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Article ; Online: Combined Microinvasive Glaucoma Surgery - A Review of the Literature and Future Directions.

Mai, Derek D / Ingram, Zoe / Oberfeld, Blake / Solá-Del Valle, David

2023 Volume 38, Issue 6, Page(s) 529–536

Abstract: The use of microinvasive invasive glaucoma surgery (MIGS) in the treatment of glaucoma has increased exponentially over the last 10 years. However, practice patterns vary widely given the relative newness of these technologies. Some surgeons perform two ... ...

Abstract	The use of microinvasive invasive glaucoma surgery (MIGS) in the treatment of glaucoma has increased exponentially over the last 10 years. However, practice patterns vary widely given the relative newness of these technologies. Some surgeons perform two or more MIGS simultaneously, such as those that target aqueous production and those that target aqueous outflow. These combined MIGS (cMIGS) may result in lower intraocular pressure (IOP) and reduced medication burden as compared to single MIGS (sMIGS). Current evidence suggests some cMIGS are more effective in reducing medication burden for at least 12 months versus sMIGS. This review focuses on the current evidence related to the efficacy of cMIGS as well as novel combinations of standalone MIGS, limitations of the current literature, and future directions for research.
MeSH term(s)	Humans ; Glaucoma/surgery ; Ophthalmologic Surgical Procedures ; Intraocular Pressure ; Tonometry, Ocular ; Glaucoma Drainage Implants
Language	English
Publishing date	2023-02-28
Publishing country	England
Document type	Review ; Journal Article
ZDB-ID	632820-9
ISSN	1744-5205 ; 0882-0538
ISSN (online)	1744-5205
ISSN	0882-0538
DOI	10.1080/08820538.2023.2181665
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Article: Comparing Outcomes of Phacoemulsification and Endocyclophotocoagulation with Either Dual Blade Goniotomy (PEcK) or Two Trabecular Stents (ICE2).

El Helwe, Hani / Oberfeld, Blake / Golsoorat Pahlaviani, Fatemeh / Falah, Henisk / Trzcinski, Jonathan / Solá-Del Valle, David

Clinical ophthalmology (Auckland, N.Z.)

2023 Volume 17, Page(s) 2879–2888

Abstract: Purpose: To compare outcomes of phacoemulsification and endocyclophotocoagulation with either dual blade goniotomy (PEcK) or two trabecular stents (ICE2).: Setting: Retrospective, nonrandomized comparative study from a level 3 triage center.: ... ...

Abstract	Purpose: To compare outcomes of phacoemulsification and endocyclophotocoagulation with either dual blade goniotomy (PEcK) or two trabecular stents (ICE2). Setting: Retrospective, nonrandomized comparative study from a level 3 triage center. Methods: One hundred and seventy charts and a total of 1294 visits were reviewed following either PEcK or ICE2 from 2018 to 2022. One hundred and twenty-eight patients had PEcK and 42 underwent ICE2. Patients with less than 30 days of follow-up were excluded. The mean follow-up time was 505 ± 308 days. Two Kaplan-Meier curves (KM) assessed survival with ≤ baseline medications while maintaining (1) [GIC - Goal IOP Criteria] IOP ≤ goal IOP or (2) [PRC - Percent Reduction Criteria] IOP reduction ≥ 20% with 5 mmHg ≤ IOP ≤ 21 mmHg for at least two consecutive visits. IOP and medication burden reduction were compared using a paired Results: Most patients were Caucasian (65%) and had mild-stage glaucoma (43%). The most common glaucoma type was primary open-angle glaucoma (58%). Average age was 72.2 years at the time of surgery. Mean preoperative IOP was 17.58 ± 4.98 mmHg on 3.00 ± 1.41 medications in PEcK and 15.36 ± 3.58 mmHg on 1.81 ± 1.11 medications in ICE2 (p = 0.015 for IOP; p < 0.001 for medications). Under GIC, the success rate was significantly higher in PEcK at POM6 (69% vs 46%, p < 0.001) and POY1 (63% vs 36%, p < 0.001). Under PRC, the success rate was significantly higher in PEcK at POM6 (73% vs 61%, p = 0.031) and POY1 (67% vs 50%, p = 0.028). Mean reductions at POY1 were 5.00 ± 4.31 mmHg on 1.35 ± 1.08 less medications after PEcK and 3.14 ± 2.83 mmHg on 1.01 ± 0.94 less medications after ICE2 (p < 0.001 at POY1 for IOP; p < 0.05 after POW6 for medications). Conclusion: Both PEcK and ICE2 reduce medication and IOP from baseline, with PEcK having more favorable GIC and PRC success rates and greater IOP and medication reduction at 1 year.
Language	English
Publishing date	2023-10-03
Publishing country	New Zealand
Document type	Journal Article
ISSN	1177-5467
ISSN	1177-5467
DOI	10.2147/OPTH.S431356
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Article: Combined MIGS: Comparing Additive Effects of Phacoemulsification, Endocyclophotocoagulation, and Kahook Dual Blade.

