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Zertuche JP, Rabasa G, Lichtenstein AH, Matthan NR, Nevitt M, Torner J, Lewis CE, Dai Z, Misra D, Felson D. Alkylresorcinol, a biomarker for whole grain intake, and its association with osteoarthritis: the MOST study. Osteoarthritis Cartilage 2022; 30:1337-1343. [PMID: 35863678 PMCID: PMC9554937 DOI: 10.1016/j.joca.2022.07.004] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 06/16/2022] [Accepted: 07/05/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Higher intake of fiber has been associated with lower risk of incident symptomatic osteoarthritis (OA). We examined whether levels of alkylresorcinol (AR), a marker of whole grain intake, were associated with OA in subjects in The Multicenter Osteoarthritis (MOST) Study. METHOD Knee x-rays and knee pain were assessed at baseline and through 60-months. Stored baseline fasting plasma samples were analyzed for AR homologues (C17:0, C19:0, C21:0, C23:0, C25:0) and total AR levels (AR sum). Two nested case-control studies, one for incident radiographic OA and one for incident symptomatic OA were performed with participants re-assessed at 15, 30 and 60 months. Multivariable conditional logistic regression with baseline covariates including age, sex, BMI, physical activity, quadriceps strength, race, smoking, depressive symptoms, diabetes and knee injury tested the association of log transformed AR levels with OA outcomes. RESULTS Seven hundred seventy-seven subjects were, on average, in their 60's, and most were women. For 60-month cumulative incidence, there was no significant association between quartiles of AR concentration and incident radiographic (e.g., for incident radiographic OA, highest vs lowest quartile of AR sum showed RR = 0.93 (95% CI 0.59, 1.47), and for symptomatic OA RR was 1.22 (95% CI 0.76, 1.94). In secondary analyses examining 30-month incidence, high AR levels were associated with a reduced risk of X-ray OA (RR = 0.31 (95% CI 0.15, 0.64). CONCLUSION In primary analyses, AR levels were not associated with risk of OA, but secondary analyses left open the possibility that high AR levels may protect against OA.
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Affiliation(s)
| | | | | | | | - M Nevitt
- University of California, San Francisco, USA.
| | | | - C E Lewis
- University of Alabama at Birmingham, USA.
| | - Z Dai
- Flinders University, College of Medicine and Public Health, Adelaide, Australia.
| | - D Misra
- Beth Israel Deaconess Medical Center, HMS, USA.
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Caldwell MT, Goyal N, Dudley A, Dehlendorf C, Scott J, Parke D, Vallee P, Daniels G, Manteuffel J, Thomas CSD, Hambrick N, Guetterman TC, Misra D, Joseph CLM. POSTER ABSTRACTS. Contraception 2021. [DOI: 10.1016/j.contraception.2021.07.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Davidson ME, Hawkins M, Panzera A, Owens-Young J, Misra D. Perceived racism and preterm birth: Baltimore preterm birth cohort study. Ann Epidemiol 2021. [DOI: 10.1016/j.annepidem.2021.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gupta L, Zanwar A, Aggarwal R, Lawrence A, Misra D, Agarwal V, Misra R, Aggarwal A. AB0581 HIGH PREVALENCE OF TUBERCULOSIS IN ADULTS AND CHILDREN WITH IIM AS COMPARED WITH SLE: RETROSPECTIVE DATA REVIEW FROM A LARGE COHORT AT A TERTIARY CARE CENTER IN INDIA. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Infections are the most common cause of morbidity and mortality in idiopathic inflammatory myositis (IIM). India is endemic for Tuberculosis (TB) with a prevalence of 2.3 cases per thousand population.Objectives:Thus, we studied the prevalence of TB in our cohort of IIM patients and compared with that in systemic lupus erythematosus (SLE).Methods:Medical records from paper charts and electronic medical records were reviewed for adults and juvenile patients with SLE (ACR criteria 1997) and IIM (Bohan and Peter criteria 1975) first presented at a tertiary care hospital in India from 1989 to 2016. Clinical variables including disease characteristics variables, the frequency, site, duration and complication of active TB as well as dose of corticosteroids and other immunosuppressive drugs were extracted retrospectively from the medical records. Descriptive statistics were used to describe the cohort and TB characteristics. Chi-square and t-test were used to evaluate association of TB with clinical diagnosis as well as medication data.Results:There were 167 (132 adults and 35 juvenile) IIM and 280 (131 adults and 149 juvenile) SLE in our cohort. Active TB occurred in 24 (14.4%) of all IIM cases (18, 13.6% adults; 6, 17.1% juvenile) as compared to 18 (6.4%) of all SLE cases (8, 6.1% adults; 10, 6.7% juvenile, p value < 0.01). Of all the TB in myositis, most often it was seen in Dermatomyositis (n=11, 45.8%) followed by Polymyositis (5, 20.8%), and occasionally in Overlap myositis (3, 12.5) and juvenile dermatomyositis (1,4.1%).Considering an annual TB rate of 211 per 100,000 of the general population, the risk of developing active TB was 62-fold higher in patients with IIM and 27-fold higher in those with lupus. Patients with IIM had higher odds of developing TB as compared with Lupus [odds ratio 2.86 (CI 1.5-5.47), p=0.007).Amongst 24 IIM patients with TB, 10 had pulmonary TB and 14 had extra-pulmonary TB. The median glucocorticoid dose at the diagnosis of TB was 0.25 (0-1.5) mg/kg/day. Half the cases of active TB occurred during inactive myositis. Seventeen patients with active TB were followed up over 27 months (8-184), with remission of TB in all cases but required prolonged courses of Anti-Tuberculous Therapy (ATT) in 25% cases with 10 ATT related adverse events in 8 patients and 5 patients with relapse of myositis due to lowering of immunosuppression.Conclusion:Patients with IIM have higher prevalence of active TB as compared with SLE patients. The risk is highest in patients with Dermatomyositis possibly related to high doses of steroids. Extra-pulmonary forms of TB are more common, and patients commonly require prolonged course of ATT and may suffer relapses of myositis during ATT. Screening for latent TB may be useful in IIM patients before prescribing steroids and other immunosuppressive drugs.References:[1]TB Statistics India | National, treatment outcome & state statistics [Internet]. TB Facts | TB, tests, drugs, statistics. [cited 2019 Jun 13]. Available from:https://www.tbfacts.org/tb-statistics-india/[2]Muhammed H, Gupta L, Zanwar A, Misra DP, Lawrence A, Agarwal V, Aggarwal A, Misra R;OPC0243: Infections are leading cause of in-hospital mortality in patients with inflammatory myositis; Indian J Rheumatol 2018;13, Suppl S2:93-241[3]Gaitonde S, Pathan E, Sule A, Mittal G, Joshi VR. Efficacy of isoniazid prophylaxis in patients with systemic lupus erythematosus receiving long term steroid treatment. Ann Rheum Dis. 2002 Mar;61(3):251–3.[18]He D, Bai F, Zhang S, Jiang T, Shen J, Zhu Q, et al. High incidence of tuberculosis infection in rheumatic diseases and impact for chemoprophylactic prevention of tuberculosis activation during biologics therapy. Clin Vaccine Immunol CVI. 2013 Jun;20(6):842–7.Figure 1.(A) Prevalence and (B) sites of tuberculosisTable 1.Table 2.Clinical profile of patients with TuberculosisDisclosure of Interests:Latika Gupta: None declared, Abhishek Zanwar: None declared, Rohit Aggarwal Grant/research support from: Pfizer, Genentech, BMS, Mallinckrodt, Consultant of: Pfizer, Genentech, BMS, Mallinckrodt, Bristol Myers-Squibb, octapharma, CSL Behring, AstraZeneca, Corbus, Kezar, Abbvie, Able Lawrence: None declared, Durga Misra: None declared, Vikas Agarwal: None declared, Ramnath Misra: None declared, Amita Aggarwal: None declared
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Gangadharan Nair H, Rai MK, Singh M, Anuja A, Singh K, Mohindra N, Jain N, Kumar S, Agarwal V, Misra D. SAT0319 SUBCLINICAL ATHEROSCLEROSIS IN INDIAN PATIENTS WITH SCLERODERMA – CLINICAL AND SEROLOGICAL ASSOCIATIONS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Scleroderma has been associated with increased risk of cardiovascular events, however,studies on this from India are sparse.We evaluated clinical and serological factors associated with subclinical atherosclerosis in Indian patients with scleroderma, in a cross-sectional design.Objectives:To compare carotid intima-medial thickness (CIMT, mean value of both carotids) as a measure of subclinical atherosclerosis (SCA) between patients with scleroderma (n=61) fulfilling 2013 ACR/EULAR criteria, and healthy controls (n=41).- To compare clinical (body mass index – BMI, waist-hip ratio – WHR, fasting lipid profile) and serological factors (microparticles, endothelial microparticles, inflammatory cytokines associated with increased cardiovascular risk) between patients with scleroderma and healthy controls.- To identify factors associated with SCA in scleroderma patients.Methods:Subclinical atherosclerosis(SCA) was defined by presence of carotid plaques, or increased CIMT >2 standard deviations compared with Indian reference standards for age and sex. Total microparticles (TMP) were measured of plasma after ultracentrifugation as per previously described protocol using microbeads of 3 μm size (TMP were of size 0.1-1 μm); of these, microparticles positive for CD31 and CD142 were endothelial microparticles (EMP). Serum cytokines (IL-1, IL-6, TNF-α, IL-17) were measured by ELISA using manufacturer instructions. Linear regression was used to identify the determinants of CIMT in scleroderma. Binomial logistic regression was used to identify factors associated with subclinical athersclerosis in scleroderma.VariablePatients with scleroderma (n=61)Healthy controls (n=41)p valueAge37.8 ± 11.9235.37 ± 6.690.2375Gender (M:F)11:506:350.6516Diabetes/Hypertension/Tobacco use1/2/00/0/0NSBody mass index (kg/m2)20.11 ± 3.8224.38 ± 4.45<0.0001Waist-hip ratio0.86 ± 0.110.89 ± 0.070.1251Total cholesterol (mg/dL)142.5 ± 30.7147.3 ± 39.50.4948Triglycerides (mg/dL)99.4 ± 37121.4 ± 460.0087HDL cholesterol (mg/dL)46.9 ± 4.946.1 ± 4.20.4029LDL cholesterol (mg/dL)93.6 ± 10.593.3 ± 7.50.8520VLDL cholesterol (mg/dL)19.9 ± 7.424.7 ± 9.70.0057Carotid intima-medial thickness (mm)0.68 ± 0.100.53 ± 0.03<0.0001Total microparticles (per±L)12913 ± 24936272 ± 1533<0.0001Endothelial microparticles (per±L)2623 ± 1032829 ± 439.5<0.0001Serum IL-1±(pg/mL)38.19 ± 13.4631.38 ± 18.290.0326IL-6 (pg/mL)176.6 ± 85.74128.9 ± 53.610.0020IL-17 (pg/mL)56.3 ± 20.4553.89 ± 20.510.5611TNF±(pg/mL)49.65 ± 26.7142.09 ± 30.410.1879Results:Despite lower BMI, triglycerides and VLDL cholesterol, CIMT was significantly higher in patients with scleroderma. Patients with scleroderma had significantly higher total microparticles and endothelial microparticles in plasma, and serum IL-1± and IL-6 (Table 1). On multivariable regression, age was the only significant determinant of CIMT. 28 (45.9%) patients had SCA; 13 (21.3%) had carotid plaques. Patients with SCA had higher proportion of males (9/28 in those with SCA vs 2/33 in those without SCA). Binomial logistic regression did not identify any other significant predictors of SCA.Table 1Comparison between patients with scleroderma and healthy controlsSerum IL-1± (pg/mL)38.19 ± 13.4631.38 ± 18.290.0326IL-6 (pg/mL)176.6 ± 85.74128.9 ± 53.610.0020IL-17 (pg/mL)56.3 ± 20.4553.89 ± 20.510.5611TNF± (pg/mL)49.65 ± 26.7142.09 ± 30.410.1879Conclusion:Patients with scleroderma had significant burden of subclinical atherosclerosis, which could not be explained by traditional or novel cardiovascular risk factors.References:[1]Psarras A, Soulaidopoulos S, Garyfallos A, Kitas G, Dimitroulas T. A critical view on cardiovascular risk in systemic sclerosis. Rheumatol Int. 2017 Jan; 37(1):85-95.[2]Jung C, Drummer K, Oelzner P, Figulla HR, Boettcher J, Franz M, et al. The association between endothelial microparticles and inflammation in patients with systemic sclerosis and Raynaud’s phenomenon as detected by functional imaging. Clin HemorheolMicrocirc. 2015; 61(3):549-557.Acknowledgments:Supported by IRA(Indian Rheumatology Association) Research Grant to DP Misra.Disclosure of Interests:None declared
