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Wee T, Gupta N, Miller E, Pauranik A. Not Dandy Walker variant: a review of prominent retrocerebellar CSF space in children. Clin Radiol 2024; 79:330-337. [PMID: 38429135 DOI: 10.1016/j.crad.2024.01.025] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 01/10/2024] [Accepted: 01/14/2024] [Indexed: 03/03/2024]
Abstract
The prominent retrocerebellar cerebrospinal fluid (CSF) space can be frequently encountered on paediatric neuroimaging studies. In cases involving abnormal vermian development where imaging does not align with the established criteria of Dandy-Walker malformation (DWM), the term "Dandy-Walker variant or continuum" has been historically employed to describe the aberrant posterior fossa development. Instead, the emphasis is on a more elaborate description of the findings in the posterior fossa. Moreover, combining the findings in the supratentorial brain can occasionally predict certain neurogenetic disorders that mimic Dandy-Walker phenotype. The present review demonstrates and differentiates the imaging features of various entities that result in an enlarged retrocerebellar CSF space, such as inferior vermian hypoplasia (IVH) and several neurogenetic conditions.
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Affiliation(s)
- T Wee
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - N Gupta
- Department of Medical Imaging, Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | - E Miller
- Department of Diagnostic and Interventional Radiology, University of Toronto, Toronto, ON, Canada
| | - A Pauranik
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada; Department of Radiology, BC Children's Hospital, Vancouver, BC, Canada.
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Gupta N, Konsam BD, Walia R, Bhadada SK, Chhabra R, Dhandapani S, Singh A, Ahuja CK, Sachdeva N, Saikia UN. An objective way to predict remission and relapse in Cushing disease using Bayes' theorem of probability. J Endocrinol Invest 2024:10.1007/s40618-024-02336-z. [PMID: 38619729 DOI: 10.1007/s40618-024-02336-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 02/12/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVE In this study on patients with Cushing disease, post-transsphenoidal surgery (TSS), we attempt to predict the probability of remaining in remission, at least for a year and relapse after that, using Bayes' theorem and the equation of conditional probability. The number of parameters, as well as the weightage of each, is incorporated in this equation. DESIGN AND METHODS The study design was a single-centre ambispective study. Ten clinical, biochemical, radiological and histopathological parameters capable of predicting Cushing disease remission were identified. The presence or absence of each parameter was entered as binary numbers. Bayes' theorem was applied, and each patient's probability of remission and relapse was calculated. RESULTS A total of 145 patients were included in the study. ROC plot showed a cut-off value of the probability of 0.68, with a sensitivity of 82% (range 73-89%) and a specificity of 94% (range 83-99%) to predict the probability of remission. Eighty-one patients who were in remission at 1 year were followed up for relapse and 23 patients developed relapse of the disease. The Bayes' equation was able to predict relapse in only 3 out of 23 patients. CONCLUSIONS Using various parameters, remission of Cushing disease can be predicted by applying Bayes' theorem of conditional probability with a sensitivity and a specificity of 82% and 94%, respectively. This study provided an objective way of predicting remission after TSS and relapse in patients with Cushing disease giving a weightage advantage to every parameter.
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Affiliation(s)
- N Gupta
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), 1010, Nehru Extension Block, Chandigarh, 160012, India
| | - B D Konsam
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), 1010, Nehru Extension Block, Chandigarh, 160012, India
| | - R Walia
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), 1010, Nehru Extension Block, Chandigarh, 160012, India.
| | - S K Bhadada
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), 1010, Nehru Extension Block, Chandigarh, 160012, India
| | - R Chhabra
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - S Dhandapani
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - A Singh
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - C K Ahuja
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - N Sachdeva
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), 1010, Nehru Extension Block, Chandigarh, 160012, India
| | - U N Saikia
- Department of Histopathology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Sudharson NA, Lister P, Gupta N, Sharma M. Promoting informed choices: navigating global dental care challenges. Br Dent J 2024; 236:582. [PMID: 38671093 DOI: 10.1038/s41415-024-7362-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 03/11/2024] [Indexed: 04/28/2024]
Affiliation(s)
- N A Sudharson
- Assistant Professor, Department of Prosthodontics, Christian Dental College, Ludhiana, India.
| | - P Lister
- Dentist, Emmanuel Hospital Association, Division of Dentistry, Unit of Christian Dental College, Ludhiana, India.
| | - N Gupta
- Senior Dental Consultant, Shri Rama Charitable Hospital, Prabhat Nagar, Dholewal, Ludhiana, India.
| | - M Sharma
- Sure Smiles Dental Clinics, Silgudi, West Bengal, India.
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Das A, Ariyakumar G, Gupta N, Kamdar S, Barugahare A, Deveson-Lucas D, Gee S, Costeloe K, Davey MS, Fleming P, Gibbons DL. Identifying immune signatures of sepsis to increase diagnostic accuracy in very preterm babies. Nat Commun 2024; 15:388. [PMID: 38195661 PMCID: PMC10776581 DOI: 10.1038/s41467-023-44387-5] [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: 09/03/2022] [Accepted: 12/12/2023] [Indexed: 01/11/2024] Open
Abstract
Bacterial infections are a major cause of mortality in preterm babies, yet our understanding of early-life disease-associated immune dysregulation remains limited. Here, we combine multi-parameter flow cytometry, single-cell RNA sequencing and plasma analysis to longitudinally profile blood from very preterm babies (<32 weeks gestation) across episodes of invasive bacterial infection (sepsis). We identify a dynamically changing blood immune signature of sepsis, including lymphopenia, reduced dendritic cell frequencies and myeloid cell HLA-DR expression, which characterizes sepsis even when the common clinical marker of inflammation, C-reactive protein, is not elevated. Furthermore, single-cell RNA sequencing identifies upregulation of amphiregulin in leukocyte populations during sepsis, which we validate as a plasma analyte that correlates with clinical signs of disease, even when C-reactive protein is normal. This study provides insights into immune pathways associated with early-life sepsis and identifies immune analytes as potential diagnostic adjuncts to standard tests to guide targeted antibiotic prescribing.
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Affiliation(s)
- A Das
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK.
- Division of Infection and Immunity, University College London, London, WC1E 6BT, UK.
| | - G Ariyakumar
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK
| | - N Gupta
- Department of Neonatology, Evelina London Neonatal Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - S Kamdar
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK
| | - A Barugahare
- Bioinformatics Platform and Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, 3800, Australia
| | - D Deveson-Lucas
- Bioinformatics Platform and Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, 3800, Australia
| | - S Gee
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK
| | - K Costeloe
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - M S Davey
- Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, 3800, Australia
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - P Fleming
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Neonatology, Homerton Healthcare NHS Foundation Trust, London, UK
| | - D L Gibbons
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK.
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Whitcroft KL, Altundag A, Balungwe P, Boscolo-Rizzo P, Douglas R, Enecilla MLB, Fjaeldstad AW, Fornazieri MA, Frasnelli J, Gane S, Gudziol H, Gupta N, Haehner A, Hernandez AK, Holbrook EH, Hopkins C, Hsieh JW, Huart C, Husain S, Kamel R, Kim JK, Kobayashi M, Konstantinidis I, Landis BN, Lechner M, Macchi A, Mazal PP, Miri I, Miwa T, Mori E, Mullol J, Mueller CA, Ottaviano G, Patel ZM, Philpott C, Pinto JM, Ramakrishnan VR, Roth Y, Schlosser RJ, Stjärne P, Van Gerven L, Vodicka J, Welge-Luessen A, Wormald PJ, Hummel T. Position paper on olfactory dysfunction: 2023. Rhinology 2023; 61:1-108. [PMID: 37454287 DOI: 10.4193/rhin22.483] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
BACKGROUND Since publication of the original Position Paper on Olfactory Dysfunction in 2017 (PPOD-17), the personal and societal burden of olfactory disorders has come sharply into focus through the lens of the COVID-19 pandemic. Clinicians, scientists and the public are now more aware of the importance of olfaction, and the impact of its dysfunction on quality of life, nutrition, social relationships and mental health. Accordingly, new basic, translational and clinical research has resulted in significant progress since the PPOD-17. In this updated document, we present and discuss currently available evidence for the diagnosis and management of olfactory dysfunction. Major updates to the current version include, amongst others: new recommendations on olfactory related terminology; new imaging recommendations; new sections on qualitative OD and COVID-19 OD; updated management section. Recommendations were agreed by all co-authors using a modified Delphi process. CONCLUSIONS We have provided an overview of current evidence and expert-agreed recommendations for the definition, investigation, and management of OD. As for our original Position Paper, we hope that this updated document will encourage clinicians and researchers to adopt a common language, and in so doing, increase the methodological quality, consistency, and generalisability of work in this field.
