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Mohanty S, Tsai JH, Ning N, Martinez A, Verma RP, Heisen M, Weaver J, Feemster KA, Chun B, Weiss TW, Schmier JK. Understanding healthcare providers' preferred attributes of pediatric pneumococcal conjugate vaccines in the United States. Hum Vaccin Immunother 2024; 20:2325745. [PMID: 38566496 PMCID: PMC10993915 DOI: 10.1080/21645515.2024.2325745] [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: 10/10/2023] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
As higher-valent pneumococcal conjugate vaccines (PCVs) become available for pediatric populations in the US, it is important to understand healthcare provider (HCP) preferences for and acceptability of PCVs. US HCPs (pediatricians, family medicine physicians and advanced practitioners) completed an online, cross-sectional survey between March and April 2023. HCPs were eligible if they recommended or prescribed vaccines to children age <24 months, spent ≥25% of their time in direct patient care, and had ≥2 y of experience in their profession. The survey included a discrete choice experiment (DCE) in which HCPs selected preferred options from different hypothetical vaccine profiles with systematic variation in the levels of five attributes. Relative attribute importance was quantified. Among 548 HCP respondents, the median age was 43.2 y, and the majority were male (57.9%) and practiced in urban areas (69.7%). DCE results showed that attributes with the greatest impact on HCP decision-making were 1) immune response for the shared serotypes covered by PCV13 (31.4%), 2) percent of invasive pneumococcal disease (IPD) covered by vaccine serotypes (21.3%), 3) acute otitis media (AOM) label indication (20.3%), 4) effectiveness against serotype 3 (17.6%), and 5) number of serotypes in the vaccine (9.5%). Among US HCPs, the most important attribute of PCVs was comparability of immune response for PCV13 shared serotypes, while the number of serotypes was least important. Findings suggest new PCVs eliciting high immune responses for serotypes that contribute substantially to IPD burden and maintaining immunogenicity against serotypes in existing PCVs are preferred by HCPs.
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Affiliation(s)
- Salini Mohanty
- Merck Research Laboratories, Merck & Co. Inc, Rahway, NJ, USA
| | - Jui-Hua Tsai
- Evidence & Access, OPEN Health, Bethesda, MD, USA
| | - Ning Ning
- Evidence & Access, OPEN Health, Newton, MA, USA
| | - Ana Martinez
- Evidence & Access, OPEN Health, Bethesda, MD, USA
| | | | - Marieke Heisen
- Evidence & Access, OPEN Health, Rotterdam, The Netherlands
| | - Jessica Weaver
- Merck Research Laboratories, Merck & Co. Inc, Rahway, NJ, USA
| | | | - Bianca Chun
- Merck Research Laboratories, Merck & Co. Inc, Rahway, NJ, USA
| | - Thomas W. Weiss
- Merck Research Laboratories, Merck & Co. Inc, Rahway, NJ, USA
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Mohanty S, Done N, Liu Q, Song Y, Wang T, Gaburo K, Sarpong EM, White M, Weaver JP, Signorovitch J, Weiss T. Incidence of pneumococcal disease in children ≤48 months old in the United States: 1998-2019. Vaccine 2024; 42:2758-2769. [PMID: 38485640 DOI: 10.1016/j.vaccine.2024.03.013] [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: 11/09/2023] [Revised: 02/12/2024] [Accepted: 03/05/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Pneumococcal disease (PD) is a major cause of morbidity and mortality among children, particularly in the youngest age groups. This study aimed to assess the incidence of PD over time by age group in young children with commercial or Medicaid coverage in the US. METHODS Episodes of invasive pneumococcal disease (IPD), all-cause pneumonia (ACP), and acute otitis media (AOM) were identified in the MarketScan® Commercial and Medicaid claims databases using diagnosis codes among children aged ≤ 48 months with confirmed date of birth (DoB), at any time during the study period (1998-2019). DoB was assigned using diagnosis codes for birth or delivery using the child's or mother's medical claims to ensure accurate age determination. Annual incidence rates (IRs) were calculated as number of disease episodes/100,000 person-years (PY) for IPD and ACP and episodes/1,000 PY for AOM, for children aged 0-6, 7-12, 12-24, and 25-48 months. RESULTS Annual IPD IRs declined from 53 to 7 episodes/100,000 PY between 1998 and 2019 in commercially-insured and 58 to 9 episodes/100,000 PY between 2001 and 2019 in Medicaid-insured children. Annual ACP IRs declined from 5,600 to 3,952 episodes/100,000 PY, and from 6,706 to 4,521 episodes/100,000 PY, respectively, over these periods. In both populations, children aged 0-6 months had the highest incidence of IPD and inpatient ACP. Annual AOM IRs declined from 1,177 to 738 episodes/1,000 PY (commercially-insured) and 633 to 624 episodes/1,000 PY (Medicaid-insured), over these periods. IRs were higher in rural vs. urban areas for all disease manifestations. CONCLUSIONS Incidence rates of IPD, ACP, and AOM decreased in children with commercial insurance and Medicaid coverage from 1998 to 2019. However, burden of disease remained substantial, with higher annual IRs for IPD and ACP for Medicaid-insured vs. commercially-insured children. IPD and inpatient ACP were most common in the youngest children 0-6 months old, followed by the 7-12-month age group.
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Affiliation(s)
- Salini Mohanty
- Merck & Co., Inc., 126 East Lincoln Ave., Rahway, NJ 07065, USA.
| | - Nicolae Done
- Analysis Group, Inc., 111 Huntington Avenue, Boston, MA 02199, USA
| | - Qing Liu
- Analysis Group, Inc., 111 Huntington Avenue, Boston, MA 02199, USA
| | - Yan Song
- Analysis Group, Inc., 111 Huntington Avenue, Boston, MA 02199, USA
| | - Travis Wang
- Analysis Group, Inc., 111 Huntington Avenue, Boston, MA 02199, USA
| | - Katherine Gaburo
- Analysis Group, Inc., 111 Huntington Avenue, Boston, MA 02199, USA
| | - Eric M Sarpong
- Merck & Co., Inc., 126 East Lincoln Ave., Rahway, NJ 07065, USA
| | - Meghan White
- Merck & Co., Inc., 126 East Lincoln Ave., Rahway, NJ 07065, USA
| | | | | | - Thomas Weiss
- Merck & Co., Inc., 126 East Lincoln Ave., Rahway, NJ 07065, USA
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Mohanty S, Cossrow N, Yu KC, Ye G, White M, Gupta V. Clinical and economic burden of invasive pneumococcal disease and non-invasive all-cause pneumonia in hospitalized US adults: A multicenter analysis from 2015-2020. Int J Infect Dis 2024:107023. [PMID: 38555060 DOI: 10.1016/j.ijid.2024.107023] [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: 11/21/2023] [Revised: 02/12/2024] [Accepted: 03/23/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVES To evaluate the clinical and economic outcomes in adults hospitalized with invasive pneumococcal disease (IPD) and non-invasive all-cause pneumonia (ACP) overall and by antimicrobial resistance (AMR) status. METHODS Hospitalized adults from the BD Insights Research Database with an ICD10 code for IPD, non-invasive ACP or a positive Streptococcus pneumoniae culture/urine antigen test were included. Descriptive statistics and multivariable analyses were used to evaluate outcomes (in-hospital mortality, length of stay [LOS], cost per admission, and hospital margin [costs - payments]). RESULTS The study included 88,182 adult patients at 90 US hospitals (October 2015-February 2020). Most (98.6%) had non-invasive ACP and 40.2% were <65 years old. Of 1,450 culture-positive patients, 37.7% had an isolate resistant to ≥1 antibiotic class. Observed mortality, median LOS, cost per admission, and hospital margins were 8.3%, 6 days, $9,791, and $11, respectively. Risk factors for mortality included ≥50 years of age, higher risk of pneumococcal disease (based on chronic or immunocompromising conditions), and intensive care unit admission. Patients with IPD had similar mortality rates and hospital margins compared with non-invasive ACP, but greater costs per admission and LOS. CONCLUSION IPD and non-invasive ACP are associated with substantial clinical and economic burden across all adult age groups. Expanded pneumococcal vaccination programs may help reduce disease burden and decrease hospital costs.
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Affiliation(s)
| | | | - Kalvin C Yu
- Becton, Dickinson & Company, Franklin Lakes, NJ, USA
| | - Gang Ye
- Becton, Dickinson & Company, Franklin Lakes, NJ, USA
| | | | - Vikas Gupta
- Becton, Dickinson & Company, Franklin Lakes, NJ, USA
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Ghosh Laskar S, Sinha S, Kumar A, Samanta A, Mohanty S, Kale S, Khan F, Lewis Salins S, Murthy V. Reducing Salivary Toxicity with Adaptive Radiotherapy (ReSTART): A Randomized Controlled Trial Comparing Conventional IMRT to Adaptive IMRT in Head and Neck Squamous Cell Carcinomas. Clin Oncol (R Coll Radiol) 2024:S0936-6555(24)00112-2. [PMID: 38575432 DOI: 10.1016/j.clon.2024.03.015] [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: 12/16/2023] [Revised: 02/14/2024] [Accepted: 03/13/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND The utility of Adaptive Radiotherapy (ART) in Head and Neck Squamous Cell Carcinoma (HNSCC) remains to be ascertained. While multiple retrospective and single-arm prospective studies have demonstrated its efficacy in decreasing parotid doses and reducing xerostomia, adequate randomized evidence is lacking. METHODS AND ANALYSIS ReSTART (Reducing Salivary Toxicity with Adaptive Radiotherapy) is an ongoing phase III randomized trial of patients with previously untreated, locally advanced HNSCC of the oropharynx, larynx, and hypopharynx. Patients are randomized in a 1:1 ratio to the standard Intensity Modulated Radiotherapy (IMRT) arm {Planning Target Volume (PTV) margin 5 mm} vs. Adaptive Radiotherapy arm (standard IMRT with a PTV margin 3 mm, two planned adaptive planning at 10th and 20th fractions). The stratification factors include the primary site and nodal stage. The RT dose prescribed is 66Gy in 30 fractions for high-risk PTV and 54Gy in 30 fractions for low-risk PTV over six weeks, along with concurrent chemotherapy. The primary endpoint is to compare salivary toxicity between arms using salivary scintigraphy 12 months' post-radiation. To detect a 25% improvement in the primary endpoint at 12 months in the ART arm with a two-sided 5% alpha value and a power of 80% (and 10% attrition ratio), a sample size of 130 patients is required (65 patients in each arm). The secondary endpoints include acute and late toxicities, locoregional control, disease-free survival, overall survival, quality of life, and xerostomia scores between the two arms. DISCUSSION The ReSTART trial aims to answer an important question in Radiation Therapy for HNSCC, particularly in a resource-limited setting. The uniqueness of this trial, compared to other ongoing randomized trials, includes the PTV margins and the xerostomia assessment by scintigraphy at 12 months as the primary endpoint.
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Affiliation(s)
- S Ghosh Laskar
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
| | - S Sinha
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
| | - A Kumar
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
| | - A Samanta
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
| | - S Mohanty
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
| | - S Kale
- Department of Medical Physics, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
| | - F Khan
- Clinical Research Secretariat (CRS), Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
| | - S Lewis Salins
- Department of Radiation Oncology, Kasturba Medical College, Manipal, India.
| | - V Murthy
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
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Mohanty S, Johansson Kostenniemi U, Silfverdal SA, Salomonsson S, Iovino F, Sarpong EM, Bencina G, Bruze G. Increased Risk of Long-Term Disabilities Following Childhood Bacterial Meningitis in Sweden. JAMA Netw Open 2024; 7:e2352402. [PMID: 38241045 PMCID: PMC10799263 DOI: 10.1001/jamanetworkopen.2023.52402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/30/2023] [Indexed: 01/22/2024] Open
Abstract
Importance Few studies have examined the incidence of long-term disabilities due to bacterial meningitis in childhood with extended follow-up time and a nationwide cohort. Objective To describe the long-term risks of disabilities following a childhood diagnosis of bacterial meningitis in Sweden. Design, Setting, and Participants This nationwide retrospective registry-based cohort study included individuals diagnosed with bacterial meningitis (younger than 18 years) and general population controls matched (1:9) by age, sex, and place of residence. Data were retrieved from the Swedish National Patient Register from January 1, 1987, to December 31, 2021. Data were analyzed from July 13, 2022, to November 30, 2023. Exposure A diagnosis of bacterial meningitis in childhood recorded in the National Patient Register between 1987 and 2021. Main Outcomes and Measures Cumulative incidence of 7 disabilities (cognitive disabilities, seizures, hearing loss, motor function disorders, visual disturbances, behavioral and emotional disorders, and intracranial structural injuries) after bacterial meningitis in childhood. Results The cohort included 3623 individuals diagnosed with bacterial meningitis during childhood and 32 607 controls from the general population (median age at diagnosis, 1.5 [IQR, 0.4-6.2] years; 44.2% female and 55.8% male, median follow-up time, 23.7 [IQR, 12.2-30.4] years). Individuals diagnosed with bacterial meningitis had higher cumulative incidence of all 7 disabilities, and 1052 (29.0%) had at least 1 disability. The highest absolute risk of disabilities was found for behavioral and emotional disorders, hearing loss, and visual disturbances. The estimated adjusted hazard ratios (HRs) showed a significant increased relative risk for cases compared with controls for all 7 disabilities, with the largest adjusted HRs for intracranial structural injuries (26.04 [95% CI, 15.50-43.74]), hearing loss (7.90 [95% CI, 6.68-9.33]), and motor function disorders (4.65 [95% CI, 3.72-5.80]). The adjusted HRs for cognitive disabilities, seizures, hearing loss, and motor function disorders were significantly higher for Streptococcus pneumoniae infection (eg, 7.89 [95% CI, 5.18-12.02] for seizure) compared with Haemophilus influenzae infection (2.46 [95% CI, 1.63-3.70]) or Neisseria meningitidis infection (1.38 [95% CI, 0.65-2.93]). The adjusted HRs for cognitive disabilities, seizures, behavioral and emotional disorders, and intracranial structural injuries were significantly higher for children diagnosed with bacterial meningitis at an age below the median. Conclusions and Relevance The findings of this cohort study of individuals diagnosed with bacterial meningitis during childhood suggest that exposed individuals may have had an increased risk for long-term disabilities (particularly when diagnosed with pneumococcal meningitis or when diagnosed at a young age), highlighting the need to detect disabilities among surviving children.
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Affiliation(s)
- Salini Mohanty
- Center for Observational and Real-World Evidence (CORE), Merck & Co Inc, Rahway, New Jersey
| | | | | | | | - Federico Iovino
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Eric M. Sarpong
- Real-World Data Analytics and Innovation, Merck & Co Inc, Rahway, New Jersey
| | | | - Gustaf Bruze
- Division of Clinical Epidemiology, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
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Sahoo S, Rathod W, Vardikar H, Biswal M, Mohanty S, Nayak SK. Biomedical waste plastic: bacteria, disinfection and recycling technologies-a comprehensive review. Int J Environ Sci Technol (Tehran) 2023:1-18. [PMID: 37360566 PMCID: PMC10189688 DOI: 10.1007/s13762-023-04975-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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/27/2023] [Accepted: 04/25/2023] [Indexed: 06/28/2023]
Abstract
Plastic recycling reduces the wastage of potentially useful materials as well as the consumption of virgin materials, thereby lowering the energy consumption, air pollution by incineration, soil and water pollution by landfilling. Plastics used in the biomedical sector have played a significant role. Reducing the transmission of the virus while protecting the human life in particular the frontline workers. Enormous volumes of plastics in biomedical waste have been observed during the outbreak of the pandemic COVID-19. This has resulted from the extensive use of personal protective equipment such as masks, gloves, face shields, bottles, sanitizers, gowns, and other medical plastics which has created challenges to the existing waste management system in the developing countries. The current review focuses on the biomedical waste and its classification, disinfection, and recycling technology of different types of plastics waste generated in the sector and their corresponding approaches toward end-of-life option and value addition. This review provides a broader overview of the process to reduce the volume of plastics from biomedical waste directly entering the landfill while providing a knowledge step toward the conversion of "waste" to "wealth." An average of 25% of the recyclable plastics are present in biomedical waste. All the processes discussed in this article accounts for cleaner techniques and a sustainable approach to the treatment of biomedical waste. Graphical abstract
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Affiliation(s)
- S. Sahoo
- Laboratory for Advanced Research in Polymeric Materials, Central Institute of Petrochemical Engineering and Technology, Bhubaneswar, Odisha 751024 India
- Ravenshaw University, Cuttack, Odisha 753003 India
| | - W. Rathod
- Laboratory for Advanced Research in Polymeric Materials, Central Institute of Petrochemical Engineering and Technology, Bhubaneswar, Odisha 751024 India
| | - H. Vardikar
- Laboratory for Advanced Research in Polymeric Materials, Central Institute of Petrochemical Engineering and Technology, Bhubaneswar, Odisha 751024 India
| | - M. Biswal
- Laboratory for Advanced Research in Polymeric Materials, Central Institute of Petrochemical Engineering and Technology, Bhubaneswar, Odisha 751024 India
| | - S. Mohanty
- Laboratory for Advanced Research in Polymeric Materials, Central Institute of Petrochemical Engineering and Technology, Bhubaneswar, Odisha 751024 India
| | - S. K. Nayak
- Ravenshaw University, Cuttack, Odisha 753003 India
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Hu T, Song Y, Done N, Mohanty S, Liu Q, Sarpong EM, Lemus-Wirtz E, Signorovitch J, Weiss T. Economic burden of acute otitis media, pneumonia, and invasive pneumococcal disease in children in the United States after the introduction of 13-valent pneumococcal conjugate vaccines during 2014-2018. BMC Health Serv Res 2023; 23:398. [PMID: 37098521 PMCID: PMC10127426 DOI: 10.1186/s12913-023-09244-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 03/06/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Streptococcus pneumoniae remains a leading cause of morbidity, mortality, and healthcare resource utilization (HRU) among children. This study quantified HRU and cost of acute otitis media (AOM), pneumonia, and invasive pneumococcal disease (IPD). METHODS The IBM MarketScan® Commercial Claims and Encounters and Multi-State Medicaid databases from 2014 to 2018 were analyzed. Children with AOM, all-cause pneumonia, or IPD episodes were identified using diagnosis codes in inpatient and outpatient claims. HRU and costs were described for each condition in the commercial and Medicaid-insured populations. National estimates of the number of episodes and total cost ($US 2019 for each condition were extrapolated using data from the US Census Bureau. RESULTS Approximately 6.2 and 5.6 million AOM episodes were identified in commercial and Medicaid-insured children, respectively, during the study period. Mean cost per AOM episode was $329 (SD $1505) for commercial and $184 (SD $1524) for Medicaid-insured children. A total of 619,876 and 531,095 all-cause pneumonia cases were identified among commercial and Medicaid-insured children, respectively. Mean cost per all-cause pneumonia episode was $2304 (SD $32,309) in the commercial and $1682 (SD $19,282) in the Medicaid-insured population. A total of 858 and 1130 IPD episodes were identified among commercial and Medicaid-insured children, respectively. Mean cost per IPD episode was $53,213 (SD $159,904) for commercial and $23,482 (SD $86,209) for the Medicaid-insured population. Nationally, there were over 15.8 million cases of AOM annually, with total estimated cost of $4.3 billion, over 1.5 million cases of pneumonia annually, with total cost of $3.6 billion, and about 2200 IPD episodes annually, for a cost of $98 million. CONCLUSIONS The economic burden of AOM, pneumonia, and IPD among US children remains substantial. IPD and its manifestations were associated with higher HRU and costs per episode, compared to AOM and all-cause pneumonia. However, owing to their higher frequencies, AOM and all-cause pneumonia were the main contributors to the economic burden of pneumococcal disease nationally. Additional interventions, such as the development of pneumococcal conjugate vaccinees with sustained protection of existing vaccine type serotypes as well as broader inclusion of additional serotypes, are necessary to further reduce the burden of disease caused by these manifestations.
