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Kesrouani A, Jaber L, Daou L, Mcheik C, Nasr B, Saliba Z. Perinatal outcome in prenatally diagnosed cardiac rhabdomyoma case series. J Neonatal Perinatal Med 2023; 16:563-567. [PMID: 37718863 DOI: 10.3233/npm-221186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
OBJECTIVE This study aims to determine the characteristics and outcome of prenatally diagnosed cardiac rhabdomyomas. STUDY DESIGN This retrospective descriptive study includes cases referred to our university hospital. We studied sonographic characteristics of rhabdomyoma along with the neonatal outcome. RESULTS Eight cases were included, with a mean gestational age at diagnosis at 31 weeks of gestation and five patients diagnosed after 32 weeks. We noted a male gender in 75%, multiple rhabdomyoma in 50%, mostly situated in the interventricular septum (41%) and valvular regurgitation in 25%. Most patients delivered at term, including five cesareans (62.5%). Six babies survived (75%); three of them were later diagnosed with tuberous sclerosis (50%). CONCLUSION Cardiac rhabdomyoma have variable ultrasound features. The usual favorable outcome can however be complicated by neonatal death (12%), valvular regurgitation and cerebral tuber.
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Affiliation(s)
- A Kesrouani
- Obstetrics and-Gynecology Department, St Joseph University, Beirut, Lebanon
- Prenatal Unit, Bellevue Medical Center, Hotel-Dieu de France University Hospital, Beirut, Lebanon
| | - L Jaber
- Pediatrics Department, St Joseph University, Beirut, Lebanon
| | - L Daou
- Pediatrics Department, St Joseph University, Beirut, Lebanon
| | - C Mcheik
- Obstetrics and-Gynecology Department, St Joseph University, Beirut, Lebanon
- Prenatal Unit, Bellevue Medical Center, Hotel-Dieu de France University Hospital, Beirut, Lebanon
| | - B Nasr
- Prenatal Unit, Bellevue Medical Center, Hotel-Dieu de France University Hospital, Beirut, Lebanon
| | - Z Saliba
- Pediatrics Department, St Joseph University, Beirut, Lebanon
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Barlera T, Nasr B, da Silva Santos N, Teixeira R, Martins S, de Souza C, de Seixas Alves M, Lederman H, Luisi F. A RARE CASE OF PRIMARY OCULAR POST-TRANSPLANT LYMPHOPROLIFERATIVE DISORDER IN A BRAZILIAN CHILD. Leuk Res 2022. [DOI: 10.1016/s0145-2126(22)00280-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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3
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Vale L, Kunonga P, Coughlan D, Kontogiannis V, Astin M, Beyer F, Richmond C, Wilson D, Bajwa D, Javanbakht M, Bryant A, Akor W, Craig D, Lovat P, Labus M, Nasr B, Cunliffe T, Hinde H, Shawgi M, Saleh D, Royle P, Steward P, Lucas R, Ellis R. Optimal surveillance strategies for patients with stage 1 cutaneous melanoma post primary tumour excision: three systematic reviews and an economic model. Health Technol Assess 2021; 25:1-178. [PMID: 34792018 DOI: 10.3310/hta25640] [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: 12/23/2022] Open
Abstract
BACKGROUND Malignant melanoma is the fifth most common cancer in the UK, with rates continuing to rise, resulting in considerable burden to patients and the NHS. OBJECTIVES The objectives were to evaluate the effectiveness and cost-effectiveness of current and alternative follow-up strategies for stage IA and IB melanoma. REVIEW METHODS Three systematic reviews were conducted. (1) The effectiveness of surveillance strategies. Outcomes were detection of new primaries, recurrences, metastases and survival. Risk of bias was assessed using the Cochrane Collaboration's Risk-of-Bias 2.0 tool. (2) Prediction models to stratify by risk of recurrence, metastases and survival. Model performance was assessed by study-reported measures of discrimination (e.g. D-statistic, Harrel's c-statistic), calibration (e.g. the Hosmer-Lemeshow 'goodness-of-fit' test) or overall performance (e.g. Brier score, R 2). Risk of bias was assessed using the Prediction model Risk Of Bias ASsessment Tool (PROBAST). (3) Diagnostic test accuracy of fine-needle biopsy and ultrasonography. Outcomes were detection of new primaries, recurrences, metastases and overall survival. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Review data and data from elsewhere were used to model the cost-effectiveness of alternative surveillance strategies and the value of further research. RESULTS (1) The surveillance review included one randomised controlled trial. There was no evidence of a difference in new primary or recurrence detected (risk ratio 0.75, 95% confidence interval 0.43 to 1.31). Risk of bias was considered to be of some concern. Certainty of the evidence was low. (2) Eleven risk prediction models were identified. Discrimination measures were reported for six models, with the area under the operating curve ranging from 0.59 to 0.88. Three models reported calibration measures, with coefficients of ≥ 0.88. Overall performance was reported by two models. In one, the Brier score was slightly better than the American Joint Committee on Cancer scheme score. The other reported an R 2 of 0.47 (95% confidence interval 0.45 to 0.49). All studies were judged to have a high risk of bias. (3) The diagnostic test accuracy review identified two studies. One study considered fine-needle biopsy and the other considered ultrasonography. The sensitivity and specificity for fine-needle biopsy were 0.94 (95% confidence interval 0.90 to 0.97) and 0.95 (95% confidence interval 0.90 to 0.97), respectively. For ultrasonography, sensitivity and specificity were 1.00 (95% confidence