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Mehta M, Schug B, Blume HH, Beuerle G, Jiang W, Koenig J, Paixao P, Tampal N, Tsang YC, Walstab J, Wedemeyer R, Welink J. The Global Bioequivalence Harmonisation Initiative (GBHI): Report of the fifth international EUFEPS/AAPS conference. Eur J Pharm Sci 2023; 190:106566. [PMID: 37591469 DOI: 10.1016/j.ejps.2023.106566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
The series of conferences of the Global Bioequivalence Harmonisation Initiative (GBHI) was started in 2015 by the European Federation for Pharmaceutical Sciences (EUFEPS). All GBHI meetings so far were co-organised together with the American Association of Pharmaceutical Scientists (AAPS). Beginning with the 3rd workshop US-FDA joined as co-sponsor - to support global harmonisation of regulatory recommendations for bioequivalence (BE) assessment. At the 5th GBHI conference, the following BE topics were intensively discussed, and the following main conclusions were drawn: (1) Statistical considerations for BE assessment in specific situations covering scaling approaches for highly variable drug (HVD) products, two-stage adaptive design and opportunities of modelling and simulation to support BE: even though special BE study concepts like adaptive designs are not often used in practise so far, a majority of the workshop participants were in favour of a more frequent application of such approaches. The regulatory conditions relevant in this context need further concretisation and harmonisation between the regions. Moreover, modelling and simulation were considered as a promising and evolving approach, also for BE development programmes. (2) Fed versus fasting conditions in BE trials: Findings that BE between generic products could be confirmed only after fasted administration but failed under fed conditions seem more an exception than the rule. Obviously, BCS class IV compounds are most problematic in this context. Differences in critical excipients such as surfactants or pH-modifiers may be relevant reasons for different sensitivity for interactions in fasted versus fed conditions. Consequently, such deviations in composition of generic preparations should be avoided. Moreover, confirmation of BE may be generally difficult comparing different dosage forms, such like capsules versus tablets, especially in fed state. (3) BE assessment of locally acting drug products applied topically to the skin: Appropriateness and potential benefit of in-vitro tests as alternatives to clinical efficacy studies have been comprehensively discussed. In addition to the already well-established in-vitro release and permeation tests, other techniques were suggested, e.g., Raman spectroscopy or dermal open flow microperfusion. Validation of those methods is challenging and, despite significant progress already achieved during previous years, more research is needed before they may be fully accepted for regulatory purposes. (4) BE evaluation of narrow therapeutic index (NTI) drugs: The discrepancies amongst regulatory agencies in necessity of tighter BE acceptance ranges, the recommendations for inclusion of peak and total drug exposure into BE assessment with more restrictive criteria and the importance of comparison of the product-related within-subject variability for NTI drugs were debated. Arguments in favour and against the different approaches were presented and discussed but need further consideration before harmonisation can be achieved. The highly interactive meeting and extensive exchange between regulators and scientists from industry and academia resulted in useful progress in open BE issues and supported the goal of science-driven harmonisation.
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Affiliation(s)
- M Mehta
- U.S. Food and Drug Administration (FDA), Silver Spring, MD, USA
| | - B Schug
- SocraTec R&D GmbH, Oberursel/Erfurt, Germany.
| | - H H Blume
- SocraTec C&S GmbH, Oberursel, Germany; Frankfurt Foundation Quality of Medicines, Frankfurt/Main, Germany
| | | | - W Jiang
- U.S. Food and Drug Administration (FDA), Silver Spring, MD, USA
| | - J Koenig
- Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany
| | - P Paixao
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, Portugal
| | - N Tampal
- U.S. Food and Drug Administration (FDA), Silver Spring, MD, USA
| | | | - J Walstab
- SocraTec R&D GmbH, Oberursel/Erfurt, Germany
| | - R Wedemeyer
- SocraTec R&D GmbH, Oberursel/Erfurt, Germany
| | - J Welink
- Medicines Evaluation Board, Utrecht, the Netherlands
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Mehta M, Polli JE, Seo P, Bhoopathy S, Berginc K, Kristan K, Cook J, Dressman JB, Mandula H, Munshi U, Shanker R, Volpe DA, Gordon J, Veerasingham S, Welink J, Almeida S, Gonzalez P, Painter D, Tsang YC, Vaidyanathan J, Velagapudi R. Drug Permeability - Best Practices for Biopharmaceutics Classification System (BCS)-Based Biowaivers: A workshop Summary Report. J Pharm Sci 2023; 112:1749-1762. [PMID: 37142122 DOI: 10.1016/j.xphs.2023.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 04/28/2023] [Accepted: 04/28/2023] [Indexed: 05/06/2023]
Abstract
The workshop "Drug Permeability - Best Practices for Biopharmaceutics Classification System (BCS) Based Biowaivers" was held virtually on December 6, 2021, organized by the University of Maryland Center of Excellence in Regulatory Science and Innovation (M-CERSI), and the Food and Drug Administration (FDA). The workshop focused on the industrial, academic, and regulatory experiences in generating and evaluating permeability data, with the aim to further facilitate implementation of the BCS and efficient development of high-quality drug products globally. As the first international permeability workshop since the BCS based biowaivers was finalized as the ICH M9 guideline, the workshop included lectures, panel discussions, and breakout sessions. Lecture and panel discussion topics covered case studies at IND, NDA, and ANDA stages, typical deficiencies relating to permeability assessment supporting BCS biowaiver, types of evidence that are available to demonstrate high permeability, method suitability of a permeability assay, impact of excipients, importance of global acceptance of permeability methods, opportunities to expand the use of biowaivers (e.g. non-Caco-2 cell lines, totality-of-evidence approach to demonstrate high permeability) and future of permeability testing. Breakout sessions focused on 1) in vitro and in silico intestinal permeability methods; 2) potential excipient effects on permeability and; 3) use of label and literature data to designate permeability class.
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Affiliation(s)
- M Mehta
- US Food & Drug Administration, Silver Spring, MD, USA.
| | - J E Polli
- University of Maryland, Baltimore, MD, USA
| | - P Seo
- US Food & Drug Administration, Silver Spring, MD, USA
| | | | | | | | - J Cook
- Pfizer Inc, Groton, CT, USA
| | - J B Dressman
- Fraunhofer Institute of Translational Medicine and Pharmacology, Frankfurt, Germany
| | - H Mandula
- US Food & Drug Administration, Silver Spring, MD, USA
| | - U Munshi
- US Food & Drug Administration, Silver Spring, MD, USA
| | | | - D A Volpe
- US Food & Drug Administration, Silver Spring, MD, USA
| | - J Gordon
- World Health Organization, Geneva, Switzerland
| | | | - J Welink
- European Medicines Agency, Amsterdam, the Netherlands
| | - S Almeida
- Medicines for Europe, Brussels, Belgium
| | - P Gonzalez
- Biopharmaceutical Evaluation Center, Santiago, Chile
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Grewal J, Bortner B, Gregoski M, Cook D, Britt A, Hajj J, Rofael M, Sheidu M, Montovano M, Mehta M, Hajduczok A, Rajapreyar I, Brailovski Y, Genuardi M, Kanwar M, Atluri P, Lander M, Shah P, Hsu S, Kilic A, Houston B, Tedford R. Validation of the Heartmate 3 Risk Score in a Real World Patient Cohort. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1590] [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: 04/05/2023] Open
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Rao R, Mehta M, Sheth DR, Hogan G. Four-Year Nutritional Outcomes in Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy Patients: an Australian Experience. Obes Surg 2023; 33:750-760. [PMID: 36698049 PMCID: PMC9877492 DOI: 10.1007/s11695-023-06461-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 01/10/2023] [Accepted: 01/17/2023] [Indexed: 01/27/2023]
Abstract
Nutritional deficiencies following malabsorptive surgeries are a major concern. PURPOSE To present clinical-based, mid-term nutritional outcomes in single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) patients using a nutritional supplement based on the American Society for Metabolic & Bariatric Surgery (ASMBS) guidelines. SETTING Single private institute, Australia. MATERIALS AND METHODS Data from 196 patients who underwent a primary SADI-S by a single surgeon from January 2017 through March 2022 were retrospectively analysed. All patients received either original or altered formulated nutritional supplementation throughout the study. In total, three formulae, slightly different from each other, were used at three different time points to formulate the supplement. RESULTS In total, 196 patients were included. The average age and preoperative body mass index were 44.9 ± 6.7 years and 43.6 ± 22.5 kg/m2, respectively. Nutritional follow-up was available on 77.5%, 73.2%, 73.4%, and 59.7% of patients at 12, 24, 36, and 48 months, respectively. At baseline, 48.3%, 30%, 14.9%, 13.3%, 12.4%, 3.8%, 2.3%, and 0.5% of the patients had vitamin D, calcium, folic acid, total protein, iron, vitamin B12, copper, and vitamin A deficiencies, respectively. Postoperatively, mild to moderate vitamin deficiencies were noted in 14.2% of the patients in the first 18 months; however, at 4 years, the cohort had zero nutritional deficiencies. There were no long-term complications, revisions/conversions, or mortalities related to nutritional deficiencies. CONCLUSION Factors, like preoperative and postoperative early, aggressive correction of nutritional deficiencies, regular laboratory monitoring and follow-ups with the multidisciplinary team, and adherence to our formulated nutritional supplement, have contributed to favourable nutritional outcomes at 4 years.
