Author: "Adel H. Allam" - Searchworks@Jio Institute Digital Library Search Results

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56 results on '"Adel H. Allam"'

1. Very Low Prevalence and Incidence of Atrial Fibrillation among Bolivian Forager-Farmers

Author: Christopher J. Rowan, Michael A. Eskander, Edmond Seabright, Daniel Eid Rodriguez, Edhitt Cortez Linares, Raul Quispe Gutierrez, Juan Copajira Adrian, Daniel Cummings, Bret Beheim, Kirsten Tolstrup, Abinash Achrekar, Thomas Kraft, David E. Michalik, Michael I. Miyamoto, Adel H. Allam, L. Samuel Wann, Jagat Narula, Benjamin C. Trumble, Jonathan Stieglitz, Randall C. Thompson, Gregory S. Thomas, Hillard S. Kaplan, and Michael D. Gurven
Subjects: Infectious and parasitic diseases, RC109-216, Public aspects of medicine, RA1-1270
Abstract: Background: Atrial fibrillation is the most common arrhythmia in post-industrialized populations. Older age, hypertension, obesity, chronic inflammation, and diabetes are significant atrial fibrillation risk factors, suggesting that modern urban environments may promote atrial fibrillation. Objective: Here we assess atrial fibrillation prevalence and incidence among tropical horticulturalists of the Bolivian Amazon with high levels of physical activity, a lean diet, and minimal coronary atherosclerosis, but also high infectious disease burden and associated inflammation. Methods: Between 2005–2019, 1314 Tsimane aged 40–94 years (52% female) and 534 Moseten Amerindians aged 40–89 years (50% female) underwent resting 12-lead electrocardiograms to assess atrial fibrillation prevalence. For atrial fibrillation incidence assessment, 1059 (81% of original sample) Tsimane and 310 Moseten (58%) underwent additional ECGs (mean time to follow up 7.0, 1.8 years, respectively). Findings: Only one (male) of 1314 Tsimane (0.076%) and one (male) of 534 Moseten (0.187%) demonstrated atrial fibrillation at baseline. There was one new (female) Tsimane case in 7395 risk years for the 1059 participants with >1 ECG (incidence rate = 0.14 per 1,000 risk years). No new cases were detected among Moseten, based on 542 risk years. Conclusion: Tsimane and Moseten show the lowest levels of atrial fibrillation ever reported, 1/20 to ~1/6 of rates in high-income countries. These findings provide additional evidence that a subsistence lifestyle with high levels of physical activity, and a diet low in processed carbohydrates and fat is cardioprotective, despite frequent infection-induced inflammation. Findings suggest that atrial fibrillation is a modifiable lifestyle disease rather than an inevitable feature of cardiovascular aging.
Published: 2021
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2. The dilemma of ischemic heart failure; how FDG-PET can guide therapy and improve outcomes? Case report

Author: Mohamed A. Mandour Ali, Sallam Lotfy, Ibrahem M. Koura, Mahmoud Derbala, and Adel H. Allam
Subjects: Myocardial viability, SPECT/PET, Ischemic heart failure, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Patients with ischemic LV dysfunction are at increasing risk of adverse cardiac events including sudden cardiac death. Proper revascularization of viable ischemic myocardium (compared to medical treatment alone) is associated with improvement of LV systolic function, less cardiac morbidities & mortalities and better functional capacity and well-being. Many diagnostic tools are used in clinical practice for assessment of myocardial viability. Dobutamine stress Echocardiography (DSE) is the most widely used technique, while delayed enhancement cardiac magnetic resonance (DE-CMR) and Flourine-18-fluorodeoxy-glucose positron emission tomography (18F-FDG PET) are considered the standard of care for assessment of myocardial viability. Our case report illustrates how FDG PET myocardial viability assessment can guide therapy and improve outcomes in a difficult clinical and angiographic situation.
Published: 2013
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3. Extracardiac mediastinal uptake incidentally seen during myocardial SPECT studies; are all neoplastic?

Author: Mohamed A. Mandour Ali, Ibrahim M. Koura, Ayman A. Sadek, Abdullah H. Khalil, and Adel H. Allam
Subjects: Myocardial SPECT Imaging, Extracardiac mediastinal uptake, Incidental findings during myocardial SPECT imaging, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Incidentally seen non-cardiac findings during myocardial single photon emission computed tomography (SPECT) imaging are not uncommon. These findings may be an indirect but important indication for a variety of non-cardiac disorders that may occasionally mimic cardiac symptoms. Some of these disorders are gastric diseases, liver and gallbladder diseases, spleen disorders, sternal and vertebral pathologies, and pulmonary diseases. Many reports emphasized the value of reviewing raw data in the process of reporting SPECT studies, a rule that is easily forgotten by nuclear medicine specialists. This systematic way of reviewing raw data is not only used for quality control purposes, but also for better detection of non-cardiac incidental findings.
Published: 2012
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4. Decorated bodies for eternal life: A multidisciplinary study of late Roman Period stucco-shrouded portrait mummies from Saqqara (Egypt).

Author: Stephanie Zesch, Manuela Gander, Marc Loth, Stephanie Panzer, M Linda Sutherland, Adel H Allam, Ibrahem Badr, Gregory S Thomas, Saskia Wetzig, Albert Zink, and Wilfried Rosendahl
Subjects: Medicine, Science
Abstract: This study focuses on the multidisciplinary investigation of three stucco-shrouded mummies with mummy portrait from Egypt dating from the late 3rd to the middle of the 4th century AD, corresponding to the late Roman Period. These three mummies were excavated in the early 17th and late 19th centuries in the Saqqara necropolis near the ancient Egyptian capital of Memphis. Two of them experienced an interesting collection history, when they became part of the collection of the Elector of Saxony and King of Poland August II in Dresden, Germany, in 1728. The investigation includes information about the mummies' discovery, collection history and shroud decoration obtained through Egyptological expertise. In addition, information on the state of preservation, technique of artificial mummification, age at death, sex, body height and health of the deceased was achieved through computed tomography (CT) analysis. Research yielded an adult male, a middle-aged female and a young female. Due to the rather poorly preserved bodies of the male and middle-aged female, a specific technique of artificial mummification could not be ascertained. Brain and several internal organs of the well-preserved young female were identified. Wooden boards, beads of necklaces, a hairpin, and metal dense items, such as lead seals, nails and two coins or medallions were discovered. Paleopathological findings included carious lesions, Schmorl's nodes, evidence of arthritis and a vertebral hemangioma. The study revealed insights on the decoration and burial preparation of individuals of upper socioeconomic status living in the late Roman Period, as well as comprehensive bioanthropological information of the deceased.
Published: 2020
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5. Brain volume, energy balance, and cardiovascular health in two nonindustrial South American populations

Author: Hillard Kaplan, Paul L. Hooper, Margaret Gatz, Wendy J. Mack, E. Meng Law, Helena C. Chui, M. Linda Sutherland, James D. Sutherland, Christopher J. Rowan, L. Samuel Wann, Adel H. Allam, Randall C. Thompson, David E. Michalik, Guido Lombardi, Michael I. Miyamoto, Daniel Eid Rodriguez, Juan Copajira Adrian, Raul Quispe Gutierrez, Bret A. Beheim, Daniel K. Cummings, Edmond Seabright, Sarah Alami, Angela R. Garcia, Kenneth Buetow, Gregory S. Thomas, Caleb E. Finch, Jonathan Stieglitz, Benjamin C. Trumble, Michael D. Gurven, and Andrei Irimia
Subjects: Multidisciplinary, Brain volume, cardiovascular health, South America, energy balance
Abstract: Little is known about brain aging or dementia in nonindustrialized environments that are similar to how humans lived throughout evolutionary history. This paper examines brain volume (BV) in middle and old age among two indigenous South American populations, the Tsimane and Moseten, whose lifestyles and environments diverge from those in high-income nations. With a sample of 1,165 individuals aged 40 to 94, we analyze population differences in cross-sectional rates of decline in BV with age. We also assess the relationships of BV with energy biomarkers and arterial disease and compare them against findings in industrialized contexts. The analyses test three hypotheses derived from an evolutionary model of brain health, which we call the embarrassment of riches (EOR). The model hypothesizes that food energy was positively associated with late life BV in the physically active, food-limited past, but excess body mass and adiposity are now associated with reduced BV in industrialized societies in middle and older ages. We find that the relationship of BV with both non-HDL cholesterol and body mass index is curvilinear, positive from the lowest values to 1.4 to 1.6 SDs above the mean, and negative from that value to the highest values. The more acculturated Moseten exhibit a steeper decrease in BV with age than Tsimane, but still shallower than US and European populations. Lastly, aortic arteriosclerosis is associated with lower BV. Complemented by findings from the United States and Europe, our results are consistent with the EOR model, with implications for interventions to improve brain health.
Published: 2023

6. Pathway‐based genome analysis of cognitive impairment in a forager‐horticulturalist South American population

Author: Angela R Garcia, Yih‐Kuang Lu, Margaret Gatz, Daniel Eid Rodriguez, Raul Quispe Gutierrez, Juan J Copajira Adrian, Jesus Bani Cuata, M Linda Sutherland, James D Sutherland, Daniel K Cummings, Thomas Kraft, Wendy J Mack, Helena C Chui, Meng Law, Giuseppe Barisano, Amy R Borenstein, Andrei Irimia, Ellen E Walters, Gregory S Thomas, Randall C Thompson, Michael I Miyamoto, David E Michalik, L Samuel Wann, Adel H Allam, Christopher J Rowan, Heather M Highland, Kari E North, Caleb E Finch, Jonathan Stieglitz, Michael D Gurven, Benjamin C Trumble, Hillard Kaplan, and Kenneth Buetow
Subjects: Psychiatry and Mental health, Cellular and Molecular Neuroscience, Developmental Neuroscience, Epidemiology, Health Policy, Neurology (clinical), Geriatrics and Gerontology
Published: 2022

