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Nishio Lucar AG, Patel A, Mehta S, Yadav A, Doshi M, Urbanski MA, Concepcion BP, Singh N, Sanders ML, Basu A, Harding JL, Rossi A, Adebiyi OO, Samaniego-Picota M, Woodside KJ, Parsons RF. Expanding the access to kidney transplantation: Strategies for kidney transplant programs. Clin Transplant 2024; 38:e15315. [PMID: 38686443 DOI: 10.1111/ctr.15315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 03/05/2024] [Accepted: 03/28/2024] [Indexed: 05/02/2024]
Abstract
Kidney transplantation is the most successful kidney replacement therapy available, resulting in improved recipient survival and societal cost savings. Yet, nearly 70 years after the first successful kidney transplant, there are still numerous barriers and untapped opportunities that constrain the access to transplant. The literature describing these barriers is extensive, but the practices and processes to solve them are less clear. Solutions must be multidisciplinary and be the product of strong partnerships among patients, their networks, health care providers, and transplant programs. Transparency in the referral, evaluation, and listing process as well as organ selection are paramount to build such partnerships. Providing early culturally congruent and patient-centered education as well as maximizing the use of local resources to facilitate the transplant work up should be prioritized. Every opportunity to facilitate pre-emptive kidney transplantation and living donation must be taken. Promoting the use of telemedicine and kidney paired donation as standards of care can positively impact the work up completion and maximize the chances of a living donor kidney transplant.
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Affiliation(s)
- Angie G Nishio Lucar
- Department of Medicine, University of Virginia Health, Charlottesville, Virginia, USA
| | - Ankita Patel
- Recanati-Miller Transplantation Institute, The Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Shikha Mehta
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Anju Yadav
- Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Mona Doshi
- Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Megan A Urbanski
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | | | - Neeraj Singh
- Willis Knighton Health System, Shreveport, Louisiana, USA
| | - M Lee Sanders
- Department of Internal Medicine, Division of Nephrology, Organ Transplant Center, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Arpita Basu
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jessica L Harding
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Ana Rossi
- Piedmont Transplant Institute, Atlanta, Georgia, USA
| | - Oluwafisayo O Adebiyi
- Department of Medicine, Indiana University Health Hospital, Indianapolis, Indiana, USA
| | | | | | - Ronald F Parsons
- Department of Surgery, University of Pennsylvannia, Philadelphia, Pennsylvania, USA
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Richardson LA, Basu A, Chien LC, Pang T, Alman AC, Snell-Bergeon JK. Longitudinal associations of the alternative healthy eating index with coronary artery calcification and pericardial adiposity in US adults with and without type 1 diabetes. Nutr Metab Cardiovasc Dis 2024:S0939-4753(24)00122-4. [PMID: 38670920 DOI: 10.1016/j.numecd.2024.03.019] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 03/02/2024] [Accepted: 03/15/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND AND AIM Long-term associations between the alternative healthy eating index (AHEI) score and two predictive indicators for CVD, pericardial adipose tissue (PAT) and coronary artery calcification (CAC) volume, are lacking. Our study aims to investigate the longitudinal associations of the AHEI score with measures of CAC and PAT in adults with and without type 1 diabetes (T1D). METHODS AND RESULTS The prospective Coronary Artery Calcification in T1D (CACTI) study included 652 people with T1D and 764 people without diabetes (non-DM) (19-56 years old) and was conducted in 2000-2002, 2003-2004, and 2006-2007. At each visit, food frequency questionnaires were collected and PAT and CAC were measured using electron beam computed tomography. Two variables were used for CAC analyses: a continuous variable for the square-root tranformed volume (SRV) for each visit and a second variable identified CAC progression from baseline to visit 3. Mixed effect models and a logistic regression model were used to conduct statistical analyses. A one-point increase in the AHEI score was significantly associated with a -0.12 cm3 (95% CI: -0.17, -0.08; p-value<0.0001) decrease in PAT volume in combined analyses, a -0.16 cm3 (95% CI: -0.22, -0.09; p-value<0.0001) decrease in the non-DM group, a marginally significant -0.07 cm3 (95% CI: -0.14, 0.002; p-value = 0.0571) decrease in the T1D group, and was not associated with either CAC outcome. CONCLUSION The AHEI score is inversely associated with PAT; the association revealed greater magnitude of PAT reduction in the non-DM group. The AHEI score did not associate with CAC progression.
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Affiliation(s)
- Leigh Ann Richardson
- Department of Epidemiology and Biostatistics, University of Nevada at Las Vegas, USA
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, University of Nevada at Las Vegas, USA.
| | - Lung-Chang Chien
- Department of Epidemiology and Biostatistics, University of Nevada at Las Vegas, USA
| | - Tiantian Pang
- College of Public Health, University of South Florida, USA
| | - Amy C Alman
- College of Public Health, University of South Florida, USA
| | - Janet K Snell-Bergeon
- Barbara Davis Center for Diabetes, University of Colorado, Anschutz Medical Campus, USA
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Casey MJ, Murakami N, Ong S, Adler JT, Singh N, Murad H, Parajuli S, Concepcion BP, Lubetzky M, Pavlakis M, Woodside KJ, Faravardeh A, Basu A, Tantisattamo E, Aala A, Gruessner AC, Dadhania DM, Lentine KL, Cooper M, Parsons RF, Alhamad T. Medical and Surgical Management of the Failed Pancreas Transplant. Transplant Direct 2024; 10:e1543. [PMID: 38094134 PMCID: PMC10715788 DOI: 10.1097/txd.0000000000001543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/09/2023] [Accepted: 08/11/2023] [Indexed: 02/22/2024] Open
Abstract
Despite the continued improvements in pancreas transplant outcomes in recent decades, a subset of recipients experience graft failure and can experience substantial morbidity and mortality. Here, we summarize what is known about the failed pancreas allograft and what factors are important for consideration of retransplantation. The current definition of pancreas allograft failure and its challenges for the transplant community are explored. The impacts of a failed pancreas allograft are presented, including patient survival and resultant morbidities. The signs, symptoms, and medical and surgical management of a failed pancreas allograft are described, whereas the options and consequences of immunosuppression withdrawal are reviewed. Medical and surgical factors necessary for successful retransplant candidacy are detailed with emphasis on how well-selected patients may achieve excellent retransplant outcomes. To achieve substantial medical mitigation and even pancreas retransplantation, patients with a failed pancreas allograft warrant special attention to their residual renal, cardiovascular, and pulmonary function. Future studies of the failed pancreas allograft will require improved reporting of graft failure from transplant centers and continued investigation from experienced centers.
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Affiliation(s)
- Michael J. Casey
- Division of Nephrology, Medical University of South Carolina, Charleston, SC
| | - Naoka Murakami
- Division of Renal Medicine, Brigham and Women Hospital, Boston, MA
| | - Song Ong
- Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL
| | - Joel T. Adler
- Division of Transplant Surgery, University of Texas at Austin, Austin, TX
| | | | - Haris Murad
- Section of Nephrology, The Aga Khan University, Medical College, Pakistan
| | | | | | | | | | | | | | - Arpita Basu
- Division of Renal Medicine, Emory University, Atlanta, GA
| | | | - Amtul Aala
- Division of Nephrology, Beth Israel Deaconess, Boston, MA
| | | | | | - Krista L. Lentine
- Division of Nephrology, SSM Health Saint Louis University Transplant Center, St. Louis, MO
| | - Matthew Cooper
- Division of Transplant Surgery, Medical College of Wisconsin, Milwaukee, WI
| | - Ronald F. Parsons
- Division of Transplant Surgery, University of Pennsylvania, Philadelphia, PA
| | - Tarek Alhamad
- Division of Nephrology, Washington University in St Louis, St. Louis, MO
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Basu A, Richardson LA, Carlos A, Abubakr NH, Weltman RL, Ebersole JL. The Associations of Cardiometabolic and Dietary Variables with Clinical Periodontitis in Adults with and without Type 2 Diabetes: A Cross-Sectional Study. Nutrients 2023; 16:81. [PMID: 38201914 PMCID: PMC10780717 DOI: 10.3390/nu16010081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
Periodontitis is a commonly occurring inflammatory oral disease affecting a large proportion of global and US adults and is characterized by the destruction of the tooth-supporting apparatus. Its etiology is multifactorial, and type 2 diabetes and diet play critical roles in its remission and progression. However, few studies have addressed nutritional and serum vitamin D status in adults with periodontitis in the presence of diabetes. A cross-sectional study (n = 78), and a sub-set of age- and BMI-matched case-control studies (n = 50), were conducted to examine differences in dietary and cardiometabolic variables, and serum vitamin D in adults with periodontitis with or without diabetes. Participants provided fasting blood samples and 24-h diet recalls on at least two different days. Data on health history, body weight, height, nutritional habits, and clinical features of periodontitis were also collected. The Mann-Whitney U Test (with exact p-value estimation by Monte Carlo simulation) was used to examine differences by diabetes status in continuous and ordinal variables. Results revealed significantly lower serum vitamin D, and dietary intake of fruits, vegetables, dairy, vitamins A and C in adults with periodontitis with vs. without diabetes in the sub-study (all p < 0.05). In the overall sample, adults with diabetes presented with higher caries risk measures and lower numbers of teeth than those without diabetes; plaque and bleeding scores did not differ by diabetes status. Finally, a significant associations of food habits was observed, especially consuming protein-rich foods twice a day with a lower bleeding score, and daily consumption of fried or fast foods with a fewer number of teeth present (all p < 0.05). The present findings show significant dietary and serum vitamin D inadequacies among adults with periodontitis, and diabetes further aggravates the observed malnourishment and oral health.
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Affiliation(s)
- Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA;
| | - Leigh Ann Richardson
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA;
| | - Alicia Carlos
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA; (A.C.); (N.H.A.); (J.L.E.)
| | - Neamat Hassan Abubakr
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA; (A.C.); (N.H.A.); (J.L.E.)
| | - Robin L. Weltman
- Department of Clinical Sciences, School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA;
| | - Jeffrey L. Ebersole
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA; (A.C.); (N.H.A.); (J.L.E.)
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Richardson LA, Basu A, Chien LC, Alman AC, Snell-Bergeon JK. Longitudinal associations of physical activity with inflammatory markers in US adults with and without type 1 diabetes. Diabetes Res Clin Pract 2023; 206:110978. [PMID: 37890704 PMCID: PMC10841646 DOI: 10.1016/j.diabres.2023.110978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/28/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023]
Abstract
AIMS To investigate the longitudinal associations of different levels of moderate-to-vigorous physical activity (MVPA) with C-reactive protein (CRP), plasminogen activator inhibitor-1 (PAI-1), and fibrinogen. METHODS We conducted longitudinal analyses with data from the Coronary Artery Calcification in T1D (CACTI) cohort, which included individuals with type 1 diabetes (T1D, n = 563) and without diabetes mellitus (non-DM, n = 692) with ∼ 3 years follow-up. Individuals were divided into groups to perform two analyses: 1) those who performed any MVPA and those who were sedentary (0 mins/week) and 2) those who performed 1-149 mins/week, ≥150 mins/week, or who were sedentary. Mixed effect models with an unstructured covariance structure were applied. RESULTS Compared to sedentary individuals, any MVPA was associated with a -2.96 % decrease in fibrinogen (p-value = 0.0043) and a -11.23 % decrease in PAI-1 (p-value = 0.0007) in combined analyses. Stratified analyses found 1-149 mins/week and ≥ 150 mins/week were associated with significant decreases in fibrinogen, -5.31 % and -3.44 %, respectively, in those with T1D. Both the non-DM and T1D groups had significant decreases in PAI-1 associated with ≥ 150 mins/week (-9.11 % and -16.96 %, respectively). CONCLUSIONS Our findings highlight that meeting ≥ 150 mins/week of MVPA is inversely associated with inflammatory markers linked with increased CVD risk.
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Affiliation(s)
- Leigh Ann Richardson
- Department of Epidemiology and Biostatistics, University of Nevada at Las Vegas, United States
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, University of Nevada at Las Vegas, United States.
| | - Lung-Chang Chien
- Department of Epidemiology and Biostatistics, University of Nevada at Las Vegas, United States
| | - Amy C Alman
- College of Public Health, University of South Florida, United States
| | - Janet K Snell-Bergeon
- Barbara Davis Center for Diabetes, University of Colorado, Anschutz Medical Campus, United States
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Weigert M, Li Y, Zhu L, Eckart H, Bajwa P, Krishnan R, Ackroyd S, Lastra RR, Bilecz A, Basu A, Lengyel E, Chen M. A Cellular atlas of the human fallopian tube reveals the metamorphosis of secretory epithelial cells during the menstrual cycle and menopause. medRxiv 2023:2023.11.22.23298470. [PMID: 38045369 PMCID: PMC10690352 DOI: 10.1101/2023.11.22.23298470] [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] [Indexed: 12/05/2023]
Abstract
The fallopian tube, connecting the uterus with the ovary, is a dynamic organ that undergoes cyclical changes and is the site of several diseases, including serous cancer. Here, we use single-cell technologies to construct a comprehensive cell map of healthy pre-menopausal fallopian tubes, capturing the impact of the menstrual cycle and menopause on different fallopian tube cells at the molecular level. The comparative analysis between pre- and post-menopausal fallopian tubes reveals substantial shifts in cellular abundance and gene expression patterns, highlighting the physiological changes associated with menopause. Further investigations into menstrual cycle phases illuminate distinct molecular states in secretory epithelial cells caused by hormonal fluctuations. The markers we identified characterizing secretory epithelial cells provide a valuable tool for classifying ovarian cancer subtypes. Graphical summary Graphical summary of results. During the proliferative phase (estrogen high ) of the menstrual cycle, SE2 cells (OVGP1 + ) dominate the fallopian tube (FT) epithelium, while SE1 cells (OVGP1 - ) dominate the epithelium during the secretory phase. Though estrogen levels decrease during menopause, SE post-cells (OVGP1 + , CXCL2 + ) make up most of the FT epithelium.
