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Ahluwalia K, Du Z, Martinez-Camarillo JC, Naik A, Thomas BB, Pollalis D, Lee SY, Dave P, Zhou E, Li Z, Chester C, Humayun MS, Louie SG. Unveiling Drivers of Retinal Degeneration in RCS Rats: Functional, Morphological, and Molecular Insights. Int J Mol Sci 2024; 25:3749. [PMID: 38612560 PMCID: PMC11011632 DOI: 10.3390/ijms25073749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/12/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
Retinal degenerative diseases, including age-related macular degeneration and retinitis pigmentosa, significantly contribute to adult blindness. The Royal College of Surgeons (RCS) rat is a well-established disease model for studying these dystrophies; however, molecular investigations remain limited. We conducted a comprehensive analysis of retinal degeneration in RCS rats, including an immunodeficient RCS (iRCS) sub-strain, using ocular coherence tomography, electroretinography, histology, and molecular dissection using transcriptomics and immunofluorescence. No significant differences in retinal degeneration progression were observed between the iRCS and immunocompetent RCS rats, suggesting a minimal role of adaptive immune responses in disease. Transcriptomic alterations were primarily in inflammatory signaling pathways, characterized by the strong upregulation of Tnfa, an inflammatory signaling molecule, and Nox1, a contributor to reactive oxygen species (ROS) generation. Additionally, a notable decrease in Alox15 expression was observed, pointing to a possible reduction in anti-inflammatory and pro-resolving lipid mediators. These findings were corroborated by immunostaining, which demonstrated increased photoreceptor lipid peroxidation (4HNE) and photoreceptor citrullination (CitH3) during retinal degeneration. Our work enhances the understanding of molecular changes associated with retinal degeneration in RCS rats and offers potential therapeutic targets within inflammatory and oxidative stress pathways for confirmatory research and development.
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Affiliation(s)
- Kabir Ahluwalia
- Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA 90089, USA; (K.A.); (A.N.); (P.D.); (E.Z.); (Z.L.); (C.C.)
| | - Zhaodong Du
- USC Ginsburg Institute of for Biomedical Therapeutics, University of Southern California, Los Angeles, CA 90033, USA; (Z.D.); (J.C.M.-C.); (B.B.T.); (D.P.); (S.Y.L.); (M.S.H.)
| | - Juan Carlos Martinez-Camarillo
- USC Ginsburg Institute of for Biomedical Therapeutics, University of Southern California, Los Angeles, CA 90033, USA; (Z.D.); (J.C.M.-C.); (B.B.T.); (D.P.); (S.Y.L.); (M.S.H.)
- Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Aditya Naik
- Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA 90089, USA; (K.A.); (A.N.); (P.D.); (E.Z.); (Z.L.); (C.C.)
| | - Biju B. Thomas
- USC Ginsburg Institute of for Biomedical Therapeutics, University of Southern California, Los Angeles, CA 90033, USA; (Z.D.); (J.C.M.-C.); (B.B.T.); (D.P.); (S.Y.L.); (M.S.H.)
- Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Dimitrios Pollalis
- USC Ginsburg Institute of for Biomedical Therapeutics, University of Southern California, Los Angeles, CA 90033, USA; (Z.D.); (J.C.M.-C.); (B.B.T.); (D.P.); (S.Y.L.); (M.S.H.)
- Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Sun Young Lee
- USC Ginsburg Institute of for Biomedical Therapeutics, University of Southern California, Los Angeles, CA 90033, USA; (Z.D.); (J.C.M.-C.); (B.B.T.); (D.P.); (S.Y.L.); (M.S.H.)
- Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
- Department of Physiology & Neuroscience, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Priyal Dave
- Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA 90089, USA; (K.A.); (A.N.); (P.D.); (E.Z.); (Z.L.); (C.C.)
| | - Eugene Zhou
- Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA 90089, USA; (K.A.); (A.N.); (P.D.); (E.Z.); (Z.L.); (C.C.)
| | - Zeyang Li
- Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA 90089, USA; (K.A.); (A.N.); (P.D.); (E.Z.); (Z.L.); (C.C.)
| | - Catherine Chester
- Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA 90089, USA; (K.A.); (A.N.); (P.D.); (E.Z.); (Z.L.); (C.C.)
| | - Mark S. Humayun
- USC Ginsburg Institute of for Biomedical Therapeutics, University of Southern California, Los Angeles, CA 90033, USA; (Z.D.); (J.C.M.-C.); (B.B.T.); (D.P.); (S.Y.L.); (M.S.H.)
- Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Stan G. Louie
- Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA 90089, USA; (K.A.); (A.N.); (P.D.); (E.Z.); (Z.L.); (C.C.)
- USC Ginsburg Institute of for Biomedical Therapeutics, University of Southern California, Los Angeles, CA 90033, USA; (Z.D.); (J.C.M.-C.); (B.B.T.); (D.P.); (S.Y.L.); (M.S.H.)
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Lu A, Ebright B, Naik A, Tan HL, Cohen NA, Bouteiller JMC, Lazzi G, Louie SG, Humayun MS, Asante I. Hydroxypropyl-Beta Cyclodextrin Barrier Prevents Respiratory Viral Infections: A Preclinical Study. Int J Mol Sci 2024; 25:2061. [PMID: 38396738 PMCID: PMC10888609 DOI: 10.3390/ijms25042061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
The emergence and mutation of pathogenic viruses have been occurring at an unprecedented rate in recent decades. The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has developed into a global public health crisis due to extensive viral transmission. In situ RNA mapping has revealed angiotensin-converting enzyme 2 (ACE2) expression to be highest in the nose and lower in the lung, pointing to nasal susceptibility as a predominant route for infection and the cause of subsequent pulmonary effects. By blocking viral attachment and entry at the nasal airway using a cyclodextrin-based formulation, a preventative therapy can be developed to reduce viral infection at the site of entry. Here, we assess the safety and antiviral efficacy of cyclodextrin-based formulations. From these studies, hydroxypropyl beta-cyclodextrin (HPBCD) and hydroxypropyl gamma-cyclodextrin (HPGCD) were then further evaluated for antiviral effects using SARS-CoV-2 pseudotypes. Efficacy findings were confirmed with SARS-CoV-2 Delta variant infection of Calu-3 cells and using a K18-hACE2 murine model. Intranasal pre-treatment with HPBCD-based formulations reduced viral load and inflammatory signaling in the lung. In vitro efficacy studies were further conducted using lentiviruses, murine hepatitis virus (MHV), and influenza A virus subtype H1N1. These findings suggest HPBCD may be used as an agnostic barrier against transmissible pathogens, including but not limited to SARS-CoV-2.
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Affiliation(s)
- Angela Lu
- Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA 90089, USA; (A.L.); (B.E.); (A.N.); (S.G.L.)
| | - Brandon Ebright
- Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA 90089, USA; (A.L.); (B.E.); (A.N.); (S.G.L.)
| | - Aditya Naik
- Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA 90089, USA; (A.L.); (B.E.); (A.N.); (S.G.L.)
| | - Hui L. Tan
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA 19104, USA; (H.L.T.); (N.A.C.)
| | - Noam A. Cohen
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA 19104, USA; (H.L.T.); (N.A.C.)
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA
| | - Jean-Marie C. Bouteiller
- Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90007, USA; (J.-M.C.B.); (G.L.); (M.S.H.)
| | - Gianluca Lazzi
- Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90007, USA; (J.-M.C.B.); (G.L.); (M.S.H.)
- Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Stan G. Louie
- Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA 90089, USA; (A.L.); (B.E.); (A.N.); (S.G.L.)
| | - Mark S. Humayun
- Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90007, USA; (J.-M.C.B.); (G.L.); (M.S.H.)
- Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Isaac Asante
- Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA 90089, USA; (A.L.); (B.E.); (A.N.); (S.G.L.)
- Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
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Ahluwalia K, Martinez-Camarillo JC, Thomas BB, Naik A, Gonzalez-Calle A, Pollalis D, Lebkowski J, Lee SY, Mitra D, Louie SG, Humayun MS. Polarized RPE Secretome Preserves Photoreceptors in Retinal Dystrophic RCS Rats. Cells 2023; 12:1689. [PMID: 37443724 PMCID: PMC10340490 DOI: 10.3390/cells12131689] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Retinal degenerative diseases, including age-related macular degeneration (AMD) and retinitis pigmentosa, lack effective therapies. Conventional monotherapeutic approaches fail to target the multiple affected pathways in retinal degeneration. However, the retinal pigment epithelium (RPE) secretes several neurotrophic factors addressing diverse cellular pathways, potentially preserving photoreceptors. This study explored human embryonic stem cell-derived, polarized RPE soluble factors (PRPE-SF) as a combination treatment for retinal degeneration. PRPE-SF promoted retinal progenitor cell survival, reduced oxidative stress in ARPE-19 cells, and demonstrated critical antioxidant and anti-inflammatory effects for preventing retinal degeneration in the Royal College of Surgeons (RCS) rat model. Importantly, PRPE-SF treatment preserved retinal structure and scotopic b-wave amplitudes, suggesting therapeutic potential for delaying retinal degeneration. PRPE-SF is uniquely produced using biomimetic membranes for RPE polarization and maturation, promoting a protective RPE secretome phenotype. Additionally, PRPE-SF is produced without animal serum to avoid immunogenicity in future clinical development. Lastly, PRPE-SF is a combination of neurotrophic factors, potentially ameliorating multiple dysfunctions in retinal degenerations. In conclusion, PRPE-SF offers a promising therapeutic candidate for retinal degenerative diseases, advancing the development of effective therapeutic strategies for these debilitating conditions.
