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Agarwal S, Choi SW, Fletcher SN, Klein AA, Gill R. The incidence and effect of resternotomy following cardiac surgery on morbidity and mortality: a 1-year national audit on behalf of the Association of Cardiothoracic Anaesthesia and Critical Care. Anaesthesia 2020; 76:19-26. [PMID: 32406071 DOI: 10.1111/anae.15070] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2020] [Indexed: 12/11/2022]
Abstract
Over 30,000 adult cardiac operations are carried out in the UK annually. A small number of these patients need to return to theatre in the first few days after the initial surgery, but the exact proportion is unknown. The majority of these resternotomies are for bleeding or cardiac tamponade. The Association of Cardiothoracic Anaesthesia and Critical Care carried out a 1-year national audit of resternotomy in 2018. Twenty-three of the 35 centres that were eligible participated. The overall resternotomy rate (95%CI) within the period of admission for the initial operation in these centres was 3.6% (3.37-3.85). The rate varied between centres from 0.69% to 7.6%. Of the 849 patients who required resternotomy, 127 subsequently died, giving a mortality rate (95%CI) of 15.0% (12.7-17.5). In patients who underwent resternotomy, the median (IQR [range]) length of stay on ICU was 5 (2-10 [0-335]) days, and time to tracheal extubation was 20 (12-48 [0-2880]) hours. A total of 89.3% of patients who underwent resternotomy were transfused red cells, with a median (IQR [range]) of 4 (2-7 [1-1144]) units of red blood cells. The rate (95%CI) of needing renal replacement therapy was 23.4% (20.6-26.5). This UK-wide audit has demonstrated that resternotomy after cardiac surgery is associated with prolonged intensive care stay, high rates of blood transfusion, renal replacement therapy and very high mortality. Further research into this area is required to try to improve patient care and outcomes in patients who require resternotomy in the first 24 h after cardiac surgery.
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Affiliation(s)
- S Agarwal
- Department of Anaesthesia, Manchester University Hospitals, Manchester, UK
| | - S W Choi
- Department of Anaesthesiology, University of Hong Kong
| | - S N Fletcher
- Departments of Anaesthesia and Critical Care, St George's Hospital, London, UK
| | - A A Klein
- Department of Anaesthesia and Intensive Care, Royal Papworth Hospital, Cambridge, UK
| | - R Gill
- Shackleton Department of Anaesthesia, University Hospital Southampton, UK
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Gupta N, Agarwal S. Advanced-PRF: Clinical evaluation in impacted mandibular third molar sockets. J Stomatol Oral Maxillofac Surg 2020; 122:43-49. [PMID: 32360489 DOI: 10.1016/j.jormas.2020.04.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 03/27/2020] [Accepted: 04/20/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This prospective study evaluated the efficacy and healing potential of modified formulation of PRF, commonly known as Advanced PRF (A-PRF) in impacted mandibular third molar extraction sockets. MATERIALS AND METHODS 20 patients with bilateral impacted mandibular third molars were included in this study. Surgical disimpactions were done at 3-4 weeks interval in opposing quadrants of patient. One quadrant received A-PRF while the opposing quadrant in same patient was taken as control. Comparative evaluation was done in terms of pain assessment, analgesics required, swelling, soft tissue healing and trismus on 1st, 3 and 7day follow-up. Comparative assessment of bone healing was also done on 1st, 3and 6month follow-up. RESULTS This study involved 12 female and 8 male patients with in age range of 18-35 years. The evaluation of pain, swelling, trismus and soft tissue healing on 3rd postoperative day revealed considerable improvement on A-PRF sites as compared to control sites. The outcomes were found to be statistically significant with p values 0.008, 0.031, 0.0001, 0.05 respectively. Even the analgesic consumption was remarkably less when A-PRF was used (P=0.004). Bone healing evaluation in A-PRF sites on 1st, 3and 6month has shown significantly improved results with P<0.05. CONCLUSION Our study infers that A-PRF has enhanced the healing potential of soft tissue as well as bone in extraction socket. Apart from that it has also shown promising results in relief of immediate postoperative symptoms like pain, swelling and trismus which improves the comfort and acceptability of surgical procedures by patients. Enhanced healing and patient comfort in cost effective manner are the highlighting features of A-PRF.
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Affiliation(s)
- N Gupta
- Department of Oral and Maxillofacial Surgery, Identity ENT & Dental Centre, Dehradun (U.K) 248001, India.
| | - S Agarwal
- Department of ENT, Identity ENT & Dental Centre, Dehradun (U.K), India
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Ahmed A, Agarwal S. Teaching an old dog new tricks: three-dimensional visual spatialisation of viscoelastic testing and artificial intelligence. Anaesthesia 2020; 75:1006-1009. [PMID: 32166753 DOI: 10.1111/anae.15022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2020] [Indexed: 11/27/2022]
Affiliation(s)
- A Ahmed
- Department of Anaesthesia and Critical Care, Glenfield Hospital, University Hospitals of Leicester, Leicester, Leicester, UK
| | - S Agarwal
- Department of Anaesthesia and Intensive Care Medicine, Manchester University Hospital, Manchester, UK
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104
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Katna R, Kalyani N, Agarwal S, Singh S, Deshpande A, Bhosale B. Impact of comorbidities on perioperative outcomes for carcinoma of oral cavity. Ann R Coll Surg Engl 2020; 102:232-235. [PMID: 31841025 PMCID: PMC7027403 DOI: 10.1308/rcsann.2019.0155] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2019] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Surgical management of oral cavity carcinoma involves composite resection with reconstruction. Comorbidities increase the risk of perioperative complications. Objective stratification is important for uneventful recovery. The Charlson Comorbidity Index and the Washington University Head and Neck Comorbidity Index were used to assess perioperative morbidity and mortality. MATERIALS AND METHODS This was a prospective study of 531 patients with head and neck squamous cell carcinoma who were treated between January 2014 and December 2017. Patients' comorbidity scores on the Charlson Comorbidity Index and Washington University Head and Neck Comorbidity Index were recorded. RESULTS The median age of the cohort was 49 years. Median Charlson Comorbidity Index score was 3 and Washington University Head and Neck Comorbidity Index was 0. There were five mortalities with a Charlson Comorbidity Index score of 4 or more. Fifteen patients had either infection, leak or postoperative bleeding. A Charlson Comorbidity Index of 4 or more was associated with higher event rate and poor overall survival (p=0.001). CONCLUSION Higher Charlson Comorbidity Index score is associated with increased incidence of peri-operative morbidity and mortality, while the Washington University Head and Neck Comorbidity Index is a poor predictor of the same.