7. Worldwide Disparities in Recovery of Cardiac Testing 1 Year Into COVID-19

Author: Andrew J. Einstein, Cole Hirschfeld, Michelle C. Williams, Joao V. Vitola, Nathan Better, Todd C. Villines, Rodrigo Cerci, Leslee J. Shaw, Andrew D. Choi, Sharmila Dorbala, Ganesan Karthikeyan, Bin Lu, Valentin Sinitsyn, Alexey A. Ansheles, Takashi Kudo, Chiara Bucciarelli-Ducci, Bjarne Linde Nørgaard, Pál Maurovich-Horvat, Roxana Campisi, Elisa Milan, Lizette Louw, Adel H. Allam, Mona Bhatia, Lorenzo Sewanan, Eli Malkovskiy, Yosef Cohen, Michael Randazzo, Jagat Narula, Olga Morozova, Thomas N.B. Pascual, Yaroslav Pynda, Maurizio Dondi, Diana Paez, Gerd Hinterleitner, Yao Lu, Zhuoran Xu, Cole B. Hirschfeld, Ikenna Erinne, Mrinali Shetty, Andrew Choi, Juan Lopez-Mattei, Purvi Parwani, Artan Goda, Ervina Shirka, Salah Bouyoucef, Lydia Chelghoum, Farouk Mansouri, Abdelkader Medjahedi, Qais Naili, Mokhtar Ridouh, Diego Alasia, Lucia Alberghina, Natalia Aramayo, Diego Buchara, Franco Gabriel Busso, Jose Javier Bustos Rivadero, Jorge Camilletti, Hugo Campanelli, Ricardo Belisario Castro, Mariana Daicz, Horacio del Riego, Laura Dragonetti, Diego Echazarreta, Juan Erriest, Fernando Faccio, Adolfo Facello, Hugo Gallegos, Ricardo Geronazzo, Horacio Glait, Victor Hasbani, Victor Jäger, Julio Manuel Lewkowicz, Jose Lotti, Neiva Maciel, Osvaldo Masoli, Edgardo Mastrovito, Maria Medus, Maria Fernanda Merani, Susana Molteni, Marcos Montecinos, Gustavo Parisi, Claudio Pereyra Sueldo, Diego Perez de Arenaza, Luis Quintana, Alejandro Radzinschi, Marcela Redruello, Marina Rodríguez, Horacio Rojas, Arturo Romero Acuña, Daniel Schere, Sonia Traverso, Gustavo Vazquez, Susana Zeffiro, Mari Sakanyan, Scott Beuzeville, Raef Boktor, Michael Crowley, D'Arne Downie, Girish Dwivedi, Barry Elison, Omar Farouque, Kim Jasper, Subodh Joshi, Joseph Lee, Kenneth Lee, Elaine Lui, Peter Mcconachie, Joanne Meaker, Dee Nandurkar, Johanne Neill, Edward O'Rourke, Patricia O'Sullivan, George Pandos, Manuja Premaratne, David Prior, Natalie Rutherford, Connor Saunders, Kim Taubman, Andrew Tauro, Andrew Taylor, James Theuerle, Paul Thomas, Jonathan Tow, Anthony Upton, Shankar Vamadevan, Victor Wayne, Eva Alina Wegner, David Wong, John Younger, Dietrich Beitzke, Gudrun Feuchtner, Oliver Sommer, Konrad Weiss, Natallia Maroz-Vadalazhskaya, Uladzimir Tserakhau, Filip Homans, Caroline M. Van De Heyning, Raúl Araujo, Valentina Soldat-Stankovic, Sinisa Stankovic, Augusto Almeida, Carlos Anselmi, Guilherme S.A. Azevedo, Marcio Sommer Bittencourt, Diego Bromfman Pianta, Estevan Cabeda, Lara Carreira, Igor Coelho, Fernando de Amorim Fernandes, Andrea de Lorenzo, Roberta Delgado, Fernanda Erthal, Fabio Fernandes, Juliano Fernandes, Thiago Ferreira de Souza, Murilo Foppa, Wilson Furlan Matos Alves, Cibele Gontijo, Ilan Gottlieb, Gabriel Grossman, Maria Helena Albernaz Siqueira, Cesar Higa Nomura, Katia Hiromoto Koga, Ronaldo Lima, Rafael Lopes, Hugo Humberto Marçal Filho, Paulo Masiero, Luiz Mastrocola, Maria Eduarda Menezes de Siqueira, Claudio Mesquita, Danilo Naves, Filipe Penna, Ibraim Pinto, Thércio Rocha, Juliana Leal Rocha, Alfredo Rodrigues, Leila Salioni, Adelina Sanches, Marcelo Santos, Leonardo Sara Da Silva, Paulo Schvartzman, Cristina Sebastião Matushita, Tiago Senra, Marcelo Silva, Carlos Eduardo Soares, Bernardo Spiro, Carlos Eduardo Suaide Silva, Rafael Torres, Guilherme Urpia Monte, Andrea Vilela, Alexandre Volney Villa, Joao Vitola, Themissa Voss, Roberto Waltrick, Marcello Zapparoli, Hamid Naseer, Marina Garcheva-Tsacheva, Tiémégna Florence Ouattara, Sarameth Thou, Soley Varoeun, Gad Abikhzer, Rob Beanlands, Michael Chetrit, Dominique Dabreo, Carole Dennie, Matthias Friedrich, Mohmmed Nassoh Hafez, Kate Hanneman, Robert Miller, Anastasia Oikonomou, Idan Roifman, Gary Small, Vikas Tandon, Adwait Trivedi, James White, Katherine Zukotynski, Rita Alay, Carmen Concha, Teresa Massardo, Pedro Abad, Kelly Anzola, Harold Arturo, Luis Benitez, Alberto Cadena, Carlos Caicedo Zamudio, Antonio Calderón, Claudia T. Gutierrez Villamil, Claudia Jaimes, Juan L. Londono, Nelson Lopez, Sonia Merlano-Gaitan, Ramon Murgieitio-Cabrera, Manuel Valencia, Damiana Vergel, Alejandro Zuluaga Santamaria, Felix Solis, Tonci Batinic, Maja Franceschi, Maja Hrabak Paar, Marina Prpic, Cuba: Juan Felipe Batista, Lazaro Omar Cabrera, Amalia Peix, Yamilé Peña, Luis Manuel Rochela Vázquez, Ioannis Ntalas, Milan Kaminek, Vladimir Kincl, Otto Lang, Jawdat Abdulla, Morten Bøttcher, Martin Busk, Uka Geisler, Lars C. Gormsen, Nicolaj Hansson, Søren Hess, Jens Hove, Lars Thorbjoern Jensen, Magnus T. Jensen, Kristian Hay Kragholm, Bjarne L. Nørgaard, Kristian Øvrehus, Jan Rasmussen, Niels Peter Rønnow Sand, Hanne Sondergaard, Tomas Zaremba, Herwin Speckter, Nelson Amores, Mayra Sanchez Velez, Taghreed Abd Alrahman, Sherif Abd Elsamad, Alia Abdelfattah, Adel Allam, Sameh Elkaffas, Mona Hassan, Elshaymaa Hussein, Ahmed Ibrahim, Ahmed Kandeel, Mohamed Mandour Ali, Mahmoud Shaaban, Camila Flores, Verónica Vanesa Gómez Leiva, Anita Liiver, Martti Larikka, Valtteri Uusitalo, Denis Agostini, Clothilde Berger, Matthieu Dietz, Fabien Hyafil, Mickaël Ohana, Kevin Prigent, Hamza Regaieg, Laure Sarda-Mantel, Darach O. H-Ici, Harold Ayetey, George Angelidis, Christina Fragkaki, Chrysoula Fragkiadaki, Panagiotis Georgoulias, Maria Koutelou, Elena Kyrozi, Niki Lama, Vassilis Prassopoulos, Michael Spartalis, Theodora Zaglavara, Carla Gonzalez, Goleat Gutierrez, Alejandro Maldonado, Yassine Martinez, Attila Kovács, Bálint Szilveszter, Nilesh Banthia, Vivek Bhat, Partha Choudhury, Vijay Sai Chowdekar, Johann Christopher, Tushar Garg, Naresh Kumar Goyal, Ripen Kumar Gupta, Abhishek Gupta, Julie Hephzibah, Shashank Jain, Jesu Krupa, Parveen Kumar, Sukriti Kumar, Arati Lalchandani, Animesh Mishra, Vivaswan Dutt Mishra, Parul Mohan, Ahmad Ozair, Shivani Pandey, Ramanathapuram Parameswaran, Chetan Patel, Tapan Patel, Shivani Patel, Leena Robinson Vimala, Dr Pradosh Kumar Sarangi, Shantanu Sengupta, Arvind Sethi, Amit Sharma, Awadhesh Kumar Sharma, Punit Sharma, Apurva Shrigiriwar, Santosh Singh, Harpreet Singh, Ashwani Sood, Atul Verma, Ajay Vyas, Erwin Affandi Soeriadi, Edison Bun, Febby Hutomo, Hilman Syawaluddin, Ryan Yudistiro, Amjed Albadr, Majid Assadi, Farshad Emami, Alireza Emami-Ardekani, Saeed Farzanehfar, Ramezan Jafari, Reyhaneh Manafi-Farid, Maryam Tajik, Yoav Arnson, Shmuel Fuchs, Ronen Goldkorn, John Kennedy, Marina Leitman, Aryeh Shalev, Wanda Acampa, Domenico Albano, Pierpaolo Alongi, Gaspare Arnone, Roberta Assante, Anna Baritussio, Matteo Bauckneht, Francesco Bianco, Rachele Bonfiglioli, Francesco Bovenzi, Isabella Bruno, Andrea Bruno, Elena Busnardo, Elena Califaretti, Roberta Casoni, Vittorio Censullo, Franca Chierichetti, Marcello Chiocchi, Corrado Cittanti, Alberto Clemente, Alberto Cuocolo, Maria Luisa De Rimini, Giuseppe De Vincentis, Veronica Della Tommasina, Santo Dellegrottaglie, Paola Anna Erba, Laura Evangelista, Lara Faggi, Evelina Faragasso, Luigia Florimonte, Viviana Frantellizzi, Marco Gatti, Angela Gaudiano, Fabrizia Gelardi, Alberto Gerali, Alessia Gimelli, Marco Guglielmo, Lucia Leccisotti, Riccardo Liga, Carlo Liguori, Giampiero Longo, Margherita Maffione, Claudio Marcassa, Giovanni Matassa, Donato Mele, Luca Mircoli, Andrea Paccagnella, Sara Pacella, Federica Padovano, Dario Pellegrini, Valeria Pergola, Luca Pugliese, Natale Quartuccio, Lucia Rampin, Fabrizio Ricci, Giuseppe Rubini, Vincenzo Russo, Gianmario Sambuceti, Alessandra Scatteia, Roberto Sciagrà, Gianluca Spidalieri, Antonella Stefanelli, Carlo Tedeschi, Guido Ventroni, Dainia Baugh, Ernest Madu, Tadao Aikawa, Hiroshi Asano, Shinichiro Fujimoto, Koichiro Fujise, Yoshimitsu Fukushima, Kae Fukuyama, Yasutaka Ichikawa, Reiko Ideguchi, Nobuo Iguchi, Masamichi Imai, Hayato Ishimura, Satoshi Isobe, Kimiteru Ito, Yu Izawa, Toshiaki Kadokami, Tokuo Kasai, Takao Kato, Takashi Kawamoto, Shigeru Kiryu, Shinichiro Kumita, Osamu Manabe, Hirotaka Maruno, Naoya Matsumoto, Masao Miyagawa, Masao Moroi, Shigeki Nagamachi, Kenichi Nakajima, Ryo Nakazato, Mamoru Nanasato, Masanao Naya, Takashi Norikane, Yasutoshi Ohta, Yoichi Otomi, Hideki Otsuka, Noriko Oyama-Manabe, Masaki Saito, Masayoshi Sarai, Junichi Sato, Daisuke Sato, Shinya Shiraishi, Kentaro Takanami, Kazuya Takehana, Yasuyo Taniguchi, Hiroki Teragawa, Nobuo Tomizawa, Kyoko Umeji, Yasushi Wakabayashi, Shinichiro Yamada, Shinya Yamazaki, Tatsuya Yoneyama, Mohammad Rawashdeh, Tairkhan Dautov, Khalid Makhdomi, Mostafa Abass, Masoud Garashi, Qaisar Siraj, Marika Kalnina, Mohamad Haidar, Renata Komiagiene, Giedre Kviecinskiene, Donatas Vajauskas, Noor Khairiah A. Karim, Mady Doucoure, Luise Reichmuth, Anthony Samuel, Mohamed Lemine Dieng, Ambedhkar Shantaram Naojee, Estrella Aguilera Hernandez, Cesar Rene Alducin Tellez, Erick Alexánderson-Rosas, Erika Barragan, Manuel Cabada, Daniel Calderón, Isabel Carvajal-Juarez, José Esparza, Manlio Gerardo Gama-Moreno, Virginia Garcia Quinto, Nelsy Coromoto Gonzalez, Mary Carmen Herrera-Zarza, Aloha Meave, Jesus Gregorio Medina Verdugo, Gabriela Melendez, Rafael Humberto Morales Murguia, Carlos Salvador Navarro Quiroz, Mario Ornelas, Andres Preciado-Anaya, Oscar Ulises Preciado-Gutiérrez, Adriana Puente, Aristóteles Ramírez Salazar, Sandra Graciela Rosales Uvera, Sandra Rosales-Uvera, Jose Antonio Serna Macias, Lilia Sierra-Galan, Lilia M. Sierra-Galan, Juan Carlos Tirado Alderete, Enrique Vallejo, Marc Faraggi, Erdenechimeg Sereegotov, Nouzha Ben Rais, Nadia Ismaili Alaoui, Thiri Kyiphyu, Su Thet Oo, Soe Myat Win, Htin Zar, Ram Ghimire, Madhu Neupane, Andor Glaudemans, Riemer Slart, Derk Verschure, Berry Allen, John Edmond, Clare Mckenzie, Stuart Tie, Niels Van Pelt, Kirsten Worthington, Calum Young, Idrissa Adamou Soli, Shehu Kana, Uchenna Onubogu, Mahmoud Sani, Anders Tjellaug Bråten, Arve Jørgensen, Hanne-Elin Vassbotn, Humoud Al Dhuhli, Zabah Jawa, Naima Tag, Shazia Fatima, Muhammad Babar Imran, Muhammad Numair Younis, Mohammad Saadullah, Yariela Herrera Malo, Dora Lenturut-Katal, Manuel Castillo, José Ortellado, Afroza Akhter, F. Aaysha Cader, Raihan Hussain, Saidur Rahman Khan, Tapati Mandal, Faria Nasreen, Yunqiang An, Dianbo Cao, Lianggeng Gong, Yang Hou, Chongfu Jia, Tao Li, Caiying Li, Hui Liu, Wenya Liu, Jinkang Liu, Ming-Yen Ng, Heshui Shi, Chunxiang Tang, Ximing Wang, Zhaoqian Wang, Yining Wang, Jiang Wu, Yan Yi, Li Yuan, Tong Zhang, Longjiang Zhang, Edith Chavez, Carlos Cruz, Christian Llontop, Rosanna Morales, Paz Abrihan, Asela Bustos-Barroso, Michele Duldulao-Ogbac, Christopher Eduarte, Jerry Obaldo, Alvin Quinon, Belinda San Juan, Carlo Joe San Juan, Marie Rhiamar Sauler-Gomez, Mila Uy, Magdalena Kostkiewicz, Jolanta Kunikowska, Anna Teresinska, Tomasz Urbanik, Nuno Bettencourt, Ricardo Fontes-Carvalho, Cristina Gavina, Lino Gonçalves, Filipe Macedo, Nuno Moreno, Carla Sousa, Ana Teresa Timoteo, Maria João Vidigal, Mahmoud Al Heidous, Subramaniyan Ramanathan, Samer Arnous, Said Aytani, Angela Byrne, Tadhg Gleeson, David Kerins, Julie O'Brien, Ji-In Bang, Henry Bom, Miju Cheon, Gi Jeong Cheon, Sang-Geon Cho, Chae Moon Hong, Yong Hyu Jeong, Won Jun Kang, Yeon-Koo Kang, Ji-Young Kim, So Won Oh, Young So, Ho-Chun Song, Kyoung Sook Won, Soo Woong Yoo, Irena Mitevska, Marija Vavlukis, Barbara Gužic Salobir, Monika Štalc, Theodora Benedek, Marian Pop, Claudiu Stan, Alexey Ansheles, Olga Dariy, Nina Gagarina, Irina Itskovich, Anatoliy Karalkin, Alexander Kokov, Gulya Marina, Ekaterina Migunova, Viktor Pospelov, Daria Ryzhkova, Guzaliya Sayfullina, Vladimir Sergienko, Irina Shurupova, Margarita Vakhromeeva, Nailia Valiullina, Konstantin Zavadovsky, Kirill Zhuravlev, Rami Abazid, Turki Al Garni, Mirvat Alasnag, Ahmed Aljizeeri, Hamid Amer, Ahmad Amro, Hesham Hamdy, Osama Smettei, Dragana Sobic Saranovic, Marina Vlajkovic, Felix Keng, Jason See, Zuzana Berecova, Jana Polakova Mistinova, Osayande Evbuomwan, Nerisha Govender, Jonathan Hack, Bawinile Hadebe, Khanyisile Hlongwa, Mitchell Kaplan, Hoosen Lakhi, Katarina Milos, Moshe Modiselle, Stuart More, Ntanganedzeni Muambadzi, Leonie Scholtz, Manuel Barreiro-Perez, Isabel Blanco, Jordi Broncano, Alicia Camarero, Irene Casáns-Tormo, Javier De Haro, Albert Flotats, Elia García, Ceferino Gutierrez Mendiguchia, Amelia Jimenez-Heffernan, Ruben Leta, Javier Lopez Diaz, Luis Lumbreras Vega, Ana Manovel-Sánchez, Amparo Martinez Monzonis, Bianca Patrut, Virginia Pubul, Ricardo Ruano Perez, Nahla Zeidan, Damayanthi Nanayakkara, Ahmed Suliman, Henrik Engblom, Mustafa Murtadha, Ellen Ostenfeld, Magnus Simonsson, Hatem Alkadhi, Ronny Ralf Buechel, Peter Burger, Christoph Gräni, Christel Kamani, Nadine Kawel-Böhm, Bernd Klaeser, Robert Manka, John Prior, Tawika Kaewchur, Benjapa Khiewvan, Arpakorn Kositwattanarerk, Sirianong Namwongprom, Tanyaluck Thientunyakit, Haluk Burcak Sayman, Mahmut Yüksel, Mugisha Julius Sebikali, Emmy Okello, Pavlo Korol, Iryna Noverko, Maryna Satyr, Tahir Ahmad, Khaled Alfakih, Ivo Andrade, Susan Buckingham, Anda Bularga, John-Paul Carpenter, Graham Cole, David Cusack, Sarojini David, Patrick Davis, Timothy Fairbairn, Arjun Ghosh, Prasad Guntur Ramkumar, Mark Hamilton, Faisal Haque, Benjamin Hudson, Annette Johnstone, V.J. Karthikeyan, Mike Kay, Mohammad Ali Khan, Jamie Kitt, Chen Sheng Low, Elisa Mcalindon, David Mccreavy, Brian Morrissey, Manish Motwani, Dilip Na, Edward Nicol, Dilip Patel, Jonathan Rodrigues, Chris Rofe, Rebecca Schofield, Thomas Semple, Azeem Sheikh, Apurva Sinha, Deepak Subedi, William Topping, Katherine Tweed, Stephen Richard Underwood, Jonathan Weir-Mccall, Hamed Zuhairy, Taimur Abbasi, Shady Abohashem, Sandra Abramson, Mouaz Al-Mallah, Mohan Ashok Kumar, Mallory Balmer-Swain, Daniel Berman, Adam Bernheim, Sabha Bhatti, Robert Biederman, Erik Bieging, Scott Bingham, Stephen Bloom, Sean Blue, Andressa Borges, Kelley Branch, Paco Bravo, Sujatha Buddhe, Matthew Budoff, Renée Bullock-Palmer, Michael Cahill, Candace Candela, Jane Cao, Saurav Chatterjee, Yiannis Chatzizisis, Nita Ray Chaudhuri, Michael Cheezum, Anjali Chelliah, Tiffany Chen, Marcus Chen, Lu Chen, Aalap Chokshi, Jina Chung, Sorin Danciu, William DeSisto, Michael Dilorenzo, Rami Doukky, William Duvall, Maros Ferencik, Cameron Foster, Anthon Fuisz, Michael Gannon, David German, Myron Gerson, Jeffrey Geske, Fadi Hage, Agha Haider, Sofia Haider, Yasmin Hamirani, Karen Hassen, Robert Hendel, Jacqueline Henkel, Stephen Horgan, Mark Hyun, Rajesh Janardhanan, Scott Jerome, Dinesh Kalra, David Kassop, Mona Kinkhabwala, George Kinzfogl, Bernard Koch, Lynne Koweek, Joseph Krepp, Younghoon Kwon, Jay Layer, John Lesser, Steve Leung, Bernadette Lisske, Kathleen Magurany, Jeremy Markowitz, Brenda Mccullough, Azita Moalemi, Chanan Moffitt, Juan Montanez, Warren Moore, Shamil Morayati, Mahmud Mossa-Basha, Zorana Mrsic, Venkatesh Murthy, Prashant Nagpal, Katarina Nelson, Prabhjot Nijjar, Rupal O’Quinn, Edward Passen, Toral Patel, Pravin Patil, Amit Pursnani, Nancy Quachang, Mark Rabbat, Pragya Ranjan, Patricia Rodriguez Lozano, Mary Schemmer, Rebecca Seifried, Nishant Shah, Amee Shah, Sujata Shanbhag, Gaurav Sharma, Robert Skotnicki, Michael Sobczak, Prem Soman, Vincent Sorrell, Monvadi Srichai, Jim Streeter, Leah Strickland, Suliman Suliman, Naghmeh Tebyanian, Dustin Thomas, Randall Thompson, Seth Uretsky, Srikanth Vallurupalli, Marian Vandyck-Acquah, Vikas Verma, Todd Villines, Joseph Weinstein, David Wolinsky, Karolina Zareba, Michael Zgaljardic, Mario Beretta, Rodolfo Ferrando, Miguel Kapitan, Fernando Mut, Omoa Djuraev, Gulnora Rozikhodjaeva, Luisa Vera, Binh Duong Duc, Xuan Canh Nguyen, Phuoc Minh Hiep Nguyen, Translational Immunology Groningen (TRIGR), Cardiovascular Centre (CVC), Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Molecular Pharmacology, Drug Design, Einstein, A, Hirschfeld, C, Williams, M, Vitola, J, Better, N, Villines, T, Cerci, R, Shaw, L, Choi, A, Dorbala, S, Karthikeyan, G, Lu, B, Sinitsyn, V, Ansheles, A, Kudo, T, Bucciarelli-Ducci, C, Norgaard, B, Maurovich-Horvat, P, Campisi, R, Milan, E, Louw, L, Allam, A, Bhatia, M, Sewanan, L, Malkovskiy, E, Cohen, Y, Randazzo, M, Narula, J, Morozova, O, Pascual, T, Pynda, Y, Dondi, M, Paez, D, Hinterleitner, G, Lu, Y, Xu, Z, Erinne, I, Shetty, M, Lopez-Mattei, J, Parwani, P, Goda, A, Shirka, E, Bouyoucef, S, Chelghoum, L, Mansouri, F, Medjahedi, A, Naili, Q, Ridouh, M, Alasia, D, Alberghina, L, Aramayo, N, Buchara, D, Busso, F, Bustos Rivadero, J, Camilletti, J, Campanelli, H, Castro, R, Daicz, M, del Riego, H, Dragonetti, L, Echazarreta, D, Erriest, J, Faccio, F, Facello, A, Gallegos, H, Geronazzo, R, Glait, H, Hasbani, V, Jager, V, Lewkowicz, J, Lotti, J, Maciel, N, Masoli, O, Mastrovito, E, Medus, M, Merani, M, Molteni, S, Montecinos, M, Parisi, G, Sueldo, C, Perez de Arenaza, D, Quintana, L, Radzinschi, A, Redruello, M, Rodriguez, M, Rojas, H, Acuna, A, Schere, D, Traverso, S, Vazquez, G, Zeffiro, S, Sakanyan, M, Beuzeville, S, Boktor, R, Crowley, M, Downie, D, Dwivedi, G, Elison, B, Farouque, O, Jasper, K, Joshi, S, Lee, J, Lee, K, Lui, E, Mcconachie, P, Meaker, J, Nandurkar, D, Neill, J, O'Rourke, E, O'Sullivan, P, Pandos, G, Premaratne, M, Prior, D, Rutherford, N, Saunders, C, Taubman, K, Tauro, A, Taylor, A, Theuerle, J, Thomas, P, Tow, J, Upton, A, Vamadevan, S, Wayne, V, Wegner, E, Wong, D, Younger, J, Beitzke, D, Feuchtner, G, Sommer, O, Weiss, K, Maroz-Vadalazhskaya, N, Tserakhau, U, Homans, F, Van De Heyning, C, Araujo, R, Soldat-Stankovic, V, Stankovic, S, Almeida, A, Anselmi, C, Azevedo, G, Bittencourt, M, Pianta, D, Cabeda, E, Carreira, L, Coelho, I, de Amorim Fernandes, F, de Lorenzo, A, Delgado, R, Erthal, F, Fernandes, F, Fernandes, J, Ferreira de Souza, T, Foppa, M, Matos Alves, W, Gontijo, C, Gottlieb, I, Grossman, G, Albernaz Siqueira, M, Nomura, C, Koga, K, Lima, R, Lopes, R, Marcal Filho, H, Masiero, P, Mastrocola, L, Menezes de Siqueira, M, Mesquita, C, Naves, D, Penna, F, Pinto, I, Rocha, T, Rocha, J, Rodrigues, A, Salioni, L, Sanches, A, Santos, M, Da Silva, L, Schvartzman, P, Matushita, C, Senra, T, Silva, M, Soares, C, Spiro, B, Suaide Silva, C, Torres, R, Monte, G, Vilela, A, Villa, A, Voss, T, Waltrick, R, Zapparoli, M, Naseer, H, Garcheva-Tsacheva, M, Ouattara, T, Thou, S, Varoeun, S, Abikhzer, G, Beanlands, R, Chetrit, M, Dabreo, D, Dennie, C, Friedrich, M, Hafez, M, Hanneman, K, Miller, R, Oikonomou, A, Roifman, I, Small, G, Tandon, V, Trivedi, A, White, J, Zukotynski, K, Alay, R, Concha, C, Massardo, T, Abad, P, Anzola, K, Arturo, H, Benitez, L, Cadena, A, Zamudio, C, Calderon, A, Gutierrez Villamil, C, Jaimes, C, Londono, J, Lopez, N, Merlano-Gaitan, S, Murgieitio-Cabrera, R, Valencia, M, Vergel, D, Santamaria, A, Solis, F, Batinic, T, Franceschi, M, Paar, M, Prpic, M, Felipe Batista, C, Cabrera, L, Peix, A, Pena, Y, Rochela Vazquez, L, Ntalas, I, Kaminek, M, Kincl, V, Lang, O, Abdulla, J, Bottcher, M, Busk, M, Geisler, U, Gormsen, L, Hansson, N, Hess, S, Hove, J, Jensen, L, Jensen, M, Kragholm, K, Ovrehus, K, Rasmussen, J, Ronnow Sand, N, Sondergaard, H, Zaremba, T, Speckter, H, Amores, N, Velez, M, Alrahman, T, Elsamad, S, Abdelfattah, A, Elkaffas, S, Hassan, M, Hussein, E, Ibrahim, A, Kandeel, A, Ali, M, Shaaban, M, Flores, C, Gomez Leiva, V, Liiver, A, Larikka, M, Uusitalo, V, Agostini, D, Berger, C, Dietz, M, Hyafil, F, Ohana, M, Prigent, K, Regaieg, H, Sarda-Mantel, L, H-Ici, D, Ayetey, H, Angelidis, G, Fragkaki, C, Fragkiadaki, C, Georgoulias, P, Koutelou, M, Kyrozi, E, Lama, N, Prassopoulos, V, Spartalis, M, Zaglavara, T, Gonzalez, C, Gutierrez, G, Maldonado, A, Martinez, Y, Kovacs, A, Szilveszter, B, Banthia, N, Bhat, V, Choudhury, P, Chowdekar, V, Christopher, J, Garg, T, Goyal, N, Gupta, R, Gupta, A, Hephzibah, J, Jain, S, Krupa, J, Kumar, P, Kumar, S, Lalchandani, A, Mishra, A, Mishra, V, Mohan, P, Ozair, A, Pandey, S, Parameswaran, R, Patel, C, Patel, T, Patel, S, Vimala, L, Kumar Sarangi, D, Sengupta, S, Sethi, A, Sharma, A, Sharma, P, Shrigiriwar, A, Singh, S, Singh, H, Sood, A, Verma, A, Vyas, A, Soeriadi, E, Bun, E, Hutomo, F, Syawaluddin, H, Yudistiro, R, Albadr, A, Assadi, M, Emami, F, Emami-Ardekani, A, Farzanehfar, S, Jafari, R, Manafi-Farid, R, Tajik, M, Arnson, Y, Fuchs, S, Goldkorn, R, Kennedy, J, Leitman, M, Shalev, A, Acampa, W, Albano, D, Alongi, P, Arnone, G, Assante, R, Baritussio, A, Bauckneht, M, Bianco, F, Bonfiglioli, R, Bovenzi, F, Bruno, I, Bruno, A, Busnardo, E, Califaretti, E, Casoni, R, Censullo, V, Chierichetti, F, Chiocchi, M, Cittanti, C, Clemente, A, Cuocolo, A, De Rimini, M, De Vincentis, G, Della Tommasina, V, Dellegrottaglie, S, Erba, P, Evangelista, L, Faggi, L, Faragasso, E, Florimonte, L, Frantellizzi, V, Gatti, M, Gaudiano, A, Gelardi, F, Gerali, A, Gimelli, A, Guglielmo, M, Leccisotti, L, Liga, R, Liguori, C, Longo, G, Maffione, M, Marcassa, C, Matassa, G, Mele, D, Mircoli, L, Paccagnella, A, Pacella, S, Padovano, F, Pellegrini, D, Pergola, V, Pugliese, L, Quartuccio, N, Rampin, L, Ricci, F, Rubini, G, Russo, V, Sambuceti, G, Scatteia, A, Sciagra, R, Spidalieri, G, Stefanelli, A, Tedeschi, C, Ventroni, G, Baugh, D, Madu, E, Aikawa, T, Asano, H, Fujimoto, S, Fujise, K, Fukushima, Y, Fukuyama, K, Ichikawa, Y, Ideguchi, R, Iguchi, N, Imai, M, Ishimura, H, Isobe, S, Ito, K, Izawa, Y, Kadokami, T, Kasai, T, Kato, T, Kawamoto, T, Kiryu, S, Kumita, S, Manabe, O, Maruno, H, Matsumoto, N, Miyagawa, M, Moroi, M, Nagamachi, S, Nakajima, K, Nakazato, R, Nanasato, M, Naya, M, Norikane, T, Ohta, Y, Otomi, Y, Otsuka, H, Oyama-Manabe, N, Saito, M, Sarai, M, Sato, J, Sato, D, Shiraishi, S, Takanami, K, Takehana, K, Taniguchi, Y, Teragawa, H, Tomizawa, N, Umeji, K, Wakabayashi, Y, Yamada, S, Yamazaki, S, Yoneyama, T, Rawashdeh, M, Dautov, T, Makhdomi, K, Abass, M, Garashi, M, Siraj, Q, Kalnina, M, Haidar, M, Komiagiene, R, Kviecinskiene, G, Vajauskas, D, Karim, N, Doucoure, M, Reichmuth, L, Samuel, A, Dieng, M, Naojee, A, Hernandez, E, Alducin Tellez, C, Alexanderson-Rosas, E, Barragan, E, Cabada, M, Calderon, D, Carvajal-Juarez, I, Esparza, J, Gama-Moreno, M, Quinto, V, Gonzalez, N, Herrera-Zarza, M, Meave, A, Medina Verdugo, J, Melendez, G, Morales Murguia, R, Navarro Quiroz, C, Ornelas, M, Preciado-Anaya, A, Preciado-Gutierrez, O, Puente, A, Salazar, A, Rosales Uvera, S, Rosales-Uvera, S, Serna Macias, J, Sierra-Galan, L, Tirado Alderete, J, Vallejo, E, Faraggi, M, Sereegotov, E, Ben Rais, N, Alaoui, N, Kyiphyu, T, Oo, S, Win, S, Zar, H, Ghimire, R, Neupane, M, Glaudemans, A, Slart, R, Verschure, D, Allen, B, Edmond, J, Mckenzie, C, Tie, S, Van Pelt, N, Worthington, K, Young, C, Soli, I, Kana, S, Onubogu, U, Sani, M, Braten, A, Jorgensen, A, Vassbotn, H, Al Dhuhli, H, Jawa, Z, Tag, N, Fatima, S, Imran, M, Younis, M, Saadullah, M, Malo, Y, Lenturut-Katal, D, Castillo, M, Ortellado, J, Akhter, A, Cader, F, Hussain, R, Khan, S, Mandal, T, Nasreen, F, An, Y, Cao, D, Gong, L, Hou, Y, Jia, C, Li, T, Li, C, Liu, H, Liu, W, Liu, J, Ng, M, Shi, H, Tang, C, Wang, X, Wang, Z, Wang, Y, Wu, J, Yi, Y, Yuan, L, Zhang, T, Zhang, L, Chavez, E, Cruz, C, Llontop, C, Morales, R, Abrihan, P, Bustos-Barroso, A, Duldulao-Ogbac, M, Eduarte, C, Obaldo, J, Quinon, A, San Juan, B, San Juan, C, Sauler-Gomez, M, Uy, M, Kostkiewicz, M, Kunikowska, J, Teresinska, A, Urbanik, T, Bettencourt, N, Fontes-Carvalho, R, Gavina, C, Goncalves, L, Macedo, F, Moreno, N, Sousa, C, Timoteo, A, Vidigal, M, Al Heidous, M, Ramanathan, S, Arnous, S, Aytani, S, Byrne, A, Gleeson, T, Kerins, D, O'Brien, J, Bang, J, Bom, H, Cheon, M, Cheon, G, Cho, S, Hong, C, Jeong, Y, Kang, W, Kang, Y, Kim, J, Oh, S, So, Y, Song, H, Won, K, Yoo, S, Mitevska, I, Vavlukis, M, Salobir, B, Stalc, M, Benedek, T, Pop, M, Stan, C, Dariy, O, Gagarina, N, Itskovich, I, Karalkin, A, Kokov, A, Marina, G, Migunova, E, Pospelov, V, Ryzhkova, D, Sayfullina, G, Sergienko, V, Shurupova, I, Vakhromeeva, M, Valiullina, N, Zavadovsky, K, Zhuravlev, K, Abazid, R, Al Garni, T, Alasnag, M, Aljizeeri, A, Amer, H, Amro, A, Hamdy, H, Smettei, O, Saranovic, D, Vlajkovic, M, Keng, F, See, J, Berecova, Z, Mistinova, J, Evbuomwan, O, Govender, N, Hack, J, Hadebe, B, Hlongwa, K, Kaplan, M, Lakhi, H, Milos, K, Modiselle, M, More, S, Muambadzi, N, Scholtz, L, Barreiro-Perez, M, Blanco, I, Broncano, J, Camarero, A, Casans-Tormo, I, De Haro, J, Flotats, A, Garcia, E, Mendiguchia, C, Jimenez-Heffernan, A, Leta, R, Diaz, J, Vega, L, Manovel-Sanchez, A, Monzonis, A, Patrut, B, Pubul, V, Perez, R, Zeidan, N, Nanayakkara, D, Suliman, A, Engblom, H, Murtadha, M, Ostenfeld, E, Simonsson, M, Alkadhi, H, Buechel, R, Burger, P, Grani, C, Kamani, C, Kawel-Bohm, N, Klaeser, B, Manka, R, Prior, J, Kaewchur, T, Khiewvan, B, Kositwattanarerk, A, Namwongprom, S, Thientunyakit, T, Sayman, H, Yuksel, M, Sebikali, M, Okello, E, Korol, P, Noverko, I, Satyr, M, Ahmad, T, Alfakih, K, Andrade, I, Buckingham, S, Bularga, A, Carpenter, J, Cole, G, Cusack, D, David, S, Davis, P, Fairbairn, T, Ghosh, A, Ramkumar, P, Hamilton, M, Haque, F, Hudson, B, Johnstone, A, Karthikeyan, V, Kay, M, Khan, M, Kitt, J, Low, C, Mcalindon, E, Mccreavy, D, Morrissey, B, Motwani, M, Na, D, Nicol, E, Patel, D, Rodrigues, J, Rofe, C, Schofield, R, Semple, T, Sheikh, A, Sinha, A, Subedi, D, Topping, W, Tweed, K, Underwood, S, Weir-Mccall, J, Zuhairy, H, Abbasi, T, Abohashem, S, Abramson, S, Al-Mallah, M, Kumar, M, Balmer-Swain, M, Berman, D, Bernheim, A, Bhatti, S, Biederman, R, Bieging, E, Bingham, S, Bloom, S, Blue, S, Borges, A, Branch, K, Bravo, P, Buddhe, S, Budoff, M, Bullock-Palmer, R, Cahill, M, Candela, C, Cao, J, Chatterjee, S, Chatzizisis, Y, Chaudhuri, N, Cheezum, M, Chelliah, A, Chen, T, Chen, M, Chen, L, Chokshi, A, Chung, J, Danciu, S, Desisto, W, Dilorenzo, M, Doukky, R, Duvall, W, Ferencik, M, Foster, C, Fuisz, A, Gannon, M, German, D, Gerson, M, Geske, J, Hage, F, Haider, A, Haider, S, Hamirani, Y, Hassen, K, Hendel, R, Henkel, J, Horgan, S, Hyun, M, Janardhanan, R, Jerome, S, Kalra, D, Kassop, D, Kinkhabwala, M, Kinzfogl, G, Koch, B, Koweek, L, Krepp, J, Kwon, Y, Layer, J, Lesser, J, Leung, S, Lisske, B, Magurany, K, Markowitz, J, Mccullough, B, Moalemi, A, Moffitt, C, Montanez, J, Moore, W, Morayati, S, Mossa-Basha, M, Mrsic, Z, Murthy, V, Nagpal, P, Nelson, K, Nijjar, P, O'Quinn, R, Passen, E, Patil, P, Pursnani, A, Quachang, N, Rabbat, M, Ranjan, P, Lozano, P, Schemmer, M, Seifried, R, Shah, N, Shah, A, Shanbhag, S, Sharma, G, Skotnicki, R, Sobczak, M, Soman, P, Sorrell, V, Srichai, M, Streeter, J, Strickland, L, Suliman, S, Tebyanian, N, Thomas, D, Thompson, R, Uretsky, S, Vallurupalli, S, Vandyck-Acquah, M, Verma, V, Weinstein, J, Wolinsky, D, Zareba, K, Zgaljardic, M, Beretta, M, Ferrando, R, Kapitan, M, Mut, F, Djuraev, O, Rozikhodjaeva, G, Vera, L, Duc, B, Nguyen, X, Hiep Nguyen, P, Einstein, Andrew J, Hirschfeld, Cole, Williams, Michelle C, Vitola, Joao V, Better, Nathan, Villines, Todd C, Cerci, Rodrigo, Shaw, Leslee J, Choi, Andrew D, Dorbala, Sharmila, Karthikeyan, Ganesan, Lu, Bin, Sinitsyn, Valentin, Ansheles, Alexey A, Kudo, Takashi, Bucciarelli-Ducci, Chiara, Nørgaard, Bjarne Linde, Maurovich-Horvat, Pál, Campisi, Roxana, Milan, Elisa, Louw, Lizette, Allam, Adel H, Bhatia, Mona, Sewanan, Lorenzo, Malkovskiy, Eli, Cohen, Yosef, Randazzo, Michael, Narula, Jagat, Morozova, Olga, Pascual, Thomas N B, Pynda, Yaroslav, Dondi, Maurizio, Paez, Diana, and Cuocolo, Alberto
Subjects: cardiac testing, Health Personnel, delivery of health care, coronavirus, COVID-19, global health, 610 Medicine & health, cardiovascular disease, health personnel, humans, pandemics, surveys and questionnaires, coronaviru, Surveys and Questionnaires, Humans, Cardiology and Cardiovascular Medicine, Delivery of Health Care, Pandemics, COVID-19/epidemiology
Abstract: BACKGROUND: The extent to which health care systems have adapted to the COVID-19 pandemic to provide necessary cardiac diagnostic services is unknown.OBJECTIVES: The aim of this study was to determine the impact of the pandemic on cardiac testing practices, volumes and types of diagnostic services, and perceived psychological stress to health care providers worldwide.METHODS: The International Atomic Energy Agency conducted a worldwide survey assessing alterations from baseline in cardiovascular diagnostic care at the pandemic's onset and 1 year later. Multivariable regression was used to determine factors associated with procedure volume recovery.RESULTS: Surveys were submitted from 669 centers in 107 countries. Worldwide reduction in cardiac procedure volumes of 64% from March 2019 to April 2020 recovered by April 2021 in high- and upper middle-income countries (recovery rates of 108% and 99%) but remained depressed in lower middle- and low-income countries (46% and 30% recovery). Although stress testing was used 12% less frequently in 2021 than in 2019, coronary computed tomographic angiography was used 14% more, a trend also seen for other advanced cardiac imaging modalities (positron emission tomography and magnetic resonance; 22%-25% increases). Pandemic-related psychological stress was estimated to have affected nearly 40% of staff, impacting patient care at 78% of sites. In multivariable regression, only lower-income status and physicians' psychological stress were significant in predicting recovery of cardiac testing.CONCLUSIONS: Cardiac diagnostic testing has yet to recover to prepandemic levels in lower-income countries. Worldwide, the decrease in standard stress testing is offset by greater use of advanced cardiac imaging modalities. Pandemic-related psychological stress among providers is widespread and associated with poor recovery of cardiac testing.
Published: 2022

