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Barroso E, Mark T, Acevedo R, Rao S, Jordan H, Burzynski J, Remegio W, Ea E, Compas L. Patient navigator's role in latent tuberculosis infection at a New York City Health Department Chest Clinic. J Clin Tuberc Other Mycobact Dis 2024; 36:100446. [PMID: 38708035 PMCID: PMC11070235 DOI: 10.1016/j.jctube.2024.100446] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024] Open
Abstract
Background Philippines is one of the top ten countries of birth among individuals with tuberculosis in New York City (NYC). The NYC Health Department (HD) screened Filipino-born New Yorkers for latent TB infection (LTBI), but few of those tested positive completed evaluation and treatment. Objective To increase the proportion of Filipinos with a positive QuantiFeron-TB Gold Plus (QFT-Plus) complete LTBI evaluation and treatment. Methods Nine community-based LTBI screening events were conducted during September-December 2021. Patients with positive QFT-Plus results were offered no-cost LTBI evaluation and treatment at HD Chest Clinic. The HD engaged culturally- and linguistically-competent Filipino patient navigators (PN) to facilitate LTBI evaluation and treatment. Results Of 77 Filipinos screened, 17 (22%) tested positive. Fourteen (82%) were evaluated for LTBI; eight of the 14 (57%) completed LTBI treatment. Conclusions Pairing patients with culturally- and linguistically- competent Filipino PNs contributed to an increase in the proportion of Filipinos with a positive QFT-Plus who completed LTBI evaluation and treatment. TB prevention programs may wish to consider PNs in LTBI patient care.
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Affiliation(s)
- E. Barroso
- Bureau of Tuberculosis Control, New York City Department of Health and Mental Hygiene, Queens, NY, USA
- Philippine Nurses Association of New York, New York, NY, USA
| | - T. Mark
- Bureau of Tuberculosis Control, New York City Department of Health and Mental Hygiene, Queens, NY, USA
| | - R. Acevedo
- Bureau of Tuberculosis Control, New York City Department of Health and Mental Hygiene, Queens, NY, USA
| | - S. Rao
- Bureau of Tuberculosis Control, New York City Department of Health and Mental Hygiene, Queens, NY, USA
| | - H.T. Jordan
- Bureau of Tuberculosis Control, New York City Department of Health and Mental Hygiene, Queens, NY, USA
| | - J. Burzynski
- Bureau of Tuberculosis Control, New York City Department of Health and Mental Hygiene, Queens, NY, USA
| | - W. Remegio
- Philippine Nurses Association of New York, New York, NY, USA
| | - E. Ea
- Kalusugan Coalition, Queens, NY, USA
| | - L. Compas
- Philippine Nurses Association of New York, New York, NY, USA
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2
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Cao B, Li Q, Xu P, Zhang Y, Cai S, Rao S, Zeng M, Dai Y, Jiang S, Zhou J. Vesical Imaging-Reporting and Data System (VI-RADS) as a grouping imaging biomarker combined with a decision-tree mode to preoperatively predict the pathological grade of bladder cancer. Clin Radiol 2024; 79:e725-e735. [PMID: 38360514 DOI: 10.1016/j.crad.2024.01.031] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/12/2024] [Accepted: 01/22/2024] [Indexed: 02/17/2024]
Abstract
AIM To investigate whether the Vesical Imaging-Reporting and Data System (VI-RADS) could be used to develop a new non-invasive preoperative grade-prediction system to partially predict high-grade bladder cancer (HG-BC). MATERIALS AND METHODS The present study enrolled 89 primary BC patients prospectively from March 2022 to June 2023. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of VI-RADS for predicting HG-BC and muscle-invasive bladder cancer (MIBC) in the entire group. In the low VI-RADS (≤2) group, the decision tree-based method was used to obtain significant predictors and construct the decision-tree model (DT model). The performance of the DT model and low VI-RADS scores for predicting HG-BC was determined using ROC, calibration, and decision curve analyses. RESULTS At a cut-off of ≥3, the specificity and positive predictive value of VI-RADS for predicting HG-BC in the entire group was 100%, and the area under the ROC curve (AUC) was 0.697. Among 65 patients with low VI-RADS scores, the DT model showed an AUC of 0.884 in predicting HG-BC compared to 0.506 for low VI-RADS scores. Calibration and decision curve analyses showed that the DT model performed better than the low VI-RADS scores. CONCLUSION Most VI-RADS scores ≥3 correspond to HG-BCs. VI-RADS could be used as a grouping imaging biomarker for a pathological grade-prediction procedure, which in combination with the DT model for low VI-RADS (≤2) populations, would provide a potential preoperative non-invasive method of predicting HG-BC.
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Affiliation(s)
- B Cao
- Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Radiology, Shanghai Geriatric Medical Center, Shanghai, China
| | - Q Li
- Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, China
| | - P Xu
- Department of Urology, Xuhui Hospital, Fudan University, Shanghai, China
| | - Y Zhang
- MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China
| | - S Cai
- Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, China
| | - S Rao
- Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Radiology, Shanghai Geriatric Medical Center, Shanghai, China
| | - M Zeng
- Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Radiology, Shanghai Geriatric Medical Center, Shanghai, China
| | - Y Dai
- MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China
| | - S Jiang
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Urology, Zhongshan Hospital Wusong Branch, Fudan University, Shanghai, China.
| | - J Zhou
- Department of Radiology, Fudan University Zhongshan Hospital Xiamen Branch, Xiamen, China; Xiamen Municipal Clinical Research Center for Medical Imaging, Xiamen, China; Xiamen Key Clinical Specialty for Radiology, Xiamen, China.
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3
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Gupta R, Bermudez F, Vora T, Homayouni N, Weissman G, Kadakkal A, Afari-Armah N, Rao S, Lam PH, Rodrigo ME, Hofmeyer M, Krishnan M, Balsara K, Najjar SS, Sheikh FH. Surveillance Imaging and Management of Cardiac Sarcoidosis After Advanced Heart Failure Therapies. Am J Cardiol 2024:S0002-9149(24)00311-4. [PMID: 38663574 DOI: 10.1016/j.amjcard.2024.04.033] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 04/20/2024] [Accepted: 04/20/2024] [Indexed: 05/07/2024]
Affiliation(s)
- Richa Gupta
- XXX, Medstar Washington Hospital Center, Washington DC, District of Columbia; XXX, Georgetown University School of Medicine, Washington, DC, District of Columbia
| | - Francisca Bermudez
- XXX, Georgetown University School of Medicine, Washington, DC, District of Columbia
| | - Tania Vora
- XXX, MedStar Health, Baltimore, Maryland
| | - Navid Homayouni
- XXX, Medstar Washington Hospital Center, Washington DC, District of Columbia; XXX, Georgetown University School of Medicine, Washington, DC, District of Columbia
| | - Gaby Weissman
- XXX, Medstar Washington Hospital Center, Washington DC, District of Columbia; XXX, Georgetown University School of Medicine, Washington, DC, District of Columbia
| | - Ajay Kadakkal
- XXX, Medstar Washington Hospital Center, Washington DC, District of Columbia
| | - Nana Afari-Armah
- XXX, Medstar Washington Hospital Center, Washington DC, District of Columbia; XXX, Georgetown University School of Medicine, Washington, DC, District of Columbia
| | - Sriram Rao
- XXX, Medstar Washington Hospital Center, Washington DC, District of Columbia; XXX, Georgetown University School of Medicine, Washington, DC, District of Columbia
| | - Phillip H Lam
- XXX, Medstar Washington Hospital Center, Washington DC, District of Columbia; XXX, Georgetown University School of Medicine, Washington, DC, District of Columbia
| | - Maria E Rodrigo
- XXX, Medstar Washington Hospital Center, Washington DC, District of Columbia
| | - Mark Hofmeyer
- XXX, Medstar Washington Hospital Center, Washington DC, District of Columbia; XXX, Georgetown University School of Medicine, Washington, DC, District of Columbia
| | - Mrinalini Krishnan
- XXX, Medstar Washington Hospital Center, Washington DC, District of Columbia; XXX, Georgetown University School of Medicine, Washington, DC, District of Columbia
| | - Keki Balsara
- XXX, Medstar Washington Hospital Center, Washington DC, District of Columbia; XXX, Georgetown University School of Medicine, Washington, DC, District of Columbia
| | - Samer S Najjar
- XXX, Georgetown University School of Medicine, Washington, DC, District of Columbia; XXX, MedStar Health, Baltimore, Maryland
| | - Farooq H Sheikh
- XXX, Medstar Washington Hospital Center, Washington DC, District of Columbia; XXX, Georgetown University School of Medicine, Washington, DC, District of Columbia.