interval 0.03 to 1.00) and 0.99 (95% confidence interval 0.96 to 0.99), respectively. For the reference standards and flow and timing domains, the risk of bias was rated as being high for both studies. The cost-effectiveness results suggest that, over a lifetime, less intensive surveillance than recommended by the National Institute for Health and Care Excellence might be worthwhile. There was considerable uncertainty. Improving the diagnostic performance of cancer nurse specialists and introducing a risk prediction tool could be promising. Further research on transition probabilities between different stages of melanoma and on improving diagnostic accuracy would be of most value. LIMITATIONS Overall, few data of limited quality were available, and these related to earlier versions of the American Joint Committee on Cancer staging. Consequently, there was considerable uncertainty in the economic evaluation. CONCLUSIONS Despite adoption of rigorous methods, too few data are available to justify changes to the National Institute for Health and Care Excellence recommendations on surveillance. However, alternative strategies warrant further research, specifically on improving estimates of incidence, progression of recurrent disease; diagnostic accuracy and health-related quality of life; developing and evaluating risk stratification tools; and understanding patient preferences. STUDY REGISTRATION This study is registered as PROSPERO CRD42018086784. FUNDING This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol 25, No. 64. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Luke Vale
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Patience Kunonga
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Diarmuid Coughlan
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | | | - Margaret Astin
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Fiona Beyer
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Catherine Richmond
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Dor Wilson
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Dalvir Bajwa
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Mehdi Javanbakht
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Andrew Bryant
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Wanwuri Akor
- Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Dawn Craig
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Penny Lovat
- Institute of Translation and Clinical Studies, Newcastle University, Newcastle upon Tyne, UK
| | - Marie Labus
- Business Development and Enterprise, Newcastle University, Newcastle upon Tyne, UK
| | - Batoul Nasr
- Dermatological Sciences, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Timothy Cunliffe
- Dermatology Department, James Cook University Hospital, Middlesbrough, UK
| | - Helena Hinde
- Dermatology Department, James Cook University Hospital, Middlesbrough, UK
| | - Mohamed Shawgi
- Radiology Department, James Cook University Hospital, Middlesbrough, UK
| | - Daniel Saleh
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.,Princess Alexandra Hospital Southside Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Pam Royle
- Patient representative, ITV Tyne Tees, Gateshead, UK
| | - Paul Steward
- Patient representative, Dermatology Department, James Cook University Hospital, Middlesbrough, UK
| | - Rachel Lucas
- Patient representative, Dermatology Department, James Cook University Hospital, Middlesbrough, UK
| | - Robert Ellis
- Institute of Translation and Clinical Studies, Newcastle University, Newcastle upon Tyne, UK.,South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
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Didier R, Le Ven F, Eltchaninoff H, Nasr B, Lefevre T, Fajadet J, Teiger E, Carrie D, Meneveau N, Ghostine S, Souteyrand G, Cuisset T, Le Breton H, Inug B, Gilard M. High post-procedural transvalvular gradient or delayed gradient increase after transcatheter aortic valve implantation: the FRANCE-2 registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Mean gradient (MG) elevation can be detected immediately post-procedure or secondarily during follow-up. Comparison between these two parameters and impact on outcomes has not previously been investigated.
Objectives
The study aimed to identify incidence, influence on prognosis and parameters associated with immediate high post-procedural mean transvalvular gradient (PPMG) and delayed mean gradient increase (DMGI), in the FRANCE 2 (French Aortic National CoreValve and Edwards 2) registry.
Methods
The registry includes all consecutive symptomatic patients with severe aortic stenosis. Three groups were analyzed: 1) PPMG <20mmHg without DMGI >10 mmHg (control); 2) PPMG <20mmHg with DMGI >10 mmHg (group 1); 3) PPMG ≥20 mmHg (group 2).
Results
From January 2010 to January 2012, 4201 consecutive patients were prospectively enrolled in the registry. The control group comprised 2078 patients; the group 1, 131 patients; and the group 2, 144 patients. DMGI exceeded 10 mmHg in 5.6%, and was not associated with greater 4-year mortality than in control group (32.6% vs. 40.1%, p=0.27, respectively). PPMG was at least 20 mmHg in 6.1%, and was associated with higher 4-year mortality than in control group (48.7% versus 40.1%, p=0.005, respectively) (Figure 1). Two-thirds of patients with initial PPMG ≥20 mmHg had finally a MG <20 mmHg at 1 year, with mortality similar to controls (39.2% vs. 40.1%, p=0.73).
Conclusions
Patients with PPMG >20 mmHg 1 year post-TAVI had higher 4-year mortality than the general population of the registry, unlike patients with MG normalization at 1 year.
