Publications by authors named "T Romo"

112 Publications

QRS fragmentation is associated with increased risk of ventricular arrhythmias in high-risk patients; Data from the SMASH 1 Study.

Ann Noninvasive Electrocardiol 2022 Jul 15:e12985. Epub 2022 Jul 15.

Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway.

Introduction: QRS fragmentation (fQRS), defined as the presence of additional spikes within the QRS complex, has been associated with myocardial conduction abnormalities and arrhythmogenicity.

Objective: We aimed to assess whether fQRS is associated with incident ventricular arrhythmias (VA) in high-risk patients treated with implantable cardioverter-defibrillator (ICD) for primary and secondary prevention.

Methods: In a prospective observational multicenter study, we included 495 patients treated with ICD. fQRS was analyzed according to previously validated criteria, by two physicians blinded for outcome data. Incident VA were obtained from ICD recordings.

Results: ECG recordings interpretable for fQRS were available in 459 patients (93%), aged 66 ± 12 years with left ventricular ejection fraction 40% ± 13%. fQRS was present in 52 patients (11%) with comparable baseline characteristics to patients without fQRS, except higher age, higher prevalence of coronary artery disease (CAD), lower prevalence of cardiomyopathy, and more frequently a secondary prevention ICD indication. Among patients with native QRS, those with fQRS had similar QRS duration and axis to those without fQRS. During 3.1 ± 0.7 years follow-up, 126 patients (28%) had ≥1 VA . fQRS was associated with increased risk of VA (HR 3.41 [95% CI 2.27-5.13], p < .001), which persisted after adjusting for age, gender, sex, BMI, CAD, heart failure, renal function, ICD indication, QRS duration, QRS axis, Q waves, and bundle branch block. fQRS was more strongly associated with VA in patients with a primary (HR 6.05 [95% CI 3.16-11.60]) versus secondary (HR 2.39 [95% CI 1.41-4.04]) ICD indication (p-for-interaction = .047).

Conclusions: fQRS is associated with threefold increased risk of VA in high-risk patients, independent of established risk factors.
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http://dx.doi.org/10.1111/anec.12985DOI Listing
July 2022

Draft Genome Sequence of sp. Strain MMG025, Isolated from Giant Kelp.

Microbiol Resour Announc 2022 Jun 9;11(6):e0012222. Epub 2022 May 9.

Department of Biology and Viral Information Institute, San Diego State University, San Diego, California, USA.

Here, we report the draft genome sequence of sp. strain MMG025, isolated from the surface of giant kelp and assembled and analyzed by undergraduate students participating in a marine microbial genomics course. A genomic comparison suggests that MMG025 is a novel species, providing a resource for future microbiology and biotechnology investigations.
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http://dx.doi.org/10.1128/mra.00122-22DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9202385PMC
June 2022

Clinical Outcomes in Dorsal Preservation Rhinoplasty: A Meta-Analysis.

Facial Plast Surg Aesthet Med 2022 May-Jun;24(3):187-194. Epub 2022 Feb 15.

Manhattan Eye, Ear, and Throat Hospital, New York, New York, USA.

Dorsal preservation rhinoplasty (PR-D) attempts to preserve as much of the native nasal anatomy as possible when performing a hump reduction, but clinical outcomes are unclear. In patients undergoing PR-D rhinoplasty, this article investigates the rates of complications and revisions. This meta-analysis was prospectively registered on the PROSPERO database. The Pubmed, Embase, and Scopus databases were searched. Pooled incidence was calculated in a meta-analysis within a random-effects model. Twenty-two studies representing a cohort of 5660 patients were included in this study. Postoperative hump recurrence rates (4.18%, 95% confidence interval [CI]: 2.41-6.40%), rates of revision rhinoplasty (3.48%, 95% CI: 1.77-5.74%), rates of postoperative nasal deviation (1.13%, 95% CI 0.37-2.28%), and rates of infection (1.89%, 95% CI: 0.35-4.62%) were all found to be low. PR-D has low rates of revision surgery, residual or recurrent hump, postoperative nasal deviation, and postoperative infection.
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http://dx.doi.org/10.1089/fpsam.2021.0312DOI Listing
June 2022

The treatment of neurogenic lower urinary tract dysfunction in persons with spinal cord injury: An open label, pilot study of anticholinergic agent vs. mirabegron to evaluate cognitive impact and efficacy.