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Affiliation(s)
- R Katna
- Jaslok Hospital and Research Centre, Mumbai, India
- Bombay Hospital and Research Centre, Mumbai, India
| | - N Kalyani
- Jaslok Hospital and Research Centre, Mumbai, India
| | - S Agarwal
- Bombay Hospital and Research Centre, Mumbai, India
| | - S Singh
- Jaslok Hospital and Research Centre, Mumbai, India
- Bombay Hospital and Research Centre, Mumbai, India
| | - A Deshpande
- Jaslok Hospital and Research Centre, Mumbai, India
- Bombay Hospital and Research Centre, Mumbai, India
| | - B Bhosale
- Jaslok Hospital and Research Centre, Mumbai, India
- Bombay Hospital and Research Centre, Mumbai, India
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105
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Stockbridge A, Agarwal S, Sudhir R, Perkins T, Savory S, Pinglay P, Rao P, Das I, Brozik J, Machin R, Deshpande A, Bajaj A, Barnes D, Agrawal S, Bennett J, Tufail M. Optimal lung cancer pathway implementation in a tertiary care centre and its impact on reducing emergency presentations. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30046-5] [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: 10/25/2022]
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de Vos S, Swinnen LJ, Wang D, Reid E, Fowler N, Cordero J, Dunbar M, Enschede SH, Nolan C, Petrich AM, Ross JA, Salem AH, Verdugo M, Agarwal S, Zhou L, Kozloff M, Nastoupil LJ, Flowers CR. Venetoclax, bendamustine, and rituximab in patients with relapsed or refractory NHL: a phase Ib dose-finding study. Ann Oncol 2019; 29:1932-1938. [PMID: 30060083 PMCID: PMC6158762 DOI: 10.1093/annonc/mdy256] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [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: 11/12/2022] Open
Abstract
Background Venetoclax is a selective, potent inhibitor of the anti-apoptotic B-cell leukemia/lymphoma-2 protein approved for treatment of chronic lymphocytic leukemia. We conducted a dose-finding study of venetoclax in combination with bendamustine-rituximab (BR) in patients with relapsed/refractory non-Hodgkin's lymphoma (NHL). Patients and methods BR was given for six cycles at standard doses. Intermittent and continuous oral venetoclax administration was explored at 50-1200 mg daily doses. Co-primary objectives included safety, pharmacokinetics (PKs), maximum-tolerated dose (MTD), and recommended phase II dose (RP2D); secondary objective was preliminary efficacy. Results Sixty patients were enrolled: 32 with follicular lymphoma, 22 with diffuse large B-cell lymphoma, and 6 with marginal zone lymphoma. Nausea (70%), neutropenia (68%), diarrhea (55%), and thrombocytopenia (52%) were the most frequent adverse events (AEs). Most common grade 3/4 AEs were neutropenia (60%) and lymphopenia (38%). Serious AEs were reported in 24 patients; the most frequent were febrile neutropenia and disease progression (8% each). Five patients died from either disease progression (n = 4) or respiratory failure (n = 1). MTD was not reached; RP2D for venetoclax-BR combination was established as 800 mg daily continuously. Venetoclax PK exposure with and without BR was comparable. For all patients, overall response rate was 65%. Median duration of overall response, overall survival, and progression-free survival was 38.3 months [95% confidence interval (CI) 10.4-NR], not yet reached, and 10.7 months (95% CI 4.3-21.0), respectively. Conclusions This study established the safety profile of venetoclax in combination with BR, and results demonstrated tolerability and preliminary efficacy of the combination. Additional follow-up is needed to better determine the future role of BR plus venetoclax in the treatment of relapsed/refractory B-cell NHL. Trial registered Clinicaltrials.gov, NCT01594229.
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Affiliation(s)
- S de Vos
- David Geffen School of Medicine at UCLA, Los Angeles.
| | - L J Swinnen
- Division of Hematologic Malignancies, Department of Oncology, Johns Hopkins University, Baltimore
| | - D Wang
- Division of Hematology/Oncology, Department of Medicine, Henry Ford Hospital, Detroit
| | - E Reid
- Division of Hematology-Oncology, Moores Cancer Center, University of California San Diego, La Jolla
| | - N Fowler
- Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston
| | | | | | | | - C Nolan
- AbbVie Inc., North Chicago, USA
| | | | | | - A H Salem
- AbbVie Inc., North Chicago, USA; Ain Shams University, Cairo, Egypt
| | | | | | - L Zhou
- AbbVie Inc., North Chicago, USA
| | - M Kozloff
- Department of Oncology, Cancer Research Center, Ingalls Memorial Hospital, Harvey
| | - L J Nastoupil
- Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston
| | - C R Flowers
- Division of Hematology and Oncology, Winship Cancer Institute, Emory University-School of Medicine, Atlanta, USA
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Erdoes G, Koster A, Meesters MI, Ortmann E, Bolliger D, Baryshnikova E, Ahmed A, Lance MD, Ravn HB, Ranucci M, Heymann C, Agarwal S. The role of fibrinogen and fibrinogen concentrate in cardiac surgery: an international consensus statement from the Haemostasis and Transfusion Scientific Subcommittee of the European Association of Cardiothoracic Anaesthesiology. Anaesthesia 2019; 74:1589-1600. [DOI: 10.1111/anae.14842] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2019] [Indexed: 12/23/2022]
Affiliation(s)
- G. Erdoes
- Department of Anaesthesiology and Pain Medicine Inselspital, Bern University Hospital University of Bern Switzerland
| | - A. Koster
- Institute for Anaesthesiology, Heart and Diabetes Centre NRW Ruhr‐University Bochum Bad Oeynhausen Germany
| | - M. I. Meesters
- Department of Anaesthesiology University Medical Centre Utrecht The Netherlands
| | - E. Ortmann
- Department of Anaesthesia Kerckhoff Heart and Lung Centre Bad Nauheim Germany
| | - D. Bolliger
- Department of Anaesthesia Surgical Intensive Care Prehospital Emergency Medicine, and Pain Therapy University Hospital Basel Switzerland
| | - E. Baryshnikova
- Department of Cardiovascular Anaesthesia and Intensive Care Unit IRCCS Policlinico San Donato Milan Italy
| | - A. Ahmed
- Department of Anaesthesia University Hospitals of Leicester NHS Trust LeicesterUK
| | - M. D. Lance
- Hamad Medical Corporation, HMC Anaesthesiology ICU and Peri‐operative Medicine Doha Qatar
| | - H. B. Ravn
- Department of Cardiothoracic Anaesthesiology Copenhagen University Hospital Copenhagen Denmark
| | - M. Ranucci
- Department of Cardiovascular Anaesthesia and Intensive Care Unit IRCCS Policlinico San Donato Milan Italy
| | - C. Heymann
- Department of Anaesthesia Intensive Care Medicine, Emergency Medicine and Pain Therapy Vivantes Klinikum im Friedrichshain Berlin Germany
| | - S. Agarwal
- Department of Anaesthesia Manchester University Hospitals Manchester UK
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108
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Agarwal S, Dhar A, Kulkarni M, Kundu A, Majumdar SN, Mukamel D, Schehr G. Harmonically Confined Particles with Long-Range Repulsive Interactions. Phys Rev Lett 2019; 123:100603. [PMID: 31573302 DOI: 10.1103/physrevlett.123.100603] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Indexed: 06/10/2023]
Abstract
We study an interacting system of N classical particles on a line at thermal equilibrium. The particles are confined by a harmonic trap and repel each other via pairwise interaction potential that behaves as a power law ∝∑[under i≠j][over N]|x_{i}-x_{j}|^{-k} (with k>-2) of their mutual distance. This is a generalization of the well-known cases of the one-component plasma (k=-1), Dyson's log gas (k→0^{+}), and the Calogero-Moser model (k=2). Because of the competition between harmonic confinement and pairwise repulsion, the particles spread over a finite region of space for all k>-2. We compute exactly the average density profile for large N for all k>-2 and show that while it is independent of temperature for sufficiently low temperature, it has a rich and nontrivial dependence on k with distinct behavior for -2<k<1, k>1 and k=1.
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Affiliation(s)
- S Agarwal
- International Centre for Theoretical Sciences, Tata Institute of Fundamental Research, Bengaluru 560089, India
- Birla Institute of Technology and Science, Pilani 333031, India
| | - A Dhar
- International Centre for Theoretical Sciences, Tata Institute of Fundamental Research, Bengaluru 560089, India
| | - M Kulkarni
- International Centre for Theoretical Sciences, Tata Institute of Fundamental Research, Bengaluru 560089, India
| | - A Kundu
- International Centre for Theoretical Sciences, Tata Institute of Fundamental Research, Bengaluru 560089, India
| | - S N Majumdar
- LPTMS, CNRS, Univ. Paris-Sud, Universite Paris-Saclay, 91405 Orsay, France
| | - D Mukamel
- Department of Physics of Complex Systems, Weizmann Institute of Science, Rehovot 7610001, Israel
| | - G Schehr
- LPTMS, CNRS, Univ. Paris-Sud, Universite Paris-Saclay, 91405 Orsay, France
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109
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Agarwal S, Tiwari P, Deep A, Kidwai S, Gupta S, Thakur KG, Singh R. System-Wide Analysis Unravels the Differential Regulation and In Vivo Essentiality of Virulence-Associated Proteins B and C Toxin-Antitoxin Systems of Mycobacterium tuberculosis. J Infect Dis 2019. [PMID: 29529224 DOI: 10.1093/infdis/jiy109] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Toxin-antitoxin (TA) systems are bicistronic genetic modules that are ubiquitously present in bacterial genomes. The Mycobacterium tuberculosis genome encodes 90 putative TA systems, and these are considered to be associated with maintenance of bacterial genomic stability or bacterial survival under unfavorable environmental conditions. The majority of these in M. tuberculosis have been annotated as belonging to the virulence-associated protein B and C (VapBC) family. However, their precise role in bacterial physiology has not been elucidated. Here, we functionally characterized VapC toxins from M. tuberculosis and show that overexpression of some homologs inhibits growth of Mycobacterium bovis bacillus Calmette-Guérin in a bacteriostatic manner. Expression profiling of messenger RNA revealed that these VapC toxins were differentially induced upon exposure of M. tuberculosis to stress conditions. We also unraveled that transcriptional cross-activation exists between TA systems in M. tuberculosis. This study provides the first evidence for the essentiality of VapBC3 and VapBC4 systems in M. tuberculosis virulence.
