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Hochstetler LJ, Olney WJ, Bishop JM, Warriner ZD, VanHoose JD, Mynatt RP, Ali D, Schadler A, Parli SE. Antibiotics for Patients With a Planned Re-Laparotomy for Intra-Abdominal Infection. Surg Infect (Larchmt) 2024; 25:192-198. [PMID: 38407831 PMCID: PMC11001956 DOI: 10.1089/sur.2023.255] [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] [Indexed: 02/27/2024] Open
Abstract
Background: Appropriate antimicrobial therapy for the management of intra-abdominal infection (IAI) continues to evolve based on available literature. The Study to Optimize Peritoneal Infection Therapy (STOP-IT) trial provided evidence to support four days of antibiotic agents in IAI post-source control but excluded patients with a planned re-laparotomy. This study aimed to determine the short- and long-term recurrent infection risk in this population. Patients and Methods: This is a single-center, retrospective, observational study of adult patients admitted to a quaternary medical center between January 1, 2016, and August 1, 2022, with IAI requiring planned laparotomy. Patients were designated as receiving five or less days of antibiotic agents (short course) or more than five days (long course) after source control. The primary outcome was IAI recurrence within 30 days. Results: Of the 104 patients who met inclusion criteria, 78 were included in analysis. Average age was 57 ± 13.3 years, 56% were male, 94% Caucasian, with a mean Acute Physiology and Chronic Health Evaluation (APACHE) II score of 17 ± 7.09. All other baseline characteristics and clinical severity markers were similar between the two groups. Regarding the primary outcome of IAI recurrence, there was no difference when comparing those who received short course versus those who received long course therapy (41.2% vs. 44.4%; p = 0.781). No differences were found between groups with respect to secondary outcomes. Conclusions: In patients admitted with IAI managed with planned re-laparotomy those who received short course antimicrobial therapy were not found to have an increase in IAI recurrence compared to those with longer courses of therapy.
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Affiliation(s)
- Lauren J. Hochstetler
- Department of Pharmacy Services, University of Kentucky HealthCare, Lexington, Kentucky, USA
| | - William J. Olney
- Department of Pharmacy Services, University of Kentucky HealthCare, Lexington, Kentucky, USA
- Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, Kentucky, USA
| | - Jacqueline M. Bishop
- Department of Pharmacy Services, University of Kentucky HealthCare, Lexington, Kentucky, USA
- Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, Kentucky, USA
| | | | - Jeremy D. VanHoose
- Department of Pharmacy Services, University of Kentucky HealthCare, Lexington, Kentucky, USA
| | - Ryan P. Mynatt
- Department of Pharmacy Services, University of Kentucky HealthCare, Lexington, Kentucky, USA
| | - Dina Ali
- Department of Pharmacy Services, University of Kentucky HealthCare, Lexington, Kentucky, USA
- Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, Kentucky, USA
| | - Aric Schadler
- Kentucky Children's Hospital, Lexington, Kentucky, USA
- University of Kentucky College of Pharmacy, Lexington, Kentucky, USA
| | - Sara E. Parli
- Department of Pharmacy Services, University of Kentucky HealthCare, Lexington, Kentucky, USA
- Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, Kentucky, USA
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2
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Yeager LS, Behal M, Flannery AH, Ali D, Livingston J, Woodward B, Cook AM. Characterizing redundancy in pharmacy residency research projects. Am J Health Syst Pharm 2024:zxae065. [PMID: 38470172 DOI: 10.1093/ajhp/zxae065] [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: 03/09/2024] [Indexed: 03/13/2024] Open
Abstract
DISCLAIMER In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE Each year, roughly 5,000 residents conduct research on clinical and practice-based topics to meet the requirements of the ASHP residency standards related to research and project management. Several investigators have evaluated residency research project publication rates, but redundancy among projects has not been evaluated. The primary objective of this study was to determine the rate of redundancy among pharmacy residency research projects. METHODS This was a retrospective cohort analysis of abstracts accepted to various regional pharmacy residency conferences from 2017 through 2020. Each abstract was placed in a pharmacy domain by therapeutic area. The categorized data for each year were then further evaluated to identify clinical categories for the year. Topics were labeled as redundant if at least 10 projects fell into the same focus area within a clinical category. Descriptive statistics were used to quantify the incidence of redundancy each year. RESULTS A total of 4,027 abstracts were included. The most common pharmacy domains were infectious disease, internal medicine, and benefit of pharmacy services. Overall, 8.2% projects (332 of 4,027) were categorized as redundant. The most common focus areas were rapid diagnostics, opioid reduction protocols, and vancomycin area-under-the-curve vs trough monitoring. CONCLUSION Pharmacy residency research projects encompassed topics across a wide range of pharmacotherapy areas. Approximately 1 in 12 projects was redundant. This is likely because the project addressed a "hot topic" in practice and may represent an opportunity for institutions to collaborate to optimize project efficiency and impact.
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Affiliation(s)
| | - Michael Behal
- University of Kentucky College of Pharmacy, Lexington, KY, USA
| | | | - Dina Ali
- University of Kentucky HealthCare, Lexington, KY, USA
| | | | - Blake Woodward
- University of Kentucky College of Pharmacy, Lexington, KY, USA
| | - Aaron M Cook
- Neuroscience-Pulmonary/Critical Care, University of Kentucky HealthCare, Lexington, KY, USA
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3
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Piffoux M, Delpon G, Ducrot C, Alexis A, Allignet B, Dupraz C, Egnell M, Kernec M, Milewski C, Rivera S, Vitré J, Ali D, Supiot S. Insights on the carbon footprint of radiotherapy in France. Cancer Radiother 2023; 27:487-490. [PMID: 37558609 DOI: 10.1016/j.canrad.2023.07.009] [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: 07/12/2023] [Revised: 07/20/2023] [Accepted: 07/20/2023] [Indexed: 08/11/2023]
Abstract
The French healthcare system is responsible for 8% of the national footprint. Achieving a net zero emissions scenario will require a 4-5 fold decrease of carbon emissions in the coming years. The carbon footprint of radiation therapy has not been specifically studied to date. In this review we summarize the content of the carbon footprint dedicated session at the annual meeting of the French society of radiation oncology (SFRO). We discuss the French healthcare system carbon footprint and its major drivers and our work on the estimation of the carbon footprint of external beam radiation therapy in the French setting. We developed a dedicated methodology to estimate the carbon footprint related to radiation therapies, and describe the main drivers of emissions based on a single centre as an example, namely patient's rides, accelerators acquisition and maintenance and data storage. Based on the carbon footprint calculated in our centres, we propose mitigation strategies and an estimation of their respective potential. Our results may be extrapolated to other occidental settings by adapting emission factors (kilograms of carbon per item or euro) to other national settings. External beam radiation therapy has a major carbon footprint that may be mitigated in many ways that may impact how radiation therapy treatments are delivered, as well as the national organization of the radiotherapy sector. This needs to be taken into account when thinking about the future of radiotherapy.
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Affiliation(s)
- M Piffoux
- Département d'oncologie médicale, hospices civils de Lyon, Citohl, Lyon, France; Direction de la recherche clinique et de l'innovation, centre Léon-Bérard, Lyon, France.
| | - G Delpon
- Département de physique médicale, Institut de cancérologie de l'Ouest centre René-Gauducheau, Saint-Herblain, France; Laboratoire Subatech, UMR 6457 CNRS-IN2P3, IMT Atlantique, Nantes, France
| | - C Ducrot
- Département de chirurgie orthopédique, hôpital Femme-Mère-Enfant, hospices civils de Lyon, Bron, France; Laboratoire mort cellulaire et cancers de l'enfant, U1052, Inserm, U5286, CNRS, centre de recherche en cancérologie de Lyon, Lyon, France
| | - A Alexis
- Département de physique médicale, Institut de cancérologie de l'Ouest centre René-Gauducheau, Saint-Herblain, France
| | - B Allignet
- Département de radiothérapie, centre Léon-Bérard, Lyon, France; Insa-Lyon, université Claude-Bernard Lyon-1, laboratoire Creatis UMR 5220, U1294, Lyon, France; Université Jean-Monnet, Saint-Étienne, France
| | - C Dupraz
- Direction de la recherche clinique et de l'innovation, centre Léon-Bérard, Lyon, France
| | - M Egnell
- The Shift Project, Paris, France
| | - M Kernec
- The Shift Project, Paris, France
| | - C Milewski
- Institut Gustave-Roussy, Villejuif, France
| | - S Rivera
- Institut Gustave-Roussy, Villejuif, France
| | - J Vitré
- Institut Gustave-Roussy, Villejuif, France
| | - D Ali
- Centre de radiothérapie de Versailles, Versailles, France
| | - S Supiot
- Département de radiothérapie, Institut de cancérologie de l'Ouest centre René-Gauducheau, Saint-Herblain, France; Laboratoire US2B, CNRS UMR 6286, université de Nantes, Nantes, France
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4
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McGregor G, Powell R, Begg B, Birkett ST, Nichols S, Ennis S, McGuire S, Prosser J, Fiassam O, Hee SW, Hamborg T, Banerjee P, Hartfiel N, Charles JM, Edwards RT, Drane A, Ali D, Osman F, He H, Lachlan T, Haykowsky MJ, Ingle L, Shave R. High-intensity interval training in cardiac rehabilitation (HIIT or MISS UK): A multi-centre randomised controlled trial. Eur J Prev Cardiol 2023:7031580. [PMID: 36753063 DOI: 10.1093/eurjpc/zwad039] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/09/2023] [Accepted: 02/07/2023] [Indexed: 02/09/2023]
Abstract
BACKGROUND There is a lack of international consensus regarding the prescription of high-intensity interval exercise training (HIIT) for people with coronary artery disease (CAD) attending cardiac rehabilitation (CR). AIM To assess the clinical effectiveness and safety of low-volume HIIT compared with moderate intensity steady-state (MISS) exercise training for people with CAD. METHODS We conducted a multi-centre RCT, recruiting 382 patients from 6 outpatient CR centres. Participants were randomised to twice-weekly HIIT (n = 187) or MISS (n = 195) for 8 weeks. HIIT consisted of 10 × 1-minute intervals of vigorous exercise (>85% maximum capacity) interspersed with 1-minute periods of recovery. MISS was 20-40 minutes of moderate intensity continuous exercise (60-80% maximum capacity). The primary outcome was the change in cardiorespiratory fitness (peak oxygen uptake, VO2 peak) at 8-week follow-up. Secondary outcomes included cardiovascular disease risk markers, cardiac structure and function, adverse events, and health-related quality of life. RESULTS At 8 weeks, VO2 peak improved more with HIIT (2.37 mL.kg-1.min-1; SD, 3.11) compared with MISS (1.32 mL.kg-1.min-1; SD, 2.66). After adjusting for age, sex and study site, the difference between arms was 1.04 mL.kg-1.min-1 (95% CI, 0.38 to 1.69; p = 0.002). Only 1 serious adverse event was possibly related to HIIT. CONCLUSIONS In stable CAD, low-volume HIIT improved cardiorespiratory fitness more than MISS by a clinically meaningful margin. Low-volume HIIT is a safe, well tolerated, and clinically effective intervention that produces short-term improvement in cardiorespiratory fitness. It should be considered by all CR programmes as an adjunct or alternative to MISS. TRIAL REGISTRATION ClinicalTrials.gov: NCT02784873. https://clinicaltrials.gov/ct2/show/NCT02784873.
