1
|
Jin L, Xie Z, Lorkiewicz P, Srivastava S, Bhatnagar A, Conklin DJ. Endothelial-dependent relaxation of α-pinene and two metabolites, myrtenol and verbenol, in isolated murine blood vessels. Am J Physiol Heart Circ Physiol 2023; 325:H1446-H1460. [PMID: 37889254 DOI: 10.1152/ajpheart.00380.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/11/2023] [Accepted: 10/20/2023] [Indexed: 10/28/2023]
Abstract
Epidemiological evidence shows that residential proximity to greenspaces is associated with lower risk of all-cause and cardiovascular mortality; however, the mechanism(s) underlying this link remains unclear. Plants emit biogenic volatile organic compounds such as α-pinene that could elicit beneficial cardiovascular effects. To explore the role of α-pinene more directly, we studied the metabolism and the vascular effects of α-pinene. We found that exposure of mice to α-pinene (1 ppm, 6 h) generated two phase I oxidation metabolites, cis- and trans-verbenol [(1R,2R,5R)-verbenol and (1 R,2S,5R)-verbenol)] and myrtenol [(1S,5R)-(+)-myrtenol] that were identified in urine by GC-MS. Precontracted naïve murine male and female aorta and superior mesenteric artery (SMA) were relaxed robustly (60% tension reduction) by increasing concentrations of α-pinene, myrtenol, and verbenol to 0.3 mM, whereas 1 mM α-pinene was vasotoxic. The SMA was six times more sensitive than the aorta to α-pinene. Both myrtenol and verbenol were equally potent and efficacious as parent α-pinene in male and female SMA. The sensitive portion of the α-pinene-, myrtenol-, and verbenol-induced relaxations in male SMA was mediated by 1) endothelium, 2) eNOS-derived NO, and 3) guanylyl cyclase (GC) activity. Moreover, α-pinene activated the transient receptor potential ankyrin-1 (TRPA1) channel whereas the metabolites did not. Endothelial-derived NO regulates blood flow, blood pressure, and thrombosis, and it is plausible that inhaled (and ingested) α-pinene (or its metabolites) augments NO release to mediate the cardiovascular benefits of exposure to greenness.NEW & NOTEWORTHY A common plant-derived biogenic volatile organic compound, α-pinene, and two of its metabolites, myrtenol and verbenol, stimulate vasorelaxation in murine superior mesenteric artery. Both α-pinene- and its metabolites induce vasorelaxation by activation of the endothelium, nitric oxide, and guanylyl cyclase. α-Pinene also activates the transient receptor potential ankyrin-1. Positive associations between greenness exposure and human cardiovascular health may be a result of the vascular action of α-pinene and its metabolites, a novel consideration.
Collapse
Affiliation(s)
- L Jin
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, United States
| | - Z Xie
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, United States
- Division of Environmental Medicine, Department of Medicine, University of Louisville, Louisville, Kentucky, United States
| | - P Lorkiewicz
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, United States
- Division of Environmental Medicine, Department of Medicine, University of Louisville, Louisville, Kentucky, United States
| | - S Srivastava
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, United States
- Division of Environmental Medicine, Department of Medicine, University of Louisville, Louisville, Kentucky, United States
| | - A Bhatnagar
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, United States
- Division of Environmental Medicine, Department of Medicine, University of Louisville, Louisville, Kentucky, United States
| | - D J Conklin
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, United States
- Division of Environmental Medicine, Department of Medicine, University of Louisville, Louisville, Kentucky, United States
| |
Collapse
|
2
|
Bhatnagar A, Collins B, Collins SP, Jean W, Aulisi E, Harris B, Nayar V, Anaizi A, Watson J, Carrasquilla M, Suy S, Conroy D. Marginless 5-Fraction Robotic Radiosurgery for Unfavorable Nonfunctioning Pituitary Macroadenoma: 5-year Outcomes from a Single Institution Protocol. Int J Radiat Oncol Biol Phys 2023; 117:e165. [PMID: 37784765 DOI: 10.1016/j.ijrobp.2023.06.1000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Nonfunctioning macroadenoma is a commonly diagnosed pituitary tumor. Resection is the favored treatment, with radiosurgery often utilized for residual or progressing disease. Long-term outcomes are established for single-session radiosurgery, but mature outcomes are lacking for multisession radiosurgery. We report our institution's 5-year efficacy and safety results for unfavorable nonfunctioning pituitary macroadenoma patients treated with marginless 5-fraction robotic radiosurgery. MATERIALS/METHODS Between 2010-2020, patients who completed marginless 5-fraction radiosurgery for the treatment of unfavorable nonfunctioning pituitary macroadenomas were included. A tumor was considered unfavorable if the gross tumor volume (GTV) was larger than 5 cc or if it closely approached a critical structure (optic apparatus, brainstem or pituitary gland). Local control was calculated using the Kaplan-Meier Method. RESULTS Twenty predominately female patients (60%), age from 21-77 (median: 53 years) were included in this study. All underwent primary resection. Indications for radiosurgery included unresectable recurrence (85%) and residual disease progression (70%). Median tumor volume was 3.4 cm3 (range: 0.3-20.8 cm3) and 40% of the tumors were suprasellar. A mean dose of 28.8 Gy (range: 25 Gy-30 Gy), was delivered to a median isodose line of 80% (range: 75%-89%). The median optic chiasm maximum point dose was 21.8 Gy (range: 12.0-25.9 Gy). Toxicity was minimal with 12 patients (40%) developing acute short-lived headaches and 1 patient (5%) developing a brief ipsilateral 6th nerve palsy. There was no radiation induced optic or pituitary dysfunction identified in this cohort. At a median follow up of 5 years local control was 95%. There was 1 in-field failure pathologically confirmed following surgery for pituitary tumor hemorrhage and 2 radiographically confirmed out-of-field failures in patients with large tumors (>20 cc). CONCLUSION The treatment of unfavorable nonfunctioning pituitary macroadenoma with marginless 5-fraction robotic radiosurgery provides excellent local control to date, with minimal toxicity. However, tumors with GTV's greater than 20 cc may require conventionally fractionated treatment with a margin to optimize local control.
Collapse
Affiliation(s)
- A Bhatnagar
- Department of Radiation Medicine, MedStar Georgetown University Hospital, Washington, DC
| | | | - S P Collins
- Department of Radiation Medicine, MedStar Georgetown University Hospital, Washington, DC
| | - W Jean
- Lehigh Valley Health Network, Leigh County, PA
| | - E Aulisi
- Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC
| | - B Harris
- Department of Pathology, Medstar Georgetown University Hospital, Washington, DC
| | - V Nayar
- Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC
| | - A Anaizi
- Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC
| | - J Watson
- Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC
| | - M Carrasquilla
- Department of Radiation Medicine, MedStar Georgetown University Hospital, Washington, DC
| | - S Suy
- Department of Radiation Medicine, MedStar Georgetown University Hospital, Washington, DC
| | - D Conroy
- Department of Radiation Medicine, MedStar Georgetown University Hospital, Washington, DC
| |
Collapse
|
3
|
Kaur M, Bhatnagar A, Dhillon O, Yadav AS. Genotoxic Effects of Rice-Agrochemicals on Channa punctatus (Bloch) and Cyprinus carpio (Linnaeus) Using Micronucleus Assay and Alkaline Single Cell Gel Electrophoresis. Nat Env Poll Tech 2022. [DOI: 10.46488/nept.2022.v21i04.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Rice-cum-fish culture is a cost-effective practice for marginal farmers but the major constraint is the indiscriminate use of agrochemicals. Present work was designed to assess the genotoxic effects of rice agrochemicals in Channa punctatus (Experiment 1 CP1 to CP3) and Cyprinus carpio (Experiment 2 CC1 to CC3); using micronucleus, chromosome aberration, and single cell gel electrophoresis/Comet assay. Two experiments with three treatments (CP1/CC1: without pesticide; CP2/CC2: recommended doses; CP3/CC3: farmers’ dose) were maintained in triplicates. The presence of tail DNA and micronuclei depicted significant DNA damage (P<0.05) in all the treated fish. The mean percent frequency of MN showed significant (P<0.05) differences with respect to the initial. The chromosomal aberrations and mean frequencies of tail DNA (%) were significantly abundant in CP3 and CC3 indicating high a genotoxic effect. Keeping in view the low genotoxic effects, treatment of CP2 and CC2 with recommended doses of pesticides may be disseminated to farmers.
Collapse
|
4
|
Ghanem A, Bhatnagar A, Elshaikh M, Burmeister C, Elshaikh M. Recurrence Risk Stratification for Women with FIGO Stage I Uterine Endometrioid Carcinoma Who Underwent Surgical Lymph Node Evaluation. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
5
|
Jones AM, Clode L, Fenton P, Bates A, Bhatnagar A. OA08.05 A Quality Improvement Project Determining if Dietitian Input with the UHS Lung Oncology Team Improved Patient Outcomes. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
6
|
Holm RH, Nagarkar M, Yeager RA, Talley D, Chaney AC, Rai JP, Mukherjee A, Rai SN, Bhatnagar A, Smith T. Surveillance of RNase P, PMMoV, and CrAssphage in wastewater as indicators of human fecal concentration across urban sewer neighborhoods, Kentucky. FEMS Microbes 2022; 3:1-12. [PMID: 37228897 PMCID: PMC10117713 DOI: 10.1093/femsmc/xtac003] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/24/2021] [Accepted: 01/25/2022] [Indexed: 09/03/2023] Open
Abstract
Wastewater surveillance has been widely used as a supplemental method to track the community infection levels of severe acute respiratory syndrome coronavirus 2. A gap exists in standardized reporting for fecal indicator concentrations, which can be used to calibrate the primary outcome concentrations from wastewater monitoring for use in epidemiological models. To address this, measurements of fecal indicator concentration among wastewater samples collected from sewers and treatment centers in four counties of Kentucky (N = 650) were examined. Results from the untransformed wastewater data over 4 months of sampling indicated that the fecal indicator concentration of human ribonuclease P (RNase P) ranged from 5.1 × 101 to 1.15 × 106 copies/ml, pepper mild mottle virus (PMMoV) ranged from 7.23 × 103 to 3.53 × 107 copies/ml, and cross-assembly phage (CrAssphage) ranged from 9.69 × 103 to 1.85 × 108 copies/ml. The results showed both regional and temporal variability. If fecal indicators are used as normalization factors, knowing the daily sewer system flow of the sample location may matter more than rainfall. RNase P, while it may be suitable as an internal amplification and sample adequacy control, has less utility than PMMoV and CrAssphage as a fecal indicator in wastewater samples when working at different sizes of catchment area. The choice of fecal indicator will impact the results of surveillance studies using this indicator to represent fecal load. Our results contribute broadly to an applicable standard normalization factor and assist in interpreting wastewater data in epidemiological modeling and monitoring.
