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Bajjad AA, Ahemad MS, Gupta S, Mehjabeen F, Guin S, Mehra S, Rajesh R. Assessment of clinical validity of KPG index for 3D classification of impacted maxillary canines by cone beam computed tomography in patients. Orthod Craniofac Res 2024. [PMID: 38577813 DOI: 10.1111/ocr.12788] [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] [Accepted: 03/27/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVES The primary objective of this study was to assess the validity of the KPG index in predicting the difficulty of treatment involving impacted maxillary canines. The secondary objective was to assess the reliability and reproducibility of the index. MATERIALS AND METHODS A retrospective study was conducted on 96 maxillary impacted canines (MIC) in 60 patients aged 13-35 years. Cone-beam computed tomography (CBCT) scans were used to predict the treatment difficulty of MIC using the KPG index. Patient case files were assessed for the actual difficulty encountered in treating MIC. Cohen's kappa correlation coefficient was used for intra-observer reliability and Kendell's W test was used for inter-observer reliability. Spearman's correlation coefficient test was used to assess the correlation between predicted and actual treatment. RESULTS Easy and moderately difficult cases exhibited a moderate correlation between actual and predicted treatment outcomes, whereas difficult cases displayed a weak correlation. The perfect correlation was observed exclusively in extremely difficult cases. The intra-observer reliability for assessing CBCT scans using the KPG guide was found to be 0.88, and the inter-rater reliability was 0.94. CONCLUSION The KPG index displayed 87%, 71%, 50% and 100% validity in easy, moderately difficult, difficult, and extremely difficult cases, respectively. This index showed good reliability and reproducibility. However, it is imperative to consider a multitude of other factors, including the patient's age, presence of associated root resorption in adjacent teeth, and duration of treatment, to make an informed decision between surgical exposure and extraction.
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Affiliation(s)
- A A Bajjad
- Department of Orthodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar-Pradesh, India
| | - M S Ahemad
- Department of Orthodontics, Saraswati Dhanwantari Dental College and PG Institute, Parbhani, Maharashtra, India
| | - S Gupta
- Department of Orthodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar-Pradesh, India
| | - F Mehjabeen
- Department of Orthodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar-Pradesh, India
| | - S Guin
- Department of Orthodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar-Pradesh, India
| | - S Mehra
- Department of Orthodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar-Pradesh, India
| | - R Rajesh
- Department of Orthodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar-Pradesh, India
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Butala RR, Samant PD, Mehra S. Olecranon Osteotomy by a Gigli Saw versus Chevron's Osteotomy for Exposure of Intra-articular Distal Humerus: A Comparative Study. Malays Orthop J 2022; 16:61-69. [PMID: 36589383 PMCID: PMC9791905 DOI: 10.5704/moj.2211.011] [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: 02/19/2021] [Accepted: 03/07/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction Olecranon osteotomy is employed for the fixation of intraarticular distal humeral fractures. We conducted a prospective, randomised study comparing Chevron's osteotomy with olecranon osteotomy by a Gigli saw for exposure of the intraarticular distal humerus in terms of functional outcome and intra-operative ease of the surgery. Materials and methods Thirty patients with skeletally mature AO/OTA type 13- B and 13-C distal humerus fractures were randomly allocated to Chevron's or Gigli saw groups. Each group consisted of a total of 15 patients. Both the groups were assessed on post-operative parameters including arm, shoulder or hand pain, ability to perform certain routine activities, tingling sensations and pain while sleeping. Results In the Gigli saw group, 12 patients had no gross limitation of activity and 13 were able to perform moderate activities with ease. Similar results were observed in the Chevron's group. The mean difference between the two groups in Oxford Score was 0.60, within the 95% confidence interval and in line with QuickDASH-11 Score. Conclusion Chevron's technique offers stability and better healing, providing a larger surface area for bone union. However, it is challenging and time-consuming. Also, literature suggests that the Gigli saw has multiple benefits, saves time and effort, and heals by switching blood supply from centrifugal to centripetal post-operatively. Our study suggests that both Chevron's technique and the use of the Gigli saw are effective in distal humeral intra-articular fractures as assessed by multiple parameters. Hence both techniques can be equally used depending on the surgeon's preference.
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Affiliation(s)
- RR Butala
- Department of Orthopaedics, Padmashree Dr DY Patil University, Navi Mumbai, India
| | - PD Samant
- Department of Orthopaedics, Padmashree Dr DY Patil University, Navi Mumbai, India
| | - S Mehra
- Department of Orthopaedics, Padmashree Dr DY Patil University, Navi Mumbai, India,Corresponding Author: Shivam Mehra, 569/153 Kha, Bargawan Barabirwa, Kanpur road, Lucknow, Uttar Pradesh-226012, India
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Mehra S, Hariharan N, Deka S. AB0318 PREVALENCE OF SECONDARY SJOGREN’S SYNDROME IN PATIENTS WITH RHEUMATOID ARTHRITIS- A SINGLE CENTER STUDY FROM NORTHERN INDIA. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundSjogren’s syndrome (SS) is a systemic autoimmune disease characterized by lymphocytic infiltration of salivary and lacrimal glands leading to dry eyes and dry mouth. Sjogren’s syndrome either present alone (primary Sjogren’s syndrome) or sometimes can occur with other autoimmune diseases like rheumatoid arthritis, systemic lupus erythematosus, and scleroderma. In such instances, the condition is termed secondary Sjogren’s syndrome. SS may be a marker of more aggressive joint disease in patients with RA, and hence it is essential to characterize the symptoms in the RA cohort, which may help in the management and treatment of the disease.ObjectivesPrimary ObjectiveThe primary objective of the current study is to estimate the prevalence of secondary Sjogren’s syndrome in a cohort of patients with rheumatoid arthritis.Secondary ObjectiveTo compare the clinical characteristics in rheumatoid arthritis patients with Sjogren’s syndrome and in rheumatoid arthritis patients without Sjogren’s syndrome.MethodsThe study was conducted from 2016-2018 in a tertiary care hospital in the Department of Rheumatology, New Delhi, India. Patients with a rheumatologist-diagnosed RA were enrolled. There were 726 patients with rheumatoid arthritis. Patients were enquired about their symptoms. Out of 726, 193 had secondary Sjogren’s syndrome (26.58%). In patients without Sjogren’s syndrome, complete clinical data were available only for 377 patients hence the analysis on the comparison of clinical characteristics was limited to 377 patients. The other patients were excluded due to lack of the data required for the study.ResultsIt was identified that out of 726 patients, 193 had symptoms of secondary Sjogren’s like dry eyes dry mouth, or both. It was found that in patients with secondary Sjogren’s syndrome (n=193), the mean age was significantly higher than those patients without secondary Sjogren’s syndrome (n=377) [52.58 ± 12.36 Vs. 48.42 ± 13.98, p=0.0005]. Similarly, the mean disease duration was significantly higher among RA patients with secondary SS than those without SS [10.76 ± 8.34 Vs. 6.81 ± 7.29, p<0.0001]. Similarly, co-morbidities like hypertension, diabetes mellitus, and hypothyroidism were more seen in patients with rheumatoid arthritis with Sjogren’s syndrome.In a meta-analysis involving 18 studies1, it was identified that the prevalence of SS in RA was 19.5%. The differences in the prevalence of secondary SS in RA patients could be attributable to inter-ethnic variation, disease duration, and clinical scores employed in the studies. Similar to our study, Santhosh et al.2 reported that patients with secondary SS had a longer disease duration than those without secondary SS.ConclusionThe prevalence of Sjogren’s syndrome among patients with rheumatoid arthritis in the North Indian cohort of patients with RA was 26.58%.References[1]Alani H, Henty JR, Thompson NL, Jury E, Ciurtin C. Systematic review and meta-analysis of the epidemiology of polyautoimmunity in Sjögren’s syndrome (secondary Sjögren’s syndrome) focusing on autoimmune rheumatic diseases. Scandinavian journal of rheumatology. 