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Al-Tourah L, Mithoowani S, Lim W, Ikesaka R. The incidence of major bleeding in adult patients with urogenital and gynecological cancer being treated with direct oral anticoagulants (DOACs): a systematic review. J Thromb Thrombolysis 2024; 57:630-637. [PMID: 38429468 DOI: 10.1007/s11239-024-02956-5] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/06/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Direct oral anticoagulants (DOACs) are the mainstay of treatment for venous thromboembolism (VTE) and non-valvular atrial fibrillation (AF), with or without an underlying cancer. Patients with cancer have a 2-3-fold increase in risk for bleeding complications compared to non-cancer patients taking anticoagulant therapy, however the incidence of bleeding for urogenital and gynecological cancers on DOACs are uncertain. AIMS To assess the bleeding risk associated with the use of DOACs in patients with urogenital and/or gynecological cancers. METHOD We conducted a systematic review of randomized controlled trials (RCTs) and prospective cohort studies to address the safety of DOACs for VTE and AF when used in patients with urogenital and/or gynecological malignancy. The primary outcomes assessed were major and clinically relevant non-major (CRNMB) bleeding, with minor bleeding considered as a secondary outcome. MEDLINE, EMBASE and COCHRANE Central Registry of Controlled Trials were searched up to and including Oct 28, 2022. The study protocol was registered in PROSPERO (CRD42022370981). Studies were independently assessed for inclusion and data extracted in duplicate. RESULT Seven studies met our inclusion criteria (Fig. 1): 2 RCTs and 5 prospective cohort studies. A total of 676 patients treated with DOACs were included, 628 (92.8%) had VTE and 48 (7.1%) had AF. In patients with VTE treated with DOACs, the pooled major bleeding rate was 2.1%, 95% confidence intervals (CI) 0.9-3.3% (Fig. 2). Pooled estimates could not be determined for AF patients given small event and patient numbers. CONCLUSION Major bleeding rates in urogenital and/or gynecological cancer patients treated with DOACs are similar to that of the general cancer population.
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Affiliation(s)
- L Al-Tourah
- Clinical Thrombosis Fellow, McMaster University, Hamilton, ON, Canada
| | - S Mithoowani
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - W Lim
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Rick Ikesaka
- Department of Medicine, McMaster University, Hamilton, ON, Canada.
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Tan MS, Arvinder-Singh HS, Lim WY, Amar-Singh HSS. Parental control on handphone access and usage among Malaysian children. Med J Malaysia 2022; 77:607-611. [PMID: 36169074] [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: 06/16/2023]
Abstract
INTRODUCTION Parental control for a child's handphone access is important to ensure online safety. This study was to determine parental control on handphone access and the usage amongst Malaysian children. MATERIALS AND METHODS A cross-sectional survey was conducted electronically between April 2017 and March 2018 among parents with children above 2 years of age, who owned a handphone. The 10-item questionnaire included questions about rules applied to the use of handphones, education on cybersafety, the characteristics and activities of their youngest children who had full-time access to a handphone, and parental perceptions of their children's usage of handphones. A total of 215 parents were included. RESULTS From this, 92% controlled their children's handphones use by setting rules. The commonest rules were limiting the time of handphone usage (77%) and being aware of whom the child was communicating with (77%). The majority (94%) educated their children on cybersafety, and the commonest discussed topic was not to communicate with strangers (93%). The children's average age of first handphone ownership was 10.6 (SD: 3.6) years, and the use of the handphone averaged 17.4 (SD: 18.5) hours a week. Despite the rules and education provided, only a quarter of parents were confident of their children's capability to manage their own safety when using handphones (27%). CONCLUSION In summary, Malaysian parents did control their children's handphone usage.
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Affiliation(s)
- M S Tan
- Hospital Kapala Batas, Paediatric Department, Penang, Malaysia.
| | | | - W Y Lim
- National Institute of Health, Institute for Clinical Research, Centre of Clinical Epidemiology, Selangor, Malaysia
| | - H S S Amar-Singh
- Galen Centre for Health and Social Policy, Kuala Lumpur, Malaysia
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Androulakis E, Briasoulis A, Falconer D, Lim W, Siasos G, Ahluwalia N, Graham A, Papageorgiou N. Long-term outcomes of catheter ablation for ventricular arrhythmias in post- myocarditis patients; Insights from a meta-analysis of current datv. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0379] [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
In the past decade, catheter ablation (CA) has become a rapidly expanding treatment option for ventricular tachycardia (VT), however it is not commonly utilized for patients with post-myocarditis VT. We aimed to systematically review up-to-date evidence regarding feasibility, effectiveness, and safety of CA, with a specific focus on long-term relapse rate and procedural complications.
Methods
A structured electronic database search (PubMed, Embase, Cochrane) of the scientific literature was performed for studies describing outcomes at up to 7.3 years after CA. The primary outcome measured was VT recurrence post-ablation. Procedural success was defined as freedom of ventricular arrhythmias (at the end of follow-up after an ablation procedure). The secondary outcome was significant procedural complications which included procedural death, stroke, cardiac tamponade, acute myocardial infarction, major vascular complications, and major bleeding, assessed on a study-by-study basis.
Results
A total of 186 patients were included in analysis with most patients (88%) being male.
Over the follow up period there was a 18% relapse rate (n=34) (Confidence Interval (CI); 0.12–0.24, I2≈0, p=0.77) with the majority of patients remaining VT free for the duration of follow up. Only one study recorded the percentage of re-do procedures. The overall procedural complication rate was 3.0% (n=7, (CI; 0.01–0.07, I2≈0, p=0.44) and of note, there were no peri-procedural deaths or heart transplant surgeries reported. However, a single study reported a mortality of 10% (n=2) during the follow up period.
Conclusions
CA is an effective and durable long-term therapeutic strategy for post myocarditis VT patients with limited relapse rate and very low complication rates based on these non-randomised data. Larger randomised-controlled trials with standardised treatment and long follow-up are required to compare CA versus conventional treatment in the post-acute myocardial phase.
