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Srivastava A, Grover S, Sooriakumaran P, Rajan S, El-Douaihy Y, Tewari A. Pathologic outcomes in patients with clinically low-risk prostate cancer deemed eligible for active surveillance. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
110 Background: Active surveillance (AS) is becoming increasingly popular as a treatment option for men with clinically localized low-risk prostate cancer. Gleason score ≤ 6 and clinical stage ≤ T2a are selection criteria for AS. However, Gleason upgrading or upstaging from the diagnostic biopsy to the surgical specimen is not uncommon. We thus sought to identify risk factors that could more accurately predict Gleason upgrading and/or upstaging in AS-eligible men. Methods: 786 patients from our prospective database of 2,412 men who underwent robotic-assisted radical prostatectomy by a single surgeon from January 2005 to August 2010 would have fulfilled standard AS criteria (Gleason sum ≤ 6, clinical stage ≤T2a disease, PSA <10ng/ml, <3 positive cores and ≤50% cancer present in a single core). This formed the basis of our study cohort. Clinicopathologic parameters, including number of cores at initial biopsy, biopsy cancer volume, preoperative PSA, number of cancer-positive cores, body mass index, and prostate volume were recorded prospectively. Data were evaluated using chi- square and multivariate logistic regression analyses. Receiver operator characteristic curves (ROC) were constructed to determine the optimal cutoff values. Results: 320 of 786 AS-eligible patients (40.7%) had Gleason upgrading at final pathology following radical prostatectomy. Upstaging was present in 591 patients (75.1%). 626 patients (79.6%) had Gleason upgrading and/or upstaging. On univariate analysis, BMI, PSA density, preoperative PSA, lower prostate volume and maximum percentage of cancer in biopsy cores were predictors of Gleason upgrading and/or upstaging. On multivariate analysis, all variables, except for BMI and PSA density, lost statistical significance. PSA density > 0.1 ng/ml/cm3 and BMI >29 kg/m2 are the optimal cutoff values based on ROC analysis. Conclusions: PSA density and BMI are significant predictors of Gleason upgrading and/or upstaging, and should be incorporated into contemporary selection criteria for AS protocols. No significant financial relationships to disclose.
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Sooriakumaran P, John M, Srivastava A, El-Douaihy Y, Grover S, Bhagat D, Rajan S, Leung R, Tewari A. Nomograms to predict 3-year biochemical recurrence after robotic-assisted laparoscopic radical prostatectomy based on preoperative and perioperative variables of 774 patients. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
115 Background: Predictors of biochemical recurrence after robotic-assisted laparoscopic radical prostatectomy (RALP) are not well reported in the literature. We wanted to investigate preoperative predictors as well as the influence of nerve sparing and positive surgical margin status on 3-year biochemical recurrence. Methods: 774 patients with at least 3 year follow up had undergone RALP by a single surgeon at our institution. Biochemcial recurrence was defined as a postoperative PSA >0.2 ng/ml. Multivariable logistic regression models were used to develop the biochemical recurrence predictive nomograms: nomogram 1- age, BMI, PSA density, clinical stage, biopsy Gleason, percent positive cores, perineural invasion; nomogram 2- age, BMI, PSA density, clinical stage, biopsy Gleason, percent positive cores, perineural invasion, nerve sparing, positive surgical margins (none, unifocal, or multifocal). The predictive accuracy of the models was assessed in terms of discrimination and calibration. Results: Both nomograms discriminated well between patients that recurred and those that did not (bootstrap corrected c-indices of 0.766 and 0.806 for nomograms 1 and 2 respectively). Nomogram 1 was well calibrated, but nomogram 2 over- predicted the probability of biochemical recurrence in patients at >30% risk. Conclusions: Our nomogram based on age, BMI, PSA density, clinical stage, biopsy Gleason, percent positive cores, and perineural invasion on preoperative biopsy has a good predictive ability to differentiate between RALP-treated patients that biochemically recur by 3 years from those that do not. Adding nerve sparing and surgical margin status further improved discriminatory ability but at the expense of over-prediction for patients at high risk. These nomograms may be used to guide the use of nerve sparing and the management of positive margins in men undergoing RALP for clinically localized prostate cancer. No significant financial relationships to disclose.
