Publications by authors named "Samuel Morgan"

18 Publications

  • Page 1 of 1

Quotation Errors in High-Impact-Factor Orthopaedic and Sports Medicine Journals.

JB JS Open Access 2021 Jul-Sep;6(3). Epub 2021 Aug 25.

Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.

Inappropriate referencing of the existing literature has the potential to propagate false information. Quotation errors are defined as citations in which the referenced article fails to substantiate the authors' claims. The aim of this study was to determine the rate of quotation errors in high-impact general orthopaedic and sports medicine journals and to determine whether there are article or journal-related factors that are related to the rate of inaccuracies.

Methods: A total of 250 citations from the 5 orthopaedic and sports medicine journals with the highest impact factors in 2019 (per Journal Citation Reports) were chosen using a random sequence generator. Reviewers rated the chosen citations by comparing the claims made by the authors with the data and conclusions of the referenced source to determine whether quotation errors were present. Logistic regression was utilized to assess for article- and journal-related factors related to the rate of quotation errors.

Results: The overall quotation error rate was 13.6%. A total of 2.8% of the claims were completely unsubstantiated. The number of quotation errors did not significantly differ between the included journals. Single citations were significantly more likely than string citations to result in citations that could not be fully substantiated (χ = 4.57; odds ratio = 2.22; 95% confidence interval = 1.06 to 4.66; p = 0.03). No relationship was found between the rate of quotation errors and the total number of citations in the article, study type, or the graded level of evidence of the article.

Conclusions: Quotation errors in high-impact factor orthopaedic and sports medicine journals are common. This is particularly important given the higher likelihood that studies in these journals are cited elsewhere, thus propagating the inaccuracies. Efforts from both authors and journals are needed to reduce quotation errors in the orthopaedic literature.
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http://dx.doi.org/10.2106/JBJS.OA.21.00019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8386904PMC
August 2021

Flexible Cystoscopy in the Setting of Macroscopic Hematuria: Do the Findings Justify Its Use?

Urol Int 2021 Jul 20:1-7. Epub 2021 Jul 20.

Department of Urology, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel.

Background: Patients hospitalized due to gross hematuria frequently complete evaluation in the outpatient setting. The use of office flexible cystoscopy during hospitalization may lead to prompt diagnosis and treatment but can be limited due to low visualization and artifacts that can hamper diagnostic ability.

Objective: The objective of this study was to assess flexible cystoscopy findings and yield performed in patients hospitalized due to gross hematuria.

Methods: Medical records of patients who underwent flexible cystoscopy while hospitalized during September 2018-December 2019 were reviewed. Cystoscopic findings were categorized into (1) suspicious mass in the bladder or prostate, (2) nonsuspicious changes in the bladder, and (3) nondiagnostic exam. Descriptive statistics were used to report the clinical characteristics of the study cohort and the findings of cystoscopy. Univariate logistic regression analyses were used to identify predictors of malignant findings.

Results: The study cohort consisted of 69 patients (median age of 76 years). Initial cystoscopy findings were suspicious for malignancy in 26/69 patients (38%), nonsuspicious for malignancy in 34/69 patients (49%), and nondiagnostic in 9/69 patients (13%). The median follow-up time was 9 months (range 4-14 months). Twenty patients (29%) were diagnosed with malignancy (sensitivity of 75% and specificity of 78%). The procedure led to either diagnosis or treatment of 39 patients (57%). However, in 30 patients (43%), the initial cystoscopy did not aid in the diagnosis, led to misdiagnoses, or required a follow-up cystoscopy. On univariate analyses, none of the precystoscopy variables were predictive of bladder malignancy.

Conclusion: Flexible cystoscopy in the setting of acute hematuria requiring hospitalization did not lead to diagnosis or treatment in over 40% of cases. In this setting, consideration should be given to performing an upfront cystoscopy under anesthesia.
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http://dx.doi.org/10.1159/000517374DOI Listing
July 2021

Prognostic Implication of Tricuspid Regurgitation in ST-segment Elevation Myocardial Infarction Patients.

Isr Med Assoc J 2021 Jul;23(7):441-446

Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Background: Tricuspid regurgitation (TR) is associated with adverse prognosis in various patient populations but currently no data is available about the prevalence and prognostic implication of TR in ST-segment elevation myocardial infarction (STEMI) patients.