2018 Mar 4;47(2):141-54.[2]Santosh K, Dhir V, Singh S, Sood A, Gupta A, Sharma A, Sharma S. Prevalence of secondary Sjögren’s syndrome in Indian patients with rheumatoid arthritis: a single-center study. International journal of rheumatic diseases. 2017 Jul;20(7):870-4.Disclosure of InterestsNone declared
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van den Helder J, Verlaan S, Tieland M, Mehra S, Visser B, Kröse B, Engelbert R, Weijs P. How to establish increased protein intake in a blended lifestyle intervention in community-dwelling older adults? Subgroup-analysis of the vitamin rct. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.281] [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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Jacobs D, Park H, Young M, Olino K, Rahmati R, Mehra S, Burtness B, Judson B. Assessment of Lymph Node Evaluation in Patients with Clinically Node Negative Merkel Cell Carcinoma of the Head and Neck. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Loganadane V G, Kann B, Park H, Johnson S, Mehra S, Judson B, Bhatia A, Belkacemi Y, Yarbrough W, Burtness B, Husain Z. Clinical Outcomes of Head and Neck Cancer Patients who Undergo Resection, but Forgo Adjuvant Therapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1628] [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: 11/25/2022]
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Triolo TM, Fouts A, Pyle L, Yu L, Gottlieb PA, Steck AK, Greenbaum CJ, Atkinson M, Baidal D, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Clements M, Colman P, DiMeglio L, Gitelman S, Goland R, Gottlieb P, Herold K, Knip M, Krischer J, Lernmark A, Moore W, Moran A, Muir A, Palmer J, Peakman M, Philipson L, Raskin P, Redondo M, Rodriguez H, Russell W, Spain L, Schatz D, Sosenko J, Wentworth J, Wherrett D, Wilson D, Winter W, Ziegler A, Anderson M, Antinozzi P, Benoist C, Blum J, Bourcier K, Chase P, Clare-Salzler M, Clynes R, Eisenbarth G, Fathman C, Grave G, Hering B, Insel R, Kaufman F, Kay T, Leschek E, Mahon J, Marks J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Pugliese A, Roep B, Roncarolo M, Savage P, Simell O, Sherwin R, Siegelman M, Skyler J, Steck A, Thomas J, Trucco M, Wagner J, Krischer JP, Leschek E, Rafkin L, Bourcier K, Cowie C, Foulkes M, Insel R, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, Zafonte SJ, Rafkin L, Sosenko JM, Kenyon NS, Santiago I, Krischer JP, Bundy B, Abbondondolo M, Dixit S, Pasha M, King K, Adcock H, Atterberry L, Fox K, Englert N, Mauras J, Permuy K, Sikes T, Adams T, Berhe B, Guendling L, McLennan L, Paganessi C, Murphy M, Draznin M, Kamboj S, Sheppard V, Lewis L, Coates W, Amado D, Moore G, Babar J, Bedard D, Brenson-Hughes J, Cernich M, Clements R, Duprau S, Goodman L, Hester L, Huerta-Saenz A, Asif I, Karmazin T, Letjen S, Raman D, Morin W, Bestermann E, Morawski J, White A, Brockmyer R, Bays S, Campbell A, Boonstra M, Stapleton N, Stone A, Donoho H, Everett H, Hensley M, Johnson C, Marshall N, Skirvin P, Taylor R, Williams L, Burroughs C, Ray C, Wolverton D, Nickels C, Dothard P, Speiser M, Pellizzari L, Bokor K, Izuora S, Abdelnour P, Cummings S, Cuthbertson D, Paynor M, Leahy M, Riedl S, Shockley R, Saad T, Briones S, Casella C, Herz K, Walsh J, Greening F, Deemer M, Hay S, Hunt N, Sikotra L, Simons D, Karounos R, Oremus L, Dye L, Myers D, Ballard W, Miers R, Eberhard C, Sparks K, Thraikill K, Edwards J, Fowlkes S, Kemp A, Morales L, Holland L, Johnson P, Paul A, Ghatak K, Fiske S, Phelen H, Leyland T, Henderson D, Brenner E, Oppenheimer I, Mamkin C, Moniz C, Clarson M, Lovell A, Peters V, Ford J, Ruelas D, Borut D, Burt M, Jordan S, Castilla P, Flores M, Ruiz L, Hanson J, Green-Blair R, Sheridan K, Garmeson J, Wintergerst G, Pierce A, Omoruyi M, Foster S, Kingery A, Lunsford I, Cervantes T, Parker P, Price J, Urben I, Guillette H, Doughty H, Haydock V, Parker P, Bergman S, Duncum C, Rodda A, Perelman R, Calendo C, Barrera E, Arce-Nunez Y, Geyer S, Martinez M, De la Portilla I, Cardenas L, Garrido M, Villar R, Lorini E, Calandra G, D’Annuzio K, Perri N, Minuto C, Hays B, Rebora R, Callegari O, Ali J, Kramer B, Auble S, Cabrera P, Donohoue R, Fiallo-Scharer M, Hessner P, Wolfgram A, Henderson C, Kansra N, Bettin R, McCuller A, Miller S, Accacha J, Corrigan E, Fiore R, Levine T, Mahoney C, Polychronakos V, Henry M, Gagne H, Starkman M, Fox D, Chin F, Melchionne L, Silverman I, Marshall L, Cerracchio J, Cruz A, Viswanathan J, Heyman K, Wilson S, Chalew S, Valley S, Layburn A, Lala P, Clesi M, Genet G, Uwaifo A, Charron T, Allerton W, Hsiao B, Cefalu L, Melendez-Ramirez R, Richards C, Alleyn E, Gustafson M, Lizanna J, Wahlen S, Aleiwe M, Hansen H, Wahlen C, Karges C, Levy A, Bonaccorso R, Rapaport Y, Tomer D, Chia M, Goldis L, Iazzetti M, Klein C, Levister L, Waldman E, Keaton N, Wallach M, Regelmann Z, Antal M, Aranda C, Reynholds A, Vinik P, Barlow M, Bourcier M, Nevoret J, Couper S, Kinderman A, Beresford N, Thalagne H, Roper J, Gibbons J, Hill S, Balleaut C, Brennan J, Ellis-Gage L, Fear T, Gray L, Law P, Jones C, McNerney L, Pointer N, Price K, Few D, Tomlinson N, Leech D, Wake C, Owens M, Burns J, Leinbach A, Wotherspoon A, Murray K, Short G, Curry S, Kelsey J, Lawson J, Porter S, Stevens E, Thomson S, Winship L, Liu S, Wynn E, Wiltshire J, Krebs P, Cresswell H, Faherty C, Ross L, Denvir J, Drew T, Randell P, Mansell S, Lloyd J, Bell S, Butler Y, Hooton H, Navarra A, Roper G, Babington L, Crate H, Cripps A, Ledlie C, Moulds R, Malloy J, Norton B, Petrova O, Silkstone C, Smith K, Ghai M, Murray V, Viswanathan M, Henegan O, Kawadry J, Olson L, Maddox K, Patterson T, Ahmad B, Flores D, Domek S, Domek K, Copeland M, George J, Less T, Davis M, Short A, Martin J, Dwarakanathan P, O’Donnell B, Boerner L, Larson M, Phillips M, Rendell K, Larson C, Smith K, Zebrowski L, Kuechenmeister M, Miller J, Thevarayapillai M, Daniels H, Speer N, Forghani R, Quintana C, Reh A, Bhangoo P, Desrosiers L, Ireland T, Misla C, Milliot E, Torres S, Wells J, Villar M, Yu D, Berry D, Cook J, Soder A, Powell M, Ng M, Morrison Z, Moore M, Haslam M, Lawson B, Bradley J, Courtney C, Richardson C, Watson E, Keely D, DeCurtis M, Vaccarcello-Cruz Z, Torres K, Muller S, Sandberg H, Hsiang B, Joy D, McCormick A, Powell H, Jones J, Bell S, Hargadon S, Hudson M, Kummer S, Nguyen T, Sauder E, Sutton K, Gensel R, Aguirre-Castaneda V, Benavides, Lopez D, Hemp S, Allen J, Stear E, Davis T, O’Donnell R, Jones A, Roberts J, Dart N, Paramalingam L, Levitt Katz N, Chaudhary K, Murphy S, Willi B, Schwartzman C, Kapadia D, Roberts A, Larson D, McClellan G, Shaibai L, Kelley G, Villa C, Kelley R, Diamond M, Kabbani T, Dajani F, Hoekstra M, Sadler K, Magorno J, Holst V, Chauhan N, Wilson P, Bononi M, Sperl A, Millward M, Eaton L, Dean J, Olshan H, Stavros T, Renna C, Milliard, Brodksy L, Bacon J, Quintos L, Topor S, Bialo B, Bancroft A, Soto W, Lagarde H, Tamura R, Lockemer T, Vanderploeg M, Ibrahim M, Huie V, Sanchez R, Edelen R, Marchiando J, Palmer T, Repas M, Wasson P, Wood K, Auker J, Culbertson T, Kieffer D, Voorhees T, Borgwardt L, DeRaad K, Eckert E, Isaacson H, Kuhn A, Carroll M, Xu P, Schubert G, Francis S, Hagan T, Le M, Penn