Collapse
Affiliation(s)
- R H Holm
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, 302 E. Muhammad Ali Blvd., Louisville, KY 40202, USA
| | - M Nagarkar
- Center for Environmental Solutions and Emergency Response, United States Environmental Protection Agency, Cincinnati, OH 45220, USA
| | - R A Yeager
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, 302 E. Muhammad Ali Blvd., Louisville, KY 40202, USA
- Department of Environmental and Occupational Health Sciences, School of Public Health and Information Sciences, University of Louisville, 485 E. Gray St., Louisville, KY 40202, USA
| | - D Talley
- Louisville/Jefferson County Metropolitan Sewer District, Morris Forman Water Quality Treatment Center, 4522 Algonquin Parkway, Louisville, KY 40211, USA
| | - A C Chaney
- Sanitation District No. 1 of Northern Kentucky, 1045 Eaton Dr., Ft. Wright, Kentucky 41017, USA
| | - J P Rai
- Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, 505 S. Hancock St., Louisville, KY 40202, USA
| | - A Mukherjee
- Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, 505 S. Hancock St., Louisville, KY 40202, USA
| | - S N Rai
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, 302 E. Muhammad Ali Blvd., Louisville, KY 40202, USA
- Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, 505 S. Hancock St., Louisville, KY 40202, USA
- Brown Cancer Center, School of Medicine, University of Louisville, 505 S. Hancock St., Louisville, KY 40202, USA
- Center for Integrative Environmental Health Sciences, 500 S. Preston St., Suite 1319, Louisville, KY 40202, USA
| | - A Bhatnagar
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, 302 E. Muhammad Ali Blvd., Louisville, KY 40202, USA
| | - T Smith
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, 302 E. Muhammad Ali Blvd., Louisville, KY 40202, USA
| |
Collapse
|
7
|
Al-Ishaq Z, Asif U, Roy M, Sikdar O, Bhatnagar A, Sircar T. Glomus tumour of the nipple in a male patient. Ann R Coll Surg Engl 2021; 104:e60-e63. [PMID: 34821523 DOI: 10.1308/rcsann.2021.0141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A glomus tumour is a benign mesenchymal tumour. It is extremely rare in the breast. We report a case of glomus tumour of the nipple in a 54-year-old man. To the best of the authors' knowledge, this is the first case report of a glomus tumour of the nipple. We describe the different presenting symptoms, method of diagnosis and treatment.
Collapse
Affiliation(s)
| | - U Asif
- The Royal Wolverhampton NHS Trust, UK
| | - M Roy
- Medical School, University of Birmingham, UK
| | - O Sikdar
- Imperial College School of Medicine, UK
| | | | - T Sircar
- The Royal Wolverhampton NHS Trust, UK
| |
Collapse
|
8
|
Jin L, Lorkiewicz P, Xie Z, Bhatnagar A, Srivastava S, Conklin DJ. Acrolein but not its metabolite, 3-Hydroxypropylmercapturic acid (3HPMA), activates vascular transient receptor potential Ankyrin-1 (TRPA1): Physiological to toxicological implications. Toxicol Appl Pharmacol 2021; 426:115647. [PMID: 34271065 PMCID: PMC8343963 DOI: 10.1016/j.taap.2021.115647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 11/17/2022]
Abstract
Acrolein, an electrophilic α,β-unsaturated aldehyde, is present in foods and beverages, and is a product of incomplete combustion, and thus, reaches high ppm levels in tobacco smoke and structural fires. Exposure to acrolein is linked with cardiopulmonary toxicity and cardiovascular disease risk. The hypothesis of this study is the direct effects of acrolein in isolated murine blood vessels (aorta and superior mesenteric artery, SMA) are transient receptor potential ankyrin-1 (TRPA1) dependent. Using isometric myography, isolated aorta and SMA were exposed to increasing levels of acrolein. Acrolein inhibited phenylephrine (PE)-induced contractions (approximately 90%) in aorta and SMA of male and female mice in a concentration-dependent (0.01-100 μM) manner. The major metabolite of acrolein, 3-hydroxypropylmercapturic acid (3HPMA), also relaxed PE-precontracted SMA. As the SMA was 20× more sensitive to acrolein than aorta (SMA EC50 0.8 ± 0.2 μM; aorta EC50 > 29.4 ± 4.4 μM), the mechanisms of acrolein-induced relaxation were studied in SMA. The potency of acrolein-induced relaxation was inhibited significantly by: 1) mechanically-impaired endothelium; 2) Nω-Nitro-L-arginine methyl ester hydrochloride (L-NAME); 3) guanylyl cyclase (GC) inhibitor (ODQ); and, 4) a TRPA1 antagonist (A967079). TRPA1 positive immunofluorescence was present in the endothelium. Compared with other known TRPA1 agonists, including allyl isothiocyanate (AITC), cinnamaldehyde, crotonaldehyde, and formaldehyde, acrolein stimulated a more potent TRPA1-dependent relaxation. Acrolein, at high concentration [100 μM], induced tension oscillations (spasms) independent of TRPA1 in precontracted SMA but not in aorta. In conclusion, acrolein is vasorelaxant at low levels (physiological) yet vasotoxic at high levels (toxicological).
Collapse
Affiliation(s)
- L Jin
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, USA; Diabetes and Obesity Center, University of Louisville, Louisville, KY, USA; American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville, Louisville, KY, USA
| | - P Lorkiewicz
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, USA; Diabetes and Obesity Center, University of Louisville, Louisville, KY, USA; American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville, Louisville, KY, USA
| | - Z Xie
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, USA; Diabetes and Obesity Center, University of Louisville, Louisville, KY, USA
| | - A Bhatnagar
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, USA; Diabetes and Obesity Center, University of Louisville, Louisville, KY, USA; American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville, Louisville, KY, USA; Superfund Research Center, University of Louisville, Louisville, KY, USA
| | - S Srivastava
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, USA; Diabetes and Obesity Center, University of Louisville, Louisville, KY, USA; American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville, Louisville, KY, USA; Superfund Research Center, University of Louisville, Louisville, KY, USA
| | - D J Conklin
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, USA; Diabetes and Obesity Center, University of Louisville, Louisville, KY, USA; American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville, Louisville, KY, USA; Superfund Research Center, University of Louisville, Louisville, KY, USA.
| |
Collapse
|
9
|
Yeager R, Holm RH, Saurabh K, Fuqua JL, Talley D, Bhatnagar A, Smith T. Wastewater Sample Site Selection to Estimate Geographically Resolved Community Prevalence of COVID-19: A Sampling Protocol Perspective. Geohealth 2021; 5:e2021GH000420. [PMID: 34222738 PMCID: PMC8240399 DOI: 10.1029/2021gh000420] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/10/2021] [Indexed: 05/22/2023]
Abstract
Wastewater monitoring for virus infections within communities can complement conventional clinical surveillance. Currently, most SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) clinical testing is voluntary and inconsistently available, except for a few occupational and educational settings, and therefore likely underrepresents actual population prevalence. Randomized testing on a regular basis to estimate accurate population-level infection rates is prohibitively costly and is hampered by a range of limitations and barriers associated with participation in clinical research. In comparison, community-level fecal monitoring can be performed through wastewater surveillance to effectively surveil communities. However, epidemiologically defined protocols for wastewater sample site selection are lacking. Herein, we describe methods for developing a geographically resolved population-level wastewater sampling approach in Jefferson County, Kentucky, and present preliminary results. Utilizing this site selection protocol, samples (n = 237) were collected from 17 wastewater catchment areas, September 8 to October 30, 2020 from one to four times per week in each area and compared to concurrent clinical data aggregated to wastewater catchment areas and county level. SARS-CoV-2 RNA was consistently present in wastewater during the studied period, and varied by area. Data obtained using the site selection protocol showed variation in geographically resolved wastewater SARS-CoV-2 RNA concentration compared to clinical rates. These findings highlight the importance of neighborhood-equivalent spatial scales and provide a promising approach for viral epidemic surveillance, thus better guiding spatially targeted public health mitigation strategies.
Collapse
Affiliation(s)
- R. Yeager
- Christina Lee Brown Enviroment InstituteUniversity of LouisvilleLouisvilleKYUSA
- Department of Environmental and Occupational Health SciencesSchool of Public Health and Information SciencesUniversity of LouisvilleLouisvilleKYUSA
| | - R. H. Holm
- Christina Lee Brown Enviroment InstituteUniversity of LouisvilleLouisvilleKYUSA
| | - K. Saurabh
- James Graham Brown Cancer CenterSchool of MedicineUniversity of LouisvilleLouisvilleKYUSA
- Department of OncologySt. Jude Children's Research HospitalMemphisTNUSA
| | - J. L. Fuqua
- Center for Predictive MedicineUniversity of LouisvilleLouisvilleKYUSA
- Department of Pharmacology and ToxicologyUniversity of LouisvilleLouisvilleKYUSA
| | - D. Talley
- Morris Forman Water Quality Treatment CenterLouisvilleKYUSA
| | - A. Bhatnagar
- Christina Lee Brown Enviroment InstituteUniversity of LouisvilleLouisvilleKYUSA
| | - T. Smith
- Christina Lee Brown Enviroment InstituteUniversity of LouisvilleLouisvilleKYUSA
| |
Collapse
|
10
|
Dabas R, Varadaraj G, Sandhu S, Bhatnagar A, Pal R. Kawasaki-like multisystem inflammatory syndrome associated with COVID-19 in an adult: a case report. Br J Dermatol 2021; 185:859-861. [PMID: 34115386 PMCID: PMC9214080 DOI: 10.1111/bjd.20574] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 05/04/2021] [Accepted: 05/30/2021] [Indexed: 12/16/2022]
Affiliation(s)
- R Dabas
- Department of Dermatology, Command Hospital Air Force Bangalore, Bengaluru, India
| | - G Varadaraj
- Department of Medicine, Command Hospital Air Force Bangalore, Bengaluru, India
| | - S Sandhu
- Department of Dermatology, Command Hospital Air Force Bangalore, Bengaluru, India
| | - A Bhatnagar
- Department of Dermatology, Command Hospital Air Force Bangalore, Bengaluru, India
| | - R Pal
- Department of Dermatology, Command Hospital Air Force Bangalore, Bengaluru, India
| |
Collapse
|
11
|
Sachdeva KS, Arora N, Solanki R, Singla R, Sarin R, Bhatnagar A, Khanna A, Atahavale A, Shridhar R, Barua SR, Parmar M, Farooq SI, Ramachandran R, Alavadi U, Swamickan R, Tonsing J, Patel Y, Singla N. Strengthened capacity of India´s bedaquiline Conditional Access Programme for introducing new drugs and regimens. Int J Tuberc Lung Dis 2021; 24:1067-1072. [PMID: 33126941 DOI: 10.5588/ijtld.20.0136] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Addressing TB in India is critical to meeting global targets. With the scale-up of diagnostic networks and the availability of new TB drugs, India had the opportunity to improve the detection and treatment outcomes in drug-resistant TB (DR-TB).OBJECTIVE: To document how the introduction of new drugs and regimens is helping India improve the care of DR-TB patients.DESIGN: In 2016, India´s National TB Programme (NTP) introduced bedaquiline (BDQ) under a Conditional Access Programme (BDQ-CAP) at six sites after providing extensive training and strengthening laboratory testing, pre-treatment evaluation, active drug safety monitoring and management (aDSM) and follow-up systems.RESULTS: An interim analysis reflected earlier and better culture conversion rates: 83% of the 620 patients converted within a median time of 60 days. However, 248 serious adverse events were reported, including 73 deaths (12%) and 100 cardiotoxicity events (16.3%). Encouraged by the evidence of safety and efficacy of BDQ, the NTP took steps to systematically expand its access to cover the entire population by 2018.CONCLUSION: The cautious yet focused approach used to introduce BDQ under BDQ-CAP paved the way for the rapid introduction of delamanid, as well as the shorter treatment regimen and the all-oral regimen for DR-TB.