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Affiliation(s)
- K L Whitcroft
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
- and UCL Ear Institute, Faculty of Brain Sciences, University College London, London, UK
- and The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Studies, University of London, London, UK
| | - A Altundag
- Department of Otorhinolaryngology, Istanbul Surgery Hospital, Istanbul, Turkey
| | - P Balungwe
- Faculté de Médecine, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
- and Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - P Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - R Douglas
- Department of Otorhinolaryngology, University of Auckland, New Zealand
| | - M L B Enecilla
- Department of Otorhinolaryngology-Head and Neck Surgery, St. Luke's Medical Center, Global City, Philippines
- and Department of Otolaryngology - Head and Neck Surgery, Asian Hospital and Medical Center, Muntinlupa, Philippines
- and Department of Otorhinolaryngology, Medical Center Taguig, Taguig, Philippines
| | - A W Fjaeldstad
- The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Studies, University of London, London, UK
- and Department of Otorhinolaryngology, University Clinic for Flavour, Balance and Sleep, Regional Hospital Gødstrup, Herning, Denmark
- and Department of Clinical Medicine, Flavour Institute, Aarhus University, Aarhus, Denmark
- and Center for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, Oxford, UK
| | - M A Fornazieri
- Department of Clinical Surgery, Universidade Estadual de Londrina and Pontifícia Universidade Católica do Paraná, Londrina, Brazil
| | - J Frasnelli
- Research Chair in Chemosensory Neuroanatomy, Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- and Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada
| | - S Gane
- The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Studies, University of London, London, UK
- and Royal National Throat Nose and Ear Hospital, UCLH, London
| | - H Gudziol
- Department of Otorhinolaryngology, University of Jena, Jena, Germany
| | - N Gupta
- Department of Otorhinolaryngology, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - A Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - A K Hernandez
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
- and Department of Otolaryngology - Head and Neck Surgery, Asian Hospital and Medical Center, Muntinlupa, Philippines
- and Department of Otolaryngology - Head and Neck Surgery, Philippine General Hospital, University of the Philippines - Manila, Manila, Philippines
| | - E H Holbrook
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - C Hopkins
- Guys and St Thomas NHS Trust, London, United Kingdom
| | - J W Hsieh
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Geneva Medical School, Geneva, Switzerland
| | - C Huart
- Department of Otorhinolaryngology, Cliniques universitaires Saint-Luc, Brussels, Belgium
- and Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - S Husain
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - R Kamel
- Department of Otorhinolaryngology, Cairo University, Cairo, Egypt
| | - J K Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University, College of Medicine, Seoul, Republic of Korea
| | - M Kobayashi
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - I Konstantinidis
- Smell and Taste Clinic, Second Academic Otorhinolaryngology Department, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - B N Landis
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Geneva Medical School, Geneva, Switzerland
| | - M Lechner
- Division of Surgery and Interventional Science, University College London, London, UK
- and UCL Cancer Institute, University College London, London, UK
- and ENT Department, Homerton Healthcare NHS Foundation Trust, London, UK
| | - A Macchi
- ENT Clinic, University of Insubria, ASST Sette Laghi, Varese, Italy
| | - P P Mazal
- Servicio de Otorrinolaringología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - I Miri
- Service Médecine Physique Réadaptation fonctionnelle, Institut Mohamed Kassab d'Orthopédie, Mannouba, Tunisia
| | - T Miwa
- Department of Otorhinolaryngology, Kanazawa Medical University, Uchinada, Kahoku, Ishikawa, Japan
| | - E Mori
- Department of Otorhinolaryngology, Jikei University, School of Medicine, Tokyo, Japan
| | - J Mullol
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, Universitat de Barcelona
- IDIBAPS
- CIBERES. Barcelona, Catalonia, Spain
| | - C A Mueller
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - G Ottaviano
- Department of Neurosciences DNS, Otolaryngology Section, University, Padua, Italy
| | - Z M Patel
- Department of Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK
- and The Smell and Taste Clinic, James Paget University Hospital, Gorleston, UK
| | - J M Pinto
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medicine and Biological Sciences, Chicago, IL, USA
| | - V R Ramakrishnan
- Department of Otolaryngology-Head and Neck Surgery, Indiana University of School Medicine, Indianapolis, IN, USA
| | - Y Roth
- The Institute for Nose and Sinus Therapy and Clinical Investigations, Department of Otolaryngology - Head and Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler Faculty of Medicine, Holon, Israel
| | - R J Schlosser
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - P Stjärne
- Section of Rhinology, Department of Otorhinolaryngology, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden
| | - L Van Gerven
- Department of Otorhinolaryngology, UZ Leuven, Belgium
- and Department of Neurosciences, Experimental Otorhinolaryngology, KU Leuven, Belgium
- and Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Unit, KU Leuven, Belgium
| | - J Vodicka
- Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Pardubice, Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic
| | - A Welge-Luessen
- University Hospital Basel - Otorhinolaryngology, Basel, Switzerland
| | - P J Wormald
- Department of Surgery-Otorhinolaryngology Head and Neck Surgery, University of Adelaide, Adelaide, SA, Australia
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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Jain S, Cetnar A, Woollard J, Gupta N, Blakaj D, Chakravarti A, Ayan AS. Pulse parameter optimizer: an efficient tool for achieving prescribed dose and dose rate with electron FLASH platforms. Phys Med Biol 2023; 68:19NT01. [PMID: 37735967 DOI: 10.1088/1361-6560/acf63e] [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: 04/24/2023] [Accepted: 09/01/2023] [Indexed: 09/23/2023]
Abstract
Purpose. Commercial electron FLASH platforms deliver ultra-high dose rate doses at discrete combinations of pulse parameters including pulse width (PW), pulse repetition frequency (PRF) and number of pulses (N), which dictate unique combinations of dose and dose rates. Additionally, collimation, source to surface distance, and airgaps also vary the dose per pulse (DPP). Currently, obtaining pulse parameters for the desired dose and dose rate is a cumbersome manual process involving creating, updating, and looking up values in large spreadsheets for every treatment configuration. This work presents a pulse parameter optimizer application to match intended dose and dose rate precisely and efficiently.Methods. Dose and dose rate calculation methods have been described for a commercial electron FLASH platform. A constrained optimization for the dose and dose rate cost function was modelled as a mixed integer problem in MATLAB (The MathWorks Inc., Version9.13.0 R2022b, Natick, Massachusetts). The beam and machine data required for the application were acquired using GafChromic film and alternating current current transformers (ACCTs). Variables for optimization included DPP for every collimator, PW and PRF measured using ACCT and airgap factors.Results. Using PW, PRF,Nand airgap factors as parameters, a software was created to optimize dose and dose rate, reaching the closest match if exact dose and dose rates are not achievable. Optimization took 20 s or less to converge to results. This software was validated for accuracy of dose calculation and precision in matching prescribed dose and dose rate.Conclusion. A pulse parameter optimization application was built for a commercial electron FLASH platform to increase efficiency in dose, dose rate, and pulse parameter prescription process. Automating this process reduces safety concerns associated with manual look up and calculation of these parameters, especially when many subjects at different doses and dose rates are to be safely managed.