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Affiliation(s)
- Sakshi Agarwal
- Tuberculosis Research Laboratory, Vaccine and Infectious Disease Research Centre, Translational Health Science and Technology Institute, Faridabad, Haryana
| | - Prabhakar Tiwari
- Tuberculosis Research Laboratory, Vaccine and Infectious Disease Research Centre, Translational Health Science and Technology Institute, Faridabad, Haryana
| | - Amar Deep
- Tuberculosis Research Laboratory, Vaccine and Infectious Disease Research Centre, Translational Health Science and Technology Institute, Faridabad, Haryana.,Structural Biology Laboratory, G. N. Ramachandran Protein Centre, Institute of Microbial Technology, Council of Scientific and Industrial Research, Chandigarh, India
| | - Saqib Kidwai
- Tuberculosis Research Laboratory, Vaccine and Infectious Disease Research Centre, Translational Health Science and Technology Institute, Faridabad, Haryana
| | - Shamba Gupta
- Tuberculosis Research Laboratory, Vaccine and Infectious Disease Research Centre, Translational Health Science and Technology Institute, Faridabad, Haryana
| | - Krishan Gopal Thakur
- Structural Biology Laboratory, G. N. Ramachandran Protein Centre, Institute of Microbial Technology, Council of Scientific and Industrial Research, Chandigarh, India
| | - Ramandeep Singh
- Tuberculosis Research Laboratory, Vaccine and Infectious Disease Research Centre, Translational Health Science and Technology Institute, Faridabad, Haryana
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Agarwal S, van Saet A, Kaakinen T, Mzallassi Z, Griffin M, Siegemund M, Faßl J, Paulus P, Cholley B, Klein A. The implementation of patient blood management– A survey of european practice. J Cardiothorac Vasc Anesth 2019. [DOI: 10.1053/j.jvca.2019.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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111
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Mirzoeva S, Agarwal S, Baida G, Lesovaya E, Readhead B, Dudley J, Budunova I. 310 PI3-Kinase inhibitors represent a novel class of drug repurposing candidates to prevent glucocorticoid-induced skin atrophy. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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112
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Mathur S, Calhoun A, Sun Z, Nianlan Y, Agarwal S. Comparison of transcutaneous with arterial and end tidal carbon dioxide during thoracic surgery - A prospective observational study. J Cardiothorac Vasc Anesth 2019. [DOI: 10.1053/j.jvca.2019.07.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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114
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Deep A, Tiwari P, Agarwal S, Kaundal S, Kidwai S, Singh R, Thakur KG. Structural, functional and biological insights into the role of Mycobacterium tuberculosis VapBC11 toxin-antitoxin system: targeting a tRNase to tackle mycobacterial adaptation. Nucleic Acids Res 2019; 46:11639-11655. [PMID: 30329074 PMCID: PMC6265470 DOI: 10.1093/nar/gky924] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 10/04/2018] [Indexed: 01/10/2023] Open
Abstract
Toxin–antitoxin (TA) systems are involved in diverse physiological processes in prokaryotes, but their exact role in Mycobacterium tuberculosis (Mtb) virulence and in vivo stress adaptation has not been extensively studied. Here, we demonstrate that the VapBC11 TA module is essential for Mtb to establish infection in guinea pigs. RNA-sequencing revealed that overexpression of VapC11 toxin results in metabolic slowdown, suggesting that modulation of the growth rate is an essential strategy for in vivo survival. Interestingly, overexpression of VapC11 resulted in the upregulation of chromosomal TA genes, suggesting the existence of highly coordinated crosstalk among TA systems. In this study, we also present the crystal structure of the VapBC11 heterooctameric complex at 1.67 Å resolution. Binding kinetic studies suggest that the binding affinities of toxin–substrate and toxin–antitoxin interactions are comparable. We used a combination of structural studies, molecular docking, mutational analysis and in vitro ribonuclease assays to enhance our understanding of the mode of substrate recognition by the VapC11 toxin. Furthermore, we have also designed peptide-based inhibitors to target VapC11 ribonuclease activity. Taken together, we propose that the structure-guided design of inhibitors against in vivo essential ribonucleases might be a novel strategy to hasten clearance of intracellular Mtb.
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Affiliation(s)
- Amar Deep
- Structural Biology Laboratory, G. N. Ramachandran Protein Centre, Council of Scientific and Industrial Research-Institute of Microbial Technology (CSIR-IMTECH), Chandigarh 160036, India
| | - Prabhakar Tiwari
- Tuberculosis Research Laboratory, Vaccine and Infectious Disease Research Centre, Translational Health Science and Technology Institute, NCR-Biotech Science Cluster, 3rd Milestone, Faridabad Gurgaon Expressway, Faridabad 121001, India
| | - Sakshi Agarwal
- Tuberculosis Research Laboratory, Vaccine and Infectious Disease Research Centre, Translational Health Science and Technology Institute, NCR-Biotech Science Cluster, 3rd Milestone, Faridabad Gurgaon Expressway, Faridabad 121001, India
| | - Soni Kaundal
- Structural Biology Laboratory, G. N. Ramachandran Protein Centre, Council of Scientific and Industrial Research-Institute of Microbial Technology (CSIR-IMTECH), Chandigarh 160036, India
| | - Saqib Kidwai
- Tuberculosis Research Laboratory, Vaccine and Infectious Disease Research Centre, Translational Health Science and Technology Institute, NCR-Biotech Science Cluster, 3rd Milestone, Faridabad Gurgaon Expressway, Faridabad 121001, India
| | - Ramandeep Singh
- Tuberculosis Research Laboratory, Vaccine and Infectious Disease Research Centre, Translational Health Science and Technology Institute, NCR-Biotech Science Cluster, 3rd Milestone, Faridabad Gurgaon Expressway, Faridabad 121001, India
| | - Krishan G Thakur
- Structural Biology Laboratory, G. N. Ramachandran Protein Centre, Council of Scientific and Industrial Research-Institute of Microbial Technology (CSIR-IMTECH), Chandigarh 160036, India
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115
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Ramalingam G, Choi S, Agarwal S, Kunst G, Gill R, Fletcher SN, Klein AA, Shashidaran P, Waghmare K, Kadayam R, Flynn F, Gavin N, Mairead‐Machugh U, Bell M, Hawthorn A, Sajgalik P, Burri N, Meraglia A. Complications related to peri‐operative transoesophageal echocardiography – a one‐year prospective national audit by the Association of Cardiothoracic Anaesthesia and Critical Care. Anaesthesia 2019; 75:21-26. [DOI: 10.1111/anae.14734] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2019] [Indexed: 12/26/2022]
Affiliation(s)
- G. Ramalingam
- Department of Anaesthesia and Intensive Care Royal Papworth Hospital CambridgeUK
| | - S.‐W. Choi
- Department of Anaesthesiology Faculty of Medicine The University of Hong Kong HongKongHKSAR
| | - S. Agarwal
- Department of Cardiothoracic Anaesthesia Manchester Royal Infirmary ManchesterUK
| | - G. Kunst
- Department of Cardiothoracic Anaesthesia Kings College Hospital LondonUK
| | - R. Gill
- Department of Cardiothoracic Anaesthesia University Hospital Southampton UK
| | - S. N. Fletcher
- Department of Cardiothoracic Anaesthesia St Georges University Hospitals London UK
| | - A. A. Klein
- Department of Anaesthesia and Intensive Care Royal Papworth Hospital CambridgeUK
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Okosun J, Bödör C, Batlevi C, Nagy N, Michot J, Schneider T, Alizadeh H, Simon Z, Vose J, Younes A, Ribrag V, Fitzgibbon J, Yang J, Agarwal S, Newberry K, Michaud N. EZH2 GAIN-OF-FUNCTION MUTATIONS ARE NOT ASSOCIATED WITH MORE FAVORABLE PROGNOSIS IN RELAPSED/REFRACTORY FOLLICULAR LYMPHOMA (FL): A PRELIMINARY ANALYSIS ON 590 PATIENTS. Hematol Oncol 2019. [DOI: 10.1002/hon.6_2630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- J. Okosun
