851
|
Kumar P, Kumar P, Dixit A, Gupta V, Singh HP, Sargaiyan V. Cross-sectional evaluation of awareness of prevention of dental caries among general pediatricians in ghaziabad district, India. Ann Med Health Sci Res 2014; 4:S302-6. [PMID: 25364606 PMCID: PMC4212394 DOI: 10.4103/2141-9248.141976] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Oral diseases are largely preventable and it is hoped that with the early exposure to oral health-care activities, the prevalence of oral diseases will be reduced in children and they would be more receptive to dental services. AIM The present study evaluated the awareness of prevention of dental caries among pediatricians in Ghaziabad district, India. SUBJECTS AND METHODS A cross-sectional survey was undertaken among the pediatricians in Ghaziabad district, India. Total subjects including in the survey were 88 pediatricians, through systemic random sampling. Both the gender was including Male-37.8% (35/88) and Female-62.2% (53/88). Pre-tested, structured and self administered questionnaire was used in the survey and data analysis was done by using 'SPSS' software version 16.0 (IBM, United States). RESULTS Our study indicated that most of the pediatricians in Ghaziabad district had moderate knowledge 39.7% (35/88), followed by good knowledge 36.5% (32/88) and poor knowledge 23.8% (21/88) about dental caries. Practice guidelines and opinions of pediatricians in the survey were moderate 64.7% (57/88) in about more than half, followed by poor 23.8% (21/88) and followed by good 11.5% (10/88). The attitude for prevention of dental caries was positive in almost everybody 81.8% (72/88). CONCLUSION The present survey concluded that pediatricians in Ghaziabad district, India had a good attitude and practices, but had moderate knowledge and lacked proper awareness about dental caries.
Collapse
|
852
|
Gupta V, Gotlib J, Radich JP, Kröger NM, Rondelli D, Verstovsek S, Deeg HJ. Janus kinase inhibitors and allogeneic stem cell transplantation for myelofibrosis. Biol Blood Marrow Transplant 2014; 20:1274-81. [PMID: 24680977 PMCID: PMC4465357 DOI: 10.1016/j.bbmt.2014.03.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 03/20/2014] [Indexed: 01/13/2023]
Abstract
Myelofibrosis (MF) is a manifestation of several disorders of hematopoiesis, collectively referred to as myeloproliferative neoplasms. Allogeneic hematopoietic stem cell transplantation (ASCT) is the only therapy with proven curative potential. However, most patients with MF are in their 6th or 7th decade of life, and only some of these patients have been considered suitable transplantation candidates. The development of reduced-intensity conditioning regimens with limited toxicity has allowed clinicians to offer ASCT to a growing number of older patients. The availability of Janus Kinase (JAK) 1/2 inhibitors allows clinicians to provide symptom relief and improved quality of life for MF patients. These drugs may also affect the decision regarding, in particular, the timing of ASCT. Future studies need to address the role of JAK1/2 inhibitors in patients who are transplantation candidates and determine their role before and, possibly, after transplantation. The identification of indications for the use of JAK1/2 inhibitors in the context of transplantation may lead to new therapeutic strategies for patients with MF.
Collapse
|
853
|
Samal DK, Behera G, Gupta V, Majumdar K, Khurana U. Isolated lichen planus of lower lip: a case report. Indian J Otolaryngol Head Neck Surg 2014; 67:151-3. [PMID: 25621274 DOI: 10.1007/s12070-014-0768-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 08/16/2014] [Indexed: 12/23/2022] Open
Abstract
Lichen planus is an idiopathic inflammatory condition, which may involve mucosa of the oral cavity, gastrointestinal tract, larynx or the cutaneous surface either in isolation or in combinations. Mucosal lichen planus is more common than the cutaneous variant. Isolated lip involvement is very rare and should be differentiated from other similar leukoplakic lesions. We are reporting a rare case of oral lichen planus in an elderly male that was exclusively localised to the lower lip.