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Affiliation(s)
- Ravi Rao
- Perth Surgical & Bariatrics, 30 Churchill Avenue, WA, 6008, Subiaco, Perth, Australia.
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Liao J, Mehta M, Hsu F. LIMITED CUTANEOUS SYSTEMIC SCLEROSIS MIMICKING HEREDITARY ANGIOEDEMA WITH NORMAL C1 INHIBITOR. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.830] [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: 11/11/2022]
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Bhatt N, Chitranshi J, Mehta M. Testing Herzberg’s two factor theory on millennials. CM 2022. [DOI: 10.18137/cardiometry.2022.22.231236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This study tests Herzberg’s two-factor theory of motivation on working millennials. The purpose of the study is to evaluate what the assumptions and the findings of the original study hold for millennials. With the increasing trend of amalgamation of work life and personal life, job satisfaction and general job happiness have never been more on an individual’s personal life. This impact is far-reaching, with strong indications of affecting the employees’ physical, mental, and social health. In such a scenario, organizations need to keep their employees motivated and satisfied. For studying Herzberg’s two-factor theory of motivation on working millennials, we have selected respondents with work experience of at least one year. We have not restricted the study to any particular industry; hence our sample is across all industries. The type of sampling used was convenient sampling. From the analysis, we have found that for the concerned sample, hygiene factors tower above the motivating factors in terms of job satisfaction for millennials. From the data collection and analysis, we proved that both motivators and hygiene factors affect job satisfaction, unlike what has been said by Herzberg. This study will contribute to the exciting literature on motivation.
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Gopalan S, Mehta M. Study of trust of government handling of Covid-19 in India and USA and disinformation tactics used by the government. CM 2022. [DOI: 10.18137/cardiometry.2022.22.323334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This research aims to find out the status of trust the people of the world’s two prominent democracies – The United States of America, known worldwide as the most powerful democracy, and the Republic of India, known as the World’s Largest Democracy in the handling of the COVID-19 epidemic, that has gripped the entire world by storm. Also, the second objective of this study is to find out if the population of the two nations believe that their governments have actively used disinformation tactics – once thought to be used only by a despot or autocratic governments, on its populace to control the COVID-19 panic and hysteria surrounding it. This study also aims to understand the relationship between trust and disinformation, if any. The study aims to fulfill its objective via individual responses. The survey was conducted via Google Forms and was floated via social media apps like Face book, Linked In, Whatsapp, Instagram, and popular chat sites such as Omegle and Reddit.
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Malukar S, Kunikullaya U, Parikh A, Mehta M, Patel Shah S, Shivhare V, Rath S, Kulshrestha A, T A, Singh J, Dash N, Patel D. PO-1346 Single Institute Retrospective Audit of protracted hypo-fractionated RT in Advanced Carcinoma Cervix. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03310-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Martins DA, Mazibuko N, Zelaya F, Vasilakopoulou S, Loveridge J, Oates A, Maltezos S, Mehta M, Wastling S, Howard M, McAlonan G, Murphy D, Williams SCR, Fotopoulou A, Schuschnig U, Paloyelis Y. Author Correction: Effects of route of administration on oxytocin-induced changes in regional cerebral blood flow in humans. Nat Commun 2022; 13:1876. [PMID: 35361784 PMCID: PMC8971402 DOI: 10.1038/s41467-022-29419-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
- D A Martins
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - N Mazibuko
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - F Zelaya
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - S Vasilakopoulou
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - J Loveridge
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - A Oates
- South London and Maudsley NHS Foundation Trust, London, UK
| | - S Maltezos
- Adult Autism and ADHD Service, South London and Maudsley NHS Foundation Trust, London, UK.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - S Wastling
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, UK.,Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, UK
| | - M Howard
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - G McAlonan
- Department of Forensic and Neurodevelopmental Science (SM), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - D Murphy
- Department of Forensic and Neurodevelopmental Science (SM), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - S C R Williams
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - A Fotopoulou
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | | | - Y Paloyelis
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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Mehta M, Shafi S, Leeds S. M028 SYSTEMIC REACTION AFTER TOPICAL CAPSAICIN. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.202] [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: 10/19/2022]
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Spira A, Ramalingam S, Neal J, Piotrowska Z, Mekhail T, Tsao A, Gentzler R, Riely G, Bazhenova L, Gadgeel S, Nguyen D, Johnson M, Vincent S, Jin S, Griffin C, Bunn V, Lin J, Churchill E, Mehta M, Janne P. OA15.01 Mobocertinib in EGFR Exon 20 Insertion–Positive Metastatic NSCLC Patients With Disease Control on Prior EGFR TKI Therapy. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.082] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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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Nguyen D, Ramalingam S, Spira A, Riely G, Kim T, Yang JH, Piotrowska Z, Campelo MG, Felip E, Bazhenova L, Jin S, Griffin C, Diderichsen P, Gupta N, Bunn V, Lin J, Churchill E, Mehta M, Zhou C, Janne P. 1218P Characterization of GI toxicities and their impact on efficacy in patients (pts) with EGFR exon 20 insertion+ (ex20ins+) non-small cell lung cancer (NSCLC) treated with mobocertinib (TAK-788) who previously received platinum chemotherapy. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Christopoulos P, Ou SH, Lin J, Berg D, Hong JL, Yin Y, Lin J, Bunn V, Lin H, Mehta M, Thomas M. 1224P Systematic review and meta-analysis of immunotherapy effectiveness for pretreated patients with non-small cell lung cancer harboring EGFR exon 20 insertions. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Hida T, Nishino M, Yoh K, Asato T, Kitagawa T, Zhang S, Mehta M, Ohe Y. 1246P A phase I dose-escalation study of mobocertinib (TAK-788), an oral tyrosine kinase inhibitor (TKI), in Japanese NSCLC patients. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Ou SH, Lin H, Hong JL, Yin Y, Jin S, Lin J, Mehta M, Nguyen D, Neal J. 1211P Indirect comparison of mobocertinib and standard of care in platinum-pretreated patients with NSCLC with EGFR exon 20 insertion. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Yang JH, Ramalingam S, Kim T, Kim SW, Riely G, Mekhail T, Nguyen D, Campelo MG, Felip E, Bazhenova L, Jin S, Griffin C, Bunn V, Lin J, Churchill E, Mehta M, Janne P, Zhou C. 1231P Characterization and management of mobocertinib (TAK-788) induced skin toxicity in patients with EGFR exon 20 insertion+ (ex20ins+) non-small cell lung cancer (NSCLC) who previously received platinum chemotherapy. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1836] [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] Open
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Ratanchandani K, Kunikullaya S, Parikh A, Mehta M, Patel S, Shivhare V, Rath S, Modi V, Jain H, Anand D, Bathija N. PO-1038 Radiotherapy with Temozolomide for Pediatric Glioblastoma:A single institute retrospective analysis. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07489-2] [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: 11/29/2022]
