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Maredia H, Hand JL, Tollefson MM. Pathogenesis-directed treatment of linear porokeratosis with topical cholesterol-lovastatin. Pediatr Dermatol 2024; 41:296-297. [PMID: 37726979 DOI: 10.1111/pde.15427] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/19/2023] [Indexed: 09/21/2023]
Abstract
A 2-year-old boy presented with an extensive, asymptomatic, photosensitive eruption refractory to topical steroids and tretinoin; examination and biopsies were consistent with generalized linear porokeratosis involving the face, limbs, and trunk. Treatment with topical cholesterol-lovastatin was initiated, and it successfully improved early erythematous lesions. Whole exome sequencing that targeted mevalonate pathway genes crucial in cholesterol synthesis later revealed a pathogenic, paternally inherited, porokeratosis-associated MVD, c.70+5 G>A, mutation. Topical cholesterol-lovastatin is a safe and effective empiric treatment for porokeratosis when used in the early, erythematous phase, and its success is likely mediated through its role in targeting mevalonate pathway mutations.
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Affiliation(s)
- Hasina Maredia
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Jennifer L Hand
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Clinical Genomics, Mayo Clinic, Rochester, Minnesota, USA
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Pediatrics, Jacobs School of Medicine, Buffalo, New York, USA
| | - Megha M Tollefson
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Maredia H, Campbell E, Munavalli G, Cohen J, Comfere N, Wyles S. Delayed foreign body reaction to polymethyl methacrylate-based dermal filler following SARS-CoV-2 vaccination. Int J Dermatol 2024. [PMID: 38402538 DOI: 10.1111/ijd.17095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 01/20/2024] [Accepted: 02/05/2024] [Indexed: 02/26/2024]
Affiliation(s)
- Hasina Maredia
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | | | - Girish Munavalli
- Dermatology, Laser, & Vein Specialists of the Carolinas, Charlotte, NC, USA
| | - Joel Cohen
- Department of Dermatology, University of California Irvine, Irvine, CA, USA
| | - Nneka Comfere
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Saranya Wyles
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
- Center for Aesthetic Medicine and Surgery, Mayo Clinic, Rochester, MN, USA
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Maredia H, Sartori-Valinotti JC, Ranganath N, Tosh PK, O'Horo JC, Shah AS. Supportive Care Management Recommendations for Mucocutaneous Manifestations of Monkeypox Infection. Mayo Clin Proc 2023:S0025-6196(23)00030-7. [PMID: 37125977 PMCID: PMC10148669 DOI: 10.1016/j.mayocp.2023.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 01/10/2023] [Accepted: 01/27/2023] [Indexed: 05/02/2023]
Affiliation(s)
| | | | - Nischal Ranganath
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN
| | - Pritish K Tosh
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN
| | - John C O'Horo
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
| | - Aditya S Shah
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN
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Affiliation(s)
- Hasina Maredia
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Antonio Cozzio
- Department of Dermatology, St. Gallen Hospital, St. Gallen, Switzerland
| | - Reinhard Dummer
- Department of Dermatology, University Hospital Zürich Skin Cancer Center and University Zürich, Zürich, Switzerland
| | - Egle Ramelyte
- Department of Dermatology, University Hospital Zürich Skin Cancer Center and University Zürich, Zürich, Switzerland
| | - Ellen J Kim
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sima Rozati
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Maredia H, Eseonu A, Grossberg AL, Cohen BA. Recurrent Mycoplasma pneumoniae-associated reactive infectious mucocutaneous eruption responsive to systemic steroids: A case series. JAAD Case Rep 2021; 11:139-143. [PMID: 33997214 PMCID: PMC8100349 DOI: 10.1016/j.jdcr.2021.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Hasina Maredia
- Correspondence to: Hasina Maredia, MD, 733 N Broadway, Baltimore, MD 21205. @hmaredia
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Maredia H, Bowring MG, Massie AB, Bae S, Kernodle A, Oyetunji S, Merlo C, Higgins RSD, Segev DL, Bush EL. Better Understanding the Disparity Associated With Black Race in Heart Transplant Outcomes: A National Registry Analysis. Circ Heart Fail 2021; 14:e006107. [PMID: 33525893 PMCID: PMC7887117 DOI: 10.1161/circheartfailure.119.006107] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Black heart transplant recipients have higher risk of mortality than White recipients. Better understanding of this disparity, including subgroups most affected and timing of the highest risk, is necessary to improve care of Black recipients. We hypothesize that this disparity may be most pronounced among young recipients, as barriers to care like socioeconomic factors may be particularly salient in a younger population and lead to higher early risk of mortality. METHODS We studied 22 997 adult heart transplant recipients using the Scientific Registry of Transplant Recipients data from January 2005 to 2017 using Cox regression models adjusted for recipient, donor, and transplant characteristics. RESULTS Among recipients aged 18 to 30 