, University Hospital Essen, Westgerman Heart-and Vascular Centre, Essen, Germany
| | - K Hellhammer
- Division of Cardiology, Pneumology, and Vascular Medicine, Department of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - A Polzin
- Division of Cardiology, Pneumology, and Vascular Medicine, Department of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - M Kelm
- Division of Cardiology, Pneumology, and Vascular Medicine, Department of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - T Zeus
- Division of Cardiology, Pneumology, and Vascular Medicine, Department of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
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Mortensen M, Nordestgaard B, Afzal S, Falk E. ACC/AHA guidelines superior to ESC/EAS guidelines for primary prevention with statins: The Copenhagen general population study. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Afzal S, Tybjærg-Hansen A, Jensen G, Nordestgaard B. Body mass index and mortality over 3 decades. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Afzal S, Sattar MA, Johns EJ, Abdulla MH, Akhtar S, Hashmi F, Abdullah NA. Interaction between irbesartan, peroxisome proliferator-activated receptor (PPAR-γ), and adiponectin in the regulation of blood pressure and renal function in spontaneously hypertensive rats. J Physiol Biochem 2016; 72:593-604. [DOI: 10.1007/s13105-016-0497-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Accepted: 06/08/2016] [Indexed: 01/30/2023]
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Ur-Rehman A, Gul S, Abbasi MA, Nafeesa K, Akhtar MN, Khan KM, Ahmad I, Afzal S. Synthesis and Evaluation of some New 5-Substituted-1,3,4- oxadiazol-2yl-4-(morpholin-4yl Sulfonyl)benzyl Sulfides as Antibacterial Agent. TROP J PHARM RES 2015. [DOI: 10.4314/tjpr.v14i11.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Rasool S, Rehman A, Abbasi MA, Gul S, Akhtar MN, Ahmad I, Afzal S. Synthesis of N'-Substituted-2-(5-(4-Chlorophenyl)-1,3,4- oxadiazol-2-ylthio)acetohydrazide Derivatives as Suitable Antibacterial Agents. TROP J PHARM RES 2015. [DOI: 10.4314/tjpr.v14i6.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Kobylecki C, Afzal S, Davey Smith G, Nordestgaard B. Genetically high plasma vitamin C, intake of fruit and vegetables, and risk of ischemic heart disease and all-cause mortality: A mendelian randomization study. Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.922] [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: 10/23/2022]
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Siddiqa A, Rehman A, Abbasi MA, Rasool S, Khan KM, Ahmad I, Afzal S. Synthesis and antibacterial evaluation of 2-(1,3- Benzodioxol-5-ylcarbonyl)arylsulfonohydrazide derivatives. TROP J PHARM RES 2014. [DOI: 10.4314/tjpr.v13i10.17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Soltanifar D, Afzal S, Harrison S, Sultan P. Caesarean delivery in a parturient with type III hereditary angioedema. Int J Obstet Anesth 2014; 23:398-9. [DOI: 10.1016/j.ijoa.2014.05.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 05/28/2014] [Accepted: 05/29/2014] [Indexed: 11/24/2022]