Figure 1
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): French National Society of Cardiology
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Affiliation(s)
- R Didier
- Hospital Cavale Blanche, department of cardiology, Brest, France
| | - F Le Ven
- Hospital Cavale Blanche, department of cardiology, Brest, France
| | | | - B Nasr
- Hospital Cavale Blanche, Vascular Surgery, Brest, France
| | - T Lefevre
- Jacques Cartier Private Hospital, Massy, France
| | | | - E Teiger
- Henri Mondor University Hospital Chenevier APHP, Creteil, France
| | - D Carrie
- Rangueil Hospital of Toulouse, Toulouse, France
| | - N Meneveau
- University of Besançon, Besancon, France
| | - S Ghostine
- Marie Lannelongue Hospital, Le Plessis Robinson, France
| | - G Souteyrand
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - T Cuisset
- Hospital La Timone of Marseille, Marseille, France
| | - H Le Breton
- Hospital Pontchaillou of Rennes, Rennes, France
| | - B Inug
- Bichat Hospital, University Paris-Diderot, INSERM-UMR1148, FACT French Alliance for Cardiovascular T, Paris, France
| | - M Gilard
- Hospital Cavale Blanche, department of cardiology, Brest, France
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5
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Ellis R, Tang D, Nasr B, Greenwood A, McConnell A, Anagnostou M, Elias M, Verykiou S, Bajwa D, Ewen T, Reynolds N, Barrett P, Carling E, Watson G, Armstrong J, Allen A, Horswell S, Labus M, Lovat P. 测量两种蛋白质, 帮助评估哪种黑色素瘤最有可能传播. Br J Dermatol 2020. [DOI: 10.1111/bjd.18675] [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: 11/29/2022]
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6
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Ellis R, Tang D, Nasr B, Greenwood A, McConnell A, Anagnostou M, Elias M, Verykiou S, Bajwa D, Ewen T, Reynolds N, Barrett P, Carling E, Watson G, Armstrong J, Allen A, Horswell S, Labus M, Lovat P. Measuring two proteins to help assess which melanomas are most likely to spread. Br J Dermatol 2020. [DOI: 10.1111/bjd.18658] [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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7
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Ellis R, Tang D, Nasr B, Greenwood A, McConnell A, Anagnostou ME, Elias M, Verykiou S, Bajwa D, Ewen T, Reynolds NJ, Barrett P, Carling E, Watson G, Armstrong J, Allen AJ, Horswell S, Labus M, Lovat PE. Epidermal autophagy and beclin 1 regulator 1 and loricrin: a paradigm shift in the prognostication and stratification of the American Joint Committee on Cancer stage I melanomas. Br J Dermatol 2019; 182:156-165. [PMID: 31056744 PMCID: PMC6973157 DOI: 10.1111/bjd.18086] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND The updated American Joint Committee on Cancer (AJCC) staging criteria for melanoma remain unable to identify high-risk stage I tumour subsets. OBJECTIVES To determine the utility of epidermal autophagy and beclin 1 regulator 1 (AMBRA1)/loricrin (AMLo) expression as a prognostic biomarker for AJCC stage I cutaneous melanoma. METHODS Peritumoral AMBRA1 expression was evaluated in a retrospective discovery cohort of 76 AJCC stage I melanomas. AMLo expression was correlated with clinical outcomes up to 12 years in two independent powered, retrospective validation and qualification cohorts comprising 379 AJCC stage I melanomas. RESULTS Decreased AMBRA1 expression in the epidermis overlying primary melanomas in a discovery cohort of 76 AJCC stage I tumours was associated with a 7-year disease-free survival (DFS) rate of 81·5% vs. 100% survival with maintained AMBRA1 (P < 0·081). Following an immunohistochemistry protocol for semi-quantitative analysis of AMLo, analysis was undertaken in validation (n = 218) and qualification cohorts (n = 161) of AJCC stage I melanomas. Combined cohort analysis revealed a DFS rate of 98·3% in the AMLo low-risk group (n = 239) vs. 85·4% in the AMLo high-risk cohort (n = 140; P < 0·001). Subcohort multivariate analysis revealed that an AMLo hazard ratio (HR) of 4·04 [95% confidence interval (CI) 1·69-9·66; P = 0·002] is a stronger predictor of DFS than Breslow depth (HR 2·97, 95% CI 0·93-9·56; P = 0·068) in stage IB patients. CONCLUSIONS Loss of AMLo expression in the epidermis overlying primary AJCC stage I melanomas identifies high-risk tumour subsets independently of Breslow depth. What's already known about this topic? There is an unmet clinical need for biomarkers of early-stage melanoma. Autophagy and beclin 1 regulator 1 (AMBRA1) is a proautophagy regulatory protein with known roles in cell proliferation and differentiation, and is a known tumour suppressor. Loricrin is a marker of epidermal terminal differentiation. What does this study add? AMBRA1 has a functional role in keratinocyte/epidermal proliferation and differentiation. The combined decrease/loss of peritumoral AMBRA1 and loricrin is associated with a significantly increased risk of metastatic spread in American Joint Committee on Cancer (AJCC) stage I tumours vs. melanomas, in which peritumoral AMBRA1 and loricrin are maintained, independently of Breslow depth. What is the translational message? The integration of peritumoral epidermal AMBRA1/loricrin biomarker expression into melanoma care guidelines will facilitate more accurate, personalized risk stratification for patients with AJCC stage I melanomas, thereby facilitating stratification for appropriate follow-up and informing postdiagnostic investigations, including sentinel lymph node biopsy, ultimately resulting in improved disease outcomes and rationalization of healthcare costs.