years, Black recipients had 2.05-fold (95% CI, 1.67-2.51) higher risk of mortality compared with non-Black recipients (P<0.001, interaction P<0.001); however, the risk was significant only in the first year post-transplant (first year: adjusted hazard ratio, 2.30 [95% CI, 1.60-3.31], P<0.001; after first year: adjusted hazard ratio, 0.84 [95% CI, 0.54-1.29]; P=0.4). This association was attenuated among recipients aged 31 to 40 and 41 to 60 years, in whom Black recipients had 1.53-fold ([95% CI, 1.25-1.89] P<0.001) and 1.20-fold ([95% CI, 1.09-1.33] P<0.001) higher risk of mortality. Among recipients aged 61 to 80 years, no significant association was seen with Black race (adjusted hazard ratio, 1.12 [95% CI, 0.97-1.29]; P=0.1). CONCLUSIONS Young Black recipients have a high risk of mortality in the first year after heart transplant, which has been masked in decades of research looking at disparities in aggregate. To reduce overall racial disparities, clinical research moving forward should focus on targeted interventions for young Black recipients during this period.
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Affiliation(s)
- Hasina Maredia
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Mary Grace Bowring
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Allan B. Massie
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, MD
| | - Sunjae Bae
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Amber Kernodle
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Shakirat Oyetunji
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Christian Merlo
- Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, MD
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Robert S. D. Higgins
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Dorry L. Segev
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, MD
| | - Errol L. Bush
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
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Maredia H, Eseonu A, Rozati S. Disseminated Eruptive Blue Nevi in a Young Adult Patient. Cureus 2020; 12:e11298. [PMID: 33282575 PMCID: PMC7710343 DOI: 10.7759/cureus.11298] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Common blue nevi tend to be singular or localized, with multiple eruptive blue nevi being a rare occurrence. We report the case of a young adult who presented with multiple asymptomatic lesions that had appeared gradually over a few years. Physical examination revealed 30 distinct, blue-gray macules diffusely over the medial buttocks, lower back, and dorsal arms. Histopathology showed pigmented dendritic melanocytes with associated melanophages, features characteristic of blue nevus. This case demonstrates that eruptive blue nevi can present as numerous, disseminated lesions over multiple anatomic sites. Recognition of the various patterns of eruptive blue nevi and their benign nature can reduce unnecessary biopsies and work-up.
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Affiliation(s)
- Hasina Maredia
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Amarachi Eseonu
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Sima Rozati
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, USA
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Affiliation(s)
- Hasina Maredia
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sima Rozati
- Johns Hopkins University School of Medicine, Baltimore, MD
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Affiliation(s)
- Hasina Maredia
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shawn G. Kwatra
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Maredia H, Simkin D, Soni A, Loss MJ. Eruptive porokeratosis during pembrolizumab treatment of invasive cutaneous squamous cell carcinoma. Int J Dermatol 2019; 59:e141-e142. [DOI: 10.1111/ijd.14701] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 08/07/2019] [Accepted: 10/04/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Hasina Maredia
- Department of Dermatology Johns Hopkins University School of Medicine Baltimore MD USA
| | - Daren Simkin
- Department of Dermatology Johns Hopkins University School of Medicine Baltimore MD USA
| | - Abha Soni
- Department of Dermatology Johns Hopkins University School of Medicine Baltimore MD USA
| | - Manisha J. Loss
- Department of Dermatology Johns Hopkins University School of Medicine Baltimore MD USA
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Maredia H, Hawley NL, Lambert-Messerlian G, Fidow U, Reupena MS, Naseri T, McGarvey S. Reproductive health, obesity, and cardiometabolic risk factors among Samoan women. Am J Hum Biol 2018; 30:e23106. [PMID: 29663637 PMCID: PMC5980683 DOI: 10.1002/ajhb.23106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 11/30/2017] [Accepted: 01/14/2018] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES Obesity leads to deleterious effects on not only cardiovascular health but also on the reproductive health of women. We estimate the prevalence of menstrual irregularity and of polycystic ovarian syndrome (PCOS) in Samoan women, among whom obesity prevalence is extremely high. We explore the association of these reproductive health conditions with adiposity, cardiometabolic risk factors, and androgen levels. METHODS A cross-sectional sample of Samoan women 25-39 years of age (n = 470) from a larger population-based genome-wide association study of adiposity and cardiometabolic disease was assessed for the