Publications by authors named "Coghlan J"

Background: Acromial stress fractures can occur after reverse total shoulder arthroplasty (RTSA). We performed this study to assess the incidence, risk factors, characteristics, and outcome of acromial stress fractures and reactions after RTSA.

Methods: We determined the incidence of acromial stress fractures and reactions in a cohort of patients who underwent RTSA, and assessed risk factors using a case-control design.

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Background: Avoiding inclination of the glenoid baseplate in reverse shoulder arthroplasty often requires considerable glenoid reaming. It is proposed that the use of a metal wedged baseplate in all patients can achieve neutral inclination with reduced glenoid reaming.

Materials And Methods: A prospective clinical single-centre study with minimum two-year follow-up was carried out.

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Objectives: We examined adverse event (AE) reports relating to cabotegravir/rilpivirine (CAB/RPV) in the US FDA Adverse Event Reporting System (FAERS), focusing on therapeutic failure (TF) and non-therapeutic failure (NTF) outcomes.

Methods: FAERS is a database of AE and medication error reports from post-marketing surveillance. The study was granted exempt approval by the Binghamton University Institutional Review Board.

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Article Synopsis
  • Systemic sclerosis complicated by pulmonary arterial hypertension (SSc-PAH) presents significant risks, and this study aimed to evaluate if exercise-based cardiac assessments could predict patient outcomes better than traditional resting measures.
  • Fifty intermediate-risk SSc-PAH patients underwent cardio MRI during exercise, finding that most had normal resting cardiac metrics but that peak exercise indicators, specifically RV indexed end-systolic volume (ESVi), were key for predicting survival.
  • The study concluded that exercise CMR could help identify patients at higher risk of mortality, enhancing risk assessment practices even when resting tests appear normal.
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Background: In the EDITA trial, patients with systemic sclerosis (SSc) and mild pulmonary vascular disease (PVD) treated with ambrisentan had a significant decline of pulmonary vascular resistance (PVR) but not of mean pulmonary arterial pressure (mPAP) vs. placebo after six months. The EDITA-ON study aimed to assess long-term effects of open label therapy with ambrisentan vs.

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Article Synopsis
  • The study investigates how heart size and function, measured through cardiovascular magnetic resonance (CMR), can predict outcomes in patients with pulmonary hypertension associated with systemic sclerosis (SSc-PH).
  • Out of 148 SSc-PH patients monitored over a median of 3.5 years, 45% died, with findings indicating that older age, right ventricular dilation, and higher native myocardial T1 values were linked to increased mortality risk.
  • Importantly, right ventricular end-systolic volume index (RVESVi) and native T1 were identified as independent predictors of mortality, with specific thresholds set for better patient outcomes, highlighting the significance of myocardial tissue characterization in prognosis.
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Systemic sclerosis is an autoimmune disease characterized by fibrosis and small vessel vasculopathy, which affects various organ systems, such as the heart. Takotsubo cardiomyopathy is a transient cardiomyopathy in reaction to an emotional or physical trigger. There may be clinical and pathogenetic overlap between Takotsubo cardiomyopathy and primary systemic sclerosis heart disease, and some patients with systemic sclerosis have been diagnosed with recurrent Takotsubo cardiomyopathy.

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Pulmonary arterial hypertension (PAH) is characterised by pulmonary vascular remodelling causing premature death from right heart failure. Established DNA variants influence PAH risk, but susceptibility from epigenetic changes is unknown. We addressed this through epigenome-wide association study (EWAS), testing 865,848 CpG sites for association with PAH in 429 individuals with PAH and 1226 controls.

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Article Synopsis
  • The DETECT algorithm is used to screen for pulmonary arterial hypertension (PAH) in patients with systemic sclerosis (SSc) using noninvasive data and guiding referrals for further testing.
  • A recent analysis showed that the performance of DETECT in identifying PAH risk using the updated 2022 ESC/ERS definitions was slightly less sensitive (88.2%) compared to the previous 2014 definitions (95.8%), but its specificity improved.
  • Despite the changes in PAH definitions, DETECT remains a valid tool for screening PAH in SSc patients, confirming its ongoing relevance in clinical practice.
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Article Synopsis
  • - ATTR-CM is a form of heart failure linked to a specific TTR gene mutation (p.(V142I)) prevalent in 3-4% of individuals of African descent, potentially affecting 1.6 million people in the U.S.
  • - A study analyzed 413 patients with this mutation, finding that they had significant heart functional impairment and lower 5-year survival rates compared to patients with wild-type ATTR-CM, emphasizing the seriousness of the condition.
  • - The aggressive nature of p.(V142I)-ATTRv-CM was highlighted by findings of myocyte loss and widespread infiltration in the heart muscle, indicating a high risk for biventricular failure and poor patient outcomes.
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Pulmonary hypertension (PH) is common, with an estimated prevalence of approximately 1% that increases with age. Prompt and accurate diagnosis is key to institute timely and appropriate therapy to improve symptoms and prognosis. The international guidelines for the diagnosis and management of PH have recently been updated, with a lowering of the haemodynamic threshold for diagnosis to a mean pulmonary artery pressure >20 mmHg.

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Background: Acromioclavicular joint (ACJ) Osteoarthritis (OA) is very common in the general population. Despite this, there is little mention of concomitant glenohumeral and ACJ arthropathy in the literature, and no documented incidence of symptomatic ACJ OA post total shoulder arthroplasty (TSA). We present the incidence and timescale of the problem, and the response to treatments.