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Affiliation(s)
- Kabir Ahluwalia
- Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA 90089, USA; (K.A.); (A.N.)
| | - Juan-Carlos Martinez-Camarillo
- USC Ginsburg Institute of for Biomedical Therapeutics, University of Southern California, Los Angeles, CA 90033, USA; (J.-C.M.-C.); (B.B.T.); (A.G.-C.); (D.P.); (S.Y.L.); (D.M.)
- USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Biju B. Thomas
- USC Ginsburg Institute of for Biomedical Therapeutics, University of Southern California, Los Angeles, CA 90033, USA; (J.-C.M.-C.); (B.B.T.); (A.G.-C.); (D.P.); (S.Y.L.); (D.M.)
- USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Aditya Naik
- Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA 90089, USA; (K.A.); (A.N.)
| | - Alejandra Gonzalez-Calle
- USC Ginsburg Institute of for Biomedical Therapeutics, University of Southern California, Los Angeles, CA 90033, USA; (J.-C.M.-C.); (B.B.T.); (A.G.-C.); (D.P.); (S.Y.L.); (D.M.)
- USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Dimitrios Pollalis
- USC Ginsburg Institute of for Biomedical Therapeutics, University of Southern California, Los Angeles, CA 90033, USA; (J.-C.M.-C.); (B.B.T.); (A.G.-C.); (D.P.); (S.Y.L.); (D.M.)
- USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Jane Lebkowski
- Regenerative Patch Technologies LLC, Menlo Park, CA 94028, USA;
| | - Sun Young Lee
- USC Ginsburg Institute of for Biomedical Therapeutics, University of Southern California, Los Angeles, CA 90033, USA; (J.-C.M.-C.); (B.B.T.); (A.G.-C.); (D.P.); (S.Y.L.); (D.M.)
- USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
- Department of Physiology & Neuroscience, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Debbie Mitra
- USC Ginsburg Institute of for Biomedical Therapeutics, University of Southern California, Los Angeles, CA 90033, USA; (J.-C.M.-C.); (B.B.T.); (A.G.-C.); (D.P.); (S.Y.L.); (D.M.)
| | - Stan G. Louie
- Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA 90089, USA; (K.A.); (A.N.)
- USC Ginsburg Institute of for Biomedical Therapeutics, University of Southern California, Los Angeles, CA 90033, USA; (J.-C.M.-C.); (B.B.T.); (A.G.-C.); (D.P.); (S.Y.L.); (D.M.)
| | - Mark S. Humayun
- USC Ginsburg Institute of for Biomedical Therapeutics, University of Southern California, Los Angeles, CA 90033, USA; (J.-C.M.-C.); (B.B.T.); (A.G.-C.); (D.P.); (S.Y.L.); (D.M.)
- USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
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Nair MS V, Schaub J, Alakwaa F, McCown P, Naik A, Ladd P, Harned R, Looker H, Pottumarthi P, Luping L, Pyle L, Brosius F, Nelson R, Kretzler M, Bjornstad P. WCN23-0761 SGLT2 INHIBITOR TREATMENT MAY ENHANCE KIDNEY OXYGENATION AND ATTENUATE HIF1A EXPRESSION IN YOUNG PERSONS WITH TYPE 2 DIABETES. Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.02.439] [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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5
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ALAKWAA F, McCown P, Naik A, Schaub J, Menon R, Otto E, Nair V, Eddy S, Pyle L, Hartman J, Hodgin J, Nelson R, Brosius Division F, Kretzler M, Bjornstad P. WCN23-0471 THE ENHANCEMENT OF METALLOTHIONEIN BIND METAL PATHWAY WITH SGLT2 INHIBITORS IN KIDNEY PROXIMAL TUBULES OF ADOLESCENTS WITH TYPE 2 DIABETES USING SINGLE CELL RNA-SEQ DATA. Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.02.432] [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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Naik A, Decock J. Commentary: Cancer-testis antigen lactate dehydrogenase C4 as a novel biomarker of male infertility and cancer. Front Oncol 2023; 13:1115620. [PMID: 36814815 PMCID: PMC9939683 DOI: 10.3389/fonc.2023.1115620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 01/26/2023] [Indexed: 02/09/2023] Open
Affiliation(s)
- A. Naik
- Translational Cancer and Immunity Center (TCIC), Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha, Qatar
| | - J. Decock
- Translational Cancer and Immunity Center (TCIC), Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha, Qatar,College of Health and Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha, Qatar,*Correspondence: J. Decock,
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Smith E, Naik A, Krist D, Shaffer A, Liang E, Goel M, Smith R. A Comparison of Modalities to Differentiate Radiation Necrosis from Tumor Progression: A Diagnostic Meta-Analysis. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Karam M, Abul A, Kahlar N, Naik A, Tay J, Rahman S, Matteucci P. 294 Stem Cell Enriched Fat Grafts Versus Autologous Fat Grafts for Facial Reconstruction: A Systematic Review and Meta-Analysis. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.301] [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: 11/05/2022]
Abstract
Abstract
Aim
To compare the results of stem cell-enhanced fat grafting to autologous fat grafting for face reconstruction.
Method
A systematic review and meta-analysis were carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines, and an electronic search was carried out to identify all Randomised Controlled Trials (RCTs), case control studies, and cohort studies comparing the outcomes of stem cell-enrichment fat grafting versus routine fat grafting for facial reconstruction. The primary outcome measures were volume retention and infection rate. Secondary outcome measures included post-surgery patient satisfaction, redness and swelling, fat necrosis, cysts, and operation time. For the analysis, fixed and random effects modelling were utilised.
Results
Eight studies with a total of 275 participants were assessed. In terms of mean volume retention, there was a significant difference between the stem cell-enrichment fat grafting and routine grafting groups (standardised Mean Difference [MD] = 2.49, P 0.00001). However, there was no significant difference in infection rates between the two groups (OR = 0.36, P = 0.30). Except for the operation duration, which was shorter in the latter, the intervention group had similar results to the control group for all secondary outcomes.
Conclusions
When compared to conventional fat grafting, stem cell-enriched fat grafting is a better alternative for facial reconstruction surgery since it enhances mean volume retention and does not worsen patient satisfaction or surgical complications.
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Affiliation(s)
- M Karam
- Farwaniya Hospital , Kuwait City , Kuwait
| | - A Abul
- University of Leeds , Leeds , United Kingdom
| | - N Kahlar
- Southwest Birmingham Trust , Birmingham , United Kingdom
| | - A Naik
- James Cook University Hospital , Middlesbrough , United Kingdom
| | - J Tay
- Bradford Royal Infirmary , Bradford , United Kingdom
| | - S Rahman
- Pinderfields General Hospital , Wakefield , United Kingdom
| | - P Matteucci
- Hull royal infirmary , Hull , United Kingdom
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Aedma S, Gupta R, Mahajan S, Mahajan P, Patel M, Malik A, Naik A, Mehta S, Patel NC. Transcatheter aortic valve implantation outcomes compared between bicuspid aortic and tricuspid aortic valve stenosis: an updated systematic review and meta-analysis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
TAVI has emerged as an attractive treatment modality based on promising recent trial data. Patients with BAV, a commonly encountered clinical condition have largely been excluded from a majority of trials.
Purpose
Elderly patients with BAV and severe AS are increasingly encountered in clinical practice. This meta-analysis compares clinical outcomes between bicuspid and tricuspid AV patients to address the current knowledge-gap and identify optimal management strategies of these patients.
Methods
A comprehensive literature search was performed in PubMed, Embase, and Cochrane to identify the available observational studies comparing outcomes of TAVI in BAV and TAV patients. Summary effects were calculated using a DerSimonian and Laird random-effects model as odds ratio with 95% confidence intervals for all the clinical endpoints.
Results
16 Observational studies met inclusion criteria, comprising 10,053 patients with BAV and 173,307 patients with TAV that underwent TAVI. No significant differences in 30-day and long-term mortality rates were observed. Patients with BAV had an increased risk of stroke (OR 1.23; 95% CI [1.06–1.44], p=0.007), re-intervention (OR 1.90; 95% CI [1.15–3.15], p=0.01), paravalvular leak (OR 1.42; 95% CI [1.25–1.61], p<0.ehab724.22251), conversion to open surgery (OR 1.93; 95% CI [1.21–3.07], p=0.006), and new pacemaker implantation (1.57; 95% CI (1.06 - 2.33, p=0.02). Adverse event rates are lower with the use of newer generation of valves. No significant difference in major vascular complications, major bleeding, or incidence of AKI was noted.
