Publications by authors named "David C Tong"
Article Synopsis
- End-stage kidney disease patients on dialysis face increased COVID-19 risks due to factors like age, comorbidities, and challenges in maintaining social distancing during treatment.
- A study at Emory Hospitals from March to May 2020 involved 64 hospitalized dialysis patients with COVID-19, revealing a median age of 64 years and a high percentage (84%) being African-American, with significant symptoms including fever (72%) and cough (61%).
- Mortality was reported at 17%, with risk factors for death including age over 65, elevated C-reactive protein and D-dimer levels, and history of peripheral vascular disease, while COVID-19 patients had a higher likelihood of thromboembolic complications compared to non
Aims: Recent randomized trials demonstrated a benefit of low-dose colchicine added to guideline-based treatment in patients with recent myocardial infarction or chronic coronary disease. We performed a systematic review and meta-analysis to obtain best estimates of the effects of colchicine on major adverse cardiovascular events (MACE).
Methods And Results: We searched the literature for randomized clinical trials of long-term colchicine in patients with atherosclerosis published up to 1 September 2020.
Article Synopsis
- The study aimed to analyze the progression and duration of symptoms in 337 outpatient COVID-19 patients and identify factors predicting symptom length.
- Common early symptoms included cough, loss of smell, and body aches, with cough lasting the longest at a median of 17 days.
- Results indicated that initial symptom severity significantly predicted the duration of symptoms, with a typical progression from systemic to lower respiratory issues over time.*
Article Synopsis
- The study focused on developing and testing a risk assessment tool for patients with acute COVID-19 in a telemedicine setting to predict hospitalizations, aiming to improve resource allocation.
- Researchers evaluated data from a telemedicine program in Atlanta, where patients were classified into three risk tiers (low, intermediate, high) based on their likelihood of needing hospitalization.
- Results showed that 1.3% of low-risk patients were hospitalized, compared to 8.1% of intermediate-risk and 23% of high-risk patients, indicating that the tool effectively identifies patients at greater risk of hospitalization.
Article Synopsis
- The study investigated the feasibility of discharging low-risk STEMI patients early after successful primary percutaneous coronary intervention (PPCI) using the Zwolle risk score (ZRS).
- Out of 183 participants, 132 were identified as low-risk, and those discharged within 72 hours showed no major adverse cardiovascular events (MACE) over 30 days, while also having shorter hospital stays.
- The findings suggest that early discharge for low-risk STEMI patients post-PPCI is potentially safe, but more extensive studies are needed to confirm these results.
Article Synopsis
- Inflammation significantly impacts acute coronary syndromes (ACS), and colchicine, traditionally used for gout, shows promise for treating ACS due to its anti-inflammatory effects.
- A double-blind trial with 795 patients compared colchicine treatment (0.5 mg twice daily) with a placebo, alongside standard medication, over 12 months.
- Results indicated fewer adverse events in the colchicine group (24 vs. 38), but a higher total death rate (8 vs. 1) and more non-cardiovascular deaths, while adverse effects were similar between both groups, primarily involving gastrointestinal issues.
Article Synopsis
- The study investigates the prognostic significance of elevated triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratios in Australian patients suspected of having coronary artery disease (CAD).
- A total of 482 patients underwent coronary angiography, and those with a TG/HDL-C ratio of 2.5 or higher showed a higher prevalence of CAD and worse long-term health outcomes, including higher rates of mortality and major adverse cardiac events (MACE).
- The findings suggest that an elevated TG/HDL-C ratio is an independent predictor of long-term mortality and a strong indicator of increased risk for MACE in this patient population.
Article Synopsis
- Inflammation and microvascular dysfunction (MVD) are linked to adverse heart issues in ischemic heart disease patients, prompting a study to explore their association with myocardial injury.
- The study evaluated 74 patients undergoing coronary interventions, measuring microvascular function (IMR) and inflammation (hsCRP), with severe MVD identified at IMR ≥ 30.
- Results showed that higher levels of hsCRP corresponded to worse microvascular function and increased heart injury markers, with significant differences in lifestyle factors like smoking and diabetes between high and low CRP groups.
Objective: Reducing time to reperfusion for ST-segment elevation myocardial infarction (STEMI) is essential in improving outcomes. Consequently, numerous strategies have been employed to reduce median door-to-balloon time (DTBT).
Methods: CODE STEMI is an ED physician-activated STEMI notification system.
Article Synopsis
- Acute coronary syndromes (ACS) are not just caused by plaques or vessel narrowing; they are a complex condition that requires a deeper understanding.
- Recent studies have challenged traditional ways of diagnosing and managing ACS, highlighting the inadequacies of current prognostic models.