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Affiliation(s)
- G McGregor
- Department of Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK.,Centre for Sport Exercise & Life Sciences, Coventry University, UK.,Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - R Powell
- Department of Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK.,Centre for Sport Exercise & Life Sciences, Coventry University, UK
| | - B Begg
- Cardiff Centre for Exercise & Health, Cardiff Metropolitan University, Cardiff, Wales UK.,Aneurin Bevan University Health Board, Gwent, Wales, UK
| | - S T Birkett
- Department of Sport and Exercise Sciences. Manchester Metropolitan University, Manchester, UK
| | - S Nichols
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK.,Sport and Physical Activity Research Centre, Sheffield Hallam University, Sheffield, UK
| | - S Ennis
- Department of Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK.,Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - S McGuire
- Department of Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK.,Centre for Sport Exercise & Life Sciences, Coventry University, UK
| | - J Prosser
- Department of Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - O Fiassam
- Department of Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - S W Hee
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - T Hamborg
- Pragmatic Clinical Trials Unit, Centre for Evaluation and Methods, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - P Banerjee
- Centre for Sport Exercise & Life Sciences, Coventry University, UK.,Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.,Department of Cardiology, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - N Hartfiel
- Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University, Bangor, UK
| | - J M Charles
- Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University, Bangor, UK
| | - R T Edwards
- Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University, Bangor, UK
| | - A Drane
- Cardiff Centre for Exercise & Health, Cardiff Metropolitan University, Cardiff, Wales UK
| | - D Ali
- Department of Cardiology, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - F Osman
- Department of Cardiology, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - H He
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.,Department of Cardiology, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - T Lachlan
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.,Department of Cardiology, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - M J Haykowsky
- College of Health Sciences, Faculty of Nursing, University of Alberta, Edmonton, Canada
| | - L Ingle
- Department of Sport, Health & Exercise Science, University of Hull, Hull, UK
| | - R Shave
- Centre for Heart Lung and Vascular Health, University of British Columbia - Okanagan, Canada
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5
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Azongmo M, Zhu L, Lorenzo-Villalba N, Cardos B, Yerna M, Ali D. [A particular state of shock: spontaneous rupture of a heterotopic pregnancy]. Rev Med Liege 2023; 78:21-23. [PMID: 36634062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Heterotopic pregnancy is a rare pathology. It is defined as the coexistence of an intrauterine pregnancy and an extrauterine pregnancy, whatever its location. The presence of an intrauterine pregnancy in a woman of childbearing age does not therefore exclude the presence of an associated ectopic pregnancy. Late diagnosis can lead to fatal consequences for the mother, subsequent fertility as well as for the intrauterine pregnancy. We report the case of a 28-year old female patient, without any notion of assisted reproduction, who was admitted to the emergency department for hemorrhagic shock. The diagnosis of ruptured tubal heterotopic pregnancy was made intraoperatively.
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Affiliation(s)
- M Azongmo
- Service des Urgences, CHU Liège, Belgique
| | - L Zhu
- Service des Urgences, Hôpital de Jolimont, La Louvière, Belgique
| | - N Lorenzo-Villalba
- Service de Médecine Interne, Diabète et Maladies métaboliques, Hôpitaux Universitaires de Strasbourg, France
| | - B Cardos
- Département des Sciences de la Santé publique, ULiège, Belgique
| | - M Yerna
- Service des Urgences, CHC MontLégia, Liège, Belgique
| | - D Ali
- Service des Urgences, CHC MontLégia, Liège, Belgique
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6
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Rozoqi SS, Salih BA, Ali D. Determination of Ceruloplasmin Oxidase Activity, Copper and Iron in Seminal Fluid of Fertile and Infertile Males. Egypt J Chem 2022. [DOI: 10.21608/ejchem.2022.161174.6930] [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: 11/09/2022]
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Gach-Kuniewicz B, Goncerz G, Ali D, Kacprzyk M, Zarzecki M, Loukas M, Walocha J, Mizia E. Variations of coronary sinus tributaries among patients undergoing cardiac resynchronization therapy. Folia Morphol (Warsz) 2022; 82:282-290. [PMID: 35607878 DOI: 10.5603/fm.a2022.0044] [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: 02/19/2022] [Revised: 03/29/2022] [Accepted: 04/07/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND In cardiac resynchronization therapy, the coronary venous system is used for left ventricular pacing electrode placement. Despite the well-known anatomy of the coronary sinus and its tributaries, heart failure patients' remodeled and enlarged left ventricles may impede the successful lead placement because of acquired anatomical obstacles. MATERIALS AND METHODS Fifty-five patients qualified for cardiac resynchronization therapy treatment (CRT) were divided into ischemic and non-ischemic cardiomyopathy. Forty-four control groups without heart failure underwent dual-source computed tomography (CT). Rendered reconstructions of cardiac coronary systems were compared. RESULTS The presence of main tributaries was comparable in all groups. The left marginal vein, small cardiac vein, and oblique vein of the left atrium were present in 63%, 60%, and 51% of the hearts in all the groups. CRT referred CT's had significantly longer distances between posterior and lateral cardiac veins over the left ventricle (p < 0.05), wider angles of tributaries (p = 0.03), and smaller lumen of coronary sinus (p = 0.03). In the non-ischemic group, the posterior interventricular and great cardiac veins are more extensive than in the control group. Age-related analysis of vessel size shows a moderate correlation between age and diminishing mean vessel size in all the groups studied. CONCLUSIONS The general structure of the coronary heart system is consistent in patients with and without heart failure. The variance of the general structure, or the presence of adequate veins, is an individual variation. The use of CT and analysis of the coronary veins allow better planning of the CRT-D implantation procedure and may reduce the risk of ineffective left ventricular electrode implantation.
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Affiliation(s)
- B Gach-Kuniewicz
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland.
| | - G Goncerz
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - D Ali
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - M Kacprzyk
- Department of Electrocardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - M Zarzecki
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - M Loukas
- Department of Anatomical Sciences, St. George's University, Grenada, West Indies.,Department of Anatomy, Varmia and Mazury University, Olsztyn, Poland
| | - J Walocha
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - E Mizia
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
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Kenneally AM, Warriner Z, VanHoose JD, Ali D, McCleary EJ, Davenport DL, Parli SE. Evaluation of Antibiotic Duration after Surgical Debridement of Necrotizing Soft Tissue Infection. Surg Infect (Larchmt) 2022; 23:357-363. [PMID: 35262418 DOI: 10.1089/sur.2021.256] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Necrotizing soft tissue infection (NSTI) is known to be a medical emergency with high morbidity and mortality. Guidelines do not specify the optimal duration of antibiotic agents after completion of surgical debridements of NSTI, which has created variable practice. It was hypothesized that patients with NSTI who receive 48 hours or less of post-operative antibiotic agents after final debridement have similar rates of subsequent intervention or infection recurrence, suggesting that a shorter duration of antibiotic agents may treat NSTI adequately after final surgical debridement. Patients and Methods: This was a retrospective study including adults with NSTI identified through International Classification of Diseases, Ninth Revision (ICD-9), International Classification of Diseases, Tenth Revision (ICD-10), and Current Procedural Terminology (CPT) codes admitted to one academic institution between January 1, 2010 and July 31, 2020. Demographics, surgical practices, antibiotic practices, and clinical outcomes including inpatient mortality, hospital length of stay (LOS), intensive care unit (ICU) LOS, total antibiotic days, necrotizing infection clinical composite end point (NICCE) success, and infection recurrence were compared based on the duration of antibiotic agents after final debridement. Results: Three hundred twenty-two patients with NSTI were included and baseline characteristics and clinical severity markers were well balanced between the two groups. In 71 patients (22%) who received less than 48 hours of antibiotic agents after final debridement there was no difference in recurrence (1.4% vs. 3.6%; p = 0.697), mortality (1.4% vs. 4.4%; p = 0.476), or ICU LOS (1 vs. 2 days; p = 0.300], but they did have a shorter hospital LOS (7 vs. 10 days; p = 0.011). Conclusions: Shorter duration of antibiotic therapy after final surgical debridement of NSTI may be appropriate in patients without another indication for antibiotic agents.
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Affiliation(s)
- Allison M Kenneally
- Department of Pharmacy Services, University of Kentucky HealthCare, Lexington, Kentucky, USA
| | - Zachary Warriner
- Department of Surgery, University of Kentucky, Lexington, Kentucky, USA
| | - Jeremy D VanHoose
- Department of Pharmacy Services, University of Kentucky HealthCare, Lexington, Kentucky, USA
| | - Dina Ali
- Department of Pharmacy Services, University of Kentucky HealthCare, Lexington, Kentucky, USA.,Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, Kentucky, USA
| | - Emily J McCleary
- Department of Pharmacy Services, University of Kentucky HealthCare, Lexington, Kentucky, USA
| | - Dan L Davenport
- Division of Healthcare Outcomes and Optimal Patient Services, University of Kentucky Medical Center, Lexington, Kentucky, USA
| | - Sara E Parli
- Department of Pharmacy Services, University of Kentucky HealthCare, Lexington, Kentucky, USA.,Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, Kentucky, USA
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Stilmant AC, Zhu L, Gorur Y, Cardos B, Yerna M, Ali D. [Fatal serotonin syndrome induced by ecstasy consumption]. Rev Med Liege 2022; 77:8-12. [PMID: 35029334] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The use of amphetamines and amphetamine derivatives such as ecstasy can cause serotonin toxic syndrome, an uncommon but potentially serious adverse effect. Although most of the reported cases evolve spontaneously and favourably, in rare cases, serious complications can occur leading to the death of the patient. We report the case of a 27-year-old man admitted to our emergency department for altered consciousness with hyperthermia at 42°C after illicit drug use. The patient developed severe multivisceral failure and disseminated intravascular coagulopathy despite maximalist management focused on cooling and multiorgan supportive therapy. The patient died within hours of admission. The diagnosis is essentially based on the patient history and clinical examination. The first treatment is to stop the toxic and then, to treat the symptoms and support possible organ failures.
