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Koay KL, Mohd Zim MA, Botross NP, Thong YK, Nordin N, Ramachandran A, See PW, Pemasiri WDRH, Chai ST, Wong YYP, Kong JY, Lim SWS, Chia PLM, Gan GCR, Cai CZ, Kok YQ, Loh HY, Su EJE, Shamsuddin AR, Md Tarekh NA, Sood S. Appendectomy and asthma: a search for an association in older subjects. Med J Malaysia 2024; 79:47-51. [PMID: 38287757] [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] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
INTRODUCTION Several risk factors found to be associated with postoperative complications and cancer surgery, which carry a significant morbidity risk to cancer patients. Therefore, prehabilitation is necessary to improve the functional capability and nutritional status of a patient prior to surgery, so that the patient can withstand any postoperative activity and associated deterioration. Thus, this study aims to assess the effectiveness of prehabilitation interventions on the functional status of patients with gastric and oesophageal cancer who underwent esophagectomy and gastrectomy. MATERIAL AND METHODS An interventional study was carried out among oesophageal and gastric cancer patients who had undergone surgery at the National Cancer Institute of Malaysia. The prehabilitation process took a maximum of two weeks, depending on the patient's optimisation before surgery. The prehabilitation is based on functional capacity (ECOG performance status), muscle function (handgrip strength), cardio-respiratory function (peak flow meter) and nutritional status (calorie and protein). Postoperative outcomes are measured based on the length of hospital stay, complications, and Clavien-Dindo Classification. RESULTS Thirty-one patients were recruited to undergo a prehabilitation intervention prior to gastrectomy (n=21) and esophagectomy (n=10). Demographically, most of the cancer patients were males (67.7%) with an ideal mean of BMI (23.5±6.0). Physically, the majority of them had physical class (ASA grade) Grade 2 (67.7%), ECOG performance status of 1 (61.3%) and SGA grade B (51.6%). The functional capacity and nutritional status showed a significant improvement after one week of prehabilitation interventions: peak expiratory flow meter (p<0.001), handgrip (p<0.001), ECOG performance (p<0.001), walking distance (p<0.001), incentive spirometry (p<0.001), total body calorie (p<0.001) and total body protein (p=0.004). However, those patients who required two weeks of prehabilitation for optimization showed only significant improvement in peak expiratory flow meter (p<0.001), handgrip (p<0.001), and incentive spirometry (p<0.001). Prehabilitation is significantly associated postoperatively with the length of hospital stay (p=0.028), complications (p=0.011) and Clavien-Dindo Classification (p=0.029). CONCLUSION Prehabilitation interventions significantly increase the functional capacity and nutritional status of cancer patients preoperatively; concurrently reducing hospital stays and complications postoperatively. However, certain cancer patients might require over two weeks of prehabilitation to improve the patient's functional capacity and reduce complications postoperatively.
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Affiliation(s)
- K L Koay
- Hospital Serdang, Department of General Surgery, Kajang, Selangor, Malaysia
| | - M A Mohd Zim
- Universiti Teknologi MARA, Faculty of Medicine, Medical Department and Respiratory Unit, Shah Alam, Selangor, Malaysia
| | - N P Botross
- Monash University Malaysia, Department of Medicine, Johor Bahru, Johor, Malaysia
| | - Y K Thong
- Klinik Kesihatan Sungai Besi, Sungai Besi, Kuala Lumpur, Malaysia
| | - N Nordin
- Universiti Teknologi MARA, Faculty of Medicine, Medical Department and Respiratory Unit, Shah Alam, Selangor, Malaysia
| | - A Ramachandran
- Lyell McEwin Hospital, Adelaide, South Australia, Australia
| | - P W See
- Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
| | | | - S T Chai
- Hospital Shah Alam, Shah Alam, Selangor, Malaysia
| | - Y Y P Wong
- Sarawak General Hospital, Department of Anesthesiology, Kuching, Sarawak, Malaysia
| | - J Y Kong
- Hospital Sultan Ismail, Department of Medicine, Johor Bahru, Johor, Malaysia
| | - S W S Lim
- Western Health, Melbourne, Victoria, Australia
| | - P L M Chia
- Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
| | - G C R Gan
- Hospital Tuanku Jaafar, Department of Orthopedics, Seremban, Negri Sembilan, Malaysia
| | - C Z Cai
- Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
| | - Y Q Kok
- Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
| | - H Y Loh
- Hospital Townsville, Townsville, Queensland, Australia
| | - E J E Su
- Hospital Sibu, Sibu, Sarawak, Malaysia
| | | | | | - S Sood
- International Medical University, Department of Surgery, Bukit Jalil, Kuala Lumpur, Malaysia.
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Brabon A, Labens R, Ramachandran A, Dart AJ, Dowling BA. Gastrojejunostomy as a treatment for gastric outflow disorders in four adult horses. Aust Vet J 2023. [PMID: 37253644 DOI: 10.1111/avj.13249] [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] [Received: 11/23/2022] [Revised: 04/12/2023] [Accepted: 04/30/2023] [Indexed: 06/01/2023]
Abstract
Four adult horses with histories of moderate abdominal pain and inappetence were diagnosed with delayed gastric emptying and gastric impaction attributed to pyloroduodenal obstruction (three cases) or duodenitis (one case). A stapled side-to-side gastrojejunostomy was performed on all horses. Two horses returned to work and survived ≥3 years. One horse was euthanased 6 months post-surgery due to recurrent abdominal pain, and one was found dead 5 months postsurgery after an unattended foaling.
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Affiliation(s)
- A Brabon
- Faculty of Science, School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - R Labens
- Faculty of Science, School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - A Ramachandran
- Department of Veterinary Clinical Sciences, University Veterinary Centre, Camden, The University of Sydney, Werombi Road, 2570, Camden, New South Wales, Australia
| | - A J Dart
- Department of Veterinary Clinical Sciences, University Veterinary Centre, Camden, The University of Sydney, Werombi Road, 2570, Camden, New South Wales, Australia
| | - B A Dowling
- Department of Veterinary Clinical Sciences, University Veterinary Centre, Camden, The University of Sydney, Werombi Road, 2570, Camden, New South Wales, Australia
- Townsville Veterinary Clinic, 22 Anne Street, Aitkenvale, Queensland, Australia
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3
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Simpson S, Bettauer V, Ramachandran A, Kraemer S, Mahon S, Medina M, Vallès Y, Dumeaux V, Vallès H, Walsh D, Hallett MT. A metagenomic-based study of two sites from the Barbadian reef system. Coral Reefs 2023; 42:359-366. [PMID: 37009568 PMCID: PMC10060342 DOI: 10.1007/s00338-022-02330-y] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 11/05/2022] [Indexed: 06/19/2023]
Abstract
UNLABELLED We study the microbiome of sea water collected from two locations of the Barbadian coral reefs. The two sites differ in several environmental and ecological variables including their endogenous benthic community and their proximity to urban development and runoffs from inland watersheds. The composition of the microbial communities was estimated using whole genome DNA shotgun sequencing with adjuvant measurements of chemical and environmental qualities. Although both sites exhibit a similar degree of richness, the less urbanized site (Maycocks reef at Hangman's Bay) has a strong concentration of phototrophs whereas the more urbanized location (Bellairs reef at Folkstone) is enriched for copiotrophs, macroalgal symbionts and marine-related disease-bearing organisms from taxa scattered across the tree of life. Our results are concordant with previous profiles of warm ocean surface waters, suggesting our approach captures the state of each coral reef site, setting the stage for longitudinal studies of marine microbiome dynamics in Barbados. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s00338-022-02330-y.
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Affiliation(s)
- S. Simpson
- Department of Computer Science and Software Engineering, Concordia University, Montreal, Canada
| | - V. Bettauer
- Department of Computer Science and Software Engineering, Concordia University, Montreal, Canada
| | - A. Ramachandran
- Department of Biology, Concordia University, Montreal, Canada
| | - S. Kraemer
- Department of Biology, Concordia University, Montreal, Canada
| | - S. Mahon
- Coral Reef Restoration Alliance (CORALL), Bridgetown, Barbados
| | - M. Medina
- Department of Biology, Pennsylvania State University, University Park, PA USA
| | - Y. Vallès
- Department of Biology and Chemical Sciences, University of the West Indies, Cave Hill, Barbados
| | - V. Dumeaux
- Department of Anatomy and Cell Biology, University of Western Ontario, London, Canada
| | - H. Vallès
- Department of Biology and Chemical Sciences, University of the West Indies, Cave Hill, Barbados
| | - D. Walsh
- Department of Biology, Concordia University, Montreal, Canada
| | - M. T. Hallett
- Department of Biochemistry, University of Western Ontario, London, Canada
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4
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Allan D, Chatzistergos PE, Mahadevan S, Healy A, Sundar L, Ramachandran A, Kumar S, Punnoose A, Chockalingam N, Naemi R. Increased exposure to loading is associated with decreased plantar soft tissue hardness in people with diabetes and neuropathy. Diabetes Res Clin Pract 2022; 187:109865. [PMID: 35398144 DOI: 10.1016/j.diabres.2022.109865] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/30/2022] [Accepted: 04/02/2022] [Indexed: 11/03/2022]
Abstract
AIMS Literature indicates that altered plantar loading in people with diabetes could trigger changes in plantar soft tissue biomechanics which, in turn, could affect the risk for ulceration. To stimulate more research in this area, this study uses in vivo testing to investigate the link between plantar loading and tissue hardness. METHODS Tissue hardness and plantar pressure distribution were measured for six plantar areas in 39 people with diabetes and peripheral neuropathy. RESULTS Spearman correlation analysis revealed that increased pressure time integral at the 1st metatarsal-head region (r = -0.354, n = 39, P = 0.027) or at the heel (r = -0.378, n = 39, P = 0.018) was associated with reduced hardness in the same regions. After accounting for confounding parameters, generalised estimating equations analysis also showed that 10% increase in pressure time integral at the heel was associated with ≈ 1 unit reduction in hardness in the same region. CONCLUSIONS For the first time, this study reveals that people with diabetes and neuropathy who tend to load their feet more heavily also tend to have plantar soft tissues with lower hardness. The observed difference in tissue hardness is likely to affect the tissue's vulnerability to overload injury. More research will be needed to explore the implications of the observed association for the risk of ulceration.