Funding Acknowledgement
Type of funding sources: None. Relapse rate during follow-upProcedural complication rate
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Affiliation(s)
- E Androulakis
- Royal Brompton and Harefield Hospital, London, United Kingdom
| | | | - D Falconer
- Barts Health NHS Trust, London, United Kingdom
| | - W Lim
- Barts Health NHS Trust, London, United Kingdom
| | - G Siasos
- National & Kapodistrian University of Athens Medical School, Athens, Greece
| | - N Ahluwalia
- Barts Health NHS Trust, London, United Kingdom
| | - A Graham
- Barts Health NHS Trust, London, United Kingdom
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Tan A, Lai G, Saw S, Chua K, Takano A, Ong B, Koh T, Jain A, Tan W, Ng Q, Kanesvaran R, Rajasekaran T, Kalshnikova E, Shchegrova S, H. -Ta, Lin J, Renner D, Sethi H, Zimmermann B, Aleshin A, Lim W, Tan E, Skanderup A, Ang M, Tan D. MA07.06 Circulating Tumor DNA for Monitoring Minimal Residual Disease and Early Detection of Recurrence in Early Stage Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.144] [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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Tan W, Chua B, Yin D, Tan S, Tan D, Ang M, Kanesvaran R, Jain A, Rajasekaran T, Lai G, Toh C, Tan E, Ng Q, Lim W. P76.46 First-Line Osimertinib in Asian Patients with Advanced EGFR-Mutant Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1103] [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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Tan A, Lai G, Tan G, Seet A, Takano A, Alvarez J, Skanderup A, Tan W, Ang M, Kanesvaran R, Ng Q, Jain A, Rajasekaran T, Lim W, Tan E, Lim K, Tan D. FP14.13 Molecular Characterisation and Clinical Outcomes in RET Rearranged Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.156] [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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Tan A, Ong B, Koh T, Chen J, Oo H, Lai G, Tan W, Ang M, Kanesvaran R, Ng Q, Jain A, Rajasekaran T, Zhai W, Skanderup A, Lim K, Tan E, Lim W, Tan D, Takano A. P38.03 Immunohistochemical, Histologic and Genomic Characterisation of Early Stage Pulmonary Invasive Mucinous Adenocarcinoma. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.784] [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: 11/15/2022]
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Lai G, Alvarez J, Yeo J, Sim N, Tan A, Zhou S, Suteja L, Lim T, Rohatgi N, Yeong J, Takano A, Lim K, Gogna A, Too C, Zhuang K, Jain A, Tan W, Kanesvaran R, Ng Q, Ang M, Rajasekaran T, Wang L, Toh C, Lim W, Tam W, Ginhoux F, Tan S, Skanderup A, Tan D, Tan E. OA01.06 Randomised Phase 2 Study of Nivolumab (N) Versus Nivolumab and Ipilimumab (NI) Combination in EGFR Mutant NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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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Tan A, Chua K, Teng Y, Takano A, Alvarez J, Nahar R, Rohatgi N, Lai G, Aung Z, Yeong J, Lim K, Naeini M, Kassam I, Jain A, Tan W, Gogna A, Too C, Kanesvaran R, Ng Q, Ang M, Rajasekaran T, Devanand A, Phua G, Tan B, Lee Y, Wang L, Teo A, Khng A, Lim M, Suteja L, Toh C, Lim W, Iyer N, Tam W, Tan E, Zhai W, Hillmer A, Skanderup A, Tan D. MA13.08 Genomic and Transcriptomic Features of Distinct Resistance Trajectories in EGFR Mutant Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.269] [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: 11/17/2022]
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Alvarez J, Chua K, Sim N, Abedi M, Chen J, Tan A, Lai G, Takano A, Lim W, Tan E, Lim K, Zhai W, Tan D, Skanderup A. P59.08 THOR: Multi-Ethnic, Open Access Thoracic Cancer Genomics Resource. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.959] [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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Quek SJ, Sim YF, Lai B, Lim W, Hong CH. The effect of parenting styles on enforcement of oral health behaviours in children. Eur Arch Paediatr Dent 2021; 22:83-92. [PMID: 32418053 DOI: 10.1007/s40368-020-00537-7] [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] [Received: 10/05/2019] [Accepted: 05/03/2020] [Indexed: 01/13/2023]
Abstract
PURPOSE To examine the relationship between parenting styles and parental attitudes towards oral health practices in children. METHODS Parents of children aged 4-6 years presenting to four public dental clinics completed the Parenting Styles Dimensions Questionnaire (PSDQ) and a questionnaire on parental attitudes, child diet and oral hygiene practices. Child oral health was evaluated using Plaque Index (PI) and dmft-Index. RESULTS Three hundred and eighty-nine children (mean age: 62.3 ± 9.8 months) were recruited. The median dmft was 4 (IQR = 9) and median PI was 1.5 (IQR = 0.8). An authoritative parenting style was observed in 95.1% of parents. Authoritative parents were more likely to monitor sweets/snacks intake (P = 0.004) and less inclined to offer sweets/snacks in exchange for good behaviour (P = 0.04) than permissive parents. However, actual between-meal snacking frequency did not differ between styles (P = 0.43). Permissive parents were less likely to ensure bedtime toothbrushing (P = 0.001) or brush thoroughly when busy or tired (P = 0.03) compared to authoritative parents; these attitudes were associated with higher frequencies of actual omission of bedtime toothbrushing (P = 0.006) in their children. A higher frequency of omitting bedtime toothbrushing significantly predicted a permissive parenting style (OR = 12.1, P = 0.009). Parenting styles were not associated with dmft (P = 0.72) and/or PI (P = 0.34). CONCLUSIONS Authoritative parenting was associated with positive attitudes regarding both preventive dietary and oral hygiene practices. Actual oral hygiene practices were more ideal in children with authoritative parents, but parenting styles had no impact on actual dietary habits.
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Affiliation(s)
- S J Quek
- Department of Restorative Dentistry (Paediatric Dentistry), National Dental Centre Singapore, 5 Second Hospital Avenue, Singapore, 168938, Singapore.
| | - Y F Sim
- Faculty of Dentistry, National University of Singapore, 9 Lower Kent Ridge Road, Level 10, Singapore, 119085, Singapore
| | - B Lai
- Department of Restorative Dentistry (Paediatric Dentistry), National Dental Centre Singapore, 5 Second Hospital Avenue, Singapore, 168938, Singapore
| | - W Lim
- Youth Preventive Services Division, School Dental Services & School Dental Centre, Health Promotion Board, 3 Second Hospital Avenue, #04-00, Singapore, 168937, Singapore
| | - C H Hong
- Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, National University of Singapore, 9 Lower Kent Ridge Road, Level 10, Singapore, 119085, Singapore
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Lim W, Eadie K, Konings M, van de Sande W. MycetOS – An open research model discover new drugs to treat one of the most neglected disease – Mycetoma. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1018] [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: 10/22/2022] Open
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13
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Lim W, Eadie K, Rijnders B, Fahal A, Oliver J, Birch M, van de Sande W. Olorofim is potent against Madurella mycetomatis – the most common causative agent of Eumycetoma. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1015] [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] Open
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Ho HJ, Lim WY, Ang B, Chow A. Use of surveillance technology to enhance exposure management for healthcare workers during the COVID-19 pandemic. J Hosp Infect 2020; 107:101-102. [PMID: 32980491 PMCID: PMC7833647 DOI: 10.1016/j.jhin.2020.09.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 09/19/2020] [Indexed: 11/30/2022]
Affiliation(s)
- H J Ho
- Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore.