8. Prevalence of dementia and mild cognitive impairment in indigenous Bolivian forager-horticulturalists

Author: Margaret Gatz, Wendy J. Mack, Helena C. Chui, E. Meng Law, Giuseppe Barisano, M. Linda Sutherland, James D. Sutherland, Daniel Eid Rodriguez, Raul Quispe Gutierrez, Juan Copajira Adrian, Jesus Bani Cuata, Amy R. Borenstein, Ellen E. Walters, Andrei Irimia, Christopher J. Rowan, L. Samuel Wann, Adel H. Allam, Randall C. Thompson, Michael I. Miyamoto, David E. Michalik, Daniel K. Cummings, Edmond Seabright, Angela R. Garcia, Paul L. Hooper, Thomas S. Kraft, Caleb E. Finch, Gregory S. Thomas, Jonathan Stieglitz, Benjamin C. Trumble, Michael D. Gurven, and Hillard Kaplan
Subjects: Bolivia, Aging, Epidemiology, Clinical Sciences, Neuroimaging, Neurodegenerative, Alzheimer's Disease, Cellular and Molecular Neuroscience, Developmental Neuroscience, Alzheimer Disease, cognitive dysfunction, Clinical Research, Behavioral and Social Science, Prevalence, Acquired Cognitive Impairment, Humans, Tsimane, Moseten, Health Policy, Neurosciences, Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD), Brain Disorders, Psychiatry and Mental health, Mental Health, Good Health and Well Being, Geriatrics, Neurological, Disease Progression, Biomedical Imaging, Dementia, Neurology (clinical), mental status and dementia tests, Geriatrics and Gerontology
Abstract: IntroductionWe evaluated the prevalence of dementia and mild cognitive impairment (MCI) in indigenous Tsimane and Moseten, who lead a subsistence lifestyle.MethodsParticipants from population-based samples ≥60 years of age (n=623) were assessed using adapted versions of the Modified Mini-Mental State Examination, informant interview, longitudinal cognitive testing and brain computed tomography (CT) scans.ResultsTsimane exhibited five cases of dementia (among n=435; crude prevalence=1.2%, 95% confidence interval [CI]: 0.4, 2.7); Moseten exhibited one case (among n=169; crude prevalence=0.6%, 95% CI: 0.0, 3.2), all age≥80 years. Age-standardized MCI prevalence was 7.7% (95% CI: 5.2, 10.3) in Tsimane and 9.8% (95% CI: 4.9, 14.6) in Moseten. Cognitive impairment was associated with visuospatial impairments, parkinsonian symptoms, and vascular calcification in the basal ganglia.DiscussionThe prevalence of dementia in this cohort is among the lowest in the world. Widespread intracranial medial arterial calcifications suggest a previously unrecognized, non-Alzheimer's disease (AD) dementia phenotype.
Published: 2022