- Hematology, Barts Cancer Institute; Queen Mary University of London; London United Kingdom
| | - C. Bödör
- Hematology; Semmelweis University; Budapest Hungary
| | - C. Batlevi
- Medical Oncology; Memorial Sloan Kettering Cancer Center; New York United States
| | - N. Nagy
- Cancer Research; Semmelweis University; Budapest Hungary
| | - J. Michot
- Hematology and Innovative Drugs; Gustave Roussy; Villejuif France
| | - T. Schneider
- Medical Oncology and Hematology; National Institute of Oncology; Budapest Hungary
| | - H. Alizadeh
- Internal Medicine; University of Pecs; Pecs Hungary
| | - Z. Simon
- Biochemistry and Molecular Biology; University of Debrecen; Debrecen Hungary
| | - J. Vose
- Oncology & Hematology; University of Nebraska Medical Center; Omaha United States
| | - A. Younes
- Medical Oncology; Memorial Sloan Kettering Cancer Center; New York United States
| | - V. Ribrag
- DITEP; Gustave Roussy; Villejuif France
| | - J. Fitzgibbon
- Hematology, Barts Cancer Institute; Queen Mary University of London; London United Kingdom
| | - J. Yang
- Biostatistics; Epizyme; Cambridge United States
| | - S. Agarwal
- Chief Medical Officer; Epizyme; Cambridge United States
| | | | - N.R. Michaud
- Translational Medicine; Epizyme; Cambridge United States
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Carey ME, Agarwal S, Horne R, Davies M, Slevin M, Coates V. Exploring organizational support for the provision of structured self-management education for people with Type 2 diabetes: findings from a qualitative study. Diabet Med 2019; 36:761-770. [PMID: 30868654 DOI: 10.1111/dme.13946] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/08/2019] [Indexed: 01/27/2023]
Abstract
AIM To explore the organizational context in which Type 2 diabetes structured group education is provided. METHODS Four Clinical Commissioning Groups in England providing Type 2 diabetes structured self-management education participated in a qualitative study exploring the context for provision of that education. Using UK National Diabetes Audit returns, two Clinical Commissioning Groups were selected that had non-attendance rates of ≤25%, and two that had non-attendance rates of ≥50%. Between May 2016 and August 2017, 20 interviews were conducted with Clinical Commissioning Group staff including: commissioners, healthcare professionals, managers, general practitioners and diabetes educators. Data gathering was prolonged as it proved challenging to engage with healthcare staff as a result of frequent local restructuring and service disruption. RESULTS Local audits revealed discrepancies in basic data such as referral and attendance numbers compared with national audit data. There was a commonality in the themes identified from interviews: diabetes education was rarely embedded in service structure; where education uptake was poor, a lack of central support to delivery teams was noticeable; and where education uptake was positive, delivery teams were actively engaged, sometimes relying on enthusiastic individuals. Both situations put the local sustainability of diabetes education at risk. CONCLUSIONS There appears to be a link between attendance rates and organizational issues, therefore, when considering how to increase attendance rates, the state of the diabetes education infrastructure should be reviewed. Good uptake of diabetes education can be too reliant on the enthusiastic commitment of small teams or individuals delivering the education.
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Affiliation(s)
- M E Carey
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
- College of Life Sciences, University of Leicester, Leicester, UK
| | - S Agarwal
- College of Life Sciences, University of Leicester, Leicester, UK
| | - R Horne
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - M Davies
- Belfast Health and Social Care Trust, Belfast, UK
| | - M Slevin
- School of Nursing, Ulster University, Coleraine, UK
| | - V Coates
- School of Nursing, Ulster University, Coleraine, UK
- Western Health and Social Care Trust, Londonderry, UK
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Tiwari P, Gosain TP, Singh M, Sankhe GD, Arora G, Kidwai S, Agarwal S, Chugh S, Saini DK, Singh R. Inorganic polyphosphate accumulation suppresses the dormancy response and virulence in Mycobacterium tuberculosis. J Biol Chem 2019; 294:10819-10832. [PMID: 31113860 DOI: 10.1074/jbc.ra119.008370] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 03/13/2019] [Revised: 05/07/2019] [Indexed: 11/06/2022] Open
Abstract
Stringent response pathways involving inorganic polyphosphate (PolyP) play an essential role in bacterial stress adaptation and virulence. The intracellular levels of PolyP are modulated by the activities of polyphosphate kinase-1 (PPK1), polyphosphate kinase-2 (PPK2), and exopolyphosphatases (PPXs). The genome of Mycobacterium tuberculosis encodes two functional PPXs, and simultaneous deletion of ppx1 and ppx2 results in a defect in biofilm formation. We demonstrate here that these PPXs cumulatively contribute to the ability of M. tuberculosis to survive in nutrient-limiting, low-oxygen growth conditions and also in macrophages. Characterization of single (Δppx2) and double knockout (dkppx) strains of M. tuberculosis indicated that PPX-mediated PolyP degradation is essential for establishing bacterial infection in guinea pigs. RNA-Seq-based transcriptional profiling revealed that relative to the parental strain, the expression levels of DosR regulon-regulated dormancy genes were significantly reduced in the dkppx mutant strain. In concordance, we also provide evidence that PolyP inhibits the autophosphorylation activities associated with DosT and DosS sensor kinases. The results in this study uncover that enzymes involved in PolyP homeostasis play a critical role in M. tuberculosis physiology and virulence and are attractive targets for developing more effective therapeutic interventions.
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Affiliation(s)
- Prabhakar Tiwari
- Tuberculosis Research Laboratory, Vaccine and Infectious Disease Research Centre, Translational Health Science and Technology Institute, Haryana 121001, India and
| | - Tannu Priya Gosain
- Tuberculosis Research Laboratory, Vaccine and Infectious Disease Research Centre, Translational Health Science and Technology Institute, Haryana 121001, India and
| | - Mamta Singh
- Tuberculosis Research Laboratory, Vaccine and Infectious Disease Research Centre, Translational Health Science and Technology Institute, Haryana 121001, India and
| | | | - Garima Arora
- Tuberculosis Research Laboratory, Vaccine and Infectious Disease Research Centre, Translational Health Science and Technology Institute, Haryana 121001, India and
| | - Saqib Kidwai
- Tuberculosis Research Laboratory, Vaccine and Infectious Disease Research Centre, Translational Health Science and Technology Institute, Haryana 121001, India and
| | - Sakshi Agarwal
- Tuberculosis Research Laboratory, Vaccine and Infectious Disease Research Centre, Translational Health Science and Technology Institute, Haryana 121001, India and
| | - Saurabh Chugh
- Tuberculosis Research Laboratory, Vaccine and Infectious Disease Research Centre, Translational Health Science and Technology Institute, Haryana 121001, India and
| | - Deepak K Saini
- Centre for BioSystems Science and Engineering and; Department of Molecular Reproduction, Development, and Genetics, Biological Sciences Building, Indian Institute of Science, Bangalore, Karnataka 560012, India
| | - Ramandeep Singh
- Tuberculosis Research Laboratory, Vaccine and Infectious Disease Research Centre, Translational Health Science and Technology Institute, Haryana 121001, India and.
