Publications by authors named "Zakkar M"

Background: Atrial fibrillation (AF) is the most common arrhythmia worldwide. However, data regarding readmissions following index admission for AF in the developing world are not well described. This study assessed the rate, predictors, and trends of 6-month readmission after index admission for AF in Syria.

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Background: Atrial fibrillation (AF) is the most common arrhythmia worldwide. Data regarding 30-day readmission following index admission for AF in the developing world are poorly described.

Objectives: The study aimed to assess the rate, predictors, and trends of 30-day readmission after index admission for AF in Syria.

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Background: Atrioventricular block (AVB) is a cardiac conduction disorder that can lead to significant clinical outcomes, particularly in resource-limited and conflict-affected regions. In Syria, healthcare infrastructure has been severely impacted by ongoing conflict, potentially affecting the prevalence and management of AVB.

Methods: We conducted a cross-sectional study at Tishreen University Hospital in Latakia, Syria, with patients > 40 who presented to the emergency department (ED) from June 1 to August 1, 2024.

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  • Vein graft disease refers to the inflammation and atherosclerosis that affects saphenous vein grafts used in coronary artery bypass surgery over time.
  • The study employed a novel spatial transcriptomic analysis to explore how arterial blood flow affects gene expression in the long saphenous vein, identifying 413 significant genes that respond to haemodynamic changes.
  • Findings revealed key pathways related to inflammation and tissue remodeling that could serve as potential therapeutic targets to prevent vein graft disease in the future.
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  • - The study evaluated the Arabic version of the EQ-5D tool for measuring health-related quality of life in atrial fibrillation patients in Syria, addressing a gap in existing data.
  • - Involving 432 participants, the research demonstrated strong reliability and validity of the EQ-5D through various testing methods, confirming its effectiveness for this patient group.
  • - The successful validation of the EQ-5D in this context encourages its broader use across Arabic-speaking regions, potentially enhancing healthcare decision-making and patient care strategies.
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Purpose: In Northwest Territories (NWT), Canada, infection rates for chlamydia, gonorrhea, and syphilis are three to ten times higher than the national averages and have been steadily increasing. However, data are scarce on the socioeconomic, psychological, and behavioural factors associated with the proliferation of sexually transmitted infections (STIs) in NWT. To this extent, this study explores Indigenous mothers' perspectives on sexual health, STI risk factors and healthcare-seeking behaviours in NWT.

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  • * Key predictors for CHF readmission included older age (≥60 years), diabetes mellitus, valvular heart disease, and hypertension, highlighting the need for careful management of these factors.
  • * The findings suggest that integrated care addressing lifestyle and comorbidities is crucial for improving health outcomes in resource-limited settings, especially among AF patients.
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: Grafting of LIMA to LAD has long been considered the gold-standard conduit choice for patients undergoing CABG. Despite this, the LSV remains the most used conduit by volume and some patients may not receive even a single arterial conduit. However, the outcomes in this group are not frequently explored.

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Interactions with the police can impact an individual's short and long-term physical, mental, and social wellbeing, as well as levels of violence and unrest within a community. As such, this study aimed to explore experiences with the police among individuals experiencing socioeconomic disadvantages in Edmonton, Canada. For this qualitative study, participants (n = 39) were recruited from an emergency shelter for women, a drop-in community organization supporting individuals experiencing socioeconomic disadvantages, and a centre providing settlement support for newcomers to Canada.

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  • Atrial fibrillation (AF) is the most common arrhythmia globally, but there is a lack of data on how it is managed in Syria; this study focused on inpatient treatment and cardiovascular mortality in Latakia.
  • Conducted from June 2021 to June 2023 at Tishreen's University Hospital, the study reviewed the records of 596 AF patients, examining demographics, treatment strategies, and clinical outcomes such as mortality and complications during their hospital stay.
  • The findings revealed that these patients were generally younger than those in other countries, with active thyroid disease, chronic obstructive pulmonary disease (COPD), and valvular heart disease (VHD) identified as significant risk factors for increased cardiovascular mortality.
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Introduction: Symptomatic aortic valve stenosis (AS) is associated with asymmetric basal septal hypertrophy (ABSH) in 10% of cases. In this cohort, it has been suggested that rectification of the left ventricular outflow tract obstruction (LVOTO) by concomitant septal myectomy (CSM) can improve the results of aortic valve replacement (AVR).

Objective: This study aims to present the technique of AVR with CSM for severe AS with ABSH and to determine the associated early and late post-operative outcomes.

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Objective: Fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) are invasive methods to assess the functional significance of intermediate severity coronary lesions. Both indexes have been extensively validated in clinical trials in guiding revascularisation in patients with stable ischaemic heart disease undergoing percutaneous coronary intervention (PCI) with improved clinical outcomes. However, the role of these tools in coronary artery bypass grafting (CABG) is less clear.

