1
|
Patel KK, Toft N, Kovaliski J, Page B, Appuhamilage RMJJE, Taggart PL. Bayesian evaluation of temporal changes in sensitivity and specificity of three serological tests for multiple circulating strains of rabbit haemorrhagic disease virus. Prev Vet Med 2024; 225:106137. [PMID: 38359470 DOI: 10.1016/j.prevetmed.2024.106137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 01/11/2024] [Accepted: 01/28/2024] [Indexed: 02/17/2024]
Abstract
Competition and indirect ELISAs are currently being used to monitor rabbit haemorrhagic disease viruses (RHDV1 and RHDV2) in rabbits worldwide. Temporal changes in the sensitivity (Se) and specificity (Sp) of RHDV1 competition-ELISA (cELISA1), RHDV2 competition-ELISA (cELISA2), and RHDV1 Immunoglobulin G (IgG1) ELISA, were investigated using Bayesian Latent Class models (BCLM) in the Australian wild rabbit population where both viruses circulate simultaneously and a long-term serological dataset exists. When cELISA1 was compared to IgG1 ELISA, the Se of cELISA1 improved while the Sp of IgG1 ELISA declined over the 2011-21. This corresponded with a decline in the true RHDV1 prevalence in 2018-21, suggesting that a large proportion of RHDV1 exposed rabbits survived the introduction and dominance of RHDV2 up to approximately 2017/2018, after which they died and were not replaced. The Se and Sp estimates for 2014-15 for both cELISA1 and IgG1 ELISA, and the true prevalence when analysing all three tests together were similar to those obtained from the analysis of cELISA1/IgG1 ELISA. The same was also true for the Se and Sp of cELISA2 and IgG1 ELISA estimates from 2018 onwards. This suggests that RHDV1 was the dominant infection type in 2014-15, but RHDV2 was the dominant infection type in 2018-21. Further, the increase in Se of cELISA2 and the low Sp of IgG1 ELISA in the cELISA2/IgG1 ELISA analysis, compared to the Se of cELISA2 and Sp of IgG1 ELISA when analysing all three tests together suggests that the underlying infection status was more influenced by RHDV2 and that the higher Se of IgG1 ELISA is due to cross-reaction of RHDV2 antibodies on IgG1 ELISA. The true prevalence data suggest that RHDV2 exposure peaked in 2017. Our findings show that test characteristics changed in response to the changing virus prevalences over time. IgG1 ELISA, currently having a high Se, should be used to monitor both viruses and will perform better than both cELISAs.
Collapse
Affiliation(s)
- Kandarp K Patel
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, South Australia 5371, Australia; Biosecurity, Department of Primary Industries and Regions (PIRSA), Urrbrae, South Australia, 5064, Australia; Centre for Invasive Species Solutions, Bruce, Australian Capital Territory 2617, Australia.
| | - Nils Toft
- IQinAbox, Værløse, Denmark; Toft Analytics, Copenhagen, Denmark
| | - John Kovaliski
- Biosecurity, Department of Primary Industries and Regions (PIRSA), Urrbrae, South Australia, 5064, Australia; Centre for Invasive Species Solutions, Bruce, Australian Capital Territory 2617, Australia
| | - Bradley Page
- Biosecurity, Department of Primary Industries and Regions (PIRSA), Urrbrae, South Australia, 5064, Australia; Centre for Invasive Species Solutions, Bruce, Australian Capital Territory 2617, Australia
| | - Ridma M J Jayasinghe Ellakkala Appuhamilage
- Biosecurity, Department of Primary Industries and Regions (PIRSA), Urrbrae, South Australia, 5064, Australia; Centre for Invasive Species Solutions, Bruce, Australian Capital Territory 2617, Australia
| | - Patrick L Taggart
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, South Australia 5371, Australia; Centre for Invasive Species Solutions, Bruce, Australian Capital Territory 2617, Australia; Vertebrate Pest Research Unit, Department of Primary Industries NSW, Queanbeyan, New South Wales 2620, Australia; School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, New South Wales 2052, Australia; Bush Heritage Australia, Melbourne, Victoria 3000, Australia
| |
Collapse
|
2
|
Patel KK, Austin C, Warner K, Pickett M, Khabiri A, Mahzounieh M, Hemmatzadeh F, Taggart PL. The impact of integrating rabbit haemorrhagic disease virus (K5) release with pindone baiting on wild rabbit populations. Ecol Evol 2024; 14:e10991. [PMID: 38476706 PMCID: PMC10928239 DOI: 10.1002/ece3.10991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 12/12/2023] [Accepted: 01/04/2024] [Indexed: 03/14/2024] Open
Abstract
Several conventional and recently available tools are available for an integrated control of European rabbits in Australia. We quantified the impact of the release of rabbit haemorrhagic disease virus K5 (RHDV K5, hereafter K5) and pindone (2-pivalyl-1,3-indandione) baiting at 13 sites within Cudlee Creek fire scar in the Adelaide Hills, South Australia. K5 release was followed by pindone baiting between December 2021 and March 2022; the application of both control methods followed industry best practice. We counted rabbits using spotlights before and after the application of both control methods. Fly samples and livers from dead rabbits were collected to track K5 transmission within and between sites, and to detect the natural circulation of rabbit haemorrhagic disease virus 2 (RHDV2). K5 release had minimal impact on rabbit populations, with treated populations increasing by a mean of 65.5% at 14 days post-release and 27.9% at 77 days post-K5 release across all sites, comparable to the changes at control sites. K5 detection in flies up to 77 days post its release, and its detection in rabbit livers, demonstrates that it can survive and transmit in the environment for prolonged periods and that it can lethally infect some rabbits. This limited impact of K5 is consistent with previous studies and may be explained by pre-existing RHDV/RHDV2 immunity in the target populations or the presence of young rabbits with natural innate RHDV immunity. The detection of K5 in flies from control sites demonstrates that it was vectored beyond its release location. A reduction in rabbit counts post-pindone baiting was observed at most treatment sites, with a mean population reduction of 36.6% across all sites. Landholders need to carefully and strategically plan their integrated rabbit control programmes. Not all combinations of controls, even if theoretically logical, achieve meaningful outcomes for rabbit management.
Collapse
Affiliation(s)
- Kandarp K. Patel
- School of Animal and Veterinary SciencesThe University of AdelaideRoseworthySouth AustraliaAustralia
- Davies Livestock Research CentreThe University of AdelaideRoseworthySouth AustraliaAustralia
- Centre for Invasive Species SolutionsBruceAustralian Capital TerritoryAustralia
| | - Catherine Austin
- Landscapes Hills and FleurieuMount BarkerSouth AustraliaAustralia
| | - Katrina Warner
- Landscapes Hills and FleurieuMount BarkerSouth AustraliaAustralia
| | - Marcus Pickett
- Marcus Pickett Ecological ServicesLobethalSouth AustraliaAustralia
| | - Aliakbar Khabiri
- School of Animal and Veterinary SciencesThe University of AdelaideRoseworthySouth AustraliaAustralia
| | - Mohammadreza Mahzounieh
- School of Animal and Veterinary SciencesThe University of AdelaideRoseworthySouth AustraliaAustralia
| | - Farhid Hemmatzadeh
- School of Animal and Veterinary SciencesThe University of AdelaideRoseworthySouth AustraliaAustralia
| | - Patrick L. Taggart
- School of Animal and Veterinary SciencesThe University of AdelaideRoseworthySouth AustraliaAustralia
- Centre for Invasive Species SolutionsBruceAustralian Capital TerritoryAustralia
- Bush Heritage AustraliaVictor HarborSouth AustraliaAustralia
- School of Biological, Earth and Environmental SciencesUniversity of New South WalesSydneyNew South WalesAustralia
| |
Collapse
|
3
|
Peng NYG, Hall RN, Huang N, West P, Cox TE, Mahar JE, Mason H, Campbell S, O’Connor T, Read AJ, Patel KK, Taggart PL, Smith IL, Strive T, Jenckel M. Utilizing Molecular Epidemiology and Citizen Science for the Surveillance of Lagoviruses in Australia. Viruses 2023; 15:2348. [PMID: 38140589 PMCID: PMC10747141 DOI: 10.3390/v15122348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 12/24/2023] Open
Abstract
Australia has multiple lagoviruses with differing pathogenicity. The circulation of these viruses was traditionally determined through opportunistic sampling events. In the lead up to the nationwide release of RHDVa-K5 (GI.1aP-GI.1a) in 2017, an existing citizen science program, RabbitScan, was augmented to allow members of the public to submit samples collected from dead leporids for lagovirus testing. This study describes the information obtained from the increased number of leporid samples received between 2015 and 2022 and focuses on the recent epidemiological interactions and evolutionary trajectory of circulating lagoviruses in Australia between October 2020 and December 2022. A total of 2771 samples were tested from January 2015 to December 2022, of which 1643 were lagovirus-positive. Notable changes in the distribution of lagovirus variants were observed, predominantly in Western Australia, where RHDV2-4c (GI.4cP-GI.2) was detected again in 2021 after initially being reported to be present in 2018. Interestingly, we found evidence that the deliberately released RHDVa-K5 was able to establish and circulate in wild rabbit populations in WA. Overall, the incorporation of citizen science approaches proved to be a cost-efficient method to increase the sampling area and enable an in-depth analysis of lagovirus distribution, genetic diversity, and interactions. The maintenance of such programs is essential to enable continued investigations of the critical parameters affecting the biocontrol of feral rabbit populations in Australia, as well as to enable the detection of any potential future incursions.