Collapse
|
854
|
Sanggaard KW, Bechsgaard JS, Fang X, Duan J, Dyrlund TF, Gupta V, Jiang X, Cheng L, Fan D, Feng Y, Han L, Huang Z, Wu Z, Liao L, Settepani V, Thøgersen IB, Vanthournout B, Wang T, Zhu Y, Funch P, Enghild JJ, Schauser L, Andersen SU, Villesen P, Schierup MH, Bilde T, Wang J. Erratum: Corrigendum: Spider genomes provide insight into composition and evolution of venom and silk. Nat Commun 2014. [PMCID: PMC5784270 DOI: 10.1038/ncomms5590] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
855
|
Mittal K, Gupta V, Khanna P, Kaushik JS, Sharma A. Evaluation of Integrated Management of Neonatal and Childhood Illness (IMNCI) algorithm for diagnosis and referral in under-five children. Indian J Pediatr 2014; 81:797-9. [PMID: 24081896 DOI: 10.1007/s12098-013-1225-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 08/14/2013] [Indexed: 11/27/2022]
Abstract
A prospective observational study was conducted on 500 children to evaluate the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) algorithm for diagnosis and referral of children aged 0-59 mo. IMNCI algorithm performed well in diagnosis [except sepsis in 0-7 d (p < 0.01) and malaria in 2-59 mo (p < 0.01)] and referral of under five illnesses. The proportion of children with the mismatch between 'IMNCI' diagnosis and 'Gold Standard' diagnosis were highest (38.7 %) among children 0-7 d of age. The authors conclude that IMNCI algorithm in young children has good sensitivity for referring children with severe illnesses and is a good tool for diagnosis of most of childhood illnesses in under-five children.
Collapse
|
856
|
Sethi S, Arora S, Gupta V, Kumar S. Cutaneous Mycobacterium fortuitum Infection: Successfully Treated with Amikacin and Ofloxacin Combination. Indian J Dermatol 2014; 59:383-4. [PMID: 25071259 PMCID: PMC4103276 DOI: 10.4103/0019-5154.135491] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Cutaneous infections caused by atypical mycobacteria are uncommon and the diagnosis can be missed unless there is strong clinical suspicion supported by laboratory confirmation. We report a case of chronic discharging sinus caused by Mycobacterium fortuitum in a young healthy immunocompetent individual. The patient recovered completely following amikacin and ofloxacin therapy.
Collapse
|
857
|
Gupta V. Assessment of red blood cell parameters and peripheral smear at different temperatures in case of cold agglutination disease. Ann Med Health Sci Res 2014; 4:S25-8. [PMID: 25031901 PMCID: PMC4083734 DOI: 10.4103/2141-9248.131703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cold agglutination disease (CAD) is characterized by an auto-antibody which is able to agglutinate red blood cells (RBCs) at temperatures lower than that of the body, and subsequently to activate the complement system responsible for lysis of RBCs. Patients show hemolytic anemia of varying degrees of severity, which arise or worsen upon exposure to low temperatures. We describe a case who presented with fever and symptoms of asthenia. His investigations yielded bizarre RBC parameters which led to suspicion of a rare CAD, which was confirmed on reviewing RBC parameters, peripheral smear and direct Coomb's test at different temperatures. Hence, we suggest assessment of bizarre RBC parameters and peripheral smear can help in laboratory testing and diagnosis of CAD. It should also not pose embarrassment in laboratory testing to the pathologist for making an early and accurate diagnosis, thus emphasizing the need for an early treatment of CAD.
