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Bae J, Qayyum S, Zhang J, Das A, Reyes I, Aronowitz E, Stavarache MA, Kaplitt MG, Masurkar A, Kim SG. Feasibility of measuring blood-brain barrier permeability using ultra-short echo time radial magnetic resonance imaging. J Neuroimaging 2024; 34:320-328. [PMID: 38616297 PMCID: PMC11090723 DOI: 10.1111/jon.13199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/14/2024] [Accepted: 03/14/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND AND PURPOSE The purpose of this study is to evaluate the feasibility of using 3-dimensional (3D) ultra-short echo time (UTE) radial imaging method for measurement of the permeability of the blood-brain barrier (BBB) to gadolinium-based contrast agent. In this study, we propose to use the golden-angle radial sparse parallel (GRASP) method with 3D center-out trajectories for UTE, hence named as 3D UTE-GRASP. We first examined the feasibility of using 3D UTE-GRASP dynamic contrast-enhanced (DCE)-magnetic resonance imaging (MRI) for differentiating subtle BBB disruptions induced by focused ultrasound (FUS). Then, we examined the BBB permeability changes in Alzheimer's disease (AD) pathology using Alzheimer's disease transgenic mice (5xFAD) at different ages. METHODS For FUS experiments, we used four Sprague Dawley rats at similar ages where we compared BBB permeability of each rat receiving the FUS sonication with different acoustic power (0.4-1.0 MPa). For AD transgenic mice experiments, we included three 5xFAD mice (6, 12, and 16 months old) and three wild-type mice (4, 8, and 12 months old). RESULTS The result from FUS experiments showed a progressive increase in BBB permeability with increase of acoustic power (p < .05), demonstrating the sensitivity of DCE-MRI method for detecting subtle changes in BBB disruption. Our AD transgenic mice experiments suggest an early BBB disruption in 5xFAD mice, which is further impaired with aging. CONCLUSION The results in this study substantiate the feasibility of using the proposed 3D UTE-GRASP method for detecting subtle BBB permeability changes expected in neurodegenerative diseases, such as AD.
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Affiliation(s)
- Jonghyun Bae
- Vilcek Institute of Graduate Biomedical Science, New York University School of Medicine
- Center for Biomedical Imaging, Radiology, New York University School of Medicine
- Center for Advanced Imaging Innovation and Research, Radiology, New York University School of Medicine
- Department of Radiology, Weill Cornell Medical College
| | - Sawwal Qayyum
- Department of Radiology, Weill Cornell Medical College
| | - Jin Zhang
- Department of Radiology, Weill Cornell Medical College
| | - Ayesha Das
- Department of Radiology, Weill Cornell Medical College
| | - Isabel Reyes
- Center for Cognitive Neurology, Department of Neurology, New York University School of Medicine
- Department of Neuroscience & Physiology, New York University School of Medicine
- Neuroscience Institute, New York University School of Medicine
| | | | | | | | - Arjun Masurkar
- Center for Cognitive Neurology, Department of Neurology, New York University School of Medicine
- Department of Neuroscience & Physiology, New York University School of Medicine
- Neuroscience Institute, New York University School of Medicine
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Ben Youss Z, Arefin TM, Qayyum S, Yi R, Zhang J, Zaim Wadghiri Y, Alon L, Yaghmazadeh O. Open-source versatile 3D-print animal conditioning platform design for in vivo preclinical brain imaging in awake mice and anesthetized mice and rats. Lab Anim (NY) 2024; 53:33-42. [PMID: 38279029 PMCID: PMC11095950 DOI: 10.1038/s41684-023-01320-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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 12/14/2023] [Indexed: 01/28/2024]
Abstract
Proper animal conditioning is a key factor in the quality and success of preclinical neuroimaging applications. Here, we introduce an open-source easy-to-modify multimodal 3D printable design for rodent conditioning for magnetic resonance imaging (MRI) or other imaging modalities. Our design can be used for brain imaging in anesthetized or awake mice, and in anesthetized rats. We show ease of use and reproducibility of subject conditioning with anatomical T2-weighted imaging for both mice and rats. We also demonstrate the application of our design for awake functional MRI in mice using both visual evoked potential and olfactory stimulation paradigms. In addition, using a combined MRI, positron emission tomography and X-ray computed tomography experiment, we demonstrate that our proposed cradle design can be utilized for multiple imaging modalities.