Objectives: To investigate the possible implication of TR among STEMI patients.

Methods: We conducted a retrospective study of STEMI patients undergoing primary percutaneous coronary intervention (PCI), and its relation to major clinical and echocardiographic parameters. Patient records were assessed for the prevalence and severity of TR as well as the relation to the clinical profile, key echocardiographic parameters, in-hospital outcomes, and long-term mortality. Patients with previous myocardial infarction or known previous TR were excluded.

Results: The study included 1071 STEMI patients admitted between September 2011 and May 2016 (age 61 ± 13 years; predominantly male). A total of 205 patients (19%) had mild TR while another 32 (3%) had moderate or greater TR. Patients with significant TR demonstrated worse echocardiographic parameters, were more likely to have in-hospital complications, and had higher long-term mortality (28% vs. 6%, P < 0.001). Following adjustment for significant clinical and echocardiographic parameters, mortality hazard ratio of at least moderate to severe TR remained significant (2.44, 95% confidence interval 1.06-5.6, P = .036) for patients with moderate to severe TR.

Conclusions: Among STEMI patients after primary PCI, the presence of moderate to severe TR was independently associated with adverse outcomes and significantly lower survival rate.
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July 2021

Detection of Renal Injury Following Primary Coronary Intervention among ST-Segment Elevation Myocardial Infarction Patients: Doubling the Incidence Using Neutrophil Gelatinase-Associated Lipocalin as a Renal Biomarker.

J Clin Med 2021 May 14;10(10). Epub 2021 May 14.

Department of Cardiology, Tel-Aviv Sourasky Medical Center affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 64239, Israel.

Background: A subgroup of patients with acute kidney injury (AKI) do not fulfil the functional criteria for AKI diagnosis but show elevated levels of new biomarkers reflecting tubular injury, suggesting that these patients suffer "subclinical AKI". We investigated the incidence and possible implications of "subclinical AKI", compared to no and clinical AKI among ST elevation myocardial infarction patients (STEMI) treated with primary coronary intervention (PCI).

Methods: We included 223 patients with STEMI treated with PCI. Neutrophil gelatinase-associated lipocalin (NGAL) was used as a marker of renal tubular damage in the absence of functional AKI, with NGAL levels ≥100 ng/mL suggesting subclinical AKI. Patients were assessed for the occurrence of in-hospital adverse outcomes.

Results: Of the study patients, 45 (25%) had subclinical AKI. These patients were more likely to have left ventricular ejection fraction ≤45% (33% vs. 23%. = 0.01), in-hospital adverse outcomes (73% vs. 48%; = 0.005), and a combination of the two. The multivariate regression model demonstrated that subclinical AKI was independently associated with in-hospital adverse outcomes (OR 3.71, 95% CI 1.30-10.62, = 0.02).

Conclusions: Subclinical AKI is common among STEMI patients and is independently associated with adverse outcomes, even in the absence of functional AKI.
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http://dx.doi.org/10.3390/jcm10102120DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8156451PMC
May 2021

Mid-term clinical and radiographic outcomes of porous-coated metaphyseal sleeves used in revision total knee arthroplasty.

Knee Surg Relat Res 2021 May 4;33(1):16. Epub 2021 May 4.

Orthopedic Department, affiliated to the Sackler Faculty of Medicine, Tel Aviv Sourasky Medical Center, Ichilov Hospital, Tel Aviv University, 6 Weizman St, 6423906, Tel Aviv, Israel.

Background: The management of bone defects remains one of the major challenges surgeons are faced with in revision total knee arthroplasty (RTKA). Large and uncontained bone defects are traditionally managed with metaphyseal sleeves that facilitate osseointegration and have reported construct stability. While many studies have presented excellent short-term outcomes using metaphyseal sleeves, less is known on their performance in the longer term. The purpose of this study was to present our mid-term results of the metaphyseal sleeves used in patients undergoing RTKA.

Materials And Methods: Between January 2007 and January 2015, 30 patients underwent RTKA with the use of a CCKMB prosthesis combined with an osteointegrative sleeve. The main indications for RTKA were instability in 40% of the cases (n = 12), aseptic loosening in 30% (n = 9), infection in 26.7% (n = 8), and "other" in 3.3% (n = 1). The minimal follow-up time was 5 years and the mean follow-up time was 82.4 months (SD = 22.6). Clinical outcomes were assessed by Knee Society scores (KSS), range of motion and rate of re-operation.