E, Wickham C, Leyva K, Rivera J, Padilla I, Rodriguez N, Young K, Jospe J, Czyzyk B, Johnson U, Nadgir N, Marlen G, Prakasam C, Rieger N, Glaser E, Heiser B, Harris C, Alies P, Foster H, Slater K, Wheeler D, Donaldson M, Murray D, Hale R, Tragus D, Word J, Lynch L, Pankratz W, Badias F, Rogers R, Newfield S, Holland M, Hashiguchi M, Gottschalk A, Philis-Tsimikas R, Rosal S, Franklin S, Guardado N, Bohannon M, Baker A, Garcia T, Aguinaldo J, Phan V, Barraza D, Cohen J, Pinsker U, Khan J, Wiley L, Jovanovic P, Misra M, Bassi M, Wright D, Cohen K, Huang M, Skiles S, Maxcy C, Pihoker K, Cochrane J, Fosse S, Kearns M, Klingsheim N, Beam C, Wright L, Viles H, Smith S, Heller M, Cunningham A, Daniels L, Zeiden J, Field R, Walker K, Griffin L, Boulware D, Bartholow C, Erickson J, Howard B, Krabbenhoft C, Sandman A, Vanveldhuizen J, Wurlger A, Zimmerman K, Hanisch L, Davis-Keppen A, Bounmananh L, Cotterill J, Kirby M, Harris A, Schmidt C, Kishiyama C, Flores J, Milton W, Martin C, Whysham A, Yerka T, Bream S, Freels J, Hassing J, Webster R, Green P, Carter J, Galloway D, Hoelzer S, Roberts S, Said P, Sullivan H, Freeman D, Allen E, Reiter E, Feinberg C, Johnson L, Newhook D, Hagerty N, White L, Levandoski J, Kyllo M, Johnson C, Gough J, Benoit P, Iyer F, Diamond H, Hosono S, Jackman L, Barette P, Jones I, Sills S, Bzdick J, Bulger R, Ginem J, Weinstock I, Douek R, Andrews G, Modgill G, Gyorffy L, Robin N, Vaidya S, Crouch K, O’Brien C, Thompson N, Granger M, Thorne J, Blumer J, Kalic L, Klepek J, Paulett B, Rosolowski J, Horner M, Watkins J, Casey K, Carpenter C, Michelle Kieffer MH, Burns J, Horton C, Pritchard D, Soetaert A, Wynne C, Chin O, Molina C, Patel R, Senguttuvan M, Wheeler O, Lane P, Furet C, Steuhm D, Jelley S, Goudeau L, Chalmers D, Greer C, Panagiotopoulos D, Metzger D, Nguyen M, Horowitz M, Linton C, Christiansen E, Glades C, Morimoto M, Macarewich R, Norman K, Patin C, Vargas A, Barbanica A, Yu P, Vaidyanathan W, Nallamshetty L, Osborne R, Mehra S, Kaster S, Neace J, Horner G, Reeves C, Cordrey L, Marrs T, Miller S, Dowshen D, Oduah V, Doyle S, Walker D, Catte H, Dean M, Drury-Brown B, Hackman M, Lee S, Malkani K, Cullen K, Johnson P, Parrimon Y, Hampton M, McCarrell C, Curtis E, Paul, Zambrano Y, Paulus K, Pilger J, Ramiro J, Luvon Ritzie AQ, Sharma A, Shor A, Song X, Terry A, Weinberger J, Wootten M, Lachin JM, Foulkes M, Harding P, Krause-Steinrauf H, McDonough S, McGee PF, Owens Hess K, Phoebus D, Quinlan S, Raiden E, Batts E, Buddy C, Kirpatrick K, Ramey M, Shultz A, Webb C, Romesco M, Fradkin J, Leschek E, Spain L, Savage P, Aas S, Blumberg E, Beck G, Brillon D, Gubitosi-Klug R, Laffel L, Vigersky R, Wallace D, Braun J, Lernmark A, Lo B, Mitchell H, Naji A, Nerup J, Orchard T, Steffes M, Tsiatis A, Veatch R, Zinman B, Loechelt B, Baden L, Green M, Weinberg A, Marcovina S, Palmer JP, Weinberg A, Yu L, Babu S, Winter W, Eisenbarth GS, Bingley P, Clynes R, DiMeglio L, Eisenbarth G, Hays B, Leschek E, Marks J, Matheson D, Rafkin L, Rodriguez H, Spain L, Wilson D, Redondo M, Gomez D, McDonald A, Pena S, Pietropaolo M, Shippy K, Batts E, Brown T, Buckner J, Dove A, Hammond M, Hefty D, Klein J, Kuhns K, Letlau M, Lord S, McCulloch-Olson M, Miller L, Nepom G, Odegard J, Ramey M, Sachter E, St. Marie M, Stickney K, VanBuecken D, Vellek B, Webber C, Allen L, Bollyk J, Hilderman N, Ismail H, Lamola S, Sanda S, Vendettuoli H, Tridgell D, Monzavi R, Bock M, Fisher L, Halvorson M, Jeandron D, Kim M, Wood J, Geffner M, Kaufman F, Parkman R, Salazar C, Goland R, Clynes R, Cook S, Freeby M, Pat Gallagher M, Gandica R, Greenberg E, Kurland A, Pollak S, Wolk A, Chan M, Koplimae L, Levine E, Smith K, Trast J, DiMeglio L, Blum J, Evans-Molina C, Hufferd R, Jagielo B, Kruse C, Patrick V, Rigby M, Spall M, Swinney K, Terrell J, Christner L, Ford L, Lynch S, Menendez M, Merrill P, Pescovitz M, Rodriguez H, Alleyn C, Baidal D, Fay S, Gaglia J, Resnick B, Szubowicz S, Weir G, Benjamin R, Conboy D, deManbey A, Jackson R, Jalahej H, Orban T, Ricker A, Wolfsdorf J, Zhang HH, Wilson D, Aye T, Baker B, Barahona K, Buckingham B, Esrey K, Esrey T, Fathman G, Snyder R, Aneja B, Chatav M, Espinoza O, Frank E, Liu J, Perry J, Pyle R, Rigby A, Riley K, Soto A, Gitelman S, Adi S, Anderson M, Berhel A, Breen K, Fraser K, Gerard-Gonzalez A, Jossan P, Lustig R, Moassesfar S, Mugg A, Ng D, Prahalod P, Rangel-Lugo M, Sanda S, Tarkoff J, Torok C, Wesch R, Aslan I, Buchanan J, Cordier J, Hamilton C, Hawkins L, Ho T, Jain A, Ko K, Lee T, Phelps S, Rosenthal S, Sahakitrungruang T, Stehl L, Taylor L, Wertz M, Wong J, Philipson L, Briars R, Devine N, Littlejohn E, Grant T, Gottlieb P, Klingensmith G, Steck A, Alkanani A, Bautista K, Bedoy R, Blau A, Burke B, Cory L, Dang M, Fitzgerald-Miller L, Fouts A, Gage V, Garg S, Gesauldo P, Gutin R, Hayes C, Hoffman M, Ketchum K, Logsden-Sackett N, Maahs D, Messer L, Meyers L, Michels A, Peacock S, Rewers M, Rodriguez P, Sepulbeda F, Sippl R, Steck A, Taki I, Tran BK, Tran T, Wadwa RP, Zeitler P, Barker J, Barry S, Birks L, Bomsburger L, Bookert T, Briggs L, Burdick P, Cabrera R, Chase P, Cobry E, Conley A, Cook G, Daniels J, DiDomenico D, Eckert J, Ehler A, Eisenbarth G, Fain P, Fiallo-Scharer R, Frank N, Goettle H, Haarhues M, Harris S, Horton L, Hutton J, Jeffrrey J, Jenison R, Jones K, Kastelic W, King MA, Lehr D, Lungaro J, Mason K, Maurer H, Nguyen L, Proto A, Realsen J, Schmitt K, Schwartz M, Skovgaard S, Smith J, Vanderwel B, Voelmle M, Wagner R, Wallace A, Walravens P, Weiner L, Westerhoff B, Westfall E, Widmer K, Wright H, Schatz D, Abraham A, Atkinson M, Cintron M, Clare-Salzler M, Ferguson J, Haller M, Hosford J, Mancini D, Rohrs H, Silverstein J, Thomas J, Winter W, Cole G, Cook R, Coy R, Hicks E, Lewis N, Marks J, Pugliese A, Blaschke C, Matheson D, Pugliese A, Sanders-Branca N, Ray Arce LA, Cisneros M, Sabbag S, Moran A, Gibson C, Fife B, Hering B, Kwong C, Leschyshyn J, Nathan B, Pappenfus B, Street A, Boes MA, Peterson Eck S, Finney L, Albright Fischer T, Martin A, Jacqueline Muzamhindo C, Rhodes M, Smith J, Wagner J, Wood B, Becker D, Delallo K, Diaz A, Elnyczky B, Libman I, Pasek B, Riley K, Trucco M, Copemen B, Gwynn D, Toledo F, Rodriguez H, Bollepalli S, Diamond F, Eyth E, Henson D, Lenz A, Shulman D, Raskin P, Adhikari S, Dickson B, Dunnigan E, Lingvay I, Pruneda L, Ramos-Roman M, Raskin P, Rhee C, Richard J, Siegelman M, Sturges D, Sumpter K, White P, Alford M, Arthur J, Aviles-Santa ML, Cordova E, Davis R, Fernandez S, Fordan S, Hardin T, Jacobs A, Kaloyanova P, Lukacova-Zib I, Mirfakhraee S, Mohan A, Noto H, Smith O, Torres N, Wherrett D, Balmer D, Eisel L, Kovalakovska R, Mehan M, Sultan F, Ahenkorah B, Cevallos J, Razack N, Jo Ricci M, Rhode A, Srikandarajah M, Steger R, Russell WE, Black M, Brendle F, Brown A, Moore D, Pittel E, Robertson A, Shannon A, Thomas JW, Herold K, Feldman L, Sherwin R, Tamborlane W, Weinzimer S, Toppari J, Kallio T, Kärkkäinen M, Mäntymäki E, Niininen T, Nurmi B, Rajala P, Romo M, Suomenrinne S, Näntö-Salonen K, Simell O, Simell T, Bosi E, Battaglia M, Bianconi E, Bonfanti R, Grogan P, Laurenzi A, Martinenghi S, Meschi F, Pastore M, Falqui L, Teresa Muscato M, Viscardi M, Bingley P, Castleden H, Farthing N, Loud S, Matthews C, McGhee J, Morgan A, Pollitt J, Elliot-Jones R, Wheaton C, Knip M, Siljander H, Suomalainen H, Colman P, Healy F, Mesfin S, Redl L, Wentworth J, Willis J, Farley M, Harrison L, Perry C, Williams F, Mayo A, Paxton J, Thompson V, Volin L, Fenton C, Carr L, Lemon E, Swank M, Luidens M, Salgam M, Sharma V, Schade D, King C, Carano R, Heiden J, Means N, Holman L, Thomas I, Madrigal D, Muth T, Martin C, Plunkett C, Ramm C, Auchus R, Lane W, Avots E, Buford M, Hale C, Hoyle J, Lane B, Muir A, Shuler S, Raviele N, Ivie E, Jenkins M, Lindsley K, Hansen I, Fadoju D, Felner E, Bode B, Hosey R, Sax J, Jefferies C, Mannering S, Prentis R, She J, Stachura M, Hopkins D, Williams J, Steed L, Asatapova E, Nunez S, Knight S, Dixon P, Ching J, Donner T, Longnecker S, Abel K, Arcara K, Blackman S, Clark L, Cooke D, Plotnick L, Levin P, Bromberger L, Klein K, Sadurska K, Allen