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Cartwright E, Slater S, Saffery C, Tran A, Turkes F, Smith G, Aresu M, Kohoutova D, Terlizzo M, Zhitkov O, Rana I, Johnston EW, Sanna I, Smyth E, Mansoor W, Fribbens C, Rao S, Chau I, Starling N, Cunningham D. Phase II trial of domatinostat (4SC-202) in combination with avelumab in patients with previously treated advanced mismatch repair proficient oesophagogastric and colorectal adenocarcinoma: EMERGE. ESMO Open 2024; 9:102971. [PMID: 38518549 PMCID: PMC10972804 DOI: 10.1016/j.esmoop.2024.102971] [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: 12/20/2023] [Revised: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 03/24/2024] Open
Abstract
BACKGROUND Most oesophagogastric adenocarcinomas (OGAs) and colorectal cancers (CRCs) are mismatch repair proficient (MMRp), responding poorly to immune checkpoint inhibition. We evaluated the safety and efficacy of domatinostat (histone deacetylase inhibitor) plus avelumab (anti-PD-L1 antibody) in patients with previously treated inoperable, advanced/metastatic MMRp OGA and CRC. PATIENTS AND METHODS Eligible patients were evaluated in a multicentre, open-label dose escalation/dose expansion phase II trial. In the escalation phase, patients received escalating doses of domatinostat [100 mg once daily (OD), 200 mg OD, 200 mg twice daily (BD)] orally for 14 days followed by continuous dosing plus avelumab 10 mg/kg administered intravenously 2-weekly (2qw) to determine the recommended phase II dose (RP2D). The trial expansion phase evaluated the best objective response rate (ORR) during 6 months by RECIST version 1.1 using a Simon two-stage optimal design with 2/9 and 1/10 responses required to proceed to stage 2 in the OGA and CRC cohorts, respectively. RESULTS Patients (n = 40) were registered between February 2019 and October 2021. Patients in the dose escalation phase (n = 12) were evaluated to confirm the RP2D of domatinostat 200 mg BD plus avelumab 10 mg/kg. No dose-limiting toxicities were observed. Twenty-one patients were treated at the RP2D, 19 (9 OGA and 10 CRC) were assessable for the best ORR; 2 patients with CRC did not receive combination treatment and were not assessable for the primary endpoint analysis. Six patients were evaluated in the dose escalation and expansion phases. In the OGA cohort, the best ORR was 22.2% (95% one-sided confidence interval lower bound 4.1) and the median duration of disease control was 11.3 months (range 9.9-12.7 months). No responses were observed in the CRC cohort. No treatment-related grade 3-4 adverse events were reported at the RP2D. CONCLUSIONS Responses in the OGA cohort met the criteria to expand to stage 2 of recruitment with an acceptable safety profile. There was insufficient signal in the CRC cohort to progress to stage 2. TRIAL REGISTRATION NCT03812796 (registered 23rd January 2019).
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Affiliation(s)
- E Cartwright
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - S Slater
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - C Saffery
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - A Tran
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - F Turkes
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - G Smith
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - M Aresu
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - D Kohoutova
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - M Terlizzo
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - O Zhitkov
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - I Rana
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - E W Johnston
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - I Sanna
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - E Smyth
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - W Mansoor
- Oesophago-Gastric Cancer Services, The Christie NHS Foundation Trust, Manchester, UK
| | - C Fribbens
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - S Rao
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - I Chau
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - N Starling
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - D Cunningham
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London.
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Fateri C, Roth B, Rao S, Peta A, Limfueco L, Bui TL, Kar N, Glavis-Bloom J, Cumpanas A, Landman J, Houshyar R. Utilization of Re-VASC, the Novel Retroperitoneal Neovascularity Scoring System, for Characterization of T1a Small Renal Masses. J Endourol 2024; 38:301-305. [PMID: 38149604 DOI: 10.1089/end.2023.0421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023] Open
Abstract
Purpose: Early characterization of small (T1a, <4 cm) renal masses is imperative for patient care and treatment planning. Renal biopsy is a sensitive and specific procedure that can accurately differentiate small renal masses as malignant or benign. However, it is an invasive procedure with a nonnegligible complication rate and is not performed routinely at most institutions. In this study, we sought to apply the Retroperitoneal Vascularity Assessment and Scoring in Carcinoma (Re-VASC) scoring system to T1a renal masses and analyzed whether it could differentiate these masses as benign or malignant. Methods: We obtained Institutional Review Board approval to retrospectively examine the records of all patients who presented to our single, urban academic referral center for surgical treatment of renal cell carcinoma (RCC). For the malignant group, patients with a diagnosis of T1a RCC from pathologic evaluation were included. Additionally, patients with a histopathological diagnosis of a T1a nonmalignant renal mass (fat poor-angiomyolipoma or oncocytoma) were included in our benign group. Results: This study includes 57 benign and 69 malignant T1a renal tumors. Average size for benign and malignant masses were 2.47 and 2.63, respectively (p = 0.267). Analysis demonstrated no significant difference between both groups in terms of sex, laterality, or size. The average Re-VASC score of benign and malignant masses was 0.175 and malignant masses was 0.784, respectively (p < 0.001). Additionally, the Re-VASC score was independently associated with malignancy with an odds ratio of 2.223 (p = 0.0109). Conclusion: The Re-VASC scoring system exhibits significantly greater values for malignant T1a renal masses when compared to benign masses. As a result, it shows promise as an adjunctive tool to renal biopsy for clinical decision-making. Further assessment of Re-VASC's true efficacy as a diagnostic marker will include prospective evaluation of a larger multicenter population.
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Affiliation(s)
- Cameron Fateri
- Department of Radiology and University of California, Irvine, Orange, California, USA
| | - Bradley Roth
- Department of Radiology and University of California, Irvine, Orange, California, USA
| | - Sriram Rao
- Department of Radiology and University of California, Irvine, Orange, California, USA
| | - Akhil Peta
- Department of Urology, University of California, Irvine, Orange, California, USA
| | - Luke Limfueco
- Department of Urology, University of California, Irvine, Orange, California, USA
| | - Thanh-Lan Bui
- Department of Urology, University of California, Irvine, Orange, California, USA
| | - Nina Kar
- Department of Urology, University of California, Irvine, Orange, California, USA
| | - Justin Glavis-Bloom
- Department of Radiology and University of California, Irvine, Orange, California, USA
| | - Andrei Cumpanas
- Department of Urology, University of California, Irvine, Orange, California, USA
| | - Jaime Landman
- Department of Radiology and University of California, Irvine, Orange, California, USA
- Department of Urology, University of California, Irvine, Orange, California, USA
| | - Roozbeh Houshyar
- Department of Radiology and University of California, Irvine, Orange, California, USA
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Shah H, Lee I, Rao S, Suddath W, Rodrigo M, Mohammed S, Molina E, García-Garcia HM, Kenigsberg BB. Quantitative flow ratio computed from invasive coronary angiography as a predictor for cardiac allograft vasculopathy after cardiac transplant. Int J Cardiovasc Imaging 2024; 40:451-458. [PMID: 38117378 DOI: 10.1007/s10554-023-03012-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/16/2023] [Indexed: 12/21/2023]
Abstract
Cardiac allograft vasculopathy (CAV) is a significant determinant of long-term survival in heart transplant recipients. Standard CAV screening typically utilizes invasive coronary angiography (ICA). Quantitative flow ratio (QFR) is a computational method for functional testing of coronary stenosis, and may add diagnostic value to ICA in assessing CAV. Consecutive subjects who received heart transplantation and underwent two separate routine coronary angiograms between January 2013 and April 2016 were enrolled. Coronary angiograms and IVUS were performed per local protocol at 1, 2, 3 and 5 years post-transplant. QFR was calculated offline. CAV was assessed semi-quantitively based on coronary angiogram results. Twenty-two patients were enrolled. Mean time from transplant to first included ICA was 2.1 years. QFR in at least 1 coronary vessel was interpretable in 19/22 (86%) of initial ICA (QFR1). QFR1 correlated well with the CAV score derived from the second ICA (CAV2) with a clustering of CAV at lower QFR values. In a receiver-operating characteristic (ROC) analysis, an optimal QFR threshold of 0.88 yielded 0.94 sensitivity and 0.67 specificity (AUC of 0.79) for at least non-obstructive subsequent CAV. Initial angiographically and intravascular ultrasound derived CAV severity poorly predicted subsequent CAV severity. QFR derived from invasive coronary angiography predicts subsequent development of CAV more accurately than angiography and intravascular ultrasound. This novel method of coronary flow assessment in recipients of heart transplantation may be useful to diagnose and predict subsequent CAV development.
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Affiliation(s)
- Harsh Shah
- Department of Cardiology, Jefferson Einstein Hospital, Philadelphia, PA, USA
| | - Injoon Lee
- Department of Medicine, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Sriram Rao
- Department of Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - William Suddath
- Department of Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Maria Rodrigo
- Department of Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Selma Mohammed
- Department of Cardiology, Creighton University School of Medicine, Omaha, NE, USA
| | - Ezequiel Molina
- Department of Cardiac Surgery, Piedmont Heart Institute, Atlanta, GA, USA
| | - Hector M García-Garcia
- MedStar Cardiovascular Research Network, MedStar Washington Hospital Center, Washington, DC, USA
| | - Benjamin B Kenigsberg
- Department of Cardiology, MedStar Washington Hospital Center, Washington, DC, USA.
- Department of Critical Care, MedStar Washington Hospital Center, 110 Irving St., NW, Rm A121, Washington, DC, 20010, USA.
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7
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Rao S, Glavis-Bloom J, Bui TL, Afzali K, Bansal R, Carbone J, Fateri C, Roth B, Chan W, Kakish D, Cortes G, Wang P, Meraz J, Chantaduly C, Chow DS, Chang PD, Houshyar R. Artificial Intelligence for Improved Hepatosplenomegaly Diagnosis. Curr Probl Diagn Radiol 2023; 52:501-504. [PMID: 37277270 DOI: 10.1067/j.cpradiol.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/14/2023] [Accepted: 05/08/2023] [Indexed: 06/07/2023]
Abstract
Hepatosplenomegaly is commonly diagnosed by radiologists based on single dimension measurements and heuristic cut-offs. Volumetric measurements may be more accurate for diagnosing organ enlargement. Artificial intelligence techniques may be able to automatically calculate liver and spleen volume and facilitate more accurate diagnosis. After IRB approval, 2 convolutional neural networks (CNN) were developed to automatically segment the liver and spleen on a training dataset comprised of 500 single-phase, contrast-enhanced CT abdomen and pelvis examinations. A separate dataset of ten thousand sequential examinations at a single institution was segmented with these CNNs. Performance was evaluated on a 1% subset and compared with manual segmentations using Sorensen-Dice coefficients and Pearson correlation coefficients. Radiologist reports were reviewed for diagnosis of hepatomegaly and splenomegaly and compared with calculated volumes. Abnormal enlargement was defined as greater than 2 standard deviations above the mean. Median Dice coefficients for liver and spleen segmentation were 0.988 and 0.981, respectively. Pearson correlation coefficients of CNN-derived estimates of organ volume against the gold-standard manual annotation were 0.999 for the liver and spleen (P < 0.001). Average liver volume was 1556.8 ± 498.7 cc and average spleen volume was 194.6 ± 123.0 cc. There were significant differences in average liver and spleen volumes between male and female patients. Thus, the volume thresholds for ground-truth determination of hepatomegaly and splenomegaly were determined separately for each sex. Radiologist classification of hepatomegaly was 65% sensitive, 91% specific, with a positive predictive value (PPV) of 23% and an negative predictive value (NPV) of 98%. Radiologist classification of splenomegaly was 68% sensitive, 97% specific, with a positive predictive value (PPV) of 50% and a negative predictive value (NPV) of 99%. Convolutional neural networks can accurately segment the liver and spleen and may be helpful to improve radiologist accuracy in the diagnosis of hepatomegaly and splenomegaly.
