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  1. AU=Tremoulet Adriana H.
  2. AU="Foggia, Maria"
  3. AU=Eccles Michael R
  4. AU="Karrison, Theodore"
  5. AU="Espigado, I"
  6. AU="Dean, Andrew"

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  1. Artikel ; Online: Adjunctive therapies in Kawasaki disease.

    Tremoulet, Adriana H

    International journal of rheumatic diseases

    2017  Band 21, Heft 1, Seite(n) 76–79

    Abstract: ... resistance, defined as recrudescence of fever more than 36 h after IVIg completion, is a risk factor ...

    Abstract Despite the administration of intravenous immunoglobulin (IVIg) at a dose of 2 g/kg, approximately 3-5% of children with acute Kawasaki disease (KD) may develop coronary artery aneurysms. IVIg-resistance, defined as recrudescence of fever more than 36 h after IVIg completion, is a risk factor for coronary artery abnormalities. Thus, several adjunctive therapies are being evaluated for use in IVIg-resistant KD patients and in patients with coronary artery abnormalities. In this review the role of some of these adjunctive therapies in treatment of children with KD is discussed.
    Mesh-Begriff(e) Adjuvants, Immunologic/adverse effects ; Adjuvants, Immunologic/therapeutic use ; Drug Resistance ; Humans ; Immunoglobulins, Intravenous/administration & dosage ; Immunoglobulins, Intravenous/adverse effects ; Immunologic Factors/administration & dosage ; Immunologic Factors/adverse effects ; Mucocutaneous Lymph Node Syndrome/diagnosis ; Mucocutaneous Lymph Node Syndrome/drug therapy ; Mucocutaneous Lymph Node Syndrome/immunology ; Treatment Outcome
    Chemische Substanzen Adjuvants, Immunologic ; Immunoglobulins, Intravenous ; Immunologic Factors
    Sprache Englisch
    Erscheinungsdatum 2017-10-27
    Erscheinungsland England
    Dokumenttyp Journal Article ; Review
    ZDB-ID 2426924-4
    ISSN 1756-185X ; 1756-1841
    ISSN (online) 1756-185X
    ISSN 1756-1841
    DOI 10.1111/1756-185X.13208
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: A deep convolutional neural network for Kawasaki disease diagnosis.

    Xu, Ellen / Nemati, Shamim / Tremoulet, Adriana H

    Scientific reports

    2022  Band 12, Heft 1, Seite(n) 11438

    Abstract: Kawasaki disease (KD), the most common cause of acquired heart disease in children, can be easily missed as it shares clinical findings with other pediatric illnesses, leading to risk of myocardial infarction or death. KD remains a clinical diagnosis for ...

    Abstract Kawasaki disease (KD), the most common cause of acquired heart disease in children, can be easily missed as it shares clinical findings with other pediatric illnesses, leading to risk of myocardial infarction or death. KD remains a clinical diagnosis for which there is no diagnostic test, yet there are classic findings on exam that can be captured in a photograph. This study aimed to develop a deep convolutional neural network, KD-CNN, to differentiate photographs of KD clinical signs from those of other pediatric illnesses. To create the dataset, we used an innovative combination of crowdsourcing images and downloading from public domains on the Internet. KD-CNN was then pretrained using transfer learning from VGG-16 and fine-tuned on the KD dataset, and methods to compensate for limited data were explored to improve model performance and generalizability. KD-CNN achieved a median AUC of 0.90 (IQR 0.10 from tenfold cross validation), with a sensitivity of 0.80 (IQR 0.18) and specificity of 0.85 (IQR 0.19) to distinguish between children with and without clinical manifestations of KD. KD-CNN is a novel application of CNN in medicine, with the potential to assist clinicians in differentiating KD from other pediatric illnesses and thus reduce KD morbidity and mortality.
    Mesh-Begriff(e) Child ; Crowdsourcing ; Humans ; Medicine ; Mucocutaneous Lymph Node Syndrome/diagnosis ; Myocardial Infarction ; Neural Networks, Computer
    Sprache Englisch
    Erscheinungsdatum 2022-07-06
    Erscheinungsland England
    Dokumenttyp Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-022-15495-x
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel ; Online: Multisystem Inflammatory Syndrome therapies in children (MISTIC): A randomized trial.