| | - W Y Lim
- Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore
| | - B Ang
- Department of Infection Prevention and Control, Tan Tock Seng Hospital, Singapore; National Centre for Infectious Diseases, Singapore
| | - A Chow
- Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore
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Leong C, Teoh T, Bentley L, O'Rourke E, Lim W, Htun N, Premaratne M. Downstream Impact Of Expansion Of Computed Tomography Coronary Angiography: An Australian Single Tertiary Center Experience. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ko Y, Lee G, Kim B, Park M, Jang Y, Lim W. Modification of the RANKL-RANK-binding site for the immunotherapeutic treatment of osteoporosis. Osteoporos Int 2020; 31:983-993. [PMID: 31863125 DOI: 10.1007/s00198-019-05200-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 10/16/2019] [Indexed: 12/20/2022]
Abstract
UNLABELLED Here, we proposed the use of mutated RANKL as an immunogen for active immunization and to induce anti-cytokine antibodies for osteoporosis treatment. INTRODUCTION Osteoclasts are responsible for bone resorption in bone-related disorders. Anti-cytokine therapeutic antibodies such as denosumab are effective for the treatment of osteoporosis. However, problems with antibody manufacturing and the immunogenicity caused by multiple antibody doses have led to the use of auto-cytokines as immunogens to induce anti-cytokine antibodies. METHODS RANKL was point-mutated based on the crystal structure of the complex of RANKL and its receptor RANK. RESULTS As a proof of concept, immunization with RANKL produced high levels of specific antibodies and blocked osteoclast development in vitro and inhibited osteoporosis in RANKL-treated or ovariectomized mouse models. CONCLUSIONS The results demonstrate the successful use of mutated RANKL as an immunogen for the induction of anti-RANKL immune response. This strategy is useful in general anti-cytokine immunotherapy to avoid toxic side effects of osteoporosis treatment.
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Affiliation(s)
- Y Ko
- Department of Orthopaedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea
- Laboratory of Orthopaedic Research, Chosun University Hospital, Gwangju, 61453, South Korea
| | - G Lee
- Department of Orthopaedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea
- Laboratory of Orthopaedic Research, Chosun University Hospital, Gwangju, 61453, South Korea
| | - B Kim
- Department of Orthopaedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea
- Laboratory of Orthopaedic Research, Chosun University Hospital, Gwangju, 61453, South Korea
| | - M Park
- Department of Orthopaedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea
- Laboratory of Orthopaedic Research, Chosun University Hospital, Gwangju, 61453, South Korea
| | - Y Jang
- Department of Orthopaedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea
- Laboratory of Orthopaedic Research, Chosun University Hospital, Gwangju, 61453, South Korea
- Department of Premedical Program, School of Medicine, Chosun University, Gwangju, 61452, South Korea
| | - W Lim
- Department of Orthopaedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea.
- Laboratory of Orthopaedic Research, Chosun University Hospital, Gwangju, 61453, South Korea.
- Department of Premedical Program, School of Medicine, Chosun University, Gwangju, 61452, South Korea.
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Maclean E, Yap J, Saberwal B, Kolvekar S, Lim W, Wijesuriya N, Papageorgiou N, Dhillon G, Hunter R, Lowe M, Lambiase P, Chow A, Abbas H, Schilling R, Rowland E, Ahsan S. Initial experience with the convergent procedure for longstanding persistent atrial fibrillation: A 5 year dataset. Data Brief 2020; 30:105417. [PMID: 32258280 PMCID: PMC7118295 DOI: 10.1016/j.dib.2020.105417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/03/2020] [Accepted: 03/05/2020] [Indexed: 12/02/2022] Open
Abstract
In patients with longstanding persistent atrial fibrillation (AF), outcomes from catheter ablation remain suboptimal. The convergent procedure combines minimally invasive surgical ablation with subsequent catheter ablation, and may contribute towards maintenance of sinus rhythm in this patient group. We performed the convergent procedure on 43 patients with longstanding persistent AF from 2013–2018. Patients underwent clinical review at 3, 6, and 12 months and thereafter as necessitated by their symptoms. Our dataset describes patients’ baseline characteristics and rhythm control protocols, as well as outcomes including arrhythmia recurrence, the need for antiarrhythmic drugs, requirement for repeat rhythm control procedures, and complications. These data provide a real world insight into the risks and benefits of the convergent procedure in patients with longstanding persistent AF.
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Affiliation(s)
- E. Maclean
- Barts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK
- William Harvey Research Institute, Charterhouse Square, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, United Kingdom
| | - J. Yap
- Barts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK
| | - B. Saberwal
- Barts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK
| | - S. Kolvekar
- Barts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK
| | - W. Lim
- Barts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK
| | - N. Wijesuriya
- Barts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK
| | - N. Papageorgiou
- Barts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK
| | - G. Dhillon
- Barts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK
| | - R.J. Hunter
- Barts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK
- William Harvey Research Institute, Charterhouse Square, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, United Kingdom
| | - M. Lowe
- Barts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK
| | - P. Lambiase
- Barts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK
- William Harvey Research Institute, Charterhouse Square, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, United Kingdom
| | - A. Chow
- Barts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK
| | - H. Abbas
- Barts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK
| | - R. Schilling
- Barts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK
- William Harvey Research Institute, Charterhouse Square, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, United Kingdom
| | - E. Rowland
- Barts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK
| | - S. Ahsan
- Barts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK
- Corresponding author.
