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Esparham A, Shoar S, Mehri A, Khorgami Z, Modukuru VR. The Impact of Metabolic Bariatric Surgery on Cardiovascular Diseases in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease. Obes Surg 2024:10.1007/s11695-024-07238-w. [PMID: 38662250 DOI: 10.1007/s11695-024-07238-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/12/2024] [Accepted: 04/16/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE There is a strong association between metabolic dysfunction-associated steatotic liver disease (MASLD) and obesity which are both important risk factors for cardiovascular diseases (CVDs). The current study aimed to assess the association of MBS with different CVDs in patients with MASLD. MATERIALS AND METHODS The National Inpatient Sample (NIS) database from 2016 to 2020 were analyzed by using ICD-10 codes. A propensity score matching in a 1:1 ratio was done to match the MBS and non-MBS groups. RESULTS After weighted analysis, 1,124,155 and 68,215 patients were included in non-MBS and MBS groups, respectively. MBS was associated with significantly lower risk of hospitalization for coronary artery disease (OR 0.633 (0.569-0.703), p value < 0.001), acute myocardial infarction (OR 0.606 (0.523-0.701), p value < 0.001), percutaneous coronary intervention (OR 0.578 (0.489-0.682), p value < 0.001), and thrombolysis (OR 0.765 (0.589-0.993), p value = 0.044) compared to the non-MBS group in patients with MASLD. Furthermore, MBS was associated with 52% reduced risk of hospitalization for hemorrhagic stroke in patients with MASLD (OR 0.481, 95% CI 0.337-0.686, p value < 0.001). However, ischemic stroke was not significant between the two groups (OR 1.108 (0.905-1.356), p value = 0.322). In addition, MBS was associated with 63% and 60% reduced risk of hospitalization for heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF) in patients with MASLD (OR 0.373, 95% CI 0.300-0.465 and OR 0.405, 95% CI 0.325-0.504, p value < 0.001 for both), respectively. CONCLUSION The current study showed that MBS is significantly associated with a reduced risk of hospitalization for CVD in patients with MASLD.
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Affiliation(s)
- Ali Esparham
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Saeed Shoar
- Department of Clinical Research, Scientific Writing Corp, Houston, TX, USA
| | - Ali Mehri
- Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zhamak Khorgami
- Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Surgery, School of Community Medicine, University of Oklahoma, Tulsa, OK, USA
| | - Venkat R Modukuru
- Bariatric and Metabolic Surgery Program, Newark Beth Israel Medical Center, RWJ Barnabas Health, Rutgers NJ Medical School, Newark, NJ, USA
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Patarroyo - Aponte G, Shoar S, Ashley DM, Noorbaksh A, Patel D, Young AY, Akkanti BH, Warner MT, Patarroyo - Aponte MM, Kar B, Gregoric ID, Ha C, Patel B. The Role of Palliative Care Consultation in Withdrawal of Life-Sustaining Treatment among ICU Patients Receiving Veno-Venous Extracorporeal Membrane Oxygenation (VV-ECMO): A Retrospective Case-Control Study. Am J Hosp Palliat Care 2024; 41:150-157. [PMID: 37117039 PMCID: PMC10751975 DOI: 10.1177/10499091231173092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
Background: Extracorporeal membrane oxygenation (ECMO) has extended the survivability of critically ill patients beyond their unsupported prognosis and has widened the timeframe for making an informed decision about the goal of care. However, an extended time window for survival does not necessarily translate into a better outcome and the sustaining treatment is ultimately withdrawn in many patients. Emerging evidence has implicated the determining role of palliative care consult (PCC) in direction of the care that critically ill patients receive. Objective: To evaluate the impact of PCC in withdrawal of life-sustaining treatment (WOLST) among critically ill patients, who were placed on venovenous ECMO (VV-ECMO) at the intensive care unit (ICU) of a tertiary care hospital. Methods: In a retrospective observational study, electronic medical records of 750 patients admitted to the ICU of our hospital between January 1, 2015, and October 31, 2021, were reviewed. Data was collected for patients on VV-ECMO, for whom WOLST was withdrawn during the ICU stay. Clinical characteristics and the underlying reasons for WOLST were compared between those who received PCC (PCC group) and those who did not (non-PCC group). Results: A total of 95 patients were included in our analysis, 63 in the PCC group and 32 in the non-PCC group. The average age of the study population was 48.8 ± 12.6 years, and 64.2% were male. There was no statistically significant difference between the two groups in terms of demographics or clinical characteristics at the time of ICU admission. The average duration of ICU stay and VV-ECMO were 14.1 ± 19.9 days and 9.4 ± 16.6 days, respectively. The number of PCC visits was correlated with the length of ICU stay. The average duration of ICU stay (40.3 ± 33.2 days vs 27.8 ± 19.3 days, P = .05) and ECMO treatment (31.9 ± 27 days vs 18.6 ± 16.1 days, P = .01) were significantly longer in patients receiving PCC than those not receiving PCC. However, the frequency of life sustaining measures or the underlying reasons for WOLST did not significantly differ between the two groups (P > .05). Conclusion: Among ICU patients requiring ECMO support, longer duration of ICU stay and treatment with a higher number of life-sustaining measures seemed to be correlated with the number of PCC visits. The underlying reasons for WOLST seem not to be affected by PCC.
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Affiliation(s)
- Gabriel Patarroyo - Aponte
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
- Memorial Hermann, Texas Medical Center, Houston, TX, USA
| | - Saeed Shoar
- Department of Clinical Research, Scientific Collaborative Initiative, Houston/Largo, TX/MD, USA
| | - Deptmer M. Ashley
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
- Memorial Hermann, Texas Medical Center, Houston, TX, USA
| | - Ali Noorbaksh
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dev Patel
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Alisha Y. Young
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
- Memorial Hermann, Texas Medical Center, Houston, TX, USA
| | - Bindu H. Akkanti
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
- Memorial Hermann, Texas Medical Center, Houston, TX, USA
| | - Mark T. Warner
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
- Memorial Hermann, Texas Medical Center, Houston, TX, USA
| | - Maria M. Patarroyo - Aponte
- Memorial Hermann, Texas Medical Center, Houston, TX, USA
- Department of Advanced Cardiopulmonary Therapies and Transplantation, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Biswajit Kar
- Memorial Hermann, Texas Medical Center, Houston, TX, USA
- Department of Advanced Cardiopulmonary Therapies and Transplantation, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Igor D. Gregoric
- Memorial Hermann, Texas Medical Center, Houston, TX, USA
- Department of Advanced Cardiopulmonary Therapies and Transplantation, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Caroline Ha
- Department of Palliative Care and Rehabilitation Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Bela Patel
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
- Memorial Hermann, Texas Medical Center, Houston, TX, USA
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Esparham A, Shoar S, Mehri A, Khorgami Z, Modukuru VR. Bariatric Surgery and Risk of Hospitalization for Gastrointestinal Cancers in the USA: a Propensity Score Matched Analysis of National Inpatient Sample Study. Obes Surg 2023; 33:3797-3805. [PMID: 37861878 DOI: 10.1007/s11695-023-06883-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/15/2023] [Accepted: 10/04/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND There are some concerns about the higher risk of certain gastrointestinal (GI) cancers in patients with a history of bariatric metabolic surgery (BMS). The current study aimed to investigate the association of BMS with GI cancer hospital admission including esophageal, gastric, colorectal, small intestinal, liver, gallbladder, bile duct, and pancreatic cancers. METHODS The analysis utilized the US national inpatient sample (NIS) data from 2016 to 2020, employing ICD-10 codes. A propensity score matching in a 3:1 ratio was done to match the BMS and non-BMS groups. RESULTS A total of 328,369 patients with a history of BMS and 4,989,154 with obesity and without a history of BMS were included in this study. BMS was independently associated with a higher risk of gastric and pancreatic cancers hospital admission (OR: 1.69 (CI 95%: 1.42-2.01) and OR: 1.46 (CI 95%: 1.27-1.68)), respectively. In addition, BMS was independently associated with a lower risk of colorectal and liver cancer hospital admission (OR: 0.57 (CI 95%: 0.52-0.62) and OR: 0.72 (CI 95%: 0.52-0.98)), respectively. Besides, esophageal, gallbladder, bile duct, and small intestinal cancer were not significantly different between the two groups. In patients with GI cancer, although the BMS group had significantly lower total charges and length of hospital stay compared to the non-BMS group, the rate of in-hospital mortality was not significantly different. CONCLUSION The current study showed that bariatric surgery may be associated with a higher risk of gastric and pancreatic cancer and a lower risk of colorectal and liver cancer hospital admission. Further research is needed to explore this association.
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Affiliation(s)
- Ali Esparham
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Saeed Shoar
- Department of Clinical Research, ScientificWriting Corp, Houston, TX, USA
| | - Ali Mehri
- Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zhamak Khorgami
- Department of Surgery, University of Oklahoma, School of Medicine, Tulsa, OK, USA
- Harold Hamm Diabetes Center, University of Oklahoma, Health Sciences Center, Oklahoma City, OK, USA
| | - Venkat R Modukuru
- Bariatric and Metabolic Surgery Program, Newark Beth Israel Medical Center, RWJ Barnabas Health, Rutgers NJ Medical School, Newark, NJ, USA
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Bolaji OA, Shoar S, Ouedraogo F, Demelash S, Adabale O. Prevalence and factors associated with cognitive frailty in heart failure: a systematic review and meta-analysis protocol. BMJ Open 2023; 13:e074737. [PMID: 37949630 PMCID: PMC10649368 DOI: 10.1136/bmjopen-2023-074737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 10/04/2023] [Indexed: 11/12/2023] Open
Abstract
INTRODUCTION Heart failure (HF) is a global health issue affecting millions of people worldwide. Cognitive frailty, a syndrome characterised by physical frailty and cognitive impairment without dementia, is increasingly recognised in this population. Cognitive frailty is associated with worse outcomes, including increased hospitalisation, disability and mortality. This systematic review and meta-analysis aimed to investigate the incidence, prevalence and predictors of cognitive frailty in HF patients. METHODS A systematic search will be conducted in MEDLINE/PubMed, EMBASE/Ovid, Web of Science and Google Scholar from inception to the latest search date. Eligible studies will report original data on adult patients (age ≥18 years) with HF, focusing on the incidence, prevalence and predictors of cognitive frailty. Two investigators will independently extract data and assess study quality using the Newcastle-Ottawa Scale and mixed-methods appraisal tool. Meta-analyses and meta-regression will be performed to estimate the pooled prevalence of cognitive frailty in HF patients and to identify predictors associated with increased risk, respectively. Subgroup analyses will be conducted to explore potential sources of heterogeneity. ETHICS AND DISSEMINATION This systematic review does not require ethical approval and informed consent, as it does not use identifiable patient data. The results of this study will be submitted for publication in a peer-reviewed medical journal. This comprehensive meta-analysis of the literature on cognitive frailty among HF patients will inform tailored interventions and management strategies, ultimately improving patients' quality of life and outcomes.
