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  1. Article ; Online: Arterial Zones That Take a Pause in Early Plaque Development.

    Williams, Kevin Jon

    Arteriosclerosis, thrombosis, and vascular biology

    2023  Volume 43, Issue 5, Page(s) 650–653

    MeSH term(s) Humans ; Lipoproteins, LDL ; Arteriosclerosis ; Plaque, Atherosclerotic
    Chemical Substances Lipoproteins, LDL
    Language English
    Publishing date 2023-03-30
    Publishing country United States
    Document type Editorial ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 1221433-4
    ISSN 1524-4636 ; 1079-5642
    ISSN (online) 1524-4636
    ISSN 1079-5642
    DOI 10.1161/ATVBAHA.123.319302
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1705: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Eradicating Atherosclerotic Events by Targeting Early Subclinical Disease: It Is Time to Retire the Therapeutic Paradigm of Too Much, Too Late.

    Williams, Kevin Jon

    Arteriosclerosis, thrombosis, and vascular biology

    2023  Volume 44, Issue 1, Page(s) 48–64

    Abstract: Recent decades have seen spectacular advances in understanding and managing atherosclerotic cardiovascular disease, but paradoxically, clinical progress has stalled. Residual risk of atherosclerotic cardiovascular disease events is particularly vexing, ... ...

    Abstract Recent decades have seen spectacular advances in understanding and managing atherosclerotic cardiovascular disease, but paradoxically, clinical progress has stalled. Residual risk of atherosclerotic cardiovascular disease events is particularly vexing, given recognized lifestyle interventions and powerful modern medications. Why? Atherosclerosis begins early in life, yet clinical trials and mechanistic studies often emphasize terminal, end-stage plaques, meaning on the verge of causing heart attacks and strokes. Thus, current clinical evidence drives us to emphasize aggressive treatments that are delayed until patients already have advanced arterial disease. I call this paradigm "too much, too late." This brief review covers exciting efforts that focus on preventing, or finding and treating, arterial disease before its end-stage. Also included are specific proposals to establish a new evidence base that could justify intensive short-term interventions (induction-phase therapy) to treat subclinical plaques that are early enough perhaps to heal. If we can establish that such plaques are actionable, then broad screening to find them in early midlife individuals would become imperative-and achievable. You have a lump in your coronaries! can motivate patients and clinicians. We must stop thinking of a heart attack as a disease. The real disease is atherosclerosis. In my opinion, an atherosclerotic heart attack is a medical failure. It is a manifestation of longstanding arterial disease that we had allowed to progress to its end-stage, despite knowing that atherosclerosis begins early in life and despite the availability of remarkably safe and highly effective therapies. The field needs a transformational advance to shift the paradigm out of end-stage management and into early interventions that hold the possibility of eradicating the clinical burden of atherosclerotic cardiovascular disease, currently the biggest killer in the world. We urgently need a new evidence base to redirect our main focus from terminal, end-stage atherosclerosis to earlier, and likely reversible, human arterial disease.
    MeSH term(s) Humans ; Atherosclerosis/diagnosis ; Atherosclerosis/prevention & control ; Plaque, Atherosclerotic ; Arteries ; Myocardial Infarction
    Language English
    Publishing date 2023-11-16
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 1221433-4
    ISSN 1524-4636 ; 1079-5642
    ISSN (online) 1524-4636
    ISSN 1079-5642
    DOI 10.1161/ATVBAHA.123.320065
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1705: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Corrigendum to "Imbalanced insulin action in chronic overnutrition: Clinical harm, molecular mechanisms, and a way forward" [Atherosclerosis 247 (April 2016) 225-282].