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Affiliation(s)
- A C Stilmant
- Service des Urgences, CHC MontLégia, Liège, Belgique
| | - L Zhu
- Service des Urgences, CHU Liège, Belgique
| | - Y Gorur
- Service de Radiologie, Clinique André Renard, Herstal, Belgique
| | - B Cardos
- Service des Urgences, Clinique André Renard, Herstal, Belgique
| | - M Yerna
- ) Service des Urgences, CHC MontLégia, Liège, Belgique
| | - D Ali
- Service des Urgences, CHC MontLégia, Liège, Belgique
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10
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Moga DC, Abner EL, Schmitt FA, Eckmann L, Huffmyer M, Martinez AI, Beech BF, George R, El Khouli RH, Ali D, Jicha GA. Intervention for Cognitive Reserve Enhancement in Delaying the Onset of Alzheimer’s Symptomatic Expression (INCREASE) Study: Results from a Randomized Controlled Study of Medication Therapy Management Targeting a Delay in Prodromal Dementia Symptom Progression. J Prev Alzheimers Dis 2022; 9:646-654. [PMID: 36281668 PMCID: PMC9145115 DOI: 10.14283/jpad.2022.55] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Cognitive reserve has been hypothesized as a mechanism to explain differences in individual risk for symptomatic expression of Alzheimer’s Disease (AD). Inappropriate medications may diminish cognitive reserve, precipitating the transition from preclinical AD (pAD) to a symptomatic state. To date, there is limited data on the potential impact of medication optimization as a potential tool for slowing the symptomatic expression of AD. Objectives (1) To test the efficacy of a medication therapy management intervention designed to bolster cognitive reserve in community-dwelling older adults without dementia. (2) To evaluate the efficacy of intervention by baseline pAD status. Design A 1-year randomized controlled trial was conducted in community-dwelling older adults without dementia. Randomization was stratified by amyloid β positron emission tomography levels. Setting Community-based, Lexington, Kentucky. Participants Adults 65 years or older with no evidence of dementia and reporting at least one potentially inappropriate medication as listed in the Beers 2015 criteria were recruited. The study aimed to enroll 90 participants based on the a priori sample size calculation. Intervention Medication therapy management versus standard of care. Measurements Primary outcomes were: (1) one-year changes in the Medication Appropriateness Index; (2) one-year changes in Trail Making Test B under scopolamine challenge. Results The medication therapy management intervention resulted in significant improvement in Medication Appropriateness Index scores. Overall, there was no beneficial effect of the medication therapy management on Trail Making Test B scores, however stratified analysis demonstrated improvement in Trail Making Test B challenged scores associated with the medication therapy management for those with elevated amyloid β positron emission tomography levels consistent with pAD. Conclusions Medication therapy management can reduce inappropriate medication use in older adults at risk for AD. Our study indicated beneficial cognitive effects in those with preclinical Alzheimer’s Disease. No statistically significant effects were evident in the study group as a whole, or in those without preclinical cerebral amyloidosis. Further work designed to improve the effectiveness of the medication therapy management approach and defining other preclinical pathologic states that may benefit from medication optimization are readily achievable goals for promoting improved cognitive health and potentially delaying the onset of symptomatic AD.
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Affiliation(s)
- D C Moga
- Daniela C. Moga, 241 Lee T. Todd Jr. Building, 789 S. Limestone, Lexington, KY 40536, 859-323-9682,
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ALFadhalah T, Al Mudaf B, Alghanim HA, Al Salem G, Ali D, Abdelwahab HM, Elamir H. Correction to: Baseline assessment of patient safety culture in primary care centres in Kuwait: a national cross-sectional study. BMC Health Serv Res 2021; 21:1270. [PMID: 34819049 PMCID: PMC8611892 DOI: 10.1186/s12913-021-07280-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Talal ALFadhalah
- Quality and Accreditation Directorate, Ministry of Health, Kuwait City, Kuwait
| | - Buthaina Al Mudaf
- Assistant Undersecretary of Public Health Affairs, Ministry of Health, Kuwait City, Kuwait
| | - Hanaa A Alghanim
- Safety Department, Quality and Accreditation Directorate, Ministry of Health, Kuwait City, Kuwait
| | - Gheed Al Salem
- Accreditation Affairs Department, Quality and Accreditation Directorate, Ministry of Health, Kuwait City, Kuwait
| | - Dina Ali
- Safety Department, Quality and Accreditation Directorate, Ministry of Health, Kuwait City, Kuwait
| | - Hythem M Abdelwahab
- National Blood Transfusion Services, Ministry of Health and Population, Giza, Egypt
| | - Hossam Elamir
- Research and Technical Support Department, Quality and Accreditation Directorate, Ministry of Health, Kuwait City, Kuwait.
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12
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Mundodan J, Hasnain S, Khogali H, Al Bayat SS, Ali D, Alateeg S, Al-Romaihi H, Al-Thani MHJ. Validation of rapid antibody (IgG-IgM) test kit for SARS COV-2 infection in Qatar. J Public Health Res 2021; 11. [PMID: 34781629 PMCID: PMC8874874 DOI: 10.4081/jphr.2021.2421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/31/2021] [Indexed: 11/28/2022] Open
Abstract
Background: In response to the growing coronavirus disease 2019 (COVID-19) pandemic and the shortage of laboratory based molecular testing capacity and reagents, multiple diagnostic test manufacturers have developed rapid and easy to use devices to facilitate testing outside laboratory settings. These kits are either based on detection of proteins from SARS-CoV-2 virus or detection of antigen or human antibodies generated in response to the infection. However, it is important to understand their performance characteristics and they must be validated in the local population setting. Design and methods: The objective is to assess the validity of the rapid test for IgG and IgM immunoglobulins compared to the current gold standard reverse transcription polymerase chain reaction (RT-PCR) test. A total of 16951 asymptomatic individuals were tested by the Ministry of Public Health track-and-trace team using both rapid immunodiagnostic test and RT-PCR as part of screening across various random settings with potential risk of community interaction prior to gradual lifting of restrictions in Qatar. Rapid test was considered to be posiive if both IgG and IgM are positive, while only IgG/IgM positive was considered as rapid test negative. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Results: The sensitivity of rapid test kit was found to be 0.9%, whereas the specificity was found to be 97.8%. the PPV was found to be 0.3% whereas the NPV was found to be 99.4%. Conclusions: Based on the outcome and results of the study, it appears that the sensitivity and PPV of the rapid antibody test are low. As such, this test is not recommended for use to assist in taking clinic-based decisions or decisions related to quarantine/isolation. Significance for public health It is important to understand the performance characteristics of the Rapid Antibody (IgG-IgM) kits and they must be validated in the local population setting before they can be recommended for use.
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Affiliation(s)
- Jesha Mundodan
- Public Health Department, Ministry of Public Health, Doha.
| | - Samina Hasnain
- Public Health Department, Ministry of Public Health, Doha.
| | - Hayat Khogali
- Vaccination section / National COVID Track 'n Trace Team, Public Health Department, Ministry of Public Health, Doha.
| | - Soha Shawqi Al Bayat
- Vaccination section / National COVID Track 'n Trace Team, Public Health Department, Ministry of Public Health, Doha.
| | - Dina Ali
- Primary Health Care Corporation, Doha.
| | - Saif Alateeg
- Contact tracing, Health Protection and Communicable Diseases Control (HP-CDC), Public Health Department, Ministry of Public Health, Doha.
| | - Hamad Al-Romaihi
- Director of Health Protection and Communicable Diseases (HP-CDC), Public Health Department, Ministry of Public Health, Doha.
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13
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ALFadhalah T, Al Mudaf B, Alghanim HA, Al Salem G, Ali D, Abdelwahab HM, Elamir H. Baseline assessment of patient safety culture in primary care centres in Kuwait: a national cross-sectional study. BMC Health Serv Res 2021; 21:1172. [PMID: 34711229 PMCID: PMC8555195 DOI: 10.1186/s12913-021-07199-1] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 10/18/2021] [Indexed: 11/28/2022] Open
Abstract
Background Assessments of the culture surrounding patient safety can inform healthcare settings on how their structures and processes impact patient outcomes. This study investigated patient safety culture in Primary Health Care Centres in Kuwait, and benchmarked the findings against regional and international results. This study also examined the association between predictors and outcomes of patient safety culture in these settings. Methods This cross-sectional quantitative study used the Medical Office Survey on Patient Safety Culture. The study was targeted at staff of all the Primary Health Care Centres in Kuwait with at least one year of experience. Data were analysed using SPSS 23 at a significance level of ≤ .05. Univariate (means, standard deviations, frequencies, percentages) and bivariate (chi-squared tests, student t-tests, ANOVA F-tests, Kruskal–Wallis tests, Spearman’s correlation) analyses provided an overview of participant socio-demographics and the association between patient safety culture composites and outcomes. We undertook a multivariate regression analysis to predict the determinants of patient safety culture. Results were benchmarked against similar local (Kuwait, 2014), regional (Yemen, 2015) and international (US, 2018) studies. Results The responses of 6602 employees from 94 centres were included in the study, with an overall response rate of 78.7%. The survey revealed Teamwork (87.8% positive ratings) and Organisational Learning (78.8%) as perceived areas of strength. Communication about Error (57.7%), Overall Perceptions of Patient Safety and Quality (57.4%), Communication Openness (54.4%), Owner/Managing Partner/Leadership Support for Patient Safety (53.8%) and Work Pressure and Pace (28.4%) were identified as areas requiring improvement. Benchmarking analysis revealed that Kuwait centres are performing at benchmark levels or better on four and six composites when compared to international and regional findings, respectively. Regression modelling highlighted significant predictions regarding patient safety outcomes and composites. Conclusions This is the first major study addressing the culture of patient safety in public Primary Health Care Centres regionally. Improving patient safety culture is critical for these centres to improve the quality and safety of the healthcare services they provide. The findings of this study can guide country-level strategies to develop the systems that govern patient safety practices. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07199-1.
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Affiliation(s)
- Talal ALFadhalah
- Quality and Accreditation Directorate, Ministry of Health, Kuwait City, Kuwait
| | - Buthaina Al Mudaf
- Assistant Undersecretary of Public Health Affairs, Ministry of Health, Kuwait City, Kuwait
| | - Hanaa A Alghanim
- Safety Department, Quality and Accreditation Directorate, Ministry of Health, Kuwait City, Kuwait
| | - Gheed Al Salem
- Accreditation Affairs Department, Quality and Accreditation Directorate, Ministry of Health, Kuwait City, Kuwait
| | - Dina Ali
- Safety Department, Quality and Accreditation Directorate, Ministry of Health, Kuwait City, Kuwait
| | - Hythem M Abdelwahab
- National Blood Transfusion Services, Ministry of Health and Population, Giza, Egypt
| | - Hossam Elamir
- Research and Technical Support Department, Quality and Accreditation Directorate, Ministry of Health, Kuwait City, Kuwait.
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14
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Ali D, Tran P, Weight N, Ennis S, Weickert M, Miller M, Cappuccio F, Banerjee P. Heart failure with preserved ejection fraction (HFpEF) pathophysiology study (IDENTIFY-HF): rise in arterial stiffness associates with HFpEF with increase in comorbidities. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0722] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
There has been a shift in paradigm proposing that comorbidities play a significant role towards the pathophysiology of the heart failure with preserved ejection fraction (HFpEF) syndrome. Further, HFpEF patients have abnormal macrovascular function, potentially contributing significantly in altered ventricular-vascular coupling in these patients. However, our full understanding of the role of comorbidities, arterial stiffness and it relationship with HFpEF remains incomplete.
Purpose
The IDENTIFY-HF study aims to shed light on the HFpEF pathophysiology and investigates whether gradually increase in arterial stiffness (in addition to ageing) due to increasing common comorbidities, such as hypertension and diabetes, is associated with HFpEF.
Methods
Arterial compliance was assessed in five groups (Groups A to E) matched for age, (≥70 years), sex and renal function: Group A; normal healthy volunteers without major comorbidities (control). Group B; patients with hypertension only. Group C; patients with hypertension and diabetes mellitus only. Group D; patients with HFpEF. Group E; patients with heart failure and reduced ejection fraction (HFrEF); the parallel group. Arterial compliance was assessed using pulse wave velocity (PWV), as the primary outcome measure and was compared between Group A to D. A separate comparison was made between Groups D and E. To avoid confounding factors, participants were asked to omit their morning blood pressure medication and abstain from caffeine for 12 hours prior to the study.