prevalence of oligomenorrhea/amenorrhea (OM/AM) using a self-reported questionnaire. Serum androgens and anti-Müllerian hormone levels were assayed to determine hyperandrogenemia and presence of polycystic ovaries (PCO), respectively, using criterion values. PCOS was classified using NIH guidelines of having at least two of the three conditions: menstrual irregularity, hyperandrogenism, and PCO. We contrasted socio-demographic, reproductive health, and cardiometabolic risk factors between those with and without OM/AM and similarly for PCOS. RESULTS The prevalence of OM/AM was 7.4% (95% CI: 5.1, 9.8), and women with OM/AM had significantly higher central adiposity. PCOS was estimated at 6.8% (95% CI: 4.5, 9.1), and those with PCOS were younger but had higher overall and central adiposity measures, higher triglycerides, and higher prevalence of insulin resistance than women without PCOS. CONCLUSIONS The prevalence of menstrual irregularity and PCOS are less than hypothesized given the high levels of adiposity in this population. Nevertheless, Samoan women with menstrual irregularity and other features of PCOS have significantly poorer metabolic health.
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Affiliation(s)
- H. Maredia
- Departments of Pathology and Laboratory Medicine and Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, RI 02912, USA
- Department of Epidemiology and International Health Institute, Brown University School of Public Health, Providence, RI 02912, USA
| | - N. L. Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, 06520, USA
| | - G. Lambert-Messerlian
- Departments of Pathology and Laboratory Medicine and Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, RI 02912, USA
| | - U. Fidow
- Department of Obstetrics and Gynecology, Tupua Tamasese Meaole Hospital, National Health Service, Government of Samoa, Apia, Samoa
| | - M. S. Reupena
- Bureau of Statistics, Government of Samoa, Apia, Samoa
| | - T. Naseri
- Ministry of Health, Government of Samoa, Apia, Samoa
| | - S.T. McGarvey
- Department of Epidemiology and International Health Institute, Brown University School of Public Health, Providence, RI 02912, USA
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Maredia H, Bowring M, Massie A, Oyetunji S, Merlo C, Higgins R, Segev D, Bush E. WS11.1 Is the lung allocation score associated with waitlist and post-transplant survival among cystic fibrosis lung transplant recipients? J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30219-9] [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: 10/19/2022]
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Maredia H, Bowring M, Massie A, Oyetunji S, Merlo C, Higgins R, Segev D, Bush E. Age and Race Disparities among Pediatric and Adult Cystic Fibrosis Lung Transplant Recipients. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1183] [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: 10/19/2022] Open
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14
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Maredia H, Bowring M, Massie A, Oyetunji S, Merlo C, Higgins R, Segev D, Bush E. Lung Allocation Score Does Not Accurately Predict Post-Transplant Survival Among Cystic Fibrosis Lung Transplant Recipients. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.123] [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] Open
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DesRosiers T, Mehtani N, Gornet M, Zuo SW, Hrdina R, Vandiver AR, Purvis T, LaVigne A, Dichoso T, Towle DW, Staiano P, Kapoor S, Rogers D, Pham A, Lange R, Fan C, Shrock C, Maredia H, Doong J, Song A. The Shift: When People Become Patients. Md Med 2016; 17:29-31. [PMID: 27443129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Bourjeily G, Curran P, Butterfield K, Maredia H, Carpenter M, Lambert-Messerlian G. Placenta-secreted circulating markers in pregnant women with obstructive sleep apnea. J Perinat Med 2015; 43:81-7. [PMID: 24846956 DOI: 10.1515/jpm-2014-0052] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 04/22/2014] [Indexed: 11/15/2022]
Abstract
AIMS Obstructive sleep apnea (OSA) is associated with placenta-mediated adverse clinical outcomes. We aimed at comparing placenta-secreted proteins, such as first and second trimester Down syndrome screening markers which have been linked to preeclampsia, and markers of angiogenesis in pregnant women with OSA, and pregnant controls at low risk for OSA. METHODS A case-control study of pregnant women with OSA and controls at low risk for OSA was performed. Levels of first and second trimester markers were reported as multiple of median (MoM), and adjusted for body mass index (BMI). Stored samples were tested for markers of angiogenesis and adjusted for gestational age, BMI, and chronic hypertension. RESULTS A total of 24 women with OSA and 166 controls had screening markers. BMI was higher in cases compared to controls, P=0.01. MoM levels of placenta associated plasma protein-A (PAPP-A) were significantly lower in cases versus controls, even after adjusting for BMI (0.52 IQR 0.48 vs. 1.01 IQR 0.63, P=0.009). The ratio of soluble vascular endothelial growth factor receptor 1 to placental growth factor was significantly higher in cases than controls, even after adjusting for confounders (4.42 IQR 2.52 vs. 2.93 IQR 2.01, P=0.009). CONCLUSION Circulating placenta-secreted glycoproteins and markers of angiogenesis are altered in pregnant women with OSA.