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Jacobsen P, Benn M, Afzal S, Nordestgaard B. Genetically reduced 25-hydroxyvitamin d and risk of ischemic heart disease and myocardial infarction: A mendelian randomization study. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Classen CF, William D, Linnebacher M, Farhod A, Kedr W, Elsabe B, Fadel S, Van Gool S, De Vleeschouwer S, Koks C, Garg A, Ehrhardt M, Riva M, De Vleeschouwer S, Agostinis P, Graf N, Van Gool S, Yao TW, Yoshida Y, Zhang J, Ozawa T, James D, Nicolaides T, Kebudi R, Cakir FB, Gorgun O, Agaoglu FY, Darendeliler E, Van Gool S, De Vleeschouwer S, Al-Kofide A, Al-Shail E, Khafaga Y, Al-Hindi H, Dababo M, Haq AU, Anas M, Barria MG, Siddiqui K, Hassounah M, Ayas M, van Zanten SV, Jansen M, van Vuurden D, Huisman M, Vugts D, Hoekstra O, van Dongen G, Kaspers G, Cockle J, Ilett E, Scott K, Bruning-Richardson A, Picton S, Short S, Melcher A, Benesch M, Warmuth-Metz M, von Bueren AO, Hoffmann M, Pietsch T, Kortmann RD, Eyrich M, Graf N, Rutkowski S, Fruhwald MC, Faber J, Kramm C, Porkholm M, Valanne L, Lonnqvist T, Holm S, Lannering B, Riikonen P, Wojcik D, Sehested A, Clausen N, Harila-Saari A, Schomerus E, Thorarinsdottir HK, Lahteenmaki P, Arola M, Thomassen H, Saarinen-Pihkala UM, Kivivuori SM, Buczkowicz P, Hoeman C, Rakopoulos P, Pajovic S, Morrison A, Bouffet E, Bartels U, Becher O, Hawkins C, Gould TWA, Rahman CV, Smith SJ, Barrett DA, Shakesheff KM, Grundy RG, Rahman R, Barua N, Cronin D, Gill S, Lowisl S, Hochart A, Maurage CA, Rocourt N, Vinchon M, Kerdraon O, Escande F, Grill J, Pick VK, Leblond P, Burzynski G, Janicki T, Burzynski S, Marszalek A, Ramani N, Zaky W, Kannan G, Morani A, Sandberg D, Ketonen L, Maher O, Corrales-Medina F, Meador H, Khatua S, Brassesco M, Delsin L, Roberto G, Silva C, Ana L, Rego E, Scrideli C, Umezawa K, Tone L, Kim SJ, Kim CY, Kim IA, Han JH, Choi BS, Ahn HS, Choi HS, Haque F, Rahman R, Layfield R, Grundy R, Gandola L, Pecori E, Biassoni V, Schiavello E, Chiruzzi C, Spreafico F, Modena P, Bach F, Pignoli E, Massimino M, Drogosiewicz M, Dembowska-Baginska B, Jurkiewicz E, Filipek I, Perek-Polnik M, Swieszkowska E, Perek D, Bender S, Jones DT, Warnatz HJ, Hutter B, Zichner T, Gronych J, Korshunov A, Eils R, Korbel JO, Yaspo ML, Lichter P, Pfister SM, Yadavilli S, Becher OJ, Kambhampati M, Packer RJ, Nazarian J, Lechon FC, Fowkes L, Khabra K, Martin-Retortillo LM, Marshall LV, Vaidya S, Koh DM, Leach MO, Pearson AD, Zacharoulis S, Lechon FC, Fowkes L, Khabra K, Martin-Retortillo LM, Marshall LV, Schrey D, Barone G, Vaidya S, Koh DM, Pearson AD, Zacharoulis S, Panditharatna E, Stampar M, Siu A, Gordish-Dressman H, Devaney J, Kambhampati M, Hwang EI, Packer RJ, Nazarian J, Chung AH, Mittapalli RK, Elmquist WF, Becher OJ, Castel D, Debily MA, Philippe C, Truffaux N, Taylor K, Calmon R, Boddaert N, Le Dret L, Saulnier P, Lacroix L, Mackay A, Jones C, Puget S, Sainte-Rose C, Blauwblomme T, Varlet P, Grill J, Entz-Werle N, Maugard C, Bougeard G, Nguyen A, Chenard MP, Schneider A, Gaub MP, Tsoli M, Vanniasinghe A, Luk P, Dilda P, Haber M, Hogg P, Ziegler D, Simon S, Tsoli M, Vanniasinghe A, Monje M, Gurova K, Gudkov A, Haber M, Ziegler D, Zapotocky M, Churackova M, Malinova B, Zamecnik J, Kyncl M, Tichy