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Basu A, Hooyman A, Richardson LA, Alman AC, Snell-Bergeon JK. Longitudinal Associations of Dietary Fiber Intake with Glycated Hemoglobin and Estimated Insulin Sensitivity in Adults with and without Type 1 Diabetes. Nutrients 2023; 15:4620. [PMID: 37960272 PMCID: PMC10648902 DOI: 10.3390/nu15214620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 10/27/2023] [Accepted: 10/29/2023] [Indexed: 11/15/2023] Open
Abstract
Dietary fiber, an essential bioactive compound in plant-based diets, is of public health concern based on habitual low intakes in the general population. Not much data are available on how habitual dietary fiber is associated with glycemic control in type 1 diabetes (T1D) as well as in prediabetes and normoglycemic adults. To address this gap, we conducted a six-year longitudinal analysis of an original cohort in adults with and without T1D (n = 1255; T1D: n = 563; non-diabetes mellitus (non-DM): n = 692). Dietary data were collected from a validated food frequency questionnaire, biochemical measures were obtained after an overnight fast, and anthropometric measurements were collected at baseline as well as after three and six years for the follow-up study. Glycated hemoglobin (HbA1c) and estimated insulin sensitivity (eIS) were the main outcomes examined. In adjusted analyses, dietary fiber intake was inversely associated with HbA1c in a minimally adjusted model, but it was positively associated with eIS in a model involving all relevant covariates in non-DM adults. These associations were not significant in the T1D group. Furthermore, when examined by HbA1c cut-offs for glycemic control, an inverse association with dietary fiber was only observed in adults with prediabetes (all p < 0.05). At a six-year mean (±SD) dietary fiber intake of 17.4 ± 8.8 g for non-DM and 17.0 ± 8.2 g for the T1D group, protective associations against poor glycemic control were observed in those without diabetes and in prediabetes.
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Affiliation(s)
- Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA;
| | - Andrew Hooyman
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA;
- School of Biological Health Systems Engineering, Arizona State University, Tempe, AZ 85281, USA
| | - Leigh Ann Richardson
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada Las Vegas, Las Vegas, NV 89154, USA;
| | - Amy C. Alman
- College of Public Health, University of South Florida, Tampa, FL 33620, USA;
| | - Janet K. Snell-Bergeon
- Barbara Davis Center for Diabetes, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA;
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Basu A. Carotenoid Status in Children: A Biomarker for Eye Health and Fruit and Vegetable Intake. J Nutr 2023; 153:2775-2777. [PMID: 37573013 DOI: 10.1016/j.tjnut.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/04/2023] [Accepted: 08/01/2023] [Indexed: 08/14/2023] Open
Affiliation(s)
- Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada at Las Vegas, NV, United States.
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Basu P, Maier C, Averitt DL, Basu A. NLR family pyrin domain containing 3 (NLRP3) inflammasomes and peripheral neuropathic pain - Emphasis on microRNAs (miRNAs) as important regulators. Eur J Pharmacol 2023; 955:175901. [PMID: 37451423 DOI: 10.1016/j.ejphar.2023.175901] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
Neuropathic pain is caused by the lesion or disease of the somatosensory system and can be initiated and/or maintained by both central and peripheral mechanisms. Nerve injury leads to neuronal damage and apoptosis associated with the release of an array of pathogen- or damage-associated molecular patterns to activate inflammasomes. The activation of the NLR family pyrin domain containing 3 (NLRP3) inflammasome contributes to neuropathic pain and may represent a novel target for pain therapeutic development. In the current review, we provide an up-to-date summary of the recent findings on the involvement of NLRP3 inflammasome in modulating neuropathic pain development and maintenance, focusing on peripheral neuropathic conditions. Here we provide a detailed review of the mechanisms whereby NLRP3 inflammasomes contribute to neuropathic pain via (1) neuroinflammation, (2) apoptosis, (3) pyroptosis, (4) proinflammatory cytokine release, (5) mitochondrial dysfunction, and (6) oxidative stress. We then present the current research literature reporting on the antinociceptive effects of several natural products and pharmacological interventions that target activation, expression, and/or regulation of NLRP3 inflammasome. Furthermore, we emphasize the effects of microRNAs as another regulator of NLRP3 inflammasome. In conclusion, we summarize the possible caveats and future perspectives that might provide successful therapeutic approaches against NLRP3 inflammasome for treating or preventing neuropathic pain conditions.
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Affiliation(s)
- Paramita Basu
- Pittsburgh Center for Pain Research, The Pittsburgh Project to End Opioid Misuse, Department of Anesthesiology & Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA.
| | - Camelia Maier
- Division of Biology, School of the Sciences, Texas Woman's University, Denton, TX, 76204-5799, USA.
| | - Dayna L Averitt
- Division of Biology, School of the Sciences, Texas Woman's University, Denton, TX, 76204-5799, USA.
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV, 89154, USA.
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Zuelch ML, Radtke MD, Holt RR, Basu A, Burton-Freeman B, Ferruzzi MG, Li Z, Shay NF, Shukitt-Hale B, Keen CL, Steinberg FM, Hackman RM. Perspective: Challenges and Future Directions in Clinical Research with Nuts and Berries. Adv Nutr 2023; 14:1005-1028. [PMID: 37536565 PMCID: PMC10509432 DOI: 10.1016/j.advnut.2023.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/11/2023] [Accepted: 07/31/2023] [Indexed: 08/05/2023] Open
Abstract
Consumption of nuts and berries are considered part of a healthy eating pattern. Nuts and berries contain a complex nutrient profile consisting of essential vitamins and minerals, fiber, polyunsaturated fatty acids, and phenolics in quantities that improve physiological outcomes. The spectrum of health outcomes that may be impacted by the consumptions of nuts and berries includes cardiovascular, gut microbiome, and cognitive, among others. Recently, new insights regarding the bioactive compounds found in both nuts and berries have reinforced their role for use in precision nutrition efforts. However, challenges exist that can affect the generalizability of outcomes from clinical studies, including inconsistency in study designs, homogeneity of test populations, variability in test products and control foods, and assessing realistic portion sizes. Future research centered on precision nutrition and multi-omics technologies will yield new insights. These and other topics such as funding streams and perceived risk-of-bias were explored at an international nutrition conference focused on the role of nuts and berries in clinical nutrition. Successes, challenges, and future directions with these foods are presented here.
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Affiliation(s)
- Michelle L Zuelch
- Department of Nutrition, University of California, Davis, CA, United States
| | - Marcela D Radtke
- Department of Nutrition, University of California, Davis, CA, United States
| | - Roberta R Holt
- Department of Nutrition, University of California, Davis, CA, United States
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV, United States
| | - Britt Burton-Freeman
- Department of Food Science and Nutrition, Illinois Institute of Technology, Chicago, IL, United States
| | - Mario G Ferruzzi
- Department of Pediatrics, Arkansas Children's Nutrition Center, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Zhaoping Li
- UCLA Center for Human Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Neil F Shay
- Department of Food Science and Technology, Oregon State University, Corvallis, OR, United States
| | - Barbara Shukitt-Hale
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States
| | - Carl L Keen
- Department of Nutrition, University of California, Davis, CA, United States; Department of Internal Medicine, University of California, Davis, CA, United States
| | | | - Robert M Hackman
- Department of Nutrition, University of California, Davis, CA, United States.
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Caine SB, Plant S, Furbish K, Yerton M, Smaragdi E, Niclou B, Lorusso JM, Chang JY, Bitter C, Basu A, Miller S, Huang CY, Komson R, Liu D, Behar S, Thomsen M. Sprague Dawley rats from different vendors vary in the modulation of prepulse inhibition of startle (PPI) by dopamine, acetylcholine, and glutamate drugs. Psychopharmacology (Berl) 2023; 240:2005-2012. [PMID: 37580441 PMCID: PMC10471717 DOI: 10.1007/s00213-023-06444-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 07/31/2023] [Indexed: 08/16/2023]
Abstract
RATIONALE Rodent vendors are often utilized interchangeably, assuming that the phenotype of a given strain remains standardized between colonies. Several studies, however, have found significant behavioral and physiological differences between Sprague Dawley (SD) rats from separate vendors. Prepulse inhibition of startle (PPI), a form of sensorimotor gating in which a low-intensity leading stimulus reduces the startle response to a subsequent stimulus, may also vary by vendor. Differences in PPI between rat strains are well known, but divergence between colonies within the SD strain lacks thorough examination. OBJECTIVES We explored intrastrain variation in PPI by testing SD rats from two vendors: Envigo and Charles River (CR). METHODS We selected drugs acting on four major neurotransmitter systems that have been repeatedly shown to modulate PPI: dopamine (apomorphine; 0.5, 1.5, 3.0 mg/kg), acetylcholine (scopolamine; 0.1, 0.5, 1.0 mg/kg), glutamate (dizocilpine; 0.5, 1.5, 2.5 mg/kg), and serotonin (2,5-Dimethoxy-4-iodoamphetamine, DOI; 0.25, 0.5, 1.0 mg/kg). We determined PPI and startle amplitude for each drug in male and female Envigo and CR SD rats. RESULTS SD rats from Envigo showed dose-dependent decreases in PPI after apomorphine, scopolamine, or dizocilpine administration, without significant effects on startle amplitude. SD rats from CR were less sensitive to modulation of PPI and/or more sensitive to modulation of startle amplitude, across the three drugs. CONCLUSIONS SD rats showed vendor differences in sensitivity to pharmacological modulation of PPI and startle. We encourage researchers to sample rats from separate vendors before experimentation to identify the most suited source of subjects for their specific endpoints.
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Affiliation(s)
- S B Caine
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - S Plant
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - K Furbish
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - M Yerton
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - E Smaragdi
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - B Niclou
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - J M Lorusso
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - J Y Chang
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - C Bitter
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - A Basu
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - S Miller
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - C-Y Huang
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - R Komson
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - D Liu
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - S Behar
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - M Thomsen
- Laboratory of Neuropsychiatry, Psychiatric Centre Copenhagen, Mental Health Services in the Capital Region of Denmark, Forskningsenheder, Hovedvejen 17, 1. sal, 2000 Frederiksberg, Copenhagen, Denmark.
- Department of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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12
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Coscia L, Cohen D, Dube GK, Hofmann RM, Moritz MJ, Gattis S, Basu A. Outcomes With Belatacept Exposure During Pregnancy in Kidney Transplant Recipients: A Case Series. Transplantation 2023; 107:2047-2054. [PMID: 37287109 PMCID: PMC10442140 DOI: 10.1097/tp.0000000000004634] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/03/2023] [Accepted: 03/10/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Posttransplant fertility returns quickly, and female recipients of child-bearing age may conceive while on immunosuppression. However, pregnancy after transplantation confers risks to the recipient, transplant, and fetus, including gestational hypertension, preeclampsia, gestational diabetes, transplant dysfunction, preterm labor, and low birthweight infants. Additionally, mycophenolic acid (MPA) products are teratogenic. Literature evidence regarding belatacept, a selective T-cell costimulation blocker, during pregnancy and while breastfeeding is extremely limited. When female transplant recipients on a belatacept-based regimen are desirous of pregnancy or at the time of conception, transplant providers manage the immunosuppression regimen in 1 of 2 ways: (1) switch both belatacept and MPA to a calcineurin inhibitor-based regimen with or without azathioprine, which is the more common practice but requires several modifications, having potential negative outcomes; or (2) only switch MPA to azathioprine while continuing belatacept. METHODS This case series includes 16 pregnancies in 12 recipients with exposure to belatacept throughout pregnancy and while breastfeeding. Patient information was obtained from several sources, including Transplant Pregnancy Registry International, providers at Emory University, and Columbia University, as well as literature review. RESULTS Pregnancy outcomes included 13 live births and 3 miscarriages. No birth defects or fetal deaths were reported in any of the live births. Seven infants were breastfed while their mothers continued belatacept. Outcomes appear comparable to those documented with the administration of calcineurin inhibitors. CONCLUSIONS This case series provides data supporting the continued administration of belatacept during pregnancy. Additional research will assist in developing better guidelines to counsel female transplant recipients on belatacept desiring to pursue pregnancy.
