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  1. Article ; Online: The future of stenting in patients with type A aortic dissection

    Amer Harky / Jeremy Chan / Beverly MacCarthy-Ofosu

    Journal of International Medical Research, Vol

    a systematic review

    2020  Volume 48

    Abstract: Acute type A aortic dissection (ATAAD) carries high morbidity and mortality rates and is a clinical emergency. The reported mortality rate is 50% to 65% within the first 48 hours without surgical intervention. Open surgery therefore remains the gold ... ...

    Abstract Acute type A aortic dissection (ATAAD) carries high morbidity and mortality rates and is a clinical emergency. The reported mortality rate is 50% to 65% within the first 48 hours without surgical intervention. Open surgery therefore remains the gold standard management for ATAAD. However, in patients who are deemed unfit for surgery and where possible, endovascular repair offers a useful alternative to medical treatment alone or high-risk open surgical repair. Several case reports, case series, and retrospective studies have reported good outcomes following endovascular treatment. The endovascular option also has comparable early and late outcomes, favourable aortic remodelling, and satisfactory overall survival despite having a higher-risk patient cohort. However, stenting in patients with ATAAD undoubtedly still has several limitations and technical challenges.
    Keywords Medicine (General) ; R5-920
    Language English
    Publishing date 2020-01-01T00:00:00Z
    Publisher SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: The Correlation Between Stroke and Coronavirus Disease (COVID-19)

    Ashleigh Pittams / Ariana Axiaq / Amna Qamar / Bianca Botezatu / Amer Harky

    European Medical Journal (2021)

    Where is the Evidence?

    2021  

    Abstract: Stroke is the second leading cause of death globally. Despite the decreasing trend in stroke mortality, its incidence and prevalence follow an upwards trajectory that is envisaged to continue for years to come. Previous literature has suggested a role ... ...

    Abstract Stroke is the second leading cause of death globally. Despite the decreasing trend in stroke mortality, its incidence and prevalence follow an upwards trajectory that is envisaged to continue for years to come. Previous literature has suggested a role for infectious disease in stroke aetiology; however, the pathophysiological basis for this has never fully been understood. Emerging infections, such as coronavirus disease (COVID-19), present new challenges that must be addressed, to prevent them from contributing to the predicted rise in stroke incidence. Almost one in 20 patients diagnosed with COVID-19 experience a stroke thereafter, hence achieving better understanding of the interactions between these disease entities is of major clinical significance.
    Keywords brain ; cerebrovascular accident ; infection ; nervous system ; Medicine ; R
    Language English
    Publishing date 2021-02-01T00:00:00Z
    Publisher European Medical Journal
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Necrotizing enterocolitis and congenital heart disease

    HadiKashif / EyadAbuelgasim / NafisaHussain / JessicaLuyt / AmerHarky

    Annals of Pediatric Cardiology, Vol 14, Iss 4, Pp 507-

    2021  Volume 515

    Abstract: Necrotizing enterocolitis (NEC) remains a prominent surgical emergency among infant population, associated with a significant mortality, as well as various subsequent morbidities. Congenital heart disease (CHD) has an increased associated incidence with ... ...

    Abstract Necrotizing enterocolitis (NEC) remains a prominent surgical emergency among infant population, associated with a significant mortality, as well as various subsequent morbidities. Congenital heart disease (CHD) has an increased associated incidence with NEC in infant population. Recent research has provided insight into the pathophysiology of NEC in patients with CHD and how this differs from those without CHD. The deviation from normal circulatory physiology has a suggested association in the pathophysiology of NEC in CHD, which may have implications for the risk factors of NEC in infants with CHD, the effect on outcomes of NEC, and whether alternative approaches to management may need to be considered in comparison to classical NEC. This review aims to highlight studies that provide insight and awareness into the relationship between NEC and CHD, in order that clinicians may direct themselves more clearly toward optimal management for infants in this category.
    Keywords bowel surgery ; interventions ; outcomes ; pediatrics ; Medicine ; R ; RJ1-570 ; Diseases of the circulatory (Cardiovascular) system ; RC666-701
    Subject code 690
    Language English
    Publishing date 2021-01-01T00:00:00Z
    Publisher Wolters Kluwer Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: The controversy of using angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in COVID-19 patients

    Amer Harky / Cheryl Yan Ting Chor / Henry Nixon / Milad Jeilani

    Journal of the Renin-Angiotensin-Aldosterone System, Vol

    2021  Volume 22

    Keywords Medicine (General) ; R5-920
    Language English
    Publishing date 2021-01-01T00:00:00Z
    Publisher Hindawi - SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Aortic endovascular stenting in patients with systemic connective tissue disorders

    Amer Harky / Rizwan Iqbal / Vincenzo Giordano / Ahmed Al-Adhami

    Journal of International Medical Research, Vol

    does the prohibitive dogma still stand tall?