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Affiliation(s)
- D Allan
- Centre for Biomechanics and Rehabilitation Technologies, School of Health, Science and Wellbeing, Staffordshire University, Stoke-On-Trent, United Kingdom
| | - P E Chatzistergos
- Centre for Biomechanics and Rehabilitation Technologies, School of Health, Science and Wellbeing, Staffordshire University, Stoke-On-Trent, United Kingdom.
| | | | - A Healy
- Centre for Biomechanics and Rehabilitation Technologies, School of Health, Science and Wellbeing, Staffordshire University, Stoke-On-Trent, United Kingdom
| | - L Sundar
- India Diabetes Research Foundation, Chennai, India
| | | | - S Kumar
- Sri Ramachandra University, Chennai, India
| | - A Punnoose
- Sri Ramachandra University, Chennai, India
| | - N Chockalingam
- Centre for Biomechanics and Rehabilitation Technologies, School of Health, Science and Wellbeing, Staffordshire University, Stoke-On-Trent, United Kingdom
| | - R Naemi
- Centre for Biomechanics and Rehabilitation Technologies, School of Health, Science and Wellbeing, Staffordshire University, Stoke-On-Trent, United Kingdom
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Ramachandran A, Siddiqui E, Reyentovich A, Lonze B, Saraon T, Rao S, Katz S, Goldberg R, Kadosh B, DiVita M, Cruz J, Carillo J, Smith D, Moazami N, Gidea C. Transplant Outcomes in Hearts with Moderate to Severe Left Ventricular Hypertrophy After the 2018 OPTN/UNOS Allocation Changes. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1690] [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] Open
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6
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Jaeschke H, Akakpo J, Ramachandran A. Paracetamol hepatotoxicity: Discovering new drugs based on mechanistic insight from animal studies. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00380-5] [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: 11/28/2022]
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Ramachandran A, Sivakumar K, Shanmugasundharam A, Sangunathan U, Krishnamurthy R. Evaluation of potable groundwater zones identification based on WQI and GIS techniques in Adyar River basin, Chennai, Tamilnadu, India. ACTA ACUST UNITED AC 2021. [DOI: 10.1016/j.chnaes.2020.02.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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8
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Ramachandran A, Wilbur GR, O'Neal S, Deppe DG, Hall KC. Suppression of decoherence tied to electron-phonon coupling in telecom-compatible quantum dots: low-threshold reappearance regime for quantum state inversion. Opt Lett 2020; 45:6498-6501. [PMID: 33258845 DOI: 10.1364/ol.403590] [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] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/01/2020] [Indexed: 06/12/2023]
Abstract
We demonstrate suppression of dephasing tied to deformation potential coupling of confined electrons to longitudinal acoustic (LA) phonons in optical control experiments on large semiconductor quantum dots (QDs) with emission compatible with the low-dispersion telecommunications band at 1.3 µm. By exploiting the sensitivity of the electron-phonon spectral density to the size and shape of the QD, we demonstrate a fourfold reduction in the threshold pulse area required to enter the decoupled regime for exciton inversion using adiabatic rapid passage (ARP). Our calculations of the quantum state dynamics indicate that the symmetry of the QD wave function provides an additional means to engineer the electron-phonon interaction. Our findings will support the development of solid-state quantum emitters in future distributed quantum networks using semiconductor QDs.
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Kumar A, Paulose R, Sadasivan S, Bajad C, Ramachandran A, Nair P. Sarcoidosis, steroids and Strongyloides-what's the catch? Clin Microbiol Infect 2020; 27:S1198-743X(20)30561-9. [PMID: 32950714 PMCID: PMC7497548 DOI: 10.1016/j.cmi.2020.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 09/02/2020] [Accepted: 09/06/2020] [Indexed: 10/29/2022]
Affiliation(s)
- A Kumar
- Department of Microbiology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekara, Kochi 682041, Kerala, India.
| | - R Paulose
- Department of Pathology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekara, Kochi 682041, Kerala, India
| | - S Sadasivan
- Department of Gastroenterology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekara, Kochi 682041, Kerala, India
| | - C Bajad
- Department of Pathology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekara, Kochi 682041, Kerala, India
| | - A Ramachandran
- Department of Microbiology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekara, Kochi 682041, Kerala, India
| | - P Nair
- Department of Gastroenterology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekara, Kochi 682041, Kerala, India
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Kumar A, Sathyapalan D, Ramachandran A, Subhash K, Biswas L, Beena KV. SARS-CoV-2 antibodies in healthcare workers in a large university hospital, Kerala, India. Clin Microbiol Infect 2020; 27:481-483. [PMID: 32949718 PMCID: PMC7493758 DOI: 10.1016/j.cmi.2020.09.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/02/2020] [Accepted: 09/06/2020] [Indexed: 11/01/2022]
Affiliation(s)
- A Kumar
- Department of Microbiology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekkara, Kochi 682041, Kerala, India.
| | - D Sathyapalan
- Department of Medicine & Infectious Diseases, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekkara, Kochi 682041, Kerala, India
| | - A Ramachandran
- Department of Microbiology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekkara, Kochi 682041, Kerala, India
| | - K Subhash
- Department of Microbiology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekkara, Kochi 682041, Kerala, India
| | - L Biswas
- Centre for Nanoscience and Molecular Medicine, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekkara, Kochi 682041, Kerala, India
| | - K V Beena
- Medical Administration, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Ponekkara, Kochi 682041, Kerala, India
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Subhasree S, Anitha P, Kannan K, Ramachandran A, Sheri JJ, Jayavel R. Anticorrosion Behavior of ZnO Nanoparticles Coated on Mild Steel in NaCl Solution. J Nanosci Nanotechnol 2020; 20:4061-4068. [PMID: 31968421 DOI: 10.1166/jnn.2020.17526] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This work focuses on the environment protected, ecological procedure by the combination of ZnO nanoparticles utilizing the extraction of Ocimum sanctum. The prepared nanoparticles are examined by different methods like Fourier-transform infrared spectroscopy (FTIR), X-ray Diffraction (XRD), Field emission scanning electron microscopy (FE-SEM), Energy Dispersive X-ray Analysis (EDAX). A systematic study has been made on the result of ZnO nano-coating for the corrosion behavior of mild steel. The ZnO nanoparticles of average diameter in the range 18-22 nm were coated on mild steel in nickel bath solution. The anticorrosion properties on the coated mild steel was carefully tested in 3.5% NaCl solution by performing potentio-dynamic polarization measurement and electrochemical impedance spectroscopy. Surface morphology of the coated mild steel immersed in corrosive solution was judged by using SEM with EDAX. The ZnO nano coating has shown a perfect protection against corrosion and the shielding capability is in the range between 86-95%. The incorporation of ZnO nanoparticles has upgraded the process of mild steel in all corrosion media are subjected to investigation.
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Affiliation(s)
- S Subhasree
- Department of Chemistry, Government College of Engineering, Salem 11, India
| | - P Anitha
- Department of Chemistry, Government College of Engineering, Salem 11, India
| | - K Kannan
- Department of Chemistry, Government College of Engineering, Salem 11, India
| | - A Ramachandran
- Department of Chemistry, Government College of Engineering, Salem 11, India
| | - J J Sheri
- Department of Biosciences, Mangalore University, Mangalagangotri 574199, India
| | - R Jayavel
- Centre for Nanoscience and Technology, Anna University, Chennai 600025, India
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Chawla R, Makkar BM, Aggarwal S, Bajaj S, Das AK, Ghosh S, Gupta A, Gupta S, Jaggi S, Jana J, Keswadev J, Kalra S, Keswani P, Kumar V, Maheshwari A, Moses A, Nawal CL, Panda J, Panikar V, Ramchandani GD, Rao PV, Saboo B, Sahay R, Setty KR, Viswanathan V, Aravind SR, Banarjee S, Bhansali A, Chandalia HB, Das S, Gupta OP, Joshi S, Kumar A, Kumar KM, Madhu SV, Mittal A, Mohan V, Munichhoodappa C, Ramachandran A, Sahay BK, Sai J, Seshiah V, Zargar AH. RSSDI consensus recommendations on insulin therapy in the management of diabetes. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-019-00783-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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13
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Matt C, Ramachandran A, Allison R, Wall C, Dieterly A, Brandão J. LISTERIA MONOCYTOGENES IN AN INLAND BEARDED DRAGON (POGONA VITTICEPS). J Exot Pet Med 2019. [DOI: 10.1053/j.jepm.2018.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Tabesh M, Magliano DJ, Tanamas SK, Surmont F, Bahendeka S, Chiang C, Elgart JF, Gagliardino JJ, Kalra S, Krishnamoorthy S, Luk A, Maegawa H, Motala AA, Pirie F, Ramachandran A, Tayeb K, Vikulova O, Wong J, Shaw JE. Cardiovascular disease management in people with diabetes outside North America and Western Europe in 2006 and 2015. Diabet Med 2019; 36:878-887. [PMID: 30402961 PMCID: PMC6618273 DOI: 10.1111/dme.13858] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2018] [Indexed: 01/07/2023]
Abstract
AIM Optimal treatment of cardiovascular disease is essential to decrease mortality among people with diabetes, but information is limited on how actual treatment relates to guidelines. We analysed changes in therapeutic approaches to anti-hypertensive and lipid-lowering medications in people with Type 2 diabetes from 2006 and 2015. METHODS Summary data from clinical services in seven countries outside North America and Western Europe were collected for 39 684 people. Each site summarized individual-level data from outpatient medical records for 2006 and 2015. Data included: demographic information, blood pressure (BP), total cholesterol levels and percentage of people taking statins, anti-hypertensive medication (angiotensin-converting enzyme inhibitors, calcium channel blockers, angiotensin II receptor blockers, thiazide diuretics) and antiplatelet drugs. RESULTS From 2006 to 2015, mean cholesterol levels decreased in six of eight sites (range: -0.5 to -0.2), whereas the proportion with BP levels > 140/90 mmHg increased in seven of eight sites. Decreases in cholesterol paralleled increases in statin use (range: 3.1 to 47.0 percentage points). Overall, utilization of anti-hypertensive medication did not change. However, there was an increase in the use of angiotensin II receptor blockers and a decrease in angiotensin-converting enzyme inhibitors. The percentage of individuals receiving calcium channel blockers and aspirin remained unchanged. CONCLUSIONS Our findings indicate that control of cholesterol levels improved and coincided with increased use of statins. The percentage of people with BP > 140/90 mmHg was higher in 2015 than in 2006. Hypertension treatment shifted from using angiotensin-converting enzyme inhibitors to angiotensin II receptor blockers. Despite the potentially greater tolerability of angiotensin II receptor blockers, there was no associated improvement in BP levels.