Oberfeld, Blake / Golsoorat Pahlaviani, Fatemeh / Hall, Nathan / Falah-Trzcinski, Henisk / Trzcinski, Jonathan / Chang, Ta / Solá-Del Valle, David

Clinical ophthalmology (Auckland, N.Z.)

2023 Volume 17, Page(s) 1647–1659

Abstract: Purpose: Combining two or more MIGS (cMIGS) promises to be more efficacious than single MIGS (sMIGS). This study compared the efficacy of PEcK, which combines Phacoemulsification (Phaco), Endocyclophotocoagulation (ECP), and Kahook dual blade (KDB), ... ...

Abstract	Purpose: Combining two or more MIGS (cMIGS) promises to be more efficacious than single MIGS (sMIGS). This study compared the efficacy of PEcK, which combines Phacoemulsification (Phaco), Endocyclophotocoagulation (ECP), and Kahook dual blade (KDB), relative to both of its constituent sMIGS, Phaco/ECP (Endo Optiks, NJ) and Phaco/KDB (New World Medical, CA) for the first time. Patients and methods: Data was collected retrospectively from 1833 visits of 271 patients who underwent PEcK, Phaco/ECP, or Phaco/KDB from 2016-2021 at Massachusetts Eye and Ear. Primary outcomes included Generalized Estimating Equations (GEE) of intraocular pressure (IOP) and medication burden, as well as survival models. Results: Mean preoperative IOP was 17.6 ± 5.0 (SD) mmHg on 3.0 ± 1.4 medications in the PEcK group (n = 128), 17.9 ± 5.1 mmHg on 2.2 ± 1.5 medications in the Phaco/ECP group (n = 78), and 16.1 ± 4.3 mmHg on 0.4 ± 1.0 medications in the Phaco/KDB group (n = 65). For more than 36 months, all procedures resulted in significant patterns of IOP and medication reduction (all p < 0.001), before and after statistical adjustment. The reduction pattern in IOP was significantly different when comparing all groups over time and favored PEcK (p = 0.04), but the reduction pattern in medications was not significantly different (p = 0.11). Procedures did not differ in procedural time (p = 0.18) or in survival to maintain ≥20% IOP reduction (p = 0.43) without additional medication or procedure. There was a trend toward significant difference in maintaining IOP ≤ goal IOP that favored PEcK over Phaco/ECP after adjustment (p = 0.09). Conclusion: PEcK may confer greater IOP reduction without added procedural time compared to Phaco/ECP and Phaco/KDB in predominantly mild or moderate glaucoma. Further research on cMIGS may benefit from adopting this comparative analysis to constituent MIGS.
Language	English
Publishing date	2023-06-08
Publishing country	New Zealand
Document type	Journal Article
ISSN	1177-5467
ISSN	1177-5467
DOI	10.2147/OPTH.S410471
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Article ; Online: Arrhythmias and COVID-19: A Review.

Dherange, Parinita / Lang, Joshua / Qian, Pierre / Oberfeld, Blake / Sauer, William H / Koplan, Bruce / Tedrow, Usha

JACC. Clinical electrophysiology

2020 Volume 6, Issue 9, Page(s) 1193–1204

Abstract: Current understanding of the impact of coronavirus disease-2019 (COVID-19) on arrhythmias continues to evolve as new data emerge. Cardiac arrhythmias are more common in critically ill COVID-19 patients. The potential mechanisms that could result in ... ...

