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Ngo L, Woodman R, Walters T, Denman R, Yang I, Ranasinghe I. Long-term outcomes of 265,737 patients hospitalised with atrial fibrillation and atrial flutter from 2008 to 2015. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0294] [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
Atrial fibrillation/atrial flutter (AF/AFL) hospitalisations are common, however, little is known about the long-term outcomes of these episodes.
Objective
To examine the incidence of mortality, all-cause and cause-specific re-hospitalisations at up to 8 years after a hospitalisation for AF/AFL.
Methods
Unique patients hospitalised with a primary diagnosis of AF/AFL from 2008–2015 were identified using nation-wide hospitalisation data from Australia and New Zealand. All-cause mortality was the primary outcome. Secondary endpoints included all-cause and cause-specific re-hospitalisations. Results were reported as incident rate per 100 patient-years.
Results
We included 265,737 patients (mean age 69.9±13.9y, female 45.2%, elective 28.7%). The median length of stay was 1 day (Interquartile range [IQR] 0–4 days) and the median CHA2DS2-VASc score was 2 (IQR 1–2). During the index hospitalisation, 9,837 (3.7%) patients underwent catheter or surgical ablation and 52,634 (19.8%) underwent cardioversion. During the median follow-up time of 3.4 years (range 0–8.0 years), 53,669 patients died (incident rate of 5.7/100 patient-years) with a survival probability gradually decreasing from 92.8% (95% CI 92.7–92.9%) at 1-year to 65.4% (95% CI 64.9–65.8%) at 8-years post-discharge (Table 1 and Figure 1). All-cause re-hospitalisations occurred in 210,118 patients (incident rate of 22.2/100 patient-years) with a rehospitalisation-free survival probability of 7.1% (95% CI 6.9—7.3%) at the end of follow-up. Unplanned re-hospitalisations occurred more frequently than planned episodes (incident rate of 17.2 vs. 16.6/100 patient-years respectively). AF/AFL accounted for 25.1% of all-cause re-hospitalisations (incident rate of 8.9/100 patient-years) and the probability of freedom from re-hospitalisations for AF/AFL was 55.4% (95% CI 55.0–55.8%) at 8-years. Incident rates of re-hospitalisations for catheter ablation (1.5/100 patient-years), stroke (1.6/100 patient-years), heart failure (2.7/100 patient-years), and acute myocardial infarction (1.0/100 patient-years) were low. In subgroup analyses, worse survival was observed in female patients, older age groups, patients with comorbid heart failure, hypertension, diabetes, and those who did not undergo ablation during the index hospitalisation.
Conclusion
Nearly two-thirds of patients were surviving by 8-years following an AF/AFL hospitalisation with a low rate of re-hospitalisations for stroke, heart failure, and myocardial infarction. However, re-hospitalisations for recurrent atrial arrhythmia were common. Efforts to reduce re-hospitalisations, especially unplanned encounters, are required to improve patient outcomes.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): National Heart Foundation of Australia
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Affiliation(s)
- L Ngo
- University of Queensland, Brisbane, Australia
| | - R Woodman
- Flinders University, Flinders Centre for Epidemiology and Biostatistics, Adelaide, Australia
| | - T Walters
- St Vincents Private Hospital Northside, Brisbane, Australia
| | - R Denman
- The Prince Charles Hospital, Brisbane, Australia
| | - I Yang
- The Prince Charles Hospital, Brisbane, Australia
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2
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Ngo L, Ali A, Ganesan A, Woodman R, McGavigan A, Adams R, Ranasinghe I. Trends in complications and mortality following catheter ablation of atrial fibrillation: results from 22,582 ablations in Australia and New Zealand from 2010 to 2015. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0615] [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
Recent studies from the United States report rising rates of in-hospital complications and mortality following catheter ablation of atrial fibrillation (AF) but whether such a trend is observed in other populations is uncertain.
Purpose
To examine the trends in complications and mortality following AF ablations up to 30 days after discharge in Australia and New Zealand (ANZ) using nationwide data.
Methods
All patients ≥18y undergoing catheter ablation of AF from 2010–2015 were identified using hospitalisation data from all public and most private hospitals in ANZ. The primary endpoint was one or more procedural complications during the hospital stay or within 30 days of discharge. The secondary endpoints were mortality and other specific complications. Unadjusted trend was evaluated using Cochran-Armitage test while that of complications, adjusting for differences in other characteristics, was evaluated using multivariate logistic regression with the year of ablation modelled as a continuous variable. Results are reported as odd ratios (OR) and 95% confidence intervals (CI).
