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Kumar P, Rao T, Prasad Y, Rao C, Rajyam P, Sarma M, Ashok G, Rao P. Role of Chandipura virus in an “epidemic brain attack” in Andhra Pradesh, India. JOURNAL OF PEDIATRIC NEUROLOGY 2015. [DOI: 10.1055/s-0035-1557208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
Fungal infections of the urinary tract are usually encountered following prolonged antibiotic use, instrumentation and indwelling urinary catheters. These type of infections are mostly seen in immuno-compromised patients. Candida is the most common among the fungal infections of urinary tract followed by Aspergillus infection. Here is a case report of a 26 year old diabetic female who presented with abdominal pain, fever, nausea and vomiting. She had undergone double-J stenting 15-20 days back. The cause of the symptoms was not detected till the patient underwent C.T Scan-KUB with excretory urography which showed the displaced D-J stent. Then on performing replacement of D-J stent, cystoscopy was done and the tissue sample was sent for microbiological and histopathological examination. On Microbiological examination, Aspergillus flavus was isolated from the tissue, which was culprit behind the disease. Patient was then treated with anti-fungal drugs, following which she gradually improved.
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Rao P, Hong L, Gjertson D, Balaz I, Fishbein M, Deng M, Harre N, Leuchter R, Banchs H, DeNofrio D, Eisen H, Ewald G, Kfoury A, Kobashigawa J, Starling R, Torre-Amione G, Van Bakel A, Reed E. Effect of Everolimus Immunotherapy on HLA Antibody Production in Heart Transplantation. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Iyer A, Gao L, Doyle A, Rao P, Cropper JR, Soto C, Dinale A, Kumarasinghe G, Jabbour A, Hicks M, Jansz PC, Feneley MP, Harvey RP, Graham RM, Dhital KK, MacDonald PS. Normothermic ex vivo perfusion provides superior organ preservation and enables viability assessment of hearts from DCD donors. Am J Transplant 2015; 15:371-80. [PMID: 25612491 DOI: 10.1111/ajt.12994] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 08/11/2014] [Accepted: 08/25/2014] [Indexed: 01/25/2023]
Abstract
The shortage of donors in cardiac transplantation may be alleviated by the use of allografts from donation after circulatory death (DCD) donors. We have previously shown that hearts exposed to 30 min warm ischemic time and then flushed with Celsior supplemented with agents that activate ischemic postconditioning pathways, show complete recovery on a blood-perfused ex vivo working heart apparatus. In this study, these findings were assessed in a porcine orthotopic heart transplant model. DCD hearts were preserved with either normothermic ex vivo perfusion (NEVP) using a clinically approved device, or with standard cold storage (CS) for 4 h. Orthotopic transplantation into recipient animals was subsequently undertaken. Five of six hearts preserved with NEVP demonstrated favorable lactate profiles during NEVP and all five could be weaned off cardiopulmonary bypass posttransplant, compared with 0 of 3 hearts preserved with CS (p < 0.05, Fisher's exact test). In conclusion, DCD hearts flushed with supplemented Celsior solution and preserved with NEVP display viability before and after transplantation. Viability studies of human DCD hearts using NEVP are warranted.
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Yiu EM, Brockley CR, Lee KJ, Carroll K, de Valle K, Kennedy R, Rao P, Delatycki MB, Ryan MM. Peripheral nerve ultrasound in pediatric Charcot-Marie-Tooth disease type 1A. Neurology 2015; 84:569-74. [PMID: 25576636 DOI: 10.1212/wnl.0000000000001236] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate differences in nerve cross-sectional area (CSA) as measured by peripheral nerve ultrasound in children with Charcot-Marie-Tooth disease type 1A (CMT1A) compared to healthy controls. METHODS This was a cross-sectional, matched, case-control study. CSA of the median, ulnar, tibial, and sural nerves was measured by peripheral nerve ultrasound. The mean difference in CSA between children with CMT1A and controls at each nerve site was determined. The relationship between nerve CSA and age/body metrics, and between nerve CSA and neurologic disability in CMT1A, was also evaluated. RESULTS Twenty-nine children with CMT1A and 29 age- and sex-matched controls were enrolled. Nerve CSA was significantly increased in children with CMT1A compared to controls (1.9- to 3.5-fold increase, p < 0.001). The increase in nerve CSA with age was disproportionately greater in those with CMT1A. Nerve CSA showed a strong positive linear correlation with age, height, and weight in both the CMT1A and control groups. Disease severity correlated with both nerve CSA and age. CONCLUSIONS Children with CMT1A have significantly increased nerve CSA compared to controls, and the increase in nerve CSA with age is disproportionately greater in CMT1A, suggesting ongoing nerve hypertrophy throughout childhood. Nerve CSA correlates with neurologic disability. These findings demonstrate the utility of peripheral nerve ultrasound as a diagnostic tool in pediatric neuropathies, and as an outcome measure in natural history studies and clinical trials in CMT1A. CLASSIFICATION OF EVIDENCE This study provides Class IV evidence that measurement of nerve CSA by peripheral nerve ultrasound accurately identifies patients with CMT1A.