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Affiliation(s)
- Zakia Ben Youss
- Bernard and Irene Schwartz Center for Biomedical Imaging (CBI), Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Tanzil Mahmud Arefin
- Center for Neurotechnology in Mental Health Research, Department of Biomedical Engineering, The Pennsylvania State University, University Park, PA, USA
| | - Sawwal Qayyum
- Department of Radiology, Weill Cornell Medical College, New York, NY, USA
| | - Runjie Yi
- Neuroscience Institute, New York University School of Medicine, New York, NY, USA
| | - Jiangyang Zhang
- Bernard and Irene Schwartz Center for Biomedical Imaging (CBI), Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Youssef Zaim Wadghiri
- Bernard and Irene Schwartz Center for Biomedical Imaging (CBI), Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University School of Medicine, New York, NY, USA.
| | - Leeor Alon
- Bernard and Irene Schwartz Center for Biomedical Imaging (CBI), Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University School of Medicine, New York, NY, USA.
| | - Omid Yaghmazadeh
- Neuroscience Institute, New York University School of Medicine, New York, NY, USA.
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Kiser K, Zhang J, Qayyum S, Bracken WC, Kim SG. Simultaneous estimation of the cellular water exchange rate, intracellular volume fraction, and longitudinal relaxation rate in cancer cells. NMR Biomed 2023; 36:e4914. [PMID: 36889984 DOI: 10.1002/nbm.4914] [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] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 11/24/2022] [Accepted: 01/27/2023] [Indexed: 06/15/2023]
Abstract
The purpose of the current study was to investigate the feasibility of simultaneously estimating the cellular water efflux rate ( k ie ), intracellular longitudinal relaxation rate ( R 10 i ), and intracellular volume fraction ( v i ) of a cell suspension using multiple samples with different gadolinium concentrations. Numerical simulation studies were conducted to assess the uncertainty in the estimation of k ie , R 10 i , and v i from saturation recovery data using single (SC) or multiple concentrations (MC) of gadolinium-based contrast agent (GBCA). In vitro experiments with 4 T1 murine breast cancer and SCCVII squamous cell cancer models were conducted at 11 T to compare parameter estimation using the SC protocol with that using the MC protocol. The cell lines were challenged with a Na+ /K+ -ATPase inhibitor, digoxin, to assess the treatment response in terms of k ie , R 10 i , and v i . Data analysis was conducted using the two-compartment exchange model for parameter estimation. The simulation study data demonstrate that the MC method, compared with the SC method, reduces the uncertainty of the estimated k ie by decreasing the interquartile ranges from 27.3% ± 3.7% to 18.8% ± 5.1% and the median differences from ground truth from 15.0% ± 6.3% to 7.2% ± 4.2%, while estimating R 10 i and v i simultaneously. In the cell studies, the MC method demonstrated reduced uncertainty in overall parameter estimation compared with the SC approach. MC method-measured parameter changes in cells treated with digoxin increased R 10 i by 11.7% (p = 0.218) and k ie by 5.9% (p = 0.234) for 4 T1 cells, respectively, and decreased R 10 i by 28.8% (p = 0.226) and k ie by 1.6% (p = 0.751) for SCCVII cells, respectively. v i did not change noticeably by the treatment. The results of this study substantiate the feasibility of using saturation recovery data of multiple samples with different GBCA concentrations for simultaneous measurement of the cellular water efflux rate, intracellular volume fraction, and intracellular longitudinal relaxation rate in cancer cells.