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Affiliation(s)
- Tianyan Hu
- Merck & Co., Inc, 126 East Lincoln Ave, P.O. Box 2000, Rahway, NJ, 07065, USA
| | - Yan Song
- Analysis Group, Inc, Boston, MA, USA
| | | | - Salini Mohanty
- Merck & Co., Inc, 126 East Lincoln Ave, P.O. Box 2000, Rahway, NJ, 07065, USA.
| | - Qing Liu
- Analysis Group, Inc, Boston, MA, USA
| | - Eric M Sarpong
- Merck & Co., Inc, 126 East Lincoln Ave, P.O. Box 2000, Rahway, NJ, 07065, USA
| | | | | | - Thomas Weiss
- Merck & Co., Inc, 126 East Lincoln Ave, P.O. Box 2000, Rahway, NJ, 07065, USA
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Hu T, Sarpong EM, Song Y, Done N, Liu Q, Lemus-Wirtz E, Signorovitch J, Mohanty S, Weiss T. Incidence of non-invasive all-cause pneumonia in children in the United States before and after the introduction of pneumococcal conjugate vaccines: a retrospective claims database analysis. Pneumonia (Nathan) 2023; 15:8. [PMID: 37016411 PMCID: PMC10074783 DOI: 10.1186/s41479-023-00109-5] [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: 10/06/2022] [Accepted: 01/25/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Pneumonia is the most serious form of acute respiratory infection and Streptococcus pneumoniae is a leading cause of pediatric bacterial pneumonia. Pneumococcal conjugate vaccines were introduced in the United States (US) in 2000 (7-valent [PCV7]) and 2010 (13-valent [PCV13]). This study estimated annual incidence rates (IRs) of all-cause pneumonia (ACP) among US children aged < 18 years before and after the introduction of PCV7 and PCV13. METHODS ACP episodes were identified in the IBM MarketScan Commercial and Medicaid Databases using diagnosis codes. Annual IRs were calculated overall and by inpatient and outpatient settings as the number of episodes per 100,000 person-years (PY) for all children aged < 18 years and by age group (< 2, 2-4, and 5-17 years). National estimates of annual pneumonia IRs were extrapolated using Census Bureau data. Interrupted time series (ITS) analyses were used to assess immediate and gradual changes in monthly pneumonia IRs, adjusting for seasonality. RESULTS In the commercially-insured population, ACP IRs declined between the pre-PCV7 period (1998-1999) and late PCV13 period (2014-2018) from 5,322 to 3,471 episodes per 100,000 PY for children aged < 2 years, from 4,012 to 3,794 episodes per 100,000 PY in children aged 2-4 years but increased slightly from 1,383 to 1,475 episodes per 100,000 PY in children aged 5-17 years. The ITS analyses indicated significant decreases in monthly ACP IRs in the early PCV7 period (2001-2005) among younger children and in the early PCV13 period (2011-2013) among all children. Increases were observed in the late PCV7 period (2006-2009) among all age groups, but were only significant among older children. IRs of inpatient ACP decreased across all age groups, but outpatient pneumonia IRs remained stable during the study timeframe, even increasing slightly in children aged 5-17 years. More prominent declines were observed for Medicaid-insured children across all age groups; however, Medicaid IRs were higher than IRs of commercially-insured children during the entire study timeframe. CONCLUSIONS ACP disease burden remains high in US children of all ages despite overall reductions in incidence rates during 1998-2018 following the introduction of PCV7 and PCV13.
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Affiliation(s)
- Tianyan Hu
- Merck & Co., Inc., 126 East Lincoln Ave., Rahway, NJ, 07065, USA
| | - Eric M Sarpong
- Merck & Co., Inc., 126 East Lincoln Ave., Rahway, NJ, 07065, USA
| | - Yan Song
- Analysis Group, Inc., 111 Huntington Ave, Floor 14, Boston, MA, 02199, USA
| | - Nicolae Done
- Analysis Group, Inc., 111 Huntington Ave, Floor 14, Boston, MA, 02199, USA
| | - Qing Liu
- Analysis Group, Inc., 111 Huntington Ave, Floor 14, Boston, MA, 02199, USA
| | | | - James Signorovitch
- Analysis Group, Inc., 111 Huntington Ave, Floor 14, Boston, MA, 02199, USA
| | - Salini Mohanty
- Merck & Co., Inc., 126 East Lincoln Ave., Rahway, NJ, 07065, USA.
| | - Thomas Weiss
- Merck & Co., Inc., 126 East Lincoln Ave., Rahway, NJ, 07065, USA
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Mohanty S, Feemster K, Yu KC, Watts JA, Gupta V. Trends in Streptococcus pneumoniae Antimicrobial Resistance in US Children: A Multicenter Evaluation. Open Forum Infect Dis 2023; 10:ofad098. [PMID: 36968964 PMCID: PMC10034583 DOI: 10.1093/ofid/ofad098] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Indexed: 03/09/2023] Open
Abstract
Abstract
Background
Antimicrobial resistance (AMR) poses a significant challenge for treating pneumococcal disease. This study assessed AMR trends in Streptococcus pneumoniae from US children.
Methods
We evaluated antibiotic resistance, defined as facility antimicrobial susceptibility reports of intermediate/resistant, in 30-day non-duplicate S. pneumoniae isolates from children (<18 years) with invasive (blood or cerebrospinal fluid/neurological) or non-invasive (respiratory or ear/nose/throat) isolates at 219 US hospital inpatient/outpatient settings in the BD Insights Research Database (January 2011-February 2020). We used descriptive statistics to characterize the percentage of AMR isolates and generalized estimated equations to assess variations in resistance over time.
Results
Of 7,605 S. pneumoniae isolates analyzed, 6,641 (87.3%) were from non-invasive sources. Resistance rates were higher in non-invasive versus invasive isolates. Isolates showed high observed rates of resistance to ≥1 drug class (56.8%), ≥2 drug classes (30.7%), macrolides (39.9%), and penicillin (39.6%) and significant annual increases in resistance to ≥1 drug class (+0.9%), ≥2 drug classes (+1.8%), and macrolides (+5.0%).
Conclusions
Among US children over the last decade, S. pneumoniae isolates showed persistently high rates of resistance to antibiotics and significant increases in ≥1 drug class, ≥2 drug classes, and macrolide resistance rates. Efforts to address AMR in S. pneumoniae may require vaccines targeting resistant serotypes and antimicrobial stewardship efforts.
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Affiliation(s)
| | | | - Kalvin C Yu
- Becton, Dickinson & Company , Franklin Lakes, NJ , USA
| | - Janet A Watts
- Becton, Dickinson & Company , Franklin Lakes, NJ , USA
| | - Vikas Gupta
- Becton, Dickinson & Company , Franklin Lakes, NJ , USA
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Scheltes D, Mohanty S, Smits G, van der Steen-Banasik E, Murthy V, Hoskin P. Function Preservation With Brachytherapy: Reviving the Art. Improving Quality of Life With Brachytherapy for Urological Malignancies. Clin Oncol (R Coll Radiol) 2023:S0936-6555(23)00022-5. [PMID: 36764876 DOI: 10.1016/j.clon.2023.01.017] [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: 10/24/2022] [Revised: 12/29/2022] [Accepted: 01/23/2023] [Indexed: 02/03/2023]
Abstract
Brachytherapy for localised prostate, muscle-invasive bladder and penile cancer is well established, providing high tumour dose delivery and minimising normal tissue doses compared with external beam techniques. In prostate cancer, the main impact on quality of life relates to diminished sexual function and irritative or obstructive urinary symptoms, which are seen up to 15 years after treatment. Significant changes in bowel function are rare. Compared with radical prostatectomy or external beam radiotherapy, irritative or obstructive urinary symptoms are more prominent, whereas incontinence is less than after radical prostatectomy and bowel changes are less than after external beam radiotherapy. For muscle-invasive bladder cancer, when compared with radical cystectomy, although no difference is seen for urinary symptoms or fatigue, role and social functioning scores are higher and there is better post-treatment sexual function in both men and women. Compared with surgical treatment for penile cancer, brachytherapy results in better erectile function scores than after glansectomy and partial penectomy and high quality of life scores, with good satisfaction ratings for cosmetic appearance.
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Affiliation(s)
- D Scheltes
- Radiotherapy Group, Location Arnhem, Arnhem, the Netherlands
| | - S Mohanty
- Department of Radiation Oncology, ACTREC, Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, India
| | - G Smits
- Rijnstate Hospital, Arnhem, the Netherlands
| | | | - V Murthy
- Department of Radiation Oncology, ACTREC, Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, India
| | - P Hoskin
- Mount Vernon Cancer Centre, Northwood, UK; Division of Cancer Sciences, University of Manchester, Manchester, UK.
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Mohanty S, Podmore B, Cuñado Moral A, Weiss T, Matthews I, Sarpong E, Méndez I, Qizilbash N. Incidence of acute otitis media from 2003 to 2019 in children ≤ 17 years in England. BMC Public Health 2023; 23:201. [PMID: 36717794 PMCID: PMC9885604 DOI: 10.1186/s12889-023-14982-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/03/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in 2006 and the 13-valent pneumococcal conjugate vaccine (PCV13) in 2010 in the UK. PCVs are active immunization for the prevention of invasive disease, pneumonia and acute otitis media (AOM) caused by Streptococcus pneumoniae in children. The aim of this observational study was to estimate incidence rates (IRs) of AOM in children ≤17 years from 2003 to 2019 in England, before and after the introduction of pneumococcal conjugate vaccines (PCVs). METHODS AOM episodes were identified using Read diagnosis codes in children aged ≤17 years in the Clinical Practice Research Datalink (CPRD) Gold database from 2003 to 2019. Annual IRs with 95% confidence intervals (CI) by age group were calculated as the number of episodes/person-years (PY) at risk. Interrupted time series analyses were conducted to estimate incidence rate ratios (IRR) across post-PCV7 (2007-2009), early post-PCV13 (2011-2014) and late post-PCV13 (2015-2019) periods compared to the pre-PCV7 period (2003-2005) using generalized linear models. RESULTS From 2003 to 2019, 274,008 all-cause AOM episodes were identified in 1,500,686 children. The overall AOM IR was 3690.9 (95% CI 3677.1-3704.8) per 100,000 PY. AOM IRs were highest in children aged < 5 years and decreased by age; < 2 years: 8286.7 (95% CI 8216.8-8357.1); 2-4 years: 7951.8 (95% CI 7902.5-8001.4); 5-17 years: 2184.4 (95% CI 2172.1-2196.8) (per 100,000 PY). Overall AOM IRs declined by 40.3% between the pre-PCV7 period and the late-PCV13 period from 4451.9 (95% CI 4418.1-4485.9) to 2658.5 (95% CI 2628.6-2688.7) per 100,000 PY, and across all age groups. IRRs indicated a significant decrease in AOM IRs in all the post-vaccination periods, compared to the pre-PCV7 period: post-PCV7 0.87 (95% CI 0.85-0.89), early post-PCV13 0.88 (95% CI 0.86-0.91), and late post-PCV13 0.75 (95% CI 0.73-0.78). CONCLUSIONS The AOM IRs declined during the 2003-2019 period; however, the clinical burden of AOM remains substantial among children ≤17 years in England.
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Affiliation(s)
- Salini Mohanty
- Merck & Co., Inc, Center for Observational and Real-World Evidence (CORE), Rahway, NJ, USA.
| | - Bélène Podmore
- OXON Epidemiology Ltd, Epidemiology & Statistics, Madrid, Spain
| | | | - Thomas Weiss
- grid.417993.10000 0001 2260 0793Merck & Co., Inc, Center for Observational and Real-World Evidence (CORE), Rahway, NJ USA
| | - Ian Matthews
- grid.419737.f0000 0004 6047 9949MSD (UK) Ltd, Value, Access and Devolved nations (VAD), London, UK
| | - Eric Sarpong
- grid.417993.10000 0001 2260 0793Merck & Co., Inc., Real-world Data Analytics and Innovation (RDAI), Rahway, NJ USA
| | - Ignacio Méndez
- OXON Epidemiology Ltd, Epidemiology & Statistics, Madrid, Spain
| | - Nawab Qizilbash
- OXON Epidemiology Ltd, Epidemiology & Statistics, Madrid, Spain
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Mohanty S, Podmore B, Cuñado Moral A, Matthews I, Sarpong E, Lacetera A, Qizilbash N. Incidence of pneumococcal disease from 2003 to 2019 in children ≤17 years in England. Pneumonia (Nathan) 2023; 15:2. [PMID: 36683061 PMCID: PMC9868000 DOI: 10.1186/s41479-022-00103-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/15/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Pneumococcal disease is a leading cause of communicable disease morbidity and mortality globally. We aimed to estimate invasive pneumococcal disease (IPD), pneumococcal pneumonia (PP) and all-cause pneumonia (ACP) incidence rates (IRs) in children aged 0-17 years in England from 2003 to 2019. METHODS A retrospective study in children ≤17 years old from 2003 to 2019 using the Clinical Practice Research Datalink (CPRD) Gold and Hospital Episodes Statistics Admitted Patient Care (HES APC) databases. IPD episodes were identified in hospital records (HES APC). PP (caused by Streptococcus pneumoniae only) and ACP episodes (caused by any pathogen) were identified in primary care (CPRD) and in hospital records (HES APC). Annual IRs by age-group were calculated as the number of episodes/person-years (PY) at risk, with 95% confidence intervals (95% CI). Interrupted time series analyses were conducted to assess changes in IRs across the post-PCV7 (2007-2009), early post-PCV13 (2011-2014) and late post-PCV13 (2015-2019) periods compared to the pre-PCV7 period (2003-2005) using generalized linear models. RESULTS 170 IPD episodes, 769 PP episodes and 12,142 ACP episodes were identified in 1,500,686 children in 2003-2019. The overall IPD, PP and ACP IRs (per 100,000 PY) were 2.29 (95% CI 1.96-2.66), 10.34 (95% CI 9.62-11.10) and 163.37 (95% CI 160.47-166.30), respectively. The highest IPD, PP and ACP IRs were observed in children aged < 2 years compared to older children (2-4 and 5-17 years). IPD IRs decreased between the pre-PCV7 period and the late post-PCV13 period from 3.28 (95% CI 2.42-4.33) to 1.41 (95% CI 0.80-2.29), IRR 0.28 (95% CI 0.09-0.90), p-value 0.033. PP IRs declined between the pre-PCV7 period and the late post-PCV13 period from 14.65 (95% CI 12.77-16.72) to 3.87 (95% CI 2.81-5.20), IRR 0.19 (95% CI 0.09-0.38), p-value < 0.001. ACP IRs declined between the pre-PCV7 period and the late post-PCV13 period from 167.28 (95% CI 160.78-173.96) to 124.96 (95% CI 118.54-131.63), IRR 0.77 (95% CI 0.66-0.88), p-value < 0.001. CONCLUSIONS The clinical burden of IPD, PP and ACP declined in children in England aged 0-17 years between 2003 and 2019, especially in the late post-PCV13 period. This study highlights the importance of PCV vaccination in reducing the burden of PD and ACP in children in England.
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Affiliation(s)
- Salini Mohanty
- grid.417993.10000 0001 2260 0793Merck & Co., Inc, Center for Observational and Real-World Evidence (CORE), Rahway, NJ USA
| | - Bélène Podmore
- OXON Epidemiology Ltd, Epidemiology & Statistics, Madrid, Spain
| | | | - Ian Matthews
- grid.419737.f0000 0004 6047 9949MSD (UK) Ltd, Value, Access and Devolved nations (VAD), London, UK
| | - Eric Sarpong
- grid.417993.10000 0001 2260 0793Merck & Co., Inc., Real-world Data Analytics and Innovation (RDAI), Rahway, NJ USA
| | | | - Nawab Qizilbash
- OXON Epidemiology Ltd, Epidemiology & Statistics, Madrid, Spain
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Mohanty S, Podmore B, Cuñado Moral A, Matthews I, Sarpong E, Azpeitia A, Qizilbash N. Healthcare resource utilisation and cost of pneumococcal disease from 2003 to 2019 in children ≤17 years in England. PLoS One 2023; 18:e0283084. [PMID: 37018218 PMCID: PMC10075442 DOI: 10.1371/journal.pone.0283084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 03/02/2023] [Indexed: 04/06/2023] Open
Abstract
OBJECTIVE To estimate healthcare resource utilisation (HCRU) and costs associated with pneumococcal disease (PD) in children aged ≤17 years in England from 2003-2019. METHODS A retrospective study in children aged ≤17 years was conducted using the Clinical Practice Research Datalink Gold primary care database and Hospital Episodes Statistics Admitted Patient Care database from 2003-2019. Episodes of invasive pneumococcal disease (IPD) were identified in hospital, pneumococcal pneumonia (PP) and all-cause pneumonia (ACP) episodes in primary care and in hospital, and acute otitis media (AOM) episodes in primary care. General practitioner (GP) visits and inpatient admission yearly rates were calculated per 1,000 persons. The average inpatient and primary care cost per episode were calculated. The Mann-Kendall test was used to assess monotonic time trends. RESULTS 1,500,686 children were followed from 2003-2019. The highest average inpatient cost per episode [£34,255 (95%CI 27,222-41,288)] was in IPD, followed by ACP [£3,549 (95%CI 3,405-3,693)] and PP [£1,498 (95%CI 1,153-1,843)]. The highest primary care costs per episode were in AOM [£48.7 (95%CI 48.7-48.7)], followed by PP [£38.4 (95%CI 37.0-39.7)] and ACP [£28.6 (95%CI 28.2-29.1)]. The highest inpatient admission and GP visits yearly rates were observed in children aged <2 years. Across years, a significant decrease in GP visits yearly rates was observed for PP, ACP and AOM in children overall (p-value<0.001). A decrease in primary care costs was observed for ACP (p-value<0.001). There was an increasing trend in AOM primary care costs (p-value<0.001). No significant trends were observed in inpatient admission yearly rates in PP, ACP or IPD and inpatient costs per episode in PP, ACP and IPD. CONCLUSION From 2003-2019, primary care HCRU and costs decreased (except for PP cost), but no trends in inpatient HCRU and costs were observed. The economic burden of pneumonia, IPD and AOM remains substantial in children aged ≤17 years in England.
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Affiliation(s)
- Salini Mohanty
- Merck & Co., Inc, Center for Observational and Real-World Evidence (CORE), Rahway, New Jersey, United States of America
| | - Bélène Podmore
- OXON Epidemiology Ltd, Epidemiology & Statistics, Madrid, Spain
| | | | - Ian Matthews
- MSD (UK) Ltd, Value, Access and Devolved Nations (VAD), London, United Kingdom
| | - Eric Sarpong
- Merck & Co., Inc., Real-world Data Analytics and Innovation (RDAI), Rahway, New Jersey, United States of America
| | - Agueda Azpeitia
- OXON Epidemiology Ltd, Epidemiology & Statistics, Madrid, Spain
| | - Nawab Qizilbash
- OXON Epidemiology Ltd, Epidemiology & Statistics, Madrid, Spain
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Mohanty S, Tsai JH, Ning N, Pena-Molina A, Verma RP, Heisen M, Weaver J, Feemster KA, Weiss T, Schmier J. 583. Preferences and Attitudes of Healthcare Providers towards Pneumococcal Conjugate Vaccines (PCVs) for Children Ages Two and Under in the United States (US). Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.635] [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: 12/23/2022] Open
Abstract
Abstract
Background
As higher-valent PCVs are currently in late-stage clinical development for pediatric use, it is important to understand how healthcare providers (HCPs) evaluate vaccine attributes when making recommendations for newer PCVs. The Advisory Committee on Immunization Practices considers feasibility and stakeholder acceptability in making vaccine recommendations; this study examined HCP preferences and attitudes towards new, higher-valent PCVs in children in the US.