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Agarwal S, Mirzoeva S, Readhead B, Lesovaya E, Dudley J, Budunova I. 727 Use of PI3K/mTOR/Akt inhibitors as skin protectors to spare skin from glucocorticoid-induced atrophy. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Charlesworth M, Agarwal S. Recycling old data – an ethical and pragmatic way to generate new evidence? Anaesthesia 2019; 74:1087-1090. [DOI: 10.1111/anae.14648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2019] [Indexed: 12/14/2022]
Affiliation(s)
- M. Charlesworth
- Department of Cardiothoracic Anaesthesia Wythenshawe Hospital Manchester University Hospitals NHS Foundation Trust ManchesterUK
| | - S. Agarwal
- Department of Cardiothoracic Anaesthesia Manchester Royal Infirmary Manchester University Hospitals NHS Foundation Trust Manchester UK
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Muhammad Dawood N, nadeem R, Agarwal S, Jawed S, Khan A, Hallak Y. IMPACT OF DURATION OF CARDIOPULMONARY BYPASS UPON POSTOPERATIVE MECHANICAL VENTILATION DURATION IN PATIENTS UNDERGOING CARDIAC SURGERIES: REGRESSION ANALYSIS OF METADATA. Chest 2019. [DOI: 10.1016/j.chest.2019.02.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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122
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Affiliation(s)
- S Agarwal
- Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - J Kendall
- Liverpool Heart and Chest NHS Foundation Trust, Liverpool, UK
| | - C Quarterman
- Liverpool Heart and Chest NHS Foundation Trust, Liverpool, UK
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Shivakumar V, Agarwal S, Sreeraj V, Narayanaswamy J, Bose A, Kalmady S, Shenoy S, Venkatasubramanian G. tDCS for schizophrenia: Clinical studies from India. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.642] [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: 10/27/2022] Open
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124
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Stein EM, Dash A, Bucovsky M, Agarwal S, Fu J, Lentzsch S, Shane E. Disrupted radial and tibial microarchitecture in patients with monoclonal gammopathy of undetermined significance. Osteoporos Int 2019; 30:629-635. [PMID: 30488275 PMCID: PMC10081445 DOI: 10.1007/s00198-018-4787-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 11/12/2018] [Accepted: 11/18/2018] [Indexed: 02/06/2023]
Abstract
UNLABELLED Patients with monoclonal gammopathy of undetermined significance (MGUS) had abnormalities in volumetric BMD (vBMD), microarchitecture, and stiffness at both the radius and tibia by high-resolution peripheral quantitative CT compared to matched controls. This is the first report demonstrating that patients with MGUS have microarchitectural deficits at multiple skeletal sites. INTRODUCTION Fracture risk is elevated in patients with monoclonal gammopathy of undetermined significance (MGUS). However, the pathogenesis of bone disease in these patients is poorly understood. Prior work using high-resolution peripheral CT (HRpQCT) demonstrated abnormal microarchitecture at the radius, with predominantly cortical abnormalities. We hypothesized that patients with MGUS have abnormal microarchitecture at both radius and tibia compared to controls, reflecting global skeletal effects of the disease. METHODS This case-control study enrolled 36 subjects; patients with MGUS (n = 12) were matched 1:2 by age, sex, and race to controls (n = 24). Areal BMD (aBMD) was measured by DXA, vBMD, and microarchitecture by HRpQCT, and whole bone stiffness by finite element analysis. Serum was drawn for markers of bone metabolism and inflammation. RESULTS By DXA, MGUS patients had lower aBMD at the lumbar spine, femoral neck, and 1/3 radius. Markers of bone metabolism and inflammation did not differ. By HRpQCT at the radius, MGUS patients had lower total, trabecular and cortical density, lower trabecular number, and greater trabecular separation and heterogeneity. At the tibia, MGUS patients had lower total and trabecular density, lower trabecular number, greater separation and heterogeneity, and lower whole bone stiffness. CONCLUSIONS Patients with MGUS had lower vBMD, cortical, and trabecular abnormalities at the radius compared to matched controls. At the tibia, trabecular abnormalities predominated. These results suggest that in addition to previously described cortical deficits, deterioration of trabecular bone may contribute to a generalized skeletal fragility in patients with MGUS.
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Affiliation(s)
- E M Stein
- Endocrinology and Metabolic Bone Disease Service, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.
| | - A Dash
- Endocrinology and Metabolic Bone Disease Service, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
| | - M Bucovsky
- Division of Endocrinology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - S Agarwal
- Division of Endocrinology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - J Fu
- Multiple Myeloma and Amyloidosis Service, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - S Lentzsch
- Multiple Myeloma and Amyloidosis Service, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - E Shane
- Division of Endocrinology, Columbia University College of Physicians and Surgeons, New York, NY, USA
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125
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Agarwal S, Shivakumar V, Narayanaswamy J, Sreeraj V, Bose A, Nawani H, Kalmady S, Nitsche M, Venkatasubramanian G. TDCS in schizophrenia: mechanistic basis for investigative and interventional applications. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.624] [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: 10/27/2022] Open
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126
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Affiliation(s)
- S Biswas
- From the Department of Medicine, All India Institute of Medical Sciences (AIIMS), 3rd Floor Teaching Block, Ansari Nagar, New Delhi, New Delhi, India
| | - S Agarwal
- From the Department of Medicine, All India Institute of Medical Sciences (AIIMS), 3rd Floor Teaching Block, Ansari Nagar, New Delhi, New Delhi, India
| | - M Soneja
- From the Department of Medicine, All India Institute of Medical Sciences (AIIMS), 3rd Floor Teaching Block, Ansari Nagar, New Delhi, New Delhi, India
| | - A Biswas
- From the Department of Medicine, All India Institute of Medical Sciences (AIIMS), 3rd Floor Teaching Block, Ansari Nagar, New Delhi, New Delhi, India
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127
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Agarwal S, Ahmed RM, D'Mello M, Foxe D, Kaizik C, Kiernan MC, Halliday GM, Piguet O, Hodges JR. Predictors of survival and progression in behavioural variant frontotemporal dementia. Eur J Neurol 2019; 26:774-779. [PMID: 30565360 DOI: 10.1111/ene.13887] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 12/06/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Predicting the course of behavioural variant frontotemporal dementia (bvFTD) remains a major clinical challenge. This study aimed to identify factors that predict survival and clinical progression in bvFTD. METHODS Consecutive patients with clinically probable bvFTD were prospectively followed up over an 8-year period. Baseline neuropsychological variables, presence of a known pathogenic frontotemporal dementia gene mutation and a systematic visual magnetic resonance imaging assessment at baseline were examined as candidate predictors using multivariate modelling. RESULTS After screening 121 cases, the study cohort consisted of 75 patients with probable bvFTD, with a mean age of 60.8 ± 8.5 years, followed up for a mean duration of 7.2 ± 3.5 years from symptom onset. Median survival time from disease onset was 10.8 years and median survival, prior to transition to nursing home, was 8.9 years. A total of 25 of the 75 patients died during the study follow-up period. Survival without dependence was predicted by shorter disease duration at presentation (hazard ratio, 0.49, P = 0.001), greater atrophy in the anterior cingulate cortex (hazard ratio, 1.75, P = 0.047), older age (hazard ratio, 1.07, P = 0.026) and a higher burden of behavioural symptoms (hazard ratio, 1.04, P = 0.015). In terms of disease progression, presence of a known pathogenic frontotemporal dementia mutation (β = 0.46, P < 0.001) was the strongest predictor of progression. Deficits in letter fluency (β = -0.43, P = 0.017) and greater atrophy in the motor cortex (β = 0.51, P = 0.03) were also associated with faster progression. CONCLUSIONS This study provides novel clinical predictors of survival and progression in bvFTD. Our findings are likely to have an impact on prognostication and care planning in this difficult disease.
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Affiliation(s)
- S Agarwal
- Neurology Unit, Addenbrooke's Hospital, Cambridge, UK.,Central Clinical School and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales
| | - R M Ahmed
- Central Clinical School and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales
| | - M D'Mello
- School of Psychology and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales
| | - D Foxe
- School of Psychology and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales.,Neuroscience Research Australia (NeuRA), University of New South Wales, Sydney, New South Wales, Australia
| | - C Kaizik
- Central Clinical School and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales.,Neuroscience Research Australia (NeuRA), University of New South Wales, Sydney, New South Wales, Australia
| | - M C Kiernan
- Central Clinical School and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales
| | - G M Halliday
- Central Clinical School and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales.,School of Psychology and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales.,Neuroscience Research Australia (NeuRA), University of New South Wales, Sydney, New South Wales, Australia
| | - O Piguet
- School of Psychology and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales.,Neuroscience Research Australia (NeuRA), University of New South Wales, Sydney, New South Wales, Australia
| | - J R Hodges
- Central Clinical School and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales
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Affiliation(s)
- S Agarwal
- Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - A Sasi
- Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - A Ray
- Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - R S Jadon
- Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - N Vikram
- Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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Roy M, Goswami B, Goswami S, Jadhav A, Agarwal S. Dosimetric plan evaluation of hypofractionated 3-dimensional conformal radiotherapy (3DCRT) and 2-dimensional (2D) simulator planning in whole breast irradiation after breast conserving surgery. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy427.009] [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: 11/14/2022] Open
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Abstract
Introduction: Early diagnosis of osteoarticular tuberculosis (OATB) is essential to prevent significant functional disability. There is no single test for diagnosis. Despite an array of investigations available, definitive diagnosis at early stage before starting antitubercular drugs is still a challenge. Materials and Methods: A cross sectional study was carried out between February 2016 and October 2017. All children less than 18 years of age with suspected osteoarticular tuberculosis were included. The cases were subjected to simple needle aspiration from whichever site was accessible. Multiple sample aspirations were done at site of involvement. Smears were prepared from the aspirated material. Results: Ziehl-Neelsen staining for Acid Fast Bacilli (AFB) showed deep pink red rods under light microscopy. Features suggestive of tuberculosis can be seen by May-Grünwald-Giemsa (MGG) staining. Auramine-O staining method of detecting AFB under fluorescent microscope shows the bacilli as greenish yellow slender curved rods in dark background. Fluorescent microscopy has higher sensitivity and comparable specificity. In our study, microbiological confirmation of OATB could be done in 100% cases where the lesion could be accessed for aspiration. The molecular techniques are relatively more expensive and not available everywhere. Conclusion: Meticulous search for AFB in a well stained smear using three different staining methods provides a direct evidence of infection over costly imaging especially in poor patients seen in resource limited settings.
