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Marima R, Basera A, Miya T, Damane BP, Kandhavelu J, Mirza S, Penny C, Dlamini Z. Exosomal long non-coding RNAs in cancer: Interplay, modulation, and therapeutic avenues. Noncoding RNA Res 2024; 9:887-900. [PMID: 38616862 PMCID: PMC11015109 DOI: 10.1016/j.ncrna.2024.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/20/2024] [Accepted: 03/29/2024] [Indexed: 04/16/2024] Open
Abstract
In the intricate field of cancer biology, researchers are increasingly intrigued by the emerging role of exosomal long non-coding RNAs (lncRNAs) due to their multifaceted interactions, complex modulation mechanisms, and potential therapeutic applications. These exosomal lncRNAs, carried within extracellular vesicles, play a vital partin tumorigenesis and disease progression by facilitating communication networks between tumor cells and their local microenvironment, making them an ideal candidates for use in a liquid biopsy approach. However, exosomal lncRNAs remain an understudied area, especially in cancer biology. Therefore this review aims to comprehensively explore the dynamic interplay between exosomal lncRNAs and various cellular components, including interactions with tumor-stroma, immune modulation, and drug resistance mechanisms. Understanding the regulatory functions of exosomal lncRNAs in these processes can potentially unveil novel diagnostic markers and therapeutic targets for cancer. Additionally, the emergence of RNA-based therapeutics presents exciting opportunities for targeting exosomal lncRNAs, offering innovative strategies to combat cancer progression and improve treatment outcomes. Thus, this review provides insights into the current understanding of exosomal lncRNAs in cancer biology, highlighting their crucial roles, regulatory mechanisms, and the evolving landscape of therapeutic interventions. Furthermore, we have also discussed the advantage of exosomes as therapeutic carriers of lncRNAs for the development of personalized targeted therapy for cancer patients.
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Bhadresha K, Mirza S, Penny C, Mughal MJ. Targeting AXL in Mesothelioma: from functional characterization to clinical implication. Crit Rev Oncol Hematol 2023:104043. [PMID: 37268175 DOI: 10.1016/j.critrevonc.2023.104043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/24/2023] [Accepted: 05/30/2023] [Indexed: 06/04/2023] Open
Abstract
Malignant pleural mesothelioma (MM) is a highly aggressive and lethal cancer with a poor survival rate. Current treatment approaches primarily rely on chemotherapy and radiation, but their effectiveness is limited. Consequently, there is an urgent need for alternative treatment strategies, a comprehensive understanding of the molecular mechanisms underlying MM, and the identification of potential therapeutic targets. Extensive studies over the past decade have emphasized the role of Axl in driving tumor development and metastasis, while high levels of Axl expression have been associated with immune evasion, drug resistance, and reduced patient survival in various cancer types. Ongoing clinical trials are investigating the efficacy of Axl inhibitors for different cancers. However, the precise role of Axl in MM progression, development, and metastasis, as well as its regulatory mechanisms within MM, remain inadequately understood. This review aims to comprehensively investigate the involvement of Axl in MM. We discuss Axl role in MM progression, development, and metastasis, along with its specific regulatory mechanisms. Additionally, we examined the Axl associated signaling pathways, the relationship between Axl and immune evasion, and the clinical implications of Axl for MM treatment. Furthermore, we discussed the potential utility of liquid biopsy as a non-invasive diagnostic technique for early detection of Axl in MM. Lastly, we evaluated the potential of a microRNA signature that targets Axl. By consolidating existing knowledge and identifying research gaps, this review contributes to a better understanding of Axl's role in MM and sets the stage for future investigations and the development of effective therapeutic interventions.
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Mirza S, Bhadresha K, Mughal MJ, McCabe M, Shahbazi R, Ruff P, Penny C. Liquid biopsy approaches and immunotherapy in colorectal cancer for precision medicine: Are we there yet? Front Oncol 2023; 12:1023565. [PMID: 36686736 PMCID: PMC9853908 DOI: 10.3389/fonc.2022.1023565] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 12/08/2022] [Indexed: 01/07/2023] Open
Abstract
Colorectal cancer (CRC) is the second leading cause of cancer-related deaths globally, with nearly half of patients detected in the advanced stages. This is due to the fact that symptoms associated with CRC often do not appear until the cancer has reached an advanced stage. This suggests that CRC is a cancer with a slow progression, making it curable and preventive if detected in its early stage. Therefore, there is an urgent clinical need to improve CRC early detection and personalize therapy for patients with this cancer. Recently, liquid biopsy as a non-invasive or nominally invasive approach has attracted considerable interest for its real-time disease monitoring capability through repeated sample analysis. Several studies in CRC have revealed the potential for liquid biopsy application in a real clinical setting using circulating RNA/miRNA, circulating tumor cells (CTCs), exosomes, etc. However, Liquid biopsy still remains a challenge since there are currently no promising results with high specificity and specificity that might be employed as optimal circulatory biomarkers. Therefore, in this review, we conferred the plausible role of less explored liquid biopsy components like mitochondrial DNA (mtDNA), organoid model of CTCs, and circulating cancer-associated fibroblasts (cCAFs); which may allow researchers to develop improved strategies to unravel unfulfilled clinical requirements in CRC patients. Moreover, we have also discussed immunotherapy approaches to improve the prognosis of MSI (Microsatellite Instability) CRC patients using neoantigens and immune cells in the tumor microenvironment (TME) as a liquid biopsy approach in detail.
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Mirza S, Penny C, Jain NK, Rawal RM. Curcumin mediated dendritic cell maturation by modulating cancer associated fibroblasts-derived exosomal miRNA-146a. J Cancer Res Ther 2023; 19:S649-S657. [PMID: 38384034 DOI: 10.4103/jcrt.jcrt_1286_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/20/2022] [Indexed: 02/23/2024]
Abstract
BACKGROUND Though cancer associated fibroblasts (CAFs), being a main component of tumor microenvironment (TME), are known to modulate immune response through secretion of various growth hormones, exosomes carrying miRNAs and cytokines; their effect on dendritic cells (DCs) are yet to be elucidated. Thus, aim of this study was to assess the effect of miRNAs and cytokines released by lung-CAFs and to evaluate immunomodulatory potential of curcumin on DC maturation through modulating their TME. MATERIAL AND METHODS To check the effect of CAFs derived exosomes on DC maturation, we cultured imDCs in the presence of CAFs derived conditioned media (CAFs-CM) and characterized by the presence of maturation markers CD80, CD83, CD86 and CTLA4 using qRT-PCR. Additionally, expression of miR-221, miR-222, miR-155, miR-142-3p and miR-146a was assessed to evaluate the role of epigenetic regulators on DC maturation. Likewise, cytokine profiling of CAFs-CM as well as CAFs-CM treated with curcumin was also conducted using ELISA. RESULTS Results revealed the generation of regulatory DCs which were characterized by decreased expression of maturation markers in the presence of CAFs-CM. In addition, such DCs showed higher expression of epigenetic regulator miR-146a which was positively correlated with increased expression of anti-inflammatory cytokines like IL-6, IL-10, TGF-β and decreased expression of TNF-α (pro-inflammatory). Moreover, curcumin had the potential to convert regulatory DCs generated by CAFs into mDCs, which were characterized by high expression of co-stimulatory molecules, low expression of CTLA4, lower levels of immune suppressive cytokines production and lower levels of miR-146a. CONCLUSION Collectively, these findings provide insight into understanding the immunomodulatory role of curcumin in targeting CAFs and modulating TME, thus enhancing antitumor immune response in DC based therapy.
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McCabe M, Penny C, Magangane P, Mirza S, Perner Y. Left-sided colorectal cancer distinct in indigenous African patients compared to other ethnic groups in South Africa. BMC Cancer 2022; 22:1089. [PMID: 36280820 PMCID: PMC9590207 DOI: 10.1186/s12885-022-10185-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/14/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction A large proportion of indigenous African (IA) colorectal cancer (CRC) patients in South Africa are young (< 50 years), with no unique histopathological or molecular characteristics. Anatomical site as well as microsatellite instability (MSI) status have shown to be associated with different clinicopathological and molecular features. This study aimed to ascertain key histopathological features in microsatellite stable (MSS) and low-frequency MSI (MSI-L) patients, to provide insight into the mechanism of the disease. Methods A retrospective cohort (2011–2015) of MSS/MSI-L CRC patient samples diagnosed at Charlotte Maxeke Johannesburg Academic Hospital was analyzed. Samples were categorized by site [right colon cancer (RCC) versus left (LCC)], ethnicity [IA versus other ethnic groups (OEG)] and MSI status (MSI-L vs MSS). T-test, Fischer’s exact and Chi-square tests were conducted. Results IA patients with LCC demonstrated an increased prevalence in males, sigmoid colon, signet-ring-cell morphology, MSI-L with BAT25/26 marker instability and advanced disease association. Conclusion This study revealed distinct histopathological features for LCC, and suggests BAT25 and BAT26 as negative prognostic markers in African CRC patients. Larger confirmatory studies are recommended.