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Anuja A, Singh H, Misra D, Agarwal V, Gupta L. AB0149 PERIPHERAL T HELPER SUBSET PROFILING DIFFERS IN VARIOUS SUBSETS OF IDIOPATHIC INFLAMMATORY MYOSITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:There is dearth of biomarkers in Idiopathic Inflammatory Myositis(IIM) to identify ongoing inflammation in the muscle and distinguish it from inactivity or damage.Objectives:Since myositis is autoantibody mediated and tertiary lymphoid organogenesis (TLO) reported in the diseased muscles, we investigated peripheral blood T helper subset profiling as a reflection of ongoing muscle inflammation.Methods:Twenty-six patients of IIM (ACR EULAR criteria) were compared with 15 healthy controls (HC) and 21 patients with sarcoidosis (Table 1). Peripheral blood mononuclear cells were stained with combinations of antibodies to identify Th1, Th17, Th17.1 and Treg cells after stimulation assays (BD Biosciences). Myositis Specific and Associated autoantibodies were tested by the line immunoassay (Euroimmune, Germany).Table 1.Baseline characteristics of patients with inflammatory myositisCharacteristicsDemographic details (n, % or median, IQR)Healthy Control (median, IQR)Age37±25.2526.0±32Gender(M:F)5 vs. 2112 vs. 3Diagnosis PM3 DM15 OM4 ASS4Disease course Monocyclic5 Polycyclic7 Chronic continuous1 Undefined13Clinical Profile Myositis4 (15.3%) ILD5 (19.23%) Rash3 (11.53%) Arthritis6 (23.07%) Other16 (23.69)Disease duration (years)1.3 ± 6.91Disease activity Active12 [PM(1), OM(1), ASS(4), DM(5)] Inactive14 [PM(2),OM(2),ASS(0),DM(8)]Antinuclear AntibodiesPositive Nuclear Speckled9 (34.61%) Homogenous4 (15.38%) Nucleolar1 (3.8%) Other5 (19.23%)Cytoplasmic3 (11.53%)Negative4 (15.38%)Myositis Specific AntibodiesPositive ARS2(7.6%) Mi-23(11.53%) SAE-12(7.6%) NXP22(7.6%) MDA50MAA Ku1(3.8%) dsDNA0 U1RNP0 Ro524(15.38%)Negative12(46.15%)Results:All T helper subsets were higher in myositis as compared with healthy controls (figure 1A a-d). Between various IIM subsets, polymyositis had higher Th1 and Treg cells (Figure 1B b, c) while Th17 and Th17.1 cells(c) were higher in Overlap Myositis (Figure 1B a, d) as compared with healthy controls. Patients with sarcoidosis had similar subset profiling as myositis.(Figure 5a-f)Figure 1A. Representative plot depicting all T helper subsets quantified were higher in myositis as compared with healthy controls1B: Representative plot comparing %T cell subsets in various subsets of myositis with healthy controls showing that % Th1 cells (a) and Tregs (d) are highest in Polymyositis than controls while % Th17 (b) and % Th17.1 cells (c) are higher in Overlap MyositisPatients who were had either arthritis or were positive for myositis specific autoantibodies had higher Th17.1 cells (Figure 3 a(iii) & b(iii)) than those negative for MSA. There was no difference in T cell profile between the various autoantibody subsets (Figure 6a-d).There was no difference in subsets between active and inactive disease although active disease had lower Th1/Treg, Th17/Treg and Th17.1/Treg ratios.Conclusion:T Helper cell subsets are distinct from HC but similar to sarcoidosis patients. However, they differ in various subsets of myositis, suggesting different pathogenic mechanisms are operative. Autoantibody positivity is associated with elevated Th17.1 population suggesting plasticity in TLO which needs to be explored further. However, T cell profiling cannot distinguish active from inactive disease limited predictive potential as a biomarker.Figure 2A. Comparisons between various phenotypic subsets suggest patients positive for MSA had higher Th17.1 cells (Figure 2A a(iii)) than those negative for MSA. Similarly, patients with arthritis had higher Th17.1 cells(Figure 2A b (iii)). 2B Representative dot plot of T cell subsets ratio (Th1, Th17 & Th17.1) with Treg subsets (a) Th17/Treg ratio observed higher in lower cells in active as compared with inactive disease. 2C Representative dot plot T cell subsets in Sacodosis and myositis2D Representative dot plot comparing percentage of T cell subsets in various antibody subsets of myositisAcknowledgments:The authors thank APLAR for funding Myositis antibody testing.Disclosure of Interests:None declared
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R N, Jain A, Muhammed H, Aggarwal A, Agarwal V, Gupta L, Misra D, Lawrence A, Misra R. SAT0230 MACROPHAGE ACTIVATION SYNDROME IN SLE AND SYSTEMIC ONSET JIA: SIMILAR OR DISSIMILAR. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Macrophage activation syndrome (MAS) is a serious complication in rheumatic disease. Fever and hyperferritinemia are common in systemic onset JIA and cytopenias are common in SLE thus recognising MAS in them is a challenge.Objectives:We compared clinical, laboratory parameters, various classification criteria for MAS, and its outcome in SLE and sJIA.Methods:Clinical and laboratory data were extracted from clinician diagnosed cases of MAS with SLE/sJIA who were admitted between 2004-2018 at a tertiary care hospital. Percentage of patients satisfying Ravelli, International consensus, HLH 2004 and criteria proposed by Parodi et al1were calculated.Results:Among 33 patients (18 females) with MAS 19 had SLE and 14 had sJIA. MAS was more likely to be the presenting manifestation of disease in SLE as compared to sJIA (p<0.05). There were no differences in the clinical features among these two diseases. EBV and CMV were identified in 2 patients each as the trigger for MAS.Patients with SLE had lower baseline TLC and platelet whereas patients with sJIA-MAS had significantly higher median CRP (p = 0.002), fall in TLC (p=0.012) and delta ESR/CRP ratio (p=0.02) and lower fibrinogen level (p=0.006). Neutrophil to lymphocyte ratio, Ferritin/CRP ratio and number of patients with Ferritin/ESR >80 were similar. Bone Marrow hemophagocytosis was seen in only in 21% of patients.Only 6/33 fulfilled HLH criteria but criteria meant for sJIA or SLE performed well for both diseases and majority of patients could be diagnosed using them. Treatment included steroids(100%), cyclosporine(30%), Tacrolimus(21%), cyclophosphamide(21%), etoposide(3%) and thalidomide(12%). Mortality was similar in both groups.Table 1.Agreement amongst MAS/HLH criteria in SLE and sJIA MASSLE-MASHLHRavelli et alConsensusParodi et alHLH4444Ravelli et al4191918Consensus4191918Parodi et al4181818sJIA-MASHLHRavelli et alConsensusParodi et alHLH2222Ravelli et al2121112Consensus2111212Parodi et al2121214Table 2.Comparison with various other cohortsMinoia et alsJIAn (%)Our studysJIA, n (%)Our Study SLE, n (%)SLE, n (%) Ai-Chun Liu et alJuvenile SLE n (%)Parodi et alNumber36214193238MAS as presenting feature (%)80 (22)4 (28)12 (63)NA24 (63)Most common manifestation (%)Fever (96)Fever (100)Fever (89)Fever (96)Fever (89)Most common triggerDisease activityDisease activityDisease activityDisease activityDisease activityBM done251 (72.3)8 (57)12 (63)32 (96)38 (100)BM hemophagocytosis150 (60.7)2 (25)5 (41)32 (100)20 (52)Mortality28 (8)2 (14)2 (10.5)4 (12.5)4 (11.4)Patients meeting JIA criteria %NA-100NA100Patients meeting HLH criteria %NA1419NA66Conclusion:MAS is more likely to be presenting manifestation in SLE compared to sJIA. Though lab parameters are significantly different in MAS associated with SLE & sJIA, criteria meant for MAS in sJIA or SLE MAS performed equally well in both diseases.References:[1]Parodi A et al, Macrophage activation syndrome in juvenile systemic lupus erythematosus: a multinational multicenter study of thirty-eight patients. Arthritis Rheum. 2009 Nov;60(11):3388-99.Disclosure of Interests:None declared
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SINGH PhD H, Prasad N, Jaiswal A, Misra D, Agarwal V. SAT-468 Can steroid responsiveness be regulated epigenetically in childhood nephrotic syndrome? Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.498] [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] Open
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Affiliation(s)
- D Misra
- Divisions of Gerontology and Rheumatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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Wei J, Neogi T, Terkeltaub R, Fenves AZ, Zeng C, Misra D, Choi HK, Lei G, Zhang Y. Thiazide diuretics and risk of knee replacement surgery among patients with knee osteoarthritis: a general population-based cohort study. Osteoarthritis Cartilage 2019; 27:1454-1461. [PMID: 31181261 DOI: 10.1016/j.joca.2019.05.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/30/2019] [Accepted: 05/29/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Thiazide diuretic use is associated with higher bone mineral density (BMD) and possibly lower serum magnesium levels than loop diuretic use, and both high BMD and low serum magnesium have been linked to high prevalent knee osteoarthritis. This study aimed to compare the risk of a clinically relevant endpoint, knee replacement (KR) surgery, among initiators of thiazide and loop diuretics. DESIGN Among patients aged ≥50 years with a diagnosis of knee osteoarthritis in The Health Improvement Network (THIN) in United Kingdom, we conducted a propensity score-matched cohort study to examine the relation of thiazide diuretic initiation vs loop diuretic initiation to the risk of KR over 5 years. RESULTS Among thiazide and loop diuretic initiators (n = 3,488 for each group; mean age: 73 years; female ratio: 59%), 359 (28.6/1,000 person-years) and 283 (24.1/1,000 person-years) KRs occurred during the follow-up period, respectively. The hazard ratio (HR) of KR for thiazide diuretic initiation vs loop diuretic initiation was 1.26 (95% confidence interval [CI]: 1.08-1.47). The adherence-adjusted HR of KR for continuous use of thiazide diuretics was 1.44 (95% CI: 1.21-1.72). CONCLUSIONS In this population-based cohort of patients with knee osteoarthritis, thiazide diuretic use was associated with a higher risk of KR than loop diuretic use. This association may potentially be due to thiazide diuretics' effect on BMD and serum magnesium.