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WANG J, Byrnes E, Lee V, Wong G, Zhu K, Hodgson J, Robertson G, Lim W, Prince R, Lewis J. SUN-121 ASSOCIATION BETWEEN A NOVEL BIOMARKER, SERUM MIDKINE, AND ASYMPTOMATIC AND CLINICAL CARDIOVASCULAR DISEASE IN ELDERLY WOMEN. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.648] [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: 10/24/2022] Open
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BEK S, Marshner S, Wong G, Sud K, Chow C, Lim W, Lee V. SAT-201 ASSOCIATION BETWEEN SMOKING AND ALL-CAUSE AND CAUSE- SPECIFIC MORTALITY IN INCIDENT DIALYSIS PATIENTS-AN ANZDATA REGISTRY ANALYSIS. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.215] [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] Open
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Maclean E, Yap J, Saberwal B, Kolvekar S, Lim W, Wijesuriya N, Papageorgiou N, Dhillon G, Hunter R, Lowe M, Lambiase P, Chow A, Abbas H, Schilling R, Rowland E, Ahsan S. The convergent procedure versus catheter ablation alone in longstanding persistent atrial fibrillation: A single centre, propensity-matched cohort study. Int J Cardiol 2020; 303:49-53. [DOI: 10.1016/j.ijcard.2019.10.053] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/15/2019] [Accepted: 10/31/2019] [Indexed: 12/11/2022]
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Wong P, Sng BL, Lim WY. Rescue supraglottic airway devices at caesarean delivery: What are the options to consider? Int J Obstet Anesth 2019; 42:65-75. [PMID: 31843342 DOI: 10.1016/j.ijoa.2019.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 10/17/2019] [Accepted: 11/05/2019] [Indexed: 10/25/2022]
Abstract
Tracheal intubation is considered the gold standard means of securing the airway in obstetric general anaesthesia because of the increased risk of aspiration. Obstetric failed intubation is relatively rare. Difficult airway guidelines recommend the use of a supraglottic airway device to maintain the airway and to allow rescue ventilation. Failed intubation is associated with a further increased risk of aspiration, therefore there is an argument for performing supraglottic airway-guided flexible bronchoscopic intubation (SAGFBI). The technique of SAGFBI has a high success rate in the non-obstetric population, it protects the airway and it minimises task fixation on repeated attempts at laryngoscopic tracheal intubation. However, after failed intubation via laryngoscopy, there is a lack of specific recommendations or indications for SAGFBI in current obstetric difficult airway guidelines in relation to achieving tracheal intubation. Our narrative review explores the issues pertaining to airway management in these cases: the use of supraglottic airway devices and the techniques of, and technical issues related to, SAGFBI. We also discuss the factors involved in the decision-making process as to whether to proceed with surgery with the airway maintained only with a supraglottic airway device, or to proceed only after SAGFBI.
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Affiliation(s)
- P Wong
- Department of Anaesthesiology, Singapore General Hospital, Outram Road, Singapore.
| | - B L Sng
- Department of Women's Anaesthesia, KK Women's & Children's Hospital, Singapore
| | - W Y Lim
- Department of Anaesthesiology, Singapore General Hospital, Outram Road, Singapore
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Hong Y, Lim W, Jung S, Kim S, Lee D. Computational fluid dynamic study in obstructive sleep apnea patients. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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Honarbakhsh S, Providencia R, Garcia-Hernandez J, Martin CA, Hunter RJ, Lim WY, Kirkby C, Sharifzadehgan A, Waldmann C, Marijon E, Munoz-Esparza C, Lacunza J, Gimeno-Blanes JR, Lambiase PD. P6586Brugada syndrome risk stratification - Evaluation of clinical and ECG risk markers in a multicenter international primary prevention cohort. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1174] [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
Risk stratification for sudden cardiac death (SCD) in Brugada syndrome (BrS) is a significant challenge.
Purpose
To evaluate the importance of clinical and ECG factors in the likelihood of developing significant ventricular arrhythmias (VAs)/SCD in BrS patients.
Methods
VA occurrence during follow-up were assessed and the role of 16 proposed clinical or ECG risk markers evaluated in a multicenter international study of BrS patients and no history of cardiac arrest. Markers with predictive power were identified and incorporated into a risk score model.
Results
Across 15 international centers, 1084 patients were included. During a follow-up of 5.3 years (IQR 2.7–9.0 years)- 110 patients had VA occurrence (10.1%) with an annual event rate of 1.7% (95% CI 1.4–2.0). Of the 16 proposed risk factors, diagnosis by family screening of sudden cardiac death (HR 4.65; p<0.001), probable arrhythmia related syncope (HR 3.88, p<0.001), type 1 spontaneous ECG (HR 3.56; p<0.001), Early Repolarisation (HR 3.15; p<0.001) and type 1 Brugada pattern in peripheral leads (HR 2.42; p<0.001) were associated with a higher VA occurrence risk during follow-up. These 5 variables were incorporated into a risk score model whereby each variable was allocated a point score based on the variable's predictive strength. The total points obtained from the model for a patient could then be translated into the predicted VA occurrence risk during follow-up (Figure 1). The model showed a sensitivity of 63.5% (95% CI 50.0–76.9) and specificity of 84.2% (95% CI 81.1–87.1) in predicting VA occurrence at 5-years follow-up. The model showed a greater discriminative power compared to an existing model (AUC 0.83 vs. 0.71; p<0.001).
Figure 1
Conclusions
This multicenter study with longest reported follow-up to date identified 5 risk markers for VA occurrence. Utilizing these markers in a risk score model can aid BrS risk stratification to enable individualized risk prediction and ICD prescription.