Abstract	Current understanding of the impact of coronavirus disease-2019 (COVID-19) on arrhythmias continues to evolve as new data emerge. Cardiac arrhythmias are more common in critically ill COVID-19 patients. The potential mechanisms that could result in arrhythmogenesis among COVID-19 patients include hypoxia caused by direct viral tissue involvement of lungs, myocarditis, abnormal host immune response, myocardial ischemia, myocardial strain, electrolyte derangements, intravascular volume imbalances, and drug sides effects. To manage these arrhythmias, it is imperative to increase the awareness of potential drug-drug interactions, to monitor QTc prolongation while receiving COVID therapy and provide special considerations for patients with inherited arrhythmia syndromes. It is also crucial to minimize exposure to COVID-19 infection by stratifying the need for intervention and using telemedicine. As COVID-19 infection continues to prevail with a potential for future surges, more data are required to better understand pathophysiology and to validate management strategies.
MeSH term(s)	Arrhythmias, Cardiac/epidemiology ; Arrhythmias, Cardiac/etiology ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/epidemiology ; Global Health ; Humans ; Morbidity/trends ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/epidemiology ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-08-10
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2846739-5
ISSN	2405-5018 ; 2405-500X ; 2405-500X
ISSN (online)	2405-5018 ; 2405-500X
ISSN	2405-500X
DOI	10.1016/j.jacep.2020.08.002
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Article ; Online: Frequency Content of Unipolar Electrograms May Predict Deep Intramural Excitable Substrate: Insights From Intramural Needle Catheter Ablation of Ventricular Tachycardia.

Qian, Pierre C / Oberfeld, Blake / Schaeffer, Benjamin / Nakamura, Tomofumi / John, Roy M / Sapp, John L / Stevenson, William G / Tedrow, Usha B

JACC. Clinical electrophysiology

2020 Volume 6, Issue 7, Page(s) 760–769

Abstract: Objectives: This study sought to identify midmyocardial arrhythmogenic substrates by examining the frequency content of unipolar endocardial surface electrograms, comparing sites with transmural scar versus sites with intramural excitable substrate (IES) ...

Abstract	Objectives: This study sought to identify midmyocardial arrhythmogenic substrates by examining the frequency content of unipolar endocardial surface electrograms, comparing sites with transmural scar versus sites with intramural excitable substrate (IES) as identified during needle catheter ablation for ventricular tachycardia (VT). Background: Midmyocardial arrhythmogenic substrates are a common reason catheter ablation for VT may fail. Methods: A total of 659 intramural needle sites were studied in 26 patients (age 61 ± 9 years, 85% male, 69% nonischemic cardiomyopathy) who underwent intramural needle catheter ablation for VT. Among 136 sites where endocardial pacing did not capture (threshold >10 mA), needle pacing captured at 29 indicating IES, and did not capture at 107 indicating transmural scar. Intramural needle ablation was performed at 21 of 29 IES sites. Analysis of voltage amplitude, duration, and power spectra of endocardial and intramural needle electrograms was performed. Results: IES sites compared with transmural scar had higher endocardial unipolar electrogram voltage, 0.99 (interquartile range [IQR]: 0.69 to 1.62) mV versus 0.78 (IQR: 0.61 to 1.09) mV; p = 0.038; higher unipolar intramural needle electrogram voltage, 1.16 (0.80 to 1.69) mV versus 0.76 (0.6 to 1.12) mV; p = 0.003; higher endocardial unipolar frequency power particularly in the 5- to 20-Hz band, 1.97 (IQR: 0.93 to 3.89) mV Conclusions: The frequency content of unipolar electrograms may complement voltage in the detection of deep intramural substrates to facilitate VT catheter ablation. (Intramural Needle Ablation for Ablation of Recurrent Ventricular Tachycardia; NCT01791543).
MeSH term(s)	Cardiomyopathies/diagnosis ; Cardiomyopathies/surgery ; Catheter Ablation ; Cicatrix ; Endocardium ; Female ; Humans ; Male ; Middle Aged ; Tachycardia, Ventricular/diagnosis ; Tachycardia, Ventricular/surgery
Language	English
Publishing date	2020-04-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	2846739-5
ISSN	2405-5018 ; 2405-500X ; 2405-500X
ISSN (online)	2405-5018 ; 2405-500X
ISSN	2405-500X
DOI	10.1016/j.jacep.2020.03.003
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Article ; Online: Arrhythmias and COVID-19

Dherange, Parinita / Lang, Joshua / Qian, Pierre / Oberfeld, Blake / Sauer, William H. / Koplan, Bruce / Tedrow, Usha

JACC: Clinical Electrophysiology

2020 Volume 6, Issue 9, Page(s) 1193–1204

Keywords	Physiology (medical) ; Cardiology and Cardiovascular Medicine ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ZDB-ID	2846739-5
ISSN	2405-500X ; 2405-5018 ; 2405-500X
ISSN (online)	2405-500X ; 2405-5018
ISSN	2405-500X
DOI	10.1016/j.jacep.2020.08.002
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: SnapShot: COVID-19.