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Affiliation(s)
- Sriram Rao
- University of California, Irvine School of Medicine, Irvine, CA
| | - Justin Glavis-Bloom
- Department of Radiological Sciences, University of California, Irvine Medical Center, Orange, CA
| | - Thanh-Lan Bui
- Department of Radiological Sciences, University of California, Irvine Medical Center, Orange, CA
| | - Kasra Afzali
- Department of Radiological Sciences, University of California, Irvine Medical Center, Orange, CA
| | - Riya Bansal
- University of California, Irvine School of Medicine, Irvine, CA
| | - Joseph Carbone
- Department of Radiological Sciences, University of California, Irvine Medical Center, Orange, CA
| | - Cameron Fateri
- University of California, Irvine School of Medicine, Irvine, CA
| | - Bradley Roth
- University of California, Irvine School of Medicine, Irvine, CA
| | - William Chan
- University of California, Irvine School of Medicine, Irvine, CA
| | - David Kakish
- Department of Radiological Sciences, University of California, Irvine Medical Center, Orange, CA
| | - Gillean Cortes
- Department of Radiological Sciences, University of California, Irvine Medical Center, Orange, CA
| | - Peter Wang
- Department of Radiological Sciences, University of California, Irvine Medical Center, Orange, CA
| | - Jeanette Meraz
- Department of Radiological Sciences, University of California, Irvine Medical Center, Orange, CA
| | - Chanon Chantaduly
- Department of Radiological Sciences, University of California, Irvine Medical Center, Orange, CA
| | - Dan S Chow
- Department of Radiological Sciences, University of California, Irvine Medical Center, Orange, CA
| | - Peter D Chang
- Department of Radiological Sciences, University of California, Irvine Medical Center, Orange, CA
| | - Roozbeh Houshyar
- Department of Radiological Sciences, University of California, Irvine Medical Center, Orange, CA.
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8
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Rath CP, Athalye-Jape G, Nathan E, Doherty D, Rao S, Patole S. Benefits of routine probiotic supplementation in preterm infants. Acta Paediatr 2023; 112:2352-2358. [PMID: 37505925 DOI: 10.1111/apa.16924] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 07/30/2023]
Abstract
AIM We introduced routine probiotic supplementation (RPS) of preterm infants in June 2012. We previously reported that RPS reduced the incidence of necrotising enterocolitis (NEC) and mortality in such infants. In this study, we assessed if the benefits of RPS were sustained for infants in the current era. METHOD We compared the outcomes of preterm infants in recent epoch 3 (RPS, 1st June 2014 to 31st December 2019) versus epoch 2 (RPS, 1st June 2012 to 31st May 2014) and epoch 1 (no RPS, 1st December 2008 to 30th November 2010). Multiple logistic and Cox regression models were used to compare the outcomes. RESULTS There were 645 infants in epoch 1, 712 in epoch 2 and 1715 in epoch 3. Age at full feeds was significantly lower in epoch 3 vs. 2 and epoch 3 vs. 1 in infants <28 weeks of gestation. NEC and late-onset sepsis (LOS) were significantly lower in epoch 3 vs. 1 in infants <28 weeks. LOS and age at full feeds were significantly lower in epoch 3 vs. 2 and epoch 3 vs. 1 in infants with gestation 28 to 32 weeks. CONCLUSION The benefits associated with RPS were sustained during epoch 3.
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Affiliation(s)
- C P Rath
- Neonatology Directorate, King Edward Memorial Hospital for Women, Subiaco, Western Australia, Australia
- School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
| | - G Athalye-Jape
- Neonatology Directorate, King Edward Memorial Hospital for Women, Subiaco, Western Australia, Australia
- School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
| | - E Nathan
- Biostatistics, Women and Infants Research Foundation, Subiaco, Western Australia, Australia
- Division of Obstetrics and Gynaecology, University of Western Australia, Crawley, Western Australia, Australia
| | - D Doherty
- Biostatistics, Women and Infants Research Foundation, Subiaco, Western Australia, Australia
- Division of Obstetrics and Gynaecology, University of Western Australia, Crawley, Western Australia, Australia
| | - S Rao
- School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
- Neonatal Directorate, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - S Patole
- Neonatology Directorate, King Edward Memorial Hospital for Women, Subiaco, Western Australia, Australia
- School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
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Enoch SJ, Hasarova Z, Cronin MTD, Bridgwood K, Rao S, Kluxen FM, Frericks M. Metabolism-based category formation for the prioritisation of genotoxicity hazard assessment for plant protection product residues (part 3): Strobilurins. Regul Toxicol Pharmacol 2023; 144:105484. [PMID: 37633329 DOI: 10.1016/j.yrtph.2023.105484] [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: 07/12/2023] [Revised: 08/15/2023] [Accepted: 08/23/2023] [Indexed: 08/28/2023]
Abstract
In dietary risk assessment of plant protection products, residues of active ingredients and their metabolites need to be evaluated for their genotoxic potential. The European Food Safety Authority recommend a tiered approach focussing assessment and testing on classes of similar chemicals. To characterise similarity, in terms of metabolism, a metabolic similarity profiling scheme has been developed from an analysis of 46 chemicals of strobilurin fungicides and their metabolites for which either Ames, chromosomal aberration or micronucleus test results are publicly available. This profiling scheme consists of a set of ten sub-structures, each linked to a key metabolic transformation present in the strobilurin metabolic space. This metabolic similarity profiling scheme was combined with covalent chemistry profiling and physico-chemistry properties to develop chemical categories suitable for chemical prioritisation via read-across. The method is a robust and reproducible approach to such read-across predictions, with the potential to reduce unnecessary testing. The key challenge in the approach was identified as being the need for metabolism data and individual groups of plant protection products as the basis for the development of such profiling schemes.
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Affiliation(s)
- S J Enoch
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, England, UK.
| | - Z Hasarova
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, England, UK
| | - M T D Cronin
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, England, UK
| | | | - S Rao
- Gowan Company, Yuma, AZ, USA
| | - F M Kluxen
- ADAMA Deutschland GmbH, Cologne, Germany
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10
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O'Cathail SM, Qiao M, Muirhead R, Adams R, Rao S, Fisher K, Seymour L, Brown R, Lille T, Ooms A, Maughan TS, Hawkins MA. A Phase 1 Trial of the Safety, Tolerability, and Biological Effects of Intravenous Enadenotucirev (EnAd), a Novel Oncolytic Virus, in Combination with Chemoradiotherapy in Locally Advanced Rectal Cancer (CEDAR). Int J Radiat Oncol Biol Phys 2023; 117:e329-e330. [PMID: 37785164 DOI: 10.1016/j.ijrobp.2023.06.2379] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Novel treatment combinations are required to increase response rates in rectal cancer. EnAd is an intravenous, tumor selective, oncolytic adenovirus with high affinity for malignant colorectal epithelial cells. Pre-clinical evidence of synergy with radiation warranted further clinical evaluation and assessment of safety in combination with chemoradiation (CRT), 25 × 2Gy and concurrent capecitabine. MATERIALS/METHODS EnAd was escalated using 2 dose levels of viral particles (1 × 1012, 3 × 1012), given Monday, Wednesday, Friday over 3 schedules (pre-CRT, pre & post CRT). Toxicity and efficacy were used as dual end points in escalation decisions. A 2-parameter and 3-parameter logistic Time to Event Continual Reassessment Method (TiTE-CRM) were used estimate the dose-toxicity and dose-efficacy relationship, respectively. Results are shown as probability and 95% credible interval (Cr.I). The dose limiting toxicity (DLT) window was 13 weeks. Patients who had not completed their DLT window at the time of a dose decision were included in the safety analysis but down-weighted according to their follow-up time and amount of IMP received. Efficacy was assessed at 13 weeks using MRI Tumor Regression Grade (mrTRG), where mrTRG 1-2 equals response. The trial (NCT03916510) was conducted in 4 UK centers. RESULTS A total of 13 patients were enrolled, 12 of whom were evaluable. Median age was 57 (range 31-84), and 10/13 were male. One patient had two G3 adverse events (AE); diarrhea, acute kidney injury. All other adverse events (AEs) were G1 or 2, with no G4/5 events. The most common AE by organ system was gastrointestinal (20.8%, G1). There were two observed DLTs on Dose schedule 3; leg swelling and acute kidney injury. Responses and toxicities increased with escalating schedules of EnAd (Table 1). CONCLUSION CEDAR is the first trial to successfully combine an intravenous oncolytic adenovirus with radiation, demonstrating the feasibility and acceptability of this approach, and a new paradigm in radiosensitization in rectal cancer. Within this small Phase I study, EnAd demonstrated an acceptable safety profile with evidence of a higher-than-expected rate of response by mrTRG. Translation analysis of tissue, blood and microbiome for biological correlates of radiation synergy is underway. FUNDING PsiOxus, CRUK (A24474). SPONSOR University of Oxford.
