Publications by authors named "William Adair"

12 Publications

  • Page 1 of 1

Prevalence and Disease Spectrum of Extracoronary Arterial Abnormalities in Spontaneous Coronary Artery Dissection.

JAMA Cardiol 2021 Nov 24. Epub 2021 Nov 24.

Department of Cardiovascular Sciences, University of Leicester, NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom.

Importance: Spontaneous coronary artery dissection (SCAD) has been associated with fibromuscular dysplasia (FMD) and other extracoronary arterial abnormalities. However, the prevalence, severity, and clinical relevance of these abnormalities remain unclear.

Objective: To assess the prevalence and spectrum of FMD and other extracoronary arterial abnormalities in patients with SCAD vs controls.

Design, Setting, And Participants: This case series included 173 patients with angiographically confirmed SCAD enrolled between January 1, 2015, and December 31, 2019. Imaging of extracoronary arterial beds was performed by magnetic resonance angiography (MRA). Forty-one healthy individuals were recruited to serve as controls for blinded interpretation of MRA findings. Patients were recruited from the UK national SCAD registry, which enrolls throughout the UK by referral from the primary care physician or patient self-referral through an online portal. Participants attended the national SCAD referral center for assessment and MRA.

Exposures: Both patients with SCAD and healthy controls underwent head-to-pelvis MRA (median time between SCAD event and MRA, 1 [IQR, 1-3] year).

Main Outcome And Measures: The diagnosis of FMD, arterial dissections, and aneurysms was established according to the International FMD Consensus. Arterial tortuosity was assessed both qualitatively (presence or absence of an S curve) and quantitatively (number of curves ≥45%; tortuosity index).

Results: Of the 173 patients with SCAD, 167 were women (96.5%); mean (SD) age at diagnosis was 44.5 (7.9) years. The prevalence of FMD was 31.8% (55 patients); 16 patients (29.1% of patients with FMD) had involvement of multiple vascular beds. Thirteen patients (7.5%) had extracoronary aneurysms and 3 patients (1.7%) had dissections. The prevalence and degree of arterial tortuosity were similar in patients and controls. In 43 patients imaged with both computed tomographic angiography and MRA, the identification of clinically significant remote arteriopathies was similar. Over a median 5-year follow-up, there were 2 noncardiovascular-associated deaths and 35 recurrent myocardial infarctions, but there were no primary extracoronary vascular events.

Conclusions And Relevance: In this case series with blinded analysis of patients with SCAD, severe multivessel FMD, aneurysms, and dissections were infrequent. The findings of this study suggest that, although brain-to-pelvis imaging allows detection of remote arteriopathies that may require follow-up, extracoronary vascular events appear to be rare.
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http://dx.doi.org/10.1001/jamacardio.2021.4690DOI Listing
November 2021

Novel use of arterial spin labelling in the imaging of peripheral vascular malformations.

BJR Case Rep 2020 Sep 24;6(3):20200021. Epub 2020 Mar 24.

University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester LE1 5WW, United Kingdom.

We present a novel use of arterial spin labelling (ASL), a MRI perfusion technique, to assess a high-flow, peripheral vascular malformation (PVM), specifically a large arteriovenous malformation in the left forearm of a 20-year-old female. While there has been experience with ASL in the assessment of intracranial vascular malformations, there has been no known use of ASL in the evaluation of PVMs. We also discuss the potential benefits and limitations of ASL in the imaging of PVMs. The promising results from this case warrant further research on ASL in the investigation of PVMs.
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http://dx.doi.org/10.1259/bjrcr.20200021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7465750PMC
September 2020

Operationalizing the reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework to evaluate the collective impact of autonomous community programs that promote health and well-being.

BMC Public Health 2019 Jun 24;19(1):803. Epub 2019 Jun 24.

School of Health & Exercise Sciences, University of British Columbia, 1147 Research Rd, Kelowna, British Columbia, V1V 1V7, Canada.

Background: The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework is a useful tool for evaluating the impact of programs in community settings. RE-AIM has been applied to evaluate individual programs but seldom used to evaluate the collective impact of community-based, public health programming developed and delivered by multiple autonomous organizations. The purposes of this paper were to (a) demonstrate how RE-AIM can be operationalized and applied to evaluate the collective impact of similar autonomous programs that promote health and well-being and (b) provide preliminary data on the collective impact of Canadian spinal cord injury (SCI) peer mentorship programs on the delivery of peer mentorship services.

Methods: Criteria from all five RE-AIM dimensions were operationalized to evaluate multiple similar community-based programs. For this study, nine provincial organizations that serve people with SCI were recruited from across Canada. Organizations completed a structured self-report questionnaire and participated in a qualitative telephone interview to examine different elements of their peer mentorship program. Data were analyzed using summary statistics.

Results: Having multiple indicators to assess RE-AIM dimensions provided a broad evaluation of the impact of Canadian SCI peer mentorship programs. Peer mentorship programs reached 1.63% of the estimated Canadian SCI population. The majority (67%) of organizations tracked the effectiveness of peer mentorship through testimonials and reports. Setting-level adoption rates were high with 100% of organizations offering peer mentorship in community and hospital settings. On average, organizations allocated 10.4% of their operating budget and 9.8% of their staff to implement peer mentorship and 89% had maintained their programming for over 10 years. Full interpretation of the collective impact of peer mentorship programs was limited as complete data were only collected for 52% of survey questions.