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Affiliation(s)
- S Honarbakhsh
- Barts Health NHS Trust, Electrophysiology, London, United Kingdom
| | - R Providencia
- Barts Health NHS Trust, Electrophysiology, London, United Kingdom
| | - J Garcia-Hernandez
- University College London, Farr Research Institute, London, United Kingdom
| | - C A Martin
- Papworth Hospital NHS Trust, Electrophysiology, Cambridge, United Kingdom
| | - R J Hunter
- Barts Health NHS Trust, Electrophysiology, London, United Kingdom
| | - W Y Lim
- Barts Health NHS Trust, Electrophysiology, London, United Kingdom
| | - C Kirkby
- Barts Health NHS Trust, Electrophysiology, London, United Kingdom
| | - A Sharifzadehgan
- European Hospital Georges Pompidou, Electrophysiology, Paris, France
| | - C Waldmann
- European Hospital Georges Pompidou, Electrophysiology, Paris, France
| | - E Marijon
- European Hospital Georges Pompidou, Electrophysiology, Paris, France
| | - C Munoz-Esparza
- Hospital Clínico Univeristario Virgen de la Arrixaca, Electrophysiology, Murcia, Spain
| | - J Lacunza
- Hospital Clínico Univeristario Virgen de la Arrixaca, Electrophysiology, Murcia, Spain
| | - J R Gimeno-Blanes
- Hospital Clínico Univeristario Virgen de la Arrixaca, Electrophysiology, Murcia, Spain
| | - P D Lambiase
- Barts Health NHS Trust, Electrophysiology, London, United Kingdom
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Bae S, Lim W, Jeong J, Lee S, Choi J, Park H, Jung Y, Jung S, Nam S. The prognostic significance of preoperative tumour marker (CEA, CA15-3) elevation in breast cancer patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.099] [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: 11/12/2022] Open
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25
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Lim WY, Loh L, Desai SR, Tien SL, Goh BK, Wong P. Major liver surgery in a Jehovah’s Witness patient: challenges for safe surgery. South Afr J Anaesth Analg 2019. [DOI: 10.36303/sajaa.2019.25.3.2220] [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: 11/05/2022]
Abstract
Jehovah’s Witnesses presenting for major surgery run the risk of major bleeding, which is complicated by the refusal to accept blood transfusion. We present a case of a 63-year-old woman, a Jehovah’s Witness, who was diagnosed with hepatocellular carcinoma and advised for curative laparoscopic liver segmentectomy. Due to the risk of significant intraoperative haemorrhage, her perioperative care was coordinated in a multidisciplinary manner. Informed consent requires the physician to advise on the material risks of undertaking major surgery without blood transfusion and the possible alternatives. Conflicting ethical issues of patient autonomy and beneficence related to refusal of blood products also arise. Perioperative strategies to minimise blood loss, maximise haematopoiesis and tolerance of anaemia to facilitate safe surgery in such patients are also presented. Written patient consent obtained.
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Affiliation(s)
- WY Lim
- Singapore General Hospital
| | - L Loh
- Singapore General Hospital
| | | | | | - BK Goh
- Singapore General Hospital
| | - P Wong
- Singapore General Hospital
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Beynel L, Appelbaum L, Luber B, Crowell C, Hilbig S, Lim W, Nguyen D, Chrapliwy N, Davis S, Cabeza R, Lisanby H, Deng Z. Effects of online repetitive transcranial magnetic stimulation (rTMS) on cognition: a meta-analysis and recommendations for future studies. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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27
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Koh J, Lim W, Neoh J, Hescham S, Blokland A, Chan Y, Temel Y, Lim L, Wu E. Pacemaker in the aged brain: From molecular profiling to memory enhancement. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.412] [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] Open
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An J, Yang J, Lee WH, Kim JB, Kim JK, Kim H, Paek SH, Lee JW, Woo J, Kwon H, Lim W, Paik NS, Kim YK, Moon BI. Abstract P2-02-09: Not presented. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-02-09] [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: 11/16/2022]
Abstract
Abstract
This abstract was not presented at the conference.
Citation Format: An J, Yang J, Lee W-H, Kim JB, Kim J-k, Kim H, Paek SH, Lee JW, Woo J, Kwon H, Lim W, Paik NS, Kim Y-K, Moon B-I. Not presented [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-02-09.
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Affiliation(s)
- J An
- Ewha Womans University School of Medicine, Seoul, Republic of Korea; MD Healthcare Company, Seoul, Republic of Korea
| | - J Yang
- Ewha Womans University School of Medicine, Seoul, Republic of Korea; MD Healthcare Company, Seoul, Republic of Korea
| | - W-H Lee
- Ewha Womans University School of Medicine, Seoul, Republic of Korea; MD Healthcare Company, Seoul, Republic of Korea
| | - JB Kim
- Ewha Womans University School of Medicine, Seoul, Republic of Korea; MD Healthcare Company, Seoul, Republic of Korea
| | - J-k Kim
- Ewha Womans University School of Medicine, Seoul, Republic of Korea; MD Healthcare Company, Seoul, Republic of Korea
| | - H Kim
- Ewha Womans University School of Medicine, Seoul, Republic of Korea; MD Healthcare Company, Seoul, Republic of Korea
| | - SH Paek
- Ewha Womans University School of Medicine, Seoul, Republic of Korea; MD Healthcare Company, Seoul, Republic of Korea
| | - JW Lee
- Ewha Womans University School of Medicine, Seoul, Republic of Korea; MD Healthcare Company, Seoul, Republic of Korea
| | - J Woo
- Ewha Womans University School of Medicine, Seoul, Republic of Korea; MD Healthcare Company, Seoul, Republic of Korea
| | - H Kwon
- Ewha Womans University School of Medicine, Seoul, Republic of Korea; MD Healthcare Company, Seoul, Republic of Korea
| | - W Lim
- Ewha Womans University School of Medicine, Seoul, Republic of Korea; MD Healthcare Company, Seoul, Republic of Korea
| | - NS Paik
- Ewha Womans University School of Medicine, Seoul, Republic of Korea; MD Healthcare Company, Seoul, Republic of Korea
| | - Y-K Kim
- Ewha Womans University School of Medicine, Seoul, Republic of Korea; MD Healthcare Company, Seoul, Republic of Korea
| | - B-I Moon
- Ewha Womans University School of Medicine, Seoul, Republic of Korea; MD Healthcare Company, Seoul, Republic of Korea
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Leow K, Szulc P, Schousboe J, Kiel D, Teixeira-Pinto A, Shaikh H, Sawang M, Bondonno N, Hodgson J, Sharma A, Thompson P, Prince R, Craig J, Lim W, Wong G, Lewis J. Prognostic Value of Abdominal Aortic Calcification: A Systematic Review and Meta-analysis of Observational Studies. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.555] [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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Bae S, Jung S, Korean Breast Cancer Society K, Nam S, Jung Y, Park B, Lim W, Jung S, Kim H, You JY, Lee S. Differences in prognosis and efficacy of chemotherapy by p53 expression in triple negative breast cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy426] [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: 11/12/2022] Open
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31
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Ng D, Tan R, Sultana R, Ang M, Lim W, Chong D, Cwl C, Koo SL, Seet S, Tan Z, Tan I. Prevalence of vitamin D deficiency in Chinese patients with early stage colorectal cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy431.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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32