Collapse
Affiliation(s)
- Nias Y. G. Peng
- Commonwealth Scientific and Industrial Research Organisation, Health and Biosecurity, Canberra, ACT 2601, Australia; (N.Y.G.P.); (R.N.H.); (N.H.); (H.M.); (I.L.S.); (T.S.)
| | - Robyn N. Hall
- Commonwealth Scientific and Industrial Research Organisation, Health and Biosecurity, Canberra, ACT 2601, Australia; (N.Y.G.P.); (R.N.H.); (N.H.); (H.M.); (I.L.S.); (T.S.)
- Centre for Invasive Species Solutions, Bruce, ACT 2617, Australia; (P.W.); (A.J.R.); (K.K.P.); (P.L.T.)
- Ausvet Pty Ltd., Canberra, ACT 2617, Australia
| | - Nina Huang
- Commonwealth Scientific and Industrial Research Organisation, Health and Biosecurity, Canberra, ACT 2601, Australia; (N.Y.G.P.); (R.N.H.); (N.H.); (H.M.); (I.L.S.); (T.S.)
| | - Peter West
- Centre for Invasive Species Solutions, Bruce, ACT 2617, Australia; (P.W.); (A.J.R.); (K.K.P.); (P.L.T.)
- Vertebrate Pest Research Unit, NSW Department of Primary Industries, Orange, NSW 2880, Australia;
| | - Tarnya E. Cox
- Vertebrate Pest Research Unit, NSW Department of Primary Industries, Orange, NSW 2880, Australia;
| | - Jackie E. Mahar
- School of Medical Sciences, The University of Sydney, Sydney, NSW 2050, Australia;
- Commonwealth Scientific and Industrial Research Organisation, Australian Animal Health Laboratory and Health and Biosecurity, Geelong, VIC 3220, Australia
| | - Hugh Mason
- Commonwealth Scientific and Industrial Research Organisation, Health and Biosecurity, Canberra, ACT 2601, Australia; (N.Y.G.P.); (R.N.H.); (N.H.); (H.M.); (I.L.S.); (T.S.)
| | - Susan Campbell
- Department of Primary Industries and Regional Development WA, Albany, WA 6630, Australia;
| | - Tiffany O’Connor
- Centre for Invasive Species Solutions, Bruce, ACT 2617, Australia; (P.W.); (A.J.R.); (K.K.P.); (P.L.T.)
- Elizabeth Macarthur Agricultural Institute, NSW Department of Primary Industries, Menangle, NSW 2568, Australia
| | - Andrew J. Read
- Centre for Invasive Species Solutions, Bruce, ACT 2617, Australia; (P.W.); (A.J.R.); (K.K.P.); (P.L.T.)
- Elizabeth Macarthur Agricultural Institute, NSW Department of Primary Industries, Menangle, NSW 2568, Australia
| | - Kandarp K. Patel
- Centre for Invasive Species Solutions, Bruce, ACT 2617, Australia; (P.W.); (A.J.R.); (K.K.P.); (P.L.T.)
- Invasive Species Unit, Department of Primary Industries and Regions SA, Urrbrae, SA 5064, Australia
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, SA 5371, Australia
| | - Patrick L. Taggart
- Centre for Invasive Species Solutions, Bruce, ACT 2617, Australia; (P.W.); (A.J.R.); (K.K.P.); (P.L.T.)
- Vertebrate Pest Research Unit, NSW Department of Primary Industries, Queanbeyan, NSW 2620, Australia
| | - Ina L. Smith
- Commonwealth Scientific and Industrial Research Organisation, Health and Biosecurity, Canberra, ACT 2601, Australia; (N.Y.G.P.); (R.N.H.); (N.H.); (H.M.); (I.L.S.); (T.S.)
| | - Tanja Strive
- Commonwealth Scientific and Industrial Research Organisation, Health and Biosecurity, Canberra, ACT 2601, Australia; (N.Y.G.P.); (R.N.H.); (N.H.); (H.M.); (I.L.S.); (T.S.)
- Centre for Invasive Species Solutions, Bruce, ACT 2617, Australia; (P.W.); (A.J.R.); (K.K.P.); (P.L.T.)
| | - Maria Jenckel
- Commonwealth Scientific and Industrial Research Organisation, Health and Biosecurity, Canberra, ACT 2601, Australia; (N.Y.G.P.); (R.N.H.); (N.H.); (H.M.); (I.L.S.); (T.S.)
| |
Collapse
|
4
|
Dorji T, Jayasingha Ellakkala Appuhamilage RMJ, Bird PL, Huang N, O’Connor TW, Patel KK, Strive T, Taggart PL. Optimising the Delivery of RHDV to Rabbits for Biocontrol: An Experimental Evaluation of Two Novel Methods of Virus Delivery. Viruses 2023; 15:1814. [PMID: 37766220 PMCID: PMC10536075 DOI: 10.3390/v15091814] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023] Open
Abstract
Rabbit haemorrhagic disease virus (RHDV) is established as a landscape-scale biocontrol that assists the management of invasive European rabbits and their impacts in both Australia and New Zealand. In addition to this, it is also available to land managers to augment rabbit control efforts at a local scale. However, current methods of deploying RHDV to rabbits that rely on the consumption of virus-treated baits can be problematic as rabbits are reluctant to consume bait when there is abundant, green, protein-rich feed available. We ran a suite of interrupted time-series experiments to compare the duration of infectivity of two conventional (carrot and oat baits) and two novel (meat bait and soil burrow spray) methods of deploying RHDV to rabbits. All methods effectively killed exposed rabbits. Soil burrow spray and carrot baits resulted in infection and mortality out to 5 days post their deployment in the field, and meat baits caused infection out to 10 days post their deployment. In contrast, oat baits continued to infect and kill exposed rabbits out to 20 days post deployment. Molecular assays demonstrated high viral loads in deployed baits beyond the duration for which they were infectious or lethal to rabbits. Based on our results, we suggest that the drying of meat baits may create a barrier to effective transmission of RHDV by adult flies within 10 days. We therefore hypothesise that fly larvae production and development on infected tissues is critical to prolonged viral transmission from meat baits, and similarly from carcasses of RHDV mortalities, via mechanical fly vectors. Our study demonstrates that meat baits and soil spray could provide additional virus deployment options that remove the need for rabbits to consume baits at times when they are reluctant to do so.
Collapse
Affiliation(s)
- Tshewang Dorji
- Biosecurity, Department of Primary Industries and Regions (PIRSA), Urrbrae, SA 5064, Australia; (T.D.); (R.M.J.J.E.A.); (K.K.P.)
- School of Food, Agriculture and Wine, The University of Adelaide, Urrbrae, SA 5064, Australia
| | | | - Peter L. Bird
- Waite Conservation Reserve, University of Adelaide, Urrbrae, SA 5064, Australia;
| | - Nina Huang
- Health & Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Acton, ACT 2601, Australia; (N.H.); (T.S.)
| | - Tiffany W. O’Connor
- Virology Laboratory, Elizabeth Macarthur Agricultural Institute, Department of Primary Industries NSW, Menangle, NSW 2568, Australia
| | - Kandarp K. Patel
- Biosecurity, Department of Primary Industries and Regions (PIRSA), Urrbrae, SA 5064, Australia; (T.D.); (R.M.J.J.E.A.); (K.K.P.)