Oberfeld, Blake / Achanta, Aditya / Carpenter, Kendall / Chen, Pamela / Gilette, Nicole M / Langat, Pinky / Said, Jordan Taylor / Schiff, Abigail E / Zhou, Allen S / Barczak, Amy K / Pillai, Shiv

Cell

2020 Volume 181, Issue 4, Page(s) 954–954.e1

Abstract: Coronavirus disease 2019 (COVID-19) is a novel respiratory illness caused by SARS-CoV-2. Viral entry is mediated through viral spike protein and host ACE2 enzyme interaction. Most cases are mild; severe disease often involves cytokine storm and organ ... ...

Abstract	Coronavirus disease 2019 (COVID-19) is a novel respiratory illness caused by SARS-CoV-2. Viral entry is mediated through viral spike protein and host ACE2 enzyme interaction. Most cases are mild; severe disease often involves cytokine storm and organ failure. Therapeutics including antivirals, immunomodulators, and vaccines are in development. To view this SnapShot, open or download the PDF.
MeSH term(s)	Animals ; Betacoronavirus/classification ; Betacoronavirus/genetics ; Betacoronavirus/physiology ; Clinical Laboratory Techniques/methods ; Coronavirus Infections/diagnosis ; Coronavirus Infections/drug therapy ; Coronavirus Infections/immunology ; Coronavirus Infections/pathology ; Coronavirus Infections/prevention & control ; Coronavirus Infections/therapy ; Coronavirus Infections/transmission ; Humans ; Pandemics ; Pneumonia, Viral/immunology ; Pneumonia, Viral/pathology ; Pneumonia, Viral/therapy ; Pneumonia, Viral/transmission ; Viral Vaccines/immunology
Chemical Substances	COVID-19 vaccine ; Viral Vaccines
Keywords	covid19
Language	English
Publishing date	2020-04-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	187009-9
ISSN	1097-4172 ; 0092-8674
ISSN (online)	1097-4172
ISSN	0092-8674
DOI	10.1016/j.cell.2020.04.013
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Article ; Online: A neurobiological link between transportation noise exposure and metabolic disease in humans.

Osborne, Michael T / Naddaf, Nicki / Abohashem, Shady / Radfar, Azar / Ghoneem, Ahmed / Dar, Tawseef / Wang, Ying / Patrich, Tomas / Oberfeld, Blake / Tung, Brian / Pitman, Roger K / Mehta, Nehal N / Shin, Lisa M / Lo, Janet / Rajagopalan, Sanjay / Koenen, Karestan C / Grinspoon, Steven K / Fayad, Zahi A / Tawakol, Ahmed

Psychoneuroendocrinology

2021 Volume 131, Page(s) 105331

Abstract: Background: Chronic transportation noise exposure associates with cardiovascular events through a link involving heightened stress-associated neurobiological activity (as amygdalar metabolic activity, AmygA) on : Methods: VAT was measured in a ... ...

Abstract	Background: Chronic transportation noise exposure associates with cardiovascular events through a link involving heightened stress-associated neurobiological activity (as amygdalar metabolic activity, AmygA) on Methods: VAT was measured in a retrospective cohort (N = 403) who underwent clinical Results: Higher noise exposure (upper tertile vs. others) associated with greater: baseline VAT (standardized β [95% confidence interval (CI)]= 0.230 [0.021, 0.438], p = 0.031), gains in VAT (0.686 [0.185, 1.187], p = 0.008 adjusted for baseline VAT), and DM (hazard ratio [95% CI]=2.429 [1.031, 5.719], p = 0.042). The paths of: ↑noise exposure→↑AmygA→↑baseline VAT and ↑noise exposure→↑AmygA→↑subsequent DM were significant (p < 0.05). Conclusions: Increased transportation noise exposure associates with greater VAT and DM. This relationship is partially mediated by stress-associated neurobiological activity. These findings suggest altered neurobiology contributes to noise exposure's link to metabolic diseases.
MeSH term(s)	Diabetes Mellitus, Type 2/epidemiology ; Fluorodeoxyglucose F18 ; Humans ; Intra-Abdominal Fat/diagnostic imaging ; Neurobiology ; Noise, Transportation/adverse effects ; Positron Emission Tomography Computed Tomography ; Retrospective Studies
Chemical Substances	Fluorodeoxyglucose F18 (0Z5B2CJX4D)
Language	English
Publishing date	2021-06-17
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	197636-9
ISSN	1873-3360 ; 0306-4530
ISSN (online)	1873-3360
ISSN	0306-4530
DOI	10.1016/j.psyneuen.2021.105331
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Article: Arrhythmias and COVID-19: A Review