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Affiliation(s)
- M. Tabesh
- Baker Heart and Diabetes InstituteMelbourneAustralia
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - D. J. Magliano
- Baker Heart and Diabetes InstituteMelbourneAustralia
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - S. K. Tanamas
- Baker Heart and Diabetes InstituteMelbourneAustralia
| | | | - S. Bahendeka
- MKPGMS‐Uganda Martyrs University & St. Francis Hospital NsambyaKampalaUganda
| | - C.‐E. Chiang
- General Clinical Research CenterTaipei Veterans General HospitalTaipeiTaiwan
| | - J. F. Elgart
- CENEXA. Centro de Endocrinología Experimental y Aplicada (UNLP‐CONICET)La PlataArgentina
| | - J. J. Gagliardino
- CENEXA. Centro de Endocrinología Experimental y Aplicada (UNLP‐CONICET)La PlataArgentina
| | - S. Kalra
- Bharti Research Institute of Diabetes & EndocrinologyBharti HospitalKarnalHaryanaIndia
| | | | - A. Luk
- Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - H. Maegawa
- Shiga University of Medical ScienceShigaJapan
| | - A. A. Motala
- Department of Diabetes and EndocrinologyUniversity of KwaZulu NatalDurbanSouth Africa
| | - F. Pirie
- Department of Diabetes and EndocrinologyUniversity of KwaZulu NatalDurbanSouth Africa
| | | | - K. Tayeb
- Diabetes Center at AlNoor Specialist HospitalMakkahSaudi Arabia
| | - O. Vikulova
- FGBU ‘Endocrinology Research Center’Ministry of HealthMoscowRussia
| | - J. Wong
- Royal Prince Alfred Hospital Diabetes Centre and the University of SydneySydneyAustralia
| | - J. E. Shaw
- Baker Heart and Diabetes InstituteMelbourneAustralia
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
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Akakpo JY, Ramachandran A, Kandel SE, Ni HM, Kumer SC, Rumack BH, Jaeschke H. 4-Methylpyrazole protects against acetaminophen hepatotoxicity in mice and in primary human hepatocytes. Hum Exp Toxicol 2018; 37:1310-1322. [PMID: 29739258 DOI: 10.1177/0960327118774902] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [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] [Indexed: 01/28/2023]
Abstract
Liver injury due to acetaminophen (APAP) overdose is the major cause of acute liver failure in the United States. While treatment with N-acetylcysteine is the current standard of care for APAP overdose, anecdotal evidence suggests that administration of 4-methylpyrazole (4MP) may be beneficial in the clinic. The objective of the current study was to examine the protective effect of 4MP and its mechanism of action. Male C57BL/6J mice were co-treated with 300 mg/kg of APAP and 50 mg/kg of 4MP. The severe liver injury induced by APAP at 6 h as indicated by elevated plasma alanine aminotransferase activities, centrilobular necrosis, and nuclear DNA fragmentation was almost completely eliminated by 4MP. In addition, 4MP largely prevented APAP-induced activation of c-Jun N-terminal kinase (JNK), mitochondrial translocation of phospho-JNK and Bax, and the release of mitochondrial intermembrane proteins. Importantly, 4MP inhibited the generation of APAP protein adducts and formation of APAP-glutathione (GSH) conjugates and attenuated the depletion of the hepatic GSH content. These findings are relevant to humans because 4MP also prevented APAP-induced cell death in primary human hepatocytes. In conclusion, early treatment with 4MP can completely prevent liver injury after APAP overdose by inhibiting cytochrome P450 and preventing generation of the reactive metabolite.
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Affiliation(s)
- J Y Akakpo
- 1 Department of Pharmacology, Toxicology and Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - A Ramachandran
- 1 Department of Pharmacology, Toxicology and Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - S E Kandel
- 1 Department of Pharmacology, Toxicology and Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - H M Ni
- 1 Department of Pharmacology, Toxicology and Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - S C Kumer
- 2 Department of Surgery, University of Kansas Medical Center, Kansas City, KS, USA
| | - B H Rumack
- 3 Department of Emergency Medicine and Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - H Jaeschke
- 1 Department of Pharmacology, Toxicology and Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
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Ghosh S, Unnikrishnan AG, Saboo B, Kesavadev J, Aravind SR, Bajaj S, Rajput R, Seshadri K, Verma N, Gupta A, Makkar BM, Saikia M, Kale S, Damodaran S, Dengra A, Eashwar TKM, Maheshwari A, Pendsey S, Phatak SR, Sharma SK, Singh SK, Ramachandran A, Zargar AH, Joshi SR, Sadikot SM. Evidence-based recommendations for insulin intensification strategies after basal insulin in type 2 diabetes. Diabetes Metab Syndr 2017; 11 Suppl 1:S507-S521. [PMID: 28433618 DOI: 10.1016/j.dsx.2017.03.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Indexed: 01/27/2023]
Abstract
Over the time due to progressive nature of diabetes, proactive intensification of the existing insulin therapy becomes imminent as it minimizes patients' exposure to chronic hypo/hyperglycaemia and reduces weight gain while achieving individualized glycaemic targets. This review focuses on the strength of evidence behind various options for intensification, primarily the insulins as also the GLP-1 analogues. The recommendations presented here are meant to serve as a guide for the physician managing type 2 diabetes patients requiring insulin intensification upon failing of basal insulin therapy.
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Affiliation(s)
- Sujoy Ghosh
- Department of Endocrinology and Metabolism, Institute of Post-Graduate Medical Education and Research, Kolkata, India.
| | | | | | | | | | - Sarita Bajaj
- Department of Medicine, Motilal Nehru Medical College, Allahabad, India
| | - Rajesh Rajput
- Department of Endocrinology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, India
| | - Krishna Seshadri
- Department of Endocrinology and Metabolism, Shri Rama Chandra University, Chennai, India
| | | | | | | | | | | | | | - Ashish Dengra
- Mahi Diabetes & Thyroid Care and Research Center, Jabalpur, India
| | | | - Anuj Maheshwari
- Department of Medicine, Babu Banarasi Das University, Lucknow, India
| | | | | | | | - Surya Kumar Singh
- Department of Endocrinology and Metabolism, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | | | - Abdul H Zargar
- Advanced Center for Diabetes and Endocrine Care, Srinagar, India
| | - Shashank R Joshi
- Lilavati and Bhatia Hospital and Grant Medical College, Mumbai, India
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Naemi R, Chatzistergos P, Suresh S, Sundar L, Chockalingam N, Ramachandran A. Can plantar soft tissue mechanics enhance prognosis of diabetic foot ulcer? Diabetes Res Clin Pract 2017; 126:182-191. [PMID: 28259007 DOI: 10.1016/j.diabres.2017.02.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/16/2017] [Accepted: 02/02/2017] [Indexed: 10/20/2022]
Abstract
AIM To investigate if the assessment of the mechanical properties of plantar soft tissue can increase the accuracy of predicting Diabetic Foot Ulceration (DFU). METHODS 40 patients with diabetic neuropathy and no DFU were recruited. Commonly assessed clinical parameters along with plantar soft tissue stiffness and thickness were measured at baseline using ultrasound elastography technique. 7 patients developed foot ulceration during a 12months follow-up. Logistic regression was used to identify parameters that contribute to predicting the DFU incidence. The effect of using parameters related to the mechanical behaviour of plantar soft tissue on the specificity, sensitivity, prediction strength and accuracy of the predicting models for DFU was assessed. RESULTS Patients with higher plantar soft tissue thickness and lower stiffness at the 1st Metatarsal head area showed an increased risk of DFU. Adding plantar soft tissue stiffness and thickness to the model improved its specificity (by 3%), sensitivity (by 14%), prediction accuracy (by 5%) and prognosis strength (by 1%). The model containing all predictors was able to effectively (χ2 (8, N=40)=17.55, P<0.05) distinguish between the patients with and without DFU incidence. CONCLUSION The mechanical properties of plantar soft tissue can be used to improve the predictability of DFU in moderate/high risk patients.
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Affiliation(s)
- R Naemi
- School of Life Sciences and Education, Staffordshire University, Stoke on Trent, United Kingdom.
| | - P Chatzistergos
- School of Life Sciences and Education, Staffordshire University, Stoke on Trent, United Kingdom
| | - S Suresh
- India Diabetes Research Foundation, Chennai, India
| | - L Sundar
- India Diabetes Research Foundation, Chennai, India
| | - N Chockalingam
- School of Life Sciences and Education, Staffordshire University, Stoke on Trent, United Kingdom
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18
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Nanditha A, Snehalatha C, Ram J, Selvam S, Vijaya L, Shetty SA, Arun R, Ramachandran A. Impact of lifestyle intervention in primary prevention of Type 2 diabetes did not differ by baseline age and BMI among Asian-Indian people with impaired glucose tolerance. Diabet Med 2016; 33:1700-1704. [PMID: 26773871 DOI: 10.1111/dme.13071] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 11/11/2015] [Accepted: 01/11/2016] [Indexed: 01/28/2023]
Abstract
AIM To investigate whether the effectiveness of lifestyle interventions on the incidence of diabetes was influenced by the baseline age and BMI of the Asian-Indian participants with prediabetes. METHODS Pooled data, obtained from two of our Indian Diabetes Prevention Programmes (2006, n=236 and 2013, n=473; total N=709) which had similar baseline characteristics and intervention principles, were analysed. For the present secondary analysis we dichotomously categorized the participants' baseline age (<45 and ≥45 years) and BMI (<25.0 and ≥ 25.0 kg/m2 ). Glycaemic status was ascertained at 6-monthly intervals by oral glucose tolerance tests. The incidence rates of diabetes and relative risk reduction in both the intervention and the control group were calculated for categories of baseline age and BMI. Interactions between the intervention and baseline age and BMI on diabetes risk were also analysed. RESULTS Incident diabetes was diagnosed in 227 of the total 709 participants (32.0%) [control group 139 participants (38.8%) vs intervention group 88 participants (24.2%)] during the median follow-up period of 2 years. The overall relative risk reduction was 35.4% (95% CI 19.3-48.3). Lifestyle intervention was equally effective in both age groups [relative risk reduction in those aged <45 years: 43.7% (95% CI 19.8-60.5) and in those aged ≥ 45 years: 28.9% (95% CI 5.3-46.6) P for interaction = 0.52] and in categories of BMI [BMI <25 kg/m2 : 36.1% (95% CI 9.5-54.9); and BMI ≥ 25 kg/m2 : 34.8% (95% CI 12.9-51.2); P for interaction = 0.95]. CONCLUSIONS In Asian-Indian individuals with prediabetes, the effectiveness of lifestyle intervention was not modified by baseline age and BMI.
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Affiliation(s)
- A Nanditha
- India Diabetes Research Foundation, Chennai, India
- Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India
| | - C Snehalatha
- India Diabetes Research Foundation, Chennai, India
- Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India
| | - J Ram
- India Diabetes Research Foundation, Chennai, India
| | - S Selvam
- India Diabetes Research Foundation, Chennai, India
| | - L Vijaya
- India Diabetes Research Foundation, Chennai, India
| | - S A Shetty
- India Diabetes Research Foundation, Chennai, India
- Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India
| | - R Arun
- India Diabetes Research Foundation, Chennai, India
- Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India
| | - A Ramachandran
- India Diabetes Research Foundation, Chennai, India
- Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India
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Khunti K, Alsifri S, Aronson R, Cigrovski Berković M, Enters‐Weijnen C, Forsén T, Galstyan G, Geelhoed‐Duijvestijn P, Goldfracht M, Gydesen H, Kapur R, Lalic N, Ludvik B, Moberg E, Pedersen‐Bjergaard U, Ramachandran A. Rates and predictors of hypoglycaemia in 27 585 people from 24 countries with insulin-treated type 1 and type 2 diabetes: the global HAT study. Diabetes Obes Metab 2016; 18:907-15. [PMID: 27161418 PMCID: PMC5031206 DOI: 10.1111/dom.12689] [Citation(s) in RCA: 164] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 04/22/2016] [Accepted: 05/04/2016] [Indexed: 12/16/2022]
Abstract
AIMS To determine the global extent of hypoglycaemia experienced by patients with diabetes using insulin, as there is a lack of data on the prevalence of hypoglycaemia in developed and developing countries. METHODS This non-interventional, multicentre, 6-month retrospective and 4-week prospective study using self-assessment questionnaire and patient diaries included 27 585 patients, aged ≥18 years, with type 1 diabetes (T1D; n = 8022) or type 2 diabetes (T2D; n = 19 563) treated with insulin for >12 months, at 2004 sites in 24 countries worldwide. The primary endpoint was the proportion of patients experiencing at least one hypoglycaemic event during the observational period. RESULTS During the prospective period, 83.0% of patients with T1D and 46.5% of patients with T2D reported hypoglycaemia. Rates of any, nocturnal and severe hypoglycaemia were 73.3 [95% confidence interval (CI) 72.6-74.0], 11.3 (95% CI 11.0-11.6) and 4.9 (95% CI 4.7-5.1) events/patient-year for T1D and 19.3 (95% CI 19.1-19.6), 3.7 (95% CI 3.6-3.8) and 2.5 events/patient-year (95% CI 2.4-2.5) for T2D, respectively. The highest rates of any hypoglycaemia were observed in Latin America for T1D and Russia for T2D. Glycated haemoglobin level was not a significant predictor of hypoglycaemia. CONCLUSIONS We report hypoglycaemia rates in a global population, including those in countries without previous data. Overall hypoglycaemia rates were high, with large variations between geographical regions. Further investigation into these differences may help to optimize therapy and reduce the risk of hypoglycaemia.