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Petersen K, Schaap M, Mirza S, Ng N, Maehara A, Matsumura M, Safian R. 452 Quantitative Assessment Of AI-based CCTA Plaque Volume Compared With IVUS. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Bijani S, Shaikh F, Mirza S, Weng In Siu S, Jain N, Rawal R, Richards NGJ, Shah A, Radadiya A. Novel Dihydropyrimidinone Derivatives as Potential P-Glycoprotein Modulators. ACS OMEGA 2022; 7:16278-16287. [PMID: 35601326 PMCID: PMC9118204 DOI: 10.1021/acsomega.1c05839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 04/15/2022] [Indexed: 05/22/2023]
Abstract
P-glycoprotein (Pgp), an ATP binding cassette (ABC) transporter, is an ATP-dependent efflux pump responsible for cancer multidrug resistance. As part of efforts to identify human Pgp (hPgp) inhibitors, we prepared a series of novel triazole-conjugated dihydropyrimidinones using a synthetic approach that is well suited for obtaining compound libraries. Several of these dihydropyrimidinone derivatives modulate human P-glycoprotein (hPgp) activity with low micromolar EC50 values. Molecular docking studies suggest that these compounds bind to the M-site of the transporter.
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Bijani S, Iqbal D, Mirza S, Jain V, Jahan S, Alsaweed M, Madkhali Y, Alsagaby SA, Banawas S, Algarni A, Alrumaihi F, Rawal RM, Alturaiki W, Shah A. Green Synthesis and Anticancer Potential of 1,4-Dihydropyridines-Based Triazole Derivatives: In Silico and In Vitro Study. Life (Basel) 2022; 12:519. [PMID: 35455010 PMCID: PMC9029820 DOI: 10.3390/life12040519] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/17/2022] [Accepted: 03/21/2022] [Indexed: 11/16/2022] Open
Abstract
A library of 1,4-dihydropyridine-based 1,2,3-triazol derivatives has been designed, synthesized, and evaluated their cytotoxic potential on colorectal adenocarcinoma (Caco-2) cell lines. All compounds were characterized and identified based on their 1H and 13C NMR (Nuclear Magnetic Resonance) spectroscopic data. Furthermore, molecular docking of best anticancer hits with target proteins (protein kinase CK2α, tankyrase1, and tankyrase2) has been performed. Our results implicated that most of these compounds have significant antiproliferative activity with IC50 values between 0.63 ± 0.05 and 5.68 ± 0.14 µM. Moreover, the mechanism of action of most active compounds 13ab' and 13ad' suggested that they induce cell death through apoptosis in the late apoptotic phase as well as dead phase, and they could promote cell cycle arrest at the G2/M phase. Furthermore, the molecular docking study illustrated that 13ad' possesses better binding interaction with the catalytic residues of target proteins involved in cell proliferation and antiapoptotic pathways. Based on our in vitro and in silico study, 13ad' was found to be a highly effective anti-cancerous compound. The present data indicate that dihydropyridine-linked 1,2,3-triazole conjugates can be generated as potent anticancer agents.
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Zeb Khan S, Mirza S, Sadiq MSK, Karim S, Alkahtany MF, Almadi KH, Aldahian N, Abdulwahed A, Almutairi B, Mustafa M, Vohra F, Abduljabbar T. Immunohistochemical expression of PCNA, STRO-1 and CD 44 in the healing of experimentally induced periapical lesions in rats. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2021; 25:7679-7686. [PMID: 34982429 DOI: 10.26355/eurrev_202112_27614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of the study was to determine the expression of cell proliferating marker, anti-proliferating cell nuclear antigen (anti-PCNA) and mesenchymal stem cell (MSC) markers (anti-STRO-1 and anti-CD44) in periapical periodontitis and their role in the healing of periapical lesion in periapical periodontitis. MATERIALS AND METHODS Ninety Sprague-Dawley male rats (100 g) were divided into 3 groups: Experimental group I (EG I: n = 30), experimental group II (EG II: n=30) and control group (CG: n = 30). Periapical lesions were experimentally developed by leaving the dental pulp of maxillary first molars mesial root open to oral environment for 4 weeks. Conventional root canal treatment was performed in EG II. Maxillary first molars along with alveolar bone were resected and fixed. The processed samples were stained with routine hematoxylin and eosin (H&E), and evaluated immunohistochemically using antibodies against anti-PCNA, anti-STRO-1, and anti-CD44 polyclonal antibodies. Data were analyzed using Chi-square test and a p-value of <0.05 was considered significant. RESULTS Immunostaining of anti-PCNA showed 30%, 70% and 53.3% positive staining in CG, EG I, and EG II, respectively (p<0.001). Moreover, the CD44 staining was 20% in CG in contrast to 63.6% in EG I and 43.3 in EG II. STRO-1 staining in CG was 10%, 50% in the EG I and 36.6% in the EG II (p<0.001). CONCLUSIONS Periapical inflammatory tissues expressed significant proliferative cell marker PCNA and mesenchymal stem cell markers STRO-1, and CD44. These findings further reaffirm the promising role of mesenchymal stem cells in the healing of periapical periodontitis.
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Mirza S, Sadiq MSK, Alqahtani A, Al-Saleh S, Alqutub MN, Almubarak AM, Zeb Khan S, Vohra F, Abduljabbar T. The effect of 805 nm near-infrared photobiomodulation on proliferation and differentiation of bone marrow stem cells in murine rats. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2021; 25:6319-6325. [PMID: 34730212 DOI: 10.26355/eurrev_202110_27002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To evaluate the effect of near infra-red gallium-aluminium-arsenide (GaAlAs) diode laser (805 nm) irradiation on proliferation and differentiation of rat femoral bone marrow-derived mesenchymal stem cells (BMSCs) cultured in osteogenic medium. MATERIALS AND METHODS BMSCs were obtained from femurs of 60 Sprague Dawley rats (200 gm). The control group comprised isolated BMSCs supplemented with an osteogenic differentiation medium. On the other hand, in the experimental group, the BMSCs were irradiated with a near-infrared laser in addition to an osteogenic differentiation medium. The experimental group was irradiated with a soft tissue laser comprising of allium-aluminium-arsenic (Ga-Al-Ar) Diode at a near-infrared wavelength of 805 nm in continuous mode. The different output powers applied were 0.5 W, 1.0 W, 1.5 W and 2.0 W respectively. Various energy levels of 1, 4, 7 and 10 J were used for irradiation. Alkaline phosphatase (ALP) assay and Alizarin staining were performed to confirm osteogenic differentiation. Statistical analysis was done using a one-way ANOVA and a p-value of <0.05 was considered significant. RESULTS According to our findings, 1.27 J/cm2 was the optimal energy density value that significantly increased the BMSC proliferation at the output of 1.5 W with the power density of 1.27 W/cm2. On 1.27 J/cm2, there was a significant difference compared to the control group on the first day, and the osteogenic differentiation increased significantly on the 4th day compared to the 1st day. CONCLUSIONS According to our findings, 1.27 J/cm2 was the optimal energy density value that significantly increased the BMSC proliferation at the output of 1.5 W with the power density of 1.27 W/cm2.