    Jain, Sonia / He, Feng / Brown, Kiana / Burns, Jane C / Tremoulet, Adriana H

    Contemporary clinical trials communications

    2023  Band 32, Seite(n) 101060

    Abstract: Background: Multisystem Inflammatory Syndrome in Children (MIS-C), which occurs 2-6 weeks after initial exposure to SARS-CoV-2, was first identified in early 2020 when patients presented with fever and significant inflammation, often requiring ... ...

    Abstract Background: Multisystem Inflammatory Syndrome in Children (MIS-C), which occurs 2-6 weeks after initial exposure to SARS-CoV-2, was first identified in early 2020 when patients presented with fever and significant inflammation, often requiring management in the intensive care unit. To date, there has been no clinical trial to determine the most effective treatment. This study compares anti-inflammatory treatments that were selected based on current treatments for Kawasaki disease, a coronary artery vasculitis that shares many clinical features with MIS-C.
    Methods: This randomized, comparative effectiveness trial of children with MIS-C uses the small N Sequential Multiple Assignment Randomized Trial (snSMART) design for rare diseases to compare multiple therapies within an individual. Study participants were treated first with intravenous immunoglobulin (IVIG), and if needed, subjects were then randomized to one of three additional treatments (steroids, anakinra, or infliximab). Participants were re-randomized to remaining treatments if they did not demonstrate clinical improvement.
    Conclusion: This trial continues to enroll eligible participants to determine the most effective therapies in addition to IVIG and best order in which to use them to treat MIS-C.
    Trial registration: NCT04898231.
    Sprache Englisch
    Erscheinungsdatum 2023-01-20
    Erscheinungsland Netherlands
    Dokumenttyp Journal Article
    ISSN 2451-8654
    ISSN (online) 2451-8654
    DOI 10.1016/j.conctc.2023.101060
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  4. Artikel ; Online: The role of statins in inflammatory vasculitides.

    Tremoulet, Adriana H

    Autoimmunity

    2015  Band 48, Heft 3, Seite(n) 177–180

    Abstract: While the statins are best known for their cholesterol lowering capabilities, they also appear to have anti-inflammatory, anti-oxidant and endothelial-repairing properties that have raised the question as to whether this class of drugs can be of benefit ... ...

    Abstract While the statins are best known for their cholesterol lowering capabilities, they also appear to have anti-inflammatory, anti-oxidant and endothelial-repairing properties that have raised the question as to whether this class of drugs can be of benefit in non-atherosclerotic, acute and chronic vasculitides. These effects, independent of the lipid-lowering effects, make the statins a class of drugs that are primed for repurposing and being used in disease states where innate and adaptive immunity and endothelial damage play a key role. Thus far, statins have been used in Behcet's, rheumatoid arthritis and Kawasaki disease with some promising results. Further study is needed to better understand the innate and adaptive immunological response to statins in cardiovascular diseases as well as the full potential of statins in acute and chronic inflammatory vasculitides.
    Mesh-Begriff(e) Adaptive Immunity ; Adolescent ; Adult ; Anti-Inflammatory Agents/therapeutic use ; Arthritis, Rheumatoid/drug therapy ; Arthritis, Rheumatoid/immunology ; Arthritis, Rheumatoid/pathology ; Atorvastatin Calcium/therapeutic use ; Behcet Syndrome/drug therapy ; Behcet Syndrome/immunology ; Behcet Syndrome/pathology ; Child ; Child, Preschool ; Clinical Trials as Topic ; Drug Repositioning ; Humans ; Immunity, Innate ; Infant ; Inflammation/drug therapy ; Inflammation/immunology ; Inflammation/pathology ; Mucocutaneous Lymph Node Syndrome/drug therapy ; Mucocutaneous Lymph Node Syndrome/immunology ; Mucocutaneous Lymph Node Syndrome/pathology
    Chemische Substanzen Anti-Inflammatory Agents ; Atorvastatin Calcium (48A5M73Z4Q)
    Sprache Englisch
    Erscheinungsdatum 2015-05
    Erscheinungsland England
    Dokumenttyp Editorial
    ZDB-ID 1025450-x
    ISSN 1607-842X ; 0891-6934
    ISSN (online) 1607-842X
    ISSN 0891-6934
    DOI 10.3109/08916934.2015.1027818
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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    Verfügbar in ZB MED Köln/Königswinter