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Affiliation(s)
- R Ellis
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, U.K.,Department of Dermatology, James Cook University Hospital, Middlesbrough, U.K
| | - D Tang
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, U.K.,Department of Dermatology, James Cook University Hospital, Middlesbrough, U.K
| | - B Nasr
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, U.K.,Department of Pathology, University of North Durham Hospital, Durham, U.K
| | - A Greenwood
- Department of Pathology, James Cook University Hospital, Middlesbrough, U.K
| | - A McConnell
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, U.K
| | - M E Anagnostou
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, U.K
| | - M Elias
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, U.K
| | - S Verykiou
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, U.K
| | - D Bajwa
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, U.K
| | - T Ewen
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, U.K
| | - N J Reynolds
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, U.K
| | - P Barrett
- Department of Pathology, University of North Durham Hospital, Durham, U.K
| | - E Carling
- Department of Pathology, St James's University Hospital, Leeds, U.K
| | - G Watson
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, U.K.,Department of Pathology, James Cook University Hospital, Middlesbrough, U.K
| | - J Armstrong
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, U.K
| | - A J Allen
- NIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle University, Newcastle upon Tyne, U.K
| | - S Horswell
- Bioinformatics and Bio Statistics Group, The Francis Crick Institute, London, U.K
| | - M Labus
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, U.K
| | - P E Lovat
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, U.K
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8
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Ellis R, McConnell A, Tang D, Nasr B, Greenwood A, Watson G, Barrett P, Horswell S, Labus M, Lovat P. 996 Epidermal AMBRA1 and Loricrin; A paradigm shift in prognostication and stratification of AJCC stage I melanoma. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.1072] [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: 10/27/2022]
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9
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Muthiah S, Tang D, Nasr B, Verykiou S. A new era in holistic care: bridging the gap between dermatologists and oncologists for the treatment of malignant melanoma. Br J Dermatol 2018; 178:1-4. [PMID: 29357596 DOI: 10.1111/bjd.15385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- S Muthiah
- Dermatological Sciences, Institute of Cellular Medicine, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, U.K
- Newcastle upon Tyne Hospitals, NHS Foundation Trust, Newcastle, U.K
| | - D Tang
- Dermatological Sciences, Institute of Cellular Medicine, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, U.K
- James Cook University Hospital, Middlesbrough, Teeside, U.K
| | - B Nasr
- Dermatological Sciences, Institute of Cellular Medicine, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, U.K
- James Cook University Hospital, Middlesbrough, Teeside, U.K
| | - S Verykiou
- Dermatological Sciences, Institute of Cellular Medicine, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, U.K
- Newcastle upon Tyne Hospitals, NHS Foundation Trust, Newcastle, U.K
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10
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Bajwa DS, Nasr B, Carmichael AJ, Rajan N. Milia: a useful clinical marker of CYLD mutation carrier status. Clin Exp Dermatol 2017; 43:193-195. [PMID: 29023940 DOI: 10.1111/ced.13296] [Citation(s) in RCA: 2] [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] [Accepted: 02/11/2017] [Indexed: 11/30/2022]
Affiliation(s)
- D S Bajwa
- Institute of Genetic Medicine, University of Newcastle upon Tyne, Newcastle upon Tyne, UK.,Department of Dermatology, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 3BZ, UK
| | - B Nasr
- Department of Dermatology, James Cook University Hospital, Middlesbrough, North Yorkshire, UK
| | - A J Carmichael
- Department of Dermatology, James Cook University Hospital, Middlesbrough, North Yorkshire, UK
| | - N Rajan
- Institute of Genetic Medicine, University of Newcastle upon Tyne, Newcastle upon Tyne, UK.,Department of Dermatology, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 3BZ, UK
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Panaget S, Coste A, Badra A, De Moreuil C, Le Bars H, Talarmin J, Nasr B, Gouny P, Albert B, Le Berre R. Étude rétrospective des infections de prothèses vasculaires dans un CHRU de 2011 à 2016. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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12
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Coste A, De Moreuil C, Nasr B, Albert B, Badra A, Talarmin J, Bezon E, Le Berre R. BACT-11 - Étude rétrospective sur 3 ans des anévrismes infectieux de l’aorte native. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30306-7] [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: 10/21/2022]
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13
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Narimani T, Douraghi M, Owlia P, Rastegar A, Esghaei M, Nasr B, Talebi M. Heterogeneity in resistant fecal Bacteroides fragilis group collected from healthy people. Microb Pathog 2016; 95:1-6. [PMID: 26945562 DOI: 10.1016/j.micpath.2016.02.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 01/19/2016] [Revised: 02/23/2016] [Accepted: 02/26/2016] [Indexed: 11/19/2022]
Abstract
Normal nonpathogenic flora would represent a constant lake of resistance genes potentially transferable to human pathogens. To assess the prevalence of resistance genes and genetic variability of Bacteroides fragilis group (BFG) from normal flora, 177 Bacteroides isolates obtained from the fecal samples of healthy individuals. These isolates were subjected to antibiotic susceptibility testing and pulsed field gel electrophoresis (PFGE). The isolates were further tested for the presence of ermF, tetQ and bft genes by PCR. Our results indicated the presence of different clonal strains (1 common type and 57 single types) among the resistant isolates. The resistance rate for the six antibiotics in this study was between 1% and 95%. Most of the isolates (99%) were susceptible to metronidazole. ermF and tetQ were detected in all erythromycin and tetracycline resistant isolates. None of the isolates were carried bft gene. These data suggest dissemination of heterogenic clonal groups in healthy persons and resistance to 5 high commonly used antibiotics.