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  • Cardiac surgery causes significant inflammation, and the use of corticosteroids is being examined as a way to reduce this inflammation and prevent complications post-surgery, but their safety and effectiveness remain uncertain.
  • The study aims to compare the effects of corticosteroids versus no treatment in adults undergoing cardiac surgery, focusing on mortality, myocardial and pulmonary complications, among other outcomes like atrial fibrillation and length of hospital stay.
  • The research involved comprehensive searches for randomised controlled trials and analyzed data using standard methods to assess various outcomes, with new studies added since the original 2011 review.
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  • - The study compares early clinical outcomes of two surgical methods—off-pump coronary artery bypass (OPCABG) and on-pump coronary artery bypass (ONCABG)—in patients with severe renal impairment, based on a large national registry from the UK (1996-2019).
  • - Out of 8,628 patients identified with severe renal issues, 1,142 underwent OPCABG; a propensity-matched analysis showed no significant difference in in-hospital mortality, postoperative dialysis, or stroke rates between the two methods.
  • - Although ONCABG had a higher rate of return to the operating room for bleeding, OPCABG resulted in a shorter hospital stay by one day, with mortality rates remaining similar across
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  • Osteopontin plays a key role in vascular calcification and is activated shortly after vein graft surgery, with microcalcification forming within a week.
  • Research using a pig model and human veins indicated that a short treatment with dexamethasone can reduce osteopontin activation and its related microcalcification.
  • The study highlights the connection between osteopontin activation, microcalcification, and the impact of hemodyamic changes on vein grafts, suggesting potential therapeutic approaches to manage these conditions.
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  • The study investigates the effects of concurrent aortic valve replacement (AVR) and coronary artery bypass grafting on patient outcomes, highlighting that combined surgeries may lead to higher risks compared to performing them separately.
  • Data from over 51,000 patients over 23 years reveal that more bypass grafts correlate with increased mortality, particularly for those receiving two or more grafts alongside AVR, while a single arterial conduit decreases both mortality and the need for dialysis.
  • A survey of 103 cardiac surgeons shows varying opinions on the influence of bypass graft numbers on patient outcomes, with some supporting the potential of staged or hybrid surgical approaches for complex cases.
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  • The long saphenous vein is commonly used in cardiac surgeries, but its long-term effectiveness is often compromised by vein graft disease (VGD), largely due to endothelial dysfunction.
  • This study reviews existing research on how different preservation solutions used during vein harvesting affect endothelial health and contribute to VGD in vein grafts specifically for coronary artery bypass grafting (CABG).
  • The findings suggest that standard saline can harm venous endothelium, while alternatives like TiProtec and DuraGraft show promising results, but overall research quality remains low and more rigorous trials are needed.
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  • * Dysfunction in endothelial cells is a major factor in vein graft disease, which can occur after coronary artery bypass surgery and leads to complications like intimal hyperplasia and accelerated artery blockage.
  • * The review discusses the role of endothelial cells in vein graft disease and explores current surgical and medical strategies aimed at improving endothelial function to enhance patient recovery and outcomes.
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  • - Coronary artery bypass grafting is still the preferred treatment for many patients with serious coronary artery disease, with the long saphenous vein being the most commonly used conduit despite issues with long-term graft success.
  • - Saphenous vein grafts often face challenges due to intimal hyperplasia, a condition that causes narrowing and blockage due to chronic inflammation, making long-term graft patency a significant concern.
  • - The paper reviews various studies utilizing large animal models to better understand vein graft disease and explores the effectiveness of different treatments, particularly the use of external stents or mesh in these models.
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Unlabelled: Patients can use social media to describe their healthcare experiences. Several social media platforms, such as the Care Opinion platform, host large volumes of patient stories. However, the large number of these stories and the healthcare system's workload make exploring these stories a difficult task for healthcare providers and administrators.

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  • Atherosclerosis is a chronic inflammatory disease responsible for high morbidity and mortality rates, and current treatments are inadequate, necessitating further research into its underlying mechanisms.
  • This review analyzes 34 studies that employ single-cell and next-generation sequencing techniques to investigate the cellular and molecular aspects of atherosclerosis and vascular inflammation.
  • Findings highlight significant contributions from smooth muscle cells, macrophages, and stem/progenitor cells, while noting considerable variability in study outcomes from single-cell sequencing approaches.
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  • Diseases of the thoracic aorta have a familial component, with up to 30% of cases being hereditary, but nonsyndromic types lack clear symptoms, making early detection difficult.
  • A feasibility study was conducted on patients with nonsyndromic thoracic aorta diseases (NS-TADs) who underwent screening with imaging and genetic evaluations, including 16 patients and 54 of their relatives.
  • Results showed that 24% of relatives had some aortic dilation, and 68% of family members in the familial group required further surveillance, highlighting the importance of genetic testing and family screening for early diagnosis.*
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The long saphenous vein is commonly used in cardiac surgery to bypass occluded coronary arteries. Its use is complicated by late stenosis and occlusion due to the development of intimal hyperplasia. It is accepted that intimal hyperplasia is a multifactorial inflammatory process that starts immediately after surgery.

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We hypothesized that body mass index (BMI) dependent changes in myocardial gene expression and energy-related metabolites underlie the biphasic association between BMI and mortality (the obesity paradox) in cardiac surgery. We performed transcriptome profiling and measured a panel of 144 metabolites in 53 and 55, respectively, myocardial biopsies from a cohort of sixty-six adult patients undergoing coronary artery bypass grafting (registration: NCT02908009). The initial analysis identified 239 transcripts with biphasic BMI dependence.

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There has been a growing use of social media by patients to share their healthcare experiences and produce information that can be helpful to other patients seeking healthcare services. These stories can reveal issues in healthcare quality. However, faced with the inherent risks of social media, healthcare providers have been skeptical about the value of these stories, and many healthcare systems have adopted restrictive and protective policies to control the use of social media by healthcare providers.

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