Results
From the 95 volunteers recruited, PWV was obtained in 94 subjects. The mean PWV in group A, B, C, D and E was 10.2-, 12.2-, 13.0-, 13.7- and 10.0 m/s respectively. After adjusting for covariance (age, sex, BMI and renal function), the mean difference between Group A (healthy volunteers) and D (HFpEF) was 2.14 m/s (p=0.023). Whilst the mean difference between the HFpEF and HFrEF group D and E respectively was 2.68 m/s (p=0.003).
Conclusion
Rise in comorbidities increases arterial stiffness, as measured by pulse wave velocity, which in turn significantly associates with HFpEF (p=0.023). It is therefore possible that the HFpEF syndrome may not be due to a primary cardiac pathology but rather an end-result of non-cardiac comorbidities affecting vascular resistance with perhaps some secondary cardiac involvement.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): 1)West Midlands Clinical Research Network, National Institute of Health Research, UK2)Research, Development & Innovation department of the University Hospitals Coventry & Warwickshire NHS Trust (RDI, UHCW), UK.
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Affiliation(s)
- D Ali
- Royal Brompton and Harefield NHS, Harefield, United Kingdom
| | - P Tran
- University Hospitals of Coventry and Warwickshire NHS Trust, Cardiology, Coventry, United Kingdom
| | - N Weight
- University Hospitals of Coventry and Warwickshire NHS Trust, Cardiology, Coventry, United Kingdom
| | - S Ennis
- University Hospitals of Coventry and Warwickshire NHS Trust, Cardiology, Coventry, United Kingdom
| | - M Weickert
- University Hospitals of Coventry and Warwickshire NHS Trust, Cardiology, Coventry, United Kingdom
| | - M Miller
- University of Warwick, Warwick Medical School, Coventry, United Kingdom
| | - F Cappuccio
- University of Warwick, Warwick Medical School, Coventry, United Kingdom
| | - P Banerjee
- University of Warwick, Warwick Medical School, Coventry, United Kingdom
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15
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Abstract
Sesamol is the main constituent of sesame seed oil and is obtained from Sesamum indicum. Oral squamous cell carcinoma (OSCC) is one of the most common neoplasms affecting the oral cavity. In this study, we investigated the cytotoxic potentials of sesamol on human oral squamous carcinoma (SCC-25) cells. Human oral squamous carcinoma cells were treated with different concentrations (62.5, 125, and 250 μM/mL) of sesamol for 24 h. Cytotoxicity was analyzed by 3- (4, 5- dimethylthiazol -2- yl) -2, 5-diphenyltetrazolium bromide (MTT) assay. Intracellular reactive oxygen species (ROS) expression was investigated by dichloro-dihydro-fluorescein diacetate assay. Apoptosis-related morphology was analyzed by acridine orange/ethidium bromide staining. Caspase-9 expression was analyzed by confocal microscopic double immunofluorescence staining. Mitochondrial apoptosis-related markers are analyzed using qPCR. Sesamol treatment caused a significant cytotoxic effect in OSCC cells. Sesamol-induced cytotoxic effect was associated with intracellular ROS generation. Sesamol treatments induced a significant increase in the early and late apoptotic cells. This treatment also induced caspase-9 expression in OSCC cells. Sesamol treatments caused downregulation of Harvey rat sarcoma viral oncogene homolog (HRAS) expression at protein and gene levels. Sesamol treatment modulates intrinsic apoptotic marker gene expression in OSCC cells. Overall results confirm the anti-cancer potential of sesamol and it seems to be a promising candidate for OSCC.
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Affiliation(s)
- D Ezhilarasan
- Department of Pharmacology, The Blue Laboratory, Molecular Medicine and Toxicology Division, Saveetha Dental College and Hospitals, 194347Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - D Ali
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - R Varghese
- Department of Microbiology, Faculty of Science and Informatics, 37442University of Szeged, Szeged, Hungary
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16
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Al Bayat S, Mundodan J, Hasnain S, Sallam M, Khogali H, Ali D, Alateeg S, Osama M, Elberdiny A, Al-Romaihi H, Al-Thani MHJ. Can the cycle threshold (Ct) value of RT-PCR test for SARS CoV2 predict infectivity among close contacts? J Infect Public Health 2021; 14:1201-1205. [PMID: 34416598 PMCID: PMC8362640 DOI: 10.1016/j.jiph.2021.08.013] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/03/2021] [Accepted: 08/09/2021] [Indexed: 12/23/2022] Open
Abstract
Background COVID-19 global pandemic is an unprecedented health emergency. Rapid identification and isolation of infected individuals is crucial. Qatar’s National Health Strategic Command Group adopted a cut off 30 for Ct value of RT-PCR result of a positive case to decide on duration of isolation and quarantine period for their close contacts. Aim To test if Ct value cut off 30 reflects on the infectivity potential among close contacts. Methodology All positive cases reported during July’ 2020 whose contacts had been traced and swabbed were extracted from database after removing personal identifiers. Close-contact was defined as anybody who has been within 2 m distance of a confirmed positive case for 15 min or more, without any personal protection equipment. Descriptive analysis was done and test of significance of difference in positivity among the contacts of those with ct < 30 and >30 was done. Results 2308 COVID-19 positive cases were followed up. More than three-quarters had a Ct value < 30, with a mean Ct value of 24.05(+6.48). On an average 6 contacts were swabbed per case. More than half the positive cases followed up had at least one secondary case, with median positivity rate 12.5%. A significant relation was noted between Ct value cut-off 30 and secondary transmission (1.5 times more risk among those with Ct value < 30). A significant difference was noted in median positivity rate between close contacts of positive cases with Ct value > 30 or <30. Conclusion Further studies combining PCR assays, culture studies and contact tracing are needed to define which factors can be used to reliably predict the infectious status of patients with COVID-19.
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Affiliation(s)
| | | | | | | | | | - Dina Ali
- HP-CDC, Public Health Department, MOPH, Qatar.
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17
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Akl M, Ali D, Ismail M, Hashem M. Antibacterial Activity of Eco Friendly Biologically Synthesized Copper Oxide Nanoparticles. Egypt J Chem 2021. [DOI: 10.21608/ejchem.2021.67430.3481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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18
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Ali D, Barra ME, Blunck J, Brophy GM, Brown CS, Caylor M, Clark SL, Hensler D, Jones M, Lamer-Rosen A, Levesque M, Mahmoud LN, Mahmoud SH, May C, Nguyen K, Panos N, Roels C, Shewmaker J, Smetana K, Traeger J, Shadler A, Cook AM. Stress-Related Gastrointestinal Bleeding in Patients with Aneurysmal Subarachnoid Hemorrhage: A Multicenter Retrospective Observational Study. Neurocrit Care 2020; 35:39-45. [PMID: 33150575 DOI: 10.1007/s12028-020-01137-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 10/15/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND/OBJECTIVE Stress-related mucosal bleeding (SRMB) occurs in approximately 2-4% of critically ill patients. Patients with aneurysmal subarachnoid hemorrhage (aSAH) have a (diffuse) space-occupying lesion, are critically ill, often require mechanical ventilation, and frequently receive anticoagulation or antiplatelet therapy after aneurysm embolization, all of which may be risk factors for SRMB. However, no studies have evaluated SRMB in patients with aSAH. Aims of the study were to determine the incidence of SRMB in aSAH patients, evaluate the effect of acid suppression on SRMB, and identify specific risk factors for SRMB. METHODS This was a multicenter, retrospective, observational study conducted across 17 centers. Each center reviewed up to 50 of the most recent cases of aSAH. Patients with length of stay (LOS) < 48 h or active GI bleeding on admission were excluded. Variables related to demographics, aSAH severity, gastrointestinal (GI) bleeding, provision of SRMB prophylaxis, adverse events, intensive care unit (ICU), and hospital LOS were collected for the first 21 days of admission or until hospital discharge, whichever came first. Descriptive statistics were used to analyze the data. A multivariate logistic regression modeling was utilized to examine the relationship between specific risk factors and the incidence of clinically important GI bleeding in patients with aSAH. RESULTS A total of 627 patients were included. The overall incidence of clinically important GI bleeding was 4.9%. Of the patients with clinically important GI bleeding, 19 (61%) received pharmacologic prophylaxis prior to evidence of GI bleeding, while 12 (39%) were not on pharmacologic prophylaxis at the onset of GI bleeding. Patients who received an acid suppressant agent were less likely to experience GI bleeding than patients who did not receive pharmacologic prophylaxis prior to evidence of bleeding (OR 0.39, 95% CI 0.18-0.83). The multivariate regression analysis identified any instance of elevated intracranial pressure, creatinine clearance < 60 ml/min and the incidence of cerebral vasospasm as specific risk factors associated with GI bleeding. Cerebral vasospasm has not previously been described as a risk for GI bleeding (OR 2.5 95% CI 1.09-5.79). CONCLUSIONS Clinically important GI bleeding occurred in 4.9% of patients with aSAH, similar to the general critical care population. Risk factors associated with GI bleeding were prolonged mechanical ventilation (> 48 h), creatinine clearance < 60 ml/min, presence of coagulopathy, elevation of intracranial pressure, and cerebral vasospasm. Further prospective research is needed to confirm this observation within this patient population.
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Affiliation(s)
- Dina Ali
- University of Kentucky HealthCare, Lexington, USA.
| | | | - Joseph Blunck
- Saint Luke's Health System-Kansas City, Kansas City, USA
| | | | | | - Meghan Caylor
- Hospital of the University of Pennsylvania, Philadelphia, USA
| | | | | | | | | | | | | | | | - Casey May
- Ohio State Wexner Medical Center, Columbus, USA
| | | | | | | | | | | | | | - Aric Shadler
- University of Kentucky College of Pharmacy, Lexington, USA
| | - Aaron M Cook
- University of Kentucky HealthCare, Lexington, USA
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19
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Nebie A, Ali D, Bosquee L, Gorur Y, Cardos B. [Central nervous system tuberculosis : don't miss the diagnosis !]. Rev Med Liege 2020; 75:703-705. [PMID: 33155442] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We are presented a 35-year-old patient with no previous relevant medical history who was admitted to the emergency department for fever, altered mental status and diffuse abdominal pain. Initial evaluation failed to the demonstrated the presence of thoracic or abdominal deep infection. The clinical course was marked by a deterioration of the neurological condition. The cerebral MRI showed diffuse and extensive involvement of the brainstem and cerebellar hemispheres associated with hydrocephalus consistent with tuberculous meningoencephalitis. Antituberculous therapy was started with some delay but no clinical improvement was achieved and the patient died.
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Affiliation(s)
- A Nebie
- Services des Urgences, CHU Liège, Belgique
| | - D Ali
- Services des Urgences, CHU Liège, Belgique
| | - L Bosquee
- Service de Pneumologie, Clinique André Renard, Herstal, Belgique
| | - Y Gorur
- Service de Radiologie, Clinique André Renard, Herstal, Belgique
| | - B Cardos
- Services des Urgences, Clinique André Renard, Herstal, Belgique
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20
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Ali D, Gorur Y, Cardos B. [Complication of a successful cardiopulmonary resuscitation]. Rev Med Liege 2020; 75:565-568. [PMID: 32909405] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A case of bilateral extensive subcutaneous emphysema secondary to external cardiac massage is reported. This is a rare complication. It occurs with a pneumothorax after resuscitation maneuvers. The diagnosis is based on a bundle of anamnestic, clinical and radiological arguments. This case demonstrates the importance of performing a simple prehospital thoracostomy on the finger without chest tube placement and demonstrates the need for systematic investigation of possible complications in any patient who has undergone external cardiac massage.