- The review focuses on new risk factors like plaque characteristics and inflammation that could help predict outcomes better and suggests that new treatments targeting these factors could enhance long-term recovery for patients with ACS.
Article Synopsis
- Colchicine has transitioned from a historical poison to an important drug used to manage various inflammatory conditions in modern pharmacology.
- The drug works by binding to tubulin, influencing cellular processes that regulate inflammation, although it has a narrow therapeutic range and can cause gastrointestinal side effects.
- This review covers colchicine's historical background, its pharmacokinetics and mechanisms of action, and the latest evidence supporting its use in treating cardiac conditions, particularly cardiovascular disease.
Article Synopsis
- A study evaluated the SMART (Simplified Management of Acute stroke using Revised Treatment) criteria for thrombolysis, aiming to expand patient eligibility compared to traditional IV rt-PA exclusion criteria.
- The research analyzed 539 patients who received IV thrombolysis, showing no significant differences in outcomes or safety between patients treated locally and those treated elsewhere in the network.
- The findings suggest that using SMART criteria is both safe and effective, potentially increasing the number of patients eligible for thrombolysis treatment.
Objective: Excess accumulation of advanced glycation end products (AGEs) contributes to aging and chronic diseases. We aimed to obtain evidence that exposure to AGEs plays a role in the development of type 1 diabetes (T1D).
Research Design And Methods: The effect of AGEs was examined on insulin secretion by MIN6N8 cells and mouse islets and in vivo in three separate rodent models: AGE-injected or high AGE-fed Sprague-Dawley rats and nonobese diabetic (NODLt) mice.
Objective: A number of factors contribute to diabetes-associated vascular dysfunction. In the present study, we tested whether exposure to advanced glycation end-products (AGEs) impairs vascular reactivity independently of hyperglycemia and examined the potential mechanisms responsible for diabetes and AGE-associated vascular dysfunction.
Methods: Vasodilator function was studied using infusion of exogenous AGEs into Sprague-Dawley rats as compared with control and streptozotocin-induced diabetic rats all followed for 16 weeks (n = 10 per group).
Article Synopsis
- - Studies on diabetic Sprague Dawley rats evaluated the impact of alagebrium (an AGE inhibitor) and ramipril (an ACE inhibitor) on renal function and various mediators of diabetic kidney disease over a 32-week period.
- - While both treatments individually reduced albuminuria, combining them did not yield additional benefits; however, they both effectively lowered circulating levels of carboxymethyllysine, a harmful AGE, without affecting renal levels.
- - The results indicate that while both treatments have unique effects on diabetes-related kidney issues, they share some similar outcomes, suggesting potential pathways for developing future therapies targeting diabetic nephropathy.
Purpose: The first aim of the study was to determine whether (99m)Tc-HYNIC-annexin V, a marker of cellular stress and apoptosis, can detect ischemic injury in patients with acute stroke. Secondly, we wished to test radiolabeled annexin's ability to monitor therapy in a rodent model of focal ischemic injury.
Methods: SPECT imaging of patients was performed between 1 and 2 h after intravenous injection of 30 mCi (1,110 MBq) of tracer.
Article Synopsis
- * The auto-AIF was tested against manual methods using data from 22 stroke patients, focusing on various mapping parameters and comparing the time to identify AIF.
- * Results showed that the auto-AIF outperformed manual techniques in accuracy and speed, indicating its potential to enhance the consistency and efficiency of PWI analysis in acute stroke evaluation.
Article Synopsis
- Despite improvements in medical and surgical care, infective endocarditis continues to pose significant health risks due to rising antimicrobial resistance among pathogens.
- The American Heart Association has released an updated treatment document, incorporating a new evidence-based scoring system and detailed recommendations for diagnosis and management, crafted by a team of experts.
- Key additions include pediatric dosing guidelines and tools for evaluating culture-negative cases, aimed at enhancing the care provided to both adults and children affected by this serious condition.
Article Synopsis
- The study assessed a mechanical thrombectomy protocol for treating acute strokes, focusing on angiographic results and clinical outcomes.
- Ten patients received treatment, with an 80% success rate in restoring blood flow, particularly benefiting those with anterior circulation strokes.
- The procedure showed improved recanalization without complications, but further research is necessary to fully understand its effectiveness and potential benefits.
Background And Purpose: Angioplasty and stent placement have been reported for the treatment of intracranial stenosis. This study was undertaken to assess the efficacy and long-term clinical outcome of angioplasty without stent placement for patients with symptomatic intracranial stenosis.
Methods: A retrospective study was done to evaluate 36 patients with 37 symptomatic atherosclerotic intracranial stenosis who underwent primary balloon angioplasty.