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Rao AR, Noronha V, Ramaswamy A, Kumar A, Pillai A, Gattani S, Sehgal A, Kumar S, Castelino R, Dhekale R, Krishnamurthy J, Mahajan S, Daptardar A, Sonkusare L, Deodhar J, Ansari N, Vagal M, Mahajan P, Timmanpyati S, Nookala M, Chitre A, Kapoor A, Gota V, Banavali S, Badwe RA, Prabhash K. Correlation of the Geriatric Assessment with Overall Survival in Older Patients with Cancer. Clin Oncol (R Coll Radiol) 2024; 36:e61-e71. [PMID: 37953073 DOI: 10.1016/j.clon.2023.11.003] [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: 07/18/2023] [Revised: 10/09/2023] [Accepted: 11/02/2023] [Indexed: 11/14/2023]
Abstract
AIMS Global guidelines recommend that all older patients with cancer receiving chemotherapy should undergo a geriatric assessment. However, utilisation of the geriatric assessment is often constrained by its time-intensive nature, which limits its adoption in settings with limited resources and high demand. There is a lack of evidence correlating the results of the geriatric assessment with survival from the Indian subcontinent. Therefore, the aims of the present study were to assess the impact of the geriatric assessment on survival in older Indian patients with cancer and to identify the factors associated with survival in these older patients. MATERIALS AND METHODS This was an observational study, conducted in the geriatric oncology clinic of the Tata Memorial Hospital (Mumbai, India). Patients aged 60 years and older with cancer who underwent a geriatric assessment were enrolled. We assessed the non-oncological geriatric domains of function and falls, nutrition, comorbidities, cognition, psychology, social support and medications. Patients exhibiting impairment in two or more domains were classified as frail. RESULTS Between June 2018 and January 2022, we enrolled 897 patients. The median age was 69 (interquartile range 65-73) years. The common malignancies were lung (40.5%), oesophagus (31.9%) and genitourinary (12.1%); 54.6% had metastatic disease. Based on the results of the geriatric assessment, 767 (85.4%) patients were frail. The estimated median overall survival in fit patients was 24.3 (95% confidence interval 18.2-not reached) months, compared with 11.2 (10.1-12.8) months in frail patients (hazard ratio 0.54; 95% confidence interval 0.41-0.72, P < 0.001). This difference in overall survival remained significant after adjusting for age, sex, primary tumour and metastatic status (hazard ratio 0.56; 95% confidence interval 0.41-0.74, P < 0.001). In the patients with a performance status of 0 or 1 (n = 454), 365 (80.4%) were frail; the median overall survival in the performance status 0-1 group was 33.0 months (95% confidence interval 24.31-not reached) in the fit group versus 14.4 months (95% confidence interval 12.25-18.73) in the frail patients (hazard ratio 0.50; 95% confidence interval 0.34-0.74, P = 0.001). In the multivariate analysis, the geriatric assessment domains that were predictive of survival were function (hazard ratio 0.68; 95% confidence interval 0.52-0.88; P = 0.003), nutrition (hazard ratio 0.64; 95% confidence interval 0.48-0.85, P = 0.002) and cognition (hazard ratio 0.67; 95% confidence interval 0.49-0.91, P = 0.011). DISCUSSION The geriatric assessment is a powerful prognostic tool for survival among older Indian patients with cancer. The geriatric assessment is prognostic even in the cohort of patients thought to be the fittest, i.e. performance status 0 and 1. Our study re-emphasises the critical importance of the geriatric assessment in all older patients planned for cancer-directed therapy.
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Affiliation(s)
- A R Rao
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - V Noronha
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - A Ramaswamy
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - A Kumar
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - A Pillai
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - S Gattani
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - A Sehgal
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Mumbai, India
| | - S Kumar
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Mumbai, India
| | - R Castelino
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Mumbai, India
| | - R Dhekale
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - J Krishnamurthy
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - S Mahajan
- Department of Physiotherapy, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - A Daptardar
- Department of Physiotherapy, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - L Sonkusare
- Department of Psycho-oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - J Deodhar
- Department of Psycho-oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - N Ansari
- Department of Occupational Therapy, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - M Vagal
- Department of Occupational Therapy, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - P Mahajan
- Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - S Timmanpyati
- Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - M Nookala
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Mumbai, India
| | - A Chitre
- Department of Physiotherapy, Mahamana Pandit Madan Mohan Malviya Cancer Center & Homi Bhabha Cancer Hospital, Varanasi, India
| | - A Kapoor
- Department of Medical Oncology, Mahamana Pandit Madan Mohan Malviya Cancer Center & Homi Bhabha Cancer Hospital, Varanasi, India
| | - V Gota
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Mumbai, India
| | - S Banavali
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - R A Badwe
- Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - K Prabhash
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India.
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Rex NB, McDonough RV, Ospel JM, Kashani N, Sehgal A, Fladt JC, McTaggart RA, Nogueira R, Menon B, Demchuk AM, Tymianski M, Hill MD, Goyal M. CT Perfusion Does Not Modify the Effect of Reperfusion in Patients with Acute Ischemic Stroke Undergoing Endovascular Treatment in the ESCAPE-NA1 Trial. AJNR Am J Neuroradiol 2023; 44:1045-1049. [PMID: 37620153 PMCID: PMC10494951 DOI: 10.3174/ajnr.a7954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/27/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND AND PURPOSE Although reperfusion is associated with improved outcomes in patients with acute ischemic stroke undergoing endovascular treatment, many patients still do poorly. We investigated whether CTP modifies the effect of near-complete reperfusion on clinical outcomes, ie, whether poor clinical outcomes despite near-complete reperfusion can be partly or fully explained by CTP findings. MATERIALS AND METHODS Data are from the Safety and Efficacy of Nerinetide in Subjects Undergoing Endovascular Thrombectomy for Stroke (ESCAPE-NA1) trial. Admission CTP was processed using RAPID software, generating relative CBF and CBV volume maps at standard thresholds. CTP lesion volumes were compared in patients with-versus-without near-complete reperfusion. Associations between each CTP metric and clinical outcome (90-day mRS) were tested using multivariable logistic regression, adjusted for baseline imaging and clinical variables. Treatment-effect modification was assessed by introducing CTP lesion volume × reperfusion interaction terms in the models. RESULTS CTP lesion volumes and reperfusion status were available in 410/1105 patients. CTP lesion volumes were overall larger in patients without near-complete reperfusion, albeit not always statistically significant. Increased CBF <34%, CBV <34%, CBV <38%, and CBV <42% lesion volumes were associated with worse clinical outcome (ordinal mRS) at 90 days. CTP core lesion volumes did not modify the treatment effect of near-complete recanalization on clinical outcome. CONCLUSIONS CTP did not modify the effect of near-complete reperfusion on clinical outcomes. Thus, CTP cannot explain why some patients with near-complete reperfusion have poor clinical outcomes.
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Affiliation(s)
- N B Rex
- From the Department of Diagnostic Imaging (N.B.R., R.A.M.), Brown University, Providence, Rhode Island
- Department of Diagnostic Imaging (N.B.R., R.V.M., J.M.O., B.M., A.M.D., M.D.H., M.G.), University of Calgary, Calgary, Alberta, Canada
| | - R V McDonough
- Department of Diagnostic Imaging (N.B.R., R.V.M., J.M.O., B.M., A.M.D., M.D.H., M.G.), University of Calgary, Calgary, Alberta, Canada
| | - J M Ospel
- Department of Diagnostic Imaging (N.B.R., R.V.M., J.M.O., B.M., A.M.D., M.D.H., M.G.), University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences (J.M.O., A.S., J.C.F., B.M., A.M.D., M.D.H., M.G.), University of Calgary, Calgary, Alberta, Canada
| | - N Kashani
- Department of Neurosurgery (N.K.), University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - A Sehgal
- Department of Clinical Neurosciences (J.M.O., A.S., J.C.F., B.M., A.M.D., M.D.H., M.G.), University of Calgary, Calgary, Alberta, Canada
| | - J C Fladt
- Department of Clinical Neurosciences (J.M.O., A.S., J.C.F., B.M., A.M.D., M.D.H., M.G.), University of Calgary, Calgary, Alberta, Canada
- Department of Neurology and Stroke Center (J.C.F.), University Hospital Basel, Basel, Switzerland
| | - R A McTaggart
- From the Department of Diagnostic Imaging (N.B.R., R.A.M.), Brown University, Providence, Rhode Island
| | - R Nogueira
- Department of Neurology and Neurosurgery (R.N.), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - B Menon
- Department of Diagnostic Imaging (N.B.R., R.V.M., J.M.O., B.M., A.M.D., M.D.H., M.G.), University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences (J.M.O., A.S., J.C.F., B.M., A.M.D., M.D.H., M.G.), University of Calgary, Calgary, Alberta, Canada
| | - A M Demchuk
- Department of Diagnostic Imaging (N.B.R., R.V.M., J.M.O., B.M., A.M.D., M.D.H., M.G.), University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences (J.M.O., A.S., J.C.F., B.M., A.M.D., M.D.H., M.G.), University of Calgary, Calgary, Alberta, Canada
| | | | - M D Hill
- Department of Diagnostic Imaging (N.B.R., R.V.M., J.M.O., B.M., A.M.D., M.D.H., M.G.), University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences (J.M.O., A.S., J.C.F., B.M., A.M.D., M.D.H., M.G.), University of Calgary, Calgary, Alberta, Canada
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Fatima S, Sehgal A, Mishra SK, Mina U, Goel V, Vijayan N, Tawale JS, Kothari R, Ahlawat A, Sharma C. Particle composition and morphology over urban environment (New Delhi): Plausible effects on wheat leaves. Environ Res 2021; 202:111552. [PMID: 34153336 DOI: 10.1016/j.envres.2021.111552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 06/13/2023]
Abstract
Particulate matter (PM) deposition on leaves adversely affects physical, chemical and biological nature of agricultural crops resulting in their loss of productivity and yield. Wheat being a staple food in major parts of Northern India and around the World, has been selected for research purpose by designing a study to explore the probable effects of PM deposition on wheat leaves and wheat crops to ensure the food security. PM5 (Particulate matter with aerodynamic diameter <5 μm) and Dry Deposited Particulate Matter (DDPM) on wheat leaves (Leaf_DDPM) were collected from the wheat crop field in Indian Agriculture Research Institute (IARI), New Delhi for growing and harvesting season of wheat crops (i.e. December 2014 to April 2015). The EDS (Energy Dispersive Spectroscopy) analysis was used for this study and the individual particle analysis revealed the presence of both acidic and alkaline components like C, Al, Si, Fe, Ca, K, S and Mg. The offline characterization tool i.e. SEM (Scanning Electron Microscope) was utilized for obtaining the micrographs which clearly showed the presence of some angular, sharp-edged and spherical particles consisting of both smooth and rough texture. Apart from that, prevalence of slightly non-spherical particles with aspect ratio of range (>1.20-1.40) and CIR (>0.70-0.80) for both PM5 and leaf_DDPM were observed. The size distribution of individual particles for both PM5(#194 particles) and Leaf_DDPM(#657 particles) revealed that Surface Equivalent Radius (SER) and Volume Equivalent Radius (VER) of particles observed to be 0.40-0.80 μm while surface area to be 0-1 μm2. These particles may easily block stomatal openings (with typical diameter range: 42-51 μm) of wheat leaves and damage internal leaf tissues while particle VER determines the interaction of incoming solar radiation with leaf surfaces. Average PM5 concentrations ± Standard deviations (μg/m3) were reported to be 231.05 ± 113.03. The XRF (X-Ray Fluorescence) spectrometer analysis of bulk PM5 revealed the concentrations of non-carbonaceous elements (μg/m3) as N (67.34 ± 16.09), Si (27.44 ± 11.01), Al (7.79 ± 3.37), S (3.88 ± 2.24), Na (2.29 ± 0.94), Mg (1.65 ± 0.62), K (0.51 ± 0.26), Ca (0.60 ± 0.26), Fe (0.54 ± 0.26), Cr (1.10 ± 0.70), Zn (0.05 ± 0.03), P (0.10 ± 0.03), Cu (0.07 ± 0.06). The dominant elemental oxides were calculated as SiO2, Al2O3, SO42-, Na2O, MgO, K2O, CaO, Fe2O3, Cr2O3, ZnO, P2O5, Cu2O with variable concentrations. In high humid conditions, with relative humidity (~85%) during the vegetative and flowering growth stages of wheat crops, presence of C and S rich acidic and hygroscopic particles may cause the corrosion of wheat leaves that ultimately affect the wheat crops.