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Affiliation(s)
- S Jain
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - A Cetnar
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - J Woollard
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - N Gupta
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - D Blakaj
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - A Chakravarti
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - A S Ayan
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
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Abstract
Zika virus (ZIKV) is an arthropod-borne flavivirus that presents with acute febrile illness associated with rash, arthralgia and conjunctivitis. After years of sporadic reports in Africa, the three major outbreaks of this disease occurred in Yap Islands (2007), French Polynesia (2013-14) and South Americas (2015-16). Although, serological surveys suggested the presence of ZIKV in India in 1950s, cross-reactivity could not be ruled out. The first four proven cases of ZIKV from India were reported in 2017. This was followed by major outbreaks in the states of Rajasthan and Madhya Pradesh in 2018. Fortunately, the outbreaks in India were not associated with neurological complications. These outbreaks in India highlighted the spread of this disease beyond geographical barriers owing to the growing globalization, increased travel and ubiquitous presence of its vector, the Aedes mosquito. In this review, we discuss the epidemiology, clinical features and management of ZIKV in India.
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Affiliation(s)
- N Gupta
- From the Department of Medicine, All India Institute of Medical Sciences, 3rd Floor, Teaching Block, New Delhi 110029
| | - P Kodan
- From the Department of Medicine, All India Institute of Medical Sciences, 3rd Floor, Teaching Block, New Delhi 110029
| | - K Baruah
- National Vector Borne Disease Control Programme, Ministry of Health and Family Welfare, Government of India, 22 Shyam Nath Marg, New Delhi 110054, India
| | - M Soneja
- From the Department of Medicine, All India Institute of Medical Sciences, 3rd Floor, Teaching Block, New Delhi 110029
| | - A Biswas
- From the Department of Medicine, All India Institute of Medical Sciences, 3rd Floor, Teaching Block, New Delhi 110029
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Panwar V, Gupta N, Bhoriwal SK. Left main bronchus completely occluded by tumour fragment following right pneumonectomy. Anaesth Rep 2023; 11:e12261. [PMID: 38028659 PMCID: PMC10680573 DOI: 10.1002/anr3.12261] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- V. Panwar
- Department of Onco‐Anaesthesia and Palliative MedicineDr. B.R.A. Institute‐Rotary Cancer Hospital, All India Institute of Medical SciencesNew DelhiIndia
| | - N. Gupta
- Department of Onco‐Anaesthesia and Palliative MedicineDr. B.R.A. Institute‐Rotary Cancer Hospital, All India Institute of Medical SciencesNew DelhiIndia
| | - S. K. Bhoriwal
- Department of Surgical OncologyDr. B.R.A. Institute‐Rotary Cancer Hospital, All India Institute of Medical SciencesNew DelhiIndia
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van Riel L, van Hulst RA, van Hest L, van Moorselaar RJA, Boerrigter BG, Franken SM, Wolthuis RMF, Dubbink HJ, Marciniak SJ, Gupta N, van de Beek I, Houweling AC. Recommendations on scuba diving in Birt-Hogg-Dubé syndrome. Expert Rev Respir Med 2023; 17:1003-1008. [PMID: 37991821 PMCID: PMC10763569 DOI: 10.1080/17476348.2023.2284375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/10/2023] [Indexed: 11/23/2023]
Abstract
INTRODUCTION Although very uncommon, severe injury and death can occur during scuba diving. One of the main causes of scuba diving fatalities is pulmonary barotrauma due to significant changes in ambient pressure. Pathology of the lung parenchyma, such as cystic lesions, might increase the risk of pulmonary barotrauma. AREAS COVERED Birt-Hogg-Dubé syndrome (BHD), caused by pathogenic variants in the FLCN gene, is characterized by skin fibrofolliculomas, an increased risk of renal cell carcinoma, multiple lung cysts and spontaneous pneumothorax. Given the pulmonary involvement, in some countries patients with BHD are generally recommended to avoid scuba diving, although evidence-based guidelines are lacking. We aim to provide recommendations on scuba diving for patients with BHD, based on a survey of literature on pulmonary cysts and pulmonary barotrauma in scuba diving. EXPERT OPINION In our opinion, although the absolute risks are likely to be low, caution is warranted. Given the relative paucity of literature and the potential fatal outcome, patients with BHD with a strong desire for scuba diving should be informed of the potential risks in a personal assessment. If available a diving physician should be consulted, and a low radiation dose chest computed tomography (CT)-scan to assess pulmonary lesions could be considered.
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Affiliation(s)
- L. van Riel
- Department of Human Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Department of Human Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, Netherlands
| | - RA. van Hulst
- Department of Hyperbaric Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - L. van Hest
- Department of Human Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - RJA. van Moorselaar
- Department of Urology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - BG. Boerrigter
- Department of Pulmonary Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - SM. Franken
- Department of Dermatology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - RMF. Wolthuis
- Department of Human Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, Netherlands
| | - HJ. Dubbink
- Department of Pathology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - SJ. Marciniak
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK
- Royal Papworth Hospital, Trumpington, Cambridge, UK
| | - N. Gupta
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - I. van de Beek
- Family Cancer Clinic, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - AC. Houweling
- Department of Human Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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George E, MacPherson C, Pruthi S, Bilaniuk L, Fletcher J, Houtrow A, Gupta N, Glenn OA. Long-Term Imaging Follow-up from the Management of Myelomeningocele Study. AJNR Am J Neuroradiol 2023:ajnr.A7926. [PMID: 37385677 PMCID: PMC10337608 DOI: 10.3174/ajnr.a7926] [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: 04/18/2023] [Accepted: 05/23/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND AND PURPOSE Short-term results demonstrate that prenatal repair of a myelomeningocele is associated with a reduction in hydrocephalus and an increased likelihood of the reversal of Chiari II malformations compared with postnatal repair. The purpose of this study was to identify the long-term imaging findings at school age among subjects who underwent pre- versus postnatal repair of a myelomeningocele. MATERIALS AND METHODS A subset of subjects enrolled in the Management of Myelomeningocele Study who underwent either prenatal (n = 66) or postnatal (n = 63) repair of a lumbosacral myelomeningocele and had follow-up brain MR imaging at school age were included. The prevalence of posterior fossa features of Chiari II malformation and supratentorial abnormalities and the change in these findings from fetal to school-age MR imaging were compared between the 2 groups. RESULTS Prenatal repair of a myelomeningocele was associated with higher rates of normal location of fourth ventricle and lower rates of hindbrain herniation, cerebellar herniation, tectal beaking, brainstem distortion, and kinking at school age compared with postnatal repair (all P < .01). Supratentorial abnormalities, including corpus callosal abnormalities, gyral abnormalities, heterotopia, and hemorrhage, were not significantly different between the 2 groups (all P > .05). The rates of resolution of brainstem kinking, tectal beaking, cerebellar and hindbrain herniation, and normalization of fourth ventricle size from fetal to school age MR imaging were higher among the prenatal compared with postnatal surgery group (all, P < .02). CONCLUSIONS Prenatal repair of a myelomeningocele is associated with persistent improvement in posterior fossa imaging findings of Chiari II malformation at school age compared with postnatal repair.
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Affiliation(s)
- E George
- From the Departments of Radiology and Biomedical Imaging (E.G., O.A.G.)
| | - C MacPherson
- Biostatistics Center (C.M.), Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - S Pruthi
- Department of Radiology (S.P.), Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee
| | - L Bilaniuk
- Department of Radiology (L.B.), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - J Fletcher
- Department of Psychology (J.F.), University of Houston, Houston, Texas
| | - A Houtrow
- Department of Physical Medicine and Rehabilitation (A.H.), University of Pittsburgh, Pittsburgh, Pennsylvania
| | - N Gupta
- Neurological Surgery (N.G.)
- Pediatrics (N.G.), University of California, San Francisco, San Francisco, California
| | - O A Glenn
- From the Departments of Radiology and Biomedical Imaging (E.G., O.A.G.)