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, SA 5371, Australia
| | - Tanja Strive
- Health & Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Acton, ACT 2601, Australia; (N.H.); (T.S.)
| | - Patrick L. Taggart
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, SA 5371, Australia
- Vertebrate Pest Research Unit, Department of Primary Industries NSW, Queanbeyan, NSW 2620, Australia
- School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, NSW 2000, Australia
| |
Collapse
|
5
|
Ramsey DS, Patel KK, Campbell S, Hall RN, Taggart PL, Strive T. Sustained Impact of RHDV2 on Wild Rabbit Populations across Australia Eight Years after Its Initial Detection. Viruses 2023; 15:v15051159. [PMID: 37243245 DOI: 10.3390/v15051159] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
Following the arrival of rabbit haemorrhagic disease virus 2 (RHDV2) in Australia, average rabbit population abundances were reduced by 60% between 2014 and 2018 based on monitoring data acquired from 18 sites across Australia. During this period, as the seropositivity to RHDV2 increased, concurrent decreases were observed in the seroprevalence of both the previously circulating RHDV1 and RCVA, a benign endemic rabbit calicivirus. However, the detection of substantial RHDV1 seropositivity in juvenile rabbits suggested that infections were continuing to occur, ruling out the rapid extinction of this variant. Here we investigate whether the co-circulation of two pathogenic RHDV variants was sustained after 2018 and whether the initially observed impact on rabbit abundance was still maintained. We monitored rabbit abundance and seropositivity to RHDV2, RHDV1 and RCVA at six of the initial eighteen sites until the summer of 2022. We observed sustained suppression of rabbit abundance at five of the six sites, with the average population reduction across all six sites being 64%. Across all sites, average RHDV2 seroprevalence remained high, reaching 60-70% in adult rabbits and 30-40% in juvenile rabbits. In contrast, average RHDV1 seroprevalence declined to <3% in adult rabbits and 5-6% in juvenile rabbits. Although seropositivity continued to be detected in a low number of juvenile rabbits, it is unlikely that RHDV1 strains now play a major role in the regulation of rabbit abundance. In contrast, RCVA seropositivity appears to be reaching an equilibrium with that of RHDV2, with RCVA seroprevalence in the preceding quarter having a strong negative effect on RHDV2 seroprevalence and vice versa, suggesting ongoing co-circulation of these variants. These findings highlight the complex interactions between different calicivirus variants in free-living rabbit populations and demonstrate the changes in interactions over the course of the RHDV2 epizootic as it has moved towards endemicity. While it is encouraging from an Australian perspective to see sustained suppression of rabbit populations in the eight years following the arrival of RHDV2, it is likely that rabbit populations will eventually recover, as has been observed with previous rabbit pathogens.
Collapse
Affiliation(s)
- David S Ramsey
- Arthur Rylah Institute, Department of Energy, Environment and Climate Action, Heidelberg, VIC 3083, Australia
| | - Kandarp K Patel
- Biosecurity, Department of Primary Industries and Regions (PIRSA), Urrbrae, SA 5064, Australia
- Centre for Invasive Species Solutions, The University of Canberra, Bruce, ACT 2617, Australia
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, SA 5371, Australia
| | - Susan Campbell
- Invasive Species and Environment Biosecurity, Department of Primary Industries and Regional Development, Albany, WA 6330, Australia
| | - Robyn N Hall
- Centre for Invasive Species Solutions, The University of Canberra, Bruce, ACT 2617, Australia
- Commonwealth Scientific and Industrial Research Organisation, Health and Biosecurity, Canberra, ACT 2601, Australia
| | - Patrick L Taggart
- Centre for Invasive Species Solutions, The University of Canberra, Bruce, ACT 2617, Australia
- Vertebrate Pest Research Unit, Department of Primary Industries NSW, Queanbeyan, NSW 2800, Australia
| | - Tanja Strive
- Centre for Invasive Species Solutions, The University of Canberra, Bruce, ACT 2617, Australia
- Commonwealth Scientific and Industrial Research Organisation, Health and Biosecurity, Canberra, ACT 2601, Australia
| |
Collapse
|
6
|
Shank BR, Primeaux B, Yeung EK, Horowitz SB, Lee IY, Roccograndi L, Feng L, Kaufman GP, Lee HC, Manasanch EE, Patel KK, Orlowski RZ, Weber DM, Becnel MR, Thomas SK. Hyperfractionated Cyclophosphamide and Dexamethasone Alone or in Combination with Daratumumab and/or Carfilzomib for the Treatment of Relapsed or Refractory Multiple Myeloma: A Single-Center Retrospective Analysis. Clin Lymphoma Myeloma Leuk 2023; 23:279-290. [PMID: 36797154 PMCID: PMC10038830 DOI: 10.1016/j.clml.2022.12.004] [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] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 11/19/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Hyperfractionated cyclophosphamide and dexamethasone (HyperCd) alone, or with carfilzomib(K) and/or daratumumab(D), represents a potential treatment option when rapid disease control is needed for patients with aggressive presentations of relapsed/refractory multiple myeloma (RRMM). PATIENTS AND METHODS This is a single-center, retrospective analysis of adult patients with RRMM who received HyperCd with or without K and/or D between May 1, 2016 and August 1, 2019 at the University of Texas MD Anderson Cancer Center. We here report treatment response and safety outcomes. RESULTS Data from 97 patients, 12 with plasma cell leukemia (PCL), were reviewed in this analysis. Patients had had a median of 5 prior lines of therapy and received a median of 1 consecutive cycle of hyperCd-based therapy. The overall response rate (ORR) of all patients was 71.8% (HyperCd 75%, HyperCdK 64.3%, D-HyperCd 73.3%, and D-HyperCdK 76.9%). Median progression-free survival and overall survival among all patients was 4.3 months (HyperCd 3.1 months, HyperCdK 4.5 months, D-HyperCd 3.3 months, and D-HyperCdK 6 months) and 9.0 months (HyperCd 7.4 months, HyperCdK 9.0 months, D-HyperCd 7.5 months, and D-HyperCdK 15.2 months), respectively. Grade 3/4 hematologic toxicities were common, thrombocytopenia being the most frequent at 76%. Notably, 29-41% of patients per treatment group had existing grade 3/4 cytopenias at initiation of hyperCd-based therapy. CONCLUSION HyperCd-based regimens provided rapid disease control among MM patients, even when heavily pre-treated and with few remaining treatment options. Grade 3/4 hematologic toxicities were frequent, but manageable with aggressive supportive care.
Collapse
Affiliation(s)
- B R Shank
- Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - B Primeaux
- Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - E K Yeung
- Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S B Horowitz
- Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - I Y Lee
- Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - L Roccograndi
- Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - L Feng
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - G P Kaufman
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - H C Lee
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - E E Manasanch
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - K K Patel
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - R Z Orlowski
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - D M Weber
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M R Becnel
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S K Thomas
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX.