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Affiliation(s)
- K. Khunti
- Diabetes Research CentreUniversity of LeicesterLeicesterUK
| | - S. Alsifri
- Al Hada Military HospitalTaifSaudi Arabia
| | - R. Aronson
- LMC Diabetes and EndocrinologyTorontoCanada
| | | | | | - T. Forsén
- Department of General Practice and Primary Health CareUniversity of HelsinkiHelsinkiFinland
| | - G. Galstyan
- Endocrinology Research CenterMoscowRussian Federation
| | | | - M. Goldfracht
- Clalit Health ServicesTel AvivIsrael
- The TechnionHaifaIsrael
| | | | | | - N. Lalic
- Faculty of Medicine, Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of SerbiaUniversity of BelgradeBelgradeSerbia
| | - B. Ludvik
- Rudolfstiftung Hospital and Medical University of ViennaViennaAustria
| | - E. Moberg
- Karolinska InstitutetStockholmSweden
| | | | - A. Ramachandran
- India Diabetes Research Foundation and Dr A Ramachandran's Diabetes HospitalsChennaiIndia
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20
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Rushendra Revathy TD, Palanivelu K, Ramachandran A. Direct mineral carbonation of steelmaking slag for CO2 sequestration at room temperature. Environ Sci Pollut Res Int 2016; 23:7349-7359. [PMID: 26681331 DOI: 10.1007/s11356-015-5893-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 11/27/2015] [Indexed: 06/05/2023]
Abstract
Rapid increase of CO2 concentration in the atmosphere has forced the international community towards adopting actions to restrain from the impacts of climate change. Moreover, in India, the dependence on fossil fuels is projected to increase in the future, implying the necessity of capturing CO2 in a safe manner. Alkaline solid wastes can be utilized for CO2 sequestration by which its disposal issues in the country could also be met. The present work focuses to study direct mineral carbonation of steelmaking slag (SS) at room temperature and low-pressure conditions (<10 bar). Direct mineral carbonation of SS was carried out in a batch reactor with pure CO2 gas. The process parameters that may influence the carbonation of SS, namely, CO2 gas pressure, liquid to solid ratio (L/S) and reaction time were also studied. The results showed that maximum sequestration of SS was attained in the aqueous route with a capacity of 82 g of CO2/kg (6 bar, L/S ratio of 10 and 3 h). In the gas-solid route, maximum sequestration capacity of about 11.1 g of CO2/kg of SS (3 bar and 3 h) was achieved indicating that aqueous route is the better one under the conditions studied. These findings demonstrate that SS is a promising resource and this approach could be further developed and used for CO2 sequestration in the country. The carbonation process was evidenced using FT-IR, XRD, SEM and TG analysis.
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Affiliation(s)
- T D Rushendra Revathy
- Centre for Climate Change and Adaptation Research, Anna University, Chennai, 600 025, India.
| | - K Palanivelu
- Centre for Climate Change and Adaptation Research, Anna University, Chennai, 600 025, India
- Centre for Environmental Studies, Anna University, Chennai, 600 025, India
| | - A Ramachandran
- Centre for Climate Change and Adaptation Research, Anna University, Chennai, 600 025, India
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21
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Reddy YNV, Abraham G, Sundaram V, Reddy PP, Mathew M, Nagarajan P, Mehra N, Ramachandran A, Ali AAM, Reddy YNV. Is there a genetic predisposition to new-onset diabetes after kidney transplantation? Saudi J Kidney Dis Transpl 2016; 26:1113-20. [PMID: 26586047 DOI: 10.4103/1319-2442.168558] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Kidney transplant recipients may develop new-onset diabetes after transplantation (NODAT) and transplant-associated hyperglycemia (TAH) (NODAT or new-onset impaired glucose tolerance-IGT). We studied 251 consecutive renal transplant South Asian recipients for incidence of NODAT and its risk factors between June 2004 and January 2009. Pre-transplant glucose tolerance test (GTT) identified non-diabetics (n = 102, IGT-24, NGT-78) for analysis. Baseline immunosuppression along with either cyclosporine (CsA) (n = 70) or tacrolimus (Tac) (n = 32) was given. Patients underwent GTT 20 days (mean) post-transplant to identify NODAT, normal (N) or IGT. TAH was observed in 40.2% of the patients (40% in CsA and 40.6% in Tac) (P = 0.5). NODAT developed in 13.7% of the patients (12.9% in CsA and 15.6% in Tac) (P = 0.5). Overall, Hepatitis C (P = 0.007), human leukocyte antigen (HLA) B52 (P = 0.03) and lack of HLA A28 (A68/69) (P = 0.03) were associated with TAH. In the Tac group, higher Day 1 dosage (P <0.001), HLA A1 (P = 0.04), B13 (P = 0.03) and lack of DR2 (P = 0.004) increased the risk of TAH. In the CsA group, HLA A10 (P = 0.03), failure of triglyceride (P = 0.001) or low-density lipoprotein (LDL) (P = 0.03) to lower or high-density lipoprotein to rise (P = 0.001), and higher post-transplant LDL (P <0.001) and cholesterol levels (P = 0.02) were associated with NODAT or TAH. Post-transplant fasting plasma glucose on Day 1 had sensitivity-54.5%, specificity-50.1%, positive predictive value-18.1% and negative predictive value-84.8% for detecting NODAT. In conclusion, there is a genetic predisposition to NODAT and TAH in South Asia as seen by the HLA associations, and a predisposition exists to the individual diabetogenic effects of Tac and CsA based on HLA type. This could lead to more careful selection of calcineurin inhibitors based on HLA types in the South Asian population.
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Affiliation(s)
- Yogesh N V Reddy
- Madras Medical Mission Hospital, Chennai, India; Division of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota, USA,
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Ramachandran A, Praveen D, Jaganathan R, Palanivelu K. Projected and Observed Aridity and Climate Change in the East Coast of South India under RCP 4.5. ScientificWorldJournal 2015; 2015:169761. [PMID: 26771002 PMCID: PMC4681802 DOI: 10.1155/2015/169761] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 11/03/2015] [Accepted: 11/08/2015] [Indexed: 12/03/2022] Open
Abstract
In the purview of global warming, the present study attempts to project changes in climate and quantify the changes in aridity of two coastal districts in south India under the RCP 4.5 trajectory. Projected climate change output generated by RegCM 4.4 model, pertaining to 14 grid points located within the study area, was analyzed and processed for this purpose. The meteorological parameters temperature and precipitations were used to create De Martonne Aridity Index, to assess the spatial distribution of aridity. The original index values ranged from 13.7 to 16.4 mm/°C, characterizing this area as a semidry climate. The outcome from the changed scenario analysis under RCP 4.5 showed that, during the end of the 21st century, the aridity may be increased more as the index values tend to reduce. The increasing trend in the drying phenomenon may be attributed to the rising of mean annual temperatures.
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Affiliation(s)
- A. Ramachandran
- Centre for Climate Change and Adaptation Research, Anna University, Guindy, Chennai 600025, India
| | - Dhanya Praveen
- Centre for Climate Change and Adaptation Research, Anna University, Guindy, Chennai 600025, India
| | - R. Jaganathan
- Tamil Nadu Agricultural University, Coimbatore, Tamil Nadu 641003, India
| | - K. Palanivelu
- Centre for Climate Change and Adaptation Research, Anna University, Guindy, Chennai 600025, India
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Abstract
The craniofacial skeleton is derived from both neural crest cells and mesodermal cells; however, the majority of the bone, cartilage, and connective tissue is derived from the neural crest. Dentin sialophosphoprotein (DSPP) is a precursor protein that is expressed by the connective tissues of the craniofacial skeleton, namely, bone and dentin with high expression levels in the dentin matrix. Gene ablation studies have shown severe dental defects in DSPP-null mutant mice. Therefore, to elucidate the role of DSPP on the developing dental-craniofacial complex, we evaluated phenotypic changes in the structure of intramembranous bone and dentin mineralization using 3 different age groups of DSPP-null and wild-type mice. Results from micro-computed tomographic, radiographic, and optical microscopic analyses showed defective dentin, alveolar and calvarial bones, and sutures during development. The impaired mineralization of the cranial bone correlated well with low expression levels of Runx2, Col1, and OPN identified using calvarial cells from DSPP-null and wild-type mice in an in vitro culture system. However, the upregulation of MMP9, MMP2, FN, and BSP was observed. Interestingly, the null mice also displayed low serum phosphate levels, while calcium levels remained unchanged. Alizarin red and von Kossa staining confirmed the dysfunction in the terminal differentiation of osteoblasts obtained from the developing calvaria of DSPP-null mice. Immunohistochemical analysis of the developing molars showed changes in Runx2, Gli1, Numb, and Notch expression in the dental pulp cells and odontoblasts of DSPP-null mice when compared with wild-type mice. Overall, these observations provide insight into the role of DSPP in the normal development of the calvaria, alveolar bone, and dentin-pulp complex.
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Affiliation(s)
- Y Chen
- Brodie Tooth Development Genetics and Regenerative Medicine Research Laboratory, Department of Oral Biology, University of Illinois at Chicago, Chicago, IL, USA
| | - Y Zhang
- Brodie Tooth Development Genetics and Regenerative Medicine Research Laboratory, Department of Oral Biology, University of Illinois at Chicago, Chicago, IL, USA
| | - A Ramachandran
- Brodie Tooth Development Genetics and Regenerative Medicine Research Laboratory, Department of Oral Biology, University of Illinois at Chicago, Chicago, IL, USA
| | - A George
- Brodie Tooth Development Genetics and Regenerative Medicine Research Laboratory, Department of Oral Biology, University of Illinois at Chicago, Chicago, IL, USA
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Blick C, Ramachandran A, McCormick R, Wigfield S, Cranston D, Catto J, Harris AL. Identification of a hypoxia-regulated miRNA signature in bladder cancer and a role for miR-145 in hypoxia-dependent apoptosis. Br J Cancer 2015; 113:634-44. [PMID: 26196183 PMCID: PMC4647685 DOI: 10.1038/bjc.2015.203] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/27/2015] [Accepted: 05/06/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Hypoxia leads to the stabilisation of the hypoxia-inducible factor (HIF) transcription factor that drives the expression of target genes including microRNAs (miRNAs). MicroRNAs are known to regulate many genes involved in tumourigenesis. The aim of this study was to identify hypoxia-regulated miRNAs (HRMs) in bladder cancer and investigate their functional significance. METHODS Bladder cancer cell lines were exposed to normoxic and hypoxic conditions and interrogated for the expression of 384 miRNAs by qPCR. Functional studies were carried out using siRNA-mediated gene knockdown and chromatin immunoprecipitations. Apoptosis was quantified by annexin V staining and flow cytometry. RESULTS The HRM signature for NMI bladder cancer lines includes miR-210, miR-193b, miR-145, miR-125-3p, miR-708 and miR-517a. The most hypoxia-upregulated miRNA was miR-145. The miR-145 was a direct target of HIF-1α and two hypoxia response elements were identified within the promoter region of the gene. Finally, the hypoxic upregulation of miR-145 contributed to increased apoptosis in RT4 cells. CONCLUSIONS We have demonstrated the hypoxic regulation of a number of miRNAs in bladder cancer. We have shown that miR-145 is a novel, robust and direct HIF target gene that in turn leads to increased cell death in NMI bladder cancer cell lines.