Collapse
Affiliation(s)
- K S Sachdeva
- Central TB Division, Ministry of Health and Family Welfare, Government of India, New Delhi
| | - N Arora
- International Union Against Tuberculosis and Lung Disease South East Asia, New Delhi
| | - R Solanki
- BJ Medical College and Hospital, Ahmedabad
| | - R Singla
- National Institute for TB and Respiratory Disease, New Delhi
| | - R Sarin
- National Institute for TB and Respiratory Disease, New Delhi
| | - A Bhatnagar
- Rajan Babu Institute for Pulmonary Medicine and Tuberculosis, New Delhi
| | - A Khanna
- Government of National Capital Territory of Delhi, New Delhi
| | - A Atahavale
- King Edward Memorial College & Group of TB Hospital, Mumbai
| | - R Shridhar
- Government Hospital of Thoracic Medicine, Chennai
| | | | - M Parmar
- World Health Organisation, India Country Office, New Delhi
| | - S I Farooq
- International Union Against Tuberculosis and Lung Disease South East Asia, New Delhi
| | - R Ramachandran
- World Health Organisation, India Country Office, New Delhi
| | - U Alavadi
- United States Agency for International Development India, New Delhi, India
| | - R Swamickan
- United States Agency for International Development India, New Delhi, India
| | - J Tonsing
- International Union Against Tuberculosis and Lung Disease South East Asia, New Delhi
| | - Y Patel
- Central TB Division, Ministry of Health and Family Welfare, Government of India, New Delhi
| | - N Singla
- National Institute for TB and Respiratory Disease, New Delhi
| |
Collapse
|
12
|
Fuqua JL, Rouchka EC, Waigel S, Sokoloski K, Chung D, Zacharias W, Zhang M, Chariker J, Talley D, Santisteban I, Varsani A, Moyer S, Holm RH, Yeager RA, Smith T, Bhatnagar A. A rapid assessment of wastewater for genomic surveillance of SARS-CoV-2 variants at sewershed scale in Louisville, KY. medRxiv 2021:2021.03.18.21253604. [PMID: 33791725 PMCID: PMC8010757 DOI: 10.1101/2021.03.18.21253604] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
In this communication, we report on the genomic surveillance of SARS-CoV-2 using wastewater samples in Jefferson County, KY. In February 2021, we analyzed seven wastewater samples for SARS-CoV-2 genomic surveillance. Variants observed in smaller catchment areas, such as neighborhood manhole locations, were not necessarily consistent when compared to associated variant results in downstream treatment plants, suggesting catchment size or population could impact the ability to detect diversity.
Collapse
Affiliation(s)
- J L Fuqua
- Department of Pharmacology and Toxicology, University of Louisville, 505 S. Hancock St., Louisville, KY 40202, United States
- Center for Predictive Medicine, University of Louisville, 505 S. Hancock St., Louisville, KY 40202, United States
| | - E C Rouchka
- Department of Computer Science and Engineering, University of Louisville, 522 East Gray St., Louisville, KY 40202, United States
- KY-INBRE Bioinformatics Core, University of Louisville, 522 East Gray St., Louisville, KY 40202, United States
| | - S Waigel
- Department of Medicine, University of Louisville, 530 S. Hancock Jackson St., Louisville, KY 40402, United States
| | - K Sokoloski
- Center for Predictive Medicine, University of Louisville, 505 S. Hancock St., Louisville, KY 40202, United States
- Department of Microbiology and Immunology, University of Louisville, 505 S. Hancock St., Louisville, KY 40202, United States
| | - D Chung
- Center for Predictive Medicine, University of Louisville, 505 S. Hancock St., Louisville, KY 40202, United States
- Department of Microbiology and Immunology, University of Louisville, 505 S. Hancock St., Louisville, KY 40202, United States
| | - W Zacharias
- Department of Medicine, University of Louisville, 530 S. Hancock Jackson St., Louisville, KY 40402, United States
| | - M Zhang
- Department of Neuroscience Training, University of Louisville, 505 S. Hancock St, Louisville, KY 40202
| | - J Chariker
- Department of Computer Science and Engineering, University of Louisville, 522 East Gray St., Louisville, KY 40202, United States
- KY-INBRE Bioinformatics Core, University of Louisville, 522 East Gray St., Louisville, KY 40202, United States
| | - D Talley
- Louisville/Jefferson County Metropolitan Sewer District, Morris Forman Water Quality Treatment Center, 4522 Algonquin Parkway, Louisville KY 40211, United States
| | - I Santisteban
- Department of Pharmacology and Toxicology, University of Louisville, 505 S. Hancock St., Louisville, KY 40202, United States
- Center for Predictive Medicine, University of Louisville, 505 S. Hancock St., Louisville, KY 40202, United States
| | - A Varsani
- The Biodesign Center of Fundamental and Applied Microbiomics, School of Life Sciences, Center for Evolution and Medicine, Arizona State University, Tempe, AZ 85287, United States
| | - S Moyer
- Department of Health Management and System Sciences, School of Public Health and Information Sciences, University of Louisville, 485 E. Gray St., Louisville, KY 40202, United States
- Department of Public Health and Wellness, Louisville Metro Government, 400 E. Grays St., Louisville, KY 40202, United States
| | - R H Holm
- Christina Lee Brown Envirome Institute, University of Louisville, 302 E. Muhammad Ali Blvd., Louisville, KY 40202, United States
| | - R A Yeager
- Christina Lee Brown Envirome Institute, University of Louisville, 302 E. Muhammad Ali Blvd., Louisville, KY 40202, United States
- Department of Environmental and Occupational Health Sciences, School of Public Health and Information Sciences, University of Louisville, 485 E. Gray St., Louisville, KY 40202, United States
| | - T Smith
- Christina Lee Brown Envirome Institute, University of Louisville, 302 E. Muhammad Ali Blvd., Louisville, KY 40202, United States
| | - A Bhatnagar
- Christina Lee Brown Envirome Institute, University of Louisville, 302 E. Muhammad Ali Blvd., Louisville, KY 40202, United States
| |
Collapse
|
13
|
Bhatnagar A, Sanghvi S, Mathur R, Sarda P. Clinical profile and outcome of patients with congenital heart disease treated with percutaneous transcatheter intervention. Indian Heart J 2020. [DOI: 10.1016/j.ihj.2020.11.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
14
|
Bashir I, Sahu S, Pandita S, Kharbanda M, Sharma R, Bhatnagar A. PO-0813: Total tumor volume as a prognostic factor in head and neck cancer patients. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00830-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
15
|
McIntyre W, Belley-Côté E, Vadakken M, Rai A, Lengyel A, Rochwerg B, Bhatnagar A, Deif B, Um K, Spence J, Connolly S, Bangdiwala S, Rao-Melacini P, Healey J, Whitlock R. HIGH-SENSITIVITY ESTIMATE OF THE INCIDENCE OF NEW-ONSET ATRIAL FIBRILLATION IN CRITICALLY ILL PATIENTS. Can J Cardiol 2020. [DOI: 10.1016/j.cjca.2020.07.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
16
|
Singh A, Bhatnagar A. Management Of Superficial Partial Thickness Burn With Collagen Sheet Dressing Compared With Paraffin Gauze And Silver Sulfadiazine. Ann Burns Fire Disasters 2020; 33:233-238. [PMID: 33304214 PMCID: PMC7680202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 06/22/2020] [Indexed: 06/12/2023]
Abstract
Burn injury is a global problem that equally concerns under-developed and developing countries. An ideal dressing material has to maintain a moist environment, act as a bacterial barrier and as a medium for free exchange of gases, while providing a barrier against toxic contaminants. Sixty-eight consecutive patients with fresh acute superficial partial thickness burns ≤ 15% BSA, registered in two tertiary care teaching hospitals in North India between January 2015 to December 2019, were divided into two groups: a collagen dressing group (group A) and a paraffin gauze (PG) plus silver sulfadiazine (SSD) group (group B). Forty-four patients received collagen dressing and 24 patients received conventional paraffin gauze (PG) plus silver sulfadiazine (SSD) dressing. Patients were followed up for clinical outcome until burn wounds healed. We observed complete healing in 5-7 days for 26 cases (59%) in group A, in 8-12 days for 16 cases (66.66%) in group B. A total of 95.5% of group A patients required analgesia only for ≤ 2days, while 90.90% of group B patients required analgesia for ≥ 6 days. Ninety percent of group A patients required none or a single dressing change with shorter hospital stay. In group B, 22 cases required 3-5 dressing changes. Collagen dressing has proved to be highly advantageous for acute small areas of partial thickness burns (< 15% BSA). It confers better pain relief, and minimal or no dressing change with better rate of wound healing. Pediatric patients preferred collagen sheet dressing. Conventional dressings tend to adhere to the wound surface, and their need for frequent changes traumatises newly epithelialized surfaces and may delay healing.
Collapse
Affiliation(s)
- A. Singh
- Dr Ankur Bhatnagar, Additional Professor
Dept. of Plastic Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS)F-2314, RajajiPuram, Lucknow 226017India+91 9305345897
| | | |
Collapse
|
17
|
Bhatnagar A. Designing health risk assessment report for wellness clinic patients. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
With the emergence of electronic medical records and patient portals, patients are increasingly able to access their health records, including laboratory reports. However, laboratory reports are usually written for clinicians rather than patients, who may not understand much of the information in the report. While several professional guidelines define the technical content of test reports, there are very few guidelines on a patient-friendly presentation of such laboratory reports. The complexity of lab test reports poses a major challenge to patient understanding that warrants the development of a report more appropriate for them.
Methodology
User feedback was obtained on the Lab Report / medical summaries of a tertiary level hospital based on a pre-tested questionnaire Health Risk Assessment Report was prepared with a view to address patient barriers Functionality enhancements were arrived at for estimating work effort by business analyst of the Customer Relationship Management team.
Results
Patients' health literacy, awareness of inherited diseases, e-health literacy and risk perception were found to be impacting the interpretation of lab results. Based on the user feedback (88% opting for graphical and pictorial presentation), 13 functionality enhancements have been arrived at and submitted to the Customer Relationship Management team for initiating a change management report taking into consideration the training load and cost implications.
Conclusions
Patient friendly systems (CRM) enhance the understanding on the criticality of their health conditions, impacting health seeking behavior. Effective CRMs help hospitals in providing cost effective health care to the community. The enhancements, however, have to be in adherence to the EHR standards of the country.
Key messages
Effective CRMs help hospitals in providing cost effective health care to the community. Patient friendly systems (CRM) enhance the understanding on the criticality of their health conditions, impacting health seeking behavior.
Collapse
Affiliation(s)
- A Bhatnagar
- Public Health Administration, National Health Systems Resource Centre, New Delhi, India
| |
Collapse
|
18
|
Al-Ishaq Z, Al-Ishaq Z, Sikdar O, Roy M, Bhatnagar A, Sircar T. Lipomodelling of the Breast Following Excision of a Giant Juvenile Fibroadenoma. Surg Case Rep 2020. [DOI: 10.31487/j.scr.2020.08.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Giant juvenile fibroadenomas form 1-8% of breast lesions in the adolescent population. We report a case of
giant fibroadenoma in a 17-year-old girl who underwent simple lump excision through a lateral breast fold
incision followed by lipomodelling to correct the dimpling of the breast. With this dual approach, excellent
cosmetic outcome can be achieved for average-sized giant fibroadenoma without the need for more complex
technique.