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Affiliation(s)
- S Fatima
- CSIR- National Physical Laboratory, Dr. K. S. Krishnan Marg, New Delhi, 110012, India; AcSIR, Kamla Nehru Nagar, Ghaziabad, U.P., 201002, India
| | - A Sehgal
- CSIR- National Physical Laboratory, Dr. K. S. Krishnan Marg, New Delhi, 110012, India; Babasaheb Bhimrao Ambedkar University, Lucknow, 226025, India
| | - S K Mishra
- CSIR- National Physical Laboratory, Dr. K. S. Krishnan Marg, New Delhi, 110012, India; AcSIR, Kamla Nehru Nagar, Ghaziabad, U.P., 201002, India.
| | - U Mina
- Centre for Environment Science and Climate Resilient Agriculture, ICAR-IARI, New Delhi, 110012, India; School of Environmental Sciences, Jawaharlal Nehru University, New Delhi, 110067, India
| | - V Goel
- CSIR- National Physical Laboratory, Dr. K. S. Krishnan Marg, New Delhi, 110012, India; AcSIR, Kamla Nehru Nagar, Ghaziabad, U.P., 201002, India; School of Interdisciplinary Research, Indian Institute of Technology, Delhi, 110016, India
| | - N Vijayan
- CSIR- National Physical Laboratory, Dr. K. S. Krishnan Marg, New Delhi, 110012, India; AcSIR, Kamla Nehru Nagar, Ghaziabad, U.P., 201002, India
| | - J S Tawale
- CSIR- National Physical Laboratory, Dr. K. S. Krishnan Marg, New Delhi, 110012, India
| | - R Kothari
- Babasaheb Bhimrao Ambedkar University, Lucknow, 226025, India; Department of Environmental Sciences, Central University Jammu, Samba (J&K), 181143, India
| | - A Ahlawat
- Leibniz Institute for Tropospheric Research, Leipzig, 04328, Germany
| | - C Sharma
- CSIR- National Physical Laboratory, Dr. K. S. Krishnan Marg, New Delhi, 110012, India; AcSIR, Kamla Nehru Nagar, Ghaziabad, U.P., 201002, India
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McDonough R, Cimflova P, Kashani N, Ospel JM, Kappelhof M, Singh N, Sehgal A, Sakai N, Fiehler J, Chen M, Goyal M. Patient-Relevant Deficits Dictate Endovascular Thrombectomy Decision-Making in Patients with Low NIHSS Scores with Medium-Vessel Occlusion Stroke. AJNR Am J Neuroradiol 2021; 42:1834-1838. [PMID: 34413064 DOI: 10.3174/ajnr.a7253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/27/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE There is a paucity of evidence regarding the safety of endovascular treatment for patients with acute ischemic stroke due to primary medium-vessel occlusion. The aim of this study was to examine the willingness among stroke physicians to perform endovascular treatment in patients with mild-yet-disabling deficits due to medium-vessel occlusion. MATERIALS AND METHODS In an international cross-sectional survey consisting of 7 primary medium-vessel occlusion case scenarios, participants were asked whether the presence of personally disabling deficits would influence their decision-making for endovascular treatment despite the patients having low NIHSS scores (<6). Decision rates were calculated on the basis of physician characteristics. Univariable logistic regression clustered by respondent and scenario identity was performed. RESULTS Three hundred sixty-six participants from 44 countries provided 2562 answers to the 7 medium-vessel occlusion scenarios included in this study. In scenarios in which the deficit was relevant to the patient's profession, 56.9% of respondents opted to perform immediate endovascular treatment compared with 41.0% when no information regarding the patient's profession was provided (risk ratio = 1.39, P < .001). The largest effect sizes were seen for female participants (risk ratio = 1.68; 95% CI, 1.35-2.09), participants older than 60 years of age (risk ratio = 1.61; 95% CI, 1.23-2.10), those with more experience in neurointervention (risk ratio = 1.60; 95% CI, 1.24-2.06), and those who personally performed >100 endovascular treatments per year (risk ratio = 1.63; 95% CI, 1.22-2.17). CONCLUSIONS The presence of a patient-relevant deficit in low-NIHSS acute ischemic stroke due to medium-vessel occlusion is an important factor for endovascular treatment decision-making. This may have relevance for the conduct and interpretation of low-NIHSS endovascular treatment in randomized trials.
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Affiliation(s)
- R McDonough
- From the Department of Diagnostic and Interventional Neuroradiology (R.M., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Diagnostic Imaging (R.M., N.K., M.K., A.S., M.G.), Foothills Medical Center, University of Calgary, Calgary, Alberta, Canada
| | - P Cimflova
- Department of Medical Imaging (P.C., M.G.), St. Anne's University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Department of Clinical Neurosciences (P.C., N.S.), Foothills Medical Center, University of Calgary, Calgary, Alberta, Canada
| | - N Kashani
- Department of Diagnostic Imaging (R.M., N.K., M.K., A.S., M.G.), Foothills Medical Center, University of Calgary, Calgary, Alberta, Canada
| | - J M Ospel
- Division of Neuroradiology (J.M.O.), Clinic of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - M Kappelhof
- Department of Diagnostic Imaging (R.M., N.K., M.K., A.S., M.G.), Foothills Medical Center, University of Calgary, Calgary, Alberta, Canada
- Department of Radiology and Nuclear Medicine (M.K.), University of Amsterdam, Amsterdam, the Netherlands
| | - N Singh
- Department of Clinical Neurosciences (P.C., N.S.), Foothills Medical Center, University of Calgary, Calgary, Alberta, Canada
| | - A Sehgal
- Department of Diagnostic Imaging (R.M., N.K., M.K., A.S., M.G.), Foothills Medical Center, University of Calgary, Calgary, Alberta, Canada
| | - N Sakai
- Department of Neurosurgery (N.S.), Kobe City Medical Centre General Hospital, Kobe, Japan
| | - J Fiehler
- From the Department of Diagnostic and Interventional Neuroradiology (R.M., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Chen
- Department of Neurological Sciences (M.C.), Rush University Medical Center, Chicago, Illinois
| | - M Goyal
- Department of Diagnostic Imaging (R.M., N.K., M.K., A.S., M.G.), Foothills Medical Center, University of Calgary, Calgary, Alberta, Canada
- Department of Medical Imaging (P.C., M.G.), St. Anne's University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
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May R, Sehgal A, Hand R. Potential for Long-Lasting Changes in Dialysis Dietitian Responsibilities Due to the COVID-19 Pandemic: Results of a Survey. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Vancomycin remains a useful agent in the infection doctor's toolkit, particularly for Staphylococcus aureus and MRSA infections. Therapeutic drug monitoring (TDM) is essential to maintain efficacy and avoid toxicity. Until recently, trough-based dosing has been the recommended method but in recent years the reliability of this has been questioned. The 2020 Infectious Diseases Society of America (IDSA) vancomycin guideline update has sent a clear message that trough-based dosing is not to be relied on, instead recommending dosing via 24 h AUC/MIC. The UK, however, has yet to follow suit in this, despite the wealth of evidence showing that trough-based dosing puts patients at higher risk of nephrotoxicity. Clearly, it is time to incorporate AUC/MIC-based dosing to utilize this effective antibiotic safely.