Methods
Semi-structured qualitative interviews were conducted with 13 HCPs (6 pediatricians, 3 family practitioners, 3 nurse practitioners, and 1 physician assistant). US HCPs were recruited from an online panel and were eligible if they recommended or prescribed vaccines to children ≤ 2 years and spent ≥ 2 days a week providing care to pediatric patients. Providers were asked to rate a list of PCV attributes (generated by literature search) by their importance in influencing their PCV choices (1, not important; 10, most important). Interviews were recorded, transcribed, and analyzed.
Results
Among HCPs (mean age=49 years; 62% women; 38% urban, 38% suburban; mean years in practice=18 years), three main themes emerged: 1) Preferred attributes: The three most important PCV characteristics that affect HCPs’ recommendations are effectiveness against serotype 3 (rated 9.1), percent serotype coverage for invasive pneumococcal disease (IPD) (rated 8.9), and immune response for the shared PCV13 serotypes (rated 8.2). 2) PCV choice: Most respondents are interested in having more PCV options, particularly options with higher efficacy or broader serotype coverage. 3) Immunogenicity vs serotype coverage: Between a higher immune response to certain serotypes and broader serotype coverage, 46% of HCPs prefer PCVs that elicit a higher immune response but narrower coverage, 31% prefer a PCV with broader serotype coverage, and 23% require more data before making a determination.
Conclusion
Both immune response and breadth of serotype coverage may influence HCPs decisions when recommending new PCVs. Additional analyses and interviews are underway to validate these findings and further explore other factors that may influence their preferences for recommending PCVs.
Disclosures
Salini Mohanty, DrPH, MPH, Merck & Co., Inc.: Employee Jui-Hua Tsai, MD, MHS, OPEN Health: Employee of OPEN Health, which received funding from Merck & Co., Inc. to conduct this research Ning Ning, PhD, MS, Open Health: I am an employee of OPEN Health, which received funding from Merck Ana Pena-Molina, MPH, OPEN Health: I am an employee of OPEN Health, which received funding from Merck Rishi P. Verma, MPH, OPEN Health: I am an employee of OPEN Health, which received funding from Merck Marieke Heisen, PhD, MSc, OPEN Health: I am an employee of OPEN Health, which received funding from Merck Jessica Weaver, PhD, MPH, Merck & Co., Inc.: Employee Kristen A. Feemster, MD, MPH, MSHPR, FAAP, Merck & Co., Inc.: Employee Thomas Weiss, DrPH, MPH, Merck & Co., Inc.: Employee Jordana Schmier, MA, OPEN Health: I am an employee of OPEN Health, which received funding from Merck.
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15
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Mohanty S, Hu T, Yang G, Khan TK, Owusu-Edusei K, Sukarom I. Health and economic burden associated with 15-valent pneumococcal conjugate vaccine serotypes in Korea and Hong Kong. Hum Vaccin Immunother 2022; 18:2046433. [PMID: 35420975 PMCID: PMC9196648 DOI: 10.1080/21645515.2022.2046433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Use of pneumococcal conjugate vaccines (PCVs) has greatly reduced the incidence of invasive pneumococcal disease (IPD). V114 (VAXNEUVANCE™, Merck Sharp & Dohme Corp. a subsidiary of Merck & Co. Inc. Kenilworth, NJ, USA) is a 15-valent PCV currently approved in adults in the United States, containing the 13 serotypes in licensed PCV13 and 2 additional serotypes (22F and 33F) which are important contributors to residual pneumococcal disease. This study quantified the health and economic burden of IPD attributable to V114 serotypes in hypothetical birth cohorts from Korea and Hong Kong. A Markov model was used to estimate the case numbers and costs of IPD in unvaccinated birth cohorts over 20 years. The model was applied to 3 scenarios in Korea (pre-PCV7, pre-PCV13, and post-PCV13) and to 2 scenarios in Hong Kong (pre-PCV7 and post-PCV13). For Korea, the model predicted 62, 26, and 8 IPD cases attributable to V114 serotypes in the pre-PCV7, pre-PCV13, and post-PCV13 scenarios, respectively. Costs of V114-type IPD fell from $1.691 million pre-PCV7 to $.212 million post-PCV13. For Hong Kong, the model estimated 62 V114-associated IPD cases in the pre-PCV7 scenario and 46 in the post-PCV13 scenario. Costs attributed to all V114 serotypes were $2.322 million and $1.726 million in the pre-PCV7 and post-PCV13 periods, respectively. Vaccine-type serotypes are predicted to cause continuing morbidity and cost in Korea (19A) and Hong Kong (3 and 19A). New pediatric pneumococcal vaccines must continue to protect against serotypes in licensed vaccines to maintain disease reduction, while extending coverage to non-vaccine serotypes.
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Affiliation(s)
- Salini Mohanty
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Kenilworth, NJ, USA
| | - Tianyan Hu
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Kenilworth, NJ, USA
| | | | - Tsz K Khan
- Global Medical and Scientific Affairs, MSD, Hong Kong, China
| | - Kwame Owusu-Edusei
- Biostatistics & Research Decision Sciences (BARDS), Merck & Co., Inc., Kenilworth, NJ, USA
| | - Isaya Sukarom
- Center for Observational and Real-World Evidence (CORE), MSD Thailand, Bangkok, Thailand
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Panda S, Moharana L, Biswas G, Parida P, Mishra S, Pattnaik J, Devaraj S, Mohanty S, Karunanidhi S, Singuluri S, Saju S, Sehrawat A, Mudgal S, Subudhi G, Rathnam K, Cyriac S, Philips A, Jose A, Ganesan P. 382P Real-world data on treatment outcome of ALK positive non-small cell lung cancer from an Indian multi-centric cancer registry. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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17
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Vegendla P, Bergeron A, Mohanty S, Talamo A, Heidet F, Ade B, Betzler BR. Ex-Core Thermo-Fluidics Optimization for Transformational Challenge Reactor. NUCL SCI ENG 2022. [DOI: 10.1080/00295639.2022.2123195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Prasad Vegendla
- Argonne National Laboratory, Nuclear Science and Engineering Division, 9700 South Cass Avenue, Lemont, Illinois 60439
| | - A. Bergeron
- Argonne National Laboratory, Nuclear Science and Engineering Division, 9700 South Cass Avenue, Lemont, Illinois 60439
| | - S. Mohanty
- Argonne National Laboratory, Nuclear Science and Engineering Division, 9700 South Cass Avenue, Lemont, Illinois 60439
| | - A. Talamo
- Argonne National Laboratory, Nuclear Science and Engineering Division, 9700 South Cass Avenue, Lemont, Illinois 60439
| | - F. Heidet
- Argonne National Laboratory, Nuclear Science and Engineering Division, 9700 South Cass Avenue, Lemont, Illinois 60439
| | - B. Ade
- Oak Ridge National Laboratory, P.O. Box 2008, Oak Ridge, Tennessee 37831-6170
| | - B. R. Betzler
- Oak Ridge National Laboratory, P.O. Box 2008, Oak Ridge, Tennessee 37831-6170
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18
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Hu T, Song Y, Done N, Liu Q, Sarpong EM, Lemus-Wirtz E, Signorovitch J, Mohanty S, Weiss T. Incidence of invasive pneumococcal disease in children with commercial insurance or Medicaid coverage in the United States before and after the introduction of 7- and 13-valent pneumococcal conjugate vaccines during 1998-2018. BMC Public Health 2022; 22:1677. [PMID: 36064378 PMCID: PMC9442936 DOI: 10.1186/s12889-022-14051-6] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 08/17/2022] [Indexed: 11/29/2022] Open
Abstract
Background Invasive pneumococcal disease (IPD) is a major cause of pediatric morbidity and mortality. Pneumococcal conjugate vaccines (PCVs) were introduced in the US in 2000 (PCV7) and 2010 (PCV13). This study estimated the annual incidence rates (IRs) and time trends of IPD to quantify the burden of disease in children before and after the introduction of PCV7 and PCV13 in the US. Methods IPD episodes were identified in the IBM MarketScan Commercial and Medicaid Databases using claims with International Classification of Diseases 9/10th Revision, Clinical Modification codes. Annual IRs were calculated as the number of IPD episodes/100,000 person-years (PYs) for children < 18 years and by age group (< 2, 2–4, and 5–17 years). National estimates of annual IPD IRs were extrapolated using Census Bureau data. Interrupted time series (ITS) analyses were conducted to assess immediate and gradual changes in IPD IRs before and after introduction of PCV7 and PCV13. Results In commercially insured children, IPD IRs decreased from 9.4 to 2.8 episodes/100,000 PY between the pre-PCV7 (1998–1999) and late PCV13 period (2014–2018) overall, and from 65.6 to 11.6 episodes/100,000 PY in children < 2 years. In the Medicaid population, IPD IRs decreased from 11.3 to 4.2 episodes/100,000 PY between the early PCV7 (2001–2005) and late PCV13 period overall, and from 42.6 to 12.8 episodes/100,000 PY in children < 2 years. The trends of IRs for meningitis, bacteremia, and bacteremic pneumonia followed the patterns of overall IPD episodes. The ITS analyses indicated significant decreases in the early PCV7 period, increases in the late PCV7 and decreases in the early PCV13 period in commercially insured children overall. However, increases were also observed in the late PCV13 period in children < 2 years. The percentage of cases with underlying risk factors increased in both populations. Conclusions IRs of IPD decreased from 1998 to 2018, following introduction of PCV7 and PCV13, with larger declines during the early PCV7 and early PCV13 periods, and among younger children. However, the residual burden of IPD remains substantial. The impact of future PCVs on IPD IRs will depend on the proportion of vaccine-type serotypes and vaccine effectiveness in children with underlying conditions. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14051-6.
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Affiliation(s)
- Tianyan Hu
- Merck & Co., Inc., 126 East Lincoln Ave, P.O. Box 2000, Rahway, NJ, 07065, USA
| | - Yan Song
- Analysis Group, Inc., 111 Huntington Avenue 14th Floor, Boston, MA, 02199, USA
| | - Nicolae Done
- Analysis Group, Inc., 111 Huntington Avenue 14th Floor, Boston, MA, 02199, USA
| | - Qing Liu
- Analysis Group, Inc., 111 Huntington Avenue 14th Floor, Boston, MA, 02199, USA
| | - Eric M Sarpong
- Merck & Co., Inc., 126 East Lincoln Ave, P.O. Box 2000, Rahway, NJ, 07065, USA
| | - Esteban Lemus-Wirtz
- Analysis Group, Inc., 111 Huntington Avenue 14th Floor, Boston, MA, 02199, USA
| | - James Signorovitch
- Analysis Group, Inc., 111 Huntington Avenue 14th Floor, Boston, MA, 02199, USA
| | - Salini Mohanty
- Merck & Co., Inc., 126 East Lincoln Ave, P.O. Box 2000, Rahway, NJ, 07065, USA.
| | - Thomas Weiss
- Merck & Co., Inc., 126 East Lincoln Ave, P.O. Box 2000, Rahway, NJ, 07065, USA
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Mohanty S, Johnson KD, Yu KC, Watts JA, Gupta V. A Multicenter Evaluation of Trends in Antimicrobial Resistance among Streptococcus pneumoniae Isolates from Adults in the United States. Open Forum Infect Dis 2022; 9:ofac420. [PMID: 36168549 PMCID: PMC9511122 DOI: 10.1093/ofid/ofac420] [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: 06/15/2022] [Accepted: 08/31/2022] [Indexed: 11/22/2022] Open
Abstract
Background Management of pneumococcal disease is complicated by high rates of antimicrobial resistance (AMR). This study assessed AMR trends for Streptococcus pneumoniae isolates from adults with pneumococcal disease. Methods From January 2011 to February 2020, we evaluated 30-day nonduplicate S. pneumoniae isolates from 290 US hospitals (BD Insights Research Database) from adults (≥18 years) in inpatient and outpatient settings. Isolates were required to have ≥1 AMR result for invasive (blood, cerebrospinal fluid/neurologic) or noninvasive (respiratory or ear/nose/throat) pneumococcal disease samples. Determination of AMR was based on facility reports of intermediate or resistant. Descriptive statistics and generalized estimated equations were used to assess variations over time. Results Over the study period, 34 039 S. pneumoniae isolates were analyzed (20 749 [61%] from noninvasive sources and 13 290 [39%] from invasive sources). Almost half (46.6%) of the isolates were resistant to ≥1 drug, and noninvasive isolates had higher rates of AMR than invasive isolates. Total S. pneumoniae isolates had high rates of resistance to macrolides (37.7%), penicillin (22.1%), and tetracyclines (16.1%). Multivariate modeling identified a significant increasing trend in resistance to macrolides (+1.8%/year; P < .001). Significant decreasing trends were observed for penicillin (−1.6%/year; P < .001), extended-spectrum cephalosporins (ESCs; −0.35%/year; P < .001), and ≥3 drugs (−0.5%/year; P < .001). Conclusions Despite decreasing trends for penicillin, ESCs, and resistance to ≥3 drugs, AMR rates are persistently high in S. pneumoniae isolates among US adults. Increasing macrolide resistance suggests that efforts to address AMR in S. pneumoniae may require antimicrobial stewardship efforts and higher-valent pneumococcal conjugate vaccines.
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Affiliation(s)
| | | | - Kalvin C Yu
- Becton, Dickinson & Company , Franklin Lakes, NJ , USA
| | - Janet A Watts
- Becton, Dickinson & Company , Franklin Lakes, NJ , USA
| | - Vikas Gupta
- Becton, Dickinson & Company , Franklin Lakes, NJ , USA
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Astengo M, Paganino C, Amicizia D, Sticchi L, Orsi A, Icardi G, Piazza MF, Mohanty S, Senese F, Prandi GM, Ansaldi F. Incidence of Hospitalisation and Emergency Department Visits for Pneumococcal Disease in Children, Adolescents, and Adults in Liguria, Italy: A Retrospective Analysis from 2012-2018. Vaccines (Basel) 2022; 10:vaccines10091375. [PMID: 36146453 PMCID: PMC9504569 DOI: 10.3390/vaccines10091375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/05/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
Streptococcus pneumoniae infection is responsible for significant morbidity and mortality, particularly in young children and older adults. The aim of this study was to investigate the incidence of hospitalisation and emergency department (ED) visits in relation to episodes of pneumococcal disease (PD) following the introduction of pneumococcal conjugate vaccines (PCVs) into the Liguria region of Italy. Between 2012 and 2018, episodes of all-cause pneumonia (80,152), pneumococcal-specific pneumonia (1254), unspecified pneumonia (66,293), acute otitis media (AOM; 17,040), and invasive PD (IPD; 1788) were identified from in-patient claims, ED and hospital discharge records, and the Liguria Chronic Condition Data Warehouse. In children < 15 years of age, pneumococcal pneumonia-related hospitalisations decreased from 35 to 13 per 100,000 person-years during the study period (p < 0.001); this decrease is potentially related to PCV use in children. All-cause pneumonia hospitalisations remained stable, whereas IPD hospitalisations increased and AOM hospitalisations decreased. In adults, hospitalisations for all-cause pneumonia increased from 5.00 to 7.50 per 1000 person-years (+50%; p < 0.001). Pneumococcal and unspecified pneumonia hospital admissions increased significantly during the study period, considerably affecting those ≥ 65 years of age. IPD hospitalisations varied across all age groups, but a significant change was not observed. Despite pneumococcal vaccination, substantial burden remains for PD in children and adults in Liguria, Italy.
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Affiliation(s)
- Matteo Astengo
- Regional Health Agency of Liguria (ALiSa), Piazza della Vittoria 15, 16121 Genoa, Italy
- Correspondence: ; Tel.: +39-0105488257
| | - Chiara Paganino
- Regional Health Agency of Liguria (ALiSa), Piazza della Vittoria 15, 16121 Genoa, Italy
| | - Daniela Amicizia
- Regional Health Agency of Liguria (ALiSa), Piazza della Vittoria 15, 16121 Genoa, Italy
- Department of Health’s Science (DiSSal), University of Genoa, 16132 Genoa, Italy
| | - Laura Sticchi
- Department of Health’s Science (DiSSal), University of Genoa, 16132 Genoa, Italy
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
| | - Andrea Orsi
- Department of Health’s Science (DiSSal), University of Genoa, 16132 Genoa, Italy
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
| | - Giancarlo Icardi
- Department of Health’s Science (DiSSal), University of Genoa, 16132 Genoa, Italy
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
| | | | - Salini Mohanty
- Merck & Co., Inc., 126 East Lincoln Ave., P.O. Box 2000, Rahway, NJ 07065, USA
| | | | | | - Filippo Ansaldi
- Regional Health Agency of Liguria (ALiSa), Piazza della Vittoria 15, 16121 Genoa, Italy
- Department of Health’s Science (DiSSal), University of Genoa, 16132 Genoa, Italy
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Singh N, Patel G, Dogra Y, Mohanty S, Seth T. P-795 Comparison of intra-ovarian platelet rich plasma versus autologous bone marrow derived stem cell instillation in women with diminished ovarian reserve for ovarian rejuvenation. Hum Reprod 2022. [PMCID: PMC9384354 DOI: 10.1093/humrep/deac107.731] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
To compare role of intra-ovarian platelet rich plasma (PRP) versus marrow derived stem cell (SC) instillation for improvement in ovarian reserve (AFC, AMH and FSH)
Summary answer
Both PRP and SC therapy improves the ovarian reserve however, response to PRP is superior to SC post intervention
What is known already
With increasing incidence of females with diminished ovarian reserve (DOR), posing a serious challenge in terms of limited treatment options for these couples. Clinicians are trying to find effective strategies besides oocyte donation or adoption Of late, novel ovarian rejuvenation approaches has been investigated which are currently available for research purposes only. Multiple studies are evaluating effect of intra-ovarian PRP or autologous SC instillation, the results are encouraging as they are showing improvement in ovarian reserve thus bringing a paradigm shift in treatment options. None of the published studies so far have compared PRP versus SC in DOR population.
Study design, size, duration
A prospective comparative study was conducted at Division of Reproductive Medicine of a tertiary care institute. 72 infertile females (20-39 years) with poor ovarian reserve (AMH <1.2 ng /ml; AFC<5) were enrolled in the study between January 2020 to December 2021. The two comparative groups underwent either intra-ovarian PRP instillation (n = 42) or autologous SC transplantation (n = 30).
Participants/materials, setting, methods
After the two groups were matched (PRP vs SC) for baseline characteristics (Age, AMH, AFC, FSH, Estradiol), 30 subjects in each group were compared for change in serum FSH/AMH/Estradiol levels, AFC, right and left ovarian volume at 1st month and 3rd month post intervention from the baseline. This was also compared between the two groups using Student t-test. The cost and procedural pain measured using Visual analog scale (VAS) were also compared between the groups.
Main results and the role of chance
After matching for baseline characteristics, significant ∼ 1.8/2 and ∼1.5/1.6 fold increase in AFC at 1st/3rd month post intervention (p<0.001) was observed after PRP instillation and SC transplantation respectively. This significant improvement was observed more in PRP group than SC group at 3rd month post intervention (7.07 vs 5.60, p=0.02), while no significant difference existed at 1st month of follow up. However, there was no significant improvement in serum FSH, AMH and Estradiol levels (p0.05) from the baseline at 1st and 3rd month post intervention in both the groups. Similarly, there was no significant difference between the two groups in serum FSH level (7.98 IU/ml vs 9.62 IU/ml, p=0.062; 8.26 IU/ml vs 9.50 IU/ml, p=0.15), AMH level (1.62 ng/ml vs 1.02 ng/ml, p=0.27; 1.35 ng/ml vs 0.95 ng/ml, p=0.24), Estradiol level (49.12 pg/ml vs 56.48 pg/ml p=0.443; 54.7 pg/ml vs 61.12 pg/ml, p=0.44), right ovarian volume (3.13 cm3 vs 2.49 cm3, p=0.06; 3.37 cm3 vs 2.74 cm3,p=0.063) and left ovarian volume (2.98 cm3 vs 2.47 cm3, p=0.102; 2.87 cm3 vs 2.34 cm3,p=0.103) at 1st and 3rd month post intervention respectively. PRP was more cost-effective and associated with less pain (32.5 mm vs 28.13 mm, p=0.02), and better patient compliance.