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Sooriakumaran P, Srivastava A, John M, Bhagat D, Grover S, Rajan S, El-Douaihy Y, Leung R, Tewari A. The relationship between prostate volume and histopathologic criteria of known prognostic importance in 2,207 men with prostate cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
197 Background: There is a paucity of data investigating the relationship between histopathologic variables of oncologic importance and prostate volume, and we aimed to investigate this. Methods: 2,207 consecutive patients who underwent robotic-assisted radical prostatectomy (RARP) were studied. Preoperative demographic and both pre- and post-operative histopathologic parameters were compared among the small prostate (< 40cc), intermediate size (40-70cc), and large prostate (> 70cc) groups. Results: Patients with smaller prostates were younger, had slightly lower BMIs, and lower PSAs than those with smaller prostates (p < 0.001). They also had worse histopathologic criteria (Gleason, core positivity, and maximum percent cancer) on preoperative biopsy and had worse radical specimen Gleason sums (p < 0.001), percent cancer (p < 0.001), and pathologic stage (p = 0.016). 11.5% of men in the small prostate group suffered a positive surgical margin (PSM) compared to 8.3% and 5.6% in the intermediate and large prostate groups, respectively (p = 0.008; Table). Basilar, posterolateral, and multifocal PSMs were commoner in the small prostate group. Conclusions: Younger men have smaller prostates and worse preoperative histopathologic parameters despite lower PSAs. Men with small prostates undergoing RARP have worse final Gleason sums, tumor volume, extraprostatic extension (EPE), and PSM rates than those with larger prostates. We would thus caution against conservative management of men with clinically localized prostate cancer who have small prostates. [Table: see text] No significant financial relationships to disclose.
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Rajan S, Wason AM, Carder PJ. Conservative management of screen-detected radial scars: role of mammotome excision. J Clin Pathol 2010; 64:65-8. [DOI: 10.1136/jcp.2010.083485] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Rajan S, Ramu P, Umamaheswaran G, Adithan C. Association of aldosterone synthase (CYP11B2 C-344T) gene polymorphism & susceptibility to essential hypertension in a south Indian Tamil population. Indian J Med Res 2010; 132:379-385. [PMID: 20966514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND & OBJECTIVE Renin-angiotensin aldosterone system (RAAS) plays an important role in the regulation of blood pressure. Aldosterone, synthesized by aldosterone synthase in the adrenal cortex is encoded by the CYP11B2 gene. In this case-control study we examined the association between CYP11B2 C-344T polymorphism and essential hypertension in south Indian Tamil population. METHODS The study was conducted in 406 hypertensive cases and 424 healthy controls from Tamil population. Genotyping was performed by PCR-restriction fragment length polymorphism method. Statistical analysis was performed by logistic regression analysis. RESULTS The 344TT homozygous variant genotype (OR-1.8; 95% CI: 1.1-2.8; P=0.02) and T allele (P=0.007) were found to be significantly associated with hypertension. In gender based analysis, the risk was significantly higher in male hypertensives (OR-1.8; 95% CI: 1.0-3.6, P=0.05) but not in female subjects. INTERPRETATION & CONCLUSION A significant association between CYP11B2 gene polymorphism and essential hypertension was observed and the risk was confined to male subjects in south Indian Tamil population.
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Rajan S, Shaaban A, Dall B, Sharma N. Flat epithelial atypia: biological significance on core biopsy. Breast Cancer Res 2010. [PMCID: PMC2978819 DOI: 10.1186/bcr2655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Lortie L, Gould WD, Rajan S, McCready RG, Cheng KJ. Reduction of Selenate and Selenite to Elemental Selenium by a Pseudomonas stutzeri Isolate. Appl Environ Microbiol 2010; 58:4042-4. [PMID: 16348829 PMCID: PMC183223 DOI: 10.1128/aem.58.12.4042-4044.1992] [Citation(s) in RCA: 157] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A Pseudomonas stutzeri isolate rapidly reduced both selenite and selenate ions to elemental selenium at initial concentrations of both anions of up to 48.1 mM. Optimal selenium reduction occurred under aerobic conditions between pH 7.0 and 9.0 and at temperatures of 25 to 35 degrees C. Reduction of both selenite and selenate was unaffected by a number of anions except for sulfite, chromate, and tungstate ions, which inhibited both growth and reduction.
