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Raspe M, Lo K, Sommer N, Andreas S. [Tobacco cessation: one of the most effective medical measures]. Inn Med (Heidelb) 2024; 65:365-375. [PMID: 38446181 DOI: 10.1007/s00108-024-01683-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 03/07/2024]
Abstract
Tobacco smoking is widespread in Germany. An increase in the number of teenagers and young adults that smoke has recently been a cause for concern. The high prevalence in Germany is contrasted by inadequate preventive measures compared to international standards. Smoking behavior should always be inquired about and documented in the same way as vital signs. All smokers, regardless of the reason for contact and motivation, should receive short, low-threshold advice, e.g. using the ABC approach (ask, brief advice, cessation). In addition to repeated advice and referral to further services, the use of nicotine replacement or drug therapy is essential for the success of quitting. The combination of long- and short-acting nicotine replacement products doubles the success rate. Electronic nicotine delivery systems are not recommended for smoking cessation.
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Affiliation(s)
- Matthias Raspe
- Fächerverbund für Infektiologie, Pneumologie und Intensivmedizin, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
| | - Kevin Lo
- Department für Pneumologie, Medizinische Klinik II, Excellence Cluster Cardio Pulmonary Institute (CPI), Universitätsklinikum Gießen und Marburg (UKGM), Justus-Liebig-Universität Gießen, Aulweg 130, 35392, Gießen, Deutschland
- Mitglied des Deutschen Zentrums für Lungenforschung (DZL), Gießen, Deutschland
| | - Natascha Sommer
- Department für Pneumologie, Medizinische Klinik II, Excellence Cluster Cardio Pulmonary Institute (CPI), Universitätsklinikum Gießen und Marburg (UKGM), Justus-Liebig-Universität Gießen, Aulweg 130, 35392, Gießen, Deutschland
- Mitglied des Deutschen Zentrums für Lungenforschung (DZL), Gießen, Deutschland
| | - Stefan Andreas
- Mitglied des Deutschen Zentrums für Lungenforschung (DZL), Gießen, Deutschland
- Lungenfachklinik Immenhausen, Robert-Koch-Straße 3, 34376, Immenhausen, Deutschland
- Abteilung Kardiologie und Pneumologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
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2
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Idowu A, Lo K, Adebolu O, Ibe F, Al-Madani M. Outcomes Of Restrictive Versus Liberal Blood Transfusion in Patients With Acute Myocardial Infarction and Anemia: An Updated Meta-Analysis of Randomized Controlled Trials. Am J Cardiol 2024; 212:48-50. [PMID: 38042271 DOI: 10.1016/j.amjcard.2023.11.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 11/26/2023] [Indexed: 12/04/2023]
Affiliation(s)
- Abiodun Idowu
- Department of Medicine, Einstein Medical Center, Philadelphia, Pennsylvania.
| | - Kevin Lo
- Division of Cardiovascular Medicine, Brigham and Women's Hospital Heart and Vascular Center, Boston, Massachusetts
| | - Olayinka Adebolu
- Department of Medicine, Einstein Medical Center, Philadelphia, Pennsylvania
| | - Festus Ibe
- Department of Medicine, Einstein Medical Center, Philadelphia, Pennsylvania
| | - Mohammad Al-Madani
- Division of Interventional Cardiology, Einstein Medical Center, Philadelphia, Pennsylvania
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3
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Ogugua FM, Aguilar FA, Gamam A, Maqsood MH, Yoo TK, Kasmi F, AlKowatli O, Lo K. Treating Iron Deficiency (ID) Anemia in Heart Failure (HF) Patients with IV Iron: A Meta-Analysis. Cureus 2023; 15:e41895. [PMID: 37581143 PMCID: PMC10423640 DOI: 10.7759/cureus.41895] [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] [Accepted: 07/14/2023] [Indexed: 08/16/2023] Open
Abstract
Findings on the effects of iron on heart failure (HF) hospitalizations and mortality among patients with iron deficiency (ID) and HF remain conflicting across different studies. We performed a meta-analysis of clinical trials assessing the clinical, hematic and cardiovascular benefits of treating ID in HF patients. We completed a systematic search for studies comparing IV iron to placebo in HF patients with ID. The primary outcomes were rates of HF hospitalization and all-cause mortality. Secondary outcomes included change in hematic values, New York Heart Association (NYHA) class and ejection fraction. We applied a random-effects model with planned sensitivity analyses of studies with skewed effect sizes. Nine studies were included with a total of 2,261 patients. Analysis revealed that treatment of HF patients with IV iron replacement significantly reduced the odds of HF hospitalization (odds ratio (OR): 0.44; 95% confidence interval (CI): 0.24 to 0.78; p=0.005, I2=67%),) but did not significantly impact all-cause mortality compared to placebo (OR: 0.89; 95%, CI: 0.67 to 1.19; p=0.44, I2: 0%). Analysis showed that IV iron treatment group had significantly higher serum ferritin, transferrin saturation and hemoglobin (Hb) levels. They also had lower NYHA class -1.90 (95% CI (-2.91 to -0.89); p<0.001, I2:89%) with higher ejection fraction 0.50 (95% CI (0.09 to 0.90) p=0.016, I2:86%). Treatment with IV iron in HF patients with ID is associated with a significant reduction of HF hospitalization but no effects on all-cause mortality. There were also significant increases in hematic values and ejection fraction with a reduction in NYHA class.
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Affiliation(s)
| | | | | | | | | | - Fedi Kasmi
- Internal Medicine, Sheikh Khalifa Hospital, Ajman, ARE
| | - Oubada AlKowatli
- Internal Medicine, Advocate Illinois Masonic Medical Center, Chicago, USA
| | - Kevin Lo
- Internal Medicine, Einstein Medical Center Philadelphia, Philadelphia, USA
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Wu CY, Cilic A, Pak O, Dartsch RC, Wilhelm J, Wujak M, Lo K, Brosien M, Zhang R, Alkoudmani I, Witte B, Pedersen F, Watz H, Voswinckel R, Günther A, Ghofrani HA, Brandes RP, Schermuly RT, Grimminger F, Seeger W, Sommer N, Weissmann N, Hadzic S. CEACAM6 as a Novel Therapeutic Target to Boost HO-1-mediated Antioxidant Defense in COPD. Am J Respir Crit Care Med 2023; 207:1576-1590. [PMID: 37219322 DOI: 10.1164/rccm.202208-1603oc] [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: 08/24/2022] [Accepted: 05/23/2023] [Indexed: 05/24/2023] Open
Abstract
Rationale: Tobacco smoking and air pollution are primary causes of chronic obstructive pulmonary disease (COPD). However, only a minority of smokers develop COPD. The mechanisms underlying the defense against nitrosative/oxidative stress in nonsusceptible smokers to COPD remain largely unresolved. Objectives: To investigate the defense mechanisms against nitrosative/oxidative stress that possibly prevent COPD development or progression. Methods: Four cohorts were investigated: 1) sputum samples (healthy, n = 4; COPD, n = 37), 2) lung tissue samples (healthy, n = 13; smokers without COPD, n = 10; smoker+COPD, n = 17), 3) pulmonary lobectomy tissue samples (no/mild emphysema, n = 6), and 4) blood samples (healthy, n = 6; COPD, n = 18). We screened 3-nitrotyrosine (3-NT) levels, as indication of nitrosative/oxidative stress, in human samples. We established a novel in vitro model of a cigarette smoke extract (CSE)-resistant cell line and studied 3-NT formation, antioxidant capacity, and transcriptomic profiles. Results were validated in lung tissue, isolated primary cells, and an ex vivo model using adeno-associated virus-mediated gene transduction and human precision-cut lung slices. Measurements and Main Results: 3-NT levels correlate with COPD severity of patients. In CSE-resistant cells, nitrosative/oxidative stress upon CSE treatment was attenuated, paralleled by profound upregulation of heme oxygenase-1 (HO-1). We identified carcinoembryonic antigen cell adhesion molecule 6 (CEACAM6) as a negative regulator of HO-1-mediated nitrosative/oxidative stress defense in human alveolar type 2 epithelial cells (hAEC2s). Consistently, inhibition of HO-1 activity in hAEC2s increased the susceptibility toward CSE-induced damage. Epithelium-specific CEACAM6 overexpression increased nitrosative/oxidative stress and cell death in human precision-cut lung slices on CSE treatment. Conclusions: CEACAM6 expression determines the hAEC2 sensitivity to nitrosative/oxidative stress triggering emphysema development/progression in susceptible smokers.
