139 results on '"Reed RM"'
Search Results
102. Mechanical ventilation after lung transplantation. An international survey of practices and preferences.
- Author
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Beer A, Reed RM, Bölükbas S, Budev M, Chaux G, Zamora MR, Snell G, Orens JB, Klesney-Tait JA, Schmidt GA, Brower RG, and Eberlein M
- Subjects
- Adult, Aged, Humans, Middle Aged, Positive-Pressure Respiration methods, Surveys and Questionnaires, Tidal Volume, Lung Transplantation, Practice Patterns, Physicians' statistics & numerical data, Primary Graft Dysfunction therapy, Respiration, Artificial methods, Ventilator-Induced Lung Injury prevention & control
- Abstract
Rationale: Between 10% and 57% of lung transplant (LTx) recipients develop primary graft dysfunction (PGD) within 72 hours of LTx. PGD is clinically and histologically analogous to the acute respiratory distress syndrome. In patients at risk for or with acute respiratory distress syndrome, lung-protective ventilation strategies (low tidal volume and positive end-expiratory pressure) improve outcomes. There is, however, little information available on mechanical ventilation strategies after LTx., Objectives: Our aim in this international survey was to describe the current practices of mechanical ventilation immediately after LTx., Methods: An electronic survey was sent to the medical and surgical directors of U.S. LTx programs (n = 111) and to members of the Pulmonary Council of the International Society for Heart and Lung Transplantation (n = 470)., Results: A total of 149 individuals from 18 countries responded to the questionnaire. The most common modes of ventilation were pressure assist/control (37%) and volume assist/control (35%). Tidal volumes were most often determined by recipient characteristics. Donor characteristics were rarely considered (35%) and were infrequently known by the team managing the ventilator (42%). When presented with a choice of ideal tidal volumes, a majority of respondents selected 6 ml/kg recipient predicted body weight (58%), fewer selected 10 ml/kg (21%), and none selected 15 ml/kg. A majority preferred limiting the fraction of inspired oxygen rather than positive end-expiratory pressure (PEEP) (69% versus 31%, P = 0.006). The median minimum PEEP was 5 cm H2O, and the median maximum PEEP was 11.5 cm H2O. The presence of PGD increased the perceived importance of monitoring plateau pressure to adjust tidal volumes. The median plateau pressure limit perceived as a threshold triggering reduction in tidal volume was 30 cm H2O., Conclusions: Most respondents reported using lung-protective approaches to mechanical ventilation after lung transplantation. Low tidal volumes based on recipient characteristics were frequently chosen. Donor characteristics often were not considered and frequently were not known by the team managing mechanical ventilation after LTx.
- Published
- 2014
- Full Text
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103. Sizing strategies in heart and lung transplantation: you cannot manage what you do not measure.
- Author
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Reed RM and Eberlein M
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- Female, Humans, Male, Organ Size, Heart anatomy & histology, Heart Transplantation standards, Lung anatomy & histology, Lung Transplantation standards, Tissue Donors, Tissue and Organ Procurement standards
- Published
- 2014
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104. Letter by Eberlein and Reed regarding article, "transplantation for idiopathic pulmonary arterial hypertension: improvement in the lung allocation score era".
- Author
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Eberlein M and Reed RM
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- Female, Humans, Male, Health Care Rationing trends, Heart Transplantation, Hypertension, Pulmonary mortality, Hypertension, Pulmonary surgery, Lung Transplantation, Tissue and Organ Procurement methods, Waiting Lists mortality
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- 2014
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105. Hyperbilirubinaemia and haemolytic anaemia in acute alcoholic hepatitis: there's oil in them thar veins.
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Hashmi S, Allison MG, McCurdy MT, and Reed RM
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- Adult, Anemia, Hemolytic complications, Binge Drinking complications, Cholangitis diagnosis, Cholecystitis diagnosis, Coombs Test, Diagnosis, Differential, Female, Hepatitis, Alcoholic complications, Humans, Hyperbilirubinemia complications, Syndrome, Anemia, Hemolytic diagnosis, Hepatitis, Alcoholic diagnosis, Hyperbilirubinemia diagnosis
- Abstract
A Caucasian woman in her late 30s was evaluated after a period of binge drinking and found to have hyperbilirubinaemia for which she was referred for consideration of cholecystectomy. After exclusion of other possibilities, Zieve's syndrome was diagnosed. This is a condition of hyperbilirubinaemia, Coombs' negative haemolytic anaemia and hyperlipidaemia associated with alcoholism. Abstinence from alcohol remains the only known effective treatment, and appreciation of the entity can prevent unnecessary biliary procedures. The patient improved with supportive measures and was discharged in stable condition.
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- 2014
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106. Pitfalls of single lung transplantation (SLT) for chronic obstructive pulmonary disease.
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Singhal A and Reed RM
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- Humans, Lung Transplantation methods, Lung Neoplasms etiology, Lung Transplantation adverse effects, Pulmonary Disease, Chronic Obstructive surgery
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- 2014
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107. A bad shortcut: partial anomalous pulmonary venous return.
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Ramani GV, Kligerman SJ, and Reed RM
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- Aged, Cardiac Catheterization, Coronary Sinus diagnostic imaging, Echocardiography, Female, Heart Septal Defects, Atrial complications, Humans, Hypertension, Pulmonary complications, Imaging, Three-Dimensional, Pulmonary Veins diagnostic imaging, Scimitar Syndrome complications, Tomography, X-Ray Computed, Vena Cava, Superior diagnostic imaging, Ventricular Dysfunction, Right complications, Coronary Sinus abnormalities, Heart Septal Defects, Atrial diagnostic imaging, Hypertension, Pulmonary diagnostic imaging, Pulmonary Veins abnormalities, Scimitar Syndrome diagnostic imaging, Vena Cava, Superior abnormalities, Ventricular Dysfunction, Right diagnostic imaging
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- 2014
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108. Holt-Oram: when the key to a broken heart is in the hand.
- Author
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Naderi N, McCurdy MT, and Reed RM
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- Abnormalities, Multiple pathology, Heart Defects, Congenital pathology, Heart Septal Defects, Atrial pathology, Humans, Lower Extremity Deformities, Congenital pathology, Male, Metacarpophalangeal Joint abnormalities, Metacarpophalangeal Joint pathology, Middle Aged, Upper Extremity Deformities, Congenital pathology, Abnormalities, Multiple diagnosis, Heart Defects, Congenital diagnosis, Heart Septal Defects, Atrial diagnosis, Lower Extremity Deformities, Congenital diagnosis, Upper Extremity Deformities, Congenital diagnosis
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- 2014
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109. Cardiac size and sex-matching in heart transplantation : size matters in matters of sex and the heart.