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Caraballo PJ, Parkulo M, Blair D, Elliott M, Schultz C, Sutton J, Rao P, Bruflat J, Bleimeyer R, Crooks J, Gabrielson D, Nicholson W, Rohrer Vitek C, Wix K, Bielinski SJ, Pathak J, Kullo I. Clinical Decision Support to Implement CYP2D6 Drug-Gene Interaction. Stud Health Technol Inform 2015; 216:946. [PMID: 26262248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The level of CYP2D6 metabolic activity can be predicted by pharmacogenomic testing, and concomitant use of clinical decision support has the potential to prevent adverse effects from those drugs metabolized by this enzyme. Our initial findings after implementation of clinical decision support alerts integrated in the electronic health records suggest high feasibility, but also identify important challenges.
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Chimmanamada D, Ying W, Zhang J, Proia D, Przewloka T, Jiang J, Vutukuri D, Lu G, Osman S, Chen S, Chu J, Rao P, Zhou D, Inoue T, Ogawa LS, Singh R, Tatsuta N, Sonderfan A, Cortis C. 260 Hsp90 Inhibitor Drug Conjugates (HDC): Payloads and possibilities. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70386-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Li H, Guan XD, Han S, Wang TS, Rao P, Shi LW. Patient-Reported Medical Expenditures For Insulin-Treated Diabetes Patients In Eastern, Central And Western Regions Of China. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2014; 17:A747. [PMID: 27202701 DOI: 10.1016/j.jval.2014.08.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Liu X, Hoang A, Zhou L, Kalra S, Sun M, Ding Z, Bai S, German P, Zhang X, Tamboli P, Rao P, Karam J, Wood C, Matin S, Tannir N, Sircar K, Jonasch E. Anti-Angiogenic Therapy Induces T-Lymphocyte Infiltration Associated with Poor Survival in Metastatic Renal Cell Carcinoma Patients. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu342.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Price S, Garcia-Ramirez J, Bertelsman C, Hu Y, Rivard M, Tanderup K, Rao P, Grigsby P, Esthappan J. MRI-Based Verification of Plaque Positioning and Treatment Planning for Episcleral Brachytherapy. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Iyer A, Gao L, Doyle A, Rao P, Jayewardene D, Wan B, Kumarasinghe G, Jabbour A, Hicks M, Jansz PC, Feneley MP, Harvey RP, Graham RM, Dhital KK, Macdonald PS. Increasing the tolerance of DCD hearts to warm ischemia by pharmacological postconditioning. Am J Transplant 2014; 14:1744-52. [PMID: 25040306 DOI: 10.1111/ajt.12782] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 03/10/2014] [Accepted: 03/30/2014] [Indexed: 01/25/2023]
Abstract
Donation after circulatory death (DCD) offers a potential additional source of cardiac allografts. We used a porcine asphyxia model to evaluate viability of DCD hearts subjected to warm ischemic times (WIT) of 20–40 min prior to flushing with Celsior (C) solution. We then assessed potential benefits of supplementing C with erythropoietin, glyceryl trinitrate and zoniporide (Cs), a combination that we have shown previously to activate ischemic postconditioning pathways. Hearts flushed with C/Cs were assessed for functional, biochemical and metabolic recovery on an ex vivo working heart apparatus. Hearts exposed to 20-min WIT showed full recovery of functional and metabolic profiles compared with control hearts (no WIT). Hearts subjected to 30- or 40-min WIT prior to C solution showed partial and no recovery, respectively. Hearts exposed to 30-min WIT and Cs solution displayed complete recovery, while hearts exposed to 40-min WIT and Cs solution demonstrated partial recovery. We conclude that DCD hearts flushed with C solution demonstrate complete recovery up to 20-min WIT after which there is rapid loss of viability. Cs extends the limit of WIT tolerability to 30 min. DCD hearts with ≤30-min WIT may be suitable for transplantation and warrant assessment in a transplant model.
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Rao P, Korin Y, Warshaw B, Sarwal M, Tsai E, Ettenger R, Grimm P, Ikle D, Sledge T, Kirk A, Reed E. HLA and MICA Alloantibody Profiling in Pediatric Renal Transplant Recipients: Report From The Clinical Trials in Organ Transplantation in Children (CTOTC-02). Transplantation 2014. [DOI: 10.1097/00007890-201407151-00034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rao P, Dewan P. Sharing the caring: paediatric radiology in paediatric surgery outreach. Pediatr Radiol 2014; 44:646-7. [PMID: 24854926 DOI: 10.1007/s00247-014-2929-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Accepted: 02/10/2014] [Indexed: 11/29/2022]
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Sasmal P, Jaleel M, Rao P, Munikumar M, Bhattacharya M, Kumar N, Neelima P, Rawoof K, Rao P, Abbineni C, Roshaiah M, Sridhar S, Kumar T, Vinu M, Potluri V, Misra P, Talwar R, Das S. Novel 4-Oxothienopyrimidinyl Propanoic Acid Derivatives as AMPActivated Protein Kinase (AMPK) Activators. LETT DRUG DES DISCOV 2014. [DOI: 10.2174/1570180811666140122003044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Mao GW, Rao P. Mechanism by which Silver Additions Inhibit Anodic Corrosion of 4·5% Antimony-Lead Alloys. ACTA ACUST UNITED AC 2013. [DOI: 10.1179/000705971798323928] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Grover S, Parakh P, Sharma A, Rao P, Modi M, Kumar A. Catatonia in systemic lupus erythematosus: a case report and review of literature. Lupus 2013; 22:634-8. [DOI: 10.1177/0961203313486951] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although, neuropsychiatric morbidity is quite high in patients with systemic lupus erythematosus (SLE), catatonia has been rarely reported. We report a case of a 22-year-old female who presented with catatonic symptoms at the time of relapse of SLE and have discussed the presentation in the context of existing literature with regard to phenomenology of catatonia, psychiatric co-morbidity and treatment of catatonia in patients with SLE.
