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McCloskey K, Ponsonby AL, Collier F, Allen K, Tang MLK, Carlin JB, Saffery R, Skilton MR, Cheung M, Ranganathan S, Dwyer T, Burgner D, Vuillermin P. The association between higher maternal pre-pregnancy body mass index and increased birth weight, adiposity and inflammation in the newborn. Pediatr Obes 2018; 13:46-53. [PMID: 27723247 DOI: 10.1111/ijpo.12187] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 08/29/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Excess adiposity and adiposity-related inflammation are known risk factors for cardiovascular disease in adults; however, little is known regarding the determinants of adiposity-related inflammation at birth. OBJECTIVES The aim of this study was to investigate the association between maternal pre-pregnancy BMI and newborn adiposity and inflammation. METHODS Paired maternal (28-week gestation) and infant (umbilical cord) blood samples were collected from a population-derived birth cohort (Barwon Infant Study, n = 1074). Data on maternal comorbidities and infant birth anthropomorphic measures were compiled, and infant aortic intima-media thickness was measured by trans-abdominal ultrasound. In a selected subgroup of term infants (n = 161), matched maternal and cord lipids, high-sensitivity C-reactive protein (hsCRP) and maternal soluble CD14 were measured. Analysis was completed by using pairwise correlation and linear regression. Because of their non-normal distribution, pathology blood measures were log transformed prior to analysis. RESULTS Maternal pre-pregnancy BMI was positively associated with increased birth weight (mean difference 17.8 g per kg m-2 , 95% CI 6.6 to 28.9; p = 0.002), newborn mean skin-fold thickness (mean difference 0.1 mm per kg m-2 , 95% CI 0.0 to 0.1; p < 0.001) and cord blood hsCRP (mean difference of 4.2% increase in hsCRP per kg m-2 increase in pre-pregnancy BMI, 95% CI 0.6 to 7.7%, p = 0.02), but not cord blood soluble CD14. Inclusion of maternal hsCRP as a covariate attenuated the associations between pre-pregnancy BMI and both newborn skin-fold thickness and cord blood hsCRP. CONCLUSION Higher maternal pre-pregnancy BMI is associated with increased newborn adiposity and inflammation. These associations may be partially mediated by maternal inflammation during pregnancy.
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Gray L, Leong O, O’Hely M, Collier F, Ranganathan S, Sly P, Tang M, Allen K, Vuillermin P. P43: FOOD ALLERGY BUT NOT SENSITISED TOLERANCE ASSOCIATES WITH SUBSEQUENT ASTHMA. Intern Med J 2017. [DOI: 10.1111/imj.43_13578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Molloy J, Koplin JJ, Allen KJ, Tang MLK, Collier F, Carlin JB, Saffery R, Burgner D, Ranganathan S, Dwyer T, Ward AC, Moreno-Betancur M, Clarke M, Ponsonby AL, Vuillermin P. Vitamin D insufficiency in the first 6 months of infancy and challenge-proven IgE-mediated food allergy at 1 year of age: a case-cohort study. Allergy 2017; 72:1222-1231. [PMID: 28042676 DOI: 10.1111/all.13122] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Ecological evidence suggests vitamin D insufficiency (VDI) due to lower ambient ultraviolet radiation (UVR) exposure may be a risk factor for IgE-mediated food allergy. However, there are no studies relating directly measured VDI during early infancy to subsequent challenge-proven food allergy. OBJECTIVE To prospectively investigate the association between VDI during infancy and challenge-proven food allergy at 1 year. METHODS In a birth cohort (n = 1074), we used a case-cohort design to compare 25-hydroxyvitamin D3 (25(OH)D3 ) levels among infants with food allergy vs a random subcohort (n = 274). The primary exposures were VDI (25(OH)D3 <50 nM) at birth and 6 months of age. Ambient UVR and time in the sun were combined to estimate UVR exposure dose. IgE-mediated food allergy status at 1 year was determined by formal challenge. Binomial regression was used to examine associations between VDI, UVR exposure dose and food allergy and investigate potential confounding. RESULTS Within the random subcohort, VDI was present in 45% (105/233) of newborns and 24% (55/227) of infants at 6 months. Food allergy prevalence at 1 year was 7.7% (61/786), and 6.5% (53/808) were egg-allergic. There was no evidence of an association between VDI at either birth (aRR 1.25, 95% CI 0.70-2.22) or 6 months (aRR 0.93, 95% CI 0.41-2.14) and food allergy at 1 year. CONCLUSIONS There was no evidence that VDI during the first 6 months of infancy is a risk factor for food allergy at 1 year of age. These findings primarily relate to egg allergy, and larger studies are required.