C, Michaud D, Snodgrass H, Burghen G, Chatha S, Clark C, Silverberg J, Wittmer C, Gardner J, LeBoeuf C, Bell P, McGlore O, Tennet H, Alba N, Carroll M, Baert L, Beaton H, Cordell E, Haynes A, Reed C, Lichter K, McCarthy P, McCarthy S, Monchamp T, Roach J, Manies S, Gunville F, Marosok L, Nelson T, Ackerman K, Rudolph J, Stewart M, McCormick K, May S, Falls T, Barrett T, Dale K, Makusha L, McTernana C, Penny-Thomas K, Sullivan K, Narendran P, Robbie J, Smith D, Christensen R, Koehler B, Royal C, Arthur T, Houser H, Renaldi J, Watsen S, Wu P, Lyons L, House B, Yu J, Holt H, Nation M, Vickers C, Watling R, Heptulla R, Trast J, Agarwal C, Newell D, Katikaneni R, Gardner C, Del A, Rio A, Logan H, Collier C, Rishton G, Whalley A, Ali S, Ramtoola T, Quattrin L, Mastrandea A, House M, Ecker C, Huang C, Gougeon J, Ho D, Pacuad D, Dunger J, May C, O’Brien C, Acerini B, Salgin A, Thankamony R, Williams J, Buse G, Fuller M, Duclos J, Tricome H, Brown D, Pittard D, Bowlby A, Blue T, Headley S, Bendre K, Lewis K, Sutphin C, Soloranzo J, Puskaric H, Madison M, Rincon M, Carlucci R, Shridharani B, Rusk E, Tessman D, Huffman H, Abrams B, Biederman M, Jones V, Leathers W, Brickman P, Petrie D, Zimmerman J, Howard L, Miller R, Alemzadeh D, Mihailescu R, Melgozza-Walker N, Abdulla C, Boucher-Berry D, Ize-Ludlow R, Levy C, Swenson, Brousell N, Crimmins D, Edler T, Weis C, Schultz D, Rogers D, Latham C, Mawhorter C, Switzer W, Spencer P, Konstantnopoulus S, Broder J, Klein L, Knight L, Szadek G, Welnick B, Thompson R, Hoffman A, Revell J, Cherko K, Carter E, Gilson J, Haines G, Arthur B, Bowen W, Zipf P, Graves R, Lozano D, Seiple K, Spicer A, Chang J, Fregosi J, Harbinson C, Paulson S, Stalters P, Wright D, Zlock A, Freeth J, Victory H, Maheshwari A, Maheshwari T, Holmstrom J, Bueno R, Arguello J, Ahern L, Noreika V, Watson S, Hourse P, Breyer C, Kissel Y, Nicholson M, Pfeifer S, Almazan J, Bajaj M, Quinn K, Funk J, McCance E, Moreno R, Veintimilla A, Wells J, Cook S, Trunnel J, Henske S, Desai K, Frizelis F, Khan R, Sjoberg K, Allen P, Manning G, Hendry B, Taylor S, Jones W, Strader M, Bencomo T, Bailey L, Bedolla C, Roldan C, Moudiotis B, Vaidya C, Anning S, Bunce S, Estcourt E, Folland E, Gordon C, Harrill J, Ireland J, Piper L, Scaife K, Sutton S, Wilkins M, Costelloe J, Palmer L, Casas C, Miller M, Burgard C, Erickson J, Hallanger-Johnson P, Clark W, Taylor A, Lafferty S, Gillett C, Nolan M, Pathak L, Sondrol T, Hjelle S, Hafner J, Kotrba R, Hendrickson A, Cemeroglu T, Symington M, Daniel Y, Appiagyei-Dankah D, Postellon M, Racine L, Kleis K, Barnes S, Godwin H, McCullough K, Shaheen G, Buck L, Noel M, Warren S, Weber S, Parker I, Gillespie B, Nelson C, Frost J, Amrhein E, Moreland A, Hayes J, Peggram J, Aisenberg M, Riordan J, Zasa E, Cummings K, Scott T, Pinto A, Mokashi K, McAssey E, Helden P, Hammond L, Dinning S, Rahman S, Ray C, Dimicri S, Guppy H, Nielsen C, Vogel C, Ariza L, Morales Y, Chang R, Gabbay L, Ambrocio L, Manley R, Nemery W, Charlton P, Smith L, Kerr B, Steindel-Kopp M, Alamaguer D, Liljenquist G, Browning T, Coughenour M, Sulk E, Tsalikan M, Tansey J, Cabbage N. Identical and Nonidentical Twins: Risk and Factors Involved in Development of Islet Autoimmunity and Type 1 Diabetes. Diabetes Care 2019; 42:192-199. [PMID: 30061316 PMCID: PMC6341285 DOI: 10.2337/dc18-0288] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/28/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE There are variable reports of risk of concordance for progression to islet autoantibodies and type 1 diabetes in identical twins after one twin is diagnosed. We examined development of positive autoantibodies and type 1 diabetes and the effects of genetic factors and common environment on autoantibody positivity in identical twins, nonidentical twins, and full siblings. RESEARCH DESIGN AND METHODS Subjects from the TrialNet Pathway to Prevention Study (N = 48,026) were screened from 2004 to 2015 for islet autoantibodies (GAD antibody [GADA], insulinoma-associated antigen 2 [IA-2A], and autoantibodies against insulin [IAA]). Of these subjects, 17,226 (157 identical twins, 283 nonidentical twins, and 16,786 full siblings) were followed for autoantibody positivity or type 1 diabetes for a median of 2.1 years. RESULTS At screening, identical twins were more likely to have positive GADA, IA-2A, and IAA than nonidentical twins or full siblings (all P < 0.0001). Younger age, male sex, and genetic factors were significant factors for expression of IA-2A, IAA, one or more positive autoantibodies, and two or more positive autoantibodies (all P ≤ 0.03). Initially autoantibody-positive identical twins had a 69% risk of diabetes by 3 years compared with 1.5% for initially autoantibody-negative identical twins. In nonidentical twins, type 1 diabetes risk by 3 years was 72% for initially multiple autoantibody-positive, 13% for single autoantibody-positive, and 0% for initially autoantibody-negative nonidentical twins. Full siblings had a 3-year type 1 diabetes risk of 47% for multiple autoantibody-positive, 12% for single autoantibody-positive, and 0.5% for initially autoantibody-negative subjects. CONCLUSIONS Risk of type 1 diabetes at 3 years is high for initially multiple and single autoantibody-positive identical twins and multiple autoantibody-positive nonidentical twins. Genetic predisposition, age, and male sex are significant risk factors for development of positive autoantibodies in twins.
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Affiliation(s)
- Taylor M. Triolo
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Alexandra Fouts
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Laura Pyle
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Liping Yu
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Peter A. Gottlieb
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Andrea K. Steck
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
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Saeed N, Kelly J, Deshpande H, Bhatia A, Burtness B, Judson B, Mehra S, Osborn H, Yarbrough W, Peter P, Holt E, Decker R, Husain Z, Park H. Adjuvant External Beam Radiation Therapy for Surgically Resected, Non-Metastatic Anaplastic Thyroid Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Vashistha H, Marrero L, Reiss K, Cohen AJ, Malhotra A, Javed T, Bradley A, Abbruscato F, Giusti S, Jimenez A, Mehra S, Kaushal D, Giorgio M, Pelicci PG, Kakoki M, Singhal PC, Bunnell B, Meggs LG. Aging phenotype(s) in kidneys of diabetic mice are p66ShcA dependent. Am J Physiol Renal Physiol 2018; 315:F1833-F1842. [PMID: 30207172 DOI: 10.1152/ajprenal.00608.2017] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The p66ShcA protein controls cellular responses to oxidative stress, senescence, and apoptosis. Here, we test the hypothesis that aging phenotype(s) commonly associated with the broad category of chronic kidney disease are accelerated in diabetic kidneys and linked to the p66ShcA locus. At the organ level, tissue stem cells antagonize senescent phenotypes by replacing old dysfunctional cells. Using established methods, we isolated a highly purified population of stem cell antigen-1-positive mesenchymal stem cells (Sca-1+ MSCs) from kidneys of wild-type (WT) and p66 knockout (p66 KO) mice. Cells were plated in culture medium containing normal glucose (NG) or high glucose (HG). Reactive oxygen species (ROS) metabolism was substantially increased in WT MSCs in HG medium in association with increased cell death by apoptosis and acquisition of the senescent phenotype. DNA microarray analysis detected striking differences in the expression profiles of WT and p66 KO-MSCs in HG medium. Unexpectedly, the analysis for p66 KO-MSCs revealed upregulation of Wnt genes implicated in self-renewal and differentiation. To test the in vivo consequences of constitutive p66 expression in diabetic kidneys, we crossed the Akita diabetic mouse with the p66KO mouse. Homozygous mutation at the p66 locus delays or prevents aging phenotype(s) in the kidney that may be precursors to diabetic nephropathy.