Results
A total of 22,582 AF ablations were included (mean age 62.2±11.6y, 29.1% female, 94.4% elective procedures). The number of ablations increased by 26.4% during the study period (3,097 in 2010 to 3,915 in 2015). Rates of heart failure (8.98% to 10.09%, p for trend=0.010), diabetes (4.52% to 12.46%, p<0.001), chronic kidney disease (2.36% to 4.29%, p<0.001) significantly increased over time but that of hypertension decreased (15.27% to 12.29%, p<0.001). The incidence of overall complications (6.55% in 2010 to 6.67% in 2015, OR 0.99, 95% CI 0.96–1.03) was unchanged during the study period (Figure 1A). When individual complications were considered, mortality rate was low with no statistically significant change with time (0.19% to 0.15%, OR 1.03, 95% CI 0.84–1.28) (Figure 1A) while the rate of acute kidney injury (0.23% to 0.51%, OR 1.17, 95% CI 1.02–1.34) increased and that of venous thromboembolism (0.16% to 0.0%, OR 0.71, 95% CI 0.54–0.94) decreased (Figure 1B). Though the incidence of any bleeding (4.49% to 3.98%, OR 0.97, 95% CI 0.93–1.01) was unchanged, that of major bleeding requiring blood transfusion (0.97% to 0.64%, OR 0.87, 95% CI 0.79–0.96) declined significantly (Figure 1B). No significant trend was observed in other complications or when in-hospital (5.13% to 5.21%, OR 1.00, 95% CI 0.97–1.04) and post-discharge (1.55% to 1.63%, OR 0.97, 95% CI 0.91–1.03) complications were separately evaluated.
Conclusions
Though more patients with heart failure, diabetes and chronic kidney disease underwent catheter ablation of AF over time in ANZ, the overall complication rate was unchanged with a significant decrease in the incidences of major bleeding and venous thromboembolism. However, rate of acute kidney injury nearly doubled, and this could be a potential target for efforts to further improve procedural safety.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): The National Heart Foundation of Australia
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Affiliation(s)
- L Ngo
- University of Adelaide, Adelaide, Australia
| | - A Ali
- University of Adelaide, Adelaide, Australia
| | - A Ganesan
- Flinders Medical Centre and Flinders University, Adelaide, Australia
| | - R Woodman
- Flinders University, Flinders Centre for Epidemiology and Biostatistics, Adelaide, Australia
| | - A McGavigan
- Flinders Medical Centre and Flinders University, Adelaide, Australia
| | - R Adams
- Southern Adelaide Local Health Network, Respiratory and Sleep Services, Adelaide, Australia
| | - I Ranasinghe
- University of Queensland, Medicine, Brisbane, Australia
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Ngo L, Ali A, Ganesan A, Woodman R, McGavigan A, Adams R, Ranasinghe I. Differences between public and private hospitals in complications following catheter ablation of atrial fibrillation: a cohort study in Australia. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0593] [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
Comparing outcomes of care between public and private hospitals is critical to inform patients and improve care quality.
Purpose
To compare complication rates following catheter ablation of atrial fibrillation (AF) up to 30-days post discharge between public and private hospitals.
Methods
We included patients ≥18 years who underwent AF ablation in the Australian states of New South Wales, Queensland, Victoria, and Western Australia from 2010–2015. The primary outcome was the occurrence of any complication up to 30-days after discharge. The association between provider type and the risk of complications was examined using logistic regression with inverse probability of treatment weighting (IPTW) propensity scores to account for differences in measured confounders. The minimum strength of association required for an unmeasured confounder to nullify any observed association was estimated using the E value.