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Mirza S, Goodman S, Zhang Y, Do H, Mehta B, Lyman S, Mandl LA, Figgie M, Parks M, Russell L, Bass A. POS0285 ARE RACIAL DISPARITIES IN REVISION TKA OUTCOMES ASSOCIATED WITH HOSPITAL OR SURGEON VOLUME? Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Total knee arthroplasty (TKA) outcomes are linked to surgical volume,1 despite the increase in TKA utilization, racial disparities in TKA outcomes persist. Blacks in the US are at a higher risk of aseptic revision of TKA (R-TKA) when compared to Whites, yet the reasons for this are not understood.Objectives:The objective of this study is to examine the relationship between hospital and surgeon annual TKA volume and R-TKA outcomes by race.Methods:This is an observational cohort study. New York Statewide Planning and Research Cooperative System data for 2004 – 2013 was used to identify patients who underwent primary TKA. Data through 2015 was used to identify R-TKA within 2 years of the index TKA. Hospital characteristics were obtained from the AHA Annual Survey. Surgeon data was collected from New York State Education Department and New York State Physician Profile. Surgeon annual TKA volume was categorized based on cutoffs established by Wilson et al1 as </=12, 13-59, 60-145 or >/= 146, and hospital TKA volume as </=89, 90-235, 236-644 and >/=645. We calculated the odds of R-TKA in Whites and Blacks separately and generated crude odds ratios (OR) comparing Blacks to Whites to examine trends across volume categories. A multivariable logistic regression model adjusted for known R-TKA risk factors was also performed.Results:A total of 163,576 patients were included. Mean (SD) age was 66.4 (10.4) years, 107,233 (65.6%) were female, 124,277 (76.6%) were White and 15,990 (9.8%) were Black. 2925 patients underwent aseptic R-TKA. In logistic regression analysis, Blacks had a higher risk of R-TKA (OR 1.42, 95%CI 1.26-1.6) (Table 1). Risk of R-TKA was also higher when surgeon annual volume was </=12 (OR 1.5, 95%CI 1.25-1.8) or 13-59 (OR 1.16, 95%CI 1.04-1.29) TKA compared to the highest volume surgeons (>/=146). Patients who had surgery at a hospital with annual volume of 236-634 TKA were less likely to undergo R-TKA compared to the highest volume hospitals (>/=645) (OR 0.88, 95%CI 0.79-0.98). Other risk factors for R-TKA were younger age and worker’s compensation, while patients with inflammatory arthritis had a lower risk. Figures 1A and 1B show the odds of R-TKA in Whites and Blacks, respectively, by hospital and surgeon volume. Figure 1C shows the crude OR for Blacks to Whites for each category pair. The OR ranged from 0.9 to 2.5, with the largest disparity found in patients who have TKA performed by surgeons with 60-145 annual TKA volume at the highest volume hospitals (>/=645).Conclusion:Patients having TKA by a surgeon performing <60 TKA per year have higher risk of R-TKA. Racial disparities in R-TKA risk are highest for TKA by surgeons performing 60-145 TKA per year at hospitals performing >/=645 TKA per year. Future studies should examine factors, such as whether trainees are involved the surgery, that may vary based on social determines of health, such as patient race and payor.References:[1]Wilson S. et al Meaningful thresholds for the volume-outcome relationship in total knee arthroplasty. Journal of bone and joint surgery. 2016;98:1683Table 1.Logistic regression of risk for R-TKAVariable (reference)LevelOdds ratio95% CIp-valueAge--0.950.94-0.95<.001Sex (female)Male1.070.99-1.150.108Race (whiteAsian0.650.42-0.960.031Black1.421.26-1.6<.001Unknown0.810.64-1.020.07Other1.050.92-1.210.446Insurance (Medicare)Medicaid0.890.75-1.060.193Other0.890.7-1.130.331Private0.820.74-0.91<.001Work compensation1.561.35-1.8<.001Surgeon volume (>/=146)</=121.51.25-1.8<.00113-591.161.04-1.290.00660-1451.00.91-1.110.957Hospital volume (>/=645)</= 890.980.84-1.150.84890-2350.990.88-1.120.869236-6440.880.79-0.980.018Hospital bed size (>400 beds)6-1991.131.02-1.250.024200-3991.060.96-1.170.262Other variables in model: diabetes, obesity, renal disease, COPD, osteoarthritis, osteonecrosis, dislocation, inflammatory arthritis, surgical complication, infection, no college, poverty >20%, years since residency, US/Canada medical school, orthopedic board certified, AHA control, teaching, rural hospitalDisclosure of Interests:Serene Mirza: None declared, Susan Goodman: None declared, Yi Zhang: None declared, Huong Do: None declared, Bella Mehta: None declared, Stephen Lyman: None declared, Lisa A. Mandl: None declared, Mark Figgie: None declared, Michael Parks Consultant of: Zimmer biomet, Grant/research support from: Zimmer biomet, Linda Russell: None declared, Anne Bass: None declared
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Hakim AJ, Victory KR, Chevinsky JR, Hast MA, Weikum D, Kazazian L, Mirza S, Bhatkoti R, Schmitz MM, Lynch M, Marston BJ. Mitigation policies, community mobility, and COVID-19 case counts in Australia, Japan, Hong Kong, and Singapore. Public Health 2021; 194:238-244. [PMID: 33965795 PMCID: PMC7879096 DOI: 10.1016/j.puhe.2021.02.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The objective of the study was to characterize the timing and trends of select mitigation policies, changes in community mobility, and coronavirus disease 2019 (COVID-19) epidemiology in Australia, Japan, Hong Kong, and Singapore. STUDY DESIGN Prospective abstraction of publicly available mitigation policies obtained from media reports and government websites. METHODS Data analyzed include seven kinds of mitigation policies (mass gathering restrictions, international travel restrictions, passenger screening, traveler isolation/quarantine, school closures, business closures, and domestic movement restrictions) implemented between January 1 and April 26, 2020, changes in selected measures of community mobility assessed by Google Community Mobility Reports data, and COVID-19 epidemiology in Australia, Japan, Hong Kong, and Singapore. RESULTS During the study period, community mobility decreased in Australia, Japan, and Singapore; there was little change in Hong Kong. The largest declines in mobility were seen in places that enforced mitigation policies. Across settings, transit-associated mobility declined the most and workplace-associated mobility the least. Singapore experienced an increase in cases despite the presence of stay-at-home orders, as migrant workers living in dormitories faced challenges to safely quarantine. CONCLUSIONS Public policies may have different impacts on mobility and transmission of severe acute respiratory coronavirus-2 transmission. When enacting mitigation policies, decision makers should consider the possible impact of enforcement measures, the influence on transmission of factors other than movement restrictions, and the differential impact of mitigation policies on subpopulations.
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Sandlin K, Sandlin K, Hernandez L, Bader H, Mirza S, Blaszczyk A. Observations of Polypharmacy and Interactions on Varying COVID-19 Medication Regimens in Nursing Home Residents. J Am Med Dir Assoc 2021; 22:B22-B23. [PMID: 34287171 PMCID: PMC7902204 DOI: 10.1016/j.jamda.2021.01.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mirza S, Haque F, Hodgson S, Lind M, Maraveyas A, Brown V. 60P Real-world experience of immunotherapy in elderly cancer patients in a UK cancer centre. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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McCabe M, Perner Y, Magobo R, Mirza S, Penny C. Descriptive epidemiological study of South African colorectal cancer patients at a Johannesburg Hospital Academic institution. JGH Open 2020; 4:360-367. [PMID: 32514437 PMCID: PMC7273728 DOI: 10.1002/jgh3.12248] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/01/2019] [Accepted: 08/04/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIM Epidemiological studies of colorectal cancer (CRC) in South Africa (SA) have been poorly characterized. Black and white SA population groups have demonstrated distinct CRC clinical presentations, suggesting that black SA patients follow a different carcinogenic pathway than their white counterparts. Thus, the aim of this study was to identify unique demographic and histopathological features associated with black SA patients to facilitate earlier diagnosis and to improve disease management. METHODS This preliminary descriptive epidemiological study included 665 retrospective CRC cases diagnosed between the period 2011 and 2015 at the Charlotte Maxeke Johannesburg Academic Hospital. Demographic and histopathological features in black versus other race groups (ORG) were compared, and Student's t-test, Chi-square, and Fischer's exact tests were used for statistical analysis. RESULTS Statistical analysis demonstrated that patients with left-sided tumors of invasive adenocarcinoma were predominantly black and male. These patients were considerably younger when compared to ORG (median 56 vs 62 years, respectively), P < 0.0001. However, no significant propensity for other histological features was illustrated. Polyps were mostly tubular adenomas (51%) and tubulovillous adenomas (TVAs) (44%). TVAs were mostly high-grade lesions (P < 0.0001) and associated with left-sided CRC (P = 0.0325). CONCLUSION These findings verify that black SA CRC patients have an earlier disease onset in comparison to ORG; however, no increased tendency for tumor site, precursor lesion, stage of disease, or gender was evident. Thus, a deeper molecular characterization of CRC is required to understand the underlying causes associated with earlier disease onset in black SA CRC patients.