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Affiliation(s)
- D Ali
- Service des Urgences, CHU Liège, Belgique
| | - Y Gorur
- Service d'Imagerie médicale, CHU Liège, Belgique
| | - B Cardos
- Service des Urgences, Clinique André Renard, Herstal, Belgique
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21
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Ali D, Gorur Y, Cardos B. [Postpartum cerebral thrombophlebitis : a diagnosis not to be missed]. Rev Med Liege 2020; 75:529-531. [PMID: 32779905] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Cerebral thrombophlebitis is a rare but serious complication of pregnancy and postpartum. This condition is characterized by a misleading symptomatology. It must be systematically discussed in case of the persistence of a headache in the aftermath of childbirth and the diagnosis must be confirmed early with the help of computed tomography and cerebral magnetic resonance. NMR is the reference examination. The treatment is essentially based on anticoagulants. The functional prognosis remains good if the diagnosis is made in time and the treatment is initiated early. We report the case of a young 25-year-old woman who presented postpartum cerebral thrombophlebitis with a late diagnosis. The evolution was marked by severe neurological sequelae. This is why we emphasize the interest of imaging in the early diagnosis of this pathology.
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Affiliation(s)
- D Ali
- Service des Urgences, CHC Saint-Joseph, Liège, Belgique
| | - Y Gorur
- Service de Radiologie, Clinique André Renard, Herstal, Belgique
| | - B Cardos
- Service des Urgences, Clinique André Renard, Herstal, Belgique
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22
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Cannon L, Ali D, Parli SE, Martin C, Cook AM. Sleep quality during an overnight on-call program. Am J Health Syst Pharm 2020; 77:1060-1065. [PMID: 34279563 DOI: 10.1093/ajhp/zxaa113] [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] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Many institutions deploy pharmacy residents to expand clinical pharmacy services, often in the form of overnight, in-house on-call programs. There is little published evidence regarding pharmacy resident sleep and sleepiness after a night of overnight, in-house on-call activity. A prospective observational cohort study was conducted to determine the relationship between overnight, in-house on-call programs and pharmacy resident sleep and sleep quality. METHODS The cohort study included both postgraduate year 1 and postgraduate year 2 pharmacy residents. Each resident participated in 10 to 15 overnight on-call shifts. Sleep and sleep quality were assessed using devices worn on residents' wrists on the nights prior to, during, and after on-call shifts. Resident sleepiness was assessed via the Epworth Sleepiness Scale (ESS) during specified baseline and postcall periods. Univariate and multivariate analysis were used to assess the relationship between measurements of sleep, sleep quality, and sleepiness. RESULTS We enrolled a total of 23 residents in the study and recorded data on 269 on-call shifts. Frequently (42.6% of shifts) residents had no time to sleep during overnight on-call shifts. Among those who did have sleep time, the mean sleep time during an overnight, in-house on-call shift was 1.22 (SD, 1.56) hours. Additionally, ESS scores indicated a 2.4-fold increase in sleepiness on the morning after vs the morning before on-call shifts. CONCLUSION Residents often did not sleep while on call. Sleep periods overnight were short and of poor quality. Predictably, residents reported increased sleepiness after an overnight on-call shift. Residents received an average of approximately 10 clinical consultation calls per overnight shift.
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Affiliation(s)
- Laura Cannon
- Pharmacy Practice Division, University of Texas at Austin College of Pharmacy, Austin, TX
| | | | | | - Craig Martin
- Department of Pharmacy Practice & Science, University of Kentucky College of Pharmacy, Lexington, KY
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23
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Elsherif W, Ali D. Antibacterial effect of silver nanoparticles on antibiotic resistant E. coli O157:H7 isolated from some dairy products. BJVM 2020. [DOI: 10.15547/bjvm.2019-0027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Food safety is a worldwide health goal so foodborne diseases are a main health concern. A total 150 of dairy products samples (locally made yoghurt, ice cream and Talaga cheese) (50 for each type) were examined for E.coli O157:H7 detection and PCR confirmation using fliCH7 gene. E. coli O157:H7 was detected at 18%, 4%, 8% respectively, in samples. The isolates showed broad antibiotic resistance against vancomycin (84.6%), penicillin G (76.9%), cloxacillin (69.2%) and tetracycline (61.5%). Because of increasing number of microorganisms that are resistant to multiple antibiotics causing continuing economic losses in dairy manufacturing, there is an urgent need for development of alternative, cost-effective, and efficient antimicrobial agents to overcome antimicrobial resistance. Here, silver nanoparticle (AgNPs) solution was prepared, identified by transmission electron microscopy (TEM) with an average size 26.5 nm and examined for bactericidal activity against E. coli O157:H7 by using well diffusion assay. The mean inhibition zones of 25 and 50 µg/ml concentrations of Ag-NPs were 15.0±1.2 and 20.9±1.4 mm, respectively. In addition, the statistical analysis showed highly significant differences in the bactericidal effect of different Ag-NPs concentrations on E. coli O157:H7 strains. Bacterial sensitivity to nanoparticles is a key factor in manufacture, so nanoparticles were considered suitable for long life application in food packaging and food safety.
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24
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Ali D, Gorur Y, Cardos B. [Mediastinal hydatid cyst]. Rev Med Liege 2019; 74:561-562. [PMID: 31729842] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Mediastinal hydatid cyst is an exceptional pathology that poses a problem of diagnosis with the other cystic lesions of the mediastinum. Diagnosis is suspected on ultrasound and CT exams and confirmed by surgical findings and histopathological characteristics.
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Affiliation(s)
- D Ali
- Service des Urgences, CHU Liège, Belgique
| | - Y Gorur
- Service de Radiologie, Clinique André Renard, Herstal, Belgique
| | - B Cardos
- Service des Urgences, Clinique André Renard, Herstal, Belgique
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Ali D, Gorur Y, Bosquée L, Cardos B, Lorenzo Villalba N. [Hypoxemic measles pneumonitis in an immunocompetent adult]. Rev Med Liege 2019; 74:499-502. [PMID: 31609551] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Measles is a highly contagious viral disease and one of the biggest causes of morbidity and mortality in the world. Transmission occurs from person to person through direct contact or by aerosolization of pharyngeal secretions. It can be responsible for severe respiratory and neurological complications. The diagnosis is clinical, confirmed by serology, PCR or culture of the measles virus. Treatment is symptomatic and prevention is based on a well conducted vaccination. In severe cases, the use of vitamin A is recommended by the World Health Organization, at least in chidren. Antivirals (ribavirin) have not been shown to be effective in clinical practice. We present a severe respiratory form of measles, affecting a young immunocompetent adult.
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Affiliation(s)
- D Ali
- Service des Urgences, CHC Saint-Joseph, Liège, Belgique
| | - Y Gorur
- Service d'Imagerie médicale, CHU Liège, Belgique
| | | | - B Cardos
- Service des Urgences, Clinique André Renard, Herstal, Belgique
| | - N Lorenzo Villalba
- Service de Médecine interne, Diabète et Maladies métaboliques, Hôpitaux Universitaires de Strasbourg, France
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Elghazawy H, Alorabi M, Helal T, Aref A, Kelany M, Eid Abdallah L, Sayed F, Ali D, Zaki D, Ahmed M. Clinico-pathological relationship between androgen receptor (AR) and tumor infiltrating lymphocytes (TILs) in triple negative breast cancer (TNBC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz095.070] [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] Open
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Cain J, Stowe CD, Ali D, Romanelli F. How Faculty Recognized for Teaching Excellence Interpret and Respond to Student Ratings of Teaching. Am J Pharm Educ 2019; 83:6680. [PMID: 31223153 PMCID: PMC6581342 DOI: 10.5688/ajpe6680] [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] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 11/22/2017] [Indexed: 06/09/2023]
Abstract
Objective. To determine how experienced pharmacy educators who have been recognized for teaching excellence interpret and respond to end-of-course student ratings of their teaching. Methods. An expert sampling technique was used to identify pharmacy faculty members who had been recognized by the American Association of Colleges of Pharmacy (AACP) for teaching excellence as potential participants in the study. Sixteen of these faculty members were independently identified by two or more of the researchers as trusted candidates for the study, and 10 of these were randomly selected and invited to be interviewed via a web-conferencing platform. The interviews were transcribed and thematic analysis was used to identify overall themes. Results. Nine pharmacy faculty members representing both practice-based (n=5) and non-practice (n=4) backgrounds participated in the interviews. The three primary themes that emerged from the interviews regarding approach to interpreting student evaluations of instruction were "Use to improve," "Trends," and "Value input." The four primary themes that emerged regarding advice for new instructors were "Use to improve," "Reflect," "Do not take personally," and "Themes." Conclusion. The faculty participants recognized for teaching excellence were consistent in their attitudes of valuing student feedback and using it as a tool for continuous quality improvement. While recognizing the limitations of student ratings of teaching, the participants used them as part of a reflective and holistic approach to teaching. These teaching experts provided valuable insight for new instructors, such as do not compromise instruction and do not take student ratings personally.
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Affiliation(s)
- Jeff Cain
- University of Kentucky College of Pharmacy, Lexington, Kentucky
| | - Cindy D. Stowe
- Sullivan University College of Pharmacy, Louisville, Kentucky
| | - Dina Ali
- University of Kentucky Healthcare, Lexington, Kentucky
| | - Frank Romanelli
- University of Kentucky College of Pharmacy, Lexington, Kentucky
- Executive Associate Editor, American Journal of Pharmaceutical Education, Arlington, Virginia
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Katubi KM, Alzahrani FM, Ali D, Alarifi S. Dose- and duration-dependent cytotoxicity and genotoxicity in human hepato carcinoma cells due to CdTe QDs exposure. Hum Exp Toxicol 2019; 38:914-926. [PMID: 30995871 DOI: 10.1177/0960327119843578] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nanotechnology has achieved more commercial attention over recent years, and its application has increased concerns about its discharge in the environment. In this study, we have chosen human hepatic carcinoma (HuH-7) cells because liver tissue has played an important role in human metabolism. Therefore, the objective of this study was to determine DNA damaging and apoptotic potential of cadmium telluride quantum dots (CdTe QDs; average particle size (APS) 10 nm, 1-25 µg/ml) on HuH-7 cells and the basic molecular mechanism of its cellular toxicity. Cytotoxicity of different concentrations of CdTe QDs on HuH-7 cells was determined by 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) and lactate dehydrogenase (LDH) tests. Moreover, reactive oxygen species (ROS) generation, mitochondrial membrane potential, DNA damage, and Hoechst 33342 fluorescent staining morphological analysis of necrotic/apoptotic cells were detected; cellular impairment in mitochondria and DNA was confirmed by JC-1 and comet assay, respectively. A dose- and time-dependent cytotoxicity effect of CdTe QDs exposure was observed HuH-7 cells; the significant (p < 0.05) cytotoxicity was found at 25 μg/ml of CdTe QDs exposure. The percentage of cytotoxicity of CdTe QDs (25 μg/ml) in HuH-7 cells reached 62% in 48 h. CdTe QDs elicited intracellular ROS generation and mitochondrial depolarization, and DNA integrity cells collectively advocated the apoptotic cell death at higher concentration. DNA damage was observed in cells due to CdTe QDs exposure, which was mediated by oxidative stress. This study exploring the effects of CdTe QDs in HuH-7 cells has provided valuable insights into the mechanism of toxicity induced by CdTe QDs.