    Williams, Kevin Jon / Wu, Xiangdong

    Atherosclerosis

    2021  Volume 328, Page(s) 60–61

    Language English
    Publishing date 2021-06-04
    Publishing country Ireland
    Document type Published Erratum
    ZDB-ID 80061-2
    ISSN 1879-1484 ; 0021-9150
    ISSN (online) 1879-1484
    ISSN 0021-9150
    DOI 10.1016/j.atherosclerosis.2021.05.021
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    Zs.A 226: Show issues Location:
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  4. Article: State of current management of the heightened risk for atherosclerotic cardiovascular events in an established cohort of patients with lupus erythematosus.

    Zhao, Megan / Feng, Rui / Werth, Victoria P / Williams, Kevin Jon

    Lupus science & medicine

    2023  Volume 10, Issue 2

    Abstract: Objective: Patients with lupus erythematosus (LE) are at heightened risk for clinical events, chiefly heart attacks and strokes, from atherosclerotic cardiovascular disease (ASCVD). We recently proposed new guidelines to assess and manage ASCVD event ... ...

    Abstract Objective: Patients with lupus erythematosus (LE) are at heightened risk for clinical events, chiefly heart attacks and strokes, from atherosclerotic cardiovascular disease (ASCVD). We recently proposed new guidelines to assess and manage ASCVD event risk specifically in LE. Here, we examined current cardiovascular management in light of these new recommendations.
    Methods: We studied our entire UPenn Longitudinal Lupus Cohort of patients with cutaneous LE, without (CLE-only) or with (CLE+SLE) concurrent systemic LE, for whom we had full access to medical records (n=370, LE-ASCVD Study Cohort).
    Results: Of our LE-ASCVD Study Cohort, 336 out of 370 (90.8%) had a designated primary-care physician. By the new guidelines, the most recent low-density lipoprotein (LDL) levels were above-goal for 249 out of 370 (67.3%). Two-hundred sixty-six (71.9%) had hypertension, which was undertreated or untreated in 198 out of 266 (74.4%). Of current smokers, 51 out of 63 (81.0%) had no documented smoking cessation counselling or referrals. Diabetes and triglyceridaemia were generally well managed. Of the cohort, 278 qualified for two widely used online estimators of ASCVD event risk in primary prevention: the ACC-ASCVD Risk Estimator Plus and QRisk3. We also stratified these 278 patients into our recently defined categories of ASCVD event risk in LE. These three methods for estimating ASCVD event risk showed clinically meaningful discordance for 169 out of 278 (60.8%). The documented rate of ASCVD events in the first 10 years after enrolment was 13.5% (95% CI 8.9%, 17.9%), similar between CLE-only and CLE+SLE, indicating an at-risk population despite the preponderance of women and an average age at enrolment of only 47 years.
    Conclusion: Patients with CLE-only or CLE+SLE are undertreated compared with the new guidelines and, accordingly, they experience a significant burden of ASCVD events. Moreover, it is unclear how to accurately assess their future ASCVD event risk, except that it is substantial. Efforts are underway to improve ASCVD event risk estimation and guideline implementation in patients with lupus.
    MeSH term(s) Humans ; Female ; Middle Aged ; Lupus Erythematosus, Systemic/complications ; Lupus Erythematosus, Systemic/epidemiology ; Atherosclerosis/complications ; Atherosclerosis/epidemiology ; Stroke/epidemiology ; Stroke/etiology ; Stroke/prevention & control ; Myocardial Infarction ; Hypertension
    Language English
    Publishing date 2023-08-20
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 2779620-6
    ISSN 2053-8790
    ISSN 2053-8790
    DOI 10.1136/lupus-2023-000908
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Guenther Boden, MD (1935-2015): A Pioneer in Human Studies of Nutrition and Obesity-And the Mystery of Insulin Resistance for Handling Glucose.

    Williams, Kevin Jon / Horton, Edward S / Siraj, Elias S

    Diabetes care

    2020  Volume 43, Issue 12, Page(s) 2910–2915

    Language English
    Publishing date 2020-11-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 441231-x
    ISSN 1935-5548 ; 0149-5992
    ISSN (online) 1935-5548
    ISSN 0149-5992
    DOI 10.2337/dci20-0041
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    Zs.A 1434: Show issues Location:
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    Zs.MO 365: Show issues

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  6. Article ; Online: Pelvic floor symptoms among premenopausal women with pelvic organ prolapse in the Democratic Republic of the Congo.