Results: The mean Knee Society score increased significantly from 72.1 preoperatively to 90.0 postoperatively (p < 0.001). The cumulative incidence of re-operation in our study was 13.3% (n = 4). Our study reported no cases of aseptic loosening or mobile-bearing spin-out. Knee flexion to 90° and more was impossible in seven cases (23.3%) preoperatively and in one case (3.3%) postoperatively.

Conclusion: Porous-coated metaphyseal sleeves demonstrated excellent rates of survivorship and radiographic ingrowth in the mid-term setting. However, further studies are required to assess their outcomes in the long-term.
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http://dx.doi.org/10.1186/s43019-021-00103-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8097806PMC
May 2021

Scaphoid plating for recalcitrant scaphoid fractures: a systematic review.

J Hand Surg Eur Vol 2021 Jul 16;46(6):616-620. Epub 2021 Apr 16.

Gold Coast University Hospital, Southport, QLD, Australia.

We conducted a systematic review of scaphoid plating for recalcitrant scaphoid fractures using EMBASE, Pubmed, Cochrane and MEDLINE. Thirteen studies were included. Ninety-three per cent of cases reported were male with a mean age of 27 years. Bony union was reported in eleven studies and achieved in 72% to 100% of cases. Scaphoid plates showed no significant difference in union incidence compared with headless compression screws. Mean removal incidence of plates was 21%. Postoperative flexion-extension arc was 119°. Grip strength improved by 14% postoperatively over that before surgery. There was a general improvement in patient-reported outcome measures. Eighty-six per cent of reported participants returned to their previous work. In these clinical reports, plates frequently required removal more frequently than headless compression screws.
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http://dx.doi.org/10.1177/17531934211005637DOI Listing
July 2021

Good clinical and radiological outcomes of the varus-valgus constrained mobile-bearing implant in revision total knee arthroplasty.

Int Orthop 2021 05 17;45(5):1199-1204. Epub 2021 Mar 17.

Orthopedic Department, Tel Aviv Sourasky Medical Center, Ichilov Hospital, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman St., 6423906, Tel Aviv, Israel.

Purpose: Knee instability is one of the most common indications for having to undergo revision total knee arthroplasty (RTKA) and can be prevented with adequate implant selection and good surgical technique. Varus-valgus constrained implants (VVC) are indicated for cases of RTKA with absent ligament function in order to provide the necessary stability. While mobile-bearing articulations are thought to decrease the risk of aseptic loosening in comparison to their fixed-bearing counterparts, there is limited data on their outcomes. The purpose of our study is to present the clinical and radiological outcomes for patients undergoing an RTKA procedure with the mobile-bearing VVC implant.

Methods: Between January 2008 to January 2018, 93 patients underwent RTKA with the use of varus-valgus mobile-bearing (VVCMB) prosthesis. The main indications for RTKA were instability 38.7% (n = 36), aseptic loosening 31.2% (n = 29), infection in 26.9% (n = 25), and other 3.3%. The mean follow-up time was 56 months. Clinical outcomes were assessed by knee society scores, range of motion, and rate of re-operation.

Results: The mean knee society score increased significantly from 65.52 pre-operatively to 89.65 post-operatively (p < 0.001). The five year cumulative incidence of re-operation in our study was 7.53% (n = 7). Our study reported no cases of aseptic loosening or mobile-bearing spin-out. The number of flexion contractures decreased from n = 23 (24.7%) pre-operatively to n = 11 (11.8%) post-operatively (p < 0.05).

Conclusion: The VVC mobile-bearing prosthesis demonstrated good clinical outcomes and mid-term survivorship in patients undergoing RTKA. Additional follow-up is required in the long term.
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http://dx.doi.org/10.1007/s00264-021-05003-7DOI Listing
May 2021

Dynamic locking plate vs. cannulated cancellous screw for displaced intracapsular hip fracture: A comparative study.

J Orthop 2021 Mar-Apr;24:15-18. Epub 2021 Feb 12.

Orthopedic Department, Tel Aviv Sourasky Medical Center, Ichilov Hospital, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Introduction: There is no consensus regarding the optimal device for displaced intracapsular hip fractures. This retrospective study compared two techniques (1) cannulated cancellous screw (CCS), and (2) Targon Femoral Neck (TFN) plate.