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Munro C, Quinlan C, Ranganathan S. 44 Changes in estimated glomerular filtration rate (eGFR) with ivacaftor treatment in the paediatric cystic fibrosis (CF) population. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30409-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Haricharan S, Nagabhushana, Srinivasan S, Rajani MB, Ranganathan S. Locating Iron Production Sites in Telangana, India Using Satellite Imagery. CURR SCI INDIA 2016. [DOI: 10.18520/cs/v111/i9/1536-1543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Frayman K, Armstrong D, Carzino R, Ferkol T, Grimwood K, Storch G, Wylie K, Ranganathan S. 80 The microbiome in early cystic fibrosis lung disease: A longitudinal analysis. J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30257-5] [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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Sayers I, Sharma A, Ranganathan S, Cain T, Skoric B. WS20.5 Cystic fibrosis related structural lung disease on high resolution computed tomography before and after ivacaftor therapy. J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30120-x] [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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Carzino R, King L, Ranganathan S. 78 Differences in infection, inflammation and structural abnormalities between the right and left lung. J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30255-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rizk B, Turki R, Lotfy H, Ranganathan S, Zahed H, Freeman A, Shilbayeh Z, Sassy M, Shalaby M, Malik R. Surgery for endometriosis-associated infertility: do we exaggerate the magnitude of effect? Facts Views Vis Obgyn 2015; 7:109-18. [PMID: 26177374 PMCID: PMC4498168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Surgery remains the mainstay in the diagnosis and management of endometriosis. The number of surgeries performed for endometriosis worldwide is ever increasing, however do we have evidence for improvement of infertility after the surgery and do we exaggerate the magnitude of effect of surgery when we counsel our patients? The management of patients who failed the surgery could be by repeat surgery or assisted reproduction. What evidence do we have for patients who fail assisted reproduction and what is their best chance for achieving pregnancy? MATERIAL AND METHODS In this study we reviewed the evidence-based practice pertaining to the outcome of surgery assisted infertility associated with endometriosis. Manuscripts published in PubMed and Science Direct as well as the bibliography cited in these articles were reviewed. Patients with peritoneal endometriosis with mild and severe disease were addressed separately. Patients who failed the primary surgery and managed by repeat or assisted reproduction technology were also evaluated. Patients who failed assisted reproduction and managed by surgery were also studied to determine of the best course of action. RESULTS In patients with minimal and mild pelvic endometriosis, excision or ablation of the peritoneal endometriosis increases the pregnancy rate. In women with severe endometriosis, controlled trials suggested an improvement of pregnancy rate. In women with ovarian endometrioma 4 cm or larger ovarian cystectomy increases the pregnancy rate, decreases the recurrence rate, but is associated with decrease in ovarian reserve. In patients who have failed the primary surgery, assisted reproduction appears to be significantly more effective than repeat surgery. In patients who failed assisted reproduction, the management remains to be extremely controversial. Surgery in expert hands might result in significant improvement in pregnancy rate. CONCLUSION In women with minimal and mild endometriosis, surgical excision or ablation of endometriosis is recommended as first line with doubling the pregnancy rate. In patients with moderate and severe endometriosis surgical excision also is recommended as first line. In patients who failed to conceive spontaneously after surgery, assisted reproduction is more effective than repeat surgery. Following surgery, the ovarian reserve may be reduced as determined by Anti Mullerian Hormone. The antral follicle count is not significantly reduced. In women with large endometriomas > 4 cm the ovarian endometrioma should be removed. In women who have failed assisted reproduction, further management remains controversial in the present time.