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Affiliation(s)
- K M Katubi
- 1 Chemistry Department, College of Science, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - F M Alzahrani
- 1 Chemistry Department, College of Science, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - D Ali
- 2 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - S Alarifi
- 2 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
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Alkahtane AA, Albasher G, Al-Sultan NK, Alqahtani WS, Alarifi S, Almeer RS, Alghamdi J, Ali D, Alahmari A, Alkahtani S. Long-term treatment with finasteride induces apoptosis and pathological changes in female mice. Hum Exp Toxicol 2019; 38:762-774. [PMID: 30943778 DOI: 10.1177/0960327119842195] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Androgenetic alopecia is the most common type of alopecia, and it affects humans of both genders. Finasteride is a type II selective 5α-reductase inhibitor that is administered orally to treat androgenetic alopecia and benign prostatic hyperplasia in human males. However, its effect on the vital organs of females is unknown. This study was designed to investigate the effects of finasteride on the vital organs such as liver, kidney, and heart of female mice. To study the prospective effects of finasteride, female mice were orally administered two doses of finasteride (0.5 and 1.5 mg/kg) once daily for 35 days, and serum levels of various biochemical parameters and histopathology of various organs were examined. The results showed that serum levels of alkaline phosphatase were significantly increased by both high- and low-dose finasteride, whereas cholesterol was significantly increased by the high dose only. Creatine kinase was significantly increased by the high and low doses, whereas glucose was significantly decreased by both doses. Histopathological analysis and DNA damage assays showed that finasteride has adverse effects within both the short and the long periods in female mice. In addition, the proapoptotic genes Bax and caspase-3 were significantly increased by high dose finasteride, whereas the antiapoptotic gene Bcl-2 was significantly decreased by the low and high doses. In conclusion, finasteride is not currently approved for therapeutic use in females, and the findings in this study suggest caution in any future consideration of such use.
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Affiliation(s)
- A A Alkahtane
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - G Albasher
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - N K Al-Sultan
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - W S Alqahtani
- 2 Department of Forensic Biology, College of Forensic Sciences, Naif Arab University for Security Sciences, Riyadh, Saudi Arabia
| | - S Alarifi
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - R S Almeer
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - J Alghamdi
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - D Ali
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - A Alahmari
- 3 Department of Biology, Science College, King Khalid University, Abha, Saudi Arabia
| | - S Alkahtani
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
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Aal AA, Mahmoud K, Moawad S, Ertel N, Hamed B, Ali D, Massoud M, Shawali I, Rageeb P, Mokhtar A, Almehmi A. Abstract No. 583 Urgent-start peritoneal dialysis catheter placement: outcomes of radiologic versus laparoscopic techniques. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Ali D, Cardos B. [Upper extremity deep venous effort thrombosis : management of the Paget-Schroetter syndrome in the emergency department]. Rev Med Liege 2017; 72:432-435. [PMID: 29058833] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We report a case of upper extremity deep venous effort thrombosis complicating a thoracic outlet syndrome in a 44-year-old patient. The appearance of this complication was sudden. A clinical examination followed by imaging with phlebography leads to a quick diagnosis. Effort thrombosis is a classic example of an entity which, if treated correctly, has minimal long-term sequelae but, if ignored, is associated with significant long-term morbidity. An appropriate medical and interventional care has been implemented as soon as possible. Once primary thrombosis is recognized, catheter-directed thrombolytic therapy is usually successful if initiated early, but often unmasks an underlying problem.
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Affiliation(s)
- D Ali
- Service des Urgences, CHU de liège, site Sart Tilman, 4000 Liège, Belgique
| | - B Cardos
- Service des Urgences, Clinique André Renard, Herstal, Belgique
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Alam M, Alandis NM, Sharmin E, Ahmad N, Alrayes BF, Ali D. Characterization of Leucaena ( Leucaena leucephala) oil by direct analysis in real time (DART) ion source and gas chromatography. Grasas y Aceites 2017. [DOI: 10.3989/gya.0939162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
For the first time, we report the characterization of triacylglycerols and fatty acids in Leucaena (Leucaena leucephala) oil [LUCO], an unexplored nontraditional non-medicinal plant belonging to the family Fabaceae. LUCO was converted to fatty acid methyl esters (FAMEs). We analyzed the triacylglycerols (TAGs) of pure LUCO and their FAMEs by time-of-flight mass spectrometry (TOF-MS) followed by multivariate analysis for discrimination among the FAMEs. Our investigations for the analysis of LUCO samples represent noble features of glycerides. A new type of ion source, coupled with high-resolution TOF-MS was applied for the comprehensive analysis of triacylglycerols. The composition of fatty acid based LUCO oil was studied using Gas Chromatography (GC-FID). The major fatty acid components of LUCO oil are linoleic acid (52.08%) oleic acid (21.26%), palmitic acid (7.91%) and stearic acid (6.01%). A metal analysis in LUCO was done by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The structural elucidation and thermal stability of LUCO were studied by FT-IR, 1H NMR, 13C NMR spectroscopic techniques and TGA-DSC, respectively. We also measured the cytotoxicity of LUCO.
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Ali D, Mohammad DK, Mujahed H, Jonson-Videsäter K, Nore B, Paul C, Lehmann S. Anti-leukaemic effects induced by APR-246 are dependent on induction of oxidative stress and the NFE2L2/HMOX1 axis that can be targeted by PI3K and mTOR inhibitors in acute myeloid leukaemia cells. Br J Haematol 2016; 174:117-26. [PMID: 26991755 DOI: 10.1111/bjh.14036] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 12/20/2015] [Accepted: 12/25/2015] [Indexed: 12/23/2022]
Abstract
The small molecule APR-246 (PRIMA-1(MET) ) is a novel drug that restores the activity of mutated and unfolded TP53 protein. However, the mechanisms of action and potential off-target effects are not fully understood. Gene expression profiling in TP53 mutant KMB3 acute myeloid leukaemia (AML) cells showed that genes which protected cells from oxidative stress to be the most up-regulated. APR-246 exposure also induced reactive oxygen species (ROS) formation and depleted glutathione in AML cells. The genes most up-regulated by APR-246, confirmed by quantitative real time polymerase chain reaction, were heme oxygenase-1 (HMOX1, also termed HO-1), SLC7A11 and RIT1. Up-regulation of HMOX1, a key regulator of cellular response to ROS, was independent of TP53 mutational status. NFE2L2 (also termed Nrf2), a master regulator of HMOX1 expression, showed transcriptional up-regulation and nuclear translocation by APR-246. Down-regulation of NFE2L2 by siRNA in AML cells significantly increased the antitumoural effects of APR-246. The PI3K inhibitor wortmannin and the mTOR inhibitor rapamycin inhibited APR-246-induced nuclear translocation of NFE2L2 and counteracted the protective cellular responses to APR-246, resulting in synergistic cell killing together with APR-246. In conclusion, ROS induction is important for antileukaemic activities of APR-246 and inhibiting the protective response of the Nrf-2/HMOX1 axis using PI3K inhibitors, enhances the antileukaemic effects.
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Affiliation(s)
- Dina Ali
- Haematology Centre and Centre for Haematology and Regenerative Medicine (HERM), Karolinska University Hospital, Stockholm, Sweden
| | - Dara K Mohammad
- Department of Laboratory Medicine, Clinical Research Centre, Karolinska Institutet, Karolinska Hospital Huddinge, Stockholm, Sweden
| | - Huthayfa Mujahed
- Haematology Centre and Centre for Haematology and Regenerative Medicine (HERM), Karolinska University Hospital, Stockholm, Sweden
| | | | - Beston Nore
- Department of Laboratory Medicine, Clinical Research Centre, Karolinska Institutet, Karolinska Hospital Huddinge, Stockholm, Sweden
| | - Christer Paul
- Haematology Centre and Centre for Haematology and Regenerative Medicine (HERM), Karolinska University Hospital, Stockholm, Sweden
| | - Sören Lehmann
- Haematology Centre and Centre for Haematology and Regenerative Medicine (HERM), Karolinska University Hospital, Stockholm, Sweden.,Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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Abstract
AbstractIn Leishmania species, protein disulfide isomerase (PDI) is an essential enzyme that catalyzes thiol-disulfide interchange. The present work describes the isolation, cloning, sequencing and expression of the pdI-2 gene. Initially, the gene was amplified from L. tropica genomic DNA by PCR using specific primers before cloning into the expression vector pET-15b. The construct pET/pdI-2 was transformed into BL21(DE3) cells and induced for the protein expression. SDS-PAGE and western blot analysis showed that the expressed protein is about 51 kDa. Cloned gene sequence analysis revealed that the deduced amino acid sequence showed significant homology with those of several parasites PDIs. Finally, recombinant protein was purified with a metal-chelating affinity column. The putative protein was confirmed as a thiol - disulfide oxidoreductase by detecting its activity in an oxidoreductase assay. Assay result of assay suggested that the PDI-2 protein is required for both oxidation and reduction of disulfide bonds in vitro. Antibodies reactive with this 51 kDa protein were detected by Western blot analysis in sera from human infected with L. tropica. This work describes for the first time the enzymatic activity of recombinant L. tropica PDI-2 protein and suggests a role for this protein as an antigen for the detection of leishmaniasis infection.