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Affiliation(s)
- F Heard
- Microbiology Department, Queens Medical Centre, Nottingham University Hospitals Trust, Derby Road, Nottingham NG7 2UH, UK
| | - A Sehgal
- Intensive Care Department, Lincoln Hospital, United Lincolnshire Hospitals Trust, Greetwell Road, Lincoln LN2 5QY, UK
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Abstract
BACKGROUND Hypoxic ischemic encephalopathy (HIE) affects one to two newborns per 1,000 live births and oftentimes involves multi-organ insult. The objectives were to assess the evolution of cardiac function in infants with HIE treated with therapeutic hypothermia using echocardiography (ECHO). METHODS Archived data during the period 2010-2016 was assessed. Amongst the infants with baseline ECHO assessments, a sub-cohort which had assessments in all the three phases (baseline/pre-active cooling [T1], cooling [T2] and rewarming [T3]) was analyzed separately. RESULTS Thirty three infants formed part of the overall cohort, the gestation and birthweight were 39.6 ± 1.6 weeks and 3306 ± 583 g, respectively. Baseline (T1) information noted impaired cardiac performance (right ventricle stroke volume 1.08 ± 0.04 ml/kg, fractional area change [FAC] 24 ± 0.5% and tricuspid annular peak systolic excursion [TAPSE] 7.46 ± 0.11mm). Serial information was available for 24 of 33 infants. Cardiac function improved significantly between the cooling and the re-warming kphases. This included changes in right ventricular output (127 ± 34 vs 164 ± 47 ml/kg/min, p <0.01) and FAC (20 ± 3 vs 28 ± 2%, p<0.01). Pairwise comparisons for fractional shortening did not show significant changes. From the cooling to the rewarming phase, maximum change was noted in FAC (26.3 ± 9.8%) while minimum change was noted in fractional shortening (median, interquartile range) of 4.6% (1.4, 9.1). Significant correlation between TAPSE and time to peak velocity as a proportion of right ventricular ejection time was noted (r2 = 0.68, p <0.001). CONCLUSIONS In infants with moderate to severe HIE, cardiac function evolves during various phases of therapeutic hypothermia. Low output state during cooling may be due to a combination of the disease state (HIE) and cooling therapy.
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Affiliation(s)
- A Sehgal
- Monash Newborn, Monash Children's Hospital, Clayton, Australia.,Department of Pediatrics, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - N Linduska
- Monash Newborn, Monash Children's Hospital, Clayton, Australia
| | - C Huynh
- Monash Newborn, Monash Children's Hospital, Clayton, Australia
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Mullane KM, Morrison VA, Camacho LH, Arvin A, McNeil SA, Durrand J, Campbell B, Su SC, Chan ISF, Parrino J, Kaplan SS, Popmihajlov Z, Annunziato PW, Cerana S, Dictar MO, Bonvehi P, Tregnaghi JP, Fein L, Ashley D, Singh M, Hayes T, Playford G, Morrissey O, Thaler J, Kuehr T, Greil R, Pecherstorfer M, Duck L, Van Eygen K, Aoun M, De Prijck B, Franke FA, Barrios CHE, Mendes AVA, Serrano SV, Garcia RF, Moore F, Camargo JFC, Pires LA, Alves RS, Radinov A, Oreshkov K, Minchev V, Hubenova AI, Koynova T, Ivanov I, Rabotilova B, Minchev V, Petrov PA, Chilingirov P, Karanikolov S, Raynov J, Grimard D, McNeil S, Kumar D, Larratt LM, Weiss K, Delage R, Diaz-Mitoma FJ, Cano PO, Couture F, Carvajal P, Yepes A, Torres Ulloa R, Fardella P, Caglevic C, Rojas C, Orellana E, Gonzalez P, Acevedo A, Galvez KM, Gonzalez ME, Franco S, Restrepo JG, Rojas CA, Bonilla C, Florez LE, Ospina AV, Manneh R, Zorica R, Vrdoljak DV, Samarzija M, Petruzelka L, Vydra J, Mayer J, Cibula D, Prausova J, Paulson G, Ontaneda M, Palk K, Vahlberg A, Rooneem R, Galtier F, Postil D, Lucht F, Laine F, Launay O, Laurichesse H, Duval X, Cornely OA, Camerer B, Panse J, Zaiss M, Derigs HG, Menzel H, Verbeek M, Georgoulias V, Mavroudis D, Anagnostopoulos A, Terpos E, Cortes D, Umanzor J, Bejarano S, Galeano RW, Wong RSM, Hui P, Pedrazzoli P, Ruggeri L, Aversa F, Bosi A, Gentile G, Rambaldi A, Contu A, Marei L, Abbadi A, Hayajneh W, Kattan J, Farhat F, Chahine G, Rutkauskiene J, Marfil Rivera LJ, Lopez Chuken YA, Franco Villarreal H, Lopez Hernandez J, Blacklock H, Lopez RI, Alvarez R, Gomez AM, Quintana TS, Moreno Larrea MDC, Zorrilla SJ, Alarcon E, Samanez FCA, Caguioa PB, Tiangco BJ, Mora EM, Betancourt-Garcia RD, Hallman-Navarro D, Feliciano-Lopez LJ, Velez-Cortes HA, Cabanillas F, Ganea DE, Ciuleanu TE, Ghizdavescu DG, Miron L, Cebotaru CL, Cainap CI, Anghel R, Dvorkin MV, Gladkov OA, Fadeeva NV, Kuzmin AA, Lipatov ON, Zbarskaya II, Akhmetzyanov FS, Litvinov IV, Afanasyev BV, Cherenkova M, Lioznov D, Lisukov IA, Smirnova YA, Kolomietz S, Halawani H, Goh YT, Drgona L, Chudej J, Matejkova M, Reckova M, Rapoport BL, Szpak WM, Malan DR, Jonas N, Jung CW, Lee DG, Yoon SS, Lopez Jimenez J, Duran Martinez I, Rodriguez Moreno JF, Solano Vercet C, de la Camara R, Batlle Massana M, Yeh SP, Chen CY, Chou HH, Tsai CM, Chiu CH, Siritanaratkul N, Norasetthada L, Sriuranpong V, Seetalarom K, Akan H, Dane F, Ozcan MA, Ozsan GH, Kalayoglu Besisik SF, Cagatay A, Yalcin S, Peniket A, Mullan SR, Dakhil KM, Sivarajan K, Suh JJG, Sehgal A, Marquez F, Gomez EG, Mullane MR, Skinner WL, Behrens RJ, Trevarthe DR, Mazurczak MA, Lambiase EA, Vidal CA, Anac SY, Rodrigues GA, Baltz B, Boccia R, Wertheim MS, Holladay CS, Zenk D, Fusselman W, Wade III JL, Jaslowsk AJ, Keegan J, Robinson MO, Go RS, Farnen J, Amin B, Jurgens D, Risi GF, Beatty PG, Naqvi T, Parshad S, Hansen VL, Ahmed M, Steen PD, Badarinath S, Dekker A, Scouros MA, Young DE, Graydon Harker W, Kendall SD, Citron ML, Chedid S, Posada JG, Gupta MK, Rafiyath S, Buechler-Price J, Sreenivasappa S, Chay CH, Burke JM, Young SE, Mahmood A, Kugler JW, Gerstner G, Fuloria J, Belman ND, Geller R, Nieva J, Whittenberger BP, Wong BMY, Cescon TP, Abesada-Terk G, Guarino MJ, Zweibach A, Ibrahim EN, Takahashi G, Garrison MA, Mowat RB, Choi BS, Oliff IA, Singh J, Guter KA, Ayrons K, Rowland KM, Noga SJ, Rao SB, Columbie A, Nualart MT, Cecchi GR, Campos LT, Mohebtash M, Flores MR, Rothstein-Rubin R, O'Connor BM, Soori G, Knapp M, Miranda FG, Goodgame BW, Kassem M, Belani R, Sharma S, Ortiz T, Sonneborn HL, Markowitz AB, Wilbur D, Meiri E, Koo VS, Jhangiani HS, Wong L, Sanani S, Lawrence SJ, Jones CM, Murray C, Papageorgiou C, Gurtler JS, Ascensao JL, Seetalarom K, Venigalla ML, D'Andrea M, De Las Casas C, Haile DJ, Qazi FU, Santander JL, Thomas MR, Rao VP, Craig M, Garg RJ, Robles R, Lyons RM, Stegemoller RK, Goel S, Garg S, Lowry P, Lynch C, Lash B, Repka T, Baker J, Goueli BS, Campbell TC, Van Echo DA, Lee YJ, Reyes EA, Senecal FM, Donnelly G, Byeff P, Weiss R, Reid T, Roeland E, Goel A, Prow DM, Brandt DS, Kaplan HG, Payne JE, Boeckh MG, Rosen PJ, Mena RR, Khan R, Betts RF, Sharp SA, Morrison VA, Fitz-Patrick D, Congdon J, Erickson N, Abbasi R, Henderson S, Mehdi A, Wos EJ, Rehmus E, Beltzer L, Tamayo RA, Mahmood T, Reboli AC, Moore A, Brown JM, Cruz J, Quick DP, Potz JL, Kotz KW, Hutchins M, Chowhan NM, Devabhaktuni YD, Braly P, Berenguer RA, Shambaugh SC, O'Rourke TJ, Conkright WA, Winkler CF, Addo FEK, Duic JP, High KP, Kutner ME, Collins R, Carrizosa DR, Perry DJ, Kailath E, Rosen N, Sotolongo R, Shoham S, Chen T. Safety and efficacy of inactivated varicella zoster virus vaccine in immunocompromised patients with malignancies: a two-arm, randomised, double-blind, phase 3 trial. The Lancet Infectious Diseases 2019; 19:1001-1012. [DOI: 10.1016/s1473-3099(19)30310-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 05/02/2019] [Accepted: 05/03/2019] [Indexed: 12/25/2022]
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Bailleul J, Yazal T, Sung D, Dao A, Palomera D, Sehgal A, Vlashi E. Irradiation Reprograms GBM Metabolism Towards an Antioxidant Profile That Drives Radiation Resistance. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.189] [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: 11/28/2022]