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Affiliation(s)
- T Narimani
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - M Douraghi
- Department of Microbiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - P Owlia
- Molecular Microbiology Research Center(MMRC), Shahed University, Tehran, Iran
| | - A Rastegar
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - M Esghaei
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - B Nasr
- Department of Microbiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - M Talebi
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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Nasr B, Kaladji A, Vent PA, Chaillou P, Costargent A, Patra P, Quillard T, Gouëffic Y. State-of-the-art treatment of common femoral artery disease. J Cardiovasc Surg (Torino) 2015; 56:309-316. [PMID: 25644828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Atherosclerotic common femoral artery (CFA) disease is a well-known and frequent cause of symptomatic peripheral artery disease (PAD). Not so long ago, surgical treatment was considered the gold standard and the main treatment option. Therapeutic advances have, however, provided a wide and suitable armamentarium. These advances concern medical treatment and the direct treatment of lesions by open surgery or endovascular treatment. The aim of this manuscript was to summarize therapeutic updates and to describe the current endovascular and open surgical procedures used to treat common femoral artery disease.
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Affiliation(s)
- B Nasr
- CHU de Brest, Service de Chirurgie Vasculaire, Brest, France -
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15
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Stirnemann JJ, Nasr B, Essaoui M, Bussieres L, Ville Y. A nomogram for perioperative prognostic risk-assessment in twin-twin transfusion syndrome. Prenat Diagn 2012; 33:103-8. [DOI: 10.1002/pd.4015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- J. J. Stirnemann
- Department of Obstetrics and Fetal Medicine, GHU Necker Enfants-Malades; University Paris Descartes; Paris France
- Department of Statistics and Applied Mathematics, MAP5, UMR CNRS 8145; University Paris Descartes; Paris France
| | - B. Nasr
- Department of Obstetrics and Fetal Medicine, GHU Necker Enfants-Malades; University Paris Descartes; Paris France
| | - M. Essaoui
- Department of Obstetrics and Fetal Medicine, GHU Necker Enfants-Malades; University Paris Descartes; Paris France
| | - L. Bussieres
- Department of Obstetrics and Fetal Medicine, GHU Necker Enfants-Malades; University Paris Descartes; Paris France
- Department of Clinical Research, URC Paris-Ouest, Ambroise Paré Hospital; University Versailles Saint-Quentin; Paris France
| | - Y. Ville
- Department of Obstetrics and Fetal Medicine, GHU Necker Enfants-Malades; University Paris Descartes; Paris France
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Stirnemann JJ, Nasr B, Proulx F, Essaoui M, Ville Y. Evaluation of the CHOP cardiovascular score as a prognostic predictor of outcome in twin-twin transfusion syndrome after laser coagulation of placental vessels in a prospective cohort. Ultrasound Obstet Gynecol 2010; 36:52-57. [PMID: 20582931 DOI: 10.1002/uog.7713] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To investigate the prognostic value of cardiac function assessment by the previously reported CHOP (Children's Hospital of Philadelphia) cardiovascular score in twin-twin transfusion syndrome (TTTS). METHODS All consecutive monochorionic pregnancies presenting with TTTS over a 24-month period were evaluated by preoperative echocardiography before percutaneous laser coagulation of chorionic vessels. Each of the 12 items of the CHOP score was evaluated prospectively and the cardiovascular score was categorized into stages using previously published cut-offs. The outcome considered for this study was neonatal survival of neither, one or both twins. RESULTS In total, 215 pregnancies were enrolled. Due to technical issues, CHOP evaluation was incomplete in 16% of cases and follow-up was unavailable in 12%. Overall, there was a significant relationship between the CHOP score and the Quintero staging system, although this relationship was significantly reduced when parameters used in the Quintero system were removed from the CHOP score. Based upon neonatal survival, the CHOP score did not show any prognostic value regarding overall pregnancy outcome or individual recipient survival. CONCLUSION Cardiac function assessment using the CHOP score is not of clinical use as a prognostic marker in TTTS. This suggests that cardiac function may not be of interest for preoperative staging when laser coagulation is the first-line treatment, other than to confirm the diagnosis of TTTS requiring surgery.
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Affiliation(s)
- J J Stirnemann
- Department of Obstetrics and Maternal-Fetal Medicine, GHU Necker-Enfants Malades, University Paris Descartes, Paris, France
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Chalouhi GE, Bernard JP, Benoist G, Nasr B, Ville Y, Salomon LJ. A comparison of first trimester measurements for prediction of delivery date. J Matern Fetal Neonatal Med 2010; 24:51-7. [DOI: 10.3109/14767051003728229] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Stirnemann JJ, Mougeot M, Proulx F, Nasr B, Essaoui M, Fouron JC, Ville Y. Profiling fetal cardiac function in twin-twin transfusion syndrome. Ultrasound Obstet Gynecol 2010; 35:19-27. [PMID: 20020467 DOI: 10.1002/uog.7488] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES Cardiomyopathy in the recipient twin is a marker of severity in twin-twin transfusion syndrome (TTTS), making it a potentially valuable tool for staging the disease. This study aimed to provide a quantitative description of cardiac function in the recipient twin. METHODS Consecutive monochorionic pregnancies complicated with TTTS and treated by percutaneous laser coagulation underwent fetal echocardiography before surgery. An unsupervised classification analysis was conducted to identify groups of twins with similar cardiac profiles. The predictive value of the recipient twin's preoperative cardiac function based on these profiles was assessed, using perinatal death of at least one twin as the main outcome. The cardiac function profiles that we identified were compared with the current Quintero staging. RESULTS A total of 107 pregnancies were included, with six of these lost to follow-up; 63/107 complete cases were available for multivariate description of the recipient's cardiac function. Three different preoperative cardiac profiles were identified with increasing right and left myocardial performance index, decreasing right and left shortening fraction, and increasing ductus venosus pulsatility index. Although the three groups represented progressive stages of the syndrome-related cardiomyopathy, no correlation was found with pregnancy outcome. Of Quintero Stage 1 cases, 55% showed significant alterations of cardiac function in the recipient twin. CONCLUSIONS Progressive cardiomyopathy can be assessed quantitatively in the recipient twin and does not influence pregnancy outcome when fetoscopic laser coagulation is the first-line treatment. Compared with the current staging, cardiac profiling allows discrimination of cases with significant myocardial dysfunction.
