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Darrel Francis

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https://www.readbyqxmd.com/read/28749898/recurrence-of-granular-corneal-dystrophy-type-1-after-phototherapeutic-keratectomy-lamellar-keratoplasty-and-penetrating-keratoplasty-in-a-single-population
#1
Darrell R Lewis, Marianne O Price, Matthew T Feng, Francis W Price
PURPOSE: To describe the recurrence of granular corneal dystrophy type 1 (GCD1) after penetrating keratoplasty (PKP), anterior lamellar keratoplasty (ALK), deep anterior lamellar keratoplasty (DALK), and phototherapeutic keratectomy (PTK) in a single population. The time required to achieve best-corrected visual acuity (BCVA) after each intervention was also analyzed. METHODS: Retrospective review of all patients with GCD1 from a single center between 1989 and 2016...
October 2017: Cornea
https://www.readbyqxmd.com/read/28737621/baroreflex-activation-therapy-a-new-approach-to-the-management-of-advanced-heart-failure-with-reduced-ejection-fraction
#2
Edoardo Gronda, Darrel Francis, Faiez Zannad, Christian Hamm, Josep Brugada, Emilio Vanoli
: Chronic heart failure is a common clinical condition characterized by persistent excessive sympathetic nervous system activation. The derangement of the sympathetic activity has relevant implications for disease progression and patient survival. Aiming to positively impact patient outcome, autonomic nervous system modulatory therapies have been developed and tested in animal and clinical studies. As a general gross assumption, direct vagal stimulation and baroreflex activation are considered equivalent. This assumption does not take into account the fact that direct cervical vagal nerve stimulation involves activation of both afferent and efferent fibers innervating not only the heart, but the entire visceral system, leading to undesired responses to and from this compartment...
September 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28645927/is-this-muscle-pain-caused-by-my-statin
#3
EDITORIAL
Matthew J Shun-Shin, Darrel P Francis
No abstract text is available yet for this article.
June 23, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28597606/the-mortality-risk-of-deferring-optimal-medical-therapy-in-heart-failure-a-systematic-comparison-against-norms-for-surgical-consent-and-patient-information-leaflets
#4
Sameer Zaman, Saman S Zaman, Timothy Scholtes, Matthew J Shun-Shin, Carla M Plymen, Darrel P Francis, Graham D Cole
AIMS: The prescription of optimal medical therapy for heart failure is often delayed despite compelling evidence of a reduction in mortality. We calculated the absolute risk resulting from delayed prescription of therapy. For comparison, we established the threshold applied by clinicians when discussing the risk for death associated with an intervention, and the threshold used in official patient information leaflets. METHODS AND RESULTS: We undertook a meta-analysis of randomized controlled trials to calculate the excess mortality caused by deferral of medical therapy for 1 year...
June 8, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28573718/automatic-detection-of-end-diastolic-and-end-systolic-frames-in-2d-echocardiography
#5
Massoud Zolgharni, Madalina Negoita, Niti M Dhutia, Michael Mielewczik, Karikaran Manoharan, S M Afzal Sohaib, Judith A Finegold, Stefania Sacchi, Graham D Cole, Darrel P Francis
BACKGROUND: Correctly selecting the end-diastolic and end-systolic frames on a 2D echocardiogram is important and challenging, for both human experts and automated algorithms. Manual selection is time-consuming and subject to uncertainty, and may affect the results obtained, especially for advanced measurements such as myocardial strain. METHODS AND RESULTS: We developed and evaluated algorithms which can automatically extract global and regional cardiac velocity, and identify end-diastolic and end-systolic frames...
June 1, 2017: Echocardiography
https://www.readbyqxmd.com/read/28538960/diagnostic-accuracy-of-computed-tomography-derived-fractional-flow-reserve-a-systematic-review
#6
Christopher M Cook, Ricardo Petraco, Matthew J Shun-Shin, Yousif Ahmad, Sukhjinder Nijjer, Rasha Al-Lamee, Yuetsu Kikuta, Yasutsugu Shiono, Jamil Mayet, Darrel P Francis, Sayan Sen, Justin E Davies
Importance: Computed tomography-derived fractional flow reserve (FFR-CT) is a novel, noninvasive test for myocardial ischemia. Clinicians using FFR-CT must be able to interpret individual FFR-CT results to determine subsequent patient care. Objective: To provide clinicians a means of interpreting individual FFR-CT results with respect to the range of invasive FFRs that this interpretation might likely represent. Evidence Review: We performed a systematic review in accordance with guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses...