- Author
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Reed RM, Netzer G, Hunsicker L, Mitchell BD, Rajagopal K, Scharf S, and Eberlein M
- Subjects
- Adult, Body Weight physiology, Donor Selection methods, Female, Heart Transplantation mortality, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Organ Size physiology, Retrospective Studies, Sex Characteristics, Tissue and Organ Procurement methods, Heart anatomy & histology, Heart Transplantation methods
- Abstract
Objective: This study evaluated whether worsened outcomes in sex mismatch are related to mismatch of organ size in heart transplantation., Background: Sizing for organ allocation in heart transplantation currently incorporates only body weight differences between the donor and recipient. Weight correlates poorly to cardiac size, and donor–recipient weight differences are not associated with differential survival. Heart size correlates with sex, and donor–recipient sex mismatch conveys worse-than-expected outcomes., Methods: We performed a retrospective cohort study of 31,634 donor–recipient adult heart transplant pairings from the United Network for Organ Sharing transplantation registry. We used predictive models to calculate the predicted total heart mass (pHM) for recipient and donor pairs. We assessed organ size mismatch by calculating the percent difference between the donor and recipient pHM as [(pHM(recipient) – pHM(donor))/(pHM(recipient))]*100., Results: The most-undersized pHM septile demonstrated higher mortality during the first year post-transplantation (hazard ratio [HR]: 1.27; p < 0.001), which remained robust in adjusted models (HR: 1.25; p = 0.03). Survival did not vary across septiles of weight differences. On univariate analysis, sex mismatch was associated with higher mortality in male patients, but not in female patients. Controlling for differences in pHM reversed these associations. Adjusted models demonstrated worse survival associated with sex mismatch in female patients (1-year HR: 1.28; p = 0.02) but no difference in male patients (1-year HR, 1.00; p = 1.0)., Conclusions: Differences in donor–recipient pHM modulated the survival associated with donor–recipient sex mismatch and identified donor heart undersizing as an otherwise occult and potentially preventable cause of mortality following orthotopic heart transplantation.
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- 2014
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110. Pulmonary function and flow-volume loop patterns in patients with tracheobronchomalacia: is there an independent effect?
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Eberlein M, Bolukbas S, and Reed RM
- Subjects
- Female, Humans, Male, Respiratory Function Tests, Tracheobronchomalacia physiopathology
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- 2014
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111. An oversized allograft is associated with improved survival after lung transplantation for idiopathic pulmonary arterial hypertension.
- Author
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Eberlein M, Diehl E, Bolukbas S, Merlo CA, and Reed RM
- Subjects
- Adult, Allografts, Cohort Studies, Familial Primary Pulmonary Hypertension, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Lung surgery, Male, Organ Size, Retrospective Studies, Risk Factors, Survival Rate, Treatment Outcome, Hypertension, Pulmonary mortality, Hypertension, Pulmonary surgery, Lung pathology, Lung Transplantation
- Abstract
Background: Idiopathic pulmonary arterial hypertension (IPAH) is associated with high short-term mortality after bilateral lung transplantation (BLT). Previous studies have suggested that oversized allografts are associated with improved outcomes and that this association was strongest within the first year after transplant. We hypothesized that oversizing the allograft is associated with improved survival after BLT for IPAH., Methods: All adults in the United Network of Organ Sharing lung transplant registry who underwent first-time BLT for IPAH between October 1989 and April 2010 were studied. Lung size mismatch was assessed by calculating the predicted total lung capacity (pTLC) ratio of the donor to the recipient. The cohort was divided evenly into "undersized" (pTLC ratio less than the median pTLC ratio) and "oversized" (pTLC ratio exceeding the median pTLC ratio). Risk of death after BLT was analyzed using Kaplan-Meier survival and Cox proportional hazards models., Results: The mean pTLC ratio was 0.93 ± 0.10 in the 302 undersized patients compared with 1.24 ± 0.14 in the 302 oversized patients. Cohorts had comparable baseline characteristics. Median survival was 831 days longer in the oversized cohort (2,166 vs. 1,335 days, p = 0.006). In a multivariate model controlling for sex mismatch, recipient factors, acuity, donor factors, and transplant factors, oversizing was associated with decreased hazard for death at 5 years (hazard ratio, 0.73; 95% CI 0.56-0.96, p = 0.02)., Conclusion: Oversizing the allograft is associated with improved survival after BLT for IPAH. In the setting of donor organ shortages and waiting list mortality, it is not practical to intentionally oversize the allograft. However, the pTLC ratio could provide further refinement in the peri-transplant risk assessment., (Copyright © 2013 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2013
- Full Text
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112. Donor-recipient size matching and survival after lung transplantation. A cohort study.
- Author
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Eberlein M, Reed RM, Maidaa M, Bolukbas S, Arnaoutakis GJ, Orens JB, Brower RG, Merlo CA, and Hunsicker LG
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Cohort Studies, Female, Humans, Lung Transplantation mortality, Male, Middle Aged, Multivariate Analysis, Organ Size, Proportional Hazards Models, Retrospective Studies, Sex Factors, Survival Rate, Total Lung Capacity, Treatment Outcome, Young Adult, Body Height, Lung anatomy & histology, Lung Diseases surgery, Lung Transplantation methods
- Abstract
Rationale: The association between a high predicted total lung capacity (pTLC) ratio (equal to pTLC(donor)/pTLC(recipient)), suggestive of an oversized allograft, with improved survival after lung transplantation (LTx) remains controversial., Objectives: To characterize donor-recipient lung size matching based on the pTLC ratio and to investigate the relationship of the pTLC ratio with post-LTx survival., Methods: All subjects in the Scientific Registry of Transplant Recipients, who underwent first-time LTx in the lung allocation score-based system between May 4, 2005 and March 31, 2012, were studied, and the pTLC ratio was calculated on the basis of sex, height, and age. Risk of death after LTx was analyzed using Cox proportional hazards models., Measurements and Main Results: The pTLC ratio was available for 10,289 of the 10,318 study subjects (99.7%). The mean pTLC ratio was 1.015 ± 0.175 (interquartile range, 0.918-1.119). Univariate analysis showed that the pTLC ratio was strongly associated with death in the first LTx year (P < 0.0001). With the pTLC ratio entered as a spline there was a nonlinear association with declining risk of death with higher pTLC ratio from 0.5 to about 1.3, where an inflection occurred with rising risk at higher values. Accounting for the pTLC ratio, recipient and donor sex were not independently associated with death after LTx. A change of pTLC ratio from 0.918 to 1.119 (the interquartile range) was associated with similar point estimates of reduced risk of death at 1 year in univariate (hazard ratio, 0.78) and comprehensive risk-adjusted multivariate models (hazard ratio, 0.86)., Conclusions: The pTLC ratio is an independent predictor of death in the first year after LTx and explains the association of sex with survival after LTx. Incorporating the pTLC ratio in the lung allocation mechanism could improve outcomes after LTx.