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Rao P, Subramanian P, Sudhakar P, Reddy T, Reddy P, Gupta H. Standardisation and quality control of homoeopathic drug Pimenta officinalis lindl. INDIAN JOURNAL OF RESEARCH IN HOMOEOPATHY 2012. [DOI: 10.53945/2320-7094.1693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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69
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Javadi P, Tummala N, Rao P, Blackham K, Koo B. P-002 Radiation exposure reduction in biplane fluoroscopic flat panel detectors. J Neurointerv Surg 2012. [DOI: 10.1136/neurintsurg-2012-010455b.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lin M, Bhagat N, Pellerin O, Rao P, Loffroy R, Ardon R, Mory B, Reyes D, Geschwind J. Abstract No. 241: Volumetric RECIST: an improved way to assess tumor response after transcatheter arterial chemoembolization (TACE). J Vasc Interv Radiol 2012. [DOI: 10.1016/j.jvir.2011.12.292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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71
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Lin M, Bhagat N, Pellerin O, Rao P, Loffroy R, Ardon R, Mory B, Reyes D, Geschwind J. Abstract No. 242: Quantitative EASL: an improved way to assess tumor response after transcatheter arterial chemoembolization (TACE). J Vasc Interv Radiol 2012. [DOI: 10.1016/j.jvir.2011.12.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Nagarajan R, Kumar A, Rao P. Microwave-Assisted One-Pot Synthesis of Pyrazolo[3,4-b]indoles and New Isoxazolo[5,4-b]indoles via Copper-Catalyzed Intramolecular C-N/C-O Bond Formation. SYNTHESIS-STUTTGART 2011. [DOI: 10.1055/s-0031-1289572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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73
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Subramanian P, Rao P, Reddy P, Gupta H. Pharmacognostic and physico-chemical evaluation of Lactuca sativa L. INDIAN JOURNAL OF RESEARCH IN HOMOEOPATHY 2011. [DOI: 10.53945/2320-7094.1731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
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74
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Rao P, Desai M, Sotelo R, Rao P, Liu C. MP-05.16 Hybrid LESS Prostatectomy for BPH: A Combined Technique. Urology 2011. [DOI: 10.1016/j.urology.2011.07.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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75
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Rao P, Subramanian P, Reddy P, Gupta H. Standardisation of homoeopathic drug - Syzygium jambos (L.) alston. INDIAN JOURNAL OF RESEARCH IN HOMOEOPATHY 2011. [DOI: 10.53945/2320-7094.1723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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76
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Sotelo R, Rao P, Garza R, Ramirez D, Carmona O, Canes D, Giedelman C, Mejia C, Gill I, Desai M. VID-01.07 Expanding Indications of Transvesical LESS Surgery. Urology 2011. [DOI: 10.1016/j.urology.2011.07.470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Unnikrishnan B, Rao P, Kumar N, Ganti S, Prasad R, Amarnath A, Reshmi B, Kaur V, Kesharwani P, Seetha M, Nautiyal A, Goel P, Aggarwal P. Profile of blood donors and reasons for deferral in coastal South India. Australas Med J 2011; 4:379-85. [PMID: 23393523 DOI: 10.4066/amj.2011.641] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND A blood transfusion is a life-saving procedure in many instances. An adequate supply of safe blood is ensured by exercising donor deferral criteria and screening for Transfusion Transmitted Infections (TTI). The aim of this paper is to study the profile of blood donors and reasons for donor deferral in coastal South India. METHOD The study was conducted at a tertiary care hospital in Mangalore. All those who donated between 1 January 2008 and 31 December 2008 were included in the study. Data was collected using a pre-tested semi-structured proforma and analysed using SPSS version 11.5. RESULTS Most of the donors were under the age of 25 (42.92%). Donors were predominantly male (95.20%). In terms of occupation, most subjects were students (28.01%) followed by businessmen (18.61%). Slightly more than three-quarters of the donors (77.20%) were replacement donors. The main reasons for deferral were consumption of medication in the past 72 hours (15.15%), hypertension (13.18%), a low haemoglobin level (12.34%) and alcohol intake in the past 72 hours (12.20%). Among the TTIs identified, most samples were positive for Hepatitis B surface Antigen - HBsAg (0.87%) or tested positive for Anti-Hepatitis C (HCV antibodies (0.36%). CONCLUSION From the study it was concluded that the majority of the donor population was young and educated. The reason for donation was mainly replacement rather than voluntary. This issue needs to be addressed by exercising proactive measures to increase the number of voluntary, nonremunerated, low-risk donors.