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Affiliation(s)
- H Vashistha
- Institute of Translational Research, Ochsner Health System , New Orleans, Louisiana.,Neurological Cancer Research, Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center , New Orleans, Louisiana
| | - L Marrero
- Neurological Cancer Research, Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center , New Orleans, Louisiana
| | - K Reiss
- Neurological Cancer Research, Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center , New Orleans, Louisiana
| | - A J Cohen
- Institute of Translational Research, Ochsner Health System , New Orleans, Louisiana
| | - A Malhotra
- Immunology and Inflammation Center, Feinstein Institute for Medical Research and Zucker School of Medicine at Hofstra-Northwell, Manhasset, New York, New York
| | - T Javed
- Institute of Translational Research, Ochsner Health System , New Orleans, Louisiana
| | - A Bradley
- Institute of Translational Research, Ochsner Health System , New Orleans, Louisiana
| | - F Abbruscato
- Institute of Translational Research, Ochsner Health System , New Orleans, Louisiana
| | - S Giusti
- Institute of Translational Research, Ochsner Health System , New Orleans, Louisiana
| | - A Jimenez
- Institute of Translational Research, Ochsner Health System , New Orleans, Louisiana
| | - S Mehra
- Department of Microbiology, Tulane Primate Center, Tulane University , New Orleans, Louisiana
| | - D Kaushal
- Department of Microbiology, Tulane Primate Center, Tulane University , New Orleans, Louisiana
| | - M Giorgio
- Department of Experimental Oncology, European Institute of Oncology , Milan , Italy
| | - P G Pelicci
- Department of Experimental Oncology, European Institute of Oncology , Milan , Italy
| | - M Kakoki
- Department of Pathology and Laboratory of Medicine, University of North Carolina , Chapel Hill, North Carolina
| | - P C Singhal
- Immunology and Inflammation Center, Feinstein Institute for Medical Research and Zucker School of Medicine at Hofstra-Northwell, Manhasset, New York, New York
| | - B Bunnell
- Department of Stem Cell and Regenerative Medicine, Tulane University , New Orleans, Louisiana
| | - L G Meggs
- Institute of Translational Research, Ochsner Health System , New Orleans, Louisiana.,Neurological Cancer Research, Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center , New Orleans, Louisiana
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van den Helder J, van Dronkelaar C, Tieland M, Mehra S, Visser B, Kröse B, Engelbert R, Weijs P. Digitally supported dietary counseling increases protein intake in community dwelling older adults: Preliminary results of the vitamin RCT. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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11
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Tiwari V, Poudel RR, Khan SA, Mehra S, Chauhan SS, Raje A. Is VEGF under-expressed in Indian children with Perthes disease? Musculoskelet Surg 2018; 102:81-85. [PMID: 28956304 DOI: 10.1007/s12306-017-0502-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 09/10/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND The role of vascular endothelial growth factor (VEGF) after ischaemic necrosis of the femoral head in Legg-Calve-Perthes disease (LCPD) has not been adequately studied in humans, especially in Indian population. Therefore, we aimed to evaluate the serum levels of VEGF-A in Indian children with various stages of LCPD and compare them with those of an age- and sex-matched control group of healthy children. METHODS In this case-control study, we enrolled 42 children (below 14 years age) suffering from LCPD and 21 age- and sex-matched healthy controls. Patients were classified radiographically according to Waldenstrom's classification. Serum VEGF-A was estimated by sandwich enzyme-linked immunosorbent assay technique. The serum values were compared between the patient group and the control group, as well as between the Waldenstrom subgroups. Results were expressed as means with ranges or median with interquartile range. RESULTS The mean age in the patient as well as the control group was 9 years (range 4-13 years). The median value (interquartile range) of serum VEGF-A was 162.5 pg/ml (673.75 pg/ml) in the patient group and 652 pg/ml (190.5 pg/ml) in the control group (p = 0.013). When compared between lower Waldenstrom stages (initial stage + stage of fragmentation) and higher Waldenstrom stages (re-ossification stage + stage of healing), the mean values of serum VEGF-A were 464.7 pg/ml (range 0-2211 pg/ml) and 301.1 pg/ml (range 0-1910 pg/ml), respectively (p = 0.305). CONCLUSIONS VEGF is under-expressed in Indian children suffering from LCPD. As VEGF acts as a key regulator of endochondral ossification, our finding may open new therapeutic approaches to the disease. Also, serum VEGF may act as a valuable marker for the follow-up of the disease. Our study also provides baseline data about serum VEGF-A levels in Indian cohort of LCPD patients. Future multi-centre studies are warranted with a larger sample size to fully appreciate the patho-physiological changes in VEGF occurring in LCPD.
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Affiliation(s)
- V Tiwari
- Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - R R Poudel
- Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - S A Khan
- Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
| | - S Mehra
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - S S Chauhan
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - A Raje
- Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
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Mehra S, Bowden J, Morton S, Sajkov D, Heraganahally S. Small bore intercostal catheters are as efficient as large bore intercostal tubes with better patient tolerance. Intern Med J 2017. [DOI: 10.1111/imj.9_13461] [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: 11/30/2022]
Affiliation(s)
- S Mehra
- Respiratory Medicine, Royal Darwin Hospital; Darwin Northern Territory Australia
| | - J Bowden
- Respiratory Medicine; Flinders Medical Centre; Bedford Park South Australia Australia
| | - S Morton
- Respiratory Medicine; Flinders Medical Centre; Bedford Park South Australia Australia
| | - D Sajkov
- Respiratory Medicine; Flinders Medical Centre; Bedford Park South Australia Australia
| | - S Heraganahally
- Respiratory Medicine, Royal Darwin Hospital; Darwin Northern Territory Australia
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Mehra S, Mehra D, Tripathi S. Iatrogenically ruptured pulmonary hydatid cyst presenting as haemoptysis: a case report. Intern Med J 2017. [DOI: 10.1111/imj.10_13461] [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: 11/28/2022]
Affiliation(s)
- S Mehra
- Respiratory, Sleep and General Medicine, Royal Darwin Hospital; Darwin Northern Territory Australia
- Pulmonary Medicine; King George Medical University; Lucknow Uttar Pradesh India
| | - D Mehra
- Pathology; James Cook University; Townsville Queensland Australia
| | - S Tripathi
- Pulmonary Medicine; King George Medical University; Lucknow Uttar Pradesh India
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Mehra S, Morrison PD, Coates F, Lawrie AC. Differences in carbon source utilisation by orchid mycorrhizal fungi from common and endangered species of Caladenia (Orchidaceae). Mycorrhiza 2017; 27:95-108. [PMID: 27639577 DOI: 10.1007/s00572-016-0732-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 08/22/2016] [Indexed: 06/06/2023]
Abstract
Terrestrial orchids depend on orchid mycorrhizal fungi (OMF) as symbionts for their survival, growth and nutrition. The ability of OMF from endangered orchid species to compete for available resources with OMF from common species may affect the distribution, abundance and therefore conservation status of their orchid hosts. Eight symbiotically effective OMF from endangered and more common Caladenia species were tested for their ability to utilise complex insoluble and simple soluble carbon sources produced during litter degradation by growth with different carbon sources in liquid medium to measure the degree of OMF variation with host conservation status or taxonomy. On simple carbon sources, fungal growth was assessed by biomass. On insoluble substrates, ergosterol content was assessed using ultra-performance liquid chromatography (UPLC). The OMF grew on all natural materials and complex carbon sources, but produced the greatest biomass on xylan and starch and the least on bark and chitin. On simple carbon sources, the greatest OMF biomass was measured on most hexoses and disaccharides and the least on galactose and arabinose. Only some OMF used sucrose, the most common sugar in green plants, with possible implications for symbiosis. OMF from common orchids produced more ergosterol and biomass than those from endangered orchids in the Dilatata and Reticulata groups but not in the Patersonii and Finger orchids. This suggests that differences in carbon source utilisation may contribute to differences in the distribution of some orchids, if these differences are retained on site.
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Affiliation(s)
- S Mehra
- School of Science, RMIT University (Bundoora West Campus), PO Box 71, Bundoora, Victoria, 3083, Australia
| | - P D Morrison
- Australian Centre for Research on Separation Science, School of Science, RMIT University (City Campus), GPO Box 2476V, Melbourne, Victoria, 3001, Australia
| | - F Coates
- Department of Environment and Primary Industries, Melbourne, Victoria, 3002, Australia
- Woods to Water Environmental Consulting, Williamstown, VIC, 3016, Australia
| | - A C Lawrie
- School of Science, RMIT University (Bundoora West Campus), PO Box 71, Bundoora, Victoria, 3083, Australia.
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Siddagangaiah V, Sharma H, Lal N, Rai J, Howse M, Ridgway D, Sharma A, Hammad A, Mehra S. Alemtuzumab induction allows better rejection free graft survival incomparison to basiliximab albeit increased post transplant viralinfections. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.382] [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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Rowe ME, Clain JB, Scherl S, Dos Reis L, Turk A, Wenig BM, Mehra S, Urken ML. Response to "Breach of the thyroid capsule and lymph node capsule in node-positive papillary and medullary thyroid cancer: Different biology". Eur J Surg Oncol 2015; 42:156-7. [PMID: 26632081 DOI: 10.1016/j.ejso.2015.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 09/30/2015] [Indexed: 10/22/2022] Open
Affiliation(s)
- M E Rowe
- Department of Otolaryngology, Mount Sinai Beth Israel, New York, NY, USA; Thyroid, Head and Neck Cancer (THANC) Foundation, New York, NY, USA.
| | - J B Clain
- Tufts University School of Medicine, Boston, MA, USA
| | - S Scherl
- Albany Medical College, Albany, NY, USA
| | - L Dos Reis
- Department of Otolaryngology, Mount Sinai Beth Israel, New York, NY, USA; Thyroid, Head and Neck Cancer (THANC) Foundation, New York, NY, USA
| | - A Turk
- Department of Pathology and Cell Biology, Columbia University, New York, NY, USA
| | - B M Wenig
- Department of Pathology, Mount Sinai Beth Israel, New York, NY, USA
| | - S Mehra
- Division of Otolaryngology-Head and Neck Surgery, Yale School of Medicine, New Haven, CT, USA
| | - M L Urken
- Department of Otolaryngology, Mount Sinai Beth Israel, New York, NY, USA; Thyroid, Head and Neck Cancer (THANC) Foundation, New York, NY, USA; Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Abstract
The July phenomenon refers to a change in patient outcomes within teaching hospitals with the arrival of new and inexperienced house staff at the start of the academic year (July to June). In our obstetric triage unit we retrospectively evaluated the door to disposition time (DTDT) for 1817 patients who presented across July, December and May of academic years 2009-2010 and 2010-2011. DTDT was examined for three visit levels: non-urgent, urgent and emergent. No significant differences in disposition time were found for emergent visits. For urgent visits the median DTDT significantly decreased from 171 min in July to 155 min in December and 135 min in May (p < 0.001). Similarly for non-urgent visits, the median DTDT was greater during July than May (179 min vs. 133 min; p < 0.05). Electronic medical records (EMRs) were implemented in November 2010. Following the introduction of EMR shorter DTDT was seen in December 2010 versus December 2009 (median, 171 min vs. 150 min; p < 0.05), respectively. Our findings suggest a 'July Phenomenon' of greater disposition intervals for urgent and non-urgent obstetric triage visits across the academic year. Additionally the use of EMRs may facilitate patient flow through the OB triage unit.
