1
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Patel SN, Thompson D, Roth N, Grodstein E. Cutaneous and renal aspergillosis resulting from orthotopic liver transplantation. BMJ Case Rep 2023; 16:e256974. [PMID: 37993141 PMCID: PMC10668145 DOI: 10.1136/bcr-2023-256974] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023] Open
Affiliation(s)
- Shreeja Nirav Patel
- Medical School, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Dane Thompson
- Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Nitzan Roth
- Department of Hepatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Elliot Grodstein
- Department of Transplant Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
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2
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Roth N, Goodwin A. Tuning electronic and phonon bands through disorder. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322091926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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3
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Støckler K, Roth N, Grønbech T, Iversen B. Epitaxial intergrowths and local oxide displacements in natural bixbyite. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322095791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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4
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Jiang Y, Da BL, Satiya J, Heda RP, Lau LF, Fahmy A, Winnick A, Roth N, Grodstein E, Thuluvath PJ, Singal AK, Schiano TD, Teperman LW, Satapathy SK. Outcomes after Liver Transplantation with Steatotic Grafts: Redefining Acceptable Cutoffs for Steatotic Grafts. Euroasian J Hepatogastroenterol 2022; 12:S5-S14. [DOI: 10.5005/jp-journals-10018-1361] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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5
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Lee BP, Roth N, Rao P, Im GY, Vogel AS, Hasbun J, Roth Y, Shenoy A, Arvelakis A, Ford L, Dawe I, Schiano TD, Davis JP, Rice JP, Eswaran S, Weinberg E, Han H, Hsu C, Fix OK, Maddur H, Ghobrial RM, Therapondos G, Dilkina B, Terrault NA. Artificial intelligence to identify harmful alcohol use after early liver transplant for alcohol-associated hepatitis. Am J Transplant 2022; 22:1834-1841. [PMID: 35416409 PMCID: PMC9541176 DOI: 10.1111/ajt.17059] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/13/2022] [Accepted: 04/10/2022] [Indexed: 01/25/2023]
Abstract
Early liver transplantation (LT) for alcohol-associated hepatitis (AH) is the fastest growing indication for LT, but prediction of harmful alcohol use post-LT remains limited. Among 10 ACCELERATE-AH centers, we examined psychosocial evaluations from consecutive LT recipients for AH from 2006 to 2017. A multidisciplinary panel used content analysis to develop a maximal list of psychosocial variables. We developed an artificial intelligence model to predict post-LT harmful alcohol use. The cohort included training (N = 91 among 8 centers) and external validation (N = 25 among 2 centers) sets, with median follow-up of 4.4 (IQR 3.0-6.0) years post-LT. In the training set, AUC was 0.930 (95%CI 0.862-0.998) with positive predictive value of 0.891 (95%CI 0.620-1.000), internally validated through fivefold cross-validation. In the external validation set, AUC was 0.692 (95%CI 0.666-0.718) with positive predictive value of 0.82 (95%CI 0.625-1.000). The model identified specific variables related to social support and substance use as highly important to predict post-LT harmful alcohol use. We retrospectively developed and validated a model that identified psychosocial profiles at LT predicting harmful alcohol use post-LT for AH. This preliminary model may inform selection and post-LT management for AH and warrants prospective evaluation in larger studies among all alcohol-associated liver disease being considered for early LT.
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Affiliation(s)
- Brian P. Lee
- University of Southern California Keck School of MedicineLos AngelesCaliforniaUSA
| | | | - Prathik Rao
- University of Southern California Keck School of MedicineLos AngelesCaliforniaUSA
| | - Gene Y. Im
- Mount Sinai Icahn School of MedicineNew York CityNew YorkUSA
| | | | - Johann Hasbun
- New York University Grossman School of MedicineNew York CityNew YorkUSA
| | - Yoel Roth
- Twitter IncSan FranciscoCaliforniaUSA
| | - Akhil Shenoy
- Columbia University Vagelos College of Physicians and SurgeonsNew York CityNew YorkUSA
| | | | - Laura Ford
- Mount Sinai Icahn School of MedicineNew York CityNew YorkUSA
| | - Inga Dawe
- Mount Sinai Icahn School of MedicineNew York CityNew YorkUSA
| | | | - Jordan P. Davis
- University of Southern California Keck School of MedicineLos AngelesCaliforniaUSA
| | | | | | - Ethan Weinberg
- University of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvaniaUSA
| | - Hyosun Han
- University of Southern California Keck School of MedicineLos AngelesCaliforniaUSA
| | - Christine Hsu
- Georgetown School of MedicineWashingtonDistrict of ColumbiaUSA
| | - Oren K. Fix
- University of North Carolina at Chapel Hill School of MedicineChapel HillNorth CarolinaUSA
| | - Haripriya Maddur
- Northwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | | | | | - Bistra Dilkina
- University of Southern California Keck School of MedicineLos AngelesCaliforniaUSA
| | - Norah A. Terrault
- University of Southern California Keck School of MedicineLos AngelesCaliforniaUSA
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6
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Roth N, Khalil N, Moore-Gillon C, James D, Gilby L, Morgan C. 737 STOOLS FOR STOOLS - COMBINING MEDICAL AND CONSERVATIVE TREATMENTS TO REDUCE CONSTIPATION IN THE ELDERLY INPATIENT POPULATION. Age Ageing 2022. [DOI: 10.1093/ageing/afac034.737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Constipation is a common cause of morbidity in the elderly. Its management is particularly challenging in the inpatient population, where many factors exacerbate constipation. We describe a Quality Improvement Project to reduce the rates of constipation on a female Medicine for the Elderly ward.
Aims
Our aim was to increase bowel chart documentation (nursing and doctor entries) and increase patient frequency of bowel motions to at least once every two days. In particular we focused on conservative measures such as the use of footstools to optimise posture when using commodes and toilets [R Hari Krishnan, Proc Inst Mech Eng H, 2019, 233(4):464–475].
Method
• Weekly monitoring of ward inpatients. • Measurements taken were: days since last bowel motion, laxatives prescribed, bowel chart and ward round documentation, and episodes of diarrhoea over the past week. • One episode of diarrhoea was defined as 3 motions of type 6 or type 7 stool in 24 hours. • A new intervention was introduced every two weeks, over a total of 2 months. Interventions: 1. Recording bowel motions at the daily ‘Board Round’ Multi-Disciplinary Meeting. 2. Ward staff education sessions. 3. Footstools for use with commodes and toilets. 4. High-fibre foods to patients with constipation.
Results
Level of constipation was successfully reduced, with 100% patients moving bowels every 2 days from a baseline of 68%. Ward round and bowel chart documentation improved to 100% and 93.3% respectively (from 41.3% and 33.3%). However, incidence of diarrhoea increased from 0 episodes/week to 8 episodes/week, with laxative prescriptions similarly increased from 50% to 86%.
Conclusion
Constipation improved with our interventions, but at the unintended cost of laxative-associated diarrhoea. Our next steps will be to reduce laxative prescriptions in favour of conservative measures, in order to reduce episodes of loose stool while maintaining our improved constipation rates.
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Affiliation(s)
- N Roth
- Department for Medicine for the Elderly, St. Mary’s Hospital, Imperial College Healthcare NHS Trust
| | - N Khalil
- Department for Medicine for the Elderly, St. Mary’s Hospital, Imperial College Healthcare NHS Trust
| | - C Moore-Gillon
- Department for Medicine for the Elderly, St. Mary’s Hospital, Imperial College Healthcare NHS Trust
| | - D James
- Department for Medicine for the Elderly, St. Mary’s Hospital, Imperial College Healthcare NHS Trust
| | - L Gilby
- Department for Medicine for the Elderly, St. Mary’s Hospital, Imperial College Healthcare NHS Trust
| | - C Morgan
- Department for Medicine for the Elderly, St. Mary’s Hospital, Imperial College Healthcare NHS Trust
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7
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Bernstein D, Roth N, Kim A, Epstein M, Hirschwerk D, Kvasnovsky CL, Satapathy SK. Presentation, patterns and predictive value of baseline liver tests on outcomes in COVID-19 patients without chronic liver disease. World J Gastroenterol 2021; 27:7350-7361. [PMID: 34876794 PMCID: PMC8611205 DOI: 10.3748/wjg.v27.i42.7350] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 07/12/2021] [Accepted: 10/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) infection is known to cause abnormal hepatic enzymes. The long term consequences of such elevations are uncertain.
AIM To assessed the prevalence and prognostic value of initial liver enzymes in a large cohort of COVID-19 patients.
METHODS We reviewed electronic medical records of 10614 COVID-19 patients without known chronic liver disease who were admitted to our health system from March 1, 2020, to April 30, 2020. We analyzed baseline demographics and liver chemistries. The primary outcome was in-hospital mortality, and the secondary outcome was a composite of in-hospital mortality or need for mechanical ventilation.
RESULTS Subjects with abnormal liver tests had increased risks of mortality and composite outcome when compared to patients with normal measurements on unadjusted analysis and after adjustment for demographic factors.
CONCLUSION In our diverse patient population, liver enzyme abnormalities are associated with increased mortality and the need for mechanical ventilation in subjects without chronic liver disease. Cholestasis patients are at the greatest risk for poor outcomes.