| |
Collapse
|
7
|
Patel KK, Strive T, Hall RN, Mutze G, Page B, Korcz M, Booth-Remmers M, Smith IL, Huang DN, Kovaliski J, Jayasinghe Ellakkala Appuhamilage RMJ, Taggart PL. Cross-protection, infection, and case fatality rates in wild European rabbits experimentally challenged with different rabbit haemorrhagic disease viruses. Transbound Emerg Dis 2022; 69:e1959-e1971. [PMID: 35315981 DOI: 10.1111/tbed.14530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/02/2022] [Accepted: 03/20/2022] [Indexed: 10/18/2022]
Abstract
Rabbit haemorrhagic disease virus 2 (RHDV2) is now the dominant calicivirus circulating in wild rabbit populations in Australia. This study compared the infection and case fatality rates of RHDV2 and two RHDVs in wild rabbits, as well as their ability to overcome immunity to the respective other strains. Wild rabbits were allocated to groups either blindly or based on prescreening for RHDV/RHDV2 antibodies at capture. Rabbits were monitored regularly until their death or humane killing at 7 days post infection. Liver and eyeball samples were collected for lagovirus testing and aging rabbits, respectively. At capture, rabbits showed high seroprevalence to RHDV2 but not to RHDV. In RHDV/RHDV2 seronegative rabbits at capture, infection rates were highest in those inoculated with RHDV2 (81.8%, 18/22), followed by K5 (53.8%, 7/13) and CZECH (40.0%, 2/5), but these differences were not statistically significant. In rabbits with previous exposure to RHDV2 at capture, infection rates were highest when inoculated with K5 (59.6%, 31/52) followed by CZECH (46.0%, 23/50), with infection rates higher in younger rabbits for both viruses. In RHDV/RHDV2 seronegative rabbits at capture, case fatality rates were highest for those inoculated with K5 (71.4%), followed by RHDV2 (50.0%) and CZECH (50.0%). In rabbits with previous exposure to RHDV2 at capture, case fatality rates were highest in rabbits inoculated with K5 (12.9%) followed by CZECH (8.7%), with no case fatalities following RHDV2 inoculation. Case fatality rates did not differ significantly between inoculums in either serostatus group at capture. Based on multivariable modelling, time to death post RHDV inoculation increased in rabbits with recent RHDV2 exposure compared to seronegative rabbits and with age. The results suggest that RHDV2 may cause higher mortalities than other variants in seronegative rabbit populations but that K5 may be more effective in reducing rabbit populations in an RHDV2-dominant landscape. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Kandarp K Patel
- Biosecurity, Department of Primary Industries and Regions (PIRSA), Urrbrae, South Australia, 5064, Australia.,School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, South Australia, 5371, Australia.,Centre for Invasive Species Solutions, Australian Capital Territory, Bruce, 2617, Australia
| | - Tanja Strive
- Centre for Invasive Species Solutions, Australian Capital Territory, Bruce, 2617, Australia.,Health & Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Acton, ACT, 2601, Australia
| | - Robyn N Hall
- Centre for Invasive Species Solutions, Australian Capital Territory, Bruce, 2617, Australia.,Health & Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Acton, ACT, 2601, Australia
| | - Greg Mutze
- Biosecurity, Department of Primary Industries and Regions (PIRSA), Urrbrae, South Australia, 5064, Australia
| | - Bradley Page
- Biosecurity, Department of Primary Industries and Regions (PIRSA), Urrbrae, South Australia, 5064, Australia.,Centre for Invasive Species Solutions, Australian Capital Territory, Bruce, 2617, Australia
| | - Matthew Korcz
- Biosecurity, Department of Primary Industries and Regions (PIRSA), Urrbrae, South Australia, 5064, Australia
| | - Mahalia Booth-Remmers
- Biosecurity, Department of Primary Industries and Regions (PIRSA), Urrbrae, South Australia, 5064, Australia.,Australian Wildlife Conservancy, Subiaco, Western Australia, 6008, Australia
| | - Ina L Smith
- Centre for Invasive Species Solutions, Australian Capital Territory, Bruce, 2617, Australia
| | - D Nina Huang
- Centre for Invasive Species Solutions, Australian Capital Territory, Bruce, 2617, Australia.,Health & Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Acton, ACT, 2601, Australia
| | - John Kovaliski
- Biosecurity, Department of Primary Industries and Regions (PIRSA), Urrbrae, South Australia, 5064, Australia.,Centre for Invasive Species Solutions, Australian Capital Territory, Bruce, 2617, Australia
| | - Ridma M J Jayasinghe Ellakkala Appuhamilage
- Biosecurity, Department of Primary Industries and Regions (PIRSA), Urrbrae, South Australia, 5064, Australia.,Centre for Invasive Species Solutions, Australian Capital Territory, Bruce, 2617, Australia
| | - Patrick L Taggart
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, South Australia, 5371, Australia.,Centre for Invasive Species Solutions, Australian Capital Territory, Bruce, 2617, Australia.,Vertebrate Pest Research Unit, Department of Primary Industries NSW, Queanbeyan, New South Wales, 2620, Australia
| |
Collapse
|
8
|
Qarajeh R, Peri-Okonny P, Sperry BW, Chan PS, Spertus JA, Thompson RC, Bateman TM, Patel FS, Mcghie AI, Patel KK. Relationship between coronary artery calcium score and myocardial blood flow reserve in patients with suspected coronary artery disease. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab111.061] [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: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Both the Coronary Artery Calcium Score (CACS), a non-invasive surrogate for atherosclerotic burden, and reduced myocardial blood flow reserve (MBFR) with normal perfusion, a non-invasive surrogate for coronary vasomotor dysfunction, independently predict future cardiovascular events. The relationship between CACS and MBFR, and potential clinical factors affecting it, is not well understood.
Methods
Among 9467 consecutive patients without known history of CAD who had normal perfusion on 82Rb PET-CT and a concomitantly measured CACS between 01/2010 - 06/2020 within our health system, we assessed the relationship between CACS and MBFR. Multiple linear regression was used to predict MBFR using CACS, adjusted for age, sex, BMI, risk factors, symptoms, resting LVEF and vital signs. Interactions of age, sex, diabetes, and symptoms with CACS were assessed to evaluate if they modified the relationship of CACS with MBFR.
Results
Mean age (SD) of the study cohort was 66.4 (12.6) years, 64% were women, 64% had chest pain and 47% had dyspnea. Reduced MBFR (<2) was present in 44% and CAC >0 in 74% of patients. There was a modest inverse correlation between MBFR and CACS, r= - 0.18, p = < 0.0001 (Figure). In adjusted analyses, CACS (β for CAC per 100 = -0.013 [95% CI: -0.015, -0.010]) was weakly associated with MBFR, and age, sex, diabetes, or symptoms did not modify this relationship (all interaction p-values >0.1). Older age, female sex, presence of hypertension, diabetes, dyspnea, lower LVEF, higher baseline HR and higher CACS independently predicted reduced MBFR, but explained only 20% of the variance in MBFR (R2 =0.20).
Conclusion
There is a weak relationship between CACS and MBFR, which is not modified by age, sex, symptoms, or other CV risk factors. Coronary calcium burden does not completely reflect the overall disease activity within the coronary circulation, and measures of coronary vasomotor function such as MBFR may offer complementary information on CAD risk to that provided by the total burden of calcified atherosclerosis.
Collapse
Affiliation(s)
- R Qarajeh
- University of Missouri, Kansas City, United States of America
| | - P Peri-Okonny
- St. Luke"s Mid America Heart Institute, Kansas City, United States of America
| | - BW Sperry
- St. Luke"s Mid America Heart Institute, Kansas City, United States of America
| | - PS Chan
- St. Luke"s Mid America Heart Institute, Kansas City, United States of America
| | - JA Spertus
- St. Luke"s Mid America Heart Institute, Kansas City, United States of America
| | - RC Thompson
- St. Luke"s Mid America Heart Institute, Kansas City, United States of America
| | - TM Bateman
- St. Luke"s Mid America Heart Institute, Kansas City, United States of America
| | - FS Patel
- University of Missouri, Kansas City, United States of America
| | - AI Mcghie
- St. Luke"s Mid America Heart Institute, Kansas City, United States of America
| | - KK Patel
- St. Luke"s Mid America Heart Institute, Kansas City, United States of America
| |
Collapse
|
9
|
Patel KK, Fitzgibbon Q, Caraguel CGB. Investigation of risk factors associated with sub-optimal holding survival in southern rock lobster (Jasus edwardsii) in Australia. Prev Vet Med 2020; 183:105122. [PMID: 32891901 DOI: 10.1016/j.prevetmed.2020.105122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 07/19/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
Abstract
Southern rock lobster (SRL1, Jasus edwardsii) are caught from the wild waters of southern Australia and form an important commodity economically for the fisheries industry in Australia. Between landing and export, SRL are held in specialised tanks within holding facilities for varying time periods before being exported to China. During the 2015-16 fishing season a lower stock survival rate was reported by some holding facilities when compared to previous fishing seasons. An investigation was undertaken to identify possible causes and favouring factors using a retrospective, single cohort, observational study. A custom questionnaire was built and trialled to collect qualitative and quantitative information on facilities infrastructure and capacity (10 questions), water systems (16 questions), SRL stock and health management (12 questions). Onsite visits and interviews of consenting holding facilities, with active holding operations, were conducted. Facilities were categorised into different capacity and management profiles based on a multivariate factor analysis. The association between facility profiles and perceived sub-optimal survival was then explored using simple logistic regression models. Out of the 83 license holders on record, 63 were in operation at the time of survey and 52 (83%) consented to participate. Perceived sub-optimal survival was reported in 22 (42%) facilities. The capacity, bio-filtration and water management practices across the surveyed facilities was highly variable but did not appear to be associated with survival. However, 'Intensive holding' facilities compared to the 'Extensive holding' facilities were significantly associated with an increased risk of sub-optimal survival (OR = 7.0, 95% CI: 2.1-26.13, P = 0.002). 'Intensive holding' facilities were more likely to hold higher annual tonnage sourced from distant, diverse and higher number of sources, to multiple handle and stock SRL in crates (as opposed to free swimming in tanks), and hold them for longer time periods. Holding practices are highly diverse across the SRL industry with little evidence of impact on survival, however, intensive and large scale holding practices appeared to be at higher risk of sub-optimal survival. A longitudinal and finer scale study is warranted to identify which one(s) of the stock management practices directly impact SRL survival during holding.
