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Short RT, Lin F, Nair S, Terry JG, Carr JJ, Kandula NR, Lloyd-Jones D, Kanaya AM. Comparing coronary artery cross-sectional area among asymptomatic South Asian, White, and Black participants: the MASALA and CARDIA studies. BMC Cardiovasc Disord 2024; 24:158. [PMID: 38486153 PMCID: PMC10938784 DOI: 10.1186/s12872-024-03811-4] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/22/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND South Asian individuals have high risk of atherosclerotic cardiovascular disease (ASCVD). Some investigators suggest smaller coronary artery size may be partially responsible. METHODS We compared the left anterior descending (LAD) artery cross-sectional area (CSA) (lumen and arterial wall) among South Asians in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study with White and Black participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study, adjusting for BMI, height, and other ASCVD risk factors. We used thin-slice non-contrast cardiac computed tomography to measure LAD CSA. We used linear regression models to determine whether race/ethnicity was associated with LAD CSA after adjusting for demographic factors, BMI, height, coronary artery calcium (CAC), and traditional cardiovascular risk factors. RESULTS Our sample included 3,353 participants: 513 self-identified as South Asian (44.4% women), 1286 as Black (59.6% women), and 1554 as White (53.5% women). After adjusting for age, BMI, height, there was no difference in LAD CSA between South Asian men and women compared to White men and women, respectively. After full adjustment for CVD risk factors, LAD CSA values were: South Asian women (19.9 mm2, 95% CI [18.8 - 20.9]) and men (22.3 mm2, 95% CI [21.4 - 23.2]; White women (20.0 mm2, 95% CI [19.4-20.5]) and men (23.6 mm2, 95% CI [23.0-24.2]); and Black women (21.6 mm2, 95% CI [21.0 - 22.2]) and men (26.0 mm2, 95% CI [25.3 - 26.7]). Height, BMI, hypertension, CAC, and age were positively associated with LAD CSA; current and former cigarette use were inversely associated. CONCLUSIONS South Asian men and women have similar LAD CSA to White men and women, and smaller LAD CSA compared to Black men and women, respectively, after accounting for differences in body size. Future studies should determine whether LAD CSA is associated with future ASCVD events.
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Grants
- R01 HL093009 NHLBI NIH HHS
- UL1 RR024131 NCRR NIH HHS
- K24 HL112827 NHLBI NIH HHS
- P30 DK098722 NIDDK NIH HHS
- P30 DK092924 NIDDK NIH HHS
- 2R01HL093009, UL1TR001872, 5K24HL112827, HHSN268201800005I, HHSN268201800007I, HHSN268201800003I, HHSN268201800006I, HHSN268201800004I, R01-HL098445 NHLBI NIH HHS
- National Heart, Lung, and Blood Institute
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Affiliation(s)
- R T Short
- University of California San Francisco, San Francisco, USA.
| | - F Lin
- University of California San Francisco, San Francisco, USA
| | - S Nair
- Vanderbilt University Medical Center, Nashville, USA
| | - J G Terry
- Vanderbilt University Medical Center, Nashville, USA
| | - J J Carr
- Vanderbilt University Medical Center, Nashville, USA
| | | | | | - A M Kanaya
- University of California San Francisco, San Francisco, USA
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Harioudh MK, Perez J, Chong Z, Nair S, So L, McCormick KD, Ghosh A, Shao L, Srivastava R, Soveg F, Ebert TS, Atianand MK, Hornung V, Savan R, Diamond MS, Sarkar SN. Oligoadenylate synthetase 1 displays dual antiviral mechanisms in driving translational shutdown and protecting interferon production. Immunity 2024; 57:446-461.e7. [PMID: 38423012 PMCID: PMC10939734 DOI: 10.1016/j.immuni.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 11/15/2023] [Accepted: 02/05/2024] [Indexed: 03/02/2024]
Abstract
In response to viral infection, how cells balance translational shutdown to limit viral replication and the induction of antiviral components like interferons (IFNs) is not well understood. Moreover, how distinct isoforms of IFN-induced oligoadenylate synthetase 1 (OAS1) contribute to this antiviral response also requires further elucidation. Here, we show that human, but not mouse, OAS1 inhibits SARS-CoV-2 replication through its canonical enzyme activity via RNase L. In contrast, both mouse and human OAS1 protect against West Nile virus infection by a mechanism distinct from canonical RNase L activation. OAS1 binds AU-rich elements (AREs) of specific mRNAs, including IFNβ. This binding leads to the sequestration of IFNβ mRNA to the endomembrane regions, resulting in prolonged half-life and continued translation. Thus, OAS1 is an ARE-binding protein with two mechanisms of antiviral activity: driving inhibition of translation but also a broader, non-canonical function of protecting IFN expression from translational shutdown.
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Affiliation(s)
- Munesh K Harioudh
- Cancer Virology Program, UPMC Hillman Cancer Center, Pittsburgh, PA, USA; Department of Microbiology and Molecular Genetics, Pittsburgh, PA, USA
| | - Joseph Perez
- Cancer Virology Program, UPMC Hillman Cancer Center, Pittsburgh, PA, USA; Department of Microbiology and Molecular Genetics, Pittsburgh, PA, USA
| | - Zhenlu Chong
- Departments of Medicine, Molecular Microbiology, Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Sharmila Nair
- Departments of Medicine, Molecular Microbiology, Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Lomon So
- Department of Immunology, School of Medicine, University of Washington, Seattle, WA, USA; Division of Immunology, Benaroya Research Institute, Seattle, WA, USA
| | - Kevin D McCormick
- Cancer Virology Program, UPMC Hillman Cancer Center, Pittsburgh, PA, USA; Department of Microbiology and Molecular Genetics, Pittsburgh, PA, USA
| | - Arundhati Ghosh
- Cancer Virology Program, UPMC Hillman Cancer Center, Pittsburgh, PA, USA; Department of Microbiology and Molecular Genetics, Pittsburgh, PA, USA
| | - Lulu Shao
- Cancer Virology Program, UPMC Hillman Cancer Center, Pittsburgh, PA, USA; Department of Microbiology and Molecular Genetics, Pittsburgh, PA, USA
| | - Rashmi Srivastava
- Cancer Virology Program, UPMC Hillman Cancer Center, Pittsburgh, PA, USA; Department of Microbiology and Molecular Genetics, Pittsburgh, PA, USA
| | - Frank Soveg
- Department of Immunology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Thomas S Ebert
- Department of Biochemistry, Ludwig Maximilians Universität, Munich, Germany
| | - Maninjay K Atianand
- Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Veit Hornung
- Department of Biochemistry, Ludwig Maximilians Universität, Munich, Germany
| | - Ram Savan
- Department of Immunology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Michael S Diamond
- Departments of Medicine, Molecular Microbiology, Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Saumendra N Sarkar
- Cancer Virology Program, UPMC Hillman Cancer Center, Pittsburgh, PA, USA; Department of Microbiology and Molecular Genetics, Pittsburgh, PA, USA; Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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Maniero C, Ng SM, Collett G, Godec T, Siddiqui I, Antoniou S, Kumar A, Janmohamed A, Nair S, Kotecha A, Khan R, Khanji MY, Kapil V, Gupta J, Gupta AK. Differential impact of COVID-19 on mental health and burnout. Occup Med (Lond) 2024; 74:45-52. [PMID: 37040624 PMCID: PMC10875923 DOI: 10.1093/occmed/kqad011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND There may be differential impact of the COVID-19 pandemic on mental health and burnout rates of healthcare professionals (HCPs) performing different roles. AIMS To examine mental health and burnout rates, and possible drivers for any disparities between professional roles. METHODS In this cohort study, online surveys were distributed to HCPs in July-September 2020 (baseline) and re-sent 4 months later (follow-up; December 2020) assessing for probable major depressive disorder (MDD), generalized anxiety disorder (GAD), insomnia, mental well-being and burnout (emotional exhaustion and depersonalization). Separate logistic regression models (at both phases) compared the risk of outcomes between roles: healthcare assistants (HCAs), nurses and midwives (nurses), allied health professionals (AHPs) and doctors (reference group). Separate linear regression models were also developed relating the change in scores to professional role. RESULTS At baseline (n = 1537), nurses had a 1.9-fold and 2.5-fold increased risk of MDD and insomnia, respectively. AHPs had a 1.7-fold and 1.4-fold increased risk of MDD and emotional exhaustion, respectively. At follow-up (n = 736), the disproportionate risk between doctors and others worsened: nurses and HCAs were at 3.7-fold and 3.6-fold increased risk of insomnia, respectively. Nurses also had a significantly increased risk of MDD, GAD, poor mental well-being and burnout. Nurses also had significantly worsened anxiety, mental well-being and burnout scores over time, relative to doctors. CONCLUSIONS Nurses and AHPs had excess risk of adverse mental health and burnout during the pandemic, and this difference worsened over time (in nurses especially). Our findings support adoption of targeted strategies accounting for different HCP roles.
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Affiliation(s)
- C Maniero
- Barts Heart Centre, St. Bartholomew’s Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
- William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
| | - S M Ng
- Barts Heart Centre, St. Bartholomew’s Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
| | - G Collett
- William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
| | - T Godec
- William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
| | - I Siddiqui
- Wellbeing Hub, Newham Training Hub, London E15 1HP, UK
- Northeast London CCG, London E15 1DA, UK
- Woodgrange Medical Practice, London E7 0QH, UK
| | - S Antoniou
- Barts Heart Centre, St. Bartholomew’s Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
| | - A Kumar
- Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan WN1 1XX, UK
| | - A Janmohamed
- St George’s University Hospitals NHS Foundation Trust, London SW17 0QT, UK
| | - S Nair
- Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Wales LL18 5UJ, UK
| | - A Kotecha
- Royal Devon and Exeter Hospital, Exeter, Devon EX2 5DW, UK
| | - R Khan
- The Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK
| | - M Y Khanji
- Barts Heart Centre, St. Bartholomew’s Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
- William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
- UCLPartners, London W1T 7HA, UK
- Newham University Hospital, Barts Health NHS Trust, London E13 8SL, UK
| | - V Kapil
- Barts Heart Centre, St. Bartholomew’s Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
- William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
- The Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK
| | - J Gupta
- South West London and St George’s Mental Health NHS Trust, London SW17 0YF, UK
| | - A K Gupta
- Barts Heart Centre, St. Bartholomew’s Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
- William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
- The Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK
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Prashanth RR, Nair S, Haribalakrishna A, Thakkar H. How early is too early? Diagnosis of tuberous sclerosis complex in a neonate. J Postgrad Med 2023; 69:243-244. [PMID: 37675664 PMCID: PMC10846816 DOI: 10.4103/jpgm.jpgm_326_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/01/2023] [Accepted: 05/29/2023] [Indexed: 09/08/2023] Open
Affiliation(s)
- RR Prashanth
- Department of Neonatology, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India
| | - S Nair
- Department of Neonatology, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India
| | - A Haribalakrishna
- Department of Neonatology, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India
| | - H Thakkar
- Department of Radiology, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India
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5
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Rakesh PS, Nair S, Kamala R, Manu MS, Mrithunjayan SK, Valamparampil MJ, Kutty VR, Sadanandan R. Local government stewardship for TB elimination in Kerala, India. Public Health Action 2023; 13:44-50. [PMID: 36949740 PMCID: PMC9983805 DOI: 10.5588/pha.22.0037] [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: 05/15/2022] [Accepted: 10/04/2022] [Indexed: 03/07/2023] Open
Abstract
SETTING The southern Indian state of Kerala has implemented 'Kerala Tuberculosis Elimination Mission' as 'People's Movement against TB' under the stewardship of local governments (LGs). The state has been certified by the Government of India for being on track to attain the UN Sustainable Development Goals related to TB elimination. OBJECTIVE To document the role of LG stewardship in the successful implementation of the TB elimination activities in Kerala. DESIGN 1) Key informant interviews with four state officials, 2) desk review of available documents, 3) in-depth interviews with seven LG leaders, three mid-level programme managers and three health department field staff. RESULTS LG involvement led to the establishment of solutions based on local problems, enhanced outreach of services to the socially vulnerable individuals, improved treatment support to patients with TB, increased community ownership of TB elimination activities, reduced TB-related stigma and social determinants being addressed. Institutional mechanisms such as LG TB elimination task forces, formal guidance in planning interventions and appreciation of their performance in the form of awards were facilitators for LG involvement. CONCLUSION LG stewardship can accelerate TB elimination. A good plan for engagement and institutional mechanisms are crucial for LG involvement.