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Affiliation(s)
- Cheng-Yu Wu
- Excellence Cluster Cardio-Pulmonary Institute, Universities of Giessen and Marburg Lung Center, member of the German Center for Lung Research (DZL), Justus Liebig University Giessen, Giessen, Germany
| | - Anis Cilic
- Excellence Cluster Cardio-Pulmonary Institute, Universities of Giessen and Marburg Lung Center, member of the German Center for Lung Research (DZL), Justus Liebig University Giessen, Giessen, Germany
| | - Oleg Pak
- Excellence Cluster Cardio-Pulmonary Institute, Universities of Giessen and Marburg Lung Center, member of the German Center for Lung Research (DZL), Justus Liebig University Giessen, Giessen, Germany
| | - Ruth Charlotte Dartsch
- Excellence Cluster Cardio-Pulmonary Institute, Universities of Giessen and Marburg Lung Center, member of the German Center for Lung Research (DZL), Justus Liebig University Giessen, Giessen, Germany
| | - Jochen Wilhelm
- Excellence Cluster Cardio-Pulmonary Institute, Universities of Giessen and Marburg Lung Center, member of the German Center for Lung Research (DZL), Justus Liebig University Giessen, Giessen, Germany
- Institute for Lung Health (ILH), Justus Liebig University Giessen, Giessen, Germany
| | - Magdalena Wujak
- Excellence Cluster Cardio-Pulmonary Institute, Universities of Giessen and Marburg Lung Center, member of the German Center for Lung Research (DZL), Justus Liebig University Giessen, Giessen, Germany
- Department of Medicinal Chemistry, Collegium Medicum in Bydgoszcz, Faculty of Pharmacy, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Kevin Lo
- Excellence Cluster Cardio-Pulmonary Institute, Universities of Giessen and Marburg Lung Center, member of the German Center for Lung Research (DZL), Justus Liebig University Giessen, Giessen, Germany
| | - Monika Brosien
- Excellence Cluster Cardio-Pulmonary Institute, Universities of Giessen and Marburg Lung Center, member of the German Center for Lung Research (DZL), Justus Liebig University Giessen, Giessen, Germany
| | - Ruoyu Zhang
- Department of General and Thoracic Surgery, University Hospital of Giessen, Giessen, Germany
| | - Ibrahim Alkoudmani
- Department of General and Thoracic Surgery, University Hospital of Giessen, Giessen, Germany
| | - Biruta Witte
- Department of General and Thoracic Surgery, University Hospital of Giessen, Giessen, Germany
| | - Frauke Pedersen
- Pulmonary Research Institute at LungenClinic Grosshansdorf, Airway Research Center North, DZL, Grosshansdorf, Germany
| | - Henrik Watz
- Pulmonary Research Institute at LungenClinic Grosshansdorf, Airway Research Center North, DZL, Grosshansdorf, Germany
| | | | - Andreas Günther
- Excellence Cluster Cardio-Pulmonary Institute, Universities of Giessen and Marburg Lung Center, member of the German Center for Lung Research (DZL), Justus Liebig University Giessen, Giessen, Germany
| | - Hossein A Ghofrani
- Excellence Cluster Cardio-Pulmonary Institute, Universities of Giessen and Marburg Lung Center, member of the German Center for Lung Research (DZL), Justus Liebig University Giessen, Giessen, Germany
| | - Ralf P Brandes
- Institute for Cardiovascular Physiology, Goethe University, Frankfurt am Main, Germany; and
| | - Ralph T Schermuly
- Excellence Cluster Cardio-Pulmonary Institute, Universities of Giessen and Marburg Lung Center, member of the German Center for Lung Research (DZL), Justus Liebig University Giessen, Giessen, Germany
| | - Friedrich Grimminger
- Excellence Cluster Cardio-Pulmonary Institute, Universities of Giessen and Marburg Lung Center, member of the German Center for Lung Research (DZL), Justus Liebig University Giessen, Giessen, Germany
- Institute for Lung Health (ILH), Justus Liebig University Giessen, Giessen, Germany
| | - Werner Seeger
- Excellence Cluster Cardio-Pulmonary Institute, Universities of Giessen and Marburg Lung Center, member of the German Center for Lung Research (DZL), Justus Liebig University Giessen, Giessen, Germany
- Institute for Lung Health (ILH), Justus Liebig University Giessen, Giessen, Germany
- Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
| | - Natascha Sommer
- Excellence Cluster Cardio-Pulmonary Institute, Universities of Giessen and Marburg Lung Center, member of the German Center for Lung Research (DZL), Justus Liebig University Giessen, Giessen, Germany
| | - Norbert Weissmann
- Excellence Cluster Cardio-Pulmonary Institute, Universities of Giessen and Marburg Lung Center, member of the German Center for Lung Research (DZL), Justus Liebig University Giessen, Giessen, Germany
| | - Stefan Hadzic
- Excellence Cluster Cardio-Pulmonary Institute, Universities of Giessen and Marburg Lung Center, member of the German Center for Lung Research (DZL), Justus Liebig University Giessen, Giessen, Germany
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Casipit B, Tito S, Ogunmola I, Idowu A, Patil S, Lo K, Bozorgnia B. Outcomes among heart failure patients hospitalized for acute pulmonary embolism and COVID-19 infection: Insight from the National Inpatient Sample. Pulm Circ 2023; 13:e12229. [PMID: 37091122 PMCID: PMC10113514 DOI: 10.1002/pul2.12229] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/24/2023] [Accepted: 04/09/2023] [Indexed: 04/25/2023] Open
Abstract
There is paucity of data regarding the outcomes of hospitalized acute pulmonary embolism (PE) patients with heart failure (HF) and Coronavirus Disease 2019 (COVID-19) infection. We utilized the 2020 National Inpatient Sample (NIS) Database in conducting a retrospective cohort study to investigate the outcomes of hospitalized acute PE patients with HF and COVID-19, looking at its impact on in-hospital mortality, thrombolysis, and thrombectomy utilization as well as hospital length of stay (LOS). A total of 23,413 hospitalized acute PE patients with HF were identified in our study, of which 1.26% (n = 295/23,413) had COVID-19 infection. Utilizing a stepwise survey multivariable logistic regression model that adjusted for confounders, COVID-19 infection among acute PE patients with HF was found to be an independent predictor of overall in-hospital mortality (adjusted odds ratio [aOR]: 2.77; 95% confidence interval [CI], 1.15-6.67; p = 0.023) and thrombolysis utilization (aOR: 5.52; 95% CI, 2.57-11.84; p ≤ 0.001) compared to those without COVID-19. However, there were comparable rates of thrombectomy utilization and LOS among acute PE patients with HF regardless of the COVID-19 infection status. On subgroup analysis, patients with HF with reduced ejection fraction was found to be associated with increased risk for in-hospital mortality (aOR: 3.89; 95% CI, 1.33-11.39; p = 0.013) and thrombectomy utilization (aOR: 4.58; 95% CI, 1.08-19.41; p = 0.042), whereas both HF subtypes were associated with increased thrombolysis utilization. COVID-19 infection among acute PE patients with HF was associated with higher over-all in-hospital mortality and increased thrombolysis utilization but had comparable hospital LOS as well as thrombectomy utilization.
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Affiliation(s)
- Bruce Casipit
- Department of MedicineEinstein Medical CenterPhiladelphiaUSA
- Department of Cardiovascular DiseaseEinstein Medical CenterPhiladelphiaUSA
| | - Sahana Tito
- Department of MedicineEinstein Medical CenterPhiladelphiaUSA
- Department of Cardiovascular DiseaseEinstein Medical CenterPhiladelphiaUSA
| | - Isaac Ogunmola
- Department of MedicineEinstein Medical CenterPhiladelphiaUSA
- Department of Cardiovascular DiseaseEinstein Medical CenterPhiladelphiaUSA
| | - Abiodun Idowu
- Department of MedicineEinstein Medical CenterPhiladelphiaUSA
- Department of Cardiovascular DiseaseEinstein Medical CenterPhiladelphiaUSA
| | - Shivaraj Patil
- Department of Cardiovascular DiseaseEinstein Medical CenterPhiladelphiaUSA
- Sidney Kimmel Medical CollegeThomas Jefferson UniversityPhiladelphiaPennsylvaniaUSA
| | - Kevin Lo
- Department of MedicineEinstein Medical CenterPhiladelphiaUSA
- Department of Cardiovascular DiseaseEinstein Medical CenterPhiladelphiaUSA
| | - Behnam Bozorgnia
- Department of Cardiovascular DiseaseEinstein Medical CenterPhiladelphiaUSA
- Sidney Kimmel Medical CollegeThomas Jefferson UniversityPhiladelphiaPennsylvaniaUSA
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Schäfer K, Tello K, Pak O, Richter M, Gierhardt M, Kwapiszewska G, Veith C, Fink L, Gall H, Hecker M, Kojonazarov B, Kraut S, Lo K, Wilhelm J, Grimminger F, Seeger W, Schermuly RT, Ghofrani HA, Zahner D, Gerstberger R, Weissmann N, Sydykov A, Sommer N. Decreased plasma levels of the brain-derived neurotrophic factor correlate with right heart congestion in pulmonary arterial hypertension. ERJ Open Res 2023; 9:00230-2022. [PMID: 36891080 PMCID: PMC9986749 DOI: 10.1183/23120541.00230-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 09/28/2022] [Indexed: 01/27/2023] Open
Abstract
Background The brain-derived neurotrophic factor (BDNF) may promote development of pulmonary hypertension and right ventricular (RV) failure. However, BDNF plasma levels were decreased in patients with left ventricular (LV) failure. Therefore, we investigated BDNF plasma levels in pulmonary hypertension patients and the role of BDNF in mouse models of pulmonary hypertension and isolated RV failure. Methods BDNF plasma levels were correlated to pulmonary hypertension in two patient cohorts, including either post- and pre-capillary pulmonary hypertension patients (first cohort) or only pre-capillary pulmonary hypertension patients (second cohort). In the second cohort, RV dimensions and load-independent function were determined by imaging and pressure-volume catheter measurements, respectively. For induction of isolated RV pressure overload, heterozygous Bdnf knockout (Bdnf+/- ) mice were subjected to pulmonary arterial banding (PAB). For induction of pulmonary hypertension, mice with inducible knockout of BDNF in smooth muscle cells (Bdnf/Smmhc knockout) were exposed to chronic hypoxia. Results Plasma BDNF levels were decreased in patients with pulmonary hypertension. Following adjustment for covariables, BDNF levels negatively correlated in both cohorts with central venous pressure. In the second cohort, BDNF levels additionally negatively correlated with RV dilatation. In animal models, BDNF downregulation attenuated RV dilatation in Bdnf+ /- mice after PAB or hypoxic Bdnf/Smmhc knockout mice, although they developed pulmonary hypertension to a similar extent. Conclusions Similar to LV failure, circulating levels of BDNF were decreased in pulmonary hypertension patients, and low BDNF levels were associated with right heart congestion. Decreased BDNF levels did not worsen RV dilatation in animal models, and thus, may be the consequence, but not the cause of RV dilatation.