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Bathija N, Rathod H, Kunikullaya S, Parikh A, Mehta M, Patel S, Shivhare V, Rath S, Modi V, Jain H, Anand D, Ratanchandani K. PO-1211 Intraluminal brachytherapy boost in esophageal cancer: A single institute retrospective analysis. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07662-3] [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: 10/20/2022]
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Mehta M, O'Toole A, Gooderham M. Real-world experience with risankizumab in patients with plaque psoriasis: a retrospective study. J Eur Acad Dermatol Venereol 2021; 35:e685-e688. [PMID: 34050980 DOI: 10.1111/jdv.17410] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- M Mehta
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - A O'Toole
- SKiN Centre for Dermatology, Peterborough, ON, Canada.,Probity Medical Research, Waterloo, ON, Canada.,Queen's University, Kingston, ON, Canada
| | - M Gooderham
- SKiN Centre for Dermatology, Peterborough, ON, Canada.,Probity Medical Research, Waterloo, ON, Canada.,Queen's University, Kingston, ON, Canada
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Abstract
BACKGROUND Correction of high regular and irregular astigmatism with rigid gas-permeable contact lenses can result in discomfort, compromised corneal physiology and fluctuations in visual acuity due to excessive lens movement. Using a non-probability sample, this study explored the optical, clinical and subjective performance of a modified countersunk piggyback lens (MCL) for the management of high regular and irregular corneal astigmatic refractive conditions, as the first phase for a larger randomised control study of the efficacy of the custom piggyback MCL system. METHOD The sample was a single group of 10 patients (n = 17 eyes) selected primarily on the basis of a history of failure with conventional management regimes. The objective clinical and optical performance of the MCL used in the management of high degrees of regular and irregular corneal astigmatic conditions was assessed, including measures of visual performance and ocular health. Subjective performance of the MCL was evaluated by patient feedback. RESULTS Objective and subjective measures were analysed using appropriate statistical analyses. There was a significant improvement in the uncorrected vision and visual acuity (VA) with the MCL, as well as a significant improvement in refractive status. There was no statistically significant increase in adverse ocular responses with the MCL. Statistical analysis of the subjective responses indicated a strong acceptance of the MCL by all subjects, thus supporting the objective analysis indicating the superior performance of the MCL over prior conventional treatment regimens. DISCUSSION The custom piggyback MCL performed successfully in the management of a range of high regular and irregular astigmatic conditions, which have been unsuccessfully managed with a range of conventional optical corrections. Despite the additional cost and handling implications of the two-lens system, the MCL was well accepted by all subjects due to its superior optical and clinical performance.
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Affiliation(s)
- M Mehta
- School of Physiotherapy, Sports Science and Optometry, University of KwaZulu-Natal, Durban, South Africa.
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Martins DA, Mazibuko N, Zelaya F, Vasilakopoulou S, Loveridge J, Oates A, Maltezos S, Mehta M, Wastling S, Howard M, McAlonan G, Murphy D, Williams SCR, Fotopoulou A, Schuschnig U, Paloyelis Y. Effects of route of administration on oxytocin-induced changes in regional cerebral blood flow in humans. Nat Commun 2020; 11:1160. [PMID: 32127545 PMCID: PMC7054359 DOI: 10.1038/s41467-020-14845-5] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 02/04/2020] [Indexed: 11/17/2022] Open
Abstract
Could nose-to-brain pathways mediate the effects of peptides such as oxytocin (OT) on brain physiology when delivered intranasally? We address this question by contrasting two methods of intranasal administration (a standard nasal spray, and a nebulizer expected to improve OT deposition in nasal areas putatively involved in direct nose-to-brain transport) to intravenous administration in terms of effects on regional cerebral blood flow during two hours post-dosing. We demonstrate that OT-induced decreases in amygdala perfusion, a key hub of the OT central circuitry, are explained entirely by OT increases in systemic circulation following both intranasal and intravenous OT administration. Yet we also provide robust evidence confirming the validity of the intranasal route to target specific brain regions. Our work has important translational implications and demonstrates the need to carefully consider the method of administration in our efforts to engage specific central oxytocinergic targets for the treatment of neuropsychiatric disorders.
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Affiliation(s)
- D A Martins
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - N Mazibuko
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - F Zelaya
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - S Vasilakopoulou
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - J Loveridge
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - A Oates
- South London and Maudsley NHS Foundation Trust, London, UK
| | - S Maltezos
- Adult Autism and ADHD Service, South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - S Wastling
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, UK
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, UK
| | - M Howard
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - G McAlonan
- Department of Forensic and Neurodevelopmental Science (SM), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - D Murphy
- Department of Forensic and Neurodevelopmental Science (SM), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - S C R Williams
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - A Fotopoulou
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | | | - Y Paloyelis
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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22
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Mehta M, Wang L, Guo C, Warner N, Li Q, Pan J, Boztug K, Uhlig H, Muise A. A39 NOVEL GAIN OF FUNCTION NON-RECEPTOR TYROSINE KINASE MUTATIONS ARE LINKED TO THE PATHOGENESIS OF VEOIBD. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.038] [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: 11/15/2022] Open
Abstract
Abstract
Background
Very early-onset inflammatory bowel disease (VEOIBD) is an emerging global disease, that results in inflammation of the digestive tract. Severe forms of VEOIBD can be caused by mutations in a single gene (monogenic variants) and, can result in death. A candidate gene which codes for a non-receptor tyrosine kinase (nRTK) has recently been implicated as a monogenic cause of IBD (unpublished). Whole exome sequencing was performed in two unrelated children who presented with symptoms of IBD identifying two distinct de novo gain of function mutations (S550Y and P342T). Both mutations are located in the highly conserved region of the nRTK, and were predicted to have similar downstream effects. Furthermore, four other patients with a variety of adult-onset immune disorders have recently been identified with rare variants in the same gene (M450I, R42P, A353T, V433M, S550F) but, their potential gain of function status remains to be determined. Studies show that this nRTK is an essential mediator in inflammation. It is expressed in both intestinal epithelial and immune cells however, its role in infantile IBD is unclear. This protein is first activated by phosphorylation and is linked to activating downstream transcription factors such as ERK and JNK. All these target proteins play a meaningful role in intestinal inflammation in patients with IBD.
Aims
Since we identified P342T and S550Y to be gain of function, we wanted to determine if the new variants exhibit a similar downstream impact on target protein expression levels when compared with S550Y and P342T. We also wanted to identify if all variants can be rescued with a known nRTK inhibitor. It is hypothesized that the new variants are gain of function and that all variants can be rescued with the inhibitor.
Methods
Using western blot analysis, the activation of ERK, JNK and nRTK was compared between wildtype (WT) and mutants. This in vitro method helped identify the degree of activation. For the second part of the study, HEK293T cells were treated with inhibitor to test for a rescue of phenotypes via western blot analysis.