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Sano D, Lekakis L, Feng L, Nastoupil L, Jain M, Spiegel J, Dahiya S, Lin Y, Ghobadi A, Lunning M, Hill B, Reagan P, Oluwole O, McGuirk J, Sehgal A, Deol A, Charalambos A, Goy A, Munoz J, Cashen A, Bennani N, Rapoport A, Vose J, Miklos D, Locke F, Neelapu S. SAFETY AND EFFICACY OF AXICABTAGENE CILOLEUCEL (AXI-CEL) IN OLDER PATIENTS: RESULTS FROM THE US LYMPHOMA CAR-T CONSORTIUM. Hematol Oncol 2019. [DOI: 10.1002/hon.113_2630] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- D. Sano
- Lymphoma/Myeloma; MD Anderson Cancer Center; Houston United States
| | - L. Lekakis
- Bone Marrow Transplant/Hematology; University Of Miami; Miami United States
| | - L. Feng
- Lymphoma/Myeloma; MD Anderson Cancer Center; Houston United States
| | - L.J. Nastoupil
- Lymphoma/Myeloma; MD Anderson Cancer Center; Houston United States
| | - M.D. Jain
- Blood; Bone Marrow Transplant and Cellular Therapy, Moffitt Cancer Center; Tampa United States
| | - J.Y. Spiegel
- Hematology; Stanford University; Stanford United States
| | - S. Dahiya
- Hematology/Bone Marrow Transplant; University of Maryland Medical Center; Baltimore United States
| | - Y. Lin
- Hematology; Mayo Clinic; Rochester United States
| | - A. Ghobadi
- Bone Marrow Transplant; Washington University Medical Campus; Saint Louis United States
| | - M. Lunning
- Hematology/Oncology; University of Nebraska Medical Center; Omaha United States
| | - B.T. Hill
- Hematology and Medical Oncology; Cleveland Clinic; Cleveland United States
| | - P. Reagan
- Lymphoma; University of Rochester Medical Center/Wilmot Cancer institute; Rochester United States
| | - O. Oluwole
- Hematology and Oncology; Vanderbilt University Medical Center; Nashville United States
| | - J. McGuirk
- Hematological Malignancies and Cellular Therapeutic; The University of Kansas Health System; Kansas City United States
| | - A. Sehgal
- Hematology and Oncology; UPMC Hillman Cancer Center; Pittsburgh United States
| | - A. Deol
- Department of Oncology; Wayne State University/Karmanos Cancer Center; Detroit United States
| | - A. Charalambos
- Hematology and Bone Marrow Transplant; University of California San francisco; San Francisco United States
| | - A.H. Goy
- Hematology and Oncology; Hackensack University Medical Center; Hackensack United States
| | - J. Munoz
- Lymphoma/Myeloma; Banner MD Anderson Cancer Center; Gilbert United States
| | - A. Cashen
- Bone Marrow Transplantation & Leukemia; Washington University Medical School; St. Louis United States
| | - N.N. Bennani
- Hematology; Mayo Clinic; Rochester United States
| | - A.P. Rapoport
- Hematology/Bone Marrow Transplant; University of Maryland Medical Center; Baltimore United States
| | - J.M. Vose
- Hematology/Oncology; University of Nebraska Medical Center; Omaha United States
| | - D.B. Miklos
- Hematology; Stanford University; Stanford United States
| | - F.L. Locke
- Blood; Bone Marrow Transplant and Cellular Therapy, Moffitt Cancer Center; Tampa United States
| | - S.S. Neelapu
- Lymphoma/Myeloma; MD Anderson Cancer Center; Houston United States
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Sehgal A, Godwin J, Maris M, Hildebrandt G, Trede N, Kostic A, Wang L, Lymp J, Bachier C. TREATMENT OF RELAPSED/REFRACTORY AGGRESSIVE NON-HODGKIN LYMPHOMA (NHL) WITH LISOCABTAGENE MARALEUCEL IN THE OUTPATIENT SETTING: RESULTS FROM TWO PHASE 2 TRIALS. Hematol Oncol 2019. [DOI: 10.1002/hon.185_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- A. Sehgal
- Hillman Cancer Center; University of Pittsburgh Medical Center; Pittsburgh United States
| | - J.E. Godwin
- Earle A Chiles Research Institute; Providence Cancer Institute; Portland United States
| | - M.B. Maris
- Hematology/Oncology; Colorado Blood Cancer Institute; Denver United States
| | - G.C. Hildebrandt
- Division of Hematology; University of Kentucky Markey Cancer Center; Lexington United States
| | - N.S. Trede
- Clinical Development; Juno Therapeutics, a Celgene Company; Seattle United States
| | - A. Kostic
- Clinical Development; Juno Therapeutics, a Celgene Company; Seattle United States
| | - L. Wang
- Biometrics; Juno Therapeutics, a Celgene Company; Seattle United States
| | - J. Lymp
- Biostatistics; Juno Therapeutics, a Celgene Company; Seattle United States
| | - C.R. Bachier
- Hematology/Oncology; Sarah Cannon Center for Blood Cancer; Knoxville United States
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Sehgal A, Allison BJ, Gwini SM, Menahem S, Miller SL, Polglase GR. Vascular aging and cardiac maladaptation in growth-restricted preterm infants. J Perinatol 2018; 38:92-97. [PMID: 29120452 DOI: 10.1038/jp.2017.135] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 07/10/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To assess arterial morphology and mechanics in preterm infants with fetal growth restriction (FGR) compared with those appropriate for gestational age (AGA) in the early neonatal period. STUDY DESIGN This observational study involved 20 preterm FGR infants (28 to 32 weeks) of gestational age (GA) and birth weight (BW) <10th centile and 20 preterm AGA infants. Vascular ultrasound was performed to measure aortic properties. RESULTS GA and BW of FGR and AGA infants were 29.8±1.3 vs 30±0.9 weeks (P=0.78) and 923.4±168 vs 1403±237 g (P<0.001), respectively. At 10.5±1.3 (s.d.) days after birth, blood pressure (systolic 51±3 vs 46±4 mm Hg, P<0.001) and maximum aorta intima-media thickness (621±76 vs 479±54 μm; P<0.001) were significantly higher in FGR infants. Arterial wall stiffness and peripheral resistance were also increased in the FGR infants (2.36±0.24 vs 2.14±0.24, P=0.008 and 22.2±5 vs 13.7±2.3 mm Hg min ml-1, P<0.001), respectively. Significant correlations between vascular mechanics and cardiac function were observed (resistance vs E/E', r=0.7 and Tei index, r=0.79). CONCLUSION Maladaptive arterial-ventricular coupling was noted. Early detection may aid in early therapeutic strategies such as afterload reduction.
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Affiliation(s)
- A Sehgal
- Monash Newborn, Monash Children's Hospital, Melbourne, VIC, Australia.,Department of Pediatrics, Monash University, Melbourne, VIC, Australia
| | - B J Allison
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia
| | - S M Gwini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - S Menahem
- Paediatric and Fetal Cardiac Units, Monash Medical Centre, Monash Health, Melbourne, VIC, Australia
| | - S L Miller
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia.,Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC, Australia
| | - G R Polglase
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia.,Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC, Australia
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Sehgal A, Crispi F, Skilton MR, de Boode WP. Clinician performed ultrasound in fetal growth restriction: fetal, neonatal and pediatric aspects. J Perinatol 2017; 37:1251-1258. [PMID: 28837134 DOI: 10.1038/jp.2017.119] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 06/02/2017] [Accepted: 06/26/2017] [Indexed: 11/09/2022]
Abstract
Fetal growth restriction (FGR) affects 7-10% pregnancies. Conventional and tissue Doppler imaging has noted cardiac compromise during fetal and early neonatal periods in this cohort. In this article, we discuss the use of salient ultrasound parameters across age groups. During fetal life, certain feto-placental sonographic parameters have been linked to adverse perinatal outcomes and are predictive of later life hypertension. During the early postnatal period altered morphometry (hypertrophied and globular hearts) with sub-clinical impairment of cardiac function has been noted in both term and preterm infants with FGR. Vascular imaging has noted thickened and stiffer arteries in association with significantly elevated blood pressure. Similar findings in the pediatric age groups indicate persistence of these alterations, and have formed the basis of intervention studies. Assessment methodology and clinical relevance of these parameters, especially in designing and monitoring of intervention strategies is discussed. Frontline care givers (obstetricians and neonatologists) are increasingly using point of care ultrasound to discern these manifestations of FGR during the sub-clinical phase.