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Affiliation(s)
- Olayiwola Akeem Bolaji
- Internal Medicine, University of Maryland Capital Region Health, Largo, Maryland, USA
- Internal Medicine, University of Maryland Capital Regional Health, Lake Arbor, Maryland, USA
| | - Saeed Shoar
- Outcome Research, Scientific Collaborative Initiative, Baytown, Texas, USA
| | - Faizal Ouedraogo
- Internal Medicine, University of Maryland Capital Region Health, Largo, Maryland, USA
| | - Simachew Demelash
- Internal Medicine, University of Maryland Capital Region Health, Largo, Maryland, USA
| | - Olanrewaju Adabale
- Department of Heart & Vascular Care, Vidant Medical Center, Greenville, North Carolina, USA
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Esparham A, Shoar S, Mehri A, Modukuru VR. Bariatric Surgery and Cardiovascular Disease Risk in Patients with Pulmonary Hypertension: A Propensity Score Matched Analysis of US National Inpatient Sample. Obes Surg 2023; 33:3230-3236. [PMID: 37639208 DOI: 10.1007/s11695-023-06799-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/14/2023] [Accepted: 08/18/2023] [Indexed: 08/29/2023]
Abstract
PURPOSE Previous research has suggested the ameliorating effect of bariatric surgery (BaS) on patients with pulmonary hypertension (PH), but there is a lack of data on the effect of bariatric surgery on the odds of cardiovascular diseases in PH patients. The current study aims to evaluate the association of BaS and coronary artery diseases (CAD), heart failure with reduced ejection fraction (HFrEF), heart failure with preserved ejection fraction (HFpEF), cardiac valve diseases, cardiac rhythm disorders, acute pulmonary embolism, and in-hospital mortality in patients with PH. METHODS The national inpatient sample (NIS) data from 2016 to 2019 were analyzed by using ICD-10 codes. A propensity score matching in a 3:1 ratio was performed to match the BaS and non-BaS groups. RESULTS A total of 3605 patients with a history of BaS and 501419 patients without a history of BaS were included. After propensity matching, BaS was independently associated with a lower CAD hospital admission and a lower rate of in-hospital mortality. On the contrary, BaS was associated with a higher prevalence of atrial fibrillation (AF) and acute pulmonary embolism in patients with PH. HFpEF, HFrEF, other cardiac rhythm disorders, complete heart block, cardiac valve diseases, and ischemic stroke were not significantly different between the two groups in patients with PH. CONCLUSION BaS is independently associated with a reduced rate of in-hospital mortality and CAD hospital admission in patients with PH. However, the risk of atrial fibrillation and acute pulmonary embolism was higher in these patients.
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Affiliation(s)
- Ali Esparham
- Student Research Committee, College of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Saeed Shoar
- Department of Clinical Research, ScientificWriting Corp, Houston, TX, USA
| | - Ali Mehri
- Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Venkat R Modukuru
- Bariatric and Metabolic Surgery Program, Newark Beth Israel Medical Center, RWJ Barnabas Health, Rutgers NJ Medical School, Newark, NJ, USA
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Shoar S, Chaudhary A, Bansro V, Asadi MS. Transcatheter aortic valve replacement among heart transplant recipients with donor aortic valve diseases: a systematic review of the literature. Am J Cardiovasc Dis 2023; 13:235-246. [PMID: 37736356 PMCID: PMC10509455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 07/16/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Despite high surgical risk among heart transplant (HTx) recipients, who develop aortic valve diseases (AVD), transcutaneous aortic valve replacement (TAVR) has been scarcely reported as a viable option in this patient population. METHODS A systematic review was conducted to identify studies reporting the outcomes of HTx recipients who developed AVD of the donor heart and underwent TAVR. Studies were eligible if they provided individual-level data for HTx recipients, who underwent TAVR on the donor heart. Review articles, editorials or commentaries, studies lacking original data, or those reporting surgical valve replacement for AVD in HTx recipients were excluded. RESULTS A total of 15 case reports, encompassing 15 patients, describing characteristics and outcomes of HTx recipients undergoing TAVR were included. These included 13 males and 2 females with an average age of 63.6±15 years. The indications for HTx were non-ischemic dilated cardiomyopathy, ischemic cardiomyopathy and ischemic dilated cardiomyopathy in 42.9%, 35.7%, and 21.4% of the patients, respectively. The main indication for aortic valve replacement (AVR) among HTx recipients was aortic stenosis (73.3%). The transcutaneous approach was preferred over surgical AVR due to high surgical risk in > 50% of the patients. Both pre-TAVR transvalvular pressure gradient and the peak aortic pressure gradient decreased after the TAVR. Paravalvular leak was minimal/none to mild in all the patients post-TAVR. Most patients had an uneventful post-TAVR recovery with no recurrence of the symptoms or echocardiographic finings at a median follow-up of 6 months. CONCLUSIONS TAVR seems to be a viable option for HTx recipients who develop donor aortic valve diseases. However, there is a paucity of knowledge on the long-term survivability of the replaced aortic valves and the clinical and echocardiographic outcomes of HTx recipients undergoing TAVR.
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Affiliation(s)
- Saeed Shoar
- Department of Clinical Research, Scientific Collaborative InitiativeLargo/Houston, MD/TX, USA
| | - Ashok Chaudhary
- Department of Internal Medicine, Griffin HospitalDerby, CT, USA
| | - Varinder Bansro
- Department of Internal Medicine, University of Maryland Capital Region HealthLargo, MD, USA
| | - Mohammad Sadegh Asadi
- Division of Heart Failure, Department of Medicine, University of Maryland School of MedicineBaltimore, MD, USA
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Shoar S, Dao CD, Higgason NM, Shoar N. Prevalence of myocardial fibrosis among patients living with HIV and factors associated with a higher prevalence rate: protocol for a systematic review and meta-analysis. BMJ Open 2023; 13:e067350. [PMID: 36918250 PMCID: PMC10016240 DOI: 10.1136/bmjopen-2022-067350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
INTRODUCTION HIV infection is an established risk factor for the development of cardiovascular diseases. Although increasing evidence implicates a higher prevalence of myocardial fibrosis (MF) among patients living with HIV (PLWH) compared with the HIV-negative population, there is a paucity of knowledge regarding its determinants and factors associated with higher odds of MF development. We aim to perform a systematic review to estimate the prevalence of MF among PLWH. Additionally, we will determine the factors associated with higher odds of MF among PLWH compared with the HIV-negative population. METHODS A systematic review will be performed by consulting the Cochrane handbook for systematic reviews of interventional studies reporting a confirmed diagnosis of MF among PLWH. Articles will be eligible if they provide the prevalence of MF among PLWH and HIV-negative populations or the odds ratio (OR) and 95% confidence interval (CI) of MF development in relation to HIV. Depending on the quality of the data and the heterogeneity among the included studies, a random-effects or fixed-effects model will be used to pool and compare the ORs of MF among PLWH and HIV-negative population. Factors associated with higher odds of MF in relation to HIV will also be determined. ETHICS AND DISSEMINATION Ethical approval and obtaining informed consent are not required for this systematic review as it does not use individual patients' data. Results of this study will be published in a peer-reviewed medical journal.
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Affiliation(s)
- Saeed Shoar
- Department of Clinical Research, Scientific Collaborative Initiative, Largo/Houston, MD/TX, USA
| | - Calvin D Dao
- School of Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Noel M Higgason
- School of Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Nasrin Shoar
- Department of Medicine, Kashan University of Medical Sciences, Kashan, Isfahan, Iran (the Islamic Republic of)
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Shoar S, Chaudhary A, Bolaji O. FACTORS ASSOCIATED WITH INCREASED MORTALITY AMONG PEOPLE LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS (PLWH) HOSPITALIZED DUE TO ACUTE MYOCARDIAL INFARCTION IN THE UNITED STATES: A 10-YEAR ANALYSIS OF THE NATIONAL INPATIENT SAMPLE DATA. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)01718-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Shoar S, Sharma SK, Charitakis K. COMPARISON OF FACTORS ASSOCIATED WITH MORTALITY AMONG PATIENTS UNDERGOING TRANSCATHETER (TAVR) AND SURGICAL AORTIC VALVE REPLACEMENT (SAVR) IN THE UNITED STATES: AN INSIGHT FROM THE NATIONAL INPATIENT SAMPLE DATA 2019. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)01537-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Esparham A, Shoar S, Kheradmand HR, Ahmadyar S, Dalili A, Rezapanah A, Zandbaf T, Khorgami Z. The Impact of Bariatric Surgery on Cardiac Structure, and Systolic and Diastolic Function in Patients with Obesity: A Systematic Review and Meta-analysis. Obes Surg 2023; 33:345-361. [PMID: 36469205 DOI: 10.1007/s11695-022-06396-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 11/25/2022] [Accepted: 11/28/2022] [Indexed: 12/07/2022]
Abstract
The purpose of this study was to provide pooled data from all studies on the impact of bariatric surgery on cardiac structure, and systolic and diastolic function evaluated by either echocardiography or cardiac magnetic resonance. PubMed, Web of Science, Embase, and Scopus databases were searched. Almost all of cardiac left-side structural indices improved significantly after bariatric surgery. However, right-side structural indices did not change significantly. Left ventricular ejection fraction and most of the diastolic function indices improved significantly after the bariatric surgery. The subgroup analysis showed that the left ventricular mass index decreased more in long-term follow-up (≥ 12 months). In addition, subgroup analysis of studies based on surgery type did not reveal any difference in outcomes between gastric bypass and sleeve gastrectomy groups.
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Affiliation(s)
- Ali Esparham
- Student Research Committee, College of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeed Shoar
- Department of Clinical Research, ScientificWriting Corp, Houston, TX, USA
| | - Hamid Reza Kheradmand
- Student Research Committee, College of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Soheil Ahmadyar
- Student Research Committee, College of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amin Dalili
- Department of Surgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Surgical Oncology Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Rezapanah
- Department of Surgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Surgical Oncology Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Tooraj Zandbaf
- Department of Surgery, School of Medicine, Islamic Azad University, Mashhad, Iran
| | - Zhamak Khorgami
- Department of Surgery, University of Oklahoma College of Community Medicine, Tulsa, OK, USA.
- Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
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Khavandi S, Tabibzadeh E, Shoar S, Mohamadkhani M, Khavandi S. COVID-19 and conjunctivitis: A contemporary literature review. J Res Clin Med 2022. [DOI: 10.34172/jrcm.2022.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a viral respiratory illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since its first appearance in December 2019, COVID-19 has been responsible for a number of global outbreaks and has claimed the lives of nearly three million people as of April 2021. High infection rate, loss of taste and smell, fever, cough, and severely adverse effects on the respiratory system have been the chief attributes of the virus. However, SARS-CoV-2 has been linked to other symptoms, many of which are extra-pulmonary or not directly related to the respiratory system. The impact of SARS-CoV-2 on various ophthalmic outcomes has been manifested in many reports and literature tracing the link between COVID-19 and ocular findings in patients suffering from COVID-19. One recurrent case report presented in the literature is related to the presentation of conjunctivitis in COVID-19 patients. Conjunctivitis is a viral infection causing inflammation in conjunctiva, episclera and eyelids resulting in a change of color in eyes, called pink eyes. Swelling, itching, pain, and eye burn are some of the common symptoms. The present study reviews the latest literature on the subject by focusing on the reports of conjunctivitis symptoms in patients with COVID-19.
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Affiliation(s)
- Siamak Khavandi
- Department of Ophthalmology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elsa Tabibzadeh
- Department of Anaesthesiology and Critical Care, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeed Shoar
- Department of Clinical Research, ScientificWriting Corporation, Houston, Texas, USA
| | - Mahdi Mohamadkhani
- Department of Ophthalmology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Soheila Khavandi
- Department of Cardiology, Tabriz University of Medical Sciences, Tabriz, Iran
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Ploch M, Ahmed T, Reyes S, Irizarry-Caro JA, Fossas-Espinosa JE, Shoar S, Amatullah A, Jogimahanti A, Antonioli M, Iliescu CA, Balan P, Naeini PS, Madjid M. Determinants of change in code status among patients with cardiopulmonary arrest admitted to the intensive care unit. Resuscitation 2022; 181:190-196. [PMID: 36174763 DOI: 10.1016/j.resuscitation.2022.08.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 08/20/2022] [Accepted: 08/22/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Patients with cardiopulmonary arrest often have a poor prognosis, prompting discussion with families about code status. The impact of socioeconomic factors, demographics, medical comorbidities and medical interventions on code status changes is not well understood. METHODS This retrospective study included adult patients presenting with cardiac arrest to the intensive care unit of a hospital group between 5/1/2010-5/1/2020. We extracted chart data on socioeconomic factors, demographics, and medical comorbidities. RESULTS We identified 1,254 patients, of which 57.5% were males. Age was different across the groups with (61.2 ± 15.5 years) and without (61.2 ± 15.5 years) code status change (p= <0.0001). Code status was changed in 583 patients (46.5%). Among patients with code status change, the highest prevalence was White patients (34.8%), followed by African Americans (30.9%), and Hispanics (25.4%). Compared to patients who did not have a code status change, those with a change in code status were older (66.7 ± 14.8 years vs 61.2 ± 15.5 years). They were also more likely to receive vasopressor/inotropic support (74.6% vs 58.5%), and broad-spectrum antibiotics (70.3% vs 57.7%). Insurance status, ethnicity, religion, education, and salary did not lead to statistically significant changes in code status. CONCLUSIONS In patients with cardiopulmonary arrest, code status change was more likely to be influenced by the presence of medical comorbidities and medical interventions during hospitalization rather than by socioeconomic factors.
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Affiliation(s)
- Michelle Ploch
- Department of Medicine, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Talha Ahmed
- Division of Cardiology, Department of Medicine, University of Texas Health Science Center at Houston, Houston, TX, United States; Heart and Vascular Institute, Memorial Hermann Hospital, Houston, TX, United States
| | - Stephan Reyes
- Department of Medicine, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Jorge A Irizarry-Caro
- Department of Medicine, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Jose E Fossas-Espinosa
- Department of Medicine, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Saeed Shoar
- Division of Cardiology, Department of Medicine, University of Texas Health Science Center at Houston, Houston, TX, United States; Heart and Vascular Institute, Memorial Hermann Hospital, Houston, TX, United States
| | - Atia Amatullah
- Department of Medicine, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Arjun Jogimahanti
- Department of Medicine, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Matthew Antonioli
- Department of Medicine, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Cesar A Iliescu
- Department of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Prakash Balan
- Department of Cardiology, Banner University Medical Center, University of Arizona College of Medicine, Phoenix, AZ, United States
| | - Payam Safavi Naeini
- Center for Cardiac Arrhythmias and Electrophysiology, Texas Heart Institute, Houston, TX, United States
| | - Mohammad Madjid
- Division of Cardiology, Department of Medicine, University of Texas Health Science Center at Houston, Houston, TX, United States; Heart and Vascular Institute, Memorial Hermann Hospital, Houston, TX, United States; Division of Cardiology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, United States.
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Ploch M, Ahmed T, Reyes S, Irizarry-Caro JA, Fossas-Espinosa JE, Shoar S, Amatullah A, Safavi-Naeini P, Jogimahanti A, Antonioli M, Iliescu CA, Balan P, Madjid M. Abstract 157: Clinical And Social Determinants Of Change In Code Status Among Patients Hospitalized With Covid-19. Circ Cardiovasc Qual Outcomes 2022. [DOI: 10.1161/circoutcomes.15.suppl_1.157] [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: 11/16/2022]
Abstract
Background:
Patients hospitalized with COVID-19 who develop cardiopulmonary arrest often have poor prognosis, prompting discussions with families about goals of care. The relationship between clinical and social determinants of code status change is poorly understood.
Methods:
This retrospective study included adult COVID-19 positive patients admitted to the intensive care unit with cardiac arrest in a multihospital center over the first 9 months of the pandemic (3/1/2020 - 12/1/2020). Data on medical and social factors was collected and adjudicated.
Results:
We identified 208 patients over the study timeline. The mean age was 63.7 ± 14.5 years and 54.3% (n=113) were male. The majority of patients with cardiopulmonary arrest had pulseless electrical activity (PEA) as their initial rhythm (91.3%, n=190). Code status was changed in 56.3% (n=117) of patients. The majority of COVID-19 patients with cardiac arrest were Hispanic (53.4%, n=111), followed by African American (27.9%, n=58), and White patients (13.5%, n=28). Race/ethnicity did not affect the rate of code status change. COVID-19 patients who had a code status change were statistically more likely to have a lower salary ($54,838 vs $62,374), have a history of stroke/transient ischemic attack (15.4 vs 4.4%, 18:4), or heart failure (28.2 vs 15.6%, 33:14), all with P<0.05. Patients with code status change had shorter courses of cardiopulmonary resuscitation (11.9 vs 16.9 minutes, P<0.05). Both groups had similar levels of aggressive care received including continuous renal replacement therapy, vasopressor and broad-spectrum antibiotics requirements. Insurance status, ethnicity, religion, and education did not lead to statistically significant changes in code status in COVID patients.
Conclusion:
Patients hospitalized with cardiopulmonary arrest and positive for COVID-19 are more likely to have a change in code status. This code status change is affected by cardiovascular comorbidities such as stroke and heart failure, along with lower income but not by insurance status, ethnicity, religion, and educational level.
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Affiliation(s)
- Michelle Ploch
- Dept of Medicine, Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Talha Ahmed
- Div of Cardiology, Dept of Medicine, Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Stephan Reyes
- Dept of Medicine, Univ of Texas Health Science Cntr at Houston, Houston, TX
| | | | | | - Saeed Shoar
- Div of Cardiology, Dept of Medicine, Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Atia Amatullah
- Dept of Medicine, Univ of Texas Health Science Cntr at Houston, Houston, TX
| | | | - Arjun Jogimahanti
- Dept of Medicine, Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Matthew Antonioli
- Dept of Medicine, Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Cesar A Iliescu
- Dept of Cardiology, Div of Internal Medicine, The Univ of Texas MD Anderson Cancer Cntr, Houston, TX
| | - Prakash Balan
- Dept of Cardiology, Univ of Arizona College of Medicine, Phoenix, AZ
| | - Mohammad Madjid
- Div of Cardiology, Dept of Medicine, David Geffen Sch of Medicine, Univ of California, Los Angeles (UCLA), Los Angeles, CA
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Shoar S, Musher DM. The white blood cell response in sputum in viral and bacterial pneumonias. Open Forum Infect Dis 2022; 9:ofac189. [PMID: 35794935 PMCID: PMC9251662 DOI: 10.1093/ofid/ofac189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/09/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Saeed Shoar
- Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Daniel M. Musher
- Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
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15
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Shoar S. Letter on Incidence and prognosis of COVID-19 amongst heart transplant recipients: a systematic review and meta-analysis. Eur J Prev Cardiol 2022; 29:e263. [PMID: 34983067 DOI: 10.1093/eurjpc/zwac002] [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: 11/14/2022]
Affiliation(s)
- Saeed Shoar
- Department of Clinical Research, ScientificCollaboration Institute, 7900 Cambridge Street, Houston, TX, TX 77054, Houston
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16
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Shoar S, Prada-Ruiz ACC, Patarroyo-Aponte G, Chaudhary A, Sadegh Asadi M. Immune Response to SARS-CoV-2 Vaccine among Heart Transplant Recipients: A Systematic Review. Clin Med Insights Circ Respir Pulm Med 2022; 16:11795484221105327. [PMID: 35693423 PMCID: PMC9174554 DOI: 10.1177/11795484221105327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 05/04/2022] [Indexed: 11/15/2022] Open
Abstract
Background Heart transplant (HTX) recipients are at a significantly higher risk of adverse clinical outcomes, due to chronic immunosuppression and co-existence of other chronic conditions, when contracting the SARS-CoV-2 infection. Although vaccination against SARS-CoV-2 is currently the most promising measure for the prevention of severe Coronavirus Disease 2019 (COVID-19) among solid organ transplant recipients, the extent of immune response and its protective efficacy among patients receiving HTX has not been sufficiently studied. Methods We performed a systematic review of the literature by inquiring PubMed/Medline to identify original studies among HTX recipients, who had received at least one dose of the SARS-CoV-2 vaccine. Data on the measured humoral or cellular immune response was collected from all the eligible studies. Factors associated with a poor immune response were further investigated within these studies. Results A total of 12 studies comprising 563 HTX recipients were included. The average age of the study participants was 60.8 years. Sixty four percent of the study population were male. Ninety percent of the patients had received an mRNA vaccine (Pfizer/ BNT162b2 or Moderna/mRNA-1273). A positive immune response to SARS-CoV-2 vaccine was variably reported in 0% to 100% of the patients. Older age (> 65 years), vaccine dose (first, second, or third), time since HTX to the first dose of the vaccine, the time interval between the latest dose of the vaccine and measurement of the immune response, and the type of immunosuppressive regimen were all indicated as potential determinants of a robust immune response to the SARS-CoV-2 vaccination. Conclusion HTX recipients demonstrate a weaker immune response to the vaccination against SARS-CoV-2 compared to the general population. Older age, anti-metabolite agents such as mycophenolate mofetil, and vaccination during the first year following the HTX have been indicated as potential determinants of a poor immune response.