Conclusions
Complication rates for BAV TAVI are higher, but mortality is similar to TAV TAVI indicating TAVI is an appropriate alternative for intermediate-high risk patients with BAV. A better understanding of valve anatomy, physician expertise, the use of newer-generation valves can help reduce these complications.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Aedma
- Carle Foundation Hospital, Internal medicine, Urbana, United States of America
| | - R Gupta
- Lehigh Valley Health Network, Cardiology, Allentown, United States of America
| | - S Mahajan
- Carle Foundation Hospital, Internal medicine, Urbana, United States of America
| | - P Mahajan
- Carle Foundation Hospital, Internal medicine, Urbana, United States of America
| | - M Patel
- Sumandeep Vidyapeeth, Vadodara, India
| | - A Malik
- New York Medical College, cardiology, Valhalla, United States of America
| | - A Naik
- Carle Foundation Hospital, Internal medicine, Urbana, United States of America
| | - S Mehta
- Carle Foundation Hospital, Internal medicine, Urbana, United States of America
| | - N C Patel
- Lehigh Valley Health Network, Cardiology, Allentown, United States of America
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Shukla MR, Patra S, Verma M, Sadasivam G, Jana N, Mahangare SJ, Vidhate P, Lagad D, Tarage A, Cheemala M, Kulkarni C, Bhagwat S, Chaudhari VD, Sayyed M, Pachpute V, Phadtare R, Gole G, Phukan S, Sunkara B, Samant C, Shingare M, Naik A, Trivedi S, Marisetti AK, Reddy M, Gholve M, Mahajan N, Sabde S, Patil V, Modi D, Mehta M, Nigade P, Tamane K, Tota S, Goyal H, Volam H, Pawar S, Ahirrao P, Dinchhana L, Mallurwar S, Akarte A, Bokare A, Kanhere R, Reddy N, Koul S, Dandekar M, Singh M, Bernstein PR, Narasimham L, Bhonde M, Gundu J, Goel R, Kulkarni S, Sharma S, Kamboj RK, Palle VP. Discovery of a Potent and Selective PI3Kδ Inhibitor ( S)-2,4-Diamino-6-((1-(7-fluoro-1-(4-fluorophenyl)-4-oxo-3-phenyl-4 H-quinolizin-2-yl)ethyl)amino)pyrimidine-5-carbonitrile with Improved Pharmacokinetic Profile and Superior Efficacy in Hematological Cancer Models. J Med Chem 2020; 63:14700-14723. [PMID: 33297683 DOI: 10.1021/acs.jmedchem.0c01264] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PI3Kδ inhibitors have been approved for B-cell malignancies like CLL, small lymphocytic lymphoma, and so forth. However, currently available PI3Kδ inhibitors are nonoptimal, showing weakness against at least one of the several important properties: potency, isoform selectivity, and/or pharmacokinetic profile. To come up with a PI3Kδ inhibitor that overcomes all these deficiencies, a pharmacophoric expansion strategy was employed. Herein, we describe a systematic transformation of a "three-blade propeller" shaped lead, 2,3-disubstituted quinolizinone 11, through a 1,2-disubstituted quinolizinone 20 to a novel "four-blade propeller" shaped 1,2,3-trisubstituted quinolizinone 34. Compound 34 has excellent potency, isoform selectivity, metabolic stability across species, and exhibited a favorable pharmacokinetic profile. Compound 34 also demonstrated a differentiated efficacy profile in human germinal center B and activated B cell-DLBCL cell lines and xenograft models. Compound 34 qualifies for further evaluation as a candidate for monotherapy or in combination with other targeted agents in DLBCLs and other forms of iNHL.
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Affiliation(s)
- Manojkumar R Shukla
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Sukanya Patra
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Mahip Verma
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Gayathri Sadasivam
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Nirmal Jana
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Sachin J Mahangare
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Prashant Vidhate
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Dipak Lagad
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Anand Tarage
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Murthy Cheemala
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Chaitanya Kulkarni
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Shankar Bhagwat
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Vinod D Chaudhari
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Majid Sayyed
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Vipul Pachpute
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Ramesh Phadtare
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Gopal Gole
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Samiron Phukan
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Brahmam Sunkara
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Charudatt Samant
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Manisha Shingare
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Aditya Naik
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Sneha Trivedi
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Ajit Kumar Marisetti
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Madhusudhan Reddy
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Milind Gholve
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Nilesh Mahajan
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Sudeep Sabde
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Vinod Patil
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Dipak Modi
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Maneesh Mehta
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Prashant Nigade
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Kaustubh Tamane
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Swati Tota
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Hemant Goyal
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Harish Volam
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Shashikant Pawar
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Prajakta Ahirrao
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Lal Dinchhana
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Sadanand Mallurwar
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Atul Akarte
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Anand Bokare
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Rupesh Kanhere
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Neetinkumar Reddy
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Sarita Koul
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Manoj Dandekar
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Minakshi Singh
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Peter R Bernstein
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Lakshmi Narasimham
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Mandar Bhonde
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Jayasagar Gundu
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Rajan Goel
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Sanjeev Kulkarni
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Sharad Sharma
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Rajender Kumar Kamboj
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
| | - Venkata P Palle
- Novel Drug Discovery and Development, Lupin Ltd., Lupin Research Park, Survey No. 46 A/47A, Village Nande, Taluka Mulshi, Pune 412115, India
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Prakash S, Das PK, Mishra D, Ray GK, Routray S, Naik A, Mukherjee S. Incidence and risk predictors analysis of adverse donor reactions in whole blood donation. Transfus Clin Biol 2020; 27:207-212. [PMID: 33027707 DOI: 10.1016/j.tracli.2020.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 09/25/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Adverse donor reactions in normal healthy blood donors is not unusual. However, these unpleasant effects have a negative impact on donor retention. Adverse event due to blood donation is multifactorial in origin. Therefore, the objective of this study was to determine the frequency and type of adverse donor reactions during or after blood donation. More importantly, this study also aimed at analyzing important risk predictors of adverse donor reaction. MATERIAL AND METHODS This was a retrospective study conducted from May 2017 to April 2019 in the department of Transfusion Medicine at a tertiary care center in eastern India. Data were stored in Microsoft excel 2016 by using a standardized format as per ISBT criteria and analyzed with software "R, version 3.5.3" to find out the various independent precipitating factor. RESULTS Overall, 107 donors (0.98%) experienced adverse events with 10,814 whole blood donations. The first time, females, younger age donors (18-30 years), and donors with a mean arterial blood pressure of less than 90mm of Hg were the most important independent risk factors predicting the possibility of adverse donor reaction. Donors' weight, hemoglobin, and the type of donation had not affected the frequency of adverse events. CONCLUSION Analysis of adverse donor reactions helps in selecting the blood donors who are at risk of donor reactions. Our study highlights the importance of proper predonation screening especially in terms of assessment of mean blood pressure, along with identification of first time and female blood donors in order to reduce untoward donor reaction.
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Affiliation(s)
- S Prakash
- Department of Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
| | - P K Das
- Department of Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
| | - D Mishra
- Department of Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
| | - G K Ray
- Department of Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
| | - S Routray
- Department of Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
| | - A Naik
- Department of Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
| | - S Mukherjee
- Department of Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
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12
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Reddy A, Savlania A, Naik A, Rastogi P, Gorsi U. Deep venous thrombosis manifestation of common femoral vein leiomyoma. Ann R Coll Surg Engl 2020; 102:e141-e144. [PMID: 32326731 DOI: 10.1308/rcsann.2020.0062] [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: 11/22/2022] Open
Abstract
Deep vein thrombosis is a common clinical condition, with well-known risk factors. An unusual case of venous leiomyoma manifesting as a deep vein thrombosis in the left femoral vein of a 55-year-old man was managed successfully at our institution with anticoagulation, en-bloc excision and reconstruction of the femoral vein with spiral vein graft.
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Affiliation(s)
- A Reddy
- Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - A Savlania
- Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - A Naik
- Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - P Rastogi
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - U Gorsi
- Department of Radiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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13
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Kostusiak M, Naik A, Lewis CJ, Allison KP. Establishing scald prevention measures in UK maternity units from takeaway drinks. Burns 2020; 46:1208-1211. [PMID: 31911073 DOI: 10.1016/j.burns.2019.12.010] [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: 08/11/2019] [Revised: 12/05/2019] [Accepted: 12/15/2019] [Indexed: 11/29/2022]
Abstract
AIM To identify policies on the consumption of hot drinks by patients and visitors on all perinatal and postnatal wards in the United Kingdom, and to seek the opinions of members of the wider burns MDT as to whether standardised patient education or regulation of hot drinks around newborn babies is required. METHODS All maternity units with postnatal wards across the United Kingdom were surveyed to establish availability of hot drinks on site and whether these were permitted on postnatal wards around infants. An online questionnaire was distributed to members of the British Burn Association to ascertain opinions on hot drinks policies. RESULTS Hot takeaway drinks were permitted around newborn infants in 194 of surveyed postnatal wards and were only banned by two units. The online survey received 49 responses from different members of the British Burn Association. Thirty responders (61%) supported a takeaway hot drink ban, while those against the policy would alternatively encourage patient education, dedicated drinking areas and introduction of safety measures. CONCLUSIONS Almost every postnatal unit in the UK has access to hot drink retailers on site allowing parents and visitors to bring them into close contact with babies. With varying local regulations, this poses potentially serious consequences during feeding or carrying. We propose a standardised antenatal education be made available, together with standardised designated areas on wards for parents and visitors to consume hot drinks away from infants.