Limitations, reasons for caution
This was a comparative study and the participants were not randomized but were matched for the baseline characteristics. Also due to impact of Covid-19 causing intermittent pause in nonessential facilities like IVF services, a smaller sample size could be enrolled and also clinical outcomes could not be evaluated
Wider implications of the findings
This study, although comparative, for the first time highlights the beneficial role of PRP over SC, thus can establish superiority of PRP as minimally invasive, economical, patient friendly and a recommended therapy for ovarian rejuvenation and folliculogenesis, providing the DOR females an opportunity to produce their own offspring.
Trial registration number
CTRI/2020/01/022726
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Affiliation(s)
- N Singh
- All India Institute Of Medical Sciences AIIMS, Department of Obstetrics & Gynaecology , New Delhi, India
| | - G Patel
- All India Institute Of Medical Sciences AIIMS, Department of Obstetrics & Gynaecology , New Delhi, India
| | - Y Dogra
- Indira Gandhi Institute of Medical Sciences, Reproductive Medicine , Shimla, India
| | - S Mohanty
- All India Institute Of Medical Sciences AIIMS, National Stem Cell Facility , New Delhi, India
| | - T Seth
- All India Institute Of Medical Sciences AIIMS, Department of Haematology , New Delhi, India
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22
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Magnocavallo M, Della Rocca D, Vetta G, Lavalle C, Mariani M, Schiavone M, Carola G, Mohanty S, Bassiouny M, Forleo G, Burkhardt D, Al–Ahmad A, Gallinghouse J, Horton R, Lakireddy D, Di Biase L, Natale A. P94 LOWER RATE OF MAJOR BLEEDING IN HIGH–RISK PATIENTS UNDERGOING LEFT ATRIAL APPENDAGE OCCLUSION: A PROPENSITY MATCHED COMPARISON WITH DIRECT ORAL ANTICOAGULATION. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Background
Stroke prophylaxis in very high risk (CHA2DS2–VASc ≥ 5) patients with atrial fibrillation (AF) is one of the major challenges faced by physicians. Specifically, initiating direct oral anticoagulants (DOACs) in these patients poses a therapeutic conundrum due to the concomitant high risk of bleeding. Left atrial appendage occlusion (LAAO) might be a potential alternative for thromboembolic (TE) prevention; however, there are no studies comparing these two strategies in very high–risk patients.
Objective
To evaluate the efficacy of LAAO versus DOACs in AF patients at very high TE risk.
Methods
Data were extracted from two prospective databases including 1053 Watchman and 1328 DOAC patients. Watchman patients with a CHA2DS2–VASc ≥ 5 accounted for 26.3% (n = 277). In order to attenuate the imbalance in covariates, a 1:1 propensity score matching technique was used (co–variates: age, sex, CHA2DS2–VASc and HAS–BLED scores). This method resulted in 554 matched patients (277 patients per group; mean age: 79±7y; 57.4% F; CHA2DS2–VASc: 5.8±0.9). The primary endpoint was a composite of cardiovascular (CV) death, TE events (Stroke/TIA/peripheral embolism) and clinically significant bleeding. The annual TE and major bleeding risks were estimated based on the CHA2DS2–VASc score and compared with the annualized observed risk.
Results
After a mean follow–up of 26±7 months, total events were 55 (9.4 event rates per 100 patient–years) in LAAO group vs. 78 (14.9 event rates per 100 patient–years) in DOAC group. DOACs had a significantly higher risk of the primary endpoint (hazard ratio [HR]: 1.30; 95% confidence interval [CI]: 1.08 to 1.56; p = 0.03). TE events (HR: 1.15; 95% CI: 0.84 to 1.57; p = 0.63) and CV death (HR: 1.13; 95% CI: 0.84 to 1.54; p = 0.63) did not differ between groups. Major bleeding events were significantly lower in LAAO patients (HR: 0.75; 95% CI: 0.51 to 0.82; p = 0.04). The unadjusted estimated risk of TE events was 12.3% with LAAO and 12.4% with DOACs. The annualized incidence of TE was 3.2% with LAAO and 4.1% with DOACs, which led to a risk reduction of 74% and 67%, respectively.
Conclusion
In a large cohort of AF patients at very high TE risk (CHA2DS2–VASc ≥ 5), LAAO showed similar stroke prevention but a significantly lower risk of major bleeding than DOACs during a > 2year follow–up.
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Affiliation(s)
- M Magnocavallo
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - D Della Rocca
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - G Vetta
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - C Lavalle
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - M Mariani
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - M Schiavone
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - G Carola
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - S Mohanty
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - M Bassiouny
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - G Forleo
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - D Burkhardt
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - A Al–Ahmad
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - J Gallinghouse
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - R Horton
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - D Lakireddy
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - L Di Biase
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - A Natale
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
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23
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Magnocavallo M, Della Rocca D, Lavalle C, Mohanty S, Carola G, Bassiouny M, Al–Ahmad A, Burkhardt D, Gallinghouse J, Lakireddy D, Horton R, Di Biase L, Natale A. C32 TRANSCATHETER LEAK OCCLUSION WITH ENDOVASCULAR COILS FOLLOWING LEFT ATRIAL APPENDAGE CLOSURE: PROCEDURAL SUCCESS AND OUTCOMES BEFORE AND AFTER LEAK CLOSURE. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac011.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Background
Whether residual peri–device leaks after left atrial appendage occlusion (LAAO) portend a higher risk of thromboembolism (TE), it is still a matter of debate.
Objectives
We report the TE risk in patients with incomplete LAA closure before and after leak closure with endovascular coils.
Methods
One hundred twenty–four Watchman patients with a significant (≥3mm) leak (mean age: 74 ± 9 years; 66.9% males; CHA2DS2–VASc: 4.4 ± 1.7; HAS–BLED: 3.1 ± 1) underwent LAA leak coiling. The expected annual TE risk was estimated based on the patients’ CHA2DS2–VASc and compared with the annualized incidence observed before and after coiling (Fig.1B).
Results
The time between LAAO and leak coiling was 8±6 months [83 patients–year (PY)]; before leak closure, 6 (4.8%) patients had a TE event (annualized rate: 7.2%). Coil deployment was successful in all cases [median n. of coils deployed: 5 (IQR: 2–10)]. Procedure time was 79 ± 40 min; the mean volume of iodinated contrast medium used was 80 ± 43mL. The overall complication rate was 2.4% (1 pericardial tamponade, 2 pericardial effusion). Follow–up TEE after 61±14 days revealed complete LAA sealing or a negligible leak in 117 cases (94.4%); the remaining 7 patients had a moderate leak. During 14±6 months post–coiling (145 PY), 1 (0.8%) patient suffered from stroke. The incidence of TE events was significantly lower after leak closure than before coiling (0.8% vs 4.8%; log–rank p = 0.02; Fig.1A). The annualized TE rates were 7.2% before and 0.7% after leak closure (Fig. 1A). According to the expected rate estimated from the patients’ CHA2DS2–VASc (9.8%), LAAO with and without significant leaks yielded to a risk reduction of 26.5% and 92.9% (Fig. 1B).
Conclusions
Transcatheter leak occlusion via endovascular coils was safe. LAA closure led to a significant reduction in TE events.
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Affiliation(s)
- M Magnocavallo
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - D Della Rocca
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - C Lavalle
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - S Mohanty
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - G Carola
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - M Bassiouny
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - A Al–Ahmad
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - D Burkhardt
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - J Gallinghouse
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - D Lakireddy
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - R Horton
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - L Di Biase
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - A Natale
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
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Magnocavallo M, Della Rocca D, Lavalle C, Vetta G, Mariani M, Carola G, Mohanty S, Fengwei Z, Tarantino N, Aung L, Alisara A, Xiaodong Z, Bassiouny M, Gallinghouse J, Burkhardt D, Al–Ahmad A, Rodney H, Di Biase L, Natale A. P4 LEFT ATRIAL APPENDAGE ANATOMICAL CHANGES FOLLOWING RADIOFREQUENCY–BASED OSTIAL ISOLATION. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Left atrial appendage (LAA) electrical isolation (ei) may be achieved via radiofrequency (RF) energy applications at the level of the appendage ostium targeting the sites of earliest activation recorded by a mapping catheter. Notably, RF has long been used in vascular, orthopedic, and aesthetic surgery to promote thermal–induced collagen matrix contraction, fibrosis, and tissue retraction. LAA anatomical changes associated to RF–induced tissue retraction have never been reported.
Objective
To quantify the anatomical changes of the LAA ostium following RF–based LAAei.
Methods
Thirty–four consecutive patients requiring AF ablation with LAAei underwent transesophageal echocardiography (TEE) within 7 days before (baseline TEE) and >6 months after (follow–up TEE) ablation. The diameter of LAA orifice and landing zone were measured at 4 different views (0°, 45°, 90°, 135°). Measurements were performed by two independent reviewers blinded to the patient’s identity.
Results
Among 34 AF patients (68±7yrs, 73.5% males), the LAA morphology was classified as chicken wing in 15 (44%) patients, windsock in 10 (29%), cactus in 6 (18%), and cauliflower in 3 (9%). At baseline TEE, the mean maximum and mean minimum ostial diameters were 25±4mm and 22±4mm, respectively. The mean maximum and mean minimum diameters of the landing zone were 26±4mm and 23±3mm, respectively. On average, LAAei was achieved after 16±7 minutes of RF at a power of 45–47W. Follow–up TEE was performed 257±148 days after LAAei. The median LAA contraction velocity was 0.1 m/s (IQR: 0.04–0.18) and was significantly impaired in all patients. At follow–up TEE, the mean maximum and mean minimum ostial diameters were 19±4mm and 17±3mm, respectively. The mean maximum and mean minimum diameters of the landing zone were 20±4mm and 18±4mm, respectively. The mean relative reduction of the ostium and the landing zone were –24.4% and –22.5%, respectively. Box–Whisker plots of the maximum and minimum ostial diameters before and after LAAei are reported in Fig. 1.
Conclusion
RF led to a > 20% reduction of the diameters of the ostium and the landing zone. These changes may have important implications for a successful percutaneous occlusion procedure and justify a staged approach of isolation and occlusion.
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Affiliation(s)
- M Magnocavallo
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - D Della Rocca
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - C Lavalle
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - G Vetta
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - M Mariani
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - G Carola
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - S Mohanty
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - Z Fengwei
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - N Tarantino
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - L Aung
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - A Alisara
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - Z Xiaodong
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - M Bassiouny
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - J Gallinghouse
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - D Burkhardt
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - A Al–Ahmad
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - H Rodney
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - L Di Biase
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - A Natale
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
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Murthy V, Chilukuri S, Mallick I, Maitre P, Agarwal A, Moses A, James F, Narang K, Kataria T, Anand A, Dutta D, Mitra S, Pavamani S, Mallick S, Mahale N, Chandra M, Narayan A, Shahid T, Sairam M, Kannan V, Mohanty S, Basu T, Hotwani C, G B. OC-0606 Multi-institutional outcomes of Gleason grade group 5 prostate cancers treated with EBRT and ADT. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02628-7] [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] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Nongrum DL, Devi YS, Mohanty S, Singh LJ, Baidya K, Chyrmang D, Rai HK. COMPARATIVE STUDY OF CONCURRENT CHEMORADIATION USING PACLITAXEL IN TWO HISTOPATHOLOGICAL SUBTYPES (SQUAMOUS CELL CARCINOMA/ADENOCARCINOMA) OF UNRESECTABLE NON-SMALL CELL LUNG CANCER. IJMMR 2022. [DOI: 10.11603/ijmmr.2413-6077.2021.2.12253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background. Lung cancer is still a global burden and with rising population and increasing life expectancy the incidence of lung cancer is still on the rise.
Objective. To compare the treatment response and toxicity of weekly paclitaxel in locally advanced unresectable non-small cell lung cancer (NSCLC), when administered concurrently with external beam radiation to the chest in two different histopathological types – adenocarcinoma and squamous cell carcinoma.
Methods. A prospective randomised control trial was conducted in 60 NSCLC patients who were divided into two arms; adenocarcinoma and squamous cell carcinoma arm. All patients were treated with chemoradiation with concurrent paclitaxel 60 mg/m2. Data were evaluated with SPSS version 21.0 for windows with p-value <0.05.
Results. Haematological toxicity was the most common side effects evident from the third week of chemotherapy. At the end of 1 month of treatment, two (6.7%) patients had complete response in Arm A and one (3.3%) patient had complete response in Arm B. One (3.3%) patient had disease progression in Arm A and two patients progressed in Arm B. At 7 months post treatment three (10%) patients had complete response in both Arm A and Arm B. Four (13.3%) patients had disease progression in Arm A and ten (33.4%) patients progressed in Arm B.
Conclusions. Paclitaxel can be used as an alternative chemotherapeutic agent to the standard cisplatin. However, further studies with larger sample size are required to confirm the findings.
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Hu T, Done N, Petigara T, Mohanty S, Song Y, Liu Q, Lemus-Wirtz E, Signorovitch J, Sarpong E, Weiss T. Incidence of acute otitis media in children in the United States before and after the introduction of 7- and 13-valent pneumococcal conjugate vaccines during 1998–2018. BMC Infect Dis 2022; 22:294. [PMID: 35346092 PMCID: PMC8962537 DOI: 10.1186/s12879-022-07275-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 02/22/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Acute otitis media (AOM) is a leading cause of office visits and antibiotic prescriptions in children. Pneumococcal conjugate vaccines were introduced in the USA in 2000 (7-valent, PCV7) and 2010 (13-valent, PCV13). Expanded valency PCVs are currently under development. To describe the impact of PCVs and quantify the residual burden of AOM, this study estimated annual incidence rates (IRs) of AOM and AOM-related complications and surgical procedures in children < 18 years in the USA before and after the introduction of PCV7 and PCV13.
Methods
AOM episodes were identified in the IBM MarketScan® Commercial and Medicaid databases using diagnosis codes (ICD-9-CM: 382.x; ICD-10-CM: H66.xx and H67.xx). Annual IRs were calculated as the number of episodes per 1000 person-years (PYs) for all children < 18 years and by age group (< 2, 2–4, and 5–17 years). National estimates of annual AOM IRs were extrapolated using Census Bureau data. Interrupted time series analyses were used to assess immediate and gradual changes in monthly AOM IRs, controlling for seasonality.
Results
In the commercially insured population, AOM IRs declined between the pre-PCV7 period (1998–1999) and the late PCV13 period (2014–2018) from 1170.1 to 768.8 episodes per 1000 PY for children < 2 years, from 547.4 to 410.3 episodes per 1000 PY in children 2–4 years, and from 115.6 to 91.8 episodes per 1000 PY in children 5–17 years. The interrupted time series analyses indicated significant immediate or gradual decreases in the early PCV7 period (2001–2005), and gradual increases in the late PCV7 period (2006–2009) in children < 2 years; however, crude IRs trended downward in all time periods. In older children, IRs decreased in the early PCV7 and early PCV13 period (2011–2013), but gradually increased in the late PCV7 period. IRs of AOM-related surgical procedures decreased, and IRs of AOM-related complications increased during the study timeframe.
Conclusions
AOM disease burden remains high in children of all ages despite overall reductions in AOM IRs during 1998–2018 following the introduction of PCV7 and PCV13. The impact of investigational PCVs on the disease burden of AOM will likely depend on AOM etiology and circulating pneumococcal serotypes.
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28
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Patel KM, McFadden SM, Mohanty S, Joyce CM, Delamater PL, Klein NP, Salmon DA, Omer SB, Buttenheim AM. Evaluation of Trends in Homeschooling Rates After Elimination of Nonmedical Exemptions to Childhood Immunizations in California, 2012-2020. JAMA Netw Open 2022; 5:e2146467. [PMID: 35107573 PMCID: PMC8811639 DOI: 10.1001/jamanetworkopen.2021.46467] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION In 2015, California passed Senate Bill No. 277 (SB 277) and became the first state in more than 30 years to eliminate nonmedical exemptions to mandatory childhood immunizations for school entry. One concern that emerged was that the law created an incentive for parents to remove children from brick-and-mortar schools to bypass the immunization requirements. OBJECTIVE To assess the trends in homeschooling rates after the elimination of nonmedical exemptions to the requirement of childhood immunizations for school entry. DESIGN, SETTING, AND PARTICIPANTS This preintervention-postintervention cross-sectional study calculated homeschooling rates as the number of students in kindergarten through grade 8 (K-8) enrolled through each of California's 3 homeschooling mechanisms (independent study program, private school affidavit, and private school satellite program) divided by all K-8 students enrolled in the same academic year. Data on homeschooling rates were obtained from the California Department of Education. Interrupted time series analyses were conducted using a linear regression model in which the outcome variable was the percentage of students enrolled in a homeschool program before and after SB 277. Data were collected and analyzed from October 3, 2012, to October 2, 2019. INTERVENTION Passage of SB 277, which eliminated nonmedical exemptions to childhood immunizations for school entry. MAIN OUTCOMES AND MEASURES Homeschooling rates for K-8 students. RESULTS Among the students included in the analysis, the homeschooling enrollment for K-8 students in California increased from 35 122 students (0.8%) during the 2012-2013 school year to 86 574 students (1.9%) during the 2019-2020 school year; however, the implementation of SB 277 was not associated with an increase in the percentage of students enrolled in homeschooling programs in California beyond the secular trend. The increase in homeschooling was greatest for the lower grade levels: kindergarten homeschooling enrollment increased from 2068 students (0.4%) in the 2012-2013 school year to 10 553 students (1.9%) in the 2019-2020 school year, whereas the grade 8 homeschool enrollment rate increased from 5146 students (1.0%) in the 2012-2013 school year to 10 485 students (2.0%) in the 2019-2020 school year. Independent study programs accounted for 20 149 students (45.3%) of homeschooling enrollment, private school affidavits accounted for 19 333 students (43.5%), and private school satellite programs accounted for 4935 students (11.1%) during the 2015-2016 school year. CONCLUSIONS AND RELEVANCE The findings of this study suggest that legislative action to limit nonmedical exemptions for compulsory vaccination for school entry is not associated with removal of students from classroom-based instruction in brick-and-mortar institutions.