M, Puchmajerova A, Stary J, Sumerauer D, Boult J, Vinci M, Taylor K, Perryman L, Box G, Jury A, Popov S, Ingram W, Monje M, Eccles S, Jones C, Robinson S, Emir S, Demir HA, Bayram C, Cetindag F, Kabacam GB, Fettah A, Boult J, Li J, Vinci M, Jury A, Popov S, Jamin Y, Cummings C, Eccles S, Bamber J, Sinkus R, Jones C, Robinson S, Nandhabalan M, Bjerke L, Vinci M, Burford A, Ingram W, Mackay A, von Bueren A, Baudis M, Clarke P, Collins I, Workman P, Jones C, Taylor K, Mackay A, Vinci M, Popov S, Ingram W, Entz-Werle N, Monje M, Olaciregui N, Mora J, Carcaboso A, Bullock A, Jones C, Vinci M, Mackay A, Burford A, Taylor K, Popov S, Ingram W, Monje M, Alonso M, Olaciregui N, de Torres C, Cruz O, Mora J, Carcaboso A, Jones C, Filipek I, Drogosiewicz M, Perek-Polnik M, Swieszkowska E, Dembowska-Baginska B, Jurkiewicz E, Perek D, Nguyen A, Pencreach E, Mackay A, Moussalieh FM, Guenot D, Namer I, Chenard MP, Jones C, Entz-Werle N, Pollack I, Jakacki R, Butterfield L, Hamilton R, Panigrahy A, Potter D, Connelly A, Dibridge S, Whiteside T, Okada H, Ahsan S, Raabe E, Haffner M, Warren K, Quezado M, Ballester L, Nazarian J, Eberhart C, Rodriguez F, Ramachandran C, Nair S, Quirrin KW, Khatib Z, Escalon E, Melnick S, Classen CF, Hofmann M, Schmid I, Simon T, Maass E, Russo A, Fleischhack G, Becker M, Hauch H, Sander A, Kramm C, Grasso C, Truffaux N, Berlow N, Liu L, Debily MA, Davis L, Huang E, Woo P, Tang Y, Ponnuswami A, Chen S, Huang Y, Hutt-Cabezas M, Warren K, Dret L, Meltzer P, Mao H, Quezado M, van Vuurden D, Abraham J, Fouladi M, Svalina MN, Wang N, Hawkins C, Raabe E, Hulleman E, Li XN, Keller C, Spellman PT, Pal R, Grill J, Monje M, Jansen MHA, Sewing ACP, Lagerweij T, Vuchts DJ, van Vuurden DG, Caretti V, Wesseling P, Kaspers GJL, Hulleman E, Cohen K, Raabe E, Pearl M, Kogiso M, Zhang L, Qi L, Lindsay H, Lin F, Berg S, Li XN, Muscal J, Amayiri N, Tabori U, Campbel B, Bakry D, Aronson M, Durno C, Gallinger S, Malkin D, Qaddumi I, Musharbash A, Swaidan M, Bouffet E, Hawkins C, Al-Hussaini M, Rakopoulos P, Shandilya S, McCully C, Murphy R, Akshintala S, Cole D, Macallister RP, Cruz R, Widemann B, Warren K, Salloum R, Smith A, Glaunert M, Ramkissoon A, Peterson S, Baker S, Chow L, Sandgren J, Pfeifer S, Popova S, Alafuzoff I, de Stahl TD, Pietschmann S, Kerber MJ, Zwiener I, Henke G, Kortmann RD, Muller K, von Bueren A, Sieow NYF, Hoe RHM, Tan AM, Chan MY, Soh SY, Hawkins C, Burrell K, Chornenkyy Y, Remke M, Golbourn B, Buczkowicz P, Barzczyk M, Taylor M, Rutka J, Dirks P, Zadeh G, Agnihotri S, Hashizume R, Ihara Y, Andor N, Chen X, Lerner R, Huang X, Tom M, Solomon D, Mueller S, Petritsch C, Zhang Z, Gupta N, Waldman T, James D, Dujua A, Co J, Hernandez F, Doromal D, Hegde M, Wakefield A, Brawley V, Grada Z, Byrd T, Chow K, Krebs S, Heslop H, Gottschalk S, Yvon E, Ahmed N, Truffaux N, Philippe C, Cornilleau G, Paulsson J, Andreiuolo F, Guerrini-Rousseau L, Puget S, Geoerger B, Vassal G, Ostman A, Grill J, Parsons DW, Lin F, Trevino LR, Gao F, Shen X, Hampton O, Lindsay H, Kosigo M, Qi L, Baxter PA, Su JM, Chintagumpala M, Dauser R, Adesina A, Plon SE, Li XN, Wheeler DA, Lau CC, Pietsch T, Gielen G, Muehlen AZ, Kwiecien R, Wolff J, Kramm C, Lulla