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Chaudhury R, Malik SK, Rajan S. An improved pollen collection and cryopreservation method for highly recalcitrant tropical fruit species of mango (Mangifera indica L.) and litchi (Litchi chinensis Sonn.). CRYO LETTERS 2010; 31:268-278. [PMID: 20919456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
An improved method for pollen collection from freshly dehiscing anthers of mango (Mangifera indica L.) and litchi (Litchi chinensis Sonn.) using the organic solvent cyclohexane has been devised. Using this method pollen quantity sufficient for large scale pollinations could be collected and stored for future use. Transport of pollen in viable conditions over long distances, from site of collection (field genebank) to cryolab was successfully devised for both these fruit species. Cryopreservation was successfully applied to achieve long-term pollen storage over periods of up to four years. Pollen viability was tested using in vitro germination, the fluorochromatic reaction (FCR) method and by fruit set following field pollination. On retesting, four year cryostored pollen of different mango and litchi varieties showed high percentage viability as good as fresh control pollens. Pollens of more than 180 cultivars of mango and 19 cultivars of litchi have been stored in the cryogenebank using the technology developed, thus facilitating breeding programmes over the long-term.
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Vijayalakshmi K, Shyamala R, Thirumurugan V, Sethuraman M, Rajan S, Badami S, Mukherjee PK. Physico-Phytochemical investigation and Anti-inflammatory screening of Capsicum annum L. and Hemidesmus indicus (Linn.) R. Br. Anc Sci Life 2010; 29:35-40. [PMID: 22557366 PMCID: PMC3336288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Capsicum annum L. (Family: Solanaceae) and Hemidesmus indicus (Linn.) R.Br. (Family: Asclepiadaceae) are commonly used in Tamilnadufor treating various ailments in the native system of medicine. The hydroalcoholic extracts of both plants at dose level of 100 mg/kg body weight showed demonstrable anti-inflammatory activity in the carrageenan-induced hind paw model in rats. Nevertheless, the overall anti-inflammatory activity exhibited by the extracts are found to be less as compared with that of standard drug Indometacin. Preliminary physico-phytochemical analysis of the plants in question were attempted. The results are highlighted and discussed.
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Hearn R, Tecle M, Rajan S, Edmonds N. Massive transfusion in paediatric trauma: a single-centre experience. Crit Care 2010. [PMCID: PMC2934220 DOI: 10.1186/cc8611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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86
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Patterson D, Rajan S, Kohli N. Combined Abdominal and Vaginal Prolapse Repair: Is Order Important? J Minim Invasive Gynecol 2009. [DOI: 10.1016/j.jmig.2009.08.380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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87
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Patterson D, Rajan S, Kohli N. Sling Plication for Recurrent Stress Urinary Incontinence. J Minim Invasive Gynecol 2009. [DOI: 10.1016/j.jmig.2009.08.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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88
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Clifton B, Rajan S, Edmonds N, Vaidya M. Cervical spine clearance in paediatric trauma: are we clear? Arch Emerg Med 2009. [DOI: 10.1136/emj.2009.082099g] [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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Rajan S, Mankad K, Wason AM, Carder P. Role of large volume 'mammotome' biopsy in the management of screen-detected radial scars. Breast Cancer Res 2009. [PMCID: PMC4284840 DOI: 10.1186/bcr2379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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90
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Harish A, Hatibu S, Ramkumar SR, Rajan S, Ajit S M. Aneurysm of mitral aortic intervalvular fibrosa--a case report and review. Indian Heart J 2009; 61:394-396. [PMID: 20635750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Aneurysm of mitral aortic intervalvular fibrosa is a rare but dreaded complication of aortic valve endocarditis. We report a patient with large aneurysm of mitral aortic intervalvular fibrosa that ruptured into left atrium, secondary to aortic valve endocarditis. Patient underwent a successful surgical repair.
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Ramu P, Rajan S, Shewade DG, Swaminathan RP, Dutta TK, Balachander J, Adithan C. GENETIC VARIANTS OF β1-ADRENOCEPTOR GENE POLYMORPHISMS (SER49GLY AND ARG389GLY) AND ESSENTIAL HYPERTENSION IN A SOUTH INDIAN TAMIL POPULATION. Clin Exp Pharmacol Physiol 2009; 36:576-82. [DOI: 10.1111/j.1440-1681.2008.05117.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Keshava Prasad H, Nelsen DA, Siegel ER, Raval GG, Rajan S, Hutchins LF. Venous thromboembolism (VTE) and erythropoiesis-stimulating agents (ESAs) in breast cancer: a single tertiary care center experience from the University of Arkansas for Medical Sciences (UAMS). Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-6137] [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
Abstract #6137
Introduction: ESAs have been associated with increased rates of death, myocardial infarction, stroke and venous thromboembolism(VTE) in dialysis patients especially when targeted to higher hemoglobin levels. VTE and progression of cancer have also been reported in cancer patients receiving ESAs with chemo- and/ or radiotherapy, without a strict correlation with hemoglobin levels. ESAs are the subject of intense scrutiny by the FDA and the center for Medicare and Medicaid Services. We conducted a retrospective cohort study of a relatively homogeneous group of breast cancer patients. The objectives were to detect any increased risk of VTE with ESA exposure, and to correlate it with the hemoglobin/hematocrit levels.