    Zs.A 2777: Hefte anzeigen Standort:
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    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
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  5. Artikel ; Online: DOACs in Patients With Giant Coronary Artery Aneurysms After Kawasaki Disease.

    Dummer, Kirsten B / Miyata, Koichi / Shimizu, Chisato / Tremoulet, Adriana H / Gleason, Jill / Gordon, John B / Burns, Jane C

    JAMA network open

    2023  Band 6, Heft 11, Seite(n) e2343801

    Mesh-Begriff(e) Humans ; Coronary Vessels ; Mucocutaneous Lymph Node Syndrome/complications ; Coronary Aneurysm/diagnostic imaging ; Coronary Aneurysm/etiology ; Immunoglobulins, Intravenous ; Patients
    Chemische Substanzen Immunoglobulins, Intravenous
    Sprache Englisch
    Erscheinungsdatum 2023-11-01
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2023.43801
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  6. Artikel ; Online: Coronary Sinus Thrombosis and Post-Myocardial Infarction Syndrome in Kawasaki Disease: Rare Causes of Pericardial Effusion.

    Wang, Hao / Pancheri, Joan M / Appleton, Robert S / Tremoulet, Adriana H / Burns, Jane C / Dummer, Kirsten B

    JACC. Case reports

    2023  Band 26, Seite(n) 102077

    Abstract: The hypercoagulable state in Kawasaki disease (KD) may lead to complex cardiovascular sequelae. We present the case of a 2-month-old infant with complete KD complicated by giant coronary artery aneurysms, coronary sinus thrombosis, and post-myocardial ... ...

    Abstract The hypercoagulable state in Kawasaki disease (KD) may lead to complex cardiovascular sequelae. We present the case of a 2-month-old infant with complete KD complicated by giant coronary artery aneurysms, coronary sinus thrombosis, and post-myocardial infarction syndrome (Dressler syndrome), resulting in 2 distinct episodes of pericardial effusion. (
    Sprache Englisch
    Erscheinungsdatum 2023-10-20
    Erscheinungsland Netherlands
    Dokumenttyp Case Reports
    ISSN 2666-0849
    ISSN (online) 2666-0849
    DOI 10.1016/j.jaccas.2023.102077
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  7. Artikel ; Online: Endothelial Cell Response in Kawasaki Disease and Multisystem Inflammatory Syndrome in Children.

    Kim, Jihoon / Shimizu, Chisato / He, Ming / Wang, Hao / Hoffman, Hal M / Tremoulet, Adriana H / Shyy, John Y-J / Burns, Jane C

    International journal of molecular sciences

    2023  Band 24, Heft 15

    Abstract: Although Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C) share some clinical manifestations, their cardiovascular outcomes are different, and this may be reflected at the level of the endothelial cell (EC). We performed ... ...

    Abstract Although Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C) share some clinical manifestations, their cardiovascular outcomes are different, and this may be reflected at the level of the endothelial cell (EC). We performed RNA-seq on cultured ECs incubated with pre-treatment sera from KD (
    Mesh-Begriff(e) Child ; Humans ; Mucocutaneous Lymph Node Syndrome/genetics ; Endothelial Cells ; Systemic Inflammatory Response Syndrome/genetics ; COVID-19 ; Connective Tissue Diseases
    Sprache Englisch
    Erscheinungsdatum 2023-08-01
    Erscheinungsland Switzerland
    Dokumenttyp Journal Article
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms241512318
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  8. Artikel: Hemolysis From Intravenous Immunoglobulin in Obese Patients With Kawasaki Disease.