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Affiliation(s)
- David Bernstein
- Department of Medicine/Hepatology, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY 11030, United States
| | - Nitzan Roth
- Department of Medicine/Hepatology, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY 11030, United States
| | - Angela Kim
- Division of Infectious Diseases, Department of Medicine Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY 11030, United States
| | - Marcia Epstein
- Division of Infectious Diseases, Department of Medicine Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY 11030, United States
| | - David Hirschwerk
- Division of Infectious Diseases, Department of Medicine Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY 11030, United States
| | - Charlotte L Kvasnovsky
- Cohen Children's Medical Center, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY 11042, United States
| | - Sanjaya K Satapathy
- Department of Medicine/Hepatology, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY 11030, United States
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8
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Da BL, Suchman K, Roth N, Rizvi A, Vincent M, Trindade AJ, Bernstein D, Satapathy SK. Cholestatic liver injury in COVID-19 is a rare and distinct entity and is associated with increased mortality. J Intern Med 2021; 290:470-472. [PMID: 33786906 PMCID: PMC8250628 DOI: 10.1111/joim.13292] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/04/2021] [Accepted: 03/24/2021] [Indexed: 12/11/2022]
Affiliation(s)
- B L Da
- From the, Division of Hepatology, North Shore University Hospital, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY, USA
| | - K Suchman
- Department of Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY, USA
| | - N Roth
- From the, Division of Hepatology, North Shore University Hospital, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY, USA
| | - A Rizvi
- Division of Gastroenterology, Long Island Jewish Medical Center, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, New Hyde Park, NY, USA
| | - M Vincent
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - A J Trindade
- Department of Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY, USA
| | - D Bernstein
- From the, Division of Hepatology, North Shore University Hospital, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY, USA
| | - S K Satapathy
- From the, Division of Hepatology, North Shore University Hospital, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY, USA
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9
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Nair V, Jandovitz N, Hirsch JS, Abate M, Satapathy SK, Roth N, Miyara SJ, Guevara S, Kressel AM, Xiang A, Wu G, Butensky SD, Lin D, Williams S, Bhaskaran MC, Majure DT, Grodstein E, Lau L, Nair G, Fahmy AE, Winnick A, Breslin N, Berlinrut I, Molmenti C, Becker LB, Malhotra P, Gautam-Goyal P, Lima B, Maybaum S, Shah SK, Takegawa R, Hayashida K, Shinozaki K, Teperman LW, Molmenti EP. An early experience on the effect of solid organ transplant status on hospitalized COVID-19 patients. Am J Transplant 2021; 21:2522-2531. [PMID: 33443778 PMCID: PMC8206217 DOI: 10.1111/ajt.16460] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 12/04/2020] [Accepted: 12/04/2020] [Indexed: 01/25/2023]
Abstract
We compared the outcome of COVID-19 in immunosuppressed solid organ transplant (SOT) patients to a transplant naïve population. In total, 10 356 adult hospital admissions for COVID-19 from March 1, 2020 to April 27, 2020 were analyzed. Data were collected on demographics, baseline clinical conditions, medications, immunosuppression, and COVID-19 course. Primary outcome was combined death or mechanical ventilation. We assessed the association between primary outcome and prognostic variables using bivariate and multivariate regression models. We also compared the primary endpoint in SOT patients to an age, gender, and comorbidity-matched control group. Bivariate analysis found transplant status, age, gender, race/ethnicity, body mass index, diabetes, hypertension, cardiovascular disease, COPD, and GFR <60 mL/min/1.73 m2 to be significant predictors of combined death or mechanical ventilation. After multivariate logistic regression analysis, SOT status had a trend toward significance (odds ratio [OR] 1.29; 95% CI 0.99-1.69, p = .06). Compared to an age, gender, and comorbidity-matched control group, SOT patients had a higher combined risk of death or mechanical ventilation (OR 1.34; 95% CI 1.03-1.74, p = .027).
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Affiliation(s)
- Vinay Nair
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York,Correspondence Vinay Nair, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY
| | | | - Jamie S. Hirsch
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York,Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York,Department of Information Services, Northwell Health, New Hyde Park, New York
| | - Mersema Abate
- Department of Surgery, Northwell Health, Manhasset, New York
| | - Sanjaya K. Satapathy
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York
| | - Nitzan Roth
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York
| | - Santiago J. Miyara
- North Shore University Hospital, Northwell Health, Manhasset, New York,Department of Surgery, Northwell Health, Manhasset, New York
| | - Sara Guevara
- Department of Surgery, Northwell Health, Manhasset, New York
| | - Adam M. Kressel
- Department of Surgery, Northwell Health, Manhasset, New York
| | - Alec Xiang
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York
| | - Grace Wu
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York
| | - Samuel D. Butensky
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York
| | - David Lin
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York
| | - Stephanie Williams
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York
| | - Madhu C. Bhaskaran
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York
| | - David T. Majure
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York,North Shore University Hospital, Northwell Health, Manhasset, New York
| | - Elliot Grodstein
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York
| | - Lawrence Lau
- North Shore University Hospital, Northwell Health, Manhasset, New York,Long Island Jewish Medical Center, Northwell Health, New Hyde Park, New York
| | - Gayatri Nair
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York
| | - Ahmed E. Fahmy
- North Shore University Hospital, Northwell Health, Manhasset, New York
| | - Aaron Winnick
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York,Department of Surgery, Northwell Health, Manhasset, New York
| | - Nadine Breslin
- North Shore University Hospital, Northwell Health, Manhasset, New York
| | - Ilan Berlinrut
- North Shore University Hospital, Northwell Health, Manhasset, New York,Long Island Jewish Medical Center, Northwell Health, New Hyde Park, New York
| | - Christine Molmenti
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York,Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York
| | - Lance B. Becker
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York,North Shore University Hospital, Northwell Health, Manhasset, New York,Long Island Jewish Medical Center, Northwell Health, New Hyde Park, New York
| | - Prashant Malhotra
- North Shore University Hospital, Northwell Health, Manhasset, New York,Long Island Jewish Medical Center, Northwell Health, New Hyde Park, New York
| | - Pranisha Gautam-Goyal
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York
| | - Brian Lima
- North Shore University Hospital, Northwell Health, Manhasset, New York
| | - Simon Maybaum
- North Shore University Hospital, Northwell Health, Manhasset, New York
| | - Samit K. Shah
- North Shore University Hospital, Northwell Health, Manhasset, New York
| | - Ryosuke Takegawa
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York
| | - Kei Hayashida
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York
| | - Koichiro Shinozaki
- North Shore University Hospital, Northwell Health, Manhasset, New York,Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York,Long Island Jewish Medical Center, Northwell Health, New Hyde Park, New York
| | - Lewis W. Teperman
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York
| | - Ernesto P. Molmenti
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York,Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York
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Gerstein S, Khatri A, Roth N, Wallach F. Coronavirus disease 2019 and extra-pulmonary tuberculosis co-infection - A case report and review of literature. J Clin Tuberc Other Mycobact Dis 2021; 22:100213. [PMID: 33521333 PMCID: PMC7817900 DOI: 10.1016/j.jctube.2021.100213] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic continues to cause significant global morbidity and mortality, leading to the need to study the course of the disease in different clinical circumstances and patient populations. While co-infection between COVID-19 and many pathogens has been reported, there has been limited published research regarding co-infection with Mycobacterium tuberculosis. We describe a case of co-infection involving COVID-19 and extra-pulmonary tuberculosis in a patient with cirrhosis, and review the current literature regarding COVID-19 and tuberculosis co-infection. In spite of several co-morbidities that have been shown to portend a poor prognosis in patients with COVID-19 infection, our patient fully recovered.
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Affiliation(s)
- Shawn Gerstein
- Division of Infectious Diseases, Department of Medicine, Northshore University Hospital, ID Suite, 400 Community Drive, Manhasset, NY 11030, United States
| | - Akshay Khatri
- Division of Infectious Diseases, Department of Medicine, Northshore University Hospital, ID Suite, 400 Community Drive, Manhasset, NY 11030, United States
| | - Nitzan Roth
- North Shore University Hospital, Sandra Atlas Bass Center for Liver Diseases and Transplantation, 400 Community Drive, Manhasset, NY 11030, United States
| | - Frances Wallach
- Division of Infectious Diseases, Department of Medicine, Northshore University Hospital, ID Suite, 400 Community Drive, Manhasset, NY 11030, United States
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11
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Stirrup J, Gregg S, Baavour R, Roth N, Breault C, Agostini D, Ernst S, Underwood SR. Hybrid solid-state SPECT/CT left atrial innervation imaging for identification of left atrial ganglionated plexi: Technique and validation in patients with atrial fibrillation. J Nucl Cardiol 2020; 27:1939-1950. [PMID: 30694425 DOI: 10.1007/s12350-018-01535-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 09/19/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Ablating left atrial (LA) ganglionated plexi (GP), identified invasively by high-frequency stimulation (HFS) during pulmonary vein isolation (PVI), may reduce atrial fibrillation (AF) recurrence. 123I-metaiodobenzylguanidine (123I-mIBG) solid-state SPECT LA innervation imaging (LAII) has the spatial resolution to detect LAGP non-invasively but this has never been demonstrated in clinical practice. METHODS 20 prospective patients with paroxysmal AF scheduled for PVI underwent 123I-mIBG LAII. High-resolution tomograms, reconstructed where possible using cardiorespiratory gating, were co-registered with pre-PVI cardiac CT. Location and reader confidence (1 [low] to 3 [high]) in discrete 123I-mIBG LA uptake areas (DUAs) were recorded and correlated with HFS. RESULTS A total of 73 DUAs were identified, of which 59 (81%) were HFS positive (HFS +). HFS + likelihood increased with reader confidence (92% [score 3]). 64% of HFS-negative DUAs occurred over the lateral and inferior LA. Cardiorespiratory gating reduced the number of DUAs per patient (4 vs 7, P = .001) but improved: HFS + predictive value (76% vs 49%); reader confidence (2 vs 1, P = .02); and inter-observer, intra-observer, and inter-study agreement (κ = 0.84 vs 0.68; 0.82 vs 0.74; 0.64 vs 0.53 respectively). CONCLUSIONS 123I-mIBG SPECT/CT LAII accurately and reproducibly identifies GPs verified by HFS, particularly when reconstructed with cardiorespiratory gating.
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Affiliation(s)
- J Stirrup
- Department of Cardiology, Royal Berkshire Hospital NHS Foundation Trust, Craven Road, Reading, RG1 5AN, United Kingdom.
| | - S Gregg
- Department of Nuclear Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom
| | - R Baavour
- Spectrum Dynamics Medical, Caesarea, Israel
| | - N Roth
- Spectrum Dynamics Medical, Caesarea, Israel
| | - C Breault
- Spectrum Dynamics Medical, Caesarea, Israel
| | - D Agostini
- Department of Nuclear Medicine, CHU Caen and Normandy University EA 4650, Caen, France
| | - S Ernst
- Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom
- Cardiovascular Research Center, Royal Brompton and National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - S R Underwood
- Department of Nuclear Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom
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12
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Nucatola D, Roth N, Gatter M. Corrigendum to "A randomized pilot study on the effectiveness and side-effect profiles of two doses of digoxin as fetocide when administered intraamniotically or intrafetally prior to second-trimester surgical abortion" [Contraception 81 (2010) 67-74]. Contraception 2019; 100:502. [PMID: 31711671 DOI: 10.1016/j.contraception.2019.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 08/07/2019] [Indexed: 11/28/2022]
Affiliation(s)
| | - Nitzan Roth
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Mary Gatter
- Planned Parenthood, Los Angeles, CA 90033, USA
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13
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Yu CY, Roth N, Jani N, Cho J, Van Dam J, Selby R, Buxbaum J. Dynamic liver test patterns do not predict bile duct stones. Surg Endosc 2019; 33:3300-3313. [PMID: 30911921 DOI: 10.1007/s00464-018-06620-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 12/04/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Numerous models have been developed to predict choledocholithiasis. Recent work has shown that these algorithms perform suboptimally. Identification of clinical predictors with high positive and negative predictive value would minimize adverse events associated with unnecessary diagnostic endoscopic retrograde cholangiopancreatography (ERCP) while limiting the use of expensive tests including magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasound (EUS) for indeterminate cases. METHODS Consecutive unique inpatients who received their first ERCP at Los Angeles County Medical Center between January 2010 and November 2016 for suspected bile duct stones were reviewed. The primary outcome was the proportion of patients with specific combinations of liver enzyme patterns, transabdominal ultrasound, and clinical features who had stones confirmed on ERCP. As a secondary outcome, we assessed the performance of the American Society for Gastrointestinal Endoscopy (ASGE) risk stratification algorithm in our population. RESULTS Of the 604 included patients, bile duct stones were confirmed in 410 (67.9%). Detailed assessment of liver enzyme patterns alone and in combination with clinical features and imaging findings yielded no highly predictive algorithms. Additionally, the ASGE high-risk criterion had a positive predictive value of only 68% for stones. For the 236 patients for whom MRCP was performed, this imaging modality was shown to have highest predictive value for the presence of stones on ERCP. CONCLUSION Exhaustive exploration of various threshold values and dynamic patterns of liver enzymes combined with clinical features and basic imaging findings did not reveal an algorithm to accurately predict the presence of stones on ERCP. The ASGE risk stratification criteria were also insensitive in our population. Though desirable, there may be no "perfect" combination of clinical features that correlate with persistent bile duct stones. MRCP or EUS may be considered to avoid unnecessary ERCP and associated complications.
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Affiliation(s)
- Chung Yao Yu
- Department of Medicine, Keck School of Medicine, University of Southern California, D & T Building Room B4H100, 1983 Marengo St, Los Angeles, CA, 90033-1370, USA
| | - Nitzan Roth
- Department of Medicine, Keck School of Medicine, University of Southern California, D & T Building Room B4H100, 1983 Marengo St, Los Angeles, CA, 90033-1370, USA
| | - Niraj Jani
- Department of Medicine, Keck School of Medicine, University of Southern California, D & T Building Room B4H100, 1983 Marengo St, Los Angeles, CA, 90033-1370, USA
| | - Jaehoon Cho
- Department of Medicine, Keck School of Medicine, University of Southern California, D & T Building Room B4H100, 1983 Marengo St, Los Angeles, CA, 90033-1370, USA
| | - Jacques Van Dam
- Department of Medicine, Keck School of Medicine, University of Southern California, D & T Building Room B4H100, 1983 Marengo St, Los Angeles, CA, 90033-1370, USA
| | - Rick Selby
- Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - James Buxbaum
- Department of Medicine, Keck School of Medicine, University of Southern California, D & T Building Room B4H100, 1983 Marengo St, Los Angeles, CA, 90033-1370, USA.
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Tholey D, Roth N, Schiano T. PRO ("The Window Is Open"): In patients with cirrhosis with prior variceal hemorrhage and ascites, the clinical benefits of nonselective beta-blockers outweigh the risks and should be prescribed. Clin Liver Dis (Hoboken) 2018; 11:119-122. [PMID: 30992801 PMCID: PMC6385954 DOI: 10.1002/cld.700] [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: 12/14/2017] [Revised: 01/26/2018] [Accepted: 02/02/2018] [Indexed: 02/04/2023] Open
Affiliation(s)
- Danielle Tholey
- Recanati/Miller Transplantation Institute, Division of Liver DiseasesMount Sinai Medical CenterNew YorkNY
| | - Nitzan Roth
- Recanati/Miller Transplantation Institute, Division of Liver DiseasesMount Sinai Medical CenterNew YorkNY
| | - Thomas Schiano
- Recanati/Miller Transplantation Institute, Division of Liver DiseasesMount Sinai Medical CenterNew YorkNY
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Cahn P, Kaplan R, Sax PE, Squires K, Molina JM, Avihingsanon A, Ratanasuwan W, Rojas E, Rassool M, Bloch M, Vandekerckhove L, Ruane P, Yazdanpanah Y, Katlama C, Xu X, Rodgers A, East L, Wenning L, Rawlins S, Homony B, Sklar P, Nguyen BY, Leavitt R, Teppler H, Cahn PE, Cassetti I, Losso M, Bloch MT, Roth N, McMahon J, Moore RJ, Smith D, Clumeck N, Vanderkerckhove L, Vandercam B, Moutschen M, Baril J, Conway B, Smaill F, Smith GHR, Rachlis A, Walmsley SL, Perez C, Wolff M, Lasso MF, Chahin CE, Velez JD, Sussmann O, Reynes J, Katlama C, Yazdanpanah Y, Ferret S, Durant J, Duvivier C, Poizot-Martin I, Ajana F, Rockstroh JK, Faetkanheuer G, Esser S, Jaeger H, Degen O, Bickel M, Bogner J, Arasteh K, Hartl H, Stoehr A, Rojas EM, Arathoon E, Gonzalez LD, Mejia CR, Shahar E, Turner D, Levy I, Sthoeger Z, Elinav H, Gori A, Monforte AD, Di Perri G, Lazzarin A, Rizzardini G, Antinori A, Celesia BM, Maggiolo F, Chow TS, Lee CKC, Azwa RISR, Mustafa M, Oyanguren M, Castillo RA, Hercilla L, Echiverri C, Maltez F, da Cunha JGS, Neves I, Teofilo E, Serrao R, Nagimova F, Khaertynova I, Orlova-Morozova E, Voronin E, Sotnikov V, Yakovlev AA, Zakharova NG, Tsybakova OA, Botes ME, Mohapi L, Kaplan R, Rassool MS, Arribas JR, Gatell JM, Negredo E, Ortega E, Troya J, Berenguer J, Aguirrebengoa K, Antela A, Calmy A, Cavassini M, Rauch A, Stoeckle M, Sheng WH, Lin HH, Tsai HC, Changpradub D, Avihingsanon A, Kiertiburanakul S, Ratanasuwan W, Nelson MR, Clarke A, Ustianowski A, Winston A, Johnson MA, Asmuth DM, Cade J, Gallant JE, Ruane PJ, Kumar PN, Luque AE, Panther L, Tashima KT, Ward D, Berger DS, Dietz CA, Fichtenbaum C, Gupta S, Mullane KM, Novak RM, Sweet DE, Crofoot GE, Hagins DP, Lewis ST, McDonald CK, DeJesus E, Sloan L, Prelutsky DJ, Rondon JC, Henn S, Scarsella AJ, Morales JO, Ramirez, Santiago L, Zorrilla CD, Saag MS, Hsiao CB. Raltegravir 1200 mg once daily versus raltegravir 400 mg twice daily, with tenofovir disoproxil fumarate and emtricitabine, for previously untreated HIV-1 infection: a randomised, double-blind, parallel-group, phase 3, non-inferiority trial. The Lancet HIV 2017; 4:e486-e494. [DOI: 10.1016/s2352-3018(17)30128-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 06/22/2017] [Accepted: 06/23/2017] [Indexed: 12/20/2022]
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Stirrup J, Voss U, Gregg S, Baavour R, Roth N, Breault C, Underwood S, Ernst S. 63123I-mIBG left atrial innervation imaging localises ganglionated plexi verified by high-frequency stimulation during AF ablation and is affected by reader confidence and uptake location. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.63] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Stirrup J, Voss U, Gregg S, Baavour R, Roth N, Breault C, Underwood S, Ernst S. P2117Systolic exclusion and respiratory gating of SPECT 123I-mIBG left atrial innervation imaging improves localisation of left atrial ganglionated plexi verified during AF ablation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2117] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Buxbaum J, Roth N, Motamedi N, Lee T, Leonor P, Salem M, Gibbs D, Vargo J. Anesthetist-Directed Sedation Favors Success of Advanced Endoscopic Procedures. Am J Gastroenterol 2017; 112:290-296. [PMID: 27402501 DOI: 10.1038/ajg.2016.285] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 06/08/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Sedation is required to perform endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) given the duration and complexity of these advanced procedures. Sedation options include anesthetist-directed sedation (ADS) vs. gastroenterologist-directed sedation (GDS). Although ADS has been shown to shorten induction and recovery times, it is not established whether it impacts likelihood of procedure completion. Our aim was to assess whether ADS impacts the success of advanced endoscopy procedures. METHODS We prospectively assessed the sedation strategy for patients undergoing ERCP and EUS between October 2010 and October 2013. Although assignment to ADS vs. GDS was not randomized, it was determined by day of the week. A sensitivity analysis using propensity score matching was used to model a randomized trial. The main outcome, procedure failure, was defined as an inability to satisfactorily complete the ERCP or EUS such that an additional endoscopic, radiographic, or surgical procedure was required. Failure was further categorized as failure due to inadequate sedation vs. technical problems. RESULTS During the 3-year study period, 60% of the 1,171 procedures were carried out with GDS and 40% were carried out with ADS. Failed procedures occurred in 13.0% of GDS cases compared with 8.9% of ADS procedures (multivariate odds ratio (OR): 2.4 (95% confidence interval (CI): 1.5-3.6)).This was driven by a higher rate of sedation failures in the GDS group, 7.0%, than in the ADS group, 1.3% (multivariate OR: 7.8 (95% CI: 3.3-18.8)). There was no difference in technical success between the GDS and ADS groups (multivariate OR: 1.2 (95% CI: 0.7-1.9)). We were able to match 417 GDS cases to 417 ADS cases based on procedure type, indication, and propensity score. Analysis of the propensity score-matched patients confirmed our findings of increased sedation failure (multivariate OR: 8.9 (95% CI: 2.5-32.1)) but not technical failure (multivariate OR: 1.2 (0.7-2.2)) in GDS compared with ADS procedures. Adverse events of sedation were rare in both groups. Failed ERCP in the GDS group resulted in a total of 93 additional days of hospitalization. We estimate that $67,891 would have been saved if ADS had been used for all ERCP procedures. No statistically significant difference in EUS success was identified, although this sub-analysis was limited by sample size. CONCLUSION ADS improves the success of advanced endoscopic procedures. Its routine use may increase the quality and efficiency of these services.
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Affiliation(s)
- James Buxbaum
- Division of Gastroenterology and Liver Diseases, The University of Southern California, Keck School of Medicine, Los Angeles, California, USA
| | - Nitzan Roth
- Division of Gastroenterology and Liver Diseases, The University of Southern California, Keck School of Medicine, Los Angeles, California, USA
| | - Nima Motamedi
- Division of Gastroenterology and Liver Diseases, The University of Southern California, Keck School of Medicine, Los Angeles, California, USA
| | - Terrance Lee
- Division of Gastroenterology and Liver Diseases, The University of Southern California, Keck School of Medicine, Los Angeles, California, USA
| | - Paul Leonor
- Division of Gastroenterology and Liver Diseases, The University of Southern California, Keck School of Medicine, Los Angeles, California, USA
| | - Mark Salem
- Division of Gastroenterology and Liver Diseases, The University of Southern California, Keck School of Medicine, Los Angeles, California, USA
| | - Dolores Gibbs
- Division of Gastroenterology and Liver Diseases, The University of Southern California, Keck School of Medicine, Los Angeles, California, USA
| | - John Vargo
- Division of Gastroenterology and Liver Diseases, The University of Southern California, Keck School of Medicine, Los Angeles, California, USA
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Ciffroy P, Péry ARR, Roth N. Perspectives for integrating human and environmental exposure assessments. Sci Total Environ 2016; 568:512-521. [PMID: 26672386 DOI: 10.1016/j.scitotenv.2015.11.083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 11/17/2015] [Accepted: 11/17/2015] [Indexed: 05/25/2023]
Abstract
Integrated Risk Assessment (IRA) has been defined by the EU FP7 HEROIC Coordination action as "the mutual exploitation of Environmental Risk Assessment for Human Health Risk Assessment and vice versa in order to coherently and more efficiently characterize an overall risk to humans and the environment for better informing the risk analysis process" (Wilks et al., 2015). Since exposure assessment and hazard characterization are the pillars of risk assessment, integrating Environmental Exposure assessment (EEA) and Human Exposure assessment (HEA) is a major component of an IRA framework. EEA and HEA typically pursue different targets, protection goals and timeframe. However, human and wildlife species also share the same environment and they similarly inhale air and ingest water and food through often similar overlapping pathways of exposure. Fate models used in EEA and HEA to predict the chemicals distribution among physical and biological media are essentially based on common properties of chemicals, and internal concentration estimations are largely based on inter-species (i.e. biota-to-human) extrapolations. Also, both EEA and HEA are challenged by increasing scientific complexity and resources constraints. Altogether, these points create the need for a better exploitation of all currently existing data, experimental approaches and modeling tools and it is assumed that a more integrated approach of both EEA and HEA may be part of the solution. Based on the outcome of an Expert Workshop on Extrapolations in Integrated Exposure Assessment organized by the HEROIC project in January 2014, this paper identifies perspectives and recommendations to better harmonize and extrapolate exposure assessment data, models and methods between Human Health and Environmental Risk Assessments to support the further development and promotion of the concept of IRA. Ultimately, these recommendations may feed into guidance showing when and how to apply IRA in the regulatory decision-making process for chemicals.
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Affiliation(s)
- P Ciffroy
- Electricité de France (EDF) R&D, National Hydraulic and Environment Laboratory, 6 quai Watier, 78400 Chatou, France
| | - A R R Péry
- AgroParisTech, UMR ECOSYS, 78850 Thiverval-Grignon, France; INRA, UMR ECOSYS, 78850 Thiverval-Grignon, France
| | - N Roth
- Swiss Centre for Applied Human Toxicology (SCAHT) Directorate, Regulatory Toxicology Unit, Missionstrasse 64, 4055 Basel, Switzerland
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20
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Roth N, Ciffroy P. A critical review of frameworks used for evaluating reliability and relevance of (eco)toxicity data: Perspectives for an integrated eco-human decision-making framework. Environ Int 2016; 95:16-29. [PMID: 27480485 DOI: 10.1016/j.envint.2016.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 07/16/2016] [Accepted: 07/20/2016] [Indexed: 06/06/2023]
Abstract
Considerable efforts have been invested so far to evaluate and rank the quality and relevance of (eco)toxicity data for their use in regulatory risk assessment to assess chemical hazards. Many frameworks have been developed to improve robustness and transparency in the evaluation of reliability and relevance of individual tests, but these frameworks typically focus on either environmental risk assessment (ERA) or human health risk assessment (HHRA), and there is little cross talk between them. There is a need to develop a common approach that would support a more consistent, transparent and robust evaluation and weighting of the evidence across ERA and HHRA. This paper explores the applicability of existing Data Quality Assessment (DQA) frameworks for integrating environmental toxicity hazard data into human health assessments and vice versa. We performed a comparative analysis of the strengths and weaknesses of eleven frameworks for evaluating reliability and/or relevance of toxicity and ecotoxicity hazard data. We found that a frequent shortcoming is the lack of a clear separation between reliability and relevance criteria. A further gaps and needs analysis revealed that none of the reviewed frameworks satisfy the needs of a common eco-human DQA system. Based on our analysis, some key characteristics, perspectives and recommendations are identified and discussed for building a common DQA system as part of a future integrated eco-human decision-making framework. This work lays the basis for developing a common DQA system to support the further development and promotion of Integrated Risk Assessment.
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Affiliation(s)
- N Roth
- Swiss Centre for Applied Human Toxicology (SCAHT) Directorate, Regulatory Toxicology Unit, Missionsstrasse 64, 4055 Basel, Switzerland.
| | - P Ciffroy
- Electricité de France (EDF) R&D, National Hydraulic and Environment Laboratory, 6 quai Watier, 78400 Chatou, France
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Lee FJ, Monteiro P, Baker D, Bloch M, Roth N, Finlayson R, Moore R, Hoy J, Martinez E, Carr A. Rosuvastatin vs. protease inhibitor switching for hypercholesterolaemia: a randomized trial. HIV Med 2016; 17:605-14. [PMID: 26987376 DOI: 10.1111/hiv.12362] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of the study was to compare the efficacy and safety of rosuvastatin initiation with those of switching of ritonavir-boosted protease inhibitors (PI/rs) in HIV-1-infected adults with hypercholesterolaemia and increased cardiovascular risk scores. METHODS In this open-label, multicentre study, HIV-1-infected adults on PI/r-based therapy with viral load < 50 HIV-1 RNA copies/mL, fasting total cholesterol ≥ 5.5 mmol/L (both for ≥ 6 months) and elevated cardiovascular risk (Framingham score ≥ 8% or diabetes or family history), and not on lipid-lowering therapy, were randomized to open-label rosuvastatin 10 mg/day or to PI/r switching, both with standardized diet/exercise advice. The primary endpoint was change in total cholesterol at week 12 (intention to treat). RESULTS There were 43 participants (23 on rosuvastatin). Baseline characteristics were: mean [± standard deviation (SD)] age 55 (8.5) years, 42 (98%) male, 41 (95%) white race, and mean (± SD) total cholesterol 6.2 (1.2) mmol/L. At enrolment, PI/rs were lopinavir/ritonavir (n = 22; 51%), atazanavir/ritonavir (n = 12; 28%) and darunavir/ritonavir (n = 9; 21%). The commonest PI/r substitutes were raltegravir (n = 9; 45%) and rilpivirine (n = 4; 20%). All participants were adherent through to week 12. Rosuvastatin yielded greater declines than PI/r switching in total (- 21.4% vs. - 8.7%, respectively; P = 0.003) and low-density lipoprotein (- 29.9% vs. - 1.0%, respectively; P < 0.001) cholesterol, but smaller declines in very low-density lipoprotein cholesterol and triglycerides (P < 0.01). Cholesterol lowering was greater in participants on atazanavir/ritonavir or once-daily darunavir/ritonavir (vs. lopinavir/ritonavir). More study drug-related adverse events (mostly grade 1 nausea/diarrhoea; 10 vs. one, respectively; P = 0.001) occurred with PI/r switching than with rosuvastatin. CONCLUSIONS In adults receiving a PI/r, rosuvastatin 10 mg/day for 12 weeks yielded larger decreases in total and low-density lipoprotein cholesterol than PI/r switching, and was better tolerated.
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Affiliation(s)
- F J Lee
- Clinical Research Program, Centre for Applied Medical Research, St Vincent's Hospital, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - P Monteiro
- Infectious Diseases Unit, Hospital Cliníc, University of Barcelona, Barcelona, Spain
| | - D Baker
- East Sydney Doctors, Sydney, NSW, Australia
| | - M Bloch
- Holdsworth House Medical Practice, Sydney, NSW, Australia
| | - N Roth
- Prahran Market Clinic, Melbourne, Vic., Australia
| | - R Finlayson
- Taylor Square Private Clinic, Sydney, NSW, Australia
| | - R Moore
- Northside Clinic, Melbourne, Vic., Australia
| | - J Hoy
- Department of Infectious Diseases, The Alfred Hospital & Monash University, Melbourne, Vic., Australia
| | - E Martinez
- Infectious Diseases Unit, Hospital Cliníc, University of Barcelona, Barcelona, Spain
| | - A Carr
- Clinical Research Program, Centre for Applied Medical Research, St Vincent's Hospital, Sydney, NSW, Australia
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Roth N, Kanel G, Kaplowitz N. Alcoholic foamy degeneration and alcoholic fatty liver with jaundice: Often overlooked causes of jaundice and hepatic decompensation that can mimic alcoholic hepatitis. Clin Liver Dis (Hoboken) 2016; 6:145-148. [PMID: 31041013 PMCID: PMC6490664 DOI: 10.1002/cld.520] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Nitzan Roth
- Division of Gastrointestinal and Liver Diseases, Department of Medicine, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCA
| | - Gary Kanel
- Department of Pathology, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCA
| | - Neil Kaplowitz
- Division of Gastrointestinal and Liver Diseases, Department of Medicine, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCA
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de Wit JBF, Murphy DA, Lal L, Audsley JM, Roth N, Moore R, Tee BK, Read T, Wright EJ. O19.2 Pre-exposure prophylaxis and risk compensation: evidence of decreased condom use at three-month follow-up among predominantly gay male participants in the vicprep study. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Leitinger D, Wilkinson A, Bartnik N, Fairley C, Tee BK, Roth N, Leslie D, El-Hayek C, Hellard M, Stoové M. P11.11 High rates of co-occurring sexually transmissible infections among men who have sex with men attending high-caseload general practice and sexual health services in victoria. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.459] [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: 11/03/2022]
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Murphy DA, de Wit JBF, Lal L, Audsley JM, Roth N, Moore R, Tee BK, Read T, Wright E. O19.3 Pills, pleasure and privacy: early experiences of pre-exposure prophylaxis among men in the vicprep study. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.184] [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: 11/03/2022]
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Wilks MF, Roth N, Aicher L, Faust M, Papadaki P, Marchis A, Calliera M, Ginebreda A, Andres S, Kühne R, Schüürmann G. White paper on the promotion of an integrated risk assessment concept in European regulatory frameworks for chemicals. Sci Total Environ 2015; 521-522:211-8. [PMID: 25841074 DOI: 10.1016/j.scitotenv.2015.03.065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 03/17/2015] [Accepted: 03/17/2015] [Indexed: 05/22/2023]
Abstract
The vision of a sustainable and safe use of chemicals to protect human health, preserve the environment and maintain the ecosystem requires innovative and more holistic approaches to risk assessment (RA) in order to better inform decision making. Integrated risk assessment (IRA) has been proposed as a solution to current scientific, societal and policy needs. It is defined as the mutual exploitation of environmental risk assessment (ERA) for human health risk assessment (HHRA) and vice versa in order to coherently and more efficiently characterize an overall risk to humans and the environment for better informing the risk analysis process. Extrapolating between species which are relevant for HHRA and ERA requires a detailed understanding of pathways of toxicity/modes of action (MoA) for the various toxicological endpoints. Significant scientific advances, changes in chemical legislation, and increasing environmental consciousness have created a favourable scientific and regulatory environment to develop and promote the concept and vision of IRA. An initial proof of concept is needed to foster the incorporation of IRA approaches into different chemical sectorial regulations and demonstrate their reliability for regulatory purposes. More familiarity and confidence with IRA will ultimately contribute to an overall reduction in in vivo toxicity testing requirements. However, significant progress will only be made if long-term support for MoA-related research is secured. In the short term, further exchange and harmonization of RA terminology, models and methodologies across chemical categories and regulatory agencies will support these efforts. Since societal values, public perceptions and cultural factors are of increasing importance for the acceptance of risk analysis and successful implementation of risk mitigation measures, the integration of socio-economic analysis and socio-behavioural considerations into the risk analysis process may help to produce a more effective risk evaluation and consideration of the risks and benefits associated with the use of chemicals.
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Affiliation(s)
- M F Wilks
- Swiss Centre for Applied Human Toxicology (SCAHT), University of Basel, Switzerland.
| | - N Roth
- Swiss Centre for Applied Human Toxicology (SCAHT), University of Basel, Switzerland
| | - L Aicher
- Swiss Centre for Applied Human Toxicology (SCAHT), University of Basel, Switzerland
| | - M Faust
- Faust & Backhaus Environmental Consulting GbR (F+B), Bremen, Germany
| | - P Papadaki
- Department of Pesticides Control & Phytopharmacy, Benaki Phytopathological Institute (BPI), Athens, Greece
| | - A Marchis
- OPERA Research Center, Catholic University of the Sacred Heart (UCSC), Piacenza, Italy
| | - M Calliera
- Institute of Agricultural and Environmental Chemistry, Catholic University of the Sacred Heart (UCSC), Piacenza, Italy
| | - A Ginebreda
- Institute of Environmental Assessment and Water Research, Spanish Council of Scientific Research (CSIC), Barcelona, Spain
| | - S Andres
- French National Institute for Industrial Environment and Risks (INERIS), Parc Technologique Alata, Verneuil-en-Halatte, France
| | - R Kühne
- UFZ Department of Ecological Chemistry, Helmholtz Centre for Environmental Research, Leipzig, Germany
| | - G Schüürmann
- UFZ Department of Ecological Chemistry, Helmholtz Centre for Environmental Research, Leipzig, Germany; Institute for Organic Chemistry, Technical University Bergakademie Freiberg, Germany
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Kirian RA, Awel S, Eckerskorn N, Fleckenstein H, Wiedorn M, Adriano L, Bajt S, Barthelmess M, Bean R, Beyerlein KR, Chavas LMG, Domaracky M, Heymann M, Horke DA, Knoska J, Metz M, Morgan A, Oberthuer D, Roth N, Sato T, Xavier PL, Yefanov O, Rode AV, Küpper J, Chapman HN. Simple convergent-nozzle aerosol injector for single-particle diffractive imaging with X-ray free-electron lasers. Struct Dyn 2015; 2:041717. [PMID: 26798816 PMCID: PMC4711644 DOI: 10.1063/1.4922648] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 05/18/2015] [Indexed: 05/06/2023]
Abstract
A major challenge in high-resolution x-ray free-electron laser-based coherent diffractive imaging is the development of aerosol injectors that can efficiently deliver particles to the peak intensity of the focused X-ray beam. Here, we consider the use of a simple convergent-orifice nozzle for producing tightly focused beams of particles. Through optical imaging we show that 0.5 μm particles can be focused to a full-width at half maximum diameter of 4.2 μm, and we demonstrate the use of such a nozzle for injecting viruses into a micro-focused soft-X-ray FEL beam.
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Affiliation(s)
| | | | - N Eckerskorn
- Laser Physics Centre, Research School of Physics and Engineering, Australian National University , Canberra, Australia
| | - H Fleckenstein
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | | | - L Adriano
- Deutsches Elektronen-Synchrotron DESY , 22607 Hamburg, Germany
| | - S Bajt
- Deutsches Elektronen-Synchrotron DESY , 22607 Hamburg, Germany
| | - M Barthelmess
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | - R Bean
- European XFEL GmbH , 22761 Hamburg, Germany
| | - K R Beyerlein
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | - L M G Chavas
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | | | - M Heymann
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | - D A Horke
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | | | | | - A Morgan
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | - D Oberthuer
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | - N Roth
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | - T Sato
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | | | - O Yefanov
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | - A V Rode
- Laser Physics Centre, Research School of Physics and Engineering, Australian National University , Canberra, Australia
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Roth N, Wohl MP, Rust NC. Invariant representations of targets are enhanced relative to distractors during object search. J Vis 2014. [DOI: 10.1167/14.15.80] [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: 11/24/2022] Open
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Roth N, Wilks M. Neurodevelopmental and neurobehavioural effects of polybrominated and perfluorinated chemicals: A systematic review of the epidemiological literature using a quality assessment scheme. Toxicol Lett 2014; 230:271-81. [DOI: 10.1016/j.toxlet.2014.02.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 02/17/2014] [Accepted: 02/18/2014] [Indexed: 11/26/2022]
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Abstract
An reinem n-Decylalkohol, sowie seinen konzentrierten und verdünnten Lösungen in vier unpolaren Flüssigkeiten wurde zwischen 20 und 60°C die komplexe DK bei 9,4,19,5 und 34,8 GHz gemessen. Wenn man die Anteile abtrennt, die das Hauptabsorptionsgebiet bei diesen Frequenzen noch beiträgt, erhält man ein Mikrowellengebiet anomaler Dispersion, das allein von Prozessen mit Kurzzeitrelaxation herrührt. Dazu gehört eine Verteilung von Relaxationszeiten, die in erster Näherung durch zwei diskrete Werte zu beschreiben ist. Die so erhaltenen charakteristischen Daten — Dispersionsstufe, Relaxationszeit und Aktivierungsenergie — werden von sehr verdünnter Lösung, die nur Einzelmoleküle enthält, bis zur reinen Dipolflüssigkeit verfolgt und geben bei der Diskussion Hinweise auf die zugrundeliegenden molekularen Vorgänge. Danach ist die kürzeste Zeitkonstante der Eigenbewegung von polaren Molekülgruppen zuzuordnen, in verdünnter Lösung allein der OH-Gruppe. Die Dipolorientierung mit längerer Relaxationszeit dagegen hat quantitativ alle Kennzeichen, die von der rotatorischen Bewegung ganzer, starrer oder flexibler Moleküle bekannt sind. Zu ihr müssen bei konzentrierten Mischungen aber noch andere Strukturen beitragen als allein Monomere, wie aus dem Relaxationszeitspektrum des Einzelmoleküls in verdünnter Heptanlösung folgt. Bei Benzol treten durch eine spezifische Wechselwirkung mit der OH-Gruppe erhebliche Verschiebungen in der Relaxationszeit-Verteilung auf, die sich noch bei höheren Alkoholkonzentrationen bemerkbar machen.
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Affiliation(s)
- G. Klages
- Physikalisches Institut, Abteilung Mikrowellenphysik, der Universität Mainz
| | - N. Roth
- Physikalisches Institut, Abteilung Mikrowellenphysik, der Universität Mainz
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Lim MSC, Hellard M, El-Hayek C, Cuevas M, Fairley C, Leslie D, Roth N, Tee B, Stoove M. P3.123 Hepatitis C Testing and Incidence in HIV-Positive Men Who Have Sex with Men in Melbourne, Victoria. A Retrospective Cohort Study. Sex Transm Infect 2013. [DOI: 10.1136/sextrans-2013-051184.0582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Roth N, Städler S, Lemann M, Hösli S, Simon HU, Simon D. Distinct eosinophil cytokine expression patterns in skin diseases - the possible existence of functionally different eosinophil subpopulations. Allergy 2011; 66:1477-86. [PMID: 21884530 DOI: 10.1111/j.1398-9995.2011.02694.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [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: 12/17/2022]
Abstract
BACKGROUND The function of eosinophils has been attributed to host defense, immunomodulation, and fibrosis. Although eosinophils are found among infiltrating cells in a broad spectrum of skin diseases, their pathogenic role remains uncertain. This study aimed to analyze the cytokine expression by eosinophils in different skin diseases. METHODS Skin specimens from different skin diseases [allergic/reactive, infectious, autoimmune, and tumors/lymphomas (LY)] were stained by antibodies directed to eosinophil cationic protein, cytokines [tumor necrosis factor (TNF)-α, interleukin (IL)-5, IL-6, IL-10, IL-11, IL-13, IL-17, IL-25, IL-33, interferon-γ, transforming growth factor (TGF)-β, and thymic stromal lymphopoietin], eotaxins (CCL11, CCL24, and CCL26), metalloproteinase (MMP)-9 as well as extracellular matrix proteins (tenascin-C and procollagen-3) and then analyzed by laser scanning microscopy. RESULTS The number of eosinophils varied considerably in and between disease groups and did not correlate with the numbers of accompanying inflammatory cells. The expression of IL-5, IL-6, IL-11, TGF-β, CCL24, and MMP-9 by eosinophils significantly differed between disease groups. Eosinophils in tumors/LY predominantly expressed IL-6, TGF-β, and CCL24, but not IL-11. On the other hand, in autoimmune diseases, eosinophils largely contributed to MMP-9 production. IL-5-generating eosinophils were particularly obvious in allergic and infectious diseases. CONCLUSION In skin diseases, eosinophil expresses a broad spectrum of cytokines. The different cytokine expression patterns suggest distinct functional roles of eosinophils in these diseases that might be related to host defense, immunomodulation, fibrosis, and/or tumor development.
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Affiliation(s)
- N Roth
- Department of Dermatology, Inselspital, Bern University Hospital, Switzerland
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Gatter M, Roth N, Safarian C, Nucatola D. Eliminating the routine postoperative surgical abortion visit. Contraception 2011. [DOI: 10.1016/j.contraception.2011.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Guy R, Goller JL, Spelman T, El-Hayek C, Gold J, Lim M, Leslie D, Tee BK, Roth N, Anderson J, Fairley CK, Kaldor J, Hellard M. Does the frequency of HIV and STI testing among men who have sex with men in primary care adhere with Australian guidelines? Sex Transm Infect 2010; 86:371-6. [PMID: 20460263 DOI: 10.1136/sti.2009.040972] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Australian guidelines recommend annual testing for HIV and sexually transmitted infections (STIs) for all men who have sex with men (MSM) and 3-6 monthly testing for those at higher risk as defined by behavioural criteria. We assessed HIV/STI re-testing rates among MSM attending primary care clinics. METHODS We conducted a retrospective follow-up of HIV negative MSM tested for HIV or STIs (chlamydia or syphilis) at four primary care clinics in the 9-month period: April to December 2006. Re-testing rates for these infections were calculated over 18 months. Logistic regression was undertaken to identify predictors of guideline adherence. RESULTS Of the MSM requiring annual HIV testing according to the guidelines, the re-testing rates at 1 y were 35% (762/2163). Among the higher risk MSM, 6-monthly HIV re-testing rates were 15% (283/1862). Within the subgroup who reported 11 or more male sexual partners within the past 6 months, HIV re-testing rates within 6 months were 19%. Independent predictors of HIV re-testing within 6 months in higher-risk MSM were reporting 11 or more male sexual partners in the last 6 months (AOR 3.1, 95% CI 1.8 to 4.8); being born overseas (AOR 2.0, 95% CI 1.2 to 3.4); and previous HIV testing more than 12 months earlier (AOR 3.3, 95% CI 1.9 to 5.5). CONCLUSION There is poor adherence to national guidelines that recommend regular re-testing of MSM for STIs, particularly among those at higher risk who require more frequent testing. Clinical strategies are urgently needed to encourage more frequent HIV/STI testing among MSM, especially in the higher risk subgroup.
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Affiliation(s)
- R Guy
- National Centre in HIV Epidemiology and Clinical Research, Sydney, New South Wales, Australia.
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Nucatola D, Roth N, Gatter M. A randomized pilot study on the effectiveness and side-effect profiles of two doses of digoxin as fetocide when administered intraamniotically or intrafetally prior to second-trimester surgical abortion. Contraception 2010; 81:67-74. [PMID: 20004276 DOI: 10.1016/j.contraception.2009.08.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2008] [Revised: 08/27/2009] [Accepted: 08/27/2009] [Indexed: 11/16/2022]
Abstract
BACKGROUND Digoxin is commonly used to facilitate second-trimester surgical abortion despite limited data regarding its safety and effectiveness for this indication. We conducted a pilot study to determine the incidence of side effects after digoxin administration and whether effectiveness can be improved with variations in dose and technique. STUDY DESIGN Fifty-two women presenting for elective termination of pregnancy between 18 and 24 weeks' gestation were randomized to one of four digoxin treatment groups: 1.0 mg intraamniotic (1.0 IA), 1.0 mg intrafetal (1.0 IF), 1.5 mg intraamniotic (1.5 IA) or 1.5 mg intrafetal (1.5 IF). Ultrasound was used to assess for the presence of fetal cardiac activity prior to the abortion procedure. Data on the presence and severity of pain, nausea and other potential side effects were collected before digoxin injection, immediately following digoxin injection and on the day after digoxin injection. RESULTS Digoxin effectively induced fetal death in 87% of women. The failure rate did not vary by route of administration (IA or IF) and was not lowered by increasing the dose from 1.0 to 1.5 mg. IF injections induced fetal death more rapidly than IA injections. Digoxin administration did not result in increased pain or nausea. CONCLUSIONS IA or IF injection of digoxin is safe and effective for inducing fetal death prior to second-trimester surgical abortion. Doses greater than 1.0 mg may not be necessary.
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Bloch M, Hoy J, Cunningham N, Roth N, Andrianopoulos N, Rayner C, Carr A. Adherence to HIV treatment guidelines for initiation of antiretroviral therapy in Australia. J Int AIDS Soc 2010. [PMCID: PMC3112952 DOI: 10.1186/1758-2652-13-s4-p172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Allayee H, Roth N, Hodis HN. Polyunsaturated fatty acids and cardiovascular disease: implications for nutrigenetics. J Nutrigenet Nutrigenomics 2009; 2:140-8. [PMID: 19776641 DOI: 10.1159/000235562] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Cardiovascular disease (CVD) arises as a result of genetic predisposition in the context of a disease-promoting environment. While several risk factors have been identified for CVD, such as elevated serum lipid levels and hypertension, most of the genes identified thus far do not appear to involve such 'conventional' risk factors. Moreover, the interactions between genes and environment, such as a diet high in certain fats, adds another level of complexity to CVD and renders identification of the underlying genetic factors even more difficult. Polyunsaturated fatty acids (PUFAs), such as the omega-6 and omega-3 fatty acids, which have multiple roles in membrane structure, lipid metabolism, blood clotting, blood pressure, and, in particular, inflammation, have been linked to the reduction in CVD. Linoleic (omega-6) and alpha-linolenic acid (omega-3) are essential fatty acids that can be converted into long-chain PUFAs, such as arachidonic acid (AA) and eicosapentaenoic acid (EPA)/docosahexaenoic acid (DHA), respectively. These long-chain PUFAs are metabolized by enzymatically catalyzed systems via cyclooxygenases and lipoxygenases. The 5-lipoxygenase (5-LO)/leukotriene (LT) biosynthesis pathway has been biochemically and genetically associated with CVD traits in mice and humans, particularly in the context of dietary AA and EPA/DHA. In this review, we summarize the biochemical metabolism of omega-3 and omega-6 PUFAs, evaluate the evidence for genetic and nutrigenetic contributions of 5-LO pathway genes to CVD, and discuss the potential of future studies that could identify other gene-dietary interactions between PUFAs and CVD traits.
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Affiliation(s)
- Hooman Allayee
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2250 Alcazar Street, Los Angeles, CA 90033, USA.
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Nucatola D, Saulsberry V, Gatter M, Roth N. Serious adverse events associated with the use of misoprostol alone for cervical preparation prior to early second trimester abortions (12-16 weeks). Contraception 2009; 79:158. [PMID: 19135576 DOI: 10.1016/j.contraception.2008.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Nucatola D, Roth N, Saulsberry V, Gatter M. Serious adverse events associated with the use of misoprostol alone for cervical preparation prior to early second trimester surgical abortion (12–16 weeks). Contraception 2008; 78:245-8. [DOI: 10.1016/j.contraception.2008.04.121] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2007] [Revised: 04/22/2008] [Accepted: 04/28/2008] [Indexed: 10/21/2022]
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Mueller T, Dieplinger B, Gegenhuber A, Haidinger D, Schmid N, Roth N, Ebner F, Landl M, Poelz W, Haltmayer M. Serum total 8-iso-prostaglandin F2α: A new and independent predictor of peripheral arterial disease. J Vasc Surg 2004; 40:768-73. [PMID: 15472607 DOI: 10.1016/j.jvs.2004.07.044] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Circulating 8-iso-prostaglandin F 2alpha (8-iso-PGF 2alpha ) has been proposed as new indicator of oxidative stress, which is involved in the pathophysiologic changes of atherosclerosis. We proposed to test the hypothesis that 8-iso-PGF 2alpha is an independent predictor of symptomatic peripheral arterial disease (PAD). METHODS A case-control study in 100 patients with symptomatic PAD and 100 control subjects matched for age, sex, and diabetes mellitus was conducted. Smokers and subjects using lipid-lowering drugs were excluded. Serum total 8-iso-PGF 2alpha was quantified with an enzyme immunoassay. RESULTS Median 8-iso-PGF 2alpha was higher in patients with PAD than in control subjects (63 vs 42 pg/mL; P = .001). Logistic regression with hypertension, body mass index, and creatinine, low-density lipoprotein (LDL) cholesterol, triglyceride, high-sensitivity C-reactive protein (hs-CRP), 8-iso-PGF 2alpha , and total homocysteine concentrations as independent variables and case-control status as dependent variable revealed significant odds ratios (OR) for hypertension (OR, 3.74; 95% confidence interval [CI], 1.85-7.53), low-density lipoprotein cholesterol (OR, 1.16, for an increment of 10 mg/dL; 95% CI, 1.07-1.27), high-sensitivity C-reactive protein (OR, 1.02, for an increment of 1 mg/L; 95% CI, 1.00-1.03), and 8-iso-PGF 2alpha (OR, 1.11, for an increment of 10 pg/mL; 95% CI, 1.03-1.20). CONCLUSIONS Serum total 8-iso-PGF 2alpha was an independent predictor of PAD in the population studied. This finding supports the hypothesis that 8-iso-PGF 2alpha is a risk marker for PAD. Our results indicate increased systemic oxidative stress in patients with PAD.
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Affiliation(s)
- T Mueller
- Department of Laboratory Medicine, Konventhospital Barmherize Brueder Linz, Austria.
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Roth N. Jewish and Muslim physicians of 'Ali Ibn Tashufīn. Korot 2001; 10:83-91. [PMID: 11639676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- N Roth
- Department of Hebrew & Semitic Studies, University of Wisconsin, Madison
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Biesinger E, Grabner B, Pawlata H, Phleps G, Poppendieck J, Roth N. [Allergies: deficits in diagnosis and therapy]. HNO 2001; 49:704-5. [PMID: 11593769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- E Biesinger
- Gesellschaft für Allergologie und klinische Immunologie e.V., Hamburg
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Smith D, Hales G, Roth N, Law M, Ray J, Druett J, Mitchell J, Mills G, Doong N, Franklin R. A randomized trial of nelfinavir, ritonavir, or delavirdine in combination with saquinavir-SGC and stavudine in treatment-experienced HIV-1-infected patients. HIV Clin Trials 2001; 2:97-107. [PMID: 11590517 DOI: 10.1310/cfyj-26jf-vvru-7an8] [Citation(s) in RCA: 8] [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] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate the 24-week impact of saquinavir-enhancing antiretroviral therapy on viral replication in patients previously treated with nucleoside analogues with or without prior saquinavir hard-gel capsules (HGC). METHOD Patients were randomized in three groups to receive the following: Group 1-nelfinavir (750 mg tid), saquinavir soft-gel capsule (SGC) (800 mg tid), and stavudine (40 mg bid); Group II-ritonavir (400 mg bid), saquinavir-SGC (400 mg bid), and stavudine (40 mg bid); or Group III-delavirdine (400 mg tid), saquinavir-SGC (800 mg tid), and stavudine (40 mg bid). Viral loads, CD4 count, and safety were assessed over a 24-week period with an additional 6-month follow-up. RESULTS 73 patients received randomized therapy; 14 of whom were SQV naïve, with a median baseline viral load of 3.6 log(10) and a CD4 count of 370 cells/mm(3). By 6 months, the median decreases in plasma viral loads were 0.26, 0.71, and 0.29 log(10) copies/mL for groups I, II, and III, respectively. The median increases in CD4 counts, for groups I, II, and III, were 52, 40, and 69 cells/mm(3) at 6 months, respectively. Changes in viral load and CD4 counts at 6 months and 1 year were not significantly different between the treatment groups. More patients discontinued therapy in the ritonavir arm (35%) for drug intolerance or toxicity compared to either the nelfinavir or delavirdine arms (15% and 5%, respectively). In a multivariate analysis, baseline viral load, younger age, and baseline saquinavir resistance were significantly associated with detectable viral load at 24 weeks. CONCLUSION The use of antiretroviral agents that pharmacokinetically boost saquinavir levels has a modest benefit in saquinavir-experienced patients.
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Affiliation(s)
- D Smith
- Community HIV Research Network, National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, Australia.
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Ben-Hur E, Chan WS, Yim Z, Zuk MM, Dayal V, Roth N, Heldman E, Lazo A, Valeri CR, Horowitz B. Photochemical decontamination of red blood cell concentrates with the silicon phthalocyanine PC 4 and red light. Dev Biol (Basel) 2000; 102:149-55. [PMID: 10794102] [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: 02/16/2023]
Abstract
Various approaches are being developed for virus inactivation of red blood cell concentrates (RBCC) in order to increase the safety of the blood supply. We have been studying the silicon phthalocyanine Pc 4 for this purpose, a photosensitizer activated with red light. Pc 4 targets the envelope of pathogenic viruses such as HIV. To protect RBC during the process two main approaches are used: (i) inclusion of quenchers of reactive oxygen species produced during the treatment. Tocopherol succinate was found to be most effective for this purpose; (ii) formulation of Pc 4, a lipophilic compound, in liposomes that reduce its binding to RBC but not to viruses. As a light source we used a light emitting diode array emitting at 670-680 nm. An efficient mixing device ensures homogenous light exposure during treatment of intact RBCC. Treatment of 50 ml RBCC with 5 microM Pc 4 and 18 J/cm(2) light results in the inactivation of > or = 5.5 log(10) HIV, > or = 6.3 log(10), VSV and > or = 5 log(10) of PRV and BVDV. The relative sensitivities of these viruses based on the slope of virus kill versus light dose are 1.0, 1.25, 1.5 and 1.9 for HIV, VSV, PRV and BVDV, respectively. To achieve the same level of virus inactivation in 350 ml RBCC, the light dose needed is 40 J/cm(2). HIV actively replicating in CEM cells is as sensitive as cell-free and HIV in latently infected cells is 3-4 times more sensitive. Parasites that can be transmitted by blood transfusion (P. falciparum and T. cruzi) are even more sensitive than viruses. Following treatment, RBCC can be stored for 28 days at 4 degrees C with haemolysis below 1%. Previous studies under less favourable conditions showed that baboon RBC circulated with an acceptable 24 hr recovery and half-life. Genetic toxicological studies of Pc 4 with or without light exposure (mutagenicity in bacteria, mammalian cells in vitro and clastogenicity in vivo) were negative. We conclude that a process using Pc 4 and red light can potentially reduce the risk of transmitting pathogens in RBCC.
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Affiliation(s)
- E Ben-Hur
- V.I. Technologies, Inc. (Vitex), New York, NY 10032, USA
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Hales G, Roth N, Smith D. Possible fatal interaction between protease inhibitors and methamphetamine. Antivir Ther 2000; 5:19. [PMID: 10846588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Smith D, Goggin L, Meldrum H, Phillips S, Russell D, Bloch M, Bodsworth NJ, Roth N, Law MG. Capturing the paradigm shift in HIV treatment: changing attitudes in the choice of combination antiretroviral drugs by high HIV caseload Australian GPs (1996-1997). AIDS Care 2000; 12:41-7. [PMID: 10716016 DOI: 10.1080/09540120047459] [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: 10/27/2022]
Abstract
The use of combination antiretroviral therapy for HIV infection is a rapidly changing field. To assess the impact of recent studies on prescribing patterns, two surveys of 21 high HIV caseload Australian GPs were undertaken in June 1996 and June 1997 to plot changes in the choice of combination antiviral therapy. Of the 17 GPs who responded to the survey in each year, the number of HIV-infected patients seen at their practices were estimated to be 5,061 in 1996 and 5,912 in 1997. In 1996, 40% of their patients were estimated to be on antiretroviral therapy compared to 60% in 1997 (p < 0.05). In 1996, most GPs preferred using dual combination therapy (59%); whereas in 1997, triple combination therapy was preferred (82%). Between 1996 and 1997, there was a significant change by high caseload Australian GPs in the choice of antiretroviral drugs with many combinations being preferred prior to presentation of efficacy data for those combinations, or recommendation through national guidelines.
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Affiliation(s)
- D Smith
- Community HIV Research Network, University of New South Wales, Darlinghurst, Australia.
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Vitale MG, Higgs GB, Liebling MS, Roth N, Roye DP. Superior mesenteric artery syndrome after segmental instrumentation: a biomechanical analysis. Am J Orthop (Belle Mead NJ) 1999; 28:461-7. [PMID: 10470672] [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: 02/13/2023]
Abstract
Superior mesenteric artery (SMA) syndrome is a rare complication that occurs after correction of scoliosis. A review of the literature suggests that the incidence of this syndrome may be decreasing, as methods for the correction of scoliosis have improved. We present the first report of SMA syndrome that occurred after segmental 'derotational' instrumentation. Computerized axial tomography was helpful in suggesting the diagnosis of this condition. The risk factors and pathophysiology of SMA syndrome are reviewed with respect to the biomechanical effects of casting and Harrington and segmental instrumentation systems on the spine. Attention to the three-dimensional nature of the scoliotic deformity, particularly in the sagittal plane, may help to predict those at risk for the development of this potentially fatal syndrome.
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Affiliation(s)
- M G Vitale
- Department of Orthopedic Surgery, Columbia Presbyterian Medical Center, New York, New York, USA
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Puza S, Roth N, Macones GA, Mennuti MT, Morgan MA. Does cesarean section decrease the incidence of major birth trauma? J Perinatol 1998; 18:9-12. [PMID: 9527937] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine whether the increase in frequency of cesarean section is associated with a decreased incidence of major birth trauma. STUDY DESIGN A retrospective cohort study was performed evaluating all neonatal cases of major birth trauma from January 1989 to December 1994. Major birth trauma was defined as peripheral plexus or nerve injuries, fractures, or lacerations. The data were grouped into two mutually exclusive periods (January 1989 to December 1990 vs January 1991 to December 1994) in which a significant difference in the cesarean section rate was known. RESULTS Of 17,957 deliveries during the period, 141 cases of birth trauma occurred. One hundred thirty-seven of the 141 medical records were available for review, and 116 were classified as having had major birth trauma and were included in the study. The overall incidence of major birth trauma was 6.5/1000 deliveries. During the two-year period (January 1989 to December 1990), 18.3% of deliveries were by cesarean section and the major birth trauma rate was 8.4/1000 deliveries. During the following 4 years, the cesarean section rate was 22.3% and the major birth trauma rate was 5.3/1000 deliveries. Significant differences in the birth trauma chi(2) = 6.12, p = 0.013) and cesarean section (chi(2) = 40.80, p < 0.001) rates were observed. Controlling for the mode of delivery lessened the association between time period and birth trauma incidence (chi(2)MH = 3.28, p = 0.07). A significant decrease in the occurrence of major birth trauma in neonates delivered by cesarean section in the later period was discovered (relative risk = 0.46, 95% confidence interval 0.22 to 0.97). This decrease appeared to be mediated by a decrease in total lacerations between the periods (chi(2) = 11.76, p < 0.001), because the rates of other types of major birth trauma did not differ in neonates delivered by cesarean section or the vaginal route. CONCLUSIONS With a 4% increase in rate of cesarean section at our institution, a significant decrease in the occurrence of major birth trauma was observed. This finding cannot be explained by a decreased risk of neonatal trauma in patients delivering vaginally, but rather by a decreased risk of neonatal trauma at cesarean section during the latter period.
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Affiliation(s)
- S Puza
- Department of Obstetrics and Gynecology, University of Pennsylvania Medical Center, Philadelphia, USA
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Monn C, Fuchs A, Högger D, Junker M, Kogelschatz D, Roth N, Wanner HU. Particulate matter less than 10 microns (PM10) and fine particles less than 2.5 microns (PM2.5): relationships between indoor, outdoor and personal concentrations. Sci Total Environ 1997; 208:15-21. [PMID: 9496645 DOI: 10.1016/s0048-9697(97)00271-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Among 17 homes in Switzerland, the relationship between indoor and outdoor levels for particulate matter less than 10 microns (PM10), particulate matter less than 2.5 microns (PM2.5) and NO2 was investigated. In 10 homes, the inhabitants also participated in conducting personal measurements. All homes were naturally ventilated. In homes without any indoor sources and where human activity was low, PM10 I/O ratios amounted to approximately 0.7. Of the indoor sources, smoking had the highest influence on I/O ratios (> 1.8). In homes not containing any apparent source, 'human activity' was an important factor accounting for high indoor levels. However, this factor is difficult to quantify. Personal exposure was in most cases higher than the indoor and the corresponding home outdoor levels. For NO2, gas-cooking was found to have the strongest influence on elevated I/O ratios (> 1.2) whilst for other homes, the I/O ratio was less than 1.
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Affiliation(s)
- C Monn
- Swiss Federal Institute of Technology, Institute of Hygiene and Applied Physiology, Zürich, Switzerland.
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