 Methods: Data were extracted from Logician, an electronic medical record database used in the Medical Oncology Clinic at UAMS. The study cohort included breast cancer patients treated at UAMS with chemotherapy between July 1, 2004 and July 1, 2007. Patients with prior history of VTE were excluded. The patients were followed until September 9, 2007 for ESA(Erythropoietin/Darbepoietin) exposure and development of VTE. The association between ESA exposure and VTE development was assessed using Cox regression with ESA exposure as a time-dependent covariate, and the results were reported as the hazard ratio (HR) along with associated chi-square statistic and p value.
 Results: 483 patients (482 female, 1 male) met the study inclusion criteria. Median (range) age was 56 yrs (27-89). 107 (22%) were African American, 361 (75%) were Caucasian, and 15 (3%) in other categories. 9 out of the total 483 pts (1.86%) developed a VTE [7 Deep Vein Thromboses (DVTs) and 2 pulmonary embolism (PE)]. 63 subjects (13%) were exposed to ESAs during the study period, and 1 of them developed a DVT. The mean Hgb/Hct in the 62 patients exposed to ESAs who did not develop VTE was 11.34/35.26; the 1 patient exposed to ESA with DVT had a Hgb/Hct of 12.5/37.9. Among the 420 patients not exposed to ESAs, 6 developed a DVT; their mean Hgb/Hct was 12.95/39.4. The 414 pts without a DVT had mean Hgb/Hct of 12.66/38.55. Comparisons of the Hgb/Hct values in the various groups with or without VTE and, with or without ESA exposure showed no significant differences between any of the groups. Cox regression showed little evidence of increased risk with ESA use for either VTEs in general (HR=1.83; X21=0.57, P=0.45) or DVT in particular (HR=1.08; X21=0.005, P=0.94).
 Conclusions: The number of VTEs in the study patients was very small, and much lower than previous reports. There was no evidence of increased risk of VTE from ESA exposure. However, due to the small number of events, this study lacked the power to detect an ESA effect unless the effect was huge. On the other hand, the very small number of VTEs in the ESA- exposed patients to may reflect our conservative ESA usage in breast cancer patients, and is reassuring that when used appropriately, ESA use is safe.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6137.
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Meyyanathan SN, Muralidharan S, Rajan S, Gopal K, Suresh B. A Simple Sample Preparation with HPLC - UV Method for Estimation of Amlodipine from Plasma: Application to Bioequivalence Study. ACTA ACUST UNITED AC 2008. [DOI: 10.2174/1875038900801010022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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94
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Sahoo AK, Narayanan N, Rajan S, Mukherjee PK. A Flavonoid Glycoside from the Leaves of Morinda Tinctoria. Nat Prod Commun 2008. [DOI: 10.1177/1934578x0800300919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Tilianin (acacetine-7- O-β-D-glucopyranoside) was isolated from the ethyl acetate extract of Morinda tinctoria Roxb. and its structure established unambiguously by a series of 1D- and 2D-NMR analyses. This is the first record of this compound for this species. The antioxidant activity of tilianin, determined using the DPPH scavenging assay, was measured with an IC50 value of 57.5 μg/mL.
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Keshava Prasad H, Nelsen D, Siegel ER, Raval G, Rajan S, Hutchins LF. Risk of venous thromboembolism (VTE) in breast cancer patients receiving erythropoietin for chemotherapy-induced anemia: A Tertiary Cancer Center experience from the University of Arkansas for Medical Sciences. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.20621] [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
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Rajan S, Budd E, Stevenson M, Doraiswami R. Unsupervised and uncued segmentation of the fundamental heart sounds in phonocardiograms using a time-scale representation. CONFERENCE PROCEEDINGS : ... ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL CONFERENCE 2008; 2006:3732-5. [PMID: 17946201 DOI: 10.1109/iembs.2006.260777] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A methodology is proposed to segment and label the fundamental activities, namely the first and second heart sounds, S1 and S2of the phonocardiogram (PCG). Information supplementary to the PCG, such as a cue from a synchronously acquired electrocardiogram (ECG), subject-specific prior information, or training examples regarding the activities, is not required by the proposed methodology. A bank of Morlet wavelet correlators is used to obtain a time-scale representation of the PCG. An energy profile of the time-scale representation and a singular value decomposition (SVD) technique are used to identify segments of the PCG that contain the fundamental activities. The robustness of the methodology is demonstrated by the correct segmentation of over 90% of 1068 fundamental activities in a challenging set of PCGs which were recorded from patients with normally functioning and abnormally functioning bioprosthetic valves. The PCGs included highly varying fundamental activities that overlapped in time and frequency with other aberrant non-fundamental activities such as murmurs and noise-like artifacts.
