1
|
Kellier DJ, de Prado BM, Haagen D, Grabner P, Raj N, Lechtenberg L, Velasquez G, Hsu JY, Farrar JT, Hershey AD, Szperka CL. Validity of self-reported migraine in adolescents and children. Headache 2023; 63:634-641. [PMID: 37140013 PMCID: PMC10478717 DOI: 10.1111/head.14498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/19/2023] [Accepted: 02/24/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVE To assess agreement for migraine day between self-report and diagnostic guidelines for children and adolescents using a headache diary. BACKGROUND Trial guidelines recommend prospective collection of headache features and adoption of migraine day as an outcome measure, but there is no clear consensus on the definition of migraine day. METHODS This is a secondary analysis of data from two projects-a prospective cohort study validating a pediatric scale of treatment expectancy and a clinical trial of occipital nerve blocks to treat status migrainosus. Participants completed a text message-based diary for 4 or 12 weeks (depending on treatment), and a detailed headache assessment on a random 20% of headache days. Using this assessment, we determined whether a headache day qualified for migraine or probable migraine, based on the International Classification of Headache Disorders, 3rd edition (ICHD-3). RESULTS Of 122 enrolled children and adolescents, 106 (86.9%) completed ≥1 detailed headache assessment (438 entries). We found moderate agreement between self-reported and ICHD-derived migraine day, with a Cohen's Kappa of 0.50 (positive predictive value [PPV]: 0.66; negative predictive value [NPV]: 0.85; correlation: 0.51). Allowing for ICHD-derived probable migraine significantly increased PPV (0.66 vs. 0.94; 95% CI: 0.57-0.74 vs. 0.90-0.97), but decreased NPV (0.85 vs. 0.293; CI: 0.77-0.90 vs. 0.199-0.40), Cohen's Kappa (0.50 vs. 0.237; CI: 0. 389-0.60 vs. 0.139-0.352), and correlation (r = 0.51 vs. 0.302; CI: 0.41-0.61 vs. 0.192-0.41). Pain severity (OR: 5.7; CI: 2.39-13.8), photophobia (OR: 4.1; CI: 1.02-16.6), and phonophobia (OR: 7.5; CI: 1.95-29.3) were significantly associated with participants' perception of migraine. CONCLUSION We found only moderate agreement between self-reported and ICHD-derived migraine day, suggesting both measures are not equal but may represent overlapping aspects of migraine as a disease. This highlights the difficulty of applying ICHD criteria to individual attacks. We recommend greater methodological transparency in future research to avoid readers conflating both measures.
Collapse
Affiliation(s)
- Danielle J. Kellier
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Children’s Hospital of Philadelphia, Philadelphia, USA
| | | | - Dana Haagen
- Children’s Hospital of Philadelphia, Philadelphia, USA
| | | | - Nichelle Raj
- Children’s Hospital of Philadelphia, Philadelphia, USA
| | | | | | - Jesse Y. Hsu
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - John T. Farrar
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Andrew D. Hershey
- Cincinnati Children’s Hospital, Cincinnati, USA
- University of Cincinnati College of Medicine, Cincinnati, USA
| | - Christina L. Szperka
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Children’s Hospital of Philadelphia, Philadelphia, USA
| |
Collapse
|
2
|
Dina D, Caley M, Raj N, O’Toole E, Connelly J. 216 Understanding the Mechanisms of Epidermal Barrier Damage and Repair Using 3D Skin Equivalent Models. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.227] [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: 11/19/2022]
|
3
|
Keane F, Park W, Varghese A, Balogun F, Yu K, El Dika I, Khalil D, Kelsen D, Reidy-Lagunes D, Ku G, Raj N, Chou J, Capanu M, Schultz N, Yaeger R, O'Reilly E. 1304P Characterizing the clinico-genomic landscape and outcomes of KRAS G12C mutated pancreas cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
4
|
Kellier DJ, de Prado BM, Haagen D, Grabner P, Raj N, Lechtenberg L, Velasquez G, Hsu JY, Farrar JT, Hershey AD, Szperka CL. Development of a text message-based headache diary in adolescents and children. Cephalalgia 2022; 42:1013-1021. [PMID: 35400198 PMCID: PMC10120392 DOI: 10.1177/03331024221090206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND International guidelines recommend diaries in migraine trials for prospective collection of headache symptoms. Studies in other patient populations suggest higher adherence with electronic diaries instead of pen-and-paper. This study examines the feasibility of a text message-based (texting) diary for children and adolescents with headache. METHODS This is a secondary analysis of data from a study validating a pediatric scale of treatment expectancy. We developed a Health Insurance Portability and Accountability Act-compliant texting diary collecting headache characteristics, medication use, and disability with 3-5 core daily questions for 4 or 12 weeks depending on headache treatment. Adherence was incentivized. RESULTS 93 participants consented to the expectancy study. Five participants opted for a paper diary for follow-up. 88 participants chose the texting diary with 28 4-week and 60 12-week participants. Five participants did not complete the enrollment visit. Of those remaining 83, 89% of 4-week and 93% of 12-week participants responded on at least 80% of days. On average, participants fully completed 88% (4-week cohort) and 90% (12-week) of diary entries. CONCLUSIONS Text messages are a promising method for collecting patient-reported data. Adherence was similar to that reported for paper diaries in other pediatric migraine trials, but time-stamped entries ensure real-time data collection.
Collapse
Affiliation(s)
- Danielle J. Kellier
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | | | - Dana Haagen
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | | | - Nichelle Raj
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Lara Lechtenberg
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Gerardo Velasquez
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Jesse Y. Hsu
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - John T. Farrar
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Andrew D. Hershey
- Cincinnati Children’s Hospital, Cincinnati, Ohio, USA
- University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Christina L. Szperka
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| |
Collapse
|
5
|
Adhikari P, Ajaj R, Alpízar-Venegas M, Auty DJ, Benmansour H, Bina CE, Bonivento W, Boulay MG, Cadeddu M, Cai B, Cárdenas-Montes M, Cavuoti S, Chen Y, Cleveland BT, Corning JM, Daugherty S, DelGobbo P, Di Stefano P, Doria L, Dunford M, Ellingwood E, Erlandson A, Farahani SS, Fatemighomi N, Fiorillo G, Gallacher D, García Abia P, Garg S, Giampa P, Goeldi D, Gorel P, Graham K, Grobov A, Hallin AL, Hamstra M, Hugues T, Ilyasov A, Joy A, Jigmeddorj B, Jillings CJ, Kamaev O, Kaur G, Kemp A, Kochanek I, Kuźniak M, Lai M, Langrock S, Lehnert B, Leonhardt A, Levashko N, Li X, Lissia M, Litvinov O, Lock J, Longo G, Machulin I, McDonald AB, McElroy T, McLaughlin JB, Mielnichuk C, Mirasola L, Monroe J, Oliviéro G, Pal S, Peeters SJM, Perry M, Pesudo V, Picciau E, Piro MC, Pollmann TR, Raj N, Rand ET, Rethmeier C, Retière F, Rodríguez-García I, Roszkowski L, Ruhland JB, Sanchez García E, Sánchez-Pastor T, Santorelli R, Seth S, Sinclair D, Skensved P, Smith B, Smith NJT, Sonley T, Stainforth R, Stringer M, Sur B, Vázquez-Jáuregui E, Viel S, Walding J, Waqar M, Ward M, Westerdale S, Willis J, Zuñiga-Reyes A. First Direct Detection Constraints on Planck-Scale Mass Dark Matter with Multiple-Scatter Signatures Using the DEAP-3600 Detector. Phys Rev Lett 2022; 128:011801. [PMID: 35061499 DOI: 10.1103/physrevlett.128.011801] [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] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/15/2021] [Accepted: 11/16/2021] [Indexed: 06/14/2023]
Abstract
Dark matter with Planck-scale mass (≃10^{19} GeV/c^{2}) arises in well-motivated theories and could be produced by several cosmological mechanisms. A search for multiscatter signals from supermassive dark matter was performed with a blind analysis of data collected over a 813 d live time with DEAP-3600, a 3.3 t single-phase liquid argon-based detector at SNOLAB. No candidate signals were observed, leading to the first direct detection constraints on Planck-scale mass dark matter. Leading limits constrain dark matter masses between 8.3×10^{6} and 1.2×10^{19} GeV/c^{2}, and ^{40}Ar-scattering cross sections between 1.0×10^{-23} and 2.4×10^{-18} cm^{2}. These results are interpreted as constraints on composite dark matter models with two different nucleon-to-nuclear cross section scalings.