Materials And Methods: Data regarding gender, operational data, complications, pain, Quality of life and function scores were retrieved.

Results: 103 patients were included, 42 were treated using CCS, compared to 61 treated using TFN. Operative time shorter for CCS (p = 0.019). Complication rates were not different (p > 0.05).

Conclusion: As CCS method take shorter operating time and reduced costs, CCS should be used for the treatment of displaced ICHF.
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http://dx.doi.org/10.1016/j.jor.2021.02.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7902286PMC
February 2021

Effects of surgeon experience and patient characteristics on accuracy of digital pre-operative planning in total hip arthroplasty.

Int Orthop 2020 10 22;44(10):1951-1956. Epub 2020 Jul 22.

Adult Reconstruction Unit, Division of Orthopedics, Sackler Faculty of Medicine, Tel Aviv Sourasky Medical Center,, Tel Aviv University, 6 Weizman Street, 6423906, Tel Aviv, Israel.

Background: The effect of surgeon experience on accuracy of digital pre-operative planning for total hip arthroplasty (THA) remains unclear. The aims of our study were to compare pre-operative planning accuracy between fellow-trained orthopaedic surgeons and residents and to explore whether surgery indication effects the prediction accuracy.

Methods: We prospectively reviewed 101 patients who underwent pre-operative digital templating for THA in our center from January 2019 to January 2020 with King Mark device. Extracted data included baseline characteristics and indication for primary arthroplasty. Pre-operative digital templating was performed separately by both a fellow-trained surgeon and a resident. Accuracy of each group was compared with the implanted components.

Results: The overall adequate pre-operative planning of the acetabular cup (exact or +/-1 size match) by the fellow-trained group was higher compared with the resident's group (77.2 and 64.3% respectively, p = 0.037), whereas the overall adequate pre-operative planning of the femoral stem (exact or +/-1 size match) was higher in the resident's group compared with the fellow-trained group (83.2 and 61.4% respectively, p < =0.001). The fellow-trained group showed better pre-operative planning of complex cases (developmental dysplasia of the hip and avascular necrosis of femoral head) than the resident's group.

Conclusions: The experience of the planner does not significantly affect the accuracy of correctly predicting component sizes. However, in complex cases, fellow-trained surgeons should assist residents in digital pre-operative templating for THA.
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http://dx.doi.org/10.1007/s00264-020-04733-4DOI Listing
October 2020

Diabetic vasculopathy: macro and microvascular injury.

Curr Pathobiol Rep 2020 Mar 27;8(1):1-14. Epub 2020 Jan 27.

Department of Surgery, Division of Vascular Surgery; University of North Carolina at Chapel Hill, NC 27599.

Purpose Of Review: Diabetes is a common and prevalent medical condition as it affects many lives around the globe. Specifically, type-2 Diabetes (T2D) is characterized by chronic systemic inflammation alongside hyperglycemia and insulin resistance in the body, which can result in atherosclerotic legion formation in the arteries and thus progression of related conditions called diabetic vasculopathies. T2D patients are especially at risk for vascular injury; adjunct in many of these patients heir cholesterol and triglyceride levels reach dangerously high levels and accumulate in the lumen of their vascular system.

Recent Findings: Microvascular and macrovascular vasculopathies as complications of diabetes can accentuate the onset of organ illnesses, thus it is imperative that research efforts help identify more effective methods for prevention and diagnosis of early vascular injuries. Current research into vasculopathy identification/treatment will aid in the amelioration of diabetes-related symptoms and thus reduce the large number of deaths that this disease accounts annually.

Summary: This review aims to showcase the evolution and effects of diabetic vasculopathy from development to clinical disease as macrovascular and microvascular complications with a concerted reference to sex-specific disease progression as well.
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http://dx.doi.org/10.1007/s40139-020-00205-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7351096PMC
March 2020

Echocardiographic L-wave as a prognostic indicator in transcatheter aortic valve replacement.

Int J Cardiovasc Imaging 2020 Oct 17;36(10):1897-1905. Epub 2020 Jun 17.

Department of Cardiology, Tel-Aviv Sourasky Medical Center, Affiliated to the Tel-Aviv University, 6 Weizzman St, 64239, Tel-Aviv, Israel.