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Affiliation(s)
- S M O'Cathail
- School of Cancer Sciences, University of Glasgow, Glasgow, NA, United Kingdom
| | - M Qiao
- University of Oxford, Oxford, United Kingdom
| | - R Muirhead
- CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United Kingdom
| | - R Adams
- Velindre Cancer Centre, Cardiff, United Kingdom
| | - S Rao
- Royal Marsden Hospital, London, NA, United Kingdom
| | - K Fisher
- University of Oxford, Oxford, NA, United Kingdom
| | - L Seymour
- University of Oxford, Oxford, United Kingdom
| | - R Brown
- PsiOxus therapeutics, Oxford, United Kingdom
| | - T Lille
- Akamis Bio, Oxford, United Kingdom
| | - A Ooms
- University of Oxford, Oxford, NA, United Kingdom
| | - T S Maughan
- MRC Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - M A Hawkins
- Department of Radiotherapy, University College London Hospitals NHS Foundation Trust, London, United Kingdom
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11
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Huynh KN, Rao S, Roth B, Bryan T, Fernando DM, Dayyani F, Imagawa D, Abi-Jaoudeh N. Targeting Hypoxia-Inducible Factor-1α for the Management of Hepatocellular Carcinoma. Cancers (Basel) 2023; 15:2738. [PMID: 37345074 DOI: 10.3390/cancers15102738] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 04/11/2023] [Revised: 05/07/2023] [Accepted: 05/09/2023] [Indexed: 06/23/2023] Open
Abstract
Hypoxia-inducible factor 1 alpha (HIF-1α) is a transcription factor that regulates the cellular response to hypoxia and is upregulated in all types of solid tumor, leading to tumor angiogenesis, growth, and resistance to therapy. Hepatocellular carcinoma (HCC) is a highly vascular tumor, as well as a hypoxic tumor, due to the liver being a relatively hypoxic environment compared to other organs. Trans-arterial chemoembolization (TACE) and trans-arterial embolization (TAE) are locoregional therapies that are part of the treatment guidelines for HCC but can also exacerbate hypoxia in tumors, as seen with HIF-1α upregulation post-hepatic embolization. Hypoxia-activated prodrugs (HAPs) are a novel class of anticancer agent that are selectively activated under hypoxic conditions, potentially allowing for the targeted treatment of hypoxic HCC. Early studies targeting hypoxia show promising results; however, further research is needed to understand the effects of HAPs in combination with embolization in the treatment of HCC. This review aims to summarize current knowledge on the role of hypoxia and HIF-1α in HCC, as well as the potential of HAPs and liver-directed embolization.
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Affiliation(s)
- Kenneth N Huynh
- Division of Interventional Radiology, Department of Radiological Sciences, University of California Irvine, Orange, CA 92868, USA
| | - Sriram Rao
- Division of Interventional Radiology, Department of Radiological Sciences, University of California Irvine, Orange, CA 92868, USA
| | - Bradley Roth
- Division of Interventional Radiology, Department of Radiological Sciences, University of California Irvine, Orange, CA 92868, USA
| | - Theodore Bryan
- Division of Interventional Radiology, Department of Radiological Sciences, University of California Irvine, Orange, CA 92868, USA
| | - Dayantha M Fernando
- Division of Interventional Radiology, Department of Radiological Sciences, University of California Irvine, Orange, CA 92868, USA
| | - Farshid Dayyani
- Division of Hematology and Oncology, Department of Medicine, Chao Family Comprehensive Cancer Center, University of California Irvine, Orange, CA 92868, USA
| | - David Imagawa
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, University of California Irvine, Orange, CA 92868, USA
| | - Nadine Abi-Jaoudeh
- Division of Interventional Radiology, Department of Radiological Sciences, University of California Irvine, Orange, CA 92868, USA
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Moeller CH, Delk KW, Rao S, Love TR, Cloete CC, Mama KR. Development of a novel immobilisation protocol for black-faced impala (Aepyceros melampus ssp. petersi) in Etosha National Park. J S Afr Vet Assoc 2023; 94:35-41. [PMID: 37358316 DOI: 10.36303/jsava.513] [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: 06/27/2023] Open
Abstract
Black-faced impala (Aepyceros melampus ssp. petersi) are endemic to Namibia where conservation management involves immobilisation and translocation, and mortality with current protocols is common. Critically evaluated field immobilisation protocols are needed to maximise animal safety. This prospective study was done in two phases: the first compared etorphine- and thiafentanil-based combinations, the second evaluated the influence of oxygen in impala receiving the thiafentanil-based combination. Animals (10 per group) received 50 mg ketamine (K) and 10 mg butorphanol (B), with either 2.0 mg etorphine (E) or 2.0 mg thiafentanil (T). A third group of ten impala were anaesthetised using TKB with supplemental nasal oxygen (O) at a rate of 5 L/minute. Behavioural, metabolic and physiological variables were assessed within five minutes of recumbency and at 10, 15, and 20 minutes post-recumbency. Statistical analyses for non-parametric data were performed to compare the treatment groups as well as time points; p ≤ 0.05 considered significant. Following darting, 7/10 EKB animals were standing when approached, compared to 2/20 in the thiafentanil treatment groups. Time to first effect was significantly higher for EKB (155 ± 105.7 seconds) compared to TKBO (61.5 ± 21.4 seconds). Time to sternal after darting was significantly higher with EKB (411.6 ± 174 seconds) compared to TKB (160.5 ± 85.4 seconds) and TKBO (166 ± 77.3 seconds). This study builds on previous work investigating the effects of potent opioids on impala and is the first evaluating their use in a field setting. The thiafentanil combination had a faster onset and resulted in a smoother induction than the etorphine combination. Additionally, oxygenation improved in animals receiving oxygen supplementation.
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Affiliation(s)
- C H Moeller
- African Wildlife Conservation Trust, Namibia
| | - K W Delk
- Chicago Zoological Society and Brookfield Zoo, United States of America
| | - S Rao
- Department of Clinical Sciences, Animal Population Health Institute, United States of America
| | - T R Love
- Chicago Zoological Society and Brookfield Zoo, United States of America
| | - C C Cloete
- Etosha Ecological Institute, Ministry of Environment, Forestry and Tourism, Namibia
| | - K R Mama
- Department of Clinical Sciences, Colorado State University, United States of America
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Pierce KV, Scansen BA, Rao S. Radiation dose during interventional cardiology procedures: portable C-arm vs. a new generation fluoroscopy system. J Vet Cardiol 2023; 47:30-40. [PMID: 37150018 DOI: 10.1016/j.jvc.2023.03.005] [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: 07/10/2021] [Revised: 03/23/2023] [Accepted: 03/29/2023] [Indexed: 05/09/2023]
Abstract
INTRODUCTION Occupational exposure to ionizing radiation poses health risks for veterinary interventionalists. There are limited veterinary studies evaluating radiation dose in the cardiac catheterization laboratory. The purpose of this study was to report direct radiation dose exposure to patients during common interventional cardiology procedures and compare these doses between two fluoroscopy units. ANIMALS One hundred and fifty-four client-owned dogs. MATERIALS AND METHODS Patient dose during procedures using a portable C-arm were retrospectively analyzed and compared to those performed in a contemporary interventional suite. Fluoroscopy equipment, procedure type, operator, patient weight, fluoroscopy time, dose area product, and air kerma were recorded and statistically modeled using univariable and multivariable linear regression to evaluate the effect of each factor. RESULTS Patient dose population (154 dogs), comprised 61 patent ductus arteriosus occlusions, 60 balloon pulmonary valvuloplasties, and 33 pacemaker implantations. Patient dose was significantly lower in the group utilizing a newer generation fluoroscopy unit vs. the group utilizing an older portable C-arm, positively correlated with patient weight, and highest during balloon pulmonary valvuloplasties compared to patent ductus arteriosus occlusions or pacemaker implantations (all p<0.010). DISCUSSION Newer fluoroscopy systems can be equipped with technologies that improve image quality while reducing patient dose and radiation exposure to interventional personnel. CONCLUSIONS We documented a significant reduction in patient radiation dose using a newer fluoroscopy system as compared to an older portable C-arm for interventional cardiology procedures in animals. Improved knowledge of patient radiation dose factors may promote better radiation safety protocols in veterinary interventional cardiology.
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Affiliation(s)
- K V Pierce
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO 80523, USA.
| | - B A Scansen
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO 80523, USA
| | - S Rao
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO 80523, USA
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14
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Patel J, Mahana I, Lam P, Hofmeyer M, Rao S, Kadakkal A, Afari-Armah N, Krishnan M, Molina E, Najjar S, Sheikh F, Rodrigo M, Gupta R. Calcineurin Inhibitor-Induced Atypical Hemolytic Uremic Syndrome after Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.505] [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: 04/05/2023] Open
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15
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Gupta R, Bermudez F, Vora T, Kadakkal A, Afari-Armah N, Rao S, Lam P, Rodrigo M, Hofmeyer M, Krishnan M, Fajardo J, Najjar S, Sheikh F. Surveillance Imaging and Management of Cardiac Sarcoidosis after Advanced Heart Failure Therapies. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.512] [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: 04/05/2023] Open
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16
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Brown M, Lekan A, Hofmeyer M, Rodrigo M, Kadakkal A, Lam P, Krishnan M, Afari-Armah N, Rao S, Gupta R, Alassar A, Molina E, Sheikh F. Hemodynamic Effects of Intra-Aortic Balloon Pump as a Bridge to Durable Left Ventricular Assist Device. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1054] [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: 04/05/2023] Open
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17
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Kulshreshtha P, Bahurupi Y, Kalyani CV, Hemanthkumar K, Varghese A, Dhar M, Sharma S, Rao S. Effectiveness of Preparedness Training Delivered to Pre-final and Final Year Nursing Undergraduates to Combat COVID-19: A Need-based Initiative. Mymensingh Med J 2023; 32:542-549. [PMID: 37002769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
A major concern during the COVID-19 pandemic has been the shortage of manpower for patient care. The recommendation of various authorised bodies encouraged the training of students from medical, nursing, and allied fields to manage COVID-19 cases by tele-consultation and monitoring of mild cases under the supervision of faculty. Anticipating a further shortage of human resources, leading to dire consequences, preparedness training for the final year and pre-final nursing undergraduates was initiated. The current study was conducted to evaluate the effectiveness of and feedback on COVID-19 preparedness training delivered to final-and pre-final-year undergraduate nursing students. A 3-day training was given to pre-final and final year nursing undergraduates on ECG, COVID-19 management protocols, personal protective equipment "donning and doffing", "hand hygiene", "biomedical waste management", "contact tracing" and cleaning and disinfection and simulation-based skills. Scores before and after training were conducted and mean scores were compared using a paired t-test. In total, 154 nursing students participated in the training program. Mean pre-test and post-test scores included: general instructions (21.69±2.5 and 25.09±3.29); skill procedures (5.4±1.21 and 6.3±1.2) and COVID management (22.84±3.26 and 26.48±2.06). There was a statistically significant improvement in knowledge and skills in all training sessions (p=0.0001). The mean post-test scores obtained at the OSCE stations for cardiac monitoring, prone positioning, compression-only CPR, airway, ECG and ABG ranged from 97.0% to 100.0% and all participants scored >70.0%. About 92.8% of the students felt that hands-on training enhanced their learning experiences. A need-based initiative of training final-and pre-final-year nursing students in COVID-19 support care effectively and efficiently created a skilled workforce.
