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Pfitzner J, Stevens HJ, Rao V, Close JS, Lance DG. One-lung ventilation in a patient with an organizing empyema and severe idiopathic pulmonary fibrosis. Br J Anaesth 2006; 97:266-8. [PMID: 16831882 DOI: 10.1093/bja/ael167] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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177
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Manimaran N, Rao V, Cheetham MJ. Local recurrence after curative resection for rectal cancer is associated with anterior position of the tumour (Br J Surg 2006; 93: 105-112). Br J Surg 2006; 93:769. [PMID: 16703649 DOI: 10.1002/bjs.5476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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178
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Rao V, Spiro JR, Rosenberg PB, Lee HB, Rosenblatt A, Lyketsos CG. An open-label study of escitalopram (Lexapro) for the treatment of 'Depression of Alzheimer's disease' (dAD). Int J Geriatr Psychiatry 2006; 21:273-4. [PMID: 16477587 DOI: 10.1002/gps.1459] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Depression is a frequent neuropsychiatric complication of Alzheimer's Disease. METHODS This study investigated the safety and effectiveness of escitalopram (LEXAPRO) for depression in AD (dAD) as defined by the NIMH consensus criteria in an 8-week, open-label treatment study. CONCLUSION Escitalopram was efficacious and safe for the treatment of dAD in this study. Larger, controlled studies are warranted to further assess the efficacy for mood and behavioral disturbances in this medically fragile population.
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Ramzy D, Tumiati L, Xu N, Khan N, Miriuka S, Delgado D, Ross H, Rao V. 138. J Heart Lung Transplant 2006. [DOI: 10.1016/j.healun.2005.11.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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180
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Zieroth S, Ross H, Rao V, Cusimano R, Delgado D, Thevarajah M, Cameron D, Nanthakumar K. 226. J Heart Lung Transplant 2006. [DOI: 10.1016/j.healun.2005.11.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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181
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Rao V, Dhar N, Shakila H, Singh R, Khera A, Jain R, Naseema M, Paramasivan CN, Narayanan PR, Ramanathan VD, Tyagi AK. Increased expression of Mycobacterium tuberculosis 19 kDa lipoprotein obliterates the protective efficacy of BCG by polarizing host immune responses to the Th2 subtype. Scand J Immunol 2005; 61:410-7. [PMID: 15882432 DOI: 10.1111/j.1365-3083.2005.01569.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Mycobacterium tuberculosis can not only neutralize immune effector functions, but also has the ability to modulate host-signalling cascades involved in the development of these responses. The 19 kDa antigen (Rv3763), a lipoprotein of M. tuberculosis, elicits high levels of interleukin (IL)-12 from macrophages in addition to its powerful immunomodulatory properties, leading to suppression of antigen-presentation signalling cascades. The present study was aimed at analysing the effect of overexpression of this antigen on the immunostimulatory properties of M. bovis Bacille Calmette-Guerin (BCG). We have constructed a recombinant BCG strain (rBCG19N) producing higher levels of the 19 kDa antigen in both the cytoplasmic (approximately eightfold) and extracellular (approximately fivefold) fractions as compared to the wildtype BCG. Immunization of mice with rBCG19N elicited high levels of interferon-gamma (IFN-gamma) and relatively low levels of IL-10 against the purified 19 kDa antigen. However, in response to total BCG sonicate, mice immunized with rBCG19N produced significantly high levels of IL-10 with relatively very low levels of IFN-gamma. This polarization of the host immune responses towards T-helper 2 subtype resulted in complete abrogation of the protective efficacy of BCG, when rBCG19N was used as a live vaccine against M. tuberculosis challenge in guinea pigs.