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Affiliation(s)
- A Sehgal
- Neonatologist, Monash Newborn, Monash Children's Hospital, Monash University, Melbourne, VIC, Australia.,Department of Paediatrics, Monash University, Melbourne, VIC, Australia
| | - F Crispi
- BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Boden Institute, IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - M R Skilton
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Camperdown, NSW, Australia
| | - W-P de Boode
- Department of Neonatology, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands
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Kunjunju AM, Gopagondanahalli KR, Chan Y, Sehgal A. Bronchopulmonary dysplasia-associated pulmonary hypertension: clues from placental pathology. J Perinatol 2017; 37:1310-1314. [PMID: 28880261 DOI: 10.1038/jp.2017.130] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 06/23/2017] [Accepted: 07/17/2017] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Bronchopulmonary dysplasia (BPD) and the associated complication of pulmonary hypertension (PH) leads to increased mortality and a longer length of stay among survivors. Placental histopathology may give early clues of subsequent events. The objective was to evaluate the relationship of maternal vascular underperfusion (MVU) changes on placental histopathology with subsequent development of BPD-associated PH in a cohort of extremely premature infants. STUDY DESIGN In a cohort of preterm infants '⩽28 weeks' gestational age (GA) and with 'severe' BPD, this retrospective study evaluated specific placental histopathological changes and assessed the relationship with subsequent development of PH. 'Severe' BPD was defined as the need for ⩾30% oxygen and/or positive pressure ventilation at 36 weeks postmenstrual age. Placental and echocardiographic assessments were done by investigators masked to the grouping and clinical outcomes. RESULTS Fifty six infants with severe BPD formed the cohort; PH was noted in 22 (39.3%) infants. The GA of the infants with and without PH was comparable (25.8±1.6 vs 25.8±1.3 weeks, P=0.9). On placental histopathological examination, 13 (23%) had features of MVU. On univariate logistic regression, the presence of changes consistent with MVU increased the relative risk of subsequent BPD-associated PH by 2.75 (95% confidence interval 1.56 to 4.85, P=0.004). The significance persisted after adjustment for GA. Stratification by the presence or absence of fetal growth restriction, yielded nonsignificant associations (P=0.17). CONCLUSION Based on the results of the present study, specific placental histopathological changes may give early clues to the subsequent development of BPD-associated PH.
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Affiliation(s)
- A M Kunjunju
- Monash Newborn, Monash University Neonatologist, Monash Children's Hospital, Melbourne, VIC, Australia
| | - K R Gopagondanahalli
- Monash Newborn, Monash University Neonatologist, Monash Children's Hospital, Melbourne, VIC, Australia
| | - Y Chan
- Department of Pathology, Monash Health, Melbourne, VIC, Australia
| | - A Sehgal
- Monash Newborn, Monash University Neonatologist, Monash Children's Hospital, Melbourne, VIC, Australia.,Department of Pediatrics, Monash University, Melbourne, Australia
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Bansal P, Bansal N, Sehgal A, Singla S. Flexible ureteroscopy for lower calyceal stones in a horseshoe kidney – Is it the new treatment of choice? African Journal of Urology 2016. [DOI: 10.1016/j.afju.2016.01.007] [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: 11/16/2022] Open
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Jha AK, Sharma V, Nikbakht M, Jain V, Sehgal A, Capalash N, Kaur J. Erratum to: “A comparative analysis of methylation status of tumor suppressor genes in paired biopsy and serum samples from cervical cancer patients among North Indian population”. RUSS J GENET+ 2016. [DOI: 10.1134/s1022795416080160] [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: 11/23/2022]
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Jhaa AK, Sharma V, Nikbakht M, Jain V, Sehgal A, Capalash N, Kaur J. [Erratum to: “A comparative analysis of methylation status of tumor suppressor genes in paired biopsy and serum samples from cervical cancer patients among North Indian population”]. Genetika 2016; 52:996. [PMID: 29369554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Sehgal A, Malikiwi A, Paul E, Tan K, Menahem S. Systemic arterial stiffness in infants with bronchopulmonary dysplasia: potential cause of systemic hypertension. J Perinatol 2016; 36:564-9. [PMID: 26914016 DOI: 10.1038/jp.2016.10] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 11/05/2015] [Accepted: 12/07/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Systemic hypertension is common among preterm infants with severe bronchopulmonary dysplasia (BPD); the exact cause is unknown. The objective of this preliminary hypothesis generating study was to examine systemic arterial structure and vasomotor function in a cohort of preterm infants with severe BPD, using a cohort of preterm infants without BPD and a cohort of term infants for comparison. STUDY DESIGN After obtaining informed consent, we measured aortic wall thickness and vasomotor function by ultrasonography in 20 infants with severe BPD, 7 infants with no BPD, and compared them with 20 healthy term infants. RESULTS Maximum aortic thickness was significantly higher in infants with BPD (827±163 μm) compared to those with no BPD (674±22 μm) and term infants (657±67 μm) (unadjusted P<0.0001). The input impedance was similarly elevated in the infants with BPD (574±127 dynes s( )cm(-5)) compared to those with no BPD (325±24 dynes s cm(-)(5)) or term infants (328±113 dynes s cm(-)(5)) (unadjusted P<0.0001). Stiffness index was significantly higher in the infants with BPD (3.4±0.6) compared to those with no BPD (2.6±0.3) or term infants (2.3±0.4) (unadjusted P<0.0001). Systemic vascular resistance was also significantly elevated in the infants with BPD. The results remained significant even after adjusting for gestational age and birth weight. Measures of vasomotor function significantly correlated with blood pressure. CONCLUSION The aortic wall thickness and vasomotor function are significantly altered in preterm infants with severe BPD. These findings may explain the higher incidence of systemic hypertension in this population.
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Affiliation(s)
- A Sehgal
- Monash Newborn, Monash Children's Hospital, Monash Health, Melbourne, VIC, Australia.,Department of Pediatrics, Monash University, Melbourne, VIC, Australia
| | - A Malikiwi
- Monash Newborn, Monash Children's Hospital, Monash Health, Melbourne, VIC, Australia
| | - E Paul
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Department of Clinical Haematology, Alfred Hospital, Melbourne, VIC, Australia
| | - K Tan
- Monash Newborn, Monash Children's Hospital, Monash Health, Melbourne, VIC, Australia.,Department of Pediatrics, Monash University, Melbourne, VIC, Australia
| | - S Menahem
- Department of Pediatrics, Monash University, Melbourne, VIC, Australia.,Paediatric and Fetal Cardiac Units, Monash Medical Centre, Monash Health, Melbourne, VIC, Australia
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Jha AK, Sharma V, Nikbakht M, Jain V, Sehgal A, Capalash N, Kaur J. A comparative analysis of methylation status of tumor suppressor genes in paired biopsy and serum samples from cervical cancer patients among north indian population. RUSS J GENET+ 2016. [DOI: 10.1134/s1022795416010075] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Jha AK, Sharma V, Nikbakht M, Jain V, Sehgal A, Capalash N, Kaur J. A COMPARATIVE ANALYSIS OF METHYLATION STATUS OF TUMOR SUPPRESSOR GENES IN PAIRED BIOPSY AND SERUM SAMPLES FROM CERVICAL CANCER PATIENTS AMONG NORTH INDIAN POPULATION. Genetika 2016; 52:255-259. [PMID: 27215041 DOI: 10.7868/s0016675816010070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Tumor-specific genetic or epigenetic alterations have been detected in serum DNA in case of various types of cancers. In breast cancer, the detection of tumor suppressor gene hypermethylation has been reported in several body fluids. Promoter hypermethylation of some genes like MYOD1, CALCA, hTERT etc. has also been detected in serum samples from cervical cancer. The present study is the first report on the comparison of promoter hypermethylation of tumor suppressor genes likep14, p15, p16, p21, p27, p57, p53, p73, RARβ2, FHIT, DAPK, STAT1 and-RB1 genes in paired biopsy and serum samples from cervical cancer patients among north Indian population. This is also the first report on the hypermethylation of these genes in serum samples from cervical cancer patients among north Indian population. According to the results of the present study, promoter hypermethylation of these genes can also be detected in serum samples of cervical cancer patients. The sensitivity of detection of promoter hypermethylation in serum samples of cervical cancer patients as compared to paired biopsy samples was found to be around 83.3%. It was observed that promoter hypermethylation was mainly observed in the serum samples in the higher stages and very rarely in the lower stages. The present study clearly showed that serum of patients with cervical cancer can also be used to study methylated genes as biomarkers.
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Sehgal A, Malikiwi A, Tan K, Menahem S. A new look at bronchopulmonary dysplasia: Role of systemic vascular & cardiac function in therapeutic options. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.721] [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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Scott F, Sehgal A, Seghal A, Joshi HM, Yeung TM, Gosselink MP. Quality of patient information on the internet for the treatment of anal fistula and anal fissure. Tech Coloproctol 2014; 18:1181-3. [PMID: 25294731 DOI: 10.1007/s10151-014-1222-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 09/15/2014] [Indexed: 12/14/2022]
Affiliation(s)
- F Scott
- Oxford University Medical School, Oxford, UK
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Parashari A, Singh V, Mittal T, Ahmed S, Grewal H, Gupta S, Sehgal A. Low cost technology for screening early cancerous lesions of oral cavity in rural settings. Ann Med Health Sci Res 2014; 4:146-8. [PMID: 24669350 PMCID: PMC3952289 DOI: 10.4103/2141-9248.126628] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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: 01/27/2023] Open
Abstract
BACKGROUND Low cost technologies are needed in resource poor rural settings for detection of pre-cancer and cancer lesions of the oral cavity. AIM The study was undertaken to investigate the feasibility of a low cost technology (Magnivisualizer) for the early detection any lesions of the oral cavity among tobacco users in a resource poor rural field setting. SUBJECTS AND METHODS A total of 1329 tobacco users were motivated to come forward for oral examination in the camp organized for this purpose. Their oral cavities were screened with a torch and Magnivisualizer by a Dentist. RESULTS With torch light, 104/1329 (7.8%) lesions were identified, though only 62/104 (59.6%) positive lesions could be differentiated into various categories. However, through Magnivisualizer 156/1329 (11.7%) lesions were detected and 153/156 (98.1%) positive lesions were differentiated into different categories. CONCLUSION Magnivisualizer offers an alternative instrument for detecting most of the early cancerous and high-grade precancerous lesions and it can be used in the rural field settings.