RR, Laskowski J, Goldman S, Gopalakrishnan V, Fangusaro J, Mackay A, Taylor K, Vinci M, Jones C, Kieran M, Fontebasso A, Papillon-Cavanagh S, Schwartzentruber J, Nikbakht H, Gerges N, Fiset PO, Bechet D, Faury D, De Jay N, Ramkissoon L, Corcoran A, Jones D, Sturm D, Johann P, Tomita T, Goldman S, Nagib M, Bendel A, Goumnerova L, Bowers DC, Leonard JR, Rubin JB, Alden T, DiPatri A, Browd S, Leary S, Jallo G, Cohen K, Prados MD, Banerjee A, Carret AS, Ellezam B, Crevier L, Klekner A, Bognar L, Hauser P, Garami M, Myseros J, Dong Z, Siegel PM, Gump W, Ayyanar K, Ragheb J, Khatib Z, Krieger M, Kiehna E, Robison N, Harter D, Gardner S, Handler M, Foreman N, Brahma B, MacDonald T, Malkin H, Chi S, Manley P, Bandopadhayay P, Greenspan L, Ligon A, Albrecht S, Pfister SM, Ligon KL, Majewski J, Gupta N, Jabado N, Hoeman C, Cordero F, Halvorson K, Hawkins C, Becher O, Taylor I, Hutt M, Weingart M, Price A, Nazarian J, Eberhart C, Raabe E, Kantar M, Onen S, Kamer S, Turhan T, Kitis O, Ertan Y, Cetingul N, Anacak Y, Akalin T, Ersahin Y, Mason G, Nazarian J, Ho C, Devaney J, Stampar M, Kambhampati M, Crozier F, Vezina G, Packer R, Hwang E, Gilheeney S, Millard N, DeBraganca K, Khakoo Y, Kramer K, Wolden S, Donzelli M, Fischer C, Petriccione M, Dunkel I, Afzal S, Carret AS, Fleming A, Larouche V, Zelcer S, Johnston DL, Kostova M, Mpofu C, Decarie JC, Strother D, Lafay-Cousin L, Eisenstat D, Fryer C, Hukin J, Bartels U, Bouffet E, Hsu M, Lasky J, Moore T, Liau L, Davidson T, Prins R, Fouladi M, Bartels U, Warren K, Hassal T, Baugh J, Kirkendall J, Doughman R, Leach J, Jones B, Miles L, Hawkins C, Bouffet E, Hargrave D, Grill J, Jones C, Jacques T, Savage S, Goldman S, Leary S, Packer R, Saunders D, Wesseling P, Varlet P, van Vuurden D, Wallace R, Flutter B, Morgenestern D, Hargrave D, Blanco E, Howe K, Lowdell M, Samuel E, Michalski A, Anderson J, Arakawa Y, Umeda K, Watanabe KI, Mizowaki T, Hiraoka M, Hiramatsu H, Adachi S, Kunieda T, Takagi Y, Miyamoto S, Venneti S, Santi M, Felicella MM, Sullivan LM, Dolgalev I, Martinez D, Perry A, Lewis PW, Allis DC, Thompson CB, Judkins AR. HIGH GRADE GLIOMAS AND DIPG. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Khan SA, Sattar MA, Rathore HA, Abdulla MH, ud din Ahmad F, Ahmad A, Afzal S, Abdullah NA, Johns EJ. Renal denervation restores the baroreflex control of renal sympathetic nerve activity and heart rate in Wistar-Kyoto rats with cisplatin-induced renal failure. Acta Physiol (Oxf) 2014; 210:690-700. [PMID: 24438102 DOI: 10.1111/apha.12237] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 10/04/2013] [Accepted: 01/10/2014] [Indexed: 12/14/2022]
Abstract
AIM There is evidence that in chronic renal failure, the sympathetic nervous system is activated. This study investigated the role of the renal innervation in suppressing high- and low-pressure baroreflex control of renal sympathetic nerve activity and heart rate in cisplatin-induced renal failure. METHODS Renal failure was induced using cisplatin (5 mg kg(-1) , i.p.) and the rats used 7 days later. Groups of rats were anaesthetized and prepared for measurement of renal sympathetic nerve activity and heart rate. Acute unilateral or bilateral renal denervation