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182
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Geaney C, Dale J, Dugan F, Rao V, Fleisher T, Straus S. Streptococcal pneumoniae sepsis in splenectomized patients with Autoimmune Lymphoproliferative Syndrome (ALPS). J Allergy Clin Immunol 2005. [DOI: 10.1016/j.jaci.2004.12.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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183
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Ramzy D, Tumiati L, Xu N, Miriuka S, Delgado D, Ross H, Rao V. Corticosteroids enhance cyclosporine-induced vascular injury: Interactive effect between endothelin-1 and nitric oxide bioavailability. J Heart Lung Transplant 2005. [DOI: 10.1016/j.healun.2004.11.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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184
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Miriuka S, Rao V, Peterson M, Tumiati L, Delgado D, Mohan R, Ramzy D, Ross H, Waddell T. Sirolimus induces endothelial progenitor cell apoptosis. J Heart Lung Transplant 2005. [DOI: 10.1016/j.healun.2004.11.057] [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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185
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Doenst T, Rao V, Weisel R, Yau T, Maganti M, Borger M. Are patients with ventricular dysfunction more tolerant to ischemia? Thorac Cardiovasc Surg 2005. [DOI: 10.1055/s-2005-861997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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186
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Vijayashree B, Ahuja YR, Regniers L, Rao V, Verschaeve L. Genotoxicity of the Musi River (Hyderabad, India) investigated with the VITOTOX test. Folia Biol (Praha) 2005; 51:133-9. [PMID: 16285206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The bacterial VITOTOX genotoxicity test was used to screen water samples collected from three different stations along the banks of the river Musi, in Hyderabad, India. Water was collected at three stations that differed from each other in the nature of the surrounding industrial and other activities. A number of different pollutants were also measured in water, soil and air samples. The three stations were found highly polluted and different with regard to the genotoxicity and toxicity of their samples. These results demonstrate the need for further biological studies in this area to generate valuable data on genomic instability, risk assessment of cancer, and to provide avenues for risk management.
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Abstract
INTRODUCTION Rabbit antithymocyte globulin (RATG) is recommended for central administration, and no evidence justifies the common practice of adding heparin to the bag, but the evaluation of thrombocytopenia may be complicated by coadministration. We recently phased out the use of heparin in RATG in our kidney and kidney-pancreas transplant recipients but subsequently observed several episodes of deep vein thrombosis (DVT), so we sought to determine the factors linked to DVT during RATG therapy. METHODS A search of billing and diagnosis codes for RATG and DVT in one hospital revealed relevant admissions from January 2000 to April 2004. RESULTS Patients (n=288) received 330 courses of RATG (central or peripheral), and nine were diagnosed with DVT. Four patients were excluded because the diagnosis was not confirmed by Doppler ultrasound (n=1), DVT occurred more than 10 days after RATG discontinuation (n=2), or DVT occurred after switching to equine antithymocyte globulin (n=1). All patients (n=5) who developed DVT related to RATG exhibited prior infusion-related reactions, received peripherally administered RATG with premedication (methylprednisolone, diphenhydramine, and acetaminophen), and did not receive heparin. The DVT occurred near the site of the infusion in 60% of cases. Four of the patients were male, and 80% had diabetes (one developed posttransplant), and all included patients received infusions over at least 6 hours for the first dose, and at least 4 hours for subsequent doses. CONCLUSIONS These results provide justification for adding heparin to the RATG bag, especially when administered peripherally.
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Blass DM, Hatanpaa KJ, Brandt J, Rao V, Steinberg M, Troncoso JC, Rabins PV. Dementia in hippocampal sclerosis resembles frontotemporal dementia more than Alzheimer disease. Neurology 2004; 63:492-7. [PMID: 15304580 DOI: 10.1212/01.wnl.0000133008.89613.82] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To characterize the clinical course of pathologically diagnosed hippocampal sclerosis dementia (HSD). BACKGROUND Dementia associated with HSD is incompletely characterized. Previous studies suggest similarities to both Alzheimer disease (AD) and frontotemporal dementia (FTD). METHODS Case-control analysis of the clinical course of patients with HSD, FTD, and AD from a neuropathology autopsy series conducted by a university hospital. Case histories were reviewed. Cumulative prevalence of behavioral, cognitive, psychiatric, and language symptoms were compared between groups, as was time of symptom onset. Clinical diagnostic criteria for FTD and AD were applied to case histories. Sensitivity and specificity of clinical FTD diagnostic criteria (Report of the Work Group on FTD and Pick's disease) were computed. RESULTS Cumulative prevalence of symptoms in HSD was most similar to that of FTD and differed from AD. Behavioral abnormalities such as decreased grooming and inappropriate behavior were more prevalent in HSD and FTD than AD. Hyperorality, inappropriate behavior, and decreased interest had earlier onset in HSD and FTD. Cognitive symptoms of disorientation, dyscalculia, apraxia, and agnosia were more prevalent in AD, as were psychiatric symptoms of hallucinations, delusions, and aggression. Most HSD patients met diagnostic criteria for FTD. Criteria sensitivity was 64.0% and specificity was 73.7%. CONCLUSIONS FTD is a clinical syndrome associated with heterogeneous neuropathology. The clinical course of HSD is more similar to that of FTD than AD. These findings, together with the neuropathologic data presented in the accompanying article, support expanding the scope of FTD (Pick complex) to include HSD.
