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Gerull S, Tschan-Plessl A, Mathew R, Nair G, Passweg JR, Halter JP. Late relapse after stopping sorafenib in allogeneic hematopoietic stem cell transplant recipients. Bone Marrow Transplant 2018; 54:769-771. [PMID: 30401969 DOI: 10.1038/s41409-018-0376-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Accepted: 10/12/2018] [Indexed: 11/09/2022]
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Absinta M, Sati P, Fechner A, Schindler MK, Nair G, Reich DS. Identification of Chronic Active Multiple Sclerosis Lesions on 3T MRI. AJNR Am J Neuroradiol 2018; 39:1233-1238. [PMID: 29724768 DOI: 10.3174/ajnr.a5660] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 03/13/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE MR imaging-pathologic studies have reported that paramagnetic rims on 7T susceptibility-based MR imaging identify, in vivo, the subset of MS lesions with compartmentalized inflammation at the lesion edge and associated remyelination failure. Here, we assessed the reliability of detecting these rims on high-resolution 3T phase images. MATERIALS AND METHODS High-resolution T2* and phase MR imaging was collected in 20 patients with MS at 3T (3D segmented EPI, 0.65 mm3) and 7T (2D gradient-echo, 0.2 × 0.2 × 1 mm) MR imaging. In each case, 5 discrete chronic (nonenhancing) MS lesions were selected on T2 FLAIR images for rim evaluation. Five raters experienced in MS imaging contributed to the rim assessment, of whom 3 worked independently on 3T data, and 2, on 7T data. Consensus agreement was reached for both 3T and 7T rim evaluations. Discrepancies between 3T and 7T were discussed, and consensus was reached. RESULTS Phase rims were seen in 34 lesions at 7T and in 36 lesions at 3T by consensus. Inter- and intrarater reliability were "substantial/good" both at 3T and 7T analysis (Cohen κ, >0.71). Based on consensus agreement, the reliability of rim visualization at 3T versus 7T was 0.78 (κ) with a pair-wise agreement of 90%. More lesions were judged to be false-positive or false-negative at 3T than at 7T. CONCLUSIONS Nearly all 7T paramagnetic rims can also be seen at 3T. Imaging at 3T opens the possibility of implementing paramagnetic rims as an outcome measure in multicenter, MR imaging-based clinical trials aimed at treating perilesional persistent inflammation and its potential effects on remyelination.
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Dworkin JD, Linn KA, Oguz I, Fleishman GM, Bakshi R, Nair G, Calabresi PA, Henry RG, Oh J, Papinutto N, Pelletier D, Rooney W, Stern W, Sicotte NL, Reich DS, Shinohara RT. An Automated Statistical Technique for Counting Distinct Multiple Sclerosis Lesions. AJNR Am J Neuroradiol 2018; 39:626-633. [PMID: 29472300 PMCID: PMC5895493 DOI: 10.3174/ajnr.a5556] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 12/10/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Lesion load is a common biomarker in multiple sclerosis, yet it has historically shown modest association with clinical outcome. Lesion count, which encapsulates the natural history of lesion formation and is thought to provide complementary information, is difficult to assess in patients with confluent (ie, spatially overlapping) lesions. We introduce a statistical technique for cross-sectionally counting pathologically distinct lesions. MATERIALS AND METHODS MR imaging was used to assess the probability of a lesion at each location. The texture of this map was quantified using a novel technique, and clusters resembling the center of a lesion were counted. Validity compared with a criterion standard count was demonstrated in 60 subjects observed longitudinally, and reliability was determined using 14 scans of a clinically stable subject acquired at 7 sites. RESULTS The proposed count and the criterion standard count were highly correlated (r = 0.97, P < .001) and not significantly different (t59 = -.83, P = .41), and the variability of the proposed count across repeat scans was equivalent to that of lesion load. After accounting for lesion load and age, lesion count was negatively associated (t58 = -2.73, P < .01) with the Expanded Disability Status Scale. Average lesion size had a higher association with the Expanded Disability Status Scale (r = 0.35, P < .01) than lesion load (r = 0.10, P = .44) or lesion count (r = -.12, P = .36) alone. CONCLUSIONS This study introduces a novel technique for counting pathologically distinct lesions using cross-sectional data and demonstrates its ability to recover obscured longitudinal information. The proposed count allows more accurate estimation of lesion size, which correlated more closely with disability scores than either lesion load or lesion count alone.