Results
We identified 18,074 AF ablations during the study period (mean age 62.3±11.4y, 28.8% female, 78.4% performed in private hospitals). Patients ablated at public hospitals were younger (59.3 vs. 63.1y, p<0.001) but had higher rates of heart failure (10.3% vs. 7.7%, p<0.001), diabetes (10.9% vs. 7.9%, p<0.001), chronic kidney disease (4.9% vs. 2.2%, p<0.001), and chronic lung diseases (4.2% vs. 3.6%, p=0.046) than those at private hospitals. The unadjusted rate of complications was higher in publics hospitals compared with private ones (7.59% vs. 5.26%, p<0.001). After IPTW, there was good covariate balance with a median standardised difference of 0.006 (range 0.0–0.032) and the adjusted difference in procedural complication rates between two sectors remained significant (OR=1.46, 95% CI 1.24–1.73). The difference was mainly driven by an elevated risk of complications requiring cardiac surgery (OR=3.85, 95% CI 1.35–10.98), acute kidney injury (OR=2.95, 95% CI 1.12–7.74), cardiorespiratory failure (OR=2.69, 95% CI 1.19–6.04), postprocedural infection (OR=2.50, 95% CI 1.28–4.86), and bleeding (OR=1.26, 95% CI 1.02–1.56) (Figure 1). The disparity in the complication rates persisted when in-hospital (OR=1.41, 95% CI 1.16–1.70) and post-discharge (OR=1.52, 95% CI 1.12–2.07) complications were analysed separately. The E value was 1.79, suggesting that the disparity might plausibly be explained by unmeasured confounders.
Conclusion
AF ablation at a public hospital was associated with a 46% higher risk of complications compared with ablation at a private hospital, mainly driven by a higher risk of complications requiring cardiac surgery, acute kidney injury, cardiorespiratory failure, infections, and bleeding. The disparity could be due to differences in care quality between two sectors or explained by unmeasured confounders such as higher procedural complexity in public hospitals.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): The National Heart Foundation of Australia
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Affiliation(s)
- L Ngo
- University of Adelaide, Adelaide, Australia
| | - A Ali
- University of Adelaide, Adelaide, Australia
| | - A Ganesan
- Flinders Medical Centre and Flinders University, Adelaide, Australia
| | - R Woodman
- Flinders University, Flinders Centre for Epidemiology and Biostatistics, Adelaide, Australia
| | - A McGavigan
- Flinders Medical Centre and Flinders University, Adelaide, Australia
| | - R Adams
- Southern Adelaide Local Health Network, Respiratory and Sleep Services, Adelaide, Australia
| | - I Ranasinghe
- University of Queensland, Medicine, Brisbane, Australia
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Ananthakrishna R, Woodman R, Grover S, Bridgman C, Selvanayagam J. Long-term clinical outcomes of troponin-positive chest pain and unobstructed coronary arteries assessed by cardiovascular magnetic resonance imaging. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and introduction
Troponin-positive chest pain with unobstructed coronary arteries is a distinct entity with different pathophysiological causes. We have previously reported on the incremental diagnostic capability of cardiovascular magnetic resonance (CMR) in this cohort. However, there is paucity of literature on the long-term clinical outcomes of these patients assessed with CMR.
Objectives
Using the unique cohort of patients previously studied, we sought to assess the long-term clinical outcomes in patients with troponin-positive chest pain and unobstructed coronary arteries, as graded by their acute CMR presentation.
Methods
A total of 122 consecutive patients with troponin-positive chest pain and unobstructed coronary arteries undergoing CMR assessment during the acute admission (2010–2014) were studied. The primary endpoint was major adverse cardiac event (MACE), defined as a composite of all-cause mortality and cardiovascular readmissions (heart failure, acute myocardial infarction [AMI], atrial or ventricular arrhythmia and stroke). Patients were grouped into 4 categories based on their initial CMR findings: AMI, acute myocarditis, Takotsubo cardiomyopathy and normal CMR.
Results
The mean age of the study cohort was 55.6±16.5 years and 56.5% were women. CMR (performed at a median of 6 days from presentation) provided a diagnosis in 87% of the patients (38% myocarditis, 28% Takotsubo cardiomyopathy and 21% AMI). Patients with a diagnosis of AMI were prescribed guideline recommended medical therapy. Over a median follow-up of 2524 days (6.9 years), 32 (26.2%) patients experienced a MACE. The all-cause mortality was 2.5%. The most common indication for cardiovascular readmissions in this cohort was heart failure (12.3%) and AMI (9%). In multivariate analysis, a CMR diagnosis of AMI (hazard ratio = 2.6; 95% confidence interval = 1.2, 5.7; p=0.019) and peak troponin (hazard ratio = 1.0003; 95% confidence interval = 1.00003, 1.0006; p=0.028) were significantly associated with MACE after adjusting for age and gender. In addition, CMR diagnosis of AMI was significantly associated with a lower event-free survival rate compared with a diagnosis of non-AMI (adjusted hazard ratio = 2.57, p=0.019) (Figure).