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Miriuka S, Delgado D, Wong B, Wang J, Rao V, Cole D, Hegele R, Ross H. Common chemokine receptor single nucleotide polymorphisms are associated with transplant vasculopathy in heart transplant recipients. J Heart Lung Transplant 2004. [DOI: 10.1016/j.healun.2003.11.359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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190
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Doenst T, Wijeysundera D, Karkouti K, Zechner C, Maganti M, Rao V, Borger MA. Hyperglycemia as risk factor for mortality in cardiac surgery – Is there a role of insulin resistance? Thorac Cardiovasc Surg 2004. [DOI: 10.1055/s-2004-816724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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191
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Rao V, Dhar N, Tyagi AK. Modulation of Host Immune Responses by Overexpression of Immunodominant Antigens of Mycobacterium tuberculosis in Bacille Calmette-Guerin. Scand J Immunol 2003; 58:449-61. [PMID: 14507310 DOI: 10.1046/j.1365-3083.2003.01321.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Based on their immunodominant nature and ability to induce appropriate immune responses in the host, several antigens of Mycobacterium tuberculosis have shown promise of protection. However, most of the candidate vaccines developed by employing various strategies have afforded protection that is at best comparable with bacillus Calmette-Guérin (BCG) in animal models. Due to the inherent ability of BCG to prime cellular responses in the host, it has become an attractive vehicle for development of a vaccine against intracellular infections. In this study, we have cloned the genes of three immunodominant antigens of M. tuberculosis viz. the ESAT6 (Rv3875), the 19 kDa lipoprotein (Rv3763) and the 38 kDa antigen (Pst homolog) (Rv0934) in pSD5 under the transcriptional control of Trrn, a strong mycobacterial promoter, and expressed them in BCG. The19 kDa antigen and the 38 kDa antigen were expressed at levels that were approximately five and eightfolds higher in the cytosols of recombinant BCG strains rBCG19T and rBCG38T, respectively, as compared with their corresponding levels in M. bovis BCG. Both these antigens were also secreted into the extracellular medium at enhanced levels (19 kDa antigen fourfold and 38 kDa antigen twofold) by rBCG strains in comparison with the wild type BCG. ESAT6 antigen, which is absent in M. bovis BCG, was also expressed at a very high level in the cytosol of the rBCG strain (rBCGE6T). Evaluation of immune responses induced by these three rBCG strains in mice shows a markedly different pattern. The rBCG strain overexpressing the 38 kDa antigen exhibited a predominant T helper 1 (Th1) response with high levels of interferon-gamma (IFN-gamma) production, whereas overexpression of the 19 kDa antigen resulted in completely polarized Th2 responses against the BCG sonicate. The rBCG-expressing ESAT6 antigen induced a mixed Th1/Th2 response. Our observations suggest that the 38 kDa antigen may hold excellent promise in the rBCG approach for the development of a vaccine against tuberculosis.
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Rao V, Targett JPG. INSTABILITY AFTER TOTAL KNEE REPLACEMENT WITH A MOBILE-BEARING PROSTHESIS IN A PATIENT WITH MULTIPLE SCLEROSIS. ACTA ACUST UNITED AC 2003. [DOI: 10.1302/0301-620x.85b5.13847] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We describe a patient with multiple sclerosis (MS), who developed recurrent dislocations after total knee arthroplasty. She had both knees replaced using similar mobile-bearing knee prostheses, but the outcome was worse in the leg which was more severely affected with MS.
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Rao V, Targett JPG. Instability after total knee replacement with a mobile-bearing prosthesis in a patient with multiple sclerosis. THE JOURNAL OF BONE AND JOINT SURGERY. BRITISH VOLUME 2003; 85:731-2. [PMID: 12892199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
We describe a patient with multiple sclerosis (MS), who developed recurrent dislocations after total knee arthroplasty. She had both knees replaced using similar mobile-bearing knee prostheses, but the outcome was worse in the leg which was more severely affected with MS.
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Abstract
Sirolimus was used as a single agent for maintenance immunosuppression in a pilot trial of 29 primary kidney transplant patients using lymphocyte depletion with Campath-1H as an induction strategy. This allowed sirolimus to be analyzed (dose, blood level, and side effect profile) in the absence of steroid and calcineurin inhibitors. A sirolimus dose of 4 mg/day resulted in blood levels in the 8 to 9 ng/mL range. Of the 29 patients, 8 patients (28%) had rejection. The sirolimus levels were not significantly different in patients with or without rejection. The cardiovascular risk profile in terms of lipid profile and hypertension control was favorable. Increase in cholesterol and triglyceride levels at one month (not statistically significant) necessitated treatment in 60% of patients with decline in levels by 6 and 12 months. Management of hypertension was also favorable with the majority of patients (55%) being on one hypertensive medication. Sirolimus monotherapy was well tolerated on the whole. Wound healing, leukopenia, and anemia were not significant problems. In conclusion, monotherapy has been well tolerated with a favorable side effect profile. However, a rejection rate of 28% was noted.