Collapse
Affiliation(s)
- Kandarp K Patel
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, SA 5371, Australia.
| | - Quinn Fitzgibbon
- Fisheries and Aquaculture Centre, Institute for Marine and Antarctic Studies, University of Tasmania, Private Bag 49, Hobart, Tasmania 7001, Australia
| | - Charles G B Caraguel
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, SA 5371, Australia
| |
Collapse
|
10
|
Patel KK, Stanislawek WL, Burrows E, Heuer C, Asher GW, Wilson PR, Howe L. Investigation of association between bovine viral diarrhoea virus and cervid herpesvirus type-1, and abortion in New Zealand farmed deer. Vet Microbiol 2018; 228:1-6. [PMID: 30593353 DOI: 10.1016/j.vetmic.2018.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 11/03/2018] [Accepted: 11/05/2018] [Indexed: 11/26/2022]
Abstract
This study tested for association between bovine viral diarrhoea virus (BVDv) and cervid herpesvirus type-1 (CvHV-1) exposure and abortion in New Zealand farmed red deer. Rising two-year-old (R2, n = 22,130) and mixed-age (MA, n = 36,223) hinds from 87 and 71 herds, respectively, throughout New Zealand were pregnancy tested using ultrasound early in gestation (Scan-1) and 55-89 days later (Scan-2) to detect mid-term abortion. Sera from aborted and non-aborted hinds at Scan-2 were tested for BVDv and CvHV-1 using virus neutralisation tests. Available uteri from aborted hinds and from hinds not rearing a calf to weaning were tested by PCR for herpesvirus DNA. In herds with aborted hinds, 10.3% of 639 R2 and 17.2% of 302 MA hinds were sero-positive for BVDv and 18.6% of 613 R2 and 68.5% of 232 MA hinds were sero-positive for CvHV-1. There was no association between BVDv sero-status and abortion at animal level (R2 p = 0.36, MA p = 0.76) whereas CvHV-1 sero-positivity was negatively associated with abortion in MA hinds (p = 0.01) but not in R2 hinds (p = 0.36), MA). Eleven of 108 uteri from aborted R2 hinds but no MA hinds were positive for herpesvirus DNA. Vaginal samples from four R2 and one MA aborted hinds tested were negative for herpesvirus DNA. A Cervid Rhadinovirus type-2 (CRhV-2) was identified in seven PCR positive uteri samples. Findings suggest that BVDv and CvHV-1 may not be associated with abortion in R2 hinds, but association needs to be tested further in MA hinds. The role of CRhV-2 requires clarification.
Collapse
Affiliation(s)
- K K Patel
- School of Veterinary Science, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.
| | - W L Stanislawek
- Animal Health Laboratory, Ministry of Primary Industries, Wallaceville, New Zealand
| | - E Burrows
- School of Veterinary Science, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand
| | - C Heuer
- EpiCentre, School of Veterinary Science, Massey University, Private Bag 11222, Palmerston North, 4442, New Zealand
| | - G W Asher
- AgResearch, Invermay Agricultural Centre, Private Bag 50034, Mosgiel, 9053, New Zealand
| | - P R Wilson
- School of Veterinary Science, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand
| | - L Howe
- School of Veterinary Science, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand
| |
Collapse
|
11
|
Shroff P, Vashi RT, Champaneri VA, Patel KK. Correlation study among water quality parameters of groundwater of Valsad district of south Gujarat(India). J Fundam and Appl Sci 2015. [DOI: 10.4314/jfas.v7i3.3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
12
|
Berzosa M, Maheshwari S, Patel KK, Shaib YH. Single-step endoscopic ultrasonography-guided drainage of peripancreatic fluid collections with a single self-expandable metal stent and standard linear echoendoscope. Endoscopy 2012; 44:543-7. [PMID: 22407382 DOI: 10.1055/s-0031-1291710] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [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: 12/13/2022]
Abstract
Endoscopic ultrasonography (EUS)-guided drainage of peripancreatic fluid collections (PFCs) is a well described alternative to surgery or percutaneous drainage. However, it is limited by the requirement for a large working channel that allows multiple plastic stent placement, which is only commercially available on therapeutic linear echoendoscopes. Herein, we describe the drainage of PFCs with a single self-expandable metal stent (SEMS) using a single-step technique and standard linear echoendoscope. Seven cases were identified during a retrospective chart review, and included all patients who had undergone EUS-guided drainage of PFCs during a 6-month period. The mean age was 46 years (range 25 - 70 years) and all patients were symptomatic. The mean diameter of PFCs was 8 cm (range 4.1 - 12.5 cm). Previous percutaneous drainage had failed in three patients. A total of 10 PFCs were drained. Three patients had two cysts drained by the same stent and one patient had two separate procedures to drain two distinct cysts. The SEMS was in place for a mean of 13 weeks (range 4 - 34 weeks). Successful placement of SEMS was achieved in all seven cases. Patients were followed for a mean of 18 weeks (range 7 - 35 weeks), and symptom improvement was achieved in all cases. Complete resolution of PFC was achieved in 9 /10 cysts. No complications were encountered. Single-step EUS-guided drainage of PFCs using a single 10-mm SEMS and a standard linear echoendoscope appears to be a feasible endoscopic technique with excellent technical and clinical success rates.
Collapse
Affiliation(s)
- M Berzosa
- Baylor College of Medicine, Houston, TX 77030, USA
| | | | | | | |
Collapse
|
13
|
Pandey A, Bigoniya P, Raj V, Patel KK. Pharmacological screening of Coriandrum sativum Linn. for hepatoprotective activity. J Pharm Bioallied Sci 2011; 3:435-41. [PMID: 21966166 PMCID: PMC3178952 DOI: 10.4103/0975-7406.84462] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Revised: 03/07/2011] [Accepted: 03/18/2011] [Indexed: 11/13/2022] Open
Abstract
Objective: Coriandrum sativum (Linn.), a glabrous, aromatic, herbaceous annual plant, is well known for its use in jaundice. Essential oil, flavonoids, fatty acids, and sterols have been isolated from different parts of C. sativum. The plant has a very effective antioxidant profile showing 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity, lipoxygenase inhibition, phospholipid peroxidation inhibition, iron chelating activity, hydroxyl radical scavenging activity, superoxide dismutation, glutathione reduction and antilipid peroxidation due to its high total phenolic content with the presence of constituents like pyrogallol, caffeic acid, glycitin, etc. Materials and Methods: This study was aimed at investigating the hepatoprotective activity of C. sativum against carbon tetrachloride (CCl4), with estimation of serum serum glutamyl oxaloacetic acid transaminase (SGOT), serum glutamyl pyruvate transaminase (SGPT), alkaine phosphatase (ALP) and bilirubin, and with liver histopathology. Results: Ethanolic extract was found to be rich in alkaloids, phenolic compounds and flavonoids, and high performance liquid chromatography (HPLC) fingerprinting showed the presence of iso-quercetin and quercetin. C. sativum signifies hepatoprotection by reducing the liver weight, activities of SGOT, SGPT, and ALP, and direct bilirubin of CCl4 intoxicated animals. Administration of C. sativum extract at 300 mg/kg dose resulted in disappearance of fatty deposit, ballooning degeneration and necrosis, indicating antihepatotoxic activity. Conclusion: The results of this study have led to the conclusion that ethanolic extract of C. sativum possesses hepatoprotective activity which may be due to the antioxidant potential of phenolic compounds.
