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Jordan A, Maraj B, Kinnucan J. Is it a Flare? Acute Appendicitis in Ulcerative Colitis Patient Found on Routine Screening Colonoscopy. Inflamm Bowel Dis 2022; 28:1472-1473. [PMID: 35700277 DOI: 10.1093/ibd/izac112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Indexed: 12/09/2022]
Affiliation(s)
- Ariel Jordan
- University of Michigan, Department of Internal Medicine, Ann Arbor, Michigan, USA
| | - Bharat Maraj
- University of Michigan, Department of Gastroenterology and Hepatology, Ann Arbor, Michigan, USA
| | - Jami Kinnucan
- Mayo Clinic-Jacksonville, Department of Gastroenterology, Jacksonville, Florida, USA
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Harding-Theobald E, Louissaint J, Maraj B, Cuaresma E, Townsend W, Mendiratta-Lala M, Singal AG, Su GL, Lok AS, Parikh ND. Systematic review: radiomics for the diagnosis and prognosis of hepatocellular carcinoma. Aliment Pharmacol Ther 2021; 54:890-901. [PMID: 34390014 PMCID: PMC8435007 DOI: 10.1111/apt.16563] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/08/2021] [Accepted: 07/25/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Advances in imaging technology have the potential to transform the early diagnosis and treatment of hepatocellular carcinoma (HCC) through quantitative image analysis. Computational "radiomic" techniques extract biomarker information from images which can be used to improve diagnosis and predict tumour biology. AIMS To perform a systematic review on radiomic features in HCC diagnosis and prognosis, with a focus on reporting metrics and methodologic standardisation. METHODS We performed a systematic review of all full-text articles published from inception through December 1, 2019. Standardised data extraction and quality assessment metrics were applied to all studies. RESULTS A total of 54 studies were included for analysis. Radiomic features demonstrated good discriminatory performance to differentiate HCC from other solid lesions (c-statistics 0.66-0.95), and to predict microvascular invasion (c-statistic 0.76-0.92), early recurrence after hepatectomy (c-statistics 0.71-0.86), and prognosis after locoregional or systemic therapies (c-statistics 0.74-0.81). Common stratifying features for diagnostic and prognostic radiomic tools included analyses of imaging skewness, analysis of the peritumoural region, and feature extraction from the arterial imaging phase. The overall quality of the included studies was low, with common deficiencies in both internal and external validation, standardised imaging segmentation, and lack of comparison to a gold standard. CONCLUSIONS Quantitative image analysis demonstrates promise as a non-invasive biomarker to improve HCC diagnosis and management. However, standardisation of protocols and outcome measurement, sharing of algorithms and analytic methods, and external validation are necessary prior to widespread application of radiomics to HCC diagnosis and prognosis in clinical practice.
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Affiliation(s)
- Emily Harding-Theobald
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - Jeremy Louissaint
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - Bharat Maraj
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - Edward Cuaresma
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - Whitney Townsend
- Division of Library Sciences, University of Michigan, Ann Arbor, MI, USA
| | | | - Amit G Singal
- Division of Digestive and Liver Diseases, University of Texas Southwestern, Dallas, TX, USA
| | - Grace L Su
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - Anna S Lok
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - Neehar D Parikh
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