July 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28366789/envisioning-the-future-of-big-data-biomedicine
#7
Alex A T Bui, John Darrell Van Horn
Through the increasing availability of more efficient data collection procedures, biomedical scientists are now confronting ever larger sets of data, often finding themselves struggling to process and interpret what they have gathered. This, while still more data continues to accumulate. This torrent of biomedical information necessitates creative thinking about how the data are being generated, how they might be best managed, analyzed, and eventually how they can be transformed into further scientific understanding for improving patient care...
May 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28329280/implantable-cardioverter-defibrillators-for-primary-prevention-of-death-in-left-ventricular-dysfunction-with-and-without-ischaemic-heart-disease-a-meta-analysis-of-8567-patients-in-the-11-trials
#8
Matthew J Shun-Shin, Sean L Zheng, Graham D Cole, James P Howard, Zachary I Whinnett, Darrel P Francis
Aims: Primary prevention implantable cardioverter defibrillators (ICDs) are established therapy for reducing mortality in patients with left ventricular systolic dysfunction and ischaemic heart disease (IHD). However, their efficacy in patients without IHD has been controversial. We undertook a meta-analysis of the totality of the evidence. Methods and results: We systematically identified all RCTs comparing ICD vs. no ICD in primary prevention. Eligible RCTs were those that recruited patients with left ventricular dysfunction, reported all-cause mortality, and presented their results stratified by the presence of IHD (or recruited only those with or without)...
June 7, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28220275/open-source-vendor-independent-automated-multi-beat-tissue-doppler-echocardiography-analysis
#9
Niti M Dhutia, Massoud Zolgharni, Michael Mielewczik, Madalina Negoita, Stefania Sacchi, Karikaran Manoharan, Darrel P Francis, Graham D Cole
Current guidelines for measuring cardiac function by tissue Doppler recommend using multiple beats, but this has a time cost for human operators. We present an open-source, vendor-independent, drag-and-drop software capable of automating the measurement process. A database of ~8000 tissue Doppler beats (48 patients) from the septal and lateral annuli were analyzed by three expert echocardiographers. We developed an intensity- and gradient-based automated algorithm to measure tissue Doppler velocities. We tested its performance against manual measurements from the expert human operators...
August 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28126309/smart-radiation-therapy-biomaterials
#10
REVIEW
Wilfred Ngwa, Francis Boateng, Rajiv Kumar, Darrell J Irvine, Silvia Formenti, Twalib Ngoma, Carsten Herskind, Marlon R Veldwijk, Georg Lars Hildenbrand, Michael Hausmann, Frederik Wenz, Juergen Hesser
Radiation therapy (RT) is a crucial component of cancer care, used in the treatment of over 50% of cancer patients. Patients undergoing image guided RT or brachytherapy routinely have inert RT biomaterials implanted into their tumors. The single function of these RT biomaterials is to ensure geometric accuracy during treatment. Recent studies have proposed that the inert biomaterials could be upgraded to "smart" RT biomaterials, designed to do more than 1 function. Such smart biomaterials include next-generation fiducial markers, brachytherapy spacers, and balloon applicators, designed to respond to stimuli and perform additional desirable functions like controlled delivery of therapy-enhancing payloads directly into the tumor subvolume while minimizing normal tissue toxicities...
March 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27970263/tct-9-a-per-vessel-level-systematic-review-of-computed-tomography-derived-ffr-ffr-ct-diagnostic-accuracy-studies-implications-for-clinical-decision-making
#11
Christopher Cook, Yousif Ahmad, Ricardo Petraco, Sukhjinder Nijjer, Matthew Shun-Shin, Rasha Al-Lamee, Yuetsu Kikuta, Yasutsugu Shiono, Jamil Mayet, Darrel Francis, Sayan Sen, Justin Davies
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27885752/biventricular-paced-qrs-area-predicts-acute-hemodynamic-crt-response-better-than-qrs-duration-or-qrs-amplitudes
#12
Jan DE Pooter, Milad El Haddad, Marc DE Buyzere, Hernandez Alfonso Aranda, Richard Cornelussen, Berthold Stegemann, Christopher A Rinaldi, Maciej Sterlinski, Adam Sokal, Darrel P Francis, Luc Jordaens, Roland X Stroobandt, Frederic VAN Heuverswyn, Frank Timmermans
INTRODUCTION: Vectorcardiographic (VCG) QRS area of left bundle branch block (LBBB) predicts acute hemodynamic response in cardiac resynchronization therapy (CRT) patients. We hypothesized that changes in QRS area occurring with biventricular pacing (BV) might predict acute hemodynamic CRT response (AHR). METHODS AND RESULTS: VCGs of 624 BV paced electrocardiograms (25 LBBB patients with 35 different pacing configurations) were calculated according to Frank's orthogonal lead system...