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Affiliation(s)
- A Parashari
- Division of Clinical Research, Institute of Cytology and Preventive Oncology, Noida, Uttar Pradesh, India
| | - V Singh
- Division of Clinical Research, Institute of Cytology and Preventive Oncology, Noida, Uttar Pradesh, India
| | - T Mittal
- Division of Clinical Research, Institute of Cytology and Preventive Oncology, Noida, Uttar Pradesh, India
| | - S Ahmed
- Division of Clinical Research, Institute of Cytology and Preventive Oncology, Noida, Uttar Pradesh, India
| | - H Grewal
- Department of Orthodontics, Guru Teg Bahadur Hospital, New Delhi, India
| | - S Gupta
- Division of Clinical Research, Institute of Cytology and Preventive Oncology, Noida, Uttar Pradesh, India
| | - A Sehgal
- Division of Clinical Research, Institute of Cytology and Preventive Oncology, Noida, Uttar Pradesh, India
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Sehgal A, Lichtenbaum R, Redleaf MI. Persistent bilateral function after unilateral facial nerve transection. Indian J Otol 2014. [DOI: 10.4103/0971-7749.136859] [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]
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Abstract
A total of 385 symptomatic patients presenting to the gynaecology and obstetrics outpatient department were screened by two sources of light: the yellow light of the tungsten bulb and the white light of the halogen bulb (100 Watt, 12 Volt), fitted with KODAK 80B filter and diffuser in an instrument called a 'Magnivisualizer' (developed by our Institute). Colposcopic examination was the gold standard for visualisation of the cervix. This study clearly brings out the significance of visual examination of the cervix using white light; as, in addition to having perfect correlation with colposcopy (0.86 for white vs 0.53 for yellow light), white light enables us to select the correct site of biopsy. Most of the rural clinics use torch or ordinary tungsten bulb, thus missing many significant lesions. In the light of our research findings, we strongly recommend the use of white light (complete spectrum of light) for screening purposes.
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Affiliation(s)
- V Singh
- Institute of Cytology and Preventive Oncology (ICMR) , Noida, Uttar Pradesh , India
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Sehgal A, Kumar M, Jain M, Dhawan DK. Modulatory Effects of Curcumin in Conjunction with Piperine on Benzo(A)Pyrene-Mediated DNA Adducts and Biotransformation Enzymes. Nutr Cancer 2013; 65:885-90. [DOI: 10.1080/01635581.2013.805421] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- A. Sehgal
- a Department of Zoology , Panjab University , Chandigarh , India
| | - M. Kumar
- a Department of Zoology , Panjab University , Chandigarh , India
| | - M. Jain
- a Department of Zoology , Panjab University , Chandigarh , India
| | - D. K. Dhawan
- b Department of Biophysics , Panjab University , Chandigarh , India
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Singh G, Arora G, Mannalithara A, Mithal A, Sehgal A, Triadafilopoulos G. Alarmingly poor adherence to low-dose aspirin: a large population-based study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p2522] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sehgal A, Mannalithra A, Mithal A, Singh G, Triadafilopoulos G. OP0043 Hip fracture in the extreme elderly: The last frontier of a growing public health problem:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1726] [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]
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Sehgal A, Mithal A, Mannalithara A, Singh G, Triadafilopoulos G. OP0270 Osteoporotic Hip Fractures in Extreme Elderly Men: A Growing Problem. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.475] [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]
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Agnes H, Kalman P, Jozsef A, Henrik B, Mucsi I, Kamata K, Sano T, Naito S, Okamoto T, Okina C, Kamata M, Murano J, Kobayashi K, Uchida M, Aoyama T, Takeuchi Y, Nagaba Y, Sakamoto H, Torino C, Torino C, Panuccio V, Clementi A, Garozzo M, Bonanno G, Boito R, Natale G, Cicchetti T, Chippari A, Logozzo D, Alati G, Cassani S, Sellaro A, D'arrigo G, Tripepi G, Roberta A, Postorino M, Mallamaci F, Zoccali C, Buonanno E, Brancaccio S, Fimiani V, Napolitano P, Spadola R, Morrone L, DI Iorio B, Russo D, Betriu A, Martinez-Alonso M, Vidal T, Valdivielso J, Fernandez E, Bernadette F, Jean-Baptiste B, Frimat L, Madala ND, Thusi GP, Sibisi N, Mazibuko BG, Assounga AGH, Tsai NC, Wang HH, Chen YC, Hung CC, Hwang SJ, Chen HC, Branco P, Adragao T, Birne R, Martins AR, Vizinho R, Gaspar A, Grilo MJ, Barata JD, Bonhorst D, Adragao P, Kim JS, Yang JW, Kim MK, Choi SO, Han BG, Nathalie N, Sunny E, Glorieux G, Daniela B, Fellype B, Sophie L, Horst D L, Ziad M, Raymond V, Yanai M, Okada K, Takeuchi K, Nitta K, Takahashi S, Morena M, Jaussent I, Halkovich A, Dupuy AM, Bargnoux AS, Chenine L, Leray-Moragues H, Klouche K, Vernhet H, Canaud B, Cristol JP, Shutov A, Serov V, Kuznetsova J, Menzorov M, Serova D, Petrescu L, Zugravu A, Capusa C, Stancu S, Cinca S, Anghel C, Timofte D, Medrihan L, Ionescu D, Mircescu G, Hsu TW, Kuo KL, Hung SC, Tarng DC, Lee S, Kim I, Lee D, Rhee H, Song S, Seong E, Kwak I, Holzmann M, Gardell C, Jeppsson A, Sartipy U, Solak Y, Yilmaz MI, Caglar K, Saglam M, Yaman H, Sonmez A, Unal HU, Gok M, Gaipov A, Kayrak M, Eyileten T, Turk S, Vural A, DI Lullo L, Floccari F, Rivera R, Granata A, D'amelio A, Logias F, Otranto G, Malaguti M, Santoboni A, Fiorini F, Connor T, Oygar D, Nitsch D, Gale D, Steenkamp R, Neild GH, Maxwell P, Louise Hogsbro I, Redal-Baigorri B, Sautenet B, Halimi JM, Caille A, Goupille P, Giraudeau B, Solak Y, Yilmaz MI, Caglar K, Saglam M, Yaman H, Unal HU, Gok M, Oguz Y, Gaipov A, Yenicesu M, Cetinkaya H, Eyileten T, Turk S, Vural A, Chen YC, Wang HH, Tsai NC, Hung CC, Hwang SJ, Chen HC, Ishimoto Y, Ohki T, Sugahara M, Kanemitsu T, Kobayashi M, Uchida L, Kotera N, Tanaka S, Sugimoto T, Mise N, Miyazaki N, Matsumoto J, Murata I, Yoshida G, Morishita K, Ushikoshi H, Nishigaki K, Ogura S, Minatoguchi S, Harvey R, Harvey R, Ala A, Banerjee D, Farmer C, Irving J, Hobbs H, Wheeler T, Klebe B, Stevens P, Selim G, Selim G, Stojceva-Taneva O, Tozija L, Stojcev N, Gelev S, Dzekova-Vidimliski P, Pavleska S, Sikole A, Qureshi AR, Evans M, Stendahl M, Prutz KG, Elinder CG, Tamagaki K, Kado H, Nakata M, Kitani T, Ota N, Ishida R, Matsuoka E, Shiotsu Y, Ishida M, Mori Y, Christelle M, Rognant N, Evelyne D, Sophie F, Laurent J, Maurice L, Silverwood R, Pierce M, Kuh D, Savage C, Ferro C, Nitsch D, Moniek DG, De Goeij M, Nynke H, Gurbey O, Joris R, Friedo D, Clayton P, Grace B, Cass A, Mcdonald S, Lorenzo V, Martin Conde M, Betriu A, Dusso A, Valdivielso JM, Fernandez E, Roggeri DP, Cannella G, Cozzolino M, Mazzaferro S, Messa P, Brancaccio D, De Souza Faria R, Fernandes N, Lovisi J, Moura Marta M, Reboredo M, Do Vale Pinheiro B, Bastos M, Hundt F, Hundt F, Pabst S, Hammerstingl C, Gerhardt T, Skowasch D, Woitas R, Lopes AA, Silva LF, Matos CM, Martins MS, Silva FA, Lopes GB, Pizzarelli F, Dattolo P, Tripepi G, Michelassi S, Rossi C, Bandinelli S, Mieth M, Mass R, Ferrucci L, Zoccali C, Parisi S, Arduino S, Attini R, Fassio F, Biolcati M, Pagano A, Bossotti C, Ferraresi M, Gaglioti P, Todros T, Piccoli GB, Salgado TM, Arguello B, Benrimoj SI, Fernandez-Llimos F, Bailey P, Tomson C, Ben-Shlomo Y, Santoro A, Rucci P, Mandreoli M, Caruso F, Corradini M, Flachi M, Gibertoni D, Rigotti A, Russo G, Fantini M, Mahapatra HS, Choudhury S, Buxi G, Sharma N, Gupta Y, Sekhar V, Mahapatra HS, Choudhury S, Buxi G, Sharma N, Gupta Y, Sekhar V, Yanagisawa N, Ando M, Ajisawa A, Tsuchiya K, Nitta K, Janusz O, Mikolaj M, Jacek M, Boleslaw R, Prakash S, Coffin R, Schold J, Einstadter D, Stark S, Rodgers D, Howard M, Sehgal A, Stevens P, Irving J, Wheeler T, Klebe B, Farmer C, Palmer S, Tong A, Manns B, Craig J, Ruospo M, Gargano L, Strippoli G, Ruospo M, Palmer S, Vecchio M, Gargano L, Petruzzi M, De Benedictis M, Pellegrini F, Strippoli G, Ohno Y, Ishimura E, Naganuma T, Kondo K, Fukushima W, Mui K, Inaba M, Hirota Y, Sun X, Sun X, Jiang S, Gu H, Chen Y, XI C, Qiao X, Chen X, Daher E, Junior GS, Jacinto CN, Pimentel RS, Aguiar GBR, Lima CB, Borges RC, Mota LPC, Melo JVL, Melo SA, Canamary VT, Alves M, Araujo SMHA, Chen YC, Hung CC, Huang YK, Tsai NC, Wang HH, Hung CC, Hwang SJ, Chen HC, Rogacev K, Cremers B, Zawada A, Seiler S, Binder N, Ege P, Grosse-Dunker G, Heisel I, Hornof F, Jeken J, Rebling N, Ulrich C, Scheller B, Bohm M, Fliser D, Heine GH, Robinson B, Wang M, Bieber B, Fluck R, Kerr PG, Wikstrom B, Krishnan M, Nissenson A, Pisoni RL, Mykleset S, Osthus TB, Waldum B, Os I, Buttigieg J, Buttigieg J, Cassar A, Farrugia Agius J, Redal-Baigorri B, Hara M, Ando M, Tsuchiya K, Nitta K, Yamato M, Yasuda K, Sasaki K. Clinical Nephrology - Epidemiology II. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs236] [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: 11/13/2022] Open
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Abstract
In the present study, the antioxidative and anticlastogenic effects of curcumin and piperine separately and in combination have been investigated against benzo(a)pyrene (BaP)-mediated toxicity in mice. Male Swiss albino mice were pretreated with curcumin (100 mg kg(-1) body weight) and piperine (20 mg kg(-1) body weight) separately as well as in combination orally in corn oil for 7 days; and subsequently, after 2 h of pretreatment, BaP was administered orally in corn oil (125 mg kg(-1) body weight). A single dose of BaP in normal mice increased the levels of lipid peroxidation (LPO), protein carbonyl content (PCC), and frequency of bone marrow micronucleated polychromatic erythrocytes (MNPCEs) but decreased significantly the levels of endogenous antioxidants such as superoxide dismutases (SODs), glutathione peroxidase (GPx), glutathione reductase (GR), catalase (CAT) and reduced glutathione (GSH) in the liver. Pretreatments with curcumin and curcumin plus piperine before administration of single dose of BaP significantly decreased the levels of LPO, PCC, and incidence of MNPCEs but elevated the level of GSH and enzyme activities of GPx, GR, SOD, CAT, and glutathione-S-transferase (GST) when compared to the BaP-treated group. The effect of curcumin plus piperine is more pronounced as compared to curcumin in attenuating BaP-induced oxidative insult and clastogenicity.