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Gupta S, Dhillon HS, Gupta N. The Comparative Accuracy of BISAP and PANC3 Scoring System for the Disease Severity and Outcome in Acute Pancreatitis in Tertiary Care Hospital from North India. Kathmandu Univ Med J (KUMJ) 2023; 21:138-143. [PMID: 38628005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Background Acute pancreatitis has local and systemic manifestations, so it's important to assess the severity by various scoring system. Among them bed side index for severity of acute pancreatitis and pancreatitis three score have been considered to be more predictive and easier. Objective To determine the comparative prognostic value of bed side index for severity of acute pancreatitis and pancreatitis 3 score and its correlation with the outcome. Method A prospective observational study was conducted on 50 cases of acute pancreatitis. The patients were assessed clinically, radiologically and biochemically and were categorised into mild, moderate and severe category as per Atlanta Classification. Bed side index for severity of acute pancreatitis and pancreatitis 3 score was calculated at the time of admission and followed till the time of discharge or they had mortality. Result Receiver operating characteristic curve, showed bed side Index for severity of acute pancreatitis score had sensitivity (66.67%), specificity (84.09%), diagnostic accuracy (84%) while pancreatitis 3 score had sensitivity (50%), specificity (81.82%), diagnostic accuracy (80%) for the severity of acute pancreatitis. Bed side index for severity of acute pancreatitis had sensitivity (100%), specificity (66.67%) and Pancreatitis 3 score had sensitivity (66.67%), specificity (80.85%) for predicting the mortality in acute pancreatitis. Conclusion Bed side index for severity of acute pancreatitis and pancreatitis 3 score are both simple, bedside tool for assessing the severity and mortality but bed side index for severity of acute pancreatitis score had better sensitivity, specificity for assessing the severity and mortality as compared to pancreatitis three score.
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Affiliation(s)
- S Gupta
- Department of General Medicine, Maharishi Markandeshwar Institute of medical sciences and research, Maharishi Markandeshwar Deemed to be University, Mullana, Ambala (Haryana), India
| | - H S Dhillon
- Department of General Medicine, Maharishi Markandeshwar Institute of medical sciences and research, Maharishi Markandeshwar Deemed to be University, Mullana, Ambala (Haryana), India
| | - N Gupta
- Department of General Medicine, Maharishi Markandeshwar Institute of medical sciences and research, Maharishi Markandeshwar Deemed to be University, Mullana, Ambala (Haryana), India
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Siddiki M, Han J, Belkin M, Plana A, Gupta N, Pinney S, Kalantari S, Grinstein J. Response in Kidney Function in Heart Failure after Milrinone Loading. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.441] [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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Yoon SH, Meyer MB, Arevalo Rivas C, Tekguc M, Zhang C, Wang JS, Castro Andrade CD, Strauss KE, Sato T, Benkusky N, Lee SM, Berdeaux R, Foretz M, Sundberg TB, Xavier RJ, Adelmann CH, Brooks DJ, Anselmo A, Sadreyev RI, Rosales IA, Fisher DE, Gupta N, Morizane R, Greka A, Pike JW, Mannstadt M, Wein MN. A parathyroid hormone/salt-inducible kinase signaling axis controls renal vitamin D activation and organismal calcium homeostasis. J Clin Invest 2023; 133:163627. [PMID: 36862513 PMCID: PMC10145948 DOI: 10.1172/jci163627] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
The renal actions of parathyroid hormone (PTH) promote 1,25-vitamin D generation; however, the signaling mechanisms that control PTH-dependent vitamin D activation remain unknown. Here we demonstrated that Salt Inducible Kinases (SIKs) orchestrated renal 1,25-vitamin D production downstream of PTH signaling. PTH inhibited SIK cellular activity by cAMP-dependent PKA phosphorylation. Whole tissue and single cell transcriptomics demonstrated that both PTH and pharmacologic SIK inhibitors regulated a vitamin D gene module in the proximal tubule. SIK inhibitors increased 1,25-vitamin D production and renal Cyp27b1 mRNA expression in mice and in human embryonic stem cell-derived kidney organoids. Global- and kidney-specific Sik2/Sik3 mutant mice showed Cyp27b1 upregulation, elevated serum 1,25-vitamin D, and PTH-independent hypercalcemia. The SIK substrate CRTC2 showed PTH and SIK inhibitor-inducible binding to key Cyp27b1 regulatory enhancers in the kidney, which were also required for SIK inhibitors to increase Cyp27b1 in vivo. Lastly, in a podocyte injury model of chronic kidney disease-mineral bone disorder (CKD-MBD), SIK inhibitor treatment stimulated renal Cyp27b1 expression and 1,25-vitamin D production. Together, these results demonstrated a PTH/SIK/CRTC signaling axis in the kidney that controls Cyp27b1 expression and 1,25-vitamin D synthesis. These findings indicate that SIK inhibitors might be helpful to stimulate 1,25-vitamin D production in CKD-MBD.
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Affiliation(s)
- Sung-Hee Yoon
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America
| | - Mark B Meyer
- Department of Nutritional Sciences, University of Wisconsin - Madison, Madison, United States of America
| | - Carlos Arevalo Rivas
- Kidney Disease Initiative, Broad Institute of MIT and Harvard, Boston, United States of America
| | - Murat Tekguc
- Nephrology Division, Massachusetts General Hospital, Boston, United States of America
| | - Chengcheng Zhang
- Nephrology Division, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America
| | - Jialiang S Wang
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America
| | - Christian D Castro Andrade
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America
| | - Katelyn E Strauss
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America
| | - Tadatoshi Sato
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America
| | - Nancy Benkusky
- Department of Biochemistry, University of Wisconsin - Madison, Madison, United States of America
| | - Seong Min Lee
- Department of Biochemistry, University of Wisconsin - Madison, Madison, United States of America
| | - Rebecca Berdeaux
- Department of Integrative Biology and Pharmacology, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, United States of America
| | - Marc Foretz
- Department of Endocrinology Metabolism and Diabetes, Université Paris Cité, Institut Cochin, CNRS, INSERM, Paris, France
| | - Thomas B Sundberg
- Immunology Program, Klarman Cell Observatory, Broad Institute of MIT and Harvard, Boston, United States of America
| | - Ramnik J Xavier
- Immunology Program, Klarman Cell Observatory, Broad Institute of MIT and Harvard, Boston, United States of America
| | - Charles H Adelmann
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America
| | - Daniel J Brooks
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America
| | - Anthony Anselmo
- Department of Molecular Biology, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America
| | - Ruslan I Sadreyev
- Department of Molecular Biology, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America
| | - Ivy A Rosales
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America
| | - David E Fisher
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America
| | - Navin Gupta
- Nephrology Division, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America
| | - Ryuji Morizane
- Nephrology Division, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America
| | - Anna Greka
- Kidney Disease Initiative, Broad Institute of MIT and Harvard, Boston, United States of America
| | - J Wesley Pike
- Department of Biochemistry, University of Wisconsin - Madison, Madison, United States of America
| | - Michael Mannstadt
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America
| | - Marc N Wein
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America
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Gupta N, Max O, Hoefert JA. A dental abscess leading to maxillary osteomyelitis. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00401-9] [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: 01/28/2023]
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Prosperi C, Thangaraj J, Hasan A, Kumar M, Truelove S, Kumar V, Winter A, Bansal A, Chauhan S, Grover G, Jain A, Kulkarni R, Sharma S, Soman B, Chaaithanya I, Kharwal S, Mishra S, Salvi N, Sharma N, Sharma S, Varghese A, Sabarinathan R, Duraiswamy A, Rani D, Kanagasabai K, Lachyan A, Gawali P, Kapoor M, Chonker S, Cutts F, Sangal L, Mehendale S, Sapkal G, Gupta N, Hayford K, Moss W, Murhekar M. Added value of the measles-rubella supplementary immunization activity in reaching unvaccinated and under-vaccinated children, a cross-sectional study in five Indian districts, 2018-20. Vaccine 2023; 41:486-495. [PMID: 36481106 PMCID: PMC9831119 DOI: 10.1016/j.vaccine.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/29/2022] [Accepted: 11/04/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Supplementary immunization activities (SIAs) aim to interrupt measles transmission by reaching susceptible children, including children who have not received the recommended two routine doses of MCV before the SIA. However, both strategies may miss the same children if vaccine doses are highly correlated. How well SIAs reach children missed by routine immunization is a key metric in assessing the added value of SIAs. METHODS Children aged 9 months to younger than 5 years were enrolled in cross-sectional household serosurveys conducted in five districts in India following the 2017-2019 measles-rubella (MR) SIA. History of measles containing vaccine (MCV) through routine services or SIA was obtained from documents and verbal recall. Receipt of a first or second MCV dose during the SIA was categorized as "added value" of the SIA in reaching un- and under-vaccinated children. RESULTS A total of 1,675 children were enrolled in these post-SIA surveys. The percentage of children receiving a 1st or 2nd dose through the SIA ranged from 12.8% in Thiruvananthapuram District to 48.6% in Dibrugarh District. Although the number of zero-dose children prior to the SIA was small in most sites, the proportion reached by the SIA ranged from 45.8% in Thiruvananthapuram District to 94.9% in Dibrugarh District. Fewer than 7% of children remained measles zero-dose after the MR SIA (range: 1.1-6.4%) compared to up to 28% before the SIA (range: 7.3-28.1%). DISCUSSION We demonstrated the MR SIA provided considerable added value in terms of measles vaccination coverage, although there was variability across districts due to differences in routine and SIA coverage, and which children were reached by the SIA. Metrics evaluating the added value of an SIA can help to inform the design of vaccination strategies to better reach zero-dose or undervaccinated children.