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Bhattacharya R, Gujar N, Singh P, Rao P, Vijayaraghavan R. Toxicity of alpha-ketoglutarate following 14-days repeated oral administration in Wistar rats. Cell Mol Biol (Noisy-le-grand) 2011; 57 Suppl:OL1543-OL1549. [PMID: 21791173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Accepted: 07/20/2011] [Indexed: 05/31/2023]
Abstract
Oral treatment of alpha-ketoglutarate (A-KG) is known to antagonise experimental cyanide poisoning in rodents. Maximum protective efficacy of A-KG has been observed at a dose of 2.0 g kg-1 body weight but no acute toxicity has been observed at this dose level. As a pre-clinical regulatory requirement, sub-acute toxicity of A-KG has to be determined in two different animal species, following repeated exposure by the intended route of use. The present study reports the toxicity and No Observed Adverse Effect Level (NOAEL) of A-KG following 14 days repeated oral administration at low (1.0 g kg-1), middle (2.0 g kg-1) and high (4.0 g kg-1) doses of A-KG in Wistar rats. After termination of the exposure, animals were further observed for 7 days to assess the recovery pattern and residual effects. Clinical signs included diarrhoea at 4.0 g kg-1 in both the sexes and decrease in mean body weight in males. This dose also caused anaemia in females which resolved after withdrawal of treatment. In males, significant increase in absolute and relative weights of organs (adrenal, liver and kidneys) and haematological changes were observed at the end of recovery period, suggesting delayed toxic manifestations at 2.0 and 4.0 g kg-1 dose. However, these observations were not accompanied by any histological changes to suggest any toxicity of A-KG of clinical significance. The NOAEL of A-KG was determined as 1.0 g kg-1 body weight. Although A-KG is intended to treat acute cyanide poisoning, caution on dosage should be observed during its repeated administration.
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Darlington Y, Nguyen TA, Moon SH, Herron A, Rao P, Zhu C, Lu X, Donehower LA. Absence of Wip1 partially rescues Atm deficiency phenotypes in mice. Oncogene 2011; 31:1155-65. [PMID: 21765465 PMCID: PMC3197977 DOI: 10.1038/onc.2011.303] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Wild-type p53-induced phosphatase 1 (WIP1) is a serine/threonine phosphatase that dephosphorylates proteins in the ataxia telangiectasia mutated (ATM)-initiated DNA damage response pathway. WIP1 may have a homeostatic role in ATM signaling by returning the cell to a normal pre-stress state following completion of DNA repair. To better understand the effects of WIP1 on ATM signaling, we crossed Atm-deficient mice to Wip1-deficient mice and characterized phenotypes of the double knockout progeny. We hypothesized that the absence of Wip1 might rescue Atm deficiency phenotypes. Atm null mice, like ATM-deficient humans with the inherited syndrome ataxia telangiectasia, exhibit radiation sensitivity, fertility defects, and are T-cell lymphoma prone. Most double knockout mice were largely protected from lymphoma development and had a greatly extended lifespan compared with Atm null mice. Double knockout mice had increased p53 and H2AX phosphorylation and p21 expression compared with their Atm null counterparts, indicating enhanced p53 and DNA damage responses. Additionally, double knockout splenocytes displayed reduced chromosomal instability compared with Atm null mice. Finally, doubly null mice were partially rescued from gametogenesis defects observed in Atm null mice. These results indicate that inhibition of WIP1 may represent a useful strategy for cancer treatment in general and A-T patients in particular.
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Wu N, Chen S, Boulanger L, Rao P, Zhao Y. Average daily dose, medication adherence, and healthcare costs among commercially-insured patients with fibromyalgia treated with duloxetine. Curr Med Res Opin 2011; 27:1131-9. [PMID: 21456939 DOI: 10.1185/03007995.2011.570744] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE What is the relationship between average daily dose (ADD) of duloxetine, adherence to therapy, and healthcare costs among patients with fibromyalgia? METHODS Employing a retrospective cohort design, this study assessed administrative claims data for commercially-insured fibromyalgia patients who initiated duloxetine in 2006. Initiation was defined as a 90-day clean period without access to duloxetine. Five study cohorts were constructed based on the ADD of duloxetine, calculated from all prescriptions dispensed over the 12-month follow-up period: <30 mg, 30 mg, 31-59 mg, 60 mg, and >60 mg (duloxetine starting dose: 30 mg/day; target dose: 60 mg/day). Medication possession ration (MPR) was used to assess duloxetine adherence, with MPR ≥0.8 as 'high' adherence. Multivariate regressions were applied to examine the association between ADD, duloxetine adherence, and healthcare costs (total, inpatient, outpatient, and pharmacy), adjusting for differences in demographic and clinical characteristics between cohorts. RESULTS Of the 4869 patients with fibromyalgia, 3% had an ADD of <30 mg, 12% had 30 mg, 21% had 31-59 mg, 46% had 60 mg, and 18% had >60 mg. High adherence to duloxetine ranged from 16% to 41% across cohorts. Controlling for demographic and clinical characteristics, patients with an ADD of 31-59 mg or >60 mg were more likely to adhere to duloxetine therapy than those in the 60 mg cohort, while patients in the <30 mg cohort were less likely to adhere to duloxetine (all p < 0.05). Total costs were significantly higher for individuals in the 31-59 mg or >60 mg ADD cohorts ($1834 and $5766) than those maintaining an ADD of 60 mg, as were outpatient ($1167 and $2275) and pharmacy costs ($502 and $2983) (all p < 0.05). Patients with an ADD of 30 mg had significantly lower total (-$1770), inpatient (-$1524), and pharmacy (-$827) costs (all p < 0.05) than those with an ADD of 60 mg. LIMITATIONS This study is subject to selection bias because some confounders might be unobserved in the administrative claims database. Indirect costs or over-the-counter medication costs were also not available. CONCLUSIONS Fibromyalgia patients with an ADD of 60 mg of duloxetine had better adherence than patients with an ADD ≤30 mg. Duloxetine patients with an ADD of 30 mg (31-59 or >60 mg) had significantly lower (higher) healthcare costs than those maintaining an ADD of 60 mg.