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Affiliation(s)
- Katharina Schäfer
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary Institute (CPI), Justus-Liebig University, Giessen, Germany.,These authors contributed equally
| | - Khodr Tello
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary Institute (CPI), Justus-Liebig University, Giessen, Germany.,These authors contributed equally
| | - Oleg Pak
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary Institute (CPI), Justus-Liebig University, Giessen, Germany.,These authors contributed equally
| | - Manuel Richter
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary Institute (CPI), Justus-Liebig University, Giessen, Germany
| | - Mareike Gierhardt
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary Institute (CPI), Justus-Liebig University, Giessen, Germany.,Instituto de Investigación en Biomedicina de Buenos Aires (IBioBA) - CONICET - Partner Institute of the Max Planck Society, Buenos Aires, Argentina
| | - Grazyna Kwapiszewska
- Ludwig Boltzmann Institute for Lung Vascular Research, Otto Loewi research Center, Medical University Graz, Graz, Austria.,Institute for Lung Health (ILH), Giessen, Germany
| | - Christine Veith
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary Institute (CPI), Justus-Liebig University, Giessen, Germany
| | - Ludger Fink
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary Institute (CPI), Justus-Liebig University, Giessen, Germany
| | - Henning Gall
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary Institute (CPI), Justus-Liebig University, Giessen, Germany
| | - Matthias Hecker
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary Institute (CPI), Justus-Liebig University, Giessen, Germany
| | | | - Simone Kraut
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary Institute (CPI), Justus-Liebig University, Giessen, Germany
| | - Kevin Lo
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary Institute (CPI), Justus-Liebig University, Giessen, Germany
| | - Jochen Wilhelm
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary Institute (CPI), Justus-Liebig University, Giessen, Germany.,Institute for Lung Health (ILH), Giessen, Germany
| | - Friedrich Grimminger
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary Institute (CPI), Justus-Liebig University, Giessen, Germany
| | - Werner Seeger
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary Institute (CPI), Justus-Liebig University, Giessen, Germany.,Institute for Lung Health (ILH), Giessen, Germany
| | - Ralph T Schermuly
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary Institute (CPI), Justus-Liebig University, Giessen, Germany
| | - Hossein A Ghofrani
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary Institute (CPI), Justus-Liebig University, Giessen, Germany.,Department of Medicine, Imperial College London, London, UK
| | - Daniel Zahner
- Central Laboratory Animal Facility, Justus-Liebig University, Giessen, Germany
| | - Rüdiger Gerstberger
- Institute of Veterinary Physiology and Biochemistry, Justus-Liebig University, Giessen, Germany
| | - Norbert Weissmann
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary Institute (CPI), Justus-Liebig University, Giessen, Germany
| | - Akylbek Sydykov
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary Institute (CPI), Justus-Liebig University, Giessen, Germany.,These authors contributed equally
| | - Natascha Sommer
- Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Excellence Cluster Cardio-Pulmonary Institute (CPI), Justus-Liebig University, Giessen, Germany.,These authors contributed equally
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Yang S, Liu L, Wang C, Lo K, Wang D. Elderly people's preferences for healthcare facilities in Shanghai: gender features and influencing factor analysis. BMC Public Health 2023; 23:356. [PMID: 36800949 PMCID: PMC9936711 DOI: 10.1186/s12889-023-15279-6] [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: 08/17/2022] [Accepted: 02/15/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND China has one of the fastest paces of the growing aging population, High-level policymakers have recently recognized the aging population presents significant challenges to the Chinese healthcare system. In this context, the healthcare-seeking behaviors of the elderly population have become an essential field of study. It is necessary to understand their access to health services and to improve their quality of life, as well as to help policymakers to formulate healthcare policy. The study empirically investigates the factors influencing the elderly population's healthcare-seeking behaviors in Shanghai, China, especially in choosing the quality of healthcare facilities to visit. METHODS We designed a cross-sectional study. The data of this study were derived from the "Shanghai elderly medical demand characteristics questionnaire" in the middle of November to early December 2017. A total of 625 individuals were included in the final sample. Logistic regression was adopted to investigate the differences in healthcare-seeking behaviors between elderly people when suffer from mild illness, severe illness and follow-up treatment. Next, the differences in gender were also discussed. RESULTS Factors affecting the healthcare-seeking behaviors of the elderly differ in mild illness and severe illness situations. For mild illness, demographic factors (gender and age) and socioeconomic factors (income and employment) play an important role in elderly healthcare choices. Female and older elderlies are more likely to choose local, lower-quality facilities, whereas those with high income and private employment are more likely to choose higher-quality facilities. For severe illness, socioeconomic factors (income and employment) are important. Furthermore, individuals with basic medical insurance are more likely to choose lower-quality facilities. CONCLUSION This study has shown that the affordability of public health services should be addressed. Medical policy support may be an important way to reduce the gap in access to medical services. We should pay attention to the gender differences in the elderly's choice of medical treatment behavior, consider the differences in the needs of male and female elderly. our findings are only for elderly Chinese participants in the greater Shanghai area.
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Affiliation(s)
- Shangguang Yang
- grid.28056.390000 0001 2163 4895Economic Development Institute, East China University of Science and Technology, 200237 Shanghai, China
| | - Luxue Liu
- grid.22069.3f0000 0004 0369 6365Student Affairs Office, East China Normal University, 200062 Shanghai, China
| | - Chunlan Wang
- grid.22069.3f0000 0004 0369 6365Population Research Institute, East China Normal University, 200062 Shanghai, China
| | - Kevin Lo
- grid.221309.b0000 0004 1764 5980Department of Geography, Hong Kong Baptist University, 999077 Hong Kong, China
| | - Danyang Wang
- Economic Development Institute, East China University of Science and Technology, 200237, Shanghai, China.
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Teoh Y, Chan T, Tsang C, Li K, Cheng KC, Cho C, Chan HC, Chiu Y, Ho B, Li T, Law M, Lee Y, Cheng C, Lo K, Lam K, Chan K, So HS, Leung C, Chan C, Yiu M, Ng C, Poon V, Leung C, Chi-Fai N. Transurethral en bloc resection versus standard resection of bladder tumour: A multi-center randomized trial (EB-StaR Study). Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00751-0] [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: 02/12/2023]
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9
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Li Y, Zhang P, Lo K, Tan J, Yang Q. Borderland Economic Resilience under COVID-19: Evidence from China-Russia Border Regions. Int J Environ Res Public Health 2022; 19:13042. [PMID: 36293618 PMCID: PMC9602610 DOI: 10.3390/ijerph192013042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/04/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic has had a great impact on the global economy and trade, and border regions have been hit severely because of their high dependency on foreign trade. To understand better the economic impact of COVID-19 on border regions, we developed a COVID-19 economic resilience analytical framework and empirically examined 10 Chinese-Russian border cities in Northeast China. We quantitatively analyzed five dimensions of economic resilience, distinguished four types of shock, and examined the determinants of economic resilience. The results show that: (1) the COVID-19 pandemic has wide-ranging impacts in the border areas, with import-export trade and retail sales of consumer goods being the most vulnerable and sensitive to the shock. The whole economy of the border areas is in the downward stage of the resistance period; (2) from a multi-dimensional perspective, foreign trade and consumption are the most vulnerable components of the borderland economic system, while industrial resilience and income resilience have improved against the trend, showing that they have good crisis resistance; (3) borderland economic resilience is a spatially heterogeneous phenomenon, with each border city showing different characteristics; (4) economic openness, fiscal expenditure, and asset investment are the key drivers of economic resilience, and the interaction between the influencing factors presents a nonlinear and bi-factor enhancement of them. The findings shed light on how border economies can respond to COVID-19, and how they are useful in formulating policies to respond to the crisis.
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Affiliation(s)
- Yuxin Li
- Northeast Institute of Geography and Agroecology, Chinese Academy of Sciences, Changchun 130102, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Pingyu Zhang
- Northeast Institute of Geography and Agroecology, Chinese Academy of Sciences, Changchun 130102, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Kevin Lo
- Department of Geography, Hong Kong Baptist University, Kowloon Tong, Hong Kong 999077, China
| | - Juntao Tan
- School of Geography, Geomatics and Planning & Urban-Rural Integration Development Research Institute, Jiangsu Normal University, Xuzhou 221116, China
| | - Qifeng Yang
- Northeast Institute of Geography and Agroecology, Chinese Academy of Sciences, Changchun 130102, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
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10
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Price LB, Rogers L, Lo K. Policy reforms for antibiotic use claims in livestock. Science 2022; 376:130-132. [PMID: 35389795 DOI: 10.1126/science.abj1823] [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: 11/02/2022]
Abstract
Antibiotics detected in "raised without antibiotics" cattle underscore the need to ensure the integrity of labeling claims.