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Affiliation(s)
- C Blick
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DS, UK
- Department of Urology, Churchill Hospital, Oxford OX3 7LE, UK
| | - A Ramachandran
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DS, UK
- Cancer Research UK London Research Institute, Lincoln's Inn Fields Laboratories, London WC2A 3LY, UK
| | - R McCormick
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DS, UK
| | - S Wigfield
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DS, UK
| | - D Cranston
- Department of Urology, Churchill Hospital, Oxford OX3 7LE, UK
| | - J Catto
- The Academic Department of Urology and Institute for Cancer Studies, University of Sheffield, Sheffield S10 2RX, UK
| | - A L Harris
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DS, UK
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25
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Oya J, Vistisen D, Christensen DL, Faurholt-Jepsen D, Mohan V, Ramachandran A, Chew SKH, Shaw JE, Jørgensen ME. Geographic differences in the associations between impaired glucose regulation and cardiovascular risk factors among young adults. Diabet Med 2015; 32:497-504. [PMID: 25523878 DOI: 10.1111/dme.12674] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2014] [Indexed: 01/26/2023]
Abstract
AIMS To assess geographic differences in the association between BMI, blood pressure and lipid levels with impaired glucose regulation among young adults from various geographical regions. METHODS This was a cross-sectional study including data from 6987 participants aged ≤ 30 years from India, Singapore, Australia, Greenland, Kenya and Tanzania. Impaired glucose regulation was determined by the 75-g oral glucose tolerance test. For each geographical region, BMI, blood pressure and lipids were examined and compared between participants with normal glucose tolerance and those with impaired glucose regulation. Multiple logistic regression models were used to assess the association between risk factors and impaired glucose regulation. RESULTS Indian and East African people had a higher prevalence of impaired glucose regulation compared with participants from other regions, despite their lower BMI. Compared with the other regions, blood pressure was lower among Indian and Singaporean people but higher in those from Greenland. Greenlanders had the highest, while Indian and East-African people, had the lowest level of HDL cholesterol. BMI was positively associated with impaired glucose regulation in all regions, and there were no statistically significant geographic differences. In the Indian, Singaporean and Australian participants, there was a positive association between blood pressure and impaired glucose regulation. Triglycerides were positively associated with and HDL cholesterol had no association with impaired glucose regulation in all geographical regions. CONCLUSIONS Higher BMI and triglyceride levels were positively associated with prevalent impaired glucose regulation in all geographical regions. There were geographic differences in the association between impaired glucose regulation and blood pressure and lipids, probably reflecting environmental and genetic factors.
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Affiliation(s)
- J Oya
- Steno Diabetes Center, Gentofte, Denmark
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Padovano JD, Ravindran S, Snee PT, Ramachandran A, Bedran-Russo AK, George A. DMP1-derived peptides promote remineralization of human dentin. J Dent Res 2015; 94:608-14. [PMID: 25694469 DOI: 10.1177/0022034515572441] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [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: 12/23/2022] Open
Abstract
Remineralization of dentin during dental caries is of considerable clinical interest. Dentin matrix protein 1 (DMP1) is a non-collagenous calcium-binding protein that plays a critical role in biomineralization. In the present study, we tested if peptides derived from DMP1 can be used for dentin remineralization. Peptide pA (pA, MW = 1.726 kDa) and peptide pB (pB, MW = 2.185), containing common collagen-binding domains and unique calcium-binding domains, were synthesized by solid-phase chemistry. An extreme caries lesion scenario was created by collagenase digestion, and the biomineral-nucleating potential of these peptides was ascertained when coated on collagenase-treated dentin matrix and control, native human dentin matrix under physiological levels of calcium and phosphate. Scanning electron microscopy analysis suggests that peptide pB was an effective nucleator when compared with pA. However, a 1:4 ratio of pA to pB was determined to be ideal for dentin remineralization, based on hydroxyapatite (HA) morphology and calcium/phosphorus ratios. Interestingly, HA was nucleated on collagenase-challenged dentin with as little as 20 min of 1:4 peptide incubation. Electron diffraction confirmed the presence of large HA crystals that produced a diffraction pattern indicative of a rod-like crystal structure. These findings suggest that DMP1-derived peptides may be useful to modulate mineral deposition and subsequent formation of HA when exposed to physiological concentrations of calcium and phosphate.
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Affiliation(s)
- J D Padovano
- Brodie Tooth Development Genetics & Regenerative Medicine Research Laboratory, Department of Oral Biology, University of Illinois at Chicago, Chicago, IL, USA
| | - S Ravindran
- Brodie Tooth Development Genetics & Regenerative Medicine Research Laboratory, Department of Oral Biology, University of Illinois at Chicago, Chicago, IL, USA
| | - P T Snee
- Department of Chemistry, College of Liberal Arts and Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - A Ramachandran
- Brodie Tooth Development Genetics & Regenerative Medicine Research Laboratory, Department of Oral Biology, University of Illinois at Chicago, Chicago, IL, USA
| | - A K Bedran-Russo
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
| | - A George
- Brodie Tooth Development Genetics & Regenerative Medicine Research Laboratory, Department of Oral Biology, University of Illinois at Chicago, Chicago, IL, USA
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Ram J, Snehalatha C, Nanditha A, Selvam S, Shetty SA, Godsland IF, Johnston DG, Ramachandran A. Hypertriglyceridaemic waist phenotype as a simple predictive marker of incident diabetes in Asian-Indian men with prediabetes. Diabet Med 2014; 31:1542-9. [PMID: 24910196 DOI: 10.1111/dme.12517] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 04/04/2014] [Accepted: 06/03/2014] [Indexed: 02/02/2023]
Abstract
AIM To determine prospectively the association of baseline hypertriglyceridaemic waist phenotype with incident diabetes in Asian-Indian men with impaired glucose tolerance. METHODS In a randomized 2-year diabetes prevention trial in 517 men with impaired glucose tolerance, 123 (23.8%) developed diabetes. Baseline anthropometric, metabolic and clinical variables were estimated. Associations of hypertriglyceridaemic waist phenotype (waist circumference ≥ 90cm and a serum triglyceride level of ≥ 1.7 mmol/l) with insulin resistance and incident diabetes were assessed using multiple linear regression and Cox's proportional hazard models, respectively. RESULTS Men with an isolated enlarged waistline and hypertriglyceridaemic waist phenotype had significantly higher BMI and percentage of total body fat compared with the group with normal waistline and triglyceride levels and the group with isolated hypertriglyceridaemia. The men with hypertriglyceridaemic waist phenotype had higher insulin resistance (mean ± sd homeostasis model assessment of insulin resistance value: 3.6 ± 1.5) compared with those in the isolated enlarged waistline, the isolated hypertriglyceridaemia or the normal waistline and triglyceride level groups (3.1 ± 1.4, 2.7 ± 1.0 and 2.5 ± 1.1, respectively, all P < 0.05 compared with hypertriglyceridaemic waist phenotype). Multiple linear regression analyses showed that hypertriglyceridaemic waist phenotype was significantly associated with insulin resistance after adjusting for age, BMI, family history, percentage of total body fat, smoking, alcohol intake, 2-h plasma glucose and HDL cholesterol level. Hypertriglyceridaemic waist phenotype was independently associated with incident diabetes after adjusting for the above confounders and gamma-glutamyl transferase (hazard ratio 1.49, 95% CI 1.01-2.21; P = 0.047). The association of hypertriglyceridaemic waist phenotype with incident diabetes was abolished when insulin resistance was introduced into the model (hazard ratio 1.39, 95% CI 0.092-2.10; P=0.12). CONCLUSIONS Hypertriglyceridaemic waist phenotype is a simple clinical proxy measurement for insulin resistance and is strongly associated with incident diabetes in Asian-Indian men with impaired glucose tolerance.
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Affiliation(s)
- J Ram
- India Diabetes Research Foundation and Dr A. Ramachandran's Diabetes Hospitals, Chennai, India
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Ramachandran A. Know the signs and symptoms of diabetes. Indian J Med Res 2014; 140:579-81. [PMID: 25579136 PMCID: PMC4311308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- A. Ramachandran
- India Diabetes Research Foundation & Dr. A. Ramachandran's Diabetes Hospitals 28, Marshalls Road, Egmore Chennai 600 008, Tamil Nadu, India
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Radhapriya P, Ramachandran A, Dhanya P, Remya K, Malini P. An appraisal of physico-chemical and microbiological characteristics of Nanmangalam Reserve Forest soil. J Environ Biol 2014; 35:1137-1144. [PMID: 25522517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A detailed evaluation was performed on the soils of Nanmangalam Reserve Forest (NRF) in order to understand its physico-chemical, microbiological and enzymatic characteristics. The results of analysis showed that soil pH was directly proportional to the soil depth and the soil moisture content was irreversibly related to varying soil depth. Soil organic carbon was positively correlated with (p < 0.01) with total nitrogen, total bacterial count, cellulytic microbes, nitrogen-fixing bacteria, microbial biomass carbon, dehydrogenase activity and soil respiration. During summer, microbial population in the organic layer was more diverse than in the deepest layer. Analysis showed that NRF had low organic carbon content (less than 1%), microbial biomass, nutrient and functional microbes. The overall results of the analysis reinstate that Nanmangalam forest soil is undergoing degradation.
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Abstract
Background: Cut-off values for endometrial thickness (ET) in asymptomatic postmenopausal woman have been standardized. However, there are no comprehensive studies to document how various factors can influence the ET after the age of menopause. Aim: To study the various factors influencing the ET in postmenopausal women. Subjects and Methods: This was a prospective observational study. A total of 110 postmenopausal women underwent detailed history taking, clinical examination, and transvaginal scan for uterine volume and ovarian volume. The volumes were calculated by using ellipsoid formula: Width × thickness × height × 0.523. The variation in ET with respect to the influencing factors such as age, duration of menopause, parity, body mass index (BMI), medical illness like diabetes/hypertension, drugs like tamoxifen, presence of myoma, uterine volume, ovarian volume, and serum estradiol (in selected patients) were measured. Descriptive analysis was performed using SPSS software (version 16, Chicago II, USA) to obtain mean, standard deviation (SD), 95% confidence intervals (CIs) and inter quartile ranges. Comparison of means was carried out using analysis of variance. Results: The mean (SD) age of the patients was 55.4 (6.91) years (95% CI, 54.1, 56.7). The mean (SD) age at menopause was 47.95 (3.90) years (95% CI, 47.2, 48.7) and the mean (SD) duration of menopause was 7.27 (6.65) years (95% CI, 6.01, 8.53). The mean (SD) ET was 3.8 (2.3) mm (95% CI, 3.36, 4.23). Medical illness like diabetes and hypertension did not alter the ET. ET increased as BMI increased and it was statistically significant. The presence of myoma increased uterine volume significantly and was associated with thick endometrial stripe. Similarly, whenever the ovaries were visualized and as the ovarian volume increased, there was an increase in ET. When ET was > 4 mm (n = 37), they were offered endocel, of which 16 agreed to undergo the procedure. None were found to have endometrial cancer. Conclusion: This study suggests that parity, BMI, presence of myoma, tamoxifen usage, uterine volume, ovarian volume and serum estradiol influence the ET in postmenopausal women.