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Affiliation(s)
- Lisa Coscia
- Transplant Pregnancy Registry International, Philadelphia, PA
| | - David Cohen
- Department of Medicine, Columbia University, New York, NY
| | | | - R. Michael Hofmann
- Department of Medicine, Trinity Health Kidney Transplant Center, Grand Rapids, MI
| | - Michael J. Moritz
- Transplant Pregnancy Registry International, Philadelphia, PA
- Surgery, Lehigh Valley Health Network, Allentown, PA
- Department of Surgery, Morsani College of Medicine, Tampa, FL
| | - Sara Gattis
- Department of Pharmacy, Emory University School of Medicine, Atlanta, GA
| | - Arpita Basu
- Department of Medicine, Division of Nephrology and Division of Transplant, Emory University School of Medicine, Atlanta, GA
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13
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Jaworsky K, DeVillez P, Alexander JM, Basu A. Effects of an Eating Pattern Including Colorful Fruits and Vegetables on Management of Gestational Diabetes: A Randomized Controlled Trial. Nutrients 2023; 15:3624. [PMID: 37630814 PMCID: PMC10458836 DOI: 10.3390/nu15163624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
Gestational diabetes mellitus (GDM), defined as abnormal glucose tolerance that presents during the second and third trimesters of pregnancy, is a growing issue in the United States and worldwide. If left untreated or poorly controlled, GDM can result in numerous consequences for both the mother and the fetus; thus, it is imperative that different avenues of management for GDM be explored. There is a paucity of studies that examine how lifestyle changes, including dietary and physical activity, affect management of GDM. We examined how counseling on lifestyle changes can affect cardiometabolic risks in women with GDM. We conducted a 12-week randomized controlled trial based on behavioral counseling in which women with GDM (N = 38) were randomized into either a nutrition education (control) (N = 18) group or nutrition intervention (N = 20) group. The nutrition education group were given dietary counseling regarding healthy dietary choices based on USDA guidelines, while the nutrition intervention group were instructed to consume a total of one cup of whole berries and one cup of leafy vegetables daily along with performing postprandial exercise (walking). Blood samples, anthropometric measures, and dietary and physical activity data, recorded in daily food and activity logs, were collected at baseline and at the end of the study and compared between the two groups. Dietary counseling on supplementation with whole berries and leafy vegetables resulted in increased fiber intake, increased antioxidant intake and total serum antioxidant capacity, improved random blood glucose, decreased serum IL-6, and improved HDL cholesterol versus the control group (all p < 0.05). These results highlight that whole berry and leafy vegetable supplementation-based dietary counseling can improve the metabolic pathways involved in gestational diabetes pathogenesis and prognosis. These functional foods must be recommended in the management of pregnancies affected by GDM.
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Affiliation(s)
- Kataryna Jaworsky
- Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89154, USA;
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA;
| | - Pamela DeVillez
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA;
| | - James M. Alexander
- Department of Obstetrics and Gynecology, UNR School of Medicine, University of Nevada, Reno, NV 89557, USA;
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA;
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14
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Chavez GN, Jaworsky K, Basu A. The Effects of Plant-Derived Phytochemical Compounds and Phytochemical-Rich Diets on Females with Polycystic Ovarian Syndrome: A Scoping Review of Clinical Trials. Int J Environ Res Public Health 2023; 20:6534. [PMID: 37569074 PMCID: PMC10418663 DOI: 10.3390/ijerph20156534] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/18/2023] [Revised: 07/19/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023]
Abstract
Polycystic ovarian syndrome (PCOS) is an endocrine condition that impacts nutritional status, metabolic, and hormonal function in females of reproductive age. This condition is associated with increased androgen production (hyperandrogenism) and decreased insulin sensitivity, which often leads to insulin resistance and hyperinsulinemia. This increase in androgen production and insulin resistance is strongly associated with a high incidence of obesity, type-2 diabetes mellitus (T2DM), cardiovascular diseases (CVD), and certain types of gonad-related cancers among females who suffer from this condition. As research continues to grow, it has been demonstrated that PCOS is a complex condition, and some of its characteristics vary among the females that have this disorder. However, it has been suggested that oxidative stress and low-grade chronic inflammation could play an important role in the development of PCOS. Current evidence suggest that phytochemicals could potentially help with weight-loss by reducing oxidative stress and low-grade inflammation, as well as aid in metabolic and hormonal regulation due to their antioxidant properties. Some of the bioactive compounds found in plants that have shown positive effects in the attenuation of PCOS include flavonoids, polyphenols, phytoestrogen, and polyunsaturated fatty acids (PUFAs). Thus, a review of the current literature published on PCOS and phytochemicals was conducted in PubMed, Google Scholar, and the Academy of Nutrition and Dietetics databases for articles published between 2013 and 2023 with a study duration of 1 to 3 months and adequate sample sizes. The main purpose of this review of literature was to investigate the metabolic effects of phytochemical compounds and phytochemical-rich diets on females with PCOS by comparing the results of several randomized clinical trials.
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Affiliation(s)
- Guadalupe Nayeli Chavez
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA; (G.N.C.); (K.J.)
| | - Kataryna Jaworsky
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA; (G.N.C.); (K.J.)
- Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89106, USA
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA; (G.N.C.); (K.J.)
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15
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Bonet J, Yadav Y, Miles J, Basu A, Cobelli C, Basu R, Dalla Man C. A new oral model of free fatty acid kinetics to assess lipolysis in subjects with and without type 2 diabetes. Am J Physiol Endocrinol Metab 2023; 325:E163-E170. [PMID: 37378622 PMCID: PMC10393336 DOI: 10.1152/ajpendo.00091.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/02/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023]
Abstract
Assessing free fatty acids (FFAs) kinetics and the role of insulin and glucose on FFA lipolysis and disposal may improve our understanding of the pathogenesis of type 2 diabetes (T2D). Some models have been proposed to describe FFA kinetics during an intravenous glucose tolerance test and only one during an oral glucose tolerance test. Here, we propose a model of FFA kinetics during a meal tolerance test and use it to assess possible differences in postprandial lipolysis in individuals with type 2 diabetes (T2D) and individuals with obesity without type 2 diabetes (ND). We studied 18 obese ND and 16 T2D undergoing three meal tolerance tests (MTT) on three occasions (breakfast, lunch, and dinner). We used plasma glucose, insulin, and FFA concentrations collected at breakfast to test a battery of models and selected the best one based on physiological plausibility, ability to fit the data, precision of parameter estimates, and the Akaike parsimony criterion. The best model assumes that the postprandial suppression of FFA lipolysis is proportional to the above basal insulin, while FFA disposal is proportional to FFA concentration. It was used to compare FFA kinetics in ND and T2D along the day. The maximum lipolysis suppression occurred significantly earlier in ND than T2D (39 ± 6 min vs. 102 ± 13 min, 36 ± 4 min vs. 78 ± 11 min, and 38 ± 6 min vs. 84 ± 13 min, P < 0.01, at breakfast, lunch, and dinner, respectively), making lipolysis significantly lower in ND than T2D. This is mainly attributable to the lower insulin concentration in the second group. This novel FFA model allows to assess lipolysis and insulin antilipolytic effect in postprandial conditions.NEW & NOTEWORTHY In this study, we propose a new mathematical model able to quantify postprandial FFA kinetics and adipose tissue insulin sensitivity in both subjects with obesity without type 2 diabetes (ND) and subjects with type 2 diabetes (T2D). Results show that the slower postprandial suppression of lipolysis in T2D contributes to the higher free fatty acid (FFA) concentration that, in turn, may contribute to hyperglycemia.
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Affiliation(s)
- J. Bonet
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Y. Yadav
- Division of Endocrinology, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, United States
| | - J. Miles
- University of Kansas Medical Center, Kansas City, Kansas, United States
| | - A. Basu
- Division of Endocrinology, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, United States
| | - C. Cobelli
- Department of Woman and Child’s Health, University of Padova, Padova, Italy
| | - R. Basu
- Division of Endocrinology, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, United States
| | - C. Dalla Man
- Department of Information Engineering, University of Padova, Padova, Italy
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16
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Pang T, Gray HL, Alman AC, Buro AW, Basu A, Lu S, Snell-Bergeon JK. Ultra-processed food consumption and obesity indicators in individuals with and without type 1 diabetes mellitus: a longitudinal analysis of the prospective Coronary Artery Calcification in Type 1 Diabetes (CACTI) cohort study. Public Health Nutr 2023; 26:1626-1633. [PMID: 37129091 PMCID: PMC10410376 DOI: 10.1017/s1368980023000848] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 02/23/2023] [Accepted: 04/25/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To evaluate the associations of ultra-processed food (UPF) consumption and obesity indicators among individuals with and without type 1 diabetes mellitus (T1DM) from the Coronary Artery Calcification in Type 1 Diabetes cohort study. DESIGN A secondary analysis. The consumption of UPF was assessed using the dietary data collected with the Harvard FFQ, and each food item was categorised according to the NOVA food processing classification. Height, weight and waist circumference were measured at baseline and after a mean of 14·6-year follow-up. Generalised estimating equations stratified by diabetes status were used to assess the associations between UPF intake and obesity indicators over 14 years of follow-up. SETTING USA. PARTICIPANTS A total of 600 adults (256 T1DM and 344 non-diabetic controls) aged 39 ± 9·1 years at baseline and followed up for over 14 years were included. RESULTS Participants with T1DM consumed significantly more UPF than non-diabetic controls at baseline: 7·6 ± 3·8 v. 6·6 ± 3·4 servings per day of UPF, respectively (P < 0·01). Participants with T1DM and with the highest UPF intake had the highest weight (βQ4 v. Q1 = 3·07) and BMI (βQ4 v. Q1 = 1·02, all P < 0·05) compared with those with the lowest UPF intake. Similar positive associations were observed in non-diabetic controls. CONCLUSIONS Individuals with T1DM may consume more UPF than non-diabetic controls. Positive associations between UPF consumption and obesity indicators suggest that limiting UPF can be recommended for obesity prevention and management. Further research is needed to confirm these findings.
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Affiliation(s)
- Tiantian Pang
- College of Public Health, University of South Florida, Tampa, FL33612, USA
| | - Heewon L Gray
- College of Public Health, University of South Florida, Tampa, FL33612, USA
| | - Amy C Alman
- College of Public Health, University of South Florida, Tampa, FL33612, USA
| | | | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Shi Lu
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
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17
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Richardson LA, Basu A, Chien LC, Alman AC, Snell-Bergeon JK. Longitudinal Associations of Healthy Dietary Pattern Scores with Coronary Artery Calcification and Pericardial Adiposity in United States Adults with and without Type 1 Diabetes. J Nutr 2023; 153:2085-2093. [PMID: 37187353 PMCID: PMC10375506 DOI: 10.1016/j.tjnut.2023.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/04/2023] [Accepted: 05/11/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Pericardial adipose tissue volume (PAT) and coronary artery calcification (CAC) are prognostic indicators for future cardiovascular events; however, no studies have assessed the long-term associations of adherence to dietary patterns (DPs) with PAT and CAC in adults with and without type 1 diabetes (T1D). OBJECTIVES We investigated the longitudinal associations of the Mediterranean Diet (MedDiet) and Dietary Approaches to Stop Hypertension (DASH) diet with PAT and CAC progression in adults with and without T1D. METHODS The Coronary Artery Calcification in Type 1 Diabetes (CACTI) study is a population-based, prospective study of 652 T1D and 764 nondiabetic mellitus (nonDM) (19-56 y) participants that began in 2000-2002 with follow-up visits in 2003-2004 and 2006-2007. At each visit, food frequency questionnaires were collected and used to develop adherence scores for the MedDiet and DASH diets. PAT and CAC were measured at each visit using electron beam computed tomography. CAC progression was defined as a ≥2.5 mm square root-transformed volume. Mixed effect models were used to conduct statistical analyses. RESULTS Combined models found a significant-0.09 cm3 (95% CI: -0.14, -0.03; P = 0.0027) inverse association in PAT for every 1-point increase in the MedDiet score and a significant-0.26 cm3 (95% CI: -0.38, -0.14; P < 0.0001) inverse association in PAT for every 1-point increase in the DASH score. In combined models, the DPs were not significantly associated with lower odds of CAC progression; however, both DPs had significant interactions by diabetes status for CAC. Only the DASH diet was associated with lower odds of CAC progression in the nonDM group (OR: 0.96; 95% CI: 0.93, 0.99; P = 0.0224). CONCLUSIONS These data suggest that the DPs are associated with lower PAT, which may reduce future cardiovascular events. The DASH diet may be beneficial for lower odds of CAC progression in those without T1D.
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Affiliation(s)
- Leigh Ann Richardson
- Department of Epidemiology and Biostatistics, University of Nevada at Las Vegas, Las Vegas, NV, United States
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, University of Nevada at Las Vegas, Las Vegas, NV, United States.
| | - Lung-Chang Chien
- Department of Epidemiology and Biostatistics, University of Nevada at Las Vegas, Las Vegas, NV, United States
| | - Amy C Alman
- College of Public Health, University of South Florida, Tampa, FL, United States
| | - Janet K Snell-Bergeon
- Barbara Davis Center for Diabetes, Anschutz Medical Campus, University of Colorado, Aurora, CO, United States
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18
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Alhamad T, Murad H, Dadhania DM, Pavlakis M, Parajuli S, Concepcion BP, Singh N, Murakami N, Casey MJ, Ji M, Lubetzky M, Tantisattamo E, Alomar O, Faravardeh A, Blosser CD, Basu A, Gupta G, Adler JT, Adey D, Woodside KJ, Ong SC, Parsons RF, Lentine KL. The Perspectives of General Nephrologists Toward Transitions of Care and Management of Failing Kidney Transplants. Transpl Int 2023; 36:11172. [PMID: 37456682 PMCID: PMC10348051 DOI: 10.3389/ti.2023.11172] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 06/14/2023] [Indexed: 07/18/2023]
Abstract
The management of failing kidney allograft and transition of care to general nephrologists (GN) remain a complex process. The Kidney Pancreas Community of Practice (KPCOP) Failing Allograft Workgroup designed and distributed a survey to GN between May and September 2021. Participants were invited via mail and email invitations. There were 103 respondents with primarily adult nephrology practices, of whom 41% had an academic affiliation. More than 60% reported listing for a second kidney as the most important concern in caring for patients with a failing allograft, followed by immunosuppression management (46%) and risk of mortality (38%), while resistant anemia was considered less of a concern. For the initial approach to immunosuppression reduction, 60% stop antimetabolites first, and 26% defer to the transplant nephrologist. Communicating with transplant centers about immunosuppression cessation was reported to occur always by 60%, and sometimes by 29%, while 12% reported making the decision independently. Nephrologists with academic appointments communicate with transplant providers more than private nephrologists (74% vs. 49%, p = 0.015). There are heterogeneous approaches to the care of patients with a failing allograft. Efforts to strengthen transitions of care and to develop practical practice guidelines are needed to improve the outcomes of this vulnerable population.