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Affiliation(s)
- Lance B Price
- Antibiotic Resistance Action Center, Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Laura Rogers
- Antibiotic Resistance Action Center, Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Kevin Lo
- Food In-Depth, San Mateo, CA, USA
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11
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Goertz A, Dejoy R, Torres R, Lo K, Azmaiparashvili Z, Patarroyo-Aponte G. Palliative Care Consultation and Cost of Stay in out of Hospital Cardiac Arrest. Am J Hosp Palliat Care 2022; 39:1333-1336. [PMID: 35353018 DOI: 10.1177/10499091221078978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Cardiac arrest is a critical condition with high clinical, economic, and emotional burden. The role of palliative medicine in the management of critical patients has grown and, in some areas, has shown reduced cost of stay. This study set out to examine the association of palliative care involvement in out of hospital post cardiac arrest patients and cost of stay. Methods: This is a single center retrospective analysis of all patients ≥18 years of age who were admitted at our institution from March 2018 to June 2019 with out of hospital cardiac arrest. Patients who immediately died in the emergency department were excluded. Patients were then classified according to whether palliative care was consulted. Total charges were obtained from the billing records and compared between those with palliative care compared to those without using Mann-Whitney U test. Results: A final sample of 98 patients that were included in the analysis. The mean age was 61.2 ± 17.3, 46% were female, and 61% were African American. Palliative care consultation was present in 27 (28%) of patients. There were no significant differences among age, gender, ethnicity, BMI, SOFA scores, and common comorbidities among those who did and did not have palliative care consultation. While there was a significantly longer ICU length of stay and mechanical ventilation days among patients with palliative care involvement P < .0001, the charges among patients with palliative care involvement were not statistically significantly different $59,245 ($3744-148,492) (median IQR) compared to those without palliative care $79,521 ($6540-157,952) P = .762. Conclusion: Length of stay increased with palliative care consultation which may relate more to the inherent clinical scenario. Cost of stay was not statistically significantly different.
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Affiliation(s)
- Aaron Goertz
- Pulmonary and critical care, 6566Albert Einstein Medical Center, Philadelphia, PA, USA
| | - Robert Dejoy
- Internal Medicine, 6566Albert Einstein Medical Center, Philadelphia, PA, USA
| | - Ricardo Torres
- Internal Medicine, 6566Albert Einstein Medical Center, Philadelphia, PA, USA
| | - Kevin Lo
- Internal Medicine, 6566Albert Einstein Medical Center, Philadelphia, PA, USA
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Tran N, Shaar M, Al-Sudani H, Sedhom R, Akhtar H, Lo K, Pressman G. The importance of right heart function in heart failure with preserved ejection fraction. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Heart failure (HF) is a complex clinical syndrome that is a frequent cause of morbidity and mortality. Although half of patients with HF have a preserved ejection fraction (HFpEF), the majority of studies have examined the prognostic impact of left heart parameters instead of the right. We thus evaluated associations of right heart hemodynamics and echocardiographic measures with outcomes in HFpEF subjects.
Purpose
To perform long-term mortality analysis of patients with decompensated HFpEF using strain imaging and right heart catheterization hemodynamics.
Methods
This was a retrospective cross-sectional study which included patients hospitalized for acute heart failure exacerbation as the primary admitting diagnosis based on clinical and laboratory parameters as determined by the primary medical team. Patients included were only those with HFpEF and with available echocardiographic and right heart catheterization (RHC) hemodynamic data done during the index admission. 2D strain analysis software was used to automatically calculate right ventricular free wall strain (RVFWS), fractional area change (FAC), and left ventricular global longitudinal strain (LVGLS). Demographic and clinical parameters were obtained including RHC hemodynamics. The outcome of interest was long term 6-year all-cause mortality. Right and left ventricular echocardiographic strain and hemodynamic parameters were compared between patients with mortality and those who survived using independent T tests and non-parametric methods as appropriate. Multivariable logistic regression was used to identify echocardiographic and hemodynamic factors independently associated with all-cause mortality. Results From a total of 100 patients, 47% were Caucasian and 53% were female. The mean age was 67.4 ± 14.3. There was an 18% long term all cause mortality rate. Of the right sided echocardiographic strain parameters, only RVFWS was statistically significantly lower among those who died (12.0 vs 15.7 p = 0.038). Meanwhile, 4 chamber LVGLS was significantly lower (13.8 vs 15.1 p = 0.016) and mean right atrial (RA) pressure was higher (13.6 vs 10.7 p = 0.076) although this did not reach statistical significance. Looking at echocardiographic strain and hemodynamic parameters as predictors of mortality, after adjusting for age, gender and race accounting for the major differences in these parameters between the survival groups, only RVFWS (OR 1.90, 95% CI 1.12-3.28; p = 0.02) and RA pressure (OR 1.85, 95% CI 1.12-3.28; p = 0.016) remained independently associated with long term all-cause mortality with C statistic of 0.751 for the overall predictive model.
Conclusion
Among patients with HFpEF admitted for acute heart failure exacerbation, baseline RVFWS and RA hemodynamic pressure measurements were independently associated with long term all-cause mortality. This suggests that right heart diagnostic parameters may hold more prognostic utility in HFpEF. Abstract Figure. Abstract Figure.
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Affiliation(s)
- N Tran
- Albert Einstein Medical Center, Philadelphia, United States of America
| | - M Shaar
- Albert Einstein Medical Center, Philadelphia, United States of America
| | - H Al-Sudani
- Albert Einstein Medical Center, Philadelphia, United States of America
| | - R Sedhom
- Albert Einstein Medical Center, Philadelphia, United States of America
| | - H Akhtar
- Albert Einstein Medical Center, Philadelphia, United States of America
| | - K Lo
- Albert Einstein Medical Center, Philadelphia, United States of America
| | - G Pressman
- Albert Einstein Medical Center, Philadelphia, United States of America
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13
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Yang S, Wang D, Xu L, Wang C, Yang X, Lo K. Private Healthcare Expenditure in China: A Regional Comparative Analysis. Healthcare (Basel) 2021; 9:healthcare9101374. [PMID: 34683054 PMCID: PMC8544429 DOI: 10.3390/healthcare9101374] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 12/12/2022] Open
Abstract
Private (out-of-pocket) healthcare expenditure (PHCE) is a complex phenomenon that is shaped by many different factors. In this paper, we analyzed the influencing factors of PHCE in China, with a specific focus on regional differences. We found that old-age dependency ratio, income, and education have significant impacts on PHCE in all regions, whereas public HCE, number of beds in medical institutions, and economic development levels have significant impacts only in some regions. The results indicate that the government should pay attention to regional inequality and implement targeted adjustments for improving the health service system. In particular, we recommend: (1) monitoring regional inequality in PHCE and other healthcare issues to unmask geographical differences in healthcare interventions; (2) adopting regional-specific policy measures—the government should divert some resources from eastern to western and central regions to increasing the support for public health undertakings and improve the quality of the local health services while providing matching medical resources by targeting the needs of the residents; (3) paying more attention to the healthcare demand of the elderly population; and (4) improving the education level of residents to improve public health and avoid high PHCE.
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Affiliation(s)
- Shangguang Yang
- Economic Development Institute, East China University of Science and Technology, Shanghai 200237, China; (S.Y.); (L.X.)
| | - Danyang Wang
- School of Business, East China University of Science and Technology, Shanghai 200237, China;
| | - Lu Xu
- Economic Development Institute, East China University of Science and Technology, Shanghai 200237, China; (S.Y.); (L.X.)
| | - Chunlan Wang
- Chinese Modern City Research Center, School of Social Development, East China Normal University, Shanghai 200062, China;
| | - Xi Yang
- David C. Lam Institute for East-West Studies, Hong Kong Baptist University, Hong Kong 999077, China;
| | - Kevin Lo
- Department of Geography, Hong Kong Baptist University, Hong Kong 999077, China
- Correspondence:
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14
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Gao X, Huang X, Lo K, Dang Q, Wen R. Vegetation responses to climate change in the Qilian Mountain Nature Reserve, Northwest China. Glob Ecol Conserv 2021. [DOI: 10.1016/j.gecco.2021.e01698] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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15
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Yang X, Lo K. Environmental health research and the COVID-19 pandemic: A turning point towards sustainability. Environ Res 2021; 197:111157. [PMID: 33887273 PMCID: PMC8542966 DOI: 10.1016/j.envres.2021.111157] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 05/07/2023]
Abstract
Based on a review of COVID-19 research from an environmental health perspective, this study theorizes the interdependence of the society, environment and health, and presents an integrated framework for environmental health problems arising due to COVID-19. Five guiding principles are proposed for conducting environmental health research, including employing a transdisciplinary approach, embracing complexity and uncertainty, addressing vulnerability, boosting resilience and promoting sustainable development. This study propagates that the pandemic could be an opportunity for sustainable transformation, wherein visionary leadership that facilitates sustainability policies based on environmental health science is required. This study can serve as a consolidated guide for professionals and stakeholders who conduct environmental health research in this challenging field.
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Affiliation(s)
- Xi Yang
- David C. Lam Institute for East-West Studies, Hong Kong Baptist University, Hong Kong, China.
| | - Kevin Lo
- David C. Lam Institute for East-West Studies, Hong Kong Baptist University, Hong Kong, China; Department of Geography, Hong Kong Baptist University, Hong Kong, China
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16
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Rivera FB, Alfonso P, Golbin JM, Lo K, Lerma E, Volgman AS, Kazory A. The Role of Serum Chloride in Acute and Chronic Heart Failure: A Narrative Review. Cardiorenal Med 2021; 11:87-98. [PMID: 33873189 DOI: 10.1159/000515604] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 01/25/2021] [Accepted: 02/27/2021] [Indexed: 11/19/2022] Open
Abstract
Clinical guidelines include diuretics for the treatment of heart failure (HF), not to decrease mortality but to decrease symptoms and hospitalizations. More attention has been paid to the worse outcomes, including mortality, associated with continual diuretic therapy due to hypochloremia. Studies have revealed a pivotal role for serum chloride in the pathophysiology of HF and is now a target of treatment to decrease mortality. The prognostic value of serum chloride in HF has been the subject of much attention. Mechanistically, the macula densa, a region in the renal juxtaglomerular apparatus, relies on chloride levels to sense salt and volume status. The recent discovery of with-no-lysine (K) (WNK) protein kinase as an intracellular chloride sensor sheds light on the possible reason of diuretic resistance in HF. The action of chloride on WNKs results in the upregulation of the sodium-potassium-chloride cotransporter and sodium-chloride cotransporter receptors, which could lead to increased electrolyte and fluid reabsorption. Genetic studies have revealed that a variant of a voltage-sensitive chloride channel (CLCNKA) gene leads to almost a 50% decrease in current amplitude and function of the renal chloride channel. This variant increases the risk of HF. Several trials exploring the prognostic value of chloride in both acute and chronic HF have shown mostly positive results, some even suggesting a stronger role than sodium. However, so far, interventional trials exploring serum chloride as a therapeutic target have been largely inconclusive. This study is a review of the pathophysiologic effects of hypochloremia in HF, the genetics of chloride channels, and clinical trials that are underway to investigate novel approaches to HF management.