Conclusions
The long-term prognosis of patients with troponin-positive chest pain and unobstructed coronary arteries is not benign. CMR diagnosis of AMI is a significant predictor of MACE even in the absence of significant coronary artery obstruction and despite guideline recommended post AMI therapy.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | - R Woodman
- Flinders University, Adelaide, Australia
| | - S Grover
- Flinders Medical Centre, Adelaide, Australia
| | - C Bridgman
- Flinders Medical Centre, Adelaide, Australia
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5
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Ngo L, Ali A, Ganesan A, McGavigan A, Woodman R, Adams R, Ranasinghe I. 217 Gender Differences in Complications following Catheter Ablation of Atrial Fibrillation: Insights From a Nationwide Cohort Study. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.224] [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: 11/25/2022]
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6
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Ngo L, Ali A, Ganesan A, McGavigan A, Woodman R, Adams R, Ranasinghe I. 032 Trends in Complications and Mortality Following Catheter Ablation of Atrial Fibrillation: Results from 22,582 Ablations in Australia and New Zealand from 2010 to 2015. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.039] [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: 11/25/2022]
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7
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Ngo L, Deman R, Walters T, Haqqani H, Woodman R, Ranasinghe I. 250 Safety and Efficacy of Leadless Pacemakers: A Systematic Review and Meta-Analysis. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.257] [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: 10/23/2022]
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8
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Ngo L, Ali A, Ganesan A, McGavigan A, Woodman R, Adams R, Ransinghe I. 209 Differences in Complication Rates following Catheter Ablation of Atrial Fibrillation in Public and Private Hospitals: A Cohort Study in Australia. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.216] [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: 10/23/2022]
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9
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Sree Raman K, Grover S, Woodman R, Ananthakrishna R, Sinhal A, Bradbrook C, Selvanayagam J. Myocardial Oxygenation in Hibernating Myocardium: Insights from Oxygen-Sensitive (OS) Cardiac Magnetic Resonance Imaging (CMR). Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.294] [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: 10/26/2022]
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10
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Shah R, Raman KS, Walls A, Woodman R, Faull R, Gleadle J, Selvanayagam J. Gadolinium Free Cardiovascular Magnetic Resonance (CMR) Stress T1 mapping in patients with Chronic Kidney Disease (CKD). Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.271] [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: 11/16/2022]
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11
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Shah R, Parnham S, Nucifora G, Liang Z, Shree Raman K, Woodman R, Gleadle J, Selvanayagam J. Prognostic Utility of Blood Oxygen Level-Dependent Cardiovascular Magnetic Resonance Imaging in Asymptomatic Patients with Chronic Kidney Disease with and Without Diabetes Mellitus. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.496] [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: 10/28/2022]
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12
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Van Ryswyk E, Quan W, Meng R, Li Q, Anderson C, Woodman R, Loffler K, Zheng D, McEvoy R. Effects of cpap therapy on blood pressure variability (BPV) in people with comorbid obstructive sleep apnoea (OSA) and cardiovascular disease (CVD): save trial. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Parnham S, Gleadle J, Ganesan A, Woodman R, De Pasquale C, Selvanayagam J. Blood Oxygen Level Dependent (BOLD) Cardiovascular Magnetic Resonance (CMR) as Predictor of Cardiac Prognosis in Asymptomatic Chronic Kidney Disease (CKD) Patients. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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14
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Woodman R, Hakendorf P, Limaye V. Seasonality of birth patterns in an Australian cohort of patients with biopsy-confirmed idiopathic inflammatory myopathy. Intern Med J 2016; 46:619-21. [PMID: 27170240 DOI: 10.1111/imj.13061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 09/20/2015] [Revised: 11/15/2015] [Accepted: 11/29/2015] [Indexed: 11/29/2022]
Abstract
Environmental exposures in the foetal period may predispose to autoimmunity. Aim of this study is to investigate whether seasonality in birth patterns exists in idiopathic inflammatory myopathies (IIM). We used Stata (StataCorp USA, version 13.0) and the user-written routine command 'circsummarise' to assess birth seasonality among South Australian patients with histologically confirmed IIM subsequent to 1980 using their date of birth. There was no evidence for a seasonal birth pattern among IIM patients overall (n = 568), however there were some ethnic variances in birth patterns among non-Caucasian patients. There was evidence for birth seasonality among both Aboriginal (mean = 7 July, Rayleigh P = 0.04) and Asian patients (mean = 12 August, Rayleigh P-value = 0.038). Non-Caucasians born in the third quarter of the calendar year may have an increased risk of developing IIM. Large international studies of IIM patients of diverse ethnicity are required to clarify the role of perinatal exposures in disease susceptibility.