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Affiliation(s)
- J Wei
- Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan, China; Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - T Neogi
- Section of Rheumatology, Boston University School of Medicine, Boston, MA, USA.
| | - R Terkeltaub
- Department of Medicine, University of California at San Diego, San Diego, CA, USA; VA San Diego Medical Center, San Diego, CA, USA.
| | - A Z Fenves
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - C Zeng
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - D Misra
- Section of Rheumatology, Boston University School of Medicine, Boston, MA, USA; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - H K Choi
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - G Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China; Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, Hunan, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Y Zhang
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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CHATURVEDI S, Prasad N, Singh H, Agarwal V, Misra D. SUN-146 5-HT2 AND 5-HT2B RECEPTOR INHIBITION ATTENUATE PERITONEAL FIBROSIS BY TARGETING NON-CANONICAL SIGNALING PATHWAYS INCLUDING STAT3. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.547] [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: 11/15/2022] Open
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Rath MM, Panigrahi MK, Pattnaik K, Bhuyan P, Kar SK, Misra B, Misra D, Meher C, Agrawal O, Rath J, Singh SP. Histological Evaluation of Non-alcoholic Fatty Liver Disease and Its Correlation with Different Noninvasive Scoring Systems with Special Reference to Fibrosis: A Single Center Experience. J Clin Exp Hepatol 2016; 6:291-296. [PMID: 28003718 PMCID: PMC5157877 DOI: 10.1016/j.jceh.2016.08.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 08/12/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Although liver biopsy remains the gold standard for the diagnosis of non-alcoholic fatty liver disease [NAFLD], many non-invasive markers of liver fibrosis have recently been proposed and assessed as surrogates of liver biopsy. AIMS AND OBJECTIVE To evaluate the degree of liver fibrosis by different non-invasive fibrosis scoring systems and to compare each non-invasive fibrosis scoring system with histological fibrosis stage. MATERIALS AND METHODS The study population consists of consecutive patients with biopsy proven NAFLD. Complete medical history was taken and physical examination was done in all patients along with appropriate biochemical evaluations. NAFLD fibrosis score, BARD score, BAAT score and APRI score were calculated and each score was compared with histological fibrosis staging. RESULTS The study population consisted of 60 patients having mean age 39.73 years (SD 9.62, range 17-63 years) including 51 (85%) males and 9 (15%) females. On histology fibrosis was present in 68.3% (41/60) patients. Out of 60 patients 41 had fibrosis and among them 17, 22, 2 patients had grade 1, 2, 3 fibrosis respectively and no one had grade 4 fibrosis. 61.67% (37/60) had definite NASH. Comparing the fibrosis of histology with the noninvasive scoring systems, the sensitivity and specificity of NAFLD fibrosis score were 5.56% and 100% respectively. BARD score had 45.83% sensitivity and 80.55% specificity. The sensitivities of BAAT score and APRI score were 0% and 29.16% respectively and the specificities were 100% and 97.22% respectively. CONCLUSION The noninvasive scoring systems like NFS, BARD, BAAT, and APRI are not sensitive enough to detect fibrosis but highly specific to include fibrosis if scores are more than cut-off values in our cohort, however they cannot replace liver biopsy. Newer more efficient non-invasive scoring systems have to be devised for the Indian NAFLD population.
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Key Words
- ALT, alanine aminotransferase
- APRI
- APRI, aspartate aminotransferase (AST)-to-platelet ratio index
- AST, aspartate aminotransferase
- BAAT
- BARD
- BMI, body mass index
- DM, diabetes mellitus
- NAFLD, non-alcoholic fatty liver disease
- NAS, NAFLD fibrosis score
- NASH, non-alcoholic steatohepatitis
- NPV, negative predictive value
- PPV, positive predictive value
- ROC, receiver operating characteristic
- SGOT, serum glutamic oxaloacetic transaminases
- SGPT, serum glutamic pyruvate transaminases
- TG, triglyceride
- TPC, total platelet count
- fibrosis
- nonalcoholic fatty liver disease (NAFLD)
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Affiliation(s)
- Mitali M. Rath
- Department of Pathology, IMS & SUM Hospital, Bhubaneswar 751003, Odisha, India
| | - Manas K. Panigrahi
- Department of Gastroenterology, AIIMS, Bhubaneswar 751019, Odisha, India
| | - Kaumudee Pattnaik
- Department of Pathology, S.C.B. Medical College, Cuttack 753007, Odisha, India
| | - Pallavi Bhuyan
- Department of Pathology, S.C.B. Medical College, Cuttack 753007, Odisha, India
| | - Sanjib K. Kar
- Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, Odisha, India
| | - Bijay Misra
- Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, Odisha, India
| | - Debasis Misra
- Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, Odisha, India
| | - Chudamani Meher
- Department of Radiology, Beam Diagnostics Centre, Bajrakabati Road, Cuttack 753001, Odisha, India
| | - Omprakash Agrawal
- Department of Radiology, Beam Diagnostics Centre, Bajrakabati Road, Cuttack 753001, Odisha, India
| | - Jayshree Rath
- Department of Pathology, S.C.B. Medical College, Cuttack 753007, Odisha, India
| | - Shivaram P. Singh
- Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, Odisha, India,Address for correspondence: Shivaram P. Singh, Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, India.Department of Gastroenterology, S.C.B. Medical CollegeCuttack753007India
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Swain M, Nath P, Parida PK, Narayan J, Padhi PK, Pati GK, Singh A, Misra B, Misra D, Kar SK, Panigrahi MK, Meher C, Agrawal O, Rout N, Pattnaik K, Bhuyan P, Mishra PK, Singh SP. Biochemical Profile of Nonalcoholic Fatty Liver Disease Patients in Eastern India with Histopathological Correlation. Indian J Clin Biochem 2016; 32:306-314. [PMID: 28811690 DOI: 10.1007/s12291-016-0612-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 08/24/2016] [Indexed: 02/07/2023]
Abstract
Aminotransferase assay is often used as a screening test as well as an endpoint for resolution of disease in nonalcoholic fatty liver disease (NAFLD). Aim of the study was to evaluate the relationship of transaminase level with metabolic variables and histology in NAFLD. Single center observational study was conducted in a gastroenterology clinic at Cuttack in coastal Odisha. Subjects were consecutive patients presenting with functional bowel disease and undergoing abdominal sonography. All participants were evaluated for the presence of metabolic syndrome (MS), insulin resistance, liver function test and lipid profile. Various parameters were compared between NAFLD subjects and controls. 53.5 % of NAFLD had normal serum transaminases, whereas 20.8 % of healthy controls had transaminitis. NAFLD patients had significantly higher BMI, fasting plasma glucose, serum transaminases, serum triglycerides, serum insulin and homeostatic model assessment (HOMA) IR than controls. NAFLD patients who had transaminitis had significantly higher incidence of MS and higher mean HOMA IR than those without. There was no significant difference in histopathological features between NAFLD with and without transaminitis. To conclude, over half of NAFLD subjects do not have transaminitis while transaminitis is present in a fifth of healthy people without fatty liver. Hence serum transaminase should not be used as screening test for NAFLD. NAFLD patients with transaminitis had a higher incidence of MS and insulin resistance than those without. However, there was no significant difference in histopathological features between these two groups.