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Gupta H, Subramanian P, Rao P, Raj J, Sharma S. Standardisation of homoeopathic drug - Aquilegia vulgaris L. INDIAN JOURNAL OF RESEARCH IN HOMOEOPATHY 2011. [DOI: 10.53945/2320-7094.1716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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Russell RK, Wilson ML, Loganathan S, Bourke B, Kiparissi F, Mahdi G, Torrente F, Rodrigues A, Davies I, Thomas A, Akobeng AK, Fagbemi A, Hyer W, Spray C, Vaish S, Rogers P, McGrogan P, Heuschkel RB, Ayub N, Fell JM, Afzal NA, Green M, Murphy MS, Rao P, Shah N, Ho GT, Naik S, Wilson DC. A British Society of Paediatric Gastroenterology, Hepatology and Nutrition survey of the effectiveness and safety of adalimumab in children with inflammatory bowel disease. Aliment Pharmacol Ther 2011; 33:946-53. [PMID: 21342211 DOI: 10.1111/j.1365-2036.2011.04603.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Adalimumab is efficacious therapy for adults with Crohn's disease (CD). AIM To summarise the United Kingdom and Republic of Ireland paediatric adalimumab experience. METHODS British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) members with Inflammatory Bowel Disease (IBD) patients <18 years old commencing adalimumab with at least 4 weeks follow-up. Patient demographics and details of treatment were then collected. Response and remission was assessed using the Paediatric Crohn's Disease Activity Index (PCDAI)/Physicians Global Assessment (PGA). RESULTS Seventy-two patients [70 CD, 1 ulcerative colitis (UC), 1 IBD unclassified (IBDU)] from 19 paediatric-centres received adalimumab at a median age of 14.8 (IQR 3.1, range 6.1-17.8) years; 66/70 CD (94%) had previously received infliximab. A dose of 80 mg then 40 mg was used for induction in 41(59%) and 40 mg fortnightly for maintenance in 61 (90%). Remission rates were 24%, 58% and 41% at 1, 6 and 12 months, respectively. Overall 43 (61%) went into remission at some point, with 24 (35%) requiring escalation of therapy. Remission rates were higher in those on concomitant immunosuppression cf. those not on immunosuppression [34/46 (74%) vs. 9/24 (37%), respectively, (χ(2) 8.8, P=0.003)]. There were 15 adverse events (21%) including four (6%) serious adverse events with two sepsis related deaths in patients who were also on immunosuppression and home parenteral nutrition (3% mortality rate). CONCLUSIONS Adalimumab is useful in treatment of refractory paediatric patients with a remission rate of 61%. This treatment benefit should be balanced against side effects, including in this study a 3% mortality rate.