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Affiliation(s)
- P S Rakesh
- WHO Technical Support Network, State TB Cell, Thiruvananthapuram, India
| | - S Nair
- Department of Pulmonary Medicine, Government Medical College, Thrissur, India
- Decentralisation Study Group, Health Action by People, Thiruvananthapuram, India
| | - R Kamala
- Decentralisation Study Group, Health Action by People, Thiruvananthapuram, India
- Department of Pulmonary Medicine, Government Medical College, Thiruvananthapuram, India
| | - M S Manu
- Decentralisation Study Group, Health Action by People, Thiruvananthapuram, India
- Directorate of Health Services, State TB Cell, Thiruvananthapuram, India
| | - S K Mrithunjayan
- Decentralisation Study Group, Health Action by People, Thiruvananthapuram, India
- Directorate of Health Services, State TB Cell, Thiruvananthapuram, India
| | - M J Valamparampil
- Decentralisation Study Group, Health Action by People, Thiruvananthapuram, India
- Directorate of Health Services, State TB Cell, Thiruvananthapuram, India
| | - V Raman Kutty
- Decentralisation Study Group, Health Action by People, Thiruvananthapuram, India
| | - R Sadanandan
- Health Systems Transformation Platform, New Delhi, India
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6
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Prajitha KC, Babu V, Rahul A, Valamparampil MJ, Sreelakshmi PR, Nair S, Varma RP. Combatting emerging infectious diseases from Nipah to COVID-19 in Kerala, India. Public Health Action 2023; 13:32-36. [PMID: 36949738 PMCID: PMC9983808 DOI: 10.5588/pha.22.0024] [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: 05/01/2022] [Accepted: 09/20/2022] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND The state of Kerala, India, has experienced several unprecedented events in the past few years. The current study was an attempt to explore perceptions of stakeholders on how the decentralised system helped during the Nipah virus (NiV) outbreaks and COVID-19 pandemic in Kerala. METHODS This study used a qualitative descriptive approach built on the advocacy paradigm. The stakeholders who were involved in decision-making and the representatives of local self-government who had real-time experience and had handled the challenges were identified using purposive sampling. Seven key informant interviews (KIIs) and nine in-depth interviews (IDIs) were conducted. RESULTS Findings indicate that decentralisation had enabled the state to effectively deal with the outbreaks and the pandemic. The survey revealed four major themes: decision-making, engagement level, people-centric action, and difficulties. Two to four categories have emerged for each theme. CONCLUSION The study results highlight the importance of human resources and service delivery as balancing factors during public health emergencies in any developing nation with limited resources. Given that very few nations have the healthcare infrastructure and resources necessary to cater to the healthcare needs of the whole population, decentralisation should be reinforced.
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Affiliation(s)
- K C Prajitha
- Department of Community Medicine, Government Medical College, Thiruvananthapuram, India
| | - V Babu
- Comprehensive Stroke Care Programme, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram, India
| | - A Rahul
- Indian Council of Medical Research Vector Control Research Centre, Puducherry, India
| | - M J Valamparampil
- State Consultant for Health and Wellness Centres, National Health Mission, Thiruvananthapuram, India
| | | | - S Nair
- Department of Respiratory Medicine, Government Medical College, Thrissur, India
| | - R P Varma
- Achutha Menon Centre for Health Science Studies, SCTIMST, Thiruvananthapuram, India
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7
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Kamala R, Ravindran RM, Krishnan RA, Nair S, Varma RP, Srilatha S, Iype T, Vidhukumar K. Role of decentralised governance in implementing the National AIDS Control Programme in Kerala. Public Health Action 2023; 13:1-5. [PMID: 36949742 PMCID: PMC9983810 DOI: 10.5588/pha.22.0029] [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: 05/03/2022] [Accepted: 07/11/2022] [Indexed: 03/07/2023] Open
Abstract
SETTING In alignment with the UN Sustainable Development Goals (SDGs), Kerala State in India aims to end the HIV/AIDS epidemic, using its strong background in local governance to implement the National AIDS Control Programme (NACP). OBJECTIVE To examine the role of local governments in the implementation of NACP in tune with SDGs. DESIGN We conducted a state-wide exploratory study using document reviews, key informant and in-depth interviews, which were analysed thematically. RESULTS Four overarching themes that emerged were 1) preparation for programme implementation, 2) positive impact of local government involvement, 3) convergence with other organisations, and 4) barriers to implementation. Local government commitment to implementing the programme was evidenced by their adoption of the HIV/AIDS policy, facilitative interdepartmental coordination and local innovations. Interventions focused on improving awareness about the disease and treatment, and social, financial and rehabilitative support, which were extended even during the COVID-19 pandemic. Fund shortages and poor visibility of the beneficiaries due to preference for anonymity were challenges to achieving the expected outcomes. CONCLUSION The NACP is ably supported by local governments in its designated domains of interventions, prevention, treatment, and care and support. The programme can achieve its target to end the AIDS epidemic by overcoming the stigma factor, which still prevents potential beneficiaries from accessing care.
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Affiliation(s)
- R Kamala
- Health Action by People, Thiruvananthapuram, India
- Department of Pulmonary Medicine, Government Medical College, Thiruvananthapuram, India
| | - R M Ravindran
- Health Action by People, Thiruvananthapuram, India
- State Health Systems Resource Centre, Thiruvananthapuram, Kerala, India
| | - R A Krishnan
- State Health Systems Resource Centre, Thiruvananthapuram, Kerala, India
| | - S Nair
- Health Action by People, Thiruvananthapuram, India
- Department of Pulmonary Medicine, Government Medical College, Thrissur, India
| | - R P Varma
- Health Action by People, Thiruvananthapuram, India
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - S Srilatha
- Health Action by People, Thiruvananthapuram, India
| | - T Iype
- Health Action by People, Thiruvananthapuram, India
- Department of Neurology, Government Medical College, Thiruvananthapuram, India
| | - K Vidhukumar
- Health Action by People, Thiruvananthapuram, India
- Department of Psychiatry, Government Medical College, Thiruvananthapuram, India
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Mirrahimi A, Stella S, de Souza R, Nair S, Markose G, Yip G, Gastaldo F. Abstract No. 34 Comparison of Type II Endoleak Treatment: Direct Sac Puncture versus Transarterial Embolization: A Retrospective Cohort Analysis. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.076] [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: 02/27/2023] Open
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Dong M, Hu N, Hua Y, Xu X, Kandadi M, Guo R, Jiang S, Nair S, Hu D, Ren J. Erratum to: “Chronic Akt activation attenuated lipopolysaccharide-induced cardiac dysfunction via Akt/GSK3β-dependent inhibition of apoptosis and ER stress” [Biochim. Biophys. Acta. 1832(6) 2013 Jun; 848–63. doi:10.1016/j.bbadis.2013.02.023. Epub 2013 Mar 6.PMID: 23474308]. Biochim Biophys Acta Mol Basis Dis 2023; 1869:166567. [DOI: 10.1016/j.bbadis.2022.166567] [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: 11/07/2022]
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10
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Nair S, Abraham J. Bioproduction and Characterization of Pigments from Streptomyces sp. Isolated from Marine Biotope. APPL BIOCHEM MICRO+ 2022. [DOI: 10.1134/s0003683822060114] [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: 12/07/2022]
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Praseetha NG, Divya UK, Nair S. Identifying the potential role of curcumin analogues as anti-breast cancer agents; an in silico approach. Egypt J Med Hum Genet 2022. [DOI: 10.1186/s43042-022-00312-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Breast cancer ranks top among newly reported cancer cases and most of the women suffers from breast cancer. Development of target therapy using phytochemicals with minimal side effects is trending in health care research. Phytochemicals targets complex multiple signalling events in cancer and are pleiotropic in nature. Thus, the present study was conducted to check the effectivity of curcumin analogues (Capsaicin, Chlorogenic acid, Ferulic acid, Zingerone, Gingerol) against the receptors that are expressed in breast cancer cells and prove its ethno-medicinal value by using bioinformatic tools and softwares like PDB, Patch Dock, PubChem, Chimera and My Presto.
Result
Out of the various curcumin analogues studied, Ferulic acid showed best binding affinity with all the breast cancer cell specific receptors (FGF, MMP9, RNRM1, TGF-beta, DHFR, VEGF and aromatase) which was confirmed through the docking studies.
Conclusion
The current work was a preliminary step towards screening suitable drug candidate against breast cancer using in silico methods. This information can be used further to carry out in vivo studies using selected natural analogues of curcumin as a suitable drug candidate against breast cancer saving time and cost.
