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Vogt K, Kulkarni A, Pandey R, Dehnad M, Konopka G, Greene R. Sleep need driven oscillation of glutamate synaptic phenotype. bioRxiv 2024:2024.02.05.578985. [PMID: 38370691 PMCID: PMC10871195 DOI: 10.1101/2024.02.05.578985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Sleep loss increases AMPA-synaptic strength and number in the neocortex. However, this is only part of the synaptic sleep loss response. We report increased AMPA/NMDA EPSC ratio in frontal-cortical pyramidal neurons of layers 2-3. Silent synapses are absent, decreasing the plastic potential to convert silent NMDA to active AMPA synapses. These sleep loss changes are recovered by sleep. Sleep genes are enriched for synaptic shaping cellular components controlling glutamate synapse phenotype, overlap with autism risk genes and are primarily observed in excitatory pyramidal neurons projecting intra-telencephalically. These genes are enriched with genes controlled by the transcription factor, MEF2c and its repressor, HDAC4. Thus, sleep genes under the influence of MEF2c and HDAC4, can provide a framework within which motor learning and training occurs mediated by sleep-dependent oscillation of glutamate-synaptic phenotypes.
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Affiliation(s)
- K.E. Vogt
- International Institute of Integrative Sleep Medicine, University of Tsukuba, Tsukuba, Japan
| | - A. Kulkarni
- Department of Neuroscience, Peter O’Donnell Brain Institute, University of Texas Southwestern Medical Center, Dallas, United States
| | - R. Pandey
- Department of Psychiatry, Peter O’Donnell Brain Institute, University of Texas Southwestern Medical Center, Dallas, United States
| | - M. Dehnad
- Department of Psychiatry, Peter O’Donnell Brain Institute, University of Texas Southwestern Medical Center, Dallas, United States
| | - G. Konopka
- Department of Neuroscience, Peter O’Donnell Brain Institute, University of Texas Southwestern Medical Center, Dallas, United States
| | - R.W. Greene
- International Institute of Integrative Sleep Medicine, University of Tsukuba, Tsukuba, Japan
- Department of Neuroscience, Peter O’Donnell Brain Institute, University of Texas Southwestern Medical Center, Dallas, United States
- Department of Psychiatry, Peter O’Donnell Brain Institute, University of Texas Southwestern Medical Center, Dallas, United States
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Arora B, Kulkarni A, Markus MA, Ströbel P, Bohnenberger H, Alves F, Ramos-Gomes F. Label-free quantification of imaging features in the extracellular matrix of left and right-sided colon cancer tissues. Sci Rep 2024; 14:7510. [PMID: 38553551 PMCID: PMC10980747 DOI: 10.1038/s41598-024-58231-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 03/26/2024] [Indexed: 04/02/2024] Open
Abstract
The molecular pathogenesis of colorectal cancer is known to differ between the right and left side of the colon. Several previous studies have focussed on the differences in clinicopathological features, proteomic and genetic biomarkers, the composition of gut microbiota, response to therapy, and the characteristics of the tumour microenvironment. However, the morphology and density of collagen in the extracellular matrix (ECM) have not been studied intensively. In this study, we employed 2-photon laser scanning microscopy (2PLSM) to visualise the intrinsic second-harmonic generation (SHG) signal emitted by collagen fibres in the heterogeneous ECM of human colon tumour tissues. Through texture analysis of the SHG signal, we quantitatively distinguished the imaging features generated by structural differences of collagen fibres in healthy colon and cancers and found marked differences. The fibres inside of tumours exhibited a loss of organisation, particularly pronounced in right-sided colon cancer (RSCC), where the chaotic regions were significantly increased. In addition, a higher collagen content was found in left-sided colon cancer (LSCC). In future, this might aid in subclassification and therapeutic decisions or even in designing new therapy regimens by taking into account the differences between collagen fibres features between colon tumours located at different sides.
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Affiliation(s)
- B Arora
- Translational Molecular Imaging, Max-Planck-Institute for Multidisciplinary Sciences, Hermann Rein-Straße 3, 37075, Göttingen, Germany
| | - A Kulkarni
- Translational Molecular Imaging, Max-Planck-Institute for Multidisciplinary Sciences, Hermann Rein-Straße 3, 37075, Göttingen, Germany
| | - M A Markus
- Translational Molecular Imaging, Max-Planck-Institute for Multidisciplinary Sciences, Hermann Rein-Straße 3, 37075, Göttingen, Germany
| | - P Ströbel
- Institute of Pathology, University Medical Center Göttingen, Robert-Koch-Straβe 40, 37075, Göttingen, Germany
| | - H Bohnenberger
- Institute of Pathology, University Medical Center Göttingen, Robert-Koch-Straβe 40, 37075, Göttingen, Germany
| | - F Alves
- Translational Molecular Imaging, Max-Planck-Institute for Multidisciplinary Sciences, Hermann Rein-Straße 3, 37075, Göttingen, Germany
- Clinic for Haematology and Medical Oncology, Institute of Interventional and Diagnostic Radiology, University Medical Center Göttingen, Robert-Koch-Straβe 40, 37075, Göttingen, Germany
- Cluster of Excellence "Multiscale Bioimaging: from Molecular Machines to Networks of Excitable Cells" (MBExC), University of Goettingen, Göttingen, Germany
| | - F Ramos-Gomes
- Translational Molecular Imaging, Max-Planck-Institute for Multidisciplinary Sciences, Hermann Rein-Straße 3, 37075, Göttingen, Germany.
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Asodaria P, Ng JY, Lascaratos G, Trikha S, Kulkarni A. Changing trends in anaesthesia for trabeculectomy: a clinical effectiveness and safety analysis. Eye (Lond) 2023; 37:3041-3043. [PMID: 36854817 PMCID: PMC10516958 DOI: 10.1038/s41433-023-02441-y] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/17/2022] [Accepted: 02/01/2023] [Indexed: 03/02/2023] Open
Affiliation(s)
- P Asodaria
- Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - J Y Ng
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.
- Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK.
| | - G Lascaratos
- Faculty of Life Sciences & Medicine, King's College London, London, UK
- Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK
| | - S Trikha
- Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK
| | - A Kulkarni
- Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK
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Kulkarni A, Wright NMA, Forget AN, Ramsay T, Mallick R, Weberpals JI. Should we abandon hormonal therapy in endometrial cancer? Outcomes of recurrent and metastatic endometrial cancer treated with systemic progestins. Cancer Med 2023; 12:16173-16180. [PMID: 37417528 PMCID: PMC10469659 DOI: 10.1002/cam4.6276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 06/05/2023] [Accepted: 06/08/2023] [Indexed: 07/08/2023] Open
Abstract
PURPOSE The objective of this study is to determine primary survival endpoints in women with recurrent and metastatic endometrial carcinoma (RMEC) treated with progestins. METHODS A retrospective chart review was conducted at The Ottawa Hospital using electronic medical records. Inclusion criteria were a diagnosis of RMEC between 2000 and 2019, endometrioid histology, and ≥one line of progestin treatment. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. RESULTS Of 2342 cases reviewed, 74 met inclusion criteria. Sixty-six (88.0%) patients received megestrol acetate and 9 (12.0%) received a progestin alternative. The distribution of tumors by grade was: 1: 25 (33.3%), 2: 30 (40.0%), and 3: 20 (26.7%). The PFS and OS for the entire study sample was 14.3 months (95% CI 6.2-17.9) and 23.3 months (14.8-36.8), respectively. The PFS for patients with Grade 1-2 RMEC was 15.7 months (8.0, 19.5), compared to 5.0 months (3.0, 23.0) with Grade 3 disease. The OS for patients with Grade 1-2 versus Grade 3, was 25.9 months (15.3, 40.3) versus 12.5 months (5.7, 35.9), respectively. Thirty-four (45.9%) and 40 (54.1%) patients were treated with 0 and ≥1 line of chemotherapy. The PFS for chemotherapy-naïve patients was 17.9 months (14.3, 27.0), versus 6.2 months (3.9, 14.8) following ≥1 line of treatment. The OS was 29.1 months (17.9, 61.1) for chemotherapy-naïve patients versus 23.0 months (10.5, 37.6) for patients previously exposed. CONCLUSIONS This real-world data on RMEC suggests there is a role for progestins in select subgroups of women. The PFS for chemotherapy-naïve patients was 17.9 months (14.3, 27.0), versus 6.2 months (3.9, 14.8) following ≥1 line of treatment. The OS was 29.1 months (17.9, 61.1) for chemotherapy-OS was 29.1 months (17.9, 61.1) for chemotherapy-naïve patients versus 23.0 months (10.5, 37.6) for patients previously exposed.