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Affiliation(s)
- Karl Kiser
- Department of Radiology, Weill Cornell Medical College, New York, New York, USA
| | - Jin Zhang
- Department of Radiology, Weill Cornell Medical College, New York, New York, USA
| | - Sawwal Qayyum
- Department of Radiology, Weill Cornell Medical College, New York, New York, USA
| | - W Clay Bracken
- Department of Biochemistry, Weill Cornell Medical College, New York, New York, USA
| | - Sungheon Gene Kim
- Department of Radiology, Weill Cornell Medical College, New York, New York, USA
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Slominski A, Kim T, Slominski R, Qayyum S, Song Y, Janjetovic Z, Placha W, Kleszczynski K, Atigadda V, Song Y, Raman C, Reiter R. 584 Melatonin and its metabolites act as agonists on the AhR and can interact with the PPARγ. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.593] [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: 11/16/2022]
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Slominski A, Kim T, Slominski R, Qayyum S, Song Y, Janjetovic Z, Podgorska E, Reddy S, Song Y, Raman C, Atigadda V, Tuckey R, Holick M. 517 20-hydroxytachysterol: Synthesis and biological activity. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.542] [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: 11/30/2022]
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Slominski A, Kim T, Qayyum S, Slominski R, Song Y, Janjetovic Z, Podgorska E, Tang E, Bilokin Y, Song Y, Raman C, Tuckey R, Holick M. 131 Enzymatically-derived hydroxy-lumisterols regulate epidermal keratinocytes and act as agonists on the aryl hydrocarbon receptor (AhR). J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Guroji P, Qayyum S, Kim T, Janjetovic Z, Athar M, Slominski A. 638 Cyp11a1 derived secosteroid, 20(OH)d3 as a novel therapeutic agent for the prevention and treatment of uvb induced skin cancer. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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8
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Qayyum S, Sehmi J, Auger D, Griguer A, Jain P, Khan M, Keenan N. 1641 Bicuspid pulmonary valve - an unusual cause of dilated pulmonary artery. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.1031] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Dilated pulmonary artery is a common finding with a variety of possible aetiologies. We present a case of unexplained dilated pulmonary artery that was associated with bicuspid pulmonary valve identified by CMR.
Case Presentation
A 67-year-old female underwent mitral valve repair for severe mitral regurgitation. She had presented with breathlessness, and had severe mitral regurgitation due to a myxomatous valve with bileaflet prolapse, confirmed with TOE. Echo showed: normal LV dimensions, LVEF 66%. RV size and systolic function normal. Coronary angiography was normal and pulmonary hypertension was not present on right heart catheterization.
At postoperative follow up she was well and asymptomatic, with echo showing good LV systolic function, intact mitral valve repair, and normal systolic pulmonary artery pressures (36mmHg). New T wave inversion was identified across the precordial leads so a CMR was performed.
CMR showed normal LV volumes and function with no wall motion abnormality or LVH. There was no fibrosis or infarction in the late phase after Gadolinium contrast. The RV was dilated (73mm diameter at base) with normal systolic function. The main pulmonary artery was dilated at 42mm. Flow mapping showed no evidence of shunt (Qp:Qs = 1:1) and the atrial septum was intact. Pulmonary valve function was normal but the valve was bicuspid in morphology.
Discussion
Bicuspid pulmonary valve is a rare finding. In our case this was identified by CMR and was associated with a dilated pulmonary artery.
Bicuspid pulmonary valve is most commonly identified in the context of pulmonary valve stenosis. Isolated pulmonary valve stenosis is a rare finding; it is most often associated with other congenital defects like Fallot. Pulmonary stenosis has been associated with pulmonary artery aneurysm, attributed to hemodynamic changes caused by the stenotic valve. However as with bicuspid aortic valve it is recognized that the "post stenotic dilation" is part of the pathology of bicuspid valve and does not need the changed haemodynamics of a stenotic valve.
During embryogenesis neural crest cells are necessary for the normal development of the semilunar valves, the septation of the outflow tract into the aorta and pulmonary artery, and the remodeling of the aortic arch. Any defect in this migration can cause abnormalities or aneurysm of the aorta or pulmonary artery together with semilunar valve defects. A study of 3,861 donor hearts dissected at the European Homograft Bank revealed only four cases (0.1%) of bicuspid pulmonary valves.
Bicuspid pulmonary valve with normal function can be difficult to identify at echocardiography. It can be well visualized by CMR and this can be combined with an assessment of the pulmonary arteries. It should be remembered as a rarer cause of dilated pulmonary artery when other causes have been excluded.