This study applies L-wave measurements of mid-diastolic trans-mitral flow. Although considered to be a marker of elevated filling pressure or delayed myocardial relaxation, its clinical and prognostic value is yet to be completely elucidated. It has been shown that transcatheter aortic valve replacement (TAVR) induces reverse remodeling and improves diastolic function and prognosis in patients with severe aortic stenosis (AS). Our purpose was to evaluate the prognostic value of L-wave following TAVR. We examined clinical and echocardiographic data of patients undergoing TAVR. L-Wave presence and velocity were recorded at baseline and at 1 month and 6 months following TAVR. The effect of the procedure on L-wave measurements and its impact on mortality and other clinical outcomes were analyzed. A total of 502 patients (mean age 82.58 ± 5.9) undergoing TAVR were included. Patients with baseline L-wave (n = 68, 12%) had a smaller stroke volume index by 5.7 ± 2.3 ml/m (p = 0.01) as compared to patients without L-wave at baseline. L-waves disappeared In 35% and 70% of patients at 1 month and at 6 months respectively. Baseline L-wave velocity was 34.8 ± 11.5 (cm/s) and decreased significantly at follow-up examinations. Patients with persistent L-wave following TAVR had higher 3-year adjusted mortality rates (HR 5.7, 95% CI 3.7-8.9, p < 0.001). Multivariate analysis of survival was also statistically significant (p < 0.001). TAVR induces L-wave disappearance and a decrease in L-wave velocity in patients with severe AS. L-wave persistence following TAVR is an independent risk factor for mortality.
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http://dx.doi.org/10.1007/s10554-020-01903-8DOI Listing
October 2020

Robotic technology: current concepts, operative techniques and emerging uses in unicompartmental knee arthroplasty.

EFORT Open Rev 2020 May 5;5(5):312-318. Epub 2020 May 5.

University College Hospital, London, UK.

Unicompartmental knee arthroplasty (UKA) is associated with improved functional outcomes but reduced implant survivorship compared to total knee arthroplasty (TKA).Surgeon-controlled errors in component positioning are the most common reason for implant failure in UKA, and low UKA case-volume is associated with poor implant survivorship and earlier time to revision surgery.Robotic UKA is associated with improved accuracy of achieving the planned femoral and tibial component positioning compared to conventional manual UKA.Robotic UKA has a learning curve of six operative cases for achieving operative times and surgical team comfort levels comparable to conventional manual UKA, but there is no learning curve effect for accuracy of implant positioning or limb alignment.Robotic UKA is associated with reduced postoperative pain, decreased opiate analgesia requirements, faster inpatient rehabilitation, and earlier time to hospital discharge compared to conventional manual UKA.Limitations of robotic UKA include high installation costs, additional radiation exposure with image-based systems, and paucity of studies showing any long-term differences in functional outcomes or implant survivorship compared to conventional manual UKA.Further clinical studies are required to establish how statistical differences in accuracy of implant positioning between conventional manual UKA and robotic UKA translate to long-term differences in functional outcomes, implant survivorship, complications, and cost-effectiveness. Cite this article: 2020;5:312-318. DOI: 10.1302/2058-5241.5.190089.
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http://dx.doi.org/10.1302/2058-5241.5.190089DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265083PMC
May 2020

A Review of De Quervain's Stenosing Tenovaginitis in the Context of Smartphone Use.

J Hand Surg Asian Pac Vol 2020 Jun;25(2):133-136

Gold Coast University Hospital, Gold Coast, Australia.

De Quervain tenosynovitis (DQT) has been associated with repetitive movements of the radial first dorsal compartment. Since 2007, smartphones have become ingrained in society. Their functionality is primarily performed by dexterity of the user's thumb(s). The aim of this study was to review the current literature regarding the correlation between DQT and smartphone usage as a systematic review has not previously been presented. A literature review was conducted electronically using the EMBASE, PubMed, Cochrane and MEDLINE search libraries during May of 2019. Studies eligible for inclusion were English-language studies assessing the link between mobile phone use and DQT. Included studies were required to report on focused outcomes. Only original data studies were included. Case studies, those with data sets collected prior to 2007, foreign language research were excluded. A positive Finkelstein's result within the cohorts was found in a mean of 51.54% of participants. Odds ratios (OR) of 1.5 to 2.3 were found with increasing frequency of text messages and DQT. Females were found to have a higher frequency of text messages daily. Internet browsing and gaming on mobile phones were associated with an OR of 2.21 and 2.61 respectively. DQT associated pain correlated to a mild disruption in daily tasks. On a visual analogue scale, this pain was represented as a 4 out of 10. In conclusion, there appears to be a linear association between frequency of text messages and incidence of DQT. Additionally, there is an association between DQT pain and a mild disruption to daily activities other than mobile phone use.
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http://dx.doi.org/10.1142/S2424835520300029DOI Listing
June 2020