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Background And Aims: Interventional studies in pulmonary arterial hypertension completed to date have shown to be effective in symptomatic patients with significantly elevated mean pulmonary artery pressure (mPAP) (≥25 mmHg) and pulmonary vascular resistance (PVR) > 3 Wood Unit (WU). However, in health the mPAP does not exceed 20 mmHg and PVR is 2 WU or lower, at rest. The ESC/ERS guidelines have recently been updated to reflect this.

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Objectives: Pulmonary arterial hypertension (PAH) occurs in various connective tissue diseases (CTDs). We sought to assess contemporary treatment patterns and survival of patients with various forms of CTD-PAH.

Methods: We analysed data from COMPERA, a European pulmonary hypertension registry, to describe treatment strategies and survival in patients with newly diagnosed PAH associated with SSc, SLE, MCTD, UCTD and other types of CTD.

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Pulmonary endarterectomy (PEA) may not achieve full clearance of vascular obstructions in patients with more distal chronic thromboembolic pulmonary hypertension (CTEPH). Balloon pulmonary angioplasty (BPA) may be indicated to treat these residual vascular lesions. We compared whether patients post-PEA (PP) treated by BPA derived similar benefit to those who had inoperable CTEPH (IC), and assessed predictors of BPA response after surgery.

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We report the radiological and functional outcomes at five years in patients with severe osteoarthritis of the glenohumeral joint and a Walch type B glenoid who have undergone stemless anatomic total shoulder replacement. A retrospective analysis of case notes, computed tomography scans and plain radiographs of patients undergoing anatomic total shoulder replacement for primary glenohumeral osteoarthritis were performed. Patients were grouped by the severity of their osteoarthritis using the modified Walch classification, glenoid retroversion and posterior humeral head subluxation.

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Further understanding of when to initiate therapies in pulmonary arterial hypertension (PAH) is important to improve long-term outcomes. analyses of GRIPHON (NCT01106014) and exploratory analyses of TRITON (NCT02558231) suggested benefit of early selexipag initiation on long-term outcomes, despite no additional benefit initial double combination on haemodynamic and functional parameters in TRITON. analyses investigated the effect of early selexipag initiation on disease progression and survival in a large, pooled PAH cohort.

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Acute lung injury (ALI) is a common but poorly defined and understood complication of balloon pulmonary angioplasty (BPA) for chronic thromboembolic pulmonary hypertension (CTEPH). Little data are available on the medium term clinical outcomes of BPA complicated by ALI. We analyzed per-procedure data from 282 procedures in 109 patients and per-patient data from 85 patients.

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Chronic thromboembolic pulmonary hypertension occurs in a proportion of patients with prior acute pulmonary embolism and is characterised by breathlessness, persistently raised pulmonary pressures and right heart failure. Surgical pulmonary endarterectomy (PEA) offers significant prognostic and symptomatic benefits for patients with proximal disease distribution. For those with inoperable disease, management options include balloon pulmonary angioplasty (BPA) and medical therapy.

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Article Synopsis
  • * Researchers analyzed data from the COMPERA registry, finding that improvements in key health measures after treatment were more significant in patients without comorbidities compared to those with 1-4 comorbidities.
  • * Despite the lesser improvements in patients with comorbidities, the study indicates that those patients can still benefit from PAH therapy, and a 4-strata risk prediction tool effectively assesses survival across all patient groups.
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Background: The world symposium on pulmonary hypertension (PH) has proposed that PH be defined as a mean pulmonary artery pressure (mPAP) > 20 mmHg as assessed by right heart catheterisation (RHC). Transthoracic echocardiography (TTE) is an established screening tool used for suspected PH. International guidelines recommend a multi-parameter assessment of the TTE PH probability although effectiveness has not been established using real world data.

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Objective: To better understand how the shoulder moves in breast cancer survivors with axillary web syndrome (AWS), we compared 3-dimensional (3D) shoulder kinematics during shoulder elevation among breast cancer survivors with and without AWS 5 years postoperatively. Although research consistently shows decreased shoulder range of motion with AWS, we do not understand the underlying biomechanics.

Design: Nested case control study.

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Objective: Pulmonary hypertension (PH) is a serious complication of systemic sclerosis (SSc). In this study, we explored the prediction of short-term risk for PH using serial pulmonary function tests (PFTs) and other disease features.

Methods: SSc patients in whom disease onset occurred ≥10 years prior to data retrieval and for whom autoantibody specificity and PFT data were available were included in this study.

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Aims: Cardiovascular involvement in systemic sclerosis (SSc) is heterogeneous and ill-defined. This study aimed to: (i) discover cardiac phenotypes in SSc by cardiovascular magnetic resonance (CMR); (ii) provide a CMR-based algorithm for phenotypic classification; and (iii) examine for associations between phenotypes and mortality.

Methods And Results: A retrospective, single-centre, observational study of 260 SSc patients who underwent clinically indicated CMR including native myocardial T1 and T2 mapping from 2016 to 2019 was performed.

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Late, repetitive or chronic remote ischaemic conditioning (CRIC) is a potential cardioprotective strategy against adverse remodelling following ST-segment elevation myocardial infarction (STEMI). In the randomised Daily Remote Ischaemic Conditioning Following Acute Myocardial Infarction (DREAM) trial, CRIC following primary percutaneous coronary intervention (P-PCI) did not improve global left ventricular (LV) systolic function. A post-hoc analysis was performed to determine whether CRIC improved regional strain.

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