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Affiliation(s)
- Saeed Shoar
- Department of Clinical Research, Scientific Collaborative Initiative, Houston, TX, USA
| | - Adriana C. Carolina Prada-Ruiz
- Division of Pediatric Cardiology, Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Gabriel Patarroyo-Aponte
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Ashok Chaudhary
- Department of Internal Medicine, Griffin Hospital, Derby, CT, USA
| | - Mohammad Sadegh Asadi
- Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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17
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Rosalia L, Ozturk C, Shoar S, Fan Y, Malone G, Cheema FH, Conway C, Byrne RA, Duffy GP, Malone A, Roche ET, Hameed A. Device-Based Solutions to Improve Cardiac Physiology and Hemodynamics in Heart Failure With Preserved Ejection Fraction. JACC Basic Transl Sci 2021; 6:772-795. [PMID: 34754993 PMCID: PMC8559325 DOI: 10.1016/j.jacbts.2021.06.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 06/03/2021] [Indexed: 12/28/2022]
Abstract
Characterized by a rapidly increasing prevalence, elevated mortality and rehospitalization rates, and inadequacy of pharmaceutical therapies, heart failure with preserved ejection fraction (HFpEF) has motivated the widespread development of device-based solutions. HFpEF is a multifactorial disease of various etiologies and phenotypes, distinguished by diminished ventricular compliance, diastolic dysfunction, and symptoms of heart failure despite a normal ejection performance; these symptoms include pulmonary hypertension, limited cardiac reserve, autonomic imbalance, and exercise intolerance. Several types of atrial shunts, left ventricular expanders, stimulation-based therapies, and mechanical circulatory support devices are currently under development aiming to target one or more of these symptoms by addressing the associated mechanical or hemodynamic hallmarks. Although the majority of these solutions have shown promising results in clinical or preclinical studies, no device-based therapy has yet been approved for the treatment of patients with HFpEF. The purpose of this review is to discuss the rationale behind each of these devices and the findings from the initial testing phases, as well as the limitations and challenges associated with their clinical translation.
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Key Words
- BAT, baroreceptor activation therapy
- CCM, cardiac contractility modulation
- CRT, cardiac resynchronization therapy
- HF, heart failure
- HFmEF, heart failure with mid-range ejection fraction
- HFpEF
- HFpEF, heart failure with preserved ejection fraction
- HFrEF, heart failure with reduced ejection fraction
- IASD, Interatrial Shunt Device
- LAAD, left atrial assist device
- LAP, left atrial pressure
- LV, left ventricular
- LVEF, left ventricular ejection fraction
- MCS, mechanical circulatory support
- NYHA, New York Heart Association
- PCWP, pulmonary capillary wedge pressure
- QoL, quality of life
- TAA, transapical approach
- atrial shunt devices
- electrostimulation
- heart failure devices
- heart failure with preserved ejection fraction
- left ventricular expanders
- mechanical circulatory support
- neuromodulation
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Affiliation(s)
- Luca Rosalia
- Health Sciences and Technology Program, Harvard–Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Caglar Ozturk
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | | | - Yiling Fan
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Grainne Malone
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Faisal H. Cheema
- HCA Healthcare, Houston, Texas, USA
- University of Houston, College of Medicine, Houston, Texas, USA
| | - Claire Conway
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Robert A. Byrne
- Department of Cardiology, Mater Private Hospital, Dublin, Ireland
- Cardiovascular Research, School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Garry P. Duffy
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
- Anatomy & Regenerative Medicine Institute, School of Medicine, College of Medicine, Nursing, and Health Sciences, National University of Ireland Galway, Galway, Ireland
- Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland
- Advanced Materials for Biomedical Engineering and Regenerative Medicine, Trinity College Dublin, and National University of Ireland Galway, Galway, Ireland
- Trinity Centre for Biomedical Engineering, Trinity College Dublin, Dublin, Ireland
| | - Andrew Malone
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Ellen T. Roche
- Health Sciences and Technology Program, Harvard–Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Aamir Hameed
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
- Trinity Centre for Biomedical Engineering, Trinity College Dublin, Dublin, Ireland
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18
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Haley KE, Almas T, Shoar S, Shaikh S, Azhar M, Cheema FH, Hameed A. The role of anti-inflammatory drugs and nanoparticle-based drug delivery models in the management of ischemia-induced heart failure. Biomed Pharmacother 2021; 142:112014. [PMID: 34391184 DOI: 10.1016/j.biopha.2021.112014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/27/2021] [Accepted: 08/03/2021] [Indexed: 12/20/2022] Open
Abstract
Ongoing advancements in the treatment of acute myocardial infarction (MI) have significantly decreased MI related mortality. Consequently, the number of patients experiencing post-MI heart failure (HF) has continued to rise. Infarction size and the extent of left ventricular (LV) remodeling are largely determined by the extent of ischemia at the time of myocardial injury. In the setting of MI or acute phase of post-MI LV remodeling, anti-inflammatory drugs including intravenous immunoglobulin (IVIG) and Pentoxifylline have shown potential efficacy in preventing post-MI remodeling in-vitro and in some clinical trials. However, systemic administration of anti-inflammatory drugs are not without their off-target side effects. Herein, we explore the clinical feasibility of targeted myocardial delivery of anti-inflammatory drugs via biodegradable polymers, liposomes, hydrogels, and nano-particle based drug delivery models (NDDM) based on existing pre-clinical and clinical models. We summarize the barriers to clinical application of targeted anti-inflammatory delivery post-MI, including challenges in achieving sufficient retention and distribution, as well as the potential need for multiple dosing. Collectively, we suggest that localized delivery of anti-inflammatory agents to the myocardium using NDDM is a promising approach for successful treatment of ischemic HF. Future studies will be instrumental in determining the most effective target and delivery modalities for orchestrating NDDM-mediated treatment of HF.
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Affiliation(s)
- Kathryn E Haley
- Graduate Entry Medicine, RCSI University of Medicine and Health Sciences, Dublin 2 Dublin, Ireland; Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin 2 Dublin, Ireland
| | - Talal Almas
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin 2 Dublin, Ireland; School of Medicine, RCSI University of Medicine and Health Sciences, Dublin 2 Dublin, Ireland
| | - Saeed Shoar
- HCA Healthcare Gulf Coast Division, Houston, TX, USA
| | - Shan Shaikh
- HCA Healthcare Gulf Coast Division, Houston, TX, USA
| | - Maimoona Azhar
- Graduate Entry Medicine, RCSI University of Medicine and Health Sciences, Dublin 2 Dublin, Ireland; Department of Surgery, St. Vincent's University Hospital, Dublin 4 Dublin, Ireland
| | - Faisal Habib Cheema
- HCA Healthcare Gulf Coast Division, Houston, TX, USA; University of Houston, College of Medicine, Houston, TX, USA
| | - Aamir Hameed
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin 2 Dublin, Ireland; Trinity Centre for Biomedical Engineering (TCBE), Trinity College Dublin (TCD), Dublin, Ireland.
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Shoar S, Centeno FH, Musher DM. Erratum to: Clinical Features and Outcomes of Community-Acquired Pneumonia Caused by Haemophilus influenzae. Open Forum Infect Dis 2021; 8:ofab226. [PMID: 34189170 PMCID: PMC8233564 DOI: 10.1093/ofid/ofab226] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Shoar S, Shah AA, Ikram W, Farooq N, Udoh A, Tabibzadeh E, Khavandi S, Khavandi S. Cardiovascular benefits of SGLT2 inhibitors in patients with heart failure: a meta-analysis of small and large randomized controlled trials. Am J Cardiovasc Dis 2021; 11:262-272. [PMID: 34322297 PMCID: PMC8303041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/06/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Sodium-glucose cotransporter 2 (SGLT2) inhibitors have shown promise in improving cardiovascular outcome in patients with heart failure (HF) and diabetes mellitus (DM). Although these benefits have been confirmed by several meta-analyses, small studies have not been included into these pooled analyses. AIM Publication of recent RCTs prompted us to perform this updated meta-analysis to examine the consistency of favorable cardiovascular outcomes of SGLT2 inhibitors in HF patients by inclusion of clinical trials with small sample size. METHODS We conducted a systematic review of the literature in PubMed/Medline and ClinicalTrials.gov to identify all RCTs investigating the benefits of SGLT2 inhibitors in patients with HF. The primary endpoint of this meta-analysis was to compare the cardiovascular death (CVD) and hospitalization for HF (HHF) between patients who received an SGLT2 inhibitor and those who received a placebo or a non-SGLT2 inhibitor. We used a risk difference (RD) and log hazard ratio (HR) to pool the reported difference across the included RCTs. RESULTS A total of 12 RCTs encompassing 59,825 patients at different stages of HF and DM were included, 32,448 patients in the SGLT2 inhibitor group and 27,377 patients in the control group. A pooled analysis of RCTs, regardless of HF severity or DM status, showed a significantly reduced RD for CVD (RD =-0.01, 95% CI [-0.01, 0.00], P=0.01) and HHF (RD =-0.02, 95% CI [-0.03, -0.01], P=0.0005) in patients who received a SGLT2 inhibitor compared to those who did not. A sub-group analysis showed a significantly reduced RD for CVD (RD =-0.01, 95% CI [-0.02, 0.00], P=0.03) and HHF (RD =-0.02, 95% CI [-0.03, 0.00], P=0.01) in patients with DM who received SGLT2 inhibitors regardless of the severity of HF. Also, regardless of DM status, RD for HHF favored the use of SGLT2 inhibitor than the control medication (RD =-0.05, 95% CI [-0.06, -0.03], P<0.00001). CONCLUSION SGLT2 inhibitors have shown a promise in reducing CVD and HHF in patients with HF, regardless of ejection fraction or diabetes status.