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Beck ES, Sati P, Sethi V, Kober T, Dewey B, Bhargava P, Nair G, Cortese IC, Reich DS. Improved Visualization of Cortical Lesions in Multiple Sclerosis Using 7T MP2RAGE. AJNR Am J Neuroradiol 2018; 39:459-466. [PMID: 29439120 DOI: 10.3174/ajnr.a5534] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 11/15/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Cortical lesions are common and often extensive in multiple sclerosis but are difficult to visualize by MRI, leaving important questions about their clinical implications and response to therapy unanswered. Our aim was to determine whether cortical lesions are better visualized using magnetization prepared 2 rapid acquisition gradient echoes (MP2RAGE) than T2*-weighted imaging on 7T MR imaging. MATERIALS AND METHODS Brain MR imaging using T1-weighted MP2RAGE at 500-μm isotropic resolution, T2*-weighted gradient-echo, and T2*-weighted segmented echo-planar imaging sequences were collected for 13 patients with MS and 5 age-matched neurologically healthy controls on a 7T research system. One MS case underwent postmortem MR imaging including gradient-echo and MP2RAGE sequences, after which cortical lesions seen on MR imaging were assessed with immunohistochemistry. RESULTS MP2RAGE detected 203 cortical lesions (median, 16 lesions/case; interquartile range, 15), compared to 92 with T2*gradient-echo (median, 7; interquartile range, 8; P < .001) and 81 with T2*EPI (median, 7; interquartile range, 5; P < .001). This increase in lesion number detected on MP2RAGE versus T2* was observed for juxtacortical, leukocortical, and intracortical lesions. Forty-three percent of all cortical lesions were identified only on MP2RAGE. White matter lesion volume correlated with total juxtacortical (r = 0.86, P < .001) and leukocortical lesion volume (r = 0.70, P < .01) but not intracortical lesion volume, suggesting that pathophysiology may differ by lesion type. Of 4 suspected lesions seen on postmortem imaging, 3 were found to be true cortical lesions while 1 represented postmortem tissue damage. CONCLUSIONS A combination of MP2RAGE and T2*-weighted imaging at 7T improved detection of cortical lesions and should enable longitudinal studies to elucidate their spatiotemporal dynamics and clinical implications.
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Binet I, Nair G, Schanz U, Studt JD. Heparin-induced thrombocytopenia associated with thrombotic microangiopathy. Hamostaseologie 2018; 33:160-3. [DOI: 10.5482/hamo-13-03-0012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 04/26/2013] [Indexed: 11/05/2022] Open
Abstract
SummarySome cases of thrombotic microangiopathy (TMA) are refractory to plasma exchange therapy (PE) with persistence or recurrence of thrombocytopenia. We report two patients suffering from TMA of different aetiologies (associated with disseminated malignancy, typical haemolytic uraemic syndrome) with recurrent or persistent thrombocytopenia despite adequate therapy including PE. Since both patients were exposed to unfractionated heparin, heparin-induced thrombocytopenia (HIT) was suspected as a cause. Pretest probabilities for HIT were intermediate. ELISA for PF4/heparin antibodies was strongly positive in both cases, and HIT was confirmed by heparin-induced platelet activation assay. Anticoagulation with lepirudin was initiated, with subsequent rapid increase of the platelet count.TMA might represent a predisposition for HIT. This could be due to TMA-related platelet activation with increased PF4 release. In TMA patients exposed to heparin and with refractory or rapidly recurrent thrombocytopenia HIT should always be considered as a possible cause.