9. The indigenous South American Tsimane exhibit relatively modest decrease in brain volume with age despite high systemic inflammation

Author: Margaret Gatz, Andrei Irimia, Maria Calvillo, Caleb E. Finch, Hillard Kaplan, Adel H. Allam, David J. Robles, Edmond Seabright, Angela R. Garcia, James D. Sutherland, L. Samuel Wann, Wendy J. Mack, Benjamin C. Trumble, Van Anh Ngo, Sarah Alami, Gregory S. Thomas, E. Meng Law, Nahian F. Chowdhury, Randall C. Thompson, Chris J. Rowan, Alexander S. Maher, Kenneth A. Rostowsky, Paul L. Hooper, Daniel K. Cummings, Michael Gurven, M. Linda Sutherland, David E. Michalik, Nikhil N. Chaudhari, Jonathan Stieglitz, and Le Couteur, David
Subjects: Male, 0301 basic medicine, THE JOURNAL OF GERONTOLOGY: Biological Sciences, Aging, Coronary Artery Disease, Disease, Cardiovascular, Systemic inflammation, 0302 clinical medicine, 80 and over, B- ECONOMIE ET FINANCE, Aged, 80 and over, education.field_of_study, Brain, Organ Size, Middle Aged, Cardiovascular disease, Heart Disease, Infectious Diseases, Brain size, Cohort, Biomedical Imaging, Female, medicine.symptom, Adult, Bolivia, Clinical Sciences, Population, 03 medical and health sciences, Atrophy, medicine, Humans, Dementia, Neurodegeneration, Indigenous Peoples, education, Life Style, Aged, Inflammation, Cerebral atrophy, business.industry, Neurosciences, South America, Atherosclerosis, medicine.disease, Brain Disorders, Good Health and Well Being, 030104 developmental biology, Brain aging, Geriatrics and Gerontology, business, Gerontology, 030217 neurology & neurosurgery, Demography
Abstract: Brain atrophy is correlated with risk of cognitive impairment, functional decline, and dementia. Despite a high infectious disease burden, Tsimane forager-horticulturists of Bolivia have the lowest prevalence of coronary atherosclerosis of any studied population and present few cardiovascular disease (CVD) risk factors despite a high burden of infections and therefore inflammation. This study (a) examines the statistical association between brain volume (BV) and age for Tsimane and (b) compares this association to that of 3 industrialized populations in the United States and Europe. This cohort-based panel study enrolled 746 participants aged 40–94 (396 males), from whom computed tomography (CT) head scans were acquired. BV and intracranial volume (ICV) were calculated from automatic head CT segmentations. The linear regression coefficient estimate β^T of the Tsimane (T), describing the relationship between age (predictor) and BV (response, as a percentage of ICV), was calculated for the pooled sample (including both sexes) and for each sex. β^T was compared to the corresponding regression coefficient estimate β^R of samples from the industrialized reference (R) countries. For all comparisons, the null hypothesis β T = β R was rejected both for the combined samples of males and females, as well as separately for each sex. Our results indicate that the Tsimane exhibit a significantly slower decrease in BV with age than populations in the United States and Europe. Such reduced rates of BV decrease, together with a subsistence lifestyle and low CVD risk, may protect brain health despite considerable chronic inflammation related to infectious burden.
Published: 2021

10. Do we need a new definition for post-stress reduction in LVEF beyond the numerical values?

Author: Adel H. Allam, Ahmed Abdel Aaty, Alia Abdelfattah, and Mohamed A. Mandour Ali
Subjects: Stress reduction, medicine.medical_specialty, Adenosine, Ejection fraction, business.industry, Stroke Volume, Prognosis, Ventricular Function, Left, Perfusion, Internal medicine, medicine, Cardiology, Humans, Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine, business
Published: 2019

11. Worldwide Diagnostic Reference Levels for Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging

Author: Cole B. Hirschfeld, Maurizio Dondi, Thomas N.B. Pascual, Mathew Mercuri, Joao Vitola, Ganesan Karthikeyan, Nathan Better, John J. Mahmarian, Salah E. Bouyoucef, Henry Hee-Seung Bom, Vikram Lele, Vincent Peter C. Magboo, Erick Alexánderson, Adel H. Allam, Mouaz H. Al-Mallah, Albert Flotats, Scott Jerome, Philipp A. Kaufmann, Osnat Luxenburg, S. Richard Underwood, Madan M. Rehani, Jenia Vassileva, Diana Paez, Andrew J. Einstein, A.J. Einstein, T.N.B. Pascual, D. Paez, M. Dondi, N. Better, S.E. Bouyoucef, G. Karthikeyan, R. Kashyap, V. Lele, V.P.C. Magboo, J.J. Mahmarian, J.B. Meeks, M. Mercuri, F. Mut, M.M. Rehani, J.V. Vitola, E. Alexanderson, A. Allam, M.H. Al-Mallah, H. Bom, A. Flotats, S. Jerome, P.A. Kaufmann, O. Luxenburg, J. Mahmarian, L.J. Shaw, S.R. Underwood, J. Vitola, W. Amouri, H. Essabbah, S.S. Gassama, K.B. Makhdomi, G.I.E. El Mustapha, N. El Ouchdi, N. Qaïs, N. Soni, W. Vangu, R.M. Abazid, B. Adams, V. Agarwal, M.A. Alfeeli, N. Alnafisi, L. Bernabe, G.G. Bural, T. Chaiwatanarat, J.M. Chandraguptha, G.J. Cheon, I. Cho, A.S. Dogan, M. Eftekhari, A. Frenkel, I. Garty, S. George, P. Geramifar, H. Golan, S. Habib, R. Hussain, H. Im, H.-J. Jeon, T. Kalawat, W.J. Kang, F. Keng, A. Klaipetch, P.G. Kumar, J. Lee, W.W. Lee, I. Lim, C.M.M. Macaisa, G. Malhotra, B.R. Mittal, M.H. Mohammad, P. Mohan, I.D. Mulyanto, D. Nariman, U.N. Nayak, K. Niaz, G. Nikolov, J.M. Obaldo, E. Ozturk, J.M. Park, S. Park, C.D. Patel, H.K. Phuong, A.P. Quinon, T.R. Rajini, Y. Saengsuda, J. Santiago, H.B. Sayman, A.S. Shinto, V. Sivasubramaniyan, M.H. Son, P. Sudhakar, G.M.S. Syed, N. Tamaki, K. Thamnirat, T. Thientunyakit, S. Thongmak, D.N. Velasco, A. Verma, U. Vutrapongwatana, Y. Wang, K.S. Won, Z. Yao, T. Yingsa-nga, R. Yudistiro, K.T. Yue, N. Zafrir, S.C. Adrian, D. Agostini, S. Aguadé, G. Armitage, M. Backlund, M. Backman, M. Baker, M.T. Balducci, C. Bavelaar, M. Berovic, F. Bertagna, R. Beuchel, A. Biggi, G. Bisi, R. Bonini, A. Bradley, L. Brudin, I. Bruno, E. Busnardo, R. Casoni, A. Choudhri, C. Cittanti, R. Clauss, D.C. Costa, M. Costa, K. Dixon, M. Dziuk, N. Egelic, I. Eriksson, G. Fagioli, D.B. de Faria, L. Florimonte, A. Francini, M. French, E. Gallagher, I. Garai, O. Geatti, D. Genovesi, L. Gianolli, A. Gimelli, E. del Giudice, S. Halliwell, M.J. Hansson, C. Harrison, F. Homans, F. Horton, D. Jędrzejuk, J. Jogi, A. Johansen, H. Johansson, M. Kalnina, M. Kaminek, A. Kiss, M. Kobylecka, M. Kostkiewicz, J. Kropp, R. Kullenberg, T. Lahoutte, O. Lang, Y.H. Larsson, M. Lázár, L. Leccisotti, N. Leners, O. Lindner, R.W. Lipp, A. Maenhout, L. Maffioli, C. Marcassa, B. Martins, P. Marzullo, G. Medolago, C.G. Mendiguchía, S. Mirzaei, M. Mori, B. Nardi, S. Nazarenko, K. Nikoletic, R. Oleksa, T. Parviainen, J. Patrina, R. Peace, C. Pirich, H. Piwowarska-Bilska, S. Popa, V. Prakash, V. Pubul, L. Puklavec, S. Rac, M. Ratniece, S.A. Rogan, A. Romeo, M. Rossi, D. Ruiz, N. Sabharwal, B.G. Salobir, A.I. Santos, S. Saranovic, A. Sarkozi, R.P. Schneider, R. Sciagra, S. Scotti, Z. Servini, L.R. Setti, S.-Å. Starck, D. Vajauskas, J. Veselý, A. Vieni, A. Vignati, I.M. Vito, K. Weiss, D. Wild, M. Zdraveska-Kochovska, R.N. Agüro, N. Alvarado, C.M. Barral, M. Beretta, I. Berrocal, J.F. Batista Cuellar, T-M. Cabral Chang, L.O. Cabrera Rodríguez, J. Canessa, G. Castro Mora, A.C. Claudia, G.F. Clavelo, A.F. Cruz Júnior, F.F. Faccio, K.M. Fernández, J.R. Gomez Garibo, U. Gonzalez, P. González E, M.A. Guzzo, J. Jofre, M. Kapitán, G. Kempfer, J.L. Lopez, T. Massardo V, I. Medeiros Colaco, C.T. Mesquita, M. Montecinos, S. Neubauer, L.M. Pabon, A. Puente, L.M. Rochela Vazquez, J.A. Serna Macias, A.G. Silva Pino, F.Z. Tártari Huber, A.P. Tovar, L. Vargas, C. Wiefels, A. Aljizeeri, R.J. Alvarez, D. Barger, W. Beardwood, J. Behrens, L. Brann, D. Brown, H. Carr, K. Churchwell, G.A. Comingore, J. Corbett, M. Costello, F. Cruz, T. Depinet, S. Dorbala, M. Earles, F.P. Esteves, E. Etherton, R.J. Fanning, J. Fornace, L. Franks, H. Gewirtz, K. Gulanchyn, C.-L. Hannah, J. Hays, J. Hendrickson, J. Hester, K. Holmes, A. Johnson, C. Jopek, H. Lewin, J. Lyons, C. Manley, J. Meden, S. Moore, W.H. Moore, V. Murthy, R. Nace, D. Neely, L. Nelson, O. Niedermaier, D. Rice, R. Rigs, K. Schiffer, E. Schockling, T. Schultz, T. Schumacker, B. Sheesley, A. Sheikh, B. Siegel, A.M. Slim, J. Smith, M. Szulc, N. Tanskersley, P. Tilkemeier, G.D. Valdez, R. Vrooman, D. Wawrowicz, D.E. Winchester, A. Alcheikh, B. Allen, E. Atkins, J. Bevan, C. Bonomini, J. Christiansen, L. Clack, E. Craig, H. Dixson, I. Duncan, S. Fredericks, S. Gales, R. Hampson, T. Hanley, K. Hartcher, J. Hassall, B. Kelley, S. Kelly, T. Kidd, T. de Kort, G. Larcos, W. Macdonald, C. McGrath, E. Murdoch, S. O'Malley, M. O'Rourke, M. Pack, R. Pearce, R. Praehofer, S. Ramsay, L. Scarlett, K. Smidt, F. Souvannavong, K. Taubman, G. Taylor, K. Tse, S. Unger, J. Weale, Columbia University Irving Medical Center (CUIMC), New York Presbyterian Hospital, International Atomic Energy Agency [Vienna] (IAEA), McMaster University [Hamilton, Ontario], University of Toronto, All India Institute of Medical Sciences [New Delhi], The Royal Melbourne Hospital, University of Melbourne, Methodist Debakey Heart and Vascular Center [Houston, TX, USA], Houston Methodist Hospital [Houston, TX, USA], Centre Hospitalier Universitaire de Bab-el-Oued, Alger, Algérie., Chonnam National University [Gwangju], Jaslok Hospital & Research Centre, University of the Philippines (UP System), University of Santo Tomas Hospital, Instituto Nacional de Cardiologia Ignacio Chavez, Universidad Nacional Autónoma de México (UNAM), Al-Azhar University [Cairo, Egypt], Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), University of Maryland [Baltimore], University hospital of Zurich [Zurich], The Gertner Institute for Epidemiology and Health Policy Research, National Heart and Lung Institute [London] (NHLI), Imperial College London-Royal Brompton and Harefield NHS Foundation Trust, Massachusetts General Hospital [Boston], and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
Subjects: medicine.medical_specialty, MESH: Radiation Dosage, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, 030204 cardiovascular system & hematology, Single-photon emission computed tomography, MESH: Tomography, Emission-Computed, Single-Photon, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Myocardial perfusion imaging, 0302 clinical medicine, MESH: Cross-Sectional Studies, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH: Diagnostic Reference Levels, Medical imaging, medicine, administered activity, Radiology, Nuclear Medicine and imaging, Medical physics, SPECT myocardial perfusion imaging, Protocol (science), MESH: Humans, medicine.diagnostic_test, business.industry, radiation dose reduction, diagnostic reference level, MESH: Predictive Value of Tests, 3. Good health, Predictive value of tests, Regional studies, Dose reduction, Cardiology and Cardiovascular Medicine, business, Emission computed tomography, MESH: Perfusion
Abstract: Objectives This study sought to establish worldwide and regional diagnostic reference levels (DRLs) and achievable administered activities (AAAs) for single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). Background Reference levels serve as radiation dose benchmarks to compare individual laboratories against aggregated data, helping to identify sites in greatest need of dose reduction interventions. DRLs for SPECT MPI have previously been derived from national or regional registries. To date there have been no multiregional reports of DRLs for SPECT MPI from a single standardized dataset. Methods Data were submitted voluntarily to the INCAPS (International Atomic Energy Agency Nuclear Cardiology Protocols Study), a cross-sectional, multinational registry of MPI protocols. A total of 7,103 studies were included. DRLs and AAAs were calculated by protocol for each world region and for aggregated worldwide data. Results The aggregated worldwide DRLs for rest-stress or stress-rest studies employing technetium Tc 99m–labeled radiopharmaceuticals were 11.2 mCi (first dose) and 32.0 mCi (second dose) for 1-day protocols, and 23.0 mCi (first dose) and 24.0 mCi (second dose) for multiday protocols. Corresponding AAAs were 10.1 mCi (first dose) and 28.0 mCi (second dose) for 1-day protocols, and 17.8 mCi (first dose) and 18.7 mCi (second dose) for multiday protocols. For stress-only technetium Tc 99m studies, the worldwide DRL and AAA were 18.0 mCi and 12.5 mCi, respectively. Stress-first imaging was used in 26% to 92% of regional studies except in North America where it was used in just 7% of cases. Significant differences in DRLs and AAAs were observed between regions. Conclusions This study reports reference levels for SPECT MPI for each major world region from one of the largest international registries of clinical MPI studies. Regional DRLs may be useful in establishing or revising guidelines or simply comparing individual laboratory protocols to regional trends. Organizations should continue to focus on establishing standardized reporting methods to improve the validity and comparability of regional DRLs.
Published: 2021

12. Very Low Prevalence and Incidence of Atrial Fibrillation among Bolivian Forager-Farmers

Author: Raul Quispe Gutierrez, Edmond Seabright, Chris J. Rowan, Abinash Achrekar, Hillard Kaplan, Gregory S. Thomas, Michael I. Miyamoto, Randall C. Thompson, Michael Gurven, Bret Alexander Beheim, Jonathan Stieglitz, Jagat Narula, Juan Copajira Adrian, Adel H. Allam, Benjamin C. Trumble, Michael A. Eskander, Daniel Cummings, Daniel Eid Rodriguez, Kirsten Tolstrup, Thomas S. Kraft, David E. Michalik, Edhitt Cortez Linares, L. Samuel Wann, and Institute for Advanced Study in Toulouse (IAST)
Subjects: Male, Aging, Infectious and parasitic diseases, RC109-216, Cardiovascular, Bolivian amazon, 0302 clinical medicine, Risk Factors, Atrial Fibrillation, Prevalence, 2.1 Biological and endogenous factors, 030212 general & internal medicine, B- ECONOMIE ET FINANCE, Original Research, 2. Zero hunger, Farmers, 030503 health policy & services, Incidence (epidemiology), Incidence, Atrial fibrillation, General Medicine, [SHS.ECO]Humanities and Social Sciences/Economics and Finance, 3. Good health, Infectious Diseases, Heart Disease, Public Health and Health Services, Female, Public aspects of medicine, RA1-1270, 0305 other medical science, medicine.medical_specialty, Bolivia, Clinical Sciences, Physical activity, 03 medical and health sciences, Clinical Research, Diabetes mellitus, Internal medicine, medicine, Humans, Obesity, Coronary atherosclerosis, Aged, Nutrition, business.industry, Prevention, medicine.disease, Atherosclerosis, business
Abstract: National audience; Background: Atrial fibrillation is the most common arrhythmia in post-industrialized populations. Older age, hypertension, obesity, chronic inflammation, and diabetes are significant atrial fibrillation risk factors, suggesting that modern urban environments may promote atrial fibrillation.Objective: Here we assess atrial fibrillation prevalence and incidence among tropical horticulturalists of the Bolivian Amazon with high levels of physical activity, a lean diet, and minimal coronary atherosclerosis, but also high infectious disease burden and associated inflammation.Methods: Between 2005–2019, 1314 Tsimane aged 40–94 years (52% female) and 534 Moseten Amerindians aged 40–89 years (50% female) underwent resting 12-lead electrocardiograms to assess atrial fibrillation prevalence. For atrial fibrillation incidence assessment, 1059 (81% of original sample) Tsimane and 310 Moseten (58%) underwent additional ECGs (mean time to follow up 7.0, 1.8 years, respectively).Findings:Only one (male) of 1314 Tsimane (0.076%) and one (male) of 534 Moseten (0.187%) demonstrated atrial fibrillation at baseline. There was one new (female) Tsimane case in 7395 risk years for the 1059 participants with >1 ECG (incidence rate = 0.14 per 1,000 risk years). No new cases were detected among Moseten, based on 542 risk years.Conclusion: Tsimane and Moseten show the lowest levels of atrial fibrillation ever reported, 1/20 to ~1/6 of rates in high-income countries. These findings provide additional evidence that a subsistence lifestyle with high levels of physical activity, and a diet low in processed carbohydrates and fat is cardioprotective, despite frequent infection-induced inflammation. Findings suggest that atrial fibrillation is a modifiable lifestyle disease rather than an inevitable feature of cardiovascular aging.
Published: 2021