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Affiliation(s)
- Frederick Berro Rivera
- Department of Medicine, Philippine General Hospital, University of the Philippines System, National Capital Region, Manila, Philippines
| | - Pia Alfonso
- University of the Philippines System, National Capital Region, Manila, Philippines
| | - Jem Marie Golbin
- University of the Philippines System, National Capital Region, Manila, Philippines
| | - Kevin Lo
- Department of Medicine, Einstein Medical Center, Philadelphia, Pennsylvania, USA
| | - Edgar Lerma
- Section of Nephrology, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
| | | | - Amir Kazory
- Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida, Gainesville, Florida, USA
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17
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Tsai M, Chen F, Luh D, Wang Y, Lo K. Effectiveness of health promoting school program: The relationship of HPS award level and outcome. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.366] [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: 11/13/2022] Open
Abstract
Abstract
Background
According to Taiwan health promoting school (HPS) accreditations program, the school was recognized with a gold award, silver award, bronze award, participation award, and non-awards. Previous studies have foci on the effectiveness of the HPS from the perspective of students' health behaviors. The main purpose of this study is to compare the students' health and social outcomes in different HPS award levels to assess the effectiveness of the HPS program.
Methods
This cross-sectional survey was conducted to 121 schools registering HPS accreditation program in 2018. Overall, a total of 8812 elementary, junior and senior high school students completed the questionnaire. The accredited schools were classified into four categories according to the award level: excellent (5 schools with gold), good (32 schools with silver), fair (23 schools with bronze and 18 schools with participation), and poor (44 schools with non-award). The outcome variables included perceived health status, well-being, and quality of life. The descriptive statistics and ANOVA were analysed using SPSS 20.0 software.
Results
There were awards level differences of students' health (F = 10.66, p<.001) and social outcomes (e.g. well-being: F = 3.76, p<.01; quality of life: F = 11.58, p<.001). From the perspective of health outcomes, the results found that schools with excellent level (Mean=3.59), good level (Mean=3.52), and fair level (Mean=3.47) were better in students' perceived health status than schools with poor level (Mean=3.38). Similarly, the results showed that schools with excellent level were better in students' well-being (Mean=7.63) and quality of life (Mean=34.56) than schools with poor level (Mean=7.25; 33.56).
Conclusions
Students from schools with excellent levels exhibited better health and social outcomes. The finding suggests that future studies evaluate and track the effectiveness to conduct the longitudinal study, and the HPS program should be effectively implemented and sustained.
Key messages
To explore the effectiveness of the health promoting school program in health and social outcomes. Note: This work was funded by the Health Promotion Administration, Ministry of Health and Welfare. Health promoting schools award level is related to students’ perceived health status, well-being, and quality of life.
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Affiliation(s)
- M Tsai
- Department of Psychology, Fu Jen Catholic University, New Taipei City, Taiwan
| | - F Chen
- Department of Public Health, Fu Jen Catholic University, New Taipei City, Taiwan
| | - D Luh
- Department of Public Health, Chung Shan Medical University, Taichung City, Taiwan
| | - Y Wang
- Health Promotion Administration, Ministry of Health and Welfare, Taipei City, Taiwan
| | - K Lo
- Center for Physical and Health Education, National Sun Yat-sen University, Kaohsiung City, Taiwan
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18
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Huang YQ, Liu L, Yu YL, Lo K, Chen CL, Huang JY, Zhou YL, Feng YQ. The relationship between famine exposure in early life and left atrial enlargement in adulthood. J Hum Nutr Diet 2020; 34:356-364. [PMID: 32830406 DOI: 10.1111/jhn.12802] [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: 05/14/2020] [Accepted: 07/09/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Increased left atrium diameter (LAD) is associated with an elevated risk of cardiovascular diseases. The relationship between nutrition status and left atrial enlargement (LAE) is still unclear. The present study aimed to investigate the association of famine exposure in early life with LAE in adulthood. METHODS Participants were divided into non-exposed, fetal, early, middle and late childhood exposed groups according to birth data. LAE was defined when LAD was ≥3.9 cm in women and ≥4.1 cm in men, or ≥2.3 cm m-2 by a sex-independent cut-off normalised for body surface area. Multivariate logistic regression was performed to calculate the odds ratio (OR) and confidence interval (CI) between famine exposure and LAE. RESULTS In total, 2522 [905 male, mean (SD) age 59.1 (3.65) years] subjects were enrolled, including 392 (15.5%) LAE subjects. The prevalence of LAE in non-exposed, fetal, early, middle and late childhood exposed groups was 55 (10.8%), 38 (11.2%), 88 (18.1%), 102 (16.7%) and 109 (19.0%), respectively. Compared to the non-exposed group, the ORs for LAE were in fetal (OR = 0.956, 95% CI = 0.605-1.500, P = 0.847), late (OR = 1.748, 95% CI = 1.208-2.555, P = 0.003), middle (OR = 1.647, 95% CI = 1.140-2.403, P = 0.008) and early (OR = 1.630, 95% CI = 1.116-2.399, P = 0.012) childhood exposed groups after adjusting potential cofounders. When stratified by gender, smoking, body mass index, hypertension and diabetes, we found that the effect of famine exposure on LAE was only modified by diabetes (Pinteraction = 0.007). CONCLUSIONS Famine exposure during childhood stage might increase the risk of LAE in adults, and this effect interacts with diabetes.
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Affiliation(s)
- Y-Q Huang
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China
| | - L Liu
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China
| | - Y-L Yu
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China
| | - K Lo
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China.,Department of Epidemiology, Centre for Global Cardio-metabolic Health, Brown University, Providence, USA
| | - C-L Chen
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China
| | - J-Y Huang
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China
| | - Y-L Zhou
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China
| | - Y-Q Feng
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China
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Desai S, Lo K, Nambudiri V, Villa C, LaChance A, Vleugels R. 448 Challenges of securing insurance approval for oral tofacitinib treatment of alopecia areata: A multi-institutional retrospective review. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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20
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Pinto WAH, Gulab A, Lo K, Brito D, Alhamshari Y, Pressman GS. ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY: AN UNDERRECOGNIZED TIME BOMB. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)33095-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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21
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Satgunaseelan L, Gauthier M, Cowley M, Lo K, Yang J, Clark J, Gupta R. 38. Retrotransposon activity in young patients with oral Squamous Cell Carcinoma (OSCC). Pathology 2020. [DOI: 10.1016/j.pathol.2020.01.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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22
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Shi H, Lo K, Simanainen U, Ma D, Lesmana B, Condor B, Parungao R, Tasi K, Hew J, Handelsman D, Cooper M, Maitz P, Wang Y. SAT-006 Dihydrotestosterone (DHT) Enhances Major Burn Injury Wound Healing by Regulating the Inflammatory Response in Mice. J Endocr Soc 2019. [PMCID: PMC6552653 DOI: 10.1210/js.2019-sat-006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/19/2022] Open
Abstract
Androgen analogy (Oxandrolone) have been reported to better maintain lean body mass, with improved hypermetabolic responses and shortened healing time for major burn injured patients. This is contradictory to that androgens inhibit local wound repair in men and male mice. The aim of this study therefore is to identify the role of pure androgen dihydrotesterone (DHT) in complex major burn injury, in particularly whether androgen targets local healing process or systemic burn induced hypermetabolism. A DHT silastic tube was subcutaneously implanted to male Balb/c mice prior to surgery as the treatment group. A 2 X 2 cm2 full thickness contact burn wound was created on the dorsal skin of wild type littermates (control) or DHT treated mice. Wound healing rate and body weight changes were measured and compared between treatment and non-treatment group. The serum level of inflammatory cytokine/chemokine was measured using a Multiplex Immunoassay System. Spleen immune cells enumeration was analysis by flow cytometry. Inflammation, re-epithelialization, cell proliferation and collagen deposition was analysed using histology, immunohistochemistry and RT-PCR. In the present study, we found DHT treatment better maintained the body weight in mice and significantly promoted wound healing over 14 days, whereas DHT treatment had no effect on burn-induced hypermetabolism. In control group, major burn injury triggered an acute systematic inflammation response, resulting in significant increased weight of spleen, excess infiltration of nucleated erythroid cells in red pulps of spleen and a significant increase in number of splenic monocytes over 21 days. DHT treatment shortened the systemic inflammation response, evidenced via reduced splenic weight and the number of monocytes in spleen and circulation at day 14 and 21. This finding is further confirmed by less infiltration of macrophages in wound area at day 14 and 21 compared to control group. Taken together, our results suggesting the DHT treatment significantly improve wound healing by accelerated turnover of inflammation response but not through the metabolism. Further studies are necessary to define the exact mechanisms and DHT treatment could be a new therapeutic approach to improve the survivability of major burn injured patient.