Collapse
|
19
|
Al-Ishaq Z, Al-Ishaq Z, Roy M, Bickley B, Bhatnagar A, Isgar B, Sircar T. A Rare Case of Metastatic Mucinous Breast Carcinoma as a First Presentation of Colon Cancer in a Male Patient: Case Report and Review of the Literature. Surg Case Rep 2020. [DOI: 10.31487/j.scr.2020.08.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The majority of breast tumors are primary; however metastatic tumor to the breast from extramammary sites
has an incidence of 0.5 to 3% and can be misinterpreted clinically as a primary breast tumor. We report a
case of metastatic mucinous breast carcinoma as a first presentation from colon cancer in a male patient
who hasn’t had any bowel symptoms. The immunohistochemical study helped in suspecting the diagnosis,
which was then confirmed by CT scan abdomen and pelvis and endoscopic biopsy of the colonic lesion.
Management of such patients usually by palliative chemotherapy due to the aggressive nature of the disease
however, surgical intervention may be indicated in symptomatic patient or risk of tumor ulceration as in our
patient.
Collapse
|
20
|
Um K, McIntyre W, Mendoza P, Duceppe E, Rochwerg B, Healey J, Koziarz A, Lengyel A, Bhatnagar A, Amit G, Chu V, Belley-Côté E. PRE- AND POST-TREATMENT WITH ANTIARRHYTHMIC DRUGS FOR ELECTRICAL CARDIOVERSION OF ATRIAL FIBRILLATION: A NETWORK META-ANALYSIS. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
21
|
McIntyre WF, Lengyel AP, Healey JS, Vadakken ME, Rai AS, Rochwerg B, Bhatnagar A, Deif B, Spence J, Bangdiwala SI, Belley-Côté EP, Whitlock RP. Design and rationale of the atrial fibrillation occurring transiently with stress (AFOTS) incidence study. J Electrocardiol 2019; 57:95-99. [PMID: 31629099 DOI: 10.1016/j.jelectrocard.2019.09.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/27/2019] [Accepted: 09/05/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Atrial fibrillation (AF) is often detected for the first time in patients hospitalized for medical illness or non-cardiovascular surgery. AF occurring transiently with stress (AFOTS) describes this manifestation of AF, which may either be the result of a non-cardiac stressor, or existing paroxysmal AF that was not previously detected. Current estimates of AFOTS incidence are imprecise: ranging from 1 to 44%, owing to the marked heterogeneity in patient populations, identification and methods used to detect AFOTS. METHODS The prospective, two-centre epidemiological AFOTS Incidence study will enroll 250 consecutive participants without a history of AF but with at increased risk of AF (Age ≥ 65 or >50 with one risk factor for AF) admitted to intensive care units (ICUs) for medical illness or non-cardiac surgery. Upon admission, participants will wear an ECG patch monitor that will remain in place for 14 days, or until discharge from hospital. Patients' consent to participation is deferred for up to 72 h after admission. The primary endpoint is the incidence of AF lasting ≥30 s. The study is powered to detect an AF incidence of 17% ± 5%. RESULTS We conducted a vanguard feasibility study, and 55 participants have completed participation. The median duration of monitoring was seven days. AF was detected by the clinical team in 8 participants (14%; 95% Confidence Interval 7-26%). CONCLUSIONS The AFOTS Incidence study will employ a systematic and highly sensitive protocol for detecting AFOTS in medical illness and non-cardiac surgery ICU patients. This study is feasible and will provide a reliable estimate of the true incidence of AFOTS in this population.
Collapse
Affiliation(s)
- W F McIntyre
- Population Health Research Institute, McMaster University, Canada.
| | - A P Lengyel
- Population Health Research Institute, McMaster University, Canada
| | - J S Healey
- Population Health Research Institute, McMaster University, Canada
| | - M E Vadakken
- Population Health Research Institute, McMaster University, Canada
| | - A S Rai
- Population Health Research Institute, McMaster University, Canada
| | - B Rochwerg
- Population Health Research Institute, McMaster University, Canada
| | - A Bhatnagar
- Population Health Research Institute, McMaster University, Canada
| | - B Deif
- Population Health Research Institute, McMaster University, Canada
| | - J Spence
- Population Health Research Institute, McMaster University, Canada
| | - S I Bangdiwala
- Population Health Research Institute, McMaster University, Canada
| | - E P Belley-Côté
- Population Health Research Institute, McMaster University, Canada
| | - R P Whitlock
- Population Health Research Institute, McMaster University, Canada
| |
Collapse
|
22
|
Jin L, Jagatheesan G, Guo L, Nystoriak M, Malovichko M, Lorkiewicz P, Bhatnagar A, Srivastava S, Conklin DJ. Formaldehyde Induces Mesenteric Artery Relaxation via a Sensitive Transient Receptor Potential Ankyrin-1 (TRPA1) and Endothelium-Dependent Mechanism: Potential Role in Postprandial Hyperemia. Front Physiol 2019; 10:277. [PMID: 30984013 PMCID: PMC6448550 DOI: 10.3389/fphys.2019.00277] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 03/04/2019] [Indexed: 11/30/2022] Open
Abstract
Formaldehyde (FA), the smallest aldehyde, is generated endogenously, and is widespread in the environment in foods, beverages and as a gas phase product of incomplete combustion. The main metabolite of FA, formate, was increased significantly in murine urine (∼3×) after overnight feeding. Because feeding increases mesenteric blood flow, we explored the direct effects of FA in isolated murine superior mesenteric artery (SMA). Over the concentration range of 30–1,200 μM, FA strongly and reversibly relaxed contractions of SMA induced by three different agonists: phenylephrine (PE), thromboxane A2 analog (U46,619) and high potassium (60K, 60 mM K+). Formate (to 1.5 mM) induced a modest relaxation. FA (>1,500 μM) irreversibly depressed vascular function in SMA indicating vasotoxicity. The sensitivity (EC50) but not the efficacy (% relaxation) of FA-induced relaxations was dependent on blood vessel type (SMA << aorta) and contractile agonist (PE, EC50= 52 ± 14 μM; U46,619, EC50= 514 ± 129 μM; 60K, EC50= 1,093 ± 87 μM). The most sensitive component of FA vasorelaxation was within physiological levels (30–150 μM) and was inhibited significantly by: (1) mechanically impaired endothelium; (2) Nω-Nitro-L-arginine methyl ester hydrochloride (L-NAME); (3) transient receptor potential ankyrin-1 (TRPA1) antagonist (A967079); (4) guanylyl cyclase (GC) inhibitor (ODQ); and, (5) K+ channel inhibitor (BaCl2). A similar mechanism of SMA vasorelaxation was stimulated by the TRPA1 agonist cinnamaldehyde. Positive TRPA1 immunofluorescent staining and gene-specific sequence were present in SMA but not in aorta. These data indicate FA, but not formate, robustly relaxes SMA via a sensitive TRPA1- and endothelium-dependent mechanism that is absent in aorta. Thus, as FA levels increase with feeding, FA likely contributes to the physiological reflex of post-prandial hyperemia via SMA vasodilatation.
Collapse
Affiliation(s)
- L Jin
- Department of Anesthesiology, Critical Care and Pain Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.,Department of Pharmacology and Toxicology, University of Louisville, Louisville, KY, United States
| | - G Jagatheesan
- Envirome Institute, University of Louisville, Louisville, KY, United States.,Diabetes and Obesity Center, University of Louisville, Louisville, KY, United States.,Department of Medicine, University of Louisville, Louisville, KY, United States.,American Heart Association Tobacco Regulation and Addiction Center, University of Louisville, Louisville, KY, United States
| | - L Guo
- Envirome Institute, University of Louisville, Louisville, KY, United States.,Diabetes and Obesity Center, University of Louisville, Louisville, KY, United States.,Department of Medicine, University of Louisville, Louisville, KY, United States.,American Heart Association Tobacco Regulation and Addiction Center, University of Louisville, Louisville, KY, United States
| | - M Nystoriak
- Envirome Institute, University of Louisville, Louisville, KY, United States.,Diabetes and Obesity Center, University of Louisville, Louisville, KY, United States.,Department of Medicine, University of Louisville, Louisville, KY, United States.,American Heart Association Tobacco Regulation and Addiction Center, University of Louisville, Louisville, KY, United States
| | - M Malovichko
- Envirome Institute, University of Louisville, Louisville, KY, United States.,Department of Medicine, University of Louisville, Louisville, KY, United States.,American Heart Association Tobacco Regulation and Addiction Center, University of Louisville, Louisville, KY, United States
| | - P Lorkiewicz
- Envirome Institute, University of Louisville, Louisville, KY, United States.,Diabetes and Obesity Center, University of Louisville, Louisville, KY, United States.,Department of Medicine, University of Louisville, Louisville, KY, United States.,American Heart Association Tobacco Regulation and Addiction Center, University of Louisville, Louisville, KY, United States
| | - A Bhatnagar
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, KY, United States.,Envirome Institute, University of Louisville, Louisville, KY, United States.,Diabetes and Obesity Center, University of Louisville, Louisville, KY, United States.,Department of Medicine, University of Louisville, Louisville, KY, United States.,American Heart Association Tobacco Regulation and Addiction Center, University of Louisville, Louisville, KY, United States
| | - S Srivastava
- Envirome Institute, University of Louisville, Louisville, KY, United States.,Diabetes and Obesity Center, University of Louisville, Louisville, KY, United States.,Department of Medicine, University of Louisville, Louisville, KY, United States.,American Heart Association Tobacco Regulation and Addiction Center, University of Louisville, Louisville, KY, United States
| | - D J Conklin
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, KY, United States.,Envirome Institute, University of Louisville, Louisville, KY, United States.,Diabetes and Obesity Center, University of Louisville, Louisville, KY, United States.,Department of Medicine, University of Louisville, Louisville, KY, United States.,American Heart Association Tobacco Regulation and Addiction Center, University of Louisville, Louisville, KY, United States
| |
Collapse
|
23
|
Nishad DK, Rawat HS, Singh T, Bhatnagar A, Mittal G. Decorporation potential of lansoprazole against radiothallium ( 201Tl) in internally contaminated BALB/c mice and New Zealand White rabbits. Hum Exp Toxicol 2018; 38:106-117. [PMID: 29909643 DOI: 10.1177/0960327118781929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION: This study examined the decorporation potential of lansoprazole (LNP) as radioactivity decorporation agent for radiothallium (201Tl) in internally contaminated BALB/c mice and New Zealand White rabbits using radiometry and gamma scintigraphy. METHODS: Animals were divided into three groups, that is, control, pretreatment-1 (1X LNP), and pretreatment-2 (2X LNP). Mice received LNP intraperitoneally, while in rabbits LNP was given through oral route 0.5 and 1.5 h before radiothallium administration, respectively. Mice and rabbits used in the experiment were administered 1.48 and 11.1 MBq radiothallium (201TlCl) through intravenous and oral route, respectively. Once started as prophylactic, LNP was continued as therapeutic twice a day till the end of study period. Radiometry and gamma scintigraphy were used to monitor radiothallium retention and uptake patterns in animals. Gamma scintigraphic images of rabbits were taken at different time intervals up to 72 h and were analyzed for comparative uptake pattern of 201TlCl in all the groups. RESULTS: LNP treatment significantly increased the 201Tl elimination over untreated control and considerably reduced the retention of 201Tl in various tissues and organs. Decrease in radiothallium uptake up to 40% was observed in LNP-treated mice as compared to untreated control. While in rabbits, whole-body radioactivity burden at 72 h was found to be 31.24%, 26%, and 18.54% in untreated control, 9 and 18 mg/kg LNP-treated groups, respectively. CONCLUSION: LNP exhibited dose-dependent decorporation potential to effectively enhance the elimination of 201Tl in mice and rabbits experimentally contaminated with 201TlCl.