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Rao P, Subramanian P, Reddy P, Gupta H. Standardisation of Ammi visnaga L. fruit - A homoeopathic drug. INDIAN JOURNAL OF RESEARCH IN HOMOEOPATHY 2011. [DOI: 10.53945/2320-7094.1709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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Loffroy R, Lin M, Rao P, Bhagat N, Noordhoek N, Radaelli A, Blijd J, Geschwind J. Abstract No. 177: Intra-procedural C-arm dual-phase cone-beam CT imaging to predict response of hepatocellular carcinoma during drug-eluting bead transcatheter arterial chemoembolization. J Vasc Interv Radiol 2011. [DOI: 10.1016/j.jvir.2011.01.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Gupta H, Subramanian P, Rao P, Kushwaha D, Nayak C. Standardization studies on Cuscuta reflexa Roxb. - A new homoeopathic drug. INDIAN JOURNAL OF RESEARCH IN HOMOEOPATHY 2010. [DOI: 10.53945/2320-7094.1759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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Abbass K, Rao P, Kibria R. Hemosuccus pancreaticus, a diagnostic challenge. Acta Gastroenterol Belg 2010; 73:532-533. [PMID: 21299169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Loffroy R, Rao P, Ota S, De Lin M, Kwak BK, Krause D, Geschwind JF. Packing technique for endovascular coil embolisation of peripheral arterial pseudo-aneurysms with preservation of the parent artery: safety, efficacy and outcomes. Eur J Vasc Endovasc Surg 2010; 40:209-15. [PMID: 20399122 DOI: 10.1016/j.ejvs.2010.03.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Accepted: 03/04/2010] [Indexed: 01/30/2023]
Abstract
OBJECTIVES To evaluate the endovascular treatment of pseudo-aneurysms (PAs) with super-selective coil embolisation using the 3D packing technique. DESIGN Retrospective study of consecutive patients in one academic centre. MATERIALS From 2002 to 2009, 16 patients (mean age 51.6 years, range 24-82) underwent PA sac packing with coils. Four patients were asymptomatic, nine had PA rupture, and three had other symptoms. Lesion location was as follows: splenic artery (8), carotid artery (2), hepatic artery (2), superior mesenteric artery (1), cystic artery (1), uterine artery (1), and hypogastric artery (1). METHODS The sac was packed with 0.018-inch controlled-detachable microcoils, preserving the parent artery. Magnetic resonance angiography was done within 6 months, at 12 months then yearly. RESULTS Technical success rate was 100%. Complete definitive PA exclusion was achieved with a single procedure in 15 (93.8%) patients. One patient with a secondary bleeding arterio-digestive fistula underwent successful surgery. No major complications or late recanalisations occurred during follow-up (mean, 24.7 months; range 6-49). CONCLUSIONS Coil PA embolisation by 3D sac packing is safe and effective and may induce less morbidity than complete parent vessel occlusion, stent placement, or open surgery. This procedure should be used whenever possible, as it preserves parent artery patency.
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Loffroy R, Rao P, Ota S, Geschwind JF. Renal artery embolisation prior to radical nephrectomy for renal cell carcinoma: when, how and why? Br J Radiol 2010; 83:630; author reply 631-2. [PMID: 20603414 DOI: 10.1259/bjr/34309294] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Rao P, Schaverien MV, Stewart KJ. Soft tissue management of children's open tibial fractures--a review of seventy children over twenty years. Ann R Coll Surg Engl 2010; 92:320-5. [PMID: 20501017 DOI: 10.1308/003588410x12664192075017] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The management of open tibial fractures in children represents a unique reconstructive challenge. The aim of the study was to evaluate the management of paediatric open tibial fractures with particular regard to soft tissue management. PATIENTS AND METHODS A retrospective case-note analysis was performed for all children presenting with an open tibial fracture at a single institution over a 20-year period for 1985 to 2005. RESULTS Seventy children were reviewed of whom 41 were males and 29 females. Overall, 91% (n = 64) of children suffered their injury as a result of a vehicle-related injury. The severity of the fracture with respect to the Gustilo classification was: Grade I, 42% (n = 29); Grade II, 24% (n = 17); Grade III, 34% (n = 24; 7 Grade 3a, 16 Grade 3b, 1 Grade 3c). The majority of children were treated with external fixation and conservative measures, with a mean hospital in-patient stay of 13.3 days. Soft tissue cover was provided by plastic surgeons in 31% of all cases. Four cases of superficial wound infection occurred (6%), one case of osteomyelitis and one case of flap failure. The limb salvage was greater than 98%. CONCLUSIONS In this series, complications were associated with delayed involvement of plastic surgeons. Retrospective analysis has shown a decreased incidence of open tibial fractures which is reported in similar studies. Gustilo grade was found to correlate with length of hospital admission and plastic surgery intervention. We advocate, when feasible, the use of local fasciocutaneous flaps (such as distally based fasciocutaneous and adipofascial flaps), which showed a low complication rate in children.
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El-Daly H, Rao P, Palazzo F, Gudi M. A rare entity of an unusual site: adenomatoid tumour of the adrenal gland: a case report and review of the literature. PATHOLOGY RESEARCH INTERNATIONAL 2010; 2010:702472. [PMID: 21151721 PMCID: PMC2990199 DOI: 10.4061/2010/702472] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Accepted: 04/11/2010] [Indexed: 11/20/2022]
Abstract
This is a case report of a 51 year old male who was found to have an incidental left sided non-functioning adrenal mass on routine medical examination and which was confirmed by CT and MRI scans. A laparoscopic left adrenalectomy was done. On gross examination the tumour was a solitary well circumscribed solid-cystic mass with a homogenous pinkish white cut surface. On microscopic examination, the tumour was composed of variably sized tubules and fenestrated channels lined by bland cuboidal cells to epithelioid cells. There was focal extension to capsule and peri-adrenal fat. Immunohistochemically the tumour cells stained with calretinin, Cam5.2, CK7, vimentin and focally with EMA. Ki-67 fraction was <1%. They were negative for ER, CD31, CD34, Factor 8, chromogranin, synaptophysin S100 and inhibin. A diagnosis of an adenomatoid tumour as made. Adenomatoid tumours are rare benign tumours of mesothelial derivation. The adrenal gland is devoid of a mesothelial lining and the most accepted hypothesis for an adenomatoid tumour originating in the adrenal gland is derivation from mesothelial rests. As the adrenal gland is an extremely rare site of occurrence for an adenomatoid tumour, it is frequently mistaken for adrenocortical tumours or a pheochromocytoma clinically and radiologically.