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Affiliation(s)
- M Kostusiak
- Department of Plastic Surgery, James Cook University Hospital, Middlesbrough, United Kingdom
| | - A Naik
- Department of Plastic Surgery, James Cook University Hospital, Middlesbrough, United Kingdom
| | - C J Lewis
- Department of Plastic Surgery, James Cook University Hospital, Middlesbrough, United Kingdom.
| | - K P Allison
- Department of Plastic Surgery, James Cook University Hospital, Middlesbrough, United Kingdom
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Sholi A, Kamel M, Nasar A, Naik A, Harrison S, Lee B, Port J, Altorki N, Stiles B. MA06.03 Poor Pulmonary Function Does Not Define “Medical Inoperability”: Short and Long Term Results of a Matched Lung Cancer Cohort. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.540] [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: 10/25/2022]
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15
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Kamel M, Sholi A, Naik A, Harrison S, Lee B, Stiles B, Altorki N, Port J. P1.12-02 Nationwide Assessment of the Role of Adjuvant Systemic Therapy in High-Risk Lung Carcinoids. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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16
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Naik A, Lewis CJ, Allison KP. Temperature dissociation of liquids in reusable thermoplastic containers-An eco-friendly scald risk? Burns 2019; 45:1621-1624. [PMID: 31371231 DOI: 10.1016/j.burns.2019.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 04/09/2019] [Revised: 06/14/2019] [Accepted: 07/10/2019] [Indexed: 01/14/2023]
Abstract
Recent global concern regarding the impact of plastic waste on the environment has resulted in efforts to utilise reusable drink containers. Research is lacking regarding temperature dissociation of drinks in reusable thermoplastic cups. This study aimed to compare the cooling time of two common hot drinks sold at a UK retailer, in the three vessels they are sold; ceramic, disposable paper (with and without lid) and reusable thermoplastic cups (with and without lid). All temperatures were collated from 250 ml volumes of black Americano coffee or café latte in the three different containers. The cooling time was measured every sixty seconds using a standardised digital thermocouple thermometer until a threshold liquid temperature of 43 °C was reached. All experiments were performed in triplicate and temperatures converted to a dimensionless logarithmic scale prior to statistical analysis. Cooling time was significantly slower for lidded cups irrespective of material. Unlidded thermoplastic cups significantly slowed cooling times for both black Americano coffee and café latte compared to ceramic and unlidded disposable paper cups. The growing trend in reusable cups does not in itself pose an increased risk of scald injury. However, we consider that the potentially increased ambulatory behaviour associated with using a lidded rather than unlidded cup may increase scald risk. We propose that further consumer guidance should be disseminated regarding the use of any lidded takeaway container to prevent scalds in both adults and children.
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Affiliation(s)
- A Naik
- Department of Plastic Surgery, James Cook University Hospital, Middlesbrough, United Kingdom
| | - C J Lewis
- Department of Plastic Surgery, James Cook University Hospital, Middlesbrough, United Kingdom.
| | - K P Allison
- Department of Plastic Surgery, James Cook University Hospital, Middlesbrough, United Kingdom
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Captain M, Natu S, Parekh A, Naik A, Behera MK. Acquired diaphragmatic hernia in a preterm low birth weight neonate. Trop Doct 2019; 49:311-313. [PMID: 31208291 DOI: 10.1177/0049475519856250] [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: 11/17/2022]
Abstract
Iatrogenic diaphragmatic hernia is rare in children and we report a preterm low birth weight neonate with a presumably acquired diaphragmatic hernia due to trauma caused by treatment following pneumothorax.
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Affiliation(s)
- Mustafa Captain
- Postgraduate, Department of Paediatrics, Smt Kashibai Navale Medical College & General Hospital, Pune, India
| | - Sanjay Natu
- Professor, Department of Paediatrics, Smt Kashibai Navale Medical College & General Hospital, Pune, India
| | - Anjali Parekh
- Associate Professor, Department of Paediatrics, Smt Kashibai Navale Medical College & General Hospital, Pune, India
| | - A Naik
- Professor and Head, Department of General Surgery, Smt Kashibai Navale Medical College & General Hospital, Pune, India
| | - M K Behera
- Professor and Head, Department of Paediatrics, Smt Kashibai Navale Medical College & General Hospital, Pune, India
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Abstract
This randomized controlled trial was designed to evaluate whether the combination of low dose oral midazolam (0.25 mg/kg) and low dose oral ketamine (3 mg/kg) provides better premedication than oral midazolam (0.5 mg/kg) or oral ketamine (6 mg/kg). Seventy-eight children of ASA physical status I or II scheduled for elective ophthalmic surgery were randomly divided into three groups and given premedication in the holding area 30 minutes before surgery. Two subjects from each group vomited the medication and were excluded, leaving 72 subjects for further analysis. The onset of sedation was earlier in the combination group than the other two groups. At 10 minutes after premedication 12.5% in the combination group had an acceptable sedation score compared with none in the other two groups. After 20 minutes 54% in the combination group had an acceptable sedation score, 21% in the midazolam group and 16% in the ketamine group (P<0.05). There were no significant differences in the parental separation score, response to induction and emergence score. The mean time for best parental separation score was significantly less in the combination group (19±8 min) than either the midazolam (28±7) or ketamine (29±7 min) groups (P<0.05). Recovery was earlier in the combination group, as the time required to reach a modified Aldrete score of 10 was significantly less in the combination group (22±5 min) than in the oral midazolam (36±11 min) or ketamine (38±8 min) groups. The incidence of excessive salivation was significantly higher in the ketamine alone group (P<0.05). In conclusion, the combination of oral ketamine (3 mg/kg) and midazolam (0.25 mg/kg) has minimal side effects and gives a faster onset and more rapid recovery than ketamine 6 mg/kg or midazolam 0.5 mg/kg for premedication in children.
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Affiliation(s)
- V Darlong
- Department of Anaesthesia and Intensive Care, All India Institute of Medical Sciences, New Delhi, India
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19
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Catlin C, Farrell TW, Naik A, Widera E, Moye J. AMERICAN GERIATRICS SOCIETY MEMBER SURVEY ON THE “UNBEFRIENDED”. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.3247] [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: 11/12/2022] Open
Affiliation(s)
- C Catlin
- Boston VA Research Institute, Providence, Rhode Island, United States
| | | | - A Naik
- Baylor College of Medicine, Houston, TX, USA
| | - E Widera
- University of California, San Francisco, San Francisco, CA, USA
| | - J Moye
- New England Geriatric Research Education and Clinical Center, Boston, MA, USA
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20
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Makris UE, Fraenkel L, Naik A, Cary Reid M. IMPROVING OUTCOMES FOR OLDER VETERANS WITH CHRONIC BACK PAIN AND DEPRESSION: INTERVENTION DEVELOPMENT. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.3039] [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: 11/13/2022] Open
Affiliation(s)
- U E Makris
- VA North Texas Health Care System, Dallas, Texas, United States
| | - L Fraenkel
- VA Connecticut Health Care System, West Haven, CT, USA; Yale University, New Haven, CT, USA
| | - A Naik
- MIchael E. DeBakey VA Medical Center, Houston, TX, USA; Baylor College of Medicine, Houston, TX, USA
| | - M Cary Reid
- Weill Cornell Medical College, New York, NY, USA
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21
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Rana S, Naik A, Pillai S, Massimino K, Vetto J, Pommier R, Kubicky CD. Outcomes of Intraoperative Radiotherapy for Breast Cancer: Experience from a Multidisciplinary Breast Oncology Program at an NCI Designated Cancer Center. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.695] [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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22
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Flynn PM, John MT, Naik A, Kohli N, VanWormer JJ, Self K. Psychometric properties of the English version of the Oral Health Literacy Adults Questionnaire - OHL-AQ. Community Dent Health 2017; 33:274-280. [PMID: 28537364 DOI: 10.1922/cdh_3868flynn07] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 02/01/2016] [Indexed: 11/11/2022]
Abstract
Objective To test the psychometric properties of the Oral Health Literacy Adult Questionnaire (OHL-AQ) in English. The OHL-AQ was designed to test functional oral health literacy in general populations and was initially validated in Iran. Methods The instrument was administered to 405 adult subjects (mean age 45 (SD 16) years and 67% female) attending the 2014 Minnesota State Fair. The OHL-AQ is composed of 17 items measuring four conceptual dimensions: reading comprehension, numeracy, listening, and decision-making. Participants selected the best answer for written or verbally administered items and entered answers on an electronic tablet. Item responses for each individual were combined into a summary score (range 0-17) with higher scores indicating better oral health literacy. Score dimensionality, reliability, and validity were investigated. Results For dimensionality, both exploratory factor analysis and a parallel analysis yielded evidence for scale unidimensionality. Reliability was sufficient indicated by a Cronbach's alpha ⟩0.74. Validity of scores was supported by "small" and "medium" effect sizes for construct validity. "Small" effect sizes were observed for global oral health self-report, OHIP-5 scores, treatment urgency, and having a regular dentist. "Medium" effect sizes were seen for presence of dentures, number of natural teeth present, and educational level. Conclusions Dimensionality, reliability and validity of the English version of the OHL-AQ in a general adult English-speaking population is supported, providing sufficient psychometric properties in an important target population of the instrument.
