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  1. Article ; Online: Coronary computed tomography angiography in the evaluation of acute chest pain in patients with elevated high sensitive cardiac troponin I (hs-cTn) level.

    Qasum, Majd / Massalha, Samia / Marcusohn, Erez / Elias, Adi / Darawshi, Said / Zukermann, Robert

    American heart journal plus : cardiology research and practice

    2023  Volume 27, Page(s) 100276

    Abstract: Aims CCTA is a well-established and safe imaging modality for the diagnosis of CAD and is gate keeping for invasive coronary angiography (ICA). We aimed to examine CCTA performance in patients presenting with ACP and dynamic hs-cTn elevation compatible ... ...

    Abstract Aims CCTA is a well-established and safe imaging modality for the diagnosis of CAD and is gate keeping for invasive coronary angiography (ICA). We aimed to examine CCTA performance in patients presenting with ACP and dynamic hs-cTn elevation compatible with MI but not exceeding 7 folds of the URL. We also examined the performance of GRACE and PTP consortium scores in this population of patients.
    Language English
    Publishing date 2023-02-17
    Publishing country United States
    Document type Journal Article
    ISSN 2666-6022
    ISSN (online) 2666-6022
    DOI 10.1016/j.ahjo.2023.100276
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Transesophageal echocardiography and computerized tomography angiography mismatch in left atrial appendage thrombus evaluation.

    Bloch-Isenberg, Natalie / Zukermann, Robert / Massalha, Samia / Qasum, Majd / Reiner Benaim, Anat / Marcusohn, Erez

    Journal of cardiovascular medicine (Hagerstown, Md.)

    2023  Volume 25, Issue 1, Page(s) 63–67

    Abstract: Background: Transesophageal echocardiography (TEE) is the gold standard test for the diagnosis of left atrial appendage (LAA) thrombus. Nonetheless, computerized tomography angiography (CTA) is readily used to exclude LAA thrombus before pulmonary vein ... ...

    Abstract Background: Transesophageal echocardiography (TEE) is the gold standard test for the diagnosis of left atrial appendage (LAA) thrombus. Nonetheless, computerized tomography angiography (CTA) is readily used to exclude LAA thrombus before pulmonary vein isolation (PVI) and LAA closure procedures. We aimed to assess the comparability of LAA thrombus diagnosis using chest CTA scans in patients with atrial fibrillation who underwent TEE.
    Methods: Retrospective collection of consecutive patients with atrial fibrillation who underwent TEE and chest CTA within 30 days and had evidence of spontaneous echo contrast (SEC) or LAA thrombus on TEE. Clinical, demographic, and echo data were collected. Prospective analysis of the CTA for evidence of LAA thrombus in the same group of patients was performed. We compared the findings of the two modalities.
    Results: Out of 1550 patients with atrial fibrillation who underwent TEE examinations in the study period, 63 patients underwent TEE within 30 days of a chest CTA scan. Twenty-three patients had LAA thrombus and 40 had some degree of SEC according to TEE. On CTA, 11 were interpreted as positive with a high level of suspicion for the presence of an LAA thrombus. Six patients (26.1%) had LAA thrombus according to both CT and TEE. Therefore, low concordance was found between test results (chi-squared continuity correction = 5.5, df  = 1, and P -value = 0.01902).
    Conclusion: The discrepancy between CTA and TEE results suggests these examinations might be more suitable as complementary examinations to exclude LAA thrombus.
    MeSH term(s) Humans ; Echocardiography, Transesophageal/methods ; Atrial Fibrillation/complications ; Atrial Fibrillation/diagnostic imaging ; Atrial Fibrillation/surgery ; Atrial Appendage/diagnostic imaging ; Retrospective Studies ; Computed Tomography Angiography ; Thrombosis/diagnostic imaging ; Thrombosis/etiology ; Heart Diseases/diagnosis ; Angiography
    Language English
    Publishing date 2023-12-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2223461-5
    ISSN 1558-2035 ; 1558-2027
    ISSN (online) 1558-2035
    ISSN 1558-2027
    DOI 10.2459/JCM.0000000000001538
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Predictors of infectious foci on FDG PET/CT in Staphylococcus aureus bacteremia.