    2020  Volume 48

    Abstract: Endovascular repair of thoracic aortic diseases can provide satisfactory outcomes in elective and certain emergency cases involving the descending thoracic and aortic arch. However, open repair remains the gold standard method of aortic root pathologies ... ...

    Abstract Endovascular repair of thoracic aortic diseases can provide satisfactory outcomes in elective and certain emergency cases involving the descending thoracic and aortic arch. However, open repair remains the gold standard method of aortic root pathologies and certain aortic arch pathologies, such as extended dissection. Nevertheless, the use of endovascular stenting in patients with connective tissue disorders has not been fully explored because the aortic tissues are fragile and the likelihood of keeping the stent in place is low because of its progressive dilatation and subsequent requirement for open repair at a later stage when the stent graft fails. Our brief review focuses on current evidence of the use of stents in patients with connective tissue disorders and whether such practice can be expanded further.
    Keywords Medicine (General) ; R5-920
    Language English
    Publishing date 2020-10-01T00:00:00Z
    Publisher SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: COVID‐19 and Oncology

    Marco Shiu Tsun Leung / Shangzhe George Lin / Jason Chow / Amer Harky

    Cancer Medicine, Vol 9, Iss 19, Pp 7161-

    Service transformation during pandemic

    2020  Volume 7171

    Abstract: Abstract Background The COVID‐19 pandemic has challenged healthcare systems around the world, where resources have refocused on increasing critical bed capacity to prepare for the peak in incidence of COVID‐19. Oncology faces an unprecedented challenge ... ...

    Abstract Abstract Background The COVID‐19 pandemic has challenged healthcare systems around the world, where resources have refocused on increasing critical bed capacity to prepare for the peak in incidence of COVID‐19. Oncology faces an unprecedented challenge as patients require multidisciplinary care and are more likely to be immunosuppressed. Services in oncology have been transformed using minimal resources over a short period of time. This transformation continues and telemedicine is playing a key role. Aims We explore how services in oncology have transformed to deliver services including consultations, systemic anticancer therapy, and surgery for patients, while shielding them from contracting COVID‐19. We assess the risks and benefits of the service transformation in the immediate, interim, and long term, and how telemedicine supports the process. Methods We performed a comprehensive review of the literature using suitable keywords on the search engines of PubMed, SCOPUS, Google Scholar, and latest official data from May to June 2020. Results Through the published literature on this topic, we discuss the transformations in oncology and the impact on patients and healthcare workers due to the COVID‐19 pandemic. We reflect on the lessions from COVID‐19 and assess the role of telemedicine in the future of oncology services. Conclusion Transformation of services in oncology effectively shields patients from COVID‐19 infections, and telemedicine plays a role in virtual consultations. The long‐term effects are yet to be seen, such as safety of home‐based treatment, and effectiveness of virtual communication on patient care. As oncology requires a multidisciplinary approach, telemedicine will play a key role to improve patient‐centered cancer care in the future.
    Keywords chemotherapy ; COVID‐19 ; oncology service ; SARS‐CoV‐2 ; systemic anticancer therapy ; telemedicine ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282 ; covid19
    Subject code 027
    Language English
    Publishing date 2020-10-01T00:00:00Z
    Publisher Wiley
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Book ; Online: Author response for "Can symptoms of anosmia and dysgeusia be diagnostic for COVID‐19?"

    Syeda Anum Zahra / Sashini Iddawela / Kiran Pillai / Rozina Yasmin Choudhury / Amer Harky

    2020  

    Keywords covid19
    Publisher Wiley
    Publishing country us
    Document type Book ; Online
    DOI 10.1002/brb3.1839/v2/response1
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Real-world Accuracy of Transthoracic Echocardiography in Diagnosing Bicuspid Aortic Valve Morphology

    Oliver James Harrison / Abdul Badran / Amer Harky / Daniel Muller / Benoy N. Shah / Sunil K. Ohri

    Artery Research, Vol 26, Iss

    A Single Center UK Experience

    2020  Volume 1

    Abstract: Objectives: The aim of this study was to compare the diagnostic accuracy of Transthoracic Echocardiography (TTE) in assessing Bicuspid Aortic Valve (BAV) morphology. Methods: Case notes of 408 patients (>18 years old) undergoing elective Aortic Valve (AV) ...