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Affiliation(s)
- J J Stirnemann
- Department of Obstetrics and Gynecology, GHU Necker Enfants Malades, University Paris Descartes, Paris, France
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Salomon LJ, Nasr B, Nizard J, Bernard JP, Essaoui M, Bussieres L, Ville Y. Emergency cerclage in cases of twin-to-twin transfusion syndrome with a short cervix at the time of surgery and relationship to perinatal outcome. Prenat Diagn 2008; 28:1256-61. [DOI: 10.1002/pd.2156] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Quarello E, Stirnemann J, Nassar M, Nasr B, Bernard JP, Leleu-Huard F, Ville Y. Outcome of anaemic monochorionic single survivors following early intrauterine rescue transfusion in cases of feto-fetal transfusion syndrome. BJOG 2008; 115:595-601. [DOI: 10.1111/j.1471-0528.2007.01659.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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El Kateb A, Nasr B, Nassar M, Bernard JP, Ville Y. First-trimester ultrasound examination and the outcome of monochorionic twin pregnancies. Prenat Diagn 2008; 27:922-5. [PMID: 17590889 DOI: 10.1002/pd.1802] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To refine the incidence of abnormal first-trimester ultrasound measurements and their correlation with the outcome of monochorionic diamniotic pregnancies. METHODS First-trimester crown-rump length (CRL) and nuchal translucency thickness (NT) measurements were studied in three subgroups of a total of 200 monochorionic twin gestations referred to our center between June 2002 and February 2006. Intertwin CRL discordance was defined as > 10% and the 95th percentile of NT thickness for gestational age was used. The first group of 103 consecutive unselected monochorionic diamniotic twin pregnancies was prospectively followed up from 11-14 weeks onwards, throughout the pregnancy. The second group of 136 nonconsecutive monochorionic diamniotic twin pregnancies including 64 that developed TTTS was studied retrospectively. The third group of 100 consecutive cases of TTTS studied retrospectively for the correlation between first trimester measurements and staging and timing of occurrence of TTTS. RESULTS In group 1, the incidence of TTTS was 5 in 103 (5%, 95CI [0.7-9]). Large intertwin CRL discordance and increased NT were correlated with perinatal death. In group 2, no significant association was found between first-trimester parameters and the development of TTTS but discordance in early second trimester biometry and Doppler were. In group three, a positive correlation was found between the intertwin discordance in CRL and early occurrence of TTTS before 20 weeks of gestation (p = 0.02). CONCLUSION Monochorionic twin gestations who ultimately develop TTTS may exhibit intertwin difference in growth as early as 11-14 weeks of gestation. The earlier the discordance the earlier the development of the disease.
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Affiliation(s)
- A El Kateb
- Department of Obstetrics and Gynecology, Paris-Ouest medical school, UVSQ, CHI Poissy-Saint Germain en Laye, France
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Yamamoto M, Essaoui M, Nasr B, Malek N, Takahashi Y, Moreira de Sa R, Ville Y. Three-dimensional sonographic assessment of fetal urine production before and after laser surgery in twin-to-twin transfusion syndrome. Ultrasound Obstet Gynecol 2007; 30:972-976. [PMID: 18044798 DOI: 10.1002/uog.5218] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE Fetal urine production in twin-to-twin transfusion syndrome (TTTS) reflects the hemodynamic imbalance between the donor and recipient twins but it has not been measured in this particular condition. The aim of this study was to measure fetal urine production using three-dimensional (3D) ultrasound in donor and recipient twins before and after laser treatment for TTTS and to correlate this with umbilical venous volume flow (UVVF). METHODS Urine production rate (UPR) was measured using 3D ultrasound with Virtual Organ Computer-aided AnaLysis (VOCAL) in 106 cases of severe TTTS. The rotation angle was set at 30 degrees . The bladder volume was measured twice in each fetus (V(1) and V(2)), with an interval of 5-30 min between measurements, in order to calculate the UPR. When V(2) > V(1), UPR was calculated using the formula: V(2) - V(1) /time interval. Together with UPR, UVVF was measured before and after treatment. Both parameters were corrected for fetal weight. Inter- and intraobserver variability were calculated in 16 cases using the intraclass correlation coefficient. RESULTS Before laser treatment, UPR was significantly higher in recipients compared with donors (median, 14.8 and 0 mL/h/kg, mean 23.8 and 2.3 mL/h/kg, respectively, P < 0.001), and UPR was positively correlated with UVVF in both twins. Following laser treatment (48 h later), UPR decreased to 9 mL/h/kg (P < 0.001) in recipients, while there was no change in donors. UVVF increased significantly from a median value of 92 to 132 mL/min/kg (P < 0.01) in donors and decreased significantly from 150 to 99 mL/min/kg (P < 0.001) in recipients. CONCLUSIONS In TTTS UPR is correlated to UVVF and reflects the hemodynamic imbalance between donor and recipient twins. Following laser treatment, UPR decreases in recipients but is unaffected in donors. However, changes in UVVF occur in both twins. This suggests that although fetal renal function is driven by fetal hemodynamics, there may be a lag in the recovery of renal function in the donor twin.