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Affiliation(s)
- Huaikai Shi
- ANZAC Research Institute, Sydney, , Australia
| | - Kevin Lo
- ANZAC Research Institute, Sydney, , Australia
| | | | - Duncan Ma
- ANZAC Research Institute, Sydney, , Australia
| | | | | | | | - Kevin Tasi
- ANZAC Research Institute, Sydney, , Australia
| | | | | | | | | | - Yiwei Wang
- ANZAC Research Institute, Sydney, , Australia
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23
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Li J, Lo K, Guo M. Do Socio-Economic Characteristics Affect Travel Behavior? A Comparative Study of Low-Carbon and Non-Low-Carbon Shopping Travel in Shenyang City, China. Int J Environ Res Public Health 2018; 15:ijerph15071346. [PMID: 29954055 PMCID: PMC6068570 DOI: 10.3390/ijerph15071346] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 06/18/2018] [Accepted: 06/25/2018] [Indexed: 11/16/2022]
Abstract
Choices regarding mode of travel have an evident effect on environment pollutants and public health. This paper makes a significant contribution by examining the differences between low-carbon and non-low-carbon travel mode choices during shopping trips, and how socio-economic characteristics impact individual travel behavior based on data gathered from a questionnaire conducted in Shenyang, China. The study found that, firstly, low-carbon travel modes were more common than non-low-carbon travel modes for shopping, and the average travel distance by non-low-carbon modes was a little longer than that of low-carbon modes. Secondly, suburban and wholesale specialized commercial centers attracted more residents travelling longer distances by non-low carbon modes, especially private car, compared to regional commercial centers in inner city areas. Thirdly, strong relationships between car ownership, gender, monthly income, and travel mode choices were identified in a binary logistic regression model. This study thus highlights the importance of sustainable transportation policies to advocate low-carbon travel modes and reduce carbon emissions.
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Affiliation(s)
- Jing Li
- Northeast Institute of Geography and Agroecology, Chinese Academy of Sciences, Changchun 130102, Jilin, China.
| | - Kevin Lo
- Department of Geography, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China.
| | - Meng Guo
- School of Geographical Science, Northeast Normal University, Changchun 130024, Jilin, China.
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Sivakumar P, Humphrey J, Lo K, Ricketts T, Oliveira H, Kalmar B, Wang E, Housman D, Baralle F, Greensmith L, Buratti E, Plagnol V, Fisher E, Arozena A, Fratta P. Dissecting TDP-43 gain- and loss-of-function in neurodegeneration. Neuromuscul Disord 2018. [DOI: 10.1016/s0960-8966(18)30366-3] [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: 10/17/2022]
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Hovens MC, Lo K, Kerger M, Pedersen J, Nottle T, Kurganovs N, Ryan A, Peters JS, Moon D, Costello AJ, Corcoran NM, Hong MK. 3D modelling of radical prostatectomy specimens: Developing a method to quantify tumor morphometry for prostate cancer risk prediction. Pathol Res Pract 2017; 213:1523-1529. [DOI: 10.1016/j.prp.2017.09.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 09/18/2017] [Accepted: 09/18/2017] [Indexed: 10/18/2022]
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Tsao GS, Zhang J, Xia L, Tsang C, Lin W, Yip Y, Deng W, Lo K, Lung M. Abstract 4417: The role of EBV infection in aerobic glycolysis in nasopharyngeal carcinoma. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-4417] [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
Accumulating evidence indicates that oncogenic viral protein exerts a crucial role in activating aerobic glycolysis during tumorigenesis, but the underlying mechanisms are largely undefined. The Epstein-Barr virus (EBV)-encoded latent membrane protein 1 (LMP1) is a trans-membrane protein with potent cell signaling properties and has tumorigenic transformation property. Activation of NF-κB is a major signaling pathway mediating many downstream transformation properties of LMP1. Here we report that activation of mTORC1 by LMP1 is a key modulator for activation of NF-κB signaling to mediate aerobic glycolysis. NF-κB activation is involved for LMP1-induced upregulation of glucose transptor-1 (Glut-1) transcription and growth of nasopharyngeal carcinoma (NPC) cells. Collectively, blocking the activity of mTORC1 signaling effectively suppressed LMP1-induced NF-κB activation and Glut-1 transcription. Interfering NF-κB signaling has no effect on mTORC1 activity but effectively altered Glut-1 transcription. Luciferase promoter assay of Glut-1 also confirmed that Glut-1 is a direct target gene of NF-κB signaling. Furthermore, we demonstrated that the LMP1 C-terminal activating region (CTAR) 2 is the key domain involved in mTORC1 activation, mainly through IKKβ-mediated phosphorylation of TSC2 at Ser939. Depletion of Glut-1 effectively led to suppression of aerobic glycolysis, inhibition of cell proliferation, colony formation, and attenuation of tumorigenic growth property of LMP1-expressing nasopharyngeal epithelial (NPE) cells. These findings suggest that targeting the signaling axis of mTORC1/NF-κB/Glut-1 represents a novel therapeutic target against NPC.
Acknowledgement: 96 800x600 This project was supported by the General Research Fund (HKU 779810M, 17120814 and 17161116), CRF equipment grant (1061402980, Health and Medical Research Fund of Hong Kong (12110782), AoE grant (AoE/M-06/08) and TBRS grant (T12-401/13-R). We thank Prof. Dongyan Jin (Department of Biochemistry, The University of Hong Kong) for the kind gifts of IKK related plasmids and Prof. Zhenguo Wu (Division of Life Science, The Hong Kong University of Science and Technology) for the discussion and interpretation of the data. We also thank Mr. Tony Chan for his technical support.
Note: This abstract was not presented at the meeting.
Citation Format: George S. Tsao, Jun Zhang, Lin Xia, C Tsang, Weitao Lin, Y Yip, W Deng, K Lo, M Lung. The role of EBV infection in aerobic glycolysis in nasopharyngeal carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4417. doi:10.1158/1538-7445.AM2017-4417
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Affiliation(s)
| | - Jun Zhang
- 1Univ. of Hong Kong, Pokfulam, Hong Kong
| | - Lin Xia
- 1Univ. of Hong Kong, Pokfulam, Hong Kong
| | - C Tsang
- 1Univ. of Hong Kong, Pokfulam, Hong Kong
| | - Weitao Lin
- 1Univ. of Hong Kong, Pokfulam, Hong Kong
| | - Y Yip
- 1Univ. of Hong Kong, Pokfulam, Hong Kong
| | - W Deng
- 1Univ. of Hong Kong, Pokfulam, Hong Kong
| | - K Lo
- 2Chinese University of Hong Kong, Shatin, Hong Kong
| | - M Lung
- 1Univ. of Hong Kong, Pokfulam, Hong Kong
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Lam P, Cheng S, Lo W, Tong C, Lo K, Lam Y, Leung L, Leung P. Topical application of mesenchymal stem cells for the treatment of chronic wounds- a pilot study. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lo K, Tam W. Reply to comment on: waist-to-height ratio, body mass index and waist circumference for screening pediatric cardio-metabolic risk factors: a meta-analysis. Obes Rev 2016; 17:1342-1343. [PMID: 27749998 DOI: 10.1111/obr.12473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 09/05/2016] [Indexed: 11/27/2022]
Affiliation(s)
- K Lo
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - W Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Lo K, Wong M, Khalechelvam P, Tam W. Waist-to-height ratio, body mass index and waist circumference for screening paediatric cardio-metabolic risk factors: a meta-analysis. Obes Rev 2016; 17:1258-1275. [PMID: 27452904 DOI: 10.1111/obr.12456] [Citation(s) in RCA: 149] [Impact Index Per Article: 18.6] [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: 05/19/2016] [Revised: 06/17/2016] [Accepted: 06/29/2016] [Indexed: 02/01/2023]
Abstract
Waist-to-height ratio (WHtR) is superior to body mass index and waist circumference for measuring adult cardio-metabolic risk factors. However, there is no meta-analysis to evaluate its discriminatory power in children and adolescents. A meta-analysis was conducted using multiple databases, including Embase and Medline. Studies were included that utilized receiver-operating characteristics curve analysis and published area under the receiver-operating characteristics curves (AUC) for adiposity indicators with hyperglycaemia, elevated blood pressure, dyslipidemia, metabolic syndrome and other cardio-metabolic outcomes. Thirty-four studies met the inclusion criteria. AUC values were extracted and pooled using a random-effects model and were weighted using the inverse variance method. The mean AUC values for each index were greater than 0.6 for most outcomes including hypertension. The values were the highest when screening for metabolic syndrome (AUC > 0.8). WHtR did not have significantly better screening power than other two indexes in most outcomes, except for elevated triglycerides when compared with body mass index and high metabolic risk score when compared with waist circumference. Although not being superior in discriminatory power, WHtR is convenient in terms of measurement and interpretation, which is advantageous in practice and allows for the quick identification of children with cardio-metabolic risk factors at an early age.