Collapse
Affiliation(s)
- D K Nishad
- Department of Nuclear Medicine, Institute of Nuclear Medicine & Allied Sciences, Defence Research and Development Organization, Ministry of Defence, Delhi, India
| | - H S Rawat
- Department of Nuclear Medicine, Institute of Nuclear Medicine & Allied Sciences, Defence Research and Development Organization, Ministry of Defence, Delhi, India
| | - T Singh
- Department of Nuclear Medicine, Institute of Nuclear Medicine & Allied Sciences, Defence Research and Development Organization, Ministry of Defence, Delhi, India
| | - A Bhatnagar
- Department of Nuclear Medicine, Institute of Nuclear Medicine & Allied Sciences, Defence Research and Development Organization, Ministry of Defence, Delhi, India
| | - G Mittal
- Department of Nuclear Medicine, Institute of Nuclear Medicine & Allied Sciences, Defence Research and Development Organization, Ministry of Defence, Delhi, India
| |
Collapse
|
24
|
Gulati RK, Bhatnagar P, Bhatnagar A. Antimicrobial Efficacy of Chemical and Herbal Agents against Streptococcus mutans: An in vitro study. Pesqui bras odontopediatria clín integr 2018. [DOI: 10.4034/pboci.2018.181.50] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
25
|
Stone R, Leaper A, Cave J, Bates A, Bhatnagar A, Shaw A, Wood V, Fenton P. Impact of new provision of primary lung SABR: an audit of patient pathways and decisions around treatment modality following initiation of a local SABR service. Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30065-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
26
|
Bhardwaj S, Mittholiya K, Bhatnagar A, Bernard R, Dharmadhikari JA, Mathur D, Dharmadhikari AK. Inscription of type I and depressed cladding waveguides in lithium niobate using a femtosecond laser. Appl Opt 2017; 56:5692-5697. [PMID: 29047712 DOI: 10.1364/ao.56.005692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 06/13/2017] [Indexed: 06/07/2023]
Abstract
We describe two types of waveguides (type I and depressed cladding) inscribed in lithium niobate using a variable repetition rate (200 kHz-25 MHz), 270 fs duration fiber laser. The type I modification-based waveguides have propagation losses in the range from 1.2 to 10 dB/cm at 1550 nm, depending on experimental parameters. These waveguides are not permanent; they deteriorate over time. Such deterioration of waveguides can be slowed down from 30 days to 100 days by pre-annealing the samples and by writing at a 720 kHz laser repetition rate. The propagation losses measured at 1550 nm show significant improvement for pre-annealed samples. The depressed cladding-inscribed waveguides are permanent, but the propagation loss depends on the number of damage tracks. A track separation of ∼1 μm between adjacent damage tracks yields the lowest propagation loss of 0.5 dB/cm at 1550 nm for a 40 μm diameter waveguide. We observe multimode guidance for sizes in the range of 20-80 μm in these waveguide structures at 1550 nm. Their crystalline nature is found to remain intact, as inferred from second-harmonic generation within the waveguide region.
Collapse
|
27
|
Kaplan A, Rao K, Bhatnagar A, Changkija N, Mullen P. Community Participation in Health: Factors Associated with Active Health
Facility Committees in Nagaland, India. Ann Glob Health 2017. [DOI: 10.1016/j.aogh.2017.03.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
28
|
Tripathy JP, Bhatnagar A, Shewade HD, Kumar AMV, Zachariah R, Harries AD. Ten tips to improve the visibility and dissemination of research for policy makers and practitioners. Public Health Action 2017; 7:10-14. [PMID: 28775937 DOI: 10.5588/pha.16.0090] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 12/02/2017] [Indexed: 11/10/2022] Open
Abstract
Effective dissemination of evidence is important in bridging the gap between research and policy. In this paper, we list 10 approaches for improving the visibility of research findings, which in turn will hopefully contribute towards changes in policy. Current approaches include using social media (Facebook, Twitter, LinkedIn); sharing podcasts and other research outputs such as conference papers, posters, presentations, reports, protocols, preprint copy and research data (figshare, Zenodo, Slideshare, Scribd); and using personal blogs and unique author identifiers (ORCID, ResearcherID). Researchers and funders could consider drawing up a systematic plan for dissemination of research during the stage of protocol development.
Collapse
Affiliation(s)
- J P Tripathy
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - A Bhatnagar
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - H D Shewade
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - R Zachariah
- Médecins Sans Frontières (MSF), Brussels Operational Centre, MSF Luxembourg, Luxembourg
| | - A D Harries
- The Union, Paris, France.,London School of Hygiene & Tropical Medicine, London, United Kingdom
| |
Collapse
|
29
|
Syed AMN, Chang H, Schwartzberg B, Bremner A, Boylan S, Lopez-Penalver C, Vito C, Davis M, Dooley W, Chakravarthy AB, Coomer C, Proulx G, Golder S, Ivanov O, Fernandez K, Farha MJ, Gonzalez V, Wengler C, Bhatnagar A, Neuner GA, Kopkash K, Rahman S, Costa P. Abstract P1-10-20: A multi-center trial of intra-operative electronic brachytherapy during breast conservation surgery for early stage breast cancer: Early results of unplanned boost participants. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-10-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Objective
To assess the safety and efficacy of single-fraction, intra-operative radiation therapy (IORT) delivered as a boost using the Xoft® Axxent® Electronic Brachytherapy System® (eBx®) immediately following surgical resection for treatment of early stage breast cancer.
Methods
This phase 4, open-label, single-arm, prospective, non-randomized trial is still enrolling participants and is currently being conducted at 26 hospitals in the USA (25) and Portugal (1). 878 participants with biopsy-proven ductal carcinoma in situ (DCIS) or invasive ductal carcinoma who met the inclusion criteria underwent lumpectomy followed by single-fraction IORT to the lumpectomy cavity. Briefly, a small, presterilized lead shield piece was placed on the chest wall to reduce the dose to the ribs, and then a balloon applicator, suitable to the surgical bed, was placed in the lumpectomy cavity and inflated with saline (30-75 cc); skin was temporarily closed over the balloon and ultrasound was used to confirm a balloon surface-to-skin distance ≥ 1.0 cm. The Xoft System was used to deliver the 20 Gy dose at the balloon applicator surface. The balloon was deflated, lead shield and balloon removed and the surgical site sutured. Upon the presence of additional risk factors, 37 participants subsequently received whole breast radiation therapy (WBRT); thus, these participants received an unplanned IORT boost and were removed from the primary analysis but will continue to be followed for the duration of the 10-year study. Cosmesis (Harvard Scale) was assessed in this subset of participants. The primary outcome for the main trial is recurrence of ipsilateral breast tumor at 5 years. Trial Registry: ClinicalTrials.gov; Identifier: NCT01644669.
Early Findings
37 boost participants received WBRT (up to 50 Gy) after IORT (36 received the prescribed 20 Gy dose; one received 14 Gy). Mean follow-up time was 430 days (range 13-1119). Mean age at IORT was 62 years (range 45-78). Boost participants had either DCIS (N=5) or invasive ductal carcinoma (N=32). The DCIS nuclear grade was high (N=3), intermediate (N=1), or low (N=1). Invasive cancers were Grade 1 (N=15), 2 (N=10), 3 (N=6), or unknown (N=1). 29 participants had T1, 3 had T2, and 5 had Tis lesions. Mean tumor size was 13.04 ± 10.26 mm. For the two participants who have reached 3-year follow-up, cosmesis was excellent (N=1) and fair (N=1). For the six participants who have reached 2-year follow-up, cosmesis was excellent (N=4), good (N=1), and fair (N=1). There was one serious adverse event with a Grade 3 for skin necrosis. The most frequent side effects were seroma (10%), edema (9%), pain (9%), erythema (6%), and induration (5%). There have been no deaths, recurrences, or new primary tumors among the boost participants to date.
Conclusions
Early results from this multi-center trial suggest that IORT as a tumor-bed boost using the Xoft Axxent eBx System at the time of breast conservation surgery is safe and has low morbidity. To date, the majority of participants receiving an unplanned IORT boost have had excellent to good cosmetic results and the majority of adverse events have been low-grade.
Funding
Funded by Xoft, Inc., a subsidiary of iCAD, Inc.
Citation Format: Syed AMN, Chang H, Schwartzberg B, Bremner A, Boylan S, Lopez-Penalver C, Vito C, Davis M, Dooley W, Chakravarthy AB, Coomer C, Proulx G, Golder S, Ivanov O, Fernandez K, Farha MJ, Gonzalez V, Wengler C, Bhatnagar A, Neuner GA, Kopkash K, Rahman S, Costa P. A multi-center trial of intra-operative electronic brachytherapy during breast conservation surgery for early stage breast cancer: Early results of unplanned boost participants [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-10-20.
Collapse
Affiliation(s)
- AMN Syed
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - H Chang
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - B Schwartzberg
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - A Bremner
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - S Boylan
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - C Lopez-Penalver
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - C Vito
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - M Davis
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - W Dooley
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - AB Chakravarthy
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - C Coomer
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - G Proulx
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - S Golder
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - O Ivanov
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - K Fernandez
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - MJ Farha
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - V Gonzalez
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - C Wengler
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - A Bhatnagar
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - GA Neuner
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - K Kopkash
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - S Rahman
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| | - P Costa
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Revlon/UCLA Breast Center, Long Beach, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Sentara Northern Virginia, Woodbridge, VA; Doctors Hospital, Miami, FL; City of Hope National Medical Center, Duarte, CA; Swedish Medical Center, Englewood, CO; Oklahoma University, Oklahoma City, OK; Vanderbilt University, Nashville, TN; Staten Island University Hospital, Staten Island, NY; Exeter Hospital, Exeter, NH; Sarah Cannon at Parkridge Medical Center, Chattanooga, TN; Florida Hospital Department of Surgery, Orlando, FL; Medstar Franklin Square Medical Center, Baltimore, MD; Medstar Union Memorial Hospital, Baltimore, MD; University of Arizona, Tucson, AZ; Martin Health System, Stuart, FL; 21st Century Oncology, Casa Grande, AZ; Greater Baltimore Medical Center, Baltimore, MD; Rush University Medical Center, Chicago, IL; Diablo Valley Oncology Hematol
| |
Collapse
|
30
|
Bhatnagar A, Sinha AA, Chaudhary S, Manuja N, Kaur H, Chaitra TR. Accuracy and evaluation of a new regression equation in predicting the width of unerupted permanent canines and premolar teeth. Eur Arch Paediatr Dent 2017; 18:31-37. [PMID: 28110423 DOI: 10.1007/s40368-016-0263-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 12/19/2016] [Indexed: 11/25/2022]
Abstract
AIM To assess the applicability of two regression equations based on mixed dentition analysis and to propose and evaluate a new regression equation using the mandibular incisors and first permanent molars as predictors in calculating the size of unerupted permanent canines and premolar teeth in school children. METHODS Dental study casts of 100 children (50 males and 50 females) aged 11-14 years from schools situated in Moradabad, Uttar Pradesh, India were used. The analysis of Tanaka Johnston, Bernabe Flores-Mir and the proposed equation were tested on the casts. RESULTS The analysis of Tanaka Johnston and Bernabe Flores-Mir tended to overestimate the mesio-distal width of the canines and premolars. The proposed equation also overestimated but the mean difference showed a closer approximation with the actual measured values compared to the other two equations. CONCLUSION Validating studies with a similar population must be conducted to confirm the applicability and precision of the proposed equation.