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Kesarwani A, Bais SS, Nair S, De Costa AA, Hu T, Shi PY, Diamond MS, Chheda MG. EXTH-22. TARGETING A NEWLY DISCOVERED IMMUNE CHECKPOINT, SIGLEC-15, INCREASES ONCOLYTIC EFFICACY OF ZIKA VIRUS (ZIKV) IN GLIOBLASTOMA (GBM). Neuro Oncol 2022. [PMCID: PMC9660820 DOI: 10.1093/neuonc/noac209.821] [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: 11/16/2022] Open
Abstract
Abstract
We are developing ZIKV as a therapy for GBM. We previously demonstrated ZIKV specifically kills GBM stem cells. Using GL261 and CT2A mouse models, ZIKV induces a CD8+ T-cell mediated anti-tumor response and leads to 65% and 40% long term survivors, respectively (0%-untreated controls). ZIKV treatment significantly increases the number of myeloid cells in the tumor microenvironment (with about 10,000 infiltrating macrophages per ZIKV-treated brain, 1,000 cells per untreated brain). We hypothesized that by targeting a myeloid immune checkpoint, we would further enhance efficacy. Siglec-15 is a newly described myeloid checkpoint, and anti-siglec-15 antibody is currently in clinical trial for patients with advanced or metastatic solid tumors (NCT03665285). While there was no effect of anti-siglec-15 treatment alone, we observed increased efficacy when combined with ZIKV (cure rate: GL261-70%, CT2A-60% with ZIKV+anti-siglec-15 antibody; GL261-20%, CT2A-0% with anti-siglec-15 antibody alone; GL261-30%, CT2A-25% ZIKV alone; GL261-0%, CT2A-0% without treatment). Since recurrence is a major problem, we performed re-challenge experiments in cured mice at 6 months. Mice previously treated with anti-siglec-15 antibody and ZIKV had 70% long-term survival, compared to 30% of age matched untreated controls. This supports our earlier findings that an immunological response after ZIKV engenders long-term, tumor-specific, immune surveillance. Lastly, we used Siglec-15 knockout mice to confirm our observations. After treating Siglec-15 knockout mice bearing CT2A tumors with ZIKV, 70% animals were cured. There was no significant difference in survival between CT2A-bearing Siglec-15 knockout mice without ZIKV treatment compared to CT2A-bearing wild type hosts. Taken together, our work suggests targeting putative myeloid suppressor cells, combined with oncolytic ZIKV and its ensuing anti-cancer stem cell and activated CD8+ T-cell effects, may be an effective tool in neuro-oncology. Targeting Siglec-15 may also enhance other oncolytic or cytotoxic therapies.
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Affiliation(s)
| | | | - Sharmila Nair
- Washington University in St. Louis , St. Louis , USA
| | | | - Tong Hu
- Washington University in St. Louis , St. Louis , USA
| | - Pei-Yong Shi
- University of Texas Medical Branch , Galveston, TX , USA
| | | | - Milan G Chheda
- Washington University in St. Louis , St. Louis, MO , USA
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Haque Y, Cao Y, Lominska C, Chung C, Pickard A, Bur A, Thomas S, Woodroof J, Yilmaz E, Neupane P, McCance D, Rosenthal D, Nair S, Thorstad W, Garden A, Caudell J, Wong S, Bonner J, Harris J, Gan G. A Retrospective Analysis of NRG/RTOG 0522: Low Myofibroblast Content in the Tumor-Associated Stroma may Predict Response to Epidermal Growth Factor Receptor (EGFR) Inhibitors. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1319] [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: 10/31/2022]
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14
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Girard N, Besse B, Bernabé Caro R, Goto K, Leighl N, Ohe Y, Sabari J, Lee SH, Lin X, Schaeffer M, Nair S, Li T, Di Scala L, Potluri R, Mahadevia P, Thayu M, Kim T. EP08.02-016 Frontline and Post-Osimertinib Therapy for EGFR-mutant Advanced NSCLC: Treatment Patterns, Outcomes, Healthcare Use and Costs. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.698] [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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15
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Varadi M, Deshpande M, Nair S, Anyango S, Bertoni D, Velankar S. High-accuracy protein structure models in AlphaFold DB. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322093044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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16
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Rahmati M, Ripanelli A, Nair S, Gill A, Linara-Demakakou E, Ahuja K, Macklon N. P-335 How to define recurrent implantation failure and when to start investigating the endometrium? Lessons from three years’ experience in a dedicated unit. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.319] [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: 11/14/2022] Open
Abstract
Abstract
Study question
Should we always define recurrent implantation failure (RIF) after three unsuccessful transfers and only then start investigating the endometrium?
Summary answer
Endometrial investigations can be beneficial for patients with RIF. However, waiting for three previous failures before instituting assessment might not be appropriate in every situation.
What is known already
The definition of unexplained recurrent implantation failure (RIF) continues to be debated. This usually implies a lack of embryo implantation after the transfer of three good quality blastocysts on an apparently responsive and anatomically normal endometrium. To deal with this frustrating and distressing situation for both the patient and the clinician, additional empirical interventions are often blindly used. This approach may exacerbate rather than ameliorate any underlying aetiology. There is a need therefore to base interventions on diagnostic rationale wherever possible.
Study design, size, duration
In order to base advice and any interventions for RIF on diagnostic rationale, we created a referral unit dedicated to the investigation and treatment of patients meeting the traditional criteria for RIF. Over three years, 395 patients were referred to this unit and 237 completed their investigations. Here we present the clinical outcomes and insights obtained over these three years.
Participants/materials, setting, methods
Blood sampling for serum progesterone level and endometrial pipelle biopsy were performed after five days of luteal support in a standardised substituted cycle. The samples underwent dating by gene expression (ERA test) and immune assessment describing the recruitment and activation of the uterine Natural Killer cells (MLI test, Matrice Lab Innove). A personalised treatment plan was thus derived and suggested to the referring clinician. The outcomes after the subsequent personalised single embryo transfer were monitored.
Main results and the role of chance
The patients referred had an average of 4.3 previous good quality blastocysts transferred in the past. 58% of the referred patients had used their own eggs, including 49% after conventional IVF or ICSI, and 9% after using PGT-A. 42% of the referred patients had used donor eggs. To date, 237 patients completed their endometrial assessment. 92% of the tested patients revealed at least one disrupted endometrial marker. With the subsequent personalised single embryo transfer, an implantation rate of 58% was observed. The ongoing pregnancy rate at 12 weeks was reported at 39%.
Limitations, reasons for caution
While confirmatory prospective controlled studies are required, these data indicate that more targeted rather than blind usage of simple known therapeutics could be beneficial for patients experiencing RIF. The clinical context these referred was highly variable, including patients undergoing PGT-A and egg donation.
Wider implications of the findings
Given the higher implantation rates to be expected in some groups, waiting for at least three embryos to fail before investigating the endometrium may be inappropriate and underlie the relatively high miscarriage rate observed. The investigation of implantation failure should be driven by context rather than arbitrary definition.
Trial registration number
Not Applicable
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Affiliation(s)
- M Rahmati
- London Women's Clinic, Reproductive Medicine , London, United Kingdom
| | - A Ripanelli
- London Women's Clinic, Reproductive Medicine , London, United Kingdom
| | - S Nair
- London Women's Clinic, Reproductive Medicine , London, United Kingdom
| | - A Gill
- London Women's Clinic, Reproductive Medicine , London, United Kingdom
| | | | - K Ahuja
- London Women's Clinic, Reproductive Medicine , London, United Kingdom
| | - N Macklon
- London Women's Clinic, Reproductive Medicine , London, United Kingdom
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17
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Bodri D, Pataia V, Linara-Demakakou E, Kováts T, Vendola M, Wolska M, Nair S, Macklon N, Ahuja K. P-592 The effect of ethnicity on ovarian stimulation outcomes of altruistic oocyte donors from the largest UK vitrified egg bank: a retrospective cohort study. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.545] [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: 11/14/2022] Open
Abstract
Abstract
Study question
Are there differences in ovarian stimulation outcomes among different ethnicities in the largest UK vitrified oocyte donation programme?
Summary answer
No significant differences were observed in ovarian response between non-White and White ethnic donor groups. Only AMH and baseline AFC correlated well with ovarian response.
What is known already
Ethnic disparities in ART outcomes have received much attention recently. Studies based on national registries have reported inferior outcomes for South Asian and Black ethnicities undergoing non-donor IVF treatment. Ovarian response has also been reported to differ across ethnicities, which was attributed to genetic or environmental factors, but also ethnic differences in ovarian reserve markers and body weight. A few US studies have evaluated recipient outcomes in oocyte donation treatment and found lower success rates for Black recipients. So far, no large study has evaluated the effect of ethnicity on ovarian response in a large cohort of oocyte donors.
Study design, size, duration
All consecutive oocyte donation cycles (n = 1.421) from the UK’s largest, private vitrified egg bank between 2017 and 2021 were included in this retrospective cohort analysis. Donors underwent general health evaluation, ovarian reserve (AMH, AFC) and infectious disease screening. Ovarian stimulation with recFSH was commenced on cycle day 2-3, with starting doses ranging from 112.5-450 IU. GnRH antagonist was given from day 6, and final oocyte maturation was triggered with a GnRH agonist (0.5 ml buserelin).
Participants/materials, setting, methods
Altruistic oocyte donors (n = 1.027) were stratified according to ethnicity; White (77%), mixed (7.4%), Black (5.4%), South-Asian (4.1 %), other Asian (3.5%) and South American (2.2%). In a univariate analysis, Kruskal-Wallis test was applied to compare age, BMI, AMH between ethnic groups and total and mature oocyte number during treatment cycles. In a multi-variate analysis, the effect of ethnicity, age, BMI, AMH and baseline AFC was evaluated on the number of total and mature oocytes obtained.
Main results and the role of chance
Univariate analysis showed no difference between ethnic groups in BMI (total average:23.5±3.1) AMH (total average:29.5±16.0 pmol/L) whereas other Asians were older (30.5±4.6 years, p < 0.001) and South Americans younger (24.4±4.7 years, p = 0.005) compared to Whites (27.1±4.6 years). The total number of eggs retrieved did not differ significantly between ethnic groups; White:19.6±9.1, mixed:19.6±9.0, Black:20.1±10.3, South-Asian:18±8.3, other Asian: 17.6±8.8 and South American:17.7±8.4, p = 0.24). The same applied to mature eggs obtained: White:14.2±7.1, mixed:13.9±7.2, Black:12.7±7.1, South-Asian:13.4±7.1, other Asian: 13±7.2, South American:12.8±7.1, p = 0.19). However, oocyte maturity rate was significantly lower in Black compared to White donors (64±19% vs 73±18%, p = 0.003). In a multivariate analysis, only baseline AFC (p < 0.0001) and AMH (p < 0.0001) correlated well with either the number of retrieved total or mature eggs.
Limitations, reasons for caution
Retrospective cohort studies might have inherent biases that make comparisons difficult. Slightly different inclusion criteria (age, AMH) for different ethnicities might have affected ovarian stimulation outcomes. The size of some subgroups was too low to yield statistically meaningful results. Some baseline donor variables were not included in our analysis.
Wider implications of the findings
Ovarian response outcomes were not substantially different across various ethnic groups of altruistic, UK oocyte donors. This study indicates that reported ethnic differences in IVF outcomes is unlikely to be due to response to ovarian stimulation. Donor egg programs can anticipate similar numbers of eggs irrespective of donor ethnicity.