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Chang G, Lam C, Tsai C, Chen Y, Shih J, Aggarwal S, Wang S, Kim S, Kim Y, Wahid I, Li R, Lim W, Sriuranpong V, Chan T, Lorence R, Carriere P, Raabe C, Cseh A, Park K. P1.01-11 Named Patient Use Program for Afatinib in Advanced NSCLC with Progression on Prior Therapy: Experience from Asian Centers. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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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33
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Kwang L, Lau D, Liew A, Ju Y, Lim E, Lai G, Nahar R, Teng Y, Chua K, Alvarez J, Lim M, Leong H, Chong F, Toh D, Quah H, Suteja L, Wang L, Lim K, Lim W, Tan E, Zhai W, Tam W, Iyer N, Tan D. P2.13-21 MET Addiction Can be Circumvented Through EGFR Inhibition Via AXL in MET-Amplified Primary Resistant EGFR-Mutant NSCLCX. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1416] [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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34
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Jeong W, Bae H, Lim W, Bazer FW, Song G. Adiponectin: A prosurvival and proproliferation signal that increases bovine mammary epithelial cell numbers and protects them from endoplasmic reticulum stress responses. J Anim Sci 2018; 95:5278-5289. [PMID: 29293771 DOI: 10.2527/jas2017.1885] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Cell-cell interactions between epithelial and stromal cells are predominant in the mammary gland, and various stromal cell-derived factors can elicit mitogenic responses in adjacent epithelial cells. Adiponectin is a hormone secreted mainly by adipocytes that mediates stromal-epithelial interactions in a number of tissues. Adiponectin receptors are expressed by bovine mammary epithelial cells, but the regulatory effects of adiponectin on the development and function of the mammary gland remain unclear. We therefore sought to investigate the effects of adiponectin on bovine mammary epithelial (MAC-T) cells and the regulatory mechanisms that underlie these adiponectin-induced actions. Our results revealed an increase in MAC-T cell proliferation and cell cycle progression in response to adiponectin. The expression of nuclear proliferating cell nuclear antigen (PCNA) and cyclin D1 was induced in MAC-T cells, and intracellular signaling molecules such as serine/threonine protein kinase (AKT), 70 kDa ribosomal S6 kinase (P70S6K), ribosomal protein S6 (S6), extracellular signal-regulated kinases 1 and 2 (ERK1/2), 90 kDa ribosomal S6 kinase (P90S6K), and cyclin D1 were activated in a dose-dependent manner. The abundance of adiponectin-induced signaling proteins was suppressed following inhibition of AKT or ERK1/2 mitogen-activated protein kinase (MAPK) signaling. In addition, inhibition of AKT or ERK1/2 signaling significantly reduced adiponectin-stimulated MAC-T cell proliferation. Furthermore, adiponectin reduced tunicamycin-induced expression and activation of endoplasmic reticulum stress-related proteins in MAC-T cells and attenuated the repressive effect of tunicamycin on proliferation of MAC-T cells. Collectively, these results suggest that adiponectin-mediated signaling may affect the development and function of the mammary gland in dairy cows by increasing mammary epithelial cell numbers. These findings may result in important implications for improving our fundamental understanding of lactation physiology in livestock species.
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Jeong W, Bae H, Lim W, Bazer FW, Lee H, Song G. The functional effects and mechanisms by which fibroblast growth factor 2 (FGF2) controls bovine mammary epithelial cells: Implications for the development and functionality of the bovine mammary gland. J Anim Sci 2018; 95:5365-5377. [PMID: 29293786 DOI: 10.2527/jas2017.1877] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Fibroblast growth factor (FGF) signaling plays essential roles in tissue development and homeostasis. Accumulating evidence reveals that fibroblast growth factor 2 (FGF2) regulates ductal elongation, which requires cell proliferation and epithelial expansion in the mammary gland. However, the function and mechanisms by which FGF2 controls functionality of epithelial cells is less well defined. Here, we demonstrate the functional effects of FGF2 on bovine mammary epithelial (MAC-T) cells and the intracellular signaling mechanisms for these FGF2-induced actions. The current results show that treatment of MAC-T cells with a recombinant FGF2 induced cell proliferation and cell-cycle progression with increased expression of proliferating cell nuclear antigen and cyclin D1. Moreover, FGF2 increased phosphorylation of serine/threonine protein kinase (protein kinase B [AKT]), extracellular signal-regulated kinases 1 and 2 (ERK1/2), Jun N-terminal kinase (JNK), 70 kDa ribosomal S6 kinase (P70S6K), 90 kDa ribosomal S6 kinase (P90S6K), ribosomal protein S6 (S6), and cyclin D1 proteins. These FGF2-induced activations of signaling pathway proteins were inhibited by blocking AKT, ERK1/2, or JNK phosphorylation. The effect of FGF2 to stimulate MAC-T cell proliferation was mediated by activation of FGF receptors (FGFR) and AKT, ERK1/2, and JNK mitogen-activated protein kinase pathways in response to FGF2 stimulation. Furthermore, expression and activation of endoplasmic reticulum (ER) stress-related factors and ER stress-induced MAC-T cell death was reduced by FGF2. Together, these results suggest that the FGF2-FGFR-intracellular signaling cascades may contribute to maintaining and/or increasing numbers of mammary epithelial cells by inducing proliferation of mammary epithelial cells and by protecting cells from ER stress responses. Therefore, this study provides evidence that FGF2 signaling is a positive factor for mammary gland remodeling and for increasing persistency of milk production.
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Jeong W, Bae H, Lim W, Song G. Dicer1, AGO3, and AGO4 microRNA machinery genes are differentially expressed in developing female reproductive organs and overexpressed in cancerous ovaries of chickens. J Anim Sci 2018; 95:4857-4868. [PMID: 29293730 DOI: 10.2527/jas2017.1846] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
MicroRNA (miRNA)-mediated gene silencing is a key mechanism regulating numerous biological processes such as development of organs and tumorigenesis. The expression of miRNA machinery genes linked to miRNA biogenesis and processing is finely regulated. Despite accumulating evidence for chicken miRNA in the female reproduction system, precise regulatory mechanisms are largely unknown. Therefore, the objective of this study was to determine changes in expression levels of miRNA machinery genes in developmental stages of the oviduct and ovarian carcinogenesis of laying hens. In the present study, differential expression of miRNA machinery genes during ovarian carcinogenesis was determined using cancerous and normal ovaries collected from normal laying hens and hens with cancer. Our results showed that 3 miRNA machinery genes (, , and ) were differentially expressed as laying hens' reproductive organs developed. These genes were simultaneously upregulated in cancerous ovaries compared with those in normal ovaries. Their transcripts were abundantly localized in glandular epithelial cells of cancerous ovaries. Our results indicate that , , and play critical roles in the development of reproductive organs and ovarian carcinogenesis in laying hens, suggesting that simultaneous overexpression of these genes might serve as a prognostic factor for ovarian cancer.