February 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27712778/mechanisms-of-myocardial-ischemia-in-hypertrophic-cardiomyopathy-insights-from-wave-intensity-analysis-and-magnetic-resonance
#13
Claire E Raphael, Robert Cooper, Kim H Parker, Julian Collinson, Vassilis Vassiliou, Dudley J Pennell, Ranil de Silva, Li Yueh Hsu, Anders M Greve, Sukh Nijjer, Chris Broyd, Aamir Ali, Jennifer Keegan, Darrel P Francis, Justin E Davies, Alun D Hughes, Andrew Arai, Michael Frenneaux, Rod H Stables, Carlo Di Mario, Sanjay K Prasad
BACKGROUND: Angina is common in hypertrophic cardiomyopathy (HCM) and is associated with abnormal myocardial perfusion. Wave intensity analysis improves the understanding of the mechanics of myocardial ischemia. OBJECTIVES: Wave intensity analysis was used to describe the mechanisms underlying perfusion abnormalities in patients with HCM. METHODS: Simultaneous pressure and flow were measured in the proximal left anterior descending artery in 33 patients with HCM and 20 control patients at rest and during hyperemia, allowing calculation of wave intensity...
October 11, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27708281/the-fractal-heart-embracing-mathematics-in-the-cardiology-clinic
#14
REVIEW
Gabriella Captur, Audrey L Karperien, Alun D Hughes, Darrel P Francis, James C Moon
For clinicians grappling with quantifying the complex spatial and temporal patterns of cardiac structure and function (such as myocardial trabeculae, coronary microvascular anatomy, tissue perfusion, myocyte histology, electrical conduction, heart rate, and blood-pressure variability), fractal analysis is a powerful, but still underused, mathematical tool. In this Perspectives article, we explain some fundamental principles of fractal geometry and place it in a familiar medical setting. We summarize studies in the cardiovascular sciences in which fractal methods have successfully been used to investigate disease mechanisms, and suggest potential future clinical roles in cardiac imaging and time series measurements...
January 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/27599296/a-dock8-wip-wasp-complex-links-t-cell-receptors-to-the-actin-cytoskeleton
#15
Erin Janssen, Mira Tohme, Mona Hedayat, Marion Leick, Sudha Kumari, Narayanaswamy Ramesh, Michel J Massaad, Sumana Ullas, Veronica Azcutia, Christopher C Goodnow, Katrina L Randall, Qi Qiao, Hao Wu, Waleed Al-Herz, Dianne Cox, John Hartwig, Darrell J Irvine, Francis W Luscinskas, Raif S Geha
Wiskott-Aldrich syndrome (WAS) is associated with mutations in the WAS protein (WASp), which plays a critical role in the initiation of T cell receptor-driven (TCR-driven) actin polymerization. The clinical phenotype of WAS includes susceptibility to infection, allergy, autoimmunity, and malignancy and overlaps with the symptoms of dedicator of cytokinesis 8 (DOCK8) deficiency, suggesting that the 2 syndromes share common pathogenic mechanisms. Here, we demonstrated that the WASp-interacting protein (WIP) bridges DOCK8 to WASp and actin in T cells...
October 3, 2016: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/27559818/resonance-as-the-mechanism-of-daytime-periodic-breathing-in-patients-with-heart-failure
#16
Scott A Sands, Yoseph Mebrate, Bradley A Edwards, Shamim Nemati, Charlotte H Manisty, Akshay S Desai, Andrew Wellman, Keith Willson, Darrel P Francis, James P Butler, Atul Malhotra
RATIONALE: In patients with chronic heart failure, daytime oscillatory breathing at rest is associated with a high risk of mortality. Experimental evidence, including exaggerated ventilatory responses to CO2 and prolonged circulation time, implicates the ventilatory control system and suggests feedback instability (loop gain > 1) is responsible. However, daytime oscillatory patterns often appear remarkably irregular versus classic instability (Cheyne-Stokes respiration), suggesting our mechanistic understanding is limited...