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Affiliation(s)
- A Agarwal
- Department of Orthopaedics, Super Specialty Paediatric Hospital & Post Graduate Teaching Institute, Noida, India
| | - S Singh
- Department of Orthopaedics, Super Specialty Paediatric Hospital & Post Graduate Teaching Institute, Noida, India
| | - S Agarwal
- Department of Pediatrics, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
| | - S Gupta
- *Department of Orthopaedics, Lady Hardinge Medical College, New Delhi, India
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131
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Asim A, Agarwal S. CRELD1 gene variants leads to atrioventricular septal defects in Down syndrome. N Biotechnol 2018. [DOI: 10.1016/j.nbt.2018.05.1129] [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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132
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Erdoes G, Martinez Lopez De Arroyabe B, Bolliger D, Ahmed AB, Koster A, Agarwal S, Boer C, von Heymann C. International consensus statement on the peri-operative management of direct oral anticoagulants in cardiac surgery. Anaesthesia 2018; 73:1535-1545. [DOI: 10.1111/anae.14425] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2018] [Indexed: 02/06/2023]
Affiliation(s)
- G. Erdoes
- Department of Anaesthesiology and Pain Medicine; Inselspital; University Hospital Bern; University of Bern; Bern Switzerland
| | | | - D. Bolliger
- Department of Anaesthesia; Surgical Intensive Care; Prehospital Emergency Medicine, and Pain Therapy; University Hospital Basel; Basel Switzerland
| | - A. B. Ahmed
- Department of Anaesthesia; University Hospitals of Leicester NHS Trust; Leicester UK
- Department of Cardiovascular Sciences; University of Leicester; Leicester UK
| | - A. Koster
- Institute for Anaesthesiology, Heart and Diabetes Centre NRW; Ruhr-University Bochum; Bad Oeynhausen Germany
| | - S. Agarwal
- Department of Anaesthesia; Liverpool Heart and Chest Hospital; Liverpool UK
| | - C. Boer
- Department of Anaesthesiology; VU University Medical Centre; Amsterdam the Netherlands
| | - C. von Heymann
- Department of Anaesthesia; Intensive Care Medicine, Emergency Medicine and Pain Therapy; Vivantes Klinikum im Friedrichshain; Berlin Germany
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133
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Liu Y, Dimango E, Bucovsky M, Agarwal S, Nishiyama K, Guo XE, Shane E, Stein EM. Abnormal microarchitecture and stiffness in postmenopausal women using chronic inhaled glucocorticoids. Osteoporos Int 2018; 29:2121-2127. [PMID: 29947865 PMCID: PMC6138454 DOI: 10.1007/s00198-018-4591-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 05/27/2018] [Indexed: 12/19/2022]
Abstract
UNLABELLED Postmenopausal (PM) women using inhaled glucocorticoids (IGCs) had substantial abnormalities in volumetric BMD (vBMD), microarchitecture, and stiffness using high resolution peripheral computed tomography (HRpQCT) compared to age- and race-matched controls. Abnormalities were most severe at the radius. These preliminary results suggest that there may be major, heretofore unrecognized, skeletal deficits in PM women using IGCs. INTRODUCTION While oral glucocorticoids are well recognized to have destructive skeletal effects, less is known about the effects of IGCs. The detrimental skeletal effects of IGCs may be greatest in PM women, in whom they compound negative effects of estrogen loss and aging. The goal of this study was to evaluate microarchitecture and stiffness in PM women using chronic IGCs. METHODS This case-control study compared PM women using IGCs for ≥ 6 months (n = 20) and controls matched for age and race/ethnicity (n = 60). Skeletal parameters assessed included areal BMD (aBMD) by DXA, trabecular and cortical vBMD and microarchitecture by HRpQCT of the radius and tibia, and whole bone stiffness by finite element analysis. RESULTS By DXA, mean values in both groups were in the osteopenic range; hip aBMD was lower in IGC users (P < 0.04). By HRpQCT, IGC users had lower total, cortical, and trabecular vBMD at both radius and tibia (all P < 0.05). IGC users had lower cortical thickness, lower trabecular number, greater trabecular separation and heterogeneity at the radius (all P < 0.03), and greater heterogeneity at the tibia (P < 0.04). Whole bone stiffness was lower in IGC users at radius (P < 0.03) and tended to be lower at the tibia (P = 0.09). CONCLUSIONS PM women using IGCs had substantial abnormalities in vBMD, microarchitecture, and stiffness compared to controls. These abnormalities were most severe at the radius. These preliminary results suggest that there may be major, heretofore unrecognized, skeletal deficits in PM women using IGCs.
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Affiliation(s)
- Y Liu
- Division of Endocrinology and Metabolic Bone Disease, Hospital for Special Surgery, Weill Cornell Medical College, 535 East 70th Street, New York, NY, 10021, USA
| | - E Dimango
- Division of Pulmonology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - M Bucovsky
- Division of Endocrinology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - S Agarwal
- Division of Endocrinology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - K Nishiyama
- Division of Endocrinology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - X E Guo
- Bone Bioengineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - E Shane
- Division of Endocrinology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - E M Stein
- Division of Endocrinology and Metabolic Bone Disease, Hospital for Special Surgery, Weill Cornell Medical College, 535 East 70th Street, New York, NY, 10021, USA.
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Berner AM, Sharma A, Agarwal S, Al-Sam S, Nathan P. Fatal autoimmune myocarditis with anti-PD-L1 and tyrosine kinase inhibitor therapy for renal cell cancer. Eur J Cancer 2018; 101:287-290. [PMID: 30017380 DOI: 10.1016/j.ejca.2018.06.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 06/13/2018] [Accepted: 06/19/2018] [Indexed: 11/18/2022]
Affiliation(s)
- A M Berner
- Department of Oncology, Mount Vernon Cancer Centre, Northwood HA6 2RN, UK.
| | - A Sharma
- Department of Oncology, Mount Vernon Cancer Centre, Northwood HA6 2RN, UK
| | - S Agarwal
- Department of Histopathology, East and North Hertfordshire NHS Trust, Coreys Mill Lane, Stevenage, Hertfordshire SG1 4AB, UK
| | - S Al-Sam
- Princess Alexandra Hospital, Hamstel Road, Harlow, Essex CM20 1QX, UK
| | - P Nathan
- Department of Oncology, Mount Vernon Cancer Centre, Northwood HA6 2RN, UK
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135
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Wongsripuemtet J, Tyan AE, Carass A, Agarwal S, Gujar SK, Pillai JJ, Sair HI. Preoperative Mapping of the Supplementary Motor Area in Patients with Brain Tumor Using Resting-State fMRI with Seed-Based Analysis. AJNR Am J Neuroradiol 2018; 39:1493-1498. [PMID: 30002054 DOI: 10.3174/ajnr.a5709] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 05/08/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The supplementary motor area can be a critical region in the preoperative planning of patients undergoing brain tumor resection because it plays a role in both language and motor function. While primary motor regions have been successfully identified using resting-state fMRI, there is variability in the literature regarding the identification of the supplementary motor area for preoperative planning. The purpose of our study was to compare resting-state fMRI to task-based fMRI for localization of the supplementary motor area in a large cohort of patients with brain tumors presenting for preoperative brain mapping. MATERIALS AND METHODS Sixty-six patients with brain tumors were evaluated with resting-state fMRI using seed-based analysis of hand and orofacial motor regions. Rates of supplementary motor area localization were compared with those in healthy controls and with localization results by task-based fMRI. RESULTS Localization of the supplementary motor area using hand motor seed regions was more effective than seeding using orofacial motor regions for both patients with brain tumor (95.5% versus 34.8%, P < .001) and controls (95.2% versus 45.2%, P < .001). Bilateral hand motor seeding was superior to unilateral hand motor seeding in patients with brain tumor for either side (95.5% versus 75.8%/75.8% for right/left, P < .001). No difference was found in the ability to identify the supplementary motor area between patients with brain tumors and controls. CONCLUSIONS In addition to task-based fMRI, seed-based analysis of resting-state fMRI represents an equally effective method for supplementary motor area localization in patients with brain tumors, with the best results obtained with bilateral hand motor region seeding.