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Paek S, Kim H, Lee J, Woo J, Kim J, Kwon H, Lim W, Kim J, Moon B, Paik N. Circulating plasmacytoid and myeloid dendritic cells in breast cancer patients. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30588-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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38
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Jeong W, Bae H, Lim W, Bazer FW, Song G. Differential expression of neuregulin 1 (NRG1) and candidate miRNA regulating NRG1 transcription in the chicken oviduct in response to hormonal changes. J Anim Sci 2018; 95:3885-3904. [PMID: 28992000 DOI: 10.2527/jas2017.1663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Neuregulin 1 (NRG1), a signaling protein that binds to members of the erythroblastoma (ErbB) family, is known to play essential biological roles in mediating cell-cell interactions and orchestrating vital cell functions in the heart and nervous system. NRG1 is closely associated with developmental processes in various organs and expression of several NRG1 isoforms are regulated by estrogen. However, expression and its hormonal regulation during development of the female reproductive tract remain unknown. The reproductive system of chickens undergoes dynamic morphological and functional changes in response to estrogen and the molting process. Therefore, in the current study, we found differential expression of and candidate microRNA regulating chicken transcription in response to estrogen stimulation and/or the molting process. The results revealed that relative expression of mRNA increased in the oviducts of chicks treated with diesthylstilbestrol (DES; a synthetic non-steroidal estrogen). Additionally, abundant NRG1 mRNA expression was primarily in the glandular (GE) and luminal (LE) epithelia of the magnum in the developing chick oviduct in response to exogenous estrogen. Also, expression decreased during regression of the oviduct following induced molting by feeding high levels of zinc in the diet, and then gradually resurged as the oviduct underwent remodeling and recrudescence in laying hens. In addition, the present results revealed changes in relative expression of candidate chicken microRNA (, and ) targeting transcription in chicken oviducts in response to exogenous estrogen. In conclusion, these results provide the first evidence that is a novel estrogen-responsive gene closely correlated with the estrogen-dependent development of the oviduct of chicks and regeneration of the oviduct after molting. Further, regulation of expression involving at least 3 chicken miRNA is likely a prerequisite for those estrogen regulated developmental events.
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Soo R, Mok T, Shi YK, Zhang L, Lu S, Yang JCH, Nakagawa K, Yamamoto N, Nokihara H, Sugawara S, Nishio M, Takahashi T, Goto K, Chang J, Maemondo M, Ichinose Y, Cheng Y, Lim W, Morita S, Tamura T. EAST-LC: Randomized controlled phase III trial of S-1 versus docetaxel (DOC) in patients with non-small cell lung cancer (NSCLC) who had received a platinum-based treatment: Results from patient-reported outcomes (PROs). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx671.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kim J, Lim W, Bazer FW, Song G. Rapid Communication: MicroRNA co-expression network reveals apoptosis in the reproductive tract during molting in laying hens. J Anim Sci 2017; 95:5100-5104. [PMID: 29293709 PMCID: PMC6292248 DOI: 10.2527/jas2017.1972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 09/01/2017] [Indexed: 01/28/2023] Open
Abstract
The aim of this study was to determine the regulatory mechanisms of molting and recrudescence via studying the micro-RNA (miRNA) expression in the oviduct of laying hens. We performed a cDNA microarray analysis in the magnum tissue from the oviduct to identify the whole miRNA profiles through the molting and recrudescence periods. A total of 35 laying hens (47-wk-old) were divided into 7 groups (0 d: a control group; 6 and 12 d: 2 molting-period groups fed on a high-zinc diet; and 20, 25, 30, and 35 d: 4 recrudescence-period groups fed on a normal diet after a 12-d period on a high-zinc diet). An miRNA co-expression network (miRCN) was generated using the differentially expressed miRNA (DEM) according to the entire data integration. The significantly co-expressed miRNA ( = 111) were highly differentially expressed from 12 to 20 d, which was a transition period between molting and recrudescence, while their expression patterns were contrary to the estrogen changes. The targets of highly connected miRNA ( = 12) indicated the significant biological pathways and gene ontology (GO) terms, such as MAPK and Wnt signaling and magnesium-ion binding, which are associated with apoptotic activities. These results suggest that the miRNA of the miRCN might play a role in the apoptotic progression of the reproductive tract during molting.