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Affiliation(s)
- Manorama Swain
- Department of Biochemistry, S.C.B. Medical College, Cuttack, Odisha 753007 India
| | - Preetam Nath
- Department of Gastroenterology, S.C.B. Medical College, Cuttack, Odisha 753007 India
| | - Prasant Kumar Parida
- Department of Gastroenterology, S.C.B. Medical College, Cuttack, Odisha 753007 India
| | - Jimmy Narayan
- Department of Gastroenterology, S.C.B. Medical College, Cuttack, Odisha 753007 India
| | - Pradeep Kumar Padhi
- Department of Gastroenterology, S.C.B. Medical College, Cuttack, Odisha 753007 India
| | - Girish Kumar Pati
- Department of Gastroenterology, S.C.B. Medical College, Cuttack, Odisha 753007 India
| | - Ayaskanta Singh
- Department of Gastroenterology, IMS and SUM Hospital, Bhubaneswar, Odisha India
| | - Bijay Misra
- Department of Gastroenterology, Institute of Gastro and Kidney Care, Bhubaneswar, Odisha India
| | - Debasis Misra
- Department of Gastroenterology, IMS and SUM Hospital, Bhubaneswar, Odisha India
| | - Sanjib Kumar Kar
- Department of Gastroenterology, S.C.B. Medical College, Cuttack, Odisha 753007 India
| | | | - Chudamani Meher
- Department of Radiology, Beam Diagnostics Centre, Bajrakabati Road, Cuttack, 753001 India
| | - Omprakash Agrawal
- Department of Radiology, Beam Diagnostics Centre, Bajrakabati Road, Cuttack, 753001 India
| | - Niranjan Rout
- Department of Oncopathology, Acharya Harihara Regional Cancer Center, Cuttack, Odisha 753007 India
| | - Kaumudee Pattnaik
- Department of Pathology, S.C.B. Medical College, Cuttack, Odisha 753007 India
| | - Pallavi Bhuyan
- Department of Pathology, S.C.B. Medical College, Cuttack, Odisha 753007 India
| | - Pramila Kumari Mishra
- Department of Biochemistry, M.K.C.G. Medical College, Berhampur, Odisha 760004 India
| | - Shivaram Prasad Singh
- Department of Gastroenterology, S.C.B. Medical College, Cuttack, Odisha 753007 India
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Thomas DM, Bredlau C, Islam S, Armah KA, Kunnipparampil J, Patel K, Redman LM, Misra D, Salafia C. Relationships between misreported energy intake and pregnancy in the pregnancy, infection and nutrition study: new insights from a dynamic energy balance model. Obes Sci Pract 2016; 2:174-179. [PMID: 29071098 PMCID: PMC5523690 DOI: 10.1002/osp4.29] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 11/11/2015] [Accepted: 01/01/2016] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE Providing effective dietary counselling so that pregnancy weight gain remains within the 2009 Institute of Medicine (IOM) guidelines requires accurate maternal energy intake measures. Current practice is based on self-reported intake that has been demonstrated unreliable. This study applies an objective calculation of energy intake from a validated mathematical model to identify characteristics of individuals more likely to misreport during pregnancy. METHODS A validated maternal energy balance equation was used to calculate energy intake from gestational weight gain in 1,368 subjects. The difference between self-reported and model-predicted energy intake was tested for demographics, economic status, education level and maternal health status. RESULTS A weight gain of 15.2 kg resulted in model-predicted intake during pregnancy of 2,882.97 ± 135.71 kcal day-1, which differed from self-reported intake of 2,180.5 ± 856.0 kcal day-1. The achieved weight gain exceeded the IOM guidelines; however, the model predicted weight gain from self-reported energy intake was below IOM guidelines. Higher income (p = 0.004), education (p = 0.003), birth weight (p = 0.017), gestational diabetes (p = 0.008) and pre-existing diabetes (p < 0.001) were associated with under-reported energy intake. More children living at home (p = 0.001) were associated with more accurate self-reported intake. CONCLUSIONS When assessing self-reported energy intake in pregnancy studies, birth weight, gestational diabetes status, pre-existing diabetes, higher income and education predict higher under-reporting. Clinicians providing dietary treatment recommendations during pregnancy should be aware that individuals with pre-existing diabetes and gestational diabetes mellitus are more likely to misreport their intake. Additionally, the systems model approach can be applied early in intervention to objectively monitor dietary compliance to treatment recommendations.
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Affiliation(s)
- D M Thomas
- Center for Quantitative Obesity Research Montclair State University Montclair NJ USA
| | - C Bredlau
- Center for Quantitative Obesity Research Montclair State University Montclair NJ USA
| | - S Islam
- Center for Quantitative Obesity Research Montclair State University Montclair NJ USA
| | - K A Armah
- Center for Quantitative Obesity Research Montclair State University Montclair NJ USA
| | - J Kunnipparampil
- Center for Quantitative Obesity Research Montclair State University Montclair NJ USA
| | - K Patel
- Center for Quantitative Obesity Research Montclair State University Montclair NJ USA
| | - L M Redman
- Pennington Biomedical Research Center Louisiana State University System Baton Rouge LA USA
| | - D Misra
- Department of Family Medicine and Public Health Sciences, School of Medicine Wayne State University Detroit MI USA
| | - C Salafia
- Placental Analytics Larchmont NY USA
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Misra B, Misra D, Singh A, Pati G, Kar S, Panigrahi M, Das H, Panda C, Misra P, Mallik R, Singh S. Hepatic sarcoidosis masquerading as tuberculosis. Hamdan Med J 2016. [DOI: 10.7707/hmj.472] [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: 11/18/2022] Open
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16
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Singh SP, Singh A, Misra D, Misra B, Pati GK, Panigrahi MK, Kar SK, Bhuyan P, Pattnaik K, Meher C, Agrawal O, Rout N, Swain M, Aich P. Risk Factors Associated With Non-Alcoholic Fatty Liver Disease in Indians: A Case-Control Study. J Clin Exp Hepatol 2015; 5:295-302. [PMID: 26900270 PMCID: PMC4723647 DOI: 10.1016/j.jceh.2015.09.001] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 09/01/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/AIMS NAFLD has today emerged as the leading cause of liver disorder. There is scanty data on risk factors associated with NAFLD emanating from India. The present study was conducted to identify the risk factors associated with NAFLD. METHODS 464 consecutive NAFLD patients and 181 control patients were subjected to detailed questionnaire regarding their lifestyle and dietary risk factors. Anthropometric measurements were obtained and biochemical assays were done. Comparison of different variables was made between NAFLD patients and controls using principal component analysis (PCA). RESULTS NAFLD patients had higher BMI [26.25 ± 3.80 vs 21.46 ± 3.08 kg/m(2), P = 0.000], waist-hip ratio [0.96 ± 0.12 vs 0.90 ± 0.08, P = 0.000] and waist-height ratio [0.57 ± 0.09 vs 0.50 ± 0.06, P = 0.000] compared to controls. Fasting blood sugar [101.88 ± 31.57 vs 90.87 ± 10.74 mg/dl] and triglyceride levels [196.16 ± 102.66 vs 133.20 ± 58.37 mg/dl] were significantly higher in NAFLD group. HOMA-IR was also higher in NAFLD group [2.53 ± 2.57 vs 1.16 ± 0.58, P = 0.000]. Majority (90.2%) of NAFLD patients were sedentary. Family history of metabolic syndrome (MS) was positively correlated with NAFLD. Dietary risk factors associated with NAFLD were non-vegetarian diet [35% vs 23%, P = 0.002], fried food [35% vs 9%, P = 0.000], spicy foods [51% vs 15%, P = 0.001] and tea [55% vs 39%, P = 0.001]. Diabetes, hypertension, snoring and sleep apnoea syndrome were common factors in NAFLD. On multivariate PCA, waist/height ratio and BMI were significantly higher in the NAFLD patients. CONCLUSION The risk factors associated with NAFLD are sedentary lifestyle, obesity family history of MS, consumption of meat/fish, spicy foods, fried foods and tea. Other risk factors associated with NAFLD included snoring and MS.
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Key Words
- ALT, Alanine Transaminase
- AST, Aspartate Transaminase
- BMI, Body Mass Index
- FBG, fasting blood glucose
- HC, hip circumference
- HCC, hepatocellular carcinoma
- HDL, high-density lipoprotein
- HOMA, Homeostatic Model Assessment
- HOMA-B, beta-cell function
- IR, insulin resistance
- MS, Metabolic syndrome
- NAFLD, Non-alcoholic fatty liver disease
- NASH, non-alcoholic steatohepatitis
- PCA, Principal Component Analysis
- SD, standard deviation
- WC, waist circumference
- anthropometry
- diet
- fatty liver
- lifestyle
- metabolic syndrome
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Affiliation(s)
- Shivaram P. Singh
- Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, India,Address for correspondence: Shivaram P. Singh, Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, India. Tel.: +91 671 2505466; fax: +91 671 2433865.Department of Gastroenterology, S.C.B. Medical CollegeCuttack753007India
| | - Ayaskanta Singh
- Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, India
| | - Debasis Misra
- Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, India
| | - Bijay Misra
- Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, India
| | - Girish K. Pati
- Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, India
| | - Manas K. Panigrahi
- Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, India
| | - Sanjib K. Kar
- Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, India
| | - Pallavi Bhuyan
- Department of Pathology, S.C.B. Medical College, Cuttack 753007, India
| | - Kaumudee Pattnaik
- Department of Pathology, S.C.B. Medical College, Cuttack 753007, India
| | - Chudamani Meher
- Department of Radiology, Beam Diagnostics Centre, Bajrakabati Road, Cuttack 753001, India
| | - Omprakash Agrawal
- Department of Radiology, Beam Diagnostics Centre, Bajrakabati Road, Cuttack 753001, India
| | - Niranjan Rout
- Department of Oncopathology, A.H. Regional Cancer Center, Cuttack 753001, India
| | - Manoroma Swain
- Department of Biochemistry, S.C.B. Medical College, Cuttack 753007, India
| | - Palok Aich
- National Institute of Science Education & Research (NISER), Jatni, Khurdha 752050, India
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Singh SP, Misra B, Kar SK, Panigrahi MK, Misra D, Bhuyan P, Pattnaik K, Meher C, Agrawal O, Rout N, Swain M. Nonalcoholic fatty liver disease (NAFLD) without insulin resistance: Is it different? Clin Res Hepatol Gastroenterol 2015; 39:482-8. [PMID: 25543522 DOI: 10.1016/j.clinre.2014.08.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2013] [Revised: 07/04/2014] [Accepted: 08/12/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Nonalcoholic fatty liver disease (NAFLD) is considered the hepatic manifestation of insulin resistance [IR]. However, a significant proportion of NAFLD patients are devoid of IR. Is NAFLD sans IR a different entity? The aim of the study was to compare the anthropometric, metabolic, biochemical, ultrasonography, and histological profile of NAFLD patients with and without IR. METHODS Retrospective analyses of 336 NAFLD patients diagnosed during the last two years was done. Patients without IR were compared with those with IR. RESULTS Out of 336 patients, 153 [45.53%] were without IR. Although age, gender, BMI and transaminase levels were comparable, significantly higher proportion of patients in non-IR group were non-obese [43.14% vs. 25/14%; P=0.0005], and had mild fatty change on ultrasonography; [78.43% vs. 67.21%; P=0.022]. Higher proportion of them had elevated transaminases; [67.97% vs. 56.83%; P=0.036]. Serum triglyceride [178.52±78.78 vs. 204.86±94.72 mg/dl; P=0.02], FBG [85.39±13.80 vs. 98.93±31.56 mg/dl; P=0.00], PGBG [123.76±36.77 vs. 148.07±64.67m g/dl; P=0.00], and serum insulin [6.33±2.18 vs. 15.39±12.56 μIU/ml; P=0.00] were significantly lower in patients without IR. Although there was no difference in histology, interestingly fibrosis was seen in one third of patients despite absence of IR. CONCLUSION Nearly half of our NAFLD population was without IR; one third of them had significant fibrosis. NAFLD is probably a heterogeneous disease and IR is not the sole factor responsible for NAFLD; further studies are needed to find out other possible etiological factors.