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Affiliation(s)
- R Woodman
- Department of Epidemiology, Flinders University, Adelaide, South Australia, Australia
| | - P Hakendorf
- Clinical Epidemiology Unit, Flinders Medical Centre, Adelaide, South Australia, Australia
| | - V Limaye
- Rheumatology Department, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia
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Parnham S, Gleadle J, Leong D, Grover S, Bradbrook C, Woodman R, De Pasquale C, Selvanayagam J. Myocardial perfusion is impaired in renal and liver transplant recipients: a cardiovascular magnetic resonance imaging study. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.563] [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: 11/25/2022]
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16
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Parnham S, Gleadle J, Grover S, Bradbrook C, Woodman R, De Pasquale C, Selvanayagam J. Reduced myocardial perfusion in renal transplant patients is not associated with aortic stiffness. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.577] [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: 11/25/2022]
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17
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Parnham S, Gleadle J, Bangalore S, Grover S, Perry R, Woodman R, De Pasquale C, Selvanayagam J. Impaired myocardial oxygenation response to stress in patients with chronic kidney disease. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.543] [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: 10/23/2022]
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18
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Litt J, Kim S, Woodman R, MacIntyre R, Cunningham T. Australian zoster study: GP and patient views about herpes zoster (shingles), its complications, and the likely acceptance of a zoster vaccine (Zostavax). Int J Infect Dis 2014. [DOI: 10.1016/j.ijid.2014.03.1320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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19
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Parnham SFC, Grover S, Bradbrook C, Leong D, Depasquale C, Woodman R, Gleadle J, Selvanayagam J. Renal transplant patients have impaired myocardial perfusion independent of the degree of left ventricular hypertrophy: a CMR study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.4538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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20
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Parnham S, Grover S, Bradbrook C, De Pasquale C, Woodman R, Gleadle J, Selvanayagam J. Myocardial Perfusion is Impaired in Asymptomatic Patients Post Renal Transplantation. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.448] [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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21
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Sukumaran S, Subramaniam S, Paramasivam S, Woodman R, Carter C, Kichenadasse G. Risk factors predicting recurrence in operated endometrial cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15592] [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: 11/20/2022] Open
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22
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Hissaria P, Lester S, Hakendorf P, Woodman R, Patterson K, Hill C, Ahern MJ, Smith MD, Walker JG, Roberts-Thomson PJ. Survival in scleroderma: results from the population-based South Australian Register. Intern Med J 2010; 41:381-90. [DOI: 10.1111/j.1445-5994.2010.02281.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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23
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Mori T, Mas E, Woodman R, Burke V, Puddey I, Beilin L. Abstract: P272 EFFECT OF THE OMEGA-3 FATTY ACIDS EPA AND DHA ON PLASMA AND URINARY F2-ISOPROSTANES: RESULTS FROM TWO PLACEBOCONTROLLED HUMAN INTERVENTIONS. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70567-7] [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: 11/24/2022]
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24
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Woodman R, Playford D, Croft K, Watts G. 4P-1060 Basal production of nitric oxide is increased in the microcirculation in type 2 diabetes despite endothelial dysfunction: association with oxidative stress and blood pressure. ATHEROSCLEROSIS SUPP 2003. [DOI: 10.1016/s1567-5688(03)91317-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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25
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Jenkins D, DiFrancesco L, Chaudhry A, Morris D, Glück S, Jones A, Woodman R, Brown CB, Russell J, Stewart DA. Successful treatment of post-transplant lymphoproliferative disorder in autologous blood stem cell transplant recipients. Bone Marrow Transplant 2002; 30:321-6. [PMID: 12209355 DOI: 10.1038/sj.bmt.1703603] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2002] [Accepted: 03/22/2002] [Indexed: 11/09/2022]
Abstract
We report three cases of post-transplant lymphoproliferative disorder (PTLD) in the context of autologous stem cell transplantation (ASCT) for multiple myeloma (MM) and non-Hodgkin's lymphoma. The first two cases received ASCT for MM, one with a CD34-selected autograft and the other with an unmanipulated autograft. Both these cases of PTLD achieved a complete response following treatment with IVIG, gancyclovir, solumedrol and interferon (IFN). The third case received ASCT with an unmanipulated autograft for relapsed angioimmunoblastic lymphoma. He also achieved a complete response but only after rituximab was added to IVIG, gancyclovir, solumedrol and IFN. None of these patients experienced a relapse of their PTLD with follow-up ranging from 1.5 to 5 years. These cases highlight the importance of considering PTLD in the differential diagnosis of lymphadenopathy and fever post ASCT. They also demonstrate the possibility of durable complete remission of post-ASCT PTLD following antiviral and immune modulating therapy.