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Sharpton SR, Maraj B, Harding-Theobald E, Vittinghoff E, Terrault NA. Gut microbiome-targeted therapies in nonalcoholic fatty liver disease: a systematic review, meta-analysis, and meta-regression. Am J Clin Nutr 2019; 110:139-149. [PMID: 31124558 PMCID: PMC6599739 DOI: 10.1093/ajcn/nqz042] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 02/27/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Preclinical evidence suggests that modulation of the gut microbiome could represent a new therapeutic target in nonalcoholic fatty liver disease (NAFLD). OBJECTIVES The aim of this study was to evaluate the most current evidence for liver-specific and metabolic effects of microbiome-targeted therapies (MTTs) in persons with NAFLD. METHODS We searched multiple electronic databases for randomized controlled trials (RCTs) published from January 1, 2005 to December 1, 2018 that enrolled persons with NAFLD who received MTT rather than placebo or usual care. MTT was defined as antibiotics, probiotics, synbiotics, or fecal microbiota transplantation (FMT). Clinical outcomes were pooled with the use of random-effects models and heterogeneity was assessed with the I2 statistic. A random-effects meta-regression was performed to determine sources of heterogeneity in prevalence estimates between studies. RESULTS Twenty-one RCTs (1252 participants) were included; 9 evaluated probiotics and 12 evaluated synbiotics, with treatment duration ranging from 8 to 28 wk. No RCTs examined the efficacy of antibiotics or FMT. Probiotics/synbiotics were associated with a significant reduction in alanine aminotransferase activity [ALT, weighted mean difference (WMD): -11.23 IU/L; 95% CI: -15.02, -7.44 IU/L] and liver stiffness measurement (LSM) by elastography (reflecting inflammation and fibrosis) (WMD: -0.70 kPa; 95% CI: -1.00, -0.40 kPa), although analyses showed heterogeneity (I2 = 90.6% and I2 = 93.4%, respectively). Probiotics/synbiotics were also associated with increased odds of improvement in hepatic steatosis, as graded by ultrasound (OR: 2.40; 95% CI: 1.50, 3.84; I2 = 22.4%). No RCTs examined sequential liver biopsy findings. Probiotics (WMD: -1.84; 95% CI: -3.30, -0.38; I2 = 23.6%), but not synbiotics (WMD: -0.85; 95% CI: -2.17, 0.47; I2 = 96.6%), were associated with a significant reduction in body mass index. CONCLUSIONS The use of probiotics/synbiotics was associated with improvement in liver-specific markers of hepatic inflammation, LSM, and steatosis in persons with NAFLD. Although promising, given the heterogeneity in pooled analyses, additional well-designed RCTs are needed to define the efficacy of probiotics/synbiotics for treatment of NAFLD. This study was registered with PROSPERO as CRD42018091455.
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Affiliation(s)
| | | | | | - Eric Vittinghoff
- Biostatistics and Epidemiology, University of California San Francisco, San Francisco, CA
| | - Norah A Terrault
- Keck Medicine at University of Southern California, Los Angeles, CA,Address correspondence to NAT (e-mail: )
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Maraj B, Harding-Theobald E, Karaki F. Correction to: Vascular Ehlers-Danlos Syndrome Presenting as a Pulsatile Neck Mass: a Case Report and Review of Literature. J Gen Intern Med 2018; 33:2257. [PMID: 30306380 PMCID: PMC6258621 DOI: 10.1007/s11606-018-4692-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This paper was inadvertently published with open access; the authors have requested the copyright revert to the society. It has been re-published with appropriate licensing.
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Affiliation(s)
- Bharat Maraj
- Department of Medicine, University of California, San Francisco Medical Center, San Francisco, CA, USA.
| | - Emily Harding-Theobald
- Department of Medicine, University of California, San Francisco Medical Center, San Francisco, CA, USA
| | - Fatima Karaki
- Department of Medicine, University of California, San Francisco Medical Center, San Francisco, CA, USA
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Affiliation(s)
- Bharat Maraj
- University of California, San Francisco, San Francisco
| | - Charlie M Wray
- University of California, San Francisco, San Francisco.,San Francisco Veterans Affairs Medical Center, San Francisco, California
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Maraj B, Huang A, Patel S. Acute Colitis in a Patient with Streptococcus pyogenes Bacteremia. Am J Med 2018; 131:e13-e14. [PMID: 29024623 DOI: 10.1016/j.amjmed.2017.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 09/14/2017] [Accepted: 09/14/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Bharat Maraj
- Department of Medicine, University of California, San Francisco Medical Center, Calif.