Collapse
|
858
|
Gupta S, Misra R, Ghosh UK, Gupta V, Srivastava D. Comparison of foetomaternal circulation in normal pregnancies and pregnancy induced hypertension using color Doppler studies. INDIAN JOURNAL OF PHYSIOLOGY AND PHARMACOLOGY 2014; 58:284-289. [PMID: 25906613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The aim of present study was to assess fetomaternal blood flows in normal and abnormal pregnancies using color Doppler indices. Subjects were divided into two groups as: Group A of 25 subjects of normal pregnancy as controls and group B of 25 subjects of pregnancy induced hypertension. All the subjects were lying in the age-group of 25-35 years and having 28 to 34 weeks of gestation; the patients were evaluated by detailed history and were subjected to complete general examination. Blood pressure was taken on two occasions at least 6 hours apart. Systemic examination and obstetrical examination was done in all subjects. All cases were subjected to pathological tests- Haemogram, Test for proteins in urine. Ultrasound assessment of fetal growth was done by measuring BPD (Biparietal diameter), HC (Head circumference), FL (Femur length) and AC (Abdominal circumference): Average gestational age and effective fetal weight was then calculated by ultrasound machine. Color Doppler was used to assess the various Doppler indices indices: Pulsatility index (PI), Resistive index (RI) and Systolic diastolic ratio (S/D ratio) in bilateral uterine, umbilical and middle cerebral arteries and compared to the standard normograms. Percentage of subjects having abnormal Doppler indices were calculated. Assessment of percentage of SGA (small for gestational age) fetuses was done in all the three groups. Decline in mean values of all Doppler indices was found with advancing gestational age in normal pregnancy suggesting decreased vascular resistance and increased blood flow in fetomaternal circulation. In pregnancy induced hypertensives, the mean values of Doppler indices showed a decline as in normal pregnancy but showed an increase (more than 2 S.D. of the mean) for that gestational age in comparison to the control group suggesting increased impedance to blood flow in uteroplacental and fetomaternal circulation. Umbilical artery Doppler indices were found to be the most sensitive indicator of uteroplacental and fetoplacental insufficiency in pregnancy induced hypertensives (P = 0.001). Thus we concluded that color Doppler can detect changes in fetomaternal circulation which correlate strongly with the fetal growth and therefore associated with pregnancy outcome.
Collapse
|
859
|
Gupta V, Kamra G, Singh D, Pandey K, Arora S. Wedgeless 'V' shaped distal femoral osteotomy with internal fixation for genu valgum in adolescents and young adults. Acta Orthop Belg 2014; 80:234-240. [PMID: 25090798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The treatment of angular malalignment includes restoration of normal mechanical axis alignment and joint orientation.The supracondylar wedgeless distal femoral 'V' osteotomy, as a treatment modality, is sparsely explored in the literature. This study was conducted at a tertiary level teaching referral hospital from October 2010 to September 2012. Forty six lower limbs (in 30 patients) were operated with a wedgeless 'V' osteotomy that was fixed with a buttress 'L' plate. The pre-operative deformity, post-operative correction and knee range of movement were noted. Mobilisation was started at 3 weeks after surgery and full weight-bearing was allowed at 3 months. The knee score by Bostman et al. was used for functional outcome. The mean age of the patients in our study was 16.9 years (range: 15 years to 23 years). The patients were followed up for a mean period of 19.8 months (range, 15 months to 29 months). The mean radiological tibiofemoral angle was 22.2 degrees (range, 16 degrees to 29 degrees) before surgery, that improved to a mean postoperative value of 5.1 degrees (range, 0 degrees to 10 degrees) (p < 0.001). The mean preoperative lateral distal femoral angle was 79.23 degrees that improved to a mean value of 89.13 degrees after surgery (p < 0.001). The mean mechanical axis deviation was 19.56 mm before surgery that improved to a mean postoperative value of 3.7 mm (p < 0.001). All patients reached a correction of the deformity and 44 cases out of a total of 46 had an excellent functional outcome, 2 patients had a good functional outcome. None had an unsatisfactory outcome. Two cases had a deep wound infection that subsided after implant removal. None of the cases had other complications. The distal femoral 'V' shaped osteotomy is a simple procedure for the correction of genu valgum in individuals nearing skeletal maturity and is easy to perform. It has the advantage of being wedgeless as it does not cause limb length discrepancy. Internal fixation helps in early rehabilitation after surgery.