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Spence S, Redpath C, Nair G, Nery P, Sadek M, Birnie D. CARDIAC TAMPONADE DURING ATRIAL FIBRILLATION ABLATION, BEFORE AND AFTER INTRODUCTION OF CONTACT FORCE SENSING CATHETERS. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Al Dawood W, Birnie D, Nair G, Redpath C, Sadek M, Nery P. ATRIAL SCAR BURDEN IN PATIENTS WITH ATRIAL FIBRILLATION: INSIGHTS FROM CONTEMPORARY INTRACARDIAC MAPPING. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Gerber V, Alqarawi W, Erthal L, Nery P, Sadek M, Redpath C, Birnie D, Dwivedi G, Nair G. RELATIONSHIP BETWEEN OUTCOMES OF CATHETER ABLATION FOR PREMATURE VENTRICULAR CONTRACTIONS AND CARDIAC MAGNETIC RESONANCE SCAR. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Daoust A, Dodd S, Nair G, Bouraoud N, Jacobson S, Walbridge S, Reich DS, Koretsky A. Transverse relaxation of cerebrospinal fluid depends on glucose concentration. Magn Reson Imaging 2017; 44:72-81. [PMID: 28782676 DOI: 10.1016/j.mri.2017.08.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 07/28/2017] [Accepted: 08/02/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To evaluate the biophysical processes that generate specific T2 values and their relationship to specific cerebrospinal fluid (CSF) content. MATERIALS AND METHODS CSF T2s were measured ex vivo (14.1T) from isolated CSF collected from human, rat and non-human primate. CSF T2s were also measured in vivo at different field strength in human (3 and 7T) and rodent (1, 4.7, 9,4 and 11.7T) using different pulse sequences. Then, relaxivities of CSF constituents were measured, in vitro, to determine the major molecule responsible for shortening CSF T2 (2s) compared to saline T2 (3s). The impact of this major molecule on CSF T2 was then validated in rodent, in vivo, by the simultaneous measurement of the major molecule concentration and CSF T2. RESULTS Ex vivo CSF T2 was about 2.0s at 14.1T for all species. In vivo human CSF T2 approached ex vivo values at 3T (2.0s) but was significantly shorter at 7T (0.9s). In vivo rodent CSF T2 decreased with increasing magnetic field and T2 values similar to the in vitro ones were reached at 1T (1.6s). Glucose had the largest contribution of shortening CSF T2in vitro. This result was validated in rodent in vivo, showing that an acute change in CSF glucose by infusion of glucose into the blood, can be monitored via changes in CSF T2 values. CONCLUSION This study opens the possibility of monitoring glucose regulation of CSF at the resolution of MRI by quantitating T2.
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Shinohara RT, Oh J, Nair G, Calabresi PA, Davatzikos C, Doshi J, Henry RG, Kim G, Linn KA, Papinutto N, Pelletier D, Pham DL, Reich DS, Rooney W, Roy S, Stern W, Tummala S, Yousuf F, Zhu A, Sicotte NL, Bakshi R. Volumetric Analysis from a Harmonized Multisite Brain MRI Study of a Single Subject with Multiple Sclerosis. AJNR Am J Neuroradiol 2017; 38:1501-1509. [PMID: 28642263 PMCID: PMC5557658 DOI: 10.3174/ajnr.a5254] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 04/06/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE MR imaging can be used to measure structural changes in the brains of individuals with multiple sclerosis and is essential for diagnosis, longitudinal monitoring, and therapy evaluation. The North American Imaging in Multiple Sclerosis Cooperative steering committee developed a uniform high-resolution 3T MR imaging protocol relevant to the quantification of cerebral lesions and atrophy and implemented it at 7 sites across the United States. To assess intersite variability in scan data, we imaged a volunteer with relapsing-remitting MS with a scan-rescan at each site. MATERIALS AND METHODS All imaging was acquired on Siemens scanners (4 Skyra, 2 Tim Trio, and 1 Verio). Expert segmentations were manually obtained for T1-hypointense and T2 (FLAIR) hyperintense lesions. Several automated lesion-detection and whole-brain, cortical, and deep gray matter volumetric pipelines were applied. Statistical analyses were conducted to assess variability across sites, as well as systematic biases in the volumetric measurements that were site-related. RESULTS Systematic biases due to site differences in expert-traced lesion measurements were significant (P < .01 for both T1 and T2 lesion volumes), with site explaining >90% of the variation (range, 13.0-16.4 mL in T1 and 15.9-20.1 mL in T2) in lesion volumes. Site also explained >80% of the variation in most automated volumetric measurements. Output measures clustered according to scanner models, with similar results from the Skyra versus the other 2 units. CONCLUSIONS Even in multicenter studies with consistent scanner field strength and manufacturer after protocol harmonization, systematic differences can lead to severe biases in volumetric analyses.