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Chapman SJ, Blanco-Colino R, Pérez-Ajates S, Bautista OA, Hodson J, Blanco-Colino R, Chapman SJ, Glasbey JC, Pata F, Pellino G, Soares ASA, van Elst T, Van Straten S, Nepogodiev D, Hodson J, Borakati A, Bath MF, Yasin IH, Mclean K, Arthur T, Kovacevic M, Delibegovic S, Karamanliev M, Swamad M, Žebrák R, Paramasivam R, Martensen A, Larsen HM, Rãdeker L, Frey PE, Kechagias A, Venara A, Duchalais E, Ioannidis A, Pata F, Pellino G, Pasquali S, Simioni ASA, Farina V, Podda M, Lorenzon L, ItSURG, Schaeff V, Otto A, Jakubauskas M, van Elst TR, Chu M, Fagan PVB, Wells CI, João AA, Soares A, Juloski J, Blanco-Colino R, Pérez-Ajates S, Bautista OA, El Kasmi YEK, Espin-Basany E, Clerc D, Ciubotaru C, Popescu S, Yanishev A, Lee S, Ozkan BB, Sen AY, Aktas MK, Baki BE, Yüksek B, Glasbey JC, Kamarajah S, Mclean K, Borakati A, Yasin IH, Khaw RA, Mills E, Goodson R, Thakral N, Ablett AD, Adra M, Kwek I, Khan SM, Quinn P, Manley LR, Badran A, Ramjeeawon A, Campbell A, Tan HL, Rye DS, Rajaraman N, Norman 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Turner C, Dwyer-Hemmings L, Busuttil A, Powell J, Hensher C, Vivian F, Wcislo K, Millar Z, Hirosue S, Ogunmwonyi I, Nakakande D, Kwek I, Gaze H, Pillai S, Khoury G, Powell T, Maleyko I, Sangheli A, Ransome M, Isse M, Aromolaran O, Bholah H, Anbarasan J, Rehman S, Hu E, Timms S, Reynolds W, Hotchkies A, Misra V, Suresh G, Murray V, Theocharidou L, Malik T, Janmohamed I, Carhart B, Khan A, Asif A, Hullait R, Quinn P, Rylance A, Butt S, Leathes J, Finch BJ, Rajathasan TP, Jeddy H, Kyaw HA, Wong N, Karelia S, Clements JM, Rainey M, Joshi N, Rahman A, Gallagher M, Rebuffa N, Abdelgalil R, Lai RSY, Laurence N, Thomas S, Green C, Frostick R, Khera R, Povey M, Wong HL, McCusker C, Hlukha L, Pike G, Kamel F, Thakkar R, Donaldson C, Campos MS, Bhahirathan Y, Herron J, Bradbury M, Osunronbi T, Tam LYC, Kaabneh AK, Lawther J, Fisher P, Tribedi T, Moosa A, Ramdin A, Goble M, Downs E, Wheldon L, Baggus E, Mandal A, Nayeem A, Ahmed S, Fradley W, Wilson C, Gallagher S, Criswell T, Ward J, Mukkavilli A, Stubbs B, Fordyce W, Suchdev N, Lim SW, Tew ZY, Sookramanien SR, Chan A, Bointas G, Paul M, Ward KL, Bagnall M, Pherwani SA, Wang K, Mitchell L, Heyworth J, Ayyar S, Obukofe R, Polson R, Mason D, Mackenzie E, Russell C, Doyle N, Habib Z, Zardab M, Sartaj F, Farooq H, Tabibi M, Drury DJ, James SJ, Barnett R, Cahya E, Lou G, Coyle M, Homyer K, Zhu LY, Woods M, Chang J, O'Callaghan H, Suchett-Kaye I, Mihailidis TH, Alawattegama H, Seite E, Barrett A, Riordan E, Lam W, Dowdeswell M, Mulvenna C, Netke T, Awokoya O, Gurowich L, Dhera K, Hayat S, Williams L, Tincknell L, Spazzapan M, Teeling F, Sysum K, Latter J, Latter M, Khan S, Woodmass M, Hayden H, Kisiel A, Ali Y, Husain S, Arnold A, Pedersen AC, Cunha P, Ahmed M, Al Zawawi S, Kudva V, Liu FY, Theodoropoulou K, Miscampbell M, Robinson AV, Johnston J, Dharni A, Lamb S, Westerman T, Evans E, Campbell L, Gillespie M, Cheong CM, Kulathevanayagam K, Varghese A, Ike SI, Chu TSM, Baljer B, Mogg JAW, Rai P, Claireaux HA, Williams M, Smillie R, Goetz J, Appleby E, Fadipe T, Vaughan-Burleigh S, Mondal A, Jovaisaite A, Shah SM, Khalid N, Gutmann D, Davison S, Alame YJ, Syed L, Owen WJ, Ahsan SD, Kalderon R, Anthony-Uzoeto U, Hall CM, Zheng S, Wynter K, James C, Sapre D, Ghosh R, Baird J, Cockburn L, Blackwood O, Nadama HH, Simpson W, Jeong S, Bishop S, Bate R, Hobson C, Adam AH, Redclift C, Do J, Adeleye O, Poli F, Batterham A, Brown S, Parekh JN, Clay W, Pieri K, Jackson A, Brown S, Saxena A, Gurung B, Oyebola T, O'Brien F, Djeugam B, Gardezi S, Ul-Hasan S, Martin-Hernandez MP, Sisley M, Modi S, Antakia R, Elbayouk A, Soh YJ, Mather J, Yusuf Z, Al-Sarraf Z, Naja M, Rassool SB, Convill J, Nikookam Y, Warsame A, Tam JPH, Pace C, Kiandee M, Ridwan R, Carey C, Hirri F, McMillan MJA, Ling JJ, Powell-Chandler A, Pendelbury L, Kerimzade K, Tang A, Howard EO, Humayun S, Wadsworth OJ, Tan K, Abdelhameed F, Haglund C, Radnaeva I, Hu N, Rambhatla S, Waldron D, Madahar P, Malik S, Campbell A, Meney LC, Ibrahim I, Kang CK, Chiu JZJ, Livie V, Ibrahim B, Khalil M, Pooley G, Shishkin B, Gorgievska R, Docherty J, Southgate A, Coomes A, McGee F, Flanagan S, Thakrar C, Tan QJ, Anwar H, Clough R, Chrisp B, Cassels J, Cross GWV, Ragavoodoo A, Mercer L, Mercer C, Refalo A, Hadley R, McTighe A, Farrow F, Brodie A, Davis G, Shah DR, Bowers C, Patel S, Morice O, Burzic A, Cheung J, Shashidhara A, Theodoraki G, Birk J, Ong A, Ng MPE, Wong RTW, Maese S, Yeap B, Iqbal Z, Melaugh T, Perchard W, Scurr T, Davidson K, Campbell E, Kelk L, Ghosh A, Gibbins A, Mala D, Loizidou A, Hall O, Mecia L, Hew C, Varathan K, Tong L, Chandrasekar B, Giacci L, Buchanan E, O'Connell M, Kwak SY, Ong EH, Gardner S, Lim J, Maden C, Illahi M, Hale J, Tan ZX, Edwards S, Stahl R, Stahl J, Hickman A, Collett D, Goolam-Mahomed Z, Allen B, Atiyah A, Ahmad H, Jones J, McGregor O, Ogundiya E, Gan FW, Boulbadaoui A, Kirnon-Jackman O, Lim QX, Peckham H, Yeoh T, Yong SQ, Chen JY, Siva S, Sam ZH, Gilani M, Goh YN, Muthukumar MG, Phillips S, Makin-Taylor R, Tjoakarfa J, Giri A, Suresan S, Thavayogan R, Hey CY, Thomas P, Johnson TA, Williams RI, Rashid A, Kushairi A, Rais A, James A, Bugelli M, Chechelnitskaya Y, Sandhu N, Toh C, Tandon R, Gray M, Kumar A, Ciurleo C, Nyamali I, Hiremath S, Sinha S, Chowdhary M, Bradley E, McTiernan M, Macdonald S, Sharkey S, McLaughlin N, Amey C, Kraria L, Skan O, Kind C, Findlay JM, Tupper P, Van Rhee C, Honeyman SI, Menon G, Ahmed M, Jegatheeswaran L, Griffiths N, Madhavan A, Warne M, Malcolm FL, Lessware T, Wilkerson HT, Chatterjee-Woolman S, Yoong A, Ahmed WUR, Longshaw A, Flannery O, Green R, Leaning M, Cragg J, Sharriff H, Doherty C, Ganesananthan S, Kwan KWL, Sanders-Crook L, Bhatia S, Eames S, Lewis F, Kirupananthan P, Boh ZY, Dass S, Soma A, Newton A, Hill M, Shafiq Y, Brkljac M, Boyce L, Jasionowska S, English WJ, Lam S, Chipeta C, Yilmaz D, Jain C, Garofalidou T, Novotny SA, Locke S, Bowman C, Begaj A, Murphy C, Radcliffe K, Chong JT, Poustie M, Jeffrey E, Chaudhury N, Rajendran K, Akbar Z, Walters B, Kulendrarajah B, Tran N, Shrestha S, Parmar S, Gallagher C, Hennessy L, Pentti E, Badhrinarayanan S, Fung A, Mansoor M, Kenny R, Kan P, Lee DE, Khosla S, Samake M, Shaban F, Aftab R, Gough M, Woodburn B, Vayalapra S, McMurrugh K, Wong C, Jimulia D, Deol S, Pike S, Embury-Young Y, Turner T, Patel M, Kilgallon E, Keating R, Walsh A, Khan H, Logue G, Orekoya M, Alasmar M, Charalambides M, Llavall AC, Williamson E, Bharwada Y, Zearmal S, Evans H, Panikkar M, de la Cruz G, Caplan J, Ruparelia A, Tanvir T, Soare C, Pang YL, Trotter J, Zaidi A, Thakrar V, Pulickal P, Ahmed H, Parnell J, Khan H, Lennock S, Ford V, Pyc W, Brignall R, O'Neill D, Hanna R, Kane R, Nicola M, Rajput K, Xiao Y, Warner C, Michael S, Wright E, Juniper S, Thompson E, Hoskyns L, Kanitkar A, Ross C, Unsworth A, Rshaidat