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Affiliation(s)
| | - Bijay Misra
- Department of Gastroenterology, S.C.B. Medical College, 753007 Cuttack, India
| | - Sanjib Kumar Kar
- Department of Gastroenterology, S.C.B. Medical College, 753007 Cuttack, India
| | | | - Debasis Misra
- Department of Gastroenterology, S.C.B. Medical College, 753007 Cuttack, India
| | - Pallavi Bhuyan
- Department of Pathology, S.C.B. Medical College, 753007 Cuttack, India
| | - Kaumudee Pattnaik
- Department of Pathology, S.C.B. Medical College, 753007 Cuttack, India
| | - Chudamani Meher
- Department of Radiology, Beam Diagnostics Centre, Bajrakabati Road, 753001 Cuttack, India
| | - Omprakash Agrawal
- Department of Radiology, Beam Diagnostics Centre, Bajrakabati Road, 753001 Cuttack, India
| | - Niranjan Rout
- Department of Oncopathology, A.H. Regional Cancer Center, 753001 Cuttack, India
| | - Manorama Swain
- Department of Biochemistry, S.C.B. Medical College, 753007 Cuttack, India
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Hubele R, Schuricke M, Goullon J, Lindenblatt H, Ferreira N, Laforge A, Brühl E, de Jesus VLB, Globig D, Kelkar A, Misra D, Schneider K, Schulz M, Sell M, Song Z, Wang X, Zhang S, Fischer D. Electron and recoil ion momentum imaging with a magneto-optically trapped target. Rev Sci Instrum 2015; 86:033105. [PMID: 25832209 DOI: 10.1063/1.4914040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A reaction microscope (ReMi) has been combined with a magneto-optical trap (MOT) for the kinematically complete investigation of atomic break-up processes. With the novel MOTReMi apparatus, the momentum vectors of the fragments of laser-cooled and state-prepared lithium atoms are measured in coincidence and over the full solid angle. The first successful implementation of a MOTReMi could be realized due to an optimized design of the present setup, a nonstandard operation of the MOT, and by employing a switching cycle with alternating measuring and trapping periods. The very low target temperature in the MOT (∼2 mK) allows for an excellent momentum resolution. Optical preparation of the target atoms in the excited Li 2(2)P3/2 state was demonstrated providing an atomic polarization of close to 100%. While first experimental results were reported earlier, in this work, we focus on the technical description of the setup and its performance in commissioning experiments involving target ionization in 266 nm laser pulses and in collisions with projectile ions.
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Affiliation(s)
- R Hubele
- Max Planck Institute for Nuclear Physics, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - M Schuricke
- Max Planck Institute for Nuclear Physics, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - J Goullon
- Max Planck Institute for Nuclear Physics, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - H Lindenblatt
- Max Planck Institute for Nuclear Physics, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - N Ferreira
- Max Planck Institute for Nuclear Physics, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - A Laforge
- Max Planck Institute for Nuclear Physics, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - E Brühl
- Max Planck Institute for Nuclear Physics, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - V L B de Jesus
- Instituto Federal de Educação, Ciência e Tecnologia do Rio de Janeiro (IFRJ), Rua Lucio Tavares 1045, 26530-060 Nilópolis, Rio de Janeiro, Brazil
| | - D Globig
- Max Planck Institute for Nuclear Physics, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - A Kelkar
- Max Planck Institute for Nuclear Physics, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - D Misra
- Max Planck Institute for Nuclear Physics, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - K Schneider
- Max Planck Institute for Nuclear Physics, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - M Schulz
- Physics Department and LAMOR, Missouri University of Science and Technology, Rolla, Missouri 65409, USA
| | - M Sell
- Max Planck Institute for Nuclear Physics, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - Z Song
- Max Planck Institute for Nuclear Physics, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - X Wang
- Max Planck Institute for Nuclear Physics, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - S Zhang
- Max Planck Institute for Nuclear Physics, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - D Fischer
- Max Planck Institute for Nuclear Physics, Saupfercheckweg 1, 69117 Heidelberg, Germany
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Singh SP, Misra D, Mohapatra MK, Agrawal O, Meher C. Ultrasonographic demonstration of inner tube sign: a tropical dilemma. Trop Gastroenterol 2015; 36:68-70. [PMID: 26591965] [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: 06/05/2023]
Abstract
INTRODUCTION Ultrasonographic demonstration of intra biliary parallel lines or "inner tube sign" is considered diagnostic for biliary ascariasis in regions where ascariasis is endemic. PATIENTS & METHODS 148 patients with inner tube sign on ultrasonography were evaluated. In most, diagnosis was confirmed by ultrasonographic demonstration of restitution of normal appearance of bile duct with passage of round worms in vomitus or faeces. RESULTS Diagnosis was confirmed in 122 of 148 patients. 26 patients were lost to follow-up. Biliary ascariasis was responsible for the sign "parallel lines" in 113 patients. Of the remaining, intrabiliary stents were responsible for the "inner tube sign" in six whereas in three it was due to hydatid membranes following intrabiliary rupture of hydatid cyst. CONCLUSION Biliary ascariasis is the commonest cause of inner tube sign in the tropics. However, this sign can also be produced by biliary stents and hydatid membranes. Awareness of these possibilities is essential for sonologists in the tropics.
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Singh SP, Panigrahi MK, Misra D, Misra B, Kaar SK, Panda CR, das HS, Agrawal O, Meher C. Barium emesis during barium enema study: a definitive sign of gastrojejunocolic fistula. ACTA ACUST UNITED AC 2014; 34:273-4. [PMID: 25046895 DOI: 10.7869/tg.173] [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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Misra D, Zhang Y, Peloquin C, Choi HK, Kiel DP, Neogi T. Incident long-term warfarin use and risk of osteoporotic fractures: propensity-score matched cohort of elders with new onset atrial fibrillation. Osteoporos Int 2014; 25:1677-84. [PMID: 24833176 PMCID: PMC4180421 DOI: 10.1007/s00198-014-2662-0] [Citation(s) in RCA: 20] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 08/21/2013] [Indexed: 10/25/2022]
Abstract
UNLABELLED Association between warfarin use and fracture risk is unclear. We examined the association between long-term warfarin use and fracture risk at the hip, spine, and wrist in elders. No significant association was found between long-term warfarin use and fracture risk, despite biological plausibility. INTRODUCTION Prior studies examining the association of warfarin use and osteoporotic fractures have been conflicting, potentially related to methodological limitations. Thus, we examined the association of long-term warfarin use with risk of hip, spine, and wrist fractures among older adults with atrial fibrillation, attempting to address prior methodologic challenges. METHODS We included men and women ≥ 65 years of age with incident atrial fibrillation and without prior history of fractures from The Health Improvement Network followed between 2000 and 2010. Long-term warfarin use was defined in two ways: (1) warfarin use ≥ 1 year; (2) warfarin use ≥ 3 years. Propensity-score matched cohorts of warfarin users and nonusers were created to evaluate the association between long-term warfarin use and risk of hip, spine, and wrist fractures separately as well as combined, using Cox-proportional hazards regression models. RESULTS Among >20,000 participants with incident atrial fibrillation, the hazard ratios (HR) for hip fracture with warfarin use ≥ 1 and ≥ 3 years, respectively, were 1.08 (95%CI 0.87, 1.35) and 1.13 (95% CI 0.84, 1.50). Similarly, no significant associations were observed between long-term warfarin use and risk of spine or wrist fracture. When risk of any fracture was assessed with warfarin use, no association was found [HR for warfarin use ≥ 1 year 0.92 (95%CI 0.77, 1.10); HR for warfarin use ≥ 3 years 1.12 (95%CI 0.88, 1.43)]. CONCLUSIONS Long-term warfarin use among elders with atrial fibrillation was not associated with increased risk of osteoporotic fractures and therefore does not appear to necessitate additional surveillance or prophylaxis.
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Affiliation(s)
- D Misra
- Boston University School of Medicine, 650 Albany St, Suite X-200, Clinical Epidemiology Unit, Boston, MA, 02118, USA,
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Misra D, Pati GK, Misra B, Singh A, Kar S, Panigrahi MK, Singh SP, Agrawal O, Meher C. Malignant duodeno-colic fistula. Journal of Digestive Endoscopy 2014. [DOI: 10.4103/0976-5042.144833] [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: 11/04/2022] Open
Abstract
AbstractColo-duodenal fistula is a rare complication of gastro-intestinal malignancy and inflammatory bowel disease. The fistula often results in diarrhea and vomiting with dramatic weight loss. Vomiting may be feculent or truly fecal associated with foul smelling eructation. We present an unusual case of colonic carcinoma, where a 61-year-old female patient presented with pain abdomen and vomiting secondary to a malignant colo-duodenal fistula near the hepatic flexure. Ultrasonography showed a mass in the hepatic flexure area, and invasive adenocarcinoma was confirmed on histology from biopsy obtained during colonoscopy. Coloduodenal fistulae from colonic primaries are rare, but early diagnosis may allow curative surgery.