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Affiliation(s)
- P M Flynn
- Department of Primary Dental Care, University of Minnesota School of Dentistry, USA
| | - M T John
- Department of Diagnostic and Biological Sciences, University of Minnesota School of Dentistry, USA
| | - A Naik
- Department of Diagnostic and Biological Sciences, University of Minnesota School of Dentistry, USA
| | - N Kohli
- Department of Educational Psychology, College of Human Development, University of Minnesota, USA
| | - J J VanWormer
- Center for Clinical Epidemiology & Population Health, Marshfield Clinic Research Foundation, Marshfield Clinic, Wisconsin, USA
| | - K Self
- Department of Primary Dental Care, University of Minnesota School of Dentistry, USA
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23
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Narasimhan C, Sanyal J, Sethi R, Kothari Y, Malik FTN, Pandurangi U, Khan N, Sahu S, Lande J, Sachanandani H, Naik A. Under-utilization of pacemaker therapy for sinus node dysfunction - Real world data from South Asia. Indian Heart J 2017; 69:607-612. [PMID: 29054184 PMCID: PMC5650562 DOI: 10.1016/j.ihj.2017.02.013] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 02/20/2017] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Chronic symptomatic sinus node dysfunction (SND), the most common bradyarrhythmia, can be effectively managed by permanent cardiac pacing. Yet the care pathway and barriers to adoption of pacing therapy are not well understood - particularly in low volume implanting countries. The IMPROVE Brady study is a quality improvement initiative being conducted at centers in South Asia, Latin America, and Russia. We assessed the rates of SND diagnosis and pacemaker treatment for SND in the South Asia cohort. METHODS The prospective study enrolled patients with heart rate of ≤50 beats per minute presenting with symptoms including syncope, dizziness, and/or dyspnea from ten centers in India and Bangladesh. Patients were followed to identify the proportion diagnosed with SND and subsequently treated with pacemaker therapy. RESULTS A total of 508 patients meeting criteria were enrolled and followed on average for 8.3±8.0months. Patients were on average 58 years of age, 77% were male, and 91% had completed at least primary education. An SND diagnosis was made in 368 (72%) of patients, with the majority (80%) of diagnoses occurring within 1 month of enrollment. Of the patients with an SND diagnosis, 63 (17%) were treated with a pacemaker. Reasons for not receiving treatment were: subject refusal or deferred decision (45%), unaffordability (34%), physician determined - not-indicated (20%), and other (1%). Older age, female gender, history of hypertension, lower resting heart rate, and syncopal or pre-syncopal symptoms were associated with a higher probability of implant. CONCLUSIONS In a care pathway assessment for the diagnosis and treatment of symptomatic SND in South Asia only 1 in 6 patients received pacemaker indicated therapy, largely due to patient refusal and physician decision. Phase II of the study will be aimed to improve this treatment rate.
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Affiliation(s)
- C Narasimhan
- Division of Electrophysiology, Department of Cardiology, CARE Hospitals and CARE Foundation, Hyderabad, India.
| | - J Sanyal
- Mission Hospital, Bidhannagar Durgapur, West Bengal, India
| | - R Sethi
- King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Y Kothari
- RajaRajeswari Medical College & Hospital, Bangalore, Karnataka, India
| | - F T N Malik
- National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh
| | - U Pandurangi
- Madras Medical Mission Institute of Cardiovascular Diseases, Chennai, Tamil Nadu, India
| | - N Khan
- United Hospital Limited, Dhaka, Bangladesh
| | - S Sahu
- India Medtronic Pvt. Ltd., Mumbai, Maharashtra, India
| | - J Lande
- Medtronic plc, Mounds View, MN, USA
| | | | - A Naik
- Care Institute of Medical Sciences, Ahmedabad, Gujarat, India
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Rathi SK, Desai VK, Jariwala P, Desai H, Naik A, Joseph A. Summer Temperature and Spatial Variability of all-Cause Mortality in Surat City, India. Indian J Community Med 2017; 42:111-115. [PMID: 28553029 PMCID: PMC5427860 DOI: 10.4103/0970-0218.205216] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 11/09/2022] Open
Abstract
Background: Ample information is available on extreme heat associated mortality for few Indian cities, but scant literature is available on effect of temperature on spatial variability of all-cause mortality for coastal cities. Objective: To assess the effect of daily maximum temperature, relative humidity and heat index on spatial variability of all-cause mortality for summer months (March to May) from 2014 to 2015 for the urban population of Surat (coastal) city. Materials and Methods: Retrospective analysis of the all-cause mortality data with temperature and humidity was performed on a total of 9,237 deaths for 184 summer days (2014-2015). Climatic and all-cause mortality data were obtained through Tutiempo website and Surat Municipal Corporation respectively. Bivariate analysis performed through SPSS. Observations: Mean daily mortality was estimated at 50.2 ± 8.5 for the study period with a rise of 20% all-cause mortality at temperature ≥ 40°C and rise of 10% deaths per day during extreme danger level (HI: > 54°C) days. Spatial (Zone wise) analysis revealed rise of 61% all-cause mortality for Southeast and 30% for East zones at temperature ≥ 40°C. Conclusions: All-cause mortality increased on high summer temperature days. Presence of spatial variation in all-cause mortality provided the evidence for high risk zones. Findings may be helpful in designing the interventions at micro level.
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Affiliation(s)
- S K Rathi
- Urban Health and Climate Resilience Centre, Surat, Gujarat, India
| | - V K Desai
- Urban Health and Climate Resilience Centre, Surat, Gujarat, India
| | - P Jariwala
- Urban Health and Climate Resilience Centre, Surat, Gujarat, India
| | - H Desai
- Health Department, Surat Municipal Corporation, Surat, Gujarat, India
| | - A Naik
- Health Department, Surat Municipal Corporation, Surat, Gujarat, India
| | - A Joseph
- Health Department, Surat Municipal Corporation, Surat, Gujarat, India
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Crowe-White K, Ellis A, Locher J, Mehta T, Naik A, Ard J. Relationships between Cardiometabolic Disease Staging and Serum Antioxidant Capacity in Obese Older Adults. J Acad Nutr Diet 2016. [DOI: 10.1016/j.jand.2016.06.337] [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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Naik A, Gurjar O, Bagdare P, Gupta K, Bhandari V, Kausar M, Ladia D, Mittal H. Dosimetric comparison between intensity modulated radiotherapy and three dimensional conformal radiotherapy planning in patients with locally advanced cervical carcinoma. INT J RADIAT RES 2016. [DOI: 10.18869/acadpub.ijrr.14.3.189] [Citation(s) in RCA: 3] [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: 11/09/2022]
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Vora A, Kapoor A, Nair M, Lokhandwala Y, Narsimhan C, Ravikishore AG, Dwivedi SK, Namboodiri N, Hygriv R, Saxena A, Nabar A, Garg S, Bardoloi N, Yadav R, Nambiar A, Pandurangi U, Jhala D, Naik A, Nagmallesh, Rajagopal S, Selvaraj R, Arora V, Thachil A, Thomas J, Panicker G. Clinical presentation, management, and outcomes in the Indian Heart Rhythm Society-Atrial Fibrillation (IHRS-AF) registry. Indian Heart J 2016; 69:43-47. [PMID: 28228305 PMCID: PMC5319007 DOI: 10.1016/j.ihj.2016.06.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 05/22/2016] [Accepted: 06/10/2016] [Indexed: 11/08/2022] Open
Abstract
Aim A national atrial fibrillation (AF) registry was conducted under the aegis of the Indian Heart Rhythm Society (IHRS), to capture epidemiological data-type of AF, clinical presentation and comorbidities, current treatment practices, and 1-year follow-up outcomes. Methods A total of 1537 patients were enrolled from 24 sites in India in the IHRS-AF registry from July 2011 to August 2012. Their baseline characteristics and follow-up data were recorded in case report forms and subsequently analyzed. Results The average age of Indian AF patients was 54.7 years. There was a marginal female preponderance – 51.5% females and 48.5% males. At baseline, 20.4% had paroxysmal AF; 33% had persistent AF; 35.1% had permanent AF and 11% had first AF episode. At one-year follow-up, 45.6% patients had permanent AF. Rheumatic valvular heart disease (RHD) was present in 47.6% of patients. Hypertension, heart failure, coronary artery disease, and diabetes were seen in 31.4%, 18.7%, 16.2%, and 16.1%, respectively. Rate control was the strategy used in 75.2% patients, digoxin and beta-blockers being the most frequently prescribed rate-control drugs. Oral anticoagulation (OAC) drugs were used in 70% of patients. The annual mortality was 6.5%, hospitalization 8%, and incidence of stroke 1%. Conclusions In India, AF patients are younger and RHD is still the most frequent etiology. Almost two-third of the patients have persistent/permanent AF. At one-year follow-up, there is a significant mortality and morbidity in AF patients in India.
