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Article: The effects of sedentary behaviour on patients with peripheral arterial Disease: A systematic review.

Said, Marwa / Ghoneim, Baker / Jones, Jennifer / Tawfick, Wael

2023 Volume 36, Page(s) 102424

Abstract: Sedentary behavior has recently emerged as a risk factor for cardiometabolic diseases. The objective of this review was to assess the relationship between sedentary behavior and peripheral arterial disease (PAD). Using the Preferred Reporting Items for ... ...

Abstract	Sedentary behavior has recently emerged as a risk factor for cardiometabolic diseases. The objective of this review was to assess the relationship between sedentary behavior and peripheral arterial disease (PAD). Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we performed an electronic search across databases including Cochrane Central Register of Controlled Trials, Embase, MEDLINE (Ovid), CINHAL and PubMed to identify studies focusing on sedentary behavior and PAD. A total of 678 records fulfilled eligibility; 166 duplicates were removed, 487 were excluded at the title and abstract level and 15 studies were excluded at the full article level. Thus, our review comprised 10 studies of 20,064 patients with mean age 67.4 years. The average sedentary time was 544.9 min/day. The current review findings indicate that patients with PAD exhibited prolonged periods of sedentary behavior. Furthermore, sedentary behavior among patients with PAD was associated with lower survival rates. The included studies also reported varied outcomes regarding walking distance with some showing an association between reduced sedentary behavior and increased total walking distance. A randomized controlled trial in this review highlighted that reducing sedentary time among patients with PAD improved walking distance. Therefore, the connection between sedentary behavior and PAD seems to be bidirectional. Sedentary time could contribute to PAD development, and PAD-related symptoms may lead to prolonged sedentary behavior. A call for research investigating the link between PAD and sedentary time. Additionally, intervention studies are needed to target the reduction of sedentary time in patients with PAD.
Language	English
Publishing date	2023-09-18
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2785569-7
ISSN	2211-3355
ISSN	2211-3355
DOI	10.1016/j.pmedr.2023.102424
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Article: Redefining postoperative hypertension management in carotid surgery: a comprehensive analysis of blood pressure homeostasis and hyperperfusion syndrome in unilateral vs. bilateral carotid surgeries and implications for clinical practice.

Sultan, Sherif / Acharya, Yogesh / Dulai, Makinder / Tawfick, Wael / Hynes, Niamh / Wijns, William / Soliman, Osama

Frontiers in surgery

2024 Volume 11, Page(s) 1361963

Abstract: Background: This study evaluates the implications of blood pressure homeostasis in bilateral vs. unilateral carotid surgeries, focusing on the incidence of postoperative hypertension, hyperperfusion syndrome, and stroke as primary outcomes. It further ... ...

Abstract	Background: This study evaluates the implications of blood pressure homeostasis in bilateral vs. unilateral carotid surgeries, focusing on the incidence of postoperative hypertension, hyperperfusion syndrome, and stroke as primary outcomes. It further delves into the secondary outcomes encompassing major adverse cardiovascular events and all-cause mortality. Methods: Spanning two decades (2002-2023), this comprehensive retrospective research encompasses 15,369 carotid referrals, out of which 1,230 underwent carotid interventions. A subset of 690 patients received open carotid procedures, with a 10-year follow-up, comprising 599 unilateral and 91 bilateral surgeries. The Society for Vascular Surgery Carotid Reporting Standards underpin our methodological approach for data collection. Both univariate and multivariate analyses were utilized to identify factors associated with postoperative hypertension using the Statistical Package for the Social Sciences (SPSS) Version 22 (SPSS®, IBM® Corp., Armonk, N.Y., USA). Results: A marked acute elevation in blood pressure was observed in patients undergoing both unilateral and bilateral carotid surgeries ( Conclusion: The study identifies postoperative hypertension as a crucial independent predictor of perioperative stroke following bilateral carotid surgery. Moreover, the study elucidates the significant impact of bilateral CEA on the development of post-operative hyperperfusion syndrome or stroke, as compared to unilateral CEA. Currently almost 90% of our carotid practice is eversion carotid endartrerectomy.
Language	English
Publishing date	2024-04-04
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2773823-1
ISSN	2296-875X
ISSN	2296-875X
DOI	10.3389/fsurg.2024.1361963
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Article ; Online: Mental stress in health care professionals during COVID-19 outbreak.