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Affiliation(s)
- K Lo
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - M Wong
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong
| | - P Khalechelvam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - W Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Miner S, Daumler D, Chan P, Lo K, Gupta A, Rosberger Z, Zelkowitz P. Stress, depression, and the desire for social support among male patients in fertility and cancer clinics. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.1080] [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: 11/24/2022]
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Noguchi T, Lo K, Diemer T, Welsh DK. Lithium effects on circadian rhythms in fibroblasts and suprachiasmatic nucleus slices from Cry knockout mice. Neurosci Lett 2016; 619:49-53. [PMID: 26930624 DOI: 10.1016/j.neulet.2016.02.030] [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] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 01/05/2016] [Accepted: 02/16/2016] [Indexed: 12/16/2022]
Abstract
Lithium is widely used as a treatment of bipolar disorder, a neuropsychiatric disorder associated with disrupted circadian rhythms. Lithium is known to lengthen period and increase amplitude of circadian rhythms. One possible pathway for these effects involves inhibition of glycogen synthase kinase-3β (GSK-3β), which regulates degradation of CRY2, a canonical clock protein determining circadian period. CRY1 is also known to play important roles in regulating circadian period and phase, although there is no evidence that it is similarly phosphorylated by GSK-3β. In this paper, we tested the hypothesis that lithium affects circadian rhythms through CRYs. We cultured fibroblasts and slices of the suprachiasmatic nucleus (SCN), the master circadian pacemaker of the brain, from Cry1-/-, Cry2-/-, or wild-type (WT) mice bearing the PER2:LUC circadian reporter. Lithium was applied in the culture medium, and circadian rhythms of PER2 expression were measured. In WT and Cry2-/- fibroblasts, 10mM lithium increased PER2 expression and rhythm amplitude but not period, and 1mM lithium did not affect either period or amplitude. In non-rhythmic Cry1-/- fibroblasts, 10mM lithium increased PER2 expression. In SCN slices, 1mM lithium lengthened period ∼1h in all genotypes, but did not affect amplitude except in Cry2-/- SCN. Thus, the amplitude-enhancing effect of lithium in WT fibroblasts was unaffected by Cry2 knockout and occurred in the absence of period-lengthening, whereas the period-lengthening effect of lithium in WT SCN was unaffected by Cry1 or Cry2 knockout and occurred in the absence of rhythm amplification, suggesting that these two effects of lithium on circadian rhythms are independent of CRYs and of each other.
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Affiliation(s)
- Takako Noguchi
- Department of Psychiatry and Center for Circadian Biology, University of California, San Diego, 9500 Gilman Drive MC0603, La Jolla, CA 92093-0603, USA; Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA.
| | - Kevin Lo
- Department of Psychiatry and Center for Circadian Biology, University of California, San Diego, 9500 Gilman Drive MC0603, La Jolla, CA 92093-0603, USA.
| | - Tanja Diemer
- Department of Psychiatry and Center for Circadian Biology, University of California, San Diego, 9500 Gilman Drive MC0603, La Jolla, CA 92093-0603, USA.
| | - David K Welsh
- Department of Psychiatry and Center for Circadian Biology, University of California, San Diego, 9500 Gilman Drive MC0603, La Jolla, CA 92093-0603, USA; Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA.
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Maghen L, Shlush E, Gat I, Barretto T, Kenigsberg S, Jarvi K, Lo K, Gauthier-Fisher A, Librach C. Human umbilical cord perivascular cells exhibit properties of testicular niche support cells. Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Gat I, Maghen L, Shlush E, Quach K, Gauthier-Fisher A, Lo K, Librach C. In vitro testicular niche modelling: the ratio of spermatogonial stem cells (SSCS) to supporting somatic cells is critical for optimal SSC proliferation in vitro. Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.281] [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: 10/23/2022]
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Gaida J, Maloney S, Lo K, Morgan P. Clinical incidents involving students on placement: an analysis of incident reports to identify potential risk factors. Physiotherapy 2015; 101:219-25. [DOI: 10.1016/j.physio.2014.06.006] [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] [Received: 10/08/2013] [Accepted: 06/16/2014] [Indexed: 10/24/2022]
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Papadimitrious M, Anguille S, Bryant C, Kupresanin F, Verma N, Lo K, Clark G, Newman E, Bradstock K, Berneman Z, Fromm P, Hart D. mRNA loaded CMRF-56+ dendritic cells: a novel anti-cancer vaccination strategy (VAC13P.1122). The Journal of Immunology 2015. [DOI: 10.4049/jimmunol.194.supp.214.2] [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] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Current dendritic cell therapeutic vaccinations using tumour associated antigen (TAA) loaded monocyte derived dendritic cells (MoDC) has demonstrated anti-cancer immune responses. However, functional and transcriptional differences between blood dendritic cells (BDC) and MoDC have emerged. Using the GMP human CMRF-56 IgG4 chimeric monoclonal antibody, we are able to obtain clinical-grade BDC appropriate for loading TAA mRNA. We evaluated hCMRF-56 as an improved clinical preparation for BDC immune therapy by 1) their ability to initiate anti-tumour antigen immune response following loading of TAA mRNA 2) comparing CMRF-56+ BDC and MoDC capacity to migrate to draining lymph nodes in a preclinical xenograft model. Characterisation of the proposed clinical formulation identified up-regulation of CD40 and CD80 post GM-CSF activation and GM-CSF activation with mRNA nucleofection, respectively. Nucleofected CMRF-56+ BDC migrated towards CCL21 in vitro. CMRF-56+ BDC and MoDC were administered to SCID mice to monitor their in vivo migration to inguinal lymph nodes. Flu Matrix Protein 1 IFNγ responses were observed by CD4+ and CD8+ lymphocytes. Stimulation of CMRF-56+ BDC loaded with Wilms Tumor 1 antigen mRNA was able to induce CD4+ and CD8+ T cell responses. Our data suggests BDC can be effectively nucleofected with TAA mRNA. This demonstrates the efficacy of mRNA nucleofected BDC to warrant further clinical investigation
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Affiliation(s)
- Michael Papadimitrious
- 1Dendritic Cell Biology and Therapeutics Group, Adelaide, SA, Australia
- 2Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Sebastien Anguille
- 3Centre for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Antwerp, Belgium
| | - Christian Bryant
- 1Dendritic Cell Biology and Therapeutics Group, Adelaide, SA, Australia
- 2Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Fiona Kupresanin
- 1Dendritic Cell Biology and Therapeutics Group, Adelaide, SA, Australia
| | - Nirupama Verma
- 1Dendritic Cell Biology and Therapeutics Group, Adelaide, SA, Australia
- 2Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Kevin Lo
- 1Dendritic Cell Biology and Therapeutics Group, Adelaide, SA, Australia
- 2Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Georgina Clark
- 1Dendritic Cell Biology and Therapeutics Group, Adelaide, SA, Australia
- 2Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | | | - Kenneth Bradstock
- 1Dendritic Cell Biology and Therapeutics Group, Adelaide, SA, Australia
- 5Blood and Marrow Transplant Service, Westmead Hospital, Sydney, NSW, Australia
| | - Zwi Berneman
- 3Centre for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Antwerp, Belgium
| | - Phillip Fromm
- 1Dendritic Cell Biology and Therapeutics Group, Adelaide, SA, Australia
- 2Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Derek Hart
- 1Dendritic Cell Biology and Therapeutics Group, Adelaide, SA, Australia
- 2Sydney Medical School, University of Sydney, Sydney, NSW, Australia
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Verma ND, Munster D, Seldon T, Sheng YH, Jones M, Munro T, Mahler S, Barnard R, Vu PA, Lo K, Shahin K, Elgundi Z, Silveira P, Fromm PD, Clark GJ, Larsen S, Bradstock K, Hart DNJ. The Human Monoclonal Antibody 3C12C, Targeting Activated Dendritic Cells Is a Potential New Immunosuppressive Agent. Biol Blood Marrow Transplant 2015. [DOI: 10.1016/j.bbmt.2014.11.527] [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: 11/28/2022]
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Tadros R, Chami N, Beaudoin M, Lo K, Robb L, Lemarbre F, Talajic M, Lettre G. Novel Mutations in Familial Dilated Cardiomyopathy Identified by Whole Exome Sequencing. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.623] [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: 11/24/2022] Open
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Lo K, Tsao S, Leung S, Choi P, Lee J, Huang D. Detailed deletion mapping on the short arm of chromosome-3 in nasopharyngeal carcinomas. Int J Oncol 2012; 4:1359-64. [PMID: 21567062 DOI: 10.3892/ijo.4.6.1359] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Allelic loss on the short arm of chromosome 3 is one of the most consistent molecular genetic alterations observed in primary nasopharyngeal carcinoma (NPC). Detailed mapping of the region of common deletion on chromosome 3p will help to locate the site of candidate tumor suppressor gene(s) involved in the pathogenesis of NPC. We have examined allelic deletion in 27 primary undifferentiated NPC at 11 chromosomal loci (spanning from 3p13-3p25) using microsatellite polymorphic markers. Allelic loss was observed in 18 of 27 primary tumors (67%) when comparing tumor DNA with normal constitutional DNA of the same patient. Among these 18 cases, 10 showed allelic loss in all informative loci of chromosome 3p and 8 showed partial or interstitial deletion, The highest frequency of allelic loss was found in three loci, D3S1038 (52%), D3S1228 (50%) and D3S659 (50%). In 5 of the 8 cases with partial deletion of chromosome 3p, a common deletion region within 3p13 to 3p14.3, flanked by two loci, D3S1079 (3p13) proximally and D3S1228 (3p14.1-14.3) distally, was identified. These results suggest strongly the presence of tumor suppressor gene(s) within the 3p13 to 3p14.3 region, the deletion of which represent a critical event in the development of NPC. In the remaining 3 cases with partial chromosomal deletion, the pattern of allelic loss suggests the presence of two other regions of deletion distal to the commonly deleted region (3p13-14.3) identified. The presence of multiple deleted regions on chromosome 3p in NPC suggests that more than one tumor suppressor gene on 3p may be involved in the development of NPC.