    Abstract Objectives: The aim of this study was to compare the diagnostic accuracy of Transthoracic Echocardiography (TTE) in assessing Bicuspid Aortic Valve (BAV) morphology. Methods: Case notes of 408 patients (>18 years old) undergoing elective Aortic Valve (AV) surgery over a 2-year period were retrospectively reviewed. Aortic valve data was collected from preoperative TTE reports and intraoperative records. The diagnostic accuracy of TTE for identifying AV morphology was assessed using intraoperative findings as the gold standard. One-hundred-and-eighty-nine (46.3%) patients had a recent TTE with complete morphological assessment of the AV and an operation note documenting AV morphology. Cases that were ‘unable to be determined’ on TTE were included as false negatives. Results: TTE correctly identified AV morphology in 165 of the patients, equating to an accuracy of 79.1% (sensitivity = 72.4%, specificity = 87.3%). For BAV patients alone, accuracy was 81.3% (sensitivity = 65.8%, specificity = 90.0%), and for Tricuspid Aortic Valve (TAV) patients, accuracy was 77.1% (sensitivity = 75.5%, specificity = 81.4%). There was no significant difference in diagnostic accuracy of TTE for BAV and TAV (p = 0.464), nor was there any difference between valve calcification (p = 0.196) and functional disease (p = 0.088). Conclusion: Our data suggests that identification of BAV from TTE requires expertise and therefore it is operator dependent. A larger study is required to confirm our findings.
    Keywords Aortic valve morphology ; transthoracic echocardiography ; bicuspid aortic valve ; Specialties of internal medicine ; RC581-951 ; Diseases of the circulatory (Cardiovascular) system ; RC666-701
    Subject code 616 ; 610
    Language English
    Publishing date 2020-01-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Redo aortic valve replacement vs valve-in-valve trans-catheter aortic valve implantation

    Francesca Gatta / Yama Haqzad / George Gradinariu / Pietro Giorgio Malvindi / Zubair Khalid / Rona L. Suelo-Calanao / Nader Moawad / Aladdin Bashir / Luke J. Rogers / Clinton Lloyd / Bao Nguyen / Karen Booth / Lu Wang / Nawwar Al-Attar / Neil McDowall / Stuart Watkins / Rana Sayeed / Saleh Baghdadi / Andrea D'Alessio /
    Maria Monteagudo-vela / Jasmina Djordjevic / Matej Goricar / Solveig Hoppe / Charlotte Bocking / Azar Hussain / Betsy Evans / Salman Arif / Christopher Malkin / Mark Field / Kully Sandhu / Amer Harky / Ahmed Torky / Mauin Uddin / Muhammad Abdulhakeem / Ayman Kenawy / John Massey / Neil Cartwright / Nathan Tyson / Niki Nicou / Kamran Baig / Mark Jones / Firas Aljanadi / Colum G. Owens / Tunde Oyebanji / Joseph Doyle / Mark S. Spence / Paul F. Brennan / Ganesh Manoharan / Taha Ramadan / Sunil Ohri / Mahmoud Loubani

    Monaldi Archives for Chest Disease (2023)

    a UK propensity-matched analysis

    2023  

    Abstract: This study sought to compare the morbidity and mortality of redo aortic valve replacement (redo-AVR) versus valve-in-valve trans-catheter aortic valve implantation (valve-in-valve TAVI) for patients with a failing bioprosthetic valve. A multicentre UK ... ...

    Abstract This study sought to compare the morbidity and mortality of redo aortic valve replacement (redo-AVR) versus valve-in-valve trans-catheter aortic valve implantation (valve-in-valve TAVI) for patients with a failing bioprosthetic valve. A multicentre UK retrospective study of redo-AVR or valve-in-valve TAVI for patients referred for redo aortic valve intervention due to a degenerated aortic bioprosthesis. Propensity score matching was performed for confounding factors. From July 2005 to April 2021, 911 patients underwent redo-AVR and 411 patients valve-in-valve TAVI. There were 125 pairs for analysis after propensity score matching. Mean age was 75.2±8.5 years. In-hospital mortality was 7.2% (n=9) for redo-AVR vs 0 for valve-in-valve TAVI, p=0.002. Surgical patients suffered more post-operative complications, including IABP support (p=0.02), early re-operation (p<0.001), arrhythmias (p<0.001), respiratory and neurological complications (p=0.02 and p=0.03) and multi-organ failure (p=0.01). The valve-in-valve TAVI group had a shorter intensive care unit and hospital stay (p <0.001 for both). However, moderate aortic regurgitation at discharge and higher post-procedural gradients were more common after valve-in-valve TAVI (p<0.001 for both). Survival probabilities in patients who were successfully discharged from hospital were similar after valve-in-valve TAVI and redo-AVR over the 6-year follow-up (log-rank p=0.26). In elderly patients with a degenerated aortic bioprosthesis, valve-in-valve trans-catheter aortic valve implantation provides better early outcomes, as opposed to redo surgical aortic valve replacement, although there was no difference in mid-term survival in patients successfully discharged from hospital.
    Keywords redo aortic valve replacement ; valve-in-valve TAVI ; aortic valve ; Medicine ; R
    Language English
    Publishing date 2023-04-01T00:00:00Z
    Publisher PAGEPress Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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