Trial registration number
n/a
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Affiliation(s)
- D Bodri
- London Womens Clinic, London Egg Bank , London, United Kingdom
| | - V Pataia
- London Womens Clinic, London Egg Bank , London, United Kingdom
| | | | - T Kováts
- London Womens Clinic, London Egg Bank , London, United Kingdom
| | - M Vendola
- London Womens Clinic, London Egg Bank , London, United Kingdom
| | - M Wolska
- London Womens Clinic, London Egg Bank , London, United Kingdom
| | - S Nair
- London Womens Clinic, London Egg Bank , London, United Kingdom
| | - N Macklon
- London Womens Clinic, London Egg Bank , London, United Kingdom
| | - K Ahuja
- London Womens Clinic, London Egg Bank , London, United Kingdom
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18
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Wu K, Caterine S, Markose G, Nair S, Stella SF. Abstract No. 546 Comparison of thermal ablation therapies for painful extraspinal bone metastases: a systematic review. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.528] [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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19
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Wilks C, Nair S, Markose G, Stella S. Abstract No. 165 Combined thermal ablation and embolization for the treatment of hepatocellular carcinoma: a retrospective review in a tertiary cancer center. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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20
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Agarwal J, Sinha S, Lewis Salins S, Pandey S, Deodhar J, Salins N, Ghosh Laskar S, Budrukkar A, Gupta T, Murthy V, Swain M, Nair S, Chaturvedi P. OC-0592 Impact of palliative care referral on distress in patients undergoing RT for HNSCC: Randomized Trial. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02614-7] [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]
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21
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Soden L, Ha F, Nair S, Whitbourn R, Palmer S. Next-Day Discharge Following Transcatheter Aortic Valve Implantation: An Australian Tertiary Hospital Experience. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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22
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Pearce J, Swinson D, Cairns D, Nair S, Baxter M, Petty R, Seymour M, Hall P, Velikova G. Frailty and treatment outcome in advanced gastro-oesophageal cancer: an exploratory analysis of the GO2 trial. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00394-5] [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]
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23
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Pearce J, Hatton N, Barlow V, Lad H, Nair S, Swinson D. Leeds Oncology Frailty Initiative (LOFrI): development of a pilot service for frail patients with gastrointestinal malignancy. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00426-4] [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: 10/19/2022]
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24
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Lundon DJ, Kelly BD, Nair S, Bolton DM, Kyprianou N, Wiklund P, Tewari A. Early mortality risk stratification after SARS-CoV-2 infection. Med Intensiva 2021; 45:e40-e42. [PMID: 34717886 PMCID: PMC8549443 DOI: 10.1016/j.medine.2020.06.014] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 06/18/2020] [Indexed: 11/25/2022]
Affiliation(s)
- D J Lundon
- Department of Urology, Icahn School of Medicine, Mount Sinai Hospitals, New York, United States.
| | - B D Kelly
- Department of Urology, University of Melbourne, Austin Health, Melbourne, United States
| | - S Nair
- Department of Urology, Icahn School of Medicine, Mount Sinai Hospitals, New York, United States
| | - D M Bolton
- Department of Urology, University of Melbourne, Austin Health, Melbourne, United States
| | - N Kyprianou
- Department of Urology, Icahn School of Medicine, Mount Sinai Hospitals, New York, United States
| | - P Wiklund
- Department of Urology, Icahn School of Medicine, Mount Sinai Hospitals, New York, United States
| | - A Tewari
- Department of Urology, Icahn School of Medicine, Mount Sinai Hospitals, New York, United States.
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25
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Hey C, Zahoor S, Shreeve J, Gomes L, Varghese S, Alam T, Zaman J, Nair S. Improving the quality of discharge care plan in the heart failure with reduced ejection fraction (HFrEF) cohort: a quality improvement study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0976] [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: 11/13/2022] Open
Abstract
Abstract
Background
High-quality heart failure (HF) discharge summary (DS) is the cornerstone of effective communication during the transition from specialists to primary care. The combination of continuing involvement of multidisciplinary members, varying individual tolerance to treatments, and the need for multiple investigations beget intricate HFrEF management. The quality of the information included in DS following HF-related hospitalisation varies widely and may be sub-optimal in communicating patient's in-hospital care, leading to inadequate compliance to guideline-directed medical therapy (GDMT) and increased risk of re-hospitalisation. Notwithstanding this real-world observation, there remains a paucity of consensus on the standard of measurements of HF DS.
Purpose
We aimed to optimise the transmission of information between patients and HF multidisciplinary members to improve adherence to GDMT, follow-up (F/U) care coordination and patient education in line with the National Institute for Health and Care Excellence (NICE) and the European Society of Cardiology (ESC) recommendations.
Methods
A random sampling of the HFrEF cohort discharged from the cardiac unit at our institution following HF-related hospitalisation was performed across four distinct time points matched with respective interventions. Three iterative cycles (baseline analysis and two educational interventions – departmental teaching and dissemination of innovative mnemonics sheets – THE WET TO DRY [Figure 1]) were completed using Plan-Do-Study-Act (PDSA) methodology. The quality of patients DS was objectively analysed based on the inclusion of physiological and investigation parameters, in-patient treatment, initiation/titration of GDMT, F/U care coordination, and patient education.
Results
Sixty-six patients, mean±SD age 74.6±12.8y were enrolled between 2018–2021. The baseline reporting of presenting complaints, trigger and investigation findings were high and consistent throughout all cycles. A positive trend was observed in the reporting of physiological parameters and in-patient treatment post-interventions. Patient education and vaccines offered remained low despite improving compliance. As such, a consensus on the provision of nurse-led pre-discharge review label and interactive patient personal passport (Figure 1) was achieved via a group of cardiologists and HF specialist nurses to address identified practice gap from preceding PDSA cycles. Full adherence to GDMT and the inclusion of F/U pathway were observed following the provision of nurse-led review label (Figure 2).
Conclusion
This study demonstrates that educational interventions – departmental teaching and innovative mnemonics can be effective in improving the quality of HF DS. Structured nurse-led review label and interactive patient personal passport are feasible interventions, which can be implemented at minimal cost to sustain adherence to GDMT, F/U care coordination and individualised patient education.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- C Hey
- James Paget Hospitals, Department of Cardiology, Norfolk, United Kingdom
| | - S Zahoor
- James Paget Hospitals, Department of Cardiology, Norfolk, United Kingdom
| | - J Shreeve
- James Paget Hospitals, Department of Cardiology, Norfolk, United Kingdom
| | - L Gomes
- James Paget Hospitals, Department of Cardiology, Norfolk, United Kingdom
| | - S Varghese
- James Paget Hospitals, Department of Cardiology, Norfolk, United Kingdom
| | - T Alam
- Norfolk and Norwich University Hospital Foundation Trust, Department of Cardiology, Norfolk, United Kingdom
| | - J Zaman
- West Suffolk Hospital, Department of Cardiology, Bury St Edmunds, United Kingdom
| | - S Nair
- Norfolk and Norwich University Hospital Foundation Trust, Department of Cardiology, Norfolk, United Kingdom
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26
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Menon N, Patil V, Noronha V, Joshi A, Mathrudev V, Bhattacharjee A, Chandrasekharan A, Srinivas S, Vallathol D, Chaturvedi P, Chaukar D, Pai P, Nair S, Thiagrajan S, Ghosh Laskar S, Nawale K, Dhumal S, Tambe R, Banavali S, Prabhash K. 865MO RMAC study: A randomized study evaluating the efficacy of metronomic adjuvant chemotherapy in patients with recurrent head and neck cancers post salvage surgery, not eligible for re-irradiation. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1275] [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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27
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Pataia V, Nair S, Wolska M, Linara-Demakakou E, Shah T, Macklon N, Ahuja K. P–136 Factors predicting clinical outcomes of 511 recipients of vitrified oocyte donation from an UK-regulated egg bank. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.135] [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: 11/14/2022] Open
Abstract
Abstract
Study question
Do established donor and recipient clinical markers predict recipient clinical pregnancy and live birth rates (LBRs) in a vitrified oocyte donation programme?
Summary answer
Recipient BMI and previous miscarriages predicted cumulative LBR. Likelihood of clinical pregnancy and LBR was higher in recipients of donors aged 23–29 than donors 18–22.
What is known already
The influence of age on ovarian reserve underlies the upper limit of 35 years for UK donors. However, recent evidence suggests that oocyte aneuploidy rates follow an inverse U-shaped curve in relation to a woman’s age. Conflicting evidence exists regarding the impact of other donor-related factors including BMI, AMH, oocyte yield and prior reproductive history on recipient outcomes. Moreover, the effect of recipient age, BMI, and reproductive history on oocyte donation outcome remains unclear.
Study design, size, duration
Retrospective cohort study of 325 altruistic oocyte donors matched to a total of 511 recipients. Only first donations taking place between January 2017 and December 2019 were included.
Participants/materials, setting, methods
All oocyte donors were altruistic volunteers aged 18–35 with no prior infertility diagnosis. Donor and recipient screening for suitability and safety was carried out according to the Human Fertilisation Embryology Authority guidelines. Backward stepwise logistic regression was used to identify donor, recipient and embryology parameters predictive of recipient primary outcomes defined as clinical pregnancy and live birth, either cumulative or after the first embryo transfer (ET).
Main results and the role of chance
A total of 705 fresh and frozen/thawed ETs were performed, of which 76% were elective single embryo transfers (eSETs) of blastocysts (96.5%), resulting in a cumulative clinical pregnancy and LBR of 83.5% and 70.5% respectively after 3 ETs. Recipient BMI and previous miscarriages were predictors of cumulative LBR (p < 0.05). The ratio of transferrable embryos per oocytes received/fertilised and the number of ETs needed to achieve the intended primary outcome were predictors of cumulative clinical pregnancy and LBR (p < 0.05). Donor age 18–22 was associated with lower incidence of recipient clinical pregnancy and live birth after the first ET, as compared to donor age 23–29 (p < 0.05).
Limitations, reasons for caution
The present study included only healthy oocyte donors, thus conclusions may not apply to subfertile or less healthy women. Male factors were not accounted for.
Wider implications of the findings: We demonstrate the efficacy of vitrified oocyte donation treatment and identify recipient BMI, previous miscarriages and embryology parameters as predictors of cumulative LBR. Additionally, the choice of donors aged 18–22 instead of older donors is found not to be advantageous for increasing the chance of clinical pregnancy and live birth.