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Affiliation(s)
- A Sehgal
- Department of Zoology, Panjab University, Chandigarh, India
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Juneja A, Pandey A, Sehgal A. SP1-49 Cervical cancer in relation to tobacco habits. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976n.26] [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: 11/03/2022]
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Davies EA, Sehgal A, Linklater KM, Heaps K, Moren C, Walford C, Cook R, Moller H. Cancer in the London prison population, 1986-2005. J Public Health (Oxf) 2010; 32:526-31. [DOI: 10.1093/pubmed/fdq009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [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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Khan MA, Bahadur AK, Agarwal PN, Sehgal A, Das BC. Psychosocial disorders in women undergoing postoperative radiation and chemotherapy for breast cancer in India. Indian J Cancer 2010; 47:296-303. [DOI: 10.4103/0019-509x.64729] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
Although India is in the grip of HIV/AIDS epidemic, not much information is available on clinico-epidemiological and socio-behavioral aspects of people living with HIV/AIDS (PLWHA). This study analyzed these features using standard methodologies in 82 HIV sero-positives, AIDS patients attending ART clinic of three major government hospitals of Delhi. Majority of the patients (73%) were found to be young (<40 years) and married (79%). As high as 91.5% came from low socio-economic class and more than 95% acquired HIV transmission through heterosexual routes. A large proportion (63%) of these patients reported an extremely high level of anxiety, moderate level of stress and a borderline level of clinical depression. While most of the patients (72%) were well-adjusted with the ART, the rest of the patients reported difference in making adjustment with the treatment schedules. The study suggests that counseling and supportive therapy could play a pivotal role in controlling anxiety, stress, depression and rehabilitating people with HIV/AIDS.
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Affiliation(s)
- M A Khan
- Institute of Cytology and Preventive Oncology (ICPO), Noida, New Delhi, India
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Abstract
Oncogenic types of human papilloma viruses (HPVs) have been established to be the causative agents for cervical cancers and high-grade squamous intraepithelial lesions (HSILs). The clinical application of molecular tests for HPV detection for screening purposes has been of considerable interest. DNA amplification methods allow the use of self-collected samples (including urine) from material collected away from the original disease site. For screening of cervical pathology, detection of HPV-DNA in urine would be useful only if it represents cervical HPV infection and/or HPV-related cervical pathology. We conducted a review of the literature in order to ascertain: (1) if urine is an adequate sample for HPV-detection; (2) whether sensitive techniques are available for HPV-detection in urine and (3) if detection of HPV in urine truly represents cervical infection/pathology. The review process consisted of assembling facts and analysing the published literature on the following facts: anatomical considerations of the lower genital and the lower urinary tract, biological behaviour of HPV and its shedding behaviour, technical issues regarding sample collection, processing and HPV-DNA assay systems, concordance rates of HPV-DNA detection and their type specificity in the paired samples (urine and cervical scrapes) obtained in different clinico-epidemiological settings and comparative detection rates of HSILs in the paired samples.
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Affiliation(s)
- A Sehgal
- Division of Epidemiology and Biostatistics, Institute of Cytology and Preventive Oncology (ICMR), Noida, India.
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Rennie JM, Sehgal A, De A, Kendall GS, Cole TJ. Range of UK practice regarding thresholds for phototherapy and exchange transfusion in neonatal hyperbilirubinaemia. Arch Dis Child Fetal Neonatal Ed 2009; 94:F323-7. [PMID: 19000996 DOI: 10.1136/adc.2008.147686] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To establish the range of opinion regarding thresholds at which phototherapy and exchange transfusion are used to treat neonatal hyperbilirubinaemia in the UK. DESIGN A survey of existing charts and guidelines collected from around the UK. Threshold levels were extracted from the charts and entered into an Excel spreadsheet. Filters were applied to analyse subsets of guidelines, and calculations were carried out to analyse the rate of rise of bilirubin (in micromol/l/h) between the origin and the plateau, where this was possible. RESULTS Of 263 hospitals contacted, 163 submitted guidelines, of which most were in the form of individual charts. There was wide variation in the choice of the threshold levels at which treatment was recommended, particularly in preterm babies. At 28 weeks, for example, the range at which phototherapy was recommended extended from 100 micromol/l to 250 micromol/l, and the upper limit was even higher if data from units which used a single guideline for preterm babies of all gestations were included. There was variation in the choice of the origin of the graph and the time at which the plateau commenced (and hence the slope), whether "sickness" criteria should be adopted, and what those criteria should be. Many charts were confusing, poorly presented, sketchily drawn and lacked proper gridlines or axis labels. CONCLUSIONS For such a vitally important topic it is disappointing that there is little existing consensus and no national guidance in the UK. Guidelines for England, Wales and Northern Ireland will be available from 2010, when the National Institute for Health and Clinical Excellence completes its review.
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Affiliation(s)
- J M Rennie
- Neonatal Unit, Elizabeth Garrett Anderson & Obstetric Hospitals, University College London Hospitals, London, UK.
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Gupta S, Sodhani P, Sharma A, Sharma JK, Halder K, Charchra KL, Sardana S, Singh V, Sehgal A, Das BC. Prevalence of high-risk human papillomavirus type 16/18 infection among women with normal cytology: risk factor analysis and implications for screening and prophylaxis. Cytopathology 2009; 20:249-55. [DOI: 10.1111/j.1365-2303.2008.00611.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sardana S, Sharma S, Sodhani P, Sehgal A, DAS BC. An epidemiological study to identify the risk factors with two different types of controls in high-grade cervical lesions including invasive cancer. Eur J Cancer Care (Engl) 2009; 18:620-4. [PMID: 19549283 DOI: 10.1111/j.1365-2354.2008.00957.x] [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: 11/28/2022]
Abstract
A multidisciplinary study on pre-cancerous and early cancerous lesions of uterine cervix was carried out at our Institute from which the subjects (cases and one group of control) for the present study were selected with the objective to identify the possible risk factors related to high-grade cervical lesions including invasive cancer through an epidemiological study by selecting two different types of controls and to assess the feasibility whether the cancers of other organs could be taken as controls at the same time studying the risk factors associated with cervical cancer. One group of control was women with negative Pap smear and second group of control was the women with breast cancer but negative Pap smear. A total of 100 biopsy-proven cases of high-grade cervical intraepithelial lesions and Invasive cancer were recruited. The results of the study show that some of the risk factors associated with the cervical cancer get exaggerated when breast cancer cases were used as controls because risk factors of both cancers are opposite to each other. So it is concluded that in order to remove any bias, normal hospital controls or controls selected from multiple cancers should be taken to study the risk factors involved in cervical carcinogenesis.
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Affiliation(s)
- S Sardana
- Division of Biostatistics and Epidemiology, Institute of Cytology and Preventive Oncology (ICMR), Noida, India.