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- 2013
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113. Lung size mismatch and survival after single and bilateral lung transplantation.
- Author
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Eberlein M, Reed RM, Bolukbas S, Parekh KR, Arnaoutakis GJ, Orens JB, Brower RG, Shah AS, Hunsicker L, and Merlo CA
- Subjects
- Adult, Humans, Middle Aged, Organ Size, Survival Rate, Donor Selection, Lung Transplantation methods, Lung Transplantation mortality, Patient Selection
- Abstract
Background: A higher predicted total lung capacity (pTLC)-ratio (=pTLC donor/pTLC recipient), suggestive of oversized allografts, is associated with improved survival after lung transplantation. It is unknown whether the pTLC-ratio has a different association with survival in bilateral (BLT) versus single lung transplantation (SLT)., Methods: The pTLC-ratio was calculated for all adult patients in the United Network of Organ Sharing lung transplant (LTx) registry who underwent first-time LTx in the post lung allocation score era, between May 2005 and April 2010. The LTx recipients were stratified according to procedure (BLT vs SLT). Risk of death at 1 year after LTx was analyzed using Kaplan-Meier survival and Cox proportional hazards models., Results: In the 4,520 BLT patients, each 0.1 increase in pTLC-ratio conferred a 7% decrease in the hazard for death at 1 year (p < 0.001) in univariate analysis. This association remained significant after controlling for diagnosis, comorbidities, acuity, donor, and transplant factors (hazard ratio [HR] 0.93, 95% confidence interval [CI] 0.88 to 0.98, p = 0.01). Additional adjustment by a propensity score to account for biases to oversizing showed similar results (HR 0.94, 95% CI 0.90 to 0.99, p = 0.018). In the 2,477 SLT patients, each 0.1 increase in pTLC-ratio conveyed a 6% decrease in the hazard for death at 1 year (p = 0.002) in univariate analysis, which did not persist in the multivariate model (HR 1.00, p = 0.8)., Conclusions: A higher pTLC-ratio, suggestive of an oversized allograft, is associated with improved survival after lung transplantation. This association is primarily evident in BLT patients., (Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
- Published
- 2013
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114. Bilateral lobar lung transplantation and size mismatch by pTLC-ratio.
- Author
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Eberlein M, Bolukbas S, and Reed RM
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- Female, Humans, Male, Lung Transplantation methods
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- 2013
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115. Obstructive sleep apnea in patients with end-stage lung disease.
- Author
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Romem A, Iacono A, McIlmoyle E, Patel KP, Reed RM, Verceles AC, and Scharf SM
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- Female, Humans, Lung Diseases physiopathology, Male, Middle Aged, Polysomnography methods, Polysomnography statistics & numerical data, Respiratory Function Tests methods, Respiratory Function Tests statistics & numerical data, Retrospective Studies, Severity of Illness Index, Sleep Apnea, Obstructive physiopathology, Lung Diseases complications, Sleep Apnea, Obstructive complications
- Abstract
Objectives: Little is known about the rate of obstructive sleep apnea (OSA) in patients with end stage lung disease (ESLD). Given the potential deleterious effect of OSA in these patients, we assessed the case-rate and severity of OSA and described associated patient characteristics., Methods: Retrospective survey of 60 patients with ESLD referred for lung transplantation evaluation. Demographic, polysomnographic, spirometric, and medication utilization data were extracted and analyzed., Results: As demographic and polysomnographic data did not differ between obstructive and restrictive patients, we present analysis of pooled data. Demographics/physiology: median age was 58.5 years, 52% males, mean BMI 32.3 kg/m(2), 52% obstructive. Sleep variables (all medians): total sleep time (TST) 312 min, sleep efficiency 77%, minimal oxygen saturation 84%, apnea hypopnea (AHI) 9.7, respiratory disturbance index (RDI) 12.7 events/h of sleep. Sixty-seven percent had RDI > 5; 21% had RDI between 15 and 30; and 21% had RDI > 30. Periodic limb movement index ≥ 15/h sleep was present in 21.7%. An independent positive correlation between DLCO% and RDI was noted (r = 0.41, p < 0.01). The minimal oxygen saturation was negatively correlated with the RDI (r = -0.34, p < 0.01). The use of ACE inhibitors was associated with moderate-to-severe OSA (odd ratio of 4.67, CI 1.45-15.03; p = 0.017)., Conclusions: In patients with ESLD, organic sleep disorders are common. Greater severity of OSA was associated with the higher DLCO% and lower oxygen saturation.
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- 2013
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116. eComment. Gender mismatching in lung transplantation: lung size mismatch is the issue!
- Author
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Eberlein M, Bolukbas S, and Reed RM
- Subjects
- Female, Humans, Male, Donor Selection, Graft Survival, Lung Transplantation, Tissue Donors
- Published
- 2013
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117. Nonalcoholic fatty liver disease and serum lipoproteins: the Multi-Ethnic Study of Atherosclerosis.
- Author
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DeFilippis AP, Blaha MJ, Martin SS, Reed RM, Jones SR, Nasir K, Blumenthal RS, and Budoff MJ
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- Aged, Aged, 80 and over, Blood Glucose metabolism, Cross-Sectional Studies, Dose-Response Relationship, Drug, Ethnicity, Female, Humans, Liver pathology, Male, Middle Aged, Non-alcoholic Fatty Liver Disease, Phenotype, Prevalence, Prospective Studies, Risk Factors, Spleen pathology, Atherosclerosis blood, Atherosclerosis ethnology, Fatty Liver blood, Fatty Liver ethnology, Lipoproteins blood
- Abstract
Objective: While nonalcoholic fatty liver disease (NAFLD) is associated with the metabolic syndrome, it is not known if NAFLD plays an independent role in the atherogenic dyslipidemia phenotype., Methods and Results: The Multi-Ethnic Study of Atherosclerosis (MESA) is a population-based prospective cohort study of adults free of clinical cardiovascular disease at enrollment. We tested for a relationship between NAFLD, defined as a liver/spleen (L/S) attenuation ratio of <1 on a non-contrast cardiac CT scan, and multiple measures of fasting serum lipoprotein size, cholesterol and particle concentrations. NAFLD was present in 569 (17%) of 3362 participants. After adjustment for multiple metabolic risk factors, adiposity and measures of insulin resistance (HOMA-IR), NAFLD was independently associated with higher fasting serum triglycerides and lower serum HDL-C. Despite a lack of association with LDL-C, NAFLD was associated with higher LDL particle concentration and lower LDL particle size. Modeling the L/S ratio as a continuous variable, a severity dependent association was observed between atherogenic lipoprotein abnormalities and NAFLD., Conclusion: In a large, multi-ethnic, gender balanced cohort, CT-diagnosed NAFLD was associated with the atherogenic dyslipidemia phenotype in a dose dependent fashion. These relationships persisted after adjustment for several metabolic risk factors and HOMA-IR, suggesting a possible independent pathophysiologic role between NAFLD and dyslipidemia., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2013
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118. The effect of lung-size mismatch on mechanical ventilation tidal volumes after bilateral lung transplantation.