Collapse
|
860
|
Gupta V, Wang Y, Romero A, Myronenko A, Jordan P, Heijmen B, Hoogeman M. SU-E-J-208: Fast and Accurate Auto-Segmentation of Abdominal Organs at Risk for Online Adaptive Radiotherapy. Med Phys 2014. [DOI: 10.1118/1.4888261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
861
|
Madeshwaran M, Gupta V, Chakrabarty J, Narayan G, Kumar A. Toll like Receptors (TLRs) expression in HIV children. BMC Infect Dis 2014. [PMCID: PMC4080338 DOI: 10.1186/1471-2334-14-s3-o10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
862
|
Verstovsek S, Mesa RA, Foltz LM, Gupta V, Mascarenhas J, Ritchie EK, Hoffman R, Silver RT, Hong WJ, Kremyanskaya M, Trehu EG, Kantarjian HM, Gotlib JR. Phase 2 trial of PRM-151, an antifibrotic agent, in patients with myelofibrosis: Stage 1 results. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.7114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
863
|
Sanggaard KW, Bechsgaard JS, Fang X, Duan J, Dyrlund TF, Gupta V, Jiang X, Cheng L, Fan D, Feng Y, Han L, Huang Z, Wu Z, Liao L, Settepani V, Thøgersen IB, Vanthournout B, Wang T, Zhu Y, Funch P, Enghild JJ, Schauser L, Andersen SU, Villesen P, Schierup MH, Bilde T, Wang J. Spider genomes provide insight into composition and evolution of venom and silk. Nat Commun 2014; 5:3765. [PMID: 24801114 PMCID: PMC4273655 DOI: 10.1038/ncomms4765] [Citation(s) in RCA: 187] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 03/31/2014] [Indexed: 12/24/2022] Open
Abstract
Spiders are ecologically important predators with complex venom and extraordinarily tough
silk that enables capture of large prey. Here we present the assembled genome of the social
velvet spider and a draft assembly of the tarantula genome that represent two major
taxonomic groups of spiders. The spider genomes are large with short exons and long introns,
reminiscent of mammalian genomes. Phylogenetic analyses place spiders and ticks as sister
groups supporting polyphyly of the Acari. Complex sets of venom and silk genes/proteins are
identified. We find that venom genes evolved by sequential duplication, and that the toxic
effect of venom is most likely activated by proteases present in the venom. The set of silk
genes reveals a highly dynamic gene evolution, new types of silk genes and proteins, and a
novel use of aciniform silk. These insights create new opportunities for pharmacological
applications of venom and biomaterial applications of silk. Spiders use self-produced venom and silk for their daily survival. Here, the
authors report the assembled genome of the social velvet spider and a draft assembly of the
tarantula genome and, together with proteomic data, provide insights into the evolution of
genes that affect venom and silk production.
Collapse
|
864
|
Bhuyan S, Sharma AK, Sureka RK, Gupta V, Singh PK. Sudden bilateral reversible vision loss: a rare presentation of acute intermittent porphyria. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2014; 62:432-434. [PMID: 25438495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Acute intermittent porphyria is a rare disorder, characterised clinically by variable patterns of neurological and metabolic disturbances. We report a rare presentation with sudden onset painless bilateral reversible vision loss of cerebral origin along with a brief review of the underlying pathophysiology.