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Affiliation(s)
- S Mehra
- a Department of Obstetrics and Gynecology Women's Health , Saint Louis University , Saint Louis, Missouri, USA
| | - J A Gavard
- a Department of Obstetrics and Gynecology Women's Health , Saint Louis University , Saint Louis, Missouri, USA
| | - G Gross
- a Department of Obstetrics and Gynecology Women's Health , Saint Louis University , Saint Louis, Missouri, USA
| | - T Myles
- a Department of Obstetrics and Gynecology Women's Health , Saint Louis University , Saint Louis, Missouri, USA
| | - T Nguyen
- a Department of Obstetrics and Gynecology Women's Health , Saint Louis University , Saint Louis, Missouri, USA
| | - E Amon
- a Department of Obstetrics and Gynecology Women's Health , Saint Louis University , Saint Louis, Missouri, USA
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Mehra S, Mariaselvam C, Fortier C, Krishnamoorthy R, Tamouza R, Negi V. AB0022 Influence of HLA- DRB1 & DQB1 Alleles on Susceptibility, Clinical Manifestations and Autoantibody Repertoire of Systemic Lupus Erythematosus In South Indian Tamils. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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19
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Mehra S, Prodduturvar P, Marcu C, Chelu M. Use of Novel Oral Anticoagulants Post-cardioversion in Atrial Fibrillation: A Safety Review. ACTA ACUST UNITED AC 2015. [DOI: 10.9734/bjmmr/2015/16462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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20
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Hudson M, Satoh M, Chan JYF, Tatibouet S, Mehra S, Baron M, Fritzler M. Prevalence and clinical profiles of 'autoantibody-negative' systemic sclerosis subjects. Clin Exp Rheumatol 2014; 32:S-127-32. [PMID: 24144389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 07/11/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To determine the prevalence of autoantibody negative systemic sclerosis (SSc) and to identify the clinical correlates thereof. METHODS Clinical data and sera from 874 SSc subjects were collected and autoantibodies were tested in a central laboratory using 1) indirect immunofluorescence (IIF), 2) commercially available ELISA, addressable laser bead immunoassay (ALBIA), and line immunoassay (LIA), and 3) a sensitive immunoprecipitation (IP) assay. RESULTS Fifteen (15; 1.7%) subjects were autoantibody negative by IIF, ELISA, ALBIA, LIA and IP, and 16 (1.8%) were antinuclear antibody (ANA) positive by IIF but otherwise negative by ELISA, ALBIA, LIA and IP. Thirty-seven (37; 4.2%) were ANA positive by IIF, autoantibody negative by commercially available immunoassays, but had autoantibodies identified by IP (including Th/To in 20). Autoantibody-negative subjects had generally less severe disease than positive subjects. CONCLUSIONS Autoantibody-negative SSc is rare (<2%) and appears to be associated with a favourable prognosis.
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Affiliation(s)
- M Hudson
- Division of Rheumatology, Lady Davis Institute, Jewish General Hospital, Montreal, Canada.
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21
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Negi VS, Muralidharan N, Mehra S, Devaraju P, Mariaselvam CM, Gulati R, Salah S, Fortier C, Charron D, Krishnamoorthy R, Tamouza R. IRF5rs2004640 single nucleotide polymorphism is associated with susceptibility to rheumatoid arthritis in South Indian Tamils. ACTA ACUST UNITED AC 2014; 84:465-70. [PMID: 25284481 DOI: 10.1111/tan.12441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Revised: 08/05/2014] [Accepted: 08/13/2014] [Indexed: 11/29/2022]
Abstract
Polymorphism of interferon regulatory factor 5 (IRF5), a latent transcription factor gene has been associated with various auto-immune diseases. Our aim was to study the IRF5rs2004640 gene polymorphism and its association with disease susceptibility, disease phenotype and treatment response in South Indian Tamil patients with rheumatoid arthritis (RA).The study was conducted on 217 RA patients fulfilling the American College of Rheumatology (ACR) 2010 criteria and 482 healthy controls (HCs) without family history of autoimmune disease. The IRF5rs2004640 genotyping was performed using a TaqMan 5' allelic discrimination assay. We found that the IRF5rs2004640T allele [P < 0.0001, odds ratio (OR) 3.25, 95% confidence interval (CI) 2.55-4.12] and TT genotype (P < 0.0001, OR 4.60, 95% CI 3.23-6.57) were significantly more frequent in RA patients as compared with HCs. No association was found between IRF5rs2004640 polymorphism, clinical manifestations, autoantibody profile and treatment response. IRF5rs2004640 T (mutant) allele may be a susceptibility factor conferring risk for RA in South Indian Tamils, whereas G allele (wild type) may be protective.
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Affiliation(s)
- V S Negi
- Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Jain V, Antony P, Mithun C, Singh B, Mehra S, Usdadiya J, Negi V. AB0559 Hypokalemic Paralysis in Primary Sjogren Syndrome: is IT A Distinct Clinical Subset Which Requires Lifelong Potassium Supplementation Rather than Immunosuppressants? Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Labrique AB, Sikder SS, Wu L, Rashid M, Ali H, Ullah B, Shamim AA, Mehra S, Klemm R, Banu H, West KP, Christian P. Beyond pregnancy--the neglected burden of mortality in young women of reproductive age in Bangladesh: a prospective cohort study. BJOG 2013; 120:1085-9. [PMID: 23647788 PMCID: PMC3798124 DOI: 10.1111/1471-0528.12245] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2013] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To describe proportionate mortality and causes of death unrelated to pregnancy. DESIGN Prospective cohort study. SETTING Rural northwest Bangladesh. POPULATION A cohort of 133,617 married women of reproductive age. METHODS Verbal autopsies were conducted for women who died whilst under surveillance in the cohort trial. Physician-assigned causes of death based on verbal autopsies were used to categorise deaths. MAIN OUTCOME MEASURES The proportion of deaths due to non-communicable diseases, infectious diseases, injury or pregnancy. RESULTS Of the 1107 deaths occurring among women between 2001 and 2007, 48% were attributed to non-communicable diseases, 22% to pregnancy, 17% to infections, 9% to injury and 4% to other causes. CONCLUSIONS Although focus on pregnancy-related mortality remains important, more attention is warranted on non-communicable diseases among women of reproductive age.
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Affiliation(s)
- A B Labrique
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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Sharma H, Wong C, El-Bakry A, Hakeem A, Rajendran P, Mehra S, Hammad A, Sharma A. Uncontrolled donation after cardiac death: potential for future. Am J Transplant 2012; 12:1660; author reply 1661. [PMID: 22500931 DOI: 10.1111/j.1600-6143.2012.04040.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Guglin M, Mehra S, Mason T. 357 Comparative Effects of the Drugs Used for Pulmonary Hypertension Reversibility Testing: A Meta-Analysis. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.366] [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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Abstract
Non-human primates (NHPs) are used to model human disease owing to their remarkably similar genomes, physiology, and immune systems. Recently, there has been an increased interest in modeling tuberculosis (TB) in NHPs. Macaques are susceptible to infection with different strains of Mycobacterium tuberculosis (Mtb), producing the full spectrum of disease conditions, including latent infection, chronic progressive infection, and acute TB, depending on the route and dose of infection. Clearly, NHPs are an excellent model of human TB. While the initial aim of the NHP model was to allow preclinical testing of candidate vaccines and drugs, it is now also being used to study pathogenesis and immune correlates of protection. Recent advances in this field are discussed in this review. Key questions such as the effect of hypoxia on the biology of Mtb and the basis of reactivation of latent TB can now be investigated through the use of this model.
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Affiliation(s)
- D Kaushal
- Division of Bacteriology & Parasitology, Tulane National Primate Research Center, Covington, LA 70433, USA.
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Abstract
Dengue viremia may be the trigger for immune complex formation in patients who are predisposed to developing autoimmune disease. We report a rare case of dengue virus infection evolving into systemic lupus erythematosus (SLE) and lupus nephritis. To the best of our knowledge this is the first case of dengue fever evolving into lupus nephritis. A 22 year old female presented with having had high grade fever, skin rash, breathlessness, retro-orbital pain, abdominal pain, arthralgias and myalgias for 10 days. She tested positive for dengue immunoglobulin M (IgM). She was given supportive treatment and was subsequently discharged. Four weeks later she developed recurrent fever, arthralgia, rash and anasarca. She was suspected as having SLE with active lupus nephritis. Antinuclear antibody (ANA), and anti double stranded deoxyribonucleic acid (anti dsDNA) titers were positive and complements were low. Renal biopsy showed diffuse proliferative glomerulonephritis grade IV. She was treated with steroids and immunosuppressants to which she responded. Dengue viremia incites antibody production, which if excessive causes deposition of viral antigen-antibody immune complexes. This could possibly lead to renal tubular damage and glomerulonephritis in susceptible individuals. Dengue fever leading to development of glomerulonephritis is rarely seen. Our patient developed dengue fever and after a month presented with manifestations of SLE and lupus nephritis. Both dengue fever and SLE have common manifestations of fever, arthralgia, rash, leucopenia with thrombocytopenia and serositis. Bacterial and viral infections may act as a 'trigger' for starting or relapsing lupus activity in genetically predetermined individuals. In our case it may be possible that dengue virus could have triggered a dysfunctional immune response, resulting in the developing of autoimmunity and SLE with lupus nephritis.
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Affiliation(s)
- A Rajadhyaksha
- Dept. of Medicine and Rheumatology, KEM Hospital and Seth GS Medical College, Mumbai, India
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Santillan Salas C, Mehra S, Park E, Lahr B, Yawn B, Juhn Y. Asthma and Risk of the Novel 2009 H1N1 Influenza Infection in Children: A Population-Based Case-Control Study. J Allergy Clin Immunol 2012. [DOI: 10.1016/j.jaci.2011.12.818] [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: 10/14/2022]
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Singh SK, Mathew J, Gupta J, Mehra S, Goyal G, Sharma D. Molecular characterization of MHC class II region in guinea fowl. Br Poult Sci 2011; 51:769-75. [PMID: 21161783 DOI: 10.1080/00071668.2010.529872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
1. The MHC class II gene was amplified, cloned and sequenced in guinea fowl. 2. The NumeMHC II sequence of 754 nucleotides included complete exon 1 (91 nt), exon 2 (270 nt), exon 3 (282 nt) and exon 4 (110 nt). 3. The size of β(1) and β(2), domains were 89 and 93 amino acids, respectively in guinea fowl. 4. High amino acid variability (38·2%) was observed within guinea fowl in β(1) domain, while in β(2) domain, amino acid variability (6·3%) was low. 5. Among poultry species, the percent amino acid identity between guinea fowl and chicken, quail, pheasant and duck was 38·8, 42·2, 44·4 and 58·8 in β(1) domain; and 13·8, 17·0, 13·8 and 27·6 in β(2) domain, respectively. 6. Sequence alignment with mammalian and avian MHC showed that many of the conserved features of MHC class II glycoprotein was conserved in guinea fowl. 7. Within-species genetic distances (Poisson correction) based on cumulative amino acid variability in β(1) domain and β(2) domains was 0·141 in guinea fowl. 8. Guinea fowl showed low and similar genetic distances with all the poultry species (0·255-0·268) except duck (0·456). 9. Guinea fowl made separate branch within the major cluster having chicken, quail and pheasant, showing equal distance from these poultry species, whereas duck MHC II clustered separately.