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Aarthi V, Krishnamoorthy J, Ranganathan S. PA01.63. Scientific evaluation on Siddha drug G 7 for the management of allergic disorders of the skin. Anc Sci Life 2012. [PMCID: PMC3800867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose: In the ancient siddha literature various herbomineral components individually and in combination are documented to have wide spectrum of activity against allergic disorders of skin like pruritus, urticaria, eczema etc. The aim of the present study was to establish the effect of G7 on IL 8, IL alpha 1 and histamine both in vivo and in vitro studies. Method: The cultured keratinocytes were exposed to uv irradiation and the release of IL 8, IL alpha 1 and histamine were established by ELISA. The effect of G7 on histamine induced wheel and flare reaction were established in human subjects. Capasicin and substance P were used as positive control with intra dermal histamine. Result: G7 had significantly interfered in the release of IL 8, IL alpha 1 and histamine in vitro studies and in vivo studies G7 had significantly reduced wheal and flare reaction in human subjects. Conclusion: The findings of the study have clearly established the anti-allergic effect of G7 and its mechanism of action. Siddha system of medicine was contemporary to ayurvedic system of medicine. Siddha system however was confined to Tamil nadu while the ayurvedic system was prevalent throughout India.
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Alperin N, Ranganathan S, Bagci AM, Adams DJ, Ertl-Wagner B, Saraf-Lavi E, Sklar EM, Lam BL. MRI evidence of impaired CSF homeostasis in obesity-associated idiopathic intracranial hypertension. AJNR Am J Neuroradiol 2012; 34:29-34. [PMID: 22766676 DOI: 10.3174/ajnr.a3171] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Impaired CSF homeostasis and altered venous hemodynamics are proposed mechanisms for elevated pressure in IIH. However, the lack of ventricular expansion steered the focus away from CSF homeostasis in IIH. This study aims to measure intracranial CSF volumes and cerebral venous drainage with MR imaging to determine whether increased CSF volume from impaired CSF homeostasis and venous hemodynamics occur in obesity-related IIH. MATERIALS AND METHODS Two homogeneous cohorts of 11 newly diagnosed pretreatment overweight women with IIH and 11 overweight healthy women were prospectively studied. 3D volumetric MR imaging of the brain was used to quantify CSF and brain tissue volumes, and dynamic phase contrast was used to measure relative cerebral drainage through the internal jugular veins. RESULTS Findings confirm normal ventricular volume in IIH. However, extraventricular CSF volume is significantly increased in IIH (290 ± 52 versus 220 ± 24 mL, P = .001). This is even more significant after normalization with intracranial volume (P = .0007). GM interstitial fluid volume is also increased in IIH (602 ± 57 versus 557 ± 31 mL, P = .037). Total arterial inflow is normal, but relative venous drainage through the IJV is significantly reduced in IIH (65 ± 7% versus 81 ± 10%, P = .001). CONCLUSIONS Increased intracranial CSF volume that accumulates in the extraventricular subarachnoid space provides direct evidence for impaired CSF homeostasis in obesity-associated IIH. The finding of larger GM interstitial fluid volume is consistent with increased overall resistance to cerebral venous drainage, as evident from reduced relative cerebral drainage through the IJV. The present study confirms that both impaired CSF homeostasis and venous hemodynamics coexist in obesity-associated IIH.
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Pringle E, Ranganathan S, Harrison J. 258 Does regaining birth weight Z score by 2 years of age impact on clinical outcome in patients with cystic fibrosis? J Cyst Fibros 2012. [DOI: 10.1016/s1569-1993(12)60427-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Doan J, Ranganathan S, Massie J, Harrison J. 124 Eradication of Pseudomonas aeruginosa in children with cystic fibrosis: an Australian experience. J Cyst Fibros 2012. [DOI: 10.1016/s1569-1993(12)60294-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Aarthi V, Krishnamoorthy JR, Ranganathan S. PA01.63. Scientific evaluation on Siddha drug G 7 for the management of allergic disorders of the skin. Anc Sci Life 2012. [DOI: 10.4103/0257-7941.112120] [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] Open
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Manuel F, Ranganathan S. A new postulate on two stages of dandruff: a clinical perspective. Int J Trichology 2011; 3:3-6. [PMID: 21769228 PMCID: PMC3129121 DOI: 10.4103/0974-7753.82117] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Dandruff (pityriasis capitis, seborrheic dermatitis confined to the scalp) is a disease that has been around for centuries despite several treatment options. Almost every day new players are entering the market with various antidandruff products, perhaps due to an increase in the incidence of dandruff all over the world. Interestingly, clinicians, especially dermatologists, gave little attention to this problem. At the end, the dandruff sufferer is puzzled by the array of antidandruff products with varied claims entering the market day by day. Why have we not achieved complete treatment success against dandruff? Is dandruff a disease or disorder? It seems that our understanding about dandruff perfectly fits into the famous saying of Albert Einstein, “as the area of light increases, so does the circumferences of darkness.” Have dermatologists left dandruff unattended, only to be exploited by the personal care industry?