Trial registration number
Not applicable
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Affiliation(s)
- V Pataia
- London Egg Bank, London Egg Bank, London, United Kingdom
| | - S Nair
- London Women’s Clinic, London Women’s Clinic, London, United Kingdom
| | - M Wolska
- London Egg Bank, London Egg Bank, London, United Kingdom
| | | | - T Shah
- London Women’s Clinic, London Women’s Clinic, London, United Kingdom
| | - N Macklon
- London Women’s Clinic, London Women’s Clinic, London, United Kingdom
| | - K Ahuja
- London Women’s Clinic, London Women’s Clinic, London, United Kingdom
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28
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Affiliation(s)
- S Nair
- St Vincent's University Hospital, Dublin, Ireland
| | - H Gallagher
- St Vincent's University Hospital, Dublin, Ireland
| | - N Conlon
- St Vincent's University Hospital, Dublin, Ireland
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29
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Nair S, Mazzoccoli L, Jash A, Govero J, Bais SS, Hu T, Fontes-Garfias CR, Shan C, Okada H, Shresta S, Rich JN, Shi PY, Diamond MS, Chheda MG. Zika virus oncolytic activity requires CD8+ T cells and is boosted by immune checkpoint blockade. JCI Insight 2021; 6:144619. [PMID: 33232299 PMCID: PMC7821591 DOI: 10.1172/jci.insight.144619] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/18/2020] [Indexed: 12/12/2022] Open
Abstract
Glioblastoma multiforme (GBM) is a fatal human cancer in part because GBM stem cells are resistant to therapy and recurrence is inevitable. Previously, we demonstrated Zika virus (ZIKV) targets GBM stem cells and prevents death of mice with gliomas. Here, we evaluated the immunological basis of ZIKV-mediated protection against GBM. Introduction of ZIKV into the brain tumor increased recruitment of CD8+ T and myeloid cells to the tumor microenvironment. CD8+ T cells were required for ZIKV-dependent tumor clearance because survival benefits were lost with CD8+ T cell depletion. Moreover, while anti–PD-1 antibody monotherapy moderately improved tumor survival, when coadministered with ZIKV, survival increased. ZIKV-mediated tumor clearance also resulted in durable protection against syngeneic tumor rechallenge, which also depended on CD8+ T cells. To address safety concerns, we generated an immune-sensitized ZIKV strain, which was effective alone or in combination with immunotherapy. Thus, oncolytic ZIKV treatment can be leveraged by immunotherapies, which may prompt combination treatment paradigms for adult patients with GBM.
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Affiliation(s)
- Sharmila Nair
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Luciano Mazzoccoli
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Arijita Jash
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jennifer Govero
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sachendra S Bais
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Tong Hu
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Camila R Fontes-Garfias
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, Texas, USA
| | - Chao Shan
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, Texas, USA
| | - Hideho Okada
- Department of Neurological Surgery and.,Parker Institute for Cancer Immunotherapy, University of California San Francisco, San Francisco, California, USA
| | - Sujan Shresta
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, California, USA
| | - Jeremy N Rich
- Division of Regenerative Medicine, Department of Medicine, and.,Department of Neurosciences, University of California School of Medicine, San Diego, La Jolla, California, USA.,Sanford Consortium for Regenerative Medicine, La Jolla, California, USA
| | - Pei-Yong Shi
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, Texas, USA.,Department of Pharmacology and Toxicology and.,Sealy Center for Structural Biology and Molecular Biophysics and Sealy Center for Vaccine Development, University of Texas Medical Branch, Galveston, Texas, USA
| | - Michael S Diamond
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Pathology & Immunology.,Department of Molecular Microbiology.,The Andrew M. and Jane M. Bursky Center for Human Immunology & Immunotherapy Programs, and
| | - Milan G Chheda
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
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30
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Gan CL, Yang Z, Salahia G, Halpin S, Nair S. A single-centre experience and literature review of Flow Re-Directional Endoluminal Device (FRED) in endovascular treatment of intracranial aneurysms. Clin Radiol 2020; 76:238.e1-238.e8. [PMID: 33317786 DOI: 10.1016/j.crad.2020.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 11/04/2020] [Indexed: 10/22/2022]
Abstract
AIM To present initial single-centre experience with the Flow Re-Direction Endoluminal Device, FRED. MATERIALS AND METHODS This was a retrospective study. All patients treated with FRED from October 2015 to April 2017 were included in the study. Details of the aneurysms, complications as well as follow-up results were recorded. A PubMed search was performed using the keywords "Flow Re-Direction Endoluminal Device", "FRED", "flow diverter", "FD", "FD Stent", "flow re-direction" and "flow redirection" and the results were reviewed and compared to the present authors. RESULTS A total of 21 patients with 25 aneurysms were analysed. No patient was lost to follow-up. At 6 months follow-up, 17 aneurysms (68%) were completely occluded, five had reduced flow, two had persistent flow and the remaining one showed increased flow. Two aneurysms from the reduced flow at 6 months had achieved complete occlusion at 1 year, raising the complete occlusion rate to 76%. Overall, 22/25 (88%) aneurysms were either occluded completely or had reduced flow at 1 year. The appearances of the other aneurysms were stable in subsequent follow-ups. Three complications were recorded (one haemorrhagic, two occlusive/thromboembolic). There was no mortality in the present study. The occlusion rate at University Hospital of Wales as well as the complication rate was comparable to other centres on published data. CONCLUSION FRED is a safe and effective flow diverter, which can be used to treat complex aneurysms that would have been of higher risk and for which for conventional coiling would be ineffective or unsuitable.
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Affiliation(s)
- C L Gan
- Neuroradiology Department, University Hospital of Wales, Cardiff, UK; Directorate Neurosciences, Royal Victoria Infirmary, Newcastle Upon Tyne, UK.
| | - Z Yang
- Neuroradiology Department, University Hospital of Wales, Cardiff, UK
| | - G Salahia
- Neuroradiology Department, University Hospital of Wales, Cardiff, UK
| | - S Halpin
- Neuroradiology Department, University Hospital of Wales, Cardiff, UK; Radiology Department, Royal Glamorgan Hospital, Llantrisant, UK
| | - S Nair
- Neuroradiology Department, University Hospital of Wales, Cardiff, UK; Neuroradiology Department, Queen's Medical Centre, Nottingham, UK
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Mazzoccoli L, Nair S, Jash A, Govero J, Hu T, Shresta S, Shi PY, Rich J, Diamond M, Chheda M. IMMU-43. ZIKA VIRUS TO TREAT GLIOMA: TURNING COLD TUMORS HOT. Neuro Oncol 2020. [DOI: 10.1093/neuonc/noaa215.473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
GBM is a hallmark example of an immunotherapy-resistant tumor. Previously, we discovered that Zika virus (ZIKV) has a natural honing capacity to specifically kill GBM stem cells (GSCs). Using two syngeneic glioma models, GL261 and CT2A, we found that in vivo intratumoral ZIKV treatment reduces tumor size and extends median survival far beyond that expected for its anti-GSC effects; additionally, approximately 50% of mice were long-term survivors. We now report that ZIKV treatment is associated with an increase in tumor-specific CD8+ T cells and activated myeloid cells expressing MHC-II and NOS2. Treatment with CD8-depleting antibody abrogates the survival advantage conferred by ZIKV, demonstrating that CD8+ T cells are required for ZIKV efficacy. Remarkably, ZIKV treatment also confers protection against tumor re-challenge 1.5 years after the original treatment, and this too is dependent on CD8+ T cells. Lastly, in a bilateral tumor implantation model, intratumoral ZIKV treatment of one tumor increases overall survival, suggesting ZIKV is efficacious because it generates a global anti-tumor response. Building on the observation that ZIKV treatment increases CD8+ T cells in the tumor bed, we combined ZIKV with α-PD1 immunotherapy. We found survival was dramatically increased compared to either treatment alone. Finally, to improve safety of potential ZIKV treatment for patients, we generated an immune-sensitized virus. This strain remains efficacious as a single agent and in combination with immunotherapy in vivo. Overall, our results suggest ZIKV treatment addresses two key problems in our current treatment of GBM: it specifically targets highly resistant GSC and initiates a potent anti-tumor immune response against the remaining tumor. Our work reveals the mechanistic basis of ZIKV efficacy and demonstrates the potential for ZIKV as a therapy for GBM.
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Affiliation(s)
| | - Sharmila Nair
- Washington University School of Medicine, Saint Louis, MO, USA
| | - Arijita Jash
- Washington University School of Medicine, Saint Louis, MO, USA
| | - Jennifer Govero
- Washington University School of Medicine, Saint Louis, MO, USA
| | - Tong Hu
- Washington University School of Medicine, Saint Louis, MO, USA
| | - Sujan Shresta
- La Jolla Institute for Allergy and Immunology, La Jolla, CA, USA
| | - Pei-Yong Shi
- University of Texas Medical Branch, Galveston, TX, USA
| | - Jeremy Rich
- University of California, San Diego, San Diego, CA, USA
| | - Michael Diamond
- Washington University School of Medicine, Saint Louis, MO, USA
| | - Milan Chheda
- Washington University School of Medicine, Saint Louis, MO, USA
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Winkler ES, Bailey AL, Kafai NM, Nair S, McCune BT, Yu J, Fox JM, Chen RE, Earnest JT, Keeler SP, Ritter JH, Kang LI, Dort S, Robichaud A, Head R, Holtzman MJ, Diamond MS. SARS-CoV-2 infection of human ACE2-transgenic mice causes severe lung inflammation and impaired function. Nat Immunol 2020; 21:1327-1335. [PMID: 32839612 PMCID: PMC7578095 DOI: 10.1038/s41590-020-0778-2] [Citation(s) in RCA: 600] [Impact Index Per Article: 150.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/07/2020] [Indexed: 12/12/2022]
Abstract
Although animal models have been evaluated for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, none have fully recapitulated the lung disease phenotypes seen in humans who have been hospitalized. Here, we evaluate transgenic mice expressing the human angiotensin I-converting enzyme 2 (ACE2) receptor driven by the cytokeratin-18 (K18) gene promoter (K18-hACE2) as a model of SARS-CoV-2 infection. Intranasal inoculation of SARS-CoV-2 in K18-hACE2 mice results in high levels of viral infection in lungs, with spread to other organs. A decline in pulmonary function occurs 4 days after peak viral titer and correlates with infiltration of monocytes, neutrophils and activated T cells. SARS-CoV-2-infected lung tissues show a massively upregulated innate immune response with signatures of nuclear factor-κB-dependent, type I and II interferon signaling, and leukocyte activation pathways. Thus, the K18-hACE2 model of SARS-CoV-2 infection shares many features of severe COVID-19 infection and can be used to define the basis of lung disease and test immune and antiviral-based countermeasures.
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Affiliation(s)
- Emma S Winkler
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Adam L Bailey
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Natasha M Kafai
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Sharmila Nair
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Broc T McCune
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Jinsheng Yu
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Julie M Fox
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Rita E Chen
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - James T Earnest
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Shamus P Keeler
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Jon H Ritter
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Liang-I Kang
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Sarah Dort
- SCIREQ Scientific Respiratory Equipment, Montreal, Quebec, Canada
| | | | - Richard Head
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Michael J Holtzman
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Michael S Diamond
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA.
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO, USA.
- The Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, St. Louis, MO, USA.