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Affiliation(s)
- Tarek Alhamad
- John T. Milliken Department of Medicine, Washington University in St. Louis, Saint Louis, MO, United States
| | - Haris Murad
- John T. Milliken Department of Medicine, Washington University in St. Louis, Saint Louis, MO, United States
| | - Darshana M. Dadhania
- Department of Transplantation Medicine, Weill Cornel Medicine - New York Presbyterian Hospital, New York, NY, United States
| | - Martha Pavlakis
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard University, Boston, MA, United States
| | - Sandesh Parajuli
- Department of Medicine, University of Wisconsin - Madison, Madison, WI, United States
| | | | - Neeraj Singh
- John C. McDonald Regional Transplant Center, Willis Knighton Health System, Shreveport, LA, United States
| | - Naoka Murakami
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Michael J. Casey
- Department of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Mengmeng Ji
- John T. Milliken Department of Medicine, Washington University in St. Louis, Saint Louis, MO, United States
| | - Michelle Lubetzky
- Division of Abdominal Transplantation, Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, Austin, TX, United States
| | - Ekamol Tantisattamo
- Department of Medicine, University of California, Irvine, Orange, CA, United States
| | - Omar Alomar
- John T. Milliken Department of Medicine, Washington University in St. Louis, Saint Louis, MO, United States
| | - Arman Faravardeh
- SHARP Kidney and Pancreas Transplant Center, San Diego, CA, United States
| | - Christopher D. Blosser
- Department of Medicine, Seattle Children’s Hospital, University of Washington, Seattle, WA, United States
| | - Arpita Basu
- Department of Medicine, Emory University, Atlanta, GA, United States
| | - Gaurav Gupta
- Department of Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - Joel T. Adler
- Division of Abdominal Transplantation, Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, Austin, TX, United States
| | - Deborah Adey
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | | | - Song C. Ong
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Ronald F. Parsons
- Department of Medicine, Emory University, Atlanta, GA, United States
| | - Krista L. Lentine
- Center for Abdominal Transplantation, Saint Louis University, Saint Louis, MO, United States
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19
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Alver A, Batra K, Basu A, Izuora K. Food Diary Completion Does Not Significantly Impact Glycemic Control in an Observational Single-Institution Pilot Study of Patients with Type 2 Diabetes Mellitus. Cureus 2023; 15:e40596. [PMID: 37469812 PMCID: PMC10353833 DOI: 10.7759/cureus.40596] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2023] [Indexed: 07/21/2023] Open
Abstract
INTRODUCTION Hemoglobin A1c is frequently used to monitor glycemic control in patients with type 2 diabetes mellitus (T2DM). There is an association between dietary habits and hemoglobin A1c. Food diaries are often used to assist in dietary management and have been associated with modification of dietary habits. We aimed to investigate the impact of completing a seven-day food diary on hemoglobin A1c in subjects with T2DM. We hypothesized that patients who completed a food diary might independently modify their dietary habits, resulting in a clinically significant change in hemoglobin A1c. METHODS Forty-five subjects with T2DM who completed a seven-day food diary were included in this observational study. Subjects had a mean hemoglobin A1c at baseline of 7.56 ± 1.43 and a body mass index of 33.6 ± 7.6 kg/m². A majority were female (57.8%) and insulin-dependent (71.1%). The primary outcome of interest was a clinically significant change in hemoglobin A1c (≥0.5%). Outcomes were assessed before and within six months after the food diary completion. Chi-square, independent-sample t-tests, and logistic regression were used to analyze the data. RESULTS Twelve patients demonstrated a clinically significant decrease in hemoglobin A1c; however, this was not statistically significant regardless of gender (p = 0.5), baseline body mass index (p = 0.5), insulin use (p = 0.3), or community needs index (p = 0.7). CONCLUSIONS Although some patients had clinically significant improvements in their hemoglobin A1c, our findings suggest that the use of food diaries alone without goal-directed initiatives is insufficient to achieve differences in hemoglobin A1c in patients with T2DM and an average A1c within the range of 6%-8%.
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Affiliation(s)
- Amalie Alver
- Endocrinology, Kirk Kerkorian School of Medicine at the University of Nevada Las Vegas, Las Vegas, USA
- Emergency Medicine, University of Washington, Seattle, USA
| | - Kavita Batra
- Research, Kirk Kerkorian School of Medicine at the University of Nevada Las Vegas, Las Vegas, USA
| | - Arpita Basu
- Kinesiology and Nutrition Sciences, Kirk Kerkorian School of Medicine at the University of Nevada Las Vegas, Las Vegas, USA
| | - Kenneth Izuora
- Endocrinology, Kirk Kerkorian School of Medicine at the University of Nevada Las Vegas, Las Vegas, USA
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20
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Helm MM, Alaba T, Klimis-Zacas D, Izuora K, Basu A. Effect of Dietary Berry Supplementation on Antioxidant Biomarkers in Adults with Cardiometabolic Risks: A Systematic Review of Clinical Trials. Antioxidants (Basel) 2023; 12:1182. [PMID: 37371912 DOI: 10.3390/antiox12061182] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 05/29/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Cardiometabolic conditions are closely associated with inflammation and oxidative stress. Dietary berries may serve as a beneficial nutrition intervention to address the features of cardiometabolic dysfunction and associated oxidative stress. The high antioxidant status of dietary berries may increase antioxidant capacity and reduce biomarkers of oxidative stress. This systematic review was conducted to investigate these effects of dietary berries. The search was conducted using PubMed, Cochrane Library, Web of Science, and citation searching. Through this search we identified 6309 articles and 54 were included in the review. Each study's risk of bias was assessed using the 2019 Cochrane Methods' Risk of Bias 2 tool. Antioxidant and oxidative stress outcomes were evaluated, and the magnitude of effect was calculated using Cohen's d. A range of effectiveness was reported in the included studies and the quality of the studies differed between the parallel and crossover trials. Considering the inconsistency in reported effectiveness, future investigations are warranted to determine the acute and sustained reductions of oxidative stress biomarkers from dietary berry intake (PROSPERO registration# CRD42022374654).
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Affiliation(s)
- Macy M Helm
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA
| | - Tolu Alaba
- School of Food and Agriculture, University of Maine, Orono, ME 04469, USA
- Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, ME 04469, USA
| | - Dorothy Klimis-Zacas
- School of Food and Agriculture, University of Maine, Orono, ME 04469, USA
- Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, ME 04469, USA
| | - Kenneth Izuora
- Section of Endocrinology, Department of Internal Medicine, University of Nevada, Las Vegas, NV 89102, USA
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA
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21
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Som A, Wehrenberg-Klee E, Rosenboom J, Chandler A, Ndakwah G, Kim J, Feig V, Marcos-Vidal A, Fintelmann F, Basu A, Langer R, Traverso G, Mahmood U. Abstract No. 4 ▪ FEATURED ABSTRACT Image-Guided Intratumoral Cancer Vaccine to Treat Metastatic Immunotherapy Resistant Cancer with and without Cryoablation. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.043] [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: 02/27/2023] Open
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22
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Jaworsky K, DeVillez P, Basu A. The Role of Phytochemicals and Plant-Based Diets in Gestational Diabetes: Evidence from Clinical Trials. Int J Environ Res Public Health 2023; 20:4188. [PMID: 36901197 PMCID: PMC10001985 DOI: 10.3390/ijerph20054188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
Gestational diabetes mellitus (GDM) is defined as glucose intolerance identified during pregnancy. The increased risk of pregnancy complications and the adverse health effects for the mother and baby associated with GDM require urgent and effective ways to control the condition. The primary goal of this semi-quantitative review was to examine the effects of phytochemicals and plant-based diets on GDM in clinical studies involving women undergoing pregnancy and to summarize the findings for application in clinical practice and disease management. The articles included in this review show that intervention strategies, including fruits, vegetables, whole grains, nuts and seeds, and tea, may be beneficial in the management of GDM and lower blood glucose and improve adverse pregnancy outcomes in these women. The randomized controlled trials reviewed collectively show improved glycemic control markers, blood lipid values, and body weight and composition when supplemented with phytochemical-rich supplements and foods compared to those in the control groups. The findings support the clinical observations of lower GDM risks in women consuming plant-derived diets rich in phytochemicals. Nutrition interventions involving plant-based foods and diets are thus a practical way to reduce hyperglycemia both in patients diagnosed with GDM and those at high risk for the development of GDM.
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Affiliation(s)
- Kataryna Jaworsky
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA
- Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89154, USA
| | - Pamela DeVillez
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA
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23
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Parsons RF, Tantisattamo E, Cheungpasitporn W, Basu A, Lu Y, Lentine KL, Woodside KJ, Singh N, Scalea J, Alhamad T, Dunn TB, Rivera FHC, Parajuli S, Pavlakis M, Cooper M. Comprehensive review: Frailty in pancreas transplant candidates and recipients. Clin Transplant 2023; 37:e14899. [PMID: 36591953 DOI: 10.1111/ctr.14899] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 12/22/2022] [Accepted: 12/29/2022] [Indexed: 01/03/2023]
Abstract
Well-selected patients with kidney disease and diabetes mellitus who undergo simultaneous kidney-pancreas transplantation often experience dramatic improvements in quality of life and long-term survival compared to those who remain on medical therapy. Over the past several years the importance of frailty in the pancreas transplant candidate and recipient populations has grown. More patients with advanced age have entered the waitlist, and complications from prolonged diabetes, even in younger patients, have created increased evidence of risk for frailty. Given these concerns, and the broad challenges facing pancreas transplantation volumes overall, we generated this review to help establish the impact and implications. We summarize the interplay of immunological factors, aging, environmental factors, diabetes mellitus, and chronic kidney disease that put these patients at risk for frailty. We discuss its measurement and recommend a combination of two instruments (both well-validated and one entirely objective). We describe the outcomes for patients before and after pancreas transplantation who may have frailty, and what interventions can be taken to mitigate its effects. Broader investigation into frailty in the pancreas transplant population is needed to better understand how to select patients for pancreas transplantation and to how manage its consequences thereafter.
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Affiliation(s)
| | | | | | | | - Yee Lu
- University of Michigan, Ann Arbor, Michigan, USA
| | | | | | - Neeraj Singh
- John C. McDonald Regional Transplant Center, Shreveport, Los Angeles, USA
| | - Joseph Scalea
- Medical University of South Carolina, Charleston, South Carolina, USA
| | - Tarek Alhamad
- Washington University School of Medicine, St. Louis, Missouri, USA
| | - Ty B Dunn
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | - Martha Pavlakis
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Matthew Cooper
- Medstar Georgetown Transplant Institute, Washington DC, USA
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24
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Helm MM, Izuora K, Basu A. Nutrition-Education-Based Interventions in Gestational Diabetes: A Scoping Review of Clinical Trials. Int J Environ Res Public Health 2022; 19:ijerph191912926. [PMID: 36232232 PMCID: PMC9564999 DOI: 10.3390/ijerph191912926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 09/07/2022] [Revised: 10/03/2022] [Accepted: 10/05/2022] [Indexed: 05/03/2023]
Abstract
Cases of diabetes mellitus have seen a global increase in prevalence, but there are inherent differences in the pathology and management of different types of diabetes. Type 2 and gestational diabetes have the most similar pathophysiology. For that reason, many similar management strategies exist between type 2 and gestational diabetes, including nutrition-based interventions. Diabetes self-management education and medical nutrition therapy have been advanced as cost-effective interventions to manage hyperglycemia. Many of these interventions, however, were designed for type 2 diabetes and adapted for diabetes in gestation. Nutrition-education-based interventions in gestational diabetes have not been fully elucidated. We scrutinized this gap by conducting a scoping review of recently published peer-reviewed studies that evaluated clinical endpoints in cases of gestational diabetes with nutrition-education-based interventions. The search yielded 621 articles, and the 12 articles included were published between 2012 and 2022. The nutrition information varied across the heterogeneous diabetes self-management education, whereas the medical nutrition therapy studies were more consistent. Our literature search revealed similar outcomes across self-management education and medical nutrition therapy interventions implemented during the third trimester of pregnancies with diabetes. These results suggest that both generalized and personalized approaches to nutrition education in gestational diabetes can manage hyperglycemia and offset its adverse consequences.