Results
Results show an increased activation of nRTK, ERK and JNK in all variants with S550Y and S550F having the highest activation. Furthermore, pharmacological inhibition using small molecular kinase inhibitors resulted in decreased activation of nRTK, ERK and JNK suggesting a rescue of phenotypes.
Conclusions
Characterizing the downstream functional impact of these nRTK variants is an important first step to determine if gain of function nRTK mutations drive IBD. With a rising prevalence of IBD worldwide, these findings may lead to the development of pharmacological nRTK inhibitors as a novel personalized therapeutic approach for these patients and possibly for the broader IBD population.
Funding Agencies
CIHR
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Affiliation(s)
- M Mehta
- Biochemistry, University of Toronto, Markham, ON, Canada
| | - L Wang
- Cell biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - C Guo
- Cell biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - N Warner
- Cell biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Q Li
- Cell biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - J Pan
- Cell biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - K Boztug
- Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases, Vienna, Austria
| | - H Uhlig
- University of Oxford, Oxford, England, United Kingdom
| | - A Muise
- Hospital for Sick Children, Toronto, ON, Canada
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23
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Adams DR, Tollinche LE, Yeoh CB, Artman J, Mehta M, Phillips D, Fischer GW, Quinlan JJ, Sakai T. Short-term safety and effectiveness of sugammadex for surgical patients with end-stage renal disease: a two-centre retrospective study. Anaesthesia 2019; 75:348-352. [PMID: 31721151 DOI: 10.1111/anae.14914] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2019] [Indexed: 12/17/2022]
Abstract
Sugammadex is a novel reversal agent for aminosteroid neuromuscular blocking drugs, especially rocuronium. Given its renal excretion, sugammadex is not recommended for patients with end-stage renal disease; however, reports exist of its use in this group of patients. This two-institutional retrospective observational study aimed to review the safety profile and effectiveness of sugammadex in surgical patients with end-stage renal disease who required pre-operative renal replacement therapy. Adult surgical patients with end-stage renal disease requiring pre-operative renal replacement therapy, who received sugammadex between April 2016 and January 2019, were studied. The primary outcome was the incidence of postoperative tracheal re-intubation within 48 h. The secondary outcome was the incidence of deferred tracheal extubation in the operating theatre. One hundred and fifty-eight patients were identified from 125,653 surgical patients: 48 patients (30%) underwent renal transplantation and 110 (70%) underwent non-renal transplantation procedures. There were 22 instances (14%) of deferred tracheal extubation due to surgical and/or pre-existing medical conditions. Out of the 136 patients who had the tracheal tube removed at the end of the procedure, three patients had their trachea re-intubated within 48 h: two patients developed pulmonary oedema resulting from volume overload; and one patient had worsening sepsis. No incidence of recurrence of neuromuscular blockade was observed. Of note, 24 (18%) patients were found to have incomplete neuromuscular blockade reversal with neostigmine but administration of sugammadex led to successful tracheal extubation. In conclusion, sugammadex appears to be safe and effective in adult patients with end-stage renal disease receiving pre-operative renal replacement therapy.
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Affiliation(s)
- D R Adams
- Department of Anesthesiology and Peri-operative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - L E Tollinche
- Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - C B Yeoh
- Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - J Artman
- Department of Anesthesiology and Peri-operative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - M Mehta
- Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - D Phillips
- Department of Anesthesiology and Peri-operative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - G W Fischer
- Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - J J Quinlan
- Department of Anesthesiology and Peri-operative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - T Sakai
- Department of Anesthesiology and Peri-operative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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24
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Butler M, Robert C, Negrier S, In G, Walker J, Krajsova I, Atkinson V, Hansson J, Kapiteijn E, Loquai C, Shaw H, Cheng T, Mansard S, Grob J, Guidoboni M, Mehta M, Ascierto P, Diab A. ILLUMINATE 301: A randomized phase III study of tilsotolimod in combination with ipilimumab compared with ipilimumab alone in patients with advanced melanoma following progression on or after anti-PD-1 therapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz255.061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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25
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Mehta M, Gondi V, Ahluwalia M, Brown P. Radiosurgery followed by tumour treating fields (TTFields) for brain metastases (1-10) from NSCLC in the phase III METIS trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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26
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Gupta T, Achari R, Chatterjee A, Chen ZP, Mehta M, Bouffet E, Jalali R. Comparison of Epidemiology and Outcomes in Neuro-Oncology Between the East and the West: Challenges and Opportunities. Clin Oncol (R Coll Radiol) 2019; 31:539-548. [PMID: 31182288 DOI: 10.1016/j.clon.2019.05.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 05/10/2019] [Accepted: 05/15/2019] [Indexed: 12/24/2022]
Abstract
Although neoplasms of the brain and central nervous system (CNS) are relatively uncommon, comprising only 1-2% of the overall cancer burden, they represent a substantial source of morbidity and mortality worldwide. The age-adjusted annual incidence of CNS tumours is reportedly low; however, there is substantial global variability in its incidence, with nearly a five-fold difference between regions with the highest rates in developed countries in the West and those with the lowest rates in developing countries in South-East Asia, including India, possibly attributable to key differences in environmental factors, genetic susceptibilities and cultural practices, as well as resource constraints in low-middle income countries precluding precise ascertainment and accurate diagnosis. The burden of CNS tumours is further compounded by the fact that they require highly specialised and skilled multidisciplinary care, including access to modern neuroimaging, neurosurgery, neuropathology and molecular biology, radiotherapy, chemotherapy and rehabilitation services, which may not be widely available in an integrated manner in large parts of the world with a large variation in clinical pathways, non-uniformity of care and resultant heterogeneity in clinical outcomes. CNS tumours encompass a heterogeneous spectrum of histopathological entities with differences in presentation, distinct molecular/genetic alterations, diverse biological behaviour and varying clinical outcomes. Survival is highly dependent on histology, grade and molecular biology, but varies widely across continents, even for the same tumour type and grade. In general, survival is higher in children with primary brain tumours than in adults, largely due to the differences in histological distribution across age groups. However, there is widespread variability, with 5-year survival for paediatric brain tumours being <40% in some low-middle income countries compared with 70-80% in the developed world. This review compares the descriptive epidemiology and clinical outcomes of primary brain tumours between the East and the West that pose unique challenges but also provide new opportunities in contemporary neuro-oncological practice.
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Affiliation(s)
- T Gupta
- Department of Radiation Oncology, Tata Memorial Centre, Mumbai, India.