Conclusions: The lack of available organizational data highlights a significant challenge when using RE-AIM to evaluate the collective impact of multiple programs that promote health and well-being. Although researchers are encouraged to use RE-AIM to evaluate the collective impact of programs delivered by different organizations, documenting limitations and providing recommendations should be done to further the understanding of how best to operationalize RE-AIM in these contexts.
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http://dx.doi.org/10.1186/s12889-019-7131-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6591988PMC
June 2019

48th Walter J. Zeiter Lecture, Physiatry in the Era of Population Health Management: Why We Must Change.

Authors:
William A Adair

PM R 2017 05 8;9(5):513-520. Epub 2017 Mar 8.

Advocate Christ Medical Center, 4440 W. 95th St., Oak Lawn, IL 60453(∗). Electronic address:

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http://dx.doi.org/10.1016/j.pmrj.2017.03.001DOI Listing
May 2017

Endovascular treatment of the common femoral artery for limb ischemia.

Vasc Endovascular Surg 2013 Nov 11;47(8):639-44. Epub 2013 Sep 11.

1Department of Radiology, Leicester Royal Infirmary, Leicester, UK.

Objective: To determine the short- and mid-term outcomes of percutaneous endovascular common femoral artery (CFA) revascularization (eCFR) of the CFA.

Methods: A review of patients who underwent eCFR for limb ischemia between 2006 and 2012 was performed. Limb salvage, patient survival, survival free from reintervention, and survival free from amputation rates were determined. Median (range) follow-up was 28 (1-71) months.

Results: In all, 115 patients underwent 121 eCFR for CFA occlusion (n = 13) or stenosis (n = 108); 109 (90%) were technically successful and 7 (6%) had significant perioperative complications; access site hematoma (n = 2) and thromboembolism (n = 5). Thirty-day mortality and amputation rates were 2.5% and 0.8%, respectively. The 1- and 3-year limb salvage rates were 97% and 97%, respectively. The 1- and 3-year survival free from reintervention rates were 77% and 57%, respectively. The 1- and 3-year survival free from amputation rates were 84% and 70%, respectively.

Conclusion: These novel data demonstrate that eCFR is a durable treatment for patients with limb ischemia associated with CFA disease.
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http://dx.doi.org/10.1177/1538574413500723DOI Listing
November 2013

Isolated percutaneous transluminal angioplasty of the profunda femoris artery for limb ischemia.

Vasc Endovascular Surg 2013 Aug 3;47(6):423-8. Epub 2013 Jun 3.

Department of Radiology, Leicester Royal Infirmary, Leicester, United Kingdom.

Objective: To compare the outcome of endovascular profunda femoral artery revascularization (ePFR) with ePFR and concurrent endovascular femoropopliteal revascularization (eFPR).

Methods: A retrospective review of the consecutive patients with PFA and femoropopliteal vaso-occulsive disease who underwent ePFR or ePFR + eFPR for severe limb ischemia was performed.

Results: A total of 18 ePFRs and 26 ePFR + eFPRs were performed; 17 (94%) ePFRs and 22 (85%) ePFR + eFPRs were technically successful. The 12-month survival free from amputation and reintervention rates following isolated ePFR were 78% and 72%, respectively, and following ePFR + eFPR were 96% and 81%, respectively. There was no significant difference in the survival free from amputation (P = .4) or reintervention (P = .91) rates between the 2 groups.

Conclusion: These contemporary data suggest isolated ePFRs and ePFR + eFPRs are associated with good and comparable early limb salvage rates.
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http://dx.doi.org/10.1177/1538574413491636DOI Listing
August 2013

Solitary fibrous tumor made resectable after successful endovascular embolization.

J Gastrointest Cancer 2011 Dec;42(4):287-91

Department of Clinical Radiology, Leicester Royal Infirmary, Leicester, UK.

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http://dx.doi.org/10.1007/s12029-010-9247-8DOI Listing
December 2011

Giant coronary artery aneurysm: an unusual cause of a mediastinal mass (2008: 9b).

Eur Radiol 2008 Dec 11;18(12):3007-9. Epub 2008 Nov 11.

Department of Radiology, University Hospitals of Leicester NHS Trust, Leicester, UK.

A rare case of giant coronary artery aneurysm related to an episode of blackout is presented. The aneurysm projected as a para-cardiac mass on the chest X-ray. The echocardiographic, MDCT and coronary angiography appearances of this rare condition are demonstrated, and we discuss the differential diagnoses of right para-cardiac masses.
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http://dx.doi.org/10.1007/s00330-008-1010-1DOI Listing
December 2008

An Account of the Effects of Oil of Turpentine in a Case of Internal Hæmorrhage.

Authors:
William Adair

Med Facts Obs 1793 ;4:25-27

Surgeon General to the Garrison of Gibraltar.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5110109PMC
January 1793

A Case of Imperforated Anus.

Authors:
William Adair

Med Facts Obs 1793 ;4:27-30

Surgeon General to the Garrison of Gibraltar.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5110097PMC
January 1793
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