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Affiliation(s)
- S Hebbar
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Udupi District, Karnataka, India
| | - V Chaya
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Udupi District, Karnataka, India
| | - L Rai
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Udupi District, Karnataka, India
| | - A Ramachandran
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Udupi District, Karnataka, India
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Ramachandran A, Gupta V, Kesavadev J, Kalra S. Understanding the safety of the new ultra long acting basal insulin. J Assoc Physicians India 2014; 62:35-42. [PMID: 25330630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Hypoglycaemia is a key safety concern in diabetes management. It is potentially dangerous and the fear of hypoglycaemia may lead to sub-optimal dosing and inadequate glycaemic control. On the other hand, hypoglycaemia may generate adverse effects and disease complications, will compromise the quality of life and will substantially increase the economic burden of treatment budged. Today, treat to target clinical trial designs are mandate for clinical development of any newer anti-diabetic medication. While similar glycaemic targets are expected to be achieved by test and comparator, the newer molecules are definitely expected to show advantage over standard comparator in terms of reduction in frequency and severity of hypoglycaemia. An ultra-long acting basal analogue insulin degludec (IDeg), has been recently approved for the treatment of type 2 and type 1 diabetes mellitus (T2DM and T1DM). The pooled patient-level data for self-reported hypoglycaemia from seven phase 3a trials with IDeg has shown significantly lower episodes of nocturnal confirmed and numerical low overall confirmed hypoglycaemia with IDeg, compared to Insulin glargine (IGlar), which was more pronounced during maintenance phase of treatment in all populations. The most plausible explanation being that, the flat peakless profile of IDeg with least glycaemic variability leads to less hypoglycaemia and adds to the safety profile of this ultra-long acting insulin. The real life practice will further validate the findings of clinical trials.
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Zhang Y, Song Y, Ravindran S, Gao Q, Huang CC, Ramachandran A, Kulkarni A, George A. DSPP contains an IRES element responsible for the translation of dentin phosphophoryn. J Dent Res 2013; 93:155-61. [PMID: 24352500 DOI: 10.1177/0022034513516631] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [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: 02/05/2023] Open
Abstract
The major phosphoprotein in dentin is the aspartic acid and serine-rich protein called dentin phosphophoryn (DPP). DPP appears to be synthesized as a part of a larger compound protein, dentin sialophosphoprotein (DSPP). DSPP has never been isolated or detected in dentin extracts. It is now evident that DSPP is a chimeric protein composed of 3 parts: dentin sialoprotein (DSP), DPP, and dentin glycoprotein (DGP). Previous reports have suggested that the BMP1 protease is responsible for processing DSPP. However, unequal amounts of these products are present in the dentin matrix. Here, we provide evidence for an internal ribosome entry site in the DSPP gene that directs the synthesis of DPP. This mechanism would account for unequal amounts of intracellular DSP and DPP. The internal ribosomal entry site (IRES) activity varied in different cell types, suggesting the presence of additional regulatory elements during the translational regulation of DPP. Further, we provide evidence that DPP is transported to the extracellular matrix (ECM) through exosomes. Using tissue recombination and lentivirus-mediated gain-of-function approaches, we also demonstrate that DPP is essential for the formation of well-defined tooth structures with mineralized dentin matrix.
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Affiliation(s)
- Y Zhang
- Brodie Tooth Development Genetics & Regenerative Medicine Research Laboratory, Department of Oral Biology, University of Illinois at Chicago, Chicago, IL 60612, USA
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Abraham S, Ramachandran A. Estimation of quality of life in haemodialysis patients. Indian J Pharm Sci 2013; 74:583-7. [PMID: 23798788 PMCID: PMC3687932 DOI: 10.4103/0250-474x.110624] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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: 09/24/2011] [Revised: 12/10/2012] [Accepted: 12/16/2012] [Indexed: 12/26/2022] Open
Abstract
Since haemodialysis is an expensive treatment modality for chronic renal failure patients, it is very essential to assess the outcome of therapy in terms of quality of life. The primary objective of the study was to estimate the effect of patient counselling in quality of life of end stage renal disease patients opting haemodialysis using World Health Organisation Quality of life scale and to assess the variables affecting the quality of life of these patients. Quality of life was determined by World Health Organisation Quality of life scale questionnaire comprised of 26 items which measures four domains: physical, psychological, social and environmental domain. A total of 81 patients were selected and divided into test and control group and the test group patients received counselling regarding their disease, use of medications, importance of adherence and the complications experienced during and after dialysis. The quality of life data was collected at the interval of 1, 2, 3, 6 and 12 months and the patients were counselled at each interval. The demographic profiles revealed that majority of the patients were in the age group of 31-50 and there exists a male predominance. About the socioeconomic status, upper middle class people were mostly affected. Assessment of impact of patient counselling in the quality of life of haemodialysis indicated a significant improvement in each domain after counselling. And also found that the psychological domain showed a significant increase in the score compared to others. Patient counselling helped to gain benefits in terms of improvement in quality of life and delayed progression of renal failure. Early recognition and prevention is necessary to improve the quality of life of chronic renal failure patients. Patient counselling should be made mandatory by incorporating clinical pharmacist in the nephrology team to make the patient understand his illness and modifications in lifestyle also create a positive environment and result in better quality of life.
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Affiliation(s)
- S Abraham
- Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Viswavidyapeetham University, AIMS Healthscience Campus, Kochi-682 026, India
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Abstract
Preventing diabetes is of enormous value, particularly for the South Asian countries, which have a huge healthcare burden from the onslaught of the disease. Type 2 diabetes has been proved to be preventable using lifestyle changes, even in South Asians despite their heightened risk profile. Strategies to improve awareness about diabetes and translation of preventive measures by innovative, culturally specific programmes have to be implemented at national levels. Integrated involvement of the government, community, media, healthcare and education services, and financial support from national and international organizations, are required. South Asian countries have initiated national programmes for diabetes prevention and management. It is also encouraging to note that joint ventures between developed countries such as the USA, UK and other European countries and centres of excellence in South Asia have been initiated to develop large-scale, community-oriented, pragmatic intervention strategies.
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Affiliation(s)
- A Ramachandran
- India Diabetes Research Foundation and Dr A Ramachandran's Diabetes Hospitals, Chennai, India
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Padovano J, Ravindran S, Ramachandran A, Bedran-Russo A, George A. Dentin mineralization using DMP1-derived synthetic peptides. Dent Mater 2013. [DOI: 10.1016/j.dental.2013.08.194] [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]
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Zimmerman E, Hu S, Orwick S, Berk J, Li L, Drenberg C, Roberts M, Ramachandran A, Stewart C, Baker S. 386 Evaluation of Crenolanib (CP-868,596) for the Treatment of FLT3-ITD-positive AML. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)72184-6] [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: 10/27/2022]
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Wetmore C, Broniscer A, Wright K, Pai-Panandiker A, Patay Z, Onar-Thomas A, Ramachandran A, Gajjar A, Turner D, Stewart C. 346 First in Pediatrics Phase I Study of Crenolanib Besylate (CP-868, 596–26) Administered During and After Radiation Therapy (RT) in Newly-diagnosed Diffuse Intrinsic Pontine Glioma (DIPG) and Recurrent High Grade Glioma, Including DIPG (HGG). Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)72144-5] [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: 11/26/2022]
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Stevens RJ, Ali R, Bankhead CR, Bethel MA, Cairns BJ, Camisasca RP, Crowe FL, Farmer AJ, Harrison S, Hirst JA, Home P, Kahn SE, McLellan JH, Perera R, Plüddemann A, Ramachandran A, Roberts NW, Rose PW, Schweizer A, Viberti G, Holman RR. Cancer outcomes and all-cause mortality in adults allocated to metformin: systematic review and collaborative meta-analysis of randomised clinical trials. Diabetologia 2012; 55:2593-2603. [PMID: 22875195 DOI: 10.1007/s00125-012-2653-7] [Citation(s) in RCA: 133] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 06/12/2012] [Indexed: 12/31/2022]
Abstract
AIMS/HYPOTHESIS Observational studies suggest that metformin may reduce cancer risk by approximately one-third. We examined cancer outcomes and all-cause mortality in published randomised controlled trials (RCTs). METHODS RCTs comparing metformin with active glucose-lowering therapy or placebo/usual care, with minimum 500 participants and 1-year follow-up, were identified by systematic review. Data on cancer incidence and all-cause mortality were obtained from publications or by contacting investigators. For two trials, cancer incidence data were not available; cancer mortality was used as a surrogate. Summary RRs, 95% CIs and I (2)statistics for heterogeneity were calculated by fixed effects meta-analysis. RESULTS Of 4,039 abstracts identified, 94 publications described 14 eligible studies. RRs for cancer were available from 11 RCTs with 398 cancers during 51,681 person-years. RRs for all-cause mortality were available from 13 RCTs with 552 deaths during 66,447 person-years. Summary RRs for cancer outcomes in people randomised to metformin compared with any comparator were 1.02 (95% CI 0.82, 1.26) across all trials, 0.98 (95% CI 0.77, 1.23) in a subgroup analysis of active-comparator trials and 1.36 (95% CI 0.74, 2.49) in a subgroup analysis of placebo/usual care comparator trials. The summary RR for all-cause mortality was 0.94 (95% CI 0.79, 1.12) across all trials. CONCLUSIONS/INTERPRETATION Meta-analysis of currently available RCT data does not support the hypothesis that metformin lowers cancer risk by one-third. Eligible trials also showed no significant effect of metformin on all-cause mortality. However, limitations include heterogeneous comparator types, absent cancer data from two trials, and short follow-up, especially for mortality.