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Dhillon PS, Pointon K, Lenthall R, Nair S, Subramanian G, McConachie N, Izzath W. Regional Mechanical Thrombectomy Imaging Protocol in Patients Presenting with Acute Ischemic Stroke during the COVID-19 Pandemic. AJNR Am J Neuroradiol 2020; 41:1849-1855. [PMID: 32819897 PMCID: PMC7661079 DOI: 10.3174/ajnr.a6754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 05/29/2020] [Accepted: 07/02/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE Chest CT is a rapid, useful additional screening tool for coronavirus disease 2019 (COVID-19) in emergent procedures. We describe the feasibility and interim outcome of implementing a modified imaging algorithm for COVID-19 risk stratification across a regional network of primary stroke centers in the work-up of acute ischemic stroke referrals for time-critical mechanical thrombectomy. MATERIALS AND METHODS We undertook a retrospective review of 49 patients referred to the regional neuroscience unit for consideration of mechanical thrombectomy between April 14, 2020, and May 21, 2020. During this time, all referring units followed a standard imaging protocol that included a chest CT in addition to a head CT and CT angiogram to identify Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infective pulmonary changes. RESULTS Overall, 2 patients had typical COVID-19 radiologic features and tested positive, while 7 patients had indeterminate imaging findings and tested negative. The others had normal or atypical changes and were not diagnosed with or suspected of having COVID-19. There was an overall sensitivity of 100%, specificity of 74.1%, negative predictive value of 100%, and positive predictive value of 22.2% when using chest CT to diagnose COVID-19 in comparison with the real-time reverse transcriptase-polymerase chain reaction test. The mean additional time and radiation dose incurred for the chest CT were 184 ± 65.5 seconds and 2.47 ± 1.03 mSv. Multiple cardiovascular and pulmonary incidental findings of clinical relevance were identified in our patient population. CONCLUSIONS Chest CT provides a pragmatic, rapid additional tool for COVID-19 risk stratification among patients referred for mechanical thrombectomy. Its inclusion in a standardized regional stroke imaging protocol has enabled efficient use of hospital resources with minimal compromise or delay to the overall patient treatment schedule.
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Affiliation(s)
- P S Dhillon
- From the Interventional Neuroradiology Department (P.S.D., R.L., S.N., N.M., W.I.), Queen's Medical Centre, Nottingham University Hospitals National Health Service Trust, Nottingham, UK
| | - K Pointon
- Cardiothoracic Radiology Department (K.P.)
| | - R Lenthall
- From the Interventional Neuroradiology Department (P.S.D., R.L., S.N., N.M., W.I.), Queen's Medical Centre, Nottingham University Hospitals National Health Service Trust, Nottingham, UK
| | - S Nair
- From the Interventional Neuroradiology Department (P.S.D., R.L., S.N., N.M., W.I.), Queen's Medical Centre, Nottingham University Hospitals National Health Service Trust, Nottingham, UK
| | - G Subramanian
- Stroke Medicine Department (G.S.), Nottingham City Hospital, Nottingham University Hospitals National Health Service Trust, Nottingham, UK
| | - N McConachie
- From the Interventional Neuroradiology Department (P.S.D., R.L., S.N., N.M., W.I.), Queen's Medical Centre, Nottingham University Hospitals National Health Service Trust, Nottingham, UK
| | - W Izzath
- From the Interventional Neuroradiology Department (P.S.D., R.L., S.N., N.M., W.I.), Queen's Medical Centre, Nottingham University Hospitals National Health Service Trust, Nottingham, UK
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Denlinger C, Lu G, Nair S, Kalinka E, Hosein F, Li J, Khushalani N. 1155TiP Pan-tumour study CheckMate 8TT for long-term follow-up of cancer survivors who have participated in trials investigating nivolumab. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Kato Y, Liew BS, Sufianov AA, Rasulic L, Arnautovic KI, Dong VH, Florian IS, Olldashi F, Makhambetov Y, Isam B, Thu M, Enkhbayar T, Kumarasinghe N, Bajamal AH, Nair S, Sharif S, Sharma MR, Landeiro JA, Yampolsky CG, El-Ghandour NMF, Hossain AM, Sim S, Chemate S, Burhan H, Feng L, Andrade H, Germano IM. Correction to: Review of global neurosurgery education: Horizon of Neurosurgery in the Developing Countries. Chin Neurosurg J 2020; 6:30. [PMID: 32925985 PMCID: PMC7444201 DOI: 10.1186/s41016-020-00209-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
[This corrects the article DOI: 10.1186/s41016-020-00194-1.].
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Affiliation(s)
- Y. Kato
- Department of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - B. S. Liew
- Department of Neurosurgery, Hospital Sungai Buloh, Sungai Buloh, Selangor Malaysia
| | - A. A. Sufianov
- Federal State-Financed Institution “Federal Centre of Neurosurgery” of Ministry of Health of the Russian Federation, Tyumen, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - L. Rasulic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - K. I. Arnautovic
- Semmes-Murphey Clinic and Department of Neurosurgery, University of Tennessee, Memphis, TN USA
| | - V. H. Dong
- Neurosurgery Center of Viet Duc University Hospital, Hanoi, Vietnam
| | - I. S. Florian
- Department of Neurosurgery, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Cluj County Romania
| | - F. Olldashi
- Department of Neurosurgery, University Hospital of Trauma, Tirana, Albania
| | | | - B. Isam
- Federal State-Financed Institution “Federal Centre of Neurosurgery” of Ministry of Health of the Russian Federation, Tyumen, Russia
| | - M. Thu
- Neurosurgical Centre, Yangon General Hospital, Yangoon, Myanmar
| | - Ts. Enkhbayar
- Mongolian Neurosurgical Society, Ulaabaatar, Mongolia
| | | | - A. H. Bajamal
- Department of Neurosurgery, Dr. Soetomo General Hospital, Airlangga University, Surabaya, Indonesia
| | - S. Nair
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - S. Sharif
- Institute of Postgraduate Studies and Medical Sciences, Liaquat National Hospital & Medical College, Karachi, Pakistan
| | - M. R. Sharma
- Department of Neurosurgery, TU Teaching Hospital, Kathmandu, Nepal
| | - J. A. Landeiro
- Department of Neurosurgery, Universidade Federal Fluminense, Niterói, Brazil
| | - C. G. Yampolsky
- Department of Neurosurgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - N. M. F. El-Ghandour
- Department of Neurosurgery, Faculty of Medicine, Cairo University, 81 Nasr Road, Nasr City, Cairo Egypt
| | - A. M. Hossain
- Bangladesh Society of Neurosurgeons, Dhaka, Bangladesh
| | - S. Sim
- Khema Clinic, 18 Street, Phnom Penh, 528 Cambodia
| | - S. Chemate
- DNB Neurosurgery, Apollo Hospital, Chennai, India
| | - Hira Burhan
- Institute of Neurosciences, Nobel Medical College and Teaching Hospital, Biratnagar, Nepal
| | - L. Feng
- China International Neuroscience Institute, Beijing, China
| | - H. Andrade
- Henan Provincial People’s Hospital, Juha Hernesniemi International Center for Neurosurgery, University of Zhengzhou, Zhengzhou, China
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Winkler ES, Bailey AL, Kafai NM, Nair S, McCune BT, Yu J, Fox JM, Chen RE, Earnest JT, Keeler SP, Ritter JH, Kang LI, Dort S, Robichaud A, Head R, Holtzman MJ, Diamond MS. SARS-CoV-2 infection in the lungs of human ACE2 transgenic mice causes severe inflammation, immune cell infiltration, and compromised respiratory function. bioRxiv 2020. [PMID: 32676600 DOI: 10.1101/2020.07.09.196188] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Severe Acute Respiratory Syndrome Coronavirus -2 (SARS-CoV-2) emerged in late 2019 and has spread worldwide resulting in the Coronavirus Disease 2019 (COVID-19) pandemic. Although animal models have been evaluated for SARS-CoV-2 infection, none have recapitulated the severe lung disease phenotypes seen in hospitalized human cases. Here, we evaluate heterozygous transgenic mice expressing the human ACE2 receptor driven by the epithelial cell cytokeratin-18 gene promoter (K18-hACE2) as a model of SARS-CoV-2 infection. Intranasal inoculation of SARS-CoV-2 in K18-hACE2 mice results in high levels of viral infection in lung tissues with additional spread to other organs. Remarkably, a decline in pulmonary function, as measured by static and dynamic tests of respiratory capacity, occurs 4 days after peak viral titer and correlates with an inflammatory response marked by infiltration into the lung of monocytes, neutrophils, and activated T cells resulting in pneumonia. Cytokine profiling and RNA sequencing analysis of SARS-CoV-2-infected lung tissues show a massively upregulated innate immune response with prominent signatures of NF-kB-dependent, type I and II interferon signaling, and leukocyte activation pathways. Thus, the K18-hACE2 model of SARS-CoV-2 infection recapitulates many features of severe COVID-19 infection in humans and can be used to define the mechanistic basis of lung disease and test immune and antiviral-based countermeasures.
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Lundon DJ, Kelly BD, Nair S, Bolton DM, Kyprianou N, Wiklund P, Tewari A. Early mortality risk stratification after SARS-CoV-2 infection. Med Intensiva 2020; 45:S0210-5691(20)30219-9. [PMID: 32912654 PMCID: PMC7334967 DOI: 10.1016/j.medin.2020.06.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/10/2020] [Accepted: 06/18/2020] [Indexed: 12/28/2022]
Affiliation(s)
- D J Lundon
- Department of Urology, Icahn School of Medicine, Mount Sinai Hospitals, New York, United States.
| | - B D Kelly
- Department of Urology, University of Melbourne, Austin Health, Melbourne, United States
| | - S Nair
- Department of Urology, Icahn School of Medicine, Mount Sinai Hospitals, New York, United States
| | - D M Bolton
- Department of Urology, University of Melbourne, Austin Health, Melbourne, United States
| | - N Kyprianou
- Department of Urology, Icahn School of Medicine, Mount Sinai Hospitals, New York, United States
| | - P Wiklund
- Department of Urology, Icahn School of Medicine, Mount Sinai Hospitals, New York, United States
| | - A Tewari
- Department of Urology, Icahn School of Medicine, Mount Sinai Hospitals, New York, United States.
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Treacy P, Martini A, Falagario U, Ratnani P, Horowitz A, Wajswol E, Begemann D, Beksac A, Durand M, Wiklund P, Nair S, Kyprianou N, Tewari A. The role of connective tissue in prostate cancer growth and progression. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33007-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Liu AY, Dower A, Nair S. Dexmedetomidine infusion for sedation in a patient with myotonic dystrophy. Anaesth Rep 2020; 8:135-137. [PMID: 33210091 DOI: 10.1002/anr3.12070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2020] [Indexed: 11/10/2022] Open
Abstract
Myotonic dystrophy type 1 is the most common muscular dystrophy in adults. Anaesthetic management should take into consideration the numerous body systems affected, including the musculoskeletal; respiratory; cardiovascular; gastro-intestinal; and central nervous systems. A 42-year-old man with myotonic dystrophy presented for septoplasty and bilateral inferior turbinate reductions. He had severe upper and lower extremity myotonia and weakness, pulmonary impairment with non-obstructive patterns and first-degree atrioventricular block with reduced ejection fraction. He used bilevel positive airway pressure, a cough assist device and was paced 3% of the time with a single-chamber pacemaker. To reduce potential complications associated with opioid use and general anaesthetics, an opioid-free technique was planned using local anaesthetic infiltration and sedation with a dexmedetomidine infusion. The patient maintained spontaneous ventilation and haemodynamic stability, and had an uneventful postoperative course. Dexmedetomidine is a highly selective α2-adrenergic receptor agonist that has the ability to provide sedation, analgesia and anxiolysis with a stable haemodynamic profile. Avoiding both opioids and general anaesthetics in these patients may decrease the risk of peri-operative complications.