was performed, and renal sympathetic nerve activity and heart rate baroreflex gain curves were generated while the cardiopulmonary receptors were stimulated using an acute saline volume load. RESULTS Cisplatin administration reduced (P < 0.05) glomerular filtration rate by 27%, increased sodium fractional excretions fourfold, plasma creatinine and kidney index by 39 and 30% respectively, (all P < 0.05) compared with control rats. In the renal failure rats, baroreflex sensitivity for renal sympathetic nerve activity and heart rate was reduced (P < 0.05) by 29% and 27% (both P < 0.05) compared with control animals. Bilateral, but not unilateral, renal denervation restored baroreflex sensitivity to normal values. Volume expansion reduced (P < 0.05) renal sympathetic nerve activity by 34% in control rats, but remained unchanged in the renal failure rats. Unilateral and bilateral renal denervation progressively restored the volume expansion induced renal sympathoinhibition to control values. CONCLUSION These findings reveal a significant role of the renal sensory innervation in cisplatin-damaged kidneys which blunt the normal baroreflex control of renal sympathetic nerve activity.
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Affiliation(s)
- S. A. Khan
- Department of Physiology; School of Pharmaceutical Sciences; Universiti Sains Malaysia; Penang Malaysia
| | - M. A. Sattar
- Department of Physiology; School of Pharmaceutical Sciences; Universiti Sains Malaysia; Penang Malaysia
| | - H. A. Rathore
- Department of Physiology; School of Pharmaceutical Sciences; Universiti Sains Malaysia; Penang Malaysia
| | - M. H. Abdulla
- Department of Physiology; University College Cork; Cork Ireland
| | - F. ud din Ahmad
- Department of Physiology; School of Pharmaceutical Sciences; Universiti Sains Malaysia; Penang Malaysia
| | - A. Ahmad
- Department of Physiology; School of Pharmaceutical Sciences; Universiti Sains Malaysia; Penang Malaysia
| | - S. Afzal
- Department of Physiology; School of Pharmaceutical Sciences; Universiti Sains Malaysia; Penang Malaysia
| | - N. A. Abdullah
- Department of Pharmacology; Faculty of Medicine; Universiti Malaya; Kuala Lumpur Malaysia
| | - E. J. Johns
- Department of Physiology; University College Cork; Cork Ireland
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Fatima Z, Afzal S, Idrees M, Rafique S, Akram M, Khubaib B, Saleem S, Amin I, Shahid M. Change in demographic pattern of dengue virus infection: evidence from 2011 dengue outbreak in Punjab, Pakistan. Public Health 2013; 127:875-7. [PMID: 23973044 DOI: 10.1016/j.puhe.2013.03.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 01/23/2013] [Accepted: 03/07/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Z Fatima
- National Centre of Excellence in Molecular Biology, University of the Punjab, Lahore, Pakistan.
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Yar M, Mushtaq N, Afzal S. Synthesis, reactions, applications, and biological activity of diethanolamine and its derivatives. Russ J Org Chem 2013. [DOI: 10.1134/s1070428013070014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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