Collapse
|
865
|
Michelis FV, Messner HA, Loach D, Uhm J, Gupta V, Lipton JH, Seftel MD, Kuruvilla J, Kim DD. Early lymphocyte recovery at 28 d post-transplant is predictive of reduced risk of relapse in patients with acute myeloid leukemia transplanted with peripheral blood stem cell grafts. Eur J Haematol 2014; 93:273-80. [DOI: 10.1111/ejh.12338] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2014] [Indexed: 12/16/2022]
|
866
|
Moon JH, Sohn SK, Lambie A, Ellis L, Hamad N, Uhm J, Gupta V, Lipton JH, Messner HA, Kuruvilla J, Kim D. Validation of National Institutes of Health Global Scoring System for Chronic Graft-Versus-Host Disease (GVHD) According to Overall and GVHD-Specific Survival. Biol Blood Marrow Transplant 2014; 20:556-63. [DOI: 10.1016/j.bbmt.2014.01.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 01/10/2014] [Indexed: 02/06/2023]
|
867
|
Timilshina N, Breunis H, Brandwein JM, Minden MD, Gupta V, O'Neill S, Tomlinson GA, Buckstein R, Li M, Alibhai SMH. Do quality of life or physical function at diagnosis predict short-term outcomes during intensive chemotherapy in AML? Ann Oncol 2014; 25:883-888. [PMID: 24667720 DOI: 10.1093/annonc/mdu010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Intensive chemotherapy (IC) used to treat acute myeloid leukemia (AML) is associated with toxicity, particularly in older adults. Emerging data suggest that baseline quality of life (QOL) and physical function may predict outcomes in oncology, although data in AML are limited. We investigated the association between baseline QOL and physical function with short-term treatment outcomes in adults and elderly AML patients. MATERIALS AND METHODS We conducted a prospective, longitudinal study of adults (age 18+) AML patients undergoing IC. Before starting IC, patients completed the European Organisation for the Research and Treatment of Cancer (EORTC) 30-item questionnaire (QLQ-C30) and Functional Assessment of Cancer Therapy Fatigue subscale (FACT-Fatigue) in addition to physical function tests (grip strength, timed chair stands, 2-min walk test). Outcomes included 60-day mortality, intensive care unit (ICU) admission and achievement of complete remission (CR). Logistic regression was carried out to evaluate each outcome. RESULTS Of the 239 patients (median age 57.5 years), 56.7% were male and median Charlson comorbidity score was 0. Sixty-day mortality, ICU admission and CR occurred in 9 (3.7%), 15 (6.3%) and 167 (69.9%) patients, respectively. Using univariate regression, neither QOL nor physical function at presentation was predictive of 60-day mortality (all P > 0.05), whereas ICU admission (P < 0.001) and remission status at 30 days (P = 0.007) were. Fatigue (P = 0.004) and role functioning (P = 0.003) were predictors of ICU admission; QOL and physical function were not. A higher Charlson score predicted ICU admission (P = 0.01) and remission status (P = 0.002). The cytogenetic risk group was associated with achievement of CR (P = 0.02); QOL and physical function were not (all P > 0.05). Findings were similar when patients age 60+ were examined. Relationships between fatigue and role functioning with ICU admission deserve further exploration. CONCLUSIONS Baseline QOL and physical function tests in this prospective study were not associated with short-term mortality, ICU admission or achievement of CR after the first cycle of chemotherapy.