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Affiliation(s)
- J. Kim
- Animal Genomics and Bioinformatics Division, National Institute of Animal Science, RDA, 1500, Kongjwipatjwi-ro, Wanju, Jeonbuk 55365, Republic of Korea
| | - W. Lim
- Department of Biomedical Sciences, Catholic Kwandong University, Gangneung 25601, Republic of Korea
| | - F. W. Bazer
- Center for Animal Biotechnology and Genomics and Department of Animal Science, Texas A&M University, College Station 77843-2471
| | - G. Song
- Institute of Animal Molecular Biotechnology and Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul 02841, Republic of Korea
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Tan W, Hennedige T, Ng Q, Tan S, Tran N, Chua B, Toh C, Tan E, Tan D, Ang M, Kanesvaran R, Jain A, Lim T, Gogna A, Koh M, Yip C, Thng C, Chowbay B, Tan M, Lim W. P3.01-017 Clinical Outcomes of Patients with EGFR T790M + NSCLC on Osimertinib. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1458] [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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Lai G, Nahar R, Lim T, Kwang X, Liew P, Lim J, Aung Z, Takano A, Lim W, Lau D, Tan W, Ang M, Toh C, Tan B, Devanand A, Too C, Gogna A, Ong B, Koh T, Kanesvaran R, Ng Q, Jain A, Yuan J, Lim T, Lim A, Hillmer A, Zhai W, Iyer G, Tan E, Tam W, Tan D. OA 09.07 Clonality of c-MET Copy Number Gain as a Determinant of Primary TKI Resistance in EGFR-Mutant NSCLC. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.380] [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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Jeong W, Bae H, Lim W, Bazer FW, Song G. Differential expression of neuregulin 1 (NRG1) and candidate miRNA regulating NRG1 transcription in the chicken oviduct in response to hormonal changes1. J Anim Sci 2017. [DOI: 10.2527/jas.2017.1663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Park K, Ciardiello F, Hida T, Lim W, Lin CC, Murakami H, Nishio M, Cantero F, Cattan V, Gabarroca C, Gandossi E, Paz-Ares L. Phase I/II study of S 49076, a MET/AXL/FGFR inhibitor, in combination with gefitinib in EGFR-mutated NSCLC patients who progress on EGFR tyrosine kinase inhibitor. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx380.080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Yeo A, Chong M, Tay L, Yew S, Tan C, Ismail N, Lim W. TRENDS AND PREDICTORS OF 2-YEAR ACTIVITY PARTICIPATION IN COMMUNITY DWELLING OLDER ADULTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A. Yeo
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore, Singapore,
| | - M. Chong
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore, Singapore,
- Geriatric and Education Research Institute, MOH, Singapore, Singapore,
| | - L. Tay
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore, Singapore,
- Sengkang health, Singapore, Singapore,
| | - S.P. Yew
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore, Singapore,
| | - C. Tan
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore, Singapore,
| | - N. Ismail
- Continuing and Community Care, TTSH, Singapore, Singapore,
| | - W. Lim
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore, Singapore,
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore, Singapore
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Wang S, Phua E, Sing Ai L, Lim W, Loong Mun W, Cheah J. CARE FROM YOUR COMMUNITY: A PILOT PROGRAMME TO BRING CARE CLOSER TO SENIORS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S. Wang
- Agency for Integrated Care, Singapore, Singapore
| | - E. Phua
- Agency for Integrated Care, Singapore, Singapore
| | - L. Sing Ai
- Agency for Integrated Care, Singapore, Singapore
| | - W. Lim
- Agency for Integrated Care, Singapore, Singapore
| | - W. Loong Mun
- Agency for Integrated Care, Singapore, Singapore
| | - J. Cheah
- Agency for Integrated Care, Singapore, Singapore
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Huang L, Teo L, Lim W, Cheah J. INTEGRATED HOME AND DAY CARE PROGRAMME: A PILOT TO CARE FOR FRAIL ELDERLY IN THE COMMUNITY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- L. Huang
- Agency for Integrated Care, Singapore, Singapore
| | - L. Teo
- Agency for Integrated Care, Singapore, Singapore
| | - W. Lim
- Agency for Integrated Care, Singapore, Singapore
| | - J. Cheah
- Agency for Integrated Care, Singapore, Singapore
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Yew S, Lim W, Chong M, Yeo A, Tan C, Ismail N, Tay L. LONGITUDINAL CHANGES IN NUTRITIONAL STATUS; SARCOPENIA PROGRESSION IN COMMUNITY-DWELLING OLDER ADULTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S.P. Yew
- IGA, Tan Tock Seng Hospital, Singapore, Singapore,
| | - W. Lim
- IGA, Tan Tock Seng Hospital, Singapore, Singapore,
- Geriatric Medicine, TTSH, Singapore, Singapore,
| | - M. Chong
- IGA, Tan Tock Seng Hospital, Singapore, Singapore,
- Ministry of Health, Singapore, Singapore,
| | - A. Yeo
- IGA, Tan Tock Seng Hospital, Singapore, Singapore,
| | - C. Tan
- IGA, Tan Tock Seng Hospital, Singapore, Singapore,
| | - N. Ismail
- Continuing and Community Care, TTSH, Singapore, Singapore
| | - L. Tay
- IGA, Tan Tock Seng Hospital, Singapore, Singapore,
- Sengkang Health, Singapore, Singapore,
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Boonyawat K, Caron F, Li A, Chai-Adisaksopha C, Lim W, Iorio A, Lopes RD, Garcia D, Crowther MA. Association of body weight with efficacy and safety outcomes in phase III randomized controlled trials of direct oral anticoagulants: a systematic review and meta-analysis. J Thromb Haemost 2017; 15:1322-1333. [PMID: 28407368 DOI: 10.1111/jth.13701] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [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: 01/05/2017] [Indexed: 11/30/2022]
Abstract
Essentials The association of body weight and patient-important outcomes remains unknown. Phase III randomized controlled trials of direct oral anticoagulants (DOACs) were searched. Risk of outcomes varying among body weight subgroups is not attributable to anticoagulant type. Dose adjustment of DOACs, outside that recommended, is unlikely to improve the outcomes. Click to hear Dr Braunwald's perspective on antithrombotic therapy in cardiovascular disease SUMMARY: Background Concerns have arisen in direct oral anticoagulant (DOAC)-treated patients about safety and efficacy in extremes of body weight. The aims of this systematic review were to investigate the association of body weight and patient-important outcomes in patients treated with DOACs or warfarin, and to demonstrate the fixed-dose effect of DOACs. Methods MEDLINE and EMBASE were searched until November 2016. Phase III randomized controlled trials (RCTs) using DOACs in atrial fibrillation (AF) and acute venous thromboembolism (VTE) were included. Relative risk and 95% confidence interval were calculated. The pooled estimates were performed using a Mantel-Haenszel random effects model. Results A total of 11 phase III RCTs were included. Low body weight was associated with increased risk of thromboembolism compared with non-low body weight (relative risk [RR], 1.57; 95% confidence interval [CI], 1.34-1.85). High body weight was not associated with risk of thromboembolism compared with non-high body weight (RR, 0.88; 95% CI, 0.63-1.23). The subgroup of AF patients with high body weight had a lower risk of thromboembolism compared with non-high body weight (RR, 0.43; 95% CI, 0.28-0.67). Bleeding outcomes were comparable for all body weight comparisons. There were no clear interactions between types of anticoagulant in all outcomes. Conclusion The pooled effect of both the DOAC and comparison arms was likely to be attributable to differences in baseline thrombotic risk in each body weight category, rather than an effect of the type or dose of DOAC used for each indication. Dose adjustment of DOACs, outside that recommended in the package insert, is unlikely to improve safety or efficacy.
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Affiliation(s)
- K Boonyawat
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - F Caron
- Population Health Research Institute, Hamilton, ON, Canada
| | - A Li
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA
| | | | - W Lim
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - A Iorio
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - R D Lopes
- Duke Clinical Research Institute, Duke Medicine, Durham, NC, USA
| | - D Garcia
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - M A Crowther
- Department of Medicine, McMaster University, Hamilton, ON, Canada
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Lim W. ACUTE CARE INNOVATIONS IN DELIRIUM MANAGEMENT. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- W. Lim
- Tan Tock Seng Hospital, Singapore, Singapore
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