13. Imaging Atherosclerosis in Great Apes

Author: Randall C. Thompson, Elaine C. Thompson, Navneet Narula, L. Samuel Wann, Ian Kwong, M. Linda Sutherland, James D. Sutherland, Jagat Narula, Adel H. Allam, Christine A.M. France, David E. Michalik, Darrin Lunde, Caleb E. Finch, Gregory S. Thomas, David R. Hunt, and Bruno Frohlich
Subjects: Diagnostic Imaging, business.industry, Predictive Value of Tests, MEDLINE, Medicine, Animals, Humans, Radiology, Nuclear Medicine and imaging, Hominidae, Cardiology and Cardiovascular Medicine, Bioinformatics, business, Atherosclerosis
Published: 2020

14. Decorated bodies for eternal life: A multidisciplinary study of late Roman Period stucco-shrouded portrait mummies from Saqqara (Egypt)

Author: Albert Zink, Manuela Gander, Gregory S. Thomas, Saskia Wetzig, Adel H. Allam, Stephanie Panzer, M. Linda Sutherland, Wilfried Rosendahl, Stephanie Zesch, Marc Loth, and Ibrahem Badr
Subjects: Male, History, Burial, Body height, Physiology, Knees, Social Sciences, Hands, Knee Joints, 030218 nuclear medicine & medical imaging, Geographical Locations, 0302 clinical medicine, Skeletal Joints, Medicine and Health Sciences, 0601 history and archaeology, Musculoskeletal System, History, Ancient, Multidisciplinary, Embalming, 060102 archaeology, biology, 06 humanities and the arts, Middle Aged, Mummification, Capital (architecture), Religion, Arms, Physiological Parameters, Archaeology, Medicine, Legs, Stucco, Egypt, Female, Anatomy, Period (music), Research Article, Adult, Asia, Soft Tissues, Science, Multidisciplinary study, Portraits as Topic, Ancient history, Pelvis, 03 medical and health sciences, Young Adult, Portrait, Humans, Skeleton, Skull, Biology and Life Sciences, Mummies, biology.organism_classification, Body Height, Biological Tissue, Body Limbs, People and Places, Africa, Memphis, Tomography, X-Ray Computed
Abstract: This study focuses on the multidisciplinary investigation of three stucco-shrouded mummies with mummy portrait from Egypt dating from the late 3rd to the middle of the 4th century AD, corresponding to the late Roman Period. These three mummies were excavated in the early 17th and late 19th centuries in the Saqqara necropolis near the ancient Egyptian capital of Memphis. Two of them experienced an interesting collection history, when they became part of the collection of the Elector of Saxony and King of Poland August II in Dresden, Germany, in 1728. The investigation includes information about the mummies’ discovery, collection history and shroud decoration obtained through Egyptological expertise. In addition, information on the state of preservation, technique of artificial mummification, age at death, sex, body height and health of the deceased was achieved through computed tomography (CT) analysis. Research yielded an adult male, a middle-aged female and a young female. Due to the rather poorly preserved bodies of the male and middle-aged female, a specific technique of artificial mummification could not be ascertained. Brain and several internal organs of the well-preserved young female were identified. Wooden boards, beads of necklaces, a hairpin, and metal dense items, such as lead seals, nails and two coins or medallions were discovered. Paleopathological findings included carious lesions, Schmorl’s nodes, evidence of arthritis and a vertebral hemangioma. The study revealed insights on the decoration and burial preparation of individuals of upper socioeconomic status living in the late Roman Period, as well as comprehensive bioanthropological information of the deceased.
Published: 2020

15. Worldwide Variation in the Use of Nuclear Cardiology Camera Technology, Reconstruction Software, and Imaging Protocols

Author: Cole B. Hirschfeld, Mathew Mercuri, Thomas N.B. Pascual, Ganesan Karthikeyan, João V. Vitola, John J. Mahmarian, Nathan Better, Salah E. Bouyoucef, Henry Hee-Seung Bom, Vikram Lele, V. Peter C. Magboo, Erick Alexánderson, Adel H. Allam, Mouaz H. Al-Mallah, Sharmila Dorbala, Albert Flotats, Scott Jerome, Philipp A. Kaufmann, Osnat Luxenburg, Leslee J. Shaw, S. Richard Underwood, Madan M. Rehani, Diana Paez, Maurizio Dondi, Andrew J. Einstein, A.J. Einstein, T.N.B. Pascual, D. Paez, M. Dondi, N. Better, S.E. Bouyoucef, G. Karthikeyan, R. Kashyap, V. Lele, V.P.C. Magboo, J.J. Mahmarian, J.B. Meeks, M. Mercuri, F. Mut, M.M. Rehani, J.V. Vitola, E. Alexanderson, A. Allam, M.H. Al-Mallah, H. Bom, A. Flotats, S. Jerome, P.A. Kaufmann, O. Luxenburg, J. Mahmarian, L.J. Shaw, S.R. Underwood, J. Vitola, W. Amouri, H. Essabbah, S.S. Gassama, K.B. Makhdomi, G.I.E. El Mustapha, N. El Ouchdi, N. Qaïs, N. Soni, W. Vangu, R.M. Abazid, B. Adams, V. Agarwal, M.A. Alfeeli, N. Alnafisi, L. Bernabe, G.G. Bural, T. Chaiwatanarat, J.M. Chandraguptha, G.J. Cheon, I. Cho, A.S. Dogan, M. Eftekhari, A. Frenkel, I. Garty, S. George, P. Geramifar, H. Golan, S. Habib, R. Hussain, H. Im, H.-J. Jeon, T. Kalawat, W.J. Kang, F. Keng, A. Klaipetch, P.G. Kumar, J. Lee, W.W. Lee, I. Lim, C.M.M. Macaisa, G. Malhotra, B.R. Mittal, M.H. Mohammad, P. Mohan, I.D. Mulyanto, D. Nariman, U.N. Nayak, K. Niaz, G. Nikolov, J.M. Obaldo, E. Ozturk, J.M. Park, S. Park, C.D. Patel, H.K. Phuong, A.P. Quinon, T.R. Rajini, Y. Saengsuda, J. Santiago, H.B. Sayman, A.S. Shinto, V. Sivasubramaniyan, M.H. Son, P. Sudhakar, G.M.S. Syed, N. Tamaki, K. Thamnirat, T. Thientunyakit, S. Thongmak, D.N. Velasco, A. Verma, U. Vutrapongwatana, Y. Wang, K.S. Won, Z. Yao, T. Yingsa-nga, R. Yudistiro, K.T. Yue, N. Zafrir, S.C. Adrian, D. Agostini, S. Aguadé, G. Armitage, M. Backlund, M. Backman, M. Baker, M.T. Balducci, C. Bavelaar, M. Berovic, F. Bertagna, R. Beuchel, A. Biggi, G. Bisi, R. Bonini, A. Bradley, L. Brudin, I. Bruno, E. Busnardo, R. Casoni, A. Choudhri, C. Cittanti, R. Clauss, D.C. Costa, M. Costa, K. Dixon, M. Dziuk, N. Egelic, I. Eriksson, G. Fagioli, D.B. de Faria, L. Florimonte, A. Francini, M. French, E. Gallagher, I. Garai, O. Geatti, D. Genovesi, L. Gianolli, A. Gimelli, E. del Giudice, S. Halliwell, M.J. Hansson, C. Harrison, F. Homans, F. Horton, D. Jędrzejuk, J. Jogi, A. Johansen, H. Johansson, M. Kalnina, M. Kaminek, A. Kiss, M. Kobylecka, M. Kostkiewicz, J. Kropp, R. Kullenberg, T. Lahoutte, O. Lang, Y.H. Larsson, M. Lázár, L. Leccisotti, N. Leners, O. Lindner, R.W. Lipp, A. Maenhout, L. Maffioli, C. Marcassa, B. Martins, P. Marzullo, G. Medolago, C.G. Mendiguchía, S. Mirzaei, M. Mori, B. Nardi, S. Nazarenko, K. Nikoletic, R. Oleksa, T. Parviainen, J. Patrina, R. Peace, C. Pirich, H. Piwowarska-Bilska, S. Popa, V. Prakash, V. Pubul, L. Puklavec, S. Rac, M. Ratniece, S.A. Rogan, A. Romeo, M. Rossi, D. Ruiz, N. Sabharwal, B.G. Salobir, A.I. Santos, S. Saranovic, A. Sarkozi, R.P. Schneider, R. Sciagra, S. Scotti, Z. Servini, L.R. Setti, S.-Å. Starck, D. Vajauskas, J. Veselý, A. Vieni, A. Vignati, I.M. Vito, K. Weiss, D. Wild, M. Zdraveska-Kochovska, R.N. Agüro, N. Alvarado, C.M. Barral, M. Beretta, I. Berrocal, J.F. Batista Cuellar, T.-M. Cabral Chang, L.O. Cabrera Rodríguez, J. Canessa, G. Castro Mora, A.C. Claudia, G.F. Clavelo, A.F. Cruz Júnior, F.F. Faccio, K.M. Fernández, J.R. Gomez Garibo, U. Gonzalez, P. González E, M.A. Guzzo, J. Jofre, M. Kapitán, G. Kempfer, J.L. Lopez, T. Massardo V, I. Medeiros Colaco, C.T. Mesquita, M. Montecinos, S. Neubauer, L.M. Pabon, A. Puente, L.M. Rochela Vazquez, J.A. Serna Macias, A.G. Silva Pino, F.Z. Tártari Huber, A.P. Tovar, L. Vargas, C. Wiefels, A. Aljizeeri, R.J. Alvarez, D. Barger, W. Beardwood, J. Behrens, L. Brann, D. Brown, H. Carr, K. Churchwell, G.A. Comingore, J. Corbett, M. Costello, F. Cruz, T. Depinet, S. Dorbala, M. Earles, F.P. Esteves, E. Etherton, R.J. Fanning, J. Fornace, L. Franks, H. Gewirtz, K. Gulanchyn, C.-L. Hannah, J. Hays, J. Hendrickson, J. Hester, K. Holmes, A. Johnson, C. Jopek, H. Lewin, J. Lyons, C. Manley, J. Meden, S. Moore, W.H. Moore, V. Murthy, R. Nace, D. Neely, L. Nelson, O. Niedermaier, D. Rice, R. Rigs, K. Schiffer, E. Schockling, T. Schultz, T. Schumacker, B. Sheesley, A. Sheikh, B. Siegel, A.M. Slim, J. Smith, M. Szulc, N. Tanskersley, P. Tilkemeier, G.D. Valdez, R. Vrooman, D. Wawrowicz, D.E. Winchester, A. Alcheikh, B. Allen, E. Atkins, J. Bevan, C. Bonomini, J. Christiansen, L. Clack, E. Craig, H. Dixson, I. Duncan, S. Fredericks, S. Gales, R. Hampson, T. Hanley, K. Hartcher, J. Hassall, B. Kelley, S. Kelly, T. Kidd, T. de Kort, G. Larcos, W. Macdonald, C. McGrath, E. Murdoch, S. O'Malley, M. O'Rourke, M. Pack, R. Pearce, R. Praehofer, S. Ramsay, L. Scarlett, K. Smidt, F. Souvannavong, K. Taubman, G. Taylor, K. Tse, S. Unger, and J. Weale
Subjects: medicine.medical_specialty, Technology, camera technology, myocardial perfusion scintigraphy, nuclear cardiology protocols, radiation dose reduction, SPECT, INCAPS Investigators Group, Cardiology, 030204 cardiovascular system & hematology, Radiation Dosage, 030218 nuclear medicine & medical imaging, NO, 03 medical and health sciences, Myocardial perfusion imaging, 0302 clinical medicine, Software, Predictive Value of Tests, Internal medicine, Myocardial perfusion scintigraphy, medicine, Humans, Radiology, Nuclear Medicine and imaging, 1102 Cardiorespiratory Medicine and Haematology, Protocol (science), Tomography, Emission-Computed, Single-Photon, medicine.diagnostic_test, business.industry, Myocardial Perfusion Imaging, 1103 Clinical Sciences, Cross-Sectional Studies, Cardiovascular System & Hematology, Positron emission tomography, Dose reduction, Cardiology and Cardiovascular Medicine, business, Tomography, X-Ray Computed, Correction for attenuation, Emission computed tomography
Abstract: Objectives This study sought to describe worldwide variations in the use of myocardial perfusion imaging hardware, software, and imaging protocols and their impact on radiation effective dose (ED). Background Concerns about long-term effects of ionizing radiation have prompted efforts to identify strategies for dose optimization in myocardial perfusion scintigraphy. Studies have increasingly shown opportunities for dose reduction using newer technologies and optimized protocols. Methods Data were submitted voluntarily to the INCAPS (International Atomic Energy Agency Nuclear Cardiology Protocols Study) registry, a multinational, cross-sectional study comprising 7,911 imaging studies from 308 labs in 65 countries. The study compared regional use of camera technologies, advanced post-processing software, and protocol characteristics and analyzed the influence of each factor on ED. Results Cadmium-zinc-telluride and positron emission tomography (PET) cameras were used in 10% (regional range 0% to 26%) and 6% (regional range 0% to 17%) of studies worldwide. Attenuation correction was used in 26% of cases (range 10% to 57%), and advanced post-processing software was used in 38% of cases (range 26% to 64%). Stress-first single-photon emission computed tomography (SPECT) imaging comprised nearly 20% of cases from all world regions, except North America, where it was used in just 7% of cases. Factors associated with lower ED and odds ratio for achieving radiation dose ≤9 mSv included use of cadmium-zinc-telluride, PET, advanced post-processing software, and stress- or rest-only imaging. Overall, 39% of all studies (97% PET and 35% SPECT) were ≤9 mSv, while just 6% of all studies (32% PET and 4% SPECT) achieved a dose ≤3 mSv. Conclusions Newer-technology cameras, advanced software, and stress-only protocols were associated with reduced ED, but worldwide adoption of these practices was generally low and varied significantly between regions. The implementation of dose-optimizing technologies and protocols offers an opportunity to reduce patient radiation exposure across all world regions.
Published: 2020

16. Correlation Between Coronary Calcium Scoring and Duke’s Treadmill Score in Patients with Normal Myocardial Perfusion Imaging SPECT

Author: Ayman El Saeed Saddek, Mohamed A. Mandour Ali, Abd Al Aziz Mohie Al Deen Abd Al Aziz, and Adel H. Allam
Subjects: Score test, medicine.medical_specialty, medicine.diagnostic_test, business.industry, General Medicine, Coronary calcium, Correlation, Myocardial perfusion imaging, Internal medicine, medicine, Cardiology, In patient, Treadmill, business, Coronary atherosclerosis, Subclinical infection
Abstract: Background: Stress myocardial perfusion imaging (MPI) is a highly valuable test in the evaluation and risk stratification of ischemic heart disease. However, negative stress MPI does not exclude coronary atherosclerosis. The Coronary artery calcium (CAC) score is a validated simple test in the evaluation of coronary atherosclerosis. Our goal was to investigate the correlation between CAC score and Duke’s treadmill score, as well as the prevalence of CAC in patients with negative MPI. Methods: A total of 926 consecutive Egyptian patients, aged 30 to 60 years without known CAD, underwent CAC score testing following normal MPI. Results: In the setting of normal MPI among Egyptian patients without known CAD, mean age 48±7 years, 325 (35%) patients had a positive CAC score, and 9% had high CAC>100. Out of CAC>0, 160 were low-risk DTS. Our study showed no correlation between CAC score and DTS (P value=0.5). Age (OR=1.119, P value= 100. Conclusion: In a large number of normal MPI Egyptian patients without known CAD, CAC prevalence was 35%, confirming the beneficial value of adding CAC score test to negative MPI for cardiovascular risk stratification and screening for subclinical CAD regardless of DTS. Higher CAC values and prevalence were associated with age and male gender.
Published: 2021

17. Minimally invasive bone biopsies of fully wrapped mummies guided by computed tomography and fibre-optic endoscopy: Methods and suggested guidelines