Figure
A. Dilated MPA. B. Dilated RV. C. and D. Bicuspid pulmonary valve.
Abstract 1641 Figure. Dilated MPA. Bicuspid pulmonary valve
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Affiliation(s)
- S Qayyum
- West Hertfordshire NHS Trust, Greater London, United Kingdom of Great Britain & Northern Ireland
| | - J Sehmi
- West Hertfordshire NHS Trust, Greater London, United Kingdom of Great Britain & Northern Ireland
| | - D Auger
- West Hertfordshire NHS Trust, Greater London, United Kingdom of Great Britain & Northern Ireland
| | - A Griguer
- West Hertfordshire NHS Trust, Greater London, United Kingdom of Great Britain & Northern Ireland
| | - P Jain
- West Hertfordshire NHS Trust, Greater London, United Kingdom of Great Britain & Northern Ireland
| | - M Khan
- West Hertfordshire NHS Trust, Greater London, United Kingdom of Great Britain & Northern Ireland
| | - N Keenan
- West Hertfordshire NHS Trust, Greater London, United Kingdom of Great Britain & Northern Ireland
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Hewison C, Bastard M, Khachatryan N, Kotrikadze T, Hayrapetyan A, Avaliani Z, Kiria N, Yegiazaryan L, Chumburidze N, Kirakosyan O, Atshemyan H, Qayyum S, Lachenal N, Varaine F, Huerga H. Is 6 months of bedaquiline enough? Results from the compassionate use of bedaquiline in Armenia and Georgia. Int J Tuberc Lung Dis 2019; 22:766-772. [PMID: 29914602 DOI: 10.5588/ijtld.17.0840] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND SETTING Bedaquiline (BDQ) was initially only available through compassionate use programmes. OBJECTIVE To assess the effectiveness and safety of multidrug-resistant tuberculosis (MDR-TB) treatment containing BDQ. METHOD Retrospective analysis of data from patients receiving BDQ through compassionate use in Armenia and Georgia from April 2013 to April 2015. Logistic regression was used to assess the risk factors associated with unsuccessful treatment outcomes. RESULTS Of 82 patients included, 84.2% (69/82) had fluoroquinolone-resistant MDR-TB and 43.4% (23/53) were seropositive for the hepatitis C virus (HCV). The culture conversion rate was 84.4% (54/64), and 18.5% (10/54) reverted back to positive. In total, 79.3% (65/82) of the patients reported at least one adverse event. Serious adverse events were reported in 14 patients, with 10/14 patients experiencing fatal outcomes-6/10 related to advanced TB and 2/10 assessed as possibly related to BDQ. Treatment outcomes were as follows: 58.5% treatment success, 12.2% deaths, 7.3% failures and 21.9% lost to follow-up. HCV coinfection was associated with unsuccessful outcomes (adjusted OR 4.45, 95%CI 1.23-16.13). CONCLUSION BDQ through compassionate use showed relatively good success rates and safety profiles in a cohort with difficult-to-treat MDR-TB. High rates of reversion may indicate that >24 weeks of BDQ is necessary in some cases. HCV coinfection should be diagnosed and treatment considered in MDR-TB patients.