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Badami S, Geetha B, Sharma SV, Rajan S, Suresh B. Microwave-assisted rapid extraction of red dye from Caesalpinia sappan heartwood. Nat Prod Res 2007; 21:1091-8. [PMID: 17852745 DOI: 10.1080/14786410500160744] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Since ancient times Caesalpinia sappan heartwood dye has been well-known for its medicinal and dyeing properties. Isolation of the red dye using both conventional and newly developed microwave method was carried out. The conventional heating of 2 h provided 0.656 +/- 0.049 g of the dye and by microwave heating at 540 W for 20 min, the yield obtained was 0.747 +/- 0.047 g. Both the dyes were found to be the same as evidenced by UV, TLC and HPTLC studies. Antioxidant activity of the dyes was also carried out using DPPH and nitric oxide methods to confirm the similarity in their biological activity. The procedure developed can be used for the fast extraction of the red dye of C. sappan without affecting the nature of the product.
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Meyyanathan SN, Krishnaveni N, Suresh B, Gopinath R, Rajan S. A RP-HPLC method for simultaneous estimation of paracetamol and aceclofenac in tablets. Indian J Pharm Sci 2007. [DOI: 10.4103/0250-474x.32130] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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99
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Foca M, Rajan S, Saiman L. Rational treatment of pulmonary infections in patients with cystic fibrosis. Curr Opin Infect Dis 2006; 12:257-63. [PMID: 17035789 DOI: 10.1097/00001432-199906000-00017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The life expectancy of patients with cystic fibrosis has increased markedly during the past two decades due in large part to improved clinical care, including the use of more effective antimicrobial agents for Pseudomonas. However, the chronic lung disease of CF remains the principal cause of mortality. A growing understanding of the complex interactions between infection and inflammation has led to new approaches for treatment, including chronic use of aerosolized antibiotics, particularly tobramycin, in patients known to be colonized/infected with P. aeruginosa and anti-inflammatory treatments to slow the progression of lung disease.
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Naveen AT, Prasanna T, Farzana BL, Rajan S, Adithan C. CYP2D6 genotype and phenotype relationship in South Indians. J Postgrad Med 2006; 52:253-6. [PMID: 17102541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Genotypes of the drug-metabolizing enzyme CYP2D6 influence plasma levels of 25% of commonly prescribed drugs. This is the first study in India to investigate the genotype-phenotype relationship of CYP2D6. AIM To study the influence of some CYP2D6 genotypes on the metabolism of its substrate dextromethorphan in healthy South Indian volunteers and to assess the contribution of the CYP2D6*10 and CYP2D6*4 alleles. MATERIALS AND METHODS Twenty-six subjects from a previous CYP2D6 genotyping study of healthy volunteers were included for phenotyping in this study. Selected volunteers belonged to any one of three genotype groups:Group I - two normal activity alleles, Group II - one reduced activity allele and one normal activity allele and Group III - one loss of function allele along with either a wild type or reduced activity allele. Volunteers were phenotyped for the CYP2D6 enzyme using dextromethorphan as probe drug. Concentrations of the parent drug and metabolite dextrorphan were estimated using high performance liquid chromatography. Metabolic ratios were calculated as the ratio of parent drug to metabolite in 0-8h urine samples. STATISTICAL ANALYSIS Metabolic ratios from each genotype group were compared using the Mann-Whitney test at 5% significance, to observe their difference between genotype groups. RESULTS The mean metabolic ratios+/-SD in Groups I, II and III were 0.0039+/-0.0031, 0.0032+/-0.0017 and 0.0391+/-0.0331 respectively. The mean metabolic ratio of Group III was significantly higher when compared with Groups I or II. In heterozygous individuals, the *1 or *2 alleles compensated for the reduced enzyme activity due to the *10 allele. However, if a heterozygous individual had a *4 allele, the reduced enzyme activity could not be compensated by the *1 or *2 alleles. CONCLUSIONS The CYP2D6 enzyme activity was found to be decreased in individuals carrying *4 or *5 alleles. The *1 or *2 allele could compensate for the reduced function due to *10 allele, but not for the loss of function due to *4 allele.
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