Hassan, Mohammed / Jordan, Fionnuala / Tawfick, Wael

Irish journal of medical science

2022 Volume 191, Issue 6, Page(s) 2681–2687

Abstract: Background: In December 2019, an outbreak of novel corona virus pneumonia occurred in Wuhan City, China, and spread throughout the whole of country in a short period. Figures from China's National Health Commission show that more than 3300 health care ... ...

Abstract	Background: In December 2019, an outbreak of novel corona virus pneumonia occurred in Wuhan City, China, and spread throughout the whole of country in a short period. Figures from China's National Health Commission show that more than 3300 health care workers have been infected as of early March. In Italy, 20% of responding health care professionals was infected, and some have died. Health care professionals are exposed to different types of stress both physical and psychological in response to this serious infectious public health event. Research aims: The aim of this study is to measure the degree of mental stress among front line health care workers dealing with COVID-19 patients. Methods: We conducted the study through online survey questionnaire after obtaining the ethics approval from the Research Ethics Committee of Galway University Hospital in Ireland (Ref: C.A. 2355). All personal information of the medical staff involved in the survey has been kept confidential. Results: Three hundred nine health care members (209 male and 97 female) have agreed to participate in our survey from different hospitals and different specialties all over the world. Overall PSS Score: mean 19.42 (Standard Deviation ± 5.876, range 1-33). Frontline health care workers working in University Hospitals and tertiary referral centres had lower levels of stress compared to those working in peripheral hospitals (P = 0.007, Kruskal Wallis). Conclusion: The COVID-19 pandemic is one of the most stressful events that a health care worker may face during his life time. Most of the participants in the survey developed a moderate degree of stress.
MeSH term(s)	Humans ; Male ; Female ; COVID-19/epidemiology ; Pandemics ; Health Personnel ; SARS-CoV-2 ; Disease Outbreaks
Language	English
Publishing date	2022-01-15
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	390895-1
ISSN	1863-4362 ; 0021-1265
ISSN (online)	1863-4362
ISSN	0021-1265
DOI	10.1007/s11845-021-02880-0
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Zs.B 323: Show issues

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Article ; Online: Hyperbaric Oxygen as an Adjunct in the Treatment of Venous Ulcers: A Systematic Review.

Keohane, Colum / Westby, Daniel / Nolan, Fiona C / Twyford, Mark / Tawfick, Wael / Walsh, Stewart R

Vascular and endovascular surgery

2023 Volume 57, Issue 6, Page(s) 607–616

Abstract: Background: The use of Hyperbaric Oxygen Therapy (HBOT) in diabetic wounds has been studied extensively. Even though venous insufficiency is the most common cause of lower limb ulceration, there is comparatively little evidence regarding the use of HBOT ...

Abstract	Background: The use of Hyperbaric Oxygen Therapy (HBOT) in diabetic wounds has been studied extensively. Even though venous insufficiency is the most common cause of lower limb ulceration, there is comparatively little evidence regarding the use of HBOT for Venous Leg Ulcers (VLU). We performed a systematic-review to evaluate and synthesise available evidence, to evaluate whether patients with VLU, when treated with HBOT, had greater rates of (i) complete VLU healing or (ii) reduction in VLU area, than controls. Methods: In keeping with PRISMA guidelines, database searches of PubMed, Scopus and Embase was performed. After removal of duplicates, titles were screened for relevance by two authors, then abstracts, and in turn full text manuscripts. Data were extracted from relevant sources including one published abstract. Included studies were assessed for risk of bias using the Risk of Bias 2 (RoB-2) and Risk Of Bias In Nonrandomized Studies (ROBINS-I) tools. Results: Six studies were included. There was significant heterogeneity across the studies, with no standard control intervention, method of outcome reporting, or duration of follow up. Two studies reported 12 week follow up results and pooled analysis of complete ulcer healing showed no statistically significant difference between HBOT and controls for the outcome of complete ulcer healing OR 1.54 (95%CI = .50-4.75) P = .4478. A similar non-signifiacnt result was seen in four studies reporting 5-6 week follow up; OR 5.39 (95%CI = .57-259.57) P = .1136. Change in VLU area was reported in all studies, and pooled standardised mean difference was 1.70 (95%CI = .60 to 2.79) P = .0024, indicating a statistically significant benefit of HBOT in reducing ulcer area. Conclusion: Existing evidence suggests that HBOT does not significantly affect complete healing of VLU. There is a statistically significant benefit in terms of reducing ulcer size, though in the absence of ulcer healing the clinical significance of this is not established. Current evidence does not justify widespread use of HBOT for VLU.
MeSH term(s)	Humans ; Varicose Ulcer/therapy ; Varicose Ulcer/drug therapy ; Hyperbaric Oxygenation/adverse effects ; Ulcer/therapy ; Treatment Outcome ; Wound Healing
Language	English
Publishing date	2023-03-08
Publishing country	United States
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	2076272-0
ISSN	1938-9116 ; 1538-5744
ISSN (online)	1938-9116
ISSN	1538-5744
DOI	10.1177/15385744231162924
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Article ; Online: Pulmonary Function Testing for Patients with Abdominal Aortic Aneurysm: A Combined Decision.