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Affiliation(s)
- Saeed Shoar
- Department of Clinical Research, ScientificWriting CorpHouston, TX, USA
| | - Ahmed Ali Shah
- School of Medicine, Quaid-e-Azam Medical CollegeBahawalpur, Pakistan
| | - Waleed Ikram
- School of Medicine, Lahore Medical and Dental CollegeLahore, Pakistan
| | - Najam Farooq
- School of Medicine, Quaid-e-Azam Medical CollegeBahawalpur, Pakistan
| | - Agnes Udoh
- School of Medicine, Madonna UniversityOkija, Nigeria
| | - Elsa Tabibzadeh
- Department of Anesthesiology and Critical Care, Tabriz University of Medical SciencesTabriz, Iran
| | - Soheila Khavandi
- Department of Cardiology, Tabriz University of Medical SciencesTabriz, Iran
| | - Siamak Khavandi
- Department of Ophthalmology, Tabriz University of Medical SciencesTabriz, Iran
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21
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Jacob R, Hoang K, Graham J, Hollander J, Shoar S, Madjid M. QUALITY CONTROL ANALYSIS OF TOTAL HEPARIN DOSE NEEDED FOR ST ELEVATION MYOCARDIAL INFARCTION (STEMI) CORONARY INTERVENTIONS. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02592-4] [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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22
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Shoar S, Hosseini FS, Naderan M, Khavandi S, Tabibzadeh E, Khavandi S, Shoar N. Cardiac injury following blunt chest trauma: diagnosis, management, and uncertainty. Int J Burns Trauma 2021; 11:80-89. [PMID: 34094699 PMCID: PMC8166660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 01/26/2021] [Indexed: 06/12/2023]
Abstract
Due to the evolving nature of injuries caused by high-speed motor vehicle accidents, the incidence rate of blunt chest trauma is continuously increasing. Blunt cardiac injury (BCI) is a potentially lethal entity as a result of trauma to the chest. Due to its indistinct clinical presentation and heterogeneous definition, BCI might be missed during the initial survey of trauma patients in the acute care setting. Additionally, unnecessary operation in hemodynamically stable patients in whom the extent of cardiac injury has not been thoroughly evaluated might result in adverse clinical outcome. Due to ongoing advances in the diagnostic modalities and minimally invasive procedures in the acute care and trauma setting, patients with blunt trauma to the chest, who are also suspected of having a BCI, can be monitored with more confidence and managed accordingly as the clinical scenario evolves. While low-yield diagnostics such as chest X ray, electrocardiogram, and a bedside ultrasonography are still routinely performed in patients with suspected BCI, high-yield modalities such as computed tomography, highly sensitive cardiac biomarkers, and transesophageal echocardiography are all a next step in the management approach. In either case, the clinical judgment of the medical team plays a pivotal role in transition to the next step with adequate resuscitation remaining an inevitable part.
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Affiliation(s)
- Saeed Shoar
- Department of Clinical Research, ScientificWriting CorpHouston, TX, USA
| | | | - Mohammad Naderan
- Faculty of Medicine, Tehran University of Medical SciencesTehran, Iran
| | - Siamak Khavandi
- Department of Ophthalmology, Tabriz University of Medical SciencesTabriz, Iran
| | - Elsa Tabibzadeh
- Department of Anaesthesiology and Critical Care, Tabriz University of Medical SciencesTabriz, Iran
| | - Soheila Khavandi
- Department of Cardiology, Tabriz University of Medical SciencesTabriz, Iran
| | - Nasrin Shoar
- Faculty of Medicine, Kashan University of Medical SciencesKashan, Iran
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23
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Shoar S, Centeno FH, Musher DM. Clinical Features and Outcomes of Community-Acquired Pneumonia Caused by Haemophilus Influenza. Open Forum Infect Dis 2021; 8:ofaa622. [PMID: 33855100 PMCID: PMC8028099 DOI: 10.1093/ofid/ofaa622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 04/07/2021] [Indexed: 12/02/2022] Open
Abstract
Background Long regarded as the second most common cause of community-acquired pneumonia (CAP), Haemophilus influenzae has recently been identified with almost equal frequency as pneumococcus in patients hospitalized for CAP. The literature lacks a detailed description of the presentation, clinical features, laboratory and radiologic findings, and outcomes in Haemophilus pneumonia. Methods During 2 prospective studies of patients hospitalized for CAP, we identified 33 patients with Haemophilus pneumonia. In order to provide context, we compared clinical findings in these patients with findings in 36 patients with pneumococcal pneumonia identified during the same period. We included and analyzed separately data from patients with viral coinfection. Patients with coinfection by other bacteria were excluded. Results Haemophilus pneumonia occurred in older adults who had underlying chronic lung disease, cardiac conditions, and alcohol use disorder, the same population at risk for pneumococcal pneumonia. However, in contrast to pneumococcal pneumonia, patients with Haemophilus pneumonia had less severe infection as shown by absence of septic shock on admission, less confusion, fewer cases of leukopenia or extreme leukocytosis, and no deaths at 30 days. Viral coinfection greatly increased the severity of Haemophilus, but not pneumococcal pneumonia. Conclusions We present the first thorough description of Haemophilus pneumonia, show that it is less severe than pneumococcal pneumonia, and document that viral coinfection greatly increases its severity. These distinctions are lost when the label CAP is liberally applied to all patients who come to the hospital from the community for pneumonia.
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Affiliation(s)
- Saeed Shoar
- Baylor College of Medicine, Houston, Texas, USA.,Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
| | - Fernando H Centeno
- Baylor College of Medicine, Houston, Texas, USA.,Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
| | - Daniel M Musher
- Baylor College of Medicine, Houston, Texas, USA.,Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
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Shoar S, Khavandi S, Tabibzadeh E, Khavandi S, Naderan M, Shoar N. Recurrent coronavirus diseases 19 (COVID-19): A different presentation from the first episode. Clin Case Rep 2021; 9:2149-2152. [PMID: 33821190 PMCID: PMC8013608 DOI: 10.1002/ccr3.3967] [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] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/30/2021] [Accepted: 02/08/2021] [Indexed: 01/25/2023] Open
Abstract
A 31-year-old Caucasian male developed reinfection with SARS-CoV-2, 2 ½ months after an initial episode of ICU admission for respiratory support due to COVID-19. The second episode was in the form of malaise, aphthous gingival ulcer, and desquamating palmar lesion.
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Affiliation(s)
- Saeed Shoar
- Department of Clinical Research Scientific Writing Corporation Houston TX USA
| | - Siamak Khavandi
- Department of Ophthalmology Tabriz University of Medical Sciences Tabriz Iran
| | - Elsa Tabibzadeh
- Department of Anaesthesiology and Critical Care Tabriz University of Medical Sciences Tabriz Iran
| | - Soheila Khavandi
- Department of Cardiology Tabriz University of Medical Sciences Tabriz Iran
| | - Mohammad Naderan
- Department of Medicine and Clinical Research Tehran University of Medical Sciences Tehran Iran
| | - Nasrin Shoar
- Department of Clinical Research Scientific Writing Corporation Houston TX USA.,Department of Medicine and Clinical Research Kashan University of Medical Sciences Kashan Iran
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Shoar S. D-dimer and poor clinical outcome in patients with COVID-19: lessons from meta-analysis of case-control studies. Heart Lung 2021; 50:298. [PMID: 33482431 PMCID: PMC7803148 DOI: 10.1016/j.hrtlng.2021.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 01/06/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Saeed Shoar
- Department of Clinical Research, ScientificWriting Corporation, 3403 Garth Rd., Ste#1305, Baytown, TX, United States.
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26
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Shoar S, Ikram W, Shah AA, Farooq N, Gouni S, Khavandi S, Tabibzadeh E, Khavandi S. Non-high-density lipoprotein (non-HDL) cholesterol in adolescence as a predictor of atherosclerotic cardiovascular diseases in adulthood. Rev Cardiovasc Med 2021; 22:295-299. [PMID: 34258898 DOI: 10.31083/j.rcm2202037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 11/06/2022] Open
Abstract
Defined as the total cholesterol minus high-density lipoprotein (HDL), non-HDL cholesterol has been increasingly acknowledged as a measure of risk estimation for developing atherosclerotic cardiovascular diseases (ASCVD). Comprising of apolipoprotein B100-containing cholesterols (very low-density lipoprotein (VLDL), low-density lipoprotein (LDL), intermediate-density lipoprotein (IDL), and lipoprotein (a) (Lp(a))), and apolipoprotein B48-containing lipoproteins (chylomicrons and its remnants), elevated serum levels of non-HDL cholesterol in early adolescence has been strongly linked with the development of ASCVD in adulthood. This article reviews the evidence from longitudinal studies, which demonstrate the cumulative risk of ASCVD in relation to the elevated levels of non-HDL cholesterol earlier in life.