Spinal Cord Ser Cases 2021 06 10;7(1):50. Epub 2021 Jun 10.

Spinal Cord Injury Service, South Texas Veteran's Health Care System, San Antonio, TX, USA.

Study Design: Pre-post intervention.

Objectives: 1. To test whether replacement of oral anticholinergic (AC) agents with mirabegron for neurogenic lower urinary tract dysfunction (NLUTD) yields improved cognitive function in older persons with spinal cord injury (SCI). 2. To test whether mirabegron is safe and as efficacious as AC.

Setting: USA.

Methods: Pilot study: Twenty older (>60 y/o) persons with SCI taking chronic (>6 months) AC medication for NLUTD were enrolled. All participants were first studied on AC at baseline then switched to mirabegron for 6 months. Primary outcomes were cognitive tests of (1) executive function (TEXAS, SDMT); (2) attention (SCWT); and (3) memory (SLUMS and WMS-IV Story A/B). Secondary outcomes assessed efficacy and safety including Neurogenic Bladder Symptom Score (NBSS), bladder diary, neurogenic bowel dysfunction (NBD) survey, heart rate (HR), electrocardiogram (EKG), and mean arterial pressure (MAP).

Results: When switching from AC to mirabegron for NLUTD, older persons with SCI exhibited statistically significant improvements in immediate Story A recall (p = 0.01), delayed story A and B recall (p = 0.01, 0.004), and in TEXAS (p = 0.04). Three subscores within NBSS significantly improved (p = 0.001) and the frequency of incontinence decreased (p = 0.03) on mirabegron. NBD, HR, MAP, and EKGs were unchanged.

Conclusions: Older persons with SCI on AC for NLUTD demonstrated improved short-term and delayed memory (WMS-IV Story A/B) as well as executive function (TEXAS) when switched to mirabegron. Efficacy of mirabegron for NLUTD symptoms was superior to AC with no adverse effects on bowel or cardiovascular function.

Sponsorship: Claude D. Pepper Older Americans Independence Center.
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http://dx.doi.org/10.1038/s41394-021-00413-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8192499PMC
June 2021

Skin Necrosis Following Rhinoplasty: A Review and Proposed Strategy on Identifying High-Risk Patients.

Facial Plast Surg 2021 Aug 3;37(4):543-549. Epub 2021 Jun 3.

Department of Otolaryngology, Manhattan Eye, Ear and Throat Institute, New York, New York.

Vascular compromise leading to cutaneous loss following surgical rhinoplasty is a devastating complication. The objective of this review is to identify all reported cases in literature published in English and summarize the current evidence to identify the patients at risk of this complication following surgery. A comprehensive literature review using Medline and Embase databases was performed to capture all reported cases of cutaneous vascular compromise following rhinoplasty from database inception through September 2020. Nonsurgical rhinoplasty cases were excluded. We identified eight studies that featured vascular cutaneous compromise following surgical rhinoplasty. A total of 18 patients were included in the analysis. The majority of the patients were females with a mean age of 30.9. Risk factors included smoking in 23.5% patients and revision setting. Extensive tip thinning, tight splinting and taping with dorsal onlay grafting, or combining extended alar base excision with revision open rhinoplasty were among surgical techniques associated with vascular compromise. The most commonly affected aesthetic nasal subunit in our review was the dorsum followed by the nasal tip. Conservative management primarily was utilized in 72.2% of patients, allowing the defect to heal by secondary intention. Studies reporting on cutaneous vascular compromise following surgical rhinoplasty are of low level of evidence. This review is the largest summary reporting on this complication to date, aiming to caution surgeons about associated techniques and management options. We also share an expert opinion on preoperative assessment of nasal skin to guide surgeons to potentially avoid rhinoplasty surgery in this subset of patients.
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http://dx.doi.org/10.1055/s-0041-1730384DOI Listing
August 2021
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