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Affiliation(s)
- A. Kulkarni
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of MedicineUniversity of OttawaOttawaOntarioCanada
| | | | - A. N. Forget
- Ottawa Hospital Research InstituteOttawaOntarioCanada
| | - T. Ramsay
- Ottawa Hospital Research InstituteOttawaOntarioCanada
- School of Epidemiology, Public Health and Preventative MedicineUniversity of OttawaOttawaOntarioCanada
| | - R. Mallick
- Ottawa Hospital Research InstituteOttawaOntarioCanada
- School of Epidemiology, Public Health and Preventative MedicineUniversity of OttawaOttawaOntarioCanada
| | - J. I. Weberpals
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of MedicineUniversity of OttawaOttawaOntarioCanada
- Ottawa Hospital Research InstituteOttawaOntarioCanada
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Chalmers S, Hill J, Connell L, Ackerley S, Kulkarni A, Roddam H. The value of allied health professional research engagement on healthcare performance: a systematic review. BMC Health Serv Res 2023; 23:766. [PMID: 37464444 PMCID: PMC10355072 DOI: 10.1186/s12913-023-09555-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 05/16/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Existing evidence suggests that clinician and organisation engagement in research can improve healthcare performance. With the increase in allied health professional (AHP) research activity, it is imperative for healthcare organisations, clinicians, managers, and leaders to understand research engagement specifically within allied health fields. This systematic review aims to examine the value of research engagement by allied health professionals and organisations on healthcare performance. METHODS This systematic review had a two-stage search strategy. Firstly, the papers from a previous systematic review examining the effect of research engagement in healthcare were screened to identify papers published pre-2012. Secondly, a multi-database search was used to conduct a re-focused update of the previous review, focusing specifically on allied health to identify publications from 2012-2021. Studies which examined the value of allied health research engagement on healthcare performance were included. All stages of the review were conducted by two reviewers independently. Each study was assessed using the appropriate Joanna Briggs Institute critical appraisal tool. A narrative synthesis was completed to analyse the similarities and differences between and within the different study types. RESULTS Twenty-two studies were included, comprising of mixed research designs, of which six were ranked as high importance. The findings indicated that AHP research engagement appears related to positive findings in improvements to processes of care. The review also identified the most common mechanisms which may link research engagement with these improvements. DISCUSSION This landmark systematic review and narrative synthesis suggests value in AHP research engagement in terms of both processes of care and more tentatively, of healthcare outcomes. While caution is required because of the lack of robust research studies, overall the findings support the agenda for growing AHP research. Recommendations are made to improve transparent reporting of AHP research engagement and to contribute essential evidence of the value of AHP research engagement. TRIAL REGISTRATION This systematic review protocol was registered with the international prospective register of systematic reviews, PROSPERO (registration number CRD42021253461 ).
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Affiliation(s)
- S Chalmers
- University of Central Lancashire; Allied Health Research Unit, School of Health Sciences, University of Central Lancashire, Fylde Rd, Preston, PR1 2HE, UK.
- Bolton NHS Foundation Trust, Minerva Road, Farnworth, Bolton, Greater Manchester, BL4 0JR, UK.
| | - J Hill
- University of Central Lancashire; Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire, Fylde Rd, Preston, PR1 2HE, UK
| | - L Connell
- University of Central Lancashire; Allied Health Research Unit, School of Health Sciences, University of Central Lancashire, Fylde Rd, Preston, PR1 2HE, UK
- East Lancashire Hospitals NHS Trust, Burnley, BB10 2PQ, UK
| | - S Ackerley
- University of Central Lancashire; Allied Health Research Unit, School of Health Sciences, University of Central Lancashire, Fylde Rd, Preston, PR1 2HE, UK
| | - A Kulkarni
- Royal College of Speech & Language Therapists, 2-3 White Hart Yard, London, SE1 1NX, UK
| | - H Roddam
- Subject Matter Expert for AHP Research, Health Education England, Manchester, UK
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Verma I, Gowda A, Prabhu D, Kulkarni A, Kumar A. Comparison between Clinical Profile and Outcome of Patients Admitted with Moderate and Severe COVID-19 Illness in the First and Second Wave of COVID-19 in a Tertiary Care Centre in South India. Niger J Clin Pract 2023; 26:581-585. [PMID: 37357473 DOI: 10.4103/njcp.njcp_381_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Background SARS-coronavirus-2 has caused large number of infections globally. The infections have presented in a wave form in most of the countries. There have been differences in the clinical presentation, course, and the outcomes in the different waves. Aim This study describes the clinical features and course of the patients admitted with COVID-19 illness between the first and second wave of COVID-19 in a tertiary care center in South India. Materials and Methods This was a cross-sectional study where case record analysis of the patients admitted with moderate and severe COVID-19 illness in a tertiary care center in South India was performed. Patients admitted between August 1, 2020, and November 30, 2020, were considered to be affected in the first wave and those admitted between April 30, 2021, and July 30, 2021, were considered to be in the second wave of COVID-19. First wave and second wave periods were determined by a steep surge in infections in India as per the epidemiological data. The symptoms, comorbidities, clinical profile, severity, laboratory parameters, need for assisted ventilation, medications used, and outcome were compared between the two-time frames. Results A total of 123 patients' data were analyzed in each wave. 72 (58%) patients had fever, while 64 (52%) patients had fever in COVID second wave. In the first wave, five (4%) patients had diarrhea, and four (3.2%) patients had vomiting, whereas in second wave, 43 (34%) patients had diarrhea, and 25 (20 percent) patients had vomiting (P < 0.001). It was seen in the present study that more number of patients in the age group of 31 to 40 years had more serious illness and adverse outcomes in second wave compared with patients in first wave where age group of 51-60 years was more seriously affected. In COVID first wave, 80 (65.0%) were having moderate COVID-19 illness and 43 (35%) had severe illness. In the second wave, 70 (57%) had moderate illness and 53 (43%) patients had severe illness. In the first wave, 31 patients (25%) required non-invasive ventilation (NIV), whereas 79 patients (64%) required NIV in second wave (P < 0.001). First wave resulted in 12 (9.7%) deaths, whereas second wave resulted in 20 (16.2%) deaths. Conclusion The patients with COVID-19 illness in the second wave presented with more non-respiratory symptoms like vomiting, diarrhea, and joint pains. The patients who had severe illness in the second wave were comparatively younger than the patients of the first wave. The requirement of ventilatory support and immunosuppressants was more in the second wave.
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Affiliation(s)
- I Verma
- Department of General Medicine, M S Ramaiah Medical College and Hospitals, Bengaluru, India
| | - A Gowda
- Department of Pharmacy Practice, M S Ramaiah University of Applied Sciences, Bengaluru, India
| | - D Prabhu
- Department of General Medicine, M S Ramaiah Medical College and Hospitals, Bengaluru, India
| | - A Kulkarni
- Department of General Medicine, M S Ramaiah Medical College and Hospitals, Bengaluru, India
| | - A Kumar
- Department of General Medicine, M S Ramaiah Medical College and Hospitals, Bengaluru, India
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Kuzbari Z, Bandlamudi C, Loveday C, Garrett A, Mehine M, George A, Hanson H, Snape K, Kulkarni A, Allen S, Jezdic S, Ferrandino R, Westphalen CB, Castro E, Rodon J, Mateo J, Burghel GJ, Berger MF, Mandelker D, Turnbull C. Germline-focused analysis of tumour-detected variants in 49,264 cancer patients: ESMO Precision Medicine Working Group recommendations. Ann Oncol 2023; 34:215-227. [PMID: 36529447 DOI: 10.1016/j.annonc.2022.12.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/01/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The European Society for Medical Oncology Precision Medicine Working Group (ESMO PMWG) was reconvened to update its 2018/19 recommendations on follow-up of putative germline variants detected on tumour-only sequencing, which were based on an analysis of 17 152 cancers. METHODS We analysed an expanded dataset including 49 264 paired tumour-normal samples. We applied filters to tumour-detected variants based on variant allele frequency, predicted pathogenicity and population variant frequency. For 58 cancer-susceptibility genes, we then examined the proportion of filtered tumour-detected variants of true germline origin [germline conversion rate (GCR)]. We conducted subanalyses based on the age of cancer diagnosis, specific tumour types and 'on-tumour' status (established tumour-gene association). RESULTS Analysis of 45 472 nonhypermutated solid malignancy tumour samples yielded 21 351 filtered tumour-detected variants of which 3515 were of true germline origin. 3.1% of true germline pathogenic variants were absent from the filtered tumour-detected variants. For genes such as BRCA1, BRCA2 and PALB2, the GCR in filtered tumour-detected variants was >80%; conversely for TP53, APC and STK11 this GCR was <2%. CONCLUSION Strategic germline-focused analysis can prioritise a subset of tumour-detected variants for which germline follow-up will produce the highest yield of most actionable true germline variants. We present updated recommendations around germline follow-up of tumour-only sequencing including (i) revision to 5% for the minimum per-gene GCR, (ii) inclusion of actionable intermediate penetrance genes ATM and CHEK2, (iii) definition of a set of seven 'most actionable' cancer-susceptibility genes (BRCA1, BRCA2, PALB2, MLH1, MSH2, MSH6 and RET) in which germline follow-up is recommended regardless of tumour type.