| | - R Achari
- Department of Radiation Oncology, Tata Medical Centre, Kolkata, India
| | - A Chatterjee
- Department of Radiation Oncology, Tata Memorial Centre, Mumbai, India
| | - Z-P Chen
- Department of Neurosurgery, SunYat-sen University Cancer Centre, Guangzhou, China
| | - M Mehta
- Department of Radiation Oncology, Miami Cancer Institute, Miami, Florida, USA
| | - E Bouffet
- Neuro-Oncology Section, Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - R Jalali
- Department of Radiation Oncology, Apollo Proton Cancer Centre, Chennai, India
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27
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Fernandez Turienzo C, Bick D, Bollard M, Brigante L, Briley A, Coxon K, Cross P, Healey A, Mehta M, Melaugh A, Moulla J, Seed PT, Shennan AH, Singh C, Tribe RM, Sandall J. POPPIE: protocol for a randomised controlled pilot trial of continuity of midwifery care for women at increased risk of preterm birth. Trials 2019; 20:271. [PMID: 31088505 PMCID: PMC6518651 DOI: 10.1186/s13063-019-3352-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 04/03/2019] [Indexed: 12/20/2022] Open
Abstract
Background High rates of preterm births remain a UK public health concern. Preterm birth is a major determinant of adverse infant and longer-term outcomes, including survival, quality of life, psychosocial effects on the family and health care costs. We aim to test whether a model of care combining continuity of midwife care with rapid referral to a specialist obstetric clinic throughout pregnancy, intrapartum and the postpartum period is feasible and improves experience and outcomes for women at increased risk of preterm birth. Methods This pilot, hybrid, type 2 randomised controlled implementation trial will recruit 350 pregnant women at increased risk of preterm birth to a midwifery continuity of care intervention or standard care. The intervention will be provided from recruitment (antenatal), labour, birth and the postnatal period, in hospital and community settings and in collaboration with specialist obstetric clinic care, when required. Standard care will be the current maternity care provision by NHS midwives and obstetricians at the study site. Participants will be followed up until 6–8 weeks postpartum. The composite primary outcome is the appropriate initiation of any specified interventions related to the prevention and/or management of preterm labour and birth. Secondary outcomes are related to: recruitment and attrition rates; implementation; acceptability to women, health care professionals and stakeholders; health in pregnancy and other complications; intrapartum outcomes; maternal and neonatal postnatal outcomes; psycho-social health; quality of care; women’s experiences and health economic analysis. The trial has 80% power to detect a 15% increase in the rate of appropriate interventions (40 to 55%). The analysis will be by ‘intention to treat’ analysis. Discussion Little is known about the underlying reasons why and how models of midwifery continuity of care are associated with fewer preterm births, better maternal and infant outcomes and more positive experiences; nor how these models of care can be implemented successfully in the health services. This will be the first study to provide direct evidence regarding the effectiveness, implementation and evaluation of a midwifery continuity of care model and rapid access to specialist obstetric services for women at increased risk of preterm birth. Trial registration ISRCTN37733900. Retrospectively registered on 21 August 2017.
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Affiliation(s)
- C Fernandez Turienzo
- Department of Women and Children's Health, King's College London, St Thomas' Hospital, London, SE1 7EH, UK
| | - D Bick
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Gibbet Hill, Coventry, CV4 7A, UK
| | - M Bollard
- Lewisham and Greenwich NHS Trust, Lewisham High Street, London, SE13 6HL, UK
| | - L Brigante
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, London, SE1 8WA, UK
| | - A Briley
- Department of Women and Children's Health, King's College London, St Thomas' Hospital, London, SE1 7EH, UK
| | - K Coxon
- Department of Midwifery, Kingston University and St. George's, University of London, Hunter Wing, Cranmer Terrace, London, SW17 0RE, UK
| | - P Cross
- Department of Public Health, London Borough of Lewisham, Laurence House, London, SE6 4RU, UK
| | - A Healey
- Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, David Goldberg Centre, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - M Mehta
- Lewisham and Greenwich NHS Trust, Lewisham High Street, London, SE13 6HL, UK
| | - A Melaugh
- Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, David Goldberg Centre, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - J Moulla
- Lewisham and Greenwich NHS Trust, Lewisham High Street, London, SE13 6HL, UK
| | - P T Seed
- Department of Women and Children's Health, King's College London, St Thomas' Hospital, London, SE1 7EH, UK
| | - A H Shennan
- Department of Women and Children's Health, King's College London, St Thomas' Hospital, London, SE1 7EH, UK
| | - C Singh
- Department of Women and Children's Health, King's College London, St Thomas' Hospital, London, SE1 7EH, UK
| | - R M Tribe
- Department of Women and Children's Health, King's College London, St Thomas' Hospital, London, SE1 7EH, UK
| | - J Sandall
- Department of Women and Children's Health, King's College London, St Thomas' Hospital, London, SE1 7EH, UK.
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28
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Mehta M, Gondi V, Ahluwalia M, Brown P. Phase III METIS study: Tumor treating fields (150 kHz) and radiosurgery for supra- and/or infratentorial brain metastases (1-10) from non-small cell lung cancer (NSCLC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz068.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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29
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Mehta M, Wang L, Li Q, Warner N, Pan J, Muise A. A117 CHARACTERIZATION OF A NOVEL GAIN OF FUNCTION MUTATION IN A NON-RECEPTOR TYROSINE KINASE IN THE DEVELOPMENT OF VERY EARLY ONSET INFLAMMATORY BOWEL DISEASE. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Mehta
- SickKids Inflammatory Bowel Disease Center and Cell Biology Program, Toronto, ON, Canada
| | - L Wang
- SickKids Inflammatory Bowel Disease Center and Cell Biology Program, Toronto, ON, Canada
| | - Q Li
- SickKids Inflammatory Bowel Disease Center and Cell Biology Program, Toronto, ON, Canada
| | - N Warner
- SickKids Inflammatory Bowel Disease Center and Cell Biology Program, Toronto, ON, Canada
| | - J Pan
- SickKids Inflammatory Bowel Disease Center and Cell Biology Program, Toronto, ON, Canada
| | - A Muise
- SickKids Inflammatory Bowel Disease Center and Cell Biology Program, Toronto, ON, Canada
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30
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Mason KP, Kelhoffer ER, Prescilla R, Mehta M, Root JC, Young VJ, Robinson F, Veselis RA. Feasibility of measuring memory response to increasing dexmedetomidine sedation in children. Br J Anaesth 2018; 118:254-263. [PMID: 28100530 DOI: 10.1093/bja/aew421] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The memory effect of dexmedetomidine has not been prospectively evaluated in children. We evaluated the feasibility of measuring memory and sedation responses in children during dexmedetomidine sedation for non-painful radiological imaging studies. Secondarily, we quantified changes in memory in relation to the onset of sedation. METHODS A 10 min bolus of dexmedetomidine (2 mcg kg-1) was given to children as they named simple line drawings every five s. The absence of sedation was identified as any verbal response, regardless of correctness. After recovery, recognition memory was tested with correct Yes/No recognitions (50% novel pictures) and was matched to sedation responses during the bolus period (subsequent memory paradigm). RESULTS Of 64 accruals, 30 children (mean [SD]6.1 (1.2) yr, eight male) received dexmedetomidine and completed all study tasks. Individual responses were able to be modelled successfully in the 30 children completing all the study tasks, demonstrating feasibility of this approach. Children had 50% probability of verbal response at five min 40 s after infusion start, whereas 50% probability of subsequent recognition memory occurred sooner at four min five s. CONCLUSIONS Quantifying memory and sedation effects during dexmedetomidine infusion in verbal children was possible and demonstrated that memory function was present until shortly before verbal unresponsiveness occurred. This is the first study to investigate the effect of dexmedetomidine on memory in children. CLINICAL TRIAL REGISTRATION NCT 02354378.