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Affiliation(s)
- Debasis Misra
- Department of Gastroenterology, S.C.B. Medical College, Cuttack, Odisha, India
| | - Girish Kumar Pati
- Department of Gastroenterology, S.C.B. Medical College, Cuttack, Odisha, India
| | - Bijay Misra
- Department of Gastroenterology, S.C.B. Medical College, Cuttack, Odisha, India
| | - Ayaskanta Singh
- Department of Gastroenterology, S.C.B. Medical College, Cuttack, Odisha, India
| | - Sanjib Kar
- Department of Gastroenterology, S.C.B. Medical College, Cuttack, Odisha, India
| | | | | | - Omprakash Agrawal
- Department of Gastroenterology, Beam Diagnostics Centre, Cuttack, Odisha, India
| | - Chudamani Meher
- Department of Gastroenterology, Beam Diagnostics Centre, Cuttack, Odisha, India
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Haugen IK, Ramachandran V, Misra D, Neogi T, Niu J, Yang T, Zhang Y, Felson DT. OP0027 Hand Osteoarthritis (OA) and the Associations to Mortality and Cardiovascular Events - Data from the Framingham Study. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-eular.232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Singh SP, Singh A, Pati GK, Misra B, Misra D, Kar SK, Panigrahi MK, Meher C, Agrawal O, Rout N, Pattnaik K, Bhuyan P, Mohapatra A. A Study of Prevalence of Diabetes and Prediabetes in Patients of Non-Alcoholic Fatty Liver Disease and the Impact of Diabetes on Liver Histology in Coastal Eastern India. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/jdm.2014.44040] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Singh SP, Misra D, Panigrahi MK, Kar IB, Meher C. Corrosive esophageal injury due to elemental sodium ingestion. Trop Gastroenterol 2014; 35:44-45. [PMID: 25276906 DOI: 10.7869/tg.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Kasthurirangan S, Saha JK, Agnihotri AN, Bhattacharyya S, Misra D, Kumar A, Mukherjee PK, Santos JP, Costa AM, Indelicato P, Mukherjee TK, Tribedi LC. Observation of 2p3d(1Po)→1s3d(1De) radiative transition in He-like Si, S, and Cl ions. Phys Rev Lett 2013; 111:243201. [PMID: 24483657 DOI: 10.1103/physrevlett.111.243201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Indexed: 06/03/2023]
Abstract
We present an experimental determination of the 2p3d(1Po)→1s3d(1De) x-ray line emitted from He-like Si, S, and Cl projectile ions, excited in collisions with thin carbon foils, using a high-resolution bent-crystal spectrometer. A good agreement between the observation and state-of-the-art relativistic calculations using the multiconfiguration Dirac-Fock formalism including the Breit interaction and QED effects implies the dominance of fluorescent decay over the autoionization process for the 2p3d(^{1}P^{o}) state of He-like heavy ions. This is the first observation of the fluorescence-active doubly excited states in He-like Si, S, and Cl ions.
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Affiliation(s)
- S Kasthurirangan
- Department of Nuclear and Atomic Physics, Tata Institute of Fundamental Research, Colaba, Mumbai 400005, India and Department of Physics, Institute of Chemical Technology, Mumbai 400019, India
| | - J K Saha
- Narula Institute of Technology, Agarpara, Kolkata 700109, India
| | - A N Agnihotri
- Department of Nuclear and Atomic Physics, Tata Institute of Fundamental Research, Colaba, Mumbai 400005, India
| | | | - D Misra
- Department of Nuclear and Atomic Physics, Tata Institute of Fundamental Research, Colaba, Mumbai 400005, India
| | - A Kumar
- Nuclear Physics Division, Bhabha Atomic Research Centre, Mumbai 400085, India
| | - P K Mukherjee
- Ramakrishna Mission Vivekananda University, Howrah 711202, India
| | - J P Santos
- Centro de Física Atómica, Departamento de Física, Faculdade de Ciências e Tecnologia, FCT, Universidade Nova de Lisboa, P-2829-516 Caparica, Portugal
| | - A M Costa
- Centro de Física Atómica, Departamento de Física, Faculdade de Ciências e Tecnologia, FCT, Universidade Nova de Lisboa, P-2829-516 Caparica, Portugal
| | - P Indelicato
- Laboratoire Kastler Brossel, École Normale Supérieure, CNRS, Université P. et M. Curie-Paris 6, Case 74; 4, place Jussieu, 75252 Paris CEDEX 05, France
| | - T K Mukherjee
- Narula Institute of Technology, Agarpara, Kolkata 700109, India
| | - L C Tribedi
- Department of Nuclear and Atomic Physics, Tata Institute of Fundamental Research, Colaba, Mumbai 400005, India
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Fischer D, Globig D, Goullon J, Grieser M, Hubele R, de Jesus VLB, Kelkar A, LaForge A, Lindenblatt H, Misra D, Najjari B, Schneider K, Schulz M, Sell M, Wang X. Ion-lithium collision dynamics studied with a laser-cooled in-ring target. Phys Rev Lett 2012; 109:113202. [PMID: 23005625 DOI: 10.1103/physrevlett.109.113202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Indexed: 06/01/2023]
Abstract
We present a novel experimental tool allowing for kinematically complete studies of break-up processes of laser-cooled atoms. This apparatus, the 'MOTReMi,' is a combination of a magneto-optical trap (MOT) and a reaction microscope (ReMi). Operated in an ion-storage ring, the new setup enables us to study the dynamics in swift ion-atom collisions on an unprecedented level of precision and detail. In the inaugural experiment on collisions with 1.5 MeV/amu O(8+)-Li the pure ionization of the valence electron as well as the ionization-excitation of the lithium target was investigated.
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Affiliation(s)
- D Fischer
- Max Planck Institute for Nuclear Physics, Saupfercheckweg 1, 69117 Heidelberg, Germany
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Thomas RD, Schmidt HT, Andler G, Björkhage M, Blom M, Brännholm L, Bäckström E, Danared H, Das S, Haag N, Halldén P, Hellberg F, Holm AIS, Johansson HAB, Källberg A, Källersjö G, Larsson M, Leontein S, Liljeby L, Löfgren P, Malm B, Mannervik S, Masuda M, Misra D, Orbán A, Paál A, Reinhed P, Rensfelt KG, Rosén S, Schmidt K, Seitz F, Simonsson A, Weimer J, Zettergren H, Cederquist H. The double electrostatic ion ring experiment: a unique cryogenic electrostatic storage ring for merged ion-beams studies. Rev Sci Instrum 2011; 82:065112. [PMID: 21721735 DOI: 10.1063/1.3602928] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We describe the design of a novel type of storage device currently under construction at Stockholm University, Sweden, using purely electrostatic focussing and deflection elements, in which ion beams of opposite charges are confined under extreme high vacuum cryogenic conditions in separate "rings" and merged over a common straight section. The construction of this double electrostatic ion ring experiment uniquely allows for studies of interactions between cations and anions at low and well-defined internal temperatures and centre-of-mass collision energies down to about 10 K and 10 meV, respectively. Position sensitive multi-hit detector systems have been extensively tested and proven to work in cryogenic environments and these will be used to measure correlations between reaction products in, for example, electron-transfer processes. The technical advantages of using purely electrostatic ion storage devices over magnetic ones are many, but the most relevant are: electrostatic elements which are more compact and easier to construct; remanent fields, hysteresis, and eddy-currents, which are of concern in magnetic devices, are no longer relevant; and electrical fields required to control the orbit of the ions are not only much easier to create and control than the corresponding magnetic fields, they also set no upper mass limit on the ions that can be stored. These technical differences are a boon to new areas of fundamental experimental research, not only in atomic and molecular physics but also in the boundaries of these fields with chemistry and biology. For examples, studies of interactions with internally cold molecular ions will be particular useful for applications in astrophysics, while studies of solvated ionic clusters will be of relevance to aeronomy and biology.
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Affiliation(s)
- R D Thomas
- Department of Physics, Stockholm University, SE-106 91 Stockholm, Sweden.
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Misra D, Berry SD, Broe KE, McLean RR, Cupples LA, Tucker KL, Kiel DP, Hannan MT. Does dietary protein reduce hip fracture risk in elders? The Framingham Osteoporosis Study. Osteoporos Int 2011; 22:345-9. [PMID: 20442986 PMCID: PMC2950889 DOI: 10.1007/s00198-010-1179-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [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: 08/11/2009] [Accepted: 12/18/2009] [Indexed: 01/16/2023]
Abstract
UNLABELLED Association between dietary protein and fracture risk is unclear. We examined association between energy-adjusted protein intake and hip fracture risk in elders. The risk of hip fracture was reduced in upper quartiles of protein intake when compared with lowest quartile. INTRODUCTION Studies of the association between dietary protein intake and hip fracture risk are conflicting. Therefore, we examined protein intake and hip fracture risk in a population-based group of elderly men and women. METHODS Five hundred seventy-six women and 370 men from the Framingham Osteoporosis Study with no previous history of hip fracture completed Food Frequency Questionnaires. Energy-adjusted protein intake was evaluated as a continuous variable and as quartiles. Incidence rates and hazard ratios were calculated, adjusting for age, BMI, sex, and energy intake. RESULTS Among 946 participants (mean age 75 years), mean protein intake was found to be 68 gm/d. Increased protein intake was associated with a decreased risk of hip fracture compared to those in the lowest quartile of protein intake (Q2 HR = 0.70, Q3 HR = 0.56, and Q4 HR = 0.63; all p values ≥ 0.044), p for trend was 0.07. When a threshold effect was considered (Q2-4 vs Q1), intakes in the higher quartiles combined were associated with a significantly lower risk for hip fracture (HR = 0.63; p = 0.04). CONCLUSION Our results are consistent with reduced risk of hip fracture with higher dietary protein intake. Larger prospective studies are needed to confirm and extend this finding in elderly men and women.