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Affiliation(s)
- Macy M. Helm
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA
| | - Kenneth Izuora
- Section of Endocrinology, Department of Internal Medicine, University of Nevada, Las Vegas, NV 89154, USA
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA
- Correspondence: ; Tel.: +1-702-895-4576; Fax: +1-702-895-1500
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25
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Richardson LA, Izuora K, Basu A. Mediterranean Diet and Its Association with Cardiovascular Disease Risk Factors: A Scoping Review. Int J Environ Res Public Health 2022; 19:ijerph191912762. [PMID: 36232062 PMCID: PMC9566634 DOI: 10.3390/ijerph191912762] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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: 08/19/2022] [Revised: 09/24/2022] [Accepted: 09/29/2022] [Indexed: 05/31/2023]
Abstract
Atherosclerosis is the underlying cause of cardiovascular diseases (CVD) and is interrelated to stroke, heart attack, and heart failure. The Mediterranean Diet (MedDiet) has been closely associated with reduced CVD morbidity and mortality, but research is not well explored for this relationship in individuals with diabetes (who experience greater CVD morbidity and mortality than individuals without diabetes). The aim of this review was to explore the literature related to the MedDiet and atherosclerosis and associated risk factors in individuals with and without diabetes. In total, 570 articles were identified, and 36 articles were included. The articles were published between 2011 and 2021. Platforms used for the search were PubMed, Scopus, Cochrane Library, and ProQuest. Our literature search included clinical and observational studies. Clinical studies revealed the MedDiet was associated with improved biomarkers, plaque, and anthropometric measurements that are associated with atherosclerosis and CVD. Observational studies identified associations between the MedDiet and lower presence of atherosclerosis, improved vascular aging, and increased endothelial progenitor cells. However, most of the studies took place in Mediterranean countries. Further research is needed to better understand the long-term effects the MedDiet on atherosclerosis and its associated risk factors in diverse populations to include individuals with and without diabetes.
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Affiliation(s)
- Leigh Ann Richardson
- Department of Epidemiology and Biostatistics, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA
| | - Kenneth Izuora
- Section of Endocrinology, Department of Internal Medicine, University of Nevada at Las Vegas, Las Vegas, NV 89102, USA
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA
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26
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Giles R, Murray CE, Basu A, Dharmasekara B, Surendran S. 760 Investigating Theatre Cancellation Rates in a London Hospital. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Aim
Theatre cancellations are a major source of system inefficiency, placing an unnecessary financial burden on the NHS. The aim of this audit was to investigate the reasons for cancellations in elective surgery at a London hospital and to assess the general preoperative process.
Method
We undertook a retrospective audit of all elective theatre cancellations from the day surgery unit over a three-month period in 2021. 78 cancellations were identified, and their cause was investigated. Furthermore, we reviewed theatre lists over one month to calculate the proportion of cancelled procedures per specialty. Also, to gain a further understanding of the present protocol, we reviewed the current preoperative process.
Results
The main reason for cancellations was patients being physiologically unfit for surgery, accounting for 28.2% of all cases. The next biggest reason for cancellation, at 16.7%, was failure to comply with COVID protocol. The specialty with the largest proportion of cancellations was General Surgery, at 17.7%.
Conclusions
We believe many reasons for cancellations were avoidable. Therefore, we propose a change to the preoperative process to target multiple reasons for cancellation. We suggest a more comprehensive pre-admission phone call five days prior to surgery which includes discussions around medication compliance and changes in condition. We also suggest a set of observations and routine bloods are taken when patients come in for their COVID swab. This allows any potential cause of cancellation to be identified and rectified, or the patient could be rescheduled. This should increase efficiency of the day surgery unit.
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Affiliation(s)
- R Giles
- Imperial College London , London , United Kingdom
| | - CE Murray
- Imperial College London , London , United Kingdom
| | - A Basu
- Imperial College London , London , United Kingdom
| | | | - S Surendran
- Imperial College London , London , United Kingdom
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27
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Agha A, Basu A, Hanif W. Burnout in diabetes and endocrinology specialist registrars across England, Scotland and Wales in the pre-COVID era. Prim Care Diabetes 2022; 16:515-518. [PMID: 35667990 DOI: 10.1016/j.pcd.2022.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/11/2022] [Revised: 05/11/2022] [Accepted: 05/22/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Presence of either emotional exhaustion, depersonalization or lack of personal accomplishment define Burnout Syndrome which may lead to decreased workforce productivity, increased absenteeism, depression and medical errors as well as decreased patient satisfaction. OBJECTIVE The aim of this study was to assess the frequency of burnout syndrome among Diabetes Specialist Registrars across England, Scotland and Wales and to identify any self-reported factors which may be contributory to burnout. METHODS Over 430 Diabetes Specialist Registrars were invited to anonymously participate in an electronic survey which used Maslach Burnout Inventory and selfreporting questionnaire to identify burnout and contributory factors. RESULTS In this pre-pandemic times study, Burnout was identified in 61 (57.5%; n = 106) respondents using Maslach burnout cut-off scores. 45.2% (48/106) participants had scored high in Emotional Exhaustion, while lack of personal accomplishment and depersonalization was seen in 24.5% (26/106) and 21.6% (23/106) of the respondents respectively. The commonest self-reported stressors by participants were "General Internal Medicine workload" 60.4% (64/106) followed by "Lack of specialty training" 36.8% (39/106) and "Lack of audit/research/Continuing Professional Development time" 10.8% (11/106) CONCLUSION: Burnout syndrome is frequent among the participating Diabetes Specialist Registrars and urgent steps may be required address this problem nationally to ensure that these physicians remain physically and mentally healthy, especially after the pandemic.
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Affiliation(s)
- A Agha
- Queens Hospital Burton on Trent, University Hospitals of Derby and Burton, UK; College of Medicine & Health Sciences, United Arab Emirates University, United Arab Emirates.
| | - A Basu
- City and Sandwell Hospitals Birmingham, UK
| | - W Hanif
- Queen Elizabeth Hospital, University Hospitals Birmingham, UK
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28
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Prasad BK, Basu A, Sahu PK, Rai AK. A Study of Otological Manifestations of Temporal Bone Fractures. Indian J Otolaryngol Head Neck Surg 2022; 74:351-359. [PMID: 36032865 PMCID: PMC9411271 DOI: 10.1007/s12070-020-02111-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 08/25/2020] [Indexed: 11/30/2022] Open
Abstract
The aim of study was to evaluate various otological manifestations of temporal bone fractures and to suggest their management. This prospective observational study was conducted in a tertiary care hospital of Armed Forces over 2.5 years in 57 cases of temporal bone fracture in patients of age group of 12-59 yrs comprising 49 males and 8 females. Radioimaging was done for diagnosing the fracture, mapping its extent and for clinical correlation. Hearing was assessed by tuning forks, free field hearing and pure tone audiogram as per the fitness of patient. Majority of patients were in the age group 20-40 years who had met with road accidents. Important otological features included Battle sign (24.6%), ear canal laceration (53%), tympanic membrane perforation (7%), haemotymanum (40%), ear discharge (66.7%), hearing loss (63%), vertigo (16%), tinnitus (21%), facial paralysis (68%) and cerebrospinal fluid otorrhea (3.5%). Otic capsule sparing fracture was three times more common than violating ones. Facial palsies were treated with oral steroid with complete recovery in 56.41% cases but three required decompression surgery. 4 patients underwent tympanoplasty. Both the cerebrospinal fluid leaks stopped in 2 weeks time. Facial palsy is as common as hearing loss. TM perforation is as rare as CSF leak. Otic capsule violating fracture line is less common. Hearing loss shows recovery in most of the cases. Delayed onset positional vertigo is more common than acute vertigo. Large numbers of immediate onset complete facial palsy do recover from injury without surgery.
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29
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Rea KE, Cushman GK, Quast LF, George RP, Basu A, Ford R, Book W, Blount RL. Initial attendance and retention in adult healthcare as criteria for transition success among organ transplant recipients. Pediatr Transplant 2022; 26:e14280. [PMID: 35388604 DOI: 10.1111/petr.14280] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 03/15/2022] [Accepted: 03/26/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Adolescent and young adult (AYA) solid organ transplant recipients experience worsening medical outcomes during transition to adult healthcare. Current understanding and definitions of transition success emphasize first initiation of appointment attendance in adult healthcare; however, declines in attendance over time after transfer remain possible, particularly as AYAs are further removed from their pediatric provider and assume greater independence in their care. METHODS The current study assessed health-care utilization, medical outcomes, and transition success among 49 AYA heart, kidney, or liver recipients recently transferred to adult healthcare. Differences in outcomes were examined along two transition success criteria: (1) initial engagement in adult healthcare within 6 or 12 months of last pediatric appointment and (2) retention in adult healthcare over 3 years following last pediatric appointment. Growth curve modeling examined change in attendance over time. RESULTS Successful retention in adult healthcare was significantly related to more improved clinical outcomes, including decreased number and duration of hospitalizations and greater medication adherence, as compared to initial engagement. Significant declines in appointment attendance over 3 years were noted, and individual differences in declines were not accounted for by age at transfer or time since transplant. CONCLUSIONS Findings underscore support for AYAs after transfer, as significant declines in attendance were noted after initiating adult care. Clinical care teams should examine transition success longitudinally to address changes in health-care utilization and medical outcomes. Attention to interventions and administrative support aimed at maintaining or increasing attendance and identifying risk factors and intervention for unsuccessful transition is warranted.
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Affiliation(s)
- Kelly E Rea
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Grace K Cushman
- Department of Psychology, University of Georgia, Athens, Georgia, USA.,Alpert Medical School of Brown University, Bradley/Hasbro Children's Research Center, Providence, USA
| | - Lauren F Quast
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Roshan P George
- Department of Pediatrics, Emory University School of Medicine, Athens, Georgia, USA
| | - Arpita Basu
- Emory Transplant Center, Emory University School of Medicine, Athens, Georgia, USA
| | - Ryan Ford
- Emory Transplant Center, Emory University School of Medicine, Athens, Georgia, USA
| | - Wendy Book
- Emory Transplant Center, Emory University School of Medicine, Athens, Georgia, USA
| | - Ronald L Blount
- Department of Psychology, University of Georgia, Athens, Georgia, USA
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30
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Richardson LA, Chien LC, Basu A, Alman A, Snell-Bergeon J. Cross-Sectional Associations of Fruit and Vegetable Intake with Coronary Artery Calcification and Pericardial Adiposity. Curr Dev Nutr 2022. [PMCID: PMC9193592 DOI: 10.1093/cdn/nzac067.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
To examine the associations between fruit and vegetable (F&V) scores derived from the Mediterranean Diet (MedDiet) and Healthy Eating Index (HEI, 2015) with coronary artery calcification (CAC) and pericardial adiposity (PAT) in adults with and without type 1 diabetes (T1D).
Methods
We conducted a cross-sectional analysis of baseline data from the Coronary Artery Calcification in Type 1 Diabetes study [n = 1255; T1D: n = 563; non-DM: n = 692]. Participants completed a validated food frequency questionnaire, a physical examination, and fasting (12 h overnight fast) biochemical analyses. CAC and PAT were measured using electron beam computed tomography. Logistic regression models examined associations of F&V scores with CAC (presence or absence) and linear regression models were applied to PAT analyses. Model 1 was adjusted for age, sex and diabetes status, model 2 added total calories, and model 3 added BMI and lipids (LDL and HDL-cholesterol).
Results
F&V scores had no associations with CAC in any of these models. In models 1 and 2, a one-point increase in the MedDiet-derived total fruit score was associated with a significant −1.79% (95% CI: (−0.03, −0.01); p-value = 0.0001) decrease in PAT. In model 3, a one-point increase in the MedDiet-derived total fruit score was associated with a borderline significant decrease of −0.74% (95% CI: (−0.01, 0.00); p-value = 0.054) in PAT. In models 1 and 2 for the HEI-derived total fruit score, a one-point increase in the total fruit score was associated with a significant −3.22% (95% CI: (−0.05, −0.01); p-value = 0.0012) decrease in PAT. In model 3 for the HEI-derived total fruit score, there was no significant association between the HEI-derived total fruit score and PAT (p-value = 0.140).
Conclusions
Baseline analyses show MedDiet and HEI-derived total fruit scores maintained a significant to borderline significant inverse relationship with PAT, but F&V scores were not associated with presence of CAC.
Funding Sources
NIH and ADA.
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31
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Jarrett SA, Lo KB, Body C, Kim JJ, Zheng Z, Kundu S, Huang E, Basu A, Flynn M, Dietz-Lindo KA, Shahnavaz N, Christie J. Nausea, Vomiting, and Dyspepsia Following Solid Organ Abdominal Transplant. Cureus 2022; 14:e24274. [PMID: 35602775 PMCID: PMC9119196 DOI: 10.7759/cureus.24274] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 01/10/2023] Open
Abstract
Background and objective Multiple comorbidities may contribute to high readmission rates post-transplant procedures. In this study, we aimed to assess the rates and factors associated with hospital readmissions for dyspeptic symptoms among transplant patients. Methods This was a retrospective analysis of adult patients who underwent solid organ transplants at our institution. Pregnant patients or those patients with preexisting gastroparesis were excluded from the study. Readmissions associated with the International Classification of Diseases (ICD) codes for nausea/vomiting, weight loss, failure to thrive, abdominal pain, and/or bloating were included. Factors associated with 30-day and frequent readmissions (two or more) were explored. Results A total of 931 patients with solid organ transplants were included; 54% had undergone kidney transplants while 34% were liver transplants. Of note, 30% were readmitted within the first 30 days after discharge following transplant while 32.3% had frequent readmissions. A post-transplant upper endoscopy (EGD) was performed in 34% with food residue discovered in 19% suggesting gastroparesis. However, since only 22% of these patients had a gastric emptying study, only 6% were formally diagnosed with gastroparesis, which was independently associated with both 30-day [odds ratios (OR): 2.58, 95% confidence intervals (CI): 1.42-4.69] and frequent readmissions (OR: 6.71, 95% CI: 3.45-13.10). The presence of pre-transplant diabetes (35%) was significantly associated with a diagnosis of gastroparesis following transplant (OR: 5.17, 95% CI: 2.79-9.57). The use of belatacept (OR: 0.63, 95% CI: 0.42-0.94, p=0.023) was associated with a decrease in the odds of 30-day readmissions. Conclusion A significant number of patients were readmitted due to dyspeptic symptoms after solid organ transplants. Diabetes and gastroparesis were significantly associated with higher odds of readmissions while the use of belatacept appeared to be a protective factor.