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Affiliation(s)
- M Yamamoto
- Service de Gynécologie Obstétrique, CHI Poissy Saint Germain en Laye, Université de Paris-Ouest Versailles-St. Quentin en Yvelines, Poissy, France
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Cañizares P, Louhichi B, Gadri A, Nasr B, Paz R, Rodrigo MA, Saez C. Electrochemical treatment of the pollutants generated in an ink-manufacturing process. J Hazard Mater 2007; 146:552-7. [PMID: 17532123 DOI: 10.1016/j.jhazmat.2007.04.085] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The effluents of ink-manufacturing processes contain a large variety of pollutants such as dyes, surfactants, biocides, water soluble solvents, etc. In this work, the electrochemical oxidation of several dyes (methylene blue and rhodamine B), solvents (monoethylene glycol, diethylene glycol and glycerol) and surfactants (sodium dodecylbenzenesulfonate) has been studied. To carry out the electrolyses, a bench-scale plant with a single-compartment electrochemical flow-cell was used. Boron doped diamond (BDD) was used as anode and stainless steel (AISI 304) as cathode. For all the compounds tested, the conductive diamond electrooxidation allows achieving the almost complete removal of COD of the waste with a very high current efficiency. The efficiencies of the electrochemical processes seem to depend on the current density and on the nature of the anions contained in the waste (chlorine, sulphate, phosphate). Thus, it has been observed that the use of chloride media favours the treatment of dyes. On the contrary, the use of sulphate- or phosphate-containing solutions improves the removal of the aliphatic compounds studied (solvents). These results suggest an important role of the mediated electrochemical processes on the overall performance of the reaction system.
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Affiliation(s)
- P Cañizares
- Department of Chemical Engineering, Facultad de Ciencias Químicas, Universidad de Castilla La Mancha, Campus Universitario s/n, 13071 Ciudad Real, Spain
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Yamamoto M, Nasr B, Ortqvist L, Bernard JP, Takahashi Y, Ville Y. Intertwin discordance in umbilical venous volume flow: a reflection of blood volume imbalance in twin-to-twin transfusion syndrome. Ultrasound Obstet Gynecol 2007; 29:317-20. [PMID: 17323309 DOI: 10.1002/uog.3959] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
OBJECTIVES To compare umbilical venous volume flow (UVVF) between donor and recipient twins in twin-to-twin transfusion syndrome (TTTS) using an index that is independent of gestational age and to correlate changes in this index with outcome following endoscopic laser surgery. METHODS UVVF was calculated in 84 cases of TTTS by multiplying the umbilical vein cross-sectional area at its entry into the fetal abdomen by time averaged blood velocity. All cases were classified according to the Quintero staging system. The ratio between UVVF in recipients and donors (R/D-UVVF) in each pair of twins was calculated before and 48 h after laser treatment, and changes in R/D-UVVF were correlated with pregnancy outcome. Intraobserver and interobserver UVVF measurement reliability was assessed in 19 singletons, and 13 donor and recipient twins before laser treatment using the intraclass correlation coefficient (ICC). RESULTS Twenty-five, 32, 21 and six cases presented as Quintero Stages 1, 2, 3 and 4, respectively, at a median gestational age of 20 (range, 15-26) weeks. Intraobserver and interobserver ICC for UVVF measurement in twins were 0.97 and 0.67, respectively. UVVF was a median of 2.13-fold (range, 0.3-19-fold) higher in recipients than in donors (137 mL/min vs. 64 mL/min, P < 0.001) and increased with gestational age (r = 0.58, P < 0.001 for recipients, r = 0.62, P < 0.001 for donors). From 68 cases in which R/D-UVVF could be measured 48 h following laser surgery, cases with a favorable outcome showed a significant decrease in R/D-UVVF from a median of 1.97 to 1.27 (P < 0.01) and cases with recurrent TTTS (n = 6) did not (decrease in R/D-UVVF from a median of 2.32 to 2.19, P = 0.17). Using a cut-off of < 30% reduction of R/D-UVVF, 66% of the cases with recurrence could be predicted, and the odds ratio for recurrence was 3.13 (95% CI, 0.52-18.29). A significant UVVF imbalance between recipient and donor twins was found in cases with Quintero Stages 1-3 but not in those with Stage 4. CONCLUSIONS In TTTS, UVVF is significantly higher in recipients than in their donor cotwins and the R/D-UVVF seems adequately to indicate the flow imbalance between twins, regardless of gestational age. A decrease in R/D-UVVF could be predictive of a favorable evolution following laser treatment.