H, Demarre K, Chiang A, Bareh A, van Dellen J, Faqihinejad C, Gadhvi A, Grant R, Lewsey J, Morris A, Martin H, McClarty C, Sanyal S, Alsaif A, Palkhi A, Bhopal S, Burford C, Huq T, Sloper W, Irwin E, Matthews L, Ngu WS, Hosfield T, Muneeb F, Page O, Zeb E, Coey J, Al-Azzawi A, McIntosh J, Vucicevic A, Hughes M, Brooks L, Fanibi B, Dixon M, Njoku P, Morris D, Jobson J, Chowdhury H, Joseph N, Zulkefley N, Hunt G, Christodoulou T, Wright O, Soman S, Jamal M, Beqiri S, Borgas P, Christie S, Pereira F, Browne S, Yiu J, Dworkin A, Brayley J, Palmer A, Charalambos M, Jones CS, Toner S, Cowden R, Lee L, Nicol P, Holman O, Imtiaz M, Albert V, Leung SP, Erotocritou M, Wong J, Stroud R, Mason D, Wilkin R, Thomson W, Mackee L, Kler A, Reynolds L, Mohamed SH, Majeed Y, Fakim B, Jones A, Kowal M, Liversedge G, Carrington Z, Windebank J, Izzarina A, Akbani U, Craven J, Aldarragi A, Harding S, Millward A, Shortland TC, Bedford M, Stroud R, Obukofe R, Mackenzie E, Gopalan V, Midgen A, Khadka P, Cheng O, Taneja S, Manobharath N, Kok JY, Lim DWE, Buick T, Boland M, Piya S, Devlin R, Fairfield CJ, George RJ, Rahi M, Zaman S, Hajiev S, Ross T, Owen M, Crisp E, Thompson C, Charalambous A, Hollywood JL, Saiyed A, Hammond RFL, Matthews J, Mendonca V, Spinty J, Khan K, Cheng J, Glynn N, Muhammad U, Khan M, Anderson L, Mccormack K, Mak J, Patrawala S, Milinkovic N, Schofield R, Chauhan M, Hartley L, Hind J, Ashworth I, Nelson L, Ratnasingham D, Akbari K, Whitehead T, Dimitriadis S, Marshall K, Flint EJ, Curran M, Horner C, Heybourne A, Morgan H, Wickstone C, Panagiotou D, O'Connell E, Dean K, Iqbal R, Walsh L, Yu N, Rana N, Massie E, Ng J, Jung M, Lee YD, Harris M, White S, Delibegovic S, Boev B, Tonchev P, Prochazka V, Örhalmi J, Riško J, Skalický A, Chrz K, Ravn S, Ojakããr A, Duchalais E, Dörr-Harim C, Herrle F, Koutserimpas C, Giraudo G, Armellini A, Ruzzenente A, Mazzeo C, De Padua C, Luc AR, Maroli A, Vitali M, Ceccarelli G, Gusai GP, Quattromani R, Virgilio E, Berti S, Mulas S, Di Mola FF, Papagni V, Tuminello F, Magnoli M, Vittori L, Longheu A, Loche GA, Braccio B, De Luca E, Resta G, Ancans G, Tamosiunas A, Petrulionis M, Abdulrahman N, van de Pas KGH, Thomas G, Brandsma AM, Davids J, Rottier SJ, de Roy van Zuidewijn D, Hawkins R, Ong HI, Li Y, Desmond B, Winstanley J, Martins M, Rosete M, Americano M, Santos M, Frade S, Senhorinho R, Peixoto R, João AA, Alves-Vale C, Lamas M, O'Connor DB, Hoo M, Gopaul A, Scanlon K, O'Dwyer N, Negoi I, Jovanović M, Panyko A, De Lima H, Van Vuuren S, Centeno A, Bernado IR, Señorans MPG, Amor LG, Ramírez AC, Abrisqueta J, Gomez ME, Arroyo A, Cerdán C, Romeu NG, Forero-Torres A, Enriquez-Navascues JM, Collado-Roura F, Curchod P, Gaspar S, Imadalou L, Mutlu D, Akyol C, Uygur FA, Eray IC, Biyiklioglu O, Çetin MF, Isik AE, Karip B, Dogan H, Sarıgül L, Tunc E, Aydin T, Bodur S, Karabulut K, Francis AA, Al-hadithi A, Lau ISF, Smith E, Mahapatra S, McAuliffe O, Francis AA, Imam L, Akram B, Hossaini S, Davies R, Ko M, Collins J, Pandya A, Reilly S, Archer J, Livie J, Chaudhry FA, Ntakomyti E, Diallo R, Bylinski T, Wright J, Lawday S, Masiha E, Tung J, Shirazi B, Neilson A, Epton S, Patel N, Trussell S, Couldrey A, Donnelly C, Eftychiou S. Safety of hospital discharge before return of bowel function after elective colorectal surgery. Br J Surg 2020; 107:552-559. [PMID: 31976560 DOI: 10.1002/bjs.11422] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 10/06/2019] [Accepted: 10/08/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. METHODS A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien-Dindo classification system. RESULTS A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4-7) and 7 (6-8) days respectively (P < 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110). CONCLUSION Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients.
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Hirsch J, Mehta B, Finik J, Navarro-Millan I, Brantner C, Mirza S, Figgie M, Parks M, Russell L, Orange D, Goodman S. Racial disparities in pre-operative pain, function and disease activity for patients with rheumatoid arthritis undergoing Total knee or Total hip Arthroplasty: a New York based study. BMC Rheumatol 2020; 4:17. [PMID: 32161847 PMCID: PMC7049203 DOI: 10.1186/s41927-020-0117-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 01/30/2020] [Indexed: 01/02/2023] Open
Abstract
Background Black and Hispanic patients with osteoarthritis have more pain and worse function than Whites at the time of arthroplasty. Whether this is true for patients with rheumatoid arthritis (RA) is unknown. Methods This cross-sectional study used data on RA patients acquired between October 2013 and November 2018 prior to elective total knee (TKA) or hip arthroplasty (THA). Pain, function, and disease activity were assessed using the visual analogue scale (VAS), the Multidimensional Health Assessment Questionnaire (MDHAQ), and the Disease Activity Score (DAS28-ESR). We linked the cases to census tracts using geocoding to determine the community poverty level. Race, education, income, insurance and medications were collected via self-report. Using multivariable linear and logistic models we examined whether minority status predicted pain, function and RA disease activity at the time of arthroplasty. Results Thirty seven (23%) of the 164 patients were Black or Hispanic (minorities). The MDHAQ and DAS28-ESR were not significantly worse while VAS pain score was significantly worse in minority patients (p = 0.03). There was no significant difference in education between the groups. Insurance varied significantly; 29% of minority patients had Medicaid vs. 0% of Whites (p < 0.0001). In the multivariable analyses minority status was not significantly associated with DAS28-ESR [p = 0.66], MDHAQ [p = 0.26], or VAS pain [p = 0.18]. Conclusions For Black and/or Hispanic patients with RA undergoing THA or TKA at a high-volume specialty hospital, unlike Black or Hispanic patients with osteoarthritis (OA), there was no association with worse pain, function, or RA disease activity at the time of elective arthroplasty.