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Yadav A, Salas MAP, Coscia L, Basu A, Rossi AP, Sawinski D, Shah S. Acute kidney injury during pregnancy in kidney transplant recipients. Clin Transplant 2022; 36:e14668. [PMID: 35396888 PMCID: PMC9285565 DOI: 10.1111/ctr.14668] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/31/2022] [Accepted: 04/02/2022] [Indexed: 11/29/2022]
Abstract
Pregnancy-related acute kidney injury (AKI) is a public health problem and remains an important cause of maternal and fetal morbidity and mortality. The incidence of pregnancy-related AKI has increased in developed countries due to increase in maternal age and higher detection rates. Pregnancy in women with kidney transplants is associated with higher adverse outcomes like preeclampsia, preterm births, and allograft dysfunction, but limited data exist on causes and outcomes of pregnancy-related AKI in the kidney transplant population. Diagnosis of AKI during pregnancy remains challenging in kidney transplant recipients due to lack of diagnostic criteria. Management of pregnancy-related AKI in the kidney transplant population requires a multidisciplinary team consisting of transplant nephrologists, high-risk obstetricians, and neonatologists. In this review, we discuss pregnancy-related acute kidney injury in women with kidney transplants, etiologies, pregnancy outcomes, and management strategies. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Anju Yadav
- Division of Nephrology, Department of Medicine, Thomas Jefferson University, Philadelphia, PA
| | - Maria Aurora Posadas Salas
- Division of Nephrology and Hypertension, Department of Medicine, Medical University of South Carolina, Charleston, SC
| | - Lisa Coscia
- Transplant Pregnancy Registry International, Gift of Life Institute, Philadelphia, PA
| | - Arpita Basu
- Division of Transplant and Division of Nephrology and Hypertension, Emory University, Atlanta, GA
| | | | - Deirdre Sawinski
- Division of Nephrology and Transplantation, Weill Cornell College of Medicine, New York, NY
| | - Silvi Shah
- Division of Nephrology, Department of Medicine, University of Cincinnati, Cincinnati, OH
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33
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Chan J, Basu A, Di Scenza G, Bartlett J, Fan KS, Oo S. Corrigendum to: 1292 Aortic Valve Neocuspidization Using Glutaraldehyde-Treated Autologous Pericardium: A Literature Review. Br J Surg 2022; 109:553. [PMID: 35576375 DOI: 10.1093/bjs/znab459] [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: 11/12/2022]
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34
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Basu A, Alman AC, Snell-Bergeon JK. Associations of Dietary Antioxidants with Glycated Hemoglobin and Insulin Sensitivity in Adults with and without Type 1 Diabetes. J Diabetes Res 2022; 2022:4747573. [PMID: 35789593 PMCID: PMC9250432 DOI: 10.1155/2022/4747573] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 06/14/2022] [Indexed: 11/30/2022] Open
Abstract
Type 1 diabetes (T1D) has been associated with increased risks of atherosclerotic cardiovascular disease, and poor glycemic control and oxidative stress play a major role in its pathology. There is a lack of data on the role of dietary antioxidant micronutrients, including vitamins and trace elements, in glycemic control in T1D. The aim of this study is to examine associations of dietary intakes of micronutrients with glycemic status. We report data from a cross-sectional analysis from the coronary artery calcification in type 1 diabetes (CACTI) study (n = 1257; T1D: n = 568; nondiabetic controls: n = 689) collected between the years 2000 and 2002. Participants completed a validated food frequency questionnaire, a physical examination, and biochemical analyses. Linear regression was used to examine the associations of dietary antioxidant micronutrients with HbA1c and estimated insulin sensitivity (eIS) in models adjusted for relevant covariates and stratified by diabetes status. In adults with T1D, we observed higher dietary manganese intake associated with higher eIS in the model adjusted for age, sex, diabetes duration, and total calories. In nondiabetic controls, higher intake of manganese associated with lower HbA1c and higher eIS values that persisted in models adjusted for all relevant covariates. On the other hand, dietary copper revealed a positive association with HbA1c in models adjusted for all covariates, except BMI and plasma lipids. No associations were noted for vitamins C and E and dietary carotenoids in either group. These findings reveal dietary antioxidant micronutrients, especially trace elements such as copper and manganese deserve special attention in glycemic control in adults with T1D as well as in nondiabetic controls.This trial is register with NCT00005754.
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Affiliation(s)
- Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada Las Vegas, USA
| | - Amy C. Alman
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Janet K. Snell-Bergeon
- Barbara Davis Center for Childhood Diabetes, University of Colorado, Anschutz Medical Campus, USA
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35
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Maurye P, Basu A, Jana C, Devi MS, Kumari K, Naskar M. Mobile electrophoresis kit for high school students: Scientific practices with innovation. Biochem Mol Biol Educ 2022; 50:75-90. [PMID: 34741584 DOI: 10.1002/bmb.21588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 01/25/2021] [Revised: 08/21/2021] [Accepted: 10/20/2021] [Indexed: 06/13/2023]
Abstract
Gel electrophoresis (GE) is the most preferred and adapted technique for the separation and identification of biological molecules like proteins/peptides and nucleic acids from diverse types of organisms. All over the world, researchers, educators, and students aspiring to work in biochemistry and molecular biology disciplines use the polyacrylamide gel electrophoresis (PAGE) technique for resolving proteins/nucleic acids for understanding the structure and function of any cell. A simple PAGE technique requires a wide range of chemicals/reagents along with a well-equipped and well-spaced laboratory. We have developed a compact and impeccable mobile electrophoresis kit suitable for any vertically oriented PAGE technique. This comprehensive and portable laboratory set-up provides the complete advantages of safety, cost-efficiency, space management, and utility to the researchers for high-throughput research. All new equipment of the mobile electrophoresis kit is fabricated using inexpensive and off-the-rack components. Overall performance of the mobile kit was verified through a practical exercises executed by high school students with positive outcomes.
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Affiliation(s)
- Praveen Maurye
- Aquatic Environmental Biotechnology and Nanotechnology Division, ICAR-Central Inland Fisheries Research Institute (Indian Council of Agricultural Research), Kolkata, West Bengal, India
| | - Arpita Basu
- Biotechnology, Kendriya Vidyalaya, Ministry of Human Resource Development, Bhubaneswar, Odisha, India
| | - Chayna Jana
- Fisheries Resource Assessment and Informatics Division, ICAR-Central Inland Fisheries Research Institute (Indian Council of Agricultural Research) Barrackpore, Kolkata, West Bengal, India
| | - Manoharmayum Shaya Devi
- Aquatic Environmental Biotechnology and Nanotechnology Division, ICAR-Central Inland Fisheries Research Institute (Indian Council of Agricultural Research), Kolkata, West Bengal, India
| | - Kavita Kumari
- Aquatic Environmental Biotechnology and Nanotechnology Division, ICAR-Central Inland Fisheries Research Institute (Indian Council of Agricultural Research), Kolkata, West Bengal, India
| | - Malay Naskar
- Fisheries Resource Assessment and Informatics Division, ICAR-Central Inland Fisheries Research Institute (Indian Council of Agricultural Research) Barrackpore, Kolkata, West Bengal, India
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Basu A, Izuora K, Betts NM, Ebersole JL, Scofield RH. Dietary Strawberries Improve Biomarkers of Antioxidant Status and Endothelial Function in Adults with Cardiometabolic Risks in a Randomized Controlled Crossover Trial. Antioxidants (Basel) 2021; 10:antiox10111730. [PMID: 34829601 PMCID: PMC8614674 DOI: 10.3390/antiox10111730] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 10/26/2021] [Accepted: 10/26/2021] [Indexed: 12/13/2022] Open
Abstract
Strawberries, a popularly consumed berry fruit, are rich in bioactive compounds with antioxidant effects. In this study, we examined the effects of two dietary achievable doses of strawberries on the antioxidant status and biomarkers of endothelial function in adults with features of metabolic syndrome and a confirmed low baseline of fruit and vegetable intake. In a 14-week randomized controlled crossover study, participants were assigned to one of three groups for four weeks separated by a one-week washout period: control powder, one serving (low dose: 13 g strawberry powder/day), or 2.5 servings (high dose: 32 g strawberry powder/day). Blood samples and health data were collected at baseline and at the end of each four-week phase of intervention. Thirty-three participants completed all three phases of the trial. Significant increases were observed in serum antioxidant capacity and superoxide dismutase activity as well as decreases in lipid peroxidation after both low and high dose strawberry phases when compared with the control phase. Significant decreases were also observed in soluble vascular cell adhesion molecule-1 and tumor necrosis factor-α with the high dose strawberry phase. These data confirm that consuming strawberries for four weeks significantly improves antioxidant status, endothelial function, and inflammation in adults with cardiometabolic risks.
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Affiliation(s)
- Arpita Basu
- Department of Kinesiology and Nutrition Sciences, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA
- Correspondence: ; Tel.: +1-702-895-4576; Fax: +1-702-895-1500
| | - Kenneth Izuora
- Section of Endocrinology, University of Nevada School of Medicine at Las Vegas, Las Vegas, NV 89154, USA;
| | - Nancy M. Betts
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA;
| | - Jeffrey L. Ebersole
- School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA;
| | - Robert Hal Scofield
- Section of Endocrinology and Diabetes, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
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Chan J, Basu A, Di scenza G, Bartlett J, Fan KS, Oo S. 1292 Aortic Valve Neocuspidization Using Glutaraldehyde-Treated Autologous Pericardium: A Literature Review. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Aortic Valve Neocuspidization using glutaraldehyde-treated autologous pericardium was first performed by Ozaki et al. in 2007. This technique has become an alternative to tissue and mechanical valve as long-term anticoagulation is not required and shows promising midterm results and durability.
Method
A comprehensive search was performed on the major database using search terms “Ozaki technique” AND “Aortic Valve Neocuspidization” AND “AV Neocuspidization” AND “Autologous pericardium” AND “glutaraldehyde-treated autologous pericardium”. Articles up to 1st of August 2020 were included in this study.
Results
A total of 9 studies with a total of 1342 patients were included. The mean age was 67.36 and 54.23% were male. 66.32% and 23.92% of patients had aortic stenosis and aortic regurgitation, respectively. 66% of patients had a native tricuspid aortic valve and 31.37 % patients’ native aortic valve was bicuspid. Three studies reported their experience performing Aortic Valve Neocuspidization via mini sternotomy.
Conclusions
Aortic Valve Neocuspidization is an alternative to biological and mechanical prostheses for surgical aortic valve replacement. The short and mid-term outcome are comparable without the need for long term oral anticoagulation. Long term follow-up data is required for this novel approach to be widely adopted.
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Affiliation(s)
- J Chan
- University of Bristol, Bristol, United Kingdom
| | - A Basu
- St George’s University of London, London, United Kingdom
| | - G Di scenza
- St George’s University of London, London, United Kingdom
| | - J Bartlett
- Swansea University Medical School, Swansea, United Kingdom
| | - K S Fan
- St George’s University of London, London, United Kingdom
| | - S Oo
- Bristol Heart Institute, Bristol, United Kingdom
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Pang T, Alman AC, Gray HL, Basu A, Shi L, Snell-Bergeon JK. Empirical dietary inflammatory pattern and metabolic syndrome: prospective association in participants with and without type 1 diabetes mellitus in the coronary artery calcification in type 1 diabetes (CACTI) study. Nutr Res 2021; 94:1-9. [PMID: 34571214 DOI: 10.1016/j.nutres.2021.08.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 11/16/2022]
Abstract
The inflammatory potential of diet, assessed by Empirical Dietary Inflammatory Pattern (EDIP), may play a crucial role in the development of metabolic syndrome (MetS). However, limited research on this relationship is available. We hypothesized that EDIP is positively associated with MetS and its components. This longitudinal study included 1177 participants (526 with type 1 diabetes mellitus [T1DM] and 651 without) from the Coronary Artery Calcification in Type 1 Diabetes study. Dietary assessment and anthropometric and biochemical measurements were assessed at baseline and 14-year follow-up. MetS status was defined using the Harmonization criteria. EDIP scores were computed based on a food frequency questionnaire. Generalized linear mixed models were applied and subgroup analyses were performed by diabetes status. Mean age of study participants was 38 years and 48% were male at baseline. EDIP was positively associated with MetS (βT3 versus T1=0.81, P < .01) in T1DM but not in nondiabetic controls. Of the MetS components, low HDL-C and hypertriglyceridemia had positive associations with EDIP in both groups. Individuals with T1DM consumed more pro-inflammatory diets and had a greater risk of developing MetS than those without diabetes. The consumption of processed meat, red meat, high- and low- energy beverages was significantly higher in those with MetS than those without this condition (all P < .05). Reduced consumption of pro-inflammatory foods such as processed meat, red meat, sugar-sweetened beverages, and diet drinks may lower MetS risk in T1DM.