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Affiliation(s)
- Z Kuzbari
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - C Bandlamudi
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - C Loveday
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK. https://twitter.com/LovedayChey
| | - A Garrett
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK. https://twitter.com/DrAliceGarrett
| | - M Mehine
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - A George
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK
| | - H Hanson
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK; South West Thames Regional Genetics Service, St George's University Hospitals NHS Foundation Trust, London, UK
| | - K Snape
- South West Thames Regional Genetics Service, St George's University Hospitals NHS Foundation Trust, London, UK. https://twitter.com/genetikos
| | - A Kulkarni
- South East Thames Regional Genetics Service, Guy's and St Thomas' NHS Foundation Trust, London, UK. https://twitter.com/Anju__Kulkarni
| | - S Allen
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - S Jezdic
- Scientific and Medical Division, European Society for Medical Oncology, Lugano, Switzerland
| | - R Ferrandino
- Scientific and Medical Division, European Society for Medical Oncology, Lugano, Switzerland
| | - C B Westphalen
- Department of Medicine III and Comprehensive Cancer Center (CCC Munich LMU) University Hospital, LMU Munich, Munich, Germany
| | - E Castro
- Genitourinary Cancers Translational Research Group, Institute of Biomedical Research in Málaga (IBIMA), Málaga, Spain. https://twitter.com/Ecastromarcos
| | - J Rodon
- Investigational Cancer Therapeutics, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - J Mateo
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona; Vall d'Hebron University Hospital, Barcelona, Spain
| | - G J Burghel
- North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester, UK. https://twitter.com/BurghelG
| | - M F Berger
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - D Mandelker
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - C Turnbull
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK.
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WAKHARE P, Dighe T, Shinde N, Bale C, Chavan A, Kulkarni A, Saha D, Godbole S, Phadke C, Makan A, Sajgure A. WCN23-0439 TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN PATIENTS WITH CUFFED TUNNELLED HAEMODIALYSIS CATHETERS – A BRIDGE TO THE MISSED DIAGNOSIS? Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.02.711] [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: 03/22/2023] Open
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Kimura Y, Raghuraman N, Simoes B, Ramesh A, Kulkarni A, Srimathveeravalli G. Abstract No. 5 ▪ FEATURED ABSTRACT Adjuvant Macrophage Repolarization to M1 Phenotype Augments Post-Ablation Local Tumor Control and Improves Overall Survival in a Murine Model of Bladder Tumors. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
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Babadagli E, Kulkarni A, Le T, Fung-Kee-Fung M, Lupe K, Gaudet M, E C, Samant R. Locoregional Control Following Adjuvant Chemotherapy and Radiotherapy for Treatment of High-Risk Endometrial Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kürten C, Kulkarni A, Vujanovic L, Cillo A, Lang S, Ferris R. O1.2 Single cell RNA sequencing allows mapping of HPV transcripts in head and neck cancer epithelial cells. Oral Oncol 2022. [DOI: 10.1016/j.oraloncology.2022.106169] [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: 11/11/2022]
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Repana D, Shanmugalingam T, Gerrard G, Foot N, Kulkarni A, Naidoo K, Talukdar S, Snape K, Hanson H, Quigley K, Mokretar K, Du Parcq P, Ferguson B, Sarker D, Murugaesu N. 31P Liquid biopsies in clinical practice. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.09.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Chavan A, Dighe T, Sajgure A, Bale C, Wakhare P, Shinde N, Kulkarni A. POS-110 ACUTE KIDNEY INJURY WITH LYMPHATIC FILARIASIS IN A KIDNEY TRANSPLANT RECIPIENT : A CASE REPORT. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.07.128] [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] Open
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Seeber A, Baca Y, Xiu J, Puri S, Owonikoko T, Oliver T, Kerrigan K, Patel S, Uprety D, Mamdani H, Kulkarni A, Lopes G, Halmos B, Borghaei H, Akerley W, Liu S, Korn W, Pircher A, Wolf D, Kocher F. 1723P CLEC3B mRNA expression levels are linked to distinct genetic backgrounds, transcriptomic signatures and survival in NSCLC. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Panginikkod S, Gopalakrishnan V, Kulkarni A, Menon S. 'Double-Halo' sign in lupus enteritis. QJM 2022; 114:818-819. [PMID: 34373926 DOI: 10.1093/qjmed/hcab219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- S Panginikkod
- Department of Rheumatology, University of Massachusetts Medical School, 55 North Lake Avenue, Worcester, MA 01605, USA
| | - V Gopalakrishnan
- Department of Hospital Medicine, University of Massachusetts Medical School, 55 North Lake Avenue, Worcester, MA 01605, USA
| | - A Kulkarni
- Department of Radiology, University of Massachusetts Medical School, 55 North Lake Avenue, Worcester, MA 01605, USA
| | - S Menon
- Department of Gastroenterology, Government Medical College Kozhikode Hospital, Gastroenterology, Kozhikode, Kerala 673008, India
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Borhade T, Kulkarni A. Simulation model for Covid-19 pandemic. CM 2021. [DOI: 10.18137/cardiometry.2021.20.125133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This paper outlines computer modeling algorithms designedto predict and forecast a COVID-19. In this paper, we considera deterministic model. Theongoing COVID-19 epidemic quicklyspread across the globe. Significant behavioural, social initiativesto limit city transport, case identification and touch tracking,quarantine, advice, and knowledge to the public, creationof detection kits, etc. and state measures were conducted toreduce the epidemic and eliminate coronavirus persistence inhumans around theworld from stopping the global coronavirusoutbreak. In this paper, we propose a basic SIR epidemic modelto show a simulation, the MATLAB algorithm using bouncingdots to depict safe and sick people to simulate infection spread.The graphical model shown here is implemented using MATLABpackage version 3.0.In this paper, we discuss the importance of models becausethey help one explore what could happen. They demonstratehow different possible futures might be shaped by what weare doing now. We can examine the effects of specific interventionsin different ways such as quarantine or a lockdown &explore how simulations may predict, how infectious diseasesadvanced to show the possible result of an outbreak, and betterguide initiatives in public health regarding the pandemicresponse andpandemic past including an overview of the keycharacteristics of adverse pandemic consequences and epidemicoutbreak.
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Khan W, Baig A, Afzaal Q, Davison J, Hutchings S, Kulkarni A, Brown A, Ashford R. 854 Mortality Associated with Conversion of Total Hip Arthroplasty for Failed Fixation/Hemiarthroplasty for Neck of Femur Fractures. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
To identify the mortality associated with failed internal fixation and hemiarthroplasty of neck of femur fractures.
Method
Patients undergoing conversion of internal fixation / hemi arthroplasty were identified from theatre records and surgical databases. Data was stored in Microsoft Excel spreadsheet. Clinical outcomes at 30 days, 1 year and 5 years post conversion total hip replacement.
Results
60 cases were collected between June 2006 and November 2016. 46 females and 14 males involved in the case. The mean age of male patients was 66.5 and for females 67.9. 32 patients had previous sliding hip screw fixation,12 had intra-medullary nails, 8 had cannulated screw fixation and 5 patients had hemiarthroplasty. The mean time to failure was 22 months (Range: 2 weeks to 60 months) and there were 6 cases of late posttraumatic arthritis (range 4 yrs to 23 yrs). Average time from documented failure to conversion THR was 2 months. There were 2 superficial wound infections which were successfully treated with antibiotics. There were 2 cases of deep infection which required multiple debridement, washout, and prolonged inpatient stay. Average duration of hospital stay was 5.7days. 18 patients died before 5 years for reasons unrelated to their hip. All had a functional prosthesis at time of last review. 42 patients alive at 5 years had a functional prosthesis at last review
Conclusions
Total Hip Arthroplasty is a successful procedure for failed fixation / hemiarthroplasty despite the technical challenges. A 3–5-year mortality rate of 33.33 % reflects well against the NHFD 1year mortality of 30 %.