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Ranganathan S, Babu SM, Bangal PR, Madhavendra S, Voleti SR. The Novel Formation of Ordered and Varied Silica-Imidazole Complexes from Silicic Acid. PHOSPHORUS SULFUR 2011. [DOI: 10.1080/10426507.2010.540727] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Tendeloo G, Landuyt J, Amelinckx S, Ranganathan S. Quasi-crystals and their crystalline homologues in the Al60Mn11Ni4 ternary alloy. J Microsc 2011. [DOI: 10.1111/j.1365-2818.1988.tb04558.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Thangaraj N, Subbanna GN, Ranganathan S, Chattopadhyay K. Electron microscopy and diffraction of icosahedral and decagonal quasicrystals in aluminium-manganese alloys. J Microsc 2011. [DOI: 10.1111/j.1365-2818.1987.tb01351.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ranganathan S, Mukhopadhyay T. Dandruff: the most commercially exploited skin disease. Indian J Dermatol 2011; 55:130-4. [PMID: 20606879 PMCID: PMC2887514 DOI: 10.4103/0019-5154.62734] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The article discuss in detail about the prevalence, pathophysiology, clinical manifestations of dandruff including the etio-pathology. The article also discusses in detail about various treatment methods available for dandruff. The status of dandruff being amphibious – a disease/disorder, and relatively less medical intervention is sought after for the treatment, dandruff is the most commercially exploited skin and scalp disorder/disease by personal care industries.
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Duarte AI, Petit GH, Ranganathan S, Li JY, Oliveira CR, Brundin P, Björkqvist M, Rego AC. IGF-1 protects against diabetic features in an in vivo model of Huntington's disease. Exp Neurol 2011; 231:314-9. [PMID: 21763311 DOI: 10.1016/j.expneurol.2011.06.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 06/08/2011] [Accepted: 06/26/2011] [Indexed: 01/16/2023]
Abstract
Huntington's disease (HD) is the most prevalent polyglutamine expansion disorder. HD is caused by an expansion of CAG triplet in the huntingtin (HTT) gene, associated with striatal and cortical neuronal loss. Central and peripheral metabolic abnormalities and altered insulin-like growth factor-1 (IGF-1) levels have been described in HD. Thus, we hypothesized that restoration of IGF-1-mediated signaling pathways could rescue R6/2 mice from metabolic stress and behavioral changes induced by polyglutamine expansion. We analyzed the in vivo effect of continuous peripheral IGF-1 administration on diabetic parameters, body weight and motor behavior in the hemizygous R6/2 mouse model of HD. We used 9 week-old and age-matched wild-type mice, subjected to continuously infused recombinant IGF-I or vehicle, for 14 days. IGF-1 treatment prevented the age-related decrease in body weight in R6/2 mice. Although blood glucose levels were higher in R6/2 mice, they did not reach a diabetic state. Even though, IGF-1 ameliorated poor glycemic control in HD mice. This seemed to be associated with a decrease in blood insulin levels in R6/2 mice, which was increased following IGF-1 infusion. Similarly, blood IGF-1 levels decreased during aging in both wild-type and R6/2 mice, being significantly improved upon its continuous infusion. Although no significant differences were found in motor function in R6/2-treated mice, IGF-1 treatment highly improved paw clasping scores. In summary, these results suggest that IGF-1 has a protective role against HD-associated impaired glucose tolerance, by enhancing blood insulin levels.