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Affiliation(s)
- Kavin M Patel
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - SarahAnn M McFadden
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
- Yale Institute for Global Health, New Haven, Connecticut
| | - Salini Mohanty
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia
| | - Caroline M Joyce
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Paul L Delamater
- Department of Geography and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill
| | - Nicola P Klein
- Kaiser Permanente Vaccine Study Center, Oakland, California
| | - Daniel A Salmon
- Institute for Vaccine Safety, Departments of International Health and Health Behavior Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Saad B Omer
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
- Yale Institute for Global Health, New Haven, Connecticut
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut
| | - Alison M Buttenheim
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia
- Center for Health Incentives and Behavioral Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
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29
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Cao L, Sutcliffe W, Van Tonder R, Bernlochner FU, Adachi I, Aihara H, Asner DM, Aushev T, Ayad R, Babu V, Bahinipati S, Behera P, Belous K, Bennett J, Bessner M, Bilka T, Biswal J, Bobrov A, Bračko M, Branchini P, Browder TE, Budano A, Campajola M, Červenkov D, Chang MC, Chang P, Cheon BG, Chilikin K, Cho HE, Cho K, Cho SJ, Choi Y, Choudhury S, Cinabro D, Cunliffe S, Czank T, Dash N, De Pietro G, Dhamija R, Di Capua F, Dingfelder J, Doležal Z, Dong TV, Dubey S, Epifanov D, Ferber T, Ferlewicz D, Frey A, Fulsom BG, Garg R, Gaur V, Gabyshev N, Garmash A, Giri A, Goldenzweig P, Gu T, Gudkova K, Halder S, Hara T, Hartbrich O, Hayasaka K, Hernandez Villanueva M, Hou WS, Hsu CL, Inami K, Ishikawa A, Itoh R, Iwasaki M, Jacobs WW, Jang EJ, Jia S, Jin Y, Joo KK, Kahn J, Kang KH, Kichimi H, Kiesling C, Kim CH, Kim DY, Kim SH, Kim YK, Kimmel TD, Kinoshita K, Kodyš P, Konno T, Korobov A, Korpar S, Kovalenko E, Križan P, Kroeger R, Krokovny P, Kuhr T, Kulasiri R, Kumar M, Kumar R, Kumara K, Kuzmin A, Kwon YJ, Lee SC, Li CH, Li J, Li LK, Li YB, Li Gioi L, Libby J, Lieret K, Liventsev D, MacQueen C, Masuda M, Merola M, Metzner F, Miyabayashi K, Mizuk R, Mohanty GB, Mohanty S, Mrvar M, Nakao M, Natochii A, Nayak L, Niiyama M, Nisar NK, Nishida S, Nishimura K, Ogawa S, Ono H, Onuki Y, Oskin P, Pakhlova G, Pardi S, Park H, Park SH, Passeri A, Patra S, Paul S, Pedlar TK, Piilonen LE, Podobnik T, Popov V, Prencipe E, Prim MT, Röhrken M, Rostomyan A, Rout N, Rozanska M, Russo G, Sahoo D, Sandilya S, Sangal A, Santelj L, Sanuki T, Savinov V, Schnell G, Schueler J, Schwanda C, Schwartz AJ, Seino Y, Senyo K, Sevior ME, Shapkin M, Sharma C, Shen CP, Shiu JG, Shwartz B, Simon F, Sokolov A, Solovieva E, Starič M, Strube JF, Sumihama M, Sumiyoshi T, Takizawa M, Tamponi U, Tanida K, Tao Y, Tenchini F, Trabelsi K, Uchida M, Uglov T, Uno S, Urquijo P, Vahsen SE, Varner G, Varvell KE, Waheed E, Wang CH, Wang E, Wang MZ, Wang P, Wang XL, Watanabe M, Watanuki S, Werbycka O, Won E, Yabsley BD, Yan W, Yang SB, Ye H, Yin JH, Zhang ZP, Zhilich V, Zhukova V. Measurement of Differential Branching Fractions of Inclusive B→X_{u}ℓ^{+}ν_{ℓ} Decays. Phys Rev Lett 2021; 127:261801. [PMID: 35029480 DOI: 10.1103/physrevlett.127.261801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/09/2021] [Indexed: 06/14/2023]
Abstract
The first measurements of differential branching fractions of inclusive semileptonic B→X_{u}ℓ^{+}ν_{ℓ} decays are performed using the full Belle data set of 711 fb^{-1} of integrated luminosity at the ϒ(4S) resonance and for ℓ=e, μ. With the availability of these measurements, new avenues for future shape-function model-independent determinations of the Cabibbo-Kobayashi-Maskawa matrix element |V_{ub}| can be pursued to gain new insights in the existing tension with respect to exclusive determinations. The differential branching fractions are reported as a function of the lepton energy, the four-momentum-transfer squared, light-cone momenta, the hadronic mass, and the hadronic mass squared. They are obtained by subtracting the backgrounds from semileptonic B→X_{c}ℓ^{+}ν_{ℓ} decays and other processes, and corrected for resolution and acceptance effects.
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Affiliation(s)
- L Cao
- University of Bonn, 53115 Bonn
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | | | | | | | - I Adachi
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - H Aihara
- Department of Physics, University of Tokyo, Tokyo 113-0033
| | - D M Asner
- Brookhaven National Laboratory, Upton, New York 11973
| | - T Aushev
- National Research University Higher School of Economics, Moscow 101000
| | - R Ayad
- Department of Physics, Faculty of Science, University of Tabuk, Tabuk 71451
| | - V Babu
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - S Bahinipati
- Indian Institute of Technology Bhubaneswar, Satya Nagar 751007
| | - P Behera
- Indian Institute of Technology Madras, Chennai 600036
| | - K Belous
- Institute for High Energy Physics, Protvino 142281
| | - J Bennett
- University of Mississippi, University, Mississippi 38677
| | - M Bessner
- University of Hawaii, Honolulu, Hawaii 96822
| | - T Bilka
- Faculty of Mathematics and Physics, Charles University, 121 16 Prague
| | - J Biswal
- J. Stefan Institute, 1000 Ljubljana
| | - A Bobrov
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - M Bračko
- J. Stefan Institute, 1000 Ljubljana
- Faculty of Chemistry and Chemical Engineering, University of Maribor, 2000 Maribor
| | | | - T E Browder
- University of Hawaii, Honolulu, Hawaii 96822
| | - A Budano
- INFN-Sezione di Roma Tre, I-00146 Roma
| | - M Campajola
- INFN-Sezione di Napoli, I-80126 Napoli
- Università di Napoli Federico II, I-80126 Napoli
| | - D Červenkov
- Faculty of Mathematics and Physics, Charles University, 121 16 Prague
| | - M-C Chang
- Department of Physics, Fu Jen Catholic University, Taipei 24205
| | - P Chang
- Department of Physics, National Taiwan University, Taipei 10617
| | - B G Cheon
- Department of Physics and Institute of Natural Sciences, Hanyang University, Seoul 04763
| | - K Chilikin
- P.N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - H E Cho
- Department of Physics and Institute of Natural Sciences, Hanyang University, Seoul 04763
| | - K Cho
- Korea Institute of Science and Technology Information, Daejeon 34141
| | - S-J Cho
- Yonsei University, Seoul 03722
| | - Y Choi
- Sungkyunkwan University, Suwon 16419
| | - S Choudhury
- Indian Institute of Technology Hyderabad, Telangana 502285
| | - D Cinabro
- Wayne State University, Detroit, Michigan 48202
| | - S Cunliffe
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - T Czank
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), University of Tokyo, Kashiwa 277-8583
| | - N Dash
- Indian Institute of Technology Madras, Chennai 600036
| | | | - R Dhamija
- Indian Institute of Technology Hyderabad, Telangana 502285
| | - F Di Capua
- INFN-Sezione di Napoli, I-80126 Napoli
- Università di Napoli Federico II, I-80126 Napoli
| | | | - Z Doležal
- Faculty of Mathematics and Physics, Charles University, 121 16 Prague
| | - T V Dong
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE) and Institute of Modern Physics, Fudan University, Shanghai 200443
| | - S Dubey
- University of Hawaii, Honolulu, Hawaii 96822
| | - D Epifanov
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - T Ferber
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - D Ferlewicz
- School of Physics, University of Melbourne, Victoria 3010
| | - A Frey
- II. Physikalisches Institut, Georg-August-Universität Göttingen, 37073 Göttingen
| | - B G Fulsom
- Pacific Northwest National Laboratory, Richland, Washington 99352
| | - R Garg
- Panjab University, Chandigarh 160014
| | - V Gaur
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061
| | - N Gabyshev
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - A Garmash
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - A Giri
- Indian Institute of Technology Hyderabad, Telangana 502285
| | - P Goldenzweig
- Institut für Experimentelle Teilchenphysik, Karlsruher Institut für Technologie, 76131 Karlsruhe
| | - T Gu
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260
| | - K Gudkova
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - S Halder
- Tata Institute of Fundamental Research, Mumbai 400005
| | - T Hara
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - O Hartbrich
- University of Hawaii, Honolulu, Hawaii 96822
| | | | | | - W-S Hou
- Department of Physics, National Taiwan University, Taipei 10617
| | - C-L Hsu
- School of Physics, University of Sydney, New South Wales 2006
| | - K Inami
- Graduate School of Science, Nagoya University, Nagoya 464-8602
| | - A Ishikawa
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - R Itoh
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - M Iwasaki
- Osaka City University, Osaka 558-8585
| | - W W Jacobs
- Indiana University, Bloomington, Indiana 47408
| | - E-J Jang
- Gyeongsang National University, Jinju 52828
| | - S Jia
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE) and Institute of Modern Physics, Fudan University, Shanghai 200443
| | - Y Jin
- Department of Physics, University of Tokyo, Tokyo 113-0033
| | - K K Joo
- Chonnam National University, Gwangju 61186
| | - J Kahn
- Institut für Experimentelle Teilchenphysik, Karlsruher Institut für Technologie, 76131 Karlsruhe
| | - K H Kang
- Kyungpook National University, Daegu 41566
| | - H Kichimi
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - C Kiesling
- Max-Planck-Institut für Physik, 80805 München
| | - C H Kim
- Department of Physics and Institute of Natural Sciences, Hanyang University, Seoul 04763
| | - D Y Kim
- Soongsil University, Seoul 06978
| | - S H Kim
- Seoul National University, Seoul 08826
| | - Y-K Kim
- Yonsei University, Seoul 03722
| | - T D Kimmel
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061
| | - K Kinoshita
- University of Cincinnati, Cincinnati, Ohio 45221
| | - P Kodyš
- Faculty of Mathematics and Physics, Charles University, 121 16 Prague
| | - T Konno
- Kitasato University, Sagamihara 252-0373
| | - A Korobov
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - S Korpar
- J. Stefan Institute, 1000 Ljubljana
- Faculty of Chemistry and Chemical Engineering, University of Maribor, 2000 Maribor
| | - E Kovalenko
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - P Križan
- J. Stefan Institute, 1000 Ljubljana
- Faculty of Mathematics and Physics, University of Ljubljana, 1000 Ljubljana
| | - R Kroeger
- University of Mississippi, University, Mississippi 38677
| | - P Krokovny
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - T Kuhr
- Ludwig Maximilians University, 80539 Munich
| | - R Kulasiri
- Kennesaw State University, Kennesaw, Georgia 30144
| | - M Kumar
- Malaviya National Institute of Technology Jaipur, Jaipur 302017
| | - R Kumar
- Punjab Agricultural University, Ludhiana 141004
| | - K Kumara
- Wayne State University, Detroit, Michigan 48202
| | - A Kuzmin
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | | | - S C Lee
- Kyungpook National University, Daegu 41566
| | - C H Li
- Liaoning Normal University, Dalian 116029
| | - J Li
- Kyungpook National University, Daegu 41566
| | - L K Li
- University of Cincinnati, Cincinnati, Ohio 45221
| | - Y B Li
- Peking University, Beijing 100871
| | - L Li Gioi
- Max-Planck-Institut für Physik, 80805 München
| | - J Libby
- Indian Institute of Technology Madras, Chennai 600036
| | - K Lieret
- Ludwig Maximilians University, 80539 Munich
| | - D Liventsev
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
- Wayne State University, Detroit, Michigan 48202
| | - C MacQueen
- School of Physics, University of Melbourne, Victoria 3010
| | - M Masuda
- Research Center for Nuclear Physics, Osaka University, Osaka 567-0047
- Earthquake Research Institute, University of Tokyo, Tokyo 113-0032
| | - M Merola
- INFN-Sezione di Napoli, I-80126 Napoli
- Università di Napoli Federico II, I-80126 Napoli
| | - F Metzner
- Institut für Experimentelle Teilchenphysik, Karlsruher Institut für Technologie, 76131 Karlsruhe
| | | | - R Mizuk
- National Research University Higher School of Economics, Moscow 101000
- P.N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - G B Mohanty
- Tata Institute of Fundamental Research, Mumbai 400005
| | - S Mohanty
- Tata Institute of Fundamental Research, Mumbai 400005
- Utkal University, Bhubaneswar 751004
| | - M Mrvar
- Institute of High Energy Physics, Vienna 1050
| | - M Nakao
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - A Natochii
- University of Hawaii, Honolulu, Hawaii 96822
| | - L Nayak
- Indian Institute of Technology Hyderabad, Telangana 502285
| | - M Niiyama
- Kyoto Sangyo University, Kyoto 603-8555
| | - N K Nisar
- Brookhaven National Laboratory, Upton, New York 11973
| | - S Nishida
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - K Nishimura
- University of Hawaii, Honolulu, Hawaii 96822
| | - S Ogawa
- Toho University, Funabashi 274-8510
| | - H Ono
- Nippon Dental University, Niigata 951-8580
- Niigata University, Niigata 950-2181
| | - Y Onuki
- Department of Physics, University of Tokyo, Tokyo 113-0033
| | - P Oskin
- P.N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - G Pakhlova
- National Research University Higher School of Economics, Moscow 101000
- P.N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - S Pardi
- INFN-Sezione di Napoli, I-80126 Napoli
| | - H Park
- Kyungpook National University, Daegu 41566
| | - S-H Park
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - A Passeri
- INFN-Sezione di Roma Tre, I-00146 Roma
| | - S Patra
- Indian Institute of Science Education and Research Mohali, SAS Nagar, 140306
| | - S Paul
- Max-Planck-Institut für Physik, 80805 München
- Department of Physics, Technische Universität München, 85748 Garching
| | | | - L E Piilonen
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061
| | - T Podobnik
- J. Stefan Institute, 1000 Ljubljana
- Faculty of Mathematics and Physics, University of Ljubljana, 1000 Ljubljana
| | - V Popov
- National Research University Higher School of Economics, Moscow 101000
| | | | | | - M Röhrken
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - A Rostomyan
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - N Rout
- Indian Institute of Technology Madras, Chennai 600036
| | - M Rozanska
- H. Niewodniczanski Institute of Nuclear Physics, Krakow 31-342
| | - G Russo
- Università di Napoli Federico II, I-80126 Napoli
| | - D Sahoo
- Tata Institute of Fundamental Research, Mumbai 400005
| | - S Sandilya
- Indian Institute of Technology Hyderabad, Telangana 502285
| | - A Sangal
- University of Cincinnati, Cincinnati, Ohio 45221
| | - L Santelj
- J. Stefan Institute, 1000 Ljubljana
- Faculty of Mathematics and Physics, University of Ljubljana, 1000 Ljubljana
| | - T Sanuki
- Department of Physics, Tohoku University, Sendai 980-8578
| | - V Savinov
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260
| | - G Schnell
- Department of Physics, University of the Basque Country UPV/EHU, 48080 Bilbao
- IKERBASQUE, Basque Foundation for Science, 48013 Bilbao
| | - J Schueler
- University of Hawaii, Honolulu, Hawaii 96822
| | - C Schwanda
- Institute of High Energy Physics, Vienna 1050
| | - A J Schwartz
- University of Cincinnati, Cincinnati, Ohio 45221
| | - Y Seino
- Niigata University, Niigata 950-2181
| | - K Senyo
- Yamagata University, Yamagata 990-8560
| | - M E Sevior
- School of Physics, University of Melbourne, Victoria 3010
| | - M Shapkin
- Institute for High Energy Physics, Protvino 142281
| | - C Sharma
- Malaviya National Institute of Technology Jaipur, Jaipur 302017
| | - C P Shen
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE) and Institute of Modern Physics, Fudan University, Shanghai 200443
| | - J-G Shiu
- Department of Physics, National Taiwan University, Taipei 10617
| | - B Shwartz
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - F Simon
- Max-Planck-Institut für Physik, 80805 München
| | - A Sokolov
- Institute for High Energy Physics, Protvino 142281
| | - E Solovieva
- P.N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - M Starič
- J. Stefan Institute, 1000 Ljubljana
| | - J F Strube
- Pacific Northwest National Laboratory, Richland, Washington 99352
| | | | - T Sumiyoshi
- Tokyo Metropolitan University, Tokyo 192-0397
| | - M Takizawa
- J-PARC Branch, KEK Theory Center, High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
- Meson Science Laboratory, Cluster for Pioneering Research, RIKEN, Saitama 351-0198
- Showa Pharmaceutical University, Tokyo 194-8543
| | - U Tamponi
- INFN-Sezione di Torino, I-10125 Torino
| | - K Tanida
- Advanced Science Research Center, Japan Atomic Energy Agency, Naka 319-1195
| | - Y Tao
- University of Florida, Gainesville, Florida 32611
| | - F Tenchini
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - K Trabelsi
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay
| | - M Uchida
- Tokyo Institute of Technology, Tokyo 152-8550
| | - T Uglov
- National Research University Higher School of Economics, Moscow 101000
- P.N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - S Uno
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - P Urquijo
- School of Physics, University of Melbourne, Victoria 3010
| | - S E Vahsen
- University of Hawaii, Honolulu, Hawaii 96822
| | - G Varner
- University of Hawaii, Honolulu, Hawaii 96822
| | - K E Varvell
- School of Physics, University of Sydney, New South Wales 2006
| | - E Waheed
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - C H Wang
- National United University, Miao Li 36003
| | - E Wang
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260
| | - M-Z Wang
- Department of Physics, National Taiwan University, Taipei 10617
| | - P Wang
- Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049
| | - X L Wang
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE) and Institute of Modern Physics, Fudan University, Shanghai 200443
| | | | - S Watanuki
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay
| | - O Werbycka
- H. Niewodniczanski Institute of Nuclear Physics, Krakow 31-342
| | - E Won
- Korea University, Seoul 02841
| | - B D Yabsley
- School of Physics, University of Sydney, New South Wales 2006
| | - W Yan
- Department of Modern Physics and State Key Laboratory of Particle Detection and Electronics, University of Science and Technology of China, Hefei 230026
| | | | - H Ye
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - J H Yin
- Korea University, Seoul 02841
| | - Z P Zhang
- Department of Modern Physics and State Key Laboratory of Particle Detection and Electronics, University of Science and Technology of China, Hefei 230026
| | - V Zhilich
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - V Zhukova
- P.N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
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Mohanty S, Trivedi C, Della Rocca DG, Gianni C, MacDonald B, Mayedo A, Bassiouny M, Gallinghouse GJ, Burkhardt JD, Horton R, Al-Ahmad A, Di Biase L, Natale A. Optimal ablation targets during second catheter ablation in patients with persistent AF. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Pulmonary vein isolation (PVI) is the cornerstone of ablative therapy in atrial fibrillation (AF). However, the one-year success rate after single ablation procedure is known to be up to 60%, necessitating repeat procedures in many.
Purpose
We evaluated the impact of different ablation strategies on procedural success at the second ablation in patients with persistent AF (PerAF).
Methods
Consecutive PerAF patients scheduled to undergo their second ablation were screened and only those that have received PVI plus isolation of left atrial posterior wall (PWI) and superior vena cava (SVC) at the first procedure (n=1390), were included in the analysis. At the second ablation, all reconnected structures were ablated. Additionally, based on operators' decision, non-PV triggers were targeted for ablation.
Patients were classified into two groups based on the ablation strategy: group 1: Re-isolation of reconnected PVs, PW, SVC and group 2: additional ablation of non-PV triggers (from inter-atrial septum, coronary sinus (CS), left atrial appendage (LAA) and crista terminalis). Arrhythmia-monitoring was performed quarterly for 1 year and biannually afterwards. Ablation success was assessed off-antiarrhythmic drugs (AAD).
Results
Of the 1390 patients included in the analysis, 698 were in group 1 and 692 were in group 2.
In group 1, reconnected PV, PW and SVC were re-isolated in 98 (14%), 311 (44.5%) and 173 (24.8%) respectively. In 131 (18.7%) patients, in the absence of any reconnection, CS was empirically isolated.
In group 2, PV, PW and SVC were re-isolated in 83 (12%), 270 (39%) and 113 (16.3%) patients respectively. Additionally, non-PV triggers were ablated in 505 (73%) and empirical isolation of LAA and CS in the absence of detectable triggers and PV reconnection was performed in 187 (27%).