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Affiliation(s)
- C Hewison
- Médecins Sans Frontières (MSF), Paris
| | | | | | | | - A Hayrapetyan
- National Tuberculosis Control Centre, Yerevan, Armenia
| | - Z Avaliani
- National Centre for Tuberculosis and Lung Disease, Tbilisi, Georgia
| | - N Kiria
- National Centre for Tuberculosis and Lung Disease, Tbilisi, Georgia
| | - L Yegiazaryan
- National Tuberculosis Control Centre, Yerevan, Armenia
| | | | | | | | - S Qayyum
- Migration Health Department, International Organization for Migration, Amman, Jordan, MSF, Yerevan, Armenia
| | | | - F Varaine
- Médecins Sans Frontières (MSF), Paris
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Bhatti ZA, Waheed A, Maqbool F, Zhao YG, Qayyum S, Mehmood Q, Faridullah F. Microbial Fuel Cell Using UASB as Anode and Effects of Hydrogen Peroxide on Treatment Efficiency. J WATER CHEM TECHNO+ 2019. [DOI: 10.3103/s1063455x1901003x] [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: 11/30/2022]
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Javaid A, Hasan R, Zafar A, Chaudry MA, Qayyum S, Qadeer E, Shaheen Z, Agha N, Rizvi N, Afridi MZ, Chima MK, Khan AR, Ghafoor A, Khan S, Awan SR, Akhtar S, Choudry K, Iqbal ZH, Ansarie M, Ahmad N. Pattern of first- and second-line drug resistance among pulmonary tuberculosis retreatment cases in Pakistan. Int J Tuberc Lung Dis 2017; 21:303-308. [PMID: 28225340 DOI: 10.5588/ijtld.16.0444] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Drug resistance in general, and multidrug-resistant tuberculosis (MDR-TB) in particular, threatens global tuberculosis (TB) control efforts. Population-based estimates of drug resistance are needed to develop strategies for controlling drug-resistant TB in Pakistan. OBJECTIVE To obtain population-based data on Mycobacterium tuberculosis drug resistance in Pakistan. METHODS To obtain drug resistance data, we conducted a population-based study of TB cases in all provinces of Pakistan. We performed culture and drug susceptibility testing on M. tuberculosis isolates from patients with a prior history of anti-tuberculosis treatment (retreatment cases) from all over the country. RESULTS Of 544 isolates from previously treated cases, 289 (53.1%) were susceptible to all first-line drugs, 255 (46.9%) were resistant to at least one anti-tuberculosis drug and 132 (24.3%) were MDR-TB. Among MDR-TB isolates, 47.0% were ofloxacin (OFX) resistant. Extensively drug-resistant TB was found in two (0.4%) isolates. CONCLUSION Prevalence of drug resistance in retreatment isolates was high. The alarmingly high prevalence of OFX resistance among MDR-TB isolates may threaten the success of efforts to control and treat MDR-TB.
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Affiliation(s)
- A Javaid
- Department of Pulmonology, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar
| | - R Hasan
- Department of Microbiology, Agha Khan University, Karachi
| | - A Zafar
- Department of Microbiology, Agha Khan University, Karachi
| | | | - S Qayyum
- Ojha Institute of Chest Disease, Karachi
| | - E Qadeer
- National TB Control Programme, Islamabad
| | - Z Shaheen
- Department of Pulmonology, Nishtar Medical College, Multan
| | - N Agha
- Fatima Jinnah Chest Hospital, Quetta
| | - N Rizvi
- Department of Chest Medicine, Jinnah Postgraduate Medical Centre, Karachi
| | | | - M K Chima
- Department of Pulmonology, Services Hospital, Lahore
| | - A R Khan
- Department of Pulmonology, Ayub Medical College, Abbottabad
| | | | - S Khan
- Department of Chest Medicine, Lahore General Hospital, Lahore
| | | | - S Akhtar
- Department of Medicine, Ziauddin University, Karachi
| | - K Choudry
- Department of Pulmonology, King Edward Medical University, Lahore
| | - Z H Iqbal
- Department of Pulmonology, Allama Iqbal Medical College, Lahore
| | - M Ansarie
- Orthopaedic and Medical Institute, Karachi, Pakistan
| | - N Ahmad
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
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Sanchez-Padilla E, Marquer C, Kalon S, Qayyum S, Hayrapetyan A, Varaine F, Bastard M, Bonnet M. Reasons for defaulting from drug-resistant tuberculosis treatment in Armenia: a quantitative and qualitative study. Int J Tuberc Lung Dis 2014; 18:160-7. [PMID: 24429307 DOI: 10.5588/ijtld.13.0369] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Armenia, a country with a high prevalence of drug-resistant tuberculosis (DR-TB). OBJECTIVE To identify factors related to default from DR-TB treatment in Yerevan. DESIGN Using a retrospective cohort design, we compared defaulters with patients who were cured, completed or failed treatment. Patients who initiated DR-TB treatment from 2005 to 2011 were included in the study. A qualitative survey was conducted including semi-structured interviews with defaulters and focus group discussions with care providers. RESULTS Of 381 patients, 193 had achieved treatment success, 24 had died, 51 had failed treatment and 97 had defaulted. The number of drugs to which the patient was resistant at admission (aRR 1.16, 95%CI 1.05-1.27), the rate of treatment interruption based on patient's decision (aRR 1.03, 95%CI 1.02-1.05), the rate of side effects (aRR 1.18, 95%CI 1.09-1.27), and absence of culture conversion during the intensive phase (aRR 0.47, 95%CI 0.31-0.71) were independently associated with default from treatment. In the qualitative study, poor treatment tolerance, a perception that treatment was inefficient, lack of information, incorrect perception of being cured, working factors and behavioural problems were factors related to treatment default. CONCLUSION In addition to economic reasons, poor tolerance of and poor response to treatment were the main factors associated with treatment default.