Elsharkawi, Mohamed / Tawfick, Wael / Tubassam, Muhammad / Walsh, Stewart

European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

2021 Volume 62, Issue 6, Page(s) 1006

MeSH term(s)	Aortic Aneurysm, Abdominal/complications ; Aortic Aneurysm, Abdominal/diagnostic imaging ; Aortic Aneurysm, Abdominal/surgery ; Elective Surgical Procedures ; Humans ; Postoperative Complications
Language	English
Publishing date	2021-10-20
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	1225869-6
ISSN	1532-2165 ; 1078-5884
ISSN (online)	1532-2165
ISSN	1078-5884
DOI	10.1016/j.ejvs.2021.09.013
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Zs.A 2283: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Mobile health technologies to improve walking distance in people with intermittent claudication.

Elfghi, Marah / Dunne, Denise / Jones, Jennifer / Gibson, Irene / Flaherty, Gerard / McEvoy, John William / Sultan, Sherif / Jordan, Fionnuala / Tawfick, Wael

The Cochrane database of systematic reviews

2024 Volume 2, Page(s) CD014717

Abstract: Background: Peripheral arterial disease (PAD) is the obstruction or narrowing of the large arteries of the lower limbs, which can result in impaired oxygen supply to the muscle and other tissues during exercise, or even at rest in more severe cases. PAD ...

Abstract	Background: Peripheral arterial disease (PAD) is the obstruction or narrowing of the large arteries of the lower limbs, which can result in impaired oxygen supply to the muscle and other tissues during exercise, or even at rest in more severe cases. PAD is classified into five categories (Fontaine classification). It may be asymptomatic or various levels of claudication pain may be present; at a later stage, there may be ulceration or gangrene of the limb, with amputation occasionally being required. About 20% of people with PAD suffer from intermittent claudication (IC), which is muscular discomfort in the lower extremities induced by exertion and relieved by rest within 10 minutes; IC causes restriction of movement in daily life. Treatment for people with IC involves addressing lifestyle risk factors. Exercise is an important part of treatment, but supervised exercise programmes for individuals with IC have low engagement levels and high attrition rates. The use of mobile technologies has been suggested as a new way to engage people with IC in walking exercise interventions. The novelty of the intervention, low cost for the user, automation, and ease of access are some of the advantages mobile health (mhealth) technologies provide that give them the potential to be effective in boosting physical activity in adults. Objectives: To assess the benefits and harms of mobile health (mhealth) technologies to improve walking distance in people with intermittent claudication. Search methods: The Cochrane Vascular Information Specialist conducted systematic searches of the Cochrane Vascular Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and CINAHL, and also searched the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov. The most recent searches were carried out on 19 December 2022. Selection criteria: We included randomised controlled trials (RCTs) in people aged 18 years or over with symptomatic PAD and a clinical diagnosis of IC. We included RCTs comparing mhealth interventions to improve walking distance versus usual care (no intervention or non-exercise advice), exercise advice, or supervised exercise programmes. We excluded people with chronic limb-threatening ischaemia (Fontaine III and IV). Data collection and analysis: We used standard Cochrane methods. Our primary outcomes were change in absolute walking distance from baseline, change in claudication distance from baseline, amputation-free survival, revascularisation-free survival. Our secondary outcomes were major adverse cardiovascular events, major adverse limb events, above-ankle amputation, quality of life, and adverse events. We used GRADE to assess the certainty of the evidence. Main results: We included four RCTs involving a total of 614 participants with a clinical diagnosis of IC. The duration of intervention of the four included RCTs ranged from 3 to 12 months. Participants were randomised to either mhealth or control (usual care or supervised exercise programme). All four studies had an unclear or high risk of bias in one or several domains. The most prevalent risk of bias was in the area of performance bias, which was rated high risk as it is not possible to blind participants and personnel in this type of trial. Based on GRADE criteria, we downgraded the certainty of the evidence to low, due to concerns about risk of bias, imprecision, and clinical inconsistency. Comparing mhealth with usual care, there was no clear evidence of an effect on absolute walking distance (mean difference 9.99 metres, 95% confidence interval (CI) -27.96 to 47.93; 2 studies, 503 participants; low-certainty evidence). None of the included studies reported on change in claudication walking distance, amputation-free survival, or revascularisation-free survival. Only one study reported on major adverse cardiovascular events (MACE) and found no clear difference between groups (risk ratio 1.37, 95% CI 0.07 to 28.17; 1 study, 305 participants; low-certainty evidence). None of the included studies reported on major adverse limb events (MALE) or above-ankle amputations. Authors' conclusions: Mobile health technologies can be used to provide lifestyle interventions for people with chronic conditions, such as IC. We identified a limited number of studies that met our inclusion criteria. We found no clear difference between mhealth and usual care in improving absolute walking distance in people with IC; however, we judged the evidence to be low certainty. Larger, well-designed RCTs are needed to provide adequate statistical power to reliably evaluate the effects of mhealth technologies on walking distance in people with IC.
MeSH term(s)	Adult ; Humans ; Intermittent Claudication/drug therapy ; Peripheral Arterial Disease/complications ; Peripheral Arterial Disease/therapy ; Exercise Therapy/methods ; Walking ; Lower Extremity ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2024-02-14
Publishing country	England
Document type	Systematic Review ; Journal Article ; Review
ISSN	1469-493X
ISSN (online)	1469-493X
DOI	10.1002/14651858.CD014717.pub2
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Article ; Online: Regarding "On-Site-Modified Sheath to Overcome the Undesirable Catheterization of the Profunda Femoris Artery During Antegrade Femoral Access".