Collapse
Affiliation(s)
- A Pandey
- Department of Pharmacology, Radharaman College of Pharmacy, Ratibad, Bhopal, Madhya Pradesh, India
| | | | | | | |
Collapse
|
14
|
Richey SL, Culp SH, Jonasch E, Corn PG, Pagliaro LC, Tamboli P, Patel KK, Matin SF, Wood CG, Tannir NM. Outcome of patients with metastatic renal cell carcinoma treated with targeted therapy without cytoreductive nephrectomy. Ann Oncol 2010; 22:1048-1053. [PMID: 21115604 DOI: 10.1093/annonc/mdq563] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Cytoreductive nephrectomy (CN) became a standard procedure in metastatic renal cell carcinoma (mRCC) in the immunotherapy era. Historically, median overall survival (OS) of patients treated with interferon alpha (IFN-α) without CN was 7.8 months. Median OS in patients treated with targeted therapy (TT) without CN is unknown. PATIENTS AND METHODS We retrospectively reviewed records of patients with mRCC who received TT without CN. Kaplan-Meier methods and Cox regression analysis were used to estimate median OS and identify poor prognostic factors. RESULTS One hundred and eighty-eight patients were identified. Most patients had intermediate-risk (54.8%) or poor-risk (44.1%) disease. Median OS for all patients was 10.4 months [95% confidence interval (CI) 8.1-12.5]. By multivariable analysis, elevated baseline lactate dehydrogenase and corrected calcium, performance status of two or more, retroperitoneal nodal metastasis, thrombocytosis, current smoking, two or more metastatic sites, and lymphopenia were independent risk factors for inferior OS. Patients with four or more factors had increased risk of death (hazard ratio 8.83, 95% CI 5.02-15.5, P < 0.001) and 5.5-month median OS. Nineteen patients (10.0%) survived for 2+ years. CONCLUSIONS These data highlight the improved OS of patients with mRCC treated with TT without CN, compared with historical IFN-α treatment, and may guide the design of trials investigating the role of CN in the TT era.
Collapse
Affiliation(s)
- S L Richey
- Department of Genitourinary Medical Oncology
| | | | - E Jonasch
- Department of Genitourinary Medical Oncology
| | - P G Corn
- Department of Genitourinary Medical Oncology
| | | | - P Tamboli
- Department of Pathology, The University of Texas MD Anderson Cancer Center
| | - K K Patel
- Department of Internal Medicine, The University of Texas Health Science Center, Houston, USA
| | | | | | - N M Tannir
- Department of Genitourinary Medical Oncology.
| |
Collapse
|
15
|
Abstract
Virtually every tissue of the adult organism maintains a population of putatively slowly-cycling stem cells that maintain homeostasis of the tissue and respond to injury when challenged. These cells are regulated and supported by the surrounding microenvironment, referred to as the stem cell 'niche'. The niche includes all cellular and non-cellular components that interact in order to control the adult stem cell, and these interactions can often be broken down into one of two major mechanistic categories--physical contact and diffusible factors. The niche has been studied directly and indirectly in a number of adult stem cell systems. Herein, we will first focus on the most well-understood niches supporting the germline stem cells in the lower organisms Caenorhabditis elegans and Drosophila melanogaster before concentrating on the more complex, less well-understood mammalian niches supporting the neural, epidermal, haematopoietic and intestinal stem cells.
Collapse
Affiliation(s)
- M R Walker
- Department of Pathology and Immunology, Washington University in St. Louis, St. Louis, MO 63110, USA
| | | | | |
Collapse
|
16
|
Cassidy J, Douillard JY, Twelves C, McKendrick JJ, Scheithauer W, Bustová I, Johnston PG, Lesniewski-Kmak K, Jelic S, Fountzilas G, Coxon F, Díaz-Rubio E, Maughan TS, Malzyner A, Bertetto O, Beham A, Figer A, Dufour P, Patel KK, Cowell W, Garrison LP. Pharmacoeconomic analysis of adjuvant oral capecitabine vs intravenous 5-FU/LV in Dukes' C colon cancer: the X-ACT trial. Br J Cancer 2006; 94:1122-9. [PMID: 16622438 PMCID: PMC2361258 DOI: 10.1038/sj.bjc.6603059] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Oral capecitabine (Xeloda®) is an effective drug with favourable safety in adjuvant and metastatic colorectal cancer. Oxaliplatin-based therapy is becoming standard for Dukes' C colon cancer in patients suitable for combination therapy, but is not yet approved by the UK National Institute for Health and Clinical Excellence (NICE) in the adjuvant setting. Adjuvant capecitabine is at least as effective as 5-fluorouracil/leucovorin (5-FU/LV), with significant superiority in relapse-free survival and a trend towards improved disease-free and overall survival. We assessed the cost-effectiveness of adjuvant capecitabine from payer (UK National Health Service (NHS)) and societal perspectives. We used clinical trial data and published sources to estimate incremental direct and societal costs and gains in quality-adjusted life months (QALMs). Acquisition costs were higher for capecitabine than 5-FU/LV, but higher 5-FU/LV administration costs resulted in 57% lower chemotherapy costs for capecitabine. Capecitabine vs 5-FU/LV-associated adverse events required fewer medications and hospitalisations (cost savings £3653). Societal costs, including patient travel/time costs, were reduced by >75% with capecitabine vs 5-FU/LV (cost savings £1318), with lifetime gain in QALMs of 9 months. Medical resource utilisation is significantly decreased with capecitabine vs 5-FU/LV, with cost savings to the NHS and society. Capecitabine is also projected to increase life expectancy vs 5-FU/LV. Cost savings and better outcomes make capecitabine a preferred adjuvant therapy for Dukes' C colon cancer. This pharmacoeconomic analysis strongly supports replacing 5-FU/LV with capecitabine in the adjuvant treatment of colon cancer in the UK.
Collapse
Affiliation(s)
- J Cassidy
- Cancer Research UK, Department of Medical Oncology, University of Glasgow, Garscube Estate, Bearsden, Glasgow G61 1DB, UK, and Centre René Gauducheau, Site Hospitalier Nord, Nantes, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Patel AK, Patel KK. Future implications: compliance and failure with antiretroviral treatment. J Postgrad Med 2006; 52:197-200. [PMID: 16855321] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
HIV management is currently in an era of effective, potent antiretroviral therapy. Modern drug discovery and development have transformed HIV-1 disease into a treatable, chronic infectious disease. Complete suppression of viral replication is critical for long-term durability of antiretroviral therapy. Partial suppression, even at very low levels, is likely to lead to virologic failure and ultimately to the appearance of drug resistance. The relationship between adherence and resistance to HIV antiretroviral therapy is more complex than to state 'non-adherence increases the risk of drug resistance.' In many patients who fail to respond to initial therapy, the primary reason for failure is their inability to take the prescribed drug regimen or nonadherence.
Collapse
Affiliation(s)
- Atul K Patel
- Infectious Diseases Clinic, Ahmedabad, Gujarat, India.
| | | |
Collapse
|
18
|
Hornberger J, Farci P, Prati D, Zeuzem S, Green J, Patel KK. The economics of treating chronic hepatitis C patients with peginterferon alpha-2a (40 kDa) plus ribavirin presenting with persistently normal aminotransferase. J Viral Hepat 2006; 13:377-86. [PMID: 16842440 DOI: 10.1111/j.1365-2893.2005.00700.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Peginterferon alpha-2a (40 kDa) plus ribavirin is effective at achieving sustained viral response compared with no treatment in patients with chronic hepatitis C (CHC) and persistently normal aminotransferase levels (PNALT). The cost-effectiveness of treating CHC in the setting of PNALT has not been assessed. Disease progression in patients with PNALT was simulated in a Markov model. The rate of fibrosis progression, quality of life and costs for each health state were based on literature estimates. The perspective of the Italian National Health Service was adopted and costs (euro 2003) and benefits were discounted at 3%. Sensitivity analyses were performed on important parameters. The primary analysis compared combination therapy with peginterferon alpha-2a (40 kDa) plus ribavirin to no treatment in a cohort of patients with mean age 45 years, and was based on findings from a multinational, randomized trial in patients with PNALT. In genotype 1 patients, the risk of cirrhosis at 30 years is forecast to fall from 32% with no treatment to 19% with combination therapy, increasing quality-adjusted life years (QALYs) by 0.74 years at an incremental cost per QALY gained of euro 16,831. The 30-year risk of cirrhosis in genotype 2 or 3 is projected to fall to 9% with combination therapy, an increase in QALYs of 1.34 years, at an incremental cost per QALY gained of euro 3,000. Thus treatment of PNALT with peginterferon alpha-2a (40 kDa) plus ribavirin is projected to reduce the incidence of cirrhosis, increase life expectancy and have an acceptable cost-effectiveness ratio from a societal perspective.