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Affiliation(s)
- R J Stevens
- Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK.
| | - R Ali
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - C R Bankhead
- Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | - M A Bethel
- Diabetes Trials Unit, Oxford Centre for Diabetes Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - B J Cairns
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - R P Camisasca
- TGRD Europe, Takeda Pharmaceutical Company, London, UK
| | - F L Crowe
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - A J Farmer
- Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | - S Harrison
- Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | - J A Hirst
- Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | - P Home
- ICM-Diabetes, The Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - S E Kahn
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, Veterans Affairs Puget Sound Health Care System and University of Washington, Seattle, WA, USA
| | - J H McLellan
- Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | - R Perera
- Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | - A Plüddemann
- Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | - A Ramachandran
- India Diabetes Research Foundation, Dr A. Ramachandran's Diabetes Hospitals, Egmore, Chennai, India
| | - N W Roberts
- Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | - P W Rose
- Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | | | - G Viberti
- Unit for Metabolic Medicine, School of Medicine, King's College London, London, UK
| | - R R Holman
- Diabetes Trials Unit, Oxford Centre for Diabetes Endocrinology and Metabolism, University of Oxford, Oxford, UK
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Karpagavalli MS, Malini P, Ramachandran A. Analysis of heavy metals in dying wetland Pallikaranai, Tamil Nadu, India. J Environ Biol 2012; 33:757-761. [PMID: 23360004] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Pallikaranai wetland has high ecological significance as it has been a home for other associated biodiversities. This wetland is highly polluted due to the rapid industrialization, urbanization and dumping of solid waste. The water quality of the Pallikaranai wetland has been studied with reference to toxic metals. The metals analyzed include lead, chromium, iron, copper, nickel, zinc and cadmium. The heavy metal analysis in surface waters were in the following range; Cd: BDL--0.019 mg l(-1), Fe: BDL--1.52 mg l(-1), Cu: BDL--0.02 mg l(-1), Ni: BDL-0.60 mg l(-1), Pb: 0.03-1.13 mg l(-1), Zn: 0.002-0.14 mg l(-1) and Cr: 0.10-1.52 mg l(-1) respectively. The dominance of various heavy metals in the surface water of the Pallikaranai wetland followed the sequence: Pb > Cr > Fe > Ni > Zn > Cd > Cu. The quality of water has deterioted due to the various anthropogenic activities. Most of the metal ions were in higherconcentration compared to the standards. It has been observed that the quality of the surface water is not safe for aquatic and domestic life, hence necessary management actions should be taken to control the quality of the surface water.
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Affiliation(s)
- M Sridevi Karpagavalli
- Centre for Climate Change and Adaptation Research, Anna University, Chennai--600 025, India
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Stapleton S, Flanary J, Hamblin F, Steinbrueck S, Rodriguez L, Tuite G, Carey C, Storrs B, Lavey R, Fangusaro J, Jakacki R, Kaste S, Goldman S, Pollack I, Boyett J, Kun L, Gururangan S, Jakacki R, Dombi E, Steinberg S, Goldman S, Kieran M, Ullrich N, Widemann B, Goldman S, Fangusaro J, Lulla R, Reinholdt N, Newmark M, Urban M, Chi S, Manley P, Robison N, Kroon HA, Kieran M, Stancokova T, Husakova K, Deak L, Fangusaro J, Gururangan S, Onar-Thomas A, Packer R, Goldman S, Kaste S, Friedman H, Poussaint TY, Kun L, Boyett J, Gudrun F, Tippelt S, Zimmermann M, Rutkowski S, Warmuth-Metz M, Pietsch T, Faldum A, Bode U, Slavc I, Peyrl A, Chocholous M, Kieran M, Azizi A, Czech T, Dieckmann K, Haberler C, Macy M, Kieran M, Chi S, Cohen K, MacDonald T, Smith A, Etzl M, Naranderan A, Gore L, DiRenzo J, Trippett T, Foreman N, Dunkel I, Fisher MJ, Meyer J, Roberts T, Belasco JB, Phillips PC, Lustig R, Cahill AM, Laureano A, Huls H, Somanchi S, Denman C, Liadi I, Khatua S, Varadarajan N, Champlin R, Lee D, Cooper L, Silla L, Gopalakrishnan V, Legault G, Hagiwara M, Ballas M, Brown K, Vega E, Nusbaum A, Bloom M, Hochman T, Goldberg J, Golfinos J, Roland JT, Allen J, Karajannis M, Karajannis M, Bergner A, Giovannini M, Welling DB, Niparko J, Slattery W, Roland JT, Golfinos J, Allen J, Blakeley J, Owens C, Sung L, Lowis S, Rutkowski S, Gentet JC, Bouffet E, Henry J, Bala A, Freeman S, King A, Rutherford S, Mills S, Huson S, McBain C, Lloyd S, Evans G, McCabe M, Lee Y, Bartels U, Tabori U, Jansen L, Mabbott D, Bouffet E, Huang A, Aguilera D, Mazewski C, Fangusaro J, MacDonald T, McNall R, Hayes L, Liu Y, Castellino R, Cole D, Lester-McCully C, Widemann B, Warren K, Robison N, Campigotto F, Chi S, Manley P, Turner C, Zimmerman MA, Chordas C, Allen J, Goldman S, Rubin J, Isakoff M, Pan W, Khatib Z, Comito M, Bendel A, Pietrantonio J, Kondrat L, Hubbs S, Neuberg D, Kieran M, Wetmore C, Broniscer A, Wright K, Armstrong G, Baker J, Pai-Panandiker A, Kun L, Patay Z, Onar-Thomas A, Ramachandran A, Turner D, Gajjar A, Stewart C. CLINICAL TRIALS. Neuro Oncol 2012; 14:i16-i21. [PMCID: PMC3483342 DOI: 10.1093/neuonc/nos096] [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: 04/23/2024] Open
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Bhaskaran B, Ramachandran A, Jones R, Moufouma-Okia W. Regional climate model applications on sub-regional scales over the Indian monsoon region: The role of domain size on downscaling uncertainty. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/2012jd017956] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Radhapriya P, NavaneethaGopalakrishnan A, Malini P, Ramachandran A. Assessment of air pollution tolerance levels of selected plants around cement industry, Coimbatore, India. J Environ Biol 2012; 33:635-641. [PMID: 23029915] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Being the second largest manufacturing industry in India, cement industry is one of the major contributors of suspended particulate matter (SPM). Since plants are sensitive to air pollution, introducing suitable plant species as part of the greenbelt around cement industry was the objective of the present study. Suitable plant species were selected based on the Air pollution tolerance index (APTI) calculated by analyzing ascorbic acid (AA), pH, relative water content (RWC) and total chlorophyll (TChl) of the plants occuring in the locality. Plants were selected within a 6 km radius from the industry and were graded as per their tolerance levels by analyzing the biochemical parameters. From the statistical analysis at 0.05 level of significance a difference in the APTI values among the 27 plant species was observed, but they showed homogenous results when analysed zone wise using one-way analyses of variance. Analyses of individual parameters showed variation in the different zones surrounding the cement industry, whereas the APTI value (which is a combination of the parameter viz. AA, RWC, TChl, pH) showed more or less same gradation. Significant variation in individual parameters and APTI was seen with in the species. All the plants surrounding the cement industry are indicative of high pollution exposure comparable to the results obtain for control plants. Based on the APTI value, it was observed that about 37% of the plant species were tolerant. Among them Mangifera indica, Bougainvillea species, Psidum quajava showed high APTI values. 33% of the species were highly susceptible to the adverse effects of SPM, among which Thevetia neriifolia, Saraca indica, Phyllanthus emblica and Cercocarpus ledifolius showed low APTI values. 15% each of the species were at the intermediary and moderate tolerance levels.
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Affiliation(s)
- P Radhapriya
- Center for Climate Change and Adaptation Research, Anna University, Chennai-600 025, India.
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Ramachandran A, Snehalatha C, Samith Shetty A, Nanditha A. Predictive value of HbA1c for incident diabetes among subjects with impaired glucose tolerance--analysis of the Indian Diabetes Prevention Programmes. Diabet Med 2012; 29:94-8. [PMID: 21790773 DOI: 10.1111/j.1464-5491.2011.03392.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS The objectives of the study were to assess the predictive value of baseline HbA(1c) for incident diabetes among the participants with impaired glucose tolerance in the Indian Diabetes Prevention Programmes 1 and 2. METHODS Data at baseline and at 3-year follow-up were analysed in combined cohorts of the Indian Diabetes Prevention Programmes 1 and 2. Within the 3 years, 324 of the 845 participants developed diabetes (World Health Organization criteria). The predictive value of baseline HbA(1c) for incident diabetes was determined by logistic regression analysis. RESULTS Baseline HbA(1c) values had heterogenous distribution. The distribution was similar in isolated impaired glucose tolerance or in impaired glucose tolerance in combination with impaired fasting glucose. A progressive increase in diabetes occurred with increasing HbA(1c). HbA(1c) showed the strongest association with incident diabetes in the multiple logistic regression analysis (odds ratio 3.548, P < 0.0001). The cut-off HbA(1c) of 43 mmol/mol (6.05%) had 67% sensitivity and 60% specificity to predict future diabetes. The diagnostic sensitivity of HbA(1c) of ≥ 48 mmol/mol (≥ 6.5%) was only 51%, with a specificity of 87%, when compared with the oral glucose tolerance glucose values. CONCLUSIONS Baseline HbA(1c) was highly predictive of future diabetes in Asian Indian subjects with impaired glucose tolerance and nearly 60% of the incidence occurred with values ≥ 42 mmol/mol (≥ 6.0). Diagnostic sensitivity of HbA(1c) ≥ 48 mmol/mol (≥ 6.5%) for new diabetes was only 51% using the oral glucose tolerance test as the standard for comparison.
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Affiliation(s)
- A Ramachandran
- India Diabetes Research Foundation and Dr A. Ramachandran's Diabetes Hospitals, Chennai, India.
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Punthakee Z, Bosch J, Dagenais G, Diaz R, Holman R, Probstfield JL, Ramachandran A, Riddle MC, Rydén LE, Zinman B, Afzal R, Yusuf S, Gerstein HC. Design, history and results of the Thiazolidinedione Intervention with vitamin D Evaluation (TIDE) randomised controlled trial. Diabetologia 2012; 55:36-45. [PMID: 22038523 DOI: 10.1007/s00125-011-2357-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Accepted: 10/06/2011] [Indexed: 11/26/2022]
Abstract
AIMS/OBJECTIVE Conflicting data regarding cardiovascular effects of thiazolidinediones (TZDs) and extra-skeletal effects of vitamin D supported the need for a definitive trial. The Thiazolidinedione Intervention with vitamin D Evaluation (TIDE) trial aimed to assess the effects of TZDs (rosiglitazone and pioglitazone) on cardiovascular outcomes and the effects of vitamin D (cholecalciferol) on cancers and mortality. METHODS A large multicentre 3 × 2 factorial double-blind placebo-controlled randomised trial recruited from outpatient primary care and specialty clinics in 33 countries. From June 2009 to July 2010, 1,332 people with type 2 diabetes and other cardiovascular risk factors aged ≥ 50 years whose HbA(1c) was 6.5-9.5% (48-80 mmol/mol) when using two or fewer glucose-lowering drugs were randomised by a central computer system to placebo (n = 541), rosiglitazone 4-8 mg/day (n = 399) or pioglitazone 30-45 mg/day (n = 392); 1,221 participants were randomised to placebo (n = 614) or vitamin D 1,000 IU/day (n = 607). Participants and all study personnel were blind to treatment allocation. The primary outcome for the TZD arm was the composite of myocardial infarction, stroke or cardiovascular death, and for the vitamin D arm it was cancer or all-cause death. All randomised participants were included in the primary analysis. RESULTS From the study design, 16,000 people were to be followed for approximately 5.5 years. However, the trial was stopped prematurely because of regulatory concerns after a mean of 162 days without consideration of the accrued data. In the TZD arm, the cardiovascular outcome occurred in five participants (0.9%) in the placebo groups and three participants (0.4%) in the TZD groups (two allocated to pioglitazone, one to rosiglitazone). In the vitamin D arm, the primary outcome occurred in three participants (0.5%) in the placebo group and in two participants (0.3%) receiving vitamin D. Adverse events were comparable in all groups. CONCLUSIONS/INTERPRETATION Uncertainty persists regarding the clinically relevant risks and benefits of TZDs and vitamin D because of the early cancellation of this comprehensive trial.