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Affiliation(s)
- D Jenkins
- Department of Medicine, University of Calgary and Tom Baker Cancer Center, Calgary, Alberta, Canada
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Abstract
We describe here, the identification of a novel HLA-B*07 allele named HLA-B*0726. This allele was found in a Caucasian individual serologically typed as HLA-B7, B35. Novel DNA probe patterns for the HLA-B*07 allele were found using HLA-B specific reverse sequence-specific oligonucleotide probe (SSOP) and sequence-specific primer (SSP) typing. DNA sequencing demonstrated the presence of a new HLA-B*07 sequence variant encoding a single nucleotide substitution from a G to a T at nucleotide 539 in exon 3. This results in an amino acid substitution from arginine to leucine at residue 156 in exon 3.
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Affiliation(s)
- B Herbut
- Tissue Typing Laboratory, Calgary Laboratory Services, Foothills Medical Centre, Calgary, Canada.
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Mathison R, Woodman R, Davison JS. Regulation of leukocyte adhesion to heart by the tripeptides feG and feG(NH2). Can J Physiol Pharmacol 2001; 79:785-92. [PMID: 11599779] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
The role of the D-isomeric form of the salivary gland tripeptide FEG (feG) and its carboxyl-amidated derivative, feG(NH2), in regulating leukocyte adherence to nonfixed atrial slices from Sprague-Dawley rats was examined under static conditions. Optimal binding of the leukocytes was seen if the leukocytes were treated with platelet activating factor (PAF; 10(-9)M). The increased adherence of PAF-treated peripheral blood leukocytes was totally inhibited by both feG and feG(NH2) (10-9M), as well as by antibodies against CD18 and CD49d. In contrast, the binding of peritoneal leukocytes was blocked only by CD49d antibody. Circulating leukocytes obtained from lipopolysaccharide (LPS) treated (2 mg/kg ip) rats did not bind to atrial slices obtained from normal hearts, but readily bound to atrial slices obtained from LPS-treated rats. This leukocyte binding was inhibited by in vivo feG treatment (100 microg/kg ip, 24 h before harvest) or by treating the isolated cells with feG (10(-9)M). The amidated peptide feG(NH2) reduced neutrophil accumulation in the atrium elicited by ip injection of LPS, whereas feG was ineffective. The reduction in neutrophil infiltration into the myocardium by feG(NH2) and the prevention of leukocyte interaction with myocytes seen with both feG and feG(NH2) probably results in hindered leukocyte migration in the inflamed heart, resulting in less tissue damage. The inhibition by these tripeptides on neutrophil adhesion to myocytes suggests that salivary glands hormones regulate the severity of cardiac inflammation.
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Affiliation(s)
- R Mathison
- Department of Physiology and Biophysics, Faculty of Medicine, The University of Calgary, AB, Canada.
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Woodman R. Doctors and politicians clash over size of flu problem. BMJ 2000; 320:138. [PMID: 10634724 PMCID: PMC1128738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Woodman R. Storage of human organs prompts three inquiries. BMJ 2000; 320:77. [PMID: 10625253 PMCID: PMC1117395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Woodman R. Cardiac surgery audit raises concern over equity of access. BMJ 1999; 319:277. [PMID: 10426730 PMCID: PMC1126928 DOI: 10.1136/bmj.319.7205.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Woodman R. Royal college demands 2000 more NHS consultant physicians. BMJ 1999; 319:12. [PMID: 10390448 PMCID: PMC1116135 DOI: 10.1136/bmj.319.7201.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Woodman R. BMA calls for extra safeguards for life and death decisions. BMJ 1999; 318:1717. [PMID: 10381693 PMCID: PMC1116072 DOI: 10.1136/bmj.318.7200.1716c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Woodman R. Moratorium on GM food would perpetuate world hunger. BMJ 1999; 318:1506. [PMID: 10355990 DOI: 10.1136/bmj.318.7197.1506a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Woodman R. Controversy rekindled over pill and risk of breast cancer. West J Med 1999. [DOI: 10.1136/bmj.318.7191.1095] [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: 11/04/2022]
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Woodman R. UK launches study to follow childhood cancer survivors. West J Med 1999. [DOI: 10.1136/bmj.318.7184.626g] [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: 11/03/2022]
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