Collapse
|
868
|
Gupta V, Bansal N, Palta S, Gombar S, Chander J. Comparative in vitro activity of polymyxins against carbapenem susceptible and resistant non-fermenters from critically ill-patients. Indian J Med Microbiol 2014; 32:203-4. [DOI: 10.4103/0255-0857.129849] [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]
|
869
|
Ansell J, Goddard S, Gupta V, Warren N, Williams G, Haray P, Appleton B, Phillips S, Torkington J. A new ex vivo animal simulation model for skills training in laparoscopic colorectal surgery. ACTA ACUST UNITED AC 2014. [DOI: 10.1308/rcsbull.2014.96.4.122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The opportunity for using simulation in medical training has expanded in recent years. 1–3 Laparoscopic surgery is an area that is ideally suited to the use of simulators for the acquisition of clinical skills. 4 Simulation allows educators to have control over pre-selected scenarios, without distressing patients or encountering complications. 5
Collapse
|
870
|
Minden MD, Hogge DE, Weir SJ, Kasper J, Webster DA, Patton L, Jitkova Y, Hurren R, Gronda M, Goard CA, Rajewski LG, Haslam JL, Heppert KE, Schorno K, Chang H, Brandwein JM, Gupta V, Schuh AC, Trudel S, Yee KWL, Reed GA, Schimmer AD. Oral ciclopirox olamine displays biological activity in a phase I study in patients with advanced hematologic malignancies. Am J Hematol 2014; 89:363-8. [PMID: 24273151 DOI: 10.1002/ajh.23640] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 11/19/2013] [Accepted: 11/20/2013] [Indexed: 12/12/2022]
Abstract
The antimycotic ciclopirox olamine is an intracellular iron chelator that has anticancer activity in vitro and in vivo. We developed an oral formulation of ciclopirox olamine and conducted the first-in-human phase I study of this drug in patients with relapsed or refractory hematologic malignancies (Trial registration ID: NCT00990587). Patients were treated with 5-80 mg/m² oral ciclopirox olamine once daily for five days in 21-day treatment cycles. Pharmacokinetic and pharmacodynamic companion studies were performed in a subset of patients. Following definition of the half-life of ciclopirox olamine, an additional cohort was enrolled and treated with 80 mg/m² ciclopirox olamine four times daily. Adverse events and clinical response were monitored throughout the trial. Twenty-three patients received study treatment. Ciclopirox was rapidly absorbed and cleared with a short half-life. Plasma concentrations of an inactive ciclopirox glucuronide metabolite were greater than those of ciclopirox. Repression of survivin expression was observed in peripheral blood cells isolated from patients treated once daily with ciclopirox olamine at doses greater than 10 mg/m², demonstrating biological activity of the drug. Dose-limiting gastrointestinal toxicities were observed in patients receiving 80 mg/m² four times daily, and no dose limiting toxicity was observed at 40 mg/m² once daily. Hematologic improvement was observed in two patients. Once-daily dosing of oral ciclopirox olamine was well tolerated in patients with relapsed or refractory hematologic malignancies, and further optimization of dosing regimens is warranted in this patient population.
Collapse
|
871
|
Yee KWL, Brandwein J, Schimmer AD, Gupta V, Del Bel R, Xu W, Minden MD, Schuh AC. Salvage induction chemotherapy after azacitdine treatment failure in patients who received azacitidine as a bridge to allogeneic stem cell transplantation. Br J Haematol 2014; 166:303-6. [PMID: 24650042 DOI: 10.1111/bjh.12844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 02/05/2014] [Indexed: 12/20/2022]
|
872
|
Gonsalves WI, Rajkumar SV, Gupta V, Morice WG, Timm MM, Singh PP, Dispenzieri A, Buadi FK, Lacy MQ, Kapoor P, Gertz MA, Kumar SK. Quantification of clonal circulating plasma cells in newly diagnosed multiple myeloma: implications for redefining high-risk myeloma. Leukemia 2014; 28:2060-5. [PMID: 24618735 DOI: 10.1038/leu.2014.98] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 02/21/2014] [Indexed: 12/22/2022]
Abstract
The presence of clonal circulating plasma cells (cPCs) is a marker of high-risk disease in all stages of monoclonal gammopathies. However, the prognostic utility of quantitating cPCs using multiparametric flow cytometry in multiple myeloma (MM) patients with current treatments is unknown. There were 157 consecutive patients with newly diagnosed MM seen at the Mayo Clinic, Rochester from 2009 to 2011 that had their peripheral blood evaluated for cPCs by multiparameter flow cytometry. Survival analysis was performed by the Kaplan-Meier method and differences assessed using the log-rank test. Using a receiver operating characteristics (ROC) analysis, ⩾400 cPCs were considered as the optimal cutoff for defining high-risk disease. The presence of ⩾400 cPCs was associated with higher plasma cell (PC) proliferation and adverse cytogenetics. The median time-to-next-treatment and overall survival (OS) in patients with ⩾400 cPCs (N=37, 24%) was 14 months and 32 months compared with 26 months and not reached for the rest (P<0.001). In a multivariable model, the presence of ⩾400 cPCs and older age adversely affected OS. Flow cytometry to quantify cPCs is a valuable test for risk stratifying newly diagnosed MM patients in the era of novel agents. Future studies are needed to determine its role in developing a risk-adapted treatment approach.