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Gresch B, Kirsch M, Fierz K, Halter JP, Nair G, Denhaerynck K, De Geest S. Medication nonadherence to immunosuppressants after adult allogeneic haematopoietic stem cell transplantation: a multicentre cross-sectional study. Bone Marrow Transplant 2016; 52:304-306. [PMID: 27841860 DOI: 10.1038/bmt.2016.262] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Redpath C, Peng J, Sadek M, Nair G, Birnie D, Bery P, Green M. CONTEMPORANEOUS RESULTS OF SLOW PATHWAY ABLATION FOR ATRIOVENTRICULAR NODAL TACHYCARDIA IN A HIGH VOLUME TERTIARY REFERRAL CENTRE. Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Yeo C, MacDonald Z, Birnie D, Nery P, Redpath C, Sadek M, Nair G. CHARACTERISTICS AND PREDICTORS OF ELECTRICAL RECONNECTIONS COMPARING CONTACT FORCE (CF) VERSUS NON CF GUIDED PVI. Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Moodley K, Duby Z, Staunton C, Hendricks M, Nair G, Roubaix M, Skinner D. OA1-2 Ethical and social implications of proposed HIV cure research: stakeholder perspectives from South Africa. J Virus Erad 2016. [DOI: 10.1016/s2055-6640(20)31006-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Noguchi L, Hillier S, Richardson B, Chirenje Z, Ramjee G, Nair G, Selepe P, Palanee-Phillips T, Panchia R, Gomez K, Balkus J, Taha T, Piper J, Watts D, Marrazzo J. 5: Injectable progestin contraception and vaginal infection among south african women participating in the VOICE trial. Am J Obstet Gynecol 2015. [DOI: 10.1016/j.ajog.2015.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Nair G, Absinta M, Reich DS. Optimized T1-MPRAGE sequence for better visualization of spinal cord multiple sclerosis lesions at 3T. AJNR Am J Neuroradiol 2013; 34:2215-22. [PMID: 23764721 DOI: 10.3174/ajnr.a3637] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Spinal cord lesions are highly prevalent in MS, and their visualization can help both in diagnosis and patient follow-up. However, the sensitivity of MR imaging to spinal cord lesions remains poor, primarily because of suboptimal contrast between lesions and a normal-appearing cord. Here, we propose an optimized 3D MPRAGE sequence for improved detection of MS lesions in the spinal cord at 3T. MATERIALS AND METHODS Images were acquired by use of T2 FSE, STIR, T1-gradient recalled-echo (for T1 mapping), and T1-MPRAGE in the sagittal plane, and T2*-weighted scans in the axial plane, on 40 patients with MS and 7 healthy volunteers. Two observers qualitatively evaluated the images for lesion conspicuity. Lesions seen between the C1 and C4 segments in 10 randomly selected patients with MS were further evaluated quantitatively for contrast-to-noise ratio between the lesion and normal-appearing cord, and for lesion burden. RESULTS Spinal cord lesions were more conspicuous on the optimized T1-MPRAGE sequence than on any other sequence tested. Detailed analysis revealed that lesions were almost 3 times more conspicuous (P < .01), and the total lesion volume was 2 times greater (P < .05, n=10), in the T1-MPRAGE sequence compared with the standard STIR sequence. Correlation of clinical disability (Expanded Disability Status Score) with lesion load from each sequence also demonstrated the importance of the improved lesion conspicuity with T1-MPRAGE. CONCLUSIONS The optimized T1-MPRAGE sequence described here improves the reliability of lesion visualization and estimation of lesion burden, especially when used in conjunction with other well-established clinical sequences.
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Sarrazin J, Nair G, Nanthakumar K, Leong-Sit P, Sapp J, Kuriachan V, Singh S, Nery P, Gula L, Downar E, Chauhan V, Skanes A, Nault I. 732 Safety and Efficacy of Epicardial Access for Catheter Ablation: A Canadian Multicenter Experience. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Kahn G, Fitzwater S, Tate J, Kang G, Ganguly N, Nair G, Steele D, Arora R, Chawlasarkar M, Parashar U, Santosham M. Epidemiology and prospects for prevention of rotavirus disease in India. Indian Pediatr 2012; 49:467-74. [DOI: 10.1007/s13312-012-0076-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nair G, Van Dyk K, Shah U, Purohit DP, Pinto C, Shah AB, Grossman H, Perl D, Ganwir V, Shanker S, Sano M. Characterizing cognitive deficits and dementia in an aging urban population in India. Int J Alzheimers Dis 2012; 2012:673849. [PMID: 22792507 PMCID: PMC3390041 DOI: 10.1155/2012/673849] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2012] [Accepted: 05/07/2012] [Indexed: 12/04/2022] Open
Abstract
Rapid rise in the population of older adults in India will lead to the need for increased health care services related to diagnosis, management, and long-term care for those with dementia and cognitive impairment. A direct approach for service provision through memory clinics can be an effective, successful, and sustaining means of delivering specialized health care services. We have established a memory clinic in Mumbai, India by employing the diverse clinical skills available in Indian academic institutions, diagnostic and research expertise of clinicians and psychologists, and the support of the U.S. National Institutes of Health. Our project involved recruitment of patients, clinical and neuropsychological assessment, and standardized diagnostic procedures, demonstrating the feasibility of using research methods to develop a memory clinic. In this paper, we describe the development of a community-based memory clinic in urban India, including linguistic and cultural factors and present detailed results, including diagnostic characterization, on 194 subjects with various stages of cognitive deficits. Our findings support the feasibility of developing a memory clinic in a public hospital and successful use of research diagnostic criteria to categorize cognitive deficits observed in this population, which may be used to inform the development of other such clinics.