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Mascarenhas L, Felgenhauer JL, Bond MC, Femino JD, Laack NN, Ranganathan S, Krailo MD, Marina N. Pilot study of adding vincristine, topotecan, and cyclophosphamide to interval-compressed chemotherapy in newly diagnosed patients with localized Ewing sarcoma family of tumors: A Children's Oncology Group trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Zhang H, Petit G, Gaughwin PM, Zuo X, Ranganathan S, Smith R, Roybon L, Brundin P, Mobley WC, Li JY. B16 NGF improves the spatial working memory in R6/1 Huntington's disease transgenic mice through the augmentation of cholinergic function and neurogenesis. Journal of Neurology, Neurosurgery and Psychiatry 2010. [DOI: 10.1136/jnnp.2010.222596.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ranganathan S. Lung development, lung growth and the future of respiratory medicine. Eur Respir J 2010; 36:716-7. [DOI: 10.1183/09031936.00070210] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Smith C, Winn A, Ranganathan S, Seddon P. A fat lot of good. An 8 year longitudinal investigation of fat intakes in a paediatric CF population. J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60361-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ewer M, Grunberg S, Ranganathan S, Lane S, Russo M. Cardiac Safety Data for Casopitant, a Neurokinin-1 Receptor Antagonist, Given with Anthracycline. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-1118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Objectives: The NK-1 receptor antagonist casopitant is a promising agent for the prevention of chemotherapy-related and postoperative nausea and vomiting. However, findings suggestive of cardiac damage were noted in animal studies of long-term administration of casopitant at supratherapeutic doses. Cardiac evaluation of the concomitant use of casopitant with anthracyclines was therefore of particular interest due to myocyte loss associated with anthracycline use.Methods: Chemotherapy-naïve patients receiving anthracyclines as part of a Phase III moderately emetogenic chemotherapy study regimen were randomized to receive ondansetron and dexamethasone plus one of the following casopitant regimens: single-dose 150-mg oral casopitant (ORAL1); 3-day IV/oral casopitant (90 mg IV/50 mg oral/50 mg oral) (IV/ORAL); 3-day oral casopitant (150/50/50 mg) (ORAL3); or placebo. Serial cardiac troponin (cTnI) levels were measured using the Beckman assay. Although this assay is generally considered reliable within the range of 0.04-0.5 ng/mL, levels below the limit of quantitation (LOQ) (<0.04 ng/mL) were also evaluated in an attempt to identify patterns of change below LOQ. Further cardiac assessment consisting of left ventricular ejection fraction (LVEF) monitoring was conducted in patients with cTnI levels ³0.12 ng/mL.Results: In total, 611 patients were evaluated: 155 ORAL1, 145 IV/ORAL, 159 ORAL3, and 152 placebo; no risk factor variation between groups was observed. Adverse events were balanced across treatment groups. Cardiovascular adverse events occurred in 3% of patients in each of the placebo, ORAL1, and ORAL/IV groups and in 2% of the ORAL3 group. Three patients (0.5%) had cTnI >0.12 ng/mL (1 each IV/ORAL, ORAL3, and placebo); all LVEF determinations were normal at follow-up, with the exception of 1 patient with mitral regurgitation but normal ejection fraction. A total of 59 patients (9.7%) had median cTnI 0.04-0.12 ng/mL. Of the remaining patients with cTnI below LOQ, median baseline levels across groups were similar (ORAL1 and IV/ORAL 0.008 ng/mL; ORAL3 0.01 ng/mL; placebo 0.009 ng/mL). After 4 cycles of anthracycline, median cTnI increased to 0.02 ng/mL in all groups, with no difference noted between casopitant and placebo groups.Conclusions: Thorough monitoring of cardiac-related toxicities including cardiac (S)AEs, ECG, and ejection fraction data showed no evidence of increased risk of cardiac damage in the casopitant groups compared with control. Subclinical elevations in cTnI occurred in patients receiving anthracyclines but were not considered to be related to or accentuated by simultaneous administration of casopitant. cTnI elevations were similar across treatment groups and were well below rates reported in the literature for a patient population receiving higher doses of anthracycline. Use of appropriate cardiac biomarkers in ranges below those commonly used to detect infarction may be valuable to detect or exclude subclinical toxicity of potentially cardiotoxic agents used in combination. Additional analysis is ongoing.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1118.
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