| | - Annsa Huang
- Department of Medicine, University of California, San Francisco Medical Center, Calif
| | - Sajan Patel
- Department of Medicine, University of California, San Francisco Medical Center, Calif
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Omar MA, Ghei M, Maraj B. A Simple Technique of Managing a Urine Bag. Ann R Coll Surg Engl 2015; 97:159. [DOI: 10.1308/rcsann.2015.97.2.159a] [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: 11/22/2022] Open
Affiliation(s)
- MA Omar
- Whittington Hospital NHS Trust, UK
| | - M Ghei
- Whittington Hospital NHS Trust, UK
| | - B Maraj
- Whittington Hospital NHS Trust, UK
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Abstract
INTRODUCTION Identification of human papillomavirus (HPV) as the etiologic factor of cervical, anogenital, and a subset of head and neck cancers has stimulated the development of preventive and therapeutic HPV vaccines to control HPV-associated malignancies. Excitement has been generated by the commercialization of two preventive L1-based vaccines, which use HPV virus-like particles (VLPs) to generate capsid-specific neutralizing antibodies. However, factors such as high cost and requirement for cold chain have prevented widespread implementation where they are needed most. AREAS COVERED Next generation preventive HPV vaccine candidates have focused on cost-effective stable alternatives and generating broader protection via targeting multivalent L1 VLPs, L2 capsid protein, and chimeric L1/L2 VLPs. Therapeutic HPV vaccine candidates have focused on enhancing T cell-mediated killing of HPV-transformed tumor cells, which constitutively express HPV-encoded proteins, E6 and E7. Several therapeutic HPV vaccines are in clinical trials. EXPERT OPINION Although progress is being made, cost remains an issue inhibiting the use of preventive HPV vaccines in countries that carry the majority of the cervical cancer burden. In addition, progression of therapeutic HPV vaccines through clinical trials may require combination strategies employing different therapeutic modalities. As research in the development of HPV vaccines continues, we may generate effective strategies to control HPV-associated malignancies.
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Affiliation(s)
- Barbara Ma
- The Johns Hopkins Medical Institutions, Departments of Pathology, Baltimore, MD, USA
| | - Bharat Maraj
- The Johns Hopkins Medical Institutions, Departments of Pathology, Baltimore, MD, USA
| | - Nam Phuong Tran
- The Johns Hopkins Medical Institutions, Departments of Pathology, Baltimore, MD, USA
| | - Jayne Knoff
- The Johns Hopkins Medical Institutions, Departments of Pathology, Baltimore, MD, USA
| | - Alexander Chen
- The Johns Hopkins Medical Institutions, Departments of Pathology, Baltimore, MD, USA
| | - Ronald D Alvarez
- University of Alabama at Birmingham, Department of Obstetrics and Gynecology, Birmingham, MD, USA
| | - Chien-Fu Hung
- The Johns Hopkins Medical Institutions, Departments of Pathology, Baltimore, MD, USA
- The Johns Hopkins Medical Institutions, Departments of Oncology, Baltimore, MD, USA
| | - T.-C. Wu
- The Johns Hopkins Medical Institutions, Departments of Pathology, Baltimore, MD, USA
- The Johns Hopkins Medical Institutions, Departments of Oncology, Baltimore, MD, USA
- The Johns Hopkins Medical Institutions, Departments of Obstetrics and Gynecology, Baltimore, MD, USA
- The Johns Hopkins Medical Institutions, Departments of Molecular Microbiology and Immunology, Baltimore, MD, USA
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Dukic I, Nair R, Shaw G, Dukic M, Maraj B. UP-3.097: Does a Urological Operative Database Raise the Standard of Operative Notes? Urology 2009. [DOI: 10.1016/j.urology.2009.07.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Khan A, Duncann P, Maraj B, Miller R. UP-02.93. Urology 2006. [DOI: 10.1016/j.urology.2006.08.837] [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: 10/24/2022]
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Abstract
Bacterial hydroxy fatty acids and alpha-hydroxy fatty acids have been demonstrated in complex lipid extracts of subgingival plaque and gingival tissue. However, little is known about the relationship between these hydroxy fatty acids in plaque and gingival tissues or the significance of these complex lipids in promoting inflammatory periodontal disease. The present study determined the percentages of ester-linked and amide-linked hydroxy fatty acids in complex lipids recovered from plaque and gingival tissue samples and the relationship between bacterial hydroxy fatty acids and alpha-hydroxy fatty acids in the lipid extracts. To evaluate a potential role for these hydroxy fatty acids in inflammatory periodontal disease, gingival tissue samples were examined for a relationship between prostaglandin E2 (PGE2) and hydroxy fatty acids recovered in gingival lipid. This investigation demonstrated that alpha-hydroxy fatty acids are only ester linked in plaque lipids but are largely amide linked in gingival tissue lipids. Furthermore, the level of alpha-hydroxy fatty acid in gingival lipid is directly related to the level of the bacterial hydroxy fatty acid 3-OH iso-branched C17:0 (3-OH iC17:0) in the same lipid extract. However, the relationship between hydroxy fatty acids in gingival lipids does not parallel the fatty acid relationship observed in plaque lipids. Finally, alpha-hydroxy fatty acid levels in gingival tissue lipids correlate directly with the recovery of PGE2 in the same tissue samples. These results demonstrate that alpha-hydroxy fatty acid levels in gingival lipids are directly related to both 3-OH iC17:0 bacterial lipid levels and PGE2 levels. These results indicate that in periodontal tissues there are unusual host-parasite interactions involving penetration of bacterial lipid in association with an altered gingival lipid metabolism and prostaglandin synthesis.