At 2 years of follow-up, 425 (61%) and 602 (87%) from group 1 and 2 were arrhythmia-free off-AAD (p<0.001).
Conclusion
Including non-PV triggers as targets for ablation at the repeat procedure was associated with significantly higher success rate in persistent AF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Mohanty
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Trivedi
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - D G Della Rocca
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Gianni
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - B MacDonald
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Mayedo
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - M Bassiouny
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - G J Gallinghouse
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - J D Burkhardt
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - R Horton
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Al-Ahmad
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - L Di Biase
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Natale
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
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Mohanty S, Trivedi C, Della Rocca DG, Gianni C, MacDonald B, Mayedo A, Bassiouny M, Gallinghouse GJ, Horton R, Al-Ahmad A, Di Biase L, Burkhardt JD, Natale A. Long-term outcome of endocardial-only versus combined endocardial-epicardial homogenization of the scar for treatment of ventricular tachycardia in patients with ischemic cardiomyopathy. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
We investigated the ablation success of scar homogenization with combined (epicardial + endocardial) versus endocardial-only approach for ventricular tachycardia (VT) in patients with ischemic cardiomyopathy (ICM) at 5 years of follow-up.
Method
Consecutive ICM patients undergoing VT ablation at our center were classified into group 1: endocardial scar homogenization and group 2: endocardial +epicardial scar homogenization. Patients with previous open heart surgery were excluded.
All patients underwent bipolar substrate mapping with standard scar settings defined as normal tissue >1.5 mV and severe scar <0.5 mV. Non-inducibility of monomorphic VT was the procedural endpoint in both groups. Patients were followed up twice a year for 5 years with implantable device interrogations.
Results
A total of 361 (Group 1: 291 and group 2: 70) patients were included in the study (mean age: 67 years, male: 88.4%).
At 5 years, significantly higher number of patients from group 2 remained arrhythmia-free (figure 1). Of those patients, 87 (45%) and 51 (89%) from group 1 and 2 respectively were off-anti-arrhythmic drugs (AAD) (p<0.001). After adjusting for age, gender, hypertension, diabetes, and obstructive sleep apnea, scar homogenization using endo-epicardial approach was associated with 51% less recurrence compared to the endocardial ablation strategy (Hazard Ratio: 0.49, 95% CI: 0.27–0.89, p: 0.02).
Conclusion
In this series of patients with ischemic cardiomyopathy and VT, endo-epicardial scar homogenization was associated with a lower need for AAD and a significantly lower recurrence rate at 5-years of follow-up compared to the endocardial ablation alone.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
- S Mohanty
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Trivedi
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - D G Della Rocca
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Gianni
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - B MacDonald
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Mayedo
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - M Bassiouny
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - G J Gallinghouse
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - R Horton
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Al-Ahmad
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - L Di Biase
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - J D Burkhardt
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A.N.D.R.E.A Natale
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
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Mohanty S, Trivedi C, Della Rocca DG, Gianni C, MacDonald B, Mayedo A, Burkhardt JD, Bassiouny M, Gallinghouse GJ, Horton R, Al-Ahmad A, Di Biase L, Natale A. Linear increase in the number of non-pulmonary vein triggers from paroxysmal to persistent and long-standing persistent AF in patients undergoing repeat procedure after successful isolation of pulmona. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
This study evaluated the prevalent triggers responsible for recurrence following successful PVI in different types of atrial fibrillation (AF).
Methods
Consecutive AF patients undergoing repeat catheter ablation with permanently isolated PV were included in the analysis. High-dose isoproterenol challenge (20- 30μg/min for 15–20min) was used to confirm PV reconnection and identify non-PV triggers.
Circular mapping catheter (CMC) was used to map the site of origin of significant ectopic activity by comparing the activation sequence of the sinus beat with that of the ectopic beat. For the coronary sinus (CS), ablation catheter was positioned at the level of the mitral valve annulus, parallel to the one positioned in the CS. Left atrial appendage (LAA) firing was detected by placing the CMC in the left superior PV and thus recording far-field potentials from the LAA.
Results
This prospective study included 1850 AF patients undergoing repeat AF ablation (Table 1), of which 573 (31%) had received one and the remaining 1277 patients had received 2 earlier ablations. Permanent PVI was confirmed with isoproterenol challenge.
Table 1 shows the distribution of non-PV triggers. A linear increase in the number of non-PV triggers was observed from PAF to PerAF to LSPAF. Significantly higher number of LSPAF patients had detectable non-PV triggers compared to PerAF and PAF cases.
Conclusion
We observed a linear increase in the number of non-PV triggers in PAF to PerAF and LSPAF patients experiencing recurrence with successful isolation of PVs. As non-PV triggers are often not targeted by operators, this could be the underlying mechanism for more frequent recurrences in non-paroxysmal AF.
Funding Acknowledgement
Type of funding sources: None. Table 1
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Affiliation(s)
- S Mohanty
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Trivedi
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - D G Della Rocca
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Gianni
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - B MacDonald
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Mayedo
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - J D Burkhardt
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - M Bassiouny
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - G J Gallinghouse
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - R Horton
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Al-Ahmad
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - L Di Biase
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Natale
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
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Mohanty S, Trivedi C, Della Rocca DG, Gianni C, MacDonald B, Mayedo A, Bassiouny M, Gallinghouse GJ, Burkhardt JD, Horton R, Al-Ahmad A, Di Biase L, Natale A. Benefits of early intervention with catheter ablation in patients with atrial fibrillation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Radiofrequency catheter ablation, a widely recognized therapeutic option for atrial fibrillation (AF) has limited success rate as it is influenced by several factors including duration of AF.
Purpose
We evaluated the ablation success in AF patients intervened early versus late in the disease course.
Methods
Consecutive AF patients undergoing their first catheter ablation in 2015–16 at our center were included in the analysis. Patients were classified into two groups based on the time to ablation after AF diagnosis; 1) early: ≤12 months and 2) late: >12 months.
All received PV isolation plus isolation of posterior wall and superior vena cava. Additionally, in non-paroxysmal AF cases, non-PV triggers were identified with isoproterenol-challenge and ablated. Patients were prospectively followed up for 3 years with regular rhythm monitoring.
Results
A total of 752 and 1248 patients were included in the “early” and “late” group respectively. Baseline characteristics of the study population is provided in Table 1 A. At 4 years of follow-up, overall success rate off-antiarrhythmic drugs was significantly higher in the “early” group (65.4% vs 57%, p<0.001). After stratification by AF type, “early” group was still associated with significantly higher success rate compared to the “late” group (Table 1B).
Conclusion
In this large series with standardized ablation strategy, early intervention with catheter ablation was associated with higher success rate in all AF types.
Funding Acknowledgement
Type of funding sources: None. Table 1
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Affiliation(s)
- S Mohanty
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Trivedi
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - D G Della Rocca
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Gianni
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - B MacDonald
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Mayedo
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - M Bassiouny
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - G J Gallinghouse
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - J D Burkhardt
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - R Horton
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Al-Ahmad
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - L Di Biase
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A.N.D.R.E.A Natale
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
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Mohanty S, Trivedi C, Della Rocca DG, Gianni C, MacDonald B, Mayedo A, Burkhardt JD, Bassiouny M, Gallinghouse GJ, Horton R, Al-Ahmad A, Di Biase L, Natale A. Recovery of conduction following high power short duration approach in radiofrequency catheter ablation for atrial fibrillation: a single-center experience. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
High-power short-duration (HPSD) ablation is currently being adopted by many as the preferred procedural technique in atrial fibrillation (AF). However, the optimal duration of energy delivery to successfully create a durable lesion is not clear yet.
Purpose
We evaluated the association of electrical reconnection with lesion-duration in HPSD ablation.
Methods
Consecutive AF patients undergoing repeat procedure after a prior HPSD ablation with or without isolation of left atrial appendage (LAA) and coronary sinus (CS) were included in this analysis. HPSD ablation was defined as ablation with maximum temperature setting at 420C and power delivery at 45 W for 10–15 sec (5 seconds in the CS area and posterior wall near the esophagus). In some patients a mechanical esophageal deviation tool was used to deflect the esophagus away from the ablation site.
Results
A total of 2249 AF patients (with LAA and CS isolation: 1451; without LAA and CS isolation: 798) receiving redo ablation after a prior HPSD procedure were included in the analysis. At the prior procedure with the HPSD approach, mean duration of ablation was significantly shorter in the area facing the esophagus compared to elsewhere (5.2±1.5 vs 12.5±1.7 seconds, p<0.001). Application duration was reduced to <10 sec to avoid overheating and steam pops in 1221 (84%) patients receiving LAA and CS isolation.
At the redo, recovery of conduction was noted in the CS (592, 40.8%), LAA (493, 34%), and PV and left atrial posterior wall (LAPW) (310, 13.8%). Of the 310 patients with LAPW reconnection, 91% (n=282) had the conduction recovered in the area facing the esophagus.
In 73 patients, esophageal displacement device was used during the prior HPSD ablation. Average duration of ablation lesions in LAPW among those 73 patients was 9.2±2 seconds. PV-LAPW reconnection was observed in 3/73 (4.1%) patients.
Conclusion
HPSD ablation with lesion duration of <10 sec was associated with conduction recovery in the LAA, CS and the LAPW area facing esophagus.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Mohanty
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Trivedi
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - D G Della Rocca
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Gianni
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - B MacDonald
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Mayedo
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - J D Burkhardt
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - M Bassiouny
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - G J Gallinghouse
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - R Horton
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Al-Ahmad
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - L Di Biase
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Natale
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
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Talamo A, Bergeron A, Mohanty S, Vegendla SNP, Heidet F, Ade B, Betzler BR, Terrani K. Serpent and MCNP Calculations of the Energy Deposition in the Transformational Challenge Reactor. NUCL SCI ENG 2021. [DOI: 10.1080/00295639.2021.1977078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- A. Talamo
- Argonne National Laboratory, Nuclear Science and Engineering Division, 9700 South Cass Avenue, Lemont, Illinois 60439
| | - A. Bergeron
- Argonne National Laboratory, Nuclear Science and Engineering Division, 9700 South Cass Avenue, Lemont, Illinois 60439
| | - S. Mohanty
- Argonne National Laboratory, Nuclear Science and Engineering Division, 9700 South Cass Avenue, Lemont, Illinois 60439
| | - S. N. P. Vegendla
- Argonne National Laboratory, Nuclear Science and Engineering Division, 9700 South Cass Avenue, Lemont, Illinois 60439
| | - F. Heidet
- Argonne National Laboratory, Nuclear Science and Engineering Division, 9700 South Cass Avenue, Lemont, Illinois 60439
| | - B. Ade
- Oak Ridge National Laboratory, P.O. Box 2008, Oak Ridge, Tennessee 37831-6170
| | - B. R. Betzler
- Oak Ridge National Laboratory, P.O. Box 2008, Oak Ridge, Tennessee 37831-6170
| | - K. Terrani
- Oak Ridge National Laboratory, P.O. Box 2008, Oak Ridge, Tennessee 37831-6170
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Verma A, Mohanty S, Gupta A. Comparative Evaluation of Preoperative Local and Systemic Intramuscular Administration of Dexamethasone Injection in Mandibular Third Molar Impaction Surgery. J Oral Maxillofac Surg 2021. [DOI: 10.1016/j.joms.2021.08.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mohanty S, Hemavathy S, Verma A. Deep Subfascial Approach as an Alternative to Explore Temporomandibular Joint: A Pilot Study. J Oral Maxillofac Surg 2021. [DOI: 10.1016/j.joms.2021.08.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mohanty S, Rathaur A. Effectiveness and Pitfalls of Intraoral Distraction in Wide Alveolar Clefts: An Experience. J Oral Maxillofac Surg 2021. [DOI: 10.1016/j.joms.2021.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Joyce CM, Saulsgiver K, Mohanty S, Bachireddy C, Molfetta C, Steffy M, Yoder A, Buttenheim AM. Remote Patient Monitoring and Incentives to Support Smoking Cessation Among Pregnant and Postpartum Medicaid Members: Three Randomized Controlled Pilot Studies. JMIR Form Res 2021; 5:e27801. [PMID: 34591023 PMCID: PMC8517817 DOI: 10.2196/27801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 06/09/2021] [Accepted: 07/06/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Smoking rates among low-income individuals, including those eligible for Medicaid, have not shown the same decrease that is observed among high-income individuals. The rate of smoking among pregnant women enrolled in Medicaid is almost twice that among privately insured women, which leads to significant disparities in birth outcomes and a disproportionate cost burden placed on Medicaid. Several states have identified maternal smoking as a key target for improving birth outcomes and reducing health care expenditures; however, efficacious, cost-effective, and feasible cessation programs have been elusive. OBJECTIVE This study aims to examine the feasibility, acceptability, and effectiveness of a smartwatch-enabled, incentive-based smoking cessation program for Medicaid-eligible pregnant smokers. METHODS Pilot 1 included a randomized pilot study of smartwatch-enabled remote monitoring versus no remote monitoring for 12 weeks. Those in the intervention group also received the SmokeBeat program. Pilot 2 included a randomized pilot study of pay-to-wear versus pay-to-quit for 4 weeks. Those in a pay-to-wear program could earn daily incentives for wearing the smartwatch, whereas those in pay-to-quit program could earn daily incentives if they wore the smartwatch and abstained from smoking. Pilot 3, similar to pilot 2, had higher incentives and a duration of 3 weeks. RESULTS For pilot 1 (N=27), self-reported cigarettes per week among the intervention group declined by 15.1 (SD 27) cigarettes over the study; a similar reduction was observed in the control group with a decrease of 17.2 (SD 19) cigarettes. For pilot 2 (N=8), self-reported cigarettes per week among the pay-to-wear group decreased by 43 cigarettes (SD 12.6); a similar reduction was seen in the pay-to-quit group, with an average of 31 (SD 45.6) fewer cigarettes smoked per week. For pilot 3 (N=4), one participant in the pay-to-quit group abstained from smoking for the full study duration and received full incentives. CONCLUSIONS Decreases in smoking were observed in both the control and intervention groups during all pilots. The use of the SmokeBeat program did not significantly improve cessation. The SmokeBeat program, remote cotinine testing, and remote delivery of financial incentives were considered feasible and acceptable. Implementation challenges remain for providing evidence-based cessation incentives to low-income pregnant smokers. The feasibility and acceptability of the SmokeBeat program were moderately high. Moreover, the feasibility and acceptability of remote cotinine testing and the remotely delivered contingent financial incentives were successful. TRIAL REGISTRATION ClinicalTrials.gov NCT03209557; https://clinicaltrials.gov/ct2/show/NCT03209557.
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Affiliation(s)
- Caroline M Joyce
- Department of Epidemiology, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | | | - Salini Mohanty
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Chethan Bachireddy
- School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - Carin Molfetta
- Penn Medicine Lancaster General Health, Lancaster, PA, United States
| | - Mary Steffy
- Penn Medicine Lancaster General Health, Lancaster, PA, United States
| | - Alice Yoder
- Penn Medicine Lancaster General Health, Lancaster, PA, United States
| | - Alison M Buttenheim
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
- Center for Health Incentives and Behavioral Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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Singh N, Dogra Y, Mohanty S, Seth T. P–796 Trial of Autologous Marrow derived Stem Cell Ovarian Transplantation (TAMSCOT) in young infertile women with diminished ovarian reserve for ovarian rejuvenation – HOPE still persists. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Does autologous bone marrow derived stem cell (BMDSC) ovarian transplantation optimize ovarian reserve parameters in young infertile women with diminished ovarian reserve (DOR) ?
Summary answer
The autologous stem cell ovarian transplantation (ASCOT) improves AFC and AMH by facilitating the recruitment of existing dormant follicles in young women with DOR.
What is known already
Oocyte donation is the practical therapeutic option when patients with premature ovarian ageing desire pregnancy. It involves significant psychological burden in terms of not able to have their own biological child. ASCOT has opened new doors in poor responders and premature ovarian insufficiency through its beneficial effects on ovarian reserve and IVF outcomes. However recent studies have shown contradictory results in terms of its efficacy. No prior study has been contemplated in DOR group
Study design, size, duration
An open label non randomized controlled trial was conducted at Division of Reproductive Medicine in collaboration with stem cell facility at tertiary care institute. Forty two infertile women less than 35 years age with DOR (AFC<5, AMH<1.2ng/ml and /or high FSH>8IU/l) were enrolled in the study during a period from January 2020 to December 2020. 20 women who did not opt for the intervention were treated as control group whereas 22 women received the intervention.
Participants/materials, setting, methods
Baseline hormonal profile ( Day 2 FSH, estradiol, AMH and AFC) was done in all patients. Women with abnormal uterine cavity, endometriosis, prior ovarian surgery, abnormal karyotype were excluded. Bone marrow aspiration followed by mesenchymal stem cells isolation was performed. The stem cells were transplanted in both the ovaries through transvaginal route on the same day. Follow up visits were planned at one and six months to assess ovarian reserve parameters.
Main results and the role of chance
The mean age, BMI and duration of infertility were comparable between the control and study group (29.5±3.34vs29.36±2.95years, 21.51±1.40vs21.87±1.93kg/m2, 6.9±1.94vs7. 04±3.67 years) . The positive response in terms of improved AMH and AFC was seen in 68% (15/22) patients. The mean number of stem cells injected in these women were 77.71±25.33 million. At first follow up, there was no significant difference between mean FSH, estradiol levels and mean right and left ovarian volume (9.23±3.95 vs 9.02±3.92mIU/l, 61.46±29.25 vs 68.12±62.52 pg/ml, 2.82±2.18 vs 2.44±1.25 cc, 2.02±1.54 vs 2.72±1.06 cc, p < 0.05). There was significant increase in AMH and AFC values as compared to baseline (0.79±0.43 vs 1.26±0.82ng/ml, p = 0.03; 3.47±1.30 vs 6.40±2.23, p < 0.001). At second follow up visit, the significant increase in ovarian reserve persisted for AMH and AFC (0.79±0.43 vs 1.22±0.76 ng/ml, p = 0.02; 3.47±1.30 vs 6.93±1.71,p<0.001). There was no significant difference between serum FSH , Estradiol and ovarian volume. None of the patients developed any complication and the improvement in AFC and AMH persisted during 10 month follow up period.
Limitations, reasons for caution
The limitation of present study is small sample size and non randomization. However, time period for which positive effect lasts has not been documented in earlier studies. This study is currently being endeavored, and women with improved ovarian reserve are followed up for any spontaneous conception or following assisted reproduction.
Wider implications of the findings: The present study demonstrates beneficial role of stem cells in improving ovarian reserve parameters in women with DOR with no acquired cause. If supported by future randomized clinical studies, it could represent a paradigm shift for fertility treatment in these women providing an opportunity to have their own biological child.
Trial registration number
CTRI/2020/01/022726
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Affiliation(s)
- N Singh
- All India Institute Of Medical Sciences AIIMS, Department of Obstetrics & Gynaecology, New Delhi, India
| | - Y Dogra
- All India Institute Of Medical Sciences AIIMS, Department of Obstetrics & Gynaecology, New Delhi, India
| | - S Mohanty
- All India Institute Of Medical Sciences AIIMS, Stem cell facility, New Delhi, India
| | - T Seth
- All India Institute Of Medical Sciences AIIMS, Department of Haematology, New Delhi, India
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Singh N, Dogra Y, Mohanty S, Seth T. P-796 Trial of Autologous Marrow derived Stem Cell Ovarian Transplantation (TAMSCOT) in young infertile women with diminished ovarian reserve for ovarian rejuvenation – HOPE still persists. Hum Reprod 2021. [DOI: 10.1093/humrep/deab128.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Does autologous bone marrow derived stem cell (BMDSC) ovarian transplantation optimize ovarian reserve parameters in young infertile women with diminished ovarian reserve (DOR) ?