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Affiliation(s)
- M Yamamoto
- Service de Gynecologie et Obstetrique, CHI Poissy Saint Germain en Laye, Université Paris Ouest St Quentin en Yvelines, Poissy, France
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Cañizares P, Gadri A, Lobato J, Nasr B, Paz R, Rodrigo MA, Saez C. Electrochemical Oxidation of Azoic Dyes with Conductive-Diamond Anodes. Ind Eng Chem Res 2006. [DOI: 10.1021/ie051427n] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- P. Cañizares
- Department of Chemical Engineering, Facultad de Ciencias Químicas, Universidad de Castilla La Mancha, Campus Universitario s/n, 13071 Ciudad Real, Spain, Department de Chimie Industrielle, Institut Supérieur des Sciences Appliqueés et Technologie de Gabès, Université de Gabès, 6072 Zrig, Gabès, Tunisie, and Chemistry SectionSciences Department, Sur College of Education, B.P. 484, Sur 411, Sultanate of Oman
| | - A. Gadri
- Department of Chemical Engineering, Facultad de Ciencias Químicas, Universidad de Castilla La Mancha, Campus Universitario s/n, 13071 Ciudad Real, Spain, Department de Chimie Industrielle, Institut Supérieur des Sciences Appliqueés et Technologie de Gabès, Université de Gabès, 6072 Zrig, Gabès, Tunisie, and Chemistry SectionSciences Department, Sur College of Education, B.P. 484, Sur 411, Sultanate of Oman
| | - J. Lobato
- Department of Chemical Engineering, Facultad de Ciencias Químicas, Universidad de Castilla La Mancha, Campus Universitario s/n, 13071 Ciudad Real, Spain, Department de Chimie Industrielle, Institut Supérieur des Sciences Appliqueés et Technologie de Gabès, Université de Gabès, 6072 Zrig, Gabès, Tunisie, and Chemistry SectionSciences Department, Sur College of Education, B.P. 484, Sur 411, Sultanate of Oman
| | - B. Nasr
- Department of Chemical Engineering, Facultad de Ciencias Químicas, Universidad de Castilla La Mancha, Campus Universitario s/n, 13071 Ciudad Real, Spain, Department de Chimie Industrielle, Institut Supérieur des Sciences Appliqueés et Technologie de Gabès, Université de Gabès, 6072 Zrig, Gabès, Tunisie, and Chemistry SectionSciences Department, Sur College of Education, B.P. 484, Sur 411, Sultanate of Oman
| | - R. Paz
- Department of Chemical Engineering, Facultad de Ciencias Químicas, Universidad de Castilla La Mancha, Campus Universitario s/n, 13071 Ciudad Real, Spain, Department de Chimie Industrielle, Institut Supérieur des Sciences Appliqueés et Technologie de Gabès, Université de Gabès, 6072 Zrig, Gabès, Tunisie, and Chemistry SectionSciences Department, Sur College of Education, B.P. 484, Sur 411, Sultanate of Oman
| | - M. A. Rodrigo
- Department of Chemical Engineering, Facultad de Ciencias Químicas, Universidad de Castilla La Mancha, Campus Universitario s/n, 13071 Ciudad Real, Spain, Department de Chimie Industrielle, Institut Supérieur des Sciences Appliqueés et Technologie de Gabès, Université de Gabès, 6072 Zrig, Gabès, Tunisie, and Chemistry SectionSciences Department, Sur College of Education, B.P. 484, Sur 411, Sultanate of Oman
| | - C. Saez
- Department of Chemical Engineering, Facultad de Ciencias Químicas, Universidad de Castilla La Mancha, Campus Universitario s/n, 13071 Ciudad Real, Spain, Department de Chimie Industrielle, Institut Supérieur des Sciences Appliqueés et Technologie de Gabès, Université de Gabès, 6072 Zrig, Gabès, Tunisie, and Chemistry SectionSciences Department, Sur College of Education, B.P. 484, Sur 411, Sultanate of Oman
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Nasr B, Hedi B, Abdellatif G, Rodrigo MA. Purification of Wet-Process Phosphoric Acid by Hydrogen Peroxide Oxidation, Activated Carbon Adsorption and Electrooxidation. Chem Eng Technol 2005. [DOI: 10.1002/ceat.200407068] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Abstract
We measured 4-aminosalicylic acid (4-ASA) levels in faecal water by in-vivo equilibrium dialysis during oral ingestion of drug by two different dose protocols (A and B). In Protocol A, 5 normal subjects ingested 3 g of 4-ASA as the free acid and 20 mg of metaclopromide per day. On Day 5, small dialysis sacs filled with dextran 40 were ingested and the oral drug was continued until the sacs were retrieved from the stool. Protocol B followed the same format except that 3 g of 4-ASA was ingested twice daily and metaclopromide was omitted. In both protocols concentrations of 4-ASA and N-acetylated 4-ASA in sac contents were measured by HPLC. In-vitro dialysis studies showed bi-directional equilibrium was reached within 120 min. During Protocol A, intraluminal concentrations of total 4-ASA ranged from 14.0 to 32.2 mmol/L with a mean of 20.6 mmol/L. With Protocol B, total 4-ASA levels ranged from 20.1 to 41.3 mmol/L with a mean of 33.9 mmol/L. From 90 to 99% of the drug in the dialysates was N-acetylated. These concentrations of total 4-ASA are similar to those of 5-ASA after ingestion of therapeutic doses of sulphasalazine or absorption-resistant formulations of 5-ASA. Thus, oral 4-ASA could have a role in the treatment of inflammatory bowel disease.
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Affiliation(s)
- W Beeken
- Department of Medicine, University of Vermont, Burlington
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