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Affiliation(s)
- A Y Liu
- Michael G. DeGroote School of Medicine Hamilton Canada
| | - A Dower
- Department of Anesthesiology McMaster University and Hamilton Health Sciences Hamilton Canada
| | - S Nair
- Department of Anesthesiology McMaster University and Hamilton Health Sciences Hamilton Canada
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40
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Kato Y, Liew BS, Sufianov AA, Rasulic L, Arnautovic KI, Dong VH, Florian IS, Olldashi F, Makhambetov Y, Isam B, Thu M, Enkhbayar T, Kumarasinghe N, Bajamal AH, Nair S, Sharif S, Sharma MR, Landeiro JA, Yampolsky CG, El-Ghandour NMF, Hossain AM, Sim S, Chemate S, Burhan H, Feng L, Andrade H, Germano IM. Review of global neurosurgery education: Horizon of Neurosurgery in the Developing Countries. Chin Neurosurg J 2020; 6:19. [PMID: 32922948 PMCID: PMC7398343 DOI: 10.1186/s41016-020-00194-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 12/14/2019] [Accepted: 04/13/2020] [Indexed: 01/19/2023] Open
Abstract
Globally, the discipline of neurosurgery has evolved remarkably fast. Despite being one of the latest medical specialties, which appeared only around hundred years ago, it has witnessed innovations in the aspects of diagnostics methods, macro and micro surgical techniques, and treatment modalities. Unfortunately, this development is not evenly distributed between developed and developing countries. The same is the case with neurosurgical education and training, which developed from only traditional apprentice programs in the past to more structured, competence-based programs with various teaching methods being utilized, in recent times. A similar gap can be observed between developed and developing counties when it comes to neurosurgical education. Fortunately, most of the scholars working in this field do understand the coherent relationship between neurosurgical education and neurosurgical practice. In context to this understanding, a symposium was organized during the World Federation of Neurological Surgeons (WFNS) Special World Congress Beijing 2019. This symposium was the brain child of Prof. Yoko Kato—one of the eminent leaders in neurosurgery and an inspiration for female neurosurgeons. Invited speakers from different continents presented the stages of development of neurosurgical education in their respective countries. This paper summarizes the outcome of these presentations, with particular emphasis on and the challenges faced by developing countries in terms of neurosurgical education and strategies to cope with these challenges.
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Affiliation(s)
- Y Kato
- Department of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - B S Liew
- Department of Neurosurgery, Hospital Sungai Buloh, Sungai Buloh, Selangor Malaysia
| | - A A Sufianov
- Federal State-Financed Institution "Federal Centre of Neurosurgery" of Ministry of Health of the Russian Federation, Tyumen, Russia.,I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - L Rasulic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - K I Arnautovic
- Semmes-Murphey Clinic and Department of Neurosurgery, University of Tennessee, Memphis, TN USA
| | - V H Dong
- Neurosurgery Center of Viet Duc university hospital, Hanoi, Vietnam
| | - I S Florian
- Department of Neurosurgery, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Cluj County Romania
| | - F Olldashi
- Department of Neurosurgery, University Hospital of Trauma, Tirana, Albania
| | | | - B Isam
- Federal State-Financed Institution "Federal Centre of Neurosurgery" of Ministry of Health of the Russian Federation, Tyumen, Russia
| | - M Thu
- Neurosurgical Centre, Yangon General Hospital, Yangoon, Myanmar
| | - Ts Enkhbayar
- Mongolian Neurosurgical Society, Ulaabaatar, Mongolia
| | | | - A H Bajamal
- Department of Neurosurgery, Dr Soetomo General Hospital, Airlangga University, Surabaya, Indonesia
| | - S Nair
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - S Sharif
- Institute of Postgraduate Studies and Medical Sciences, Liaquat National Hospital & Medical College, Karachi, Pakistan
| | - M R Sharma
- Department of Neurosurgery, TU Teaching Hospital, Kathmandu, Nepal
| | - J A Landeiro
- Department of Neurosurgery, Universidade Federal Fluminense, Niterói, Brazil
| | - C G Yampolsky
- Department of Neurosurgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - N M F El-Ghandour
- Department of Neurosurgery, Faculty of Medicine, Cairo University, 81 Nasr Road, Nasr City, Cairo, Egypt
| | - A M Hossain
- Bangladesh Society of Neurosurgeons, Dhaka, Bangladesh
| | - S Sim
- Khema Clinic, 18 Street, Phnom Penh, 528 Cambodia
| | - S Chemate
- DNB Neurosurgery, Apollo Hospital, Chennai, India
| | - Hira Burhan
- Institute of Neurosciences, Nobel Medical College and Teaching Hospital, Biratnagar, Nepal
| | - L Feng
- China International Neuroscience Institute, Beijing, China
| | - H Andrade
- Department of Neurosurgery, University Medicine Mannheim, Mannheim, Germany
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Gensler LS, Chakravarty SD, Cameron C, Peterson S, Spin P, Kafka S, Nair S, Deodhar A. Propensity score matching/reweighting analysis comparing intravenous golimumab to infliximab for ankylosing spondylitis using data from the GO-ALIVE and ASSERT trials. Clin Rheumatol 2020; 39:2907-2917. [PMID: 32367407 PMCID: PMC7497341 DOI: 10.1007/s10067-020-05051-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 11/22/2019] [Revised: 02/28/2020] [Accepted: 03/20/2020] [Indexed: 12/17/2022]
Abstract
Objective To compare the relative efficacy of intravenous golimumab (GOL IV) and infliximab (IFX) for active ankylosing spondylitis (AS). Methods Propensity score (PS) methods were used to compare the efficacy of GOL IV 2 mg/kg and IFX 5 mg/kg using individual patient data (IPD) from the active arms of the phase 3 GO-ALIVE and ASSERT studies. Outcomes included the proportion of patients with a ≥ 20% improvement in the Assessment of Spondyloarthritis International Society Criteria (ASAS20), change from baseline in Bath Ankylosing Spondylitis Functional Index (BASFI) score, and change from baseline in C-reactive protein (CRP) levels from weeks 4–52. Results Before matching, 105 patients were treated with GOL IV and 201 patients were treated with IFX. After matching on all covariates, 118 patients were included in the ASAS20 analysis, 96 in the BASFI analysis, and 160 in the CRP analysis. After matching, GOL IV showed significantly greater improvement in ASAS20 response than IFX for weeks 28–44 (e.g., OR = 9.05 [95% CI 1.62–50.4] at week 44) and was comparable in change from baseline in BASFI scores and CRP levels to IFX at all time points. Results were robust for inclusion of different sets of covariates in scenario analyses. Conclusions This is the first analysis of its kind to leverage clinical trial data to compare two biologics using PS methods in the treatment of active AS. Overall, GOL IV was associated with greater improvement in ASAS20 response than IFX in patients with AS at 28, 36, and 44 weeks of follow-up.Key Points • Although intravenous golimumab (GOL IV) and infliximab (IFX) are the only two IV-based tumor necrosis factor (TNF) inhibitors with demonstrated phase 3 clinical efficacy in patients with ankylosing spondylitis (AS), no study has evaluated their comparative efficacy in a head-to-head trial. • Propensity score matching was used to derive indirect treatment comparisons of GOL IV and IFX for ≥ 20% in the Assessment of Spondyloarthritis International Society Criteria (ASAS20), change in Bath Ankylosing Spondylitis Functional Index (BASFI), and change in C-reactive protein (CRP) using individual patient data from the GO-ALIVE and ASSERT phase 3 trials. • Propensity score matched indirect comparisons showed improved relative efficacy of GOL IV compared to IFX; after matching for up to 16 baseline covariates, GOL IV was associated with significantly greater odds of ASAS20 response at weeks 28, 36, and 44 than IFX as well as equivalent changes from baseline in BASFI and CRP. • This novel application of propensity score matching using data from phase 3 trials, the first analysis of its kind in AS, allowed adjustment for important imbalances in prognostic factors between trials to generate estimates of comparative efficacy between GOL IV and IFX in the absence of a head-to-head trial between these treatments. |
Electronic supplementary material The online version of this article (10.1007/s10067-020-05051-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- L S Gensler
- Department of Medicine/Rheumatology, University of California, San Francisco, 400 Parnassus Ave, Box 0326, San Francisco, CA, 94143-0326, USA.
| | - S D Chakravarty
- Janssen Scientific Affairs, LLC, Horsham, PA, USA.,Drexel University College of Medicine, Philadelphia, PA, USA
| | - Chris Cameron
- EVERSANA™, Burlington, Ontario, Canada. .,EVERSANA™, 275 Charlotte St. Suite 207, Sydney, Nova Scotia, B1P 1C6, Canada.
| | - S Peterson
- Janssen Global Services, LLC, Horsham, PA, USA
| | - P Spin
- EVERSANA™, Burlington, Ontario, Canada
| | - S Kafka
- Janssen Scientific Affairs, LLC, Horsham, PA, USA
| | - S Nair
- Janssen Pharmaceutica NV, Turnhoutseweg 30, 2340, Beerse, Belgium
| | - A Deodhar
- Oregon Health & Science University, Portland, OR, USA
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Perez J, Harioudh MK, So L, Nair S, McCormick K, Ghosh A, Shao L, Srivastava R, Ebert T, Atianand M, Hornung V, Diamond MS, Savan R, Sarkar SN. Oligoadenylate Synthetase 1 enhances DNA sensor cGAS translation to mediate WNV antiviral activity. The Journal of Immunology 2020. [DOI: 10.4049/jimmunol.204.supp.249.15] [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] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Interferons inhibit virus replication through the expression of interferon stimulated genes (ISGs). We have found that a specific isoform of one such ISG, Oligoadenylate Synthetase 1 (OAS1) limits host susceptibility to West Nile Virus (WNV) infection through a non-canonical mechanism. This OAS1 isoform (OAS1 P46) in humans is generated due to an alternative splice acceptor site at the C-terminus of OAS1 gene. The SNP rs10774671 at this site has been associated with disease severity to WNV. We show that human OAS1-KO cells have lower basal levels of cGAS protein and can be rescued by OAS1 P46 independent of its enzyme activity. Additionally, through RNA-seq, SILAC, polysome profiling and radiolabeling experiments, we show that OAS1 does not regulate mRNA transcription but instead enhances protein translation of a select set of mRNAs, thereby increasing the steady state and induced levels of specific proteins with antiviral properties. Inducible expression of OAS1 P46 in cGAS-KO cells does not suppress WNV replication, suggesting that the antiviral activity of OAS1 is mediated through cGAS. We also have established functional equivalence between OAS1 P46 and a mouse ortholog, Oas1b (no enzyme activity), which similarly affects WNV susceptibility. Oas1b inhibits WNV infection and pathogenesis in vivo and inhibits WNV infection in vitro in cGAS-dependent manner. Through RNA-protein crosslinking experiments we have identified target mRNAs that bind to OAS1 and have demonstrated increased sensitivity of WNV in Oas1b RNA binding mutants. Our findings suggest a novel mechanism of OAS1 in which it binds to target mRNAs, enhances the translation of these RNAs and limits virus infection.