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Chapman SJ, Clerc D, Blanco-Colino R, Otto A, Nepogodiev D, Pagano G, Schaeff V, Soares A, Zaffaroni G, Žebrák R, Hodson J, Blanco-Colino R, Chapman SJ, Glasbey JC, Pata P, Pellino G, Sgrò A, Soares A, Elst T, Van Straten S, Knowles CH, Nepogodiev D, Hodson J, Borakati A, Bath MF, Yasin IH, Mclean K, Arthur T, Kovacevic M, Delibegovic S, Karamanliev M, Swamad M, Žebrák R, Paramasivam R, Martensen A, Larsen HM, Rädeker L, Frey PE, Kechagias A, Venara A, Duchalais E, Ioannidis A, Pata F, Pellino G, Pasquali S, Sgrò A, Simioni A, Farina V, Podda M, Lorenzon L, Schaeff V, Otto A, Jakubauskas M, Elst TR, Chu M, Fagan PVB, Wells CI, Alagoa João A, Soares A, Juloski J, Clerc D, Ciubotaru C, Popescu S, Yanishev A, Lee S, Ozkan BB, Yagız Sen A, Aktas MK, Baki BE, Yüksek B, Glasbey JC, Kamarajah S, Mclean K, Borakati A, Yasin IH, Khaw RA, Mills E, Goodson R, Thakral N, Ablett AD, Adra M, Kwek I, Khan SM, Quinn P, Manley LR, Badran A, Ramjeeawon A, Campbell A, Tan HL, Rye DS, Rajaraman N, Norman 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Bojičić J, Juloski J, Genčić M, Janković U, Zubowicz M, Sucháň PK, Gerstmeier J, Mészárosová K, Brazitikou E, Fytrou E, Celik M, Dubovský M, Schmalenbeck J, Sautter SC, Ceyran H, Jaich R, Fitchat N, Mathebula S, Chauke J, Mculu W, Ngwenya Z, Withey K, Piperidis A, Toyi Y, Nicolaides A, Jaffer T, Sparke A, Van Staden N, McDuling CR, Claassen L, Kruger C, Weyers J, Marx M, Lecler J, Mignon G, Vanoni A, Henkens A, Jarrar G, Odovic M, Willemin M, Milliet O, Hahnloser D, Clerc D, Demartines N, Piazza G, Teixeira H, Pittet O, Haller ML, Gagliardi B, Huot A, Blaser B, Kefleyesus A, Bugmann A, Piotet LM, Meijers L, Kurtoglu GK, Sel EK, Isler VC, Yilmaz BS, Adiyaman C, Kara M, Demirkaya HC, Korkmaz HK, Pektas AM, Güner B, İşlek EC, Tombul HB, Boztuğ CY, Tınaz A, Yılmaz M, Karaman Y, Akın FA, Dansuk S, Başçavuş M, Kaya M, Kutlu B, Seker MC, Erten V, Memis U, Koçak ZB, Karapinar YE, Fakirullahoglu M, Uslu Ö, Köseoglu E, Yeni M, Aktas MK, Aykun N, Agca MH, Bilen C, Kilinc I, Atar C, Kilic V, Aktuna C, Aba M, Alim YE, Binbuga M, Kürklü Ö, Yurdaor SS, Ceylan C, Yilmaz S, Çalar SN, Yildirim N, Yavuz G, Yagız Sen A, Can B, Cesmeli E, Kus D, Kavar RC, Cevlik AD, Cengiz U, Turk EG, Yilmaz I, Yüksek B, Erdönmez H, Gürsoy F, Serin H, Kara H, Önsal U, Özbek M, Kasar PA, Ipor A, Özen D, Ölmez M, Altintas E, Kaya Y, Toklu R, Sariçiçek T, Tipi OU, Benli GE, Tasdelen I, Tura A, Ucar A, Ekci B, Bilgili AC, Kiraz IN, Aksoy H, Cinar EN, Basak A, Erdem M, Kayacan S, Sahin C, Uysal M, Karakus K, Altiner S, Demirci ZS, Eren E, Yavas M, Tiftik E, Aksoy AB, Karagöz E, Sabanci R, Tümer SS, Kargici K, Banaz T, Abdulrahman SMF, Yesilsancak M, Yanikoglu E, Karabulut A, Yilmaz D, Kuyumcu OF, Kutluk F, Emiroglu B, Aksoy B, Mollavelioglu B, Gereklioglu D, Guler M, Toprak S, Afsar HB, Guler SE, Alizade E, Baki BE, Alemdag G, Ulusahin M, Arslan E, Gul EB, Yildirim R, Semiz A, Bektur G, Tomas K, Bilicen G, Yarenci E, Demiroglu Y, Sunal A, Baykan B, Abbasguliyev H, Mutlu V, Mahmoudi Y, Dossa SAA, Mizan SR, Demirtas B, Cavus T, Yuksek A, Mazlum SS, Yelkenci C, Baran T, Satilmisoglu M, Sahin AZ, Kilinç A, Isik K, Yumurtaci Ö, Emin A, Girit Ç, Yildirak MK, Senyigit E, Güldag A, Söyleyici B, Aytin YE, Akay FE, Iskan NG, Mutlu B, Sunay AO, Ablett AD, Tie-Gill T, Ramsay G, De Paola L, McGuckin S, Alshakhs A, Ahmeidat A, Wong J, Goergen N, Ali Z, Mullarkey L, Bath MF, Walshe R, Lewis E, Berry B, Moneim J, Mookerjee S, Christy S, Ojofeitimi O, Carroll L, Hylands A, Delaugere LP, Reveendran D, Coulter C, Ralston C, Laverty L, Gallagher P, Ahmed A, Yeo YQ, Elliott D, Bennett J, Mcnamara M, Sivarajah S, Dunmore C, Aitken G, Nair M, Aly MH, Buari M, Farhan-Alanie MMH, Ahmed K, Sheikh Z, Monks M, Lehmann J, Rotimi O, Bell T, Limnatitou D, Gormley S, Taleongpong P, Patel V, Macgregor L, Amini S, Turner C, Dwyer-Hemmings L, Busuttil A, Powell J, Hensher C, Vivian F, Wcislo K, Millar Z, Hirosue S, Ogunmwonyi I, Nakakande D, Kwek I, Gaze H, Nirmalanantha A, Bin Amran AM, Foulkes A, Jones N, Pillai S, Khoury G, Powell T, Maleyko I, Sangheli A, Ransome M, Isse M, Aromolaran O, Bholah H, Anbarasan J, Rehman S, Hu E, Timms S, Reynolds W, Hotchkies A, Misra V, Suresh G, Murray V, Theocharidou L, Malik T, Janmohamed I, Carhart B, Khan A, Asif A, Hullait R, Quinn P, Rylance A, Butt S, Leathes J, Finch BJ, Philip Rajathasan T, Jeddy H, Kyaw HA, Wong N, Karelia S, Clements JM, Rainey M, Joshi N, Rahman A, Gallagher M, Rebuffa N, Abdelgalil R, Siaw Yen Lai R, Laurence N, Thomas S, Green C, Frostick R, Khera R, Povey M, Wong HL, McCusker C, Hlukha L, Pike G, Kamel F, Thakkar R, Donaldson C, Sequeira Campos M, Bhahirathan Y, Armitage MN, Hussain AS, Hardy B, Hassan Serry MY, Herron J, Bradbury M, Osunronbi T, Tam LYC, Khanan Kaabneh A, Lawther J, Fisher P, Tribedi T, Moosa A, Ramdin A, Goble M, Downs E, Wheldon L, Baggus E, Mandal A, Nayeem A, Ahmed S, Fradley W, Wilson C, Gallagher S, Criswell T, Ward J, Mukkavilli A, Stubbs B, Fordyce W, Suchdev N, Wei Lim S, Yi Tew Z, Sookramanien SR, Chan A, Bointas G, Paul M, Ward KL, Bagnall M, Pherwani SA, Wang K, Mitchell L, Heyworth J, Ayyar S, Obukofe R, Polson R, Mason D, Mackenzie E, Russell C, Doyle N, Habib Z, Zardab M, Sartaj F, Farooq H, Tabibi M, Drury DJ, James SJ, Barnett R, Teasdale AB, Richardson ETJ, Thomas DA, Ahmed S, Williams RL, Najabat-Lattif HF, Cahya E, Lou G, Coyle M, Homyer K, Zhu LY, Woods M, Chang J, O'Callaghan H, Suchett-Kaye I, Mihailidis TH, Alawattegama H, Seite E, Barrett A, Riordan E, Lam W, Dowdeswell M, Mulvenna C, Netke T, Awokoya O, Gurowich L, Dhera K, Hayat S, Williams L, Tincknell L, Spazzapan M, Teeling F, Sysum K, Latter J, Latter M, Khan S, Guruswamy M, Beedham W, Brazier E, Elghobashy M, Bajaj M, Mann H, Etel E, Woodmass M, Hayden H, Kisiel A, Ali Y, Husain S, Arnold A, Pedersen AC, Cunha P, Ahmed M, Al Zawawi S, Kudva V, Liu FY, Theodoropoulou K, Miscampbell M, Robinson AV, Johnston J, Dharni A, Lamb S, Westerman T, Evans E, Campbell L, Gillespie M, Cheong CM, Kulathevanayagam K, Varghese A, Ike SI, Chu TSM, Baljer B, Mogg JAW, Rai P, Claireaux HA, Williams M, Smillie R, Goetz J, Appleby E, Fadipe T, Vaughan-Burleigh S, Puri G, Hussain P, James P, Flather R, Cutler A, Pathak S, Sheldon J, Collicott T, al-Ausi M, Mondal A, Jovaisaite A, Shah SM, Khalid N, Gutmann D, Davison S, Alame YJ, Syed L, Owen WJ, Ahsan SD, Kalderon R, Anthony-Uzoeto U, Macleod Hall C, Zheng S, Wynter K, James C, Sapre D, Ghosh R, Baird J, Cockburn L, Blackwood O, Nadama HH, Simpson W, Jeong S, Bishop S, Bate R, Hobson C, Adam AH, Redclift C, Do J, Adeleye O, Poli F, Batterham A, Brown S, Parekh JN, Clay W, Pieri K, Jackson A, Brown S, Saxena A, Gurung B, Oyebola T, O'Brien F, Djeugam B, Gardezi S, Ul-Hasan S, Martin-Hernandez MP, Sisley M, Modi S, Antakia R, Elbayouk A, Soh YJ, Mather J, Yusuf Z, Al-Sarraf Z, Naja M, Rassool SB, Convill J, Nikookam Y, Warsame A, Tam JPH, Pace C, Kiandee M, Ridwan R, Carey C, Hirri F, McMillan MJA, Ling JJ, Powell-Chandler A, Pendelbury L, Kerimzade K, Tang A, Howard EO, Humayun S, Wadsworth OJ, Tan K, Abdelhameed F, Haglund C, Radnaeva I, Hu N, Rambhatla S, Waldron D, Madahar P, Malik S, Campbell A, Meney LC, Ibrahim I, Kang CK, Chiu JZJ, Livie V, Ibrahim B, Khalil M, Pooley G, Shishkin B, Gorgievska R, Docherty J, Southgate A, Coomes A, McGee F, Flanagan S, Thakrar C, Tan QJ, Anwar H, Clough R, Chrisp B, Cassels J, Cross GWV, Ragavoodoo A, Mercer L, Mercer C, Refalo A, Hadley R, McTighe A, Farrow F, Brodie A, Davis G, Shah DR, Bowers C, Patel S, Morice O, Burzic A, Cheung J, Shashidhara A, Theodoraki G, Birk J, Ong A, Ng MPE, Wong