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Affiliation(s)
- K Lo
- CHINESE UNIV HONG KONG,PRINCE WALES HOSP,DEPT ANAT & CELLULAR PATHOL,SHA TIN,HONG KONG. CHINESE UNIV HONG KONG,PRINCE WALES HOSP,DEPT CLIN ONCOL,SHA TIN,HONG KONG. UNIV HONG KONG,DEPT ANAT,HONG KONG,HONG KONG
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Abstract
Multiple genetic alterations are believed to be involved in the pathogenesis of nasopharyngeal carcinomas (NPC). Loss of heterozygosity (LOH) of chromosomes 3p, 9p and 11q were previously reported in NPC. In order to further define the genetic alterations in NPC, 42 pairs of normal and tumor DNA of NPC were examined for LOH on chromosomes 5p, 5q, 6q, 14q, 15q, 16p, 16q, 17q using 16 polymorphic microsatellite markers. Frequent LOH (33%; 7 out of 21 cases) was observed in chromosome 14q at locus D14s81 (14q31). In order to define the common region of deletion, nine polymorphic microsatellite markers on 14q were examined for LOH in NPC. A common region of deletion was defined in NPC at chromosome 14q24.3-q32.1 flanked by two microsatellite markers D14s76 and D14s45. The common region of deletion (14q24.3-32.1) identified in NPC overlapped with the deleted regions of 14q reported in several human cancers. In 2 cases of NPC, the pattern of LOH revealed the presence of another commonly deleted region defined by loci D14s63 and D14s69 (mapped to 14q11.1-24.1) and located proximal to locus D14s76(14q24.3). This study suggests that multiple tumor suppressor genes present on chromosome 14q are involved in the pathogenesis of NPC.
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Affiliation(s)
- R Cheng
- UNIV HONG KONG,FAC MED,DEPT ANAT,POKFULAM,HONG KONG. CHINESE UNIV HONG KONG,PRINCE WALES HOSP,DEPT ANAT & CELLULAR PATHOL,HONG KONG,HONG KONG
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Shin H, Ingram J, Lo K, McGill A, Poppitt S. Foods for appetite control: Can carbohydrates stimulate the ileal brake and enhance satiety? Obes Res Clin Pract 2012. [DOI: 10.1016/j.orcp.2012.08.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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41
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Ingram J, Sutton K, Lo K, Walker E, Parkar S, Ansell J, Monro J, Huffman L, Poppitt S. Foods for appetite control: Developing plant-based functional foods targeting satiety. Obes Res Clin Pract 2012. [DOI: 10.1016/j.orcp.2012.08.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Dore G, Lo K, Juckes L, Bezyan S, Latt N. Clinical Experience with Baclofen in the Management of Alcohol-Dependent Patients with Psychiatric Comorbidity: A Selected Case Series. Alcohol Alcohol 2011; 46:714-20. [DOI: 10.1093/alcalc/agr131] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Geertsema RS, Zekarias B, La Franco Scheuch L, Worby C, Russo R, Gershwin LJ, Herdman DS, Lo K, Corbeil LB. IbpA DR2 subunit immunization protects calves against Histophilus somni pneumonia. Vaccine 2011; 29:4805-12. [PMID: 21557979 DOI: 10.1016/j.vaccine.2011.04.075] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Revised: 04/18/2011] [Accepted: 04/19/2011] [Indexed: 10/18/2022]
Abstract
Histophilus somni is a prevalent cause of pneumonia and septicemia in cattle. Yet evidence for protection against pneumonia by current vaccines is controversial. We have identified a new H. somni virulence factor, IbpA. Previous studies implicated three likely protective subunits or domains in IbpA (A3, A5, and DR2), which were expressed as recombinant GST fusion proteins and purified for systemic vaccination of calves. After two subcutaneous immunizations, calves were challenged intrabronchially with virulent H. somni strain 2336 and clinical signs were monitored for four days before necropsy. Serum samples were collected throughout. At necropsy, the area of gross pneumonia was estimated, bronchial lavage fluid was collected, lesions were cultured and tissue samples were fixed for histopathology. Results showed that calves immunized with IbpA DR2 had a statistically lower percentage of lung with gross lesions than controls, fewer histologic abnormalities in affected areas and no H. somni isolated from residual pneumonic lesions. Calves immunized with the control GST vaccine, IbpA3 or IbpA5 had larger H. somni positive pneumonic lesions. ELISA results for serum antibodies showed that calves immunized with the IbpA DR2 antigen had high IgG1 and IgG2 and lowest IgE responses to the immunizing antigen. Specific IgG responses were also high in the bronchial lavage fluid. High specific serum IgE responses were previously shown to be associated with more severe pneumonia, but high IgG specific anti-IbpA DR2 responses seem to be critically related to protection. Since the IbpA DR2 Fic motif has been shown to cause bovine alveolar cells to retract, we tested the neutralizing ability of pooled serum from the IbpA DR2 immunized group. This pooled serum reduced cytotoxicity by 75-80%, suggesting that the protection was due to antibody neutralization of IbpA cytotoxicity, at least in part. Therefore, IbpA DR2 appears to be an important protective antigen of H. somni. The study shows, for the first time, that immunization with a purified Fic protein protects against disease in a natural host.
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Affiliation(s)
- R S Geertsema
- Animal Care Program, Department of Pharmacology, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093-0614, USA
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Sweiss NJ, Barnathan ES, Lo K, Judson MA, Baughman R. C-reactive protein predicts response to infliximab in patients with chronic sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2010; 27:49-56. [PMID: 21086905] [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
BACKGROUND This study assessed the value of C-reactive protein as a predictor of disease severity and response to infliximab therapy in patients with chronic pulmonary sarcoidosis. DESIGN Sera were collected through week 52 from 138 patients with chronic pulmonary sarcoidosis who received placebo or infliximab in a randomized, double-blind, placebo-controlled study. We evaluated the response to therapy by baseline CRP using a dichotomous cutpoint (0.8 mg/dL) for the change from baseline in percent-predicted forced vital capacity (FVC), Saint George's Respiratory Questionnaire (SGRQ), 6-minute walk distance (6MWD), Borg's CR10 dyspnea score, and Physician Organ Assessment (POA). RESULTS CRP was elevated in 36% of patients at baseline, and was significantly reduced by infliximab by week 2. Among patients with elevated baseline CRP, infliximab-treated patients improved significantly compared with placebo-treated patients in percent-predicted FVC (+2.5 versus -2.6%), 6MWD (+8.0 versus -34.1), Borg's CR10 dyspnea score (pre-6MWD -0.8 versus +0.9, post-6MWD -1.1 versus +0.8), and POA (-3.1 versus -0.3). Patients with lower CRP levels at baseline did not show significant differences between the placebo and infliximab groups in most endpoints evaluated. CONCLUSIONS In chronic sarcoidosis patients, elevated CRP appears to identify a subset with more severe disease who may respond better to treatment with infliximab.
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Affiliation(s)
- N J Sweiss
- University of Chicago, Chicago, IL, USA.
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Lyall KA, Hurst SM, Cooney J, Jensen D, Lo K, Hurst RD, Stevenson LM. Short-term blackcurrant extract consumption modulates exercise-induced oxidative stress and lipopolysaccharide-stimulated inflammatory responses. Am J Physiol Regul Integr Comp Physiol 2009; 297:R70-81. [DOI: 10.1152/ajpregu.90740.2008] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Exercise-induced oxidative stress is instrumental in achieving the health benefits from regular exercise. Therefore, inappropriate use of fruit-derived products (commonly applied as prophalytic antioxidants) may counteract the positive effects of exercise. Using human exercise and cellular models we found that 1) blackcurrant supplementation suppressed exercise-induced oxidative stress, e.g., plasma carbonyls (0.9 ± 0.1 vs. 0.6 ± 0.1 nmol/mg protein, placebo vs. blackcurrant), and 2) preincubation of THP-1 cells with an anthocyanin-rich blackcurrant extract inhibited LPS-stimulated cytokine secretion [TNF-α (16,453 ± 322 vs. 10,941 ± 82 pg/ml, control vs. extract, P < 0.05) and IL-6 (476 ± 14 vs. 326 ± 32 pg/ml, control vs. extract, P < 0.05)] and NF-κB activation. In addition to its antioxidant and anti-inflammatory properties, we found that postexercise plasma collected after blackcurrant supplementation enhanced the differential temporal LPS-stimulated inflammatory response in THP-1 cells, resulting in an early suppression of TNF-α (1,741 ± 32 vs. 1,312 ± 42 pg/ml, placebo vs. blackcurrant, P < 0.05) and IL-6 (44 ± 5 vs. 36 ± 3 pg/ml, placebo vs. blackcurrant, P < 0.05) secretion after 24 h. Furthermore, by using an oxidative stress cell model, we found that preincubation of THP-1 cells with hydrogen peroxide (H2O2) prior to extract exposure caused a greater suppression of LPS-stimulated cytokine secretion after 24 h, which was not evident when cells were simultaneously incubated with H2O2 and the extract. In summary, our findings support the concept that consumption of blackcurrant anthocyanins alleviate oxidative stress, and may, if given at the appropriate amount and time, complement the ability of exercise to enhance immune responsiveness to potential pathogens.
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Terk M, Lo K, Cesaretti J, Stone N, Stock R. 2271. Int J Radiat Oncol Biol Phys 2006. [DOI: 10.1016/j.ijrobp.2006.07.678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ashenafi M, Boyd R, Lo K, Lee T, Hogstrom K. MO-E-224C-05: Comparison of TomoTherapy with Conventional Electron/X-Ray Treatment Plans for Chest Wall. Med Phys 2006. [DOI: 10.1118/1.2241471] [Citation(s) in RCA: 2] [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: 11/07/2022] Open
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Singh D, Lo K, Chawla A, Zini A, Jarvi K. Should All Men With Vasospermia at the Time of Vasectomy Reversal Be Offered a Vaso-epididymostomy? Fertil Steril 2005. [DOI: 10.1016/j.fertnstert.2005.07.015] [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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Odemuyiwa S, Lo K, Lacy P, Bleackley R, Moqbel R. Expression of SNARE proteins by human lymphocytes: Possible role in regulated release of mediators of immune response. J Allergy Clin Immunol 2003. [DOI: 10.1016/s0091-6749(03)80328-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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