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Affiliation(s)
- Saeed Shoar
- Department of Clinical Research, Scientific Writing Corp, Houston, TX 77054, USA
| | - Waleed Ikram
- School of Medicine, Lahore Medical and Dental College, 531 Lahore, Pakistan
| | - Ahmed Ali Shah
- School of Medicine, Quaid-e-Azam Medical College, 63100 Bahawalpur, Pakistan
| | - Najam Farooq
- School of Medicine, Quaid-e-Azam Medical College, 63100 Bahawalpur, Pakistan
| | - Srikanth Gouni
- Department of Medicine, Kakatiya Medical College, 506009 Warangal, India
| | - Soheila Khavandi
- Department of Cardiology, Tabriz University of Medical Sciences, 5166614766 Tabriz, Iran
| | - Elsa Tabibzadeh
- Department of Anesthesiology and Critical Care, Tabriz University of Medical Sciences, 5166614766 Tabriz, Iran
| | - Siamak Khavandi
- Department of Ophthalmology, Tabriz University of Medical Sciences, 5166614766 Tabriz, Iran
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27
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Shoar S, Khavandi S, Tabibzadeh E, Vaez A, Oskouei AK, Maleki AN, Shoar N. 1503. Risk Factors for Contracting Infection with SARS-CoV-2: a Prospective Case-control Study. Open Forum Infect Dis 2020. [PMCID: PMC7778221 DOI: 10.1093/ofid/ofaa439.1684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background As the COVID-19 pandemic has exhausted the healthcare system and economic infrastructures, controlling measures are directed toward population-based strategies including individual’s hygiene and safe socializing. We conducted this study to identify individual’s factors at the population level which are associated with the risk of infection with SARS-CoV-2 in a middle-to-low income country. Methods A prospective case-control study was conducted to compare the demographics, socioeconomics, and individual’s behavior between patients with COVID-19 and randomly selected healthy controls from the same population referring to a general hospital in northwest Iran. Results Data of 250 patients with a positive RT-PCR test for COVID-19 was compared with 250 healthy controls between March 1st and May 15th (Table1). Higher education, better socioeconomic status, having access to the internet or following relevant news, having an obsession for cleanliness especially regular hands washing with alcohol-based disinfectants, wearing masks in public especially those with an N-95 filter, complying with stay-home orders, and receiving the flu shot over the past season were protective against contracting COVID-19. On the contrary, cigarette smoking or opium consumption, a history of recent travel, having an individual with infection with SARS-CoV-2 within the household, and recent hospitalization were associated with COVID-19. Table1. Comparison of individual’s factors between COVID-19 positive and negative patients ![]()
Conclusion Individuals’ characteristics at a family or public level can guide healthcare authorities and lawmakers in their ongoing endeavors toward controlling the COVID-19 pandemics, especially in low-to-middle income regions. Disclosures All Authors: No reported disclosures
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Affiliation(s)
- Saeed Shoar
- ScientificWriting Corporation, BAYTOWN, Texas
| | - Siamak Khavandi
- Tabriz University of Medical Sciences, Tabriz, Azarbayjan-e Sharqi, Iran
| | - Elsa Tabibzadeh
- Tabriz University of Medical Sciences, Tabriz, Azarbayjan-e Sharqi, Iran
| | - Aydin Vaez
- Tabriz University of Medical Sciences, Tabriz, Azarbayjan-e Sharqi, Iran
| | | | | | - Nasrin Shoar
- Tabriz University of Medical Sciences, Tabriz, Azarbayjan-e Sharqi, Iran
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Shoar S, Hosseini F, Naderan M, Mehta JL. Meta-analysis of Cardiovascular Events and Related Biomarkers Comparing Survivors Versus Non-survivors in Patients With COVID-19. Am J Cardiol 2020; 135:50-61. [PMID: 32916148 PMCID: PMC7477637 DOI: 10.1016/j.amjcard.2020.08.044] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 12/15/2022]
Abstract
Since the emergence of the coronavirus disease 19 (COVID-19), a number of studies have reported the presence of cardiovascular diseases in affected patients and linked them with a higher risk of mortality. We conducted an online search in Medline/PubMed to identify original cohorts comparing data between survivors and non-survivors from COVID-19. The presence of cardiovascular events and related biomarkers were compared between the 2 groups. Data on 1,845 hospitalized patients with COVID-19 were pooled from 12 comparative studies. The overall mortality rate in relation to COVID-19 was 17.6%. Men aged > 50 years old were more likely to die from COVID-19. Significant co-morbidities contributing to mortality were hypertension, diabetes mellitus, smoking, a previous history of cardiovascular disease including chronic heart failure, and cerebrovascular accidents. A significant relationship was observed between mortality and patient presentation with dyspnea, fatigue, tachycardia, and hypoxemia. Cardiovascular disease-related laboratory biomarkers related to mortality were elevated serum level of lactate dehydrogenase, creatine kinase, brain natriuretic peptide, and cardiac troponin I. Adverse cardiovascular disease-related clinical events preceding death were shock, arrhythmias, and acute myocardial injury. In conclusion, severe clinical presentation and elevated biomarkers in COVID-19 patients with established risk factors can predict mortality from cardiovascular causes.
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Affiliation(s)
- Saeed Shoar
- Department of Clinical Research, ScientificWriting Corporation, Houston, TX
| | - Fatemeh Hosseini
- Department of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Naderan
- Department of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Jawahar L Mehta
- Department of Medicine (Cardiology), Central Arkansas Veterans Healthcare System, University of Arkansas for Medical Sciences, Little Rock, AR.
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Shoar S, Hosseini FS, Gulraiz A, Ikram W, Javed M, Naderan M, Shoar N, Modukuru VR. Intrathoracic gastric fistula after bariatric surgery: a systematic review and pooled analysis. Surg Obes Relat Dis 2020; 17:630-643. [PMID: 33334678 DOI: 10.1016/j.soard.2020.10.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 01/06/2023]
Abstract
Even in the hands of highly experienced bariatric surgeons, perioperative complications are inevitable. Of these, leaks and fistulas are amongst the scariest complications. Intrathoracic gastric fistulas (ITGF) can be associated with serious morbidity, mostly when cases are misdiagnosed or detected with delay. This is a systematic review of the literature to investigate the clinical and surgical outcomes of morbidly obese adult patients with a confirmed diagnosis of ITGF following bariatric surgery. A pooled analysis of 25 articles, encompassing 76 patients with post-bariatric ITGF, showed that the clinical outcome depends on the initial presentation, timing of the diagnosis in relation to symptom onset, and prompt and effective treatment. Any septic or unstable patient must undergo urgent surgical intervention, while stable patients might tolerate a step-up approach and watchful waiting for nonsurgical treatment. Among those who undergo surgery, treatment failure and the mortality rate are substantially high. Contingent upon a prompt management strategy, patients with postbariatric ITGF can generally have a favorable outcome in the long term.
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Affiliation(s)
- Saeed Shoar
- Department of Clinical Research, ScientificWriting Corp, Houston, TX.
| | | | - Azouba Gulraiz
- Faculty of Medicine, Nishtar Medical University, Multan, Pakistan
| | - Waleed Ikram
- Faculty of Medicine, Lahore Medical and Dental College, Lahore, Pakistan
| | - Moiz Javed
- Faculty of Medicine, Lahore Medical and Dental College, Lahore, Pakistan
| | - Mohammad Naderan
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Shoar
- Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Venkat R Modukuru
- Department of Surgery, Metropolitan Hospital Center, New York Medical College, New York, NY
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Shoar S, Batra S, Gulraiz A, Ikram W, Javed M, Hosseini F, Naderan M, Shoar N, John J, Modukuru VR, Sharma SK. Effect of pre-existing left bundle branch block on post-procedural outcomes of transcatheter aortic valve replacement: a meta-analysis of comparative studies. Am J Cardiovasc Dis 2020; 10:294-300. [PMID: 33224576 PMCID: PMC7675150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 09/03/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND As an established procedure for patients with aortic valve stenosis and a high surgical risk profile, transcatheter aortic valve replacement (TAVR) can be associated with conductance abnormalities. However, data regarding the impact of pre-existing left bundle branch block (LBBB) on post-TAVR outcome is scarce. OBJECTIVES We conducted this meta-analysis to pool available data in the literature on the impact of pre-existing LBBB on the clinical outcomes of patients undergoing TAVR. METHODS We queried Medline/PubMed, Scopus, and Cochrane Library to identify comparative studies of patients with and without a pre-existing LBBB undergoing TAVR for aortic stenosis. Risk ratio (RR) and the corresponding 95% confidence interval (95% CI) were estimated to measure the effect of pre-existing LBBB on developing post-procedure stroke, permanent pacemaker implantation (PPM), or moderate/severe aortic regurgitation (AR). RESULTS Data of three clinical trials encompassing 4,668 patients undergoing TAVR were included in this meta-analysis. Patients with pre-existing LBBB prior to TAVR had an increased risk of developing moderate/severe AR (RR = 1.04 [0.79-1.37]; P = 0.77), stroke (RR = 1.72 [0.61-4.85]; P = 0.31), and a need for PPM implantation (RR = 4.43 [0.43-45.64]; P = 0.21) following TAVR. CONCLUSION Preexisting LBBB seems to increase the risk of developing stroke, aortic regurgitation, and the need for a permanent pacemaker implantation. However, due to scarcity of data and high heterogeneity among the current studies, further clinical trials are warranted.
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Affiliation(s)
- Saeed Shoar
- Department of Clinical Research, ScientificWriting CorporationHouston, TX, USA
| | - Simran Batra
- Department of Internal Medicine, Dow University of Health SciencesKarachi, Pakistan
| | - Azouba Gulraiz
- Department of Medicine, Nishtar Medical UniversityMultan, Pakistan
| | - Waleed Ikram
- Department of Medicine, Lahore Medical and Dental CollegeLahore, Pakistan
| | - Moiz Javed
- Department of Medicine, Lahore Medical and Dental CollegeLahore, Pakistan
| | - Fatemeh Hosseini
- Faculty of Medicine, Isfahan University of Medical SciencesIsfahan, Iran
| | - Mohammad Naderan
- Faculty of Medicine, Tehran University of Medical SciencesTehran, Iran
| | - Nasrin Shoar
- Faculty of Medicine, Kashan University of Medical SciencesKashan, Iran
| | - Jobby John
- Department of Medicine, Dr. Somervell C.S.I. Medical College and HospitalKarakonam, Trivandrum, Kerala, India
| | - Venkat R Modukuru
- Department of Surgery, Metropolitan Hospital, New York College of MedicineManhattan, New York, USA
| | - Samin K Sharma
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount SinaiNY, USA
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Abstract
Background The etiology of community-acquired pneumonia (CAP) has evolved since the beginning of the antibiotic era. Recent guidelines encourage immediate empiric antibiotic treatment once a diagnosis of CAP is made. Concerns about treatment recommendations, on the one hand, and antibiotic stewardship, on the other, motivated this review of the medical literature on the etiology of CAP. Methods We conducted a systematic review of English-language literature on the etiology of CAP using methods defined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed using a combination of the keywords ‘pneumonia’, ‘CAP’, ‘etiology’, ‘microbiology’, ‘bacteriology’, and ‘pathogen’. We examined articles on antibiotics that were develop to treat pneumonia. We reviewed all ‘related articles’ as well as studies referenced by those that came up in the search. After we excluded articles that did not give sufficient microbiological data or failed to meet other predetermined criteria, 146 studies remained. Data were stratified into diagnostic categories according to the microbiologic studies that were done; results are presented as the percentage in each category of all cases in which an etiology was established. Results Streptococcus pneumoniae remains the most common cause of CAP although declining in incidence; this decline has been greater in the US than elsewhere. Haemophilus influenzae is the second most common cause of CAP, followed by Staphylococcus aureus and Gram negative bacilli. The incidence of all bacteria as causes of CAP has declined because, with routine use of PCR for viruses, the denominator, cases with an established etiology, has increased. Viruses were reported on average in about 10% of cases, but recent PCR-based studies identified a respiratory virus in about 30% of cases of CAP, with substantial rates of viral/bacterial coinfection. Conclusion The results of this study justify current guidelines for initial empiric treatment of CAP. With pneumococcus and Haemophilus continuing to predominate, efforts at antibiotic stewardship might be enhanced by greater attention to the routine use of sputum Gram stain and culture. Because viral/bacterial coinfection is relatively common, the identification of a virus by PCR does not, by itself, allow for discontinuation of the antibiotic therapy.