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Nair G, Inati S, Kranick S, Quezado M, Sereti I, Sheikh V, Reich D, Nath A. Postmortem MRI in Progressive Multifocal Leukoencephalopathy (P02.272). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p02.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Carew JD, Nair G, Andersen PM, Wuu J, Gronka S, Hu X, Benatar M. Presymptomatic spinal cord neurometabolic findings in SOD1-positive people at risk for familial ALS. Neurology 2011; 77:1370-5. [PMID: 21940617 PMCID: PMC3182757 DOI: 10.1212/wnl.0b013e318231526a] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2011] [Accepted: 06/14/2011] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE It has been speculated that amyotrophic lateral sclerosis (ALS) is characterized by a premanifest period during which neurodegeneration precedes the appearance of clinical manifestations. Magnetic resonance spectroscopy (MRS) was used to measure ratios of neurometabolites in the cervical spine of asymptomatic individuals with a mutation in the SOD1 gene (SOD1+) and compare their neurometabolic ratios to patients with ALS and healthy controls. METHODS A cross-sectional study of (1)H-MRS of the cervical spine was performed on 24 presymptomatic SOD1+ volunteers, 29 healthy controls, and 23 patients with ALS. All presymptomatic subjects had no symptoms of disease, normal forced vital capacity, and normal electromyographic examination. Relative concentrations of choline (Cho), creatine (Cr), myo-inositol (Myo), and N-acetylaspartate (NAA) were determined. RESULTS NAA/Cr and NAA/Myo ratios are reduced in both SOD1+ subjects (39.7%, p = 0.001 and 18.0%, p = 0.02) and patients with ALS (41.2%, p < 0.001 and 24.0%, p = 0.01) compared to controls. Myo/Cr is reduced (10.3%, p = 0.02) in SOD1+ subjects compared to controls, but no difference was found between patients with ALS and controls. By contrast, NAA/Cho is reduced in patients with ALS (24.0%, p = 0.002), but not in presymptomatic SOD1+ subjects compared to controls. CONCLUSIONS Changes in neurometabolite ratios in the cervical spinal cord are evident in presymptomatic SOD1+ individuals in advance of symptoms and clinical or electromyographic signs of disease. These changes reflect a reduction in NAA/Cr and NAA/Myo. Neurometabolic changes in this population resemble changes observed in patients with clinically apparent ALS. This suggests that neurometabolic changes occur early in the course of the disease process.
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Bhanot S, Nair G, Kandeel W, Awad N, Bach C, Zamora I, Barua J. UP-02.047 Experience with Single One-Centimeter Port Laparoscopic Radical Prostatectomy. Urology 2011. [DOI: 10.1016/j.urology.2011.07.865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bhanot S, Kandeel W, Nair G, Zamora I, Awad N, Bach C, Barua J. UP-02.104 The Significance of Contiguous Tumour Positivity in Needle Biopsies of Prostate. Urology 2011. [DOI: 10.1016/j.urology.2011.07.922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Macle L, Khairy P, Andrade J, Khaykin Y, Mantovan R, De Martino G, Chen J, Morillo C, Novak P, Calzolari V, Guerra P, Nair G, Torrecilla E, Rivard L, Dubuc M, Talajic M, Thibault B, Roy D, Verma A. 343 Incidence and significance of early recurrences associated with different ablation strategies for AF: Insights from the multicenter STAR-AF trial. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Nair G, Karmali R, Gregory SA, Shammo JM, Fung HC, Jimenez A, Venugopal P, Larson ML. Etoposide and cytarabine as an effective and safe cytoreductive regimen for relapsed or refractory acute myeloid leukemia. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.6539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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