    Ntakwinja, Mukanire / Werth, Adrienne / Borazjani, Ali / Iglesia, Cheryl / Williams, Kevin Jon / Mukwege, Denis

    International urogynecology journal

    2023  Volume 35, Issue 1, Page(s) 103–108

    Abstract: Introduction and hypothesis: Most of the literature on pelvic organ prolapse (POP) has been generated from postmenopausal patients in high-income countries. In the Democratic Republic of the Congo (DRC), a significant proportion of patients who present ... ...

    Abstract Introduction and hypothesis: Most of the literature on pelvic organ prolapse (POP) has been generated from postmenopausal patients in high-income countries. In the Democratic Republic of the Congo (DRC), a significant proportion of patients who present for surgical management of POP are premenopausal. Little is known about the impact of POP on pelvic floor symptoms in this population. The objective was to describe pelvic floor symptoms and sexual function among premenopausal patients presenting for POP surgery in DRC.
    Methods: We performed a prospective cohort study of symptomatic premenopausal patients undergoing fertility-sparing POP surgery at a large referral hospital in the DRC. Pelvic floor symptoms were evaluated with the Pelvic Floor Distress Inventory Questionnaire and sexual function with the Pelvic organ prolapse/urinary Incontinence Sexual Questionnaire. Data are presented as means with standard deviations or counts with percentages.
    Results: A total of 107 patients were recruited between April 2019 and December 2021. All had either stage III (95.3%) or stage IV (4.7%) prolapse. Ages were 34.2 ± 6.7 years; 78.5% were married. A majority of patients experienced low abdominal pain (82.2%), heaviness or dullness (95.3%), and bulging or protrusion of the prolapse (92.5%). Almost two-thirds of patients reported no longer being sexually active, and 80% stated that they were not sexually active because of POP. Of the 37 sexually active patients (34.6%), nearly all reported significant sexual impairment because of the prolapse, with only 4 reporting no sexual impairment.
    Conclusions: This study represents one of the largest prospective series of patients with premenopausal POP. Our results highlight the severity of pelvic floor symptoms and the negative effects on sexual function among this patient population with POP.
    MeSH term(s) Humans ; Female ; Democratic Republic of the Congo/epidemiology ; Prospective Studies ; Pelvic Floor ; Urinary Incontinence/epidemiology ; Urinary Incontinence/etiology ; Pelvic Organ Prolapse/complications ; Pelvic Organ Prolapse/epidemiology ; Pelvic Organ Prolapse/surgery ; Surveys and Questionnaires
    Language English
    Publishing date 2023-10-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 1050631-7
    ISSN 1433-3023 ; 0937-3462
    ISSN (online) 1433-3023
    ISSN 0937-3462
    DOI 10.1007/s00192-023-05670-7
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    Zs.A 3070: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  7. Article ; Online: Accelerated atherosclerotic cardiovascular risk in type 1 diabetes mellitus: Time for a new idea?

    Rao, Ajay D / Vaz, Cherie Lisa / Williams, Kevin Jon

    Atherosclerosis

    2019  Volume 286, Page(s) 150–153

    MeSH term(s) Animals ; Aorta ; Atherosclerosis ; Cardiovascular Diseases ; Diabetes Mellitus, Type 1 ; Lipoproteins, LDL ; Mice ; Risk Factors
    Chemical Substances Lipoproteins, LDL
    Language English
    Publishing date 2019-04-14
    Publishing country Ireland
    Document type Editorial ; Comment
    ZDB-ID 80061-2
    ISSN 1879-1484 ; 0021-9150
    ISSN (online) 1879-1484
    ISSN 0021-9150
    DOI 10.1016/j.atherosclerosis.2019.04.207
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    Zs.A 226: Show issues Location:
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  8. Article ; Online: Improving the mental health and mental health support available to adolescents with social care-experience via low-intensity life story work