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Affiliation(s)
- W Khan
- University Hospitals of Leicester, Leicester, United Kingdom
| | - A Baig
- University Hospitals of Leicester, Leicester, United Kingdom
| | - Q Afzaal
- University Hospitals of Leicester, Leicester, United Kingdom
| | - J Davison
- University Hospitals of Leicester, Leicester, United Kingdom
| | - S Hutchings
- University Hospitals of Leicester, Leicester, United Kingdom
| | - A Kulkarni
- University Hospitals of Leicester, Leicester, United Kingdom
| | - A Brown
- University Hospitals of Leicester, Leicester, United Kingdom
| | - R Ashford
- University Hospitals of Leicester, Leicester, United Kingdom
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Katna A, Kulkarni A, Thaker M, Vanak AT. Habitat specificity drives differences in space‐use patterns of multiple mesocarnivores in an agroecosystem. J Zool (1987) 2021. [DOI: 10.1111/jzo.12933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A. Katna
- Ashoka Trust for Research in Ecology and the Environment (ATREE) Bangalore Karnataka India
- Manipal Academy of Higher Education Manipal Karnataka India
| | - A. Kulkarni
- Ashoka Trust for Research in Ecology and the Environment (ATREE) Bangalore Karnataka India
| | - M. Thaker
- Centre for Ecological Sciences Indian Institute of Science Bangalore Karnataka India
| | - A. T. Vanak
- Ashoka Trust for Research in Ecology and the Environment (ATREE) Bangalore Karnataka India
- DBT/Wellcome Trust India Alliance Hyderabad Telangana India
- School of Life Sciences University of KwaZulu‐Natal Westville Durban South Africa
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Mandelker D, Donoghue M, Talukdar S, Bandlamudi C, Srinivasan P, Vivek M, Jezdic S, Hanson H, Snape K, Kulkarni A, Hawkes L, Douillard JY, Wallace SE, Rial-Sebbag E, Meric-Bersntam F, George A, Chubb D, Loveday C, Ladanyi M, Berger MF, Taylor BS, Turnbull C. Erratum to 'Germline-focussed analysis of tumour-only sequencing: recommendations from the ESMO Precision Medicine Working Group': [Annals of Oncology 30 (2019) 1221-1231]. Ann Oncol 2021; 32:1069-1071. [PMID: 34090768 PMCID: PMC8929238 DOI: 10.1016/j.annonc.2021.05.798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- D Mandelker
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA.
| | - M Donoghue
- Marie-Josee and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - S Talukdar
- Department of Clinical Genetics, St George's University of London, London, UK
| | - C Bandlamudi
- Marie-Josee and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - P Srinivasan
- Marie-Josee and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - M Vivek
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, USA
| | - S Jezdic
- European Society for Medical Oncology (ESMO) Head Office, Lugano, Switzerland
| | - H Hanson
- Department of Clinical Genetics, St George's University of London, London, UK
| | - K Snape
- Department of Clinical Genetics, St George's University of London, London, UK
| | - A Kulkarni
- Department ofClinical Genetics, Guy and St Thomas' NHS Foundation Trust, London, UK
| | - L Hawkes
- Department of Clinical Genetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - J-Y Douillard
- European Society for Medical Oncology (ESMO) Head Office, Lugano, Switzerland
| | - S E Wallace
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | - F Meric-Bersntam
- Department of Investigational CancerTherapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - A George
- Cancer Genetics Unit, The Royal Marsden NHS Foundation Trust, London, UK; Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - D Chubb
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - C Loveday
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - M Ladanyi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA; Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, USA
| | - M F Berger
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA; Marie-Josee and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - B S Taylor
- Marie-Josee and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Clinical Genetics, St George's University of London, London, UK; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, USA
| | - C Turnbull
- Department ofClinical Genetics, Guy and St Thomas' NHS Foundation Trust, London, UK; Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK; William Harvey Research Institute, Queen Mary University of London, London, UK; Public Health England, London, UK.
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Kimura Y, Ramesh A, Kulkarni A, Burrell W, Srimathveeravalli G. Abstract No. 207 Damage-associated molecular patterns released by irreversible electroporation–treated cancer cells skew macrophages to M2 phenotype. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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21
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Heft Neal ME, Gensterblum-Miller E, Bhangale AD, Kulkarni A, Zhai J, Smith J, Brummel C, Foltin SK, Thomas D, Jiang H, McHugh JB, Brenner JC. Integrative sequencing discovers an ATF1-motif enriched molecular signature that differentiates hyalinizing clear cell carcinoma from mucoepidemoid carcinoma. Oral Oncol 2021; 117:105270. [PMID: 33827033 DOI: 10.1016/j.oraloncology.2021.105270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/16/2021] [Accepted: 03/20/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Salivary gland tumors are comprised of a diverse group of malignancies with widely varying prognoses. These cancers can be difficult to differentiate, especially in cases with limited potential for immunohistochemistry (IHC)-based characterization. Here, we sought to define the molecular profile of a rare salivary gland cancer called hyalinizing clear cell carcinoma (HCCC), and identify a molecular gene signature capable of distinguishing between HCCC and the histopathologically similar disease, mucoepidermoid carcinoma (MEC). MATERIALS AND METHODS We performed the first integrated full characterization of five independent HCCC cases. RESULTS We discovered insulin-like growth factor alterations and aberrant IGF2 and/or IGF1R expression in HCCC tumors, suggesting a potential dependence on this pathway. Further, we identified a 354 gene signature that differentiated HCCC from MEC, and was significantly enriched for genes with an ATF1 binding motif in their promoters, supporting a transcriptional pathogenic mechanism of the characteristic EWSR1-ATF1 fusion found in these tumors. Of the differentially expressed genes, IGF1R, SGK1 and SGK3 were found to be elevated in the HCCCs relative to MECs. Finally, analysis of immune checkpoints and subsequent IHC demonstrated that CXCR4 protein was elevated in several of the HCCC cases. CONCLUSION Collectively, our data identify an ATF1-motif enriched gene signature that may have clinical utility for molecular differentiation of HCCCs from other salivary gland tumors and discover potential actionable alterations that may benefit the clinical care of recurrent HCCC patients.
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Affiliation(s)
- M E Heft Neal
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, United States
| | - E Gensterblum-Miller
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, United States
| | - A D Bhangale
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, United States
| | - A Kulkarni
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, United States
| | - J Zhai
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - J Smith
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, United States
| | - C Brummel
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, United States
| | - S K Foltin
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, United States
| | - D Thomas
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, United States
| | - H Jiang
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States; Rogel Cancer Center, University of Michigan Medical School, Ann Arbor, MI, United States
| | - J B McHugh
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, United States
| | - J C Brenner
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, United States; Rogel Cancer Center, University of Michigan Medical School, Ann Arbor, MI, United States; Department of Pharmacology, University of Michigan Medical School, Ann Arbor, MI, United States.
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22
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Kulkarni S, Peerapur B, Kulkarni A. Biofilm formation in uropathogenic Escherichia coli strains; Relationship with virulence factors and antimicrobial resistance. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.373] [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] Open
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23
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Kulkarni A, Proussaloglou E, Beffa L, Miller K, Bevis K, Wohlrab K, Lokich E, McCourt C, Glaser G, Brown A, Wethington S, Carlson M, DiSilvestro P, Occhino J, Dunivan G, Tunitsky E, Chen G, Raker C, Luis C, Robison K. Does adjuvant treatment increase risk of midurethral sling complications after concomitant surgery for endometrial cancer and stress urinary incontinence? Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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24
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Proussaloglou E, Kulkarni A, Beffa L, Miller K, Wohlrab K, Lokich E, McCourt C, Glaser G, Brown A, Wethington S, Carlson M, DiSilvestro P, Lowder J, Rahn D, Occhino J, Dunivan G, Chen G, Raker C, Robison K. Sexual dysfunction in women with endometrial cancer and stress urinary incontinence. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.06.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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25