Keohane, Colum / Walsh, Stewart / Tawfick, Wael

Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists

2020 Volume 28, Issue 1, Page(s) 173

MeSH term(s)	Aorta, Abdominal ; Catheterization ; Femoral Artery/diagnostic imaging ; Humans ; Iliac Artery ; Treatment Outcome
Language	English
Publishing date	2020-09-09
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2006618-1
ISSN	1545-1550 ; 1526-6028
ISSN (online)	1545-1550
ISSN	1526-6028
DOI	10.1177/1526602820954267
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Zs.A 4547: Show issues

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Article ; Online: Study within a trial protocol: Same-day consent vs. delayed consent in a randomized trial.

Elfghi, Marah / Jordan, Fionnuala / Sultan, Sherif / Tawfick, Wael

Journal of evidence-based medicine

2020 Volume 13, Issue 3, Page(s) 246–248

Abstract: Background: Randomized trials are designed to evaluate the effects of health care interventions. The recruitment process in a randomized trial can be challenging. Poor recruitment can have a negative impact on the allocated budget and estimated ... ...

Abstract	Background: Randomized trials are designed to evaluate the effects of health care interventions. The recruitment process in a randomized trial can be challenging. Poor recruitment can have a negative impact on the allocated budget and estimated completion date of the study and may result in an underpowered research that will not adequately answer the original research question. Aim: We aim to perform a Study Within A Trial (SWAT) to evaluate the impact of same-day consent or delayed consent on recruitment and retention in the host trial. Methods: This SWAT is designed as an observational study. However, the host trial is a randomized controlled trial evaluating the effectiveness of an intensive lifestyle modification program in patients with peripheral arterial disease. For this trial and SWAT, same-day consent is defined as the patient giving consent on the same day, after the investigator has fully explained the predesigned information leaflet for the host trial. Delayed consent is defined as the patient feeling they still need further time to consider their decision to participate or not. Swat registration: The SWAT was registered on the Northern Ireland Network for Trials Methodology Research.
Language	English
Publishing date	2020-06-15
Publishing country	England
Document type	Journal Article
ISSN	1756-5391
ISSN (online)	1756-5391
DOI	10.1111/jebm.12392
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Article: Screening for Atrial Fibrillation in Community and Primary CareSettings: A Scoping Review.