Author: Bruno Frohlich, Gregory S. Thomas, Alice Paladin, Chris J. Rowan, M. Linda Sutherland, Friederike Seyfried, Albert Zink, L. Samuel Wann, James D. Sutherland, Christina Wurst, Klaus O. Fritsch, Wilfried Rosendahl, Stephanie Zesch, Adel H. Allam, Randall C. Thompson, and David E. Michalik
Subjects: 010506 paleontology, Archeology, 060102 archaeology, medicine.diagnostic_test, business.industry, Computed tomography, 06 humanities and the arts, 01 natural sciences, humanities, Endoscopy, Ancient DNA, medicine, 0601 history and archaeology, Nuclear medicine, business, Geology, 0105 earth and related environmental sciences
Abstract: Recent advances in the recovery and analysis of ancient DNA (aDNA) and application of isotopic analysis of tissue obtained from mummified human remains has been accompanied by continued advances in non-invasive imaging using X-ray computed tomography (CT) and use of minimally invasive surgical techniques employing small fibre-optic endoscopes. We used these state-of-the-art techniques to examine ancient Egyptian mummies in the Egyptian Museum and Papyrus Collection of Berlin, obtaining bone samples for aDNA, stable isotope analyses and radiocarbon dating. CT and endoscopic guidance were applied to locate and biopsy bones using pre-existing access points in order to avoid any further damage to the precious specimens. Here we provide guidelines to obtain bone samples of fully wrapped mummies in a minimally invasive way, by using a combination of computed tomography and endoscopic guided biopsy.
Published: 2020

18. EPICARDIAL FAT THICKNESS AND HEPATIC FAT IN A REMOTE NATIVE POPULATION WITH VERY LOW RATES OF CORONARY CALCIUM

Author: Samantha I. King, Bruno Frohlich, Jonathan Stiegiltz, Benjamin C. Trumble, Edmond Seabright, Jagat Narula, Hillard Kaplan, Kevin Kennedy, Ashna Mahadev, Adel H. Allam, Randall C. Thompson, Chris J. Rowan, Angela D. Neunuebel, Gregory S. Thomas, Daniel Cummings, L. Samuel Wann, and Michael Gurven
Subjects: medicine.medical_specialty, business.industry, Internal medicine, Native population, medicine, Cardiology, Coronary calcium, Cardiology and Cardiovascular Medicine, business, Epicardial fat
Published: 2020

19. Exercise Testing in a Limited Resource Environment

Author: Mohamed A. Mandour Ali and Adel H. Allam
Subjects: Knowledge management, business.industry, Perspective (graphical), business, Limited resources
Abstract: Using Egypt as an example, the chapter Stress Testing in a Limited Financial Resource Environment reviews how exercise testing can serve as the cornerstone of noninvasive evaluation of coronary artery disease (CAD) in developing countries. Its wide availability, low cost, and safety makes it the test of choice for patients at low to intermediate likelihood of CAD. Proper patient selection and skin preparation, simple and clear patient education, and reassurance as to the purpose of the test and the crucial importance of achieving a near maximal heart rate are necessary to obtain optimal sensitivity and specificity, either as a stand-alone test or in conjunction with cardiac imaging. The use of provisional MPI in patients unable to achieve 10 metabolic equivalents without chest pain or ischemic electrocardiographic changes is reviewed.
Published: 2018

20. P2-108: USING COMPUTED TOMOGRAPHY TO ASSESS BRAIN VOLUMETRICS IN AGING

Author: Jonathan Stieglitz, Hillard Kaplan, Andrei Irimia, Michael I. Miyamoto, Juan Copajira Adrian, Sarah Alami, Caleb E. Finch, Meng Law, Helena Chang Chui, Ben C. Trumble, Kenneth A. Rostowsky, Alexander S. Maher, Nahian F. Chowdhury, Michael Gurven, Chris J. Rowan, James D. Sutherland, Adel H. Allam, Giuseppe Barisano, Edmond Seabright, Angela R. Garcia, M. Linda Sutherland, Wendy J. Mack, Daniel K. Cummings, and Daniel Eid Rodriguez
Subjects: Psychiatry and Mental health, Cellular and Molecular Neuroscience, Developmental Neuroscience, medicine.diagnostic_test, Epidemiology, business.industry, Health Policy, medicine, Computed tomography, Neurology (clinical), Geriatrics and Gerontology, Nuclear medicine, business
Published: 2019

21. The Orthopedic Diseases of Ancient Egypt

Author: L. Samuel Wann, Mahmoud Akl, Abdel-Halim Nur el-din, Gomaa Abdel-Maksoud, Adel H. Allam, Ibrahim H. A. Badr, James D. Sutherland, M. Linda Sutherland, Caleb E. Finch, Heshem Hamoud, Gregory S. Thomas, Randall C. Thompson, Klaus O. Fritsch, Muhammad Al-Tohamy Soliman, and Alexander Grossmann
Subjects: musculoskeletal diseases, medicine.medical_specialty, Histology, business.industry, Vertebral compression fracture, Elbow, Scoliosis, musculoskeletal system, medicine.disease, Osteochondritis dissecans, Surgery, medicine.anatomical_structure, Arthropathy, Orthopedic surgery, medicine, Rotator cuff, Anatomy, Ankle, business, Ecology, Evolution, Behavior and Systematics, Biotechnology
Abstract: Background: CT scanning of ancient human remains has the potential to provide insights into health and diseases. While Egyptian mummies have undergone CT scans in prior studies, a systematic survey of the orthopedic conditions afflicting a group of these ancient individuals has never been carried out. Methods: We performed whole body CT scanning on 52 ancient Egyptian mummies using technique comparable to that of medical imaging. All of the large joints and the spine were systematically examined and osteoarthritic (OA) changes were scored 0-4 using Kellgren and Lawrence classification. Results: The cruciate ligaments and menisci could be identified frequently. There were much more frequent OA changes in the spine (25 mummies) than in the large joints (15 cases of acromioclavicular and/or glenohumeral joint OA changes, five involvement of the ankle, one in the elbow, four in the knee, and one in the hip). There were six cases of scoliosis. Individual mummies had the following conditions: juvenile aseptic necrosis of the hip (Perthes disease), stage 4 osteochondritis dissecans of the knee, vertebral compression fracture, lateral patella-femoral joint hyper-compression syndrome, severe rotator cuff arthropathy, rotator cuff impingement, hip pincer impingement, and combined fracture of the greater trochantor and vertebral bodies indicating obvious traumatic injury. This report includes the most ancient discovery of several of these syndromes. Conclusions: Ancient Egyptians often suffered painful orthopedic conditions. The high frequency of scoliosis merits further study. The pattern of degenerative changes in the spine and joints may offer insights into activity levels of these people. Anat Rec, 298:1036–1046, 2015. © 2015 Wiley Periodicals, Inc.
Published: 2015

22. The mystery poor prognosticator! Pharmacologic stress MPI prevalence and predictors: Insights from the Middle East

Author: Adel H. Allam and Mohamed Mandour Ali
Subjects: Gerontology, Tomography, Emission-Computed, Single-Photon, Middle East, business.industry, Myocardial Perfusion Imaging, 030204 cardiovascular system & hematology, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Exercise Test, Prevalence, Medicine, Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine, business, Referral and Consultation
Published: 2017

23. Each Nuclear Cardiology lab should have its own lower limit of normal for functional parameters: True or False?

Author: Adel H. Allam, Alia Abd Al Fattah, and Ahmed Abdel Aaty
Subjects: Tomography, Emission-Computed, Single-Photon, medicine.medical_specialty, business.industry, Heart Ventricles, Cardiology, Myocardial Perfusion Imaging, 030204 cardiovascular system & hematology, Lower limit, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Latin America, medicine, Radiology, Nuclear Medicine and imaging, Medical physics, Cardiology and Cardiovascular Medicine, business
Published: 2017

24. Coronary atherosclerosis in indigenous South American Tsimane: a cross-sectional cohort study

Author: Guido P. Lombardi, Bret Alexander Beheim, Gregory S. Thomas, Daniel Eid Rodriguez, Hillard Kaplan, Adel H. Allam, Randall C. Thompson, James K. Min, Michael Gurven, Bruno Frohlich, Angela R. Garcia, Jagat Narula, L. Samuel Wann, James D. Sutherland, M. Linda Sutherland, Chris J. Rowan, Benjamin C. Trumble, Jonathan Stieglitz, David E. Michalik, Caleb E. Finch, and Ram Bedi
Subjects: Male, Aging, Cross-sectional study, Bolivia/epidemiology, Blood lipids, Coronary Artery Disease, 030204 cardiovascular system & hematology, Coronary Angiography, Cardiovascular, Medical and Health Sciences, Severity of Illness Index, Coronary artery disease, Cohort Studies, 0302 clinical medicine, Risk Factors, 80 and over, 2.1 Biological and endogenous factors, Atherosclerosis/blood/diagnostic imaging/ethnology/etiology, 030212 general & internal medicine, Aetiology, Tomography, Coronary Artery Disease/blood/diagnostic imaging/ethnology/etiology, Aged, 80 and over, education.field_of_study, Anthropometry, General Medicine, Middle Aged, Lipids, X-Ray Computed, Heart Disease, Inflammation Mediators/blood, Female, Inflammation Mediators, Cohort study, Adult, Bolivia, medicine.medical_specialty, Population, Article, 03 medical and health sciences, Age Distribution, Clinical Research, General & Internal Medicine, medicine, Humans, education, Life Style, Heart Disease - Coronary Heart Disease, Coronary atherosclerosis, Nutrition, Aged, Coronary Angiography/methods, business.industry, Anthropometry/methods, Lipids/blood, Prevention, Urbanization, Atherosclerosis, medicine.disease, Obesity, Surgery, purl.org/pe-repo/ocde/ford#3.02.00 [https], Good Health and Well Being, Cross-Sectional Studies, Attributable risk, business, Tomography, X-Ray Computed, Demography
Abstract: Summary Background Conventional coronary artery disease risk factors might potentially explain at least 90% of the attributable risk of coronary artery disease. To better understand the association between the pre-industrial lifestyle and low prevalence of coronary artery disease risk factors, we examined the Tsimane, a Bolivian population living a subsistence lifestyle of hunting, gathering, fishing, and farming with few cardiovascular risk factors, but high infectious inflammatory burden. Methods We did a cross-sectional cohort study including all individuals who self-identified as Tsimane and who were aged 40 years or older. Coronary atherosclerosis was assessed by coronary artery calcium (CAC) scoring done with non-contrast CT in Tsimane adults. We assessed the difference between the Tsimane and 6814 participants from the Multi-Ethnic Study of Atherosclerosis (MESA). CAC scores higher than 100 were considered representative of significant atherosclerotic disease. Tsimane blood lipid and inflammatory biomarkers were obtained at the time of scanning, and in some patients, longitudinally. Findings Between July 2, 2014, and Sept 10, 2015, 705 individuals, who had data available for analysis, were included in this study. 596 (85%) of 705 Tsimane had no CAC, 89 (13%) had CAC scores of 1–100, and 20 (3%) had CAC scores higher than 100. For individuals older than age 75 years, 31 (65%) Tsimane presented with a CAC score of 0, and only four (8%) had CAC scores of 100 or more, a five-fold lower prevalence than industrialised populations (p≤0·0001 for all age categories of MESA). Mean LDL and HDL cholesterol concentrations were 2·35 mmol/L (91 mg/dL) and 1·0 mmol/L (39·5 mg/dL), respectively; obesity, hypertension, high blood sugar, and regular cigarette smoking were rare. High-sensitivity C-reactive protein was elevated beyond the clinical cutoff of 3·0 mg/dL in 360 (51%) Tsimane participants. Interpretation Despite a high infectious inflammatory burden, the Tsimane, a forager-horticulturalist population of the Bolivian Amazon with few coronary artery disease risk factors, have the lowest reported levels of coronary artery disease of any population recorded to date. These findings suggest that coronary atherosclerosis can be avoided in most people by achieving a lifetime with very low LDL, low blood pressure, low glucose, normal body-mass index, no smoking, and plenty of physical activity. The relative contributions of each are still to be determined. Funding National Institute on Aging, National Institutes of Health; St Luke's Hospital of Kansas City; and Paleocardiology Foundation.
Published: 2017

25. Genomic Correlates of Atherosclerosis in Ancient Humans

Author: Hillard Kaplan, Michael I. Miyamoto, Albert Zink, Frank Maixner, Bruno Frohlich, Caleb E. Finch, Jagat Narula, Samantha L. Cox, Adel H. Allam, M. Linda Sutherland, Lucia Watson, Andreas Keller, James D. Sutherland, Gregory S. Thomas, Alexandre F.R. Stewart, L. Samuel Wann, Johannes Krause, Guido P. Lombardi, and Randall C. Thompson
Subjects: genetic association, Epidemiology, geographic origin, heart disease, Disease, genetic risk, Genome, computer assisted tomography, cause of death, single nucleotide polymorphism, cardiovascular disease, environmental factor, Medicine, genetics, purl.org/pe-repo/ocde/ford#3.02.04 [https], Genetic risk, three dimensional imaging, Genomics, X ray, priority journal, Italy, Egypt, Cardiology and Cardiovascular Medicine, radiography, cardiovascular risk, glacier, review, Single-nucleotide polymorphism, gene frequency, Imaging, Three-Dimensional, Iceman, genomics, Genetic predisposition, Humans, human, genome, Genetic association, Community and Home Care, paleopathology, business.industry, physical anthropology, DNA, Mummies, Atherosclerosis, ischemic heart disease, Evolutionary biology, Tomography, X-Ray Computed, business, genetic predisposition
Abstract: Paleogenetics offers a unique opportunity to study human evolution, population dynamics, and disease evolution in situ. Although histologic and computed x-ray tomographic investigations of ancient mummies have clearly shown that atherosclerosis has been present in humans for more than 5,000 years, limited data are available on the presence of genetic predisposition for cardiovascular disease in ancient human populations. In a previous whole-genome study of the Tyrolean Iceman, a 5,300-year-old glacier mummy from the Alps, an increased risk for coronary heart disease was detected. The Iceman's genome revealed several single nucleotide polymorphisms that are linked with cardiovascular disease in genome-wide association studies. Future genetic studies of ancient humans from various geographic origins and time periods have the potential to provide more insights into the presence and possible changes of genetic risk factors in our ancestors. The study of ancient humans and a better understanding of the interaction between environmental and genetic influences on the development of heart diseases may lead to a more effective prevention and treatment of the most common cause of death in the modern world.HighlightsOldest evidence on the presence of genetic predisposition for cardiovascular disease in the 5,300-year-old Tyrolean Iceman.Future genetic studies of ancient humans have the potential to provide more insights into the presence and possible changes of genetic risk factors in our ancestors.The study of ancient humans and a better understanding of the interaction between environmental and genetic influences on the development of heart diseases may lead to more effective prevention and treatment.
Published: 2014
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26. Is coronary calcium scoring too late? Total body arterial calcium burden in patients without known CAD and normal MPI

Author: Adel H. Allam, M. Linda Sutherland, Jagat Narula, Gregory S. Thomas, Chris J. Rowan, Michael A. Eskander, Bruno Frohlich, L. Samuel Wann, Randall C. Thompson, Ayman Sadek, James D. Sutherland, Mohamed Ali, David E. Michalik, and Caleb E. Finch
Subjects: Adult, Male, medicine.medical_specialty, chemistry.chemical_element, Coronary Artery Disease, 030204 cardiovascular system & hematology, Calcium, Coronary artery disease, 03 medical and health sciences, Myocardial perfusion imaging, 0302 clinical medicine, medicine.artery, Internal medicine, medicine, Thoracic aorta, Humans, Radiology, Nuclear Medicine and imaging, In patient, 030212 general & internal medicine, Vascular Calcification, Aged, medicine.diagnostic_test, business.industry, Abdominal aorta, Myocardial Perfusion Imaging, Total body, Middle Aged, medicine.disease, chemistry, Cardiology, Female, Radiology, Cardiology and Cardiovascular Medicine, business, Tomography, X-Ray Computed, Calcification
Abstract: Patients with normal myocardial perfusion imaging (MPI) have a good prognosis. However, pre-clinical coronary and extracoronary atherosclerosis may exist in the absence of myocardial ischemia. 154 Egyptian patients (mean age 53 years) underwent whole-body non-contrast CT following normal MPI. Atherosclerosis in the form of calcification was observed in ≥1 vascular bed in 115 of 154 (75%) patients. This included the iliofemoral (62%), abdominal aorta (53%), thoracic aorta (47%), coronary (47%), and carotid (25%) vascular beds. Mean total body calcium score was 3172 ± 530 AU. Extracoronary atherosclerosis in patients with a zero coronary artery calcium (CAC) score was common, occurring in the above-listed beds 42%, 36%, 29%, and 7% of the time, respectively. CAC was rarely present without iliofemoral or abdominal aortic calcification. Quantitative assessment of calcification in different vascular beds demonstrates that extracoronary atherosclerosis is common in patients who have normal MPI. Atherosclerotic calcifications are most common in the iliofemoral arteries and abdominal aorta, which typically predate coronary calcifications. An imaging strategy to detect extracoronary atherosclerosis could lead to greater understanding of the natural history of atherosclerosis in its long pre-clinical phase and possibly to earlier preventive strategies.
Published: 2016

27. Acute myocardial perfusion imaging – A useful tool for evaluation of therapeutic modalities & a predictor of urgent need for revascularization in acute coronary syndromes

Author: Adel H. Allam, Ashraf Hussein, Mohamed Khaled, Lamia Hamed, Wael Sami, Akram Abdelbary, Osama Tayeh, Sherif Mokhtar, and Alia Abdelfattah
Subjects: lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, Coronary, Ischemia, Low molecular weight heparin, Acute, Revascularization, Group B, Myocardial perfusion imaging, Internal medicine, Diabetes mellitus, medicine, Family history, medicine.diagnostic_test, business.industry, medicine.disease, Perfusion, lcsh:RC666-701, Cardiology, SestaMIBI, Cardiology and Cardiovascular Medicine, business, MPI - revascularisation in ACS
Abstract: We have been evaluating different therapeutic modalities using acute MPI, & we aimed at the use of acute MPI as a predictor of patients in need for urgent revascularization. Methods: A total of 85 patients with ACS were included in our study, 57 males, mean age 52.9 ± 10.6 years, 35% were diabetics, 50% hypertensive, 54% smokers, 30% dyslipidemic & 33% had +ve family history of CAD. Acute MPI was done by SPECT technique using triple head Gamma Camera. Every patient had two sets of images, first set done on admission by injecting 25 mCi Tc99m SestaMIBI intravenously before initiating therapeutic intervention and acquired within 6 h of injection. Second set of images was acquired 2 days later. Myocardium at risk (MAR) was calculated using 20 segment scoring system from the 1st set of images (scale 0–4/segment). Residual ischemia (RI) was calculated from the second set of images. Salvage index (SI = MAR − RI/MAR × 100) was taken as an end point for successful reperfusion (SI > 30%). All risk factors and MPI parameters were analyzed as independent predictors for the need for urgent revascularization vs. conservative strategy. Results: Patients were subdivided according to therapeutic modalities used into three groups, group I: (50 pts) received unfractionated heparin, group II: (20 pts) received low molecular weight heparin & group III: (15 pts) received GPIIb/IIIa. There was no statistical difference as regards risk factors, age, sex, & MAR. Salvage index was highest in group II & lowest in group I (39 ± 21% vs. 64 ± 33.6% vs. 58 ± 25%) P = 0.07. Successful reperfusion was achieved in 67.3% in group I & 90% of group II, 86.7% in group III (P = 0.06). Out of 85 pts, 31 patients (group A) were in need for inhospital target vessel revascularization & 54 patients (group B) showed a good response on medical treatment (conservative strategy). Compared to group B, group A had higher values of RI (11 ± 7 vs. 5 ± 4%, P 0.05. High SI > 60%, and absence of diabetes (DM) were good predictors for conservative management strategy (specificity 96%); however, SI 60% as well as absence of DM could recognize the subset of patients who can be managed conservatively whereas SI
Published: 2012
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28. Extracardiac mediastinal uptake incidentally seen during myocardial SPECT studies; are all neoplastic?