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Sileo FG, Kulkarni A, Branescu I, Homfray T, Dempsey E, Mansour S, Thilaganathan B, Bhide A, Khalil A. Non-immune fetal hydrops: etiology and outcome according to gestational age at diagnosis. Ultrasound Obstet Gynecol 2020; 56:416-421. [PMID: 32196790 DOI: 10.1002/uog.22019] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 03/02/2020] [Accepted: 03/07/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Fetal hydrops is associated with increased perinatal morbidity and mortality. The etiology and outcome of fetal hydrops may differ according to the gestational age at diagnosis. The aim of this study was to evaluate the cause, evolution and outcome of non-immune fetal hydrops (NIFH), according to the gestational age at diagnosis. METHODS This was a retrospective cohort study of all singleton pregnancies complicated by NIFH, at the Fetal Medicine Unit at St George's University Hospital, London, UK, between 2000 and 2018. All fetuses had detailed anomaly and cardiac ultrasound scans, karyotyping and infection screening. Prenatal diagnostic and therapeutic intervention, gestational age at diagnosis and delivery, as well as pregnancy outcome, were recorded. Regression analysis was used to test for potential association between possible risk factors and perinatal mortality. RESULTS We included 273 fetuses with NIFH. The etiology of the condition varied significantly in the three trimesters. Excluding 30 women who declined invasive testing, the cause of NIFH was defined as unknown in 62 of the remaining 243 cases (25.5%). Chromosomal aneuploidy was the most common cause of NIFH in the first trimester. It continued to be a significant etiologic factor in the second trimester, along with congenital infection. In the third trimester, the most common etiology was cardiovascular abnormality. Among the 152 (55.7%) women continuing the pregnancy, 48 (31.6%) underwent fetal intervention, including the insertion of pleuroamniotic shunts, fetal blood transfusion and thoracentesis. Fetal intervention was associated significantly with lower perinatal mortality (odds ratio (OR), 0.30 (95% CI, 0.14-0.61); P < 0.001); this association remained significant after excluding cases with a diagnosis of anemia or infection (OR, 0.29 (95% CI, 0.13-0.66); P = 0.003). In 104 fetuses not undergoing active fetal intervention, the gestational age at diagnosis was the only parameter that was significantly associated with the risk of perinatal mortality (OR, 0.92 (95% CI, 0.85-0.99); P = 0.035), while the affected body cavity and polyhydramnios were not (P > 0.05). CONCLUSIONS An earlier gestational age at diagnosis of NIFH was associated with an increased risk of aneuploidy and worse pregnancy outcome, including a higher risk of perinatal loss. Fetal therapy was associated significantly with lower perinatal mortality. © 2020 Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- F G Sileo
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
| | - A Kulkarni
- Neonatal Unit, St George's Hospital, St George's University of London, London, UK
| | - I Branescu
- Neonatal Unit, St George's Hospital, St George's University of London, London, UK
| | - T Homfray
- SW Thames Regional Genetics Service, St George's Hospital, St George's University of London, London, UK
| | - E Dempsey
- SW Thames Regional Genetics Service, St George's Hospital, St George's University of London, London, UK
| | - S Mansour
- SW Thames Regional Genetics Service, St George's Hospital, St George's University of London, London, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | - B Thilaganathan
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | - A Bhide
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
| | - A Khalil
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
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Lindquist A, Hui L, Poulton A, Kluckow E, Hutchinson B, Pertile MD, Bonacquisto L, Gugasyan L, Kulkarni A, Harraway J, Howden A, McCoy R, Da Silva Costa F, Menezes M, Palma-Dias R, Nisbet D, Martin N, Bethune M, Poulakis Z, Halliday J. State-wide utilization and performance of traditional and cell-free DNA-based prenatal testing pathways: the Victorian Perinatal Record Linkage (PeRL) study. Ultrasound Obstet Gynecol 2020; 56:215-224. [PMID: 31625225 DOI: 10.1002/uog.21899] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/02/2019] [Accepted: 09/26/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To perform individual record linkage of women undergoing screening with cell-free DNA (cfDNA), combined first-trimester screening (CFTS), second-trimester serum screening (STSS), and/or prenatal and postnatal cytogenetic testing with the aim to (1) obtain population-based estimates of utilization of prenatal screening and invasive diagnosis, (2) analyze the performance of different prenatal screening strategies, and (3) report the residual risk of any major chromosomal abnormality following a low-risk aneuploidy screening result. METHODS This was a retrospective study of women residing in the state of Victoria, Australia, who underwent prenatal screening or invasive prenatal diagnosis in 2015. Patient-funded cfDNA referrals from multiple providers were merged with state-wide results for government-subsidized CFTS, STSS and invasive diagnostic procedures. Postnatal cytogenetic results from products of conception and infants up to 12 months of age were obtained to ascertain cases of false-negative screening results and atypical chromosomal abnormalities. Individual record linkage was performed using LinkageWizTM . RESULTS During the study period, there were 79 140 births and 66 166 (83.6%) women underwent at least one form of aneuploidy screening. Linkage data were complete for 93.5% (n = 61 877) of women who underwent screening, and of these, 73.2% (n = 45 275) had CFTS alone, 20.2% (n = 12 486) had cfDNA alone; 5.3% (n = 3268) had STSS alone, 1.3% (n = 813) had both CFTS and cfDNA, and < 0.1% (n = 35) had both STSS and cfDNA. CFTS had a combined sensitivity for trisomies 21 (T21), 18 (T18) and 13 (T13) of 89.57% (95% CI, 82.64-93.93%) for a screen-positive rate (SPR) of 2.94%. There were 12 false-negative results in the CFTS pathway, comprising 10 cases of T21, one of T18 and one of T13. cfDNA had a combined sensitivity for T21, T18 and T13 of 100% (95% CI, 95.00-100%) for a SPR of 1.21%. When high-risk cfDNA results for any chromosome (including the sex chromosomes) and failed cfDNA tests were treated as screen positives, the SPR for cfDNA increased to 2.42%. The risk of any major chromosomal abnormality (including atypical abnormalities) detected on prenatal or postnatal diagnostic testing after a low-risk screening result was 1 in 1188 for CFTS (n = 37) and 1 in 762 for cfDNA (n = 16) (P = 0.13). The range of chromosomal abnormalities detected after a low-risk cfDNA result included pathogenic copy-number variants (n = 6), triploidy (n = 3), rare autosomal trisomies (n = 3) and monosomy X (n = 2). CONCLUSIONS Our state-wide record-linkage analysis delineated the utilization and clinical performance of the multitude of prenatal screening pathways available to pregnant women. The sensitivity of cfDNA for T21, T18 and T13 was clearly superior to that of CFTS. While there was no statistically significant difference in the residual risk of any major chromosomal abnormality after a low-risk CFTS or cfDNA result, there were fewer live infants diagnosed with a major chromosomal abnormality in the cfDNA cohort. These data provide valuable population-based evidence to inform practice recommendations and health policies. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- A Lindquist
- Reproductive Epidemiology group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Obstetrics, Mercy Hospital for Women, Heidelberg, Victoria, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
| | - L Hui
- Reproductive Epidemiology group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Obstetrics, Mercy Hospital for Women, Heidelberg, Victoria, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
- The Northern Hospital, Epping, Victoria, Australia
| | - A Poulton
- Reproductive Epidemiology group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - E Kluckow
- Reproductive Epidemiology group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - B Hutchinson
- Department of Obstetrics, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - M D Pertile
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - L Bonacquisto
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - L Gugasyan
- Cytogenetics, Monash Pathology, Monash Medical Centre, Clayton, Victoria, Australia
| | - A Kulkarni
- Cytogenetics, Monash Pathology, Monash Medical Centre, Clayton, Victoria, Australia
| | - J Harraway
- Sullivan Nicolaides Pathology, Brisbane, Queensland, Australia
| | - A Howden
- Department of Cytogenetics, Melbourne Pathology, Collingwood, Victoria, Australia
| | - R McCoy
- Molecular Genetics, Australian Clinical Labs, Clayton, Victoria, Australia
| | - F Da Silva Costa
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
| | - M Menezes
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Monash Ultrasound for Women, Richmond, Victoria, Australia
| | - R Palma-Dias
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
- Women's Ultrasound Melbourne, East Melbourne, Victoria, Australia
- Ultrasound Services, Royal Women's Hospital, Parkville, Victoria, Australia
| | - D Nisbet
- Women's Ultrasound Melbourne, East Melbourne, Victoria, Australia
- Ultrasound Services, Royal Women's Hospital, Parkville, Victoria, Australia
- Department of Medicine and Radiology, University of Melbourne, Parkville, Victoria, Australia
| | - N Martin
- Virtus Diagnostics and Pathology Services, Spring Hill, Queensland, Australia
| | - M Bethune
- Specialist Women's Ultrasound, Box Hill, Victoria, Australia
- Department of Radiology, University of Melbourne, Parkville, Victoria, Australia
| | - Z Poulakis
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Victorian Infant Hearing Screening Program, Centre for Community Child Health, Royal Children's Hospital, Parkville, Victoria, Australia
- Prevention Innovation Group, Population Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - J Halliday
- Reproductive Epidemiology group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
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27
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Mandelker D, Donoghue M, Talukdar S, Bandlamudi C, Srinivasan P, Vivek M, Jezdic S, Hanson H, Snape K, Kulkarni A, Hawkes L, Douillard JY, Wallace SE, Rial-Sebbag E, Meric-Bersntam F, George A, Chubb D, Loveday C, Ladanyi M, Berger MF, Taylor BS, Turnbull C. Germline-focussed analysis of tumour-only sequencing: recommendations from the ESMO Precision Medicine Working Group. Ann Oncol 2020; 30:1221-1231. [PMID: 31050713 PMCID: PMC6683854 DOI: 10.1093/annonc/mdz136] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
It is increasingly common in oncology practice to perform tumour sequencing using large cancer panels. For pathogenic sequence variants in cancer susceptibility genes identified on tumour-only sequencing, it is often unclear whether they are of somatic or constitutional (germline) origin. There is wide-spread disparity regarding both the extent to which systematic 'germline-focussed analysis' is carried out upon tumour sequencing data and for which variants follow-up analysis of a germline sample is carried out. Here we present analyses of paired sequencing data from 17 152 cancer samples, in which 1494 pathogenic sequence variants were identified across 65 cancer susceptibility genes. From these analyses, the European Society of Medical Oncology Precision Medicine Working Group Germline Subgroup has generated (i) recommendations regarding germline-focussed analyses of tumour-only sequencing data, (ii) indications for germline follow-up testing and (iii) guidance on patient information-giving and consent.