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Affiliation(s)
- P Kulshreshtha
- Dr Poorvi Kulshreshtha, Additional Professor, Department of Physiology, All India Institute of Medical Sciences (AIIMS), Rishikesh, India; E-mail:
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18
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Zaghlol R, Ghazzal A, Radwan S, Ahmed S, Zaghlol L, Hofmeyer M, Rodrigo ME, Kadakkal A, Lam PH, Rao S, Weintraub WS, Molina E, Sheikh FH, Najjar SS. VENTRICULAR ARRHYTHMIAS IN END-STAGE HEART FAILURE PATIENTS ON AMBULATORY INOTROPIC THERAPY. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)00896-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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19
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Stieber F, Allen N, Carpenter K, Hu P, Alagna R, Rao S, Manissero D, Howard J, Nikolayevskyy V. Durability of COVID-19 vaccine induced T-cell mediated immune responses measured using the QuantiFERON SARS-CoV-2 assay. Pulmonology 2023; 29:151-153. [PMID: 36402704 PMCID: PMC9671490 DOI: 10.1016/j.pulmoe.2022.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- F Stieber
- QIAGEN Sciences Inc, 19300 Germantown Road, Germantown, MD 20874, USA.
| | - N Allen
- QIAGEN Sciences Inc, 19300 Germantown Road, Germantown, MD 20874, USA
| | - K Carpenter
- QIAGEN Sciences Inc, 19300 Germantown Road, Germantown, MD 20874, USA
| | - P Hu
- QIAGEN Sciences Inc, 19300 Germantown Road, Germantown, MD 20874, USA
| | - R Alagna
- QIAGEN SRL, Via Filippo Sassetti 16, 20124 Milan, Italy
| | - S Rao
- QIAGEN Sciences Inc, 19300 Germantown Road, Germantown, MD 20874, USA
| | - D Manissero
- QIAGEN Manchester Ltd, Citylabs 2.0 Hathersage Road, Manchester M13 0BH, United Kingdom
| | - J Howard
- QIAGEN Sciences Inc, 19300 Germantown Road, Germantown, MD 20874, USA
| | - V Nikolayevskyy
- QIAGEN Manchester Ltd, Citylabs 2.0 Hathersage Road, Manchester M13 0BH, United Kingdom
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Rao S, Paz M, Nugent K. Tsukamurella and mycobacterium tuberculosis pneumonia co-infection. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00312-9] [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: 01/28/2023]
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21
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Speciale Z, Rao S, Yang S, Nugent K. Student use of alternative nicotine products: analysis of the national youth tobacco survey. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00525-6] [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: 01/28/2023]
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22
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Rao S, Glavis-Bloom J, Kakish D, Tran-Harding K, Chow DS, Nguyentat M, Yeates EO, Nahmias J, Houshyar R. Impact of easing COVID-19 safety measures on trauma computed tomography imaging volumes. Emerg Radiol 2023; 30:27-32. [PMID: 36307571 PMCID: PMC9616698 DOI: 10.1007/s10140-022-02096-4] [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: 08/29/2022] [Accepted: 10/20/2022] [Indexed: 01/26/2023]
Abstract
PURPOSE The coronavirus disease 2019 (COVID-19) pandemic has led to substantial disruptions in healthcare staffing and operations. Stay-at-home (SAH) orders and limitations in social gathering implemented in spring 2020 were followed by initial decreases in healthcare and imaging utilization. This study aims to evaluate the impact of subsequent easing of SAH on trauma volumes, demand for, and turnaround times for trauma computed tomography (CT) exams, hypothesizing that after initial decreases, trauma volumes have increased as COVID safety measures have been reduced. METHODS Patient characteristics, CT imaging volumes, and turnaround time were analyzed for all adult activated emergency department trauma patients requiring CT imaging at a single Level-I trauma center (1/2018-2/2022) located in the sixth most populous county in the USA. Based on COVID safety measures in place in the state of California, three time periods were compared: baseline (PRE, 1/1/2018-3/19/2020), COVID safety measures (COVID, 3/20/2020-1/25/2021), and POST (1/26/2021-2/28/2022). RESULTS There were 16,984 trauma patients across the study (PRE = 8289, COVID = 3139, POST = 5556). The average daily trauma patient volumes increased significantly in the POST period compared to the PRE and COVID periods (13.9 vs. 10.3 vs. 10.1, p < 0.001), with increases in both blunt (p < 0.001) and penetrating (p = 0.002) trauma. The average daily number of trauma CT examinations performed increased significantly in the POST period compared to the PRE and COVID periods (56.7 vs. 48.3 vs. 47.6, p < 0.001), with significant increases in average turnaround time (47 min vs. 31 and 37, p < 0.001). CONCLUSION After initial decreases in trauma radiology volumes following stay-at-home orders, subsequent easing of safety measures has coincided with increases in trauma imaging volumes above pre-pandemic levels and longer exam turnaround times.
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Affiliation(s)
- Sriram Rao
- Department of Radiological Sciences, University of California Irvine, Orange, CA, USA
| | - Justin Glavis-Bloom
- Department of Radiological Sciences, University of California Irvine, Orange, CA, USA
| | - David Kakish
- Department of Radiological Sciences, University of California Irvine, Orange, CA, USA
| | - Karen Tran-Harding
- Department of Radiological Sciences, University of California Irvine, Orange, CA, USA
| | - Daniel S Chow
- Department of Radiological Sciences, University of California Irvine, Orange, CA, USA
| | - Michael Nguyentat
- Department of Radiological Sciences, University of California Irvine, Orange, CA, USA
| | - Eric O Yeates
- Department of Surgery, University of California Irvine, Orange, CA, USA
| | - Jeffry Nahmias
- Department of Surgery, University of California Irvine, Orange, CA, USA
| | - Roozbeh Houshyar
- Department of Radiological Sciences, University of California Irvine, Orange, CA, USA.
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Nolan J, Mildred H, Broadbear JH, Knight T, Rao S. Are there underlying differences between sexually diverse and non-sexually diverse people diagnosed with Borderline Personality Disorder? Psychology & Sexuality 2022. [DOI: 10.1080/19419899.2022.2137057] [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: 10/24/2022]
Affiliation(s)
| | | | | | | | - S. Rao
- Spectrum, Eastern Health & Monash University
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24
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Condello F, Rao S, Maurina M, Sturla M, Jolly S, Pancholy SB, Bertrand O, Lefevre T, Condorelli G, Stefanini GGS, Reimers B, Valgimigli M, Ferrante G. Effects of distal radial access vs conventional radial access in patients undergoing coronary angiography and/or intervention: a meta-analysis of randomised trials. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2053] [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
Background
Recently the distal radial access (DRA) technique has been introduced for coronary angiography and intervention as an alternative to the conventional radial access (RA).
Purpose
The aim of this study was to provide a quantitative appraisal of the effects of DRA vs conventional RA for coronary angiography with or without intervention.
Methods
The PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched for randomised clinical trials (RCT) comparing DRA versus RA for coronary angiography and/or intervention. Data were pooled by meta-analysis using a random-effects model. The number of patients needed to treat for an additional beneficial outcome (NNTB) and the number needed to treat for an additional harmful outcome (NNTH) were calculated. The primary endpoint was radial artery occlusion (RAO) at the longest available follow-up. Additional secondary outcomes were assessed.
Results
A total of 13 RCT including 4,901 patients were identified and included in the final analysis. Coronary angiography alone was performed in 3 studies, percutaneous coronary intervention was performed in a variable proportion of patients ranging from 24% to 100% across studies. Study population included patients with chronic coronary syndrome in the large majority, and the proportion of acute coronary syndrome ranged from to 31% to 100% across studies. Compared with RA, DRA was associated with a significant lower risk of RAO, either detected at the longest follow-up (risk ratio [RR]: 0.36; 95% CI: 0.23 to 0.58; p<0.001, NNTB = 24.5), or in-hospital (RR: 0.32; 95% CI: 0.18 to 0.57; p<0.001, NNTB = 21.5), as well as Early discharge after transradial stenting of coronary arteries (EASY) Scale ≥ II hematoma (RR: 0.46; 95% CI: 0.22 to 0.97; p=0.04, NNTB = 66). By contrast, DRA was associated with a higher risk of access site crossover (RR: 3.43; 95% CI: 1.88 to 6.25, p<0.001, NNTH = 10), a longer time for radial artery puncture (standardized mean difference [SMD]: 3.56; 95% CI: 0.96 to 6.16; p<0.001), and sheath insertion (SMD: 0.38; 95% CI: 0.11 to 0.65, p=0.006), and a higher number of puncture attempts (SMD: 0.59, 95% CI: 0.48 to 0.69, p<0.001). A meta-regression analysis showed that increasing age in the RA group was associated with a reduced effect of DRA, compared with RA, on the risk of RAO. No significant effect of other variables such as the prevalence of female sex, diabetes, smoking status, acute coronary syndrome, and percutaneous coronary intervention was found.