    Ghanem-Zoubi, Nesrin / Abu-Elhija, Jawad / Kagna, Olga / Mustafa-Hellou, Mona / Qasum, Majd / Haber, Daniel / Paul, Mical / Keidar, Zohar

    Scientific reports

    2023  Volume 13, Issue 1, Page(s) 14063

    Abstract: We looked for predicting factors for the detection of infectious foci on 18F-fluorodeoxyglucose-positron emission tomography in combination with computed tomography (FDG PET/CT) among patients with Staphylococcus aureus bacteremia (SAB) who participated ... ...

    Abstract We looked for predicting factors for the detection of infectious foci on 18F-fluorodeoxyglucose-positron emission tomography in combination with computed tomography (FDG PET/CT) among patients with Staphylococcus aureus bacteremia (SAB) who participated in an interventional study that was conducted at Rambam Health Care Campus, between July 1, 2015 and February 1, 2019. The primary outcome was an infectious focus detected by FDG PET/CT. Independent predictors for detection of focal infection were identified using univariate followed by a logistic regression multivariate analysis. We included 149 patients with 151 separate episodes of SAB who underwent FDG-PET/CT. Focal infections were detected in 107 patients (70.8%). Independent predictors for focal infection detection were community acquisition of bacteremia with odds ratio (OR) 3.03 [95% confidence interval (CI) 1.04-8.77], p-0.042 and C reactive protein (CRP) with OR 1.09 [95% CI 1.04-1.14], p < 0.001. Primary bacteremia was inversely associated with focal infection detection with OR 0.27 [0.10-0.69], p = 0.007, as were the pre-scan blood glucose levels OR 0.9 [0.98-0.99], p-0.004. The latter stayed significant in the subgroup of patients with diabetes mellitus. To conclude, patients with community-acquired bacteremia or high CRP levels should be carefully investigated for focal infection. Patients who present with primary bacteremia seem to be at low risk for focal infection.
    MeSH term(s) Humans ; Fluorodeoxyglucose F18 ; Positron Emission Tomography Computed Tomography ; Staphylococcus aureus ; Communicable Diseases ; Bacteremia/diagnostic imaging ; Staphylococcal Infections/diagnostic imaging ; Focal Infection ; Positron-Emission Tomography
    Chemical Substances Fluorodeoxyglucose F18 (0Z5B2CJX4D)
    Language English
    Publishing date 2023-08-28
    Publishing country England
    Document type Journal Article ; 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/s41598-023-41336-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Vascular Complications Among Patients Undergoing Trans-femoral Transcatheter Aortic Valve Implantation: Prostar

    Marcusohn, Erez / Qasum, Majd / Epstein, Danny / Solomonica, Amir / Orbach, Ady / Musallam, Anees / Kerner, Arthur / Feld, Yair

    Angiology

    2022  Volume 73, Issue 7, Page(s) 635–642

    Abstract: Reliable femoral artery closure devices are essential for the success of trans-femoral Transcatheter Aortic Valve Implantation (TAVI) procedures. Accordingly, device choice might affect vascular complications and bleeding rates. This was a retrospective ... ...

    Abstract Reliable femoral artery closure devices are essential for the success of trans-femoral Transcatheter Aortic Valve Implantation (TAVI) procedures. Accordingly, device choice might affect vascular complications and bleeding rates. This was a retrospective analysis, comparing vascular complication rates among patients who underwent trans-femoral TAVI with vascular access closure using either the ProGlide parallel suture or Prostar closure devices. We included 191 patients: 106 were treated with Prostar and 85 with ProGlide. The ProGlide group had higher rate of diabetes, chronic kidney disease, peripheral arterial disease, and significantly smaller femoral arteries that were treated via larger sheaths. Valve Academic Research Consortium (VARC)-2 major complications were similar between the groups. (4.7% for ProGlide vs 3.8% for Prostar, P=1), with similar incidence of closure device failure (2 vs 3, P=1). No differences were found after univariant analysis and propensity-score matching in the incidence of major and minor bleeding nor in the rate of in-hospital mortality between ProGlide and Prostar (4.7 vs 2.8%, P=.7, 1.2 vs 2.8%, P=.63, and 1.2 vs .0%, P=.45, respectively). Parallel suture technique using two ProGlide sutures showed comparable rates of vascular complications to the Prostar closure device in higher risk population of TAVI patients.
    MeSH term(s) Aortic Valve/diagnostic imaging ; Aortic Valve/surgery ; Aortic Valve Stenosis/complications ; Aortic Valve Stenosis/surgery ; Cardiovascular Diseases/etiology ; Femoral Artery/surgery ; Hemorrhage/etiology ; Humans ; Retrospective Studies ; Transcatheter Aortic Valve Replacement/methods ; Treatment Outcome ; Vascular Closure Devices/adverse effects
    Language English
    Publishing date 2022-02-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80040-5
    ISSN 1940-1574 ; 0003-3197
    ISSN (online) 1940-1574
    ISSN 0003-3197
    DOI 10.1177/00033197211058498
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Integration of FDG-PET/CT in the Diagnostic Workup for Staphylococcus aureus Bacteremia: A Prospective Interventional Matched-cohort Study.