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Affiliation(s)
- J Wongsripuemtet
- From the Russell H. Morgan Department of Radiology and Radiological Sciences (J.W., A.E.T., S.A., S.K.G., J.J.P., H.I.S.).,Department of Radiology (J.W.), Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - A E Tyan
- From the Russell H. Morgan Department of Radiology and Radiological Sciences (J.W., A.E.T., S.A., S.K.G., J.J.P., H.I.S.)
| | - A Carass
- Department of Computer Science and Department of Electrical and Computer Engineering (A.C.), Johns Hopkins University, Baltimore, Maryland
| | - S Agarwal
- From the Russell H. Morgan Department of Radiology and Radiological Sciences (J.W., A.E.T., S.A., S.K.G., J.J.P., H.I.S.)
| | - S K Gujar
- From the Russell H. Morgan Department of Radiology and Radiological Sciences (J.W., A.E.T., S.A., S.K.G., J.J.P., H.I.S.)
| | - J J Pillai
- From the Russell H. Morgan Department of Radiology and Radiological Sciences (J.W., A.E.T., S.A., S.K.G., J.J.P., H.I.S.).,Department of Neurosurgery (J.J.P.), Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - H I Sair
- From the Russell H. Morgan Department of Radiology and Radiological Sciences (J.W., A.E.T., S.A., S.K.G., J.J.P., H.I.S.)
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136
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Agarwal S, Ghosh S, Sharma S, Kaur K, Verma I. Mycobacterium tuberculosis H37Rv expresses differential proteome during intracellular survival within alveolar epithelial cells compared with macrophages. Pathog Dis 2018; 76:5052203. [DOI: 10.1093/femspd/fty058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 06/28/2018] [Indexed: 12/20/2022] Open
Affiliation(s)
- S Agarwal
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - S Ghosh
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - S Sharma
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - K Kaur
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - I Verma
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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137
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Chan J, Kwong HM, Agarwal S. MRI prostate vs histological staging. Is MRI underestimating prostate cancer staging? Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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138
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Yadav D, Agarwal S, Sharma A, Malik E, Kandasamy D, Thakar A, Yadav R, Barward A, Kini L. Synovial sarcoma masquerading as medullary thyroid carcinoma. Cytopathology 2018; 29:468-470. [PMID: 29873853 DOI: 10.1111/cyt.12582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2018] [Indexed: 11/29/2022]
Affiliation(s)
- D Yadav
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - S Agarwal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - A Sharma
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - E Malik
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - D Kandasamy
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - A Thakar
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, New Delhi, India
| | - R Yadav
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - A Barward
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - L Kini
- Clinical Pathologist, CORE Diagnostics, New Delhi, India
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139
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Garg G, Aeron R, Singh B, Agarwal S. Primitive neuroectodermal tumor of kidney mimicking as an inflammatory renal mass. African Journal of Urology 2018. [DOI: 10.1016/j.afju.2018.02.006] [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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140
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Viswanathan L, Lekstrom-Himes J, Garg V, Agarwal S. P024 Effects of food and moderate hepatic impairment on the pharmacokinetics (PK) of tezacaftor/ivacaftor (TEZ/IVA). J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30321-7] [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: 10/14/2022]
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141
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Mahajan S, Agarwal S, Kocheri N, Jain D, Mathur SR, Iyer VK. Cytopathology of non-invasive follicular thyroid neoplasm with papillary-like nuclear features: A comparative study with similar patterned papillary thyroid carcinoma variants. Cytopathology 2018; 29:233-240. [DOI: 10.1111/cyt.12537] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2018] [Indexed: 01/31/2023]
Affiliation(s)
- S. Mahajan
- Department of Pathology; All India Institute of Medical Sciences; New Delhi India
| | - S. Agarwal
- Department of Pathology; All India Institute of Medical Sciences; New Delhi India
| | - N. Kocheri
- Department of Pathology; All India Institute of Medical Sciences; New Delhi India
| | - D. Jain
- Department of Pathology; All India Institute of Medical Sciences; New Delhi India
| | - S. R. Mathur
- Department of Pathology; All India Institute of Medical Sciences; New Delhi India
| | - V. K. Iyer
- Department of Pathology; All India Institute of Medical Sciences; New Delhi India
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142
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Agarwal S, Raymond JK, Isom S, Lawrence JM, Klingensmith G, Pihoker C, Corathers S, Saydah S, D'Agostino RB, Dabelea D. Transfer from paediatric to adult care for young adults with Type 2 diabetes: the SEARCH for Diabetes in Youth Study. Diabet Med 2018; 35:504-512. [PMID: 29377258 PMCID: PMC6130201 DOI: 10.1111/dme.13589] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/22/2018] [Indexed: 12/17/2022]
Abstract
AIM To describe factors associated with transfer from paediatric to adult care and poor glycaemic control among young adults with Type 2 diabetes, using the SEARCH for Diabetes in Youth study. METHODS Young adults with Type 2 diabetes were included if they had a baseline SEARCH visit while in paediatric care at < 18 years and ≥ 1 follow-up SEARCH visit thereafter at 18-25 years. At each visit, HbA1c , BMI, self-reported demographic and healthcare provider data were collected. Associations of demographic factors with transfer of care and poor glycaemic control (HbA1c ≥ 75 mmol/mol; 9.0%) were explored with multivariable logistic regression. RESULTS 182 young adults with Type 2 diabetes (36% male, 75% minority, 87% with obesity) were included. Most (n = 102, 56%) reported transfer to adult care at follow-up; a substantial proportion (n = 28, 15%) reported no care and 29% did not transfer. Duration of diabetes [odds ratio (OR) 1.4, 95% confidence interval (95% CI) 1.1, 1.8] and age at diagnosis (OR 1.8, 95% CI 1.4, 2.4) predicted leaving paediatric care. Transfer to adult or no care was associated with a higher likelihood of poor glycaemic control at follow-up (adult: OR 4.5, 95% CI 1.8, 11.2; none: OR 4.6, 95% CI 1.4, 14.6), independent of sex, age, race/ethnicity or baseline HbA1c level. CONCLUSIONS Young adults with Type 2 diabetes exhibit worsening glycaemic control and loss to follow-up during the transfer from paediatric to adult care. Our study highlights the need for development of tailored clinical programmes and healthcare system policies to support the growing population of young adults with youth-onset Type 2 diabetes.