Collapse
Affiliation(s)
- A Bhatnagar
- Department of Paedodontics and Preventive Dentistry, Kothiwal Dental College and Research Centre, Moradabad, UP, 244001, India.
| | - A A Sinha
- Department of Paedodontics and Preventive Dentistry, Kothiwal Dental College and Research Centre, Moradabad, UP, 244001, India
| | - S Chaudhary
- Department of Paedodontics and Preventive Dentistry, Kothiwal Dental College and Research Centre, Moradabad, UP, 244001, India
| | - N Manuja
- Department of Paedodontics and Preventive Dentistry, Kothiwal Dental College and Research Centre, Moradabad, UP, 244001, India
| | - H Kaur
- Department of Paedodontics and Preventive Dentistry, Kothiwal Dental College and Research Centre, Moradabad, UP, 244001, India
| | - T R Chaitra
- Department of Paedodontics and Preventive Dentistry, Kothiwal Dental College and Research Centre, Moradabad, UP, 244001, India
| |
Collapse
|
31
|
Bhatnagar A, Chaudhary S, Sinha AA. Evaluation of Three Different Regression Equations Based Mixed Dentition Analysis in Children of Moradabad City, India. Pesqui bras odontopediatria clín integr 2017. [DOI: 10.4034/pboci.2017.171.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
32
|
Dhir V, Sandhu A, Bhatnagar A, Dhawan V, Kaur J, Sood A, Sharma A, Sharma S. FRI0103 Erythrocyte Methotrexate Polyglutamate Levels Do Not Determine Efficacy and Tolerability of Methotrexate in Rheumatoid Arthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
33
|
Dua B, Chufal K, Jadhav G, Thakwani A, Bhatnagar A. EP-1094: Total tumour volume predicts response in head and neck cancer: regression tree analysis and models. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32344-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
34
|
Costa P, Syed A, Chang H, Schwartzberg B, Bremner A, Boylan S, Lopez-Penalver C, Vito C, Davis M, Dooley W, Chakravarthy A, Coomer C, Proulx G, Golder S, Ivanov O, Fernandex K, Farha M, Gonzalez V, Bhatnagar A, Neuner G, Kopkash K, Rahman S, Corn C. PO-0954: Early results of a multi-center trial of IORT using electronic brachytherapy for breast cancer. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32204-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
35
|
Dua B, Chufal K, Jadhav G, Thakwani A, Bhatnagar A. EP-1091: Stratifying patients of head and neck cancer into risk groups for local control: predictive models. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32341-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
36
|
Syed AMN, Chang H, Schwartzberg BS, Bremner AK, Lopez-Penalver C, Coomer C, Boylan S, Chakravarthy A, Vito CA, Bhatnagar A, Proulx GM, Dooley WC, Davis M, Golder SL, Ivanov O, Fernandez K, Rahman S. Abstract P3-12-11: One-year follow-up results of a multi-center trial of intra-operative radiation therapy using electronic brachytherapy at the time of breast conservation surgery for early stage breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p3-12-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Objectives: To describe observations of one-year follow-up of subjects treated on a multi-center, non-randomized study with a single fraction of intra-operative radiation therapy (IORT) using the Xoft® Axxent® Electronic Brachytherapy System® (eBx®) immediately following surgical resection of early stage breast cancer.
Methods: Two-hundred forty three (243) subjects were treated at seventeen (17) US hospitals. Upon meeting the inclusion/exclusion criteria, patients underwent partial mastectomy, placement of a balloon applicator suitable to the surgical bed in the lumpectomy cavity and inflated with saline (30 – 75 cc). The skin was temporarily closed over the balloon and ultrasound examination performed to confirm that the balloon surface-to-skin distance was > 1.0 cm. A single fraction of intra-operative radiation therapy was delivered to the lumpectomy cavity using the Xoft System. The prescribed dose was 20 Gy at the balloon applicator surface, and the mean treatment time was 10.2 minutes. After treatment, the balloon was deflated and removed, and skin sutured.
Results: Two-hundred forty two (242) subjects received the prescribed dose of 20 Gy; one subject received 21 Gy. Eighteen (18) subjects were removed from the primary analysis post-IORT due to positive surgical margins (N=2), positive sentinel lymph nodes (N=13), or balloon surface-to-skin distance < 1 cm (N=3). However, these eighteen subjects will continue to be followed for the duration of this 10-year study. The mean follow-up for the two-hundred twenty five evaluable subjects is 494 days (range 300-465 days). The mean patient age was 65 years (41-89). Forty-nine subjects (21.8%) had ductal carcinoma in situ, one-hundred seventy one (76%) had invasive ductal carcinoma, and five (2.2%) had unknown histology. The DCIS nuclear grade was evenly distributed between high (N=18) and low/intermediate (N=23); 5 were unknown. Invasive cancer was Grade 1-2 in 142/171 cases. Two-hundred twelve subjects (94.2%) had T1 lesions, eight (3.6%) had T2 lesions, and five (2.2%) were unknown. The mean tumor size was 10.6 mm ± 6.4 mm. At the time of the last subject visit, 49/318 reported adverse events were Grade 2 or higher, and only 1/100 had serious side effects, i.e. infection. One patient died of aortic aneurism and two developed secondary malignancies, i.e. ovarian cancer and chronic lymphocytic leukemia. The most frequent side effects were seroma (12.5%), erythema (9.1%), and induration (7.5%). Cosmesis was excellent to good in 95% of cases.
Conclusions: IORT using the Xoft System as part of the conservative treatment of breast cancer is safe, with low morbidity. Early results from this multi-center trial demonstrate this short, convenient course of radiation therapy for select patients with early stage breast cancer has excellent-to-good cosmetic results and a low rate of low-grade adverse events.
Citation Format: Syed AMN, Chang H, Schwartzberg BS, Bremner AK, Lopez-Penalver C, Coomer C, Boylan S, Chakravarthy A, Vito CA, Bhatnagar A, Proulx GM, Dooley WC, Davis M, Golder SL, Ivanov O, Fernandez K, Rahman S. One-year follow-up results of a multi-center trial of intra-operative radiation therapy using electronic brachytherapy at the time of breast conservation surgery for early stage breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-12-11.
Collapse
Affiliation(s)
- AMN Syed
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Doctors Hospital, Miami, FL; Staten Island University Hospital, Staten Island, NY; Sentara Northern Virginia, Woodbridge, VA; Vanderbilt University, Nashville, TN; City of Hope National Medical Center, Duarte, CA; Cancer Treatment Services, Casa Grande, AZ; Exeter Hospital, Exeter, NH; Oklahoma University, Oklahoma City, OK; Swedish Medical Center, Englewood, CO; Shannon Cannon Cancer Center at Parkridge Medical Center, Chattanooga, TN; Florida Hospital, Orlando, FL; MedStar Health, Baltimore, MD; Diablo Valley Oncology Hematology Medical Group, Pleasant Hill, CA
| | - H Chang
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Doctors Hospital, Miami, FL; Staten Island University Hospital, Staten Island, NY; Sentara Northern Virginia, Woodbridge, VA; Vanderbilt University, Nashville, TN; City of Hope National Medical Center, Duarte, CA; Cancer Treatment Services, Casa Grande, AZ; Exeter Hospital, Exeter, NH; Oklahoma University, Oklahoma City, OK; Swedish Medical Center, Englewood, CO; Shannon Cannon Cancer Center at Parkridge Medical Center, Chattanooga, TN; Florida Hospital, Orlando, FL; MedStar Health, Baltimore, MD; Diablo Valley Oncology Hematology Medical Group, Pleasant Hill, CA
| | - BS Schwartzberg
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Doctors Hospital, Miami, FL; Staten Island University Hospital, Staten Island, NY; Sentara Northern Virginia, Woodbridge, VA; Vanderbilt University, Nashville, TN; City of Hope National Medical Center, Duarte, CA; Cancer Treatment Services, Casa Grande, AZ; Exeter Hospital, Exeter, NH; Oklahoma University, Oklahoma City, OK; Swedish Medical Center, Englewood, CO; Shannon Cannon Cancer Center at Parkridge Medical Center, Chattanooga, TN; Florida Hospital, Orlando, FL; MedStar Health, Baltimore, MD; Diablo Valley Oncology Hematology Medical Group, Pleasant Hill, CA
| | - AK Bremner
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Doctors Hospital, Miami, FL; Staten Island University Hospital, Staten Island, NY; Sentara Northern Virginia, Woodbridge, VA; Vanderbilt University, Nashville, TN; City of Hope National Medical Center, Duarte, CA; Cancer Treatment Services, Casa Grande, AZ; Exeter Hospital, Exeter, NH; Oklahoma University, Oklahoma City, OK; Swedish Medical Center, Englewood, CO; Shannon Cannon Cancer Center at Parkridge Medical Center, Chattanooga, TN; Florida Hospital, Orlando, FL; MedStar Health, Baltimore, MD; Diablo Valley Oncology Hematology Medical Group, Pleasant Hill, CA
| | - C Lopez-Penalver
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Doctors Hospital, Miami, FL; Staten Island University Hospital, Staten Island, NY; Sentara Northern Virginia, Woodbridge, VA; Vanderbilt University, Nashville, TN; City of Hope National Medical Center, Duarte, CA; Cancer Treatment Services, Casa Grande, AZ; Exeter Hospital, Exeter, NH; Oklahoma University, Oklahoma City, OK; Swedish Medical Center, Englewood, CO; Shannon Cannon Cancer Center at Parkridge Medical Center, Chattanooga, TN; Florida Hospital, Orlando, FL; MedStar Health, Baltimore, MD; Diablo Valley Oncology Hematology Medical Group, Pleasant Hill, CA
| | - C Coomer
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Doctors Hospital, Miami, FL; Staten Island University Hospital, Staten Island, NY; Sentara Northern Virginia, Woodbridge, VA; Vanderbilt University, Nashville, TN; City of Hope National Medical Center, Duarte, CA; Cancer Treatment Services, Casa Grande, AZ; Exeter Hospital, Exeter, NH; Oklahoma University, Oklahoma City, OK; Swedish Medical Center, Englewood, CO; Shannon Cannon Cancer Center at Parkridge Medical Center, Chattanooga, TN; Florida Hospital, Orlando, FL; MedStar Health, Baltimore, MD; Diablo Valley Oncology Hematology Medical Group, Pleasant Hill, CA
| | - S Boylan
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Doctors Hospital, Miami, FL; Staten Island University Hospital, Staten Island, NY; Sentara Northern Virginia, Woodbridge, VA; Vanderbilt University, Nashville, TN; City of Hope National Medical Center, Duarte, CA; Cancer Treatment Services, Casa Grande, AZ; Exeter Hospital, Exeter, NH; Oklahoma University, Oklahoma City, OK; Swedish Medical Center, Englewood, CO; Shannon Cannon Cancer Center at Parkridge Medical Center, Chattanooga, TN; Florida Hospital, Orlando, FL; MedStar Health, Baltimore, MD; Diablo Valley Oncology Hematology Medical Group, Pleasant Hill, CA
| | - A Chakravarthy