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Affiliation(s)
- K P Mason
- Department of Anesthesia, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - E R Kelhoffer
- Department of Anesthesiology and Critical Care, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.,Department of Anesthesiology, Weill Cornell Medical College, New York, NY, USA
| | - R Prescilla
- Department of Anaesthesiology, Perioperative and Pain Medicine, Harvard Medical School, MA, USA
| | - M Mehta
- Department of Anesthesiology and Critical Care, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.,Department of Anesthesiology, Weill Cornell Medical College, New York, NY, USA
| | - J C Root
- Department of Anesthesiology and Critical Care, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.,Department of Anesthesiology, Weill Cornell Medical College, New York, NY, USA.,Department of Psychology in Anesthesiology, Neurocognitve Research Lab, Memorial Sloan-Kettering Cancer Center, New York, NY,USA
| | - V J Young
- Department of Anesthesia, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | | | - R A Veselis
- Department of Anesthesiology and Critical Care, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.,Department of Anesthesiology, Weill Cornell Medical College, New York, NY, USA
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31
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Cohen E, Harrington K, Hong D, Mesia R, Brana I, Perez Segura P, Wise-Draper T, Scott M, Mitchell P, Mugundu G, McCoon P, Cook C, Mehta M, Keilholz U. A phase Ib/II study (SCORES) of durvalumab (D) plus danvatirsen (DAN; AZD9150) or AZD5069 (CX2i) in advanced solid malignancies and recurrent/metastatic head and neck squamous cell carcinoma (RM-HNSCC): Updated results. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy287] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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32
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Gupta V, Sreenivas V, Mehta M, Ramam M. What do Vitiligo Impact Scale‐22 scores mean? Studying the clinical interpretation of scores using an anchor‐based approach. Br J Dermatol 2018; 180:580-585. [DOI: 10.1111/bjd.17040] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2018] [Indexed: 11/30/2022]
Affiliation(s)
- V. Gupta
- Department of Dermatology and Venereology All India Institute of Medical Sciences New DelhiIndia
| | - V. Sreenivas
- Department of Biostatistics All India Institute of Medical Sciences New DelhiIndia
| | - M. Mehta
- Department of Psychiatry All India Institute of Medical Sciences New DelhiIndia
| | - M. Ramam
- Department of Dermatology and Venereology All India Institute of Medical Sciences New DelhiIndia
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33
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Bähr O, Mehta M, Gondi V, Ahluwalia M, Brown P. P05.83 Tumor Treating Fields and radiosurgery for supra- and/or infratentorial brain metastases (1–10) from NSCLC in the phase 3 METIS study. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- O Bähr
- University Hospital Frankfurt, Frankfurt, Germany
| | - M Mehta
- Miami Cancer Institute, Miami, FL, United States
| | - V Gondi
- Northwestern Medicine Cancer Center, Warrenville, IL, United States
| | - M Ahluwalia
- Cleveland Clinic, Cleveland, OH, United States
| | - P Brown
- Mayo Clinic, Rochester, MN, United States
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34
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Soni BK, Makwana R, Mukherjee S, Parashari S, Suryanarayana SV, Nayak BK, Naik H, Mehta M. Neutron capture cross-sections for 159Tb isotope in the energy range of 5 to 17 MeV. Appl Radiat Isot 2018; 141:10-14. [PMID: 30144772 DOI: 10.1016/j.apradiso.2018.08.009] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/16/2018] [Accepted: 08/10/2018] [Indexed: 11/19/2022]
Abstract
The neutron capture cross-sections have been measured for the 159Tb(n, γ)160Tb reaction at the spectrum average peak neutron energies of 5.08 ± 0.165, 12.47 ± 0.825, and 16.63 ± 0.95 MeV respectively. The experiment has been carried out using the standard neutron activation technique and off-line γ-ray spectrometry. The present measurement has been done for the energies where very few measured results are available in the data library. The results have been compared with ENDF/B-VII.1 and JENDL-4.0 data libraries. The present results have also been supported by theoretical predictions of nuclear model code TALYS 1.9. Detailed covariance analysis was carried out to find the uncertainty and the correlations among the measured cross-sections.
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Affiliation(s)
- B K Soni
- Department of Physics, Faculty of Science, The M. S. University of Baroda, Vadodara 390002, Gujarat, India
| | - Rajnikant Makwana
- Department of Physics, Faculty of Science, The M. S. University of Baroda, Vadodara 390002, Gujarat, India
| | - S Mukherjee
- Department of Physics, Faculty of Science, The M. S. University of Baroda, Vadodara 390002, Gujarat, India.
| | - Siddharth Parashari
- Department of Physics, Faculty of Science, The M. S. University of Baroda, Vadodara 390002, Gujarat, India
| | - S V Suryanarayana
- Nuclear Physics Division, Bhabha Atomic Research Centre, Mumbai 400085, India
| | - B K Nayak
- Nuclear Physics Division, Bhabha Atomic Research Centre, Mumbai 400085, India
| | - H Naik
- Radiochemistry Division, Bhabha Atomic Research Centre, Mumbai 400085, India
| | - M Mehta
- Institute for Plasma Research, Gandhinagar, Gujarat 382428, India
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35
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Abstract
BACKGROUND Childhood abuse is associated with abnormalities in brain structure and function. Few studies have investigated abuse-related brain abnormalities in medication-naïve, drug-free youth that also controlled for psychiatric comorbidities by inclusion of a psychiatric control group, which is crucial to disentangle the effects of abuse from those associated with the psychiatric conditions. METHODS Cortical volume (CV), cortical thickness (CT) and surface area (SA) were measured in 22 age- and gender-matched medication-naïve youth (aged 13-20) exposed to childhood abuse, 19 psychiatric controls matched for psychiatric diagnoses and 27 healthy controls. Both region-of-interest (ROI) and whole-brain analyses were conducted. RESULTS For the ROI analysis, the childhood abuse group compared with healthy controls only, had significantly reduced CV in bilateral cerebellum and reduced CT in left insula and right lateral orbitofrontal cortex (OFC). At the whole-brain level, relative to healthy controls, the childhood abuse group showed significantly reduced CV in left lingual, pericalcarine, precuneus and superior parietal gyri, and reduced CT in left pre-/postcentral and paracentral regions, which furthermore correlated with greater abuse severity. They also had increased CV in left inferior and middle temporal gyri relative to healthy controls. Abnormalities in the precuneus, temporal and precentral regions were abuse-specific relative to psychiatric controls, albeit at a more lenient level. Groups did not differ in SA. CONCLUSIONS Childhood abuse is associated with widespread structural abnormalities in OFC-insular, cerebellar, occipital, parietal and temporal regions, which likely underlie the abnormal affective, motivational and cognitive functions typically observed in this population.
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Affiliation(s)
- L Lim
- Department of Child & Adolescent Psychiatry,Institute of Psychiatry, Psychology & Neuroscience,King's College London,London,UK
| | - H Hart
- Department of Child & Adolescent Psychiatry,Institute of Psychiatry, Psychology & Neuroscience,King's College London,London,UK
| | - M Mehta
- Department of Neuroimaging,Institute of Psychiatry, Psychology & Neuroscience,King's College London,London,UK
| | - A Worker
- Department of Neuroimaging,Institute of Psychiatry, Psychology & Neuroscience,King's College London,London,UK
| | - A Simmons
- Department of Neuroimaging,Institute of Psychiatry, Psychology & Neuroscience,King's College London,London,UK
| | - K Mirza
- Department of Child & Adolescent Psychiatry,Institute of Psychiatry, Psychology & Neuroscience,King's College London,London,UK
| | - K Rubia
- Department of Child & Adolescent Psychiatry,Institute of Psychiatry, Psychology & Neuroscience,King's College London,London,UK
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Mehta M, Outram M, Wilkinson J, Kakodkar P. Frozen ultrasound image as a prompt for stop before you block. Anaesthesia 2018; 73:396-397. [PMID: 29437218 DOI: 10.1111/anae.14221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M Mehta
- Northampton General Hospital, Northampton, UK
| | - M Outram
- Northampton General Hospital, Northampton, UK
| | - J Wilkinson
- Northampton General Hospital, Northampton, UK
| | - P Kakodkar
- Northampton General Hospital, Northampton, UK
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Mehta M, Puntambekar S, Chitale M, Puntambekar S, Parikh H. Reconstruction of the Distal Ureter Following an Extensive Resection of Ureter for Stage IV Endometriosis. J Minim Invasive Gynecol 2017. [DOI: 10.1016/j.jmig.2017.08.242] [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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38
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Puntambekar S, Puntambekar S, Manchekar M, Parikh K, Mehta M. Laparoscopic Ureteroneocystostomy Following UV Fistula in Ectopic Kidney. J Minim Invasive Gynecol 2017. [DOI: 10.1016/j.jmig.2017.08.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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39
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Bhope K, Ghate M, Mehta M, Panchal A, Pradhan S, Khirwadkar S. Development, optimization and validation of ultrasonic testing for NDE of ELM coils. Fusion Engineering and Design 2017. [DOI: 10.1016/j.fusengdes.2017.07.007] [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] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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40
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Herman T, Andrade D, Mehta M, Griffith J, Jin H, Ahmad S, Algan O, Munshi A. Targeted Inhibition of Rad51 Renders Non–small Cell Lung Cancer Cells More Sensitive to Proton Therapy. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.2034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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41
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Makwana R, Mukherjee S, Snoj L, S Barala S, Mehta M, Mishra P, Tiwari S, Abhangi M, Khirwadkar S, Naik H. Spectrum average cross section measurement of 183W (n, p) 183Ta and 184W (n, p) 184Ta reaction cross section in 252Cf(sf) neutron field. Appl Radiat Isot 2017; 127:150-155. [PMID: 28618352 DOI: 10.1016/j.apradiso.2017.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 04/25/2017] [Accepted: 06/01/2017] [Indexed: 11/26/2022]
Abstract
Neutron induced nuclear reactions are of prime importance for both fusion and fission nuclear reactor technology. Present work describes the first time measurement of spectrum average cross section of nuclear reactions 183W(n,p)183Ta and 184W(n,p)184Ta using 252Cf spontaneous fission neutron source. Standard neutron activation analysis (NAA) technique was used. The neutron spectra were calculated using Monte Carlo N Particle Code (MCNP). The effects of self-shielding and back scattering were taken into account by optimizing the detector modeling. These effects along with efficiency of detector were corrected for volume sample in the actual source-detector geometry. The measured data were compared with the previously measured data available in Exchange Format (EXFOR) data base and evaluated data using EMPIRE - 3.2.2.