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Dezube R, Arnaoutakis GJ, Reed RM, Bolukbas S, Shah AS, Orens JB, Brower RG, and Eberlein M
- Subjects
- Adult, Analysis of Variance, Body Weight, Bronchiolitis Obliterans etiology, Bronchiolitis Obliterans physiopathology, Female, Humans, Kaplan-Meier Estimate, Lung pathology, Lung physiopathology, Lung Diseases pathology, Lung Diseases physiopathology, Male, Middle Aged, Organ Size, Primary Graft Dysfunction etiology, Primary Graft Dysfunction physiopathology, Reoperation, Risk Factors, Time Factors, Total Lung Capacity, Tracheotomy, Treatment Outcome, Donor Selection, Lung surgery, Lung Diseases surgery, Lung Transplantation adverse effects, Respiration, Artificial adverse effects, Tidal Volume
- Abstract
Objectives: Mechanical ventilation tidal volumes are usually set according to an estimate of patient size in millilitres (ml) per kilogram (kg) body weight. We describe the relationship between donor-recipient lung-size mismatch and postoperative mechanical ventilation tidal volumes according to recipient- and donor-predicted body weights in a cohort of bilateral lung transplant patients., Methods: A most-undersized (10 patients with lowest predicted total lung capacity [pTLC] ratio = pTLC-donor/pTLC-recipient), a most-oversized (10 patients with highest pTLC ratio) and best-matched subset (10 patients with predicted total lung capacity ratio closest to 1.0) were selected within a cohort of 70 patients. All tidal volumes during mechanical ventilation in the first 96 h after bilateral lung transplantation were recorded. Tidal volumes were expressed in ml and ml/kg-recipient-predicted body weights and ml/kg-donor-predicted body weights., Results: Postoperative absolute tidal volumes (in ml) were comparable between subsets of patients with undersized, matched and oversized allografts (552 ± 103 vs 581 ± 107 vs 582 ± 104 ml), and tidal volumes in ml/kg-recipient-predicted body weights were also similar (8.8 ± 1.4 vs 9.3 ± 1.1 vs 9.8 ± 2.1). However, tidal volumes in ml/kg-donor-predicted body weights revealed significant differences between undersized, matched, and oversized subsets (11.4 ± 3.1 vs 9.4 ± 1.2 vs 8.1 ± 2.1, respectively; P < 0.05). Two patients developed primary graft dysfunction grade 3, both in the undersized subset. Four patients in the undersized group underwent tracheotomy (vs none in matched and one in oversized subset)., Conclusions: During mechanical ventilation after bilateral lung transplantation, undersized allografts received relatively higher tidal volumes compared with oversized allografts when the tidal volumes were related to donor-predicted body weights.
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- 2013
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119. Coronary artery disease is under-diagnosed and under-treated in advanced lung disease.
- Author
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Reed RM, Eberlein M, Girgis RE, Hashmi S, Iacono A, Jones S, Netzer G, and Scharf S
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- Adrenergic beta-Antagonists therapeutic use, Aged, Angiotensin Receptor Antagonists therapeutic use, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Antihypertensive Agents therapeutic use, Calcium Channel Blockers therapeutic use, Cardiac Catheterization, Coronary Angiography, Coronary Artery Disease epidemiology, Cross-Sectional Studies, Drug Utilization, Female, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Hypertension drug therapy, Hypertension epidemiology, Male, Middle Aged, Platelet Aggregation Inhibitors therapeutic use, Retrospective Studies, Severity of Illness Index, Coronary Artery Disease diagnosis, Coronary Artery Disease drug therapy, Lung Diseases, Interstitial epidemiology, Pulmonary Disease, Chronic Obstructive epidemiology
- Abstract
Background: Coronary artery disease is a potentially treatable comorbidity observed frequently in both chronic obstructive pulmonary disease and interstitial lung disease. The prevalence of angiographically proven coronary artery disease in advanced lung disease is not well described. We sought to characterize the treatment patterns of coronary artery disease complicating advanced lung disease and to describe the frequency of occult coronary artery disease in this population., Methods: We performed a 2-center, retrospective cross-sectional study of patients with either chronic obstructive pulmonary disease or interstitial lung disease evaluated for lung transplantation. Medications and diagnoses before the transplant evaluation were recorded in conjunction with left heart catheterization results., Results: Of 473 subjects, 351 had chronic obstructive pulmonary disease, and 122 had interstitial lung disease. In subjects diagnosed clinically with coronary artery disease, medical regimens included a statin in 78%, antiplatelet therapy in 62%, angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in 42%, and a beta-blocker in 37%. Ten percent were on no medication from these 4 classes. Fifty-seven percent of these subjects were on an antiplatelet agent as well as a statin, and 13% were on neither. Beta-blockers were less frequently prescribed in chronic obstructive pulmonary disease than interstitial lung disease (23% vs 58%, P=.007). Coronary angiography was available in 322 subjects. It demonstrated coronary artery disease in 60% of subjects, and severe coronary artery disease in 16%. Occult coronary artery disease and severe occult coronary artery disease were found in 53% and 9%, respectively. There were no significant differences in angiographic results between chronic obstructive pulmonary disease and interstitial lung disease, despite imbalanced risk factors., Conclusions: Coronary artery disease is common in patients with advanced lung disease attributable to chronic obstructive pulmonary disease or interstitial lung disease and is under-diagnosed. Guideline-recommended cardioprotective medications are suboptimally utilized in this population., (Copyright © 2012 Elsevier Inc. All rights reserved.)
- Published
- 2012
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120. Parameters of donor-recipient size mismatch and survival after bilateral lung transplantation.