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Doctors Hospital, Miami, FL; Staten Island University Hospital, Staten Island, NY; Sentara Northern Virginia, Woodbridge, VA; Vanderbilt University, Nashville, TN; City of Hope National Medical Center, Duarte, CA; Cancer Treatment Services, Casa Grande, AZ; Exeter Hospital, Exeter, NH; Oklahoma University, Oklahoma City, OK; Swedish Medical Center, Englewood, CO; Shannon Cannon Cancer Center at Parkridge Medical Center, Chattanooga, TN; Florida Hospital, Orlando, FL; MedStar Health, Baltimore, MD; Diablo Valley Oncology Hematology Medical Group, Pleasant Hill, CA
| | - CA Vito
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Doctors Hospital, Miami, FL; Staten Island University Hospital, Staten Island, NY; Sentara Northern Virginia, Woodbridge, VA; Vanderbilt University, Nashville, TN; City of Hope National Medical Center, Duarte, CA; Cancer Treatment Services, Casa Grande, AZ; Exeter Hospital, Exeter, NH; Oklahoma University, Oklahoma City, OK; Swedish Medical Center, Englewood, CO; Shannon Cannon Cancer Center at Parkridge Medical Center, Chattanooga, TN; Florida Hospital, Orlando, FL; MedStar Health, Baltimore, MD; Diablo Valley Oncology Hematology Medical Group, Pleasant Hill, CA
| | - A Bhatnagar
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Doctors Hospital, Miami, FL; Staten Island University Hospital, Staten Island, NY; Sentara Northern Virginia, Woodbridge, VA; Vanderbilt University, Nashville, TN; City of Hope National Medical Center, Duarte, CA; Cancer Treatment Services, Casa Grande, AZ; Exeter Hospital, Exeter, NH; Oklahoma University, Oklahoma City, OK; Swedish Medical Center, Englewood, CO; Shannon Cannon Cancer Center at Parkridge Medical Center, Chattanooga, TN; Florida Hospital, Orlando, FL; MedStar Health, Baltimore, MD; Diablo Valley Oncology Hematology Medical Group, Pleasant Hill, CA
| | - GM Proulx
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Doctors Hospital, Miami, FL; Staten Island University Hospital, Staten Island, NY; Sentara Northern Virginia, Woodbridge, VA; Vanderbilt University, Nashville, TN; City of Hope National Medical Center, Duarte, CA; Cancer Treatment Services, Casa Grande, AZ; Exeter Hospital, Exeter, NH; Oklahoma University, Oklahoma City, OK; Swedish Medical Center, Englewood, CO; Shannon Cannon Cancer Center at Parkridge Medical Center, Chattanooga, TN; Florida Hospital, Orlando, FL; MedStar Health, Baltimore, MD; Diablo Valley Oncology Hematology Medical Group, Pleasant Hill, CA
| | - WC Dooley
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Doctors Hospital, Miami, FL; Staten Island University Hospital, Staten Island, NY; Sentara Northern Virginia, Woodbridge, VA; Vanderbilt University, Nashville, TN; City of Hope National Medical Center, Duarte, CA; Cancer Treatment Services, Casa Grande, AZ; Exeter Hospital, Exeter, NH; Oklahoma University, Oklahoma City, OK; Swedish Medical Center, Englewood, CO; Shannon Cannon Cancer Center at Parkridge Medical Center, Chattanooga, TN; Florida Hospital, Orlando, FL; MedStar Health, Baltimore, MD; Diablo Valley Oncology Hematology Medical Group, Pleasant Hill, CA
| | - M Davis
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Doctors Hospital, Miami, FL; Staten Island University Hospital, Staten Island, NY; Sentara Northern Virginia, Woodbridge, VA; Vanderbilt University, Nashville, TN; City of Hope National Medical Center, Duarte, CA; Cancer Treatment Services, Casa Grande, AZ; Exeter Hospital, Exeter, NH; Oklahoma University, Oklahoma City, OK; Swedish Medical Center, Englewood, CO; Shannon Cannon Cancer Center at Parkridge Medical Center, Chattanooga, TN; Florida Hospital, Orlando, FL; MedStar Health, Baltimore, MD; Diablo Valley Oncology Hematology Medical Group, Pleasant Hill, CA
| | - SL Golder
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Doctors Hospital, Miami, FL; Staten Island University Hospital, Staten Island, NY; Sentara Northern Virginia, Woodbridge, VA; Vanderbilt University, Nashville, TN; City of Hope National Medical Center, Duarte, CA; Cancer Treatment Services, Casa Grande, AZ; Exeter Hospital, Exeter, NH; Oklahoma University, Oklahoma City, OK; Swedish Medical Center, Englewood, CO; Shannon Cannon Cancer Center at Parkridge Medical Center, Chattanooga, TN; Florida Hospital, Orlando, FL; MedStar Health, Baltimore, MD; Diablo Valley Oncology Hematology Medical Group, Pleasant Hill, CA
| | - O Ivanov
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Doctors Hospital, Miami, FL; Staten Island University Hospital, Staten Island, NY; Sentara Northern Virginia, Woodbridge, VA; Vanderbilt University, Nashville, TN; City of Hope National Medical Center, Duarte, CA; Cancer Treatment Services, Casa Grande, AZ; Exeter Hospital, Exeter, NH; Oklahoma University, Oklahoma City, OK; Swedish Medical Center, Englewood, CO; Shannon Cannon Cancer Center at Parkridge Medical Center, Chattanooga, TN; Florida Hospital, Orlando, FL; MedStar Health, Baltimore, MD; Diablo Valley Oncology Hematology Medical Group, Pleasant Hill, CA
| | - K Fernandez
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Doctors Hospital, Miami, FL; Staten Island University Hospital, Staten Island, NY; Sentara Northern Virginia, Woodbridge, VA; Vanderbilt University, Nashville, TN; City of Hope National Medical Center, Duarte, CA; Cancer Treatment Services, Casa Grande, AZ; Exeter Hospital, Exeter, NH; Oklahoma University, Oklahoma City, OK; Swedish Medical Center, Englewood, CO; Shannon Cannon Cancer Center at Parkridge Medical Center, Chattanooga, TN; Florida Hospital, Orlando, FL; MedStar Health, Baltimore, MD; Diablo Valley Oncology Hematology Medical Group, Pleasant Hill, CA
| | - S Rahman
- Todd Cancer Institute, Long Beach Memorial Medical Center, Long Beach, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; Sarah Cancer Research Institute at Rose Medical Center, Denver, CO; Breastlink, Murietta, CA; Doctors Hospital, Miami, FL; Staten Island University Hospital, Staten Island, NY; Sentara Northern Virginia, Woodbridge, VA; Vanderbilt University, Nashville, TN; City of Hope National Medical Center, Duarte, CA; Cancer Treatment Services, Casa Grande, AZ; Exeter Hospital, Exeter, NH; Oklahoma University, Oklahoma City, OK; Swedish Medical Center, Englewood, CO; Shannon Cannon Cancer Center at Parkridge Medical Center, Chattanooga, TN; Florida Hospital, Orlando, FL; MedStar Health, Baltimore, MD; Diablo Valley Oncology Hematology Medical Group, Pleasant Hill, CA
| |
Collapse
|
37
|
Pannu D, Malik S, Shamsunder S, Bhatnagar A. Ascites and Adnexal Mass with Raised CA125: How Arduous can be the Path of Diagnosis. JNMA J Nepal Med Assoc 2016; 54:36-39. [PMID: 27935910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Ascites, adnexal mass and elevated CA125 levels almost always suggest advanced ovarian carcinoma. We present a case of a 37 years old multiparous lady who presented with such a classical picture. Radiological picture was suggestive of ovarian carcinoma with peritoneal metastasis. However, ascitic fluid cytology was negative for malignant cells. A differential diagnosis of tubercular mass was made. Ascitic fluid was sent for adenosine deaminase test that was negative. Fine needle aspiration cytology failed to reveal any sufficient sample for evaluation. Open laparotomy and biopsy was done that showed granulomas suggestive of tuberculosis. Category one anti tubercular treatment was started and symptoms resolved within one month.
Collapse
Affiliation(s)
- D Pannu
- Department of Obstetrics and Gynecology, VMMC and Safdarjung Hospital, New Delhi, India
| | - S Malik
- Department of Obstetrics and Gynecology, VMMC and Safdarjung Hospital, New Delhi, India
| | - S Shamsunder
- Department of Obstetrics and Gynecology, VMMC and Safdarjung Hospital, New Delhi, India
| | - A Bhatnagar
- Department of Obstetrics and Gynecology, VMMC and Safdarjung Hospital, New Delhi, India
| |
Collapse
|
38
|
Syed N, Chang H, Schwartzberg B, Bremner A, Bhatnagar A, Lopez-Penalver C, Vito C, Ivanov O, Rahman S, Golder S, Proulx G, Ellenhorn J, Boylan S. Feasibility and Early Outcomes of a Multicenter Trial of Intraoperative Radiation Therapy Using Electronic Brachytherapy at the Time of Breast Conservation Surgery for Early-Stage Breast Cancer. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.2039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
39
|
Bhatnagar A. Electronic Brachytherapy for the Treatment of Non Melanoma Skin Cancer: Results Up to 5 Years. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.2174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
40
|
Dickler A, Ivanov O, Syed A, Golder S, Proulx G, Arterberry V, Cox C, Kamath S, Bhatnagar A, Smorowski K, Packianathan S. Five Year Results of a Multicenter Trial Utilizing Electronic Brachytherapy to Deliver Intraoperative Radiation Therapy in the Treatment of Early-Stage Breast Cancer. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
41
|
Leishangthem BD, Sharma A, Bhatnagar A. Role of altered mitochondria functions in the pathogenesis of systemic lupus erythematosus. Lupus 2015; 25:272-81. [PMID: 26385216 DOI: 10.1177/0961203315605370] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 08/18/2015] [Indexed: 11/17/2022]
Abstract
Mitochondria, main producers of reactive-oxygen species (ROS), were studied to examine their role in the pathogenesis of systemic lupus erythematosus (SLE). PBMCs and mitochondria were isolated from SLE patients and healthy volunteers for various parameters. Mitochondrial ROS, swelling, hyperpolarization and levels of cytochrome c, caspase3 in the cells were assessed by flow cytometry. ROS was significantly increased in SLE patients (SLE vs controls: 1.83 ± 1.03 vs 1.10 ± 0.35; p < 0.0001). Depolarized state of mitochondria was greater in patients (SLE vs controls: 7.10 ± 5.50% vs 2.5 ± 1.8%; p < 0.05). Mitochondria swelling was found to be significantly altered in patients (SLE vs controls: 112.65 ± 36.56 vs 60.49 ± 20.69; p < 0.001). Expression of cytochrome c and caspase 3 (SLE vs controls: 1.37 ± 0.37% vs 1.01 ± 0.03%; 1.57 ± 0.46% vs 1.06 ± 0.07%; p < 0.05) respectively was found to be significantly increased in SLE. Further, the enzymatic activity of mitochondrial complex was assessed in isolated mitochondria. A significant decrease in activity of Complex I (SLE vs controls: 11.79 ± 3.18 vs 15.10 ± 6.38 nmol NADH oxidized/min/mg protein, p < 0.05); Complex IV (SLE vs control: 9.41 ± 5.16 vs 13.56 ± 5.92 nmol cytochrome c oxidized/min/mg protein, p < 0.05) and Complex V (SLE vs controls: 4.85 ± 1.39 vs 6.17 ± 2.02 nmol ATP hydrolyzed/min/mg protein, p < 0.05) was found in SLE patients in comparison to healthy controls. However, Complex II did not show significant variation in either group (SLE vs controls: 42.2 ± 28.6 vs 61.71 ± 42.3 nmol succinate oxidized/min/mg protein; ns). The decrease in enzyme activities of mitochondrial Complexes I, IV and V on one hand and ROS, hyperpolarization and apoptosis on the other points toward a possible role of mitochondria in the pathogenesis of lupus.