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Subramanian P, Rao P, Gupta H, Singh V, Nayak C. Standardisation of homoeopathlc drug: Pastlnaca sativa Linn. INDIAN JOURNAL OF RESEARCH IN HOMOEOPATHY 2010. [DOI: 10.53945/2320-7094.1746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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Missiaglia E, Shepherd CJ, Patel S, Thway K, Pierron G, Pritchard-Jones K, Renard M, Sciot R, Rao P, Oberlin O, Delattre O, Shipley J. MicroRNA-206 expression levels correlate with clinical behaviour of rhabdomyosarcomas. Br J Cancer 2010; 102:1769-77. [PMID: 20502458 PMCID: PMC2883695 DOI: 10.1038/sj.bjc.6605684] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: Rhabdomyosarcomas (RMSs) are primarily paediatric sarcomas that resemble developing skeletal muscle. Our aim was to determine the effects of microRNAs (miRNA) that have been implicated in muscle development on the clinical behaviour of RMSs. Methods: Expression levels of miR-1, miR-206, miR-133a and miR-133b were quantified by RT–PCR in 163 primary paediatric RMSs, plus control tissues, and correlated with clinico-pathological features. Correlations with parallel gene expression profiling data for 84 samples were used to identify pathways associated with miR-206. Synthetic miR-206 was transfected into RMS cell lines and phenotypic responses assessed. Results: Muscle-specific miRNAs levels were lower in RMSs compared with skeletal muscle but generally higher than in other normal tissues. Low miR-206 expression correlated with poor overall survival and was an independent predictor of shorter survival in metastatic embryonal and alveolar cases without PAX3/7-FOXO1 fusion genes. Low miR-206 expression also significantly correlated with high SIOP stage and the presence of metastases at diagnosis. High miR-206 expression strongly correlated with genes linked to muscle differentiation and low expression was associated with genes linked to MAPkinase and NFKappaB pathway activation. Increasing miR-206 expression in cell lines inhibited cell growth and migration and induced apoptosis that was associated with myogenic differentiation in some, but not all, cell lines. Conclusion: miR-206 contributes to the clinical behaviour of RMSs and the pleiotropic effects of miR-206 supports therapeutic potential.
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Sharma K, Kibria R, Ali S, Rao P. Primary aortoenteric fistula caused by an infected abdominal aortic aneurysm with Mycobacterium avium complex in an HIV patient. Acta Gastroenterol Belg 2010; 73:280-282. [PMID: 20690571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Primary aortoenteric fistula (PAEF) is a rare but complex clinical entity requiring multimodality approach for diagnosis and treatment. We report the first ever case of upper gastrointestinal (UGI) hemorrhage caused by an aortoenteric fistula (AEF) secondary to Mycobacterium avium complex (MAC) in a patient with human immunodeficiency virus (HIV) infection. Esophagogastroduodenoscopy (EGD) showed an ulcer in the distal duodenum and a computed tomography (CT) scan confirmed a contained abdominal aortic aneurysm (AAA) rupture with an aorto-enteric fistula communicating with the third portion of the duodenum. Emergent surgery was undertaken which was lifesaving. A high index of suspicion, early diagnosis and prompt surgical intervention are crucial for survival of patient with PAEF.
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Pelz JB, Canosa R, Lipps M, Babcock J, Rao P. Saccadic targeting in the real world. J Vis 2010. [DOI: 10.1167/3.9.310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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de Baere T, Robinson JM, Deschamps F, Rao P, Teriitheau C, Goere D, Elias D. Preoperative Portal Vein Embolization Tailored to Prepare the Liver for Complex Resections: Initial Experience. Cardiovasc Intervent Radiol 2010; 33:976-82. [DOI: 10.1007/s00270-009-9785-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Accepted: 12/09/2009] [Indexed: 12/23/2022]
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Tekmal R, Nair H, Huffman S, Kirma N, Rao P, Evans D, Ramana K, Srivastava S. Targeting Aldose Reductase: A Novel Strategy in Treating Endocrine Resistance Using Combination Therapy. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Breast cancer is the most commonly diagnosed form of cancer in women. Among breast cancer patients about 2/3 are initially hormone sensitive or estrogen receptor (ER) positive and respond to endocrine therapy. Aromatase inhibitors (AI's) are superior class of hormonal therapeutic agents effectively control ER positive breast cancer in postmenopausal women. Acquired resistance to AI's is expected to be an emerging serious problem in clinics and recent studies have shown that tumors use adaptive signaling mechanisms to overcome AI sensitivity. Thus there is an urgent need for newer treatment modalities. Combination of endocrine and non endocrine agents that block these signaling pathways may prevent or delay the adaptive mechanism and thereby onset of resistance to hormonal therapy. In our study we have found that Fidarestat, an aldose reductase (enzyme which catalyzes the rate limiting step of glucose to fructose or sorbitol formation in polyol pathway) inhibitor effectively re-sensitize letrozole resistant LTLT-Ca breast cancer cells to letrozole. 1µM of fidarestat + 1uM letrozole was found very effective in inducing maximum cell death in LTLT-Ca cells when compared to fidarestat alone. The combination treatment not only restored ER-α levels but also down regulated HER2/MAPK signaling proteins. Aldose reductase siRNA (100nM)- treated MCF-7/Aro and MCF-7 cells upregulated ER-α in western blot and ER-functionality assays. On the other hand in aldose reductase-siRNA- treated LTLT-Ca cells, ER-α levels were down- regulated as in fidarestat treatment. Pretreatment of LTLT-Ca with fidarestat for one week showed reduced proliferation of cells and the effect was maintained until four passages with 1µM letrozole alone. Fidarestat treatment up-regulated E2-mediated transcription in LTLT-Ca cells. In order to enhance the efficacy and targeted delivery of fidarestat in LTLT–Ca cells we have used a nanoparticle-based therapeutic formulation. Folate receptor, highly expressed on epithelial carcinomas, could be a potential molecular target for tumor selective drug delivery. Physcio-chemically well characterized Fidarestat–folate nanoparticles (FFNP's) were prepared to increase the tumor selective intracellular delivery. FFNP's were found superior in exerting cytotoxicity when compared to fidarestat alone. Combination therapy was equally effective in controlling LTLT-Ca cell growth using xenograft model. Taken together, the increased glucose metabolism in LTLT-Ca cells may be critically contributing to chemotherapeutic resistance by increasing drug metabolism and decreasing uptake. Hence targeting aldose reductase in endocrine resistance may be attractive alternative to increase the sensitivity of hormonal therapy.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 67.