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Affiliation(s)
- D Misra
- Department of Rheumatology, Boston University Medical Center, Boston, MA, USA.
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Adsule SM, Misra D. Long term treatment with montelukast and levocetirizine combination in persistent allergic rhinitis: review of recent evidence. J Indian Med Assoc 2010; 108:381-382. [PMID: 21121394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Allergic rhinitis is the most prevalent of the atopic disorders, affecting 25% to 35% of persons, depending on the population studied. Considered by non-sufferers to be a trivial disease, allergic rhinitis delivers a significant personal impact on quality of life. Antihistamines have been successfully used for years in the treatment of seasonal/persistent allergic rhinitis. The new generation antihistaminics are all safe, with negligible sedative effects, excellent tolerability and have no influence on cardiac parameters. Montelukast when used as monotherapy is efficacious and improves quality of life. Combination therapy (montelukast plus levocetirizine) is a more effective strategy than monotherapy in the treatment of persistent allergic rhinitis.
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Affiliation(s)
- S M Adsule
- Allergy and Asthma Clinic, Mumbai 400007
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Misra D, Adelson K, Halpern M, Jaffer S, Nagi C, Bleiweiss I, Mandeli J, Raptis G, Germain D. Correlation of Oncotype DX Recurrence Score with Cyclin D1 and ErbB2. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-3035] [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: 11/16/2022]
Abstract
Abstract
Background: The Oncotype DX assay predicts the risk of recurrence in patients with stage I-II ER+, node negative breast cancer treated with tamoxifen. It is not understood if the Oncotype DX assay predicts the natural aggressiveness of an individual breast cancer or if it identifies a subtype of tamoxifen resistant breast cancer. In clinical practice, a high recurrence score (RS) on Oncotype DX is interpreted as a more aggressive tumor and is used to justify the use of chemotherapy. However, if the RS was actually predictive of tamoxifen resistance, patients may benefit from the use of an aromatase inhibitor, and chemotherapy may be unnecessary. Cyclin D1 and ErbB2 are two biomarkers shown to predict tamoxifen resistance.Cyclin D1 is overexpressed in approximately 35% of breast cancers. The Austrian Breast and Colorectal Cancer Study Group assessed expression of Cyclin D1 in patients taking tamoxifen within the ABCSG trial 05 and ABCSG trial 06. In both trials, Cyclin D1 overexpression correlated with a lower relapse free survival and overall survival compared to patients without Cyclin D1 overexpression.Erb2 is overexpressed in 15-30% of breast cancers. In the Gruppo Universitario Napoletano 1 trial, ER+ patients with early stage node negative breast cancer who overexpressed ErbB2 had no improvement in progression free survival and overall survival with 2 years of adjuvant tamoxifen therapy. Additional retrospective studies have supported initial reports of an association between overexpression of ErbB2 and tamoxifen resistance.Methods: 69 patients who had the Oncotype DX assay performed and had unstained pathology slides available were assessed for ErbB2 and Cyclin D1 expression. ErbB2 overexpression status was also obtained in another 74 patients who had the Oncotype DX assay performed. ErbB2 overexpression was determined from a review of medical records where ErbB2 was defined as being positive if immunohistochemical (IHC) staining intensity was 3+ with >90% of cells expressing ErbB2 or FISH revealed an amplification of >2.0. IHC analysis of Cyclin D1 was performed according to standard protocol and using commercially available antibodies. Scoring of slides for Cyclin D1 staining were performed by blinded pathologists who assessed both extent and intensity of nuclear staining for Cyclin D1.Results: The median Oncotype Dx RS within ErbB2+ patients was significantly higher than ErbB2- patients (36.5 vs. 18 p<0.0001), and approximately 50% of patients within each RS grouping (high, intermediate, and low) overexpressed cyclin D1.Conclusion: ErbB2 overexpression among high RS patients suggests the Oncotype DX assay may predict tamoxifen resistance and other markers for tamoxifen resistance need to be correlated with the RS. Although preliminary analysis of the IHC staining for Cyclin D1 does not correlate with a high RS, high Cyclin D1 expression among patients within the low RS subgroup is concerning since this subgroup may have an increased likelihood of disease relapse when treated with adjuvant tamoxifen alone.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3035.
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Affiliation(s)
- D. Misra
- 1Mount Sinai School of Medicine, NY,
| | | | | | - S. Jaffer
- 1Mount Sinai School of Medicine, NY,
| | - C. Nagi
- 1Mount Sinai School of Medicine, NY,
| | | | | | - G. Raptis
- 1Mount Sinai School of Medicine, NY,
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Reinhed P, Orbán A, Werner J, Rosén S, Thomas RD, Kashperka I, Johansson HAB, Misra D, Brännholm L, Björkhage M, Cederquist H, Schmidt HT. Precision lifetime measurements of He(-) in a cryogenic electrostatic ion-beam trap. Phys Rev Lett 2009; 103:213002. [PMID: 20366032 DOI: 10.1103/physrevlett.103.213002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2009] [Indexed: 05/29/2023]
Abstract
We have developed a small purely electrostatic ion-beam trap which may be operated in thermal equilibrium at precisely controlled temperatures down to 10 K. Thus, we avoid magnetic field induced mixing of quantum states and may effectively eliminate any influence from absorption of photons from blackbody radiation. We report the first correction-free measurement of the lifetime of the 1s2s2p {4}P{5/2}{0} level of 4He(-) yielding the high-precision result 359.0 +/- 0.7 micros. This result is an essential proof-of-principle for cryogenic electrostatic storage rings and traps for atomic and molecular physics.
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Affiliation(s)
- P Reinhed
- Department of Physics, Stockholm University, AlbaNova University Center, 10691 Stockholm, Sweden
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Salafia CM, Misra D, Miles JNV. Methodologic issues in the study of the relationship between histologic indicators of intraamniotic infection and clinical outcomes. Placenta 2009; 30:988-93. [PMID: 19775753 DOI: 10.1016/j.placenta.2009.08.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [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: 05/11/2009] [Revised: 08/24/2009] [Accepted: 08/25/2009] [Indexed: 10/20/2022]
Abstract
GOAL To determine the structure of the relationships of the histology scores for acute intraamniotic infection collected in the Collaborative Perinatal Project (CPP). MATERIALS AND METHODS 44,427 subjects of the CPP had complete histology scores available for the 9 measures that related to acute intraamniotic infection (i.e., neutrophil infiltrates in umbilical cord, amnion of extraplacental membranes and chorionic plate, decidua, chorionic plate and fetal chorionic vessels). Confirmatory factor analysis was used to determine the relationships among the different markers of maternal inflammatory responses (in amnion, chorion and decidua) and fetal inflammatory responses (in umbilical cord and fetal chorionic vessels). RESULTS A single CFA model could not be developed across all CPP sites. A well-fit model was developed from the Boston site (N=10,803) and the factor loadings applied to the histology scores from the other CPP sites. The resultant scores for the latent variables (maternal and fetal inflammatory responses) were compared across sites. There was not only considerable variability in factor loadings, and the signs of factor loadings were also inconsistent across sites. CONCLUSION Histopathology scores of neutrophil infiltrates performed by different observers do not have the same interrelationships and, by extension, the latent variables they are supposed to reflect may not be equivalent. The lack of measurement invariance renders their use as indicators of the underlying processes of maternal and fetal inflammatory responses problematic in analysis with any clinical outcome.
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Affiliation(s)
- C M Salafia
- Placental Analytics, LLC, Larchmont, NY, USA.
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Misra D, Bajpai U. Metabolite characterization in serum samples from normal healthy human subjects by 1H and 13C NMR spectroscopy. B CHEM SOC ETHIOPIA 2009. [DOI: 10.4314/bcse.v23i2.44964] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Burki T, Misra D, Ward H, Patricolo M, Cord-Udy C. Conservative management of major abdominal wound dehiscence in premature babies - a seven-year experience. Eur J Pediatr Surg 2009; 19:232-5. [PMID: 19370515 DOI: 10.1055/s-0029-1215602] [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: 10/20/2022]
Abstract
AIM The aim of the study was to analyse our experience of managing complete abdominal wound dehiscence in preterm neonates non operatively, when primary closure was not possible. We used intrasite gel (a carboxymethyl cellulose polymer which helps in wound debridement and healing) and occlusive duoderme dressings. MATERIALS AND METHODS There were seven neonates who developed abdominal dehiscence following laparotomy between January 2000 and December 2006. All had complete abdominal dehiscence with visible intestines. The defect was allowed to granulate and epithelialise by the application of intrasite gel and duoderme dressings. Dressings were changed every 3 days, or earlier, if necessary. RESULTS All babies responded well, i.e. their wounds healed without the need for immediate surgery. One patient actually had a stoma in the middle of the wound which was managed with stoma bags during the same period. The period of total epithelialisation ranged from 21 to 108 days. Two patients developed adhesive intestinal obstruction requiring surgery, at 2 and 3 months after the start of treatment. On follow-up, 2/7 patients had developed an incisional hernia. CONCLUSION Abdominal wound dehiscence can be successfully managed conservatively with intrasite gel and duoderme dressings, even if bowel is visible. This is potentially lifesaving in severely premature and septic babies in whom primary closure is not desirable. However, some patients do develop adhesive intestinal obstruction or a faecal fistula, either as a result of their primary illness or of this treatment. We believe that this series is the first of its kind to be reported in the world literature.
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Affiliation(s)
- T Burki
- Department of Paediatric Surgery, Royal London Hospital, London, United Kingdom
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Rathod RT, Misra D. FDC of montelukast with levocetirizine: focus on bilayer technology. J Indian Med Assoc 2009; 107:562-564. [PMID: 20112841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Allergic rhinitis is the most common allergic disease worldwide and affects about 18% to 40% of the general population. Anti-allergic medicines (eg, some antihistamines) can cause adverse events such as somnolence and can have an additional negative impact on quality of life. Combining montelukast with levocetirizine gives additional benefits in comparison with either drug alone and could be considered for patients whose quality of life is impaired by persistent allergic rhinitis. Montelukast sodium is alkaline, stable and levocetirizine dihydrochloride is acid stable, when we prepare a matrix tablet, both the drugs would be in contact and make it unstable during the shelf life of the formulation. Hence it is recommended to prepare bilayer tablet, as it improves and increases the stability of both the drugs in combination. Bilayer tablet of montelukast with levocetirizine is more stable with respect to stability studies, in comparison to matrix tablet.