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Affiliation(s)
- S Agarwal
- Division of Endocrinology, Diabetes, and Metabolism, University of Pennsylvania, USA
- Perelman School of Medicine, Philadelphia, USA
| | - J K Raymond
- Pediatric Endocrinology, Children's Hospital of Los Angeles, Los Angelos, USA
| | - S Isom
- Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, USA
| | - J M Lawrence
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, USA
| | - G Klingensmith
- Barbara Davis Center for Diabetes, University of Colorado, Children's Hospital Colorado, Denver, CO, USA
| | - C Pihoker
- Department of Pediatrics, University of Washington, Seattle, USA
| | - S Corathers
- Division of Endocrinology, Department of Internal Medicine, University of Cincinnati Medical Center, USA
- Division of Endocrinology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - S Saydah
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, USA
| | - R B D'Agostino
- Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, USA
| | - D Dabelea
- Pediatrics and Epidemiology, University of Colorado, Denver, CO, USA
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143
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Padmanabhan M, Agarwal S, Reddy S, Thumsi J, Srinivasan K, Subramanian M, Jaison G, Ganganna R, Sunkappa Dayashankara S, Suresh Jadhav S. Poor penetrance of Deep inspiratory breath hold (DIBH) Gating technique in treatment of left sided breast cancers in developing countries. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30409-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: 11/25/2022]
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144
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Rao PS, Agarwal S. Theoretical Study of Couple Stress Fluid Film in Rough Step Slider Bearing with Assorted Porous Structures. j nanofluids 2018. [DOI: 10.1166/jon.2018.1420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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145
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Abstract
Purpose To report the efficacy of photodynamic therapy in treatment of choroidal neovascular membrane (CNV) associated with melanocytoma of the optic disc. Methods A middle-aged man with visual acuity of 20/200 in right eye was treated with photodynamic therapy for juxtafoveal classic CNV overlying the papillomacular bundle. CNV was secondary to ocular melanocytoma, a rare event. Results At the 6-month follow-up, a scarred CNV with final visual acuity of 20/30 was noted clinically and angiographically Tomography revealed high reflective scar tissue with flat macula and microperimetry showed restoration of retinal sensitivity over the papillomacular bundle. Conclusions Photodynamic therapy effectively resolved CNV that involved papillomacular bundle (secondary to melanocytoma) and restored retinal function in papillomacular bundle.
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Affiliation(s)
- K.V. Chalam
- Department of Ophthalmology, University of Florida College of Medicine, Jacksonville - USA
| | - S.K. Gupta
- Department of Ophthalmology, University of Florida College of Medicine, Jacksonville - USA
| | - G.Y. Shah
- Department of Ophthalmology, University of Florida College of Medicine, Jacksonville - USA
| | - S. Agarwal
- Department of Ophthalmology, University of Florida College of Medicine, Jacksonville - USA
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146
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Blackshaw WJ, Bhawnani A, Pennefather SH, Al-Rawi O, Agarwal S, Shaw M. Propensity score-matched outcomes after thoracic epidural or paravertebral analgesia for thoracotomy. Anaesthesia 2018; 73:444-449. [DOI: 10.1111/anae.14205] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2017] [Indexed: 11/27/2022]
Affiliation(s)
- W. J. Blackshaw
- Anaesthetic Department; Liverpool Heart and Chest Hospital NHS Trust; Liverpool UK
| | - A. Bhawnani
- Anaesthetic Department; Liverpool Heart and Chest Hospital NHS Trust; Liverpool UK
| | - S. H. Pennefather
- Anaesthetic Department; Liverpool Heart and Chest Hospital NHS Trust; Liverpool UK
| | - O. Al-Rawi
- Anaesthetic Department; Liverpool Heart and Chest Hospital NHS Trust; Liverpool UK
| | - S. Agarwal
- Anaesthetic Department; Liverpool Heart and Chest Hospital NHS Trust; Liverpool UK
| | - M. Shaw
- Anaesthetic Department; Liverpool Heart and Chest Hospital NHS Trust; Liverpool UK
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147
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Ha F, Barra S, Brown A, Begley D, Grace A, Agarwal S. Continuous and Minimally Interrupted Novel Oral Anticoagulant are Both Safe for Atrial Fibrillation Ablation: An Updated Meta-Analysis. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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148
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Dubey IP, Jain A, Chauhan MS, Kumar R, Agarwal S, Kishore B, Vishnoi MG, Paliwal D, John AR, Kumar N, Sharma A, Pandit AG. Tumor characteristics and metabolic quantification in carcinoma breast: An institutional experience. Indian J Cancer 2017; 54:333-339. [PMID: 29199717 DOI: 10.4103/ijc.ijc_121_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND In India, carcinoma breast is the most common cancer among urban women population and second most common cancer after carcinoma cervix in rural areas. One in 22 women in India develops carcinoma of the breast in their lifetime. Fluorine-18-fluoro-2-deoxy-D-glucose (18F-FDG) uptake in breast cancer usually indicates the degree of tumor metabolism and hence can predict its behavior and prognosis. On the other hand, the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER-2) or neu state of breast cancer is a biomarker that provides important prognostic information in addition to predicting response to therapy. AIMS The main objective of this study is to assess whether a correlation exists between 18F-FDG uptake in untreated cases of breast cancer, their receptor status (ER, PR, and HER-2 or neu), tumor histology, and tumor size. SUBJECTS AND METHODS Sixty consecutive female patients, with biopsy-proven primary breast cancer, were enrolled in this prospective study for whom 18F-FDG positron emission tomography-computed tomography scan was done in the Department of Nuclear Medicine. Results obtained were analyzed using appropriate statistical tests (t-test and Pearson Chi-square tests), and interpretation was made with 95% confidence level. RESULTS In our series, a positive correlation between tumor size, high tumor grade, and standardized uptake value (SUV) was found. Tumors with positive receptor status for estrogen, progesterone, and HER-2/neu receptors had statistically insignificant lower maximum SUV (SUVmax) values than their negative counterparts. Triple-negative breast tumors (ER-, PR-, and no overexpression of HER-2/neu) are currently a subject of major interest because of their aggressiveness, poor prognosis, and lack of targeted therapy. Based on receptor status when the SUVmaxof the group with triple-negative receptor status (ER-/PR-/HER-2/neu-) was compared to rest of the patient group, it was seen that patients with negative receptor status had significantly higher mean SUVmaxvalues. CONCLUSIONS We have inferred that in patients with breast cancer, various biological parameters such as tumor size, grade, histology, and hormonal receptor status have different impact on tumor metabolic activity.
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Affiliation(s)
- I P Dubey
- Department of Nuclear Medicine, Army Hospital (Research and Referral), New Delhi, India
| | - A Jain
- Department of Nuclear Medicine, Army Hospital (Research and Referral), New Delhi, India
| | - M S Chauhan
- Department of Nuclear Medicine, Army Hospital (Research and Referral), New Delhi, India
| | - R Kumar
- Department of Nuclear Medicine, Army Hospital (Research and Referral), New Delhi, India
| | - S Agarwal
- Department of Nuclear Medicine, Army Hospital (Research and Referral), New Delhi, India
| | - B Kishore
- Department of Nuclear Medicine, Army Hospital (Research and Referral), New Delhi, India
| | - M G Vishnoi
- Department of Nuclear Medicine, Army Hospital (Research and Referral), New Delhi, India
| | - D Paliwal
- Department of Nuclear Medicine, Army Hospital (Research and Referral), New Delhi, India
| | - A R John
- Department of Nuclear Medicine, Army Hospital (Research and Referral), New Delhi, India
| | - N Kumar
- Department of Nuclear Medicine, Army Hospital (Research and Referral), New Delhi, India
| | - A Sharma
- Department of Nuclear Medicine, Army Hospital (Research and Referral), New Delhi, India
| | - A G Pandit
- Department of Nuclear Medicine, Army Hospital (Research and Referral), New Delhi, India
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149
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Rao PS, Agarwal S. Couple Stress Fluid-Based Squeeze Film Between Porous Annular Curved Plates with the Effect of Rotational Inertia. Iran J Sci Technol Trans Sci 2017. [DOI: 10.1007/s40995-017-0295-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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150
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Nambirajan A, Batool S, Mandal P, Nakra T, Agarwal S, Jain D. Rosettes in papillary carcinoma of thyroid: A rare cytomorphological indicator of aggressive variants. Cytopathology 2017; 28:560-562. [DOI: 10.1111/cyt.12489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2017] [Indexed: 11/30/2022]
Affiliation(s)
- A. Nambirajan
- Departments of Pathology and Surgery; All India Institute of Medical Sciences; New Delhi India
| | - S. Batool
- Departments of Pathology and Surgery; All India Institute of Medical Sciences; New Delhi India
| | - P. Mandal
- Departments of Pathology and Surgery; All India Institute of Medical Sciences; New Delhi India
| | - T. Nakra
- Departments of Pathology and Surgery; All India Institute of Medical Sciences; New Delhi India
| | - S. Agarwal
- Departments of Pathology and Surgery; All India Institute of Medical Sciences; New Delhi India
| | - D. Jain
- Departments of Pathology and Surgery; All India Institute of Medical Sciences; New Delhi India
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