January 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27448698/resolving-the-paradox-of-randomised-controlled-trials-and-observational-studies-comparing-multi-vessel-angioplasty-and-culprit-only-angioplasty-at-the-time-of-stemi
#17
Yousif Ahmad, Christopher Cook, Matthew Shun-Shin, Ashwin Balu, Daniel Keene, Sukhjinder Nijjer, Ricardo Petraco, Christopher S Baker, Iqbal S Malik, Michael F Bellamy, Amarjit Sethi, Ghada W Mikhail, Mahmud Al-Bustami, Masood Khan, Raffi Kaprielian, Rodney A Foale, Jamil Mayet, Justin E Davies, Darrel P Francis, Sayan Sen
BACKGROUND: Patients presenting with ST-elevation myocardial infarction commonly have multi-vessel coronary artery disease. After the culprit artery is treated, the optimal treatment strategy for the residual disease is not yet defined. Large observational studies suggest that treatment of residual disease should be deferred but smaller randomised controlled trials (RCTs) suggest multi-vessel primary percutaneous coronary intervention (MV-PPCI) at the time of STEMI is safe. We examine if allocation bias of high-risk patients could explain the conflicting results between observational studies and RCTs and aim to resolve the paradox between the two...
November 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27411361/cardiac-resynchronization-therapy-mechanisms-of-action-and-scope-for-further-improvement-in-cardiac-function
#18
Siana Jones, Joost Lumens, S M Afzal Sohaib, Judith A Finegold, Prapa Kanagaratnam, Mark Tanner, Edward Duncan, Philip Moore, Francisco Leyva, Mike Frenneaux, Mark Mason, Alun D Hughes, Darrel P Francis, Zachary I Whinnett
Aims: Cardiac resynchronization therapy (CRT) may exert its beneficial haemodynamic effect by improving ventricular synchrony and improving atrioventricular (AV) timing. The aim of this study was to establish the relative importance of the mechanisms through which CRT improves cardiac function and explore the potential for additional improvements with improved ventricular resynchronization. Methods and Results: We performed simulations using the CircAdapt haemodynamic model and performed haemodynamic measurements while adjusting AV delay, at low and high heart rates, in 87 patients with CRT devices...
July 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27389109/tyrosine-sulfated-v2-peptides-inhibit-hiv-1-infection-via-coreceptor-mimicry
#19
Raffaello Cimbro, Francis C Peterson, Qingbo Liu, Christina Guzzo, Peng Zhang, Huiyi Miao, Donald Van Ryk, Xavier Ambroggio, Darrell E Hurt, Luca De Gioia, Brian F Volkman, Michael A Dolan, Paolo Lusso
Tyrosine sulfation is a post-translational modification that facilitates protein-protein interaction. Two sulfated tyrosines (Tys173 and Tys177) were recently identified within the second variable (V2) loop of the major HIV-1 envelope glycoprotein, gp120, and shown to contribute to stabilizing the intramolecular interaction between V2 and the third variable (V3) loop. Here, we report that tyrosine-sulfated peptides derived from V2 act as structural and functional mimics of the CCR5 N-terminus and potently block HIV-1 infection...
August 2016: EBioMedicine
https://www.readbyqxmd.com/read/27294103/cardiovascular-risk-factors-from-early-life-predict-future-adult-cardiac-structural-and-functional-abnormalities-a-systematic-review-of-the-published-literature
#20
Arjun K Ghosh, Darrel P Francis, Nishi Chaturvedi, Diana Kuh, Jamil Mayet, Alun D Hughes, Rebecca J Hardy
BACKGROUND: Clinical practice evaluates cardiovascular risk based on current risk factor (RF) levels [Blood pressure (BP), body mass index (BMI) and glycaemic control] largely disregarding previous risk-factor history over the totality of the life course. RFs are related to contemporaneous echocardiographic measures of cardiac structure and function which in turn are independently related to cardiovascular morbidity and mortality in cross-sectional studies. However, the effect of lifetime or earlier RF history on future echocardiographic changes has never been systematically examined...
July 2014: Journal of Cardiology and Therapeutics
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