Collapse
|
873
|
Bachanova V, Marks DI, Zhang MJ, Wang H, de Lima M, Aljurf MD, Arellano M, Artz AS, Bacher U, Cahn JY, Chen YB, Copelan EA, Drobyski WR, Gale RP, Greer JP, Gupta V, Hale GA, Kebriaei P, Lazarus HM, Lewis ID, Lewis VA, Liesveld JL, Litzow MR, Loren AW, Miller AM, Norkin M, Oran B, Pidala J, Rowe JM, Savani BN, Saber W, Vij R, Waller EK, Wiernik PH, Weisdorf DJ. Ph+ ALL patients in first complete remission have similar survival after reduced intensity and myeloablative allogeneic transplantation: impact of tyrosine kinase inhibitor and minimal residual disease. Leukemia 2014; 28:658-65. [PMID: 23989431 PMCID: PMC3951192 DOI: 10.1038/leu.2013.253] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 08/12/2013] [Accepted: 08/22/2013] [Indexed: 01/21/2023]
Abstract
The efficacy of reduced intensity conditioning (RIC) allogeneic hematopoietic cell transplantation (HCT) for Philadelphia chromosome positive (Ph+) acute lymphoblastic leukemia (ALL) is uncertain. We analyzed 197 adults with Ph+ ALL in first complete remission; 67 patients receiving RIC were matched with 130 receiving myeloablative conditioning (MAC) for age, donor type and HCT year. Over 75% received pre-HCT tyrosine kinase inhibitors (TKIs), mostly imatinib; 39% (RIC) and 49% (MAC) were minimal residual disease (MRD)(neg) pre-HCT. At a median 4.5 years follow-up, 1-year transplant-related mortality (TRM) was lower in RIC (13%) than MAC (36%; P=0.001) while the 3-year relapse rate was 49% in RIC and 28% in MAC (P=0.058). Overall survival (OS) was similar (RIC 39% (95% confidence interval (CI) 27-52) vs 35% (95% CI 27-44); P=0.62). Patients MRD(pos) pre-HCT had higher risk of relapse with RIC vs MAC (hazard ratio (HR) 1.97; P=0.026). However, patients receiving pre-HCT TKI in combination with MRD negativity pre-RIC HCT had superior OS (55%) compared with a similar MRD population after MAC (33%; P=0.0042). In multivariate analysis, RIC lowered TRM (HR 0.6; P=0.057), but absence of pre-HCT TKI (HR 1.88; P=0.018), RIC (HR 1.891; P=0.054) and pre-HCT MRD(pos) (HR 1.6; P=0.070) increased relapse risk. RIC is a valid alternative strategy for Ph+ ALL patients ineligible for MAC and MRD(neg) status is preferred pre-HCT.
Collapse
|
874
|
Basha J, Appasani S, Vaiphei K, Gupta V, Singh K, Kochhar R. Biodegradable stents: truly biodegradable with good tissue harmony. Endoscopy 2014; 45 Suppl 2 UCTN:E116-7. [PMID: 23716086 DOI: 10.1055/s-0032-1326111] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
875
|
Gupta V, Chandra A, Noushif M, Singh SK. Giant stentolith: complication of a forgotten biliary stent. Endoscopy 2014; 45 Suppl 2 UCTN:E126. [PMID: 23716092 DOI: 10.1055/s-0032-1326367] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|