Canty, Emma / MacGilchrist, Claire / Tawfick, Wael / McIntosh, Caroline

Journal of atrial fibrillation

2021 Volume 13, Issue 5, Page(s) 2452

Abstract: Background: Atrial Fibrillation (AF) is the most common tachyarrhythmia and is associated with increased risk of stroke, morbidity and mortality. AF is responsible for up to a quarter of all strokes and is often asymptomatic until a stroke occurs ... ...

Abstract	Background: Atrial Fibrillation (AF) is the most common tachyarrhythmia and is associated with increased risk of stroke, morbidity and mortality. AF is responsible for up to a quarter of all strokes and is often asymptomatic until a stroke occurs.Screening for AF is a valuable approach to reduce the burden of stroke in the population. Objectives: The motivation for this review was to synthesise and appraise the evidence for screening for AF in the community. The aims of this scoping review are 1). To describe the prevalence of newly diagnosed AF in screening programmes 2). Identify which techniques/ tools are employed for AF screening 3). To describe the setting and personnel involved in screening for AF. Eligibility criteria: All forms of AF screening in adults (≥18 years) in primary and community care settings. Methods: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping reviews (PRISMA-ScR). Results: Fifty-nine papers were included; most were cross-sectional studies (n=41) and RCTs (n=7). Prevalence of AF ranged from 0-34.5%. Screening tools and techniquesincluded the 12-lead ECG (n=33), the 1-lead ECG smartphone based Alivecor® (n=14) and pulse palpation (n=12). Studies were undertaken in community settings (n=30) or in urban/rural primary care (n=28). Personnel collecting research data were in the main members of the research team (n=31), GPs (n=16), practice nurses (n=10), participants (n=8) and pharmacists (n=4). Conclusion: Prevalence of AF increased with advancing age. AF screening should target individuals at greatest risk of the condition including older adults≥65 years of age. Emerging novel technologies may increase the accessibility of AF screening in community and home settings. There is a need for high quality research to investigate AF prevalence and establish accuracy and validity for traditional versus novel screening tools used to screen for AF.
Language	English
Publishing date	2021-02-28
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2451936-4
ISSN	1941-6911
ISSN	1941-6911
DOI	10.4022/jafib.2452
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Article ; Online: Adipose-derived stem cells in patients with venous ulcers: Systematic review.

Elsharkawi, Mohamed / Ghoneim, Baker / Westby, Daniel / Jones, Deirdre / Tawfick, Wael / Walsh, Stewart R

Vascular

2022 Volume 31, Issue 5, Page(s) 989–993

Abstract: Objectives: Few studies have reported on the safety and durability of adipose-derived stem cells (ADSCs) to support healing in patients with venous leg ulcers (VLU). To establish if there is any evidence to support ADSC use in VLU patients, a systematic ...

Abstract	Objectives: Few studies have reported on the safety and durability of adipose-derived stem cells (ADSCs) to support healing in patients with venous leg ulcers (VLU). To establish if there is any evidence to support ADSC use in VLU patients, a systematic review was conducted. Methods: A systematic review was conducted following the PRISMA guidelines. PubMed and Embase databases were searched for relevant papers. References from retrieved papers were reviewed to identify any extra eligible studies. Results: After duplicate removal, 950 papers were screened for eligibility of which 932 were excluded based on title and abstract. Four papers were included in the final analysis (one randomised study and three non-randomised studies). 66 patients in total received ADSCs for VLU treatment. The only randomised paper reported 6-month healing rates of 75% with ADSCs compared to 50% in controls. 100% healing was achieved in one study. The remaining 2 studies reported 25% and 58% healing; however, they included patients with relatively large VLUs. Pain scores decreased after ADSCs application where reported. No serious procedure related complications were reported. Conclusion: ADSCs may enhance ulcer healing in patients with chronic VLU and appears safe based on initial reports. Large, randomised trials are needed to definitively establish the technique's role in VLU patients.
MeSH term(s)	Humans ; Varicose Ulcer/therapy ; Ulcer ; Wound Healing ; Stem Cells
Language	English
Publishing date	2022-05-01
Publishing country	England
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	2137151-9
ISSN	1708-539X ; 1708-5381
ISSN (online)	1708-539X
ISSN	1708-5381
DOI	10.1177/17085381221098279
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