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Affiliation(s)
- F Nichols
- Department of Periodontology, School of Dental Medicine, University of Connecticut, Farmington, Connecticut, USA.
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Abstract
The purpose of this experiment was to examine the approach run of the triple jump. Specifically, we examined the effect of nonregulatory stimuli (Gentile, 1972) on two different ability levels in performing the triple jump approach run. These nonregulatory constraints (situational factors such as those seen in actual competition) were employed in three jumping conditions: Control (to obtain baseline performance measures), Distance (where participants attempted to obtain as great a jump as possible), and Accuracy (participants attempted to be as accurate as possible on takeoff without sacrificing distance). The results showed that the footfall position variability for all conditions was similar to those previously reported for the long jump approach run. However, in compliance with the nonregulatory constraints, participants altered other performance parameters in executing the approach run. The situational factors created changes that revealed themselves in foot placement on the takeoff board at the end of the approach run (foot position constant error and number of fouls increased for the Distance condition) and decreased horizontal velocity at takeoff in the Accuracy condition. Changes in performance parameters were related to the context in which the skill was performed and may further reflect changes made by jumpers in the course, such as a visual-motor task in competition. We suggest that the characteristics of the approach run may not be fully revealed by the pattern of footfall variability only, as has been suggested in previous work (e.g., Lee, Lishman, & Thomson, 1982), but that the situation under which the jump is performed may have a significant effect on the performance parameters that emerge in executing this type of motor skill.
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Affiliation(s)
- B Maraj
- Department of Kinesiology, Louisiana State University, USA.
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Leek J, Lench N, Maraj B, Bailey A, Carr IM, Andersen S, Cross J, Whelan P, MacLennan KA, Meredith DM. Prostate-specific membrane antigen: evidence for the existence of a second related human gene. Br J Cancer 1995; 72:583-8. [PMID: 7669565 PMCID: PMC2033874 DOI: 10.1038/bjc.1995.377] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Prostate-specific membrane antigen (PSM) is a glycoprotein recognised by the prostate-specific monoclonal antibody 7E11-C5, which was raised against the human prostatic carcinoma cell line LNCaP. A cDNA clone for PSM has been described. PSM is of clinical importance for a number of reasons. Radiolabelled antibody is being evaluated both as an imaging agent and as an immunotherapeutic in prostate cancer. Use of the PSM promoter has been advocated for gene therapy applications to drive prostate-specific gene expression. Although PSM is expressed in normal prostate as well as in primary and secondary prostatic carcinoma, different splice variants in malignant tissue afford the prospect of developing reverse transcription-polymerase chain reaction (RT-PCR)-based diagnostic screens for the presence of prostatic carcinoma cells in the circulation. We have undertaken characterisation of the gene for PSM in view of the protein's interesting characteristics. Unexpectedly, we have found that there are other sequences apparently related to PSM in the human genome and that PSM genomic clones map to two separate and distinct loci on human chromosome 11. Investigation of the function of putative PSM-related genes will be necessary to enable us to define fully the role of PSM itself in the development of prostatic carcinoma and in the clinical management of this malignancy.
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Affiliation(s)
- J Leek
- Molecular Medicine Unit, University of Leeds, UK
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