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Affiliation(s)
- S K Singh
- Genome Mapping laboratory, Central Avian Research Institute, Izatnagar 243 122, India
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Kapur S, Mehra S, Vasavada AR. Polymorphisms of the gamma crystallin A and B genes among Indian patients with pediatric cataract. J Postgrad Med 2011; 57:201-5. [DOI: 10.4103/0022-3859.85205] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Tashkin DP, Celli B, Kesten S, Lystig T, Mehra S, Decramer M. From the authors:. Eur Respir J 2010. [DOI: 10.1183/09031936.00036110] [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: 11/05/2022]
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Troosters T, Celli B, Lystig T, Kesten S, Mehra S, Tashkin DP, Decramer M. Tiotropium as a first maintenance drug in COPD: secondary analysis of the UPLIFT(R) trial. Eur Respir J 2010; 36:65-73. [DOI: 10.1183/09031936.00127809] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Tashkin DP, Celli B, Kesten S, Lystig T, Mehra S, Decramer M. Long-term efficacy of tiotropium in relation to smoking status in the UPLIFT trial. Eur Respir J 2009; 35:287-94. [PMID: 19717481 DOI: 10.1183/09031936.00082909] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
UPLIFT (Understanding Potential Long-Term Improvements in Function with Tiotropium), a 4-yr trial of tiotropium in chronic obstructive pulmonary disease, allowed for assessment of smoking status on long-term responses to maintenance bronchodilator therapy. 5,993 patients were randomised (tiotropium/placebo). Lung function, St George's Respiratory Questionnaire, exacerbations and adverse events were followed. Patients were characterised as continuing smokers (CS), continuing ex-smokers (CE), or intermittent smokers (IS) based on self-reporting smoking behaviour. 60%, 14% and 26% of patients were CE, CS and IS, respectively. The rate of forced expiratory volume in 1 s (FEV(1)) decline for placebo patients was most rapid in CS (-52+/-4, -37+/2 and -23+/2 mL.yr(-1) in CS, IS, and CE, respectively). Tiotropium did not alter FEV(1) decline, but was associated with significant improvements in pre- and post-bronchodilator FEV(1) over placebo that persisted throughout the 4-yr trial for each smoking status (pre-bronchodilator: 127, 55 and 97 mL at 48 months in CS, IS and CE, respectively; p< or =0.0003). Tiotropium reduced exacerbation risk in CS (HR (95% CI) 0.80 (0.67-0.95)), in CE (0.85 (0.79-0.92)) and trended towards significance in IS (0.89 (0.79-1.00)). At 4 yrs, St George's Respiratory Questionnaire for tiotropium patients improved the most in CS (-4.63 units, p = 0.0006) and the least in IS (-0.60 units, p = 0.51), [corrected] compared with control. Tiotropium provided long-term benefits irrespective of smoking status, although differences among categories were observed.
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Affiliation(s)
- D P Tashkin
- Dept of Medicine, David Geffen School of Medicine, UCLA, 10833 Le Conte Avenue, Los Angeles, CA 90095-1690, USA.
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Ablorsu E, Mehra S, Tavakoli A, Augustine T, Pararajasingam R. Staged Enteric Conversion After Duodenal Necrosis in Simultaneous Kidney and Pancreas Transplant From a Donor After Cardiac Death: A Case Report. Transplant Proc 2009; 41:1778-80. [DOI: 10.1016/j.transproceed.2009.02.081] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2008] [Accepted: 02/09/2009] [Indexed: 10/20/2022]
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Nanjangud G, Rao P, Teruya-Feldstein J, Donnelly G, Qin J, Mehra S, Jhanwar S, Zelenetz A, Chaganti R. Molecular cytogenetic analysis of follicular lymphoma (FL) provides detailed characterization of chromosomal instability associated with the t(14;18)(q32;q21) positive and negative subsets and histologic progression. Cytogenet Genome Res 2007; 118:337-44. [DOI: 10.1159/000108318] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2006] [Accepted: 12/06/2006] [Indexed: 11/19/2022] Open
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Abstract
BACKGROUND AND OBJECTIVE This study aimed to assess the effectiveness of the UK National Guidelines for identifying patients with potentially malignant oral disease which were introduced in 2000. DESIGN Retrospective audit. SETTING The oral medicine unit in a university teaching hospital in London. METHODS All new referrals over a one year period were retrospectively reviewed in a departmental audit to evaluate guideline effectiveness. Reasons for referral and final diagnosis were compared in a randomly selected sub-population. RESULTS Four hundred and eighty-seven of 901 new patients referred were classified as having potentially malignant disease from the referral letter. In a randomly selected subgroup of 241 patients, 18 actually had malignant (8) or dysplastic lesions (10). Of 75 patients referred with a persistent oral ulcer, only nine were actually malignant or dysplastic. Eight of 116 patients referred with a white patch and none with red patches were found to have dysplastic or malignant lesions. The criteria failed to identify three carcinomas and two severely dysplastic lesions (15% of the malignant or dysplastic lesions). All of the latter had been referred by primary care physicians with orofacial pain of unknown cause. CONCLUSIONS UK National Guidelines discriminate poorly between potentially malignant and other oral mucosal disease.
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Affiliation(s)
- R Clow
- Westminster Institute of Education, Oxford Brookes University, Harcourt Hill Campus, Oxford, OX2 9AT, UK.
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Garg R, Gupta V, Mehra S, Singh R, Prasad R. Rifampicin induced thrombocytopenia. Indian J Tuberc 2007; 54:94-6. [PMID: 17575681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Thrombocytopenia is an uncommon but potentially life threatening complication of certain anti-tubercular drugs and is characterized by rapid destruction of platelets whenever an offending drug is taken by a susceptible person. Here is a case report of Rifampicin induced Thrombocytopenia. This case is being reported for purpose of its rare occurrence and documentation.
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Affiliation(s)
- Rajiv Garg
- Department of Pulmonary Medicine, King George's Medical University, Lucknow.
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Langdon CG, Adler M, Mehra S, Alexander M, Drollmann A. Once-daily ciclesonide 80 or 320 microg for 12 weeks is safe and effective in patients with persistent asthma. Respir Med 2006; 99:1275-85. [PMID: 16024244 DOI: 10.1016/j.rmed.2005.05.024] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2004] [Indexed: 11/18/2022]
Abstract
The efficacy and safety of ciclesonide was assessed in this randomized, placebo-controlled study in patients with persistent asthma (randomized n=360) maintained on low to moderate doses of inhaled corticosteroids. Patients were randomized to receive ciclesonide 80 or 320 microg (ex-actuator doses, equivalent to 100 and 400 microg ex-valve, respectively) or placebo once daily in the morning via metered-dose inhaler for 12 weeks. Morning peak expiratory flow was maintained throughout the treatment period in patients treated with ciclesonide and decreased significantly in patients treated with placebo (P=0.0003). Ciclesonide (80 and 320 microg) significantly increased forced expiratory volume in 1s from baseline (0.13 and 0.19 L increases, respectively; P<0.01); improvements were superior versus placebo (P=0.0044 for 80 microg ciclesonide; P<0.0001 for 320 microg ciclesonide). The probability of losing efficacy decreased in a dose-dependent manner (55% for placebo, 38% for ciclesonide 80 microg, 23% for ciclesonide 320 microg). Asthma symptom scores and rescue medication use were unchanged with ciclesonide and significantly worsened with placebo. The incidence of adverse events was comparable in all treatment groups and no cortisol suppression was observed. Therefore, ciclesonide 80 and 320 microg administered once daily was a safe and effective maintenance treatment for patients with persistent asthma.
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Affiliation(s)
- C G Langdon
- Holyport Surgery, Stroud Farm Road, Berkshire, SL62LP Holyport, UK.
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Mehra S, Christ L, Jeng L, Zinn AB, Schwartz S. Characterization of a familial balanced rec(13) in a child with mild MR and his half-sibling with two structurally rearranged chromosomes 13. Am J Med Genet A 2005; 137:217-21. [PMID: 16059944 DOI: 10.1002/ajmg.a.30866] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In this report, we describe a 7-year-old child with mild mental retardation, developmental delay, and learning disabilities. His karyotype contained a rearrangement of chromosome 13, which appeared to include a duplication of 13q31-qter and a deletion of 13p12-pter regions. The chromosomal origin of the additional material was confirmed by fluorescence in situ hybridization (FISH) using a whole chromosome painting probe specific for chromosome 13. Family studies showed that his mother carried a balanced inversion of chromosome 13 and that his half-brother carried the balanced pericentric inversion of chromosome 13 from his mother as well as another structural rearrangement involving chromosome 13 presumably from his father. The findings from this study suggested that the proband's abnormal 13 resulted from an unbalanced crossing-over between the normal and maternal inverted chromosome 13.