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Damarla M, Parniani AR, Johnston L, Maredia H, Serebreni L, Hamdan O, Sidhaye VK, Shimoda LA, Myers AC, Crow MT, Schmidt EP, Machamer CE, Gaestel M, Rane MJ, Kolb TM, Kim BS, Damico RL, Hassoun PM. Mitogen-activated protein kinase-activated protein kinase 2 mediates apoptosis during lung vascular permeability by regulating movement of cleaved caspase 3. Am J Respir Cell Mol Biol 2014; 50:932-41. [PMID: 24304496 DOI: 10.1165/rcmb.2013-0361oc] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Apoptosis is a key pathologic feature in acute lung injury. Animal studies have demonstrated that pathways regulating apoptosis are necessary in the development of acute lung injury, and that activation of p38 mitogen-activated protein kinase (MAPK) is linked to the initiation of the apoptotic cascade. In this study, we assessed the role of the MAPK-activated protein kinase (MK) 2, one of p38 MAPK's immediate downstream effectors, in the development of apoptosis in an animal model of LPS-induced pulmonary vascular permeability. Our results indicate that wild-type (WT) mice exposed to LPS demonstrate increased apoptosis, as evidenced by cleavage of caspase 3 and poly (ADP-ribose) polymerase 1 and increased deoxynucleotidyl transferase-mediated dUDP nick-end labeling staining, which is accompanied by increases in markers of vascular permeability. In contrast, MK2(-/-) mice are protected from pulmonary vascular permeability and apoptosis in response to LPS. Although there was no difference in activation of caspase 3 in MK2(-/-) compared with WT mice, interestingly, cleaved caspase 3 translocated to the nucleus in WT mice while it remained in the cytosol of MK2(-/-) mice in response to LPS. In separate experiments, LPS-induced apoptosis in human lung microvascular endothelial cells was also associated with nuclear translocation of cleaved caspase 3 and apoptosis, which were both prevented by MK2 silencing. In conclusion, our data suggest that MK2 plays a critical role in the development of apoptosis and pulmonary vascular permeability, and its effects on apoptosis are in part related to its ability to regulate nuclear translocation of cleaved caspase 3.