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Affiliation(s)
- Tiantian Pang
- College of Public Health, University of South Florida, Tampa, FL, USA.
| | - Amy C Alman
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Heewon L Gray
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Lu Shi
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
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Maurye P, Basu A, Kumari K, Dey P, Sen S, Devi MS. A unified quartet DNA gel electrophoresis instrument with integrated agarose gel casting, electrophoresis, staining, and imaging facilities. Separation Science Plus 2021. [DOI: 10.1002/sscp.202100012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Praveen Maurye
- Aquatic Environmental Biotechnology and Nanotechnology Division ICAR‐Central Inland Fisheries Research Institute (Indian Council of Agricultural Research) Barrackpore Kolkata West Bengal India
| | - Arpita Basu
- Biotechnology Kendriya Vidyalaya Ministry of Human Resource Development Bhubaneswar Orissa India
| | - Kavita Kumari
- Aquatic Environmental Biotechnology and Nanotechnology Division ICAR‐Central Inland Fisheries Research Institute (Indian Council of Agricultural Research) Barrackpore Kolkata West Bengal India
| | | | - Sohini Sen
- School of Bioscience and Engineering Jadavpur Universty Kolkata West Bengal India
| | - Manoharmayum Shaya Devi
- Aquatic Environmental Biotechnology and Nanotechnology Division ICAR‐Central Inland Fisheries Research Institute (Indian Council of Agricultural Research) Barrackpore Kolkata West Bengal India
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Alhamad T, Lubetzky M, Lentine KL, Edusei E, Parsons R, Pavlakis M, Woodside KJ, Adey D, Blosser CD, Concepcion BP, Friedewald J, Wiseman A, Singh N, Chang SH, Gupta G, Molnar MZ, Basu A, Kraus E, Ong S, Faravardeh A, Tantisattamo E, Riella L, Rice J, Dadhania DM. Kidney recipients with allograft failure, transition of kidney care (KRAFT): A survey of contemporary practices of transplant providers. Am J Transplant 2021; 21:3034-3042. [PMID: 33559315 DOI: 10.1111/ajt.16523] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/13/2021] [Accepted: 01/20/2021] [Indexed: 01/25/2023]
Abstract
Kidney allograft failure and return to dialysis carry a high risk of morbidity. A practice survey was developed by the AST Kidney Pancreas Community of Practice workgroup and distributed electronically to the AST members. There were 104 respondents who represented 92 kidney transplant centers. Most survey respondents were transplant nephrologists at academic centers. The most common approach to immunosuppression management was to withdraw the antimetabolite first (73%), while only 12% responded they would withdraw calcineurin inhibitor (CNI) first. More than 60% reported that the availability of a living donor is the most important factor in their decision to taper immunosuppression, followed by risk of infection, risk of sensitization, frailty, and side effects of medications. More than half of respondents reported that embolization was either not available or offered to less than 10% as an option for surgical intervention. Majority reported that ≤50% of failed allograft patients were re-listed before dialysis, and less than a quarter of transplant nephrologists performed frequent visits with their patients with failed kidney allograft after they return to dialysis. This survey demonstrates heterogeneity in the care of patients with a failing allograft and the need for more evidence to guide improvements in clinical practice related to transition of care.
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Affiliation(s)
- Tarek Alhamad
- Washington University in St. Louis, Saint Louis, Missouri, USA
| | - Michelle Lubetzky
- New York Presbyterian Hospital- Weill Cornell Medicine, New York, New York, USA
| | | | - Emmanuel Edusei
- New York Presbyterian Hospital- Weill Cornell Medicine, New York, New York, USA
| | | | - Martha Pavlakis
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | | | - Deborah Adey
- University of California San Francisco, San Francisco, California, USA
| | | | | | | | | | - Neeraj Singh
- Willis Knighton Health System, Shreveport, Louisiana, USA
| | - Su-Hsin Chang
- Washington University in St. Louis, Saint Louis, Missouri, USA
| | - Gaurav Gupta
- Virginia Commonwealth University, Richmond, Virginia, USA
| | | | | | | | - Song Ong
- University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Arman Faravardeh
- SHARP Kidney and Pancreas Transplant Center, San Diego, California, USA
| | | | | | - Jim Rice
- Scripps Heath, San Diego, California, USA
| | - Darshana M Dadhania
- New York Presbyterian Hospital- Weill Cornell Medicine, New York, New York, USA
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Lubetzky M, Tantisattamo E, Molnar MZ, Lentine KL, Basu A, Parsons RF, Woodside KJ, Pavlakis M, Blosser CD, Singh N, Concepcion BP, Adey D, Gupta G, Faravardeh A, Kraus E, Ong S, Riella LV, Friedewald J, Wiseman A, Aala A, Dadhania DM, Alhamad T. The failing kidney allograft: A review and recommendations for the care and management of a complex group of patients. Am J Transplant 2021; 21:2937-2949. [PMID: 34115439 DOI: 10.1111/ajt.16717] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/23/2021] [Accepted: 05/20/2021] [Indexed: 01/25/2023]
Abstract
The return to dialysis after allograft failure is associated with increased morbidity and mortality. This transition is made more complex by the rising numbers of patients who seek repeat transplantation and therefore may have indications for remaining on low levels of immunosuppression, despite the potential increased morbidity. Management strategies vary across providers, driven by limited data on how to transition off immunosuppression as the allograft fails and a paucity of randomized controlled trials to support one approach over another. In this review, we summarize the current data available for management and care of the failing allograft. Additionally, we discuss a suggested plan for immunosuppression weaning based upon the availability of re-transplantation and residual allograft function. We propose a shared-care model in which there is improved coordination between transplant providers and general nephrologists so that immunosuppression management and preparation for renal replacement therapy and/or repeat transplantation can be conducted with the goal of improved outcomes and decreased morbidity in this vulnerable patient group.
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Affiliation(s)
- Michelle Lubetzky
- Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York, USA
| | - Ekamol Tantisattamo
- Division of Nephrology, University of California Irvine, Orange, California, USA
| | - Miklos Z Molnar
- Division of Nephrology and Hypertension, University of Utah, Salt Lake City, Utah, USA
| | - Krista L Lentine
- Internal Medicine-Nephrology, Saint Louis University, St. Louis, Missouri, USA
| | - Arpita Basu
- Division of Transplantation, Emory University, Atlanta, Georgia, USA
| | - Ronald F Parsons
- Division of Transplantation, Emory University, Atlanta, Georgia, USA
| | - Kenneth J Woodside
- Department of Surgery, Section of Transplantation, University of Michigan, Ann Arbor, Michigan, USA
| | - Martha Pavlakis
- Division of Nephrology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Christopher D Blosser
- Division of Nephrology, University of Washington and Seattle Children's Hospital, Seattle, Washington, USA
| | - Neeraj Singh
- Division of Nephrology, Willis Knighton Health System, Shreveport, Louisiana, USA
| | | | - Deborah Adey
- Division of Nephrology, University of California San Francisco, San Francisco, California, USA
| | - Gaurav Gupta
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Arman Faravardeh
- SHARP Kidney and Pancreas Transplant Center, San Diego, California, USA
| | - Edward Kraus
- Department of Medicine, Johns Hopkins, Baltimore, Maryland, USA
| | - Song Ong
- Division of Nephrology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Leonardo V Riella
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - John Friedewald
- Division of Medicine and Surgery, Northwestern University, Chicago, Illinois, USA
| | - Alex Wiseman
- Division of Nephrology, University of Colorado, Denver, Colorado, USA
| | - Amtul Aala
- Division of Nephrology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Darshana M Dadhania
- Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York, USA
| | - Tarek Alhamad
- Division of Nephrology, Washington University in St. Louis, St. Louis, Michigan, USA
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Singh N, Parsons R, Lentine KL, Woodside KJ, Basu A, Cheungpasitporn W, Kensinger C, Parajuli S, Rivera FHC, Sultan S, Tantisattamo E, Zibari G, Pavlakis M, Cooper M. Simultaneous Pancreas-kidney Transplantation for Type 2 Diabetes Mellitus. Transplantation 2021; 105:e91-e92. [PMID: 34291770 DOI: 10.1097/tp.0000000000003752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Neeraj Singh
- John C. McDonald Regional Transplant Center, Willis Knighton Health System, Shreveport, LA
| | - Ronald Parsons
- Division of Transplantation, Department of Surgery, Emory University School of Medicine, Atlanta, GA
| | - Krista L Lentine
- Department of Internal Medicine, Division of Nephrology, Saint Louis University School of Medicine, St. Louis, MO
| | - Kenneth J Woodside
- Department of Surgery, Section of Transplantation, University of Michigan, Ann Arbor, MI
| | - Arpita Basu
- Division of Transplantation, Emory University School of Medicine, Atlanta, GA
| | | | | | - Sandesh Parajuli
- Department of Medicine, Division of Nephrology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Franco H Cabeza Rivera
- Department of Internal Medicine, Division of Nephrology, University of Mississippi Medical Center, Jackson, MS
| | - Samuel Sultan
- Division of Transplantation Surgery, Weill Cornell Medicine and NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY
| | - Ekamol Tantisattamo
- Division of Nephrology, Hypertension and Kidney Transplantation, University of California Irvine School of Medicine, Orange, CA
| | - Gazi Zibari
- John C. McDonald Regional Transplant Center, Willis Knighton Health System, Shreveport, LA
| | - Martha Pavlakis
- Division of Nephrology, Beth Israel Deaconess Medical Center, Boston, MA
| | - Matthew Cooper
- MedStar Georgetown Transplant Institute (MGTI), Georgetown University School of Medicine, Washington, DC
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Parsons RF, Matar A, Lentine KL, Woodside KJ, Singh N, Alhamad T, Basu A, Cabeza Rivera FH, Cheungpasitporn W, Romeo G, Rao S, Kensinger CD, Parajuli S, Sultan S, Tantisattamo E, Pavlakis M, Cooper M. Pancreas transplantation perceptions and practice: Results from a national US survey. Clin Transplant 2021; 35:e14432. [PMID: 34291503 DOI: 10.1111/ctr.14432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/28/2021] [Accepted: 07/14/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Due to a substantial decline in pancreas transplantation (PT) across the United States over the past 15 years, we sought to understand the perceptions and practices of US PT programs. METHODS Surveys were sent to members of the American Society of Transplantation Surgeons and the American Society of Transplantation by email and professional society postings between August 2019 and November 2019. RESULTS One hundred twenty three responses were recorded from 56 unique programs. Program characteristics were obtained from the Scientific Registry of Transplant Recipients. Respondents were transplant surgeons (71%), transplant nephrologists (17%), trainees (9%), and allied professionals (3%). Programs were defined according to annual volume as: low (<5 PT/year), intermediate (6-20), or high (>20). High-volume programs reported that these factors were most important for increased PT: expansion of recipient selection, more aggressive donor utilization, and hiring of PT program-specific personnel. At both the program and national level, the vast majority (82% and 79%, respectively) felt the number of PTs currently performed are not in balance with patients' needs. CONCLUSIONS Overall, programs reported that the option of PT is not offered adequately to diabetic patients and that strategies to maintain higher PT volume are most evident at intermediate, and especially, high-volume programs.
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Affiliation(s)
| | - Abraham Matar
- Department of Surgery, Emory University, Atlanta, Georgia, USA
| | - Krista L Lentine
- Department of Internal Medicine, Saint Louis University, St. Louis, Missouri, USA
| | | | - Neeraj Singh
- Willis Knighton Health System, John C. McDonald Regional Transplant Center, Shreveport, Louisiana, USA
| | - Tarek Alhamad
- John T. Milliken Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Arpita Basu
- Department of Medicine, Emory University, Atlanta, Georgia, USA
| | | | - Wisit Cheungpasitporn
- Division of Nephrology and Hypertension, Mayo Clinic, Mayo Clinic Hospital, Rochester, Minnesota, USA
| | - Giulio Romeo
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.,Joslin Diabetes Center, Boston, Massachusetts, USA
| | - Swati Rao
- Department of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Clark D Kensinger
- Piedmont Healthcare, Piedmont Transplant Institute, Atlanta, Georgia, USA
| | - Sandesh Parajuli
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA
| | - Samuel Sultan
- Division of Transplantation Surgery, Weill Cornell Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Ekamol Tantisattamo
- Division of Nephrology, Hypertension and Kidney Transplantation, University of California Irvine, Orange, California, USA
| | - Martha Pavlakis
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Matthew Cooper
- Department of Surgery, Medstar Georgetown Transplant Institute, Georgetown University School of Medicine, Washington, District of Columbia, USA
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Basu A, Betts N, Scofield H. Dietary Strawberries Improve Cardiometabolic Risks in Adults With Obesity and Elevated Serum LDL-Cholesterol in a Randomized Controlled Crossover Trial. Curr Dev Nutr 2021. [DOI: 10.1093/cdn/nzab037_007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
Dietary berries, such as strawberries are rich in bioactive compounds and have been shown to lower cardiometabolic risks. We examined the dose-response effects of two dietary achievable doses of strawberries on glycemic control and lipid profiles in adults.
Methods
In this 14-week randomized controlled crossover study, adults with obesity and elevated serum LDL-cholesterol were assigned to one of the three arms for four weeks separated by a one-week washout period: control powder, one serving strawberries (low dose: 13 g powder/day), and 2.5 servings strawberries (high dose: 32 g powder/day). Participants were instructed to follow their usual diet and lifestyle while refraining from consuming other berries and related products throughout the study. Blood samples and anthropometric measures were collected at baseline and at the end of each four-week phase of intervention.
Results
Thirty-three participants completed all three phases of the trial [(mean ± SD): Age: 53 ± 13 y; BMI: 33 ± 3.0 kg/m2). Outcome measures were analyzed using a mixed model analysis of variance with statistical significance set at P < 0.05. Findings revealed significant reduction in fasting insulin as well as homeostatic model of assessment of insulin resistance (HOMA-IR) following the high dose strawberries when compared to the low dose strawberry and control phases. Glucose and conventional lipid profiles did not differ among groups. Total and small LDL particle concentrations (nuclear magnetic resonance-determined) were significantly decreased in the high dose strawberry group compared to control and low dose group (P < 0.05).