Author: Abdullah H. Khalil, Mohamed A. Mandour Ali, Adel H. Allam, Ibrahim M. Koura, and Ayman A. Sadek
Subjects: medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.diagnostic_test, business.industry, Gallbladder disease, Myocardial SPECT Imaging, Spleen disorder, Extracardiac mediastinal uptake, Incidental findings during myocardial SPECT imaging, Single-photon emission computed tomography, medicine.disease, Gastric Diseases, lcsh:RC666-701, medicine, Radiology, Cardiology and Cardiovascular Medicine, business, Cardiac symptoms
Abstract: Incidentally seen non-cardiac findings during myocardial single photon emission computed tomography (SPECT) imaging are not uncommon. These findings may be an indirect but important indication for a variety of non-cardiac disorders that may occasionally mimic cardiac symptoms. Some of these disorders are gastric diseases, liver and gallbladder diseases, spleen disorders, sternal and vertebral pathologies, and pulmonary diseases. Many reports emphasized the value of reviewing raw data in the process of reporting SPECT studies, a rule that is easily forgotten by nuclear medicine specialists. This systematic way of reviewing raw data is not only used for quality control purposes, but also for better detection of non-cardiac incidental findings.
Published: 2012

29. Atherosclerosis in Ancient Egyptian Mummies

Author: Michael I. Miyamoto, Hany Abd El-Rahman Amer, James D. Sutherland, Gregory S. Thomas, M. Linda Sutherland, Randall C. Thompson, Ibrahem Badr, Muhammad Al-Tohamy Soliman, L. Samuel Wann, Adel H. Allam, Abd el-Halim Nur el-din, and Gomaa Abd el-Maksoud
Subjects: medicine.medical_specialty, Aorta, business.industry, Odds ratio, Disease, medicine.disease, humanities, Coronary artery disease, medicine.anatomical_structure, Radiology Nuclear Medicine and imaging, medicine.artery, Severity of illness, medicine, Radiology, Nuclear Medicine and imaging, Radiology, business, Cardiology and Cardiovascular Medicine, Paleopathology, Calcification, Artery
Abstract: Objectives The purpose of this study was to determine whether ancient Egyptians had atherosclerosis. Background The worldwide burden of atherosclerotic disease continues to rise and parallels the spread of diet, lifestyles, and environmental risk factors associated with the developed world. It is tempting to conclude that atherosclerotic cardiovascular disease is exclusively a disease of modern society and did not affect our ancient ancestors. Methods We performed whole body, multislice computed tomography scanning on 52 ancient Egyptian mummies from the Middle Kingdom to the Greco-Roman period to identify cardiovascular structures and arterial calcifications. We interpreted images by consensus reading of 7 imaging physicians, and collected demographic data from historical and museum records. We estimated age at the time of death from the computed tomography skeletal evaluation. Results Forty-four of 52 mummies had identifiable cardiovascular (CV) structures, and 20 of these had either definite atherosclerosis (defined as calcification within the wall of an identifiable artery, n = 12) or probable atherosclerosis (defined as calcifications along the expected course of an artery, n = 8). Calcifications were found in the aorta as well as the coronary, carotid, iliac, femoral, and peripheral leg arteries. The 20 mummies with definite or probable atherosclerosis were older at time of death (mean age 45.1 ± 9.2 years) than the mummies with CV tissue but no atherosclerosis (mean age 34.5 ± 11.8 years, p 2,000 years. Conclusions Atherosclerosis is commonplace in mummified ancient Egyptians.
Published: 2011
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30. ATHEROSCLEROSIS AS MANIFEST BY THORACIC AORTIC CALCIUM: INSIGHTS FROM A REMOTE NATIVE POPULATION WITH EXTREMELY LOW LEVELS OF CORONARY ATHEROSCLEROSIS AND TRADITIONAL CV RISK FACTORS

Author: Samuel Wann, Jonathan Steiglitz, Randall C. Thompson, Benjamin C. Trumble, Frances Neunuebel, Caleb E. Finch, Adel H. Allam, Chris J. Rowan, Guido P. Lombardi, David E. Michalik, M. Linda Sutherland, Bret Alexander Beheim, Hillard Kaplan, Bruno Frohlich, James D. Sutherland, Katherine M. Walsworth, Jagat Narula, Michael Gurven, Gregory S. Thomas, and James K. Min
Subjects: education.field_of_study, medicine.medical_specialty, business.industry, Population, Native population, chemistry.chemical_element, Calcium, stomatognathic diseases, Coronary artery calcium, chemistry, Internal medicine, parasitic diseases, cardiovascular system, Cardiology, Medicine, cardiovascular diseases, Cardiology and Cardiovascular Medicine, business, education, Coronary atherosclerosis
Abstract: Thoracic aortic calcium (TAC) is thought to be a manifestation of atherosclerosis with risk factors similar to those for CAD. To better understand TAC, we examined the Tsimane, a remote Bolivian Amazonian population with few CV factors and the lowest recorded levels of coronary artery calcium (CAC
Published: 2018

31. Assessing the need for nuclear cardiology and other advanced cardiac imaging modalities in the developing world

Author: Marla Kiess, Pilar Orellana, Adel H. Allam, Ellmann A, Leslee J. Shaw, Amalia Peix, João V. Vitola, Gregory S. Thomas, Chanika Siritara, B. N. Lee, Maurizio Dondi, Gianmario Sambuceti, Raffaele Giubbini, Zuo Xiang He, Fernando Mut, Felix Keng, Kevin C. Allman, and Salaheddine E. Bouyoucef
Subjects: Diagnostic Imaging, medicine.medical_specialty, media_common.quotation_subject, Population, Cardiology, Developing country, Health Services Accessibility, Gross domestic product, Education, Excellence, Internal medicine, Training, Medicine, Radiology, Nuclear Medicine and imaging, education, media_common, education.field_of_study, Modalities, Population statistics, business.industry, Developed Countries, Nuclear cardiology, Guideline, Utilization, Nuclear Medicine, Cardiology and Cardiovascular Medicine, business, Working group, Needs Assessment
Abstract: In 2005, 80% of cardiovascular disease (CVD) deaths occurred in low- to middle-income countries (i.e., developing nations). Cardiovascular imaging, such as myocardial perfusion SPECT, is one method that may be applied to detect and foster improved detection of at-risk patients. This document will review the availability and utilization for nuclear cardiology procedures worldwide and propose strategies to devise regional centers of excellence to achieve quality imaging around the world. As a means to establish the current state of nuclear cardiology, International Atomic Energy Agency member and non-member states were queried as to annual utilization of nuclear cardiology procedures. Other sources for imaging statistics included data from medical societies (American Society of Nuclear Cardiology, European Society of Cardiology, and the European Association of Nuclear Medicine) and nuclear cardiology working groups within several nations. Utilization was calculated by dividing annual procedural volume by 2007 population statistics (/100,000) and categorized as high (>1,000/100,000), moderate-high (250-999/100,000), moderate (100-249/100,000), low-moderate (50-99/100,000) and low (
Published: 2009

32. The orthopedic diseases of ancient Egypt

Author: Klaus O, Fritsch, Heshem, Hamoud, Adel H, Allam, Alexander, Grossmann, Abdel-Halim, Nur El-Din, Gomaa, Abdel-Maksoud, Muhammad Al-Tohamy, Soliman, Ibrahim, Badr, James D, Sutherland, M Linda, Sutherland, Mahmoud, Akl, Caleb E, Finch, Gregory S, Thomas, L Samuel, Wann, and Randall C, Thompson
Subjects: Adult, Male, Adolescent, Egypt, Ancient, Mummies, Middle Aged, Spine, Radiography, Young Adult, Scoliosis, Osteoarthritis, Humans, Female, Child, History, Ancient
Abstract: CT scanning of ancient human remains has the potential to provide insights into health and diseases. While Egyptian mummies have undergone CT scans in prior studies, a systematic survey of the orthopedic conditions afflicting a group of these ancient individuals has never been carried out.We performed whole body CT scanning on 52 ancient Egyptian mummies using technique comparable to that of medical imaging. All of the large joints and the spine were systematically examined and osteoarthritic (OA) changes were scored 0-4 using Kellgren and Lawrence classification.The cruciate ligaments and menisci could be identified frequently. There were much more frequent OA changes in the spine (25 mummies) than in the large joints (15 cases of acromioclavicular and/or glenohumeral joint OA changes, five involvement of the ankle, one in the elbow, four in the knee, and one in the hip). There were six cases of scoliosis. Individual mummies had the following conditions: juvenile aseptic necrosis of the hip (Perthes disease), stage 4 osteochondritis dissecans of the knee, vertebral compression fracture, lateral patella-femoral joint hyper-compression syndrome, severe rotator cuff arthropathy, rotator cuff impingement, hip pincer impingement, and combined fracture of the greater trochantor and vertebral bodies indicating obvious traumatic injury. This report includes the most ancient discovery of several of these syndromes.Ancient Egyptians often suffered painful orthopedic conditions. The high frequency of scoliosis merits further study. The pattern of degenerative changes in the spine and joints may offer insights into activity levels of these people.
Published: 2015

33. A Multinational Study to Establish the Value of Early Adenosine Technetium-99m Sestamibi Myocardial Perfusion Imaging in Identifying a Low-Risk Group for Early Hospital Discharge After Acute Myocardial Infarction

Author: Inspire Investigators, Lemuel A. Moyé, Leslee J. Shaw, Terrence D. Ruddy, Adel H. Allam, John J. Mahmarian, Milena J. Henzlova, Habib A. Dakik, Neil G. Filipchuk, Felix Keng, Craig M. Pratt, and Sherif Iskander
Subjects: Male, Technetium Tc 99m Sestamibi, medicine.medical_specialty, Adenosine, Myocardial Infarction, Risk Assessment, Myocardial perfusion imaging, Internal medicine, Multicenter trial, medicine, Humans, Prospective Studies, Myocardial infarction, Risk factor, Prospective cohort study, Aged, Tomography, Emission-Computed, Single-Photon, Ejection fraction, medicine.diagnostic_test, business.industry, Middle Aged, medicine.disease, Patient Discharge, Surgery, Cardiology, Female, Radiopharmaceuticals, Cardiology and Cardiovascular Medicine, business, TIMI
Abstract: A Multinational Study to Establish the Value of Early Adenosine Technetium-99m Sestamibi Myocardial Perfusion Imaging in Identifying a Low-Risk Group for Early Hospital Discharge After Acute Myocardial Infarction John J. Mahmarian, Leslee J. Shaw, Neil G. Filipchuk, Habib A. Dakik, Sherif S. Iskander, Terrence D. Ruddy, Milena J. Henzlova, Felix Keng, Adel Allam, Lemuel A. Moye, Craig M. Pratt, for the INSPIRE Investigators The INSPIRE (Adenosine Sestamibi Post-Infarction Evaluation) trial enrolled 728 clinically stable patients who had adenosine myocardial perfusion tomography early after acute myocardial infarction (AMI) and followed them for 1 year. Total cardiac events and death/reinfarction significantly increased within each INSPIRE risk group from low (5.4%, 1.8%), to intermediate (14%, 9.2%), to high (18.6%, 11.6%) (p < 0.01). Event rates at 1 year were lowest in patients with the smallest perfusion defects but increased when defect size exceeded 20% (p < 0.0001). Gated adenosine tomography performed early after AMI can accurately identify a sizeable low-risk group who have a
Published: 2006

34. Funerary Artifacts, Social Status, and Atherosclerosis in Ancient Peruvian Mummy Bundles

Author: Hillard Kaplan, Michael I. Miyamoto, Lucia Watson, Adel H. Allam, James D. Sutherland, Albert Zink, Clide M. Valladolid, M. Linda Sutherland, David E. Michalik, Samantha L. Cox, Gregory S. Thomas, Jagat Narula, Bruno Frohlich, Randall C. Thompson, L. Samuel Wann, Caleb E. Finch, and Guido P. Lombardi
Subjects: Adult, Male, Epidemiology, Computed tomography, Disease, Social class, Young Adult, Current sample, Peru, Humans, Medicine, purl.org/pe-repo/ocde/ford#3.02.04 [https], Statistical analysis, Child, Community and Home Care, Grave goods, Artifact (archaeology), medicine.diagnostic_test, Funeral Rites, business.industry, Mummies, Middle Aged, Atherosclerosis, Archaeology, Social Class, Child, Preschool, Ethnology, Female, Cardiology and Cardiovascular Medicine, business, Social status
Abstract: Background Evidence of atherosclerotic plaques in ancient populations has led to the reconsideration of risk factors for heart disease and of the common belief that it is a disease of modern times. Methods Fifty-one wrapped mummy bundles excavated from the sites of Huallamarca, Pedreros, and Rinconada La Molina from the Puruchuco Museum collection in Lima, Peru, were scanned using computed tomography to investigate the presence of atherosclerosis. Funerary artifacts contained within the undisturbed mummy bundles were analyzed as an attempt to infer the social status of the individuals to correlate social status with evidence of heart disease in this ancient Peruvian group. This work also provides an inventory of the museum mummy collection to guide and facilitate future research. Results Statistical analysis concluded that there is little association between the types of grave goods contained within the bundles when the groups are pooled together. However, some patterns of artifact type, material, atherosclerosis, and sex emerge when the 3 excavation sites are analyzed separately. Conclusions From the current sample, it would seem that social class is difficult to discern, but those from Huallamarca have the most markers of elite status. We had hypothesized that higher-status individuals may have had lifestyles that would place them at a higher risk for atherogenesis. There seems to be some indication of this within the site of Huallamarca, but it is inconclusive in the other 2 archeological sites. It is possible that a larger sample size in the future could reveal more statistically significant results.
Published: 2014

35. Is atherosclerosis fundamental to human aging? Lessons from ancient mummies

Author: Muhammad Al-Tohamy Soliman, Adel H. Allam, Emily M. Clarke, Gregory S. Thomas, Michael I. Miyamoto, M. Linda Sutherland, David E. Michalik, Randall C. Thompson, Samantha L. Cox, L. Samuel Wann, James D. Sutherland, Guido P. Lombardi, Alexandre F.R. Stewart, Jagat Narula, Abdel-Halim Nur el-din, Bruno Frohlich, Albert Zink, Gomaa Abd el-Maksoud, Caleb E. Finch, and Ibrahem Badr
Subjects: Adult, Male, Aging, Adolescent, Paleopathology, Autopsy, Disease, Coronary artery disease, Young Adult, Risk Factors, Multidetector Computed Tomography, parasitic diseases, Medicine, Humans, Risk factor, History, Ancient, Schistosoma haematobium, Inflammation, biology, Taenia species, business.industry, Mummies, Middle Aged, medicine.disease, biology.organism_classification, Atherosclerosis, humanities, Premature atherosclerosis, Immunology, Chronic Disease, purl.org/pe-repo/ocde/ford#3.02.27 [https], Female, Gene-Environment Interaction, Cardiology and Cardiovascular Medicine, business
Abstract: Case reports from Johan Czermak, Marc Ruffer, and others a century or more ago demonstrated ancient Egyptians had atherosclerosis three millennia ago. The Horus study team extended their findings, demonstrating that atherosclerosis was prevalent among 76 ancient Egyptian mummies and among 61 mummies from each of the ancient cultures of Peru, the American Southwest, and the Aleutian Islands. These findings challenge the assumption that atherosclerosis is a modern disease caused by present day risk factors. An extensive autopsy of an ancient Egyptian teenage male weaver named Nakht found that he was infected with four parasites: Schistosoma haematobium, Taenia species, Trichinella spiralis, and Plasmodium falciparum. Modern day patients with chronic inflammatory disease such as rheumatoid arthritis, systemic lupus erythematosus, and human immunodeficiency virus experience premature atherosclerosis. Could the burden of chronic inflammatory disease have been a risk factor for atherosclerosis in these ancient cultures? The prevalence of atherosclerosis in four diverse ancient cultures is consistent with atherosclerosis being fundamental to aging. The impact of risk factors in modern times, and potentially in ancient times, suggests a strong gene-environmental interplay: human genes provide a vulnerability to atherosclerosis, the environment determines when and if atherosclerosis becomes manifest clinically.
Published: 2014