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Affiliation(s)
| | | | - S Kalon
- Médecins Sans Frontières, Paris, France
| | - S Qayyum
- Médecins Sans Frontières, Paris, France
| | - A Hayrapetyan
- National Tuberculosis Programme Office, Yerevan, Armenia
| | - F Varaine
- Médecins Sans Frontières, Paris, France
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Shah SA, Qayyum S, Abro R, Baig S, Creswell J. Active contact investigation and treatment support: an integrated approach in rural and urban Sindh, Pakistan. Int J Tuberc Lung Dis 2014; 17:1569-74. [PMID: 24200270 DOI: 10.5588/ijtld.13.0169] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although household contacts of persons with tuberculosis (TB) have high rates of active TB, contact investigations are often not conducted. We present the results from a large-scale active contact investigation combined with treatment support in Sindh, Pakistan. METHODS Trained lay workers visited consenting smear-positive index patient homes in seven urban and 15 rural facilities. People with suspected TB were provided free transport to diagnostic centres, and sputum samples were collected for microscopy. Those diagnosed with smear-positive TB were given food baskets and sent text reminders to promote adherence. RESULTS From 3037 index cases, 19,191 household contacts were screened for TB symptoms and 3478 (18.1%) symptomatic persons were identified. Of these, 2160 (62.1%) produced sputum samples on the spot for testing and 490 (22.7%) had smear-positive results. TB prevalence in urban households was 1504 per 100,000 population compared to 4044/100,000 in rural households (P < 0.001) and 2553/100,000 overall. Treatment success was high, with 80.4% cured and 17.6% completing treatment. DISCUSSION Lay workers given basic training can conduct active contact investigations and provide treatment support to improve case detection and treatment outcomes in urban and rural areas of Pakistan. In areas with high levels of undiagnosed TB, particularly in rural areas, contact investigation should be prioritised as a means of improving case detection and early diagnosis.
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Affiliation(s)
- S A Shah
- Bridge Consultants Foundation, Karachi, Pakistan
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Imtiaz S, Alswaida A, Rehman H, Faraz N, Afshan T, Alkafoury H, Qayyum S, Al Khoiter M. Transformation of membranous into anti-GBM nephritis. Indian J Nephrol 2013; 22:370-3. [PMID: 23326049 PMCID: PMC3544060 DOI: 10.4103/0971-4065.103924] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Membranous nephropathy is a common glomerular disease. We report a 50-year-old man with a history of membranous nephropathy in remission, who presented with acute kidney injury, proteinuria, hematuria, and hypertension. He also had a high anti-glomerular basement membrane (anti-GBM) antibody titer and crescent transformation of primary pathology. The kidney functions deteriorated rapidly despite aggressive therapy with cyclophosphamide, methylprednisolone, and plasmapheresis.