Summary answer
The autologous stem cell ovarian transplantation (ASCOT) improves AFC and AMH by facilitating the recruitment of existing dormant follicles in young women with DOR.
What is known already
Oocyte donation is the practical therapeutic option when patients with premature ovarian ageing desire pregnancy. It involves significant psychological burden in terms of not able to have their own biological child. ASCOT has opened new doors in poor responders and premature ovarian insufficiency through its beneficial effects on ovarian reserve and IVF outcomes. However recent studies have shown contradictory results in terms of its efficacy. No prior study has been contemplated in DOR group
Study design, size, duration
An open label non randomized controlled trial was conducted at Division of Reproductive Medicine in collaboration with stem cell facility at tertiary care institute. Forty two infertile women less than 35 years age with DOR (AFC<5, AMH<1.2ng/ml and /or high FSH>8IU/l) were enrolled in the study during a period from January 2020 to December 2020. 20 women who did not opt for the intervention were treated as control group whereas 22 women received the intervention.
Participants/materials, setting, methods
Baseline hormonal profile ( Day 2 FSH, estradiol, AMH and AFC) was done in all patients. Women with abnormal uterine cavity, endometriosis, prior ovarian surgery, abnormal karyotype were excluded. Bone marrow aspiration followed by mesenchymal stem cells isolation was performed. The stem cells were transplanted in both the ovaries through transvaginal route on the same day. Follow up visits were planned at one and six months to assess ovarian reserve parameters.
Main results and the role of chance
The mean age, BMI and duration of infertility were comparable between the control and study group (29.5±3.34vs 29.36±2.95years, 21.51±1.40vs21.87±1.93kg/m2, 6.9±1.94vs7.04±3.67 years). The positive response in terms of improved AMH and AFC was seen in 68% (15/22) patients. The mean number of stem cells injected in these women were 77.71±25.33 million. At first follow up, there was no significant difference between mean FSH, estradiol levels and mean right and left ovarian volume (9.23±3.95 vs 9.02±3.92mIU/l, 61.46±29.25 vs 68.12±62.52 pg/ml, 2.82±2.18 vs 2.44±1.25 cc, 2.02±1.54 vs 2.72±1.06 cc, p < 0.05). There was significant increase in AMH and AFC values as compared to baseline (0.79±0.43 vs 1.26±0.82ng/ml, p = 0.03; 3.47±1.30 vs 6.40±2.23, p < 0.001). At second follow up visit, the significant increase in ovarian reserve persisted for AMH and AFC (0.79±0.43 vs 1.22±0.76 ng/ml, p = 0.02; 3.47±1.30 vs 6.93±1.71,p<0.001). There was no significant difference between serum FSH, Estradiol and ovarian volume. None of the patients developed any complication and the improvement in AFC and AMH persisted during 10 month follow up period.
Limitations, reasons for caution
The limitation of present study is small sample size and non randomization. However, time period for which positive effect lasts has not been documented in earlier studies. This study is currently being endeavored, and women with improved ovarian reserve are followed up for any spontaneous conception or following assisted reproduction.
Wider implications of the findings
The present study demonstrates beneficial role of stem cells in improving ovarian reserve parameters in women with DOR with no acquired cause. If supported by future randomized clinical studies, it could represent a paradigm shift for fertility treatment in these women providing an opportunity to have their own biological child
Trial registration number
CTRI/2020/01/022726
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Affiliation(s)
- N Singh
- All India Institute Of Medical Sciences AIIMS, Department of Obstetrics & Gynaecology, New Delhi, India
| | - Y Dogra
- All India Institute Of Medical Sciences AIIMS, Department of Obstetrics & Gynaecology, New Delhi, India
| | - S Mohanty
- All India Institute Of Medical Sciences AIIMS, Stem cell facility, New Delhi, India
| | - T Seth
- All India Institute Of Medical Sciences AIIMS, Department of Haematology, New Delhi, India
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Rajeswaran R, Chandrasekharan A, Mohanty S, Murali K, Joseph S. Role of MR cisternography in the diagnosis of cerebrospinal fluid rhinorrhoea with diagnostic nasal endoscopy and surgical correlation. Indian J Radiol Imaging 2021. [DOI: 10.4103/0971-3026.29005] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AbstractObjectives : To study the usefulness and accuracy of MR cisternography as noninvasive study in the diagnosis of cerebrospinal fluid (CSF) fistula with diagnostic sinonasal endoscopy and surgical correlation.
Material and Methods: Twenty four patients with clinically suspected CSF rhinorrhoea were examined for CSF fistula with MR cisternography. The MR imaging technique included 3mm thin T2 weighted coronal and sagittal sections using Fast spin echo. In addition 1.5mm thin T2 weighted coronal sections were also obtained using CISS (Constructive Interference in Steady State) sequence. MR findings were correlated with diagnostic sinonasal endoscopy and surgical findings.
Results : MR cisternography demonstrated the presence of fistula in 17 patients, absence of fistula in seven patients. Out of 17 patients with fistula, the diagnosis could be confirmed in 14 patients by diagnostic sinonasal endoscopy/surgery. Out of the seven patients without fistula, there was positive correlation in six patients when they were followed up clinically and by diagnostic nasal endoscopy. However in one patient, fistula was demonstrated on CT cisternography and was confirmed on sinonasal endoscopic surgery. The accuracy, sensitivity of MR cisternography was 96, 94% respectively.
Conclusion : MR cisternography is a useful and accurate noninvasive study in localizing the site and extent of CSF fistula.
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Affiliation(s)
- R Rajeswaran
- Department of Radiology and Imaging Sciences and Department of Otolaryngology, Sri Ramachandra Medical College and Research Institute, Chennai - 600 116, India
| | - A Chandrasekharan
- Department of Radiology and Imaging Sciences and Department of Otolaryngology, Sri Ramachandra Medical College and Research Institute, Chennai - 600 116, India
| | - S Mohanty
- Department of Radiology and Imaging Sciences and Department of Otolaryngology, Sri Ramachandra Medical College and Research Institute, Chennai - 600 116, India
| | - K Murali
- Department of Radiology and Imaging Sciences and Department of Otolaryngology, Sri Ramachandra Medical College and Research Institute, Chennai - 600 116, India
| | - S Joseph
- Department of Radiology and Imaging Sciences and Department of Otolaryngology, Sri Ramachandra Medical College and Research Institute, Chennai - 600 116, India
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Jandas PJ, Prabakaran K, Kumar R, Mohanty S, Nayak SK. Eco-friendly poly (hydroxybutyrate) nanocomposites: preparation and characterization. J Polym Res 2021. [DOI: 10.1007/s10965-021-02653-4] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kumar S, Panigrahi P, Mohanty S, Nayak SK, Palai AK. Tuning up the photovoltaic performances upon the utility of diketopyrrolopyrrole in PEO-based gel polymer electrolytes. Dalton Trans 2021; 50:7647-7655. [PMID: 33973615 DOI: 10.1039/d1dt00585e] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The role of diketopyrrolopyrrole (DPP-H) as an additive on the ionic conductivity of poly(ethylene oxide) (PEO)-based gel polymer electrolytes (GPE) was studied for DSSC applications. The pure PEO/PC/KI/TPAI/I2 GPE was prepared with a mixture of propylene carbonate (PC) as a non-volatile plasticizer and iodide salts, such as potassium iodide (KI), tetrapropylammonium iodide (TPAI) and iodine (I2), together with PEO. The modified GPEs were prepared with different weight percentage (wt%) ratios (0.5%, 0.75%, 1% and 1.25%) of DPP-H using acetonitrile as a solvent. The polymer gel electrolytes were characterized by X-ray diffractometer (XRD) and Fourier transform infrared spectroscopy (FTIR), and the electrochemical properties were analyzed to relate the nature of the polymer and iodine ion conducting properties. The pure PEO/PC/TPAI/KI/I2 electrolyte exhibited an ionic conductivity value of 0.084 mS·cm-1 at room temperature. Upon the optimized addition of DPP-H (0.75 wt%), the ionic conductivity was found to be improved to a maximum value of 0.393 mS·cm-1, and the highest diffusion coefficient of 1.02 × 10-6 cm2 s-1 was observed. The optimized GPEs photovoltaic characterization studies showed higher power conversion efficiency (PCE) of 6.69% for DSSC under light illumination intensity of 100 mW cm-2. The same was compared with pure electrolyte, which delivered PCE of 4.39%. To gain an in-depth understanding of the interfacial resistance of the fabricated devices, the electron lifetime and transient photo response was analyzed. These above studies showed that prepared GPE could be an efficient alternative for traditional DSSCs with liquid electrolyte.
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Affiliation(s)
- Sanath Kumar
- Laboratory for Advanced Research in Polymeric Materials, SARP:CIPET, Bhubaneswar, Odisha 751 024, India.
| | - Pranshula Panigrahi
- Laboratory for Advanced Research in Polymeric Materials, SARP:CIPET, Bhubaneswar, Odisha 751 024, India.
| | - S Mohanty
- Laboratory for Advanced Research in Polymeric Materials, SARP:CIPET, Bhubaneswar, Odisha 751 024, India.
| | - S K Nayak
- Laboratory for Advanced Research in Polymeric Materials, SARP:CIPET, Bhubaneswar, Odisha 751 024, India.
| | - Akshaya Kumar Palai
- Laboratory for Advanced Research in Polymeric Materials, SARP:CIPET, Bhubaneswar, Odisha 751 024, India.
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Das A, Mohanty S, Gharami RC, Chowdhury SN, Kumar P, Das NK, Bandyopadhyay D. Linear lesions in dermatology: a clinicoaetiopathological study. Clin Exp Dermatol 2021; 46:1452-1461. [PMID: 34022084 DOI: 10.1111/ced.14753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 05/15/2021] [Accepted: 05/18/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Linear lesions are fairly common in our daily practice. However, the appearance of these lesions can vary, thus complicating the diagnosis. AIMS To study the various clinical presentations, the demographic profile of patients and the clinicopathological correlations of dermatoses presenting with a linear distribution. METHODS We conducted an institution-based, cross-sectional, descriptive study of 281 consecutive patients with linear lesions attending dermatology clinics. MedCalc software (V11.6) was used for statistical analysis. RESULTS Patients were divided into eight groups: lesions along the lines of Blaschko (n = 136), lesions along blood vessels (n = 3), lesions along lymphatics (n = 3), Koebner phenomenon (n = 24), autoinoculation (n = 24), external factors (n = 45), infestations (n = 2) and 'other' (n = 44). The mean age at presentation was 24.50 ± 18.82 years and the male/female ratio was 1.32 : 1. The commonest symptom was itching/burning (56.94% of patients), while the commonest site was the arm (44.48%); followed by the leg (30.60%), trunk and abdomen (22.42%), head and neck (19.20%), and genitalia (0.35%). Apart from the common cases, there was a wide gamut of rare conditions (e.g. angiokeratoma circumscriptum naeviforme, porokeratotic eccrine ostial and dermal duct naevus, Blaschko-linear syringocystadenoma papilliferum, progressive cribriform and zosteriform hyperpigmentation, unilateral naevoid acanthosis nigricans, fixed drug eruption, discoid lupus erythematosus). CONCLUSION Linear lesions act as diagnostic clues to many dermatological conditions, therefore, the importance of meticulous examination in clinical dermatology cannot be overemphasized.
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Affiliation(s)
- A Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - S Mohanty
- Department of Dermatology, ERA's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India
| | - R C Gharami
- Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India
| | - S N Chowdhury
- Department of Dermatology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India
| | - P Kumar
- Department of Dermatology, Katihar Medical College and Hospital, Katihar, Bihar, India
| | - N K Das
- Department of Dermatology, Bankura Sammilani Medical College and Hospital, Bankura, West Bengal, India
| | - D Bandyopadhyay
- Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India
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Bajpai J, Pradeep V, Nandhana R, Mohanty S, Chougle Q, Engineer M, Rath S, Joshi S, Wadasadawala T, Popat P, Pathak R, Gulia S, Ghosh J, Bhargava P, Srinivas S, Shet T, Sarin R, Badwe R, Gupta S. 162P Unique challenges and outcomes of young breast cancers from a tertiary care cancer centre in India. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.176] [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: 10/21/2022] Open
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47
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Deb A, Mohanty S, Ou W, Rajagopalan S, Johnson KD. Pneumococcal vaccination coverage among adults aged 19 to 64 years with immuno-compromising conditions, cerebrospinal fluid (CSF) leaks, or cochlear implants in the US. Expert Rev Vaccines 2021; 20:331-345. [PMID: 33724134 DOI: 10.1080/14760584.2021.1898377] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background: Adults with immuno-compromising conditions, CSF leaks, or cochlear implants are at increased risk for pneumococcal disease (high-risk patients), yet pneumococcal vaccination rates in the US for this group are low.Methods: A retrospective cohort analysis was conducted from 2010 to 2018 using the Truven Health MarketScan database to estimate pneumococcal vaccination coverage among adults aged 19 to 64 years newly diagnosed with high-risk conditions, and to assess factors associated with receiving the recommended pneumococcal vaccines.Results: The study sample included 2,497,799 adults aged 19 to 64 years old with newly diagnosed high-risk conditions. Most of the study cohort had seven or more annual physician office (52%) and pharmacy (56%) visits. The proportion of high-risk adults who received at least one pneumococcal vaccination increased from 5.4% after 1 year of follow-up to 14.2% after 6 years of follow-up. Compared to those who received no pneumococcal vaccination, high-risk adults who received any pneumococcal vaccination were more likely to be older, female, enrolled in an HMO, had more healthcare encounters, and were treated by a primary care provider.Conclusion: Despite numerous healthcare encounters annually, very few high-risk adults received pneumococcal vaccines, highlighting the need for implementing targeted interventions to increase vaccine uptake in this vulnerable population.
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Affiliation(s)
- Arijita Deb
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Kenilworth, USA
| | - Salini Mohanty
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Kenilworth, USA
| | - Wanmei Ou
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Kenilworth, USA
| | | | - Kelly D Johnson
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Kenilworth, USA
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Teramoto Y, Uehara S, Masuda M, Adachi I, Aihara H, Al Said S, Asner DM, Atmacan H, Aushev T, Ayad R, Babu V, Behera P, Beleño C, Bennett J, Bhardwaj V, Bhuyan B, Bilka T, Biswal J, Bonvicini G, Bozek A, Bračko M, Browder TE, Campajola M, Červenkov D, Chang MC, Chang P, Chekelian V, Chen A, Cheon BG, Chilikin K, Cho K, Cho SJ, Choi SK, Choi Y, Choudhury S, Cinabro D, Cunliffe S, De Nardo G, Di Capua F, Doležal Z, Dong TV, Eidelman S, Ferber T, Fulsom BG, Garg R, Gaur V, Gabyshev N, Garmash A, Giri A, Goldenzweig P, Greenwald D, Hadjivasiliou C, Hara T, Hartbrich O, Hayasaka K, Hayashii H, Hedges MT, Hernandez Villanueva M, Hou WS, Hsu CL, Iijima T, Inami K, Inguglia G, Ishikawa A, Itoh R, Iwasaki M, Iwasaki Y, Jacobs WW, Jang EJ, Jia S, Jin Y, Joo CW, Joo KK, Kahn J, Kaliyar AB, Kang KH, Karyan G, Kato Y, Kawasaki T, Kichimi H, Kiesling C, Kim BH, Kim DY, Kim SH, Kim YK, Kimmel TD, Kinoshita K, Kodyš P, Korpar S, Kotchetkov D, Križan P, Kroeger R, Krokovny P, Kuhr T, Kulasiri R, Kumar R, Kumara K, Kuzmin A, Kwon YJ, Lalwani K, Lange JS, Lee IS, Lee SC, Lewis P, Li LK, Li YB, Li Gioi L, Libby J, Lieret K, Liptak Z, Liventsev D, Luo T, MacQueen C, Matsuda T, Matvienko D, Merola M, Miyabayashi K, Miyata H, Mohanty GB, Mohanty S, Moon TJ, Mori T, Mrvar M, Mussa R, Nakano E, Nakao M, Nakazawa H, Natkaniec Z, Natochii A, Nayak M, Nisar NK, Nishida S, Ogawa K, Ogawa S, Ono H, Onuki Y, Pakhlov P, Pakhlova G, Pardi S, Park H, Park SH, Patra S, Paul S, Pedlar TK, Pestotnik R, Piilonen LE, Podobnik T, Popov V, Prencipe E, Prim MT, Ritter M, Rostomyan A, Rout N, Russo G, Sahoo D, Sakai Y, Sandilya S, Sangal A, Santelj L, Sanuki T, Savinov V, Schnell G, Schueler J, Schwanda C, Seino Y, Senyo K, Sevior ME, Shapkin M, Shebalin V, Shiu JG, Singh JB, Solovieva E, Starič M, Stottler ZS, Sumihama M, Sumisawa K, Sumiyoshi T, Sutcliffe W, Takizawa M, Tamponi U, Tenchini F, Uchida M, Uglov T, Unno Y, Uno S, Urquijo P, Usov Y, Van Tonder R, Varner G, Vinokurova A, Vorobyev V, Waheed E, Wang CH, Wang E, Wang MZ, Wang P, Wang XL, Watanabe M, Won E, Xu X, Yabsley BD, Yang SB, Ye H, Yelton J, Yin JH, Zhang ZP, Zhilich V, Zhukova V, Zhulanov V. Evidence for X(3872)→J/ψπ^{+}π^{-} Produced in Single-Tag Two-Photon Interactions. Phys Rev Lett 2021; 126:122001. [PMID: 33834793 DOI: 10.1103/physrevlett.126.122001] [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] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 12/14/2020] [Accepted: 02/22/2021] [Indexed: 06/12/2023]
Abstract
We report the first evidence for X(3872) production in two-photon interactions by tagging either the electron or the positron in the final state, exploring the highly virtual photon region. The search is performed in e^{+}e^{-}→e^{+}e^{-}J/ψπ^{+}π^{-}, using 825 fb^{-1} of data collected by the Belle detector operated at the KEKB e^{+}e^{-} collider. We observe three X(3872) candidates, where the expected background is 0.11±0.10 events, with a significance of 3.2σ. We obtain an estimated value for Γ[over ˜]_{γγ}B(X(3872)→J/ψπ^{+}π^{-}) assuming the Q^{2} dependence predicted by a cc[over ¯] meson model, where -Q^{2} is the invariant mass squared of the virtual photon. No X(3915)→J/ψπ^{+}π^{-} candidates are found.