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Affiliation(s)
- S Mehra
- Center for Human Genetics and Department of Genetics, Case Western Reserve University and University Hospitals of Cleveland, Cleveland, Ohio, USA
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Chapman KR, Patel P, D'Urzo AD, Alexander M, Mehra S, Oedekoven C, Engelstätter R, Boulet LP. Maintenance of asthma control by once-daily inhaled ciclesonide in adults with persistent asthma. Allergy 2005; 60:330-7. [PMID: 15679718 DOI: 10.1111/j.1398-9995.2004.00750.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Inhaled corticosteroids (ICS) are recommended therapy for persistent asthma, although side effects can limit appropriate use. Ciclesonide, a novel ICS, is activated in the lung, thereby reducing systemic activity and side effects. This 12-week, double-blind, randomized, parallel-group, placebo-controlled study evaluated the efficacy and safety of ciclesonide in adults with persistent asthma. METHODS After a 2-week baseline period in which current ICS treatment was continued, 329 patients were randomized to receive ciclesonide 160 microg (n = 107) or 640 microg (n = 112) (ex-actuator doses, equivalent to 200 and 800 microg ex-valve, respectively), or placebo (n = 110) once daily in the morning. Efficacy was monitored by asthma symptom scores, rescue medication use, morning and evening peak expiratory flow (PEF) measurements, spirometry, and probability of study completion without experiencing lack of efficacy. RESULTS Morning PEF remained stable with either ciclesonide dose but decreased with placebo; the differences were significant (P < 0.0001) for both ciclesonide doses vs placebo. The forced expiratory volume in 1 s and forced vital capacity decreased significantly with placebo (P < 0.005), but were unchanged with ciclesonide. Lack of efficacy was significantly greater for patients switched to placebo (63%) than it was for those treated with ciclesonide 160 microg (30%) (P < 0.0001 vs placebo) or ciclesonide 640 microg (31%) (P < 0.0001 vs placebo). There were no significant differences between the two tested doses of ciclesonide with respect to efficacy and safety. Serum and 24-h urine cortisol were unaffected by ciclesonide treatment. Both doses of ciclesonide were well tolerated with no cases of oral candidiasis. CONCLUSION Ciclesonide (160 or 640 microg) once daily in the morning effectively maintains asthma control, does not affect cortisol levels, and has an adverse event profile comparable with placebo in adults with primarily mild to moderate asthma.
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Affiliation(s)
- K R Chapman
- Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
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41
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Browne L, Mehra S, Rattan R, Thomas G. Comparing lecture and e-learning as pedagogies for new and experienced professionals in dentistry. Br Dent J 2004; 197:95-7. [PMID: 15272348 DOI: 10.1038/sj.bdj.4811484] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2003] [Accepted: 09/02/2003] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate the relative effectiveness of e-learning versus lecture learning in VDPs and trainers. DESIGN Experimental comparison of two groups' learning retention. SETTING VDPs and trainers from two regions were assessed by independent researchers. METHOD One region's VDPs and trainers received e-learning; another's received a traditional one hour lecture. Retention and understanding were tested and compared. Personal preference was assessed in group interviews. RESULTS Significantly greater retention for the trainees occurred from lecturing rather than e-learning, and for the trainers e-learning was significantly more successful than lecturing. CONCLUSIONS Small numbers in this study preclude wide generalisation. However, the results point to the benefits of face-to-face interaction for inexperienced staff, and the benefits of the speed and manageability of e-learning for busy, more experienced staff. The need for a discussion facility to be incorporated into ICT innovations to CPD (via, for example, online 'chatrooms') is also highlighted, with the potential of greatly enhancing e-learning efficacy.
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Affiliation(s)
- L Browne
- Postcompulsory Education, Institute of Education, Oxford Brookes University, Oxford OX2 9AT
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42
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Wadhwa S, Mehra S, Khan RQ, Kapur V. Abnormal musculoaponeurotic tunnel in the arm: possible entrapment of the median nerve and brachial artery with high origin of nerve to pronator teres within the tunnel. Clin Anat 2004; 17:360-3. [PMID: 15108345 DOI: 10.1002/ca.10210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Median nerve and brachial artery in the arm are not usually overlapped by any structure. Connective tissue bands and muscular slips draping or enclosing this neurovascular bundle have been reported, however, which may produce clinical symptoms of nerve compression and vascular changes. We report an unusual musculoaponeurotic band that originates as the ligament of Struthers but terminates as the brachiofascialis muscle of Wood and in the process may have entrapped both the median nerve and brachial artery. The nerve to pronator teres originates from the median nerve within this tunnel. On histological examination the nerve was flattened and showed some perineurial thickening. In view of the flexor function of brachialis muscle, this anomalous musculoaponeurotic band may be considered a clinically important entity in the causation of idiopathic neurovasculopathy in the hand.
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Affiliation(s)
- S Wadhwa
- Department of Anatomy, Maulana Azad Medical College, New Delhi.
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44
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Abstract
BACKGROUND Pertussis is still a prevalent public health problem, and antibiotic therapy may decrease disease severity and limit communicability. Erythromycin is the recommended antibiotic for treatment and prophylaxis of pertussis; however, side effects of erythromycin limit its usefulness in some patients. Clarithromycin, a newer macrolide, has good in vitro activity against Bordetella pertussis and a better side effect profile. GOALS OF THE STUDY To compare the microbiologic and clinical efficacy and the clinical safety of a 7-day course of clarithromycin vs. a 14-day course of erythromycin in children with pertussis. DESIGN Prospective, randomized, single blind (investigator), parallel group trial. METHODS Children from 1 month to 16 years of age presenting with a clinically defined pertussis syndrome were eligible for the study. After obtaining informed written consent, we randomized patients to receive either clarithromycin (7.5 mg/kg/dose twice a day for 7 days) or erythromycin (13.3 mg/kg/dose three times a day for 14 days). Nasopharyngeal cultures for B. pertussis were performed at enrollment and after end of treatment. Clinical assessments were performed at enrollment, at end of treatment and at a 1-month follow-up visit. Adverse event data were collected throughout the study. RESULTS The clarithromycin (n = 76) and erythromycin (n = 77) groups were well-matched for age and previous pertussis immunization. Microbiologic eradication and clinical cure rates were 100% (31 of 31) for clarithromycin and 96% (22 of 23) for erythromycin. The clarithromycin group had significantly fewer adverse events [45% (34 of 76) for clarithromycin vs. 62% (48 of 77) for erythromycin; P = 0.035], and compliance with the medication regimen was significantly higher in these patients. CONCLUSIONS A 7-day regimen of clarithromycin and a 14-day course of erythromycin were equally effective for treatment of pertussis. Clarithromycin was better tolerated than conventional erythromycin therapy.
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Affiliation(s)
- M H Lebel
- Hôpital Sainte-Justine, University of Montreal, Montreal, Canada.
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Abstract
OBJECTIVE The objective of this study was to examine the effects of soy formulas with and without added soy fiber in children who developed diarrhea while receiving antibiotics. DESIGN In a masked, randomized parallel study, older infants and toddlers were fed commercial soy formulas with or without added soy fiber for 10 days on occurrence of diarrhea during the administration of antibiotics. Subjects were stratified by feeding (formula versus cow's milk). The primary variables were duration of diarrhea, stool characteristics, and intake. Secondary variables were weight and spit-up. RESULTS All 45 children who completed the 10-day study received >30% of their caloric intake from formula. Fiber intake from other foods did not differ between groups and averaged 0.5 g/day. Total median fiber intake of the group fed the formula with added fiber was 6.53 g/day. The mean duration of diarrhea was 25.1 +/- 5.2 hours for children fed the formula with added fiber and 51.6 +/- 10.7 hours for those fed the regular formula (P =.0013). CONCLUSION The duration of antibiotic-induced diarrhea in children fed the soy formula with added soy fiber was significantly reduced.
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Affiliation(s)
- A W Burks
- University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Arkansas, USA
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Kumar A, Bansal V, Mehra S, Minz M, Sharma AK. Cyclosporine as a cause of unilateral gynecomastia in renal transplant recipient. J Assoc Physicians India 1999; 47:746. [PMID: 10778606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- A Kumar
- Dept. of Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh
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Abstract
PURPOSE To assess whether calf imaging is necessary to identify patients at risk for developing clinically important pulmonary emboli (PE) or propagation of calf deep venous thrombosis (DVT) when the initial thigh ultrasonographic (US) scan is negative for DVT. MATERIALS AND METHODS The authors retrospectively evaluated the radiology reports from 283 patients (168 female and 115 male patients; mean age, 55.7 years; age range, 1-93 years) in whom US was performed to rule out lower extremity DVT. In all patients, the initial thigh examination was negative for DVT. All patients were classified as to the reason for the examination, risk factors for DVT (including recent surgery), whether they received anticoagulation therapy, and findings on calf US scans. Adverse outcomes were considered a clinically important PE or DVT in the thigh. RESULTS Only 1.1% of patients (95% CI = 0.2%, 3.1%) had adverse outcomes. Adverse outcomes occurred only in postsurgical patients (P = .028) and were not related to the presence or absence of calf DVT or method of treatment. CONCLUSION US of the calf is unnecessary at initial evaluation to identify patients at risk of clinically important PE or propagation of DVT into the thigh.
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Affiliation(s)
- R H Gottlieb
- Department of Radiology, University of Rochester Medical Center, NY 14642, USA
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Meek S, Hill J, Mehra S. The malaria consortium: converting expertise and partnerships into operational realities. Parasitol Today 1998; 14:211-2. [PMID: 17040759 DOI: 10.1016/s0169-4758(98)01237-x] [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] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- S Meek
- London School of Hygiene and Tropical Medicine, Keppel Street, London, UK WC1E 7HT
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Minz M, Sood S, Kumar A, Bansal V, Mehra S, Sharma AK. Impact of organ trade on attitudes toward organ donation: knowledge and attitudes toward cadaveric organ donation in north India. Transplant Proc 1998; 30:3611. [PMID: 9838581 DOI: 10.1016/s0041-1345(98)01157-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- M Minz
- Transplant Unit Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Mehra S, Bansal V, Kumar A, Jain S, Minz M, Sharma AK. Non-heart-beating cadaveric organ donation as a result of inefficient brain death certification is a useful compromise in the Indian context. Transplant Proc 1998; 30:3804-5. [PMID: 9838667 DOI: 10.1016/s0041-1345(98)01245-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- S Mehra
- Department of Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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