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Affiliation(s)
- Rajnikant Makwana
- Department of Physics, The Maharaja Sayajrao University of Baroda, Vadodara 390002, India.
| | - S Mukherjee
- Department of Physics, The Maharaja Sayajrao University of Baroda, Vadodara 390002, India.
| | - L Snoj
- Jožef Stefan Institute, Jamova cesta 39, SI-1000 Ljubljana, Slovenia
| | - S S Barala
- Defence Laboratory, Jodhpur, Rajasthan 342011, India
| | - M Mehta
- Institute for Plasma Research, Gandhinagar, Gujarat 382428, India
| | - P Mishra
- Department of Physics, The Maharaja Sayajrao University of Baroda, Vadodara 390002, India
| | - S Tiwari
- Institute for Plasma Research, Gandhinagar, Gujarat 382428, India
| | - M Abhangi
- Institute for Plasma Research, Gandhinagar, Gujarat 382428, India
| | - S Khirwadkar
- Institute for Plasma Research, Gandhinagar, Gujarat 382428, India
| | - H Naik
- Radiochemistry Division, Bhabha Atomic Research Centre, Mumbai 400085, India
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Bell EH, Zhang P, Aldape K, McElroy J, Mehta M, Fleming J, Liu Z, Coons S, Johnson D, Chakravarti A. OS01.7 MGMT promoter methylation status independently predicts progression-free survival in NRG Oncology/RTOG 9802: a phase III trial of RT vs RT + PCV in high-risk low-grade gliomas. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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43
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Jiang FX, Li K, Archer M, Mehta M, Jamieson E, Charles A, Dickinson JE, Matsumoto M, Morahan G. Differentiation of Islet Progenitors Regulated by Nicotinamide into Transcriptome-Verified β Cells That Ameliorate Diabetes. Stem Cells 2017; 35:1341-1354. [DOI: 10.1002/stem.2567] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 11/21/2016] [Accepted: 12/14/2016] [Indexed: 12/11/2022]
Affiliation(s)
- Fang-Xu Jiang
- Islet Cell Development Program, Harry Perkins Institute of Medical Research, and Centre for Medical Research
- Centre for Diabetes Research, Harry Perkins Institute of Medical Research, and Centre for Medical Research
| | - Kevin Li
- Islet Cell Development Program, Harry Perkins Institute of Medical Research, and Centre for Medical Research
- Centre for Diabetes Research, Harry Perkins Institute of Medical Research, and Centre for Medical Research
| | | | - Munish Mehta
- Centre for Diabetes Research, Harry Perkins Institute of Medical Research, and Centre for Medical Research
| | - Emma Jamieson
- Centre for Diabetes Research, Harry Perkins Institute of Medical Research, and Centre for Medical Research
| | - Adrian Charles
- School of Women's and Infants' Health; The University of Western Australia; Nedlands Australia
| | - Jan E. Dickinson
- School of Women's and Infants' Health; The University of Western Australia; Nedlands Australia
| | | | - Grant Morahan
- Centre for Diabetes Research, Harry Perkins Institute of Medical Research, and Centre for Medical Research
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Mehta M, Wen P, Nishikawa R, Reardon D, Peters K. Critical review of the addition of tumor treating fields (TTFields) to the existing standard of care for newly diagnosed glioblastoma patients. Crit Rev Oncol Hematol 2017; 111:60-65. [PMID: 28259296 DOI: 10.1016/j.critrevonc.2017.01.005] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 12/13/2016] [Accepted: 01/10/2017] [Indexed: 11/17/2022] Open
Abstract
Since 2005, the standard of care for patients with newly diagnosed glioblastoma (GBM) has consisted of maximal resection followed by radiotherapy plus daily temozolomide (TMZ), followed by maintenance TMZ. In patients selected for clinical trials, median overall survival (OS) and progression-free survival (PFS) with this regimen is 15-17 months and 6-7 months, respectively. There have been various, largely unsuccessful attempts to improve on this standard of care. With the FDA approval of the tumor-treating fields (TTFields) device, Optune, for recurrent GBM (2011), and the more recent EF-14 interim trial results and approval for newly diagnosed GBM patients, several questions have arisen. A roundtable of experts was convened at the 2015 ASCO meeting to engage in an open conversation and debate of the EF-14 results presented at that meeting and their implications for neuro-oncology practice and clinical research. In October 2015, subsequent to the roundtable discussion, TTFields received FDA approval for newly diagnosed GBM.
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Affiliation(s)
- M Mehta
- Deputy Director, Miami Cancer Institute, and Chief of Radiation Oncology, Miami, Florida.
| | - P Wen
- Department of Neurology, Harvard University, Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - R Nishikawa
- Japanese Society of Neuro-Oncology, Department of Neurosurgery, Saitama International Medical Center and University, Saitama, Japan
| | - D Reardon
- Center for Neuro-Oncology, Harvard Medical School, Boston, MA, United States
| | - K Peters
- Medicine, Duke University Medical Center, Durham, NC, United States
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Wakil SM, Ram R, Muiya NP, Mehta M, Andres E, Mazhar N, Baz B, Hagos S, Alshahid M, Meyer BF, Morahan G, Dzimiri N. Data on common variants associated with coronary artery disease/myocardial infarction in ethnic Arabs. Data Brief 2016; 7:172-176. [PMID: 27761488 PMCID: PMC5063810 DOI: 10.1016/j.dib.2016.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 01/21/2016] [Accepted: 02/02/2016] [Indexed: 11/02/2022] Open
Abstract
The data shows results acquired in a large cohort of 5668 ethnic Arabs involved in a common variants association study for coronary artery disease (CAD) and myocardial infarction (MI) using the Affymetrix Axiom Genotyping platform ("A genome-wide association study reveals susceptibility loci for myocardial infarction/coronary artery disease in Saudi Arabs" Wakil et al. (2015) [1] ). Several loci were described that conferred risk for CAD or MI, some of which were validated in an independent set of samples. Principal Component (PCA) analysis suggested that the Saudi Cohort was close to the CEU and TSI populations, thus pointing to similarity with European populations.