Conclusions
Compared with RA, DRA is associated with lower risks of RAO and EASY ≥ II hematoma, but requires longer time for radial artery puncture and sheath insertion, more puncture attempts and a higher access site crossover.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- F Condello
- Humanitas Research Hospital , Milan , Italy
| | - S Rao
- Duke Clinical Research Institute, Cardiology , Durham , United States of America
| | - M Maurina
- Humanitas Research Hospital , Milan , Italy
| | - M Sturla
- Humanitas Research Hospital , Milan , Italy
| | - S Jolly
- Mcmaster University , Ontario , Canada
| | - S B Pancholy
- The Wright Center for Graduate Medical Education , Scranton , United States of America
| | - O Bertrand
- Quebec Heart and Lung Institute , Quebec , Canada
| | - T Lefevre
- Institut Cardiovasculaire Paris Sud , Paris , France
| | | | | | - B Reimers
- Humanitas Research Hospital , Milan , Italy
| | - M Valgimigli
- Cardiocentro Ticino Institute , Lugano , Switzerland
| | - G Ferrante
- Humanitas Research Hospital , Milan , Italy
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Lai X, Yang X, Rao S, Zhu Z, Cong X, Ye J, Zhang W, Liao Y, Cheng S, Xu F. Advances in physiological mechanisms of selenium to improve heavy metal stress tolerance in plants. Plant Biol (Stuttg) 2022; 24:913-919. [PMID: 35583793 DOI: 10.1111/plb.13435] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 05/02/2022] [Indexed: 06/15/2023]
Abstract
Selenium (Se) is a metalloid mineral nutrient for human and animal health. Plants are the main foodstuff source of the Se intake of humans. For plants, the addition of an appropriate amount of Se could promotes growth and development, and improves the tolerance to environmental stress, especially stress from some of heavy metals (HM) stress, such as cadmium (Cd) and mercury (Hg). This paper mainly reviews and summarizes the physiological mechanism of Se in enhancing HM stress tolerance in plants. The antagonistic effect of Se on HM is a comprehensive effect that includes many physiological mechanisms. Se can promote the removal of excessive reactive oxygen species and reduce the oxidative damage of plant cells under HM elements stress. Se participates in the regulation of the transportation and distribution of HM ions in plants, and alleviates the damage caused by of HM stress. Moreover, Se combine with HM elements to form Se-HM complexes and promote the production of phytochelatins (PCs), thereby reducing the accumulation of HM ions in plants. Overall, Se plays an important role in plant response to HM stress, but current studies mainly focus on physiological mechanism, and further in-depth study on the molecular mechanism is essential to confirm the participation of Se in plant response to environmental stress. This review helps to comprehensively understand the physiological mechanism of Se in plant tolerance against to HM stress of plants, and provides important theoretical support for the practical application of Se in environmental remediation and agricultural development.
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Affiliation(s)
- X Lai
- College of Horticulture and Gardening, Yangtze University, Jingzhou, China
| | - X Yang
- College of Horticulture and Gardening, Yangtze University, Jingzhou, China
| | - S Rao
- College of Horticulture and Gardening, Yangtze University, Jingzhou, China
- School of Modern Industry for Selenium Science and Engineering, National R&D Center for Se-rich Agricultural Products Processing Technology, Wuhan Polytechnic University, Wuhan, China
| | - Z Zhu
- School of Modern Industry for Selenium Science and Engineering, National R&D Center for Se-rich Agricultural Products Processing Technology, Wuhan Polytechnic University, Wuhan, China
| | - X Cong
- School of Modern Industry for Selenium Science and Engineering, National R&D Center for Se-rich Agricultural Products Processing Technology, Wuhan Polytechnic University, Wuhan, China
- Enshi Se-Run Health Tech Development Co., Ltd, Enshi, China
| | - J Ye
- College of Horticulture and Gardening, Yangtze University, Jingzhou, China
| | - W Zhang
- College of Horticulture and Gardening, Yangtze University, Jingzhou, China
| | - Y Liao
- College of Horticulture and Gardening, Yangtze University, Jingzhou, China
| | - S Cheng
- School of Modern Industry for Selenium Science and Engineering, National R&D Center for Se-rich Agricultural Products Processing Technology, Wuhan Polytechnic University, Wuhan, China
| | - F Xu
- College of Horticulture and Gardening, Yangtze University, Jingzhou, China
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Segelov E, Body A, Lal L, Abdulla H, Turville S, Naing Z, Opat S, Leahy M, Balendra J, Hamad N, Mccuaig R, Rao S, Lineburg K, Smith C, MacIntyre C, Milch V, Busija L, Ahern E. 1611P Clinical determinants of SARS-CoV-2 vaccine response in adults with cancer. Ann Oncol 2022. [PMCID: PMC9472460 DOI: 10.1016/j.annonc.2022.07.1704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Hobbis L, Duncan J, Kinnaird F, Fong C, Li S, Gordon A, Chau I, Starling N, Rao S, Watkins D, Fribbens C, Cunningham D. CN45 The Gastrointestinal and Lymphoma Unit Advanced Nurse Practitioner role in clinical research at The Royal Marsden Hospital. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Turkes F, Crux R, Tran A, Cartwright E, Rana I, Johnston E, Dunlop A, Thomas J, Smith A, Smyth E, Fribbens C, Rao S, Watkins D, Chau I, Starling N, Cunningham D. 1253P Safety and efficacy of Wnt inhibition with a DKK1 inhibitor, DKN-01, in combination with atezolizumab in patients with advanced oesophagogastric adenocarcinoma: Phase IIa results of the WAKING trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Badwe R, Parmar V, Nair N, Hawaldar R, Joshi S, Pawar S, Kadayaprath G, Borthakur B, Rao S, Pandya S, B S, Chitale P, Neve R, Harris C, Srivastava A, Siddique S, Vanmali V, Dewade A, Gaikwad V, Gupta S. 137MO Effect of peri-tumoral infiltration of local anaesthetic prior to surgery on survival in early breast cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Enoch S, Hasarova Z, Cronin M, Bridgwood K, Rao S, Kluxen F, Frericks M. SOC-V-01 Read-Across of the genotoxicity of active ingredients and residues in pesticides/pesticidal products using a novel metabolic similarity approach. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.190] [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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Velasquez-Munoz A, Meza-Correa N, Rao S, Manríquez D, Román-Muniz IN, Pinedo PJ. Effect of a 2-step probiotic program on digestive health and performance of Holstein heifer calves. J Dairy Sci 2022; 105:7642-7653. [PMID: 35931480 DOI: 10.3168/jds.2021-21589] [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: 11/16/2021] [Accepted: 05/11/2022] [Indexed: 11/19/2022]
Abstract
Managing the composition of the bacterial communities in the digestive tract with the use of probiotics that enhance protective microflora could result in positive effects on health and performance of calves. The objective of this study was to evaluate a 2-step probiotic program (added to colostrum and milk) on the digestive health and growth of preweaning Holstein heifers. A randomized clinical trial was conducted from July to October 2020 in a calf rearing facility in Colorado. Calves were housed in pairs sharing the same treatment in 2 polyethylene hutches within a common area of 4.50 m2. A total of 232 calves were enrolled at birth and randomly allocated into 2 treatment groups [control (CTR) = 116; treatment (PB) = 116] and followed until weaning (64 ± 3 d). Treatment consisted of 2 formulations of a multistrain bacterial-based probiotic added in colostrum (PBF1) and milk (PBF2). Treatment calves received 2 g of PBF1 added to each colostrum feeding, and 1 g of PBF2 added to the milk at the morning feeding 3 times per week up to weaning. Calf weight was collected at birth, at 30 d of age, and at weaning. Serum total protein was determined at age 3 ± 1 d and a health assessment was completed 3 times per week. Statistical analyses were performed using SAS, with calf considered the experimental unit clustered by housing pair. Cox proportional hazard analysis and time to event analysis were used to compare time to the first diarrhea event and time to recovery between treatment groups. The total number of diarrhea events and culling were assessed by Poisson regression and logistic regression analysis, respectively. Linear regression was performed to evaluate differences in average daily gain by treatment group. Overall, the mean (± standard error) temperature humidity index (THI) was 75 (± 0.44) units during the study period, which resulted in continuous exposure to heat stress in the day hours. No difference between treatment groups was observed in serum total protein. The overall incidence of diarrhea was 96.6% (CTR = 99%, PB = 95%); no differences were determined in the hazard of a first diarrhea episode or in the median time to the first diarrhea event (11 d in both groups). Similarly, no differences were found in the likelihood of recovery or in the median time to recovery from diarrhea (7 d in both groups). Likewise, treatment group was not associated with the number of diarrhea events, mean (± standard error, g/d) average daily gain from birth to weaning [CTR = 562.5 (13.9); PB = 570.8 (13.5)], or with the odds of culling. The most prevalent pathogen isolated from feces was Clostridium, which tended to be more frequent in CTR calves than PB calves. In conclusion, the probiotic program did not affect the incidence of enteric disease or the growth of preweaning heifer calves.
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Affiliation(s)
- A Velasquez-Munoz
- Department of Animal Sciences, Colorado State University, Fort Collins 80523-1171
| | - N Meza-Correa
- Escuela de Medicina Veterinaria, Universidad Tecnológica de Pereira, Manizales, Colombia
| | - S Rao
- Department of Clinical Sciences, Colorado State University, Fort Collins 80523-1601
| | - D Manríquez
- Department of Animal Sciences, Colorado State University, Fort Collins 80523-1171
| | - I N Román-Muniz
- Department of Animal Sciences, Colorado State University, Fort Collins 80523-1171
| | - P J Pinedo
- Department of Animal Sciences, Colorado State University, Fort Collins 80523-1171.