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Affiliation(s)
- S Imtiaz
- Department of Medicine, King Khalid University, Hospital Riyadh, Saudi Arabia
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Abstract
Lead is a persistent toxic metal and associated with impairment of various body functions in occupational workers. The main objective was to determine the lead-induced oxidative stress and adverse health effects by biochemical markers in industrial workers. One hundred and forty-eight males consisting of 87 lead-exposed industrial workers and 61 controls were included. Blood lead level (BLL) was determined on a 3010B ESA lead analyzer. Blood complete counts were done on a hematology analyzer. Biochemical markers including serum uric acid, urea, creatinine, phosphate, alanine aminotransferase (ALT), and gamma glutamyltransferase (GGT) were measured on a Selectra E auto analyzer. Serum malondialdehyde (MDA) was measured spectrophotometrically and C-reactive protein (CRP) on Immulite-1000. Results revealed that lead-exposed workers had significantly high BLLs, median (range), 29.1 (9.0-61.1) microg/dL compared with controls, 8.3 (1.0-21.7) microg/dL. Oxidative stress (MDA, GGT) and inflammatory markers (high-sensitivity CRP) were significantly increased (P < or = 0.05). Blood pressure was raised, whereas hemoglobin was decreased in exposed group (P < or = 0.002). Serum urea, uric acid, phosphate, and ALT were significantly raised in lead-exposed workers (P < or = 0.001). Serum albumin, total proteins, and glomerular filtration rate (GFR) were decreased. Blood lead showed a significant positive correlation with serum GGT (r = 0.63), MDA (r = 0.71), CRP (r = 0.75), urea (r = 0.34), creatinine (r = 0.51), and uric acid (r = 0.29) (P < or = 0.01). It is concluded that lead exposure increases oxidative stress that correlates with adverse changes in hematological, renal, and hepatic function in the occupational workers. Elevated blood lead has positive correlation with oxidative stress, inflammatory and biochemical markers that might be used to detect impairment in the body function in lead exposed workers.
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Affiliation(s)
- D A Khan
- Department of Pathology Army Medical College, National University Sciences and Technology, Rawalpindi, Pakistan.
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Williams G, Coakley FV, Qayyum S, Glenn OA, Breiman RS, Callen PW. Evaluation of femur length during the second and third trimesters in fetuses with myelomeningocele. Ultrasound Obstet Gynecol 2004; 23:148-151. [PMID: 14770394 DOI: 10.1002/uog.968] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVES To determine if the femur length of fetuses with myelomeningocele is shorter in the second and third trimesters compared with that of normal fetuses. METHODS We retrospectively collected measurements of femur length, head circumference, biparietal diameter and abdominal circumference from detailed obstetric ultrasound studies performed during the second and third trimesters in 31 fetuses with myelomeningocele and 43 fetuses with no detectable anomaly. The gestational age predicted by each parameter (based on Hadlock's tables) was compared with the true gestational age (based on last menstrual period), using the ANCOVA test to determine if there was a statistically significant difference between the two groups of fetuses. RESULTS There was no significant difference in femur length (P = 0.60) or in abdominal circumference (P = 0.85) between fetuses with myelomeningocele and normal fetuses. Fetuses with myelomeningocele did have a significantly lower biparietal diameter and head circumference (P < or = 0.001). CONCLUSIONS Myelomeningocele is not associated with reduced femur length in the second and third trimesters, suggesting that the known postnatal lower extremity foreshortening in patients with myelomeningocele develops late in gestation or after birth.
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Affiliation(s)
- G Williams
- Department of Radiology, University of California San Francisco, San Francisco, CA 94143, USA
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McAlpine PJ, Feasby TE, Hahn AF, Komarnicki L, James S, Guy C, Dixon M, Qayyum S, Wright J, Coopland G. Localization of a locus for Charcot-Marie-Tooth neuropathy type Ia (CMT1A) to chromosome 17. Genomics 1990; 7:408-15. [PMID: 2365358 DOI: 10.1016/0888-7543(90)90175-t] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Phenotypic data for 71 genetic markers for members of five Caucasian kindreds were tested for linkage with the autosomal dominant mutations causing Charcot-Marie-Tooth (hereditary motor sensory) neuropathy type I, characterized by markedly reduced nerve conduction velocities. Lod score analysis gave no evidence of linkage to the closely linked chromosome 1 loci SPTA1-FY-F5-AT3 and APOA2. In contrast, these mutations were found to map closely (zeta = 10.828, theta = 0.0) to D17S58, an anonymous segment of DNA from 17p11.2-p11.1, and thus define the CMT1A locus. Segregation information data for an inferred recombinant offspring indicated that the CMT1A locus is probably proximal to MYH2, the locus encoding adult skeletal muscle myosin heavy polypeptide 2, which maps to 17p13. Analysis of the lod scores on a per kindred basis gave no evidence of genetic heterogeneity.
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Affiliation(s)
- P J McAlpine
- Department of Human Genetics, University of Manitoba, Winnipeg, Canada
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