- Author
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Eberlein M, Reed RM, Permutt S, Chahla MF, Bolukbas S, Nathan SD, Iacono A, Pearse DB, Fessler HE, Shah AS, Orens JB, and Brower RG
- Subjects
- Adult, Body Height, Cohort Studies, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Organ Size, Proportional Hazards Models, Retrospective Studies, Sex Factors, Survival Rate, Total Lung Capacity, Treatment Outcome, Lung pathology, Lung Transplantation mortality, Lung Transplantation pathology, Tissue Donors, Transplantation
- Abstract
Background: The purpose of this study was to investigate the relationship between donor-recipient height, gender and predicted estimates of total lung capacity (pTLC) mismatches and post-transplant survival., Methods: The lung transplant databases at three programs were reviewed. The pTLC ratios (donor pTLC/recipient pTLC) and height ratios (donor height/recipient height) were calculated retrospectively. Patients were grouped according to pTLC ratio ≤1.0 or >1.0 and height ratio ≤1.0 or >1.0, and according to gender (mis-)matching. A time-to-event analysis was performed for risk of death after transplantation conditional on 30-day survival using Kaplan-Meier survival and Cox proportional hazard models., Results: There were 211 adult bilateral lung transplant recipients who qualified for the analysis. Mean follow-up was comparable for all cohorts (range 2.21 to 3.85 years). In the univariate Cox proportional hazard models, a pTLC ratio >1.0 (HR 0.43, p = 0.002) and a height ratio >1.0 (HR 0.61, p = 0.03) were associated with better survival, and a female-donor-to-male-recipient gender mismatch (F-to-M) was associated with worse survival (HR 2.35, p = 0.01). In the multivariate Cox proportional hazard model accounting for F-to-M gender mismatch and height ratio >1.0, a pTLC ratio >1.0 remained associated with survival (HR 0.38, p = 0.015). However, accounting for a pTLC ratio >1.0, a height ratio of >1.0 and F-to-M mismatch were not associated with survival., Conclusions: A pTLC ratio >1.0 is associated with improved survival after bilateral lung transplantation. The pTLC ratio might better reflect allograft-thorax mismatch than the height ratio, as it also accounts for effects of gender on lung and thoracic volumes., (Copyright © 2012 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2012
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121. At the twisted heart of nicotine addiction.
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Suffredini DA and Reed RM
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- Diagnosis, Differential, Heart Diseases diagnosis, Humans, Male, Middle Aged, Pulmonary Disease, Chronic Obstructive diagnosis, Tobacco Use Disorder diagnosis, Tomography, X-Ray Computed, Electrocardiography, Heart Diseases etiology, Pulmonary Disease, Chronic Obstructive complications, Tobacco Use Disorder complications
- Abstract
This case report reviews the ECG manifestations of chronic obstructive pulmonary disease (COPD). Distinct changes of the P-wave axis, QRS axis and morphology are a direct result of the pathophysiological and anatomical changes associated with COPD. These changes are illustrated in a patient with a history of COPD presenting with hypoxaemia and symptoms of shortness of breath.
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- 2012
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122. The effect of lung size mismatch on complications and resource utilization after bilateral lung transplantation.
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Eberlein M, Arnaoutakis GJ, Yarmus L, Feller-Kopman D, Dezube R, Chahla MF, Bolukbas S, Reed RM, Klesney-Tait J, Parekh KR, Merlo CA, Shah AS, Orens JB, and Brower RG
- Subjects
- Adult, Baltimore, Female, Follow-Up Studies, Humans, Length of Stay, Lung Transplantation mortality, Male, Middle Aged, Organ Size, Prospective Studies, Retrospective Studies, Survival Rate, Transplantation, Homologous, Health Resources statistics & numerical data, Lung pathology, Lung Transplantation pathology
- Abstract
Background: Oversizing the lung allograft, as estimated by a donor-to-recipient predicted total lung capacity (pTLC) ratio > 1.0, was associated with improved long-term survival after lung transplantation (LTx) but could be associated with increased post-operative complications and higher resource utilization., Methods: The prospectively maintained LTx database at The Johns Hopkins Hospital was retrospectively reviewed for bilateral LTx patients in the post-Lung Allocation Score (LAS) era. Patients were grouped by pTLC ratio ≤ 1.0 (undersized) or > 1.0 (oversized). Post-operative complications and hospital charges were analyzed., Results: The pTLC ratio was available for 70 patients: 31 were undersized and 39 oversized. Undersized patients had a higher LAS (40.4 vs 35.8, p = 0.009), were more often in the intensive care unit (ICU) pre-LTx (35% vs 10%, p = 0.01), and had a higher occurrence of primary graft dysfunction (PGD; 25% vs 5%, p = 0.013) and tracheostomy (32% vs 10%, p = 0.02), longer index hospitalizations (20 [interquartile range (IQR), 10-46] vs 16 [IQR, 12-25] days, p = 0.048), and higher index hospitalization charges ($176,247 [IQR, $137,646-$284,012] vs $158,492 [IQR, $136,250-$191,301], p = 0.04). After adjusting for LAS and pre-LTx ICU stay, a lower pTLC ratio remained associated with higher hospital charges (p = 0.049). Airway complications were more frequent and severe in undersized patients., Conclusion: Oversized allografts were not associated with an increase in post-LTx complications. However, LTx recipients of undersized allografts were more likely to experience PGD, tracheostomy, and had higher resource utilization. Higher acuity in the undersized group might explain these findings; however, multivariate models suggest an independent association between undersizing, PGD, and resource utilization., (Published by Elsevier Inc.)
- Published
- 2012
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123. Unraveling the paradox of cardiac tamponade: case presentation and discussion of physiology.
- Author
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Reed RM, Ramani GV, and Hashmi S
- Subjects
- Anticoagulants therapeutic use, Cardiac Tamponade etiology, Cardiac Tamponade surgery, Diagnosis, Differential, Electrocardiography, Humans, Male, Middle Aged, Pericardial Effusion complications, Pericardial Effusion surgery, Pulmonary Embolism drug therapy, Tomography, X-Ray Computed, Warfarin therapeutic use, Cardiac Tamponade diagnosis, Pericardial Effusion diagnosis
- Abstract
A 53-year-old man on warfarin for postoperative pulmonary embolism presented with chest pain and was found to be in cardiac tamponade due to an atraumatic haemopericardium. Findings of tamponade and a novel approach to the pathophysiology of pericardial disease to explain these finding are presented.
- Published
- 2012
- Full Text
- View/download PDF
124. Increased adverse events after percutaneous coronary intervention in patients with COPD.
- Author
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Reed RM and Scharf S
- Subjects
- Female, Humans, Male, Angioplasty, Balloon, Coronary, Coronary Artery Disease epidemiology, Coronary Artery Disease therapy, Pulmonary Disease, Chronic Obstructive epidemiology
- Published
- 2012
- Full Text
- View/download PDF
125. Lung size mismatch in bilateral lung transplantation is associated with allograft function and bronchiolitis obliterans syndrome.