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Affiliation(s)
- A Vora
- Arrhythmia Associates, Mumbai, India.
| | - A Kapoor
- Department of Cardiology, Sanjay Gandhi Post-Graduate Institute, Lucknow, India
| | - M Nair
- Holy Family Hospital, New Delhi, India
| | | | - C Narsimhan
- Division of Electrophysiology, Care Hospital, Hyderabad, India
| | | | - S K Dwivedi
- Department of Cardiology, King George Medical University, Lucknow, India
| | - N Namboodiri
- Department of Cardiology, Sri Chitra Trinumal Hospital, Trivandrum, India
| | - R Hygriv
- KIMS Hospitals, Hyderabad, India
| | - A Saxena
- Cardiac Pacing & Electrophysiology, Fortis Escorts Hospital, New Delhi, India
| | - A Nabar
- Department of Cardiology, KEM Hospital, Mumbai, India
| | - S Garg
- Maulana Azad Medical College, New Delhi, India
| | - N Bardoloi
- Cardiology Department, Apollo Hospital, Guwahati, India
| | - R Yadav
- Department of Cardiology, AIIMS Hospital, New Delhi, India
| | - A Nambiar
- Cardiology, Baby Memorial Hospital, Kozhikode, India
| | | | - D Jhala
- Lilavati Hospital, Mumbai, India
| | - A Naik
- Division of Electrophysiology, CIMS Hospital, Ahmedabad, India
| | - Nagmallesh
- M.S. Ramaiah Memorial Hospital, Bengaluru, India
| | - S Rajagopal
- Department of Cardiology, Railway Hospital, Chennai, India
| | - R Selvaraj
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - V Arora
- Division of Electrophysiology, Max Superspeciality Hospital, Delhi, India
| | - A Thachil
- Division of Electrophysiology, Lisie Hospital, Kochi, India
| | - J Thomas
- Frontier Lifeline Hospital, Chennai, India
| | - G Panicker
- Quintiles Cardiac Safety Services, Mumbai, India
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Sakhuja A, Naik A, Amer H, Cibrik D, Eikstadt R, Schold JD, Stegall MD. Underutilization of Timely Kidney Transplants in Those With Living Donors. Am J Transplant 2016; 16:1007-14. [PMID: 26845755 DOI: 10.1111/ajt.13592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 07/26/2015] [Revised: 10/06/2015] [Accepted: 10/22/2015] [Indexed: 01/25/2023]
Abstract
Preemptive kidney transplant (PKTx) and kidney transplant (KTx) within 1 year of dialysis initiation have been associated with superior outcomes. Wait times should be minimal for transplants with living donors; however, there is lack of literature studying utilization of timely KTx in this population. We designed this retrospective study using data from United Network for Organ Sharing Standard Transplant Analysis and Research files from 2000 to 2012 to assess the trends in utilization of PKTx and Early KTx (combination of PKTx or transplant within 1 year of dialysis initiation) in recipients of living donor KTx. Only 32.6% transplants were PKTx, and 61.9% were Early KTx. A significant improvement in proportion of PKTx was seen from 27.5% in 2000 to 35.4% in 2006, with no change since. Similarly, the proportion of Early KTx increased from 61.4% in 2000 to 63.6% in 2006, with no increase since. Similar results were seen after adjusted analysis and were independent of living donor type. Although there was some improvement in utilization of timely transplants in the early part of the last decade, there has been no improvement since. Considering the benefits of timely kidney transplant, it is important to understand the reasons behind the same and to improve utilization.
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Affiliation(s)
- A Sakhuja
- Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
| | - A Naik
- Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
| | - H Amer
- Division of Nephrology and Hypertension, William J. von Liebig Center for Transplantation, Mayo Clinic, Rochester, MN
| | - D Cibrik
- Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
| | - R Eikstadt
- Kidney Epidemiology and Cost Center, University of Michigan, Ann Arbor, MI
| | - J D Schold
- Department of Nephrology and Hypertension and Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH
| | - M D Stegall
- Division of Transplant Surgery, Departments of Surgery and Immunology, William J von Liebig Center for Transplantation, Mayo Clinic, Rochester, MN
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Vora A, Lokhandwala Y, Naik A, Chopra A, Wander G, Verma J, Jaswal A, Srikanthan V, Kahali D, Singh B, Sahu S, Radhakrishnan R. Profiling arrhythmia & heart failure patients in India – The panarrhythmia & heart failure registry. Indian Heart J 2014. [DOI: 10.1016/j.ihj.2014.10.359] [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] Open
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Sciancalepore AG, Sallustio F, Girardo S, Passione LG, Camposeo A, Mele E, Di Lorenzo M, Costantino V, Schena FP, Pisignano D, Casino FG, Mostacci SD, Di Carlo M, Sabato A, Procida C, Creput C, Vanholder R, Stolear JC, Lefrancois G, Hanoy M, Nortier J, Potier J, Sereni L, Ferraresi M, Pereno A, Nazha M, Barbero S, Piccoli GB, Ficheux A, Gayrard N, Duranton F, Guzman C, Szwarc I, Bismuth -Mondolfo J, Brunet P, Servel MF, Argiles A, Bernardo A, Demers J, Hutchcraft A, Marbury TC, Minkus M, Muller M, Stallard R, Culleton B, Krieter DH, Korner T, Devine E, Ruth M, Jankowski J, Wanner C, Lemke HD, Surace A, Rovatti P, Steckiph D, Mancini E, Santoro A, Leypoldt JK, Agar BU, Bernardo A, Culleton BF, Vankova S, Havlin J, Klomp DJ, Van Beijnum F, Day JPR, Wieringa FP, Kooman JP, Gremmels H, Hazenbrink DH, Simonis F, Otten ML, Wester M, Boer WH, Joles JA, Gerritsen KG, Umimoto K, Shimamoto Y, Mastushima K, Miyata M, Muller M, Naik A, Pokropinski S, Bairstow S, Svatek J, Young S, Johnson R, Bernardo A, Rikker C, Juhasz E, Gaspar R, Rosivall L, Rusu E, Zilisteanu D, Balanica S, Achim C, Atasie T, Carstea F, Voiculescu M, Monzon Vazquez T, Saiz Garcia S, Mathani V, Escamilla Cabrera B, Cornelis T, Van Der Sande FM, Eloot S, Cardinaels E, Bekers O, Damoiseaux J, Leunissen KM, Kooman J, Baamonde Laborda E, Bosch Benitez-Parodi E, Perez Suarez G, Anton Perez G, Batista Garcia F, Lago Alonso M, Garcia Canton C, Hashimoto S, Seki M, Tomochika M, Yamamoto R, Okamoto N, Nishikawa A, Koike T, Ravagli E, Maldini L, Badiali F, Perazzini C, Lanciotti G, Steckiph D, Surace A, Rovatti P, Severi S, Rigotti A, McFarlane P, Marticorena R, Dacouris N, Pauly R, Nikitin S, Amdahl M, Bernardo A, Culleton B, Calabrese G, Mancuso D, Mazzotta A, Vagelli G, Balenzano C, Steckiph D, Bertucci A, Della Volpe M, Gonella M, Uchida T, Ando K, Kofuji M, Higuchi T, Momose N, Ito K, Ueda Y, Miyazawa H, Kaku Y, Nabata A, Hoshino T, Mori H, Yoshida I, Ookawara S, Tabei K, Umimoto K, Suyama M, Shimamoto Y, Miyata M, Kamada A, Sakai R, Minakawa A, Fukudome K, Hisanaga S, Ishihara T, Yamada K, Fukunaga S, Inagaki H, Tanaka C, Sato Y, Fujimoto S, Potier J, Bouet J, Queffeulou G, Bell R, Nolin L, Pichette V, Provencher H, Lamarche C, Nadeau-Fredette AC, Ouellet G, Leblanc M, Bezzaoucha S, Kouidmir Y, Kassis J, Alonso ML, Lafrance JP, Vallee M, Fils J, Mailley P, Cantaluppi V, Medica D, Quercia AD, Dellepiane S, Ferrario S, Gai M, Leonardi G, Guarena C, Caiazzo M, Biancone L, Enos M, Culleton B, Wiebenson D, Potier J, Hanoy M, Duquennoy S, Tingli W, Ling Z, Yunying S, Ping F, Dolley-Hitze T, Hamel D, Lombart ML, Leypoldt JK, Bernardo A, Hutchcraft AM, Vanholder R, Culleton BF, Movilli E, Camerini C, Gaggia P, Zubani R, Feller P, Pola A, Carli O, Salviani C, Manenti C, Cancarini G, Bozzoli L, Colombini E, Ricchiuti G, Pisanu G, Gargani L, Donadio C, Sidoti A, Lusini ML, Biagioli M, Ghezzi PM, Sereni L, Caiazzo M, Palladino G, Tomo T, Ishida K, Nakata T, Hamel D, Dolley-Hitze T. HAEMODIALYSIS TECHNIQUES AND ADEQUACY 1. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu153] [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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Chon WJ, Josephson MA, Gordon EJ, Becker YT, Witkowski P, Arwindekar DJ, Naik A, Thistlethwaite JR, Liao C, Ross LF. When the living and the deceased cannot agree on organ donation: a survey of US organ procurement organizations (OPOs). Am J Transplant 2014; 14:172-7. [PMID: 24369025 DOI: 10.1111/ajt.12519] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The legal concept of first person authorization (FPA) is based on the principle that a decision by a person with decision-making capacity should be respected even after he or she dies. Although the transplant community largely supports this concept, its implementation has not been universal. We conducted a web-based survey of all 58 Organ Procurement Organization (OPO)executive directors in the United States to assess OPOs' procurement policies and practices in the context of family objections. All 58 respondents(100%) responded to our survey. All OPOs except one have an online donor registration website. Most OPOs(89%) (51 of 57 respondents) estimated that the frequency of family objecting to organ donation in cases of registered donors was <10%. No OPOs reported the frequency to be higher than 25%. Only 50% (27 of 54) of the OPOs have a written policy on handling family objections. Approximately 80% of the OPOs reported honoring FPA. However, in the past 5 years, 20 OPOs (35%) have not yet participated in organ procurement from a registered deceased donor over family objection. Further research to identify the barriers and possible solutions to implementing FPA is warranted.