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Affiliation(s)
- D Mandelker
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York.
| | - M Donoghue
- Marie-Josee and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York
| | - S Talukdar
- Department of Clinical Genetics, St George's University of London, London
| | - C Bandlamudi
- Marie-Josee and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York
| | - P Srinivasan
- Marie-Josee and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York
| | - M Vivek
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, USA
| | - S Jezdic
- European Society for Medical Oncology (ESMO) Head Office, Lugano, Switzerland
| | - H Hanson
- Department of Clinical Genetics, St George's University of London, London
| | - K Snape
- Department of Clinical Genetics, St George's University of London, London
| | - A Kulkarni
- Department of Clinical Genetics, Guy and St Thomas' NHS Foundation Trust, London
| | - L Hawkes
- Department of Clinical Genetics, Oxford University Hospitals NHS Foundation Trust, Oxford
| | - J-Y Douillard
- European Society for Medical Oncology (ESMO) Head Office, Lugano, Switzerland
| | - S E Wallace
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | - F Meric-Bersntam
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - A George
- Cancer Genetics Unit, The Royal Marsden NHS Foundation Trust, London; Division of Genetics and Epidemiology, Institute of Cancer Research, London
| | - D Chubb
- Division of Genetics and Epidemiology, Institute of Cancer Research, London
| | - C Loveday
- Division of Genetics and Epidemiology, Institute of Cancer Research, London
| | - M Ladanyi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York; Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, USA
| | - M F Berger
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York; Marie-Josee and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York
| | - B S Taylor
- Marie-Josee and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York; Department of Clinical Genetics, St George's University of London, London; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, USA
| | - C Turnbull
- Department of Clinical Genetics, Guy and St Thomas' NHS Foundation Trust, London; Division of Genetics and Epidemiology, Institute of Cancer Research, London; William Harvey Research Institute, Queen Mary University of London, London; Public Health England, London, UK.
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Regmi MR, Tandan N, Parajuli P, Maini R, Lara Garcia OE, Jagtap P, Kulkarni A. Extracorporeal membranous oxygenation for a severe case of vaping associated lung injury. Pulmonology 2020; 27:69-70. [PMID: 32507701 DOI: 10.1016/j.pulmoe.2020.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/10/2020] [Accepted: 05/11/2020] [Indexed: 11/18/2022] Open
Affiliation(s)
- M R Regmi
- Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL, United States.
| | - N Tandan
- Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL, United States
| | - P Parajuli
- Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL, United States
| | - R Maini
- Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL, United States
| | - O E Lara Garcia
- Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL, United States
| | - P Jagtap
- Division of Critical Care Medicine, HSHS St. John's Hospital, Springfield, IL, United States
| | - A Kulkarni
- Division of Cardiology Medicine, Southern Illinois University School of Medicine, Springfield, IL, United States
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29
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Kapiris M, Josephs D, Kulkarni A, Valganon M, De Souza B, Campbell J, Churm F, Nickless G, Ross P, De Naurois J, Maisey N, Thillai K, Roca J, George M, Schizas A, Datta V, Westcott E, Sarker D. A retrospective analysis of 66 colorectal cancer cases from Guy’s and St Thomas’ (GSTT) Molecular Tumour Board. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz413.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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30
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Kulkarni A, McCaffrey C, Bodley J, Kung R. Laparoscopic Myomectomy in the 2nd Trimester of Pregnancy. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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31
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Hui L, Lindquist A, Poulton A, Kluckow E, Hutchinson B, Bonacquisto L, Pertile MD, Gugasyan L, Kulkarni A, Harraway J, Howden A, McCoy R, da Silva Costa F, Palma-Dias R, Nisbet D, Martin N, Behune M, Poulakis Z, Halliday J. Abstracts of the 29th World Congress on Ultrasound in Obstetrics and Gynecology, 12-16 October 2019, Berlin, Germany. Ultrasound Obstet Gynecol 2019; 54 Suppl 1:1-462. [PMID: 31799705 DOI: 10.1002/uog.20426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- L Hui
- Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia
- Reproductive Epidemiology, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - A Lindquist
- Reproductive Epidemiology, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Mercy Perinatal, Mercy Hospital for Women, Melbourne, VIC, Australia
| | - A Poulton
- Reproductive Epidemiology, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - E Kluckow
- Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia
- Reproductive Epidemiology, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - B Hutchinson
- Reproductive Epidemiology, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - L Bonacquisto
- Victorian Clinical Genetics Services, Melbourne, VIC, Australia
| | - M D Pertile
- Victorian Clinical Genetics Services, Melbourne, VIC, Australia
- Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - L Gugasyan
- Pathology, Monash Medical Centre, Melbourne, VIC, Australia
| | - A Kulkarni
- Pathology, Monash Medical Centre, Melbourne, VIC, Australia
| | - J Harraway
- Sullivan Nicolaides Pathology, Brisbane, QLD, Australia
| | - A Howden
- Cytogenetics, Melbourne Pathology, Melbourne, VIC, Australia
| | - R McCoy
- Australian Clinical Labs, Melbourne, VIC, Australia
| | - F da Silva Costa
- University of São Paulo, São Paulo, Brazil
- Obstetrics and Gynaecology, Monash University, Melbourne, VIC, Australia
| | - R Palma-Dias
- Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia
- Ultrasound Services, Royal Women's Hospital, Parkville, VIC, Australia
| | - D Nisbet
- Ultrasound Services, Royal Women's Hospital, Parkville, VIC, Australia
- Medicine and Radiology, University of Melbourne, Melbourne, VIC, Australia
| | - N Martin
- Virtus Diagnostics and Pathology Services, Brisbane, VIC, Australia
| | - M Behune
- Specialist Women's Ultrasound, Melbourne, VIC, Australia
- Medical Imaging, Mercy Hospital for Women, Melbourne, VIC, Australia
| | - Z Poulakis
- Victorian Infant Hearing Screening Program, Royal Children's Hospital, Melbourne, VIC, Australia
- Prevention Innovation Group, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - J Halliday
- Reproductive Epidemiology, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Paediatrics, University of Melbourne, Melbourne, VIC, Australia
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32
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Ramos S, Danilack V, Kulkarni A, Oliver M, Mathews C. Frailty as a predictor of delay in initiation of adjuvant chemotherapy treatment in women with ovarian cancer. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.335] [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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33
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Kulkarni A, Villavicencio J, Beffa L, Mendez H, Luis C, Raker C, Cronin B, Robison K. The effect of buffered lidocaine versus non-buffered lidocaine on pain scores during infiltration for vulvar biopsy: A randomized controlled trial. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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34
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Mattson J, Emerson J, Kulkarni A, Underwood A, Sun G, Mott S, Robison K, Hill E. Evaluation of superficial versus deep inguinal lymph node dissection in squamous cell carcinoma of the vulva. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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35
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Kulkarni A. Panga’ED: 10 year overview of maxillofacial trauma associated with witchcraft in east- central Africa. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.111] [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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36
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Wachira L, De Silva L, Orangun I, Shehzad S, Kulkarni A, Yoong W. Spontaneous preterm recurrent fundal uterine rupture at 26 weeks following laparoscopic myomectomy. J OBSTET GYNAECOL 2019; 39:731-732. [PMID: 31002002 DOI: 10.1080/01443615.2018.1557124] [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: 10/27/2022]
Affiliation(s)
- L. Wachira
- International Medical School, St. George’s University, West Indies, Grenada
| | - L. De Silva
- Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London, UK
| | - I. Orangun
- Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London, UK
| | - S. Shehzad
- School of Medicine, University College London, London, UK
| | - A. Kulkarni
- Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London, UK
| | - W. Yoong
- Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London, UK
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Abstract
Tracheal extubation can evoke an equally strong haemodyamic stress response as tracheal intubation. We present a patient with myocardial infarction who repeatedly failed tracheal extubation. He developed acute pulmonary oedema following each attempt at tracheal extubation due to sympathetic overactivity. A change of approach with extubation under propofol sedation followed by continued sympatholysis with dexmedetomidine infusion allowed successful extubation.
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Affiliation(s)
- A Kulkarni
- Intensive Care Unit, The St. George Hospital, Sydney, New South Wales
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38
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Winter H, Faull I, Bains P, Murias C, Kushnir M, Forster M, Kulkarni A, Moore D, Swanton C, Shiu K, Arkenau HT. Circulating tumour DNA experience in patients with cancer of unknown primary. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy269.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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39
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Kulkarni A, Gulesserian T, Lorenzo JMMD, Haroonian Y, Ngyuyen M, Lo Y, Wang D, Hsu D, Kaskel F, Mahgerefteh J. Left ventricular remodelling and vascular adaptive changes in adolescents with obesity. Pediatr Obes 2018; 13:541-549. [PMID: 29569422 DOI: 10.1111/ijpo.12278] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 01/16/2018] [Accepted: 01/25/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim of this study was to determine the effects of obesity on myocardial mechanics and ventriculo-arterial coupling (V-A) in children. METHODS Strain parameters, stroke volume, arterial elastance, left ventricular (LV) elastance and V-A were compared after adjusting for age and hypertension and after multivariate sub-group analysis between patients with and without obesity. RESULTS Among 123 retrospectively enrolled subjects, 6-21 years age, 79.7% males, 52% were obese. Median (range) Body Mass Index Z score was +2.35 (1.67-4.43) for obese and +0.68 (-2.48-1.63) for non-obese. Subjects with obesity had higher LV mass indexed2.7 (LVMI2.7 ) compared with non-obese (P < 0.001). Lower global longitudinal strain (GLS) (P = 0.012), global circumferential strain (GCS) (P = 0.004), average longitudinal strain rate (P = 0.002) and average circumferential strain rate (P < 0.001) were seen in subjects with obesity; no difference was noted in arterial elastance, LV end systolic elastance and V-A. Increased LVMI2.7 , decreased GLS, GCS, average longitudinal strain rate, average circumferential strain rate and maintained V-A were noted in the multivariate analysis between subgroups. CONCLUSIONS Obesity causes alterations in myocardial mechanics with preserved V-A in children. These findings may aid intervention in preventing the long-term cadiovascular effects of obesity.