- Author
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Eberlein M, Permutt S, Chahla MF, Bolukbas S, Nathan SD, Shlobin OA, Shelhamer JH, Reed RM, Pearse DB, Orens JB, and Brower RG
- Subjects
- Adult, Analysis of Variance, Female, Humans, Least-Squares Analysis, Male, Organ Size, Proportional Hazards Models, Respiratory Function Tests, Retrospective Studies, Bronchiolitis Obliterans etiology, Lung anatomy & histology, Lung Transplantation, Postoperative Complications etiology
- Abstract
Background: Size mismatch between donor lungs and a recipient thorax could affect the major determinants of maximal expiratory airflow: airway resistance, propensity of airways to collapse, and lung elastic recoil., Methods: A retrospective review of 159 adults who received bilateral lung transplants was performed. The predicted total lung capacity (pTLC) for donors and recipients was calculated based on sex and height. Size matching was represented using the following formula: pTLC ratio = donor pTLC / recipient pTLC. Patients were grouped according to those with a pTLC ratio > 1.0 (oversized) or those with a pTLC ratio ≤ 1.0 (undersized). Allograft function was analyzed in relation to the pTLC ratio and to recipient and donor predicted function., Results: The 96 patients in the oversized cohort had a mean pTLC ratio of 1.16 ± 0.13 vs 0.89 ± 0.09 in the 63 patients of the undersized group. At 1 to 6 months posttransplant, the patients in the oversized cohort had higher FEV(1)/FVC ratios (0.895 ± 0.13 vs 0.821 ± 0.13, P < .01) and lower time constant estimates of lung emptying (0.38 ± 0.2 vs 0.64 ± 0.4, P < .01) than patients in the undersized cohort. Although the FVCs expressed as % predicted for the recipient were not different between cohorts, the FVCs expressed as % predicted for the donor organ were lower in the oversized cohort compared with the undersized cohort (at 1-6 months, 52.4% ± 17.1% vs 65.3% ± 18.3%, P < .001). Kaplan-Meier estimates for the occurrence of bronchiolitis obliterans syndrome (BOS) showed that patients in the oversized cohort had a lower probability of BOS (P < .001)., Conclusions: A pTLC ratio > 1.0, suggestive of an oversized allograft, is associated with higher expiratory airflow capacity and a less frequent occurrence of BOS.
- Published
- 2012
- Full Text
- View/download PDF
126. Severe pulmonary hypertension in idiopathic nonspecific interstitial pneumonia.
- Author
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Hallowell RW, Reed RM, Fraig M, Horton MR, and Girgis RE
- Abstract
Pulmonary hypertension (PH) is a common complication of interstitial lung disease (ILD), particularly in idiopathic pulmonary fibrosis (IPF) and ILD associated with connective tissue disease, where the underlying pathology is often a nonspecific interstitial pneumonia (NSIP) pattern. The degree of PH in ILD is typically mild to moderate and radiographic changes of ILD are usually prominent. We describe four patients with idiopathic NSIP and severe PH (mPAP > 40 mmHg). The average mean pulmonary artery pressure was 51±7 mmHg and pulmonary vascular resistance was 13±4 Wood's units. Pulmonary function was characterized by mild restriction (total lung capacity 63-94% predicted) and profound reductions in DLCO (19-53% predicted). Computed tomographic imaging revealed minimal to moderate interstitial thickening without honeycombing. In two of the cases, an initial clinical diagnosis of idiopathic pulmonary arterial hypertension was made. Both were treated with intravenous epoprostenol, which was associated with worsening of hypoxemia. All four patients died or underwent lung transplant within 4 years of PH diagnonsis. Lung pathology in all four demonstrated fibrotic NSIP with medial thickening of the small and medium pulmonary arteries, and proliferative intimal lesions that stained negative for endothelial markers (CD31 and CD34) and positive for smooth muscle actin. There were no plexiform lesions. Severe pulmonary hypertension can therefore occur in idiopathic NSIP, even in the absence of advanced radiographic changes. Clinicians should suspect underlying ILD as the basis for PH when DLCO is severely reduced or gas exchange deteriorates with pulmonary vasodilator therapy.
- Published
- 2012
- Full Text
- View/download PDF
127. Impact of lung transplantation on serum lipids in COPD.
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Reed RM, Hashmi S, Eberlein M, Iacono A, Netzer G, DeFilippis A, Girgis RE, Toth PP, Scharf S, and Jones S
- Subjects
- Cholesterol, HDL drug effects, Cholesterol, LDL drug effects, Female, Humans, Immunosuppressive Agents therapeutic use, Lung Transplantation immunology, Male, Middle Aged, Pulmonary Disease, Chronic Obstructive immunology, Pulmonary Disease, Chronic Obstructive surgery, Retrospective Studies, Tacrolimus therapeutic use, Cholesterol, HDL blood, Cholesterol, LDL blood, Lung Transplantation adverse effects, Pulmonary Disease, Chronic Obstructive blood, Triglycerides blood
- Abstract
Background: Severe chronic obstructive pulmonary disease is associated with high HDL cholesterol (HDL-C). We sought to examine the effect of lung transplantation on lipid profiles in patients with COPD., Methods: We analyzed 101 lung transplant recipients in a retrospective cohort of patients from two centers in whom lipid values were available both before as well as after transplantation. Sixty-one subjects were transplanted for severe COPD (93% GOLD stage 4)., Results: Eighty-nine percent of subjects with COPD exhibited a decline in HDL-C. Median decline for the COPD cohort was 25 mg/dL (IQR 12-38 mg/dL, p < 0.0001). Non-COPD subjects exhibited no significant changes in HDL-C. Other lipid changes in the COPD cohort included a rise in triglycerides of 70 mg/dL (IQR 35 to 140, p < 0.0001). Decreases in HDL-C levels were independent from the rise in triglyceride levels. Neither LDL-C nor non-HDL-C demonstrated significant changes. Subjects with greater increases in prednisone exposure post-transplant exhibited lesser declines in HDL-C. Compared with tacrolimus, cyclosporine had no effect on observed changes in HDL-C or triglycerides, but was associated with a greater median rise in LDL-C., Conclusions: In patients with COPD, lung transplantation results in reductions in the serum levels of HDL-C. These changes are not observed in patients undergoing lung transplantation for diagnoses other than COPD., (Copyright © 2011 Elsevier Ltd. All rights reserved.)