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Bastian D, Lorgat F, Sweidan R, Kuznetsov V, Naik A, Escudero J, Becker D, Sepsi M. ICD/CRT-D implantation and programming: Western Europe compared to other regions. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kuznetsov VA, Pokushalov E, Al Kandary F, Ebrahim I, De Vusser P, Naik A, Escudero J, Gerritse B, Sepsi M. Worldwide geographic differences of patients selected for cardiac resynchronization therapy. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Naik A, Gupta N, Goel D, Ippagunta SK, Sharma RK, Aggarwal R. Lack of evidence of hepatitis E virus infection among renal transplant recipients in a disease-endemic area. J Viral Hepat 2013; 20:e138-40. [PMID: 23490383 DOI: 10.1111/jvh.12027] [Citation(s) in RCA: 33] [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: 07/01/2012] [Accepted: 09/01/2012] [Indexed: 12/09/2022]
Abstract
Persistent hepatitis E virus (HEV) infection has been reported among solid-organ transplant recipients in nonendemic areas. Such chronic infections have all been related to genotype 3 HEV, which is prevalent in these areas. Whether persistent infection occurs with genotype 1 HEV, prevalent in areas where the infection is hyperendemic, is unclear. We therefore tested sera from renal transplant recipients receiving immunosuppressive agents in India, where genotype 1 HEV infection is endemic, for alanine aminotransferase levels, and presence of IgM and IgG anti-HEV antibodies and HEV RNA. Of the 205 subjects studied [aged 16-65 (median, 38) years, 182 male], 46 (22.4%) had abnormal ALT levels (>40 IU/mL). IgG anti-HEV was detected in 52 (20.5%) and IgM anti-HEV was detected in 14 (6.8%) subjects, including four who had IgG anti-HEV; antibody positivity had no relation with serum ALT or serum creatinine. All the sera tested were negative for HEV RNA. These findings suggest that chronic infection with genotype 1 HEV is infrequent.
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Affiliation(s)
- A Naik
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Abstract
Pharmaceutical care signifies a shift of practice in pharmacy from being drug product-oriented to the one that is patient-oriented to achieve definite outcomes that improves patients’ quality of life. In order to achieve pharmaceutical care, pharmacists have to assume the role of caregiver, communicator, decision-maker, teacher, researcher, life-long learner, leader, and manager, which will help him to provide individualized care. As the patients visit community pharmacists more often, they can play a major role in providing individual care to the patients especially in the management of chronic noncommunicable diseases (NCDs). Community pharmacists have to upgrade their expertise in drug product orientation to that of clinical orientation to provide patient oriented care. Hence pharmacists have a larger role to play in managing NCDs which are rapidly increasing in India.
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Affiliation(s)
- A Tumkur
- Department of Pharmacy Management, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal, India
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Barden G, Naik A, Artinyan A, Berger D, Petersen N, Walder A, Sansgiri S, Anaya⁎ D. Baseline characteristics and health-related quality of life outcomes in elderly patients following cancer surgery. J Geriatr Oncol 2012. [DOI: 10.1016/j.jgo.2012.10.130] [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: 11/30/2022]
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Nagare N, Damre A, Singh KS, Mallurwar SR, Iyer S, Naik A, Chintamaneni M. Determination of site of absorption of propranolol in rat gut using in situ single-pass intestinal perfusion. Indian J Pharm Sci 2011; 72:625-9. [PMID: 21694996 PMCID: PMC3116309 DOI: 10.4103/0250-474x.78533] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2009] [Revised: 04/17/2010] [Accepted: 09/17/2010] [Indexed: 11/04/2022] Open
Abstract
Previously, permeability and site of intestinal absorption of propranolol have been reported using the Ussing chamber. In the present study, the utility of Single-Pass Intestinal Perfusion to study permeability and site of intestinal absorption of propranolol was evaluated in rats. Drug permeability in different regions of rat intestine viz. duodenum, jejunum, ileum and colon was measured. Propranolol (30 μg/ml) solution was perfused in situ in each intestinal segment of rats. Effective permeability (Peff) of propranolol in each segment was calculated and site of absorption was determined. The Peff of propranolol in rat duodenum, jejunum, ileum and colon was calculated to be 0.3316×10(-4) cm/s, 0.4035×10(-4)cm/s, 0.5092×10(-4) cm/s and 0.7167×10(-4) cm/s, respectively. The above results suggest that permeability of propranolol was highest through colon compared to other intestinal sites, which is in close agreement to that reported previously. In conclusion, in situ single pass intestinal perfusion can be used effectively to study intestinal permeability as well as site of intestinal absorption of compounds in rats.
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Affiliation(s)
- N Nagare
- School of Pharmacy and Technology Management, NMIMS University, V. L. Mehta Road, Vile-Parle (W), Mumbai-400 056, India
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Nawal RR, Parande M, Sehgal R, Naik A, Rao NR. A comparative evaluation of antimicrobial efficacy and flow properties for Epiphany, Guttaflow and AH-Plus sealer. Int Endod J 2011; 44:307-13. [DOI: 10.1111/j.1365-2591.2010.01829.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Babu S, Venkataramana N, Kamble R, Rao S, Naik A, Shetty R. Primary Hypothyroidism Presenting as a Sellar Mass Which Regressed with Thyroid Hormone Therapy. Neuroradiol J 2010; 23:433-6. [DOI: 10.1177/197140091002300411] [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] [Received: 05/30/2010] [Accepted: 05/31/2010] [Indexed: 11/15/2022] Open
Abstract
We describe a15-year-old girl presenting with compensatory pituitary enlargement due to primary hypothyroidism. The hyperplasia regressed following thyroxine administration. The clinical, laboratory and MRI features of the patients are described and the mechanisms of pituitary gland enlargement are discussed.
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Affiliation(s)
- S. Babu
- BGS Global Hospital; Bangalore, Karnataka, India
| | | | - R.B. Kamble
- BGS Global Hospital; Bangalore, Karnataka, India
| | - S.A.V. Rao
- BGS Global Hospital; Bangalore, Karnataka, India
| | - A. Naik
- BGS Global Hospital; Bangalore, Karnataka, India
| | - R.V. Shetty
- BGS Global Hospital; Bangalore, Karnataka, India
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Shannon J, Ho E, Naik A, Troxell M, Cox A, Maxcy C, Vetto JT. Sulforaphane supplementation in women newly diagnosed with DCIS: A biomarker study. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.tps143] [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: 11/20/2022] Open
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Karami G, Grundman N, Abolfathi N, Naik A, Ziejewski M. A micromechanical hyperelastic modeling of brain white matter under large deformation. J Mech Behav Biomed Mater 2009; 2:243-54. [DOI: 10.1016/j.jmbbm.2008.08.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2008] [Revised: 08/21/2008] [Accepted: 08/22/2008] [Indexed: 10/21/2022]
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Abolfathi N, Naik A, Sotudeh Chafi M, Karami G, Ziejewski M. A micromechanical procedure for modelling the anisotropic mechanical properties of brain white matter. Comput Methods Biomech Biomed Engin 2009; 12:249-62. [PMID: 18846460 DOI: 10.1080/10255840903097871] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This paper proposes a micromechanics algorithm utilising the finite element method (FEM) for the analysis of heterogeneous matter. The characterisation procedure takes the material properties of the constituents, axons and extracellular matrix (ECM) as input data. The material properties of both the axons and the matrix are assumed to have linear viscoelastic behaviour with a perfect bonding between them. The results of the modelling have been validated with experimental data with material white input from brainstem by considering the morphology of brainstem in which most axons are oriented in longitudinal direction in the form of a uniaxial fibrous composite material. The method is then employed to examine the undulations of axons within different subregions of white matter and to study the impact due to axon/matrix volume fractions. For such purposes, different unit cells composed of wavy geometries and with various volume factions have been exposed to the six possible loading scenarios. The results will clearly demonstrate the undulation and axon volume fraction impacts. In this respect, undulation affects the material stiffness heavily in the axon longitudinal direction, whereas the axons' volume fraction has a much greater impact on the mechanical properties of the white matter in general. Also the results show that the created stresses and strains in the axons and matrix under loading will be impacted by undulation change. With increase in undulation the matrix suffers higher stresses when subjected to tension, whereas axons suffer higher stresses in shear. The axons always exhibit higher stresses whereas the matrix exhibits higher strains. The evaluated time-dependent local stress and strain concentrations within a repeating unit cell of the material model are indicative of the mechanical behaviour of the white tissue under different loading scenarios.