    Ghanem-Zoubi, Nesrin / Kagna, Olga / Abu-Elhija, Jawad / Mustafa-Hellou, Mona / Qasum, Majd / Keidar, Zohar / Paul, Mical

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2020  Volume 73, Issue 11, Page(s) e3859–e3866

    Abstract: Background: Staphylococcus aureus bacteremia (SAB) is uniquely characterized by focal pyogenic complications that might not be apparent clinically. We investigated the benefit of adding fluorodeoxyglucose-positron emission tomography/computed tomography ...

    Abstract Background: Staphylococcus aureus bacteremia (SAB) is uniquely characterized by focal pyogenic complications that might not be apparent clinically. We investigated the benefit of adding fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in the workup of patients with SAB.
    Methods: In a matched-cohort study patients with SAB (intervention group) were prospectively recruited to undergo FDG-PET/CT 7-14 days after diagnosis. Treatment was directed by FDG-PET/CT findings. Clinical outcomes were compared with a control group of patients with SAB who had not undergone FDG-PET/CT, matched by age, Charlson score, methicillin susceptibility, and survival duration to FDG-PET/CT. The primary outcome was 90-day mortality. Residual confounding was controlled through regression analyses.
    Results: During the study period 149 patients with 151 separate episodes of SAB underwent FDG-PET/CT and were compared with 150 matched patients with 151 SAB episodes. Patients in the intervention group acquired infections more frequently in the community and had less frequently solid malignancies and more frequently high-risk SAB. Ninety-day mortality in the intervention group was significantly lower than in the control group (21/151 [13.9%] vs 43/151 [28.5%], P = .002). The difference remained significant in a subgroup analysis of patients with community-onset infections without malignancy and among patients with low-risk SAB. Controlling for other risk factors for mortality, FDG-PET/CT performance among all patients was independently associated with lower mortality (OR, .39; 95% CI, .18-.84). Patients in the intervention group had longer duration of treatment and more focus control procedures performed compared with the control group.
    Conclusions: FDG-PET/CT in patients with SAB seems to improve survival through guidance of treatment duration and co-interventions.
    MeSH term(s) Bacteremia/drug therapy ; Cohort Studies ; Fluorodeoxyglucose F18/therapeutic use ; Humans ; Positron Emission Tomography Computed Tomography ; Prospective Studies ; Risk Factors ; Staphylococcal Infections/diagnostic imaging ; Staphylococcal Infections/drug therapy ; Staphylococcus aureus
    Chemical Substances Fluorodeoxyglucose F18 (0Z5B2CJX4D)
    Language English
    Publishing date 2020-07-07
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciaa929
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: The association between fluconazole dose and MIC with mortality and persistence in candidemia.

    Ghanem-Zoubi, Nesrin / Qasum, Majd / Khoury, Johad / Zorbavel, Danny / Arnon, Merav / Geffen, Yuval / Paul, Mical

    European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology

    2019  Volume 38, Issue 9, Page(s) 1773–1780

    Abstract: To evaluate the association between fluconazole exposure parameters and clinical outcomes in patients with candidemia. We retrospectively included all adults with candidemia in a single center from January 2009 to December 2017, treated initially with ... ...