36. Computed tomographic evidence of atherosclerosis in the mummified remains of humans from around the world

Author: Michael I. Miyamoto, Albert Zink, Clide M. Valladolid, Abd el-Halim Nur el-din, L. Samuel Wann, Thomas C. Frohlich, Gregory S. Thomas, Adel H. Allam, Samantha I. King, Bruno Frohlich, M. Linda Sutherland, Janet M. Monge, James D. Sutherland, Adam M. Thompson, Caleb E. Finch, Guido P. Lombardi, Randall C. Thompson, Jagat Narula, and Samantha L. Cox
Subjects: Community and Home Care, Pathology, medicine.medical_specialty, Epidemiology, business.industry, Disease, Mummies, Atherosclerosis, Fire smoke, Computed tomographic, Chronic infection, Tomography x ray computed, Environmental risk, Italy, Environmental health, Austria, North America, Peru, Medicine, Humans, Egypt, Cardiology and Cardiovascular Medicine, business, Tomography, X-Ray Computed
Abstract: Although atherosclerosis is widely thought to be a disease of modernity, computed tomographic evidence of atherosclerosis has been found in the bodies of a large number of mummies. This article reviews the findings of atherosclerotic calcifications in the remains of ancient people—humans who lived across a very wide span of human history and over most of the inhabited globe. These people had a wide range of diets and lifestyles and traditional modern risk factors do not thoroughly explain the presence and easy detectability of this disease. Nontraditional risk factors such as the inhalation of cooking fire smoke and chronic infection or inflammation might have been important atherogenic factors in ancient times. Study of the genetic and environmental risk factors for atherosclerosis in ancient people may offer insights into this common modern disease.
Published: 2013

37. Atherosclerosis in ancient populations - Authors' reply

Author: Caleb E. Finch, Adel H. Allam, Gregory S. Thomas, Randall C. Thompson, and L. Samuel Wann
Subjects: Male, business.industry, Medicine, Humans, Female, General Medicine, Mummies, business, Atherosclerosis
Published: 2013

38. The Authors’ Reply

Author: Gregory S. Thomas, Adel H. Allam, Guido P. Lombardi, and David E. Michalik
Subjects: Community and Home Care, Epidemiology, Cardiology and Cardiovascular Medicine
Published: 2015

39. Atherosclerotic cardiovascular disease in Egyptian women: 1570 BCE-2011 CE

Author: Adel H. Allam, Linda Sutherland, Samuel Wann, Hany Abdel Rahman Amer, Goma Abdel-Maksoud, Gregory S. Thomas, Michael I. Miyamoto, Alia Abdelfattah, Caleb E. Finch, Abd el-Halim Nur el-din, Randall C. Thompson, James D. Sutherland, and Ibrahem Badr
Subjects: Pathology, medicine.medical_specialty, Egypt, Ancient, Computed tomography, Disease, Ct examination, Internal medicine, medicine, Genetic predisposition, Humans, Myocardial infarction, Vascular calcification, History, Ancient, medicine.diagnostic_test, Atherosclerotic cardiovascular disease, business.industry, Coronary Stenosis, Mummies, Middle Aged, medicine.disease, Atherosclerosis, Obesity, humanities, Cardiovascular Diseases, Female, Cardiology and Cardiovascular Medicine, business
Abstract: Background Atherosclerotic cardiovascular disease is often thought of as a disease of modernity, a disease affecting primarily men and a disease primarily affecting members of affluent Western societies. Methods We reviewed CT scans for evidence of vascular calcification as a manifestation of atherosclerosis in ancient Egyptian female mummies and compared the results to clinical features of contemporary Egyptian women, who are suffering from an epidemic of atherosclerotic cardiovascular disease. Results The common assumption that atherosclerosis is strictly a modern disease which spares women, mainly affecting men, is not true. We report the CT examination of an ancient Egyptian woman who lived more than 3000years ago, finding calcified atherosclerotic plaque in her systemic arteries and other abnormalities probably due to prior myocardial infarction. We also confirmed recent reports of a virtual epidemic of atherosclerotic cardiovascular disease in contemporary Egyptian women. Conclusions Atherosclerosis, both ancient and contemporary, is common in women as well as in men, and is related to both a genetic predisposition and to environmental factors including diet, exercise, obesity and exposure to smoke and other toxins.
Published: 2011

40. The prevalence and predictive accuracy of quantitatively defined transient ischemic dilation of the left ventricle on otherwise normal SPECT myocardial perfusion imaging studies

Author: George A. Beller, Mohamed Ali, Denny D. Watson, Jamieson M. Bourque, and Adel H. Allam
Subjects: Male, medicine.medical_specialty, Myocardial ischemia, Population, Myocardial Ischemia, Comorbidity, Risk Assessment, Sensitivity and Specificity, Myocardial perfusion imaging, Ventricular Dysfunction, Left, Reference Values, Risk Factors, Internal medicine, Prevalence, Medicine, Humans, Radiology, Nuclear Medicine and imaging, education, Tomography, Emission-Computed, Single-Photon, education.field_of_study, medicine.diagnostic_test, business.industry, Myocardial Perfusion Imaging, Virginia, Normal population, Reproducibility of Results, Middle Aged, Transient Ischemic Dilation, medicine.anatomical_structure, Ventricle, Reference values, Cardiology, Female, Radiology, Cardiology and Cardiovascular Medicine, business
Abstract: TID in the setting of otherwise normal MPI has been suggested as a marker of high risk CAD. In this study we estimate the variance of TID in a normal population and the statistical frequency of false positive TID. This will provide an indirect measurement of predictive accuracy (PA) in a mixed referral population.To study the PA of TID in otherwise normal MPI.688 consecutive patients were studied. We defined TID according to the standard method at 2 cut-off values; 1SD and 2SD, and also by a BSA normalized volume difference with gender-specific 2SD limits (NrVD).457 patients with otherwise normal MPI were analyzed. PA of TID at 1SD was 4% and 26% at 2SD. PA was slightly higher (42%) using the NrVD, however, still too low to be clinically useful as a high-risk marker. PA of TID in patients with perfusion abnormalities was 58% at 1SD, 80% at 2SD and slightly higher (93%) by NrVD.In the setting of otherwise normal MPI, elevated TIDr has a low prevalence and poor predictive accuracy and should not be considered summarily as a marker of high risk CAD.
Published: 2011

41. ATHEROSCLEROSIS IS COMMON IN ANCIENT HUMANS: RESULTS OF THE HORUS STUDY OF ANCIENT EGYPTIAN MUMMIES

Author: Gregory S. Thomas, Randall C. Thompson, Hany Abdel Rahman Amer, Gomaa Abdel-Maksoud, Adel H. Allam, Muhammad Al-Tohamy Soliman, Michael I. Miyamoto, James D. Sutherland, M. Linda Sutherland, Abdelhalim Nureldin, L. Samuel Wann, and Ibrahem Badr
Subjects: business.industry, Medicine, Ancient history, business, Cardiology and Cardiovascular Medicine
Published: 2011
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42. Atherosclerosis in ancient Egyptian mummies: the Horus study

Author: Adel H, Allam, Randall C, Thompson, L Samuel, Wann, Michael I, Miyamoto, Abd El-Halim, Nur El-Din, Gomaa Abd, El-Maksoud, Muhammad, Al-Tohamy Soliman, Ibrahem, Badr, Hany Abd, El-Rahman Amer, M Linda, Sutherland, James D, Sutherland, and Gregory S, Thomas
Subjects: Adult, Male, Chi-Square Distribution, Paleopathology, Egypt, Ancient, Calcinosis, Mummies, Middle Aged, Atherosclerosis, Risk Assessment, Severity of Illness Index, Logistic Models, Risk Factors, Age Determination by Skeleton, Odds Ratio, Humans, Female, Tomography, X-Ray Computed, History, Ancient
Abstract: The purpose of this study was to determine whether ancient Egyptians had atherosclerosis.The worldwide burden of atherosclerotic disease continues to rise and parallels the spread of diet, lifestyles, and environmental risk factors associated with the developed world. It is tempting to conclude that atherosclerotic cardiovascular disease is exclusively a disease of modern society and did not affect our ancient ancestors.We performed whole body, multislice computed tomography scanning on 52 ancient Egyptian mummies from the Middle Kingdom to the Greco-Roman period to identify cardiovascular structures and arterial calcifications. We interpreted images by consensus reading of 7 imaging physicians, and collected demographic data from historical and museum records. We estimated age at the time of death from the computed tomography skeletal evaluation.Forty-four of 52 mummies had identifiable cardiovascular (CV) structures, and 20 of these had either definite atherosclerosis (defined as calcification within the wall of an identifiable artery, n = 12) or probable atherosclerosis (defined as calcifications along the expected course of an artery, n = 8). Calcifications were found in the aorta as well as the coronary, carotid, iliac, femoral, and peripheral leg arteries. The 20 mummies with definite or probable atherosclerosis were older at time of death (mean age 45.1 ± 9.2 years) than the mummies with CV tissue but no atherosclerosis (mean age 34.5 ± 11.8 years, p0.002). Two mummies had evidence of severe arterial atherosclerosis with calcifications in virtually every arterial bed. Definite coronary atherosclerosis was present in 2 mummies, including a princess who lived between 1550 and 1580 BCE. This finding represents the earliest documentation of coronary atherosclerosis in a human. Definite or probable atherosclerosis was present in mummies who lived during virtually every era of ancient Egypt represented in this study, a time span of2,000 years.Atherosclerosis is commonplace in mummified ancient Egyptians.
Published: 2011

43. Atherosclerosis in ancient mummified human remains: Linking genetic predisposition with the occurrence of calcified plaques

Author: Adel H. Allam, Caleb E. Finch, Hillard Kaplan, Andreas Keller, Michael I. Miyamoto, Guido P. Lombardi, Frank Maixner, Samuel Wann, Samantha L. Cox, Jagat Narula, Randall C. Thompson, C. Wurst, Linda Sutherland, Bruno Frohlich, Gregory S. Thomas, Lucia Watson, James D. Sutherland, Alexandre F.R. Stewart, and Albert Zink
Subjects: Pathology, medicine.medical_specialty, Genetic predisposition, medicine, Biology, Cardiology and Cardiovascular Medicine
Published: 2015

44. Atherosclerosis: A Longue Durée Approach

Author: Hillard Kaplan, Albert Zink, Michael I. Miyamoto, Lucia Watson, Bruno Frohlich, Adel H. Allam, Randall C. Thompson, Gregory S. Thomas, M. Linda Sutherland, James D. Sutherland, Caleb E. Finch, Alexandre F.R. Stewart, L. Samuel Wann, Guido P. Lombardi, Samantha L. Cox, and Jagat Narula
Subjects: Community and Home Care, History, Epidemiology, Anthropology, business.industry, MEDLINE, Atherosclerosis, Historical Article, Hominidae, Ancient, Animals, Humans, Medicine, purl.org/pe-repo/ocde/ford#3.02.04 [https], Cardiology and Cardiovascular Medicine, business, History, Ancient
Abstract: Fernand Braudel popularized the longue durée approach to scholarly investigation in the mid-20th century…
Published: 2014

45. Why Did Ancient People Have Atherosclerosis? From Autopsies to Computed Tomography to Potential Causes

Author: Gregory S. Thomas, James D. Sutherland, Alexandre F.R. Stewart, Ibrahem Badr, L. Samuel Wann, Abd el-Halim Nur el-din, Emily M. Clarke, M. Linda Sutherland, David E. Michalik, Gomaa Abd el-Maksoud, Adel H. Allam, Samantha L. Cox, Albert Zink, Guido P. Lombardi, Lucia Watson, Muhammad Al-Tohamy Soliman, Hillard Kaplan, Michael I. Miyamoto, Clide M. Valladolid, Randall C. Thompson, Jagat Narula, Bruno Frohlich, Ian Thomas, and Caleb E. Finch
Subjects: Epidemiology, Smoke inhalation, Egypt, Ancient, Human immunodeficiency virus (HIV), Autopsy, Computed tomography, medicine.disease_cause, Computed tomographic, Risk Factors, medicine, Genetic predisposition, Humans, purl.org/pe-repo/ocde/ford#3.02.04 [https], Tomography, Inflammation complications, History, Ancient, Atherosclerosis diagnosis, Inflammation, Community and Home Care, medicine.diagnostic_test, business.industry, Mummies, Atherosclerosis, medicine.disease, Premature atherosclerosis, Rheumatoid arthritis, Immunology, Tomography, X-Ray Computed, Cardiology and Cardiovascular Medicine, business
Abstract: Computed tomographic findings of atherosclerosis in the ancient cultures of Egypt, Peru, the American Southwest and the Aleutian Islands challenge our understanding of the fundamental causes of atherosclerosis. Could these findings be true? Is so, what traditional risk factors might be present in these cultures that could explain this apparent paradox? The recent computed tomographic findings are consistent with multiple autopsy studies dating as far back as 1852 that demonstrate calcific atherosclerosis in ancient Egyptians and Peruvians. A nontraditional cause of atherosclerosis that could explain this burden of atherosclerosis is the microbial and parasitic inflammatory burden likely to be present in ancient cultures inherently lacking modern hygiene and antimicrobials. Patients with chronic systemic inflammatory diseases of today, including systemic lupus erythematosus, rheumatoid arthritis, and human immunodeficiency virus infection, experience premature atherosclerosis and coronary events. Might the chronic inflammatory load of ancient times secondary to infection have resulted in atherosclerosis? Smoke inhalation from the use of open fires for daily cooking and illumination represents another potential cause. Undiscovered risk factors could also have been present, potential causes that technologically cannot currently be measured in our serum or other tissue. A synthesis of these findings suggests that a gene-environmental interplay is causal for atherosclerosis. That is, humans have an inherent genetic susceptibility to atherosclerosis, whereas the speed and severity of its development are secondary to known and potentially unknown environmental factors.
Published: 2014

46. ATHEROSCLEROSIS IN ANCIENT AND MODERN EGYPTIANS: THE HORUS STUDY

Author: Adel H. Allam, L. Samuel Wann, Caleb E. Finch, Randall C. Thompson, James D. Sutherland, Bruno Frohlich, Sallam L. Sallam, Michael I. Miyamoto, MA Mandour Ali, M. Linda Sutherland, and Gregory S. Thomas
Subjects: business.industry, parasitic diseases, Medicine, Ancient history, Cardiology and Cardiovascular Medicine, business
Published: 2014

47. Something Old, Something New—Computed Tomography Studies of the Cardiovascular System in Ancient Egyptian Mummies

Author: Hany Abdel Rahman Amer, Adel H. Allam, Michael I. Miyamoto, Ibrahem Badr, Abdelhalium Nureldin, Ian Thomas, Samuel Wann, Gomma Adelmaksoub, Adam M. Thompson, Muhamed Al-Tohamy Soliman, Gregory S. Thomas, and Randall C. Thompson
Subjects: Clinical cardiology, Atherogenic diet, Pathology, medicine.medical_specialty, medicine.diagnostic_test, business.industry, National museum, Computed tomography, Mummies, General Medicine, Ancient history, Cardiovascular System, Coronary Vessels, Scientific evidence, medicine, Humans, Egypt, Tomography, X-Ray Computed, business
Abstract: raveling home to California after an internationalcardiology congress a few years ago, Dr GregoryThomas stopped in Cairo to visit Dr Adel Allam, anEgyptian cardiologist and nuclear cardiology expert. DrAllam took Dr Thomas to see the mummies exhibited at theworld-famous Egyptian National Museum in downtownCairo. While there, the two cardiologists took special note ofan inscription on one of the glass cases, which announcedthat the mummy on display, King Menephtah, had sufferedfrom atherosclerosis. Like most of us, Drs Allam and Thomaswere surprised that atherosclerosis could have occurred inhumans three millennia ago. They immediately questionedthe scientific evidence supporting the claim that this 3,200-year-old mummy had suffered from atherosclerosis. Didancient Egyptians really have atherosclerotic heart disease?After all, heart attacks are the product of ‘modern’ lifestyles.We believe that atherosclerosis and heart attacks are the endresult of consuming an atherogenic diet and inadequatephysical exercise. Surely the ancient Egyptians ate a morehealthy diet than modern humans and lacked the modernconveniences that enable us to pursue sedentary lifestyles?After all, the ancient Egyptians built the great pyramids byhand without modern machinery, and ‘fast food’ was yet tobe invented.These questions did not go away after Drs Allam andThomas returned to their busy clinical cardiology practicesin Egypt and the US, respectively. How do we know forsure that ancient Egyptians had cardiovascular disease?How prevalent was cardiovascular disease in ancientEgypt? What caused cardiovascular disease so long ago?Did ancient Egyptians really have atherosclerosis so longago? Are our assumptions about the modern lifestyle beingresponsible for the current epidemic of cardiovasculardisease all wrong? To answer these questions, Drs Allamand Thomas asked another question: can moderncardiovascular diagnostic techniques such as computedtomography (CT) be used to investigate the cardiovascularsystem in mummies that are thousands of years old?In a classic example of networking, Drs Allam and Thomasput together an international team of friends, friends offriends, colleagues, and grateful patients to answer thesequestions (see
Published: 2010

48. Computed Tomographic Assessment of Atherosclerosis in Ancient Egyptian Mummies

Author: Gregory S. Thomas, Adel H. Allam, Michael I. Miyamoto, L. Samuel Wann, and Randall C. Thompson
Subjects: medicine.medical_specialty, Paleopathology, business.industry, Egypt, Ancient, Mummies, General Medicine, Atherosclerosis, Computed tomographic, Humans, Medicine, Radiology, Tomography, X-Ray Computed, business, History, Ancient
Published: 2009

49. 6.51Stress Tc99m sestamibi SPECT six months post coronary artery bypass grafts predicts future cardiac events

Author: A. Ghoniem, M. Radwan, Adel H. Allam, N. Rasmi, S. Elhawary, Islam Shawky, and A. Anwar
Subjects: medicine.medical_specialty, medicine.anatomical_structure, business.industry, Internal medicine, Cardiology, medicine, Radiology, Nuclear Medicine and imaging, Bypass grafts, Cardiology and Cardiovascular Medicine, business, Tc99m Sestamibi, Artery
Published: 2007

50. 4.23Al-Azhar score: a new treadmill scoring system to diagnose coronary artery disease

Author: Islam Shawky, A. Ashraf Anwar, Adel H. Allam, Mohamm Abdel-Wahab, and Ayman Kholiefy
Subjects: Coronary artery disease, medicine.medical_specialty, Scoring system, business.industry, medicine, Physical therapy, Radiology, Nuclear Medicine and imaging, Treadmill, Cardiology and Cardiovascular Medicine, medicine.disease, business
Published: 2007

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