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Affiliation(s)
- C. Prosperi
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - J.W.V. Thangaraj
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - A.Z. Hasan
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - M.S. Kumar
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - S. Truelove
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - V.S. Kumar
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - A.K. Winter
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - A.K. Bansal
- ICMR-National JALMA Institute for Leprosy & Other Mycobacterial Diseases, Agra, India
| | - S.L. Chauhan
- ICMR- National Institute for Research in Reproductive and Child Health (NIRRCH), Mumbai, India
| | - G.S. Grover
- Directorate of Health Services, Government of Punjab, Chandigarh, India
| | - A.K. Jain
- ICMR-National Institute of Pathology, New Delhi, India
| | - R.N. Kulkarni
- ICMR- National Institute for Research in Reproductive and Child Health (NIRRCH), Mumbai, India
| | - S.K. Sharma
- ICMR-Regional Medical Research Centre, NE Region, Dibrugarh, India
| | - B. Soman
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - I.K. Chaaithanya
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - S. Kharwal
- Department of Health Research, Model Rural Health Research Unit-Hoshiarpur, Punjab, India
| | - S.K. Mishra
- Department of Health Research, Model Rural Health Research Unit-Hoshiarpur, Punjab, India
| | - N.R. Salvi
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - N.P. Sharma
- Department of Health Research, Model Rural Health Research Unit-Chabua, Assam, India
| | - S. Sharma
- Department of Health Research, Model Rural Health Research Unit-Kanpur, Uttar Pradesh, India
| | - A. Varghese
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - R. Sabarinathan
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - A. Duraiswamy
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - D.S. Rani
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - K. Kanagasabai
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - A. Lachyan
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - P. Gawali
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - M. Kapoor
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - S.K. Chonker
- Department of Health Research, Model Rural Health Research Unit-Kanpur, Uttar Pradesh, India
| | - F.T. Cutts
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - L. Sangal
- World Health Organization, Southeast Asia Region Office, New Delhi, India
| | - S.M. Mehendale
- PD Hinduja Hospital and Medical Research Centre, Mumbai, India
| | - G.N. Sapkal
- ICMR-National Institute of Virology, Pune, India
| | - N. Gupta
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - K. Hayford
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - W.J. Moss
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Corresponding author at: International Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - M.V. Murhekar
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
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Theja RS, Gupta N, Panwar V, Kumar N. Erector spinae plane block for peri-operative analgesia in a patient undergoing surgery for Ewing's sarcoma of the clavicle. Anaesth Rep 2023; 11:e12228. [PMID: 37124664 PMCID: PMC10143598 DOI: 10.1002/anr3.12228] [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] [Accepted: 04/07/2023] [Indexed: 05/02/2023] Open
Abstract
The erector spinae plane block is a regional anaesthetic technique originally developed to manage thoracic neuropathic pain. It is popular because of its ease of learning and its applicability in various types of surgeries, providing both cutaneous and visceral analgesia. We report a case of a 30-year-old man who underwent excision of Ewing's sarcoma of the clavicle with brachiocephalic vein repair and pectoralis major myocutaneous flap reconstruction under general anaesthesia, with bilateral erector spinae plane block, with catheter insertion on the side of the lesion. The operation necessitated peri-operative anticoagulation, and so erector spinae blocks were performed to provide analgesia where epidural insertion was contraindicated. Adequate pain relief was achieved during the entire postoperative stay. The erector spinae plane block is thought to work due to the direct spread and diffusion of local anaesthetic into the posterior rami of spinal nerves located deep to the erector spinae muscles, and anterior spread into paravertebral space with additional effect potentially due to systemic absorption This case highlights the role of the erector spinae plane block in complex clavicular surgery requiring peri-operative anticoagulation, and potentially obviates the need for neuraxial analgesia.
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Affiliation(s)
- R. S. Theja
- Department of Surgical Oncology, Rotary Cancer HospitalAll India Institute of Medical SciencesDelhiIndia
| | - N. Gupta
- Department of Surgical Oncology, Rotary Cancer HospitalAll India Institute of Medical SciencesDelhiIndia
| | - V. Panwar
- Department of Surgical Oncology, Rotary Cancer HospitalAll India Institute of Medical SciencesDelhiIndia
| | - N. Kumar
- Department of Surgical Oncology, Rotary Cancer HospitalAll India Institute of Medical SciencesDelhiIndia
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Lokwani P, Gupta N, Choudhary SK, Singh AK. Noise survey of neonatal intensive care unit at a government tertiary-care centre. J Neonatal Perinatal Med 2023; 16:619-625. [PMID: 38043020 DOI: 10.3233/npm-230031] [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] [Indexed: 12/04/2023]
Abstract
BACKGROUND With technological advancement, Neonatal Intensive Care Units (NICU) have become noisier than ever. Studies have shown the detrimental effects of increasing noise in NICU on growing pre-term and sick neonates. The present study aimed to survey the amount of noise in one of the NICU blocks of a government tertiary care centre and explore ways to control it when dealing with these sick babies. METHODS A detailed noise survey was carried out, for February 2023, in one of the two blocks of NICU in a government tertiary-care centre. The noise measurements were performed using two "Sound Ear 3" noise meters. The analyses were done in Leq (equivalent continuous sound levels) A-weighted decibels (dBA). RESULTS The extracted data analysis revealed that the NICU block was exposed to a mean Leq of 67.78 dBA noise with a maximum of 89.0 dBA. There was a significant difference between the values noted in devices at different locations and across different periods. There were certain instances (57 and 42 for two devices) when there were sudden spikes in the noise levels beyond 80 dBA. It was also seen that noise was more than 65 dBA most of the time (72% and 66% for the two devices). CONCLUSION The noise survey carried out over one month revealed a considerable amount of noise in the NICU of a government tertiary-care centre. The study also explored ways such as environmental modification, human behavior modification, awareness programs, and neonatal-centered modifications to reduce the noise and lower its detrimental effects on the growth of neonates.