RTW, Maese S, Yeap B, Iqbal Z, Rojoa DM, Cabaleiro Barciela C, Hussain M, Ruddy CM, Lindwe S, Qamar Y, Chuita S, Melaugh T, Hall JD, Palmer C, Kouli O, Hassane ASI, Azhar AW, Tan TK, Perchard W, Scurr T, Davidson K, Campbell E, Kelk L, Ghosh A, Gibbins A, Mala D, Loizidou A, Hall O, Mecia L, Hew C, Varathan K, Tong L, Chandrasekar B, Giacci L, Buchanan E, O'Connell M, Kwak SY, Ong EH, Gardner S, Lim J, Maden C, Illahi M, Hale J, Xuan Tan Z, Edwards S, Stahl R, Stahl J, Hickman A, Collett D, Goolam-Mahomed Z, Allen B, Atiyah A, Ahmad H, Jones J, McGregor O, Ogundiya E, Gan FW, Boulbadaoui A, Kirnon-Jackman O, Lim QX, Peckham H, Yeoh T, Yong SQ, Chen JY, Siva S, Sam ZH, Gilani M, Goh YN, Muthukumar MG, Phillips S, Makin-Taylor R, Tjoakarfa J, Giri A, Suresan S, Thavayogan R, Hey CY, Thomas P, Johnson TA, Williams RI, Rashid A, Kushairi A, Rais A, James A, Bugelli M, Chechelnitskaya Y, Sandhu N, Toh C, Tandon R, Gray M, Kumar A, Ciurleo C, Nyamali I, Hiremath S, Sinha S, Chowdhary M, Bradley E, McTiernan M, Macdonald S, Sharkey S, McLaughlin N, Amey C, Kraria L, Skan O, Kind C, Findlay JM, Tupper P, Van Rhee C, Honeyman SI, Menon G, Ahmed M, Jegatheeswaran L, Griffiths N, Madhavan A, Warne M, Malcolm FL, Lessware T, Wilkerson HT, Chatterjee-Woolman S, Yoong A, Ahmed WUR, Longshaw A, Flannery O, Green R, Leaning M, Cragg J, Sharriff H, Doherty C, Ganesananthan S, Kwan KWL, Sanders-Crook L, Bhatia S, Eames S, Lewis F, Kirupananthan P, Boh ZY, Dass S, Soma A, Newton A, Hill M, Shafiq Y, Brkljac M, Boyce L, Jasionowska S, English WJ, Lam S, Chipeta C, Yilmaz D, Jain C, Garofalidou T, Novotny SA, Locke S, Bowman C, Begaj A, Murphy C, Radcliffe K, Chong JT, Poustie M, Jeffrey E, Chaudhury N, Rajendran K, Akbar Z, Walters B, Kulendrarajah B, Tran N, Shrestha S, Parmar S, Gallagher C, Hennessy L, Pentti E, Badhrinarayanan S, Fung A, Mansoor M, Kenny R, Kan P, Lee DE, Khosla S, Samake M, Shaban F, Aftab R, Gough M, Woodburn B, Vayalapra S, McMurrugh K, Wong C, Jimulia D, Deol S, Pike S, Embury-Young Y, Turner T, Patel M, Kilgallon E, Keating R, Walsh A, Khan H, Logue G, Orekoya M, Alasmar M, Charalambides M, Clavé Llavall A, Williamson E, Bharwada Y, Zearmal S, Evans H, Panikkar M, Cruz G, Caplan J, Ruparelia A, Tanvir T, Soare C, Pang YL, Trotter J, Zaidi A, Thakrar V, Pulickal P, Ahmed H, Parnell J, Khan H, Lennock S, Ford V, Pyc W, Brignall R, O'Neill D, Hanna R, Kane R, Nicola M, Rajput K, Xiao Y, Warner C, Michael S, Wright E, Juniper S, Thompson E, Hoskyns L, Kanitkar A, Ross C, Unsworth A, Rshaidat H, Demarre K, Chiang A, Bareh A, Dellen J, Faqihinejad C, Gadhvi A, Grant R, Lewsey J, Morris A, Martin H, McClarty C, Sanyal S, Alsaif A, Palkhi A, Bhopal S, Vishnu K S, Papanikolaou A, Mitra A, Nur A, Ali F, Burford C, Huq T, Sloper W, Irwin E, Matthews L, Ngu WS, Hosfield T, Muneeb F, Page O, Zeb E, Coey J, Al-Azzawi A, McIntosh J, Vucicevic A, Hughes M, Brooks L, Fanibi B, Dixon M, Njoku P, Morris D, Jobson J, Chowdhury H, Alawode DOT, Wynell-Mayow W, Udayachandran V, Alsoof D, Ekert J, Joseph N, Zulkefley N, Hunt G, Christodoulou T, Wright O, Soman S, Jamal M, Beqiri S, Borgas P, Christie S, Pereira F, Browne S, Yiu J, Dworkin A, Brayley J, Palmer A, Charalambos M, Jones CJ, Toner S, Cowden R, Lee L, Nicol P, Holman O, Imtiaz M, Albert V, Leung SP, Erotocritou M, Wong J, Stroud R, Mason D, Wilkin R, Thomson W, Mackee L, G N, Bei Y, Sait S, Mckenna Favier S, Ibrahim A, Kler A, Reynolds L, Mohamed SH, Majeed Y, Fakim B, Jones A, Kowal M, Liversedge G, Carrington Z, Windebank J, Izzarina A, Akbani U, Craven J, Aldarragi A, Harding S, Millward A, Shortland TC, Bedford M, Stroud R, Obukofe R, Mackenzie E, Gopalan V, Midgen A, Khadka P, Cheng O, Taneja S, Manobharath N, Kok JY, Lim DWE, Buick T, Boland M, Piya S, Devlin R, Fairfield CJ, George RJ, Rahi M, Zaman S, Hajiev S, Ross T, Owen M, Crisp E, Thompson C, Charalambous A, Hollywood JL, Saiyed A, Hammond RFL, Matthews J, Mendonca V, Spinty J, Khan K, Cheng J, Glynn N, Muhammad U, Khan M, Anderson L, Mccormack K, Mak J, Patrawala S, Milinkovic N, Schofield R, Chauhan M, Hartley L, Hind J, Ashworth I, Nelson L, Ratnasingham D, Akbari K, Whitehead T, Dimitriadis S, Marshall K, Flint EJ, Curran M, Horner C, Heybourne A, Morgan H, Wickstone C, Panagiotou D, O'Connell E, Dean K, Iqbal R, Walsh L, Yu N, Rana N, Massie E, Ng J, Jung M, Lee YD, Harris M, White S, Delibegovic S, Boev B, Tonchev P, Prochazka V, Örhalmi J, Riško J, Skalický A, Chrz K, Ravn S, Ojakäär A, Duchalais E, Dörr-Harim C, Herrle F, Koutserimpas C, Giraudo G, Armellini A, Ruzzenente A, Mazzeo C, De Padua C, Realis Luc A, Maroli A, Giani I, Cufari ME, Vitali M, Ceccarelli G, Gusai GP, Quattromani R, Virgilio E, Berti S, Mulas S, Di Mola FF, Papagni V, Tuminello F, Magnoli M, Vittori L, Longheu A, Loche GA, Braccio B, De Luca E, Resta G, Ancans G, Tamosiunas A, Petrulionis M, Andrejevic P, Stellingwerf ME, Abdulrahman N, Pas KGH, Thomas G, Brandsma AM, Davids J, Rottier SJ, Roy van Zuidewijn D, Hawkins R, Ong HI, Li Y, Desmond B, Winstanley J, Martins M, Rosete M, Americano M, Santos M, Frade S, Senhorinho R, Peixoto R, Alagoa João A, Alves-Vale C, Lamas M, O'Connor DB, Hoo M, Gopaul A, Scanlon K, O'Dwyer N, Negoi I, Jovanović M, Panyko A, De Lima H, Van Vuuren S, Curchod P, Gaspar S, Imadalou L, Mutlu D, Akyol C, Uygur FA, Eray IC, Biyiklioglu O, Çetin MF, Isik AE, Karip B, Dogan H, Sarıgül L, Tunc E, Aydin T, Bodur S, Karabulut K, Francis AA, Al-hadithi A, To N, Lau ISF, Smith E, Mahapatra S, McAuliffe O, Francis AA, Imam L, Akram B, Hossaini S, Davies R, Ko M, Collins J, Pandya A, Reilly S, Archer J, Auty C, Roche CD, Livie J, Chaudhry FA, Ntakomyti E, Diallo R, Bylinski T, Wright J, Lawday S, Masiha E, Tung J, Shirazi B, Neilson A, Epton S, Patel N, Trussell S, Couldrey A, Donnelly C, Eftychiou S. Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery. Br J Surg 2020; 107:e161-e169. [PMID: 31595986 DOI: 10.1002/bjs.11326] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/06/2019] [Accepted: 07/04/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery. METHODS A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre-specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. RESULTS A total of 4164 patients were included, with a median age of 68 (i.q.r. 57-75) years (54·9 per cent men). Some 1153 (27·7 per cent) received NSAIDs on postoperative days 1-3, of whom 1061 (92·0 per cent) received non-selective cyclo-oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4·6 versus 4·8 days; hazard ratio 1·04, 95 per cent c.i. 0·96 to 1·12; P = 0·360). There were no significant differences in anastomotic leak rate (5·4 versus 4·6 per cent; P = 0·349) or acute kidney injury (14·3 versus 13·8 per cent; P = 0·666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35·3 versus 56·7 per cent; P < 0·001). CONCLUSION NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement.