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Affiliation(s)
- Dina Ali
- 1Department of Animal Biology, Faculty of Sciences, Damascus University, Damascus, Syrian Republic
| | - Abdul-Qader Abbady
- 2Department of Molecular Biology and Biotechnology, Atomic Energy Commission of Syria (AECS), Damascus, Syrian Republic
| | - Mahmoud Kweider
- 1Department of Animal Biology, Faculty of Sciences, Damascus University, Damascus, Syrian Republic
| | - Chadi Soukkarieh
- 1Department of Animal Biology, Faculty of Sciences, Damascus University, Damascus, Syrian Republic
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Abdel-hameed Z, Ali D, Thabet S, Abd-EL naser E. Quantification of some pesticide residues in raw and heat treated milk. Egyptian Journal of Chemistry and Environmental Health 2015; 1:704-714. [DOI: 10.21608/ejceh.2015.253809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Ashmore D, Dave R, Ugar A, Carmichael F, Scarsbrook A, Sayers C, Pereira O, Ali D. Surgical management of neck exploration: A retrospective audit. Int J Surg 2015. [DOI: 10.1016/j.ijsu.2015.07.223] [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: 11/16/2022]
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Bassam Bdeir M, Conboy T, Farah I, Habeeb A, Odeh R, Alameen A, Fadel E, Khateeb M, Rabai R, Ali D, Zeineddine M, Alanzi S, Mallah M. 32. Incidence and predictors of progression of Coronary Artery Disease among high risk patients with recurrent symptoms. J Saudi Heart Assoc 2015. [DOI: 10.1016/j.jsha.2015.05.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Guillet A, Brocard A, Bach Ngohou K, Graveline N, Leloup AG, Ali D, Nguyen JM, Loirat MJ, Chevalier C, Khammari A, Dreno B. Verneuil's disease, innate immunity and vitamin D: a pilot study. J Eur Acad Dermatol Venereol 2014; 29:1347-53. [PMID: 25512084 DOI: 10.1111/jdv.12857] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 10/17/2014] [Indexed: 01/20/2023]
Abstract
BACKGROUND Verneuil's disease is a chronic inflammatory skin disease of the follicles in apocrine glands rich area of the skin (axillary, inguinal, anogenital) and is associated with a deficient skin innate immunity. It is characterized by the occurrence of nodules, abscesses, fistulas, scars. Recently, vitamin D has been shown to stimulate skin innate immunity. OBJECTIVE The primary objective of the study was to assess whether Verneuil's disease was associated with vitamin D deficiency. The secondary objective was to determine whether vitamin D supplementation could improve inflammatory lesions. METHODS First, 25(OH) vitamin D3 serum levels in patients with Verneuil's disease followed at Nantes University Hospital were compared to those of healthy donors from the French Blood Bank. Then, a pilot study was conducted in 14 patients supplemented with vitamin D according to their vitamin D level at baseline at months 3 and 6. The endpoints at 6 months were decreased by at least 20% in the number of nodules and in the frequency of flare-ups. RESULTS Twenty-two patients (100%) had vitamin D deficiency (level <30 ng/mL) of whom 36% were severely deficient (level <10 ng/mL), having correlation with the disease severity (P = 0.03268) vs. 20 controls with vitamin D deficiency (91%) of whom 14% were severely deficient. In 14 patients, the supplementation significantly decreased the number of nodules at 6 months (P = 0.01133), and the endpoints were achieved in 79% of these patients. A correlation between the therapeutic success and the importance of the increase in vitamin D level after supplementation was observed (P = 0.01099). CONCLUSION Our study shows that Verneuil's disease is associated with a major vitamin D deficiency, correlated with the disease severity. It suggests that vitamin D could significantly improve the inflammatory nodules, probably by stimulating the skin innate immunity. A larger randomized study is needed to confirm these findings.
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Affiliation(s)
- A Guillet
- Service de Dermato-Cancérologie, CHU Hôtel-Dieu, Nantes, France
| | - A Brocard
- Service de Dermato-Cancérologie, CHU Hôtel-Dieu, Nantes, France
| | - K Bach Ngohou
- Laboratoire de radio-immunologie, CHU Hôtel Dieu, Nantes, France
| | - N Graveline
- Laboratoire de radio-immunologie, CHU Hôtel Dieu, Nantes, France
| | - A-G Leloup
- Laboratoire de radio-immunologie, CHU Hôtel Dieu, Nantes, France
| | - D Ali
- Laboratoire de radio-immunologie, CHU Hôtel Dieu, Nantes, France
| | - J-M Nguyen
- Service de santé publique PIMESP, Hôpital Saint Jacques, Nantes, France
| | - M-J Loirat
- Etablissement Français du Sang, CHU Hôtel Dieu, Nantes, France
| | - C Chevalier
- Etablissement Français du Sang, CHU Hôtel Dieu, Nantes, France
| | - A Khammari
- Service de Dermato-Cancérologie, CHU Hôtel-Dieu, Nantes, France
| | - B Dreno
- Service de Dermato-Cancérologie, CHU Hôtel-Dieu, Nantes, France
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Hamam D, Ali D, Vishnubalaji R, Hamam R, Al-Nbaheen M, Chen L, Kassem M, Aldahmash A, Alajez NM. microRNA-320/RUNX2 axis regulates adipocytic differentiation of human mesenchymal (skeletal) stem cells. Cell Death Dis 2014; 5:e1499. [PMID: 25356868 PMCID: PMC4237271 DOI: 10.1038/cddis.2014.462] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 09/03/2014] [Accepted: 09/17/2014] [Indexed: 12/21/2022]
Abstract
The molecular mechanisms promoting lineage-specific commitment of human mesenchymal (skeletal or stromal) stem cells (hMSCs) into adipocytes (ADs) are not fully understood. Thus, we performed global microRNA (miRNA) and gene expression profiling during adipocytic differentiation of hMSC, and utilized bioinformatics as well as functional and biochemical assays, and identified several novel miRNAs differentially expressed during adipogenesis. Among these, miR-320 family (miR-320a, 320b, 320c, 320d and 320e) were ~2.2–3.0-fold upregulated. Overexpression of miR-320c in hMSC enhanced adipocytic differentiation and accelerated formation of mature ADs in ex vivo cultures. Integrated analysis of bioinformatics and global gene expression profiling in miR-320c overexpressing cells and during adipocytic differentiation of hMSC identified several biologically relevant gene targets for miR-320c including RUNX2, MIB1 (mindbomb E3 ubiquitin protein ligase 1), PAX6 (paired box 6), YWHAH and ZWILCH. siRNA-mediated silencing of those genes enhanced adipocytic differentiation of hMSC, thus corroborating an important role for those genes in miR-320c-mediated adipogenesis. Concordant with that, lentiviral-mediated stable expression of miR-320c at physiological levels (~1.5-fold) promoted adipocytic and suppressed osteogenic differentiation of hMSC. Luciferase assay validated RUNX2 (Runt-related transcription factor 2) as a bona fide target for miR-320 family. Therefore, our data suggest miR-320 family as possible molecular switch promoting adipocytic differentiation of hMSC. Targeting miR-320 may have therapeutic potential in vivo through regulation of bone marrow adipogenesis.
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Affiliation(s)
- D Hamam
- Stem Cell Unit, Department of Anatomy, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - D Ali
- Stem Cell Unit, Department of Anatomy, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - R Vishnubalaji
- Stem Cell Unit, Department of Anatomy, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - R Hamam
- Stem Cell Unit, Department of Anatomy, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - M Al-Nbaheen
- Stem Cell Unit, Department of Anatomy, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - L Chen
- KMEB, Department of Endocrinology, University of Southern Denmark, Odense, Denmark
| | - M Kassem
- 1] Stem Cell Unit, Department of Anatomy, College of Medicine, King Saud University, Riyadh, Saudi Arabia [2] KMEB, Department of Endocrinology, University of Southern Denmark, Odense, Denmark
| | - A Aldahmash
- 1] Stem Cell Unit, Department of Anatomy, College of Medicine, King Saud University, Riyadh, Saudi Arabia [2] KMEB, Department of Endocrinology, University of Southern Denmark, Odense, Denmark
| | - N M Alajez
- Stem Cell Unit, Department of Anatomy, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Deneberg S, Kanduri M, Ali D, Bengtzen S, Karimi M, Qu Y, Kimby E, Mansouri L, Rosenquist R, Lennartsson A, Lehmann S. microRNA-34b/c on chromosome 11q23 is aberrantly methylated in chronic lymphocytic leukemia. Epigenetics 2014; 9:910-7. [PMID: 24686393 DOI: 10.4161/epi.28603] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
A commonly deleted region in chronic lymphocytic leukemia (CLL) is the 11q22-23 region, which encompasses the ATM gene. Evidence suggests that tumor suppressor genes other than ATM are likely to be involved in CLL with del(11q). A microRNA (miR) cluster including the miR-34b and miR-34c genes is located, among other genes, within the commonly deleted region (CDR) at 11q. Interestingly, these miRs are part of the TP53 network and have been shown to be epigenetically regulated. In this study, we investigated the expression and methylation status of these miRs in a well-characterized cohort of CLL, including cases with/without 11q-deletion. We show that the miR-34b/c promoter was aberrantly hypermethylated in a large proportion of CLL cases (48%, 25/52 cases). miR-34b/c expression correlated inversely to DNA methylation (P = 0.003), and presence of high H3K37me3 further suppressed expression regardless of methylation status. Furthermore, increased miR-34b/c methylation inversely correlated with the presence of 11q-deletion, indicating that methylation and del(11q) independently silence these miRs. Finally, 5-azacytidine and trichostatin A exposure synergistically increased the expression of miR-34b/c in CLL cells, and transfection of miR-34b or miR-34c into HG3 CLL cells significantly increased apoptosis. Altogether, our novel data suggest that miR-34b/c is a candidate tumor suppressor that is epigenetically silenced in CLL.
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Affiliation(s)
- Stefan Deneberg
- Department of Internal Medicine/Hematology; Karolinska Institutet; Karolinska University Hospital Huddinge; Stockholm, Sweden
| | - Meena Kanduri
- Institute of Biomedicine; Department of Clinical Chemistry and Transfusion Medicine; Sahlgrenska University Hospital; Göteborg, Sweden
| | - Dina Ali
- Department of Internal Medicine/Hematology; Karolinska Institutet; Karolinska University Hospital Huddinge; Stockholm, Sweden
| | - Sofia Bengtzen
- Department of Internal Medicine/Hematology; Karolinska Institutet; Karolinska University Hospital Huddinge; Stockholm, Sweden
| | - Mohsen Karimi
- Department of Internal Medicine/Hematology; Karolinska Institutet; Karolinska University Hospital Huddinge; Stockholm, Sweden
| | - Ying Qu
- Department of Internal Medicine/Hematology; Karolinska Institutet; Karolinska University Hospital Huddinge; Stockholm, Sweden
| | - Eva Kimby
- Department of Internal Medicine/Hematology; Karolinska Institutet; Karolinska University Hospital Huddinge; Stockholm, Sweden
| | - Larry Mansouri
- Department of Immunology, Genetics and Pathology; Science for Life Laboratory; Uppsala University; Uppsala, Sweden
| | - Richard Rosenquist
- Department of Immunology, Genetics and Pathology; Science for Life Laboratory; Uppsala University; Uppsala, Sweden
| | - Andreas Lennartsson
- Department of Biomedicine and Nutrition; NOVUM; Karolinska Institutet; Stockholm, Sweden
| | - Sören Lehmann
- Department of Internal Medicine/Hematology; Karolinska Institutet; Karolinska University Hospital Huddinge; Stockholm, Sweden
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Servagi-Vernat S, Ali D, Espinoza S, Houle A, Laccourreye O, Giraud P. Organes à risque en radiothérapie conformationnelle des tumeurs de la tête et du cou : aspect pratique de leur délinéation et des contraintes de dose. Cancer Radiother 2013. [DOI: 10.1016/j.canrad.2013.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Servagi-Vernat S, Ali D, Espinoza S, Houle A, Laccourreye O, Giraud P. Organes à risque en radiothérapie conformationnelle des tumeurs de la tête et du cou : aspect pratique de leur délinéation et des contraintes de dose. Cancer Radiother 2013. [DOI: 10.1016/j.canrad.2013.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Servagi-Vernat S, Ali D, Espinoza S, Houle A, Laccourreye O, Giraud P. Organes à risque en radiothérapie conformationnelle des tumeurs de la tête et du cou : aspect pratique de leur délinéation et des contraintes de dose. Cancer Radiother 2013; 17:695-704. [DOI: 10.1016/j.canrad.2013.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 03/25/2013] [Accepted: 03/28/2013] [Indexed: 01/17/2023]
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Ali D, Fokkert MJ, Slingerland RJ, Tolsma R, Ishak M, Van Eenennaam F, Bruheim K, Ten Berg J, Hoes A, Van 'T Hof AWJ. Feasibility of pre-hospital chest pain triage at home or in the ambulance by paramedics using the HEART score based upon a single high-sensitive troponin T analysis. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p4051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Servagi Vernat S, Ali D, Puyraveau M, Lisbona A, Fenoglietto P, Bedos L, Giraud P. PO-0804: A dosimetric comparison of helical tomotherapy and volumetric modulated arc therapy for oropharyngeal cancer. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33110-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lehmann S, Bykov VJ, Ali D, Andrén O, Cherif H, Tidefelt U, Uggla B, Yachnin J, Juliusson G, Moshfegh A, Paul C, Wiman KG, Andersson PO. Targeting p53 in Vivo: A First-in-Human Study With p53-Targeting Compound APR-246 in Refractory Hematologic Malignancies and Prostate Cancer. J Clin Oncol 2012; 30:3633-9. [DOI: 10.1200/jco.2011.40.7783] [Citation(s) in RCA: 306] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Purpose APR-246 (PRIMA-1MET) is a novel drug that restores transcriptional activity of unfolded wild-type or mutant p53. The main aims of this first-in-human trial were to determine maximum-tolerated dose (MTD), safety, dose-limiting toxicities (DLTs), and pharmacokinetics (PK) of APR-246. Patients and Methods APR-246 was administered as a 2-hour intravenous infusion once per day for 4 consecutive days in 22 patients with hematologic malignancies and prostate cancer. Acute myeloid leukemia (AML; n = 7) and prostate cancer (n = 7) were the most frequent diagnoses. Starting dose was 2 mg/kg with dose escalations up to 90 mg/kg. Results MTD was defined as 60 mg/kg. The drug was well tolerated, and the most common adverse effects were fatigue, dizziness, headache, and confusion. DLTs were increased ALT/AST (n = 1), dizziness, confusion, and sensory disturbances (n = 2). PK showed little interindividual variation and were neither dose nor time dependent; terminal half-life was 4 to 5 hours. Tumor cells showed cell cycle arrest, increased apoptosis, and upregulation of p53 target genes in several patients. Global gene expression analysis revealed changes in genes regulating proliferation and cell death. One patient with AML who had a p53 core domain mutation showed a reduction of blast percentage from 46% to 26% in the bone marrow, and one patient with non-Hodgkin's lymphoma with a p53 splice site mutation showed a minor response. Conclusion We conclude that APR-246 is safe at predicted therapeutic plasma levels, shows a favorable pharmacokinetic profile, and can induce p53-dependent biologic effects in tumor cells in vivo.