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Affiliation(s)
- Z Punthakee
- Population Health Research Institute, McMaster University, 237 Barton St E., Hamilton, ON, Canada, L8L 2X2.
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Snyder LA, Honea N, Coons SW, Eschbacher J, Smith KA, Spetzler RF, Sanai N, Groves MD, DeGroot J, Tremont I, Forman A, Kang S, Pei BL, Julie W, Schultz D, Yuan Y, Guha N, Hwu WJ, Papadopoulos N, Camphausen K, Yung WA, Ryken T, Johnston SK, Graham C, Grimm S, Colman H, Raizer J, Chamberlain MC, Mrugala MM, Adair JE, Beard BC, Silbergeld DL, Rockhill JK, Kiem HP, Lee EQ, Batchelor TT, Lassman AB, Schiff DS, Kaley TJ, Wong ET, Mikkelsen T, Purow BW, Drappatz J, Norden AD, Beroukhim R, Weiss S, Alexander BM, Sceppa C, Gerard M, Hallisey SD, Bochacki CA, Smith KH, Muzikansky AM, Wen PY, Peereboom DM, Mikkelson T, Sloan AE, Rich JN, Supko JG, Ye X, Brewer C, Lamborn K, Prados M, Grossman SA, Zhu JJ, Recht LD, Colman H, Kesari S, Kim LJ, Balch AH, Pope CC, Brulotte M, Beelen AP, Chamberlain MC, Wong ET, Ram Z, Gutin PH, Stupp R, Marsh J, McDonald K, Wheeler H, Teo C, Martin L, Palmer L, Rodriguez M, Buckland M, Koh ES, Back M, Robinson B, Joseph D, Nowak AK, Saito R, Sonoda Y, Yamashita Y, Kanamori M, Kumabe T, Tominaga T, Rodon J, Tawbi HA, Thomas AL, Amakye DD, Granvil C, Shou Y, Dey J, Buonamici S, Dienstmann R, Mita AC, Dummer R, Hutterer M, Martha N, Sabine E, Thaddaus G, Florian S, Christine M, Stefan O, Richard G, Martin M, Johanna B, Jochen T, Ullrich H, Wolfgang W, Peter V, Gunther S, Field KM, Cher L, Wheeler H, Hovey E, Nowak AK, Simes J, Sawkins K, France T, Brown C, Nicholas MK, Chmura S, Paleologos N, Krouwer H, Malkin M, Junck L, Vick NA, Lukas RV, Jaeckle KA, Anderson SK, Kosel M, Sarkaria J, Brown P, Flynn PJ, Buckner JC, Galanis E, Batchelor T, Grossman S, Brem S, Lesser G, Voloschin A, Nabors LB, Mikkelsen T, Desideri S, Supko J, Peereboom D, Westphal M, Pietsch T, Bach F, Heese O, Vredenburgh JJ, Desjardins A, Reardon DA, Peters KB, Kirkpatrick JP, Herndon JE, Coan AD, Bailey L, Janney D, Lu C, Friedman HS, Desjardins A, Reardon DA, Peters KB, Herndon JE, Gururangan S, Norfleet J, Friedman HS, Vredenburgh JJ, Lassman AB, Kaley TJ, DeAngelis LM, Hormigo A, Mellinghoff IK, Otap DD, Seger J, Doyle LA, Ludwig E, Lacouture ME, Panageas KS, Rezazadeh A, LaRocca RV, Vitaz TW, Villanueva WG, Hodes J, Haysley L, Pertschuk D, Cloughesy TF, Chang SM, Aghi MK, Vogelbaum MA, Liau LM, Shafa B, Jolly DJ, Ibanez CE, Perez OD, Robbins JM, Gruber HE, Maher EA, Stewart C, Hatanpaa K, Raisanen J, Mashimo T, Yang XL, Muralidhara C, Madden C, Ramachandran A, Mickey B, Bachoo R. ONGOING CLINICAL TRIALS. Neuro Oncol 2011; 13:iii85-iii91. [PMCID: PMC3199166 DOI: 10.1093/neuonc/nor154] [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: 11/27/2023] Open
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Gagliardino JJ, Aschner P, Baik SH, Chan J, Chantelot JM, Ilkova H, Ramachandran A. Patients' education, and its impact on care outcomes, resource consumption and working conditions: data from the International Diabetes Management Practices Study (IDMPS). Diabetes Metab 2011; 38:128-34. [PMID: 22019715 DOI: 10.1016/j.diabet.2011.09.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Revised: 09/01/2011] [Accepted: 09/01/2011] [Indexed: 10/16/2022]
Abstract
AIM To evaluate the impact of diabetes education provided to patients with type 2 diabetes mellitus (T2DM) in non-controlled studies ("real-world conditions") on quality of care, resource consumption and conditions of employment. METHODS This cross-sectional study and longitudinal follow-up describe the data (demographic and socioeconomic profiles, clinical characteristics, treatment of hyperglycaemia and associated cardiovascular risk factors, resource consumption) collected during the second phase (2006) of the International Diabetes Management Practices Study (IDMPS). Patients received diabetes education directly from the practice nurse, dietitian or educator, or were referred to ad hoc group-education programmes; all programmes emphasized healthy lifestyle changes, self-care and active participation in disease control and treatment. Educated vs non-educated T2DM patients (n=5692 in each group), paired by age, gender and diabetes duration, were randomly recruited for the IDMPS by participating primary-care physicians from 27 countries in Eastern Europe, Asia, Latin America and Africa. Outcome measures included clinical (body weight, height, waist circumference, blood pressure, foot evaluation), metabolic (HbA(1c) levels, blood lipid profile) and biochemical control measures. Treatment goals were defined according to American Diabetes Association guidelines. RESULTS T2DM patients' education significantly improved the percentage of patients achieving target values set by international guidelines. Educated patients increased their insulin use and self-care performance, had a lower rate of chronic complications and a modest increase in cost of care, and probably higher salaries and slightly better productivity. CONCLUSION Diabetes education is an efficient tool for improving care outcomes without having a major impact on healthcare costs.
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Affiliation(s)
- J J Gagliardino
- Center of Experimental and Applied Endocrinology, La Plata National Scientific and Technical Research Council-La Plata National University, PAHO/WHO Collaborating Centre for Diabetes, La Plata, Argentina.
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Langenberg C, Sharp S, Forouhi NG, Franks PW, Schulze MB, Kerrison N, Ekelund U, Barroso I, Panico S, Tormo MJ, Spranger J, Griffin S, van der Schouw YT, Amiano P, Ardanaz E, Arriola L, Balkau B, Barricarte A, Beulens JWJ, Boeing H, Bueno-de-Mesquita HB, Buijsse B, Chirlaque Lopez MD, Clavel-Chapelon F, Crowe FL, de Lauzon-Guillan B, Deloukas P, Dorronsoro M, Drogan D, Froguel P, Gonzalez C, Grioni S, Groop L, Groves C, Hainaut P, Halkjaer J, Hallmans G, Hansen T, Huerta Castaño JM, Kaaks R, Key TJ, Khaw KT, Koulman A, Mattiello A, Navarro C, Nilsson P, Norat T, Overvad K, Palla L, Palli D, Pedersen O, Peeters PH, Quirós JR, Ramachandran A, Rodriguez-Suarez L, Rolandsson O, Romaguera D, Romieu I, Sacerdote C, Sánchez MJ, Sandbaek A, Slimani N, Sluijs I, Spijkerman AMW, Teucher B, Tjonneland A, Tumino R, van der A DL, Verschuren WMM, Tuomilehto J, Feskens E, McCarthy M, Riboli E, Wareham NJ. Design and cohort description of the InterAct Project: an examination of the interaction of genetic and lifestyle factors on the incidence of type 2 diabetes in the EPIC Study. Diabetologia 2011; 54:2272-82. [PMID: 21717116 PMCID: PMC4222062 DOI: 10.1007/s00125-011-2182-9] [Citation(s) in RCA: 154] [Impact Index Per Article: 11.8] [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: 12/10/2010] [Accepted: 04/04/2011] [Indexed: 10/18/2022]
Abstract
AIMS/HYPOTHESIS Studying gene-lifestyle interaction may help to identify lifestyle factors that modify genetic susceptibility and uncover genetic loci exerting important subgroup effects. Adequately powered studies with prospective, unbiased, standardised assessment of key behavioural factors for gene-lifestyle studies are lacking. This case-cohort study aims to investigate how genetic and potentially modifiable lifestyle and behavioural factors, particularly diet and physical activity, interact in their influence on the risk of developing type 2 diabetes. METHODS Incident cases of type 2 diabetes occurring in European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts between 1991 and 2007 from eight of the ten EPIC countries were ascertained and verified. Prentice-weighted Cox regression and random-effects meta-analyses were used to investigate differences in diabetes incidence by age and sex. RESULTS A total of 12,403 verified incident cases of type 2 diabetes occurred during 3.99 million person-years of follow-up of 340,234 EPIC participants eligible for InterAct. We defined a centre-stratified subcohort of 16,154 individuals for comparative analyses. Individuals with incident diabetes who were randomly selected into the subcohort (n = 778) were included as cases in the analyses. All prevalent diabetes cases were excluded from the study. InterAct cases were followed-up for an average of 6.9 years; 49.7% were men. Mean baseline age and age at diagnosis were 55.6 and 62.5 years, mean BMI and waist circumference values were 29.4 kg/m(2) and 102.7 cm in men, and 30.1 kg/m(2) and 92.8 cm in women, respectively. Risk of type 2 diabetes increased linearly with age, with an overall HR of 1.56 (95% CI 1.48-1.64) for a 10 year age difference, adjusted for sex. A male excess in the risk of incident diabetes was consistently observed across all countries, with a pooled HR of 1.51 (95% CI 1.39-1.64), adjusted for age. CONCLUSIONS/INTERPRETATION InterAct is a large, well-powered, prospective study that will inform our understanding of the interplay between genes and lifestyle factors on the risk of type 2 diabetes development.
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Affiliation(s)
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- Medical Research Council Epidemiology Unit, Institute of Metabolic Science, Addenbrooke’s Hospital, Box 285, Cambridge CB2 0QQ, UK e-mail:
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Raol J, Ramachandran A. Aerospace Avionics and Allied Technologies. DEFENCE SCI J 2011. [DOI: 10.14429/dsj.61.1122] [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: 11/13/2022]
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Ramachandran A. Validation of the MDRF-IDRS through Boloor Diabetes Study. J Assoc Physicians India 2011; 59:462; author reply 462. [PMID: 22315759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Heinrich MC, Griffith D, McKinley A, Presnell A, Ramachandran A. The effect of crenolanib (CP-868596) on phosphorylation of the imatinib-resistant D842V PDGFRA activating mutation associated with advanced gastrointestinal stromal tumors. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10012] [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: 11/20/2022] Open
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