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Sundararaj B, Sehgal A. Short‐ and long‐term effects of imposition of total darkness on the annual ovarian cycle of the catfish,Heteropneustes Fossilis(Bloch)∗∗. ACTA ACUST UNITED AC 2008. [DOI: 10.1080/09291017009359224] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sehgal A, Sundararaj BI. Effects of blinding and/or total darkness on ovarian recrudescence or regression during the appropriate periods of the reproductive cycle of the catfish,Heteropneustes fossilis(Bloch)∗∗. ACTA ACUST UNITED AC 2008. [DOI: 10.1080/09291017009359213] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Raj N, Sehgal A, Hall J, Murrin K. Comparison of the efficacy of high dose intra-articular and intramuscular morphine analgesia in day case knee arthroscopy. Anaesthesia 2008. [DOI: 10.1046/j.1365-2044.2002.t01-2-02963.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Sehgal A, Joiner W, Crocker A, Koh K, Sathyanarayanan S, Fang Y, Wu M, Williams JA, Zheng X. Molecular analysis of sleep: wake cycles in Drosophila. Cold Spring Harb Symp Quant Biol 2008; 72:557-64. [PMID: 18419315 DOI: 10.1101/sqb.2007.72.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Sleep is controlled by two major regulatory systems: a circadian system that drives it with a 24-hour periodicity and a home-ostatic system that ensures that adequate amounts of sleep are obtained. We are using the fruit fly Drosophila melanogaster to understand both types of regulation. With respect to circadian control, we have identified molecular mechanisms that are critical for the generation of a clock. Our recent efforts have focused on the analysis of posttranslational mechanisms, specifically the action of different phosphatases that control the phosphorylation and thereby the stability and/or nuclear localization of circadian clock proteins period (PER) and timeless (TIM). Resetting the clock in response to light is also mediated through posttranslational events that target TIM for degradation by the proteasome pathway; a recently identified ubiquitin ligase, jet lag (JET), is required for this response. Our understanding of the homeostatic control of sleep is in its early stages. We have found that mushroom bodies, which are a site of synaptic plasticity in the fly brain, are important for the regulation of sleep. In addition, through analysis of genes expressed under different behavioral states, we have identified some that are up-regulated during sleep deprivation. Thus, the Drosophila model allows the use of cellular and molecular approaches that should ultimately lead to a better understanding of sleep biology.
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Affiliation(s)
- A Sehgal
- Howard Hughes Medical Institute, USA
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Gupta S, Sodhani P, Halder K, Chachra KL, Singh V, Sehgal A. Age trends in pre-cancerous and cancerous lesions of the uterine cervix in a cytology screening programme: what should be the target age group for a major thrust of screening in resource-limited settings? Cytopathology 2008; 19:106-10. [PMID: 17681014 DOI: 10.1111/j.1365-2303.2007.00459.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To identify the target age group where screening efforts may be concentrated in order to reduce the incidence of cervical cancer in resource-limited countries. STUDY DESIGN The results of cyto-screening in a hospital-based screening programme for early detection of cervical cancer were analysed retrospectively. The frequency of epithelial cell abnormalities (ECAs) was computed in different age groups. OBSERVATIONS AND RESULTS A total of 5.6% ECAs were detected on cyto-screening. The peak age incidence for squamous intraepithelial lesions (SILs) was in the 30-39 age group while that for malignancies was age >60 years. The mean ages for LSIL, HSIL and cancer were 34.7, 37.7 and 51.8 years respectively. Around 43% LSILs and 48% HSILs presented in the fourth decade. If both fourth and fifth decade are covered by screening we could detect almost two-thirds of SILs. CONCLUSIONS A distinct latent period of more than a decade between the onset of SIL and development of frank cancer provides us with ample opportunity to prevent cervical cancer through screening. Our data validate the WHO recommendation of once in a lifetime screening of women in their fourth decade, for low-resource settings. If resources permit, screening can be extended to include women in the fifth decade. This approach would enable us to pick up maximum SILs within the available resources and prevent their progression to cancer.
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Affiliation(s)
- S Gupta
- Division of Cytopathology, Institute of Cytology and Preventive Oncology (ICMR), Noida, India.
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45
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Abstract
We report a case of lumbar radiculopathy after zygapophyseal joint injections for chronic low back pain. The management of the patient and potential causes for the radiculopathy are discussed. The case acts as a reminder that the spinal nerve roots should be considered when performing intra-articular facet joint injections and demonstrates the importance of including nerve injury in the patient consent process as a rare, but significant complication.
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Affiliation(s)
- A Sehgal
- Department of Anaesthesia, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK.
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46
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Abstract
Central venous catheterization is widely used in neonatal intensive care units to support tiny preterm babies. Pericardial effusion (PCE) and cardiac tamponade are uncommon but potentially fatal complications of percutaneous, umbilical and surgically placed central venous catheters related to intracardiac position or migration. This report describes a case of PCE arising from fluid infused via umbilical venous catheter. The case study highlights two important aspects: one, occurrence of PCE in a baby with satisfactory position of the umbilical catheter, and second, the life-saving application of basic echocardiography by bedside caregivers for the diagnosis and treatment of this critical condition.
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Affiliation(s)
- A Sehgal
- Department of Pediatrics, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
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47
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Abstract
With the change in the life styles and demographic profiles of developing countries, noncommunicable diseases are emerging to be important health problems that demand appropriate control program before they assume epidemic proportion. One of these is the problem of cancer. In India, cervical cancer is a significant problem in terms of incidence, mortality and morbidity. Cervical cancer is a disease that can be prevented through both primary prevention and early detection using screening techniques. Several screening modalities are now available for early detection of cervical cancer and its precursor lesions. They all differ with regard to their test characteristics, feasibility and economic considerations. This communication reviews different aspects of these screening modalities and provides different options considering mass application.
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Affiliation(s)
- A Juneja
- National Institute of Medical Statistics (ICMR), Ansari Nagar, New Delhi, India.
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48
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Juneja A, Sehgal A, Sharma S, Pandey A. Cervical cancer screening in India: strategies revisited. Indian J Med Sci 2007; 61:34-47. [PMID: 17197739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
With the change in the life styles and demographic profiles of developing countries, noncommunicable diseases are emerging to be important health problems that demand appropriate control program before they assume epidemic proportion. One of these is the problem of cancer. In India, cervical cancer is a significant problem in terms of incidence, mortality and morbidity. Cervical cancer is a disease that can be prevented through both primary prevention and early detection using screening techniques. Several screening modalities are now available for early detection of cervical cancer and its precursor lesions. They all differ with regard to their test characteristics, feasibility and economic considerations. This communication reviews different aspects of these screening modalities and provides different options considering mass application.
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Affiliation(s)
- A Juneja
- National Institute of Medical Statistics (ICMR), Ansari Nagar, New Delhi, India.
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49
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Sodhani P, Gupta S, Sharma JK, Parashari A, Halder K, Singh V, Sehgal A. Test characteristics of various screening modalities for cervical cancer: a feasibility study to develop an alternative strategy for resource-limited settings. Cytopathology 2006; 17:348-52. [PMID: 17168917 DOI: 10.1111/j.1365-2303.2006.00351.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine test characteristics - sensitivity, specificity, positive and negative predictive values - of different screening modalities to detect cervical precancerous and cancerous lesions in order to devise an effective alternative strategy for cervical cancer screening in resource-poor settings. METHODS A total of 472 women presenting with nonspecific gynecologic symptoms were screened by cytology, visual inspection with acetic acid application (VIA), VIA with magnification (VIAM) and human papillomavirus (HPV)-DNA testing. Colposcopic examination was performed in all and on-site biopsy was taken if any grade I and above lesion was detected on colposcopy (230). On histopathological examination, 105 showed cervical intraepithelial neoplasia II and above lesions. Sensitivity, specificity and predictive values for each test were calculated taking colposcopy and or directed biopsy as the gold standard. Comparisons were made with cytology in order to assess the feasibility of alternative strategies in resource-poor settings. RESULTS VIA was less sensitive (86.7% versus 91.4%) but more specific (90.7% versus 86.6%) than cytology at low grade squamous intraepithelial lesion (LSIL) threshold but the difference was not statistically significant (P > 0.01). HPV testing improved the sensitivity over cytology (97.1% versus 91.4%) but there was a nonsignificant loss of specificity (84.2% versus 86.6%). Results of VIAM were more or less similar to VIA. CONCLUSION VIA can be used as a mass screening tool for cervical cancer in resource-poor settings.
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Affiliation(s)
- P Sodhani
- Division of Cytopathology, Institute of Cytology and Preventive Oncology (ICMR), NOIDA, Uttar Pradesh, India.
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50
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Berret JF, Sehgal A, Morvan M, Sandre O, Vacher A, Airiau M. Stable oxide nanoparticle clusters obtained by complexation. J Colloid Interface Sci 2006; 303:315-8. [PMID: 16901498 DOI: 10.1016/j.jcis.2006.07.025] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2006] [Revised: 07/11/2006] [Accepted: 07/12/2006] [Indexed: 12/01/2022]
Abstract
We report on the electrostatic complexation between polyelectrolyte-neutral copolymers and oppositely charged 6-nm crystalline nanoparticles. For two different dispersions of oxide nanoparticles, the electrostatic complexation gives rise to the formation of stable nanoparticle clusters in the range 20-100 nm. It is found that inside the clusters, the particles are "pasted" together by the polyelectrolyte blocks adsorbed on their surface. Cryo-transmission electronic microscopy allows visualization of the clusters and determination of the probability distribution functions in size and in aggregation number. The comparison between light scattering and cryo-microscopy results suggests the existence of a polymer brush around the clusters.
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Affiliation(s)
- J-F Berret
- Matière et Systèmes Complexes, UMR 7057 CNRS Université Denis Diderot Paris-VII, 140 rue de Lourmel, F-75015 Paris, France.
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