- Published
- 2011
- Full Text
- View/download PDF
128. Cellular immunoisolation for islet transplantation by a novel dual porosity electrospun membrane.
- Author
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Krishnan L, Clayton LR, Boland ED, Reed RM, Hoying JB, and Williams SK
- Subjects
- Animals, Cell Culture Techniques, Cell Separation instrumentation, Cell-Derived Microparticles, Hypoxia, Immunohistochemistry methods, Insulin metabolism, Islets of Langerhans Transplantation instrumentation, Membranes, Artificial, Mice, Microscopy, Electron, Scanning methods, Porosity, Transplantation, Heterologous methods, Cell Separation methods, Islets of Langerhans Transplantation methods
- Abstract
Immunoisolation strategies have the potential to impact the treatment of several diseases, such as hemophilia, Parkinson's and endocrine disorders, such as parathryroid disorders and diabetes. The hallmark of these disease states is the amelioration of the disease process by replacement of the deficient protein. Naturally, several cellular therapeutic strategies like genetically modified host cells, stem cells, donor cells, or even complex tissues like pancreatic islets have been investigated. Current evidence suggests that successful strategies must incorporate considerations for local hypoxia, vascularity, and immunoisolation. Additional regulatory concerns also include safe localization of implanted therapeutic cells to allow for monitoring, dose adjustment, or removal when indicated. Local hypoxia and cellular toxicity can be detrimental to the survival of freshly implanted pancreatic islets, leading to a need for a larger initial number of islets or repeated implantation procedures. The lack of adequate donors and the large number of islet equivalents needed to achieve euglycemic states amplify the nature of this problem. We have developed a novel immunoisolation device based on electrospun nylon, primarily for islet transplantation, such that the inner component functions as a cellular barrier while allowing diffusion, whereas the outer component can be optimized for tissue integration and accelerated vascularization. Devices explanted after subcutaneous implantation in wild-type B6 mice after a period of 30 days show vascular elements in the outer layer of the electrospun device. The inner layer when intact functioned as an effective barrier to cellular infiltration. The preimplantation of such a device, with a relatively thin inner barrier membrane, will allow for adequate vascularization and reduce postimplantation hypoxia. This study demonstrates the feasibility of an electrospun isolation device that can be easily assembled, modified by varying the electrospinning parameters, and functionalized with surface-active molecules to accelerate vascularization., (Copyright © 2011 Elsevier Inc. All rights reserved.)
- Published
- 2011
- Full Text
- View/download PDF
129. Advanced chronic obstructive pulmonary disease is associated with high levels of high-density lipoprotein cholesterol.
- Author
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Reed RM, Iacono A, DeFilippis A, Eberlein M, Girgis RE, and Jones S
- Subjects
- Case-Control Studies, Cholesterol, HDL drug effects, Cholesterol, LDL blood, Coronary Artery Disease blood, Coronary Artery Disease epidemiology, Female, Glucocorticoids pharmacology, Humans, Lung Transplantation, Male, Middle Aged, Prednisone pharmacology, Prospective Studies, Pulmonary Disease, Chronic Obstructive epidemiology, Retrospective Studies, Risk Factors, Severity of Illness Index, Sex Factors, Cholesterol, HDL blood, Pulmonary Disease, Chronic Obstructive blood
- Abstract
Background: Chronic obstructive pulmonary disease (COPD) is an inflammatory systemic disease associated with numerous extrapulmonary manifestations. Amongst these is an increased risk for cardiovascular disease. The mechanisms for this association remain unclear. We sought to examine lipid trends in a well-characterized cohort of patients with severe COPD., Methods: We conducted a retrospective prospective analysis of 126 consecutive individuals evaluated for lung transplantation with a diagnosis of COPD in whom lipid values were available. Observed lipid values were compared with a reference population without severe COPD., Results: Compared with the reference population, mean low-density lipoprotein cholesterol (LDL-C) levels were slightly reduced at 108 ± 44 vs 117 ± 29.5 mg/dl (p = 0.02) in men but were no different in women. Mean high-density lipoprotein cholesterol (HDL-C) levels were significantly elevated at 62 ± 24 vs 45 ± 12 mg/dl (p < 0.0001) in men and at 83 ± 27 vs 59 ± 16 mg/dl in women (p < 0.0001). Prednisone use correlated with higher HDL-C levels but did not fully explain the extent of elevation. Angiographically proven coronary artery disease was found in 61% of individuals and was unrelated to HDL-C levels., Conclusions: Severe COPD is associated with increased levels of HDL-C, which is partially attributable to oral steroid use. HDL-C in this population is not associated with reduced risk of angiographically proven coronary artery disease., (Copyright © 2011 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2011
- Full Text
- View/download PDF
130. Statin therapy is associated with decreased pulmonary vascular pressures in severe COPD.
- Author
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Reed RM, Iacono A, DeFilippis A, Jones S, Eberlein M, Lechtzin N, and Girgis RE
- Subjects
- Aged, Atorvastatin, Cross-Sectional Studies, Female, Heptanoic Acids pharmacology, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors pharmacology, Hypertension, Pulmonary complications, Male, Middle Aged, Pulmonary Disease, Chronic Obstructive complications, Pyrroles pharmacology, Regression Analysis, Simvastatin pharmacology, Heptanoic Acids therapeutic use, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Hypertension, Pulmonary drug therapy, Pulmonary Disease, Chronic Obstructive drug therapy, Pulmonary Wedge Pressure drug effects, Pyrroles therapeutic use, Simvastatin therapeutic use
- Abstract
Background: Pulmonary hypertension (PH) in COPD carries a poor prognosis. Statin therapy has been associated with numerous beneficial clinical effects in COPD, including a possible improvement in PH. We examined the association between statin use and pulmonary hemodynamics in a well-characterized cohort of patients undergoing evaluation for lung transplantation., Methods: We conducted a cross-sectional analysis of 112 subjects evaluated for lung transplant with a diagnosis of COPD. Clinical characteristics, pulmonary function, cardiac catheterization findings and medical comorbidities were compared between statins users and non-users., Results: Thirty-four (30%) subjects were receiving statin therapy. Statin users were older and had an increased prevalence of systemic hypertension and coronary artery disease (CAD). Mean pulmonary arterial pressure (mPAP) in the statin group was lower [26 ± 7 vs 29 ± 7 mmHg, p = 0.02], as was pulmonary artery wedge pressure (PAWP) [12 ± 5 vs. 15 ± 6 mmHg, p = 0.02]. Pulmonary vascular resistance did not differ between the groups. In multiple regression analysis, statin use was associated with a 4.2 mmHg (95% CI: 2 to 6.4, p = <0.001) lower PAWP and a 2.6 mmHg (95% CI: 0.3 to 4.9, p = 0.03) reduction in mPAP independent of PAWP., Conclusions: In patients with severe COPD, statin use is associated with significantly lower PAWP and mPAP. These finding should be evaluated prospectively.