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Affiliation(s)
- P Lokwani
- Audiologist, Model Early Intervention Centre, Department of Neonatology, All India Institute of Medical Sciences, Jodhpur, India
| | - N Gupta
- Department of Neonatology, All India Institute of Medical Sciences, Jodhpur, India
| | - S K Choudhary
- Department of Neonatology, All India Institute of Medical Sciences, Jodhpur, India
| | - A K Singh
- Department of Neonatology, All India Institute of Medical Sciences, Jodhpur, India
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Yadav KK, Chouhan N, Thubstan R, Norlha S, Hariharan J, Borwankar C, Chandra P, Dhar VK, Mankuzhyil N, Godambe S, Sharma M, Venugopal K, Singh KK, Bhatt N, Bhattacharyya S, Chanchalani K, Das MP, Ghosal B, Godiyal S, Khurana M, Kotwal SV, Koul MK, Kumar N, Kushwaha CP, Nand K, Pathania A, Sahayanathan S, Sarkar D, Tolamati A, Koul R, Rannot RC, Tickoo AK, Chitnis VR, Behere A, Padmini S, Manna A, Joy S, Nair PM, Jha KP, Moitra S, Neema S, Srivastava S, Punna M, Mohanan S, Sikder SS, Jain A, Banerjee S, . K, Deshpande J, Sanadhya V, Andrew G, Patil MB, Goyal VK, Gupta N, Balakrishna H, Agrawal A, Srivastava SP, Karn KN, Hadgali PI, Bhatt S, Mishra VK, Biswas PK, Gupta RK, Kumar A, Thul SG, Kalmady R, Sonvane DD, Kumar V, Gaur UK, Chattopadhyay J, Gupta SK, Kiran AR, Parulekar Y, Agrawal MK, Parmar RM, Reddy GR, Mayya YS, Pithawa CK. Commissioning of the MACE gamma-ray telescope at Hanle, Ladakh, India. CURR SCI INDIA 2022. [DOI: 10.18520/cs/v123/i12/1428-1435] [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: 01/25/2023]
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Tekguc M, Gaal RCVAN, Uzel SGM, Gupta N, Riella LV, Lewis JA, Morizane R. Kidney organoids: a pioneering model for kidney diseases. Transl Res 2022; 250:1-17. [PMID: 35750295 PMCID: PMC9691572 DOI: 10.1016/j.trsl.2022.06.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 11/18/2022]
Abstract
The kidney is a vital organ that regulates the bodily fluid and electrolyte homeostasis via tailored urinary excretion. Kidney injuries that cause severe or progressive chronic kidney disease have driven the growing population of patients with end-stage kidney disease, leading to substantial patient morbidity and mortality. This irreversible kidney damage has also created a huge socioeconomical burden on the healthcare system, highlighting the need for novel translational research models for progressive kidney diseases. Conventional research methods such as in vitro 2D cell culture or animal models do not fully recapitulate complex human kidney diseases. By contrast, directed differentiation of human induced pluripotent stem cells enables in vitro generation of patient-specific 3D kidney organoids, which can be used to model acute or chronic forms of hereditary, developmental, and metabolic kidney diseases. Furthermore, when combined with biofabrication techniques, organoids can be used as building blocks to construct vascularized kidney tissues mimicking their in vivo counterpart. By applying gene editing technology, organoid building blocks may be modified to minimize the process of immune rejection in kidney transplant recipients. In the foreseeable future, the universal kidney organoids derived from HLA-edited/deleted induced pluripotent stem cell (iPSC) lines may enable the supply of bioengineered organotypic kidney structures that are immune-compatible for the majority of the world population. Here, we summarize recent advances in kidney organoid research coupled with novel technologies such as organoids-on-chip and biofabrication of 3D kidney tissues providing convenient platforms for high-throughput drug screening, disease modelling, and therapeutic applications.
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Affiliation(s)
- Murat Tekguc
- Nephrology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Harvard Stem Cell Institute (HSCI), Cambridge, Massachusetts
| | - Ronald C VAN Gaal
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts; School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts
| | - Sebastien G M Uzel
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts; School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts
| | - Navin Gupta
- Nephrology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Harvard Stem Cell Institute (HSCI), Cambridge, Massachusetts
| | - Leonardo V Riella
- Nephrology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Jennifer A Lewis
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts; School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts
| | - Ryuji Morizane
- Nephrology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Harvard Stem Cell Institute (HSCI), Cambridge, Massachusetts; Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts.
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20
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Gupta N, Kumar R, Sharma A. 214P Versican G3 domain promotes myeloma cell proliferation, migration and invasion via activation of FAK/STAT3 signaling. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.249] [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: 12/05/2022] Open
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21
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Sarin A, Agarwal A, Dodagoudar C, Baghmar S, Qureshi S, Raj A, Kailey N, Hasthavaram N, Kumar R, Potsangbam L, Bansal R, Bhardwaj S, Rajpurohit S, Vaibhav V, Handoo A, Dadu T, Mittal A, Gupta N, Aggarwal S. 285P Reticulocyte hemoglobin equivalent as an early predictor of iron deficiency anemia in cancer patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.311] [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: 12/05/2022] Open
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22
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Su W, Anstadt E, Gupta N, Forrester V, Krausz A, Schoenfeld J, Vidimos A, Heusinkveld L, Koyfman S, Margalit D, Murad F, Ruiz E, Lukens J. A Multi-Institutional Study of Definitive Radiotherapy for Locally Advanced Basal Cell Carcinoma. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1809] [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: 10/31/2022]
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23
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Ali AB, Majoros M, Zhang X, Collings E, Gupta N, Sumption M, Lu L. Study the Impact of Magnetic Field on Dosimetry of Proton Therapy Using Monte Carlo Simulation. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2150] [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: 10/31/2022]
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24
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Chen K, Raleigh D, Sneed P, Fogh S, Nakamura J, Boreta L, Reddy A, Banerjee A, Mueller S, Auguste K, Gupta N, Braunstein S. Radiosurgery for Primary and Metastatic CNS Malignancies in the Pediatric Population. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1741] [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: 10/31/2022]
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25
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McCormick LF, Gupta N, Prakash O, Lian LY, Dart C, Helassa N. Long QT syndrome-associated calmodulin mutations and their interactions with the Kv7.1 voltage-gated potassium channel. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Calmodulin (CaM) is a highly conserved mediator of calcium (Ca2+) dependent signalling. Its flexible structure allows CaM to bind and modulate many targets, including cardiac ion channels. Genotyping has revealed several CaM mutations associated with congenital disorders of heart rhythm, known as long QT-syndrome (LQTS). LQTS patients suffer from prolonged ventricular recovery times (QT-interval) which increases their risk of significant cardiac events. Loss of function KV7.1 mutations are the largest cause of LQTS, accounting for >50% of cases. CaM facilitates Ca2+-sensitivity to KV7.1 in producing IKs, Kv7.1 mutations which reduce CaM binding promote LQTS pathology. However, the effects of LQTS-associated CaM mutations on Kv7.1 function remain unknown.
Purpose
To determine the biophysical consequences of congenital LQTS-associated CaM mutations and how they alter modulation of Kv7.1 in producing the ventricular repolarising IKs current.
Methods
WT and mutant CaM proteins were recombinantly expressed and purified for biophysical characterisation. Using circular dichroism, secondary structures and thermostability of proteins were quantified. Isothermal titration calorimetry was used to quantitatively measure interactions between CaM proteins and binding sites of KV7.1 (Helix B). NMR was employed to study the conformations of target-bound WT and mutant proteins. Whole cell currents were determined using voltage clamp electrophysiology in HEK cells.
Results
Mutations significantly changed the thermostability and secondary structure distributions of CaM, and also caused site-dependent increases in susceptibility to protease digestion. CaM interacted with Helix B (KV7.1) via both Ca2+-dependent and independent mechanisms. Ca2+ dependent binding to Helix B was much higher affinity than Ca2+-independent binding, with >2000-fold reduction in dissociation constant measured. LQTS-CaM variants reduced Helix B affinity with the largest reductions found in EF-hand IV mutants. These mutants also adopted most distinct conformations when Helix B-bound. Calmodulation of the KV7.1 channel produced larger (IKs) currents without altering channel activation kinetics. IKs exhibited Ca2+-sensitivity, in response to increased cytosolic Ca2+, larger currents were generated. Modulation by CaM mutants reduced current density at systolic Ca2+-concentrations (1000 nM), within physiological time periods (0.35 s), revealing a direct QT-prolonging modulatory effect.