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Bergstrom T, Frey M, Rao S, Bass L. Comparison of post‐operative inflammatory response in horses undergoing elective castration treated preoperatively with ceftiofur crystalline free acid or procaine penicillin G. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- T. Bergstrom
- Department of Clinical Sciences Colorado State University College of Veterinary Medicine and Biomedical Sciences Fort Collins Colorado USA
| | - M. Frey
- Department of Clinical Sciences Colorado State University College of Veterinary Medicine and Biomedical Sciences Fort Collins Colorado USA
| | - S. Rao
- Department of Clinical Sciences Colorado State University College of Veterinary Medicine and Biomedical Sciences Fort Collins Colorado USA
| | - L. Bass
- Department of Clinical Sciences Colorado State University College of Veterinary Medicine and Biomedical Sciences Fort Collins Colorado USA
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Rao S, Anandappa G, Capdevila J, Dahan L, Evesque L, Kim S, Saunders MP, Gilbert DC, Jensen LH, Samalin E, Spindler KL, Tamberi S, Demols A, Guren MG, Arnold D, Fakih M, Kayyal T, Cornfeld M, Tian C, Catlett M, Smith M, Spano JP. A phase II study of retifanlimab (INCMGA00012) in patients with squamous carcinoma of the anal canal who have progressed following platinum-based chemotherapy (POD1UM-202). ESMO Open 2022; 7:100529. [PMID: 35816951 PMCID: PMC9463376 DOI: 10.1016/j.esmoop.2022.100529] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 06/06/2022] [Indexed: 02/07/2023] Open
Abstract
Background Locally advanced or metastatic squamous carcinoma of the anal canal (SCAC) has poor prognosis following platinum-based chemotherapy. Retifanlimab (INCMGA00012), a humanized monoclonal antibody targeting programmed death protein-1 (PD-1), demonstrated clinical activity across a range of solid tumors in clinical trials. We present results from POD1UM-202 (NCT03597295), an open-label, single-arm, multicenter, phase II study evaluating retifanlimab in patients with previously treated advanced or metastatic SCAC. Patients and methods Patients ≥18 years of age had measurable disease and had progressed following, or were ineligible for, platinum-based therapy. Retifanlimab 500 mg was administered intravenously every 4 weeks. The primary endpoint was overall response rate (ORR) by independent central review. Secondary endpoints were duration of response (DOR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and safety. Results Overall, 94 patients were enrolled. At a median follow-up of 7.1 months (range, 0.9-19.4 months), ORR was 13.8% [95% confidence interval (CI) 7.6% to 22.5%], with one complete response (1.1%) and 12 partial responses (12.8%). Responses were observed regardless of human immunodeficiency virus or human papillomavirus status, programmed death ligand 1 (PD-L1) expression, or liver metastases. Stable disease was observed in 33 patients (35.1%) for a DCR of 48.9% (95% CI 38.5% to 59.5%). Median DOR was 9.5 months (range, 5.6 months-not estimable). Median (95% CI) PFS and OS were 2.3 (1.9-3.6) and 10.1 (7.9-not estimable) months, respectively. Retifanlimab safety in this population was consistent with previous experience for the PD-(L)1 inhibitor class. Conclusions Retifanlimab demonstrated clinically meaningful and durable antitumor activity, and an acceptable safety profile in patients with previously treated locally advanced or metastatic SCAC who have progressed on or are intolerant to platinum-based chemotherapy. Retifanlimab (PD-1 inhibitor) monotherapy demonstrated encouraging results in patients with platinum-refractory SCAC. Clinically meaningful antitumor activity was reported with ORR of 13.8% and stable disease in 35.1%, for a DCR of 48.9%. Observed responses in advanced SCAC were durable (median 9.5 months). Acceptable safety profile consistent with that reported for the PD-(L)1 inhibitor class. Promising results warrant further investigation of retifanlimab in advanced SCAC as well as earlier stages of disease.
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Affiliation(s)
- S Rao
- The Royal Marsden, London, UK.
| | | | - J Capdevila
- Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Teknon-IOB, Barcelona, Spain
| | - L Dahan
- Hôpital de la Timone, Marseille, France
| | - L Evesque
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - S Kim
- Centre Hospitalier Régional Universitaire de Besançon, Besançon, France
| | | | - D C Gilbert
- Sussex Cancer Centre, Royal Sussex County Hospital, Brighton, UK
| | - L H Jensen
- University Hospital of Southern Denmark, Vejle, Denmark
| | - E Samalin
- Department of Digestive Oncology, Montpellier Cancer Institute (ICM), Montpellier University, Montpellier, France
| | | | - S Tamberi
- Department of Oncology/Haematology, AUSL Romagna Oncology Unit Faenza Hospital (RA), Faenza, Italy
| | - A Demols
- Department of Gastroenterology and GI Oncology, CUB Hôpital Erasme, Université Libre de Bruxelles, Anderlecht, Belgium
| | - M G Guren
- Oslo University Hospital and University of Oslo, Oslo, Norway
| | - D Arnold
- Asklepios Tumorzentrum Hamburg, AK Altona, Hamburg, Germany
| | - M Fakih
- City of Hope Comprehensive Cancer Center, Duarte, USA
| | - T Kayyal
- Renovatio Clinical, Houston, USA
| | | | - C Tian
- Incyte Corporation, Wilmington, USA
| | | | - M Smith
- Incyte Corporation, Wilmington, USA
| | - J-P Spano
- APHP-Sorbonne University-IUC, Paris, France
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Andrews R, Di Geronimo R, Virk H, Goldman R, Pillai R, Rao S, King E, Shah A, Vu C. Abstract No. 587 Morbidity and mortality conferencing as a quality assessment tool in interventional radiology: a survey of Society of Interventional Radiology members. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.569] [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: 11/27/2022] Open
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Key C, Di Geronimo R, Jenner Z, Nelson A, Kim P, Khan A, Liou F, King E, Shah A, Pillai R, Vu C, Andrews R, Rao S. Abstract No. 257 Financial analysis of outpatient evaluation and management billing by interventional radiologists in comparison to other specialties. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Kim P, Di Geronimo R, Vu C, Pillai R, Rao S, Shah A, King E, Khan A, Liou F, Key C, Nelson A, Andrews R. Abstract No. 313 Trends in percutaneous musculoskeletal procedure volume among Medicare patients from 2010-2018 by specialty. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.394] [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: 10/18/2022] Open
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Krishna A, Ms A, Fernandes D, Ag H, Rao S, Shankar S, Banerjee S, Sunny J, Srinivas C, Lobo D. 9P A prospective study of gefitinib in patients with recurrent or metastatic cervical cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Liou F, Di Geronimo R, Rao S, Shah A, King E, Pillai R, Andrews R, Vu C, Goldman R. Abstract No. 92 Effect on intra-procedural metrics of repeat imaging with CT arteriography prior to conventional angiography: analysis of trauma patients with active extravasation on initial portal venous phase imaging. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.173] [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: 11/17/2022] Open
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Slater S, Cartwright E, Saffery C, Tran A, Smith G, Bacason M, Zhitkov O, Rana I, Johnston E, Sanna I, Aresu M, Kohoutova D, Terlizzo M, Turkes F, Smyth E, Mansoor W, Fribbens C, Rao S, Watkins D, Starling N, Chau I, Cunningham D. PD-2 EMERGE: A multi-centre, non-randomised, single-arm phase II study investigating domatinostat plus avelumab in patients with previously treated advanced mismatch repair-proficient oesophagogastric and colorectal adenocarcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Khan A, Di Geronimo R, Liou F, Kim P, Key C, Nelson A, King E, Shah A, Vu C, Jenner Z, Yap P, Pillai R, Andrews R, Rao S. Abstract No. 132 Trends in percutaneous ablation procedures among Medicare patients from 2010-2018: an analysis of procedure volume, specialty involvement, and reimbursement rates. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.213] [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: 10/18/2022] Open
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Krishna A, Ms A, Fernandes D, Ag H, Rao S, Shankar S, Banerjee S, Sunny J, Srinivas C, Lobo D. 14P A prospective study of comparision of two HDR brachytherapy regimens in treatment of cervical cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Lian D, Wang W, Liu L, Wang J, Rao S, Zhou J. CT volumetry helps predict prognosis of large hepatocellular carcinoma after resection. Clin Radiol 2022; 77:e599-e605. [PMID: 35483982 DOI: 10.1016/j.crad.2022.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 03/23/2022] [Indexed: 11/03/2022]
Abstract
AIM To determine whether the tumour volume measurement on preoperative contrast-enhanced computed tomography (CT) could be used to predict the overall survival patients with large hepatocellular carcinoma (>5 cm) after resection. MATERIALS AND METHODS This study included 171 patients with surgically confirmed hepatocellular carcinoma who underwent preoperative CT. The largest diameter, the product of the axial dimension, tumour volume, and tumour-to-liver volume ratio (TTLVR) on CT images were measured and calculated. The univariate and multivariate Cox proportional hazard ratio regression models were used to identify the impact of the tumour burden-related risk factors on overall survival. RESULTS In multivariate analysis, TTLVR (p=0.042) and major vascular invasion (p=0.006) were independently associated with overall survival of patients with hepatocellular carcinoma after the resection. The group in which the patients had a low TTLVR showed higher cumulative survival rates than patients with a TTLVR (p=0.004). Patients with a low TTLVR (≤26.23%) and absence of major vascular invasion had significantly higher cumulative survival rates compared to those patients with hepatocellular carcinoma with either or both the risk factors (p=0.001). CONCLUSION A higher TTLVR in combination with the presence of major vascular invasion was associated with poorer overall survival in patients with large hepatocellular carcinoma after resection.