Collapse
Affiliation(s)
- J Hornberger
- Acumen LLC/The SPHERE Institute, Burlingame, CA 94010, USA.
| | | | | | | | | | | |
Collapse
|
19
|
Patel KK, Loukota RA. Transcaruncular approach to fractures of the medial wall of the orbit. Br J Oral Maxillofac Surg 2005; 44:419-20. [PMID: 16198460 DOI: 10.1016/j.bjoms.2005.07.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2005] [Accepted: 07/29/2005] [Indexed: 11/22/2022]
Affiliation(s)
- K K Patel
- Pinderfields Hospital, Aberford Road, Wakefield, UK.
| | | |
Collapse
|
20
|
Patel KK, Loukota RA, Spencer RJ. Protection of the lip from the activator arm of maxillary distractors. Br J Oral Maxillofac Surg 2004; 42:575-7. [PMID: 15544892 DOI: 10.1016/j.bjoms.2004.06.009] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2004] [Indexed: 11/27/2022]
Abstract
The long spring-loaded distractor arms of maxillary distraction devices can cause pain and ulceration of the upper lip. We describe a simple method to relieve the tension and discomfort on the soft tissues using Silastic tubing.
Collapse
Affiliation(s)
- K K Patel
- Pinderfields Hospital, Aberford Road, Wakefield WF1 4DG, UK.
| | | | | |
Collapse
|
21
|
Sullivan SD, Jensen DM, Bernstein DE, Hassanein TI, Foster GR, Lee SS, Cheinquer H, Craxi A, Cooksley G, Klaskala W, Pettit K, Patel KK, Green J. Cost-effectiveness of combination peginterferon alpha-2a and ribavirin compared with interferon alpha-2b and ribavirin in patients with chronic hepatitis C. Am J Gastroenterol 2004; 99:1490-6. [PMID: 15307866 DOI: 10.1111/j.1572-0241.2004.30286.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Sustained virological response (SVR) is the primary objective in the treatment of chronic hepatitis C (CHC). Results from a recent clinical trial of patients with previously untreated CHC demonstrate that the combination of peginterferon alpha-2a and ribavirin produces a greater SVR than interferon alpha-2b and ribavirin combination therapy. However, the cost-effectiveness of peginterferon alpha-2a plus ribavirin in the U.S. setting has not been investigated. METHODS A Markov model was developed to investigate cost-effectiveness in patients with CHC using genotype to guide treatment duration. SVR and disease progression parameters were derived from the clinical trials and epidemiologic studies. The impact of treatment on life expectancy and costs were projected for a lifetime. Patients who had an SVR were assumed to remain virus-free for the rest of their lives. In genotype 1 patients, the SVRs were 46% for peginterferon alpha-2a plus ribavirin and 36% for interferon alpha-2b plus ribavirin. In genotype 2/3 patients, the SVRs were 76% for peginterferon alpha-2a plus ribavirin and 61% for interferon alpha-2b plus ribavirin. Quality of life and costs were based on estimates from the literature. All costs were based on published U.S. medical care costs and were adjusted to 2003 U.S. dollars. Costs and benefits beyond the first year were discounted at 3%. RESULTS In genotype 1, peginterferon alpha-2a plus ribavirin increases quality-adjusted life expectancy (QALY) by 0.70 yr compared to interferon alpha-2b plus ribavirin, producing a cost-effectiveness ratio of $2,600 per QALY gained. In genotype 2/3 patients, peginterferon alpha-2a plus ribavirin increases QALY by 1.05 yr in comparison to interferon alpha-2b plus ribavirin. Peginterferon alpha-2a combination therapy in patients with HCV genotype 2 or 3 is dominant (more effective and cost saving) compared to interferon alpha-2b plus ribavirin. Results weighted by genotype prevalence (75% genotype 1; 25% genotype 2 or 3) also show that peginterferon alpha-2a plus ribavirin is dominant. Peginterferon alpha-2a and ribavirin remained cost-effective (below $16,500 per QALY gained) under sensitivity analyses on key clinical and cost parameters. CONCLUSION Peginterferon alpha-2a in combination with ribavirin with duration of therapy based on genotype, is cost-effective compared with conventional interferon alpha-2b in combination with ribavirin when given to treatment-naïve adults with CHC.
Collapse
|
22
|
Abstract
Removal of skin cancers in the head and neck region usually results in a circular or oval defect, which must be reconstructed immediately using one of several techniques. Larger defects can present a difficult aesthetic problem. The purse-string suture is particularly suited to such large defects where the skin is lax. We report 51 cases where this technique was used in the head and neck region. All defects were considerably reduced in size and some required a small skin graft to complete the reconstruction. Initially many redundant skin folds and considerable local distortion were seen but these improved with time. The technique is simple, inexpensive, and the results are satisfactory in appropriately selected cases. Comprehensive discussion to prepare patients for the gross initial distortion and the long period of retention of the suture makes the procedure acceptable to patients.
Collapse
Affiliation(s)
- K K Patel
- Department of Maxillofacial Surgery, York District Hospital, Wigginton Road, York YO31 8HE, UK.
| | | | | |
Collapse
|
23
|
Abstract
OBJECTIVES To determine the dental knowledge of accident and emergency (A&E) senior house officers (SHOs). METHOD A telephone survey of A&E departments in England with more than 30 000 new attendances per year was conducted between November 1998 and July 1999. The questionnaire covered basic dental knowledge as well as scenarios of some common dental problems encountered in the A&E department. RESULTS Most SHOs in this study saw between one and five dental problems each week. Of the 102 SHOs in this survey, 52% had no previous training in examination of the mouth. Only 52% knew the approximate date of eruption of a permanent upper central incisor. In the treatment of post-extraction bleeding, 36% knew the first line of treatment. When presented with a scenario of a patient with a dental infection, only 29% gave the optimal empirical treatment. CONCLUSIONS There is a need for better dental education among medical personnel. Guidelines or algorithms for the management of some common dental problems would also be useful as well as standard written advice sheets for patients with dental problems.
Collapse
Affiliation(s)
- K K Patel
- Department of Maxillofacial Surgery, Hull Royal Infirmary, Hull, UK.
| | | |
Collapse
|
24
|
Lincoff AM, Kereiakes DJ, Mascelli MA, Deckelbaum LI, Barnathan ES, Patel KK, Frederick B, Nakada MT, Topol EJ. Abciximab suppresses the rise in levels of circulating inflammatory markers after percutaneous coronary revascularization. Circulation 2001; 104:163-7. [PMID: 11447080 DOI: 10.1161/01.cir.104.2.163] [Citation(s) in RCA: 155] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Previous investigators have shown that systemic markers of inflammation may be increased in patients with acute ischemic syndromes or after percutaneous coronary revascularization and that persistent elevation in these markers is predictive of excess risk of subsequent adverse cardiac events. By virtue of its cross-reactivity with the glycoprotein IIb/IIIa, avbeta3, and alphaMbeta2 receptors, abciximab may reduce inflammatory processes. Methods and Results-- Assays for the inflammatory markers C-reactive protein, interleukin-6, and tumor necrosis factor-alpha were performed on serum samples obtained from 160 patients in a placebo-controlled, randomized trial of abciximab during angioplasty. Eighty patients each had received a placebo or abciximab bolus plus a 12-hour infusion. Serum samples were drawn at baseline (before revascularization), 24 to 48 hours after study drug administration, and 4 weeks after study drug administration. Between baseline and 24 to 48 hours, the increase in C-reactive protein was 32% less in patients receiving abciximab than placebo (P=0.025); the rise in interleukin-6 levels was 76% less in the abciximab group (P<0.001); and the rise in tumor necrosis factor-alpha levels was 100% less with abciximab therapy (P=0.112). By 4 weeks, most marker levels had returned to baseline, with no significant differences between placebo and abciximab groups. CONCLUSIONS Systemic markers of inflammation increase in the first 24 to 48 hours after angioplasty, but the magnitude of that rise is diminished by periprocedural abciximab. Some of the long-term clinical benefit derived from this agent may be related to an anti-inflammatory effect.