- Published
- 2011
- Full Text
- View/download PDF
131. Elevated HDL cholesterol levels are associated with osteoporosis in lung transplant candidates with chronic obstructive pulmonary disease.
- Author
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Reed RM, Wise RA, Dobs AS, Lechtzin N, and Girgis RE
- Subjects
- Absorptiometry, Photon, Adult, Aged, Body Mass Index, Bone Density physiology, Female, Humans, Lung Transplantation, Male, Middle Aged, Osteoporosis diagnostic imaging, Osteoporosis etiology, Osteoporosis physiopathology, Quality of Life, Risk Factors, Cholesterol, HDL blood, Osteoporosis blood, Pulmonary Disease, Chronic Obstructive complications
- Abstract
Background: Osteoporosis is common in advanced COPD and worsens rapidly after transplantation, potentially impairing quality of life. Increased high density lipoprotein cholesterol (HDLc) has been observed in COPD and linked with osteoporosis in the general population. This association has not been previously examined in COPD., Methods: We reviewed the records of 245 COPD patients referred for lung transplant evaluation. Osteoporosis was defined by either dual energy X-ray absorptiometry scan or use of osteoporosis medications. The presence or absence of osteoporosis could be ascertained in 152 subjects. Cholesterol values and other clinical variables were assessed for their association with osteoporosis., Results: Clinical factors associated with osteoporosis included lower BMI [OR 0.81, 95% CI 0.73-0.90], higher HDLc [OR 1.04, 95% CI 1.02 to 1.07], and worse lung function. HDLc was an independent predictor of OP and demonstrated an inverse linear correlation with T-scores (r = -0.21, p = 0.05), which was stronger amongst males (r = -0.45, p = 0.004)., Conclusion: In COPD patients referred for lung transplantation, osteoporosis is highly prevalent. Raised HDLc levels are common in this group and are independently associated with OP., (Copyright © 2010 Elsevier Ltd. All rights reserved.)
- Published
- 2010
- Full Text
- View/download PDF
132. Captain Ignose to the rescue.
- Author
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Reed RM
- Subjects
- Aged, Disease Progression, Humans, Male, Keratoderma, Palmoplantar complications, Pulmonary Disease, Chronic Obstructive complications, Scurvy complications, Scurvy diagnosis, Smoking adverse effects
- Published
- 2010
- Full Text
- View/download PDF
133. An evolutionary perspective on the interaction of age and sex differences in short-term sexual strategies.
- Author
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Mathes EW, King CA, Miller JK, and Reed RM
- Subjects
- Adolescent, Adult, Age Factors, Female, Humans, Interpersonal Relations, Male, Sex Factors, Time Factors, Sexual Behavior
- Abstract
Buss and Schmitt's sexual strategies theory (1993) suggests that short-term mating represents a larger component of men's than women's mating strategies. Assuming this sex difference there is potential for conflict. Symons argued that, because men are more interested in copulation than women, this gives women greater power in establishing conditions (short- vs long-term) under which copulation takes place. The result is that the conflict in sexual strategies is resolved in favor of women's relatively greater interest in long-term sexual strategies. This research tested the hypothesis that across ages men would decrease in desire to employ short-term mating strategies in favor of long-term mating strategies. Specifically, in Study I, men and women in their teens, twenties, and thirties or older were given a measure of desire for a committed relationship. It was predicted that women, regardless of age, would score high on desire for a committed relationship. In contrast, teenage boys would score low on desire for a committed relationship while men in their thirties or older would score as high as the women. In Study II both sexes in their teens, twenties, and thirties or older were given measures of desire for promiscuous sex. It was predicted that the women, regardless of age, would score low on desire for promiscuous sex. In contrast, teenage boys would score high on desire for promiscuous sex while men in their thirties or older would score as low as the women. Support was found for both predictions.
- Published
- 2002
- Full Text
- View/download PDF
134. Combination of phenobarbital and haloperidol in resistant schizophrenia.
- Author
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Prakash R, Reed RM, and Bass AD
- Subjects
- Adult, Drug Resistance, Drug Therapy, Combination, Humans, Male, Prolactin blood, Haloperidol therapeutic use, Phenobarbital therapeutic use, Schizophrenia drug therapy
- Published
- 1984
- Full Text
- View/download PDF
135. Association of the human Lewis blood group Le(a-b-c-d-) with the failure of expression of alpha-3-L fucosyltransferase.
- Author
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Greenwell P, Johnson PH, Edwards JM, Reed RM, Moores PP, Bird A, Graham HA, and Watkins WM
- Subjects
- Black People, Female, Fucosyltransferases blood, Humans, Male, Pedigree, Phenotype, Saliva enzymology, South Africa ethnology, Texas ethnology, Black or African American, Fucosyltransferases genetics, Gene Expression Regulation, Hexosyltransferases genetics, Lewis Blood Group Antigens genetics
- Abstract
Two unrelated individuals are reported who lack alpha-3-L-fucosyltransferase activity in their serum and saliva. Both were blacks, one from the United States and the other from South Africa. No other of the tested members of their families lacked this enzyme. A survey of more than 2000 serum samples from both black and white South African blood donors, black United States donors and white United Kingdom donors failed to disclose another example of a serum deficient in alpha-3-L-fucosyltransferase activity. The two individuals lacking in alpha-3-L-fucosyltransferase activity both had the Lewis blood group phenotype Le(a-b-c-d-). No other persons with this phenotype have been reported. The absence of Lec activity in the two individuals who are deficient in alpha-3-L-fucosyltransferase is consistent with the interpretation that alpha-3-linked L-fucose is an essential part of the antigenic determinant recognised by the anti-Lec reagent used in this investigation.
- Published
- 1986
- Full Text
- View/download PDF
136. Physician and dietitians combine forces in an inservice education program.
- Author
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Reed RM
- Subjects
- California, Education, Continuing, Humans, Food Service, Hospital education
- Published
- 1967
137. Food service and dietetics: using past records to lower future costs.
- Author
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REED RM
- Subjects
- Humans, Costs and Cost Analysis, Dietetics, Food Service, Hospital, Food Services
- Published
- 1962
138. METHODS IMPROVEMENT AND THE STATUS QUO.
- Author
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REED RM
- Subjects
- Humans, United States, Food Service, Hospital
- Published
- 1964
139. Food service: conventional system may be best.
- Author
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Reed RM
- Subjects
- California, Consumer Behavior, Food Preservation, Food Service, Hospital
- Published
- 1973
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