Conclusions
Provided here are mechanistic insights as to how LQTS-associated CaM variants contribute to electrical disease of the heart. Mutations in the highly conserved structure of CaM disrupt protein conformation and perturb complex formation with KV7.1. This results in aberrant Ca2+-sensitivity of Kv7.1, reducing IKs generation. This ultimately decreases the repolarisation capacity of cells and would extend the QT interval of myocytes.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): British Heart Foundation Intermediate Basic Science Research Fellowship
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Affiliation(s)
- L F McCormick
- University of Liverpool, Department of Cardiovascular and Metabolic Medicine , Liverpool , United Kingdom
| | - N Gupta
- University of Liverpool, Department of Molecular Physiology and Cell Signalling , Liverpool , United Kingdom
| | - O Prakash
- University of Liverpool, Department of Cardiovascular and Metabolic Medicine , Liverpool , United Kingdom
| | - L Y Lian
- University of Liverpool, Department of Biochemistry and Systems Biology , Liverpool , United Kingdom
| | - C Dart
- University of Liverpool, Department of Molecular Physiology and Cell Signalling , Liverpool , United Kingdom
| | - N Helassa
- University of Liverpool, Department of Cardiovascular and Metabolic Medicine , Liverpool , United Kingdom
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26
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Helassa N, Prakash O, Gupta N, McCormick LF, Antonyuk S, Dart C. Disease-associated calmodulin mutations disrupt L-type Ca2+ channel (Cav1.2) activity and CaMKIIdelta phosphorylation in long QT syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2982] [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
Introduction
Long QT Syndrome (LQTS) is a major inherited arrhythmia syndrome that can cause sudden cardiac death. Using genome sequencing in human patients, mutations in the ubiquitous calcium (Ca2+) sensor protein calmodulin (CaM) have been associated to LQTS. CaM is an ion channel regulator and can modulate the activity of the voltage-gated calcium channel (Cav1.2) and Ca2+/CaM-dependent protein kinase II (CaMKIIδ), involved in cardiac muscle contraction. However the molecular mechanism by which CaM mutations contribute to irregular heartbeats remains unclear.
Methods
Interaction of CaM proteins with Cav1.2 and CaMKIId synthetic peptides (Cav1.2-NSCaTE51–68, Cav1.2-IQ1665–1685, Cav1.2-C1627–1652, CaMKIIδ294–315,) was investigated using Isothermal Titration Calorimetry (ITC) and X-ray crystallography. Whole-cell patch clamp electrophysiology was used to determine the effect of CaM mutations on L-type Ca2+ currents and Ca2+-dependent inactivation (CDI). CaMKIIδ phosphorylation activity was determined by western blot and fluorescence kinase assay.
Results
Binding affinity of CaMKIId and Cav1.2 peptides to the LQTS-associated CaM variants was significantly reduced, up to 7-fold. Interestingly, the Cav1.2-IQ1665–1685 peptide showed a stronger binding, up to 2-fold, towards LQTS-CaM mutants. Crystal structures of Ca2+-CaM:CaMKIId294–315 showed structural alterations induced by LQTS associated mutations. In addition, we demonstrated that CaMKIIδ autophosphorylation and kinase activity can be significantly reduced by LQTS-associated CaM mutants. Electrophysiological examination of Cav1.2 function revealed that CaM mutations significantly impaired channel CDI, without affecting the voltage dependence of activation and inactivation.
Conclusions
These data demonstrate a strong correlation between LQTS-associated CaM mutations and Cav1.2 activity. We provide molecular insights into the diverse factors contributing to CaM-mediated arrhythmias.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): British Heart Foundation Intermediate Basic Science Research Fellowship
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Affiliation(s)
- N Helassa
- University of Liverpool, Department of Cardiovascular and Metabolic Medicine , Liverpool , United Kingdom
| | - O Prakash
- University of Liverpool, Department of Cardiovascular and Metabolic Medicine , Liverpool , United Kingdom
| | - N Gupta
- University of Liverpool, Department of Molecular Physiology and Cell Signalling , Liverpool , United Kingdom
| | - L F McCormick
- University of Liverpool, Department of Cardiovascular and Metabolic Medicine , Liverpool , United Kingdom
| | - S Antonyuk
- University of Liverpool, Department of Biochemistry and Systems Biology , Liverpool , United Kingdom
| | - C Dart
- University of Liverpool, Department of Molecular Physiology and Cell Signalling , Liverpool , United Kingdom
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Prasad N, Gupta N. POS-054 TRIAD OF "FEVER, LIVER AND KIDNEY INJURY(FLIKI)": ETIOLOGY AND OUTCOMES IN NORTHERN INDIAN SETTINGS. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.07.071] [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: 10/14/2022] Open
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28
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Hanley M, Zhang S, Pavlakis N, Soo R, van der Wekken A, Ganju V, Pina A, Dong Q, Gupta N. EP08.02-109 A Drug-Drug Interaction Study of Mobocertinib and Midazolam in Patients With Advanced Non-Small Cell Lung Cancer. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.792] [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: 11/16/2022]
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29
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Rizki-Safitri A, Gupta N, Hiratsuka K, Kobayashi K, Zhang C, Ida K, Satlin LM, Morizane R. Live functional assays reveal longitudinal maturation of transepithelial transport in kidney organoids. Front Cell Dev Biol 2022; 10:978888. [PMID: 36046340 PMCID: PMC9420851 DOI: 10.3389/fcell.2022.978888] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 06/27/2022] [Accepted: 07/12/2022] [Indexed: 02/04/2023] Open
Abstract
Kidney organoids derived from hPSCs have opened new opportunities to develop kidney models for preclinical studies and immunocompatible kidney tissues for regeneration. Organoids resemble native nephrons that consist of filtration units and tubules, yet little is known about the functional capacity of these organoid structures. Transcriptomic analyses provide insight into maturation and transporter activities that represent kidney functions. However, functional assays in organoids are necessary to demonstrate the activity of these transport proteins in live tissues. The three-dimensional (3D) architecture adds complexity to real-time assays in kidney organoids. Here, we develop a functional assay using live imaging to assess transepithelial transport of rhodamine 123 (Rh123), a fluorescent substrate of P-glycoprotein (P-gp), in organoids affixed to coverslip culture plates for accurate real-time observation. The identity of organoid structures was probed using Lotus Tetragonolobus Lectin (LTL), which binds to glycoproteins present on the surface of proximal tubules. Within 20 min of the addition of Rh123 to culture media, Rh123 accumulated in the tubular lumen of organoids. Basolateral-to-apical accumulation of the dye/marker was reduced by pharmacologic inhibition of MDR1 or OCT2, and OCT2 inhibition reduced the Rh123 uptake. The magnitude of Rh123 transport was maturation-dependent, consistent with MDR1 expression levels assessed by RNA-seq and immunohistochemistry. Specifically, organoids on day 21 exhibit less accumulation of Rh123 in the lumen unlike later-stage organoids from day 30 of differentiation. Our work establishes a live functional assessment in 3D kidney organoids, enabling the functional phenotyping of organoids in health and disease.