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Affiliation(s)
- Mahendra Damarla
- 1 Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Salam RA, Maredia H, Das JK, Lassi ZS, Bhutta ZA. Community-based interventions for the prevention and control of helmintic neglected tropical diseases. Infect Dis Poverty 2014; 3:23. [PMID: 25114793 PMCID: PMC4128617 DOI: 10.1186/2049-9957-3-23] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Accepted: 07/03/2014] [Indexed: 11/10/2022] Open
Abstract
In this paper, we aim to systematically analyze the effectiveness of community-based interventions (CBIs) for the prevention and control of helminthiasis including soil-transmitted helminthiasis (STH) (ascariasis, hookworms, and trichuriasis), lymphatic filariasis, onchocerciasis, dracunculiasis, and schistosomiasis. We systematically reviewed literature published before May 2013 and included 32 studies in this review. Findings from the meta-analysis suggest that CBIs are effective in reducing the prevalence of STH (RR: 0.45, 95% CI: 0.38, 0.54), schistosomiasis (RR: 0.40, 95% CI: 0.33, 0.50), and STH intensity (SMD: -3.16, 95 CI: -4.28, -2.04). They are also effective in improving mean hemoglobin (SMD: 0.34, 95% CI: 0.20, 0.47) and reducing anemia prevalence (RR: 0.90, 95% CI: 0.85, 0.96). However, it did not have any impact on ferritin, height, weight, low birth weight (LBW), or stillbirths. School-based delivery significantly reduced STH (RR: 0.49, 95% CI: 0.39, 0.63) and schistosomiasis prevalence (RR: 0.50, 95% CI: 0.33, 0.75), STH intensity (SMD: -0.22, 95% CI: -0.26, -0.17), and anemia prevalence (RR: 0.87, 95% CI: 0.81, 0.94). It also improved mean hemoglobin (SMD: 0.24, 95% CI: 0.16, 0.32). We did not find any conclusive evidence from the quantitative synthesis on the relative effectiveness of integrated and non-integrated delivery strategies due to the limited data available for each subgroup. However, the qualitative synthesis from the included studies supports community-based delivery strategies and suggests that integrated prevention and control measures are more effective in achieving greater coverage compared to the routine vertical delivery, albeit it requires an existing strong healthcare infrastructure. Current evidence suggests that effective community-based strategies exist and deliver a range of preventive, promotive, and therapeutic interventions to combat helminthic neglected tropical diseases (NTDs). However, there is a need to implement and evaluate efficient integrated programs with the existing disease control programs on a larger scale throughout resource-limited regions especially to reach the unreachable.
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Affiliation(s)
- Rehana A Salam
- Division of Women and Child Health, The Aga Khan University, Karachi 74800, Pakistan
| | | | - Jai K Das
- Division of Women and Child Health, The Aga Khan University, Karachi 74800, Pakistan
| | - Zohra S Lassi
- Division of Women and Child Health, The Aga Khan University, Karachi 74800, Pakistan
| | - Zulfiqar A Bhutta
- Center of Excellence in Women & Child Health, The Aga Khan University, Karachi, Pakistan
- Center for Global Child Health Hospital for Sick Children, Toronto, Canada
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Das JK, Salam RA, Arshad A, Maredia H, Bhutta ZA. Community based interventions for the prevention and control of Non-Helmintic NTD. Infect Dis Poverty 2014; 3:24. [PMID: 25114794 PMCID: PMC4128610 DOI: 10.1186/2049-9957-3-24] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Accepted: 06/23/2014] [Indexed: 11/10/2022] Open
Abstract
In this paper, we aim to systematically analyze the effectiveness of community based interventions (CBI) for the prevention and control of non-helminthic diseases including dengue, trypanosomiasis, chagas, leishmaniasis, buruli ulcer, leprosy and trachoma. We systematically reviewed literature published up to May 2013 and included 62 studies in this review. Findings from our review suggest that CBI including insecticide spraying; insecticide treated bednets and curtains; community education and cleanliness campaigns; chemoprophylaxis through mass drug administration; and treatment have the potential to reduce the incidence and burden of non-helminthic diseases. Lack of data limited the subgroup analysis for integrated and non-integrated delivery strategies however, qualitative synthesis suggest that integrated delivery is more effective when compared to vertical interventions; however, such integration was possible only because of the existing vertical vector control programs. Community delivered interventions have the potential to achieve wider coverage and sustained community acceptance. Eradicating these diseases will require a multipronged approach including drug administration, health education, vector control and clean water and sanitation facilities. This would require high level governmental commitment along with strong partnerships among major stakeholders.
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Affiliation(s)
- Jai K Das
- Division of Women & Child Health, The Aga Khan University, Karachi, Pakistan
| | - Rehana A Salam
- Division of Women & Child Health, The Aga Khan University, Karachi, Pakistan
| | - Ahmed Arshad
- Division of Women & Child Health, The Aga Khan University, Karachi, Pakistan
| | | | - Zulfiqar A Bhutta
- Center of Excellence in Women & Child Health, The Aga Khan University, Karachi, Pakistan ; Center for Global Child Health, Hospital for Sick Children, Toronto, Canada
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