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Rao P, Pascale F, Seck A, Teriitheau C, Namur J, Deschamps F, Paci A, Willis S, De Baère T. Evaluation des modes d’administration d’irinotecan sur modeles VX2 lapin : etude de pharmacocinetique et reponse tumorale. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/s0221-0363(09)75500-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Catherine L, Teriitheau C, Rao P, Deschamps F, Abd el Rehim M, Hakimé A, De Baère T. Interet du scanner de perfusion apres chimioembolisation aux microparticules chargees des metastases hepatiques endocrines. JOURNAL DE RADIOLOGIE 2009; 90:1425. [DOI: 10.1016/s0221-0363(09)75616-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Bevan CA, Palmer CS, Sutcliffe JR, Rao P, Gibikote S, Crameri J. Blunt abdominal trauma in children: how predictive is ALT for liver injury? Emerg Med J 2009; 26:283-8. [PMID: 19307392 DOI: 10.1136/emj.200x.062703] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The liver is the second most commonly injured intra-abdominal organ in children. CT scanning is currently regarded as the "gold standard" in screening for intra-abdominal injury following blunt trauma. However, the risks associated with performing CT in children are not insignificant and, in addition, CT is not always readily available. This study investigates the utility of alanine aminotransferase (ALT) in screening for liver injury in paediatric trauma. METHODS Two groups of patients were compiled from a prospectively identified trauma registry-one with liver injuries and another with intra-abdominal injuries other than to the liver. Inclusion in the study required that an initial ALT level had been obtained after injury. Where CT had been performed, a paediatric radiologist blind to the ALT results graded the severity of the liver injuries. The study groups were compared and a receiver operating characteristic (ROC) curve generated to derive the optimum ALT threshold to identify liver injury. RESULTS 51 patients with liver injury and 65 with other intra-abdominal injuries were identified. An ALT level of > or =104 IU/l gave a sensitivity of 96% and a specificity of 80%. When liver injuries were stratified to identify only clinically significant liver injuries (grades III, IV and V), this ALT threshold identified 100% of patients with 70% specificity. CONCLUSIONS In this sample, ALT appears to be a useful predictor for the presence or absence of liver injury. In haemodynamically stable children with clinical suspicion of isolated liver injury, identification of a normal ALT level (<104 IU/l) may reduce the need for unnecessary transportation for CT scanning with subsequent radiation exposure.
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Farquhar SA, Goff NM, Shadbeh N, Samples J, Ventura S, Sanchez V, Rao P, Davis S. Occupational health and safety status of indigenous and Latino farmworkers in Oregon. J Agric Saf Health 2009; 15:89-102. [PMID: 19266886 DOI: 10.13031/2013.25417] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Exposure to pesticides poses great risk to agricultural workers and their families. Of the approximately 174,000 agricultural workers in Oregon, studies estimate that up to 40% of the workers in Oregon are indigenous and may be particularly vulnerable to the health risks of working in pesticide treated areas. Surveys conducted with Oregon farmworkers suggest that Latino and indigenous farmworkers differ demographically and may have diverse occupational and health needs. All Latino workers reported Spanish as their native language, while indigenous workers spoke several different native languages. Latino workers were employed mostly in orchards (28%) and nurseries (24%), while indigenous workers were mostly pickers (40%). Indigenous farmworkers reported less frequent suitable occupational safety training, and potentially less knowledge of the health consequences of pesticides. Addressing the barriers to obtaining pesticide health and safety information is of primary importance, given the changing demographics of farmworkers in Oregon. This article concludes with a discussion of these findings and the programmatic activities that have been implemented in Oregon to improve farmworkers' understanding of hazards and rights associated with agricultural work.
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