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Affiliation(s)
- Saeed Shoar
- Medical Care Line (Infectious Disease Section), Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Boulevard, Room 4B-370, Houston, TX 77030 USA
| | - Daniel M Musher
- Medical Care Line (Infectious Disease Section), Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Boulevard, Room 4B-370, Houston, TX 77030 USA.,Department of Medicine, Baylor College of Medicine, Houston, TX 77030 USA
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Shoar S, Modukuru VR, Naderan M, Shoar N. Letter to the editor on "Outpatient volumes and medical staffing resources as predictors for continuity of follow-up care during transfer of adolescents with congenital heart disease". Int J Cardiol 2020; 312:62. [PMID: 32505332 DOI: 10.1016/j.ijcard.2020.02.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 02/07/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Saeed Shoar
- Department of Clinical Research, ScientificWriting Corporation, Houston, TX, United States of America.
| | - Venkat R Modukuru
- Department of Surgery, Metropolitan Hospital Center, New York Medical College, New York, NY, United States of America
| | - Mohammad Naderan
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Shoar
- Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
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Shoar S, Naderan M, Shoar N, Modukuru VR. Letter to the Editor Concerning "Glycosylated Hemoglobin as a Surrogate for the Prediction of Cardiovascular Events in Cardiovascular Outcome Trials Comparing New Antidiabetic Drugs to Placebo". Cardiology 2020; 145:388-389. [PMID: 32353845 DOI: 10.1159/000507507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 03/09/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Saeed Shoar
- Department of Clinical Research, ScientificWriting Corporation, Houston, Texas, USA,
| | - Mohammad Naderan
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Shoar
- Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Venkat R Modukuru
- Department of Surgery, Metropolitan Hospital Center, New York Medical College, Manhattan, New York, USA
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Shoar S, Naderan M, Shoar N, Modukuru VR, Mahmoodzadeh H. Alteration Pattern of Taste Perception After Bariatric Surgery: a Systematic Review of Four Taste Domains. Obes Surg 2020; 29:1542-1550. [PMID: 30712168 DOI: 10.1007/s11695-019-03730-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Efforts continue to understand the underlying mechanism of weight loss after bariatric surgery. Taste perception has shown to be a contributing factor. However, the alteration pattern in different taste domains and among bariatric procedures has not been sufficiently investigated. OBJECTIVES To study the alteration pattern in the perception of four taste domains after different bariatric procedures. SETTINGS Private Research Institute, USA. METHODS A systematic review was conducted to pool available data in the literature on post-operative changes in the perception of sensitivity to four taste domains after Roux-en-Y gastric bypass (RYGB), laparoscopic sleeve gastrectomy (LSG), and adjustable gastric banding (AGB). RESULTS Our study showed that bariatric surgery is associated with significant change in sensitivity to all four taste domains especially salt taste, sweetness, and sourness. LSG patients showed an increased sensitivity to all four taste domains. However, RYGB patients had a variable alteration pattern of taste perception but more commonly a decreased sensitivity to sweetness and an increased sensitivity to salt taste and sourness. Additionally, AGB patients had a decreased sensitivity to sweetness, salt taste, and sourness. CONCLUSION Bariatric surgery is associated with taste change in a way which results in less preference for high-calorie food and possibly reduced calorie intake. This may explain one of the mechanisms by which bariatric surgery produces weight loss. However, data are heterogeneous, the potential effect dilutes over time, and the alteration varies significantly between different procedures.
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Affiliation(s)
- Saeed Shoar
- Department of ScientificWriting, Division of Surgical Research, Shoar Research Institute, Houston, TX, USA. .,Cancer Institute, Imam Khomeini Hospital Complex, Division of Surgical Oncology, Department of Surgery, Tehran University of Medical Science, Tehran, Iran.
| | - Mohammad Naderan
- Cancer Institute, Imam Khomeini Hospital Complex, Division of Surgical Oncology, Department of Surgery, Tehran University of Medical Science, Tehran, Iran
| | - Nasrin Shoar
- Department of ScientificWriting, Division of Surgical Research, Shoar Research Institute, Houston, TX, USA.,Faculty of Medicine, Kashan University of Medical Science, Kashan, Iran
| | - Venkat R Modukuru
- Department of ScientificWriting, Division of Surgical Research, Shoar Research Institute, Houston, TX, USA.,Faculty Surgeon, Department of Surgery, NYMC at Metropolitan Hospital Program, New York City, NY, USA
| | - Habibollah Mahmoodzadeh
- Cancer Institute, Imam Khomeini Hospital Complex, Division of Surgical Oncology, Department of Surgery, Tehran University of Medical Science, Tehran, Iran
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Khorgami Z, Shoar S, Saber AA, Howard CA, Danaei G, Sclabas GM. Outcomes of Bariatric Surgery Versus Medical Management for Type 2 Diabetes Mellitus: a Meta-Analysis of Randomized Controlled Trials. Obes Surg 2020; 29:964-974. [PMID: 30402804 DOI: 10.1007/s11695-018-3552-x] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Bariatric surgery improves type 2 diabetes (T2D) in obese patients. The sustainability of these effects and the long-term results have been under question. OBJECTIVE To compare bariatric surgery versus medical management (MM) for T2D based on a meta-analysis of randomized controlled trials (RCTs) with 2 years of follow-up. MATERIAL AND METHODS Seven RCTs with at least 2-year follow-up were identified. The primary endpoint was remission of T2D (full or partial). Four hundred sixty-three patients with T2D and body mass index > 25 kg/m2 were evaluated. RESULTS After 2 years, T2D remission was observed in 138 of 263 patients (52.5%) with bariatric surgery compared to seven of 200 patients (3.5%) with MM (risk ratio (RR) = 10, 95% CI 5.5-17.9, p < 0.001). Subgroup analysis of the Roux-en-Y gastric bypass (RYGB) showed a significant effect size at 2 years in favor of RYGB over MM for a higher decrease of HbA1C (0.9 percentage points, 95% CI 0.6-1.1, p < 0.001), decrease of fasting blood glucose (35.3 mg/dl, 95% CI 13.3-57.3, p = 0.002), increase of high-density lipoprotein (HDL) (12.2 mg/dl, 95% CI 7.6-16.8, p < 0.001), and decrease of triglycerides (32.4 mg/dl, 95% CI 4.5-60.3, p = 0.02). Four studies followed patients up to 5 years and showed 62 of 225 patients (27.5%) with remission after surgery, compared to six of 156 patients (3.8%) with MM (RR = 6, 95% CI 2.7-13, p < 0.001). CONCLUSION This meta-analysis shows a superior and persistent effect of bariatric surgery versus MM for inducement of remission of T2D. This benefit of bariatric surgery was significant at 2 years and superior to MM even after 5 years. Compared with MM, patients with RYGB had better glycemic control and improved levels of HDL and triglycerides.
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Affiliation(s)
- Zhamak Khorgami
- Department of Surgery, College of Medicine, University of Oklahoma, 4502 E 41st Street, Tulsa, OK, 74135, USA.
| | - Saeed Shoar
- Department of Surgery, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, Bariatric and Metabolic Institute, Brooklyn, NY, USA
| | - Alan A Saber
- Department of Surgery, Newark Beth Israel Medical Center, Newark, NJ, USA
| | - C Anthony Howard
- Department of Surgery, College of Medicine, University of Oklahoma, 4502 E 41st Street, Tulsa, OK, 74135, USA
| | - Goodarz Danaei
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Guido M Sclabas
- Department of Surgery, College of Medicine, University of Oklahoma, 4502 E 41st Street, Tulsa, OK, 74135, USA
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Shoar S, Rajagopal K, Hameed A, Loyalka P, Cheema FH. Independent risk factors for ICU mortality after left ventricular assist device implantation. Artif Organs 2019; 44:193-194. [PMID: 31707740 DOI: 10.1111/aor.13576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 08/05/2019] [Accepted: 09/26/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Saeed Shoar
- HCA Houston Healthcare, Gulf Coast Division, Houston, Texas
| | - Keshava Rajagopal
- Department of Advanced Cardiopulmonary Therapies and Transplantation, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas
| | - Aamir Hameed
- Tissue Engineering Research Group (TERG), Department of Anatomy, Royal College of Surgeons in Ireland (RSCI), Dublin, Ireland.,Trinity Centre for Biomedical Engineering (TCBE), Trinity College Dublin (TCD), Dublin, Ireland
| | - Pranav Loyalka
- HCA Houston Healthcare, Gulf Coast Division, Houston, Texas
| | - Faisal H Cheema
- HCA Houston Healthcare, Gulf Coast Division, Houston, Texas.,HCA Research Institute, Nashville, Tennessee.,College of Medicine, University of Houston, Houston, Texas
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Shoar S, Hosseini FS, Modukuru V, Mahmoodzadeh H. A333 Technique of Choice for Conversion from a Failed Sleeve Gastrectomy. Surg Obes Relat Dis 2019. [DOI: 10.1016/j.soard.2019.08.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Shoar S, Hosseini FS, Modukuru V, Mahmoodzadeh H. A178 Intra-thoracic Gastric Fistula after Bariatric Surgery: A Systematic Review and Pooled Analysis. Surg Obes Relat Dis 2019. [DOI: 10.1016/j.soard.2019.08.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Shoar S, Naderan M, Mahmoodzadeh H, Shoar N, Lotfi D. Night eating syndrome: a psychiatric disease, a sleep disorder, a delayed circadian eating rhythm, and/or a metabolic condition? Expert Rev Endocrinol Metab 2019; 14:351-358. [PMID: 31536375 DOI: 10.1080/17446651.2019.1657006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 08/14/2019] [Indexed: 01/10/2023]
Abstract
Introduction: Night Eating Syndrome (NES) refers to an abnormal eating behavior which presents as evening hyperphagia consuming >25% calorie intake and/or nocturnal awaking with food ingestion which occurs ≥2 times per week. Although the syndrome has been described more than seven decades ago, the literature has been growing slowly on its etiology, diagnosis, and treatment. Areas covered: The proposed treatment options for NES are all at a case-study level. Moreover, our understanding of its etiology, comorbidities, and diagnosis is still premature. We performed a literature review in Medline/PubMed to identify all the studies proposing a management plan for NES and summarized all the existing data on its diagnosis and treatment. Expert opinion: To date, none of the proposed treatment options for NES have been promising and long-term data on its efficacy is lacking. The slow growth of evidence on this debilitating but underreported condition may be due to unawareness among clinicians, under-reporting by patients, and unrecognized diagnostic criteria. Objective screening of symptoms during office visits especially for patients at a high-risk for NES will identify more patients suffering from the syndrome.