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Affiliation(s)
- R T Rathod
- German Remedies Division, Cadila Healthcare Limited, Mumbai 400018. [corrected]
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Affiliation(s)
- MC Trautner
- Neonatal Unit Homerton University Hospital London UK
| | - N Aladangady
- Neonatal Unit Homerton University Hospital/Barts and The London Queen Mary's School of Medicine London UK
| | - E Maalouf
- Neonatal Unit Homerton University Hospital London UK
| | - D Misra
- Department of Paediatric Surgery Royal London Hospital Whitechapel, London UK
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Kim DW, Misra D, Clough RW, Long GD, Prosnitz RG. Outcomes after autologous stem cell transplantation in relapsed or refractory Hodgkin disease: The Duke experience. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.8100] [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: 11/20/2022] Open
Abstract
8100 Background: High dose chemotherapy (HDT) followed by autologous stem cell transplantation (ASCT) offers patients with relapsed or refractory Hodgkin's disease (HD) the possibility of durable long term remission. We examined the characteristics and outcomes of patients treated at Duke University Medical Center between May 1997 and May 2006. Methods: We performed a retrospective chart review on all patients with relapsed or refractory HD who received HDT followed by ASCT at our institution. Various prognostic factors were also analyzed for their impact on overall survival (OS) and disease free survival (DFS). Results: Sixty-one patients received HDT followed by ASCT for relapsed or refractory HD. Median age was 33 years (range: 16 years to 64 years). The patient population was comprised primarily of males (64%), Caucasians (80%), and patients with nodular sclerosing histology (77%). Fifty-six percent of patients had primary refractory HD. At the time of relapse, 44% of patients had stage I-II disease, and 21% had B symptoms. For patients with relapsed disease, the median time from initial diagnosis to relapse was 17 months. Most patients (64%) received cyclophosphamide, etoposide, and BCNU chemotherapy as HDT. Thirty-one percent of patients received consolidative radiotherapy after HDT. Twenty-eight percent of patients had chemotherapy- responsive disease prior to undergoing HDT. Following ASCT, 46/61 (75%) of patients achieved a complete response. Transplant-related deaths occurred in 2/61 (3%) patients. With a median follow-up of 2.5 years (range: 3 months to 8.8 years), the actuarial 5-year OS and DFS were 79% and 50%, respectively. The most common post-therapy complication was pneumonitis, which occurred in 62% of patients. Three (5%) patients developed second malignancies. On univariate analysis, gender, stage at diagnosis, stage at relapse, presence of B symptoms at relapse, and the interval to first relapse did not significantly affect OS or DFS. Conclusions: Our results confirm that HDT followed by ASCT offers an excellent chance for long-term DFS and OS in patients with relapsed or refractory HD, with a low risk of treatment-related mortality. No significant financial relationships to disclose.
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Affiliation(s)
- D. W. Kim
- Duke University Medical Center, Durham, NC
| | - D. Misra
- Duke University Medical Center, Durham, NC
| | | | - G. D. Long
- Duke University Medical Center, Durham, NC
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Kumar A, Misra D, Kadhane U, Kelkar A, Dhal B, Tribedi L. L X-ray emission from fast highly charged Cu ions in collisions with gaseous targets: Saturation effect in excitation and transfer. Radiat Phys Chem Oxf Engl 1993 2006. [DOI: 10.1016/j.radphyschem.2005.07.029] [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: 11/27/2022]
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Seo PH, Sloane R, Ingram SS, Misra D, Clipp EC, Montana GS, Cohen HJ. The relationship between older cancer survivors’ reports of depression, anxiety and pain to health providers’ findings and mortality. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.8597] [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: 11/20/2022] Open
Abstract
8597 Background: Older cancer survivors may experience psychological distress due to their cancer experience and aging health. This study aimed to compare primary care and specialty providers’ inquiries of pain, depression and anxiety to older cancer survivors’ questionnaire responses. Methods: 153 patients seen in oncology clinics at the Veterans Affairs Medical Center (Durham, NC) from November 1999 until April 2000 completed the Hospital Anxiety and Depression Scale and a pain thermometer questionnaire. Blinded chart review examined health provider inquiries of pain, anxiety and depression. Cox proportional hazards survival analyses were performed on subjective pain, anxiety and depression with comorbidities and Karnofsky performance status (KPS) added in controlled models. Results: Patients were on average aged 68, had 5.4 comorbidities, 87.4% KPS, and were 3.1 years from a cancer diagnosis. Health providers missed 17 of 94 patients with significant levels of self-reported pain (sensitivity 0.82). Although 28 (20.6%) and 33 (25.8%) patients screened positively for depression and anxiety respectively, providers asked 7 patients about anxiety (sensitivity 0.15) and 16 patients about depression (sensitivity 0.25). The overall three year mortality was 37.9%. Pain was not associated with mortality. Patients screening for depression [HR 2.03 (95% CI: 1.03, 4.01)] and anxiety [HR 2.02 (95% CI: 1.01, 4.04)] had lower 3 year survival. KPS and comorbidities diminished these effects. Conclusions: In older cancer survivors, anxiety and depression may have an association with mortality. To improve detection, oncology and primary care providers should routinely inquire about mood and aim to intervene with pharmacologic or supportive treatments. No significant financial relationships to disclose.
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Affiliation(s)
- P. H. Seo
- Duke University Medical Center, Durham, NC; Durham Veterans Affairs Medical Center, Durham, NC
| | - R. Sloane
- Duke University Medical Center, Durham, NC; Durham Veterans Affairs Medical Center, Durham, NC
| | - S. S. Ingram
- Duke University Medical Center, Durham, NC; Durham Veterans Affairs Medical Center, Durham, NC
| | - D. Misra
- Duke University Medical Center, Durham, NC; Durham Veterans Affairs Medical Center, Durham, NC
| | - E. C. Clipp
- Duke University Medical Center, Durham, NC; Durham Veterans Affairs Medical Center, Durham, NC
| | - G. S. Montana
- Duke University Medical Center, Durham, NC; Durham Veterans Affairs Medical Center, Durham, NC
| | - H. J. Cohen
- Duke University Medical Center, Durham, NC; Durham Veterans Affairs Medical Center, Durham, NC
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44
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Abstract
A 33-year-old woman presented at 31 weeks' gestation with polyhydramnios that required repeated amniodrainage. An antenatal scan at 32 weeks showed dilated fetal bowel loops, which were not confirmed on subsequent scans. The amniotic fluid karyotype confirmed 47,XXX. After birth, jejunal obstruction was confirmed. To our knowledge, this is the first report of an association of triple-X syndrome and jejunal atresia.
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Affiliation(s)
- M C Trautner
- Neonatal Unit, Homerton University Hospital, London, UK
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45
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Obunai K, Misra D, Schweitzer P. 17 A CASE OF TRANSIENT LEFT VENTRICULAR APICAL BALLOONING WITHOUT CORONARY ARTERY DISEASE. J Investig Med 2005. [DOI: 10.2310/6650.2005.00006.16] [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: 11/18/2022]
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46
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Abstract
Familial duodenal atresia occurs as part of Feingold syndrome. Other features of this variable autosomal dominant condition include tracheo-oesophageal fistula and oesophageal atresia, microcephaly, hand and foot anomalies, facial dysmorphism, and developmental delay. We report a father and two sons with Feingold syndrome. One has bilateral dysplastic kidneys which have not been reported previously.
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Affiliation(s)
- M Holder-Espinasse
- Clinical and Molecular Genetics Unit, Institute of Child Health, London, UK
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47
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Kaul PP, Shyam S, Srivastava R, Misra D, Salve PR, Srivastava SP. Lead levels in ambient air and blood of pregnant mothers from the general population of Lucknow (U.P.), India. Bull Environ Contam Toxicol 2003; 71:1239-1243. [PMID: 14756294 DOI: 10.1007/s00128-003-8825-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- P P Kaul
- Industrial Toxicology Research Centre, Post Office Box 80, M.G. Marg, Lucknow 226001, India
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48
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Abstract
Feeding jejunostomy is a recognized method of managing feeding difficulties and failure to thrive in neurologically impaired children. There are, however, significant associated complications. The authors report 4 cases of the potentially fatal complication of severe jejunoileitis, which has not been reported previously in children. The possible underlying mechanisms are discussed.
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Affiliation(s)
- R Garrett-Cox
- Royal London Hospital, Whitechapel, London, England UK
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49
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Kadhane U, Misra D, Singh YP, Tribedi LC. Effect of collective response on electron capture and excitation in collisions of highly charged ions with fullerenes. Phys Rev Lett 2003; 90:093401. [PMID: 12689221 DOI: 10.1103/physrevlett.90.093401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2002] [Indexed: 05/24/2023]
Abstract
Projectile deexcitation Lyman x-ray emission following electron capture and K excitation has been studied in collisions of bare and Li-like sulphur ions (of energy 110 MeV) with fullerenes (C(60)/C(70)) and different gaseous targets. The intensity ratios of different Lyman x-ray lines in collisions with fullerenes are found to be substantially lower than those for the gas targets, both for capture and excitation. This has been explained in terms of a model based on "solidlike" effect, namely, wakefield induced stark mixing of the excited states populated via electron capture or K excitation: a collective phenomenon of plasmon excitation in the fullerenes under the influence of heavy, highly charged ions.
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Affiliation(s)
- U Kadhane
- Tata Institute of Fundamental Research, Homi Bhabha Road, Colaba, Mumbai-400005, India
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50
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Hardee PG, Coghlan KM, Misra D. Staphylococcal submandibular lymphadentitis of childhood. J Ir Dent Assoc 2002; 47:83-5. [PMID: 11764643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
The presentation of two patients with the condition is described. The difficulty of finding an underlying cause of the infection is discussed, and the importance of a history of recent head and neck infection emphasised. Recommendations are made for appropriate antibiotic therapy to cover Staphylococci as well as the more common Streptococci.
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