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Affiliation(s)
- A Kulkarni
- Division of Pediatric Cardiology, Icahn School of Medicine, Bronx Lebanon Hospital Center, Bronx, USA
| | - T Gulesserian
- Department of Pediatric and Adolescent Medicine, Pediatric Heart Center of Vienna, Medical University of Vienna, Vienna, Austria
| | - J M M D Lorenzo
- Division of Pediatric Cardiology, Children's Hospital at Montefiore, New York, USA
| | - Y Haroonian
- Division of Pediatric Cardiology, Children's Hospital at Montefiore, New York, USA
| | - M Ngyuyen
- Division of Pediatric Cardiology, Children's Hospital at Montefiore, New York, USA
| | - Y Lo
- Albert Einstein College of Medicine, New York, USA
| | - D Wang
- Albert Einstein College of Medicine, New York, USA
| | - D Hsu
- Division of Pediatric Cardiology, Children's Hospital at Montefiore, New York, USA
| | - F Kaskel
- Division of Pediatric Nephrology, Children's Hospital at Montefiore, New York, USA
| | - J Mahgerefteh
- Division of Pediatric Cardiology, Children's Hospital at Montefiore, New York, USA
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40
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Rashid A, Novak E, Kulkarni A, Brown D. P2546High birth weight and cardiovascular outcomes in the ARIC cohort study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Rashid
- Washington University School of Medicine, Internal Medicine, St. Louis, United States of America
| | - E Novak
- Washington University School of Medicine, Cardiovascular Division, St. Louis, United States of America
| | - A Kulkarni
- Washington University School of Medicine, Cardiovascular Division, St. Louis, United States of America
| | - D Brown
- Washington University School of Medicine, Cardiovascular Division, St. Louis, United States of America
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41
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Jabur WL, Nasa P, Mohammed KA, Kulkarni A, Tomaraei SN. An Observational Epidemiological Study of Exercise-induced Rhabdomyolysis Causing Acute Kidney Injury: A Single-center Experience. Indian J Nephrol 2018. [PMID: 29861559 DOI: 10.4103/ijn.ijn_350_16.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Exercise-induced rhabdomyolysis (EIR) is an uncommon cause of severe rhabdomyolysis and a very rare cause of acute kidney injury (AKI). A prospective observational study of 25 patients diagnosed with EIR was conducted in a multispecialty hospital in Dubai, from 2009 to 2015. Five out of 25 patients experienced AKI necessitating temporary renal replacement therapy. The initial presentation, biochemical parameters, and clinical course of patients were monitored, to understand epidemiology and risk factors for the development of AKI. There was male preponderance (4 out of 5 patients), higher rate of systemic symptoms (all 5 patients) versus 60% in NRAKI), oligo-anuria (all 5 patients), compartment syndrome (3 out \of 5) and severe dehydration seen in patients with RAKI group. On laboratory evaluation, there was higher rise in creatinine kinase (CK) enzyme, serum and urine myoglobin levels impaired renal function on presentation, hyperuricemia, high D-dimer level, PCV of more than 55%, found to be associated with RAKI as compared to NRAKI group. Hematuria by positive urine dipstick with absent red blood cells on urinalysis, is an insensitive tool as was present in only 62% and 43% of RAKI and NRAKI groups, respectively. It was also observed that delayed pesentation for medical care, metabolic acidosis, were commonly associated with AKI. All patients with RAKI required RRT for a comparable period of time (3-4 weeks). In all of them, no deterioration or relapse reported on follow-up of 3 months.
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Affiliation(s)
- W L Jabur
- Department of Nephrology, NMC Specialty Hospital, Dubai, UAE
| | - P Nasa
- Department of Critical Care Medicine, NMC Specialty Hospital, Dubai, UAE
| | - K A Mohammed
- Department of Medicine, Al-Nahrain College of Medicine, Baghdad, Iraq
| | - A Kulkarni
- Department of Nephrology, NMC Specialty Hospital, Dubai, UAE
| | - S N Tomaraei
- Department of Pediatrics, NMC Specialty Hospital, Dubai, UAE
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42
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Kulkarni A, Vissers J, Harvey K. PO-100 Targeting YAP and TAZ to treat hippo pathway mutant malignant mesotheliomas. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.141] [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: 11/04/2022] Open
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43
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Kopargaonkar S, Maybauer M, Kulkarni A. Magnesium sulphate as an adjuvant to fentanyl for attenuation of intubation response. Br J Anaesth 2018. [DOI: 10.1016/j.bja.2017.11.041] [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: 10/17/2022] Open
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44
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Jabur WL, Nasa P, Mohammed KA, Kulkarni A, Tomaraei SN. An Observational Epidemiological Study of Exercise-induced Rhabdomyolysis Causing Acute Kidney Injury: A Single-center Experience. Indian J Nephrol 2018; 28:101-104. [PMID: 29861559 PMCID: PMC5952447 DOI: 10.4103/ijn.ijn_350_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Exercise-induced rhabdomyolysis (EIR) is an uncommon cause of severe rhabdomyolysis and a very rare cause of acute kidney injury (AKI). A prospective observational study of 25 patients diagnosed with EIR was conducted in a multispecialty hospital in Dubai, from 2009 to 2015. Five out of 25 patients experienced AKI necessitating temporary renal replacement therapy. The initial presentation, biochemical parameters, and clinical course of patients were monitored, to understand epidemiology and risk factors for the development of AKI. There was male preponderance (4 out of 5 patients), higher rate of systemic symptoms (all 5 patients) versus 60% in NRAKI), oligo-anuria (all 5 patients), compartment syndrome (3 out \of 5) and severe dehydration seen in patients with RAKI group. On laboratory evaluation, there was higher rise in creatinine kinase (CK) enzyme, serum and urine myoglobin levels impaired renal function on presentation, hyperuricemia, high D-dimer level, PCV of more than 55%, found to be associated with RAKI as compared to NRAKI group. Hematuria by positive urine dipstick with absent red blood cells on urinalysis, is an insensitive tool as was present in only 62% and 43% of RAKI and NRAKI groups, respectively. It was also observed that delayed pesentation for medical care, metabolic acidosis, were commonly associated with AKI. All patients with RAKI required RRT for a comparable period of time (3-4 weeks). In all of them, no deterioration or relapse reported on follow-up of 3 months.
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Affiliation(s)
- W. L. Jabur
- Department of Nephrology, NMC Specialty Hospital, Dubai, UAE
| | - P. Nasa
- Department of Critical Care Medicine, NMC Specialty Hospital, Dubai, UAE
- Address for correspondence: Dr. P. Nasa, Department of Critical Care Medicine, NMC Specialty Hospital, Al Nahada 2, Dubai, UAE. E-mail:
| | - K. A. Mohammed
- Department of Medicine, Al-Nahrain College of Medicine, Baghdad, Iraq
| | - A. Kulkarni
- Department of Nephrology, NMC Specialty Hospital, Dubai, UAE
| | - S. N. Tomaraei
- Department of Pediatrics, NMC Specialty Hospital, Dubai, UAE
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45
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Bhandarkar GP, Shetty KV, Kulkarni A. Thioctic acid in oral submucous fibrosis (India's disease) - A better tomorrow. J Stomatol Oral Maxillofac Surg 2017; 119:129-134. [PMID: 29246754 DOI: 10.1016/j.jormas.2017.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/24/2017] [Accepted: 12/06/2017] [Indexed: 11/28/2022]
Abstract
Oral submucous fibrosis (OSMF), because of its common occurrence in Indian population is known as India's disease. Regardless of diagnostic and therapeutic developments, oral potentially malignant disorders (PMD) and cancers are disseminating at a distressing rate. There is this prerequisite for unrelenting determination to find out apt treatment options so that malignant transformation may be prevented and more so the prevailing morbidity and mortality. Considering the frequency with which oral submucous fibrosis undergoes malignant transformation with free radicals playing a major part, the role of antioxidants in general and thioctic acid also known as alpha lipoic acid (ALA) in particular need to be studied in these individuals. Previous few studies indicated the use of alpha lipoic acid in oral submucous fibrosis patients leading to improvement in signs and symptoms. So, it led us to set forth and propose probable role of thioctic acid in improving symptoms in these patients. As oral submucous fibrosis poses as a threat with its various signs and symptoms and as a potentially malignant disorder as well as considering the role of free radicals in malignant transformation, we proposed the possible mechanisms behind the commonest signs and symptoms in oral submucous fibrosis and role of alpha lipoic acid in managing these signs and symptoms.