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Affiliation(s)
- Salma M Wakil
- Genetics Department, King Faisal Specialist Hospital and Research Centre, Riyadh, KSA, Saudi Arabia
| | - Ramesh Ram
- Harry Perkins Institute of Medical Research, University of Western Australia, Australia
| | - Nzioka P Muiya
- Genetics Department, King Faisal Specialist Hospital and Research Centre, Riyadh, KSA, Saudi Arabia
| | - Munish Mehta
- Harry Perkins Institute of Medical Research, University of Western Australia, Australia
| | - Editha Andres
- Genetics Department, King Faisal Specialist Hospital and Research Centre, Riyadh, KSA, Saudi Arabia
| | - Nejat Mazhar
- Genetics Department, King Faisal Specialist Hospital and Research Centre, Riyadh, KSA, Saudi Arabia
| | - Batoul Baz
- Genetics Department, King Faisal Specialist Hospital and Research Centre, Riyadh, KSA, Saudi Arabia
| | - Samya Hagos
- Genetics Department, King Faisal Specialist Hospital and Research Centre, Riyadh, KSA, Saudi Arabia
| | - Maie Alshahid
- King Faisal Heart Institute, King Faisal Specialist Hospital and Research Centre, Riyadh, KSA, Saudi Arabia
| | - Brian F Meyer
- Genetics Department, King Faisal Specialist Hospital and Research Centre, Riyadh, KSA, Saudi Arabia
| | - Grant Morahan
- Harry Perkins Institute of Medical Research, University of Western Australia, Australia
| | - Nduna Dzimiri
- Genetics Department, King Faisal Specialist Hospital and Research Centre, Riyadh, KSA, Saudi Arabia
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Hong D, Falchook G, Cook C, Harb W, Lyne P, McCoon P, Mehta M, Mitchell P, Mugundu G, Scott M, Wang J. A phase 1b study (SCORES) assessing safety, tolerability, pharmacokinetics, and preliminary anti-tumor activity of durvalumab combined with AZD9150 or AZD5069 in patients with advanced solid malignancies and SCCHN. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw378.04] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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47
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Zhang H, Molitoris J, Tan S, Giacomelli I, Scartoni D, Gzell C, Bhooshan N, Choi W, Lu W, Mehta M, D'Souza W. SU-F-R-04: Radiomics for Survival Prediction in Glioblastoma (GBM). Med Phys 2016. [DOI: 10.1118/1.4955776] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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48
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Zhu M, Yam M, Mehta M, Badiyan S, Young K, Malyapa R, Regine W, Langen K. SU-F-T-188: A Robust Treatment Planning Technique for Proton Pencil Beam Scanning Cranial Spinal Irradiation. Med Phys 2016. [DOI: 10.1118/1.4956325] [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: 11/07/2022] Open
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49
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Mehta M, Branford OA, Rolfe KJ. The evidence for natural therapeutics as potential anti-scarring agents in burn-related scarring. Burns Trauma 2016; 4:15. [PMID: 27574685 PMCID: PMC4964041 DOI: 10.1186/s41038-016-0040-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 04/12/2016] [Indexed: 02/07/2023]
Abstract
Though survival rate following severe thermal injuries has improved, the incidence and treatment of scarring have not improved at the same speed. This review discusses the formation of scars and in particular the formation of hypertrophic scars. Further, though there is as yet no gold standard treatment for the prevention or treatment of scarring, a brief overview is included. A number of natural therapeutics have shown beneficial effects both in vivo and in vitro with the potential of becoming clinical therapeutics in the future. These natural therapeutics include both plant-based products such as resveratrol, quercetin and epigallocatechin gallate as examples and includes the non-plant-based therapeutic honey. The review also includes potential mechanism of action for the therapeutics, any recorded adverse events and current administration of the therapeutics used. This review discusses a number of potential 'treatments' that may reduce or even prevent scarring particularly hypertrophic scarring, which is associated with thermal injuries without compromising wound repair.
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Affiliation(s)
- M. Mehta
- British College of Osteopathic Medicine (BCOM), Finchley Road, London, NW3 5HR UK
| | - O. A. Branford
- The Royal Marsden Hospital, Fulham Rd, London, SW3 6JJ UK
| | - K. J. Rolfe
- British College of Osteopathic Medicine (BCOM), Finchley Road, London, NW3 5HR UK
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Ram R, Mehta M, Nguyen QT, Larma I, Boehm BO, Pociot F, Concannon P, Morahan G. Systematic Evaluation of Genes and Genetic Variants Associated with Type 1 Diabetes Susceptibility. J Immunol 2016; 196:3043-53. [PMID: 26912320 DOI: 10.4049/jimmunol.1502056] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 01/25/2016] [Indexed: 01/18/2023]
Abstract
Genome-wide association studies have found >60 loci that confer genetic susceptibility to type 1 diabetes (T1D). Many of these are defined only by anonymous single nucleotide polymorphisms: the underlying causative genes, as well as the molecular bases by which they mediate susceptibility, are not known. Identification of how these variants affect the complex mechanisms contributing to the loss of tolerance is a challenge. In this study, we performed systematic analyses to characterize these variants. First, all known genes in strong linkage disequilibrium (r(2) > 0.8) with the reported single nucleotide polymorphisms for each locus were tested for commonly occurring nonsynonymous variations. We found only a total of 22 candidate genes at 16 T1D loci with common nonsynonymous alleles. Next, we performed functional studies to examine the effect of non-HLA T1D risk alleles on regulating expression levels of genes in four different cell types: EBV-transformed B cell lines (resting and 6 h PMA stimulated) and purified CD4(+) and CD8(+) T cells. We mapped cis-acting expression quantitative trait loci and found 24 non-HLA loci that affected the expression of 31 transcripts significantly in at least one cell type. Additionally, we observed 25 loci that affected 38 transcripts in trans. In summary, our systems genetics analyses defined the effect of T1D risk alleles on levels of gene expression and provide novel insights into the complex genetics of T1D, suggesting that most of the T1D risk alleles mediate their effect by influencing expression of multiple nearby genes.
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Affiliation(s)
- Ramesh Ram
- Centre for Diabetes Research, Harry Perkins Institute of Medical Research, Nedlands, Western Australia 6009, Australia; Centre of Medical Research, University of Western Australia, Nedlands, Western Australia 6009, Australia
| | - Munish Mehta
- Centre for Diabetes Research, Harry Perkins Institute of Medical Research, Nedlands, Western Australia 6009, Australia; Centre of Medical Research, University of Western Australia, Nedlands, Western Australia 6009, Australia
| | - Quang T Nguyen
- Centre for Diabetes Research, Harry Perkins Institute of Medical Research, Nedlands, Western Australia 6009, Australia; Centre of Medical Research, University of Western Australia, Nedlands, Western Australia 6009, Australia
| | - Irma Larma
- Centre for Diabetes Research, Harry Perkins Institute of Medical Research, Nedlands, Western Australia 6009, Australia; Centre of Medical Research, University of Western Australia, Nedlands, Western Australia 6009, Australia
| | - Bernhard O Boehm
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 636921; Ulm University Medical Centre, Department of Internal Medicine I, Ulm University, 89081 Ulm, Germany
| | - Flemming Pociot
- Department of Pediatrics, Herlev and Gentofte Hospital, 2730 Herlev, Denmark
| | - Patrick Concannon
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL 32610; and Genetics Institute, University of Florida, Gainesville, FL 32610
| | - Grant Morahan
- Centre for Diabetes Research, Harry Perkins Institute of Medical Research, Nedlands, Western Australia 6009, Australia; Centre of Medical Research, University of Western Australia, Nedlands, Western Australia 6009, Australia;
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