    Abstract To evaluate the association between fluconazole exposure parameters and clinical outcomes in patients with candidemia. We retrospectively included all adults with candidemia in a single center from January 2009 to December 2017, treated initially with fluconazole for fluconazole-susceptible candidemia. We assessed the association between fluconazole exposure parameters and 30-day mortality or 14-day clinical failure, a composite of mortality at day 14 or persistent candidemia ≥ 72 h, in all patients and in patients with C. glabrata candidemia. During the study period, 158 patients fulfilled the inclusion criteria. Main species were C. albicans 66 (41.8%), C. glabrata 35 (22.2%), and C. parapsilosis 31 (19.6%). Sixty patients (38%) died within 30 days. Sixty-one patients (38.6%) experienced 14-day failure. In 30-day survivors, the median AUC
    MeSH term(s) Aged ; Aged, 80 and over ; Antifungal Agents/administration & dosage ; Area Under Curve ; Candida/drug effects ; Candida albicans/drug effects ; Candida glabrata/drug effects ; Candidemia/drug therapy ; Candidemia/mortality ; Drug Resistance, Fungal ; Electronic Health Records ; Female ; Fluconazole/administration & dosage ; Humans ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Retrospective Studies ; Treatment Failure
    Chemical Substances Antifungal Agents ; Fluconazole (8VZV102JFY)
    Language English
    Publishing date 2019-06-13
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 603155-9
    ISSN 1435-4373 ; 0934-9723 ; 0722-2211
    ISSN (online) 1435-4373
    ISSN 0934-9723 ; 0722-2211
    DOI 10.1007/s10096-019-03611-1
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  7. Article ; Online: The association between treatment appropriateness according to EUCAST and CLSI breakpoints and mortality among patients with candidemia: a retrospective observational study.

    Ghanem-Zoubi, Nesrin / Zorbavel, Danny / Khoury, Johad / Geffen, Yuval / Qasum, Majd / Predescu, Svetlana / Paul, Mical

    European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology

    2018  Volume 37, Issue 12, Page(s) 2397–2404

    Abstract: To evaluate the association between appropriate antifungal treatment and mortality among patients with candidemia using different breakpoint definitions. In a retrospective study, we included all adults with candidemia in a tertiary center between 2009 ... ...

    Abstract To evaluate the association between appropriate antifungal treatment and mortality among patients with candidemia using different breakpoint definitions. In a retrospective study, we included all adults with candidemia in a tertiary center between 2009 and 2015. We defined three versions of appropriate (covering) antifungal treatment, according to Clinical and Laboratory Standards Institute (CLSI) 2008, CLSI 2012, and European Committee on Antimicrobial Susceptibility Testing (EUCAST) (2017 update) breakpoints. For empiric treatment, we evaluated the association with 30-day mortality. For definitive treatment, we evaluated the association with 90-day mortality among patients surviving the first week after candidemia onset. Adjusted odds ratios (OR) from a bivariate logistic regression with 95% confidence intervals are reported. We identified 302 patients with 308 separate candidemia episodes. The crude 30-day mortality was 55% (168/308). Resistance to anidulafungin increased from 3.5 to 51.6% and to fluconazole from 15.2 to 44.1%, when applying CLSI 2008 and EUCAST definitions, respectively. Appropriate empirical treatment was significantly associated with lower 30-day mortality using the CLSI 2008 definitions, adjusted OR 0.56 (0.33-0.96). The associations were similar, though not statistically significant for EUCAST, 0.58 (0.33-1.00), and CLSI 2012, OR 0.62 (0.37-1.04). Appropriate definitive treatment according to CLSI 2012 and EUCAST was independently associated with lower 90-day mortality, ORs 0.31 (0.13-0.75) and 0.44 (0.23-0.8), respectively. With CLSI 2008, the association was similar but not statistically significant, OR 0.4 (0.11-1.41), with few isolates classified as resistant. Considering the major shift in resistance prevalence when applying CLSI 2008, CLSI 2012, and EUCAST breakpoint definitions, no major differences were observed in their association with mortality.
    MeSH term(s) Aged ; Antifungal Agents/therapeutic use ; Candida/isolation & purification ; Candidemia/drug therapy ; Candidemia/mortality ; Drug Resistance, Fungal ; Female ; Fluconazole/therapeutic use ; Humans ; Logistic Models ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Odds Ratio ; Retrospective Studies ; Treatment Outcome
    Chemical Substances Antifungal Agents ; Fluconazole (8VZV102JFY)
    Language English
    Publishing date 2018-10-03
    Publishing country Germany
    Document type Journal Article ; Observational Study
    ZDB-ID 603155-9
    ISSN 1435-4373 ; 0934-9723 ; 0722-2211
    ISSN (online) 1435-4373
    ISSN 0934-9723 ; 0722-2211
    DOI 10.1007/s10096-018-3389-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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