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Liu P, Arnold JM, Belenkie I, Demers C, Dorian P, Gianetti N, Haddad H, Howlett J, Ignazewski A, Jong P, McKelvie R, Moe G, Parker JD, Rao V, Rouleau JL, Teo K, Tsuyuki R, White M, Huckel V, Issac D, Johnstone D, LeBlanc MH, Lee H, Newton G, Niznick J, Ross H, Roth S, Roy D, Smith S, Sussex B, Yusuf S. The 2002/3 Canadian Cardiovascular Society consensus guideline update for the diagnosis and management of heart failure. Can J Cardiol 2003; 19:347-56. [PMID: 12704478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
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Abstract
Heart transplantation remains the treatment of choice for end-stage heart failure despite limited donor availability and allograft durability. Artificial heart technology was initially developed as a replacement for transplantation but the initial experience with these technologies was disappointing. The quest for a total artificial heart has largely been abandoned in favor of ventricular assist devices (VADs). VADs have gained widespread acceptance as bridge to transplant and bridge to recovery therapy. After more than a decade of clinical use, several FDA approved device designs have proved effective in treating patients with various causes of heart failure. This review describes the current, clinically available ventricular replacement and assist devices and defines the adult patient populations in which they are useful. The next generation of these devices will soon become available and their clinical utility will likely shape the future direction of heart failure therapy. Ultimately the concept of a long-term total artificial heart may be revisited.
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Delgado D, Rao V, Cusimano R, Feindel C, Grady C, Hamel M, Young E, McCurdy C, Ross H. Monitoring of cyclosporine 2-hr post-dose and trough levels in heart transplantation. J Heart Lung Transplant 2002. [DOI: 10.1016/s1053-2498(01)00565-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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198
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Miriuka S, Rao V, Weisel R, Li SH, Anderson T, Maitland A, Fedak P, Li R, Verma S. Cyclosporin induced endothelial dysfunction: effects of the nitric oxide cofactor, tetrahydrobiopterin. J Heart Lung Transplant 2002. [DOI: 10.1016/s1053-2498(01)00644-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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199
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Liu P, Arnold M, Belenkie I, Howlett J, Huckell V, Ignazewski A, LeBlanc MH, McKelvie R, Niznick J, Parker JD, Rao V, Ross H, Roy D, Smith S, Sussex B, Teo K, Tsuyuki R, White M, Beanlands D, Bernstein V, Davies R, Issac D, Johnstone D, Lee H, Moe G, Newton G, Pflugfelder P, Roth S, Rouleau J, Yusuf S. The 2001 Canadian Cardiovascular Society consensus guideline update for the management and prevention of heart failure. Can J Cardiol 2001; 17 Suppl E:5E-25E. [PMID: 11773943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
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200
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Li RK, Mickle DA, Weisel RD, Rao V, Jia ZQ. Optimal time for cardiomyocyte transplantation to maximize myocardial function after left ventricular injury. Ann Thorac Surg 2001; 72:1957-63. [PMID: 11789777 DOI: 10.1016/s0003-4975(01)03216-7] [Citation(s) in RCA: 105] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study was designed to determine the optimal time for cell transplantation after myocardial injury. METHODS The left ventricular free wall of adult rat hearts was cryoinjured and the animals were sacrificed at 0, 1, 2, 4, and 8 weeks for histologic studies. Fetal rat cardiomyocytes (transplant) or culture medium (control) were transplanted immediately (n = 8), 2 weeks (n = 8), and 4 weeks (n = 12) after cryoinjury. At 8 weeks, rat heart function, planimetry, and histologic studies were performed. RESULTS Cryoinjury produced a transmural injury. The inflammatory reaction was greatest during the first week but subsided during the second week after cryoinjury. Scar size expanded (p < 0.01) at 4 and 8 weeks. Cardiomyocytes transplanted immediately after cryoinjury were not found 8 weeks after cryoinjury. Scar size and myocardial function were similar to the control hearts. Cardiomyocytes transplanted at 2 and 4 weeks formed cardiac tissue within the scar, limited (p < 0.01) scar expansion, and had better (p < 0.001) heart function than the control groups. Developed pressure was greater (p < 0.01) in the hearts with transplanted cells at 2 weeks than at 4 weeks. CONCLUSIONS Cardiomyocyte transplantation was most successful after the inflammatory reaction resolved but before scar expansion.
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