Collapse
Affiliation(s)
- B D Leishangthem
- Department of Biochemistry, Basic Medical Sciences Block, Panjab University, Chandigarh, India
| | - A Sharma
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Bhatnagar
- Department of Biochemistry, Basic Medical Sciences Block, Panjab University, Chandigarh, India
| |
Collapse
|
42
|
Soni S, Agrawal P, Kumar N, Mittal G, Nishad DK, Chaudhury NK, Bhatnagar A, Basu M, Chhillar N. Salivary biochemical markers as potential acute toxicity parameters for acute radiation injury: A study on small experimental animals. Hum Exp Toxicol 2015; 35:221-8. [PMID: 25813962 DOI: 10.1177/0960327115579433] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Researchers have been evaluating several biodosimetric/screening approaches to assess acute radiation injury, related to mass causality. Keeping in mind this background, we hypothesized that effect of whole-body irradiation in single fraction in graded doses can affect the secretion of various salivary components that could be used as acute radiation injury/toxicity marker, which can be used in screening of large population at the time of nuclear accidents/disaster. Thirty Sprague Dawley rats treated with whole-body cobalt-60 gamma irradiation of dose 1-5 Gy (dose rate: 0.95 Gy/min) were included in this study. Whole mixed saliva was collected from all animals before and after radiation up to 72 h postradiation. Saliva was analyzed for electrolytes, total protein, urea, and amylase. Intragroup comparison of salivary parameters at different radiation doses showed significant differences. Potassium was significantly increased as the dose increased from 1 Gy to 5 Gy (p < 0.01) with effect size of difference (r > 0.5). Sodium was significantly altered after 3-5 Gy (p < 0.01, r > 0.5), except 1 and 2 Gy, whereas changes in sodium level were nonsignificant (p > 0.5). Urea, total protein, and amylase levels were also significantly increased as the radiation dose increased (p < 0.01) with large effect size of difference (r > 0.5). This study suggests that salivary parameters were sensitive toward radiation even at low radiation dose which can be used as a predictor of radiation injury.
Collapse
Affiliation(s)
- S Soni
- Department of Nuclear Medicine, Department of Radiation Biosciences, Division of Health, Institute of Nuclear Medicine and Allied Sciences (INMAS), Defence Research & Development Organization (DRDO), Brig. SK Mazumdar Road, Delhi, India
| | - P Agrawal
- Department of Nuclear Medicine, Department of Radiation Biosciences, Division of Health, Institute of Nuclear Medicine and Allied Sciences (INMAS), Defence Research & Development Organization (DRDO), Brig. SK Mazumdar Road, Delhi, India
| | - N Kumar
- Department of Nuclear Medicine, Department of Radiation Biosciences, Division of Health, Institute of Nuclear Medicine and Allied Sciences (INMAS), Defence Research & Development Organization (DRDO), Brig. SK Mazumdar Road, Delhi, India
| | - G Mittal
- Department of Nuclear Medicine, Department of Radiation Biosciences, Division of Health, Institute of Nuclear Medicine and Allied Sciences (INMAS), Defence Research & Development Organization (DRDO), Brig. SK Mazumdar Road, Delhi, India
| | - D K Nishad
- Department of Nuclear Medicine, Department of Radiation Biosciences, Division of Health, Institute of Nuclear Medicine and Allied Sciences (INMAS), Defence Research & Development Organization (DRDO), Brig. SK Mazumdar Road, Delhi, India
| | - N K Chaudhury
- Department of Nuclear Medicine, Department of Radiation Biosciences, Division of Health, Institute of Nuclear Medicine and Allied Sciences (INMAS), Defence Research & Development Organization (DRDO), Brig. SK Mazumdar Road, Delhi, India
| | - A Bhatnagar
- Department of Nuclear Medicine, Department of Radiation Biosciences, Division of Health, Institute of Nuclear Medicine and Allied Sciences (INMAS), Defence Research & Development Organization (DRDO), Brig. SK Mazumdar Road, Delhi, India
| | - M Basu
- Department of Nuclear Medicine, Department of Radiation Biosciences, Division of Health, Institute of Nuclear Medicine and Allied Sciences (INMAS), Defence Research & Development Organization (DRDO), Brig. SK Mazumdar Road, Delhi, India
| | - N Chhillar
- Department of Neurochemistry, Institute of Human Behavior and Allied Sciences, Dilshad Garden, Delhi, India
| |
Collapse
|
43
|
Sharma V, Jha AK, Kumar A, Bhatnagar A, Narayan G, Kaur J. Curcumin-Mediated Reversal of p15 Gene Promoter Methylation: Implication in Anti-Neoplastic Action against Acute Lymphoid Leukaemia Cell Line. Folia Biol (Praha) 2015; 61:81-89. [PMID: 26333125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Curcumin has been documented to exert anticancer effects by interacting with altered proliferative and apoptotic pathways in cancer models. In this study, we evaluated the potential of curcumin to reverse promoter methylation of the p15 gene in Raji cells and its ability to induce apoptosis and genomic instability. Anti-neoplastic action of curcumin showed an augmentation in reactive oxygen species (ROS) and cell cycle arrest in G1 phase. Subsequently, curcumin- exposed Raji cells showed structural abnormalities in chromosomes. These observations suggest that curcumin also causes ROS-mediated apoptosis and genomic instability. The treatment of Raji cell line with 10 μM curcumin caused hypomethylation of the p15 promoter after six days. Hypomethylation of p15 was further found to be favoured by downregulation of DNA methyltransferase 1 after 10 μM curcumin treatment for six days. Methylation-specific PCR suggested demethylation of the p15 promoter. Demethylation was further validated by DNA sequencing. Reverse-transcription PCR demonstrated that treatment with curcumin (10 μM) for six days led to the up-regulation of p15 and down-regulation of DNA methyltransferase 1. Furthermore, curcumin- mediated reversal of p15 promoter methylation might be potentiated by down-regulation of DNA methyltransferase 1 expression, which was supported by cell cycle analysis. Furthermore, curcumin acts as a double-pronged agent, as it caused apoptosis and promoter hypomethylation in Raji cells.
Collapse
Affiliation(s)
- V Sharma
- Department of Biotechnology, Panjab University, Chandigarh, India
| | - A K Jha
- Department of Biotechnology, Panjab University, Chandigarh, India
| | - A Kumar
- Department of Biotechnology, Panjab University, Chandigarh, India
| | - A Bhatnagar
- Department of Biochemistry, Panjab University, Chandigarh, India
| | - G Narayan
- Department of Molecular and Human Genetics, Banaras Hindu University, Varanasi, India
| | - J Kaur
- Department of Biochemistry, Panjab University, Chandigarh, India
| |
Collapse
|
44
|
Hahn C, Kavanagh B, Bhatnagar A, Jacobson G, Lutz S, Patton C, Potters L, Steinberg M. “Choosing Wisely”: The American Society for Radiation Oncology’s Top 5 List. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
45
|
Faivre-Finn C, Ashcroft L, Bezjak A, Bhatnagar A, Cardenal F, Falk S, Fournel P, Groom N, Harden S, Pechoux CL, Lorigan P, McMenemin R, Mohammed N, O'Brien M, Padovani L, Snee M, Surmont V, Wilson E, Blackhall F. 185 CONVERT – a successful international collaboration between the UK NCRI, Groupe Français de Pneumo-Cancérologie, Spanish Lung Cancer Group, EORTC and NCI Canada. Lung Cancer 2014. [DOI: 10.1016/s0169-5002(14)70186-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
46
|
Killick E, Bennett J, Bates A, Bhatnagar A, Fenton P, Ottensmeier C, Geldart T, Cave J, Nolan L. 26 Treatment and outcome in epidermal growth factor receptor mutant non-small cell lung cancer: A retrospective audit across four NHS trusts. Lung Cancer 2014. [DOI: 10.1016/s0169-5002(14)70027-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
47
|
Sengupta S, Vijayan PK, Singh RK, Bhatnagar A, Raina VK. Numerical simulation of turbulent flow mixing inside a square chimney structure of a research reactor. KERNTECHNIK 2013. [DOI: 10.3139/124.110321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Numerical simulation was performed to study the turbulent mixing behavior of two opposing flows inside a square chimney structure of a research reactor. The chimney design facilitates drawing pool water in the downward direction and thereby suppresses the upward flow of radioactive water jet to limit the radiation field at the reactor pool top. Analyses were carried out considering a mass flow rate of 750 kg/s for the upward flowing hot water from the core, which corresponds to Reynolds number of 3 × 106. Mass flow ratios of the downward flow and the upward flow were 0.0, 0.05, 0.1 and 0.15. The effects of mass flow ratio, chimney height on the velocity and temperature distribution inside three-dimensional chimney structure was evaluated using CFD code PHOENICS. The effect of temperature difference between the opposing flows on velocity was also analysed. It is observed that increase in downward flow causes the jet height to decrease due to the opposing momentum of downward flow against the upward jet. The effects of chimney height and temperature difference on the jet height are found to be marginal because of dominating inertial force over buoyancy force for the study.
Collapse
Affiliation(s)
- S. Sengupta
- E-mail: Research Reactor Design & Projects Division, Bhabha Atomic Research Centre, Mumbai-400085, India
| | - P. K. Vijayan
- Reactor Engineering Division, Bhabha Atomic Research Centre, Mumbai-400085, India
| | - R. K. Singh
- Reactor Safety Division, Bhabha Atomic Research Centre, Mumbai-400085, India
| | - A. Bhatnagar
- Research Reactor Design & Projects Division, Bhabha Atomic Research Centre, Mumbai-400085, India
| | - V. K. Raina
- Reactor Group, Bhabha Atomic Research Centre, Mumbai-400085, India
| |
Collapse
|
48
|
Rafie F, Henrich D, Bhatnagar A, Patel R. Fluctuations of Source Characteristics of Electronic Brachytherapy: The Importance of Quality Assurance. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.2010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
49
|
Henrich D, Kasturi T, Rafie F, Patel R, Bhatnagar A. An Innovative Collaboration and Workflow Management Platform for Surface Electronic Brachytherapy. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
50
|
Bhatnagar A. Ultra thin silicone sheet arthroplasty in the management of recurrent TM joint ankylosis in children. Int J Oral Maxillofac Surg 2013. [DOI: 10.1016/j.ijom.2013.07.667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|