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Affiliation(s)
- Sören Lehmann
- Sören Lehmann, Dina Ali, and Christer Paul, Karolinska University Hospital, Huddinge; Vladimir J.N. Bykov, Ali Moshfegh, and Klas G. Wiman, Karolinska Institutet, Stockholm; Ove Andrén, Örebro University; Ulf Tidefelt and Bertil Uggla, Örebro University Hospital, Örebro; Honar Cherif and Jeffrey Yachnin, Uppsala University Hospital, Uppsala; Gunnar Juliusson, Skåne University Hospital, Lund; and Per-Ola Andersson, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Vladimir J.N. Bykov
- Sören Lehmann, Dina Ali, and Christer Paul, Karolinska University Hospital, Huddinge; Vladimir J.N. Bykov, Ali Moshfegh, and Klas G. Wiman, Karolinska Institutet, Stockholm; Ove Andrén, Örebro University; Ulf Tidefelt and Bertil Uggla, Örebro University Hospital, Örebro; Honar Cherif and Jeffrey Yachnin, Uppsala University Hospital, Uppsala; Gunnar Juliusson, Skåne University Hospital, Lund; and Per-Ola Andersson, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Dina Ali
- Sören Lehmann, Dina Ali, and Christer Paul, Karolinska University Hospital, Huddinge; Vladimir J.N. Bykov, Ali Moshfegh, and Klas G. Wiman, Karolinska Institutet, Stockholm; Ove Andrén, Örebro University; Ulf Tidefelt and Bertil Uggla, Örebro University Hospital, Örebro; Honar Cherif and Jeffrey Yachnin, Uppsala University Hospital, Uppsala; Gunnar Juliusson, Skåne University Hospital, Lund; and Per-Ola Andersson, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ove Andrén
- Sören Lehmann, Dina Ali, and Christer Paul, Karolinska University Hospital, Huddinge; Vladimir J.N. Bykov, Ali Moshfegh, and Klas G. Wiman, Karolinska Institutet, Stockholm; Ove Andrén, Örebro University; Ulf Tidefelt and Bertil Uggla, Örebro University Hospital, Örebro; Honar Cherif and Jeffrey Yachnin, Uppsala University Hospital, Uppsala; Gunnar Juliusson, Skåne University Hospital, Lund; and Per-Ola Andersson, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Honar Cherif
- Sören Lehmann, Dina Ali, and Christer Paul, Karolinska University Hospital, Huddinge; Vladimir J.N. Bykov, Ali Moshfegh, and Klas G. Wiman, Karolinska Institutet, Stockholm; Ove Andrén, Örebro University; Ulf Tidefelt and Bertil Uggla, Örebro University Hospital, Örebro; Honar Cherif and Jeffrey Yachnin, Uppsala University Hospital, Uppsala; Gunnar Juliusson, Skåne University Hospital, Lund; and Per-Ola Andersson, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ulf Tidefelt
- Sören Lehmann, Dina Ali, and Christer Paul, Karolinska University Hospital, Huddinge; Vladimir J.N. Bykov, Ali Moshfegh, and Klas G. Wiman, Karolinska Institutet, Stockholm; Ove Andrén, Örebro University; Ulf Tidefelt and Bertil Uggla, Örebro University Hospital, Örebro; Honar Cherif and Jeffrey Yachnin, Uppsala University Hospital, Uppsala; Gunnar Juliusson, Skåne University Hospital, Lund; and Per-Ola Andersson, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Bertil Uggla
- Sören Lehmann, Dina Ali, and Christer Paul, Karolinska University Hospital, Huddinge; Vladimir J.N. Bykov, Ali Moshfegh, and Klas G. Wiman, Karolinska Institutet, Stockholm; Ove Andrén, Örebro University; Ulf Tidefelt and Bertil Uggla, Örebro University Hospital, Örebro; Honar Cherif and Jeffrey Yachnin, Uppsala University Hospital, Uppsala; Gunnar Juliusson, Skåne University Hospital, Lund; and Per-Ola Andersson, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jeffrey Yachnin
- Sören Lehmann, Dina Ali, and Christer Paul, Karolinska University Hospital, Huddinge; Vladimir J.N. Bykov, Ali Moshfegh, and Klas G. Wiman, Karolinska Institutet, Stockholm; Ove Andrén, Örebro University; Ulf Tidefelt and Bertil Uggla, Örebro University Hospital, Örebro; Honar Cherif and Jeffrey Yachnin, Uppsala University Hospital, Uppsala; Gunnar Juliusson, Skåne University Hospital, Lund; and Per-Ola Andersson, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gunnar Juliusson
- Sören Lehmann, Dina Ali, and Christer Paul, Karolinska University Hospital, Huddinge; Vladimir J.N. Bykov, Ali Moshfegh, and Klas G. Wiman, Karolinska Institutet, Stockholm; Ove Andrén, Örebro University; Ulf Tidefelt and Bertil Uggla, Örebro University Hospital, Örebro; Honar Cherif and Jeffrey Yachnin, Uppsala University Hospital, Uppsala; Gunnar Juliusson, Skåne University Hospital, Lund; and Per-Ola Andersson, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ali Moshfegh
- Sören Lehmann, Dina Ali, and Christer Paul, Karolinska University Hospital, Huddinge; Vladimir J.N. Bykov, Ali Moshfegh, and Klas G. Wiman, Karolinska Institutet, Stockholm; Ove Andrén, Örebro University; Ulf Tidefelt and Bertil Uggla, Örebro University Hospital, Örebro; Honar Cherif and Jeffrey Yachnin, Uppsala University Hospital, Uppsala; Gunnar Juliusson, Skåne University Hospital, Lund; and Per-Ola Andersson, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Christer Paul
- Sören Lehmann, Dina Ali, and Christer Paul, Karolinska University Hospital, Huddinge; Vladimir J.N. Bykov, Ali Moshfegh, and Klas G. Wiman, Karolinska Institutet, Stockholm; Ove Andrén, Örebro University; Ulf Tidefelt and Bertil Uggla, Örebro University Hospital, Örebro; Honar Cherif and Jeffrey Yachnin, Uppsala University Hospital, Uppsala; Gunnar Juliusson, Skåne University Hospital, Lund; and Per-Ola Andersson, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Klas G. Wiman
- Sören Lehmann, Dina Ali, and Christer Paul, Karolinska University Hospital, Huddinge; Vladimir J.N. Bykov, Ali Moshfegh, and Klas G. Wiman, Karolinska Institutet, Stockholm; Ove Andrén, Örebro University; Ulf Tidefelt and Bertil Uggla, Örebro University Hospital, Örebro; Honar Cherif and Jeffrey Yachnin, Uppsala University Hospital, Uppsala; Gunnar Juliusson, Skåne University Hospital, Lund; and Per-Ola Andersson, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Per-Ola Andersson
- Sören Lehmann, Dina Ali, and Christer Paul, Karolinska University Hospital, Huddinge; Vladimir J.N. Bykov, Ali Moshfegh, and Klas G. Wiman, Karolinska Institutet, Stockholm; Ove Andrén, Örebro University; Ulf Tidefelt and Bertil Uggla, Örebro University Hospital, Örebro; Honar Cherif and Jeffrey Yachnin, Uppsala University Hospital, Uppsala; Gunnar Juliusson, Skåne University Hospital, Lund; and Per-Ola Andersson, Sahlgrenska University Hospital, Gothenburg, Sweden
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Ali D, Vernat SS, Viard R, Fenoglietto P, Lisbona A, Lacornerie T, Pyuraveau M, Giraud P. PO-0728 ROTATIONAL IMRT IN HEAD AND NECK CANCER: A COMPARATIVE MULTICENTER PLANNING STUDY. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)71061-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Servagi-Vernat S, Ali D, Viard R, Fenoglietto P, Lisbona A, Zefkili S, Bosset JF, Giraud P. Étude dosimétrique et évaluation de fonctions objectives développées en RCMI. Cancer Radiother 2011. [DOI: 10.1016/j.canrad.2011.07.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Ali D, Servagi-Vernat S, Halimi P, Berges O, Deberne M, Botti M, Giraud P. Recommandations de délinéation des organes à risque en radiothérapie ORL. Cancer Radiother 2011. [DOI: 10.1016/j.canrad.2011.07.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bdeir B, Al Mallah M, Conboy T, Mukhtar A, Omer H, Odeh R, Farah I, Al-Khateeb M, Tayiem A, Rabai R, El Tayeeb A, Fadel E, Ali D, Al Dossari H. SHA 020. Impact of a nurse-led heart failure program on all cause mortality in Saudi Arabia. J Saudi Heart Assoc 2011. [DOI: 10.1016/j.jsha.2011.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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