    Geoff Wong / Jon Wilson / Kevin Williams / Claire Duddy / Simon P Hammond / Ella Mickleburgh / Rachel Hiller / Elsbeth Neil / Luke Rodgers

    BMJ Open, Vol 12, Iss

    a realist review protocol

    2022  Volume 3

    Keywords Medicine ; R
    Language English
    Publishing date 2022-03-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Improving the mental health and mental health support available to adolescents in out-of-home care via Adolescent-Focused Low-Intensity Life Story Work

    Geoff Wong / Jon Wilson / Kevin Williams / Claire Duddy / Simon P Hammond / Ella Mickleburgh / Rachel Hiller / Elsbeth Neil / Rosie Blackett

    BMJ Open, Vol 13, Iss

    a realist review

    2023  Volume 10

    Abstract: Objectives Life Story Work (LSW) is used to promote the mental health and well-being of children and adolescents living in out-of-home care. LSW should be offered to all but is conventionally delivered in high-intensity ways. Low-intensity approaches are ...

    Abstract Objectives Life Story Work (LSW) is used to promote the mental health and well-being of children and adolescents living in out-of-home care. LSW should be offered to all but is conventionally delivered in high-intensity ways. Low-intensity approaches are more accessible but there is significant variation and little guidance for supporting adolescents. We aimed to create guidance for Adolescent-Focused Low-Intensity LSW.Design Realist review.Data sources MEDLINE, Embase, PsycINFO, Sociology Collection (ProQuest), CINAHL, CDAS, Web of Science (SCIE, SSCI), Social Care Online and grey literature sources. Searches were performed between December 2021 and March 2022.Eligibility criteria Documents on children and adolescents in care, LSW and/or low-intensity interventions to improve mental health were included. Documents focusing on parenting style and contact with birth family were excluded.Analysis Documents were analysed using a realist logic of analysis. In consultation with Content Expert Groups (comprising professionals and care leavers), we developed an initial programme theory. Data relating to and challenging the initial programme theory were extracted and context-mechanism-outcome-configurations developed, critiqued and refined in an iterative fashion. Interpretations were drawn from context-mechanism-outcome-configurations to enhance the programme theory.Results 75 documents contributed to the analysis. Generally, studies were small-scale and lacked in-depth methods and evaluation descriptions. Findings indicated important factors contribute to the development of high-quality Adolescent-Focused Low-Intensity LSW. Adolescent-Focused Low-Intensity LSW should be person-centred, begin in the now, involve co-construction, record everyday positive life events and be supported by trained carer(s). Context-mechanism-outcome-configurations relating to these themes are reported.Conclusions Using this knowledge we developed initial practice guidance to support social care to deliver better quality Adolescent-Focused ...
    Keywords Medicine ; R
    Subject code 360
    Language English
    Publishing date 2023-10-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Blood plasma versus serum: which is right for sampling circulating membrane microvesicles in human subjects?

    Liu, Ming-Lin / Werth, Victoria P / Williams, Kevin Jon

    Annals of the rheumatic diseases

    2019  Volume 79, Issue 6, Page(s) e73

    MeSH term(s) Apoptosis ; Cell-Derived Microparticles ; Humans ; Lupus Erythematosus, Systemic ; Nucleotidyltransferases ; Research Subjects
    Chemical Substances Nucleotidyltransferases (EC 2.7.7.-)
    Language English
    Publishing date 2019-04-20
    Publishing country England
    Document type Letter ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 7090-7
    ISSN 1468-2060 ; 0003-4967
    ISSN (online) 1468-2060
    ISSN 0003-4967
    DOI 10.1136/annrheumdis-2019-215505
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