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Affiliation(s)
- D Lian
- Department of Radiology, Xiamen Branch, Zhongshan Hospital, Fudan University, No. 668 Jinhu Road, Huli District, Xiamen 361015, China
| | - W Wang
- Department of Radiology, Cancer Center, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Xuhui District, Shanghai 200032, China
| | - L Liu
- Department of Radiology, Cancer Center, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Xuhui District, Shanghai 200032, China
| | - J Wang
- Department of Radiology, Cancer Center, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Xuhui District, Shanghai 200032, China
| | - S Rao
- Department of Radiology, Cancer Center, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Xuhui District, Shanghai 200032, China.
| | - J Zhou
- Department of Radiology, Xiamen Branch, Zhongshan Hospital, Fudan University, No. 668 Jinhu Road, Huli District, Xiamen 361015, China.
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Ramachandran A, Siddiqui E, Reyentovich A, Lonze B, Saraon T, Rao S, Katz S, Goldberg R, Kadosh B, DiVita M, Cruz J, Carillo J, Smith D, Moazami N, Gidea C. Transplant Outcomes in Hearts with Moderate to Severe Left Ventricular Hypertrophy After the 2018 OPTN/UNOS Allocation Changes. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1690] [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: 10/18/2022] Open
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Sikand N, Maidman S, Saric M, Reyentovich A, Saraon T, Rao S, Katz S, Goldberg R, Kadosh B, DiVita M, Cruz J, Riggio S, Moazami N, Gidea C. Defining the Normal Values for Left Ventricular Global Longitudinal Strain in Adult Heart Transplanted Patients. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1146] [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] Open
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Singh M, Brar V, Hofmeyer M, Rodrigo ME, Kadakkal A, Lam P, Najjar S, Rao S. Effect Of Tricuspid Regurgitation On Decongestion And Right Atrial Pressure Changes In Patients With Decompensated Heart Failure. J Card Fail 2022. [DOI: 10.1016/j.cardfail.2022.03.067] [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: 12/01/2022]
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Patel PA, Rao S, Goswami RM, Snipelisky D, Cyrille-Superville NB, Jeng E, Sinha SS, Feliberti JP, DeVore A, Najjar SS, Grinstein J. DIFFERENCES IN HEMODYNAMIC MEASUREMENT AND INTERPRETATION BETWEEN HEART FAILURE AND INTERVENTIONAL CARDIOLOGISTS. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01222-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Fox J, Adler S, Rao S, Sukhun R, Lee L, Henry C, Lafountaine J, Sinha U, O'Reilly T. BBP-711 for the treatment of hyperoxaluria: A first-in-human, randomized, placebo-controlled safety, tolerability, pharmacokinetic, and pharmacodynamic study in healthy adult volunteers. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01001-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Anvekar A, Athalye-Jape G, Panchal H, Rao S, Kohan R. OUTCOMES OF NEONATAL CHYLOUS EFFUSIONS: A 20-YEAR WEST-AUSTRALIAN TERTIARY CENTER EXPERIENCE. Lymphology 2022. [DOI: 10.2458/lymph.4841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Neonatal chylous effusions are rare entity with limited evidence-based management. We conducted a retrospective review of neonates admitted to King Edward Memorial and Princess Margaret/Perth Children's Hospital over 20 years with laboratory-confirmed chylous effusions. A total of 51 infants with chylous effusion were identified. Median gestational age and birth weight were 35.5 weeks and 2620 grams respectively. Congenital [27/51] and acquired [24/51] cases were included. Antenatal interventions were performed in 17/22 with antenatal hydrops and 50/51 needed postnatal drains. Effusions were monitored with serial (≥2) chest ultrasounds in 29/51 infants and multiple (≥5) x-rays in 45/51 infants. Median duration of mechanical ventilation, oxygen requirement, and hospital stay was 294.5 hours, 400 hours, and 49 days respectively. 39/51 received medium chain triglyceride (MCT) diet while 8/51 received octreotide. Six infants died during hospital stay. 12/19 had normal developmental assessment at one-year. The acquired group had higher number of xrays done, need for MCT diet and inotropes, and hospital stay vs congenital group. Duration of drains, radiological investigations and immunoglobulin administration were higher in neonates who received octreotide. Syndromic association, duration of ventilation and oxygenation were risk factors for mortality. In our setting, neonatal chylous effusions are associated with significant morbidity and mortality.
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Affiliation(s)
| | | | | | - S. Rao
- Perth Children Hospital, Perth
| | - R. Kohan
- King Edward Memorial Hospital, Perth
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Enoch SJ, Hasarova Z, Cronin MTD, Bridgwood K, Rao S, Kluxen FM, Frericks M. Sub-structure-based category formation for the prioritisation of genotoxicity hazard assessment for pesticide residues: Sulphonyl ureas. Regul Toxicol Pharmacol 2022; 129:105115. [PMID: 35017022 DOI: 10.1016/j.yrtph.2022.105115] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/19/2021] [Accepted: 01/05/2022] [Indexed: 10/19/2022]
Abstract
In dietary risk assessment, residues of pesticidal ingredients or their metabolites need to be evaluated for their genotoxic potential. The European Food Safety Authority recommend a tiered approach focussing assessment and testing on classes of similar chemicals. To characterise similarity and to identify structural alerts associated with genotoxic concern, a set of chemical sub-structures was derived for an example dataset of 74 sulphonyl urea agrochemicals for which either Ames, chromosomal aberration or micronucleus test results are publicly available. This analysis resulted in a set of seven structural alerts that define the chemical space, in terms of the common parent and metabolic scaffolds, associated with the sulphonyl urea chemical class. An analysis of the available profiling schemes for DNA and protein reactivity shows the importance of investigating the predictivity of such schemes within a well-defined area of structural space. Structural space alerts, covalent chemistry profiling and physico-chemistry properties were combined to develop chemical categories suitable for chemical prioritisation. The method is a robust and reproducible approach to such read-across predictions, with the potential to reduce unnecessary testing. The key challenge in the approach was identified as being the need for pesticide-class specific metabolism data as the basis for structural space alert development.
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Affiliation(s)
- S J Enoch
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, England, UK.
| | - Z Hasarova
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, England, UK
| | - M T D Cronin
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, England, UK
| | | | - S Rao
- Gowan Company, Yuma, AZ, USA
| | - F M Kluxen
- ADAMA Deutschland GmbH, Cologne, Germany
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Rao S, Bui TL, Sasani A, Sadeghi B, Macherla A, Houshyar R, Abi-Jaoudeh N. Irreversible electroporation for pancreatic cancer using intraprocedural cone-beam computed tomography fusion navigation: a case report. J Med Case Rep 2021; 15:566. [PMID: 34819143 PMCID: PMC8613957 DOI: 10.1186/s13256-021-03152-2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/15/2021] [Indexed: 11/12/2022] Open
Abstract
Background Patients diagnosed with locally advanced pancreatic cancer are usually not eligible for surgical resection because of significant vascular involvement. Stereotactic body radiation therapy and chemotherapy are the treatments recommended by the National Comprehensive Cancer Network criteria. For patients who do not respond to or tolerate stereotactic body radiation therapy and/or chemotherapy, a new option is irreversible electroporation. Irreversible electroporation is a nonthermal minimally invasive ablation technique that uses electrical pulses to induce apoptosis of tumor cells without damage to the extracellular matrix, thus preserving ducts and vessels. Irreversible electroporation requires very precise needle placement, which has limited its ubiquitous use. Intraprocedural cone-beam computed tomography with navigation can be fused with previous imaging to provide real-time tumor navigation capabilities during the procedure to allow for more accurate needle placement and treatment. Here, we present a patient who underwent percutaneous irreversible electroporation with intraprocedural cone-beam computed tomography fusion guidance to treat his pancreatic cancer. Case presentation The patient, an 88-year-old White male, initially presented with abdominal pain, and was ultimately diagnosed with locally advanced pancreatic cancer. He has an excellent performance status and no other comorbidities. He was started on chemotherapy and radiation therapy, with good response. However, continued vascular involvement of the tumors precluded him from safe surgical resection. The patient underwent irreversible electroporation with intraprocedural cone-beam computed tomography fusion navigation. The primary lesion demonstrates no residual tumor, and the soft tissue involvement of the adjacent vasculature has stabilized. Conclusions Although not curative on its own, irreversible electroporation holds promise as a treatment option for patients with locally advanced pancreatic cancer to increase downsizing to curative surgery or increase quality of life. Cone-beam computed tomography navigation can improve irreversible electroporation by providing guidance during needle guidance. Image fusion with previous advanced imaging can improve lesion visualization and targeting, thereby improving the effectiveness of irreversible electroporation.
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Affiliation(s)
- Sriram Rao
- Department of Radiological Sciences, University of California Irvine, 101 The City Drive South, Route 140, Orange, CA, 92868, USA
| | - Thanh-Lan Bui
- Department of Radiological Sciences, University of California Irvine, 101 The City Drive South, Route 140, Orange, CA, 92868, USA
| | - Ali Sasani
- Department of Radiological Sciences, University of California Irvine, 101 The City Drive South, Route 140, Orange, CA, 92868, USA
| | - Ben Sadeghi
- Department of Radiological Sciences, University of California Irvine, 101 The City Drive South, Route 140, Orange, CA, 92868, USA
| | - Anvesh Macherla
- Department of Radiological Sciences, University of California Irvine, 101 The City Drive South, Route 140, Orange, CA, 92868, USA
| | - Roozbeh Houshyar
- Department of Radiological Sciences, University of California Irvine, 101 The City Drive South, Route 140, Orange, CA, 92868, USA.
| | - Nadine Abi-Jaoudeh
- Department of Radiological Sciences, University of California Irvine, 101 The City Drive South, Route 140, Orange, CA, 92868, USA
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