Conclusions
These data suggest that consuming strawberries at two and half servings for four weeks significantly improves insulin resistance and LDL particle profiles in adults with features of the metabolic syndrome.
Funding Sources
Supported by the NIH grant U54GM104938 (Oklahoma Shared Clinical and Translational Resource), OUHSC and the California Strawberry Commission.
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Basu A, Feng D, Planinic P, Ebersole JL, Lyons TJ, Alexander JM. Dietary Blueberry and Soluble Fiber Supplementation Reduces Risk of Gestational Diabetes in Women with Obesity in a Randomized Controlled Trial. J Nutr 2021; 151:1128-1138. [PMID: 33693835 PMCID: PMC8112774 DOI: 10.1093/jn/nxaa435] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/09/2020] [Accepted: 12/11/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a growing public health concern and maternal obesity and poor dietary intakes could be implicated. Dietary polyphenols and fiber mitigate the risk of diabetes and its complications, but little is known about their efficacy in preventing GDM. OBJECTIVES We examined the effects of whole blueberry and soluble fiber supplementation on primary outcomes of cardiometabolic profiles in women at high risk of developing GDM. METHODS Women (n = 34; mean ± SD age: 27 ± 5 y; BMI: 35.5 ± 4.0 kg/m2; previous history of GDM ∼56%; Hispanic ∼79%) were recruited in early pregnancy (<20 weeks of gestation) and randomly assigned to 1 of the following 2 groups for 18 wk: intervention (280 g whole blueberries and 12 g soluble fiber per day) and standard prenatal care (control). Both groups received nutrition education and maintained 24-h food recalls throughout the study. Data on anthropometrics, blood pressure, and blood samples for biochemical analyses were collected at baseline (<20 weeks), midpoint (24-28 weeks), and end (32-36 weeks) of gestation. Diagnosis of GDM was based on a 2-step glucose challenge test (GCT). Data were analyzed using a mixed-model ANOVA. RESULTS Maternal weight gain was significantly lower in the dietary intervention than in the control group at the end of the trial (mean ± SD: 6.8 ± 3.2 kg compared with 12.0 ± 4.1 kg, P = 0.001). C-reactive protein was also lower in the intervention than in the control group (baseline: 6.1 ± 4.0 compared with 6.8 ± 7.2 mg/L; midpoint: 6.1 ± 3.7 compared with 7.5 ± 7.3 mg/L; end: 5.5 ± 2.2 compared with 9.5 ± 6.6 mg/L, respectively, P = 0.002). Blood glucose based on GCT was lower in the intervention than in the control (100 ± 33 mg/dL compared with 131 ± 40 mg/dL, P < 0.05). Conventional lipids (total, LDL, and HDL cholesterol and triglycerides) did not differ between groups over time. No differences were noted in infant birth weight. CONCLUSIONS Whole blueberry and soluble fiber supplementation may prevent excess gestational weight gain and improve glycemic control and inflammation in women with obesity.This trial was registered at clinicaltrials.gov as NCT03467503.
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Affiliation(s)
- Arpita Basu
- Department of Kinesiology and Nutrition Sciences, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Du Feng
- School of Nursing, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Petar Planinic
- Department of Obstetrics & Gynecology, School of Medicine, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Jeffrey L Ebersole
- School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Timothy J Lyons
- Division of Endocrinology, Medical University of South Carolina, Charleston, SC, USA
| | - James M Alexander
- Department of Obstetrics & Gynecology, School of Medicine, University of Nevada at Las Vegas, Las Vegas, NV, USA
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Basu A, Chien LC, Alman AC, Snell-Bergeon JK. Associations of dietary patterns and nutrients with coronary artery calcification and pericardial adiposity in a longitudinal study of adults with and without type 1 diabetes. Eur J Nutr 2021; 60:3911-3925. [PMID: 33904996 DOI: 10.1007/s00394-021-02564-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 04/12/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE To examine the associations of dietary patterns and nutrients with coronary artery calcification (CAC) and pericardial adiposity (PAT) in adults with and without type 1 diabetes. METHODS We conducted a six-year longitudinal analysis of data from Coronary Artery Calcification in Type 1 Diabetes study [n = 1255; T1D: n = 563; non-DM: n = 692] collected at baseline, year 3 and year 6. Participants completed a validated food frequency questionnaire, a physical examination, and fasting (12 h overnight fast) biochemical analyses. CAC and PAT were measured using electron beam computed tomography. Dietary patterns were identified using factor analysis. Generalized estimating equations were used to examine associations of dietary patterns and nutrients with CAC and PAT in models adjusted for traditional cardiovascular risks. RESULTS The 'starchy veggies, meats and alcohol pattern' was associated with significantly increased risk of CAC presence in all adjusted models; an increasing trend was observed with CAC progression. Increasing intake of dietary proteins and total fats were also associated with higher risk of the presence and/or progression of CAC in adjusted models (all p < 0.05). PAT was positively associated with dietary total fats, and inversely associated with dietary intakes of saturated fats, omega-3 fats and fiber in models adjusted for age, sex, total calories, time, diabetes status, systolic blood pressure, serum lipids and physical activity. CONCLUSION Diets high in total fats and proteins, and in meats (processed and red) and alcohol may increase risks of CAC, while saturated fats, omega-3-fats and fiber may be protective against pericardial adiposity as a risk factor for coronary artery disease. ClinicalTrials.gov Identifier: NCT00005754.
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Affiliation(s)
- Arpita Basu
- Department of Kinesiology and Nutrition Sciences, University of Nevada at Las Vegas, Las Vegas, NV, USA.
| | - Lung-Chang Chien
- Department of Epidemiology and Biostatistics, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Amy C Alman
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Janet K Snell-Bergeon
- Barbara Davis Center for Childhood Diabetes, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
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Basu A, Izuora K, Betts NM, Kinney JW, Salazar AM, Ebersole JL, Scofield RH. Dietary Strawberries Improve Cardiometabolic Risks in Adults with Obesity and Elevated Serum LDL Cholesterol in a Randomized Controlled Crossover Trial. Nutrients 2021; 13:nu13051421. [PMID: 33922576 PMCID: PMC8145532 DOI: 10.3390/nu13051421] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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] [Received: 03/30/2021] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 02/08/2023] Open
Abstract
Background and aims: Dietary berries, such as strawberries, are rich in bioactive compounds and have been shown to lower cardiometabolic risk. We examined the effects of two dietary achievable doses of strawberries on glycemic control and lipid profiles in obese adults with elevated serum LDL cholesterol (LDL-C). Methods: In this 14-week randomized controlled crossover study, participants were assigned to one of the three arms for four weeks separated by a one-week washout period: control powder, one serving (low dose: 13 g strawberry powder/day), or two-and-a -half servings (high dose: 32 g strawberry powder/day). Participants were instructed to follow their usual diet and lifestyle while refraining from consuming other berries and related products throughout the study interval. Blood samples, anthropometric measures, blood pressure, and dietary and physical activity data were collected at baseline and at the end of each four-week phase of intervention. Results: In total, 33 participants completed all three phases of the trial [(mean ± SD): Age: 53 ± 13 y; BMI: 33 ± 3.0 kg/m2). Findings revealed significant reductions in fasting insulin (p = 0.0002) and homeostatic model of assessment of insulin resistance (p = 0.0003) following the high dose strawberry phase when compared to the low dose strawberry and control phases. Glucose and conventional lipid profiles did not differ among the phases. Nuclear magnetic resonance-determined particle concentrations of total VLDL and chylomicrons, small VLDL, and total and small LDL were significantly decreased after the high dose strawberry phase, compared to control and low dose phases (all p < 0.0001). Among the biomarkers of inflammation and adipokines measured, only serum PAI-1 showed a decrease after the high dose strawberry phase (p = 0.002). Conclusions: These data suggest that consuming strawberries at two-and-a-half servings for four weeks significantly improves insulin resistance, lipid particle profiles, and serum PAI-1 in obese adults with elevated serum LDL-C.
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Affiliation(s)
- Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA
- Correspondence: ; Tel.: +1-702-895-4576; Fax: +1-702-895-1500
| | - Kenneth Izuora
- Section of Endocrinology, School of Medicine, University of Nevada, Las Vegas, NV 89154, USA;
| | - Nancy M. Betts
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA;
| | - Jefferson W. Kinney
- Department of Brain Health, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA; (J.W.K.); (A.M.S.)
| | - Arnold M. Salazar
- Department of Brain Health, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA; (J.W.K.); (A.M.S.)
| | | | - R. Hal Scofield
- Section of Endocrinology and Diabetes, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
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Basu A, Alman AC, Snell-Bergeon JK. Associations of Dietary Patterns and Nutrients with Glycated Hemoglobin in Participants with and without Type 1 Diabetes. Nutrients 2021; 13:nu13031035. [PMID: 33806867 PMCID: PMC8004940 DOI: 10.3390/nu13031035] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/15/2021] [Accepted: 03/21/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Diet has been associated with poor glycemic control in diabetes. Few studies have examined this association in people with type 1 diabetes (T1D), who are at a higher risk for cardiovascular disease than people without diabetes. Methods: We report data from cross-sectional and longitudinal analyses from a coronary artery calcification in type 1 diabetes (CACTI) study (n = 1257; T1D: n = 568; non-diabetic controls: n = 689) collected between the years 2000 and 2002. Participants completed a validated food frequency questionnaire, a physical examination, and biochemical analyses. Dietary patterns based on variations in food group intake were created with principal components analysis. Linear regression was used to examine the associations of dietary patterns, macronutrients, and food groups with HbA1c in a model adjusted for relevant covariates and stratified by diabetes status. Results: Three dietary patterns were identified: “fruits, veggies, meats, cereal”, “baked desserts” and “convenience foods and alcohol” patterns. At baseline, a higher intake of the “baked dessert” pattern was significantly associated with higher HbA1c in T1D at baseline as well at year 6 of the study when adjusted for age, sex, BMI, total calories, and diabetes duration. No such associations were observed in the case of non-diabetic controls. Dietary saturated fats and animal fats were also positively associated with HbA1c in adults with T1D at baseline and/or at year 6. Conclusions: The habitual intake of a dietary pattern that is characterized by an increased intake of added sugar and saturated fats, such as in baked desserts, may increase risks of poor glycemic control in T1D.
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Affiliation(s)
- Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA
- Correspondence: ; Tel.: +1-702-895-4576
| | - Amy C. Alman
- College of Public Health, University of South Florida, Tampa, FL 33612, USA;
| | - Janet K. Snell-Bergeon
- Barbara Davis Center for Childhood Diabetes, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA;
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Pal M, Gope M, Basu A, Laha T, Masto RE, Labar R, Kundu TK, Hoque RR, Khillare PS, Balachandran S. Indoor Quality of Residential Homes and Schools of an Industrial Area in Asansol: Characterization, Bioaccessibility and Health Risk Assessment of Potentially Toxic Elements. NEPT 2021. [DOI: 10.46488/nept.2021.v20i01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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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Wen J, Basu A, Bentall A, Henderson N, Dukek B, Gandhi M, Schinstock C. Is the level of HLA eplet mismatch a risk factor for graft loss among kidney transplant recipients who have already formed de novo donor specific antibody? Hum Immunol 2021; 82:240-246. [PMID: 33618904 DOI: 10.1016/j.humimm.2021.02.004] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 01/28/2021] [Accepted: 02/08/2021] [Indexed: 10/22/2022]
Abstract
Eplet mismatches are associated with de novo DSA (dnDSA) and antibody mediated rejection (ABMR) among the general kidney transplant population. However, it is unclear whether the level of eplet mismatch can be used for risk stratification among patients with dnDSA. We performed a retrospective observational study of kidney transplant recipients with dnDSA (n = 44) transplanted between 10/2007 and 5/2014 to evaluate eplet mismatch as a risk factor for ABMR and allograft loss among dnDSA patients. High resolution typing was inferred from by imputation based on ethnicity and NMDP haplotypes, and the eplet mismatch was calculated using the Epvix algorithm. Biopsies (N = 151) from 95.3%(42/44) of patients were reviewed. The mean (SD) eplet mismatch was 69.8(22.8). The ABMR incidence was 71.4% (30/42) and 5 year death censored allograft survival was 67.4% during the mean (SD) follow-up of 5.3 (3.1) years. ABMR and death-censored allograft survival were not correlated with eplet mismatch among dnDSA patients. However, medication adherence and dnDSA MFI < 3000 were associated with reduced ABMR incidence. Among patients with both of these favorable characteristics, only 35.7% (15/42) developed ABMR. In conclusion, the level of eplet mismatch does not correlate with ABMR or allograft loss among high risk kidney transplant patients with dnDSA.
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Affiliation(s)
- Jiqiu Wen
- Jinling Hospital, Nanjing University School of Medicine, China
| | - Arpita Basu
- Emory Transplant Center and Division of Nephrology and Hypertension, Emory University School of Medicine, Atlanta, GA, United States
| | - Andrew Bentall
- William J. von Liebig Transplant Center, Mayo Clinic, Rochester, MN, United States
| | - Nicole Henderson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Brian Dukek
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Manish Gandhi
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Carrie Schinstock
- William J. von Liebig Transplant Center, Mayo Clinic, Rochester, MN, United States.
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