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Affiliation(s)
- G P Bhandarkar
- Department of oral medicine and radiology, A. J. Institute of Dental Sciences, Kuntikan, Mangalore, 575004 Karnataka, India.
| | - K V Shetty
- Department of Pedodontia, A. J. Institute of Dental Sciences, Mangalore, India.
| | - A Kulkarni
- Department of oral medicine and radiology, A. J. Institute of Dental Sciences, Mangalore, India.
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46
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Schirmer D, Kulkarni A, Kawwass J, Boulet S, Kissin D. Ovarian hyperstimulation syndrome after assisted reproductive technology: trends, predictors, and pregnancy outcomes. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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47
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Kulkarni A, Li L, Craft M, Nanda M, Lorenzo JMM, Danford D, Kutty S. Fetal myocardial deformation in maternal diabetes mellitus and obesity. Ultrasound Obstet Gynecol 2017; 49:630-636. [PMID: 27218437 DOI: 10.1002/uog.15971] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 05/14/2016] [Accepted: 05/16/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Experimental evidence suggests that changes in the fetal myocardium result from intrauterine effects of maternal diabetes mellitus and obesity. The aim of this study was to assess fetal cardiac function using two-dimensional speckle-tracking echocardiography to determine the effects of maternal diabetes and obesity on the fetal myocardium. METHODS Comparative cross-sectional evaluation of myocardial function in fetuses of mothers with diabetes mellitus (FDM) or obesity (FO) and normal gestational age-matched control fetuses (FC) was performed using two-dimensional speckle-tracking echocardiography at two centers. RESULTS In total, 178 fetuses (82 FDM, 26 FO and 70 FC) met the enrolment criteria. Mean gestational age at assessment was similar among groups: 25.3 ± 5.1 weeks for FDM, 25.0 ± 4.6 weeks for FO and 25.1 ± 4.9 weeks for FC. Mean maternal body mass index was significantly higher in FDM and FO groups compared with the FC group. Statistically significant differences in fetal cardiac function were detected between FDM and FC for global longitudinal strain (mean ± SD, -21.4 ± 6.5% vs -27.0 ± 5.2%; P < 0.001), global circumferential strain (mean ± SD, -22.6 ± 6.5% vs -26.2 ± 6.8%; P = 0.002), average longitudinal systolic strain rate (median, -1.4 (interquartile range (IQR), -1.7 to -1.1)/s vs -1.6 (IQR, -2.0 to -1.4)/s; P = 0.001) and average circumferential systolic strain rate (median, -1.4 (IQR, -1.9 to -1.1)/s vs -1.6 (IQR, -2.1 to -1.3)/s; P = 0.006). Cases of non-obese FDM also had abnormal strain parameters compared with FC. Global longitudinal strain (mean ± SD, -21.1 ± 7.5%) and average circumferential systolic strain rate (median, -1.3 (IQR, -1.8 to -1.1)/s) were significantly lower in FO compared with FC. CONCLUSIONS Unfavorable changes occur in the fetal myocardium in response to both maternal diabetes mellitus and obesity. The long-term prognostic implications of these changes require further study. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- A Kulkarni
- Department of Pediatrics, Bronx Lebanon Hospital Center, Bronx, NY, USA
| | - L Li
- Children's Hospital and Medical Center, Omaha, NE, USA
| | - M Craft
- Children's Hospital and Medical Center, Omaha, NE, USA
| | - M Nanda
- Department of Pediatrics, Bronx Lebanon Hospital Center, Bronx, NY, USA
| | - J M M Lorenzo
- Department of Pediatrics, Bronx Lebanon Hospital Center, Bronx, NY, USA
| | - D Danford
- Children's Hospital and Medical Center, Omaha, NE, USA
| | - S Kutty
- Children's Hospital and Medical Center, Omaha, NE, USA
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48
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Gawandi S, Gangawane S, Chakrabarti A, Kedare S, Bantwal K, Wadhe V, Kulkarni A, Kulkarni S, Rajan MGR. A Study of Microalbuminuria (MAU) and Advanced Glycation End Products (AGEs) Levels in Diabetic and Hypertensive Subjects. Indian J Clin Biochem 2017; 33:81-85. [PMID: 29371774 DOI: 10.1007/s12291-017-0638-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 09/16/2016] [Accepted: 01/24/2017] [Indexed: 11/24/2022]
Abstract
The prevalence of non-communicable diseases like diabetes mellitus (DM) and hypertension (HTN) is growing worldwide. Both lead to nephropathy if not controlled effectively. Microalbuminuria (MAU) is recognized as an early predictor for nephropathy. Additionally, the timely detection of advanced glycation end products (AGEs) is also considered to be an important prognostic factor for diabetic nephropathies. Hence, screening for the early detection of MAU and AGEs would be an useful and relatively inexpensive laboratory test for early clinical diagnosis for the incidence of nephropathy in these diseases. This study was conducted in DM, HTN and pregnancy induced hypertensive (PIH) subjects. MAU and Nε-Carboxymethyllysine (CML) levels were estimated by in-house RIA kits in the patient groups and controls, while the total AGEs level in serum was determined by ELISA. The levels of MAU, CML and AGE-BSA were observed to be significantly higher in DM, HTN and PIH subjects compared to controls (p < 0.001). Increased serum CML and AGEs levels in DM, HTN and PIH subjects indicated ongoing glycemic damage and their susceptibility to develop renal complications.
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Affiliation(s)
- S Gawandi
- 1Radiation Medicine Centre, Bhabha Atomic Research Centre (BARC), Mumbai, India
| | | | | | - S Kedare
- 2Medical Division, BARC, Mumbai, India
| | - K Bantwal
- 2Medical Division, BARC, Mumbai, India
| | - V Wadhe
- 2Medical Division, BARC, Mumbai, India
| | | | - S Kulkarni
- 1Radiation Medicine Centre, Bhabha Atomic Research Centre (BARC), Mumbai, India
| | - M G R Rajan
- 1Radiation Medicine Centre, Bhabha Atomic Research Centre (BARC), Mumbai, India
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49
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Gopal R, Kumar R, Anand M, Kulkarni A, Singh DP, Krishnan SR, Sharma V, Krishnamurthy M. A source to deliver mesoscopic particles for laser plasma studies. Rev Sci Instrum 2017; 88:023301. [PMID: 28249480 DOI: 10.1063/1.4974973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Intense ultrashort laser produced plasmas are a source for high brightness, short burst of X-rays, electrons, and high energy ions. Laser energy absorption and its disbursement strongly depend on the laser parameters and also on the initial size and shape of the target. The ability to change the shape, size, and material composition of the matter that absorbs light is of paramount importance not only from a fundamental physics point of view but also for potentially developing laser plasma sources tailored for specific applications. The idea of preparing mesoscopic particles of desired size/shape and suspending them in vacuum for laser plasma acceleration is a sparsely explored domain. In the following report we outline the development of a delivery mechanism of microparticles into an effusive jet in vacuum for laser plasma studies. We characterise the device in terms of particle density, particle size distribution, and duration of operation under conditions suitable for laser plasma studies. We also present the first results of x-ray emission from micro crystals of boric acid that extends to 100 keV even under relatively mild intensities of 1016 W/cm2.
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Affiliation(s)
- R Gopal
- Tata Institute of Fundamental Research, 21, Brundhavan Colony, Hyderabad 500075, India
| | - R Kumar
- Department of Physics, Indian Institute of Technology Hyderabad, Kandi, Sangareddy 502285, India
| | - M Anand
- Tata Institute of Fundamental Research, 21, Brundhavan Colony, Hyderabad 500075, India
| | - A Kulkarni
- Tata Institute of Fundamental Research, 21, Brundhavan Colony, Hyderabad 500075, India
| | - D P Singh
- Tata Institute of Fundamental Research, 21, Brundhavan Colony, Hyderabad 500075, India
| | - S R Krishnan
- Department of Physics, Indian Institute of Technology Madras, Chennai 600036, India
| | - V Sharma
- Department of Physics, Indian Institute of Technology Hyderabad, Kandi, Sangareddy 502285, India
| | - M Krishnamurthy
- Tata Institute of Fundamental Research, 21, Brundhavan Colony, Hyderabad 500075, India
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50
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Mehnert J, Ali S, Kulkarni A, Pavlick D, Goydos J, Chen S, Shrock A, Hirshfield K, Rodriguez L, Stein M, White E, Ross J, Miller V, Stephens P, Ganesan S. Landscape of RAF1 fusions in solid tumors and therapeutic utility of sorafenib. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)33022-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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