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Affiliation(s)
- Astia Rizki-Safitri
- Nephrology Division, Massachusetts General Hospital, Boston, MA, United States,Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Navin Gupta
- Nephrology Division, Massachusetts General Hospital, Boston, MA, United States,Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Ken Hiratsuka
- Nephrology Division, Massachusetts General Hospital, Boston, MA, United States,Department of Medicine, Harvard Medical School, Boston, MA, United States,Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA, United States
| | - Kenichi Kobayashi
- Nephrology Division, Massachusetts General Hospital, Boston, MA, United States,Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Chengcheng Zhang
- Nephrology Division, Massachusetts General Hospital, Boston, MA, United States,Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Kazumi Ida
- Nephrology Division, Massachusetts General Hospital, Boston, MA, United States,Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Lisa M. Satlin
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York City, NY, United States
| | - Ryuji Morizane
- Nephrology Division, Massachusetts General Hospital, Boston, MA, United States,Department of Medicine, Harvard Medical School, Boston, MA, United States,Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA, United States,Harvard Stem Cell Institute, Cambridge, MA, United States,*Correspondence: Ryuji Morizane, ,
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30
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Niyas VKM, Arjun R, Titus L, Hussain F, Sreelakshmi SL, Jomes J, Gupta N. Hybrid immunity versus vaccine immunity among Indian health care workers after ChAdOx-nCov-19 vaccine. QJM 2022; 115:565-566. [PMID: 35781827 DOI: 10.1093/qjmed/hcac155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- V K M Niyas
- Department of Infectious Diseases, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - R Arjun
- Department of Infectious Diseases, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - L Titus
- Laboratory Medicine, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - F Hussain
- Department of Infectious Diseases, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - S L Sreelakshmi
- Internal Medicine, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - J Jomes
- Department of Infectious Diseases, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - N Gupta
- Infectious Diseases, Kasturba Medical College, Manipal, Karnataka 576104, India
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31
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Gupta A, Singh M, Munda A, Gupta N. Awake videolaryngoscopy in a child with a predicted difficult airway due to a large craniofacial vascular tumour. Anaesth Rep 2022; 10:e12202. [PMID: 36504728 PMCID: PMC9722398 DOI: 10.1002/anr3.12202] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2022] [Indexed: 12/12/2022] Open
Affiliation(s)
- A. Gupta
- Department of Anaesthesiology, Pain Medicine and Critical CareAll India Institute of Medical SciencesNew DelhiIndia
| | - M. Singh
- Department of Anaesthesiology, Pain Medicine and Critical CareAll India Institute of Medical SciencesNew DelhiIndia
| | - A. Munda
- Department of Anaesthesiology, Pain Medicine and Critical CareAll India Institute of Medical SciencesNew DelhiIndia
| | - N. Gupta
- Department of Anaesthesiology, Pain Medicine and Critical CareAll India Institute of Medical SciencesNew DelhiIndia
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Koirala B, Adhikari SR, Shrestha A, Vaidya A, Aryal KK, Kalaunee SP, Shrestha A, Mishra SR, Sharma SK, Karki A, Maharjan B, Singh S, Schwarz D, Gupta N, Bukhman G, Karmacharya BM. A National Equity Initiative to Address Noncommunicable Diseases and Injuries: Findings and Recommendation from the Nepal NCDI Poverty Commission. Kathmandu Univ Med J (KUMJ) 2022; 20:376-383. [PMID: 37042383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
We aimed to assess the burden of NCDIs across socioeconomic groups, their economic impact, existing health service readiness and availability, current policy frameworks and national investment, and planned programmatic initiatives in Nepal through a comprehensive literature review. Secondary data from Global Burden of Disease estimates from GBD 2015 and National Living Standard Survey 2011 were used to estimate the burden of NCDI and present the relationship of NCDI burden with socioeconomic status. The Commission used these data to define priority NCDI conditions and recommend potential cost-effective, poverty-averting, and equity-promoting health system interventions. NCDIs disproportionately affect the health and well-being of poorer populations in Nepal and cause significant impoverishment. The Commission found a high diversity of NCDIs in Nepal, with approximately 60% of the morbidity and mortality caused by NCDIs without primary quantified behavioral or metabolic risk factors, and nearly half of all NCDI-related DALYs occurring in Nepalese younger than 40 years. The Commission prioritized an expanded set of twenty-five NCDI conditions and recommended introduction or scale-up of twenty-three evidence-based health sector interventions. Implementation of these interventions would avert an estimated 9680 premature deaths per annum by 2030 and would cost approximately $8.76 per capita. The Commission modelled potential financing mechanisms, including increased excise taxation on tobacco, alcohol, and sugar-sweetened beverages, which would provide significant revenue for NCDI-related expenditures. Overall, the Commission's conclusions are expected to be a valuable contribution to equitable NCDI planning in Nepal and similar resource-constrained settings globally.
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Affiliation(s)
- B Koirala
- Tribhuvan University, Institute of Medicine, Department of Cardiothoracic and Vascular Surgery,Maharajgunj, Kathmandu. and Kathmandu Institute of Child Health, Budhanilkantha, Kathmandu
| | - S R Adhikari
- Tribhuvan University Faculty of Humanities and Social Sciences, Central Department of Economics, Kritipur, Kathmandu
| | - A Shrestha
- Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre
| | - A Vaidya
- Kathmandu Medical College and Teaching Hospital, Department of Community Medicine, Sinamangal, Kathmandu
| | - K K Aryal
- Bergen Center for Ethics and Priority Setting in Health, Department of Global Public Health and Primary Care, University of Bergen
| | | | - A Shrestha
- Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre
| | - S R Mishra
- Nepal Development Society, Chitwan, Nepal
| | - S K Sharma
- B.P. Koirala Institute of Health Sciences, Dharan
| | - A Karki
- School of Health, Medical and Applied Sciences, Central Queensland University
| | - B Maharjan
- Kathmandu Institute of Child Health, Budhanilkantha, Kathmandu
| | - S Singh
- Kathmandu Institute of Child Health, Budhanilkantha, Kathmandu
| | - D Schwarz
- Brigham and Women's Hospital, Division of Global Health Equity; Harvard Medical School, Department of Medicine
| | - N Gupta
- Center for Integration Science, Brigham and Women's Hospital; Program in Global NCDs and Social Change, Harvard Medical School; NCD Synergies Project, Partners In Health; NCDI Poverty Network, Boston, USA
| | - G Bukhman
- Center for Integration Science, Brigham and Women's Hospital; Program in Global NCDs and Social Change, Harvard Medical School; NCD Synergies Project, Partners In Health; NCDI Poverty Network, Boston, USA
| | - B M Karmacharya
- Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre
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Abstract
Kyasanur forest disease (KFD) virus is a flavivirus that can be transmitted to humans from monkeys or other mammals through hard ticks (Haemaphysalis spinigera). The disease is endemic to 16 districts in 5 states of Southern India and is reported in the dry season, most commonly in humans travelling to the forests in these areas. The aim of this systematic review is to raise awareness of the clinical and laboratory manifestation of KFD among physicians and travel medicine practitioners. A total of 153 articles were screened of which 16 articles that met the inclusion and exclusion criteria were included for qualitative analysis. KFD is an acute haemorrhagic fever with a biphasic component in some individuals. The second phase is usually marked by neurological symptoms. Leucopoenia, thrombocytopenia and elevated transaminases are the hallmarks of the first phase of KFD. The diagnostic modality of choice in the first few days of illness is polymerase chain reaction assay, whereas serology is used in the late phase. In the absence of a specific antiviral treatment, the clinical management of patients is limited to supportive care. Avoidance of exposure and vaccination is recommended to prevent this infection.
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Affiliation(s)
- N Gupta
- From the 1Department of Infectious Diseases, Kasturba Medical College and Hospital
- Manipal Center for Infectious Diseases, Prasanna School of Public Health, Madhav Nagar, Manipal 576104, Udupi, Karnataka, India
| | - W Wilson
- Department of Emergency Medicine, Kasturba Medical College and Hospital, Manipal Academy of Higher Education, Madhav Nagar, Manipal 576104, Udupi, Karnataka, India
| | - A Neumayr
- Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Petersplatz 1, 4001, Basel, Switzerland
- Department of Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland-4811, Australia
| | - K Saravu
- From the 1Department of Infectious Diseases, Kasturba Medical College and Hospital
- Manipal Center for Infectious Diseases , Prasanna School of Public Health, Madhav Nagar, Manipal 576104, Udupi, Karnataka, India
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34
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Oleszkiewicz A, Schriever VA, Valder C, Agosin E, Altundag A, Avni H, Cao Van H, Cornejo C, Fishman G, Guarneros M, Gupta N, Kamel R, Knaapila A, Konstantinidis I, Landis BN, Larsson M, Lundström JN, Macchi A, Marino-Sanchez F, Mori E, Mullol J, Parma V, Propst EJ, