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Abu Bakar NFAB, Yeo ZL, Hussin F, Madhavan P, Lim V, Jemon K, Prabhakaran P. Synergistic effects of combined cisplatin and Clinacanthus nutans extract on triple negative breast cancer cells. J Taibah Univ Med Sci 2023; 18:1220-1236. [PMID: 37250812 PMCID: PMC10209459 DOI: 10.1016/j.jtumed.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/18/2023] [Accepted: 04/05/2023] [Indexed: 05/31/2023] Open
Abstract
Objective Triple negative breast cancer (TNBC) is the most invasive breast cancer subtype enriched with cancer stem cells. TNBCs do not express estrogen, progesterone, or human epidermal growth factor receptor 2 (HER2) receptors, making them difficult to be targeted by existing chemotherapy treatments. In this study, we attempted to identify the effects of combined cisplatin and Clinacanthus nutans treatment on MDA-MD-231 and MDA-MB-468 breast cancer cells, which represent TNBC subtypes. Methods The phytochemical fingerprint of C. nutans ethanolic leaf extract was evaluated by LC-MS/MS analysis. We investigated the effects of cisplatin (0-15.23 μg/mL), C. nutans (0-50 μg/mL), and a combination of cisplatin (3.05 μg/mL) and C. nutans (0-50 μg/mL), on cell viability, proliferation, apoptosis, invasion, mRNA expression in cancer stem cells (CD49f, KLF4), and differentiation markers (TUBA1A, KRT18) in TNBC cells. In addition, we also studied the interaction between cisplatin and C. nutans. Results Derivatives of fatty acids, carboxylic acid ester, and glycosides, were identified as the major bioactive compounds with potential anticancer properties in C. nutans leaf extract. Reductions in cell viability (0-78%) and proliferation (2-77%), as well as a synergistic anticancer effect, were identified in TNBC cells when treated with a combination of cisplatin and C. nutans. Furthermore, apoptotic induction via increased caspase-3/7 activity (MDA-MB-231: 2.73-fold; MDA-MB-468: 3.53-fold), and a reduction in cell invasion capacity to 36%, were detected in TNBC cells when compared to single cisplatin and C. nutans treatments. At the mRNA level, cisplatin and C. nutans differentially regulated specific genes that are responsible for proliferation and differentiation. Conclusion Our findings demonstrate that the combination of cisplatin and C. nutans represents a potential treatment for TNBC.
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Affiliation(s)
| | - Zhin Leng Yeo
- Department of Biosciences, Faculty of Science, Universiti Teknologi Malaysia, Skudai, Malaysia
| | - Faisal Hussin
- Department of Chemistry, Faculty of Science, Universiti Teknologi Malaysia, Skudai, Malaysia
| | - Priya Madhavan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Vuanghao Lim
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, Malaysia
| | - Khairunadwa Jemon
- Department of Biosciences, Faculty of Science, Universiti Teknologi Malaysia, Skudai, Malaysia
| | - Praseetha Prabhakaran
- Department of Biosciences, Faculty of Science, Universiti Teknologi Malaysia, Skudai, Malaysia
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Phuna ZX, Madhavan P. A reappraisal on amyloid cascade hypothesis: the role of chronic infection in Alzheimer's disease. Int J Neurosci 2023; 133:1071-1089. [PMID: 35282779 DOI: 10.1080/00207454.2022.2045290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 02/09/2022] [Indexed: 10/18/2022]
Abstract
Alzheimer disease (AD) is a progressive neurological disorder that accounted for the most common cause of dementia in the elderly population. Lately, 'infection hypothesis' has been proposed where the infection of microbes can lead to the pathogenesis of AD. Among different types of microbes, human immunodeficiency virus-1 (HIV-1), herpes simplex virus-1 (HSV-1), Chlamydia pneumonia, Spirochetes and Candida albicans are frequently detected in the brain of AD patients. Amyloid-beta protein has demonstrated to exhibit antimicrobial properties upon encountering these pathogens. It can bind to microglial cells and astrocytes to activate immune response and neuroinflammation. Nevertheless, HIV-1 and HSV-1 can develop into latency whereas Chlamydia pneumonia, Spirochetes and Candida albicans can cause chronic infections. At this stage, the DNA of microbes remains undetectable yet active. This can act as the prolonged pathogenic stimulus that over-triggers the expression of Aβ-related genes, which subsequently lead to overproduction and deposition of Aβ plaque. This review will highlight the pathogenesis of each of the stated microbial infection, their association in AD pathogenesis as well as the effect of chronic infection in AD progression. Potential therapies for AD by modulating the microbiome have also been suggested. This review will aid in understanding the infectious manifestations of AD.
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Affiliation(s)
- Zhi Xin Phuna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Selangor, Malaysia
| | - Priya Madhavan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Selangor, Malaysia
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Hasan MM, Madhavan P, Ahmad Noruddin NA, Lau WK, Ahmed QU, Arya A, Zakaria ZA. Cardioprotective effects of arjunolic acid in LPS-stimulated H9C2 and C2C12 myotubes via the My88-dependent TLR4 signaling pathway. Pharm Biol 2023; 61:1135-1151. [PMID: 37497554 PMCID: PMC10375937 DOI: 10.1080/13880209.2023.2230251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 05/21/2023] [Accepted: 06/22/2023] [Indexed: 07/28/2023]
Abstract
CONTEXT Arjunolic acid (AA) is a triterpenoid saponin found in Terminalia arjuna (Roxb.) Wight & Arn. (Combretaceae). It exerts cardiovascular protective effects as a phytomedicine. However, it is unclear how AA exerts the effects at the molecular level. OBJECTIVE This study investigates the cardioprotective effects of arjunolic acid (AA) via MyD88-dependant TLR4 downstream signaling marker expression. MATERIALS AND METHODS The MTT viability assay was used to assess the cytotoxicity of AA. LPS induced in vitro cardiovascular disease model was developed in H9C2 and C2C12 myotubes. The treatment groups were designed such as control (untreated), LPS control, positive control (LPS + pyrrolidine dithiocarbamate (PDTC)-25 µM), and treatment groups were co-treated with LPS and three concentrations of AA (50, 75, and 100 µM) for 24 h. The changes in the expression of TLR4 downstream signaling markers were evaluated through High Content Screening (HCS) and Western Blot (WB) analysis. RESULTS After 24 h of co-treatment, the expression of TLR4, MyD88, MAPK, JNK, and NF-κB markers were upregulated significantly (2-6 times) in the LPS-treated groups compared to the untreated control in both HCS and WB experiments. Evidently, the HCS analysis revealed that MyD88, NF-κB, p38, and JNK were significantly downregulated in the H9C2 myotube in the AA treated groups. In HCS, the expression of NF-κB was downregulated in C2C12. Additionally, TLR4 expression was downregulated in both H9C2 and C2C12 myotubes in the WB experiment. DISCUSSION AND CONCLUSIONS TLR4 marker expression in H9C2 and C2C12 myotubes was subsequently decreased by AA treatment, suggesting possible cardioprotective effects of AA.
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Affiliation(s)
- Md Mahmudul Hasan
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Priya Madhavan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Nur Adelina Ahmad Noruddin
- National Institutes of Biotechnology Malaysia, Malaysian Institute of Pharmaceuticals and Nutraceuticals, Serdang, Malaysia
| | - Wai Kwan Lau
- National Institutes of Biotechnology Malaysia, Malaysian Institute of Pharmaceuticals and Nutraceuticals, Serdang, Malaysia
| | - Qamar Uddin Ahmed
- Drug Discovery and Synthetic Chemistry Research Group, Department of Pharmaceutical Chemistry, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Malaysia
| | - Aditya Arya
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
- National Institutes of Biotechnology Malaysia, Malaysian Institute of Pharmaceuticals and Nutraceuticals, Serdang, Malaysia
- School of Biosciences, Faculty of Science, The University of Melbourne, Melbourne, Australia
| | - Zainul Amiruddin Zakaria
- Borneo Research for Algesia, Inflammation and Neurodegeneration (BRAIN) Group, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Jalan UMS, Kota Kinabalu, Malaysia
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Wee LH, Galvan JAA, Patil SS, Madhavan P, Mahalingam D, Yeong CH, Wong YH, Poh HQ, Suthahar S, David SD, Tan XJ, Rosli IA, Chan CMH, Baharom N, Muhamad NA, Siau CS. Understanding Factors Associated with Motivation to Quit Vaping among Vapers in the Federal Territory of Kuala Lumpur, Malaysia. Healthcare (Basel) 2023; 11:1980. [PMID: 37510421 PMCID: PMC10379365 DOI: 10.3390/healthcare11141980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/27/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023] Open
Abstract
The prevalence of vaping worldwide is showing an upward trend. This study aimed to determine the factors associated with motivation to quit vaping among vapers in the Federal Territory of Kuala Lumpur, Malaysia, through a cross-sectional, purposive sampling study. Respondents were required to complete a questionnaire consisting of vapers' sociodemographic questions, habitual behavioral pattern questions, the e-Fagerström Test of Nicotine Dependence, the Glover-Nilsson Smoking Behavioral Dependence Questionnaire, perception questions, motivation to quit questions, and withdrawal symptom questions. A total of 311 vapers participated in this study. The majority of the vapers were male (84.6%), younger (18-25 years) (55.3%), and with monthly income less than RM 4000 (USD 868; 83.9%). The level of motivation to quit vaping was found to have a significant association with the perception of vaping being as satisfying as cigarette smoking (p = 0.006) and mild to very strong nicotine dependence (p = 0.001). Participants who recorded moderate and strong habitual vaping behaviors had lower odds of having high motivation to quit vaping compared to those recording slight habitual behaviors (OR = 0.279, 95%CI(0.110-0.708), p = 0.007 and OR = 0.185, 95%CI(0.052-0.654), p = 0.009, respectively). Factors associated with higher motivation to quit vaping could be explored to gain better understanding of how to increase their motivation level for future quit attempts.
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Affiliation(s)
- Lei Hum Wee
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Non-communicable Diseases and Public Health Research Group, School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Medical Advancement for Better Quality of Life Impact Lab, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Jo Ann Andoy Galvan
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Non-communicable Diseases and Public Health Research Group, School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Medical Advancement for Better Quality of Life Impact Lab, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Sapna Shridhar Patil
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Non-communicable Diseases and Public Health Research Group, School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Medical Advancement for Better Quality of Life Impact Lab, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Priya Madhavan
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Non-communicable Diseases and Public Health Research Group, School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Medical Advancement for Better Quality of Life Impact Lab, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Dinesh Mahalingam
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- SP Care Group, Level 3, Menara SP Care, Rawang Sentral, Rawang 48000, Malaysia
| | - Chai Hong Yeong
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Non-communicable Diseases and Public Health Research Group, School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Medical Advancement for Better Quality of Life Impact Lab, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Yin How Wong
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Non-communicable Diseases and Public Health Research Group, School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Medical Advancement for Better Quality of Life Impact Lab, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Hui Qi Poh
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Sanjay Suthahar
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Shamella Diya David
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Xiao Jing Tan
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Izzah Athirah Rosli
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Caryn Mei Hsien Chan
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Nizam Baharom
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai 71800, Malaysia
| | - Nor Asiah Muhamad
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Ching Sin Siau
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
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Sugumar V, Hayyan M, Madhavan P, Wong WF, Looi CY. Current Development of Chemical Penetration Enhancers for Transdermal Insulin Delivery. Biomedicines 2023; 11:biomedicines11030664. [PMID: 36979643 PMCID: PMC10044980 DOI: 10.3390/biomedicines11030664] [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] [Received: 01/26/2023] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 02/25/2023] Open
Abstract
The use of the transdermal delivery system has recently gained ample recognition due to the ability to deliver drug molecules across the skin membrane, serving as an alternative to conventional oral or injectable routes. Subcutaneous insulin injection is the mainstay treatment for diabetes mellitus which often leads to non-compliance among patients, especially in younger patients. Apart from its invasiveness, the long-term consequences of insulin injection cause the development of physical trauma, which includes lipohypertrophy at the site of administration, scarring, infection, and sometimes nerve damage. Hence, there is a quest for a better alternative to drug delivery that is non-invasive and easily adaptable. One of the potential solutions is the transdermal delivery method. However, the stratum corneum (the top layer of skin) is the greatest barrier in transporting large molecules like insulin. Therefore, various chemical enhancers have been proposed to promote stratum corneum permeability, or they are designed to increase the permeability of the full epidermis, such as the use of ionic liquid, peptides, chemical pre-treatment as well as packaging insulin with carriers or nanoparticles. In this review, the recent progress in the development of chemical enhancers for transdermal insulin delivery is discussed along with the possible mechanistic of action and the potential outlook on the proposed permeation approaches in comparison to other therapeutical drugs
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Affiliation(s)
- Vaisnevee Sugumar
- School of Medicine, Faculty of Health & Medical Sciences, Taylor’s University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Maan Hayyan
- Chemical Engineering Program, Faculty of Engineering & Technology, Muscat University, P.O. Box 550, Muscat P.C.130, Oman
- Correspondence: (M.H.); (W.F.W.); (C.Y.L.)
| | - Priya Madhavan
- School of Medicine, Faculty of Health & Medical Sciences, Taylor’s University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Medical Advancement for Better Quality of Life Impact Lab, Taylor’s University, 1, Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Won Fen Wong
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
- Correspondence: (M.H.); (W.F.W.); (C.Y.L.)
| | - Chung Yeng Looi
- Medical Advancement for Better Quality of Life Impact Lab, Taylor’s University, 1, Jalan Taylors, Subang Jaya 47500, Malaysia
- School of Biosciences, Faculty of Health & Medical Sciences, Taylor’s University, Subang Jaya 47500, Malaysia
- Correspondence: (M.H.); (W.F.W.); (C.Y.L.)
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Abjani F, Madhavan P, Chong PP, Chinna K, Rhodes CA, Lim YAL. Urbanisation and its Associated Factors Affecting Human Gut Microbiota: Where are we Heading to? Ann Hum Biol 2023; 50:137-147. [PMID: 36650931 DOI: 10.1080/03014460.2023.2170464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
ContextThe continuous rise in urbanisation and its associated factors have been reflected in the structure of the human gut ecosystem.ObjectiveThe main focus of the review is to discuss and summarise the major risk factors associated with urbanisation that affects human gut microbiota thus affecting human health.MethodsMultiple medical literature databases, namely PubMed, Google, Google Scholar, and Web of Science were used to find relevant materials for urbanization and its major factors affecting human gut microbiota/microbiome. Both layman and Medical Subject Headings (MeSH) terms were used in the search. Due to the scarcity of the data, no limitation was set on the publication date. Relevant material in the English language which includes case reports, chapters of books, journal articles, online news reports and medical records was included in this review.ResultsBased on the data discussed in the review, it is quite clear that urbanisation and its associated factors have long-standing effects on the human gut microbiota that result in alterations of gut microbial diversity and composition. This is a matter of serious concern as chronic inflammatory diseases are on the rise in urbanised societies.ConclusionA better understanding of the factors associated with urbanisation will help us to identify and implement new biological and social approaches to prevent and treat diseases and improve health globally by deepening our understanding of these relationships and increasing studies across urbanisation gradients.HIGHLIGHTSHuman gut microbiota has been linked to almost every important function, including metabolism, intestinal homeostasis, immune system, biosynthesis of vitamins, brain processes, and its behaviour.However, dysbiosis i.e., alteration in the composition and diversity of gut microbiota is associated with the pathogenesis of many chronic conditions.In the 21st century, urbanisation represents a major demographic shift in developed and developing countries.During this period of urbanisation, humans have been exposed to many environmental exposures, all of which have led to the dysbiosis of human gut microbiota.The main focus of the review is to discuss and summarize the major risk factors associated with urbanisation and how it affects the diversity and composition of gut microbiota which ultimately affects human health.
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Affiliation(s)
- Farhat Abjani
- School of Biosciences, Faculty of Health & Medical Sciences, Taylor's University, Jalan Taylors, 47500 Subang Jaya, Selangor, Malaysia
| | - Priya Madhavan
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, Jalan Taylors, 47500 Subang Jaya, Selangor, Malaysia
| | - Pei Pei Chong
- School of Biosciences, Faculty of Health & Medical Sciences, Taylor's University, Jalan Taylors, 47500 Subang Jaya, Selangor, Malaysia
| | - Karuthan Chinna
- Faculty of Business and Management, UCSI University 56100 Cheras, Kuala Lumpur, Malaysia
| | - Charles Anthony Rhodes
- Department of Parasitology, University Malaya Medical Centre, 50603 Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Yvonne Ai Lian Lim
- Department of Parasitology, Faculty of Medicine, University of Malaya. 50603 Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
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Mohd Noor MNZ, Alauddin AS, Wong YH, Looi CY, Wong EH, Madhavan P, Yeong CH. A Systematic Review of Molecular Hydrogen Therapy in Cancer Management. Asian Pac J Cancer Prev 2023; 24:37-47. [PMID: 36708550 PMCID: PMC10152878 DOI: 10.31557/apjcp.2023.24.1.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Cancer remains a challenging target to cure, with present therapeutic methods unable to exhibit restorative outcomes without causing severe negative effects. Molecular hydrogen (H2) has been reported to be a promising adjunctive therapy for cancer treatment, having the capability to induce anti-proliferative, anti-oxidative, pro-apoptotic and anti-tumoural effects. This review summarises the findings from various articles on the mechanism, treatment outcomes, and overall effectiveness of H2 therapy on cancer management. METHODS Using Cochrane, PubMed, and Google Scholar as the search engines, full-text articles in the scope of the study, written in English and within 10 years of publication were selected. RESULTS Out of the 677 articles, 27 articles fulfilled the eligibility criteria, where data was compiled into a table, outlining the general characteristics and findings. Throughout the different forms of H2 administration, study design and types of cancers reported, outcomes were found to be consistent. CONCLUSION From our analysis, H2 plays a promising therapeutic role as an independent therapy as well as an adjuvant in combination therapy, resulting in an overall improvement in survivability, quality of life, blood parameters, and tumour reduction. Although more comprehensive research is needed, given the promising outcomes, H2 is worth considering for use as a complement to current cancer therapy.
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Affiliation(s)
| | - Adlin Sofea Alauddin
- School of Health Sciences, Faculty of Medicine and Health, International Medical University, 57000 Kuala Lumpur, Malaysia
| | - Yin How Wong
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, 47500 Subang Jaya, Malaysia
| | - Chung Yeng Looi
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, 47500 Subang Jaya, Malaysia
| | - Eng Hwa Wong
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, 47500 Subang Jaya, Malaysia
| | - Priya Madhavan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, 47500 Subang Jaya, Malaysia
| | - Chai Hong Yeong
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, 47500 Subang Jaya, Malaysia
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O'Connor U, Walsh C, Gorman D, O'Reilly G, Martin Z, Madhavan P, Murphy RT, Szirt R, Almén A, Andersson M, Camp A, Garcia V, Duch MA, Ginjaume M, Abdelrahman M, Lombardo P, Vanhavere F. Feasibility study of computational occupational dosimetry: evaluating a proof-of-concept in an endovascular and interventional cardiology setting. J Radiol Prot 2022; 42:041501. [PMID: 36130583 DOI: 10.1088/1361-6498/ac9394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/21/2022] [Indexed: 06/15/2023]
Abstract
Individual monitoring of radiation workers is essential to ensure compliance with legal dose limits and to ensure that doses are As Low As Reasonably Achievable. However, large uncertainties still exist in personal dosimetry and there are issues with compliance and incorrect wearing of dosimeters. The objective of the PODIUM (Personal Online Dosimetry Using Computational Methods) project was to improve personal dosimetry by an innovative approach: the development of an online dosimetry application based on computer simulations without the use of physical dosimeters. Occupational doses were calculated based on the use of camera tracking devices, flexible individualised phantoms and data from the radiation source. When combined with fast Monte Carlo simulation codes, the aim was to perform personal dosimetry in real-time. A key component of the PODIUM project was to assess and validate the methodology in interventional radiology workplaces where improvements in dosimetry are needed. This paper describes the feasibility of implementing the PODIUM approach in a clinical setting. Validation was carried out using dosimeters worn by Vascular Surgeons and Interventional Cardiologists during patient procedures at a hospital in Ireland. Our preliminary results from this feasibility study show acceptable differences of the order of 40% between calculated and measured staff doses, in terms of the personal dose equivalent quantity Hp(10), however there is a greater deviation for more complex cases and improvements are needed. The challenges of using the system in busy interventional rooms have informed the future needs and applicability of PODIUM. The availability of an online personal dosimetry application has the potential to overcome problems that arise from the use of current dosimeters. In addition, it should increase awareness of radiation protection among staff. Some limitations remain and a second phase of development would be required to bring the PODIUM method into operation in a hospital setting. However, an early prototype system has been tested in a clinical setting and the results from this two-year proof-of-concept PODIUM project are very promising for future development.
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Affiliation(s)
- U O'Connor
- Medical Physics and Bioengineering Department, St James's Hospital, Dublin, Ireland
- School of Medicine, Trinity College, Dublin, Ireland
| | - C Walsh
- Medical Physics and Bioengineering Department, St James's Hospital, Dublin, Ireland
| | - D Gorman
- Medical Physics and Bioengineering Department, St James's Hospital, Dublin, Ireland
| | - G O'Reilly
- Medical Physics and Bioengineering Department, St James's Hospital, Dublin, Ireland
| | - Z Martin
- Department of Vascular Surgery, St James's Hospital, Dublin, Ireland
| | - P Madhavan
- Department of Vascular Surgery, St James's Hospital, Dublin, Ireland
| | - R T Murphy
- Department of Cardiology, St James's Hospital, Dublin, Ireland
| | - R Szirt
- Department of Cardiology, St James's Hospital, Dublin, Ireland
| | - A Almén
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - M Andersson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - A Camp
- Institut de Tècniques Energètiques, Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - V Garcia
- Institut de Tècniques Energètiques, Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - M A Duch
- Institut de Tècniques Energètiques, Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - M Ginjaume
- Institut de Tècniques Energètiques, Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - M Abdelrahman
- Belgian Nuclear Research Center, Boeretang, Mol, Belgium
| | - P Lombardo
- Belgian Nuclear Research Center, Boeretang, Mol, Belgium
| | - F Vanhavere
- Belgian Nuclear Research Center, Boeretang, Mol, Belgium
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9
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Phuna ZX, Panda BP, Hawala Shivashekaregowda NK, Madhavan P. Nanoprotection from SARS-COV-2: would nanotechnology help in Personal Protection Equipment (PPE) to control the transmission of COVID-19? Int J Environ Health Res 2022:1-30. [PMID: 35253535 DOI: 10.1080/09603123.2022.2046710] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
The coronavirus disease 2019 (COVID-19) has caused a worldwide outbreak. The severe acute respiratory syndrome coronavirus 2 virus can be transmitted human-to-human through droplets and close contact where personal protective equipment (PPE) is imperative to protect the individuals. The advancement of nanotechnology with significant nanosized properties can confer a higher form of protection. Incorporation of nanotechnology into facemasks can exhibit antiviral properties. Nanocoating on surfaces can achieve self-disinfecting purposes and be applied in highly populated places. Moreover, nano-based hand sanitizers can confer better sterilizing efficacies with low skin irritation as compared to alcohol-based hand sanitizers. The present review discusses the incorporation of nanotechnology into nano-based materials and coatings in facemasks, self-surface disinfectants and hand sanitizers, in the hope to contribute to the current understanding of PPE to combat COVID-19.
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Affiliation(s)
- Zhi Xin Phuna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia
| | - Bibhu Prasad Panda
- Department of Pharmaceutical Technology, Schoolof Pharmacy, Faculty of Health & Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | | | - Priya Madhavan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia
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10
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Phuna ZX, Madhavan P. A CLOSER LOOK AT THE MYCOBIOME IN ALZHEIMER'S DISEASE: FUNGAL SPECIES, PATHOGENESIS AND TRANSMISSION. Eur J Neurosci 2022; 55:1291-1321. [DOI: 10.1111/ejn.15599] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Zhi Xin Phuna
- School of Medicine, Faculty of Health & Medical Sciences, Taylor’s University Malaysia Subang Jaya Selangor
| | - Priya Madhavan
- School of Medicine, Faculty of Health & Medical Sciences, Taylor’s University Malaysia Subang Jaya Selangor
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11
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Rao H, Choo S, Rajeswari Mahalingam SR, Adisuri DS, Madhavan P, Md. Akim A, Chong PP. Approaches for Mitigating Microbial Biofilm-Related Drug Resistance: A Focus on Micro- and Nanotechnologies. Molecules 2021; 26:1870. [PMID: 33810292 PMCID: PMC8036581 DOI: 10.3390/molecules26071870] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/03/2021] [Accepted: 02/09/2021] [Indexed: 02/07/2023] Open
Abstract
Biofilms play an essential role in chronic and healthcare-associated infections and are more resistant to antimicrobials compared to their planktonic counterparts due to their (1) physiological state, (2) cell density, (3) quorum sensing abilities, (4) presence of extracellular matrix, (5) upregulation of drug efflux pumps, (6) point mutation and overexpression of resistance genes, and (7) presence of persister cells. The genes involved and their implications in antimicrobial resistance are well defined for bacterial biofilms but are understudied in fungal biofilms. Potential therapeutics for biofilm mitigation that have been reported include (1) antimicrobial photodynamic therapy, (2) antimicrobial lock therapy, (3) antimicrobial peptides, (4) electrical methods, and (5) antimicrobial coatings. These approaches exhibit promising characteristics for addressing the impending crisis of antimicrobial resistance (AMR). Recently, advances in the micro- and nanotechnology field have propelled the development of novel biomaterials and approaches to combat biofilms either independently, in combination or as antimicrobial delivery systems. In this review, we will summarize the general principles of clinically important microbial biofilm formation with a focus on fungal biofilms. We will delve into the details of some novel micro- and nanotechnology approaches that have been developed to combat biofilms and the possibility of utilizing them in a clinical setting.
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Affiliation(s)
- Harinash Rao
- School of Medicine, Taylor’s University, Subang Jaya, Selangor 47500, Malaysia; (H.R.); (D.S.A.); (P.M.)
| | - Sulin Choo
- School of Biosciences, Taylor’s University, Subang Jaya, Selangor 47500, Malaysia;
| | | | - Diajeng Sekar Adisuri
- School of Medicine, Taylor’s University, Subang Jaya, Selangor 47500, Malaysia; (H.R.); (D.S.A.); (P.M.)
| | - Priya Madhavan
- School of Medicine, Taylor’s University, Subang Jaya, Selangor 47500, Malaysia; (H.R.); (D.S.A.); (P.M.)
| | - Abdah Md. Akim
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor 43400, Malaysia
| | - Pei Pei Chong
- School of Biosciences, Taylor’s University, Subang Jaya, Selangor 47500, Malaysia;
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12
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Benchoula K, Parhar IS, Madhavan P, Hwa WE. CREB nuclear transcription activity as a targeting factor in the treatment of diabetes and diabetes complications. Biochem Pharmacol 2021; 188:114531. [PMID: 33773975 DOI: 10.1016/j.bcp.2021.114531] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/09/2021] [Accepted: 03/17/2021] [Indexed: 02/06/2023]
Abstract
Diabetes mellitus is a metabolic disorder diagnosed by elevated blood glucose levels and a defect in insulin production. Blood glucose, an energy source in the body, is regenerated by two fundamental processes: glycolysis and gluconeogenesis. These two processes are the main mechanisms used by humans and many other animals to maintain blood glucose levels, thereby avoiding hypoglycaemia. The released insulin from pancreatic β-cells activates glycolysis. However, the glucagon released from the pancreatic α-cells activates gluconeogenesis in the liver, leading to pyruvate conversion to glucose-6-phosphate by different enzymes such as fructose 1,6-bisphosphatase and glucose 6-phosphatase. These enzymes' expression is controlled by the glucagon/ cyclic adenosine 3',5'-monophosphate (cAMP)/ proteinkinase A (PKA) pathway. This pathway phosphorylates cAMP-response element-binding protein (CREB) in the nucleus to bind it to these enzyme promoters and activate their expression. During fasting, this process is activated to supply the body with glucose; however, it is overactivated in diabetes. Thus, the inhibition of this process by blocking the expression of the enzymes via CREB is an alternative strategy for the treatment of diabetes. This review was designed to investigate the association between CREB activity and the treatment of diabetes and diabetes complications. The phosphorylation of CREB is a crucial step in regulating the gene expression of the enzymes of gluconeogenesis. Many studies have proven that CREB is over-activated by glucagon and many other factors contributing to the elevation of fasting glucose levels in people with diabetes. The physiological function of CREB should be regarded in developing a therapeutic strategy for the treatment of diabetes mellitus and its complications. However, the accessible laboratory findings for CREB activity of the previous research still not strong enough for continuing to the clinical trial yet.
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Affiliation(s)
- Khaled Benchoula
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, 1, Jalan Taylors, 47500 Subang Jaya, Selangor, Malaysia
| | - Ishwar S Parhar
- Monash University (Malaysia) BRIMS, Jeffrey Cheah School of Medicine & Health Sciences, Jalan Lagoon Selatan, Bandar Sunway, 47500 Subang Jaya, Selangor, Malaysia
| | - Priya Madhavan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, 1, Jalan Taylors, 47500 Subang Jaya, Selangor, Malaysia
| | - Wong Eng Hwa
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, 1, Jalan Taylors, 47500 Subang Jaya, Selangor, Malaysia.
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13
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Choo S, Chong P, Tay S, Wong E, Madhavan P, Yong P. Inhibition of sessile and biofilm growth in various Aspergillus species by allicin associated with disruption to structural changes in cell wall. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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14
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Mahalingam S, Madhavan P, Pei Pei C. Effects of in vitro treatment with amphotericin B, fluconazole, caspofungin and voriconazole on the ultrastructure of diutina (Candida) rugosa biofilms. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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15
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Abdul Manap AS, Madhavan P, Vijayabalan S, Chia A, Fukui K. Explicating anti-amyloidogenic role of curcumin and piperine via amyloid beta (A β) explicit pathway: recovery and reversal paradigm effects. PeerJ 2020; 8:e10003. [PMID: 33062432 PMCID: PMC7532763 DOI: 10.7717/peerj.10003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 08/30/2020] [Indexed: 12/28/2022] Open
Abstract
Previously, we reported the synergistic effects of curcumin and piperine in cell cultures as potential anti-cholinesterase and anti-amyloidogenic agents. Due to limited findings on the enrolment of these compounds on epigenetic events in AD, we aimed at elucidating the expression profiles of Aβ42-induced SH-SY5Y cells using microarray profiling. In this study, an optimized concentration of 35 µM of curcumin and piperine in combination was used to treat Aβ42 fibril and high-throughput microarray profiling was performed on the extracted RNA. This was then compared to curcumin and piperine used singularly at 49.11 µM and 25 µM, respectively. Our results demonstrated that in the curcumin treated group, from the top 10 upregulated and top 10 downregulated significantly differentially expressed genes (p < 0.05; fold change ≥ 2 or ≤ -2), there were five upregulated and three downregulated genes involved in the amyloidogenic pathway. While from top 10 upregulated and top 10 downregulated significantly differentially expressed genes (p < 0.05; fold change ≥ 2 or ≤ - 2) in the piperine treated group, there were four upregulated and three downregulated genes involved in the same pathway, whereas there were five upregulated and two downregulated genes involved (p < 0.05; fold change ≥ 2 or ≤ - 2) in the curcumin-piperine combined group. Four genes namely GABARAPL1, CTSB, RAB5 and AK5 were expressed significantly in all groups. Other genes such as ITPR1, GSK3B, PPP3CC, ERN1, APH1A, CYCS and CALM2 were novel putative genes that are involved in the pathogenesis of AD. We revealed that curcumin and piperine have displayed their actions against Aβ via the modulation of various mechanistic pathways. Alterations in expression profiles of genes in the neuronal cell model may explain Aβ pathology post-treatment and provide new insights for remedial approaches of a combined treatment using curcumin and piperine.
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Affiliation(s)
- Aimi Syamima Abdul Manap
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Priya Madhavan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Shantini Vijayabalan
- School of Pharmacy, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Adeline Chia
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Koji Fukui
- Department of Bioscience and Engineering, College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
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16
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Choo S, Chin VK, Wong EH, Madhavan P, Tay ST, Yong PVC, Chong PP. Review: antimicrobial properties of allicin used alone or in combination with other medications. Folia Microbiol (Praha) 2020; 65:451-465. [DOI: 10.1007/s12223-020-00786-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 03/10/2020] [Indexed: 12/11/2022]
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17
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Murphy SJX, Lim ST, Kinsella JA, Tierney S, Egan B, Feeley TM, Murphy SM, Walsh RA, Collins DR, Coughlan T, O'Neill D, Harbison JA, Madhavan P, O'Neill SM, Colgan MP, Cox D, Moran N, Hamilton G, Meaney JF, McCabe DJH. Relationship between 'on-treatment platelet reactivity', shear stress, and micro-embolic signals in asymptomatic and symptomatic carotid stenosis. J Neurol 2019; 267:168-184. [PMID: 31606758 DOI: 10.1007/s00415-019-09550-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Assessment of 'high on-treatment platelet reactivity (HTPR)' could enhance understanding of the pathophysiology of first or recurrent vascular events in carotid stenosis patients on antiplatelet therapy. METHODS This prospective, multi-centre study assessed antiplatelet-HTPR status and its relationship with micro-emboli signals (MES) in asymptomatic vs. symptomatic ≥ 50-99% carotid stenosis. Platelet function/reactivity was assessed under 'moderately high shear stress' with the PFA-100® and 'low shear stress' with VerifyNow® and Multiplate® analysers. Bilateral 1-h transcranial Doppler ultrasound of the middle cerebral arteries classified patients as MES + ve or MES - ve. RESULTS Data from 34 asymptomatic patients were compared with 43 symptomatic patients in the 'early phase' (≤ 4 weeks) and 37 patients in the 'late phase' (≥ 3 months) after TIA/ischaemic stroke. Median daily aspirin doses were higher in early symptomatic (225 mg; P < 0.001), but not late symptomatic (75 mg; P = 0.62) vs. asymptomatic patients (75 mg). There was a lower prevalence of aspirin-HTPR in early (28.6%; P = 0.028), but not late symptomatic (38.9%; P = 0.22) compared with asymptomatic patients (56.7%) on the PFA-100®, but not on the VerifyNow® or Multiplate® (P ≤ 0.53). Early symptomatic patients had a higher prevalence of aspirin-HTPR on the PFA-100® (28.6%) vs. VerifyNow® (9.5%; P = 0.049), but not Multiplate® assays (11.9%, P = 0.10). There was no difference in aspirin-HTPR prevalence between any symptomatic vs. asymptomatic MES + ve or MES - ve subgroup. DISCUSSION Recently symptomatic moderate-severe carotid stenosis patients had a lower prevalence of aspirin-HTPR than their asymptomatic counterparts on the PFA-100®, likely related to higher aspirin doses. The prevalence of antiplatelet-HTPR was positively influenced by higher shear stress levels, but not MES status.
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Affiliation(s)
- S J X Murphy
- Department of Neurology, AMNCH/Tallaght University Hospital, Dublin, Ireland.,Stroke Service, AMNCH/Tallaght University Hospital, Dublin, Ireland
| | - S T Lim
- Department of Neurology, AMNCH/Tallaght University Hospital, Dublin, Ireland.,Stroke Service, AMNCH/Tallaght University Hospital, Dublin, Ireland
| | - J A Kinsella
- Department of Neurology, St Vincent's University Hospital, University College Dublin, Dublin, Ireland
| | - S Tierney
- Department of Vascular Surgery, AMNCH/Tallaght University Hospital, Dublin, Ireland
| | - B Egan
- Department of Vascular Surgery, AMNCH/Tallaght University Hospital, Dublin, Ireland
| | - T M Feeley
- Department of Vascular Surgery, AMNCH/Tallaght University Hospital, Dublin, Ireland.,Dublin Midlands Hospital Group, Dublin, Ireland
| | - S M Murphy
- Department of Neurology, AMNCH/Tallaght University Hospital, Dublin, Ireland.,Stroke Service, AMNCH/Tallaght University Hospital, Dublin, Ireland.,Academic Unit of Neurology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - R A Walsh
- Department of Neurology, AMNCH/Tallaght University Hospital, Dublin, Ireland.,Academic Unit of Neurology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - D R Collins
- Age-Related Health Care Department, AMNCH/Tallaght University Hospital, Dublin, Ireland.,Stroke Service, AMNCH/Tallaght University Hospital, Dublin, Ireland
| | - T Coughlan
- Age-Related Health Care Department, AMNCH/Tallaght University Hospital, Dublin, Ireland.,Stroke Service, AMNCH/Tallaght University Hospital, Dublin, Ireland
| | - D O'Neill
- Age-Related Health Care Department, AMNCH/Tallaght University Hospital, Dublin, Ireland.,Stroke Service, AMNCH/Tallaght University Hospital, Dublin, Ireland
| | - J A Harbison
- Department of Medicine for the Elderly/Stroke Service, St. James's Hospital/Trinity College Dublin, Dublin, Ireland
| | - P Madhavan
- Department of Vascular Surgery, St. James's Hospital/Trinity College Dublin, Dublin, Ireland
| | - S M O'Neill
- Department of Vascular Surgery, St. James's Hospital/Trinity College Dublin, Dublin, Ireland
| | - M P Colgan
- Department of Vascular Surgery, St. James's Hospital/Trinity College Dublin, Dublin, Ireland
| | - D Cox
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland.,Irish Centre for Vascular Biology, Dublin, Ireland
| | - N Moran
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland.,Irish Centre for Vascular Biology, Dublin, Ireland
| | - G Hamilton
- Department of Vascular Surgery, University Department of Surgery, Royal Free Hampstead NHS Trust, London, UK
| | - J F Meaney
- Department of Radiology, Centre for Advanced Medical Imaging, St. James's Hospital/Trinity College Dublin, Dublin, Ireland
| | - D J H McCabe
- Vascular Neurology Research Foundation, C/O Department of Neurology, The Adelaide and Meath Hospital, Dublin, Incorporating the National Children's Hospital (AMNCH)/Tallaght University Hospital, Tallaght, Dublin 24, Ireland. .,Department of Neurology, AMNCH/Tallaght University Hospital, Dublin, Ireland. .,Stroke Service, AMNCH/Tallaght University Hospital, Dublin, Ireland. .,Department of Clinical Neurosciences, Royal Free Campus, UCL Queen Square Institute of Neurology, London, UK. .,Irish Centre for Vascular Biology, Dublin, Ireland. .,Stroke Clinical Trials Network Ireland, Dublin, Ireland. .,Academic Unit of Neurology, School of Medicine, Trinity College Dublin, Dublin, Ireland.
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18
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Abdul Manap AS, Wei Tan AC, Leong WH, Yin Chia AY, Vijayabalan S, Arya A, Wong EH, Rizwan F, Bindal U, Koshy S, Madhavan P. Synergistic Effects of Curcumin and Piperine as Potent Acetylcholine and Amyloidogenic Inhibitors With Significant Neuroprotective Activity in SH-SY5Y Cells via Computational Molecular Modeling and in vitro Assay. Front Aging Neurosci 2019; 11:206. [PMID: 31507403 PMCID: PMC6718453 DOI: 10.3389/fnagi.2019.00206] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 07/22/2019] [Indexed: 12/21/2022] Open
Abstract
Hallmarks of Alzheimer's disease (AD) pathology include acetylcholine (ACh) deficiency and plaque deposition. Emerging studies suggest that acetylcholinesterase (AChE) may interact with amyloid β (Aβ) to promote aggregation of insoluble Aβ plaques in brains of patients. Current therapeutic options available for AD patients, such as AChE inhibitors, provide only symptomatic relief. In this study, we screened four natural compounds believed to harbor cognitive benefits-curcumin, piperine, bacoside A, and chebulinic acid. In the first section, preliminary screening through computational molecular docking simulations gauged the suitability of the compounds as novel AChE inhibitors. From here, only compounds that met the in silico selection criteria were selected for the second section through in vitro investigations, including AChE enzyme inhibition assay, 3-(4,5-dimenthylthiazol-2-yl)-2,5-dimethyltetrazolium bromide (MTT) assay, Thioflavin T (ThT) assay, and biochemical analysis via a neuronal cell line model. Of the four compounds screened, only curcumin (-9.6 kcal/mol) and piperine (-10.5 kcal/mol) showed favorable binding affinities and interactions towards AChE and were hence selected. In vitro AChE inhibition demonstrated that combination of curcumin and piperine showed greater AChE inhibition with an IC50 of 62.81 ± 0.01 μg/ml as compared to individual compounds, i.e., IC50 of curcumin at 134.5 ± 0.06 μg/ml and IC50 of piperine at 76.6 ± 0.08 μg/ml. In the SH-SY5Y cell model, this combination preserved cell viability up to 85%, indicating that the compounds protect against Aβ-induced neuronal damage (p < 0.01). Interestingly, our results also showed that curcumin and piperine achieved a synergistic effect at 35 μM with an synergism quotient (SQ) value of 1.824. Synergistic behavior indicates that the combination of these two compounds at lower concentrations may provide a better outcome than singularly used for Aβ proteins. Combined curcumin and piperine managed to inhibit aggregation (reduced ThT intensity at 0.432 a.u.; p < 0.01) as well as disaggregation (reduced ThT intensity at 0.532 a.u.; p < 0.01) of fibrillar Aβ42. Furthermore, combined curcumin and piperine reversed the Aβ-induced up-regulation of neuronal oxidative stress (p < 0.01). In conclusion, curcumin and piperine demonstrated promising neuroprotective effects, whereas bacoside A and chebulinic acid may not be suitable lead compounds. These results are hoped to advance the field of natural products research as potentially therapeutic and curative AD agents.
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Affiliation(s)
- Aimi Syamima Abdul Manap
- School of Biosciences, Faculty of Health and Sciences, Taylor’s University, Subang Jaya, Malaysia
| | - Amelia Cheng Wei Tan
- School of Biosciences, Faculty of Health and Sciences, Taylor’s University, Subang Jaya, Malaysia
| | - Weng Hhin Leong
- School of Biosciences, Faculty of Health and Sciences, Taylor’s University, Subang Jaya, Malaysia
| | - Adeline Yoke Yin Chia
- School of Biosciences, Faculty of Health and Sciences, Taylor’s University, Subang Jaya, Malaysia
| | - Shantini Vijayabalan
- School of Pharmacy, Faculty of Health and Sciences, Taylor’s University, Subang Jaya, Malaysia
| | - Aditya Arya
- School of Medicine, Faculty of Health and Sciences, Taylor’s University, Subang Jaya, Malaysia
| | - Eng Hwa Wong
- School of Medicine, Faculty of Health and Sciences, Taylor’s University, Subang Jaya, Malaysia
| | - Farzana Rizwan
- School of Medicine, Faculty of Health and Sciences, Taylor’s University, Subang Jaya, Malaysia
| | - Umesh Bindal
- School of Medicine, Faculty of Health and Sciences, Taylor’s University, Subang Jaya, Malaysia
| | - Shajan Koshy
- School of Medicine, Faculty of Health and Sciences, Taylor’s University, Subang Jaya, Malaysia
| | - Priya Madhavan
- School of Medicine, Faculty of Health and Sciences, Taylor’s University, Subang Jaya, Malaysia
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19
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Chong PP, Chin VK, Looi CY, Wong WF, Madhavan P, Yong VC. Corrigendum: The Microbiome and Irritable Bowel Syndrome - A Review on the Pathophysiology, Current Research and Future Therapy. Front Microbiol 2019; 10:1870. [PMID: 31456783 PMCID: PMC6700555 DOI: 10.3389/fmicb.2019.01870] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 07/29/2019] [Indexed: 11/13/2022] Open
Abstract
[This corrects the article DOI: 10.3389/fmicb.2019.01136.].
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Affiliation(s)
- Pei Pei Chong
- School of Biosciences, Taylor's University, Subang Jaya, Malaysia
| | - Voon Kin Chin
- School of Biosciences, Taylor's University, Subang Jaya, Malaysia
| | - Chung Yeng Looi
- School of Biosciences, Taylor's University, Subang Jaya, Malaysia
| | - Won Fen Wong
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Priya Madhavan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Voon Chen Yong
- School of Biosciences, Taylor's University, Subang Jaya, Malaysia
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20
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Abdul Manap AS, Vijayabalan S, Madhavan P, Chia YY, Arya A, Wong EH, Rizwan F, Bindal U, Koshy S. Bacopa monnieri, a Neuroprotective Lead in Alzheimer Disease: A Review on Its Properties, Mechanisms of Action, and Preclinical and Clinical Studies. Drug Target Insights 2019; 13:1177392819866412. [PMID: 31391778 PMCID: PMC6669844 DOI: 10.1177/1177392819866412] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 07/08/2019] [Indexed: 01/24/2023] Open
Abstract
Alzheimer disease is a neurodegenerative disease that is signified by cognitive decline, memory loss, and erratic behavior. Till date, no cure for Alzheimer exists and the current Alzheimer medications have limited effectiveness. However, herbal medicines may slow down the disease’s progression, which may hopefully reduce the number of cases in the years to come. Numerous studies have been done on characterizing the neuroprotective properties from plants belonging to Scrophulariaceae family, particularly Bacopa monnieri and its polyphenolic compounds known as bacosides. This review presents the findings on bacosides in therapeutic plants and their impact on Alzheimer disease pathology. These reports present data on the clinical, cellular activities, phytochemistry, and biological applications that may be used in new drug treatment for Alzheimer disease.
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Affiliation(s)
- Aimi Syamima Abdul Manap
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Shantini Vijayabalan
- School of Pharmacy, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Priya Madhavan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Yoke Yin Chia
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Aditya Arya
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Eng Hwa Wong
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Farzana Rizwan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Umesh Bindal
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Shajan Koshy
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
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21
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Chong PP, Chin VK, Looi CY, Wong WF, Madhavan P, Yong VC. The Microbiome and Irritable Bowel Syndrome - A Review on the Pathophysiology, Current Research and Future Therapy. Front Microbiol 2019; 10:1136. [PMID: 31244784 PMCID: PMC6579922 DOI: 10.3389/fmicb.2019.01136] [Citation(s) in RCA: 142] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 05/06/2019] [Indexed: 11/16/2022] Open
Abstract
Irritable bowel syndrome (IBS) is a functional disorder which affects a large proportion of the population globally. The precise etiology of IBS is still unknown, although consensus understanding proposes IBS to be of multifactorial origin with yet undefined subtypes. Genetic and epigenetic factors, stress-related nervous and endocrine systems, immune dysregulation and the brain-gut axis seem to be contributing factors that predispose individuals to IBS. In addition to food hypersensitivity, toxins and adverse life events, chronic infections and dysbiotic gut microbiota have been suggested to trigger IBS symptoms in tandem with the predisposing factors. This review will summarize the pathophysiology of IBS and the role of gut microbiota in relation to IBS. Current methodologies for microbiome studies in IBS such as genome sequencing, metagenomics, culturomics and animal models will be discussed. The myriad of therapy options such as immunoglobulins (immune-based therapy), probiotics and prebiotics, dietary modifications including FODMAP restriction diet and gluten-free diet, as well as fecal transplantation will be reviewed. Finally this review will highlight future directions in IBS therapy research, including identification of new molecular targets, application of 3-D gut model, gut-on-a-chip and personalized therapy.
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Affiliation(s)
- Pei Pei Chong
- School of Biosciences, Taylor's University, Subang Jaya, Malaysia
| | - Voon Kin Chin
- School of Biosciences, Taylor's University, Subang Jaya, Malaysia
| | - Chung Yeng Looi
- School of Biosciences, Taylor's University, Subang Jaya, Malaysia
| | - Won Fen Wong
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Priya Madhavan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Voon Chen Yong
- School of Biosciences, Taylor's University, Subang Jaya, Malaysia
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Boyle E, McHugh SM, Elmallah A, Lynch M, McGuire D, Ahmed Z, Canning C, Colgan MP, O’Neill SM, O’Callaghan A, Martin Z, Madhavan P. Explant of aortic stent grafts following endovascular aneurysm repair. Vascular 2019; 27:487-494. [DOI: 10.1177/1708538119832727] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Failure of endovascular aneurysm repair may require explant of the stent graft in a subset of patients. We sought to assess outcomes in a cohort of patients undergoing explant of endovascular aneurysm repair in both emergency and elective settings. Methods Patients undergoing explant of endovascular aneurysm repair were identified from a prospectively maintained database, with additional information obtained through retrospective analysis of medical records. Results Over a 21-year period, 1997–2018 (May), there were 597 endovascular aneurysm repair procedures performed in our institution for abdominal aortic aneurysm. There were 19 endovascular aneurysm repair explants; five of these were referrals from other vascular centres. The median age was 73 years (range 46–81). The median length of time from insertion to explant was 39.2 months (range 0–153). Indications for elective explant were type Ia endoleak (n = 4), type 1b endoleak (n = 1), type II endoleak with increasing sac size (n = 1), type I/III endoleak (n = 1), type IV endoleak (n = 1), and increasing sac size without evident endoleak (type V, n = 2). The remaining nine cases were emergency procedures, with four patients presenting with rupture post endovascular aneurysm repair, four patients presenting with acute stent thrombosis, of which one also had a type 1a endoleak and one aorto-enteric fistula. There were no mortalities in the elective group and three mortalities in the emergency group (0 vs 33.3%, p = 0.087). Overall 30-day mortality was 15.8% Conclusion Explant of aortic stent grafts can be associated with high mortality and morbidity rates, especially in the emergent setting. Patient and device selection and post-operative surveillance remain vitally important to optimise outcomes post endovascular aneurysm repair.
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Affiliation(s)
- E Boyle
- Department of Vascular Surgery, St. James’s Hospital, Dublin 8, Ireland
| | - SM McHugh
- Department of Vascular Surgery, St. James’s Hospital, Dublin 8, Ireland
| | - A Elmallah
- Faculty of Medicine, Menoufia University, Egypt
| | - M Lynch
- Department of Vascular Surgery, St. James’s Hospital, Dublin 8, Ireland
| | - D McGuire
- Department of Vascular Surgery, St. James’s Hospital, Dublin 8, Ireland
| | - Z Ahmed
- Department of Vascular Surgery, St. James’s Hospital, Dublin 8, Ireland
| | - C Canning
- Department of Vascular Surgery, St. James’s Hospital, Dublin 8, Ireland
| | - MP Colgan
- Department of Vascular Surgery, St. James’s Hospital, Dublin 8, Ireland
| | - SM O’Neill
- Department of Vascular Surgery, St. James’s Hospital, Dublin 8, Ireland
| | - A O’Callaghan
- Department of Vascular Surgery, St. James’s Hospital, Dublin 8, Ireland
| | - Z Martin
- Department of Vascular Surgery, St. James’s Hospital, Dublin 8, Ireland
| | - P Madhavan
- Department of Vascular Surgery, St. James’s Hospital, Dublin 8, Ireland
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Peremalo T, Madhavan P, Hamzah S, Than L, Wong EH, Nasir MDM, Chong PP, Ng KP. Antifungal susceptibilities, biofilms, phospholipase and proteinase activities in the Candida rugosa complex and Candida pararugosa isolated from tertiary teaching hospitals. J Med Microbiol 2019; 68:346-354. [DOI: 10.1099/jmm.0.000940] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- T. Peremalo
- 1 School of Pharmacy, Taylor’s University Lakeside Campus, Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - P. Madhavan
- 2 School of Medicine, Taylor’s University Lakeside Campus, Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - S. Hamzah
- 1 School of Pharmacy, Taylor’s University Lakeside Campus, Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - L. Than
- 3 Department of Medical Microbiology and Parasitology, University Putra Malaysia, Selangor Darul Ehsan, Malaysia
| | - E. H. Wong
- 2 School of Medicine, Taylor’s University Lakeside Campus, Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - M. D. Mohd Nasir
- 4 Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, University Putra Malaysia, Selangor Darul Ehsan, Malaysia
| | - P. P. Chong
- 5 School of Biosciences, Faculty of Health and Medical Sciences, Taylor’s University Lakeside Campus, Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - K. P. Ng
- 6 Department of Biomedical Imaging, Faculty of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
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Madhavan P, Chong PP, Farida J, Fauziah O, Cheah YK, Arunkumar Karunanidhi A, Ng KP. Antimicrobial susceptibilities and random amplified polymorphic DNA-PCR fingerprint characterization of Candida glabrata, Candida parapsilosis and Candida rugosa from two major hospitals in Kuala Lumpur, Malaysia. Trop Biomed 2019; 36:183-193. [PMID: 33597438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The purpose of this study is to characterize 3 non-albicans Candida spp. that were collected from two major hospitals in a densely populated area of Kuala Lumpur for their susceptibilities to azole and genetic background. Fifteen non-albicans Candida clinical isolates in two major hospitals in Kuala Lumpur area of Malaysia were collected by convenience sampling during 2007 and 2010. The genetic diversity of 15 non-albicans Candida species comprising C. glabrata (n = 5), C. parapsilosis (n = 5) and C. rugosa (n = 5) were assessed by RAPD-PCR typing. Strains were initially identified using biochemical tests and CHROMagar Candida medium. Fluconazole and voriconazole susceptibilities were determined by E-test method. Commercial kits were used for DNA extraction and amplification with RAPD primers (OPA02, OPA03 and OPA08). PCR conditions were optimized and simultaneous identification was possible by agarose gel electrophoresis of PCR products and the bands obtained were analyzed using BioNumerics Applied Maths v.6.6 software. The RAPD primers used in this study generated 100% polymorphic profile. Cluster analysis using the RAPD-PCR profile showed 12.5-25% similarity among the strains. The genetic diversity was based on the strain susceptibility towards both the azoles, site of isolation and place according to their unique banding patterns. In contrast, strains susceptible to azoles were found to be genetically similar with clonal dissimilarity. The use of OPA02, OPA03 and OPA08 primers in differentiating non-albicans Candida spp. underscores the higher resolution of RAPD-PCR as a reliable tool for strain/species level differentiation.
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Affiliation(s)
- P Madhavan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, No. 1, Jalan Taylor's, 47500 Subang Jaya, Selangor Darul Ehsan, Malaysia
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Darul Ehsan, Malaysia
| | - P P Chong
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, No. 1, Jalan Taylor's, 47500 Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - J Farida
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Darul Ehsan, Malaysia
| | - O Fauziah
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Darul Ehsan, Malaysia
| | - Y K Cheah
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Darul Ehsan, Malaysia
| | - A Arunkumar Karunanidhi
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Darul Ehsan, Malaysia
| | - K P Ng
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Lembah Pantai, 50603 Kuala Lumpur, Malaysia
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25
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Rad SK, Arya A, Karimian H, Madhavan P, Rizwan F, Koshy S, Prabhu G. Mechanism involved in insulin resistance via accumulation of β-amyloid and neurofibrillary tangles: link between type 2 diabetes and Alzheimer's disease. Drug Des Devel Ther 2018; 12:3999-4021. [PMID: 30538427 PMCID: PMC6255119 DOI: 10.2147/dddt.s173970] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The pathophysiological link between type 2 diabetes mellitus (T2DM) and Alzheimer's disease (AD) has been suggested in several reports. Few findings suggest that T2DM has strong link in the development process of AD, and the complete mechanism is yet to be revealed. Formation of amyloid plaques (APs) and neurofibrillary tangles (NFTs) are two central hallmarks in the AD. APs are the dense composites of β-amyloid protein (Aβ) which accumulates around the nerve cells. Moreover, NFTs are the twisted fibers containing hyperphosphorylated tau proteins present in certain residues of Aβ that build up inside the brain cells. Certain factors contribute to the aetiogenesis of AD by regulating insulin signaling pathway in the brain and accelerating the formation of neurotoxic Aβ and NFTs via various mechanisms, including GSK3β, JNK, CamKII, CDK5, CK1, MARK4, PLK2, Syk, DYRK1A, PPP, and P70S6K. Progression to AD could be influenced by insulin signaling pathway that is affected due to T2DM. Interestingly, NFTs and APs lead to the impairment of several crucial cascades, such as synaptogenesis, neurotrophy, and apoptosis, which are regulated by insulin, cholesterol, and glucose metabolism. The investigation of the molecular cascades through insulin functions in brain contributes to probe and perceive progressions of diabetes to AD. This review elaborates the molecular insights that would help to further understand the potential mechanisms linking T2DM and AD.
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Affiliation(s)
- Sima Kianpour Rad
- Department of Molecular Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Aditya Arya
- Department of Pharmacology and Therapeutics, School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia,
- Department of Pharmacology and Therapeutics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia,
- Malaysian Institute of Pharmaceuticals and Nutraceuticals (IPharm), Bukit Gambir, Gelugor, Pulau Pinang, Malaysia,
| | - Hamed Karimian
- Department of Pharmacology and Therapeutics, School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia,
| | - Priya Madhavan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Farzana Rizwan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Shajan Koshy
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Girish Prabhu
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
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Chong PP, Chin VK, Wong WF, Madhavan P, Yong VC, Looi CY. Transcriptomic and Genomic Approaches for Unravelling Candida albicans Biofilm Formation and Drug Resistance-An Update. Genes (Basel) 2018; 9:genes9110540. [PMID: 30405082 PMCID: PMC6266447 DOI: 10.3390/genes9110540] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 10/29/2018] [Accepted: 10/30/2018] [Indexed: 11/17/2022] Open
Abstract
Candida albicans is an opportunistic fungal pathogen, which causes a plethora of superficial, as well as invasive, infections in humans. The ability of this fungus in switching from commensalism to active infection is attributed to its many virulence traits. Biofilm formation is a key process, which allows the fungus to adhere to and proliferate on medically implanted devices as well as host tissue and cause serious life-threatening infections. Biofilms are complex communities of filamentous and yeast cells surrounded by an extracellular matrix that confers an enhanced degree of resistance to antifungal drugs. Moreover, the extensive plasticity of the C. albicans genome has given this versatile fungus the added advantage of microevolution and adaptation to thrive within the unique environmental niches within the host. To combat these challenges in dealing with C. albicans infections, it is imperative that we target specifically the molecular pathways involved in biofilm formation as well as drug resistance. With the advent of the -omics era and whole genome sequencing platforms, novel pathways and genes involved in the pathogenesis of the fungus have been unraveled. Researchers have used a myriad of strategies including transcriptome analysis for C. albicans cells grown in different environments, whole genome sequencing of different strains, functional genomics approaches to identify critical regulatory genes, as well as comparative genomics analysis between C. albicans and its closely related, much less virulent relative, C. dubliniensis, in the quest to increase our understanding of the mechanisms underlying the success of C. albicans as a major fungal pathogen. This review attempts to summarize the most recent advancements in the field of biofilm and antifungal resistance research and offers suggestions for future directions in therapeutics development.
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Affiliation(s)
- Pei Pei Chong
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University Malaysia, Subang Jaya, 47500 Selangor, Malaysia.
| | - Voon Kin Chin
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University Malaysia, Subang Jaya, 47500 Selangor, Malaysia.
| | - Won Fen Wong
- Department of Microbiology, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Priya Madhavan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University Malaysia, Subang Jaya, 47500 Selangor, Malaysia.
| | - Voon Chen Yong
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University Malaysia, Subang Jaya, 47500 Selangor, Malaysia.
| | - Chung Yeng Looi
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University Malaysia, Subang Jaya, 47500 Selangor, Malaysia.
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27
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Iacob L, Canning C, Colgan M, Martin Z, O'Neill S, O'Callaghan A, Madhavan P. Primary Closure Following Carotid Endarterectomy Does not Increase the Rate of Significant Restenosis or Stroke. Eur J Vasc Endovasc Surg 2018. [DOI: 10.1016/j.ejvs.2018.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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28
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Madhavan P, Infante K, Harris B, Lucas JT, Nash C. Impact of competitive landscape and ownership dynamics on oncology combination pricing. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e18942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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29
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Madhavan P, Infante K, Harris B, Lucas JT, Nash C. Impact of clinical characteristics and unmet need on oncology combination pricing. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e18941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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30
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Madhavan P, Jamal F, Pei CP, Othman F, Karunanidhi A, Ng KP. Comparative Study of the Effects of Fluconazole and Voriconazole on Candida glabrata, Candida parapsilosis and Candida rugosa Biofilms. Mycopathologia 2018; 183:499-511. [PMID: 29380188 DOI: 10.1007/s11046-018-0243-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 01/03/2018] [Indexed: 12/30/2022]
Abstract
Infections by non-albicans Candida species are a life-threatening condition, and formation of biofilms can lead to treatment failure in a clinical setting. This study was aimed to demonstrate the in vitro antibiofilm activity of fluconazole (FLU) and voriconazole (VOR) against C. glabrata, C. parapsilosis and C. rugosa with diverse antifungal susceptibilities to FLU and VOR. The antibiofilm activities of FLU and VOR in the form of suspension as well as pre-coatings were assessed by XTT [2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide] reduction assay. Morphological and intracellular changes exerted by the antifungal drugs on Candida cells were examined by scanning electron microscope (SEM) and transmission electron microscope (TEM). The results of the antibiofilm activities showed that FLU drug suspension was capable of killing C. parapsilosis and C. rugosa at minimum inhibitory concentrations (MICs) of 4× MIC FLU and 256× MIC FLU, respectively. While VOR MICs ranging from 2× to 32× were capable of killing the biofilms of all Candida spp tested. The antibiofilm activities of pre-coated FLU were able to kill the biofilms at ¼× MIC FLU and ½× MIC FLU for C. parapsilosis and C. rugosa strains, respectively. While pre-coated VOR was able to kill the biofilms, all three Candida sp at ½× MIC VOR. SEM and TEM examinations showed that FLU and VOR treatments exerted significant impact on Candida cell with various degrees of morphological changes. In conclusion, a fourfold reduction in MIC50 of FLU and VOR towards ATCC strains of C. glabrata, C. rugosa and C. rugosa clinical strain was observed in this study.
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Affiliation(s)
- Priya Madhavan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Lakeside Campus, No. 1, Jalan Taylor's, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia. .,Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor Darul Ehsan, Malaysia.
| | - Farida Jamal
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor Darul Ehsan, Malaysia
| | - Chong Pei Pei
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor Darul Ehsan, Malaysia
| | - Fauziah Othman
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor Darul Ehsan, Malaysia
| | - Arunkumar Karunanidhi
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor Darul Ehsan, Malaysia.,Department of Pharmacology and Chemistry, Faculty of Pharmacy, Universiti Teknologi MARA, 42300, Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia
| | - Kee Peng Ng
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603, Lembah Pantai, Kuala Lumpur, Malaysia
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Rajana N, Madhavan P, Moses Babu J, b Deore B, Basavaiah K, Devi DR. Identification, method development, validation, and characterization of Aza sugars by an ion-chromatography, high-resolution mass spectrometer, and LC-MS/MS. J Anal Sci Technol 2018. [DOI: 10.1186/s40543-018-0138-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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32
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Kenny K, Madhavan P. Dispensary Separation: Perceptions of the Public Visiting Primary Care Clinics in Malaysia. MJPS 2018. [DOI: 10.21315/mjps2018.16.1.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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33
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Slomiany M, Madhavan P, Kuehn M, Richardson S. Value Frameworks in Oncology: Comparative Analysis and Implications to the Pharmaceutical Industry. Am Health Drug Benefits 2017; 10:253-260. [PMID: 28975009 PMCID: PMC5620505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 06/05/2007] [Indexed: 06/07/2023]
Abstract
BACKGROUND As the cost of oncology care continues to rise, composite value models that variably capture the diverse concerns of patients, physicians, payers, policymakers, and the pharmaceutical industry have begun to take shape. OBJECTIVES To review the capabilities and limitations of 5 of the most notable value frameworks in oncology that have emerged in recent years and to compare their relative value and application among the intended stakeholders. METHODS We compared the methodology of the American Society of Clinical Oncology (ASCO) Value Framework (version 2.0), the National Comprehensive Cancer Network Evidence Blocks, Memorial Sloan Kettering Cancer Center DrugAbacus, the Institute for Clinical and Economic Review Value Assessment Framework, and the European Society for Medical Oncology Magnitude of Clinical Benefit Scale, using a side-by-side comparative approach in terms of the input, scoring methodology, and output of each framework. In addition, we gleaned stakeholder insights about these frameworks and their potential real-world applications through dialogues with physicians and payers, as well as through secondary research and an aggregate analysis of previously published survey results. RESULTS The analysis identified several framework-specific themes in their respective focus on clinical trial elements, breadth of evidence, evidence weighting, scoring methodology, and value to stakeholders. Our dialogues with physicians and our aggregate analysis of previous surveys revealed a varying level of awareness of, and use of, each of the value frameworks in clinical practice. For example, although the ASCO Value Framework appears nascent in clinical practice, physicians believe that the frameworks will be more useful in practice in the future as they become more established and as their outputs are more widely accepted. CONCLUSIONS Along with patients and payers, who bear the burden of treatment costs, physicians and policymakers have waded into the discussion of defining value in oncology care, as well as pharmaceutical companies that seek to understand the impact of these value frameworks on each stakeholder, as they model the value and financial threshold of innovative, high-cost drugs.
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Affiliation(s)
| | | | - Michael Kuehn
- Vice President, Market Access Health, GfK, New York, NY
| | - Sasha Richardson
- Executive Vice President, Market Access Health, GfK, New York, NY
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Sutthiruk N, Botti M, Considine J, Driscoll A, Hutchinson A, Malathum K, Cucunawangsih C, Wiwing V, Puspitasari V, Shanmugakani RK, Akeda Y, Kodera T, Santanirand P, Tomono K, Yamanaka T, Moriuchi H, Kitajima H, Horikoshi Y, Lavrinenko A, Azizov I, Tabriz N, Kozhamuratov M, Serbo Y, Yang D, Lee W, Bae IK, Lee JH, Lee H, Kim JO, Jeong SH, Lee K, Peremalo T, Madhavan P, Hamzah S, Than L, Wong EH, Desa MNM, Ng KP, Geronimo M, Tayzon MF, Maño MJ, Chow A, Hon PY, Win MK, Ang B, Leo YS, Chow A, Hon PY, See T, Ang B, Marin RA, de Sousa MA, Kieffer N, Nordmann P, Poirel L, Laochareonsuk W, Petyu S, Wanasitchaiwat P, Thana S, Bunyaphongphan C, Boonsomsuk W, Maneepongpermpoon P, Jamulitrat S, Sureshkumar D, Supraja K, Sharmila S, Cucunawangsih C, Setiawan B, Lumbuun N, Nakayama H, Ota T, Shirane N, Matuoka C, Kodama K, Ohtsuka M, Bacolcol SAA, Velmonte M, Alde A, Chavez K, Esteban AJ, Lee AJ, Hsieh TC, Shio-ShinJean, Huang HJ, Huang SJ, Huang YH, Cheng PC, Yu SF, Tsao SM, Lee YT, Li CF, Lu MC, Pruetpongpun N, Khawcharoenporn T, Damronglerd P, Suwantarat N, Apisarnthanarak A, Rutjanawech S, Cushinotto L, McBride P, Williams H, Liu H, Hang PT, Anh DPP, Le N, Khu D, Nguyen L, Castillo RB, Sureshkumar D, Gopalakrishnan R, Ramasubramanian V, Sreevidya S, Jayapradha R, Umetsu A, Noda T, Hashimoto K, Hayashi A, Kabashima M, Jadczak U, Elvelund K, Johnsen M, Borgen B, Lingaas E, Mao CH, Chang FC, Liu CP, Chao RH, Chang FC, Liu CP, Pawapotako J, Prasertpan C, Malaihuan W, Uirungroj P, Prasertpan C, Saenjum C, Ouirungrog T, Uirungroj P, Borrell S, Bass P, Worth L, Xian-li Z, Xiao-long L, Xue-hua Y, Wei R, Zeng ZX, Kong MY, Lai CKC, Lee SY, Tsang NC, O’Donoghue MM, Boost MV, Suen LKP, Siu GK, Mui KW, Lai CKC, Tsang DNC, Sato Y, Tateishi M, Mihashi M, Flor JP, Bautista M, De Roxas VJ, Vergara J, Añonuevo NA, Kwek M, Acuin J, Sanchez AJ, Bathan A, Jantan JB, Guek CC, Kian EC, Pirido PA, Aron NFBM, Estacio LM, Palana FA, Gracia M, Shamsuddin NSB, Castro KT, Baloria M, Adam FB, Wei Z, Fong PB, Kalisvar M, Chow A, Ang B, Chuang IJ, Yi-ChunCho, Chiu YF, Chen LC, Lin YC, Dong SX, Lee YC, Kuan HC, Lin HH, Chi CC, Lu CT, Chang FC, Liu CP, Ya-Fen T, Li-Hsiang S, Jien-Wei L, Chao H, ChangChien P, Chen W, Lai C, Ara L, Mowla SMN, Vashkar SMK, Chan WF, ChunYau MY, LingChong KK, OnLi T, Kaur R, Yan NP, Chiu GCS, Cheung CWY, Ching PTY, Ching RHC, Lam CHS, Kan CH, Lee SSY, Chen CP, Chan RFY, Leung AFY, Wong ILC, Lam SS, Chan QWL, Chan C, Kaur R, Nematian SSS, Palenik CJ, Askarian M, Nematian SSS, Palenik CJ, Hatam N, Askarian M, Nakamura I, Fujita H, Tsukimori A, Kobayashi T, Sato A, Fukushima S, Matsumoto T, Flor JP, Añonuevo NA, Bautista M, Vergara J, De Roxas VJ, Kwek M, Flor JP, Bautista M, Vergara J, De Roxas VJ, AndreiAñonuevo N, Kwek M, Ho YM, Kum JQ, Poh BF, Marimuthu K, Ang B, Liu TY, Chu SM, Chen HZ, Chen TC, Chen Y, Tsao YC, Skuntaniyom S, Malathum K, Tipluy P, Paengta S, wongsaen R, thanomphan S, Tariyo S, Thongchuea B, Khamfu P, Thanomphan S, Songtaweesin WN, Anugulruengkit S, Samransamruajkit R, Sosothikul D, Tansrijitdee O, Nakphunsung A, Srimuan P, Sophonphan J, ThanyaweePuthanakit, Payuk K, Picheansathian W, Viseskul N, DeNardo E, Leslie R, Cartner T, Barbosa L, Werner HP, Brill FHH, Kawagoe JY, De Nardo E, Wilson SE, Macinga D, Mays-Suko P, Duley C, Hang PT, Hang TTT, Hanh TTM, Gordon C, Sureshkumar D, Durairaj R, Rohit A, Saravanakumar S, Hemalatha J, Hirano R, Sakamoto Y, Yamamoto S, Tachibana N, Miura M, Hieda F, Sakai Y, Watanabe H, Velmonte M, Bacolcol SA, Alde A, Chavez K, Esteban AJ, Lee AJ, Chow A, Lim JW, Hon PY, Hein AA, Tin G, Lim V, Ang B, Chow A, Hein AA, Lim JW, Hon PY, Lim V, Tin G, Ang B, Chow A, Tin G, Hein AA, Lim V, Lim JW, Hon PY, Ang B, Chao HC, Yeh CY, Lo MF, Chao HC, Piwpong C, Rajborirug S, Preechawetchakul P, Pruekrattananapa Y, Sangsuwan T, Jamulitrat S, Wongsaen R, Paengta S, Nilchon N, Thanompan S, Tariyo S, Le N, Khu D, Kolesnichenko S, Azizov I, Lavrinenko A, Tishkambayev Y, Lavrinenko A, Azizov I, Tishkambayev Y, Alibecov A, Kolesnichenko S, Serbo Y, Nam Y, Park JH, Hong YJ, Kim TS, Park JS, Park KU, Kim EC, Aziegbemhin SA, Enabulele O, Tung YS, Chen AC, Huang SM, Yang YY, Wu LH, Lin CC, Chang FC, Liu CP, Lien TH, Chang JH, Huang YS, Chen YS, Saenjum C, Sirilun S, Ouirungrog T, Ouirungroj P, Trakulsomboon S, Prasajak P, Kwok MWN, Ng LSH, Wong LMT, Poon LSL, Lai MKL, Cheng HHS, Fong SK, Leung CFY, Hasegawa J, Shirakawa H, Wakai S, Mieno M, Hatakeyama S, Tateishi M, Mihashi M, Sato Y, Saenjum C, Deeudom M, Tharavichitkul P, Ouirungrog T, Ouirungroj P, Chinniah T, Tan J, Prabu K, Alam S, Wynn AK, Ahmad R, Sidek A, Samsuddin DA, Ajis N, Ahmad A, Magon S, Chu B, Kuang J, Gao Y, Wang S, Hao Y, Liu R, Li D, Wang H, Yan NP, Nishio H, Mori H, Morokuma Y, Yamada T, Kiyosuke M, Yasunaga S, Toyoda K, Shimono N, Babenko D, Turmuhambetova A, Cheşcă A, Toleman MA, Babenko D, Turmuhambetova A, Cheşcă A, Toleman MA, Babenko D, Turmuhambetova A, Azizov I, Cheşcă A, Toleman MA, Akhmaltdinova LL, Turmuhambetova A, Cheşcă A, Babenko D, Magsakay MA, Macatibag A, Tayzon MF, Lerios JK, Azizov I, Lavrineko A, Babenko D, Sheck E, Edelstein M, Liu TY, Li LY, Chan CW, Pan HC, Chen TC, Vanishakije W, Jaikampun W, Cheng PC, Huang HJ, Huang SJ, Huang YH, Li SY, Yu SF, Li JF, Wu YP, Lee YT, Lin CH, Chang PC, Tariyo S, Paengta S, Wongsaen R, Thanompan S, Skuntaniyom S, Malathum K, Sukkra S, Zaman K, Zaman SF, Zaman F, Aziz A, Faisal SB, Traskine M, Ruiz-Guiñazú J, Borys D, Zaman K, Zaman SF, Zaman F, Aziz A, Faisal SB, Traskine M, Ruiz-Guiñazú J, Borys D, Lam WWY, Chow M, Choy L, Kam J, Salleh SA, Yacob R, Yusof SR, Jalil NA, Flor JP, Añonuevo NA, Bautista M, De Roxas VJ, Vergara J, Millan ML, Kwek M, Acuin JL, Lee AJ, Velmonte MA, Bacolcol SAA, Alde A, Chavez K, Esteban AJ, Ting CI, Dissayasriroj S, Chinniah TR, Prabu K, Ahmad R, Magon S, DiniSuhaimi J, Mirasin A, Morni N, Chu B, Samsuddin A, Ahmad A, Sidek A, Ajis N, AbuBakar A, Shafiee A, Safar J, Yan NP, Annie L, Ling FY, Edna L, Kristine L, Shinomiya S, Yamamoto K, Kjiwara K, Yamaguchi M, Chow A, Tin G, Zhang W, Hon PY, Poh BF, Marimuthu K, Ang B, Chan MC, Wang CC, Huang SJ, Huang HJ, Yu SF, Huang HY, Cheng PC, Li JF, Lee YT, Lai CL, Lu MC, Kosol S, Sakolwirat W, Paepong P, Jansanga S, Jaisamoot P, Thongnuanual N, Srithong C, Somsakul S, Malathum K, Plongpunth S, Punpop M, Malathum P, Malathum K, Thanomphan S, Wongsaen R, Peautiwat K, boon kirdram N, Picheansathian W, Klunklin P, Samethadka G, Suzuki N, Asada H, Katayama M, Komano A, Sato A, Nakamura I, Watanabe H, Matsumoto T, Seo HK, Hwang JH, Shin MJ, Kim SY, Kim ES, Song KH, Kim HB, Un LS, Vong CI, Flor JP, Añonuevo NA, Bautista M, De Roxas VJ, Vergara J, Kwek M, Koh J, Agustinus S, Hassan RBA, Thinn YP, Ng B, Tun SP, Ha SMT, Xiaoting X, Li L, Chuang L, Niroshika AMC, Perera KAK, Fernando DKDG, Hemamala BR, Yeh CY, Chao HC, Yang HC, Chiu HJ, Shih YL, Chien YS, Lin WY, Pan CY, Chang YY, Yea CY, Chu MH, Lee LC, Chiu HJ, Shih YL, Yang HC, Yu-Hsiu L, Siao-Pei G, Pak-On L, Mei-Fe S, Jyh-Jou C, Yu-Hsiu L, Yong-Yuan C, Kuo SY, Lin YH, Zhang JS, Leung PO, Sie MF, Chen JJ, Chen YR, Lin YH, Chen YL, Taou CF, Chen HS, Tang HJ, Chen SY, Chen YY, Der Wang F, Shih TP, Chen CY, Chen SJ, Wu MC, Yang WJ, Chou ML, Yu ML, Li LC, Chu CW, Tsou WH, Wu WC, Cheng WC, Sun CC, Shih TP, Chen CY, Lu SH, Chen SJ, Yang HL, Lu CY, Yu ML, Li LC, Chu CW, Tsou WH, Wu WC, Cheng WC, Sun CC, Hirunprapakorn N, Malathum K, Apivanich S, Pornmee T, Beowsomboon C, Rajborirug S, Pruekrattananapa Y, Sangsuwan T, Jamulitrat S, Kumkoom I, Kasatpibal N, Chitreecheur J, Kasatpibal N, Whitney JD, Saokaew S, Kengkla K, Heitkemper MM, Apisarnthanarak A, Muntajit T, Apivanich S, Malathum K, Somsakul S, Phan HT, Dinh APP, Nguyen TTK. Abstracts from the 8th International Congress of the Asia Pacific Society of Infection Control (APSIC). Antimicrob Resist Infect Control 2017. [PMCID: PMC5333188 DOI: 10.1186/s13756-017-0176-1] [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: 11/10/2022] Open
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Ahmed Z, McHugh SM, Elmallah A, Colgan MP, O'Callaghan A, O'Neill SM, Madhavan P, Martin Z. Emergency endovascular management of acute thoracic aortic pathology A safe and feasible option. Surgeon 2016; 15:325-328. [PMID: 28034631 DOI: 10.1016/j.surge.2016.10.007] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 10/16/2016] [Indexed: 11/19/2022]
Abstract
Endovascular repair has revolutionised the emergency treatment of thoracic aortic disease. We report our 10 year experience using this treatment in emergency cases. A prospectively maintained vascular database was analysed. Patients' medical records and CT images stored on the hospital PACS system were also reviewed. Statistical analysis was done using IBM SPSS V21. There were a total of 59 thoracic aortic stenting procedures of which 33 (60% males with a mean age of 58 yrs) were performed for emergency thoracic pathologies: traumatic transection (n = 10), ruptured aneurysm (n = 6), non-traumatic dissection (n = 8) and penetrating aortic ulcer (n = 9). All patients had self-expanding endografts implanted. Two patients required debranching procedures before the endovascular treatment. Thirty-day mortality was 12.1% (4/33). 70% of patients received a single device. There were 7 procedure related complications, 6 requiring re-intervention: thoracotomy and drainage in 2 patients, proximal graft extension in 2, open drainage of groin haematoma in 1 and open repair of a common femoral artery pseudo-aneurysm in one patient. In total 23 patients were transferred from 11 centres nationwide. There were no mortalities or other complications related to patient transfer from peripheral centres. Although acute thoracic aortic pathology is life threatening, appropriate blood pressure management and treatment of associated injuries can result in favourable outcomes. Endovascular repair is a safe and effective treatment option which enables patients to be treated with reduced morbidity and mortality. Transfer of patients with acute pathology to a tertiary centre can safely be performed.
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Affiliation(s)
- Z Ahmed
- St James's Vascular Institute, St James's Hospital, Dublin, Ireland.
| | - S M McHugh
- St James's Vascular Institute, St James's Hospital, Dublin, Ireland
| | - A Elmallah
- St James's Vascular Institute, St James's Hospital, Dublin, Ireland
| | - M P Colgan
- St James's Vascular Institute, St James's Hospital, Dublin, Ireland
| | - A O'Callaghan
- St James's Vascular Institute, St James's Hospital, Dublin, Ireland
| | - S M O'Neill
- St James's Vascular Institute, St James's Hospital, Dublin, Ireland
| | - P Madhavan
- St James's Vascular Institute, St James's Hospital, Dublin, Ireland
| | - Z Martin
- St James's Vascular Institute, St James's Hospital, Dublin, Ireland
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Kheirelseid E, Angelov S, Elmallah A, Boyle E, Power D, O'Callaghan A, Martin Z, O'Neill S, Colgan M, Madhavan P. Fate of Immediately Failed Angioplasty for Infra-inguinal Arterial Disease. Eur J Vasc Endovasc Surg 2016. [DOI: 10.1016/j.ejvs.2016.08.037] [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: 10/20/2022]
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Madhavan P, Sultan S, McDonnell CO, Cowman JP, Colgan MP, McEniff N, Molloy M, Moore DJ, Shanik G. Low Dose Intraarterial Thrombolysis with Tissue Plasminogen Activator: Does It Deliver as Promised? Vasc Endovascular Surg 2016; 36:351-6. [PMID: 12244423 DOI: 10.1177/153857440203600504] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The widespread use of intraarterial thrombolytic therapy has been based on perceived benefits over operative treatment and the downgrading of the magnitude of subsequent surgery. Thirty-three patients who had thrombolysis for peripheral artery occlusion were retrospectively analyzed at St. James's Hospital from 1991 to 1997. One patient received streptokinase unsuccessfully. Five other patient's records were inadequate for analysis. Twenty-seven patient's notes were analyzed for risk, duration of occlusion, duration of treatment, dosage of tissue plasminogen activator (tPA) and conduits thrombolysed. There were 15 males and 12 females. The mean age was 62 years (range, 20-87). Fourteen were current or reformed smokers. Five were diabetic. Indications for treatment included acute graft occlusion (n = 13), embolus (n = 6), and primary and secondary arterial thrombosis (n = 8). Duration of occlusion was less than 24 hours in seven, 1 to 7 days in ten, and more than 7 days in ten patients. Twelve (44.44%) patients had complete clot lysis, four (14.81%) had partial clearance, and 1 1 (40.74%) remained occluded. Eight (29.63%) had serious complications including one death. Eighteen (66.66%) patients needed further surgical intervention to maintain graft patency. Data were analyzed using the chi-square and pooled t test. No significant difference was observed in results from thrombolysis from different conduits, gender, etiology, or smoking history. Increased duration of tPA administration was associated with an increased risk of failure. Administration of total dosages greater than 60 mg was associated with a higher risk of failure. Diabetics had a poor outcome (p=0.0520). Only 44% of patients successfully underwent lysis. A primary surgical option may be a more sensible course than lysis, given that the vast majority of patients ended up having surgery anyway.
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Affiliation(s)
- P Madhavan
- Department of Vascular and Endovascular Surgery, St. James's Hospital, Dublin.
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Deshpande AA, Madhavan P, Deshpande GR, Chandel RK, Yarbagi KM, Joshi AR, Moses Babu J, Murali Krishna R, Rao IM. Novel, Precise, Accurate Ion-Pairing Method to Determine the Related Substances of the Fondaparinux Sodium Drug Substance: Low-Molecular-Weight Heparin. Sci Pharm 2016; 84:19-40. [PMID: 27110496 PMCID: PMC4839259 DOI: 10.3797/scipharm.1505-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 07/22/2015] [Indexed: 11/29/2022] Open
Abstract
Fondaparinux sodium is a synthetic low-molecular-weight heparin (LMWH). This medication is an anticoagulant or a blood thinner, prescribed for the treatment of pulmonary embolism and prevention and treatment of deep vein thrombosis. Its determination in the presence of related impurities was studied and validated by a novel ion-pair HPLC method. The separation of the drug and its degradation products was achieved with the polymer-based PLRPs column (250 mm × 4.6 mm; 5 μm) in gradient elution mode. The mixture of 100 mM n-hexylamine and 100 mM acetic acid in water was used as buffer solution. Mobile phase A and mobile phase B were prepared by mixing the buffer and acetonitrile in the ratio of 90:10 (v/v) and 20:80 (v/v), respectively. Mobile phases were delivered in isocratic mode (2% B for 0-5 min) followed by gradient mode (2-85% B in 5-60 min). An Evaporative Light Scattering Detector (ELSD) was connected to the LC system to detect the responses of chromatographic separation. Further, the drug was subjected to stress studies for acidic, basic, oxidative, photolytic, and thermal degradations as per ICH guidelines and the drug was found to be labile in acid, base hydrolysis, and oxidation, while stable in neutral, thermal, and photolytic degradation conditions. The method provided linear responses over the concentration range of the LOQ to 0.30% for each impurity with respect to the analyte concentration of 12.5 mg/mL, and regression analysis showed a correlation coefficient value (r(2)) of more than 0.99 for all the impurities. The LOD and LOQ were found to be 1.4 µg/mL and 4.1 µg/mL, respectively, for fondaparinux. The developed ion-pair method was validated as per ICH guidelines with respect to accuracy, selectivity, precision, linearity, and robustness.
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Affiliation(s)
- Amol A. Deshpande
- Analytical Research, Custom Pharmaceutical Services, Dr. Reddy’s Laboratories Ltd., Bollaram road, Miyapur, Hyderabad-500049 (AP), India
| | - P. Madhavan
- Analytical Research, Custom Pharmaceutical Services, Dr. Reddy’s Laboratories Ltd., Bollaram road, Miyapur, Hyderabad-500049 (AP), India
| | - Girish R. Deshpande
- Analytical Research, Custom Pharmaceutical Services, Dr. Reddy’s Laboratories Ltd., Bollaram road, Miyapur, Hyderabad-500049 (AP), India
| | - Ravi Kumar Chandel
- Analytical Research, Custom Pharmaceutical Services, Dr. Reddy’s Laboratories Ltd., Bollaram road, Miyapur, Hyderabad-500049 (AP), India
| | - Kaviraj M. Yarbagi
- Analytical Research, Custom Pharmaceutical Services, Dr. Reddy’s Laboratories Ltd., Bollaram road, Miyapur, Hyderabad-500049 (AP), India
| | - Alok R. Joshi
- Analytical Research, Custom Pharmaceutical Services, Dr. Reddy’s Laboratories Ltd., Bollaram road, Miyapur, Hyderabad-500049 (AP), India
| | - J. Moses Babu
- Analytical Research, Custom Pharmaceutical Services, Dr. Reddy’s Laboratories Ltd., Bollaram road, Miyapur, Hyderabad-500049 (AP), India
| | - R. Murali Krishna
- Department of Physical, Nuclear and Chemical Oceanology, Andhra University, Visakhapatnam-530003, India
| | - I. M. Rao
- Department of Physical, Nuclear and Chemical Oceanology, Andhra University, Visakhapatnam-530003, India
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Abstract
The perspective of adding stimuli-response to isoporous membranes stimulates the development of separation devices with pores, which would open or close under control of environment chemical composition, temperature or exposure to light.
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Affiliation(s)
- P. Madhavan
- King Abdullah University of Science and Technology (KAUST)
- Biological and Environmental Science and Engineering Division (BESE)
- 23955-6900 Thuwal
- Saudi Arabia
| | - B. Sutisna
- King Abdullah University of Science and Technology (KAUST)
- Physical Science and Engineering Division (PSE)
- 23955-6900 Thuwal
- Saudi Arabia
| | - R. Sougrat
- King Abdullah University of Science and Technology (KAUST)
- Advanced Nanofabrication Imaging and Characterization Core Lab
- 23955-6900 Thuwal
- Saudi Arabia
| | - S. P. Nunes
- King Abdullah University of Science and Technology (KAUST)
- Biological and Environmental Science and Engineering Division (BESE)
- 23955-6900 Thuwal
- Saudi Arabia
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Hanrahan L, Canning C, Abdulrahim O, Fitzgerald L, O'Neill S, Madhavan P, Harbison J, Colgan MP, Martin Z. Evolution of Carotid Surgical Practice in the last Decade. Ir Med J 2015; 108:235-237. [PMID: 26485830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Stroke units provide immediate care and appropriate intervention in the evolving stroke. The aims of this study were to review the practice of carotid endarterectomy (CEA) before and after the establishment of a Stroke Unit in St. James's Hospital. Prior to the introduction of the Stroke Unit, 263 CEA's were performed over a five-year period. 139/263 (53%) of these were for symptomatic disease. 229 were performed in the five years since. 179/229 (78%) of these were for symptomatic disease. The 30-day stroke and death rates were < 2% before the introduction of the Stroke Unit, and have remained unchanged. Since the introduction of the Stroke Unit, there has been a slight decrease in the overall number of CEA's performed with a 25% increase in the proportion of endarterectomies performed for symptomatic disease. Despite the reduction in surgery for asymptomatic disease the overall 30-day stroke and death rate remains excellent at 2/229 (2%).
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Ahmed Z, McHugh S, Elmallah A, Hamada N, Colgan M, O'Callaghan A, O'Neill S, Madhavan P, Martin Z. Emergency Tansfer to Specialist Thoracic Endovascular Centre: A Safe and Feasaible Option. Eur J Vasc Endovasc Surg 2015. [DOI: 10.1016/j.ejvs.2015.06.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kinsella JA, Tobin WO, Kavanagh GF, O'Donnell JS, McGrath RT, Tierney S, Feeley TM, Egan B, O'Neill D, Collins DR, Coughlan T, Harbison JA, Doherty CP, Madhavan P, Moore DJ, O'Neill SM, Colgan MP, Saqqur M, Murphy RP, Moran N, Hamilton G, McCabe DJH. Increased thrombin generation potential in symptomatic versus asymptomatic moderate or severe carotid stenosis and relationship with cerebral microemboli. J Neurol Neurosurg Psychiatry 2015; 86:460-7. [PMID: 25033981 DOI: 10.1136/jnnp-2013-307556] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The importance of thrombin generation in the pathogenesis of TIA or stroke and its relationship with cerebral microembolic signals (MES) in asymptomatic and symptomatic carotid stenosis has not been comprehensively assessed. METHODS Plasma thrombin generation parameters from patients with moderate or severe (≥ 50%) asymptomatic carotid stenosis were compared with those from patients with symptomatic carotid stenosis in the early (≤ 4 weeks) and late phases (≥ 3 months) after TIA or stroke in this prospective, pilot observational study. Thrombin generation profile was longitudinally assessed in symptomatic patients with data at each time point. Bilateral transcranial Doppler ultrasound monitoring of the middle cerebral arteries was performed whenever possible to classify patients as MES-positive or MES-negative. RESULTS Data from 31 asymptomatic, 46 'early symptomatic' and 35 'late symptomatic' patients were analysed. Peak thrombin (344.2 nM vs 305.3 nM; p = 0.01) and endogenous thrombin potential (1772.4 vs 1589.7; p = 0.047) were higher in early symptomatic than asymptomatic patients. Peak thrombin production decreased in symptomatic patients followed up from the early to late phase after TIA or stroke (339.7 nM vs 308.6 nM; p = 0.02). Transcranial Doppler ultrasound data were available in 25 asymptomatic, 31 early symptomatic and 27 late symptomatic patients. Early symptomatic MES-positive patients had a shorter 'time-to-peak thrombin' than asymptomatic MES-positive patients (p=0.04), suggesting a more procoagulant state in this early symptomatic subgroup. DISCUSSION Thrombin generation potential is greater in patients with recently symptomatic than asymptomatic carotid stenosis, and decreases over time following TIA or stroke associated with carotid stenosis. These data improve our understanding of the haemostatic/thrombotic biomarker profile in moderate-severe carotid stenosis.
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Affiliation(s)
- J A Kinsella
- Department of Neurology, The Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital, Trinity College Dublin, Dublin, Ireland
| | - W O Tobin
- Department of Neurology, The Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital, Trinity College Dublin, Dublin, Ireland
| | - G F Kavanagh
- Department of Neurology, The Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital, Trinity College Dublin, Dublin, Ireland
| | - J S O'Donnell
- Haemostasis Research Group, St James Hospital, Trinity College Dublin, Dublin, Ireland
| | - R T McGrath
- Haemostasis Research Group, St James Hospital, Trinity College Dublin, Dublin, Ireland
| | - S Tierney
- Department of Vascular Surgery, The Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital, Trinity College Dublin, Dublin, Ireland
| | - T M Feeley
- Department of Vascular Surgery, The Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital, Trinity College Dublin, Dublin, Ireland
| | - B Egan
- Department of Vascular Surgery, The Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital, Trinity College Dublin, Dublin, Ireland
| | - D O'Neill
- Age-Related Health Care, The Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital, Trinity College Dublin, Dublin, Ireland Stroke Service, The Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital, Trinity College Dublin, Dublin, Ireland
| | - D R Collins
- Age-Related Health Care, The Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital, Trinity College Dublin, Dublin, Ireland Stroke Service, The Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital, Trinity College Dublin, Dublin, Ireland
| | - T Coughlan
- Age-Related Health Care, The Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital, Trinity College Dublin, Dublin, Ireland Stroke Service, The Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital, Trinity College Dublin, Dublin, Ireland
| | - J A Harbison
- Departments of Medicine for the Elderly/Stroke Service, St James Hospital, Trinity College Dublin, Dublin, Ireland
| | - C P Doherty
- Department of Neurology, St James Hospital, Trinity College Dublin, Dublin, Ireland
| | - P Madhavan
- Department of Vascular Surgery, St James Hospital, Trinity College Dublin, Dublin, Ireland
| | - D J Moore
- Department of Vascular Surgery, St James Hospital, Trinity College Dublin, Dublin, Ireland
| | - S M O'Neill
- Department of Vascular Surgery, St James Hospital, Trinity College Dublin, Dublin, Ireland
| | - M P Colgan
- Department of Vascular Surgery, St James Hospital, Trinity College Dublin, Dublin, Ireland
| | - M Saqqur
- Department of Medicine (Neurology), University of Calgary, Alberta, Canada
| | - R P Murphy
- Department of Neurology, The Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital, Trinity College Dublin, Dublin, Ireland Stroke Service, The Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital, Trinity College Dublin, Dublin, Ireland
| | - N Moran
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - G Hamilton
- University Department of Surgery, Royal Free Hampstead NHS Trust, London, UK
| | - D J H McCabe
- Department of Neurology, The Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital, Trinity College Dublin, Dublin, Ireland Stroke Service, The Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital, Trinity College Dublin, Dublin, Ireland Department of Clinical Neurosciences, Royal Free Campus, UCL Institute of Neurology, London, UK
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Madhavan P, Jairath S, Sukumaran N, Sagar A, Molmenti E, Natarajan B, Basu A, Ali N, Bhaskaran M. Kidney transplant access in the southeast: middle view. Am J Transplant 2014; 14:2669-70. [PMID: 25219445 DOI: 10.1111/ajt.12980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- P Madhavan
- North Shore LIJ Health System, Renal Transplant Center, New York, NY
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Kinsella JA, Tobin WO, Kavanagh GF, O'Donnell JS, McGrath RT, Tierney S, Feeley TM, Egan B, O'Neill D, Collins RD, Coughlan T, Harbison JA, Doherty CP, Madhavan P, Moore DJ, O'Neill SM, Colgan MP, Saqqur M, Murphy RP, Moran N, Hamilton G, McCabe DJH. Increased endothelial activation in recently symptomatic versus asymptomatic carotid artery stenosis and in cerebral microembolic-signal-negative patient subgroups. Eur J Neurol 2014; 21:969-e55. [PMID: 24712648 DOI: 10.1111/ene.12403] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 02/07/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE von Willebrand factor propeptide (VWF:Ag II) is potentially a more sensitive marker of acute endothelial activation than von Willebrand factor antigen (VWF:Ag). These biomarkers have not been simultaneously assessed in asymptomatic versus symptomatic carotid stenosis patients. The relationship between endothelial activation and cerebral microembolic signals (MESs) detected on transcranial Doppler ultrasound is unknown. METHODS In this multicentre observational analytical study, plasma VWF:Ag and VWF:Ag II levels in patients with ≥50% asymptomatic carotid stenosis were compared with those from patients with ≥50% symptomatic carotid stenosis in the 'early' (≤4 weeks) and 'late' (≥3 months) phases after transient ischaemic attack or ischaemic stroke. Endothelial activation was also longitudinally assessed in symptomatic patients during follow-up. Transcranial Doppler ultrasound monitoring classified patients as MES-positive or MES-negative. RESULTS Data from 31 asymptomatic patients were compared with those from 46 early symptomatic and 35 late phase symptomatic carotid stenosis patients, 23 of whom had undergone carotid intervention. VWF:Ag II levels were higher in early (12.8 μg/ml; P < 0.001), late (10.6 μg/ml; P = 0.01) and late post-intervention (10.6 μg/ml; P = 0.038) symptomatic patients than asymptomatic patients (8.9 μg/ml). VWF:Ag levels decreased in symptomatic patients followed up from the early to late phase after symptom onset (P = 0.048). Early symptomatic MES-negative patients had higher VWF: Ag II levels (13.3 vs. 9.0 μg/ml; P < 0.001) than asymptomatic MES-negative patients. CONCLUSIONS Endothelial activation is enhanced in symptomatic versus asymptomatic carotid stenosis patients, in early symptomatic versus asymptomatic MES-negative patients, and decreases over time in symptomatic patients. VWF:Ag II levels are a more sensitive marker of endothelial activation than VWF:Ag levels in carotid stenosis. The potential value of endothelial biomarkers and concurrent cerebral MES detection at predicting stroke risk in carotid stenosis warrants further study.
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Affiliation(s)
- J A Kinsella
- Department of Neurology, Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital, Trinity College Dublin, Dublin, Ireland
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Canning C, Martin Z, Colgan MP, Abdulrahim O, McCafferty M, Fitzpatrick J, Haider SN, Madhavan P, O'Neill S. Fenestrated endovascular repair of complex aortic aneurysms. Ir J Med Sci 2014; 184:249-55. [PMID: 24599499 DOI: 10.1007/s11845-014-1095-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 02/18/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Fenestrated endovascular aneurysm repair (FEVAR) provides an endovascular solution for patients with large abdominal aortic aneurysms and challenging neck anatomy in addition to repair of endoleaks and pseudoaneurysms. This article reports the midterm outcomes of FEVAR from a single-tertiary referral centre in Ireland. METHODS From 2006 to 2012, nine consecutive asymptomatic patients with neck anatomy unfavourable for standard EVAR underwent endovascular repair with a customised fenestrated Zenith stent graft. An additional three patients had fenestrated grafts for repair of pseudoaneurysms (n = 2) following open AAA repair and a type I endoleak (n = 1). All patients were prospectively enrolled in a computerised database. Outcomes including mortality, morbidity, renal function, target vessel patency, endoleak and reintervention were analysed. FINDINGS The mean age and aneurysm size in the primary repair group were 74 years (65-84 years) and 6 cm (5-8.3 cm), respectively, and in the secondary repair group, the mean age was 66 years (61-75 years). No procedures required open conversion, and no visceral arteries were lost. On completion angiography, two patients in group 1 had a type I endoleak and one had a type III endoleak. There were no endoleaks in the secondary repair group. Follow-up ranged from 30 days to 6 years. There was one death within 30 days (8 %) and two deaths at 3 years from non-aneurysm-related causes. Six patients required secondary interventions. Three patients had a transient post-operative creatinine rise of >30 %. CONCLUSION Our study supports FEVAR as a feasible and effective therapy in the management of patients with complex aortic aneurysms.
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Affiliation(s)
- C Canning
- St James's Hospital, Dublin, Ireland,
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Kinsella JA, Tobin WO, Tierney S, Feeley TM, Egan B, Collins DR, Coughlan T, O'Neill D, Harbison J, Madhavan P, Moore DJ, O'Neill SM, Colgan MP, Doherty CP, Murphy RP, Saqqur M, Moran N, Hamilton G, McCabe DJH. Increased platelet activation in early symptomatic vs. asymptomatic carotid stenosis and relationship with microembolic status: results from the Platelets and Carotid Stenosis Study. J Thromb Haemost 2013; 11:1407-16. [PMID: 23621656 DOI: 10.1111/jth.12277] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [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: 12/20/2012] [Accepted: 03/31/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cerebral microembolic signals (MES) may predict increased stroke risk in carotid stenosis. However, the relationship between platelet counts or platelet activation status and MES in symptomatic vs. asymptomatic carotid stenosis has not been comprehensively assessed. SETTING University teaching hospitals. METHODS This prospective, pilot observational study assessed platelet counts and platelet activation status, and the relationship between platelet activation and MES in asymptomatic vs. early (≤ 4 weeks after TIA/stroke) and late phase (≥ 3 months) symptomatic moderate or severe (≥ 50%) carotid stenosis patients. Full blood count measurements were performed, and whole blood flow cytometry was used to quantify platelet surface activation marker expression (CD62P and CD63) and circulating leucocyte-platelet complexes. Bilateral simultaneous transcranial Doppler ultrasound monitoring of the middle cerebral arteries was performed for 1 h to classify patients as MES positive or MES negative. RESULTS Data from 31 asymptomatic patients were compared with 46 symptomatic patients in the early phase, and 35 of these patients were followed up to the late phase after symptom onset. The median platelet count (211 vs. 200 × 10(9) L(-1) ; P = 0.03) and the median percentage of lymphocyte-platelet complexes was higher in early symptomatic than asymptomatic patients (2.8 vs. 2.4%; P = 0.001). The percentage of lymphocyte-platelet complexes was higher in early symptomatic than in asymptomatic patients with ≥ 70% carotid stenosis (P = 0.0005) and symptomatic patients recruited within 7 days of symptom onset (P = 0.028). Complete TCD data were available in 25 asymptomatic, 31 early phase symptomatic and 27 late phase symptomatic patients. Twelve per cent of asymptomatic vs. 32% of early phase symptomatic (P = 0.02) and 19% of late phase symptomatic patients (P = 0.2) were MES positive. Early symptomatic MES-negative patients had a higher percentage of lymphocyte-platelet complexes than asymptomatic MES-negative patients (2.8 vs. 2.3%; P = 0.0085). DISCUSSION Recently, symptomatic carotid stenosis patients have had higher platelet counts (potentially reflecting increased platelet production, mobilization or reduced clearance) and platelet activation status than asymptomatic patients. MES were more frequently detected in early symptomatic than asymptomatic patients, but the differences between late symptomatic and asymptomatic groups were not significant. Increased lymphocyte-platelet complex formation in recently symptomatic vs. asymptomatic MES-negative patients indicates enhanced platelet activation in this early symptomatic subgroup. Platelet biomarkers, in combination with TCD, have the potential to aid risk-stratification in asymptomatic and symptomatic carotid stenosis patients.
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Affiliation(s)
- J A Kinsella
- Department of Neurology, The Adelaide and Meath Hospital Dublin/National Children's Hospital, Trinity College Dublin, Ireland
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Kheirelseid EAH, Gardiner R, Haider SN, Martin Z, Colgan MP, O'Neill SM, Madhavan P. Endovascular repair of thoracoabdominal aortic aneurysm (TAAA): early experience. Ir J Med Sci 2013; 183:153-60. [PMID: 23757213 DOI: 10.1007/s11845-013-0974-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 05/30/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Repair of thoracoabdominal aortic aneurysms (TAAA) represents a considerable technical challenge. Since its first description in 1955, open repair of TAAA has been considered the gold standard of repair. Despite improvements in surgical techniques, spinal cord protection and post-operative critical care support, patients who undergo open repair are faced with a mortality rate of 5-35 %. We report the first Irish experience of endovascular management of TAAAs. RESULTS To date five patients have undergone endovascular repair; four had hybrid repair and one a fenestrated graft. The mean age of the patients was 66.8 ± 3.4 and the mean aneurysm diameter was 6.74 ± 0.6 cm. All patients were ASA III. Two-stage hybrid repair was associated with an increased risk of complications, prolonged intensive care unit and overall hospital stay. One patient died in the perioperative period due to rupture of their aneurysm between the two stages of their hybrid repair. CONCLUSION The role of endovascular techniques in the treatment of TAAA continues to evolve. Hybrid and complete endovascular repairs do not replace conventional repair, but provide an alternative for high-risk patients who might otherwise be denied treatment.
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Affiliation(s)
- E A H Kheirelseid
- Department of Vascular and Endovascular Surgery, St. James's Hospital, St. James's Street, Dublin 8, Ireland,
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O'Callaghan A, Colgan MP, McGuigan C, Smyth F, Haider N, O'Neill S, Moore D, Madhavan P. Re: using HIPE data for research and audit: critical factors for success. Ir Med J 2013; 106:157; discussion 157. [PMID: 23914584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Roughton M, Campbell JT, Kavanagh SJ, Hoffman AM, Stewart K, Rudd AG, Roffe C, Ali AN, Bailey C, Abdulhafiz AH, Hadbavna A, Coughlan T, Collins DR, O'Neill D, Boyle K, Browne B, Colgan MP, Martin X, O'Neill S, Madhavan P, Moore D, Harbison J, Boyle K, Banghu J, Naureen M, Harbison J, Ryan DJ, Christensen S, Meaney JF, Fagan A, Kenny RA, Harbison JA, Roughton M, Campbell JT, Kavanagh SJ, Hoffman AM, Stewart K, Rudd AG. Stroke. Age Ageing 2013. [DOI: 10.1093/ageing/aft027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Casey RG, Raheem OA, Elmusharaf E, Madhavan P, Tolan M, Lynch TH. Renal cell carcinoma with IVC and atrial thrombus: a single centre's 10 year surgical experience. Surgeon 2013; 11:295-9. [PMID: 23510704 DOI: 10.1016/j.surge.2013.02.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2013] [Revised: 02/18/2013] [Accepted: 02/18/2013] [Indexed: 11/26/2022]
Abstract
UNLABELLED Renal cell carcinoma (RCC) propagates into the IVC in 4% of cases with 1% extending into the right atrium. Radical surgical resection remains the definitive curative/palliative treatment in those without significant metastases. The aim was to review our experience in patients with different levels of IVC involvement, cardiopulmonary bypass (CPB) and perioperative/long term outcomes. PATIENTS AND METHODS From 2001 to 2012, 24 radical nephrectomies with IVC thrombectomy were performed. A retrospective chart review was undertaken to record demographics, presenting symptoms, duration of surgery, peri-operative transfusion, CPB and peri-operative complications, tumour grade/stage, and patient survival. RESULTS We identified 24 patients (18 male, Age median 59 range 35-78). The commonest presenting symptoms were weight loss, pain and haematuria. The majority of tumours were right sided (n = 17) with 8 having lung metastases at presentation. Thrombus level was 16 (infradiaphragmatic), 2 (supradiaphragmatic), 6 (intra-atrial). 15 patients required sternotomy for vascular control and 9 required CPB both with a significantly longer operative time compared (6.1 ± 3.5 vs. 7.2 ± 1.2 vs. 3.5 ± 1.1 h, respectively). Peri-operative complications (n = 21) included cardiopulmonary, renal, gastrointestinal and septic problems. There were 2 peri-operative deaths. Blood transfusion was significantly less in those not requiring sternotomy or CPB using the "Cell Saver" device. The majority were Fuhrman grade 3 (n = 16) and clear cell type (n = 14). Overall 3-year survival was 100% (Laparotomy only), 40% (sternotomy + cross-clamp), and 20% (CPB). CONCLUSIONS IVC thrombectomy has significant morbidity and requires careful patient selection and a multi-disciplinary approach to optimise patient outcomes. In this series, the level of IVC thrombus and requirement for CPB directly affects patient morbidity and outcome.
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Affiliation(s)
- R G Casey
- Department of Urology, St. James's Hospital, Dublin 8, Ireland.
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