Effectiveness and Safety of Transcatheter Aortic Valve Implantation in Patients With Aortic Stenosis and Variable Ejection Fractions (<40%, 40%-49%, and >50%).

Am J Cardiol 2020 02 23;125(4):583-588. Epub 2019 Nov 23.

Department of Cardiology, Tel-Aviv Sourasky Medical Center affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address:

We evaluated the safety and efficacy of transcatheter aortic valve implantation (TAVI) in aortic stenosis patients with mid-range ejection fraction (ASmrEF) and compared it to aortic stenosis patients with reduced ejection fraction (ASrEF) and preserved ejection fraction (ASpEF). TAVI cases were stratified by baseline ejection fraction (ASrEF, ASmrEF, ASpEF) and compared for characteristics, procedural outcomes, and change in echocardiographic parameters at 1 year and mortality over a 5-year follow-up. The final study population included 708 patients who underwent TAVI. ASmrEF patients presented with improved EF at 1-year after procedure (49.0 ± 9.8 at 1 year vs 43.0 ± 2.5 at baseline, p <0.001) and showed improvements in left ventricular (LV) diameters (LV end-diastolic diameter: 50.4 ± 6.0 at 1 year vs 53.0 ± 5.5 at baseline and LV end-systolic diameter 34.7 ± 7.8 at 1 year vs 39.5 ± 5.9 at baseline, p <0.001 for both). LVEF improved for patients with ASrEF but not in ASpEF patients. LV diameters did not improve for patients in either group. Procedural safety and success rates were similar between all heart failure groups. Survival rates over a 5-year follow-up post-TAVI were not different between patients with ASmrEF, ASrEF, and ASpEF (ASrEF 78.4%, ASmrEF 81.9%, ASpEF 78.3%, p = 0.327). TAVI for patients with ASmrEF is safe and effective and results in marked improvement of LV function and structure.
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http://dx.doi.org/10.1016/j.amjcard.2019.10.059DOI Listing
February 2020

Systematic meta-analyses, field synopsis and global assessment of the evidence of genetic association studies in colorectal cancer.

Gut 2020 08 9;69(8):1460-1471. Epub 2019 Dec 9.

School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

Objective: To provide an understanding of the role of common genetic variations in colorectal cancer (CRC) risk, we report an updated field synopsis and comprehensive assessment of evidence to catalogue all genetic markers for CRC (CRCgene2).

Design: We included 869 publications after parallel literature review and extracted data for 1063 polymorphisms in 303 different genes. Meta-analyses were performed for 308 single nucleotide polymorphisms (SNPs) in 158 different genes with at least three independent studies available for analysis. Scottish, Canadian and Spanish data from genome-wide association studies (GWASs) were incorporated for the meta-analyses of 132 SNPs. To assess and classify the credibility of the associations, we applied the Venice criteria and Bayesian False-Discovery Probability (BFDP). Genetic associations classified as 'positive' and 'less-credible positive' were further validated in three large GWAS consortia conducted in populations of European origin.

Results: We initially identified 18 independent variants at 16 loci that were classified as 'positive' polymorphisms for their highly credible associations with CRC risk and 59 variants at 49 loci that were classified as 'less-credible positive' SNPs; 72.2% of the 'positive' SNPs were successfully replicated in three large GWASs and the ones that were not replicated were downgraded to 'less-credible' positive (reducing the 'positive' variants to 14 at 11 loci). For the remaining 231 variants, which were previously reported, our meta-analyses found no evidence to support their associations with CRC risk.

Conclusion: The CRCgene2 database provides an updated list of genetic variants related to CRC risk by using harmonised methods to assess their credibility.
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http://dx.doi.org/10.1136/gutjnl-2019-319313DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7398467PMC
August 2020

Can Surgeons Identify Appendicitis Macroscopically? Results From a Multicentre Prospective Study.