Collapse
Affiliation(s)
- A M Lincoff
- Department of Cardiology, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Rabinowitz HK, Babbott D, Bastacky S, Pascoe JM, Patel KK, Pye KL, Rodak J, Veit KJ, Wood DL. Innovative approaches to educating medical students for practice in a changing health care environment: the National UME-21 Project. Acad Med 2001; 76:587-597. [PMID: 11401801 DOI: 10.1097/00001888-200106000-00007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
In today's continually changing health care environment, there is serious concern that medical students are not being adequately prepared to provide optimal health care in the system where they will eventually practice. To address this problem, the Health Resources and Services Administration (HRSA) developed a $7.6 million national demonstration project, Undergraduate Medical Education for the 21st Century (UME-21). This project funded 18 U.S. medical schools, both public and private, for a three-year period (1998-2001) to implement innovative educational strategies. To accomplish their goals, the 18 UME-21 schools worked with more than 50 organizations external to the medical school (e.g., managed care organizations, integrated health systems, Area Health Education Centers, community health centers). The authors describe the major curricular changes that have been implemented through the UME-21 project, discuss the challenges that occurred in carrying out those changes, and outline the strategies for evaluating the project. The participating schools have developed curricular changes that focus on the core primary care clinical clerkships, take place in ambulatory settings, include learning objectives and competencies identified as important to providing care in the future health care system, and have faculty development and internal evaluation components. Curricular changes implemented at the 18 schools include having students work directly with managed care organizations, as well as special demonstration projects to teach students the knowledge, skills, and attitudes necessary for successfully managing care. It is already clear that the UME-21 project has catalyzed important curricular changes within 12.5% of U.S. medical schools. The ongoing national evaluation of this project, which will be completed in 2002, will provide further information about the project's impact and effectiveness.
Collapse
Affiliation(s)
- H K Rabinowitz
- Department of Family Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Abstract
The inspiratory muscles (IM) can be trained by having a subject breathe through inspiratory resistive loads or by use of unloaded hyperpnea. These disparate training protocols are characterized by high inspiratory pressure (force) or high inspiratory flow (velocity), respectively. We tested the hypothesis that the posttraining improvements in IM pressure or flow performance are specific to training protocols in a way that is similar to force-velocity specificity of skeletal muscle training. IM training was accomplished in 15 normal subjects by use of three protocols: high inspiratory pressure-no flow (group A, n = 5), low inspiratory pressure-high flow (group B, n = 5), and intermediate inspiratory pressure and flow (group C, n = 5). A control group (n = 4) did no training. Before and after training, we measured esophageal pressure (Pes) and inspiratory flow (VI) during single maximal inspiratory efforts against a range of external resistances including an occluded airway. Efforts originated below relaxation volume (Vrel), and peak Pes and VI were measured at Vrel. Isovolume maximal Pes-VI plots were constructed to assess maximal inspiratory pressure-flow performance. Group A (pressure training) performed 30 maximal static inspiratory maneuvers at Vrel daily, group B (flow training) performed 30 sets of three maximal inspiratory maneuvers with no added external resistance daily, and group C (intermediate training) performed 30 maximal inspiratory efforts on a midrange external resistance (7 mm ID) daily. Subjects trained 5 days/wk for 6 wk. Data analysis included comparison of posttraining Pes-VI slopes among training groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
|
27
|
Patel KK, Hutchinson C, Sienko DG. Sentinel surveillance of HIV infection among new inmates and implications for policies of corrections facilities. Public Health Rep 1990; 105:510-4. [PMID: 2120729 PMCID: PMC1580106] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Seroprevalence surveys of incoming inmates provide useful sentinel information on human immunodeficiency virus (HIV) infection rates among groups that practice HIV-associated high-risk behaviors. In addition, such data are beneficial to corrections officials in the formulation of institutional policies to prevent HIV infection. Inmates entering the Michigan corrections system from December 1987 to March 1988 participated in blind, anonymous serosurveys for HIV infection. Eight of 802 entering inmates (1.0 percent) were seropositive; most seropositive persons reported intravenous drug use. The most common risk behaviors reported by study participants were intravenous drug use (20.0 percent), multiple sexual partners (37.1 percent), and infrequent (that is, never or seldom) use of condoms (82.6 percent). Women reported the highest rates of intravenous drug use (35.1 percent) and needle-sharing (19.4 percent). Results from this study indicate that in spite of wide-spread HIV-associated risk behaviors, the extent of HIV-seropositivity among incoming inmates in Michigan is relatively low. Such data suggest that there is still time to impact the course of the AIDS epidemic among high-risk groups in States where the prevalence of HIV infection is relatively low. The data also indicate that the potential for HIV spread in correctional facilities is noteworthy and that HIV prevention education and substance abuse treatment services are needed in corrections facilities.
Collapse
Affiliation(s)
- K K Patel
- Special Office on AIDS Prevention, Michigan Department of Public Health, Lansing
| | | | | |
Collapse
|
28
|
Abstract
We have studied the responses of chronic leukaemic B cells to infection by Epstein-Barr virus (EBV). Our results define one population of B lymphocytes, represented by prolymphocytic leukaemic (PLL) cells, which are highly susceptible to immortalization by EBV. Another B-cell type, represented by chronic lymphocytic leukaemic (CLL) cells, can be readily infected by the virus but is resistant to immortalization. Comparative studies of viral and cellular related events early after infection in these 2 cell types reveal that both express the EB viral nuclear antigen (EBNA) complex, but the immortalization-resistant CLL cells fail to express the latent membrane protein (LMP), which can be detected in PLL cells 48 hr after infection. Circularization of the linear viral genome could be detected at 7 days post infection in the PLL cells, but only in 2 out of 4 CLL cells tested. Both CLL and PLL cells show increased surface expression of CD23 and HLA-DR molecules after infection but, whereas PLL cells show an increase in size, together with RNA and DNA synthesis indicative of cell cycle progression, CLL cells appear to be arrested in the G1/S phase of the cycle. The results suggest that the outcome of infection by EBV is determined by the nature of the target cell rather than by random virus-related events. The correlation between the block in immortalization of CLL cells and their failure to express LMP suggests that expression of this protein is essential for in vitro immortalization of B cells. The failure to detect circularization in some EBV-infected CLL cells suggests that this, as well as LMP expression, may be dependent on prior activation of the B cell by EBV, an event which may vary between the different CLL samples tested.
Collapse
MESH Headings
- Antigens, CD/analysis
- Antigens, Differentiation, B-Lymphocyte
- Antigens, Viral
- B-Lymphocytes/pathology
- B-Lymphocytes/physiology
- Cell Division
- Cell Transformation, Viral
- Cells, Cultured
- DNA, Viral/genetics
- Epstein-Barr Virus Nuclear Antigens
- Flow Cytometry
- Gene Expression Regulation, Viral
- Herpesvirus 4, Human/genetics
- Humans
- Leukemia/physiopathology
- Lymphocyte Activation
- Membrane Proteins/analysis
- Molecular Weight
- Receptors, Complement/analysis
- Receptors, Complement 3d
- Receptors, Fc/analysis
- Receptors, IgE
Collapse
Affiliation(s)
- E V Walls
- Division of Biological Sciences, Hatfield Polytechnic, Herts, London, UK
| | | | | | | | | | | |
Collapse
|
29
|
Chatterjee TK, Patel KK. Conjoint twins (1). Med J Zambia 1978; 12:123-5. [PMID: 757912] [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: 12/24/2022]
Abstract
Two cases of Conjoined twins are reported. The etiology, incidence, diagnosis and management are discussed. It is suggested that if conjoined twins are diagnosed before labour, of if there is dystocia, Caesarean section is the treatment of choice.
Collapse
|
30
|
Abstract
Five isolates of Mycoplasmatales virus-laidlawii 2 (MV-L2) derived from bovine strains of Acholeplasma laidlawii were shown to differ in host range, plaque morphology and neutralization tests with MV-L2 antiserum. Cross-testing using virus resistant clones of A. laidlawii confirmed the heterogeneity of this group. Adaptation of viruses to sub-optimal host was demonstrated.
Collapse
|
31
|
Liberson WT, Chen LC, Fok SK, Patel KK, Yu GH, Fried P. "H" reflexes and "F" waves in hemiplegics. Electromyogr Clin Neurophysiol 1977; 17:247-64. [PMID: 923505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
32
|
Abstract
Lactic acidosis is a prominent biochemical alteration which follows cerebral ischemia and is of sufficient degree to result in pH decrease in involved and adjacent tissue. Because of the significance of acidosis in the cerebral ischemic process, we have investigated ultrastruclural changes and some biochemical parameters under varying pH conditions using guinea pig cerebral cortex slices.
Metabolic rates decreased markedly during acidic incubations, and increased only minimally during basic incubations. Acidic pH affected oxygen and glucose utilization rates and fine structure to a greater degree than did an equal change in pH from 7.4 toward the alkaline. Glucose consumption was affected by pH deviations from 7.4 to a greater degree than oxygen uptake.
Collapse
|
33
|
|