Dherange, Parinita / Lang, Joshua / Qian, Pierre / Oberfeld, Blake / Sauer, William H / Koplan, Bruce / Tedrow, Usha

JACC Clin Electrophysiol

Abstract	Current understanding of the impact of coronavirus disease-2019 (COVID-19) on arrhythmias continues to evolve as new data emerge. Cardiac arrhythmias are more common in critically ill COVID-19 patients. The potential mechanisms that could result in arrhythmogenesis among COVID-19 patients include hypoxia caused by direct viral tissue involvement of lungs, myocarditis, abnormal host immune response, myocardial ischemia, myocardial strain, electrolyte derangements, intravascular volume imbalances, and drug sides effects. To manage these arrhythmias, it is imperative to increase the awareness of potential drug-drug interactions, to monitor QTc prolongation while receiving COVID therapy and provide special considerations for patients with inherited arrhythmia syndromes. It is also crucial to minimize exposure to COVID-19 infection by stratifying the need for intervention and using telemedicine. As COVID-19 infection continues to prevail with a potential for future surges, more data are required to better understand pathophysiology and to validate management strategies.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #703988
Database	COVID19

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Article ; Online: A leucopoietic-arterial axis underlying the link between ambient air pollution and cardiovascular disease in humans.

Abohashem, Shady / Osborne, Michael T / Dar, Tawseef / Naddaf, Nicki / Abbasi, Taimur / Ghoneem, Ahmed / Radfar, Azar / Patrich, Tomas / Oberfeld, Blake / Tung, Brian / Fayad, Zahi A / Rajagopalan, Sanjay / Tawakol, Ahmed

European heart journal

2020 Volume 42, Issue 7, Page(s) 761–772

Abstract: Aims: Air pollution [i.e. particulate matter with diameter <2.5 μm (PM2.5)] is a risk factor for major adverse cardiovascular events (MACE). While PM2.5 promotes leucopoiesis and atherosclerotic inflammation in experimental models, it is unknown whether ...

Abstract	Aims: Air pollution [i.e. particulate matter with diameter <2.5 μm (PM2.5)] is a risk factor for major adverse cardiovascular events (MACE). While PM2.5 promotes leucopoiesis and atherosclerotic inflammation in experimental models, it is unknown whether this occurs in humans. We tested in humans (a) whether PM2.5 associates with higher leucopoietic tissue activity and arterial inflammation (ArtI), (ii) whether these associations persist after accounting for the effects of potential confounders including socioeconomics, traffic noise, and risk factors, and (iii) whether these tissue effects mediate the association between air pollution and MACE. Methods and results: Individuals (N = 503) without cardiovascular disease (CVD) or active malignancy underwent 18 F-fluorodeoxyglucose positron emission tomography/computed tomography. Major adverse cardiovascular event was adjudicated over 5 years of follow-up. Leucopoietic tissue activity (in bone marrow and spleen) as well as ArtI were measured. Annual PM2.5 levels were assessed at each individual's home address. At baseline, higher PM2.5 associated with increased leucopoietic activity [standardized (95% CI): 0.129 (0.042, 0.215), P = 0.004] as well as ArtI [0.088 (0.006, 0.171), P = 0.036] after adjusting for CVD risk factors. Over a median 4.1 years, 40 individuals experienced MACE. PM2.5 exposure associated with MACE [Cox HR (95% CI): 1.404 (1.135, 1.737), P = 0.002], remaining significant after adjustment for CVD risk factors and other potential confounders. Mediation analysis demonstrated that increased leucopoietic activity and ArtI serially mediate the link between PM2.5 exposure and MACE. Conclusions: Higher air pollution exposure associates with heightened leucopoietic activity and ArtI and independently predicts MACE through a biological pathway that includes higher leucopoietic activity and ArtI in series.
MeSH term(s)	Air Pollutants/adverse effects ; Air Pollutants/analysis ; Air Pollution/adverse effects ; Air Pollution/analysis ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; Environmental Exposure/adverse effects ; Environmental Exposure/analysis ; Humans ; Particulate Matter/adverse effects ; Particulate Matter/analysis ; Risk Factors
Chemical Substances	Air Pollutants ; Particulate Matter
Language	English
Publishing date	2020-11-07
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	603098-1
ISSN	1522-9645 ; 0195-668X
ISSN (online)	1522-9645
ISSN	0195-668X
DOI	10.1093/eurheartj/ehaa982
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