Surg Laparosc Endosc Percutan Tech 2019 10;29(5):344-348

Department of General Surgery, Gold Coast University Hospital.

Purpose: The primary outcome was to investigate the accuracy of intraoperative macroscopic diagnosis by the operating surgeon with the results of the subsequent histopathologic examination. The secondary outcome was to identify the predictors of discrepancies between these 2 groups.

Materials And Methods: A multicentre, prospective, observational study was conducted over a period of 2 months with a 30-day follow-up period. Patients who underwent surgery with the intention of appendicectomy were recruited in the study.

Results: A total of 1169 patients were recruited. False negatives (FNs) were defined as a normal macroscopic diagnosis but histopathologically appendicitis, whereas false positive otherwise. Overall, FN rates were 22.4%, whereas false positive rates were 8.2%. The seniority of the operating surgeons did not affect the ability to accurately diagnose appendicitis macroscopically (P=0.069). However, consultant surgeons had the lowest FN rate of 15.6%. Females and preoperative ultrasound scan increased odds of FN, whereas preoperative computed tomography decreased the odds of FN appendicectomy.

Conclusion: Macroscopic identification intraoperatively is inaccurate with a FN rate of 22%.
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http://dx.doi.org/10.1097/SLE.0000000000000687DOI Listing
October 2019

Can Surgeons Identify Appendicitis Macroscopically? Results From a Multicentre Prospective Study.

Surg Laparosc Endosc Percutan Tech 2019 10;29(5):344-348

Department of General Surgery, Gold Coast University Hospital.

Purpose: The primary outcome was to investigate the accuracy of intraoperative macroscopic diagnosis by the operating surgeon with the results of the subsequent histopathologic examination. The secondary outcome was to identify the predictors of discrepancies between these 2 groups.

Materials And Methods: A multicentre, prospective, observational study was conducted over a period of 2 months with a 30-day follow-up period. Patients who underwent surgery with the intention of appendicectomy were recruited in the study.

Results: A total of 1169 patients were recruited. False negatives (FNs) were defined as a normal macroscopic diagnosis but histopathologically appendicitis, whereas false positive otherwise. Overall, FN rates were 22.4%, whereas false positive rates were 8.2%. The seniority of the operating surgeons did not affect the ability to accurately diagnose appendicitis macroscopically (P=0.069). However, consultant surgeons had the lowest FN rate of 15.6%. Females and preoperative ultrasound scan increased odds of FN, whereas preoperative computed tomography decreased the odds of FN appendicectomy.

Conclusion: Macroscopic identification intraoperatively is inaccurate with a FN rate of 22%.
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http://dx.doi.org/10.1097/SLE.0000000000000687DOI Listing
October 2019

Genome-scale data reveal that endemic Poecilia populations from small sulphidic springs display no evidence of inbreeding.

Mol Ecol 2017 Oct 24;26(19):4920-4934. Epub 2017 Aug 24.

School of Biological Sciences, Washington State University, Pullman, WA, USA.

Populations with limited ranges can be highly vulnerable to changes in their environment and are, thus, of high conservation concern. Populations that experience human-induced range reductions are often highly inbred and lack genetic diversity, but it is unknown whether this is also the case for populations with naturally small ranges. The fishes Poecilia sulphuraria (listed as critically endangered) and Poecilia thermalis, which are endemic to small hydrogen sulphide-rich springs in southern Mexico, are examples of such populations with inherently small habitats. We used geometric morphometrics and population genetics to quantify phenotypic and genetic variation within and among two populations of P. sulphuraria and one population of P. thermalis. Principal component analyses revealed phenotypic and genetic differences among the populations. Evidence for inbreeding was low compared to populations that have undergone habitat reduction. The genetic data were also used to infer the demographic history of these populations to obtain estimates for effective population sizes and migration rates. Effective population sizes were large given the small habitats of these populations. Our results imply that these three endemic extremophile populations should each be considered separately for conservation purposes. Additionally, this study suggests that populations in naturally small habitats may have lower rates of inbreeding and higher genetic diversity than expected, and therefore may be better equipped to handle environmental perturbations than anticipated. We caution, however, that the inferred lack of inbreeding and the large effective population sizes could potentially be a result of colonization by genetically diverse ancestors.
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http://dx.doi.org/10.1111/mec.14249DOI Listing
October 2017
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