    Van Anh, Khanh-Van Y / Shah, Saloni / Tremoulet, Adriana H

    Frontiers in pediatrics

    2020  Band 8, Seite(n) 146

    Abstract: Objective: ...

    Abstract Objective:
    Sprache Englisch
    Erscheinungsdatum 2020-04-03
    Erscheinungsland Switzerland
    Dokumenttyp Journal Article
    ZDB-ID 2711999-3
    ISSN 2296-2360
    ISSN 2296-2360
    DOI 10.3389/fped.2020.00146
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  9. Artikel ; Online: Comment on atorvastatin safety in kawasaki disease patients with coronary artery aneurysms.

    Tremoulet, Adriana H

    Pediatric cardiology

    2013  Band 35, Heft 1, Seite(n) 93

    Mesh-Begriff(e) Atorvastatin ; Child Development/drug effects ; Coronary Aneurysm ; Coronary Vessels ; Female ; Heptanoic Acids ; Humans ; Inflammation/drug therapy ; Male ; Mucocutaneous Lymph Node Syndrome ; Pyrroles
    Chemische Substanzen Heptanoic Acids ; Pyrroles ; Atorvastatin (A0JWA85V8F)
    Sprache Englisch
    Erscheinungsdatum 2013-09-27
    Erscheinungsland United States
    Dokumenttyp Letter ; Comment
    ZDB-ID 800857-7
    ISSN 1432-1971 ; 0172-0643
    ISSN (online) 1432-1971
    ISSN 0172-0643
    DOI 10.1007/s00246-013-0805-2
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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    Verfügbar in ZB MED Köln/Königswinter

    Zs.A 1528: Hefte anzeigen Standort:
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    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
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  10. Artikel: Long-term health outcomes in young adults after Kawasaki disease.

    Daniels, Lori B / Roberts, Samantha / Moreno, Elizabeth / Tremoulet, Adriana H / Gordon, John B / Burns, Jane C

    International journal of cardiology. Heart & vasculature

    2022  Band 40, Seite(n) 101039

    Abstract: Background: We compared the long-term health of adults with prior Kawasaki disease (KD) to controls and determined whether outcomes varied by coronary artery (CA) status.: Methods: We conducted a prospective cohort study of 258 KD subjects (mean 19 ±  ...

    Abstract Background: We compared the long-term health of adults with prior Kawasaki disease (KD) to controls and determined whether outcomes varied by coronary artery (CA) status.
    Methods: We conducted a prospective cohort study of 258 KD subjects (mean 19 ± 9 years since KD) and 148 age-similar controls who completed extensive health questionnaires. KD subjects were divided into 2 groups, Cohort 1: 109 subjects followed since KD diagnosis at our institution; Cohort 2: 149 KD subjects diagnosed elsewhere.
    Results: KD subjects and controls were of similar age at the time of questionnaire completion (p = 0.50). Overall, 128 subjects (including 60 in Cohort 1) reported normal CAs during and after KD. Compared to controls, KD subjects with normal CAs reported several medical conditions with increased prevalence including migraine headaches, shortness of breath, and leg pain with walking, among others. When limited to Cohort 1, KD subjects were significantly more likely to report chest pain (47% vs 16%, p < 0.001) or palpitations (23% vs 10%, p = 0.01) compared to controls. Prevalence of depression was similar (7% vs 5%, p = 0.73).
    Conclusions: Despite always having normal CAs in the acute and subacute phases of KD, young adults with a history of KD with normal coronaries were more likely than controls to experience cardiovascular symptoms. These differences could be influenced by anxiety or depression, but report of depression was similar between groups. Whether these health differences reflect a heightened awareness of symptoms among KD subjects, or underlying vascular pathology (i.e. vasospasm, microvascular dysfunction, other) merits further study.
    Sprache Englisch
    Erscheinungsdatum 2022-05-04
    Erscheinungsland Ireland
    Dokumenttyp Journal Article
    ZDB-ID 2818464-6
    ISSN 2352-9067
    ISSN 2352-9067
    DOI 10.1016/j.ijcha.2022.101039
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