Collapse
Affiliation(s)
- P Adhikari
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - R Ajaj
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - M Alpízar-Venegas
- Instituto de Física, Universidad Nacional Autónoma de México, A.P. 20-364, México D.F. 01000, México
| | - D J Auty
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
| | - H Benmansour
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - C E Bina
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | | | - M G Boulay
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - M Cadeddu
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
- INFN Cagliari, Cagliari 09042, Italy
| | - B Cai
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - M Cárdenas-Montes
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - S Cavuoti
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- Astronomical Observatory of Capodimonte, Salita Moiariello 16, I-80131 Napoli, Italy
- INFN Napoli, Napoli 80126, Italy
| | - Y Chen
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
| | - B T Cleveland
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario, P3E 2C6, Canada
- SNOLAB, Lively, Ontario, P3Y 1N2, Canada
| | - J M Corning
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - S Daugherty
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario, P3E 2C6, Canada
| | - P DelGobbo
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - P Di Stefano
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - L Doria
- PRISMA+, Cluster of Excellence and Institut für Kernphysik, Johannes Gutenberg-Universität Mainz, 55128 Mainz, Germany
| | - M Dunford
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - E Ellingwood
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - A Erlandson
- Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - S S Farahani
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
| | - N Fatemighomi
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
- SNOLAB, Lively, Ontario, P3Y 1N2, Canada
| | - G Fiorillo
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - D Gallacher
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - P García Abia
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - S Garg
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - P Giampa
- TRIUMF, Vancouver, British Columbia, V6T 2A3, Canada
| | - D Goeldi
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - P Gorel
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario, P3E 2C6, Canada
- SNOLAB, Lively, Ontario, P3Y 1N2, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - K Graham
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - A Grobov
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - A L Hallin
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
| | - M Hamstra
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - T Hugues
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Rektorska 4, 00-614 Warsaw, Poland
| | - A Ilyasov
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - A Joy
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - B Jigmeddorj
- Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada
| | - C J Jillings
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario, P3E 2C6, Canada
- SNOLAB, Lively, Ontario, P3Y 1N2, Canada
| | - O Kamaev
- Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada
| | - G Kaur
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - A Kemp
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - I Kochanek
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - M Kuźniak
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Rektorska 4, 00-614 Warsaw, Poland
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - M Lai
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
- INFN Cagliari, Cagliari 09042, Italy
| | - S Langrock
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario, P3E 2C6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - B Lehnert
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - A Leonhardt
- Department of Physics, Technische Universität München, 80333 Munich, Germany
| | - N Levashko
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - X Li
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - M Lissia
- INFN Cagliari, Cagliari 09042, Italy
| | - O Litvinov
- TRIUMF, Vancouver, British Columbia, V6T 2A3, Canada
| | - J Lock
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - G Longo
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - I Machulin
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - A B McDonald
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - T McElroy
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
| | - J B McLaughlin
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
- TRIUMF, Vancouver, British Columbia, V6T 2A3, Canada
| | - C Mielnichuk
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
| | - L Mirasola
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - J Monroe
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - G Oliviéro
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - S Pal
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - S J M Peeters
- University of Sussex, Sussex House, Brighton, East Sussex BN1 9RH, United Kingdom
| | - M Perry
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - V Pesudo
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - E Picciau
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
- INFN Cagliari, Cagliari 09042, Italy
| | - M-C Piro
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - T R Pollmann
- Department of Physics, Technische Universität München, 80333 Munich, Germany
| | - N Raj
- TRIUMF, Vancouver, British Columbia, V6T 2A3, Canada
| | - E T Rand
- Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada
| | - C Rethmeier
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - F Retière
- TRIUMF, Vancouver, British Columbia, V6T 2A3, Canada
| | - I Rodríguez-García
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - L Roszkowski
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Rektorska 4, 00-614 Warsaw, Poland
- BP2, National Centre for Nuclear Research, ul. Pasteura 7, 02-093 Warsaw, Poland
| | - J B Ruhland
- Department of Physics, Technische Universität München, 80333 Munich, Germany
| | - E Sanchez García
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - T Sánchez-Pastor
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - R Santorelli
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - S Seth
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - D Sinclair
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - P Skensved
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - B Smith
- TRIUMF, Vancouver, British Columbia, V6T 2A3, Canada
| | - N J T Smith
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario, P3E 2C6, Canada
- SNOLAB, Lively, Ontario, P3Y 1N2, Canada
| | - T Sonley
- SNOLAB, Lively, Ontario, P3Y 1N2, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - R Stainforth
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - M Stringer
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - B Sur
- Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada
| | - E Vázquez-Jáuregui
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario, P3E 2C6, Canada
- Instituto de Física, Universidad Nacional Autónoma de México, A.P. 20-364, México D.F. 01000, México
| | - S Viel
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - J Walding
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - M Waqar
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - M Ward
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
- SNOLAB, Lively, Ontario, P3Y 1N2, Canada
| | - S Westerdale
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- INFN Cagliari, Cagliari 09042, Italy
| | - J Willis
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
| | - A Zuñiga-Reyes
- Instituto de Física, Universidad Nacional Autónoma de México, A.P. 20-364, México D.F. 01000, México
| |
Collapse
|
6
|
Hoang R, Elsakka A, Yarmohammadi H, Erinjeri J, Boas F, Solomon S, Raj N, Reidy-Lagunes D, Gonzalez Aguirre A, Ziv E. Abstract No. 32 ▪ FEATURED ABSTRACT Predicting tumor grade and mutation status of pancreatic neuroendocrine liver metastases using computed tomography radiomic features. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.448] [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] Open
|
7
|
Sekar H, Krishnamoorthy S, Kumaresan N, Chandrasekaran D, Ramaswamy P, Sundaram S, Raj N. Clinicopathological comparison of VHL expression as a prognostic tumor marker in renal cell carcinoma: A single center experience. Niger J Clin Pract 2021; 24:614-620. [PMID: 33851686 DOI: 10.4103/njcp.njcp_57_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To assess the VHL gene expression as a prognostic marker in Renal Cell Carcinoma (RCC) and compare it with clinicopathologic features. MATERIALS AND METHODS This retrospective observational study was conducted in the department of Urology and Renal Transplantation in Sri Ramachandra Institute of Higher Education and Research, Chennai from August 2016 to August 2018. Thirty patients who have undergone a radical/partial nephrectomy with biopsy proven histological diagnosis of RCC during the study period were included in the study. Data was analyzed using Statistical package for Social Sciences version 17. RESULTS A complete loss and retained VHL expression were noted in 60% and 40% of the RCC specimens. Association between smoking and VHL expression was found to be statistically significant. There was no statistical significance found between age group, sex, chief complaints, BMI. ECOG score, hypertension, family history, location of tumor, calcification, venous system or lymphnode involvement. However, rT staging, nature of lesion and cut surface, HPE type, pT staging, HPE grade, necrosis and lympho-vascular invasion were also found to be statistically significant. CONCLUSION Complete loss of VHL expression was noted in majority of the specimens that leads to the development of RCC. Smoking has been found to be statistically significant in tumors that retain VHL expression which may contributes to more aggressive form of tumor. Association between rT staging, nature of lesion and cut surface, HPE type, pT staging, HPE grade, necrosis and lympho-vascular invasion were also found to be statistically significant.
Collapse
Affiliation(s)
- H Sekar
- Department of Urology, Physiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - S Krishnamoorthy
- Department of Urology, Physiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - N Kumaresan
- Department of Urology, Physiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - D Chandrasekaran
- Department of Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - P Ramaswamy
- Department of Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - S Sundaram
- Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - N Raj
- Consultant Urologist, R.G Stone Clinic, Chennai, Tamil Nadu, India
| |
Collapse
|
8
|
Abstract
A fully enclosed paper microfluidic device has been fabricated using pentafluoroethane (PFE) plasma deposition followed by O2 plasma etching. Structures with one and two non-interacting, fully enclosed hydrophilic channels were generated in a single paper sheet using metal masks. Furthermore, by performing an additional O2 plasma step with a secondary mask, pinholes were created at the reaction zones for reagent loading. Finally, to demonstrate the functionality of the device, a glucose assay was performed. Quantitative analysis of glucose assays showed that the device can be used for the clinically relevant range of glucose. To our knowledge, this is the first time that such structures have been fabricated without paper stacking. Multi-layer devices have enhanced functionality relative to a single channel device, because the design space for creating networks of channels within the paper substrate is greatly expanded. The fluid-filled channels in the fabricated device are isolated, thereby preventing contamination due to handling and environmental exposure. Fluid evaporation can be inhibited by sealing the device with adhesive tape without contaminating the enclosed channels. The method described is a dry process and compatible with roll-to-roll technology, thus facilitating large scale production. The novel method to fabricate enclosed μ-PADs overcomes many of the limitations experienced with current approaches and thus offers an alternative means to develop low-cost point-of-care diagnostics for resource-limited settings.
Collapse
Affiliation(s)
- N Raj
- School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, 311 Ferst Drive NW, Atlanta, GA 30332-0100, USA.
| | - V Breedveld
- School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, 311 Ferst Drive NW, Atlanta, GA 30332-0100, USA.
| | - D W Hess
- School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, 311 Ferst Drive NW, Atlanta, GA 30332-0100, USA.
| |
Collapse
|
9
|
Chavan N, Deshmukh R, Raj N. An observational study on diagnosis and management of adnexal masses in pregnancy. CLIN EXP OBSTET GYN 2019. [DOI: 10.12891/ceog4749.2019] [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: 11/01/2022]
|
10
|
Yao J, Strosberg J, Fazio N, Pavel M, Ruszniewski P, Bergsland E, Li D, Tafuto S, Raj N, Campana D, Hijioka S, Raderer M, Guimbaud R, Gajate P, Pusceddu S, Reising A, Degtyarev E, Mookerjee B, Aimone P, Singh S. Activity & safety of spartalizumab (PDR001) in patients (pts) with advanced neuroendocrine tumors (NET) of pancreatic (Pan), gastrointestinal (GI), or thoracic (T) origin, & gastroenteropancreatic neuroendocrine carcinoma (GEP NEC) who have progressed on prior treatment (Tx). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy293.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
11
|
Yu K, Mantha S, Tjan C, Kaufmann E, Brenner R, Lowery M, Ku G, Raj N, Shcherba M, Goldberg Z, Li J, Zervoudakis A, Hamilton A, Won E, Do R, O’Reilly E. A pilot study of gemcitabine, nab-paclitaxel, PEGPH20 (PAG) and rivaroxaban for advanced pancreatic adenocarcinoma: Interim safety and efficacy analysis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.113] [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: 11/14/2022] Open
|
12
|
McAleer MA, Jakasa I, Raj N, O'Donnell CPF, Lane ME, Rawlings AV, Voegeli R, McLean WHI, Kezic S, Irvine AD. Early-life regional and temporal variation in filaggrin-derived natural moisturizing factor, filaggrin-processing enzyme activity, corneocyte phenotypes and plasmin activity: implications for atopic dermatitis. Br J Dermatol 2018; 179:431-441. [PMID: 29691836 PMCID: PMC6175251 DOI: 10.1111/bjd.16691] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2018] [Indexed: 12/15/2022]
Abstract
Background Filaggrin is central to the pathogenesis of atopic dermatitis (AD). The cheeks are a common initiation site of infantile AD. Regional and temporal expression of levels of filaggrin degradation products [natural moisturizing factors (NMFs)], activities of filaggrin‐processing enzymes [bleomycin hydrolase (BH) and calpain‐1 (C‐1)] and plasmin, and corneocyte envelope (CE) maturity in early life are largely unknown. Objectives We conducted a cross‐sectional, observational study investigating regional and age‐dependent variations in NMF levels, activity of proteases and CE maturity in stratum corneum (SC) from infants to determine whether these factors could explain the observed predilection sites for AD in early life. Methods We measured NMF using a tape‐stripping method at seven sites in the SC of 129 children (aged < 12 months to 72 months) and in three sites in 56 neonates and infants (< 48 h to 3 months). In 37 of these neonates and infants, corneocyte size, maturity, BH, C‐1 and plasmin activities were determined. Results NMF levels are low at birth and increase with age. Cheek SC, compared with elbow flexure and nasal tip, has the lowest NMF in the first year of life and is the slowest to reach stable levels. Cheek corneocytes remain immature. Plasmin, BH and C‐1 activities are all elevated by 1 month of age in exposed cheek skin, but not in elbow skin. Conclusions Regional and temporal differences in NMF levels, CE maturity and protease activities may explain the predilection for AD to affect the cheeks initially and are supportive of this site as key for allergen priming in early childhood. These observations will help design early intervention and treatment strategies for AD. What's already known about this topic?Atopic dermatitis (AD) frequently starts in early infancy, and the first eczematous lesions emerge on the cheeks. Filaggrin is a major structural protein in the stratum corneum (SC). Filaggrin deficiency is associated with the development of AD and, in the context of AD, food allergies and asthma. Filaggrin is metabolized into natural moisturizing factors (NMFs), which can be measured in the SC.
What does this study add? Regional differences in NMF levels, corneocyte envelope immaturity and protease activities may help explain why infantile AD most often initially affects the cheeks. Filaggrin processing, corneocyte maturity, and protease activities show regional and temporal differences in infant skin. These findings may explain disease patterns in early‐life AD.
What is the translational message? Cheek skin may be highly relevant for allergen priming. Emollient therapy at the vulnerable cheek site might help to prevent AD and/or food sensitization.
Linked Editorial: https://doi.org/10.1111/bjd.16806. https://doi.org/10.1111/bjd.16959 available online https://goo.gl/Uqv3dl
Collapse
Affiliation(s)
- M A McAleer
- National Children's Research Centre, Our Lady's Children's Hospital, Dublin, Ireland.,Paediatric Dermatology, Our Lady's Children's Hospital, Dublin, Ireland
| | - I Jakasa
- Laboratory for Analytical Chemistry, Department of Chemistry and Biochemistry, Faculty of Food Technology and Biotechnology, University of Zagreb, Zagreb, Croatia
| | - N Raj
- School of Pharmacy, University College London, London, U.K
| | - C P F O'Donnell
- Department of Neonatology, National Maternity Hospital, Dublin, Ireland
| | - M E Lane
- School of Pharmacy, University College London, London, U.K
| | - A V Rawlings
- School of Pharmacy, University College London, London, U.K
| | - R Voegeli
- DSM Nutritional Products Ltd, Wurmisweg 571, Kaiseraugst, Switzerland
| | - W H I McLean
- Dermatology and Genetic Medicine, Division of Biological Chemistry and Drug Discovery, School of Life Sciences, University of Dundee, Dundee, U.K
| | - S Kezic
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Academic Medical Center, Amsterdam, the Netherlands
| | - A D Irvine
- National Children's Research Centre, Our Lady's Children's Hospital, Dublin, Ireland.,Paediatric Dermatology, Our Lady's Children's Hospital, Dublin, Ireland.,Department of Clinical Medicine, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
13
|
Click TH, Raj N, Chu JW. Calculation of Enzyme Fluctuograms from All-Atom Molecular Dynamics Simulation. Methods Enzymol 2016; 578:327-42. [PMID: 27497173 DOI: 10.1016/bs.mie.2016.05.024] [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: 02/18/2023]
Abstract
In this work, a computational framework is presented to compute the time evolution of force constants for a coarse grained (CG) elastic network model along an all-atom molecular dynamics trajectory of a protein system. Obtained via matching distance fluctuations, these force constants represent strengths of mechanical coupling between CG beads. Variation of coupling strengths with time is hence termed the fluctuogram of protein dynamics. In addition to the schematic procedure and implementation considerations, several ways of combining force constants and data analysis are presented to illustrate the potential application of protein fluctuograms. The unique angle provided by the fluctuogram expands the scope of atomistic simulations and is expected to impact upon fundamental understanding of protein dynamics as well as protein engineering technologies.
Collapse
Affiliation(s)
- T H Click
- Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan, ROC
| | - N Raj
- Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan, ROC
| | - J-W Chu
- Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan, ROC; Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan, ROC; Institute of Molecular Medicine and Bioengineering, National Chiao Tung University, Hsinchu, Taiwan, ROC.
| |
Collapse
|
14
|
Raj N, Voegeli R, Rawlings AV, Doppler S, Imfeld D, Munday MR, Lane ME. A fundamental investigation into aspects of the physiology and biochemistry of the stratum corneum in subjects with sensitive skin. Int J Cosmet Sci 2016; 39:2-10. [PMID: 27079667 DOI: 10.1111/ics.12334] [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: 03/13/2016] [Accepted: 04/10/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Sensitive skin is a poorly understood skin condition. Defects in stratum corneum (SC) barrier function and/or extrasensory neuronal networks in the epidermis are believed to be involved in the problem. OBJECTIVES This study aimed to unravel the relationships between bleomycin hydrolase (BH) and calpain-1 (C-1), pyrrolidone carboxylic acid (PCA) levels, corneocyte maturation, transglutaminase (TG) and plasmin activities on the cheeks of subjects with sensitive skin. METHODS Forty-eight female Caucasian subjects, Fitzpatrick skin phototypes II-III, with self-perceived sensitive facial skin, were assessed and underwent a capsaicin reactivity test. Expert grading of skin condition was conducted as well as the measurement of transepidermal water loss (TEWL), skin capacitance, SC cohesion and SC integrity. BH, C-1 and plasmin activities were measured as well as PCA levels, plasmin and TG activity. Differential Nile red and involucrin immunostaining was performed to assess corneocyte maturation and size. RESULTS About 52% of the subjects reacted to capsaicin. There were no significant differences between the capsaicin-sensitive and non-capsaicin-sensitive subjects with reference to skin grading, TEWL, skin capacitance and SC cohesion. PCA levels and BH activity were lowest in the capsaicin-sensitive panel (P < 0.05) and were correlated in non-capsaicin-sensitive subjects (r = 0.72). The activity of TG was significantly lower (48%) in the capsaicin-sensitive subjects (P < 0.001) and their corneocytes were less mature and smaller (P ≤ 0.05). SC was estimated to be thinner (6.87 ± 0.28 vs. 8.68 ± 0.26 μm; P = 0.001) in the capsaicin-sensitive subjects with a corresponding shorter SC path length (83.2 ± 4.4 μm and 113.1 ± 4.5 μm; P = 0.001). CONCLUSIONS Despite the physiological similarities between the two groups of sensitive skin subjects, differences in their biochemistry were clearly evident. Lower levels of PCA, BH and TG activities together with a greater number of smaller and immature corneocytes indicate inferior SC maturation in the capsaicin-sensitive subjects. The reduced maturation of corneocytes and thinner SC likely contributes to a greater penetration of capsaicin and the associated increased skin sensitivity.
Collapse
Affiliation(s)
- N Raj
- UCL School of Pharmacy, London, UK
| | - R Voegeli
- DSM Nutritional Products Ltd., Kaiseraugst, Switzerland
| | | | - S Doppler
- DSM Nutritional Products Ltd., Kaiseraugst, Switzerland
| | - D Imfeld
- DSM Nutritional Products Ltd., Kaiseraugst, Switzerland
| | | | - M E Lane
- UCL School of Pharmacy, London, UK
| |
Collapse
|
15
|
Raj N, Voegeli R, Rawlings AV, Summers B, Munday MR, Lane ME. Variation in the activities of late stage filaggrin processing enzymes, calpain-1 and bleomycin hydrolase, together with pyrrolidone carboxylic acid levels, corneocyte phenotypes and plasmin activities in non-sun-exposed and sun-exposed facial stratum corneum of different ethnicities. Int J Cosmet Sci 2016; 38:567-575. [PMID: 27028209 DOI: 10.1111/ics.12321] [Citation(s) in RCA: 19] [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] [Received: 03/12/2016] [Accepted: 03/22/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND Knowledge of the ethnic differences and effects of photodamage on the relative amounts of natural moisturizing factor (NMF) together with filaggrin processing enzymes in facial stratum corneum is limited. Our aim was to characterize the activities of calpain-1 (C-1), bleomycin hydrolase (BH) and the levels of pyrrolidone carboxylic acid (PCA) as a marker for total NMF levels and to relate them to plasmin activities and corneocyte maturation. METHODS Enzyme activities, PCA levels and corneocyte maturation were determined from facial tape strippings of photoexposed cheek and photoprotected post-auricular areas (PA) of healthy Caucasian (C), Black African (BA) and albino African (AA) female subjects living in South Africa. RESULTS PCA concentration levels were of the order AA > BA > C subjects, and the highest activities of BH were present in the AA subjects. BH activities were greater on the photoexposed sites for the BA and C subjects, but they were only numerically elevated in the AA subjects. Photoprotected sites had an increase in C-1 activity in pigmented groups (C and BA), whereas in the AA subjects, the opposite was measured. Plasmin activities were greater on the cheek compared with the PA site for the AA and C subjects, but the activity was low in the BA subjects. In both test sites, the AA, but not the BA and C subjects, had smaller, parakeratotic and less mature corneocytes. CONCLUSION Variation in PCA levels has been found for different ethnic groups in this study (AA > BA > C subjects). The values in the AA subjects are surprising as one might expect that the lack of pigmentation, and thereby increased photodamage, might lead to lower levels. Increased BH, but not C-1 activity, was observed in the AA subjects indicating that BH is associated with PCA production to a greater extent. Surprisingly, corneocyte maturation is still impaired with elevated PCA levels in AA subjects. The higher levels of plasmin and BH activities on the cheeks, especially for AA and C subjects, suggest that they can be used as markers for epidermal photodamage.
Collapse
Affiliation(s)
- N Raj
- UCL School of Pharmacy, London, U.K
| | - R Voegeli
- DSM Nutritional Products Ltd., Kaiseraugst, Switzerland
| | | | - B Summers
- Photobiology Laboratory, Sefako Makgatho Health Sciences University, Medunsa, South Africa
| | | | - M E Lane
- UCL School of Pharmacy, London, U.K
| |
Collapse
|
16
|
Raj N, Voegeli R, Rawlings AV, Gibbons S, Munday MR, Summers B, Lane ME. Variation in stratum corneum protein content as a function of anatomical site and ethnic group. Int J Cosmet Sci 2015; 38:224-31. [DOI: 10.1111/ics.12274] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 09/02/2015] [Indexed: 11/30/2022]
Affiliation(s)
- N. Raj
- School of Pharmacy; University College London; London U.K
| | - R. Voegeli
- DSM Nutritional Products Ltd.; Kaiseraugst Switzerland
| | - A. V. Rawlings
- School of Pharmacy; University College London; London U.K
| | - S. Gibbons
- School of Pharmacy; University College London; London U.K
| | - M. R. Munday
- School of Pharmacy; University College London; London U.K
| | - B. Summers
- Photobiology Laboratory; Sefako Makgatho University; Mednusa South Africa
| | - M. E. Lane
- School of Pharmacy; University College London; London U.K
| |
Collapse
|
17
|
Aschkenasy G, Bromberg Z, Raj N, Deutschman CS, Weiss YG. Enhanced Hsp70 expression protects against acute lung injury by modulating apoptotic pathways. PLoS One 2011; 6:e26956. [PMID: 22132083 PMCID: PMC3223157 DOI: 10.1371/journal.pone.0026956] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [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] [Received: 10/17/2010] [Accepted: 10/07/2011] [Indexed: 01/11/2023] Open
Abstract
The Acute respiratory distress syndrome (ARDS) is a highly lethal inflammatory lung disorder. Apoptosis plays a key role in its pathogenesis. We showed that an adenovirus expressing the 70 kDa heat shock protein Hsp70 (AdHSP) protected against sepsis-induced lung injury. In this study we tested the hypothesis that AdHSP attenuates apoptosis in sepsis-induced lung injury. Sepsis was induced in rats via cecal ligation and double puncture (2CLP). At the time of 2CLP PBS, AdHSP or AdGFP (an adenoviral vector expressing green fluorescent protein) were injected into the tracheas of septic rats. 48 hours later, lungs were isolated. One lung was fixed for TUNEL staining and immunohistochemistry. The other was homogenized to isolate cytosolic and nuclear protein. Immunoblotting, gel filtration and co-immunoprecipitation were performed in these extracts. In separate experiments MLE-12 cells were incubated with medium, AdHSP or AdGFP. Cells were stimulated with TNFα. Cytosolic and nuclear proteins were isolated. These were subjected to immunoblotting, co- immunoprecipitation and a caspase-3 activity assay. TUNEL assay demonstrated that AdHSP reduced alveolar cell apoptosis. This was confirmed by immunohistochemical detection of caspase 3 abundance. In lung isolated from septic animals, immunoblotting, co-immunoprecipitation and gel filtration studies revealed an increase in cytoplasmic complexes containing caspases 3, 8 and 9. AdHSP disrupted these complexes. We propose that Hsp70 impairs apoptotic cellular pathways via interactions with caspases. Disruption of large complexes resulted in stabilization of lower molecular weight complexes, thereby, reducing nuclear caspase-3. Prevention of apoptosis in lung injury may preserve alveolar cells and aid in recovery.
Collapse
Affiliation(s)
- Gabriella Aschkenasy
- Department of Anesthesiology and Critical Care Medicine and the Goldyne Savad Institute of Gene Therapy, Hadassah-Hebrew University School of Medicine, Jerusalem, Israel
| | - Zohar Bromberg
- Department of Anesthesiology and Critical Care Medicine and the Goldyne Savad Institute of Gene Therapy, Hadassah-Hebrew University School of Medicine, Jerusalem, Israel
| | - Nichelle Raj
- Department of Anesthesiology and Critical Care and the Stavropoulos Sepsis Research Program, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Clifford S. Deutschman
- Department of Anesthesiology and Critical Care and the Stavropoulos Sepsis Research Program, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Yoram G. Weiss
- Department of Anesthesiology and Critical Care Medicine and the Goldyne Savad Institute of Gene Therapy, Hadassah-Hebrew University School of Medicine, Jerusalem, Israel
- Department of Anesthesiology and Critical Care and the Stavropoulos Sepsis Research Program, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
- * E-mail:
| |
Collapse
|
18
|
Kumar R, Mahakud GC, Nagar JK, Singh SP, Raj N, Gopal K, Vijayan VK. Breath carbon monoxide level of non-smokers exposed to environmental tobacco smoke. Indian J Chest Dis Allied Sci 2011; 53:215-219. [PMID: 22128620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Environmental tobacco smoke (ETS) exposure is a health hazard for non-smokers. OBJECTIVE To measure breath carbon monoxide (CO) levels of non-smoking subjects exposed to ETS and of non-smoking subjects not exposed to ETS. RESULTS The study was conducted with the help of a pre-designed questionnaire. One hundred male subjects were selected for the study; group I consisted of 50 non-smokers (waiters in hotels/restaurants/bars) exposed to ETS and group II consisted of 50 non-smokers not exposed to ETS. All subjects underwent clinical examination. Breath CO levels of both the groups were measured by the Mini Smoklyzer. The mean breath CO level (ppm) was higher in group I compared to group II (9.18 +/- 2.84 versus 4.56 +/- 1.62; p < 0.001). The mean breath CO level was also significantly higher in ETS exposed subjects who worked for more than nine hours a day in bars, restaurants and hotels (p = 0.018) and in subjects suffering from respiratory diseases (p < 0.001) compared to normal subjects. CONCLUSION The abnormally high level of breath CO observed in passive smokers exposed to ETS may suggest that, these subjects may be prone to develop the tobacco related diseases.
Collapse
Affiliation(s)
- Raj Kumar
- Department of Respiratory Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India.
| | | | | | | | | | | | | |
Collapse
|
19
|
Troude P, Bailly E, Guibert J, Bouyer J, de La Rochebrochard E, Velez MP, Abad G, Robert JM, Bissonnette F, Kadoch IJ, Oudi M, Sazvar S, Alizadeh L, Ezabadi Z, Samani Omani R, Monnier P, Sheehy O, Fraser W, Bissonnette F, Tan SL, Trasler J, Chaabane S, Berard A, Nelson SM, Lawlor DA, Kasius JC, Eijkemans MJC, Mol BW, Fauser BC, Broekmans FJM, Farquhar C, Riddel C, MacDonald A, Raj N, Chan E, Mol BW, van den Boogaard N, Nikitin SV, Karpeev SA, Karpova SV. POSTER VIEWING SESSION - REPRODUCTIVE EPIDEMIOLOGY AND HEALTH ECONOMY. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
20
|
Raj N, Sehgal A, Hall J, Murrin K. Comparison of the efficacy of high dose intra-articular and intramuscular morphine analgesia in day case knee arthroscopy. Anaesthesia 2008. [DOI: 10.1046/j.1365-2044.2002.t01-2-02963.x] [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: 11/20/2022]
|
21
|
Weiss YG, Bromberg Z, Raj N, Raphael J, Goloubinoff P, Ben-Neriah Y, Deutschman CS. Enhanced heat shock protein 70 expression alters proteasomal degradation of IkappaB kinase in experimental acute respiratory distress syndrome. Crit Care Med 2007; 35:2128-38. [PMID: 17855826 DOI: 10.1097/01.ccm.0000278915.78030.74] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Acute respiratory distress syndrome is a common and highly lethal inflammatory lung syndrome. We previously have shown that an adenoviral vector expressing the heat shock protein (Hsp)70 (AdHSP) protects against experimental sepsis-induced acute respiratory distress syndrome in part by limiting neutrophil accumulation in the lung. Neutrophil accumulation and activation is modulated, in part, by the nuclear factor-kappaB (NF-kappaB) signal transduction pathway. NF-kappaB activation requires dissociation/degradation of a bound inhibitor, IkappaBalpha. IkappaBalpha degradation requires phosphorylation by IkappaB kinase, ubiquitination by the SCFbeta-TrCP (Skp1/Cullin1/Fbox beta-transducing repeat-containing protein) ubiquitin ligase, and degradation by the 26S proteasome. We tested the hypothesis that Hsp70 attenuates NF-kappaB activation at multiple points in the IkappaBalpha degradative pathway. DESIGN Laboratory investigation. SETTING University medical center research laboratory. SUBJECTS Adolescent (200 g) Sprague-Dawley rats and murine lung epithelial-12 cells in culture. INTERVENTIONS Lung injury was induced in rats via cecal ligation and double puncture. Thereafter, animals were treated with intratracheal injection of 1) phosphate buffer saline, 2) AdHSP, or 3) an adenovirus expressing green fluorescent protein. Murine lung epithelial-12 cells were stimulated with tumor necrosis factor-alpha and transfected. NF-kappaB was examined using molecular biological tools. MEASUREMENTS AND MAIN RESULTS Intratracheal administration of AdHSP to rats with cecal ligation and double puncture limited nuclear translocation of NF-kappaB and attenuated phosphorylation of IkappaBalpha. AdHSP treatment reduced, but did not eliminate, phosphorylation of the beta-subunit of IkappaB kinase. In vitro kinase activity assays and gel filtration chromatography revealed that treatment of sepsis-induced lung injury with AdHSP induced fragmentation of the IkappaB kinase signalosome. This stabilized intermediary complexes containing IkappaB kinase components, IkappaBalpha, and NF-kappaB. Cellular studies indicate that although ubiquitination of IkappaBalpha was maintained, proteasomal degradation was impaired by an indirect mechanism. CONCLUSIONS Treatment of sepsis-induced lung injury with AdHSP limits NF-kappaB activation. This results from stabilization of intermediary NF-kappaB/IkappaBalpha/IkappaB kinase complexes in a way that impairs proteasomal degradation of IkappaBalpha. This novel mechanism by which Hsp70 attenuates an intracellular process may be of therapeutic value.
Collapse
Affiliation(s)
- Yoram G Weiss
- Department of Anesthesiology and Critical Care Medicine and the Goldyne Savad Institute of Gene Therapy, Hadassah Hebrew University School of Medicine, Jerusalem, Israel.
| | | | | | | | | | | | | |
Collapse
|
22
|
Affiliation(s)
- L J Badcock
- Department of Rheumatology, Derbyshire Royal Infirmary, London Road, Derby DE1 2QY
| | | | | | | |
Collapse
|
23
|
Raj N, Badcock LJ, Brown GA, Deighton CM, O'Reilly SC. Undergraduate musculoskeletal examination teaching by trained patient educators--a comparison with doctor-led teaching. Rheumatology (Oxford) 2006; 45:1404-8. [PMID: 16613915 DOI: 10.1093/rheumatology/kel126] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND To compare the core hand and knee examination skills gained by undergraduates taught either by trained patient educators (PEs) or by doctors. METHODS A total of 50 final year medical students were randomized to receive training from PEs or doctors. Group A were taught hand examination by a PE with rheumatoid arthritis, and knee examination by a PE with osteoarthritis. Group B was taught hand and knee examination by a consultant rheumatologist plus an untrained patient with appropriate signs. All students were taught an established core skills set in small group workshops. Students then undertook two validated objective structured clinical examination (OSCE) stations with two blinded assessors. Pre- and post-teaching questionnaires established the students' self-reported levels of skills (SRS) and a student evaluation of teaching (SET). The study was analysed as an equivalence trial. A mean difference in OSCE scores of 10% was assumed to be of educational significance. RESULTS Although the SET scores of both groups were high, the doctor-led group received higher scores. Aside from this, the two student groups did not differ significantly. There were no significant differences in mean hand OSCE (mean difference = 0.88, P = 0.28, 95% CI = -0.73 to 2.49) or knee OSCE (mean difference = 0.28, P = 0.7, 95% CI = -1.19 to 1.75) scores. Both the upper and lower confidence intervals for each mean difference fell within the 10% range (-2.8 to 2.8 for the hand, and -2.5 to 2.5 for the knee) and equivalence was assumed. CONCLUSIONS Adequately trained PEs can deliver clearly structured undergraduate skills, teaching with equivalent learning outcomes to those of rheumatology consultants. PEs are a valuable development to augment musculoskeletal education in the face of expanding student numbers.
Collapse
Affiliation(s)
- N Raj
- Rheumatology, Derbyshire Royal Infirmary, Derby, East Midlands, UK.
| | | | | | | | | |
Collapse
|
24
|
Raj N, Sehgal A, Hall JE, Sharma A, Murrin KR, Groves ND. Comparison of the analgesic efficacy and plasma concentrations of high-dose intra-articular and intramuscular morphine for knee arthroscopy. Eur J Anaesthesiol 2005; 21:932-7. [PMID: 15719855 DOI: 10.1017/s0265021504000304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVE It is important to provide good postoperative analgesia after discharge from day case surgery. The usefulness of intra-articular morphine for analgesia after day case knee arthroscopy remains controversial. A large dose of morphine intra-articularly may provide a good long-lasting analgesia, but its efficacy and pharmacokinetics are not known and may be no better than intramuscular morphine. We compared the effect of 10 mg intra-articular and intramuscular morphine for 24 h post-injection in a randomized double-blind study. METHODS Forty adults undergoing knee arthroscopy were recruited and received either 10mg morphine intra-articularly or intramuscularly. Our primary outcome was overall visual analogue assessment of pain (0-100 mm scale where 0 is no pain and 100 is worst possible pain) between 4 h (on discharge) and 24 h (post-operatively). Plasma morphine concentrations were measured at 15 min, and 1, 2, 4 and 24 h. The use of additional analgesia was noted. RESULTS The assessment of pain experienced between discharge (4 h) and 24 h was significantly better in the intra-articular (n = 20; mean+/-SD: 18+/-19) than the intramuscular (n = 19; mean+/-SD: 34+/-20) group (P = 0.027). The number of patients consuming any additional analgesia between discharge and 24 h was significantly lower in the intra-articular morphine group (P = 0.038), with 4 (20%) patients in the intra-articular group and 11 (60%) patients in the intramuscular group consuming supplementary analgesia. There were no differences in plasma morphine concentrations between the groups. CONCLUSIONS A large dose of intra-articular morphine provided better analgesia than the same dose of intramuscular morphine, low plasma morphine levels suggesting a peripheral mechanism.
Collapse
Affiliation(s)
- N Raj
- University Hospital of Wales, Department of Anaesthetics and Intensive Care Medicine, Cardiff, UK.
| | | | | | | | | | | |
Collapse
|
25
|
Raj N, Macmillan RD, Ellis IO, Deighton CM. Rheumatologists and breasts: immunosuppressive therapy for granulomatous mastitis. Rheumatology (Oxford) 2004; 43:1055-6. [PMID: 15258294 DOI: 10.1093/rheumatology/keh246] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
26
|
Raj N, Henderson KA, Hall JE, Aguilera IM, Harmer M, Hutchings A, Williams B. Evaluation of personal, environmental and biological exposure of paediatric anaesthetists to nitrous oxide and sevoflurane. Anaesthesia 2003; 58:630-6. [PMID: 12790811 DOI: 10.1046/j.1365-2044.2003.03235.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Paediatric anaesthetists are at higher risk of exposure to waste anaesthetic gases, which often exceed set safety limits. Recommended personal diffusive sampling techniques for monitoring exposure to waste anaesthetic gases may not give a true profile of exposure and hence biological sampling may also be necessary. We evaluated the exposure of paediatric anaesthetists to nitrous oxide and sevoflurane as assessed by personal environmental and biological samples. The influence of venue and technique, and the strength of the relationship among the various sampling techniques were analysed. The study found that exposure to nitrous oxide during paediatric anaesthetic inductions is still a major problem, although exposure to sevoflurane was usually within the accepted limits. The type of breathing system used and the presence of scavenging seem to influence this exposure, though surprisingly, the induction technique or the methods of airway control do not. No significant relationship was found between the various biological indicators measured.
Collapse
Affiliation(s)
- N Raj
- Department of Anaesthetics, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XN, UK
| | | | | | | | | | | | | |
Collapse
|
27
|
|
28
|
Wilkes AR, Raj N, Hall JE. Adverse airway events during brief nasal inhalations of volatile anaesthetics: the effect of humidity and repeated exposure on incidence in volunteers preselected by response to desflurane. Anaesthesia 2003; 58:207-16. [PMID: 12603450 DOI: 10.1046/j.1365-2044.2003.02965.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Twelve volunteers known to have airways that responded adversely to 2.0 MAC desflurane were recruited. Each volunteer inhaled three single breaths of each of 0.5, 1.0 and 2.0 MAC of sevoflurane, halothane, isoflurane, desflurane and balance air, with breaths of air between, whilst breathing nasally through a face mask attached to one of three filters that provided three different levels of humidification. The incidence of any adverse airway events was recorded. The anaesthetic inhaled significantly affected the incidence of adverse airway events (p < 0.001), with the least to most irritant being sevoflurane, halothane, isoflurane and desflurane. Increasing the concentration of anaesthetic also significantly increased the incidence of adverse airway events (p < 0.001). The filter used, and hence the level of humidification, did not affect the incidence of adverse airway events (p = 0.09), but repeated exposure caused a significant reduction in the incidence of adverse airway events (p < 0.001).
Collapse
Affiliation(s)
- A R Wilkes
- Association of Anaesthetists of Great Britain and Ireland
| | | | | |
Collapse
|
29
|
Abstract
Where practicable, exposure to a hazardous substance should be eliminated or adequately controlled. A postal questionnaire survey was sent to 10% of consultants from the Association of Anaesthetists of Great Britain and Ireland, to identify the level of use of nitrous oxide in current anaesthetic practice and identify any change of practice over the last 5 years. Details of anaesthetic practice were requested in three areas: nitrous oxide usage, availability of medical air on anaesthetic machines and the use of total intravenous anaesthesia. Replies were received from 320 consultants (75%). Of these, 49% felt that, over the last 5 years, their use of nitrous oxide had decreased. Twenty per cent of anaesthetists felt that there should be some restriction in availability of nitrous oxide. Where medical air was available, 32% felt that they would use it frequently. A total of 263 (83%) stated that they use total intravenous anaesthesia to some extent. The results showed that, although 49% of consultant anaesthetists had reduced their use of nitrous oxide, this was due to medical considerations rather than concerns over health and pollution issues arising from the use of nitrous oxide.
Collapse
Affiliation(s)
- K A Henderson
- Health, Safety and Environment Unit, University of Wales College of Medicine, Heath Park Cardiff, UK
| | | | | |
Collapse
|
30
|
Weiss YG, Maloyan A, Tazelaar J, Raj N, Deutschman CS. Adenoviral transfer of HSP-70 into pulmonary epithelium ameliorates experimental acute respiratory distress syndrome. J Clin Invest 2002. [PMID: 12235111 DOI: 10.1172/jci0215888] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The acute respiratory distress syndrome (ARDS) provokes three pathologic processes: unchecked inflammation, interstitial/alveolar protein accumulation, and destruction of pulmonary epithelial cells. The highly conserved heat shock protein HSP-70 can limit all three responses but is not appropriately expressed in the lungs after cecal ligation and double puncture (2CLP), a clinically relevant model of ARDS. We hypothesize that restoring expression of HSP-70 using adenovirus-mediated gene therapy will limit pulmonary pathology following 2CLP. We administered a vector containing the porcine HSP-70 cDNA driven by a CMV promoter (AdHSP) into the lungs of rats subjected to 2CLP or sham operation. Administration of AdHSP after either sham operation or 2CLP increased HSP-70 protein expression in lung tissue, as determined by immunohistochemistry and Western blot hybridization. Administration of AdHSP significantly attenuated interstitial and alveolar edema and protein exudation and dramatically decreased neutrophil accumulation, relative to a control adenovirus. CLP-associated mortality at 48 hours was reduced by half. Modulation of HSP-70 production reduces pathologic changes and may improve outcome in experimental ARDS.
Collapse
Affiliation(s)
- Yoram G Weiss
- Department of Anesthesia, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | | | | |
Collapse
|
31
|
Weiss YG, Maloyan A, Tazelaar J, Raj N, Deutschman CS. Adenoviral transfer of HSP-70 into pulmonary epithelium ameliorates experimental acute respiratory distress syndrome. J Clin Invest 2002; 110:801-6. [PMID: 12235111 PMCID: PMC151132 DOI: 10.1172/jci15888] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The acute respiratory distress syndrome (ARDS) provokes three pathologic processes: unchecked inflammation, interstitial/alveolar protein accumulation, and destruction of pulmonary epithelial cells. The highly conserved heat shock protein HSP-70 can limit all three responses but is not appropriately expressed in the lungs after cecal ligation and double puncture (2CLP), a clinically relevant model of ARDS. We hypothesize that restoring expression of HSP-70 using adenovirus-mediated gene therapy will limit pulmonary pathology following 2CLP. We administered a vector containing the porcine HSP-70 cDNA driven by a CMV promoter (AdHSP) into the lungs of rats subjected to 2CLP or sham operation. Administration of AdHSP after either sham operation or 2CLP increased HSP-70 protein expression in lung tissue, as determined by immunohistochemistry and Western blot hybridization. Administration of AdHSP significantly attenuated interstitial and alveolar edema and protein exudation and dramatically decreased neutrophil accumulation, relative to a control adenovirus. CLP-associated mortality at 48 hours was reduced by half. Modulation of HSP-70 production reduces pathologic changes and may improve outcome in experimental ARDS.
Collapse
Affiliation(s)
- Yoram G Weiss
- Department of Anesthesia, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | | | | |
Collapse
|
32
|
Abstract
Although widely regarded as a disease of women, osteoporosis does cause considerable morbidity and mortality in men. The lifetime risk of an osteoporortic fracture for a man is 1 in 12 and 30% of all hip fractures occur in men. In women, low-trauma distal forearm fracture is widely regarded as a typical early manifestation of postmenopausal osteoporosis. Traditionally, this has not been thought to be the case for men. We present a case-control study of 147 men with distal forearm fracture compared with 198 age-matched controls. The controls were selected from a pre-existing database of dual-energy X-ray absorptiometry scans of healthy volunteers. Both groups were sent questionnaires regarding basic demographics, fracture history and risk factors for osteoporosis, and the fracture group was asked to attend for bone densitometry. There were 103 responses from the fracture group (70%), of whom 67 (47%) underwent densitometry. There were 165 (83%) responses from the control group. Secondary causes of osteoporosis could be identified in 51% of the fracture group and 37% of the control group. The fracture group had significantly lower bone mineral density at all sites measured compared with the controls (0.75 g/cm(2) vs 0.85 g/cm(2) at the femoral neck, p<0.0001; 0.95 g/cm(2) vs 1.03 g/cm(2) at the total femur, p = 0.001; and 0.99 g/cm(2) vs 1.06 g/cm(2) at the lumbar spine, p = 0.001). These differences remained after adjusting for age and body mass index ( p<0.0005 at all sites). Overall, 41.8% of the fracture group were osteoporotic in at least one site ( T-score <-2.5 SD below the mean for young men) compared with only 10.3% of controls. This study is the first to demonstrate that men with distal forearm fractures have lower bone mineral density than their peers and a higher risk of osteoporosis.
Collapse
Affiliation(s)
- S P Tuck
- Derbyshire Royal Infirmary, Derby, UK.
| | | | | |
Collapse
|
33
|
Weiss YG, Tazelaar J, Gehan BA, Bouwman A, Christofidou-Solomidou M, Yu QC, Raj N, Deutschman CS. Adenoviral vector transfection into the pulmonary epithelium after cecal ligation and puncture in rats. Anesthesiology 2001; 95:974-82. [PMID: 11605941 DOI: 10.1097/00000542-200110000-00029] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Adenoviral-targeted gene delivery to respiratory epithelium can augment production of specific proteins. Therefore, it may be valuable in treating the acute respiratory distress syndrome. The authors tested the hypothesis that adenoviral vector uptake after cecal ligation and double puncture in rats, an animal model of the acute respiratory distress syndrome, is higher than that observed in controls that did not undergo operation ("nonoperated") or those that underwent a sham operation ("sham-operated"). METHODS Adenoviruses expressing green fluorescent protein or Lac-Z were delivered into the lungs of anesthetized rats via tracheal catheter. Animals were killed 24 or 48 h later. Histopathology and green fluorescent protein expression were examined using light of fluorescence microscopy. Cellular localization of Lac-Z was determined with electron microscopy or semithin sectioning. Viral receptor density and localization were determined using imunoblotting and immunohistochemistry. RESULTS After cecal ligation and double puncture, rats were hypoxic and tachypneic. Alveoli were segmentally consolidated, contained proteinaceous debris and neutrophils, and had thickened septa. Administration of adenoviruses to rats that were sham-operated or underwent cecal ligation and double puncture resulted in high levels of marker protein expression in cells lining alveoli. Use of 3 x 10(11) plaque-forming units instead of 3 x 10(12) plaque-forming units resulted in similar levels of green fluorescent protein expression with negligible viral-mediated lymphocytic infiltration. Semithin section and electron microscopy revealed expression primarily localized to type II alveolar cells. Abundance of alpha(v)beta3 integrins and human coxsackie-adenovirus receptor (receptors that modulate viral attachment and internalization) was increased after cecal ligation and double puncture, predominantly in type II pneumocytes. CONCLUSIONS Cecal ligation and double puncture induces histologic and functional changes consistent with the acute respiratory distress syndrome, increases surface expression of viral receptors, and enhances adenoviral-mediated gene transfer.
Collapse
Affiliation(s)
- Y G Weiss
- Department of Anesthesia, University of Pennsylvania School of Medicine, Philadelphia, USA
| | | | | | | | | | | | | | | |
Collapse
|
34
|
Chen J, Raj N, Kim P, Andrejko KM, Deutschman CS. Intrahepatic nuclear factor-kappa B activity and alpha 1-acid glycoprotein transcription do not predict outcome after cecal ligation and puncture in the rat. Crit Care Med 2001; 29:589-96. [PMID: 11373425 DOI: 10.1097/00003246-200103000-00021] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Sepsis is the leading cause of death in critically ill surgical patients. Septic hepatic dysfunction, an important determinant of outcome, is poorly understood but includes inappropriate transcriptional down-regulation. This may be modulated by proinflammatory cytokines. We hypothesized that intrahepatic changes in tumor necrosis factor (TNF)/interleukin (IL)-1-linked processes, such as the activation of the p50 homodimeric and the p65/p50 heterodimeric isoforms of the transcription factor nuclear factor (NF)-kappaB or transcription of the acute phase reactant alpha1-acid glycoprotein (AGP), would correlate with recovery from sepsis. DESIGN Prospective experimental comparison of sham operation and nonlethal and lethal sepsis in male Sprague-Dawley rats. INTERVENTIONS Nonlethal sepsis was induced by using single-puncture cecal ligation and puncture (CLP). Lethal sepsis was induced via double-puncture CLP. NF-kappaB DNA binding activity was determined by using electrophoretic mobility shift analysis with differentiation of p50/p50 and p50/p65 isoforms by using appropriate antibodies. AGP transcription was assessed with transcription elongation analysis, intrahepatic IL-1beta, and TNF-alpha abundance by using immunohistochemistry, and serum IL-1beta was assessed by using ELISA. MAIN RESULTS Overall NF-kappaB activity increased equivalently over time after both single- and double-puncture CLP, with a peak occurring 3 hrs after intervention. In single-puncture CLP, there was an increase in the binding of the p50 homodimer form over time. After double-puncture CLP, no such change was observed. AGP transcription was increased equivalently in both models. Intrahepatic IL-1beta was detected 16 and 24 hrs after single-puncture CLP and 6 hrs after double-puncture CLP. After double-puncture CLP, intrahepatic TNF-alpha was detected at 6, 16, and 24 hrs. Serum IL-1beta was undetectable after both single- and double-puncture CLP. CONCLUSIONS Although AGP transcription was similar in mild and fulminant sepsis, double-puncture CLP increased the binding activity of the p50 homodimer relative to binding of the p50/p65 NF-kappaB heterodimer. These results imply that transcriptional activity not linked to acute phase responses is an important determinant of outcome in sepsis.
Collapse
Affiliation(s)
- J Chen
- Department of Anesthesia, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | | | | | | | | |
Collapse
|
35
|
Weiss YG, Bellin L, Kim PK, Andrejko KM, Haaxma CA, Raj N, Furth EE, Deutschman CS. Compensatory hepatic regeneration after mild, but not fulminant, intraperitoneal sepsis in rats. Am J Physiol Gastrointest Liver Physiol 2001; 280:G968-73. [PMID: 11292606 DOI: 10.1152/ajpgi.2001.280.5.g968] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Sepsis is the leading cause of death in surgical intensive care units. Although both mild sepsis secondary to cecal ligation and single puncture (CLP) and fulminant, double puncture CLP (2CLP) may provoke hepatocyte death, we hypothesize that regeneration compensates for cell death after CLP but not 2CLP. In male Sprague-Dawley rats, hepatic necrosis, as determined by serum alpha-glutathione S-transferase (alpha-GST) levels, was significantly but equally elevated over time after both CLP and 2CLP. Apoptosis, evaluated using both terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling and morphological examination, was minimal after both CLP and 2CLP. Regeneration, assayed by staining tissue for incorporation of exogenously administered bromodeoxyuridine, was present after CLP but not after 2CLP. To further substantiate impaired regeneration, steady-state levels of mRNAs encoding JunB, LRF-1, and cyclin D1 were determined. After 2CLP, the absence of JunB, LRF-1, and cyclin D1 mRNAs confirmed failed activation of the mitogen-activated protein kinase-linked proliferative pathway and progression through the cell cycle. Therefore, failed hepatocyte regeneration may be a manifestation of hepatic dysfunction in fulminant sepsis.
Collapse
Affiliation(s)
- Y G Weiss
- Department of Anesthesia, University of Pennsylvania School of Medicine, 3400 Spruce Street, Philadelphia, PA 19104-4283, USA
| | | | | | | | | | | | | | | |
Collapse
|
36
|
|
37
|
Affiliation(s)
- N Raj
- Department of Rheumatology, Blackburn Royal Infirmary, Bolton Road, Blackburn BB2 3LR, UK
| | | | | | | |
Collapse
|
38
|
Weiss YG, Bouwman A, Gehan B, Schears G, Raj N, Deutschman CS. Cecal ligation and double puncture impairs heat shock protein 70 (HSP-70) expression in the lungs of rats. Shock 2000; 13:19-23. [PMID: 10638664 DOI: 10.1097/00024382-200013010-00004] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Induction of the heat shock response may improve outcome from pathophysiological disturbances. This improvement is associated with and believed to result from expression of heat shock protein (HSP)-70. Therefore, we examined the temporal expression of HSP-70 in an animal model of acute respiratory distress syndrome (ARDS) secondary to fecal peritonitis. Specifically, we hypothesize that sepsis in rats impairs pulmonary HSP-70 expression. ARDS was induced in adolescent rats via cecal ligation and double puncture (2CLP). Sham-operated animals served as controls. Lung tissue was collected 0, 3, 6, 16, 24, and 48 h after 2CLP and sham operation. Northern blot hybridization analysis was performed to detect steady-state HSP-70 messenger ribonucleic (mRNA) levels. HSP-70 protein levels were determined via immunoblotting and immunohistochemistry. Mortality after 2CLP was 50% at 24 h and 75% at 48 h. Northern blot hybridization analysis revealed no significant change in steady-state HSP-70 mRNA levels in lung at any time after 2CLP. HSP-70 steady-state mRNA levels increased after sham operation and was higher than values in 2CLP at 6, 16, and 24 h. HSP-70 protein levels did not change over time in either group. Thus, the expression of HSP-70 does not change after 2CLP. Although lack of an increase in protein levels may be adaptive after sham operation, it is not appropriate after 2CLP. Therefore, failed HSP-70 expression represents a form of pulmonary epithelial dysfunction that may contribute to lung injury in sepsis.
Collapse
Affiliation(s)
- Y G Weiss
- Department of Anesthesia, University of Pennsylvania School of Medicine, Philadelphia 19104-4283, USA
| | | | | | | | | | | |
Collapse
|
39
|
Abstract
This prospective, randomised double-blinded study was designed to assess the analgesic efficacy and occurrence of nausea when tramadol is added to a nonsteroidal anti-inflammatory drug to provide analgesia following day-case third molar teeth extraction. All patients received oral diclofenac pre-operatively and one of four treatments intra-operatively: fentanyl and metoclopramide, tramadol and metoclopramide, fentanyl and ondansetron, or tramadol and ondansetron. There were no significant differences between groups in scores for pain in the early postoperative period. However, there were significant differences in nausea scores at this time, with the fentanyl-ondansetron group having the lowest and the tramadol-ondansetron group having the highest scores. There were no significant differences in the incidence of pain or nausea in the following 24 h. We conclude that the addition of tramadol to diclofenac results in no useful improvement in analgesic effect, and that the use of ondansetron fails to reduce the nausea associated with tramadol.
Collapse
Affiliation(s)
- I J Broome
- Department of Anaesthetics, Falkirk and District Royal Infirmary, UK
| | | | | | | | | |
Collapse
|
40
|
|
41
|
Pandey VK, Raj N. Synthesis of alpha-methyl-benzamido-alpha'-substituted styryl cyclohexanone thiosemicarbazones as potential antifertility agents. Pharmacol Res Commun 1986; 18:923-33. [PMID: 3809235 DOI: 10.1016/0031-6989(86)90096-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Cyclohexanone was condensed with N-hydroxymethyl benzamide in conc. sulphuric acid to give alpha-methyl-benzamido-cyclohexanone (I). The reaction of (I) with thiosemicarbazide in ethanol resulted in alpha-methyl-benzamido-cyclohexanone thiosemicarbazone (II). Condensation of (II) with various aromatic aldehydes in the presence of ethanol afforded alpha-methyl-benzamido-alpha'-substituted-styryl-cyclohexanone thiosemicarbazones (III) in yields ranging from 40 to 50 percent. The compounds exhibited pronounced antiimplantation activity in female albino rats.
Collapse
|
42
|
Raj N. The homoeopathic treatment of cholera; a historical study. Bull Indian Inst Hist Med Hyderabad 1978; 8:39-43. [PMID: 11613634] [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: 04/17/2023]
|
43
|
Raj N, Raghunathan K. Reflections from the life of Dr. Karl Julius Aegidi, the founder of the first Paediatric Homeopathic Hospital. Bull Indian Inst Hist Med Hyderabad 1977; 7:45-50. [PMID: 11610469] [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: 02/21/2023]
|
44
|
Raj N, Raghunathan K. Edward Bach; a medico-historical study of his contributions to homeopathy. Bull Indian Inst Hist Med Hyderabad 1977; 7:51-62. [PMID: 11610471] [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: 02/21/2023]
|