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McCabe M, Perner Y, Magobo R, Magangane P, Mirza S, Penny C. Microsatellite Instability assessment in Black South African Colorectal Cancer patients reveal an increased incidence of suspected Lynch syndrome. Sci Rep 2019; 9:15019. [PMID: 31636305 PMCID: PMC6803663 DOI: 10.1038/s41598-019-51316-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 09/17/2019] [Indexed: 12/12/2022] Open
Abstract
Microsatellite Instability (MSI) is a hallmark of colorectal cancer (CRC) and occurs in 15–16% of CRC. Molecular biological information of CRC in South Africa (SA) is largely unrecorded. This study was undertaken to determine the frequency of MSI, with particular reference to Lynch syndrome (LS) with a view to improve surveillance and prevention strategies. This was a retrospective study on CRC samples diagnosed between 2011–2015 at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). Samples diagnosed between 2011–2012 were screened for MSI by PCR and mismatch repair (MMR) immunohistochemistry (IHC), and additional BRAFV600E mutational analysis performed. T-tests, Fischer’s exact and Chi square statistical tests were applied. Twelve percent of patients displayed MSI, with increased frequency in black (15%) versus other ethnic group (OEG) (8%) patients. MSI patients were significantly younger than microsatellite stable (MSS) patients, however when stratified by ethnicity, black patients were predominantly younger (median age: 47), with increased MSH2/6 loss, and no BRAF mutations. These findings suggest a large proportion of young black SA CRC patients develop via the LS pathway due to earlier age onset and predominant MSH2/6 protein loss. SA patients of other ethnicities appear to follow the more well established sporadic MSI pathway.
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Xeuatvongsa A, Mott JA, Khanthamaly V, Patthammavong C, Phounphenghak K, McKinlay M, Mirza S, Lafond KE, McCarron M, Corwin A, Moen A, Olsen SJ, Bresee JS. Progress toward sustainable influenza vaccination in the Lao Peoples' Democratic Republic, 2012-2018. Vaccine 2019; 37:3002-3005. [PMID: 31027926 DOI: 10.1016/j.vaccine.2019.04.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 04/03/2019] [Accepted: 04/08/2019] [Indexed: 11/24/2022]
Abstract
Despite global recommendations for influenza vaccination of high-risk, target populations, few low and middle-income countries have national influenza vaccination programs. Between 2012 and 2017, Lao PDR planned and conducted a series of activities to develop its national influenza vaccine program as a part of its overall national immunization program. In this paper, we review the underlying strategic planning for this process, and outline the sequence of activities, research studies, partnerships, and policy decisions that were required to build Laos' influenza vaccine program. The successful development and sustainability of the program in Laos offers lessons for other low and middle-income countries interested in initiating or expanding influenza immunization.
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Mirza S, Khalif A, Khodjaev S, Alpert C, Raina A, Kanwar M, Murali S, Benza R, Hadi A. Echocardiographic Estimation of Pulmonary Artery Pulsatility Index in Pulmonary Hypertension. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Patel S, Waghela B, Shah K, Vaidya F, Mirza S, Patel S, Pathak C, Rawal R. Silibinin, A Natural Blend In Polytherapy Formulation For Targeting Cd44v6 Expressing Colon Cancer Stem Cells. Sci Rep 2018; 8:16985. [PMID: 30451890 PMCID: PMC6242811 DOI: 10.1038/s41598-018-35069-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 10/15/2018] [Indexed: 12/17/2022] Open
Abstract
Colon cancer stem cells have been attributed to poor prognosis, therapeutic resistance and aggressive nature of the malignancy. Recent reports associated CD44v6 expression with relapse, metastasis and reduced 5-year survival of colon cancer patients, thereby making it a potential therapeutic target. Thus, in this study, comprehensive prediction and screening of CD44v6 against 1674 lead compounds was conducted. Silibinin was identified as a potential compound targeting CD44v6. Inorder to substantiate these findings, the cytotoxic effect of 5FU, Silibinin and 5FU+ Silibinin was assessed on human colon carcinoma cell line HCT116 derived CD44+ subpopulation. 5FU+ Silibinin inhibited cell proliferation of CD44+ subpopulation at lower concentration than Silibinin standalone. Further, corresponding to CD44v6 knockdown cells, 5FU+ Silibinin treatment significantly decreased CD44v6, Nanog, CTNNB1 and CDKN2A expression whereas increased E-cadherin expression in HCT116 derived CD44+ cells. Moreover, synergistic effect of these drugs suppressed sphere formation, inhibited cell migration, triggered PARP cleavage and perturbation in mitochondrial membrane potential, thereby activating intrinsic apoptotic pathways and induced autophagic cell death. Importantly, 5FU+ Silibinin could inhibit PI3K/MAPK dual activation and arrest the cell cycle at G0/G1 phase. Thus, our study suggests that inhibition of CD44v6 attenuates stemness of colon cancer stem cells and holds a prospect of potent therapeutic target.
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Shah K, Patel S, Mirza S, Rawal RM. A multi-gene expression profile panel for predicting liver metastasis: An algorithmic approach. PLoS One 2018; 13:e0206400. [PMID: 30383826 PMCID: PMC6211708 DOI: 10.1371/journal.pone.0206400] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 10/14/2018] [Indexed: 12/17/2022] Open
Abstract
Background & aim Liver metastasis has been found to affect outcome in prostate, pancreatic and colorectal cancers, but its role in lung cancer is unclear. The 5 year survival rate remains extensively low owing to intrinsic resistance to conventional therapy which can be attributed to the genetic modulators involved in the pathogenesis of the disease. Thus, this study aims to generate a model for early diagnosis and timely treatment of liver metastasis in lung cancer patients. Methods mRNA expression of 15 genes was quantified by real time PCR on lung cancer specimens with (n = 32) and without (n = 30) liver metastasis and their normal counterparts. Principal Component analysis, linear discriminant analysis and hierarchical clustering were conducted to obtain a predictive model. The accuracy of the models was tested by performing Receiver Operating Curve analysis. Results The expression profile of all the 15 genes were subjected to PCA and LDA analysis and 5 models were generated. ROC curve analysis was performed for all the models and the individual genes. It was observed that out of the 15 genes only 8 genes showed significant sensitivity and specificity. Another model consisting of the selected eight genes was generated showing a specificity and sensitivity of 90.0 and 96.87 respectively (p <0.0001). Moreover, hierarchical clustering showed that tumors with a greater fold change lead to poor prognosis. Conclusion Our study led to the generation of a concise, biologically relevant multi-gene panel that significantly and non-invasively predicts liver metastasis in lung cancer patients.
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Yeung W, Twigg V, Carr S, Sinha S, Mirza S. Radiological "Teddy Bear" Sign on CT Imaging to Aid Internal Carotid Artery Localization in Transsphenoidal Pituitary and Anterior Skull Base Surgery. J Neurol Surg B Skull Base 2018; 79:401-406. [PMID: 30009122 PMCID: PMC6043166 DOI: 10.1055/s-0037-1615749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 11/19/2017] [Indexed: 10/18/2022] Open
Abstract
Objectives Internal carotid artery (ICA) injury remains a rare but potentially fatal complication of transsphenoidal pituitary or anterior skull base surgery. Preoperative imaging must be scrutinized to minimize risk. On axial computed tomography (CT), the protrusions of the ICAs into the sphenoid resemble a "teddy bear." This article aims to describe the sign, its grading system (0-2) and quantify its presence. Design Retrospective review of preoperative CT imaging. Setting Tertiary referral center in the United Kingdom. Participants One hundred patients who underwent endoscopic transsphenoidal surgery for pituitary disease were enrolled. Main Outcome Measure The presence and grading of the "teddy bear" sign were assessed on preoperative CT imaging. Results A grade 2 (strongly positive) "teddy bear" sign was identified in 40% at the level of the superior pituitary fossa, 78% at the inferior pituitary fossa, and 59% at the clivus. A grade 1 (intermediate) sign was seen in 23.5, 7.5, and 10% of cases, respectively. In 5% of cases, the sign was grade 0 at all levels-indicating poor intraoperative localization of the ICA. Conclusion The "teddy bear" sign is a useful preoperative tool for identification of anatomy predisposing patients to a higher risk of ICA injury. Those patients who have an absent or grade 0 "teddy bear" sign require extra care to ensure intraoperative localization of the ICAs which may include the use of neuronavigation or a Doppler probe. A grade 2 sign predicts good intraoperative localization of the ICA intraoperatively to inform the safe lateral limit of sellar bone resection.
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Ali R, Al-kawaz A, Toss M, Green A, Miligy I, Mesquita KA, Seedhouse C, Mirza S, Rakha E, Madhusudan S. PO-014 Targeting PARP1 in XRCC1 deficient sporadic invasive breast cancer or pre-invasive ductal carcinoma in situ for synthetic lethality and chemoprevention. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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