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Affiliation(s)
- Joseph Perez
- 1Cancer Virology Program, UPMC Hillman Cancer Center, Pittsburgh, PA
- 2Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Munesh K. Harioudh
- 1Cancer Virology Program, UPMC Hillman Cancer Center, Pittsburgh, PA
- 2Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Lomon So
- 3Department of Immunology, University of Washington School of Medicine, Seattle, WA
| | - Sharmila Nair
- 4Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO
| | - Kevin McCormick
- 2Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Arundhati Ghosh
- 1Cancer Virology Program, UPMC Hillman Cancer Center, Pittsburgh, PA
- 2Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Lulu Shao
- 1Cancer Virology Program, UPMC Hillman Cancer Center, Pittsburgh, PA
- 2Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Rashmi Srivastava
- 1Cancer Virology Program, UPMC Hillman Cancer Center, Pittsburgh, PA
- 2Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Thomas Ebert
- 5Gene Center and Department of Biochemistry, Ludwig-Maximilians-Universität München, Munic, Germany
| | - Maninjay Atianand
- 6Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Veit Hornung
- 5Gene Center and Department of Biochemistry, Ludwig-Maximilians-Universität München, Munic, Germany
| | - Michael S. Diamond
- 4Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO
| | - Ram Savan
- 3Department of Immunology, University of Washington School of Medicine, Seattle, WA
| | - Saumendra N. Sarkar
- 1Cancer Virology Program, UPMC Hillman Cancer Center, Pittsburgh, PA
- 2Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA
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Singh S, Khorsandi M, De S, Dalzell J, Morcos K, Hegazy Y, Al-Haideri H, Nair S, Doshi H, Al-Attar N, Curry P. Mitigating Risks of Primary Graft Dysfunction with Antegrade Myocardial Perfusion. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract
Abstract
Glioblastoma (GBM) kills most adults within 2 years. One reason for inevitable recurrence is that GBM stem cells (GSCs) are resistant to existing therapies. Additionally, GBM is the hallmark example of an immunotherapy-resistant tumor. Since GSCs share properties with neural stem cells, we investigated whether the natural honing and lytic activity of Zika virus (ZIKV) could be harnessed to target and kill GSCs. We published the first use of ZIKV to kill GSCs: ZIKV kills GSCs in tumors removed from patients, with minimal impact on non-GSC tumor cells and importantly, normal human brain cells were not affected by ZIKV. In vivo, ZIKV more than doubled median survival in immunocompetent mice bearing orthotopic gliomas, and in 40-50% of cases, mice were cured. In new unpublished work, we assessed brains of mice treated with ZIKV and found that treatment induces a robust inflammatory response. Using MHC-I tetramers presenting ZIKV envelope (E) protein or luciferase peptides (expressed in the tumor cells), we found that CD8+ T cells in the region of the tumor respond to both ZIKV and tumor, and anti-tumor CD8+ T cells are increased after ZIKV infection compared to vehicle. Additionally, cured mice were protected against tumor rechallenge, suggesting ZIKV induces immunologic memory that can surveil against recurrence. Using blocking antibodies, we discovered that CD8+ T cells are required for the efficacy of ZIKV, and CD8+ T cells are required for long-term protection. Our findings suggest that ZIKV may be an effective therapy for GBM for two reasons: its direct targeting of treatment-resistant tumor cells in turn produces an antitumor inflammatory response. Such a response may now be further leveraged by immunotherapies.
Citation Format: Arijita Jash, Jennifer Govero, Sharmila Nair, Michael S. Diamond, Milan G. Chheda. Leveraging Zika virus and the immune system to treat glioblastoma [abstract]. In: Proceedings of the AACR Special Conference on Tumor Immunology and Immunotherapy; 2019 Nov 17-20; Boston, MA. Philadelphia (PA): AACR; Cancer Immunol Res 2020;8(3 Suppl):Abstract nr A13.
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Affiliation(s)
- Arijita Jash
- Washington University School of Medicine, St. Louis, MO
| | | | - Sharmila Nair
- Washington University School of Medicine, St. Louis, MO
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Anandh U, Gopal B, Conjeevaram A, Cortes C, Gleeson S, Madariaga H, Malina M, Arce-Amare F, Lerma E, Turgut D, Bek S, Nair S, Paunic Z, Desai T, Pastor A. SAT-484 Trends in Twitter Coverage of Nephrology Conferences through Novel Indices of Impact. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.516] [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: 10/24/2022] Open
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46
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Aruljothy A, Russell L, Nair S, Albashir S. A185 ABDOMINAL WALL VARICES: A CASE REPORT. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.184] [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
Portal hypertension in cirrhosis results in variable and numerous portosystemic collateral circulations. Computed tomography (CT) and Doppler ultrasound (US) can identify these collateral vessels, especially abdominal wall varices, which can be encountered during a bedside paracentesis.
Aims
Describe a case of traumatic abdominal wall variceal bleed.
Methods
Case report.
Results
A 53 year-old Caucasian male presented to the emergency department (ED) with 4-days of abdominal pain and 2-months of increased abdominal girth. His medical history included Child Pugh Class B alcoholic liver cirrhosis diagnosed 1 year ago. No prior history of ascites, esophageal variceal bleed or hepatic encephalopathy. In the ED, his US showed moderate ascites with right portal vein flow reversal. A diagnostic RLQ paracentesis showed yellow ascitic fluid, no spontaneous bacterial peritonitis (SBP), and he was discharged home with diuretics.
He returned to the ED the next day for increased abdominal girth with a Hb of 103 g/L. A diagnostic RLQ paracentesis showed orange-red ascitic fluid and no SBP. The following day, a therapeutic US-guided paracentesis was attempted in the RLQ and left-lower quadrant LLQ; however, ascitic fluid aspirate was grossly bloody. The procedure was aborted. Hb was 82 g/L and progressively decreased. CT angiogram was performed and showed a 10.7 x 4.7 x 8.0 cm hyperdense fluid in the right paracolic gutter near the paracentesis site, consistent with intraperitoneal hemorrhage (Figure A). The insertion site was seen as abdominal wall musculature focal thickening around abdominal wall varices and no contrast extravasation was seen. Gastroesophageal, splenic hilar and omental varices were seen. Doppler US showed no sonographic signs of active extravasation. Interventional Radiology performed a US-guided paracentesis and aspirated 3650 mL of hemorrhagic fluid. Color Doppler US showed small varices within the subcutaneous soft tissues (Figure A).
The patient later developed hematemesis with an EGD showing a large high-risk esophageal varix actively bleeding that was banded. Given the refractory variceal bleeding, a Minnesota tube was inserted 4 days later and a transjugular intrahepatic portosystemic shunt was inserted the following day. Unfortunately, the patient developed progressive worsening hepatic encephalopy, multi-organ failure and expired 7-days later.
Conclusions
Adjunct imaging modalities such as color flow Doppler US or CT can be used as a screening tool to identify abdominal wall varices and reduce paracentesis bleeding complications.
Funding Agencies
None
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Affiliation(s)
| | - L Russell
- Gastroenterology, McMaster Univeristy, Hamilton, ON, Canada
| | - S Nair
- McMaster University, Hamilton, ON, Canada
| | - S Albashir
- McMaster University, Hamilton, ON, Canada
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Cosgrave D, Vencken S, Galligan M, McGuinness S, Soukhin E, McMullan V, Nair S, Puttappa A, Boylan J, Hussain R, Conlon N, Doran P, Nichol A. The effect of a low‐dose naloxone infusion on the incidence of respiratory depression after intrathecal morphine administration for major open hepatobiliary surgery: a randomised controlled trial. Anaesthesia 2019; 75:747-755. [DOI: 10.1111/anae.14931] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2019] [Indexed: 12/13/2022]
Affiliation(s)
- D. Cosgrave
- Department of Anaesthesia St. Vincent's University Hospital Dublin Ireland
| | - S. Vencken
- Clinical Research Centre University College Dublin Ireland
| | - M. Galligan
- Clinical Research Centre University College Dublin Ireland
| | - S. McGuinness
- Department of Anaesthesia St. Vincent's University Hospital Dublin Ireland
- Department of Anaesthesia the National Maternity Hospital Dublin Ireland
| | - E. Soukhin
- Department of Anaesthesia Auckland City Hospital Auckland New Zealand
| | - V. McMullan
- Department of Anaesthesia Tallaght University Hospital Dublin Ireland
| | - S. Nair
- Liver transplantation and cardiac anaesthesia Kings College Hospital NHS Trust London UK
| | - A. Puttappa
- Department of Anaesthesia Addenbrookes Hospital Cambridge University Hospital NHS Trust Cambridge UK
| | - J. Boylan
- Department of Anaesthesia St. Vincent's University Hospital Dublin Ireland
| | - R. Hussain
- Clinical Research Centre St. Vincent's University Hospital Dublin Ireland
| | - N. Conlon
- Department of Anaesthesia St. Vincent's University Hospital Dublin Ireland
| | - P. Doran
- Australian and New Zealand Intensive Care Research Centre Monash University Melbourne Vic. Australia
| | - A. Nichol
- Department of Intensive Care Medicine St. Vincent's University Hospital Dublin Ireland
- Clinical Research Centre St. Vincent's University Hospital Dublin Ireland
- Australian and New Zealand Intensive Care Research Centre Monash University Melbourne Vic. Australia
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Treacy P, Martini A, Ratnani P, Nair S, Horowitz A, Wiklund P, Durand M, Tewari A. La signature transcriptomique des gènes du tissu conjonctif prédit des caractéristiques péjoratives chez les patients avec un cancer de prostate localisé. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.079] [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: 10/25/2022]
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Naziri J, Savla B, Nadeem J, Adediran S, Nair S, Mcintosh A. A Retrospective Review of Unresectable Stage III and Stage IV Oligometastatic Cancers Treated with Concurrent PD-1 Inhibition and Ablative Radiotherapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1235] [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: 11/28/2022]
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White Z, Dates C, Rajbhandari R, Nair S, Nozell S, Bredel M. Impact of ANXA7 I1 Expression on PDGFRA and MET Endosomal Trafficking in Glioblastoma. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1009] [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: 10/26/2022]
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