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Affiliation(s)
- N Abolfathi
- Department of Mechanical Engineering and Applied Mechanics, North Dakota State University, Fargo, ND, USA
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Abolfathi N, Naik A, Sotudeh Chafi M, Karami G, Ziejewski M. A micromechanical procedure for modelling the anisotropic mechanical properties of brain white matter. Comput Methods Biomech Biomed Engin 2009. [DOI: 10.1080/10255840802430587] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [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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Wiedersberg S, Naik A, Leopold CS, Guy RH. Pharmacodynamics and dermatopharmacokinetics of betamethasone 17-valerate: assessment of topical bioavailability. Br J Dermatol 2008; 160:676-86. [PMID: 18782322 DOI: 10.1111/j.1365-2133.2008.08757.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [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
BACKGROUND The bioavailability of most topically delivered drugs is difficult to quantify, but is generally believed to be very low. With the exception of the vasoconstrictor assay for corticosteroids, no methodology to quantify the rate and extent of drug delivery to the skin has been validated. Recent research has examined the dermatopharmacokinetic (DPK) technique, which is based on stratum corneum (SC) tape-stripping. OBJECTIVE To compare the in vivo bioavailability of different topical formulations of betamethasone 17-valerate (BMV) using the vasoconstrictor assay and the DPK method. METHODS BMV was formulated in different vehicles and the drug concentration was adjusted to either (i) equal thermodynamic activity, or (ii) a range of values up to that corresponding to 80% of maximum thermodynamic activity. Vasoconstriction, an accepted and widely used method to determine bioavailability and bioequivalence of topical steroids, was quantified with a chromameter over 24 h post-removal of the formulation. Drug uptake into the SC was assessed by tape-stripping. RESULTS BMV at the same thermodynamic activity in different vehicles provoked similar skin blanching responses, while DPK profiles distinguished between the formulations. Further, skin blanching responses and drug uptake into the SC clearly depended upon the absolute BMV concentration applied. However, while the saturable nature of the pharmacodynamic response was clear, the tape-stripping method distinguished unequivocally between the different formulations and different concentrations. CONCLUSIONS The DPK approach offers a reliable metric with which to quantify transfer of drug from the vehicle to the SC, and may be useful for topical bioavailability and bioequivalence determinations.
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Affiliation(s)
- S Wiedersberg
- Department of Pharmacy & Pharmacology, University of Bath, Claverton, Bath, BA2 7AY, UK
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Krishnamurthy S, Kumar S, Naik A, Deshmane V. Cancer risk in patients with chronic lymphocytic thyroiditis. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.17028] [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] Open
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Affiliation(s)
- A Grillo
- Institute of Internal Medicine, Catholic University, Rome, Italy
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Dias M, Naik A, Guy RH, Hadgraft J, Lane ME. In vivo infrared spectroscopy studies of alkanol effects on human skin. Eur J Pharm Biopharm 2008; 69:1171-5. [PMID: 18406117 DOI: 10.1016/j.ejpb.2008.02.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [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: 01/07/2008] [Revised: 02/09/2008] [Accepted: 02/11/2008] [Indexed: 11/17/2022]
Abstract
Many studies investigate the permeation of actives through the skin and ignore the role of excipients. The solvents used in formulations will undoubtedly penetrate the skin where they can have a number of effects. They can extract skin lipids, they can alter the fluidity of the lipids and they can alter the polarity of the skin. The degree to which they do this and the depth into the skin where this occurs will depend on the uptake kinetics. The problem is to distinguish the different effects. Using ATR-FTIR and deuterated materials this can be achieved in vivo. The aim of the present study was to study the higher alkanols (hexanol, octanol, decanol) in vivo using a combination of ATR-FTIR spectroscopy and tape stripping. Studies conducted in vivo using deuterated vehicles confirmed the lipid extraction effects of d-hexanol and d-octanol, whereas d-decanol did not change skin lipid content. The uptake of d-decanol was higher than for the other vehicles consistent with previous observations on mouse skin for alkanols of increasing chain length. In general, solvent uptake was proportional to the induced shift in the C-H stretching frequency. Lipid disorder was induced by all vehicles studied in vivo and was proportional to the amount of vehicle present in the skin.
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Affiliation(s)
- M Dias
- Department of Pharmaceutics, University of London, London, UK
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Cázares-Delgadillo J, Naik A, Ganem-Rondero A, Quintanar-Guerrero D, Kalia YN. Transdermal Delivery of Cytochrome C—A 12.4 kDa Protein—Across Intact Skin by Constant–Current Iontophoresis. Pharm Res 2007; 24:1360-8. [PMID: 17457661 DOI: 10.1007/s11095-007-9294-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2006] [Accepted: 03/12/2007] [Indexed: 10/23/2022]
Abstract
PURPOSE To demonstrate the transdermal iontophoretic delivery of a small (12.4 kDa) protein across intact skin. MATERIALS AND METHODS The iontophoretic transport of Cytochrome c (Cyt c) across porcine ear skin in vitro was investigated and quantified by HPLC. The effect of protein concentration (0.35 and 0.7 mM), current density (0.15, 0.3 or 0.5 mA.cm(-2) applied for 8 h) and competing ions was evaluated. Co-iontophoresis of acetaminophen was employed to quantify the respective contributions of electromigration (EM) and electroosmosis (EO). RESULTS The data confirmed the transdermal iontophoretic delivery of intact Cyt c. Electromigration was the principal transport mechanism, accounting for approximately 90% of delivery; correlation between EM flux and electrophoretic mobility was consistent with earlier results using small molecules. Modest EO inhibition was observed at 0.5 mA.cm(-2). Cumulative permeation at 0.3 and 0.5 mA.cm(-2) was significantly greater than that at 0.15 mA.cm(-2); fluxes using 0.35 and 0.7 mM Cyt c in the absence of competing ions (J ( tot ) = 182.8 +/- 56.8 and 265.2 +/- 149.1 microg.cm(-2).h(-1), respectively) were statistically equivalent. Formulation in PBS (pH 8.2) confirmed the impact of competing charge carriers; inclusion of approximately 170 mM Na(+) resulted in a 3.9-fold decrease in total flux. CONCLUSIONS Significant amounts ( approximately 0.9 mg.cm(-2) over 8 h) of Cyt c were delivered non-invasively across intact skin by transdermal electrotransport.
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Affiliation(s)
- J Cázares-Delgadillo
- School of Pharmaceutical Sciences, University of Geneva & University of Lausanne, 30 Quai Ernest Ansermet, 1211, Geneva, Switzerland
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Naik A. Long QT syndrome revisited. J Assoc Physicians India 2007; 55 Suppl:58-61. [PMID: 18368869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Congenital Long QT Syndrome (cLQTS) is an inherited disease in children and adolescents who have structurally normal hearts but present with sudden death in a high proportion of untreated patients. More than 300 mutations have been identified in 7 LQT genes. Diagnosis still depends on ECG, clinical presentations and family history. Molecular genetic testing is useful to unravel borderline family members of LQT probands, but it continues to be a research tool at present. Beta blockers remain the mainstay of treatment. ICDs are highly effective in reducing SCD for high risk patients. Gene based therapy is still preliminary. Considerable thought is needed to address and treat the asymptomatic LQT family members. The main cause of Acquired LQTS is inhibition of Ikr current, usually by drugs. Care must be taken to avoid further exposure to QT prolonging drugs or conditions. Physicians need to be aware of the pharmacodynamic and pharmacokinetic interactions of various important drugs.
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Naik A, Buu O, LaHaye MD, Armour AD, Clerk AA, Blencowe MP, Schwab KC. Cooling a nanomechanical resonator with quantum back-action. Nature 2006; 443:193-6. [PMID: 16971944 DOI: 10.1038/nature05027] [Citation(s) in RCA: 464] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2006] [Accepted: 06/30/2006] [Indexed: 11/10/2022]
Abstract
Quantum mechanics demands that the act of measurement must affect the measured object. When a linear amplifier is used to continuously monitor the position of an object, the Heisenberg uncertainty relationship requires that the object be driven by force impulses, called back-action. Here we measure the back-action of a superconducting single-electron transistor (SSET) on a radio-frequency nanomechanical resonator. The conductance of the SSET, which is capacitively coupled to the resonator, provides a sensitive probe of the latter's position; back-action effects manifest themselves as an effective thermal bath, the properties of which depend sensitively on SSET bias conditions. Surprisingly, when the SSET is biased near a transport resonance, we observe cooling of the nanomechanical mode from 550 mK to 300 mK--an effect that is analogous to laser cooling in atomic physics. Our measurements have implications for nanomechanical readout of quantum information devices and the limits of ultrasensitive force microscopy (such as single-nuclear-spin magnetic resonance force microscopy). Furthermore, we anticipate the use of these back-action effects to prepare ultracold and quantum states of mechanical structures, which would not be accessible with existing technology.
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Affiliation(s)
- A Naik
- Laboratory for Physical Sciences, University of Maryland, College Park, Maryland 20740, USA
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