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Affiliation(s)
| | - S Uehara
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - M Masuda
- Research Center for Nuclear Physics, Osaka University, Osaka 567-0047
- Earthquake Research Institute, University of Tokyo, Tokyo 113-0032
| | - I Adachi
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - H Aihara
- Department of Physics, University of Tokyo, Tokyo 113-0033
| | - S Al Said
- Department of Physics, Faculty of Science, King Abdulaziz University, Jeddah 21589
- Department of Physics, Faculty of Science, University of Tabuk, Tabuk 71451
| | - D M Asner
- Brookhaven National Laboratory, Upton, New York 11973
| | - H Atmacan
- University of Cincinnati, Cincinnati, Ohio 45221
| | - T Aushev
- Higher School of Economics (HSE), Moscow 101000
| | - R Ayad
- Department of Physics, Faculty of Science, University of Tabuk, Tabuk 71451
| | - V Babu
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - P Behera
- Indian Institute of Technology Madras, Chennai 600036
| | - C Beleño
- II. Physikalisches Institut, Georg-August-Universität Göttingen, 37073 Göttingen
| | - J Bennett
- University of Mississippi, University, Mississippi 38677
| | - V Bhardwaj
- Indian Institute of Science Education and Research Mohali, SAS Nagar, 140306
| | - B Bhuyan
- Indian Institute of Technology Guwahati, Assam 781039
| | - T Bilka
- Faculty of Mathematics and Physics, Charles University, 121 16 Prague
| | - J Biswal
- J. Stefan Institute, 1000 Ljubljana
| | - G Bonvicini
- Wayne State University, Detroit, Michigan 48202
| | - A Bozek
- H. Niewodniczanski Institute of Nuclear Physics, Krakow 31-342
| | - M Bračko
- J. Stefan Institute, 1000 Ljubljana
- University of Maribor, 2000 Maribor
| | - T E Browder
- University of Hawaii, Honolulu, Hawaii 96822
| | - M Campajola
- INFN-Sezione di Napoli, 80126 Napoli
- Università di Napoli Federico II, 80126 Napoli
| | - D Červenkov
- Faculty of Mathematics and Physics, Charles University, 121 16 Prague
| | - M-C Chang
- Department of Physics, Fu Jen Catholic University, Taipei 24205
| | - P Chang
- Department of Physics, National Taiwan University, Taipei 10617
| | - V Chekelian
- Max-Planck-Institut für Physik, 80805 München
| | - A Chen
- National Central University, Chung-li 32054
| | - B G Cheon
- Department of Physics and Institute of Natural Sciences, Hanyang University, Seoul 04763
| | - K Chilikin
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - K Cho
- Korea Institute of Science and Technology Information, Daejeon 34141
| | - S-J Cho
- Yonsei University, Seoul 03722
| | - S-K Choi
- Gyeongsang National University, Jinju 52828
| | - Y Choi
- Sungkyunkwan University, Suwon 16419
| | - S Choudhury
- Indian Institute of Technology Hyderabad, Telangana 502285
| | - D Cinabro
- Wayne State University, Detroit, Michigan 48202
| | - S Cunliffe
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - G De Nardo
- INFN-Sezione di Napoli, 80126 Napoli
- Università di Napoli Federico II, 80126 Napoli
| | - F Di Capua
- INFN-Sezione di Napoli, 80126 Napoli
- Università di Napoli Federico II, 80126 Napoli
| | - Z Doležal
- Faculty of Mathematics and Physics, Charles University, 121 16 Prague
| | - T V Dong
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE) and Institute of Modern Physics, Fudan University, Shanghai 200443
| | - S Eidelman
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
- Novosibirsk State University, Novosibirsk 630090
| | - T Ferber
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - B G Fulsom
- Pacific Northwest National Laboratory, Richland, Washington 99352
| | - R Garg
- Panjab University, Chandigarh 160014
| | - V Gaur
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061
| | - N Gabyshev
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - A Garmash
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - A Giri
- Indian Institute of Technology Hyderabad, Telangana 502285
| | - P Goldenzweig
- Institut für Experimentelle Teilchenphysik, Karlsruher Institut für Technologie, 76131 Karlsruhe
| | - D Greenwald
- Department of Physics, Technische Universität München, 85748 Garching
| | - C Hadjivasiliou
- Pacific Northwest National Laboratory, Richland, Washington 99352
| | - T Hara
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - O Hartbrich
- University of Hawaii, Honolulu, Hawaii 96822
| | | | | | - M T Hedges
- University of Hawaii, Honolulu, Hawaii 96822
| | | | - W-S Hou
- Department of Physics, National Taiwan University, Taipei 10617
| | - C-L Hsu
- School of Physics, University of Sydney, New South Wales 2006
| | - T Iijima
- Graduate School of Science, Nagoya University, Nagoya 464-8602
- Kobayashi-Maskawa Institute, Nagoya University, Nagoya 464-8602
| | - K Inami
- Graduate School of Science, Nagoya University, Nagoya 464-8602
| | - G Inguglia
- Institute of High Energy Physics, Vienna 1050
| | - A Ishikawa
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - R Itoh
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - M Iwasaki
- Osaka City University, Osaka 558-8585
| | - Y Iwasaki
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - W W Jacobs
- Indiana University, Bloomington, Indiana 47408
| | - E-J Jang
- Gyeongsang National University, Jinju 52828
| | - S Jia
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE) and Institute of Modern Physics, Fudan University, Shanghai 200443
| | - Y Jin
- Department of Physics, University of Tokyo, Tokyo 113-0033
| | - C W Joo
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), University of Tokyo, Kashiwa 277-8583
| | - K K Joo
- Chonnam National University, Gwangju 61186
| | - J Kahn
- Institut für Experimentelle Teilchenphysik, Karlsruher Institut für Technologie, 76131 Karlsruhe
| | - A B Kaliyar
- Tata Institute of Fundamental Research, Mumbai 400005
| | - K H Kang
- Kyungpook National University, Daegu 41566
| | - G Karyan
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - Y Kato
- Graduate School of Science, Nagoya University, Nagoya 464-8602
| | - T Kawasaki
- Kitasato University, Sagamihara 252-0373
| | - H Kichimi
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - C Kiesling
- Max-Planck-Institut für Physik, 80805 München
| | - B H Kim
- Seoul National University, Seoul 08826
| | - D Y Kim
- Soongsil University, Seoul 06978
| | - S H Kim
- Seoul National University, Seoul 08826
| | - Y-K Kim
- Yonsei University, Seoul 03722
| | - T D Kimmel
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061
| | - K Kinoshita
- University of Cincinnati, Cincinnati, Ohio 45221
| | - P Kodyš
- Faculty of Mathematics and Physics, Charles University, 121 16 Prague
| | - S Korpar
- J. Stefan Institute, 1000 Ljubljana
- University of Maribor, 2000 Maribor
| | | | - P Križan
- J. Stefan Institute, 1000 Ljubljana
- Faculty of Mathematics and Physics, University of Ljubljana, 1000 Ljubljana
| | - R Kroeger
- University of Mississippi, University, Mississippi 38677
| | - P Krokovny
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - T Kuhr
- Ludwig Maximilians University, 80539 Munich
| | - R Kulasiri
- Kennesaw State University, Kennesaw, Georgia 30144
| | - R Kumar
- Punjab Agricultural University, Ludhiana 141004
| | - K Kumara
- Wayne State University, Detroit, Michigan 48202
| | - A Kuzmin
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | | | - K Lalwani
- Malaviya National Institute of Technology Jaipur, Jaipur 302017
| | - J S Lange
- Justus-Liebig-Universität Gießen, 35392 Gießen
| | - I S Lee
- Department of Physics and Institute of Natural Sciences, Hanyang University, Seoul 04763
| | - S C Lee
- Kyungpook National University, Daegu 41566
| | - P Lewis
- University of Bonn, 53115 Bonn
| | - L K Li
- University of Cincinnati, Cincinnati, Ohio 45221
| | - Y B Li
- Peking University, Beijing 100871
| | - L Li Gioi
- Max-Planck-Institut für Physik, 80805 München
| | - J Libby
- Indian Institute of Technology Madras, Chennai 600036
| | - K Lieret
- Ludwig Maximilians University, 80539 Munich
| | - Z Liptak
- Hiroshima University, Hiroshima 739-8511
| | - D Liventsev
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
- Wayne State University, Detroit, Michigan 48202
| | - T Luo
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE) and Institute of Modern Physics, Fudan University, Shanghai 200443
| | - C MacQueen
- School of Physics, University of Melbourne, Victoria 3010
| | - T Matsuda
- University of Miyazaki, Miyazaki 889-2192
| | - D Matvienko
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
- Novosibirsk State University, Novosibirsk 630090
| | - M Merola
- INFN-Sezione di Napoli, 80126 Napoli
- Università di Napoli Federico II, 80126 Napoli
| | | | - H Miyata
- Niigata University, Niigata 950-2181
| | - G B Mohanty
- Tata Institute of Fundamental Research, Mumbai 400005
| | - S Mohanty
- Tata Institute of Fundamental Research, Mumbai 400005
- Utkal University, Bhubaneswar 751004
| | - T J Moon
- Seoul National University, Seoul 08826
| | - T Mori
- Graduate School of Science, Nagoya University, Nagoya 464-8602
| | - M Mrvar
- Institute of High Energy Physics, Vienna 1050
| | - R Mussa
- INFN-Sezione di Torino, 10125 Torino
| | - E Nakano
- Osaka City University, Osaka 558-8585
| | - M Nakao
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - H Nakazawa
- Department of Physics, National Taiwan University, Taipei 10617
| | - Z Natkaniec
- H. Niewodniczanski Institute of Nuclear Physics, Krakow 31-342
| | - A Natochii
- University of Hawaii, Honolulu, Hawaii 96822
| | - M Nayak
- School of Physics and Astronomy, Tel Aviv University, Tel Aviv 69978
| | - N K Nisar
- Brookhaven National Laboratory, Upton, New York 11973
| | - S Nishida
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - K Ogawa
- Niigata University, Niigata 950-2181
| | - S Ogawa
- Toho University, Funabashi 274-8510
| | - H Ono
- Nippon Dental University, Niigata 951-8580
- Niigata University, Niigata 950-2181
| | - Y Onuki
- Department of Physics, University of Tokyo, Tokyo 113-0033
| | - P Pakhlov
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
- Moscow Physical Engineering Institute, Moscow 115409
| | - G Pakhlova
- Higher School of Economics (HSE), Moscow 101000
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - S Pardi
- INFN-Sezione di Napoli, 80126 Napoli
| | - H Park
- Kyungpook National University, Daegu 41566
| | | | - S Patra
- Indian Institute of Science Education and Research Mohali, SAS Nagar, 140306
| | - S Paul
- Max-Planck-Institut für Physik, 80805 München
- Department of Physics, Technische Universität München, 85748 Garching
| | | | | | - L E Piilonen
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061
| | - T Podobnik
- J. Stefan Institute, 1000 Ljubljana
- Faculty of Mathematics and Physics, University of Ljubljana, 1000 Ljubljana
| | - V Popov
- Higher School of Economics (HSE), Moscow 101000
| | | | - M T Prim
- Institut für Experimentelle Teilchenphysik, Karlsruher Institut für Technologie, 76131 Karlsruhe
| | - M Ritter
- Ludwig Maximilians University, 80539 Munich
| | - A Rostomyan
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - N Rout
- Indian Institute of Technology Madras, Chennai 600036
| | - G Russo
- Università di Napoli Federico II, 80126 Napoli
| | - D Sahoo
- Tata Institute of Fundamental Research, Mumbai 400005
| | - Y Sakai
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - S Sandilya
- University of Cincinnati, Cincinnati, Ohio 45221
| | - A Sangal
- University of Cincinnati, Cincinnati, Ohio 45221
| | - L Santelj
- J. Stefan Institute, 1000 Ljubljana
- Faculty of Mathematics and Physics, University of Ljubljana, 1000 Ljubljana
| | - T Sanuki
- Department of Physics, Tohoku University, Sendai 980-8578
| | - V Savinov
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260
| | - G Schnell
- University of the Basque Country UPV/EHU, 48080 Bilbao
- IKERBASQUE, Basque Foundation for Science, 48013 Bilbao
| | - J Schueler
- University of Hawaii, Honolulu, Hawaii 96822
| | - C Schwanda
- Institute of High Energy Physics, Vienna 1050
| | - Y Seino
- Niigata University, Niigata 950-2181
| | - K Senyo
- Yamagata University, Yamagata 990-8560
| | - M E Sevior
- School of Physics, University of Melbourne, Victoria 3010
| | - M Shapkin
- Institute for High Energy Physics, Protvino 142281
| | - V Shebalin
- University of Hawaii, Honolulu, Hawaii 96822
| | - J-G Shiu
- Department of Physics, National Taiwan University, Taipei 10617
| | - J B Singh
- Panjab University, Chandigarh 160014
| | - E Solovieva
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - M Starič
- J. Stefan Institute, 1000 Ljubljana
| | - Z S Stottler
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061
| | | | - K Sumisawa
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - T Sumiyoshi
- Tokyo Metropolitan University, Tokyo 192-0397
| | | | - M Takizawa
- J-PARC Branch, KEK Theory Center, High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
- Showa Pharmaceutical University, Tokyo 194-8543
| | - U Tamponi
- INFN-Sezione di Torino, 10125 Torino
| | - F Tenchini
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - M Uchida
- Tokyo Institute of Technology, Tokyo 152-8550
| | - T Uglov
- Higher School of Economics (HSE), Moscow 101000
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - Y Unno
- Department of Physics and Institute of Natural Sciences, Hanyang University, Seoul 04763
| | - S Uno
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - P Urquijo
- School of Physics, University of Melbourne, Victoria 3010
| | - Y Usov
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | | | - G Varner
- University of Hawaii, Honolulu, Hawaii 96822
| | - A Vinokurova
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - V Vorobyev
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
- Novosibirsk State University, Novosibirsk 630090
| | - E Waheed
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - C H Wang
- National United University, Miao Li 36003
| | - E Wang
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260
| | - M-Z Wang
- Department of Physics, National Taiwan University, Taipei 10617
| | - P Wang
- Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049
| | - X L Wang
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE) and Institute of Modern Physics, Fudan University, Shanghai 200443
| | | | - E Won
- Korea University, Seoul 02841
| | - X Xu
- Soochow University, Suzhou 215006
| | - B D Yabsley
- School of Physics, University of Sydney, New South Wales 2006
| | | | - H Ye
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - J Yelton
- University of Florida, Gainesville, Florida 32611
| | - J H Yin
- Korea University, Seoul 02841
| | - Z P Zhang
- Department of Modern Physics and State Key Laboratory of Particle Detection and Electronics, University of Science and Technology of China, Hefei 230026
| | - V Zhilich
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - V Zhukova
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - V Zhulanov
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
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Mohanty S, Dabas J, Verma A, Gupta S, Urs AB, Hemavathy S. Surgical management of the odontogenic keratocyst: A 20-year experience. Int J Oral Maxillofac Surg 2021; 50:1168-1176. [PMID: 33663899 DOI: 10.1016/j.ijom.2021.02.015] [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: 05/26/2020] [Revised: 12/31/2020] [Accepted: 02/09/2021] [Indexed: 10/22/2022]
Abstract
The objective of this study was to describe the authors' long-term experience with the management of odontogenic keratocysts (OKCs). All OKC cases treated at the study centre between 1999 and 2015, with a minimum of 5 years of follow-up by December 2019, were reviewed retrospectively. Operative procedures including decompression/marsupialization, enucleation (E), E+Carnoy's solution (CS), E+CS+peripheral ostectomy (PO), and resection were assessed for complete resolution, partial resolution, and recurrence rates. In the parakeratinized non-syndromic group, E+CS+PO resulted in the lowest recurrence rate among the minimally invasive procedures (4.3%), while enucleation resulted in the highest rate (60%). Regarding the other modalities, recurrence was 12.5% for decompression, 11.5% for marsupialization, 16.7% for E+CS, 26.7% for E+PO, and 0% for resection. In the syndromic group, marsupialization resulted in a significantly higher recurrence (23.1%), while E+CS+PO cases showed no recurrence. No recurrence was observed in the orthokeratinized group patients treated with marsupialization or with E+CS. Based on clinico-radiographic features and observed results, it is concluded that OKC, although having a high recurrence rate, is a benign lesion and responds well to conservative procedures in most cases. Radical procedures should be reserved for unresponsive lesions and those with extensive tissue destruction.
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Affiliation(s)
- S Mohanty
- Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, New Delhi, India.
| | - J Dabas
- Department of Oral and Maxillofacial Surgery, Bensups Hospital, New Delhi, India.
| | - A Verma
- Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, New Delhi, India.
| | - S Gupta
- Department of Oral Medicine and Radiology, Maulana Azad Institute of Dental Sciences, New Delhi, India.
| | - A B Urs
- Department of Oral and Maxillofacial Pathology, Maulana Azad Institute of Dental Sciences, New Delhi, India.
| | - S Hemavathy
- Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, New Delhi, India.
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Andama A, Jaganath D, Crowder R, Asege L, Nakaye M, Katumba D, Mukwatamundu J, Mwebe S, Semitala CF, Worodria W, Joloba M, Mohanty S, Somoskovi A, Cattamanchi A. The transition to Xpert MTB/RIF ultra: diagnostic accuracy for pulmonary tuberculosis in Kampala, Uganda. BMC Infect Dis 2021; 21:49. [PMID: 33430790 PMCID: PMC7802232 DOI: 10.1186/s12879-020-05727-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 12/21/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) has endorsed the next-generation Xpert MTB/RIF Ultra (Ultra) cartridge, and Uganda is currently transitioning from the older generation Xpert MTB/RIF (Xpert) cartridge to Ultra as the initial diagnostic test for pulmonary tuberculosis (TB). We assessed the diagnostic accuracy of Ultra for pulmonary TB among adults in Kampala, Uganda. METHODS We sampled adults referred for Xpert testing at two hospitals and a health center over a 12-month period. We enrolled adults with positive Xpert and a random 1:1 sample with negative Xpert results. Expectorated sputum was collected for Ultra, and for solid and liquid culture testing for Xpert-negative patients. We measured sensitivity and specificity of Ultra overall and by HIV status, prior history of TB, and hospitalization, in reference to Xpert and culture results. We also assessed how classification of results in the new "trace" category affects Ultra accuracy. RESULTS Among 698 participants included, 211 (30%) were HIV-positive and 336 (48%) had TB. The sensitivity of Ultra was 90.5% (95% CI 86.8-93.4) and specificity was 98.1% (95% CI 96.1-99.2). There were no significant differences in sensitivity and specificity by HIV status, prior history of TB or hospitalization. Xpert and Ultra results were concordant in 670 (96%) participants, with Ultra having a small reduction in specificity (difference 1.9, 95% CI 0.2 to 3.6, p=0.01). When "trace" results were considered positive for all patients, sensitivity increased by 2.1% (95% CI 0.3 to 3.9, p=0.01) without a significant reduction in specificity (- 0.8, 95% CI - 0.3 to 2.0, p=0.08). CONCLUSIONS After 1 year of implementation, Ultra had similar performance to Xpert. Considering "trace" results to be positive in all patients increased case detection without significant loss of specificity. Longitudinal studies are needed to compare the benefit of greater diagnoses to the cost of overtreatment.
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Affiliation(s)
- A Andama
- Department of Internal Medicine, Makerere University College of Health Sciences, Ground Floor Pathology Building, Room A4, Kampala, Uganda. .,Infectious Diseases Research Collaboration, Kampala, Uganda.
| | - D Jaganath
- Department of Medicine, Division of Pulmonary & Critical Care Medicine, University of California San Francisco, San Francisco, California, USA.,Center for Tuberculosis, University of California San Francisco, San Francisco, California, USA.,Department of Pediatrics, Division of Pediatric Infectious Diseases, University of California San Francisco, San Francisco, California, USA
| | - R Crowder
- Department of Medicine, Division of Pulmonary & Critical Care Medicine, University of California San Francisco, San Francisco, California, USA.,Center for Tuberculosis, University of California San Francisco, San Francisco, California, USA
| | - L Asege
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - M Nakaye
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - D Katumba
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - J Mukwatamundu
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - S Mwebe
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - C F Semitala
- Department of Internal Medicine, Makerere University College of Health Sciences, Ground Floor Pathology Building, Room A4, Kampala, Uganda.,Infectious Diseases Research Collaboration, Kampala, Uganda
| | - W Worodria
- Department of Internal Medicine, Makerere University College of Health Sciences, Ground Floor Pathology Building, Room A4, Kampala, Uganda.,Mulago National Referral Hospital, Kampala, Uganda
| | - M Joloba
- Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda
| | - S Mohanty
- Department of Chemical Engineering, Department of Materials Science Engineering, University of Utah, Salt Lake City, USA
| | - A Somoskovi
- Global Good Intellectual Ventures Laboratory, Seattle, USA
| | - A Cattamanchi
- Department of Medicine, Division of Pulmonary & Critical Care Medicine, University of California San Francisco, San Francisco, California, USA.,Center for Tuberculosis, University of California San Francisco, San Francisco, California, USA.,Center for Vulnerable Populations, Department of Medicine, University of California San Francisco, San Francisco, USA.,Curry International Tuberculosis Center, University of California San Francisco, San Francisco, USA
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