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Affiliation(s)
- Saeed Shoar
- Clinical Research Scientist, ScientificWriting Corporation , Houston , TX , USA
- Faculty of Medicine, Tehran University of Medical Science , Tehran , Iran
| | - Mohammad Naderan
- Faculty of Medicine, Tehran University of Medical Science , Tehran , Iran
| | - Habibollah Mahmoodzadeh
- Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Science , Tehran , Iran
| | - Nasrin Shoar
- Faculty of Medicine, Kashan University of Medical Science , Kashan , Iran
| | - Djamshid Lotfi
- Clinical Research Scientist, ScientificWriting Corporation , Houston , TX , USA
- Faculty of Medicine, Tehran University of Medical Science , Tehran , Iran
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Shoar S, Naini AA, Aleassa EM, Naderan M, Mahmoodzadeh H. Letter to Editor regarding "preoperative liver shrinking diet for bariatric surgery may impact wound healing: A randomized controlled trial". Surg Obes Relat Dis 2019; 15:669-670. [PMID: 31133205 DOI: 10.1016/j.soard.2018.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 10/24/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Saeed Shoar
- Clinical Research Scholar and Scientist, ScientificWriting Corporation Houston, Texas; Imam Khomeini Complex Cancer Institute, Division of Surgical Oncology, Department of Surgery, Tehran University of Medical Science, Tehran, Iran
| | - Ali Alavi Naini
- Clinical Research Scholar and Scientist, ScientificWriting Corporation Houston, Texas
| | - Essa M Aleassa
- Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Mohammad Naderan
- Imam Khomeini Complex Cancer Institute, Division of Surgical Oncology, Department of Surgery, Tehran University of Medical Science, Tehran, Iran
| | - Habibollah Mahmoodzadeh
- Imam Khomeini Complex Cancer Institute, Division of Surgical Oncology, Department of Surgery, Tehran University of Medical Science, Tehran, Iran
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Shoar S, Shoar N, Naderan M, Modukuru VR, Mahmoodzadeh H. Comment on long-term outcomes of metabolic and bariatric surgery in adolescents with severe obesity with a follow-up of at least 5 years: a systematic review. Surg Obes Relat Dis 2019; 15:349-350. [PMID: 31010654 DOI: 10.1016/j.soard.2019.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 01/10/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Saeed Shoar
- Clinical Research Scholar and Scientist, ScientificWriting Corporation, Houston, Texas; Imam Khomeini Complex Cancer Institute, Division of Surgical Oncology, Department of Surgery, Tehran University of Medical Science, Tehran, Iran
| | - Nasrin Shoar
- Department of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Naderan
- Imam Khomeini Complex Cancer Institute, Division of Surgical Oncology, Department of Surgery, Tehran University of Medical Science, Tehran, Iran
| | - Venkat R Modukuru
- Department of Surgery, New York Medical College-Metropolitan Medical Center, Manhattan, New York
| | - Habibollah Mahmoodzadeh
- Imam Khomeini Complex Cancer Institute, Division of Surgical Oncology, Department of Surgery, Tehran University of Medical Science, Tehran, Iran
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Shoar S, Shoar N, Lotfi D. Letter by Shoar et al Regarding Article, "Has Outcome of Subarachnoid Hemorrhage Changed With Improvements in Neurosurgical Services?: Study of 2000 Patients Over 2 Decades From India". Stroke 2019; 50:e112. [PMID: 30879438 DOI: 10.1161/strokeaha.118.024321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Saeed Shoar
- Division of Cardiovascular Research, Department of Medicine, ScientificWriting Corporation, Houston, TX, Faculty of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Nasrin Shoar
- Faculty of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Djamchid Lotfi
- Faculty of Medicine, Tehran University of Medical Science, Tehran, Iran
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Esmaeili S, Alizadeh R, Shoar S, Naderan M, Shoar N. Acupuncture in Preventing Postoperative Anaesthesia-Related Sore Throat: A Comparison with No Acupuncture. Acupunct Med 2018; 31:272-5. [DOI: 10.1136/acupmed-2012-010249] [Citation(s) in RCA: 14] [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] [Indexed: 11/03/2022]
Abstract
Background Postoperative sore throat occurs frequently in surgical patients as a result of tracheal intubation. Despite advances in medical and anaesthetic care, the incidence of postoperative sore throat remains high. Our study aimed to assess the efficacy of acupuncture in the prevention of postoperative sore throat following general anaesthesia. Methods A non-randomised clinical study (NRS) was carried out in a tertiary care hospital in Tehran, Iran on 228 consecutive patients undergoing elective surgeries under general anaesthesia. Of these, 114 patients were assigned to the acupuncture group and treated with body acupuncture at the PC6 point, while the remaining 114 patients received no preventive care and were treated with routine medical treatment where necessary. The incidence of sore throat within the first 24 h postoperatively was then compared between the two study groups. Results Of the 114 patients in the acupuncture group, 16 patients (14%) experienced sore throat within the first 24 h postoperatively, which was significantly lower compared to the 34 patients (29.8%) with sore throat in the medical treatment group (p<0.05). However, the frequency of patients with severe sore throat requiring medical treatment did not differ significantly (12.3% vs 16.7%, p>0.05). Conclusions Our study suggests that acupuncture could be considered as an option in prevention of postoperative anaesthesia-related sore throat.
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Affiliation(s)
- Sara Esmaeili
- Department of Anesthesiology and Intensive Care, AJA University of Medical Sciences, Tehran, Iran
- Development Association of Clinical Studies (DACS), Student Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Alizadeh
- Department of Anesthesiology and Intensive Care, AJA University of Medical Sciences, Tehran, Iran
| | - Saeed Shoar
- Development Association of Clinical Studies (DACS), Student Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
- Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Naderan
- Development Association of Clinical Studies (DACS), Student Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Shoar
- Development Association of Clinical Studies (DACS), Student Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
- Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran
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Shoar S, Naderan M, Hosseini F, Shoar N. Comment on "Transcatheter aortic valve replacement in patients with pure native aortic valve regurgitation: A systematic review and meta-analysis". Clin Cardiol 2018; 42:167-168. [PMID: 30516284 DOI: 10.1002/clc.23127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 11/13/2018] [Indexed: 11/07/2022] Open
Affiliation(s)
- Saeed Shoar
- Clinical Research Scholar and Scientist, ScientificWriting Corporation, Houston, Texas.,Faculty of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Mohammad Naderan
- Faculty of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Fatemeh Hosseini
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nasrin Shoar
- Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
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Shoar S, Naderan M, Shoar N. Letter to the editor on "Suspicious Index in Lyme Carditis (SILC): Systematic review and proposed new risk score". Clin Cardiol 2018; 41:1617-1618. [PMID: 30467884 DOI: 10.1002/clc.23122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 11/09/2018] [Accepted: 11/13/2018] [Indexed: 11/08/2022] Open
Affiliation(s)
- Saeed Shoar
- Clinical Research Scientist and Consultant, ScientificWriting Corp, Houston, Texas.,Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Naderan
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Shoar
- Clinical Research Scientist and Consultant, ScientificWriting Corp, Houston, Texas.,Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
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Shoar S, Naini FA, Athari N, Mahmoodzadeh H. Letter to Editor on "Taste Changes after Bariatric Surgery: a Systematic Review". Obes Surg 2018; 29:309-310. [PMID: 30411225 DOI: 10.1007/s11695-018-3584-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Saeed Shoar
- Clinical Research Scholar and Scientist, ScientificWriting Corporation, Houston, TX, USA. .,Imam Khomeini Complex Cancer Institute, Division of Surgical Oncology, Department of Surgery, Tehran University of Medical Science, Tehran, Iran.
| | | | - Naseem Athari
- Clinical Research Scholar and Scientist, ScientificWriting Corporation, Houston, TX, USA
| | - Habibollah Mahmoodzadeh
- Imam Khomeini Complex Cancer Institute, Division of Surgical Oncology, Department of Surgery, Tehran University of Medical Science, Tehran, Iran
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Shoar S, Wong C, Shoar N, Mahmoodzadeh H. Taste Perception after Bariatric Surgery: A Systematic Review of Alteration Pattern. J Am Coll Surg 2018. [DOI: 10.1016/j.jamcollsurg.2018.08.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Shoar S, Saber AA, Rubenstein R, Safari S, Brethauer SA, Al-Thani H, Asarian AP, Aminian A. Portomesentric and splenic vein thrombosis (PMSVT) after bariatric surgery: a systematic review of 110 patients. Surg Obes Relat Dis 2018; 14:47-59. [DOI: 10.1016/j.soard.2017.09.512] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 09/10/2017] [Accepted: 09/11/2017] [Indexed: 12/14/2022]
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Shoar S, Mahmoodzadeh H, Shoar N, Levine JL. Letter to the editor regarding "weight regain in patients with symptoms of post-bariatric surgery hypoglycemia". Surg Obes Relat Dis 2017; 13:1935-1936. [PMID: 28822707 DOI: 10.1016/j.soard.2017.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 07/08/2017] [Accepted: 07/10/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Saeed Shoar
- Clinical Research Scientist and Consultant, Houston, Texas; Department of Bariatric and Metabolic Surgery, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, Brooklyn, New York
| | - Habibollah Mahmoodzadeh
- Department of Surgery, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Shoar
- Department of Medicine, Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran
| | - Jun L Levine
- Department of Bariatric and Metabolic Surgery, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, Brooklyn, New York
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Shoar S, Ibarra S, Gonzalez A, Geisler DP. Letter to the editor regarding "Colorectal surgery and surgical site infection: is a change of attitude necessary?". Int J Colorectal Dis 2017; 32:1235-1236. [PMID: 28474261 DOI: 10.1007/s00384-017-2828-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/27/2017] [Indexed: 02/04/2023]
Affiliation(s)
- Saeed Shoar
- Division of Colon and Rectal Surgery, Houston Methodist Hospital, 6560 Fannin, Suite 1404, Houston, TX, 77030, USA.
| | - Sergio Ibarra
- Division of Colon and Rectal Surgery, Houston Methodist Hospital, 6560 Fannin, Suite 1404, Houston, TX, 77030, USA
| | - Alberto Gonzalez
- Division of Colon and Rectal Surgery, Houston Methodist Hospital, 6560 Fannin, Suite 1404, Houston, TX, 77030, USA
| | - Daniel P Geisler
- Division of Colon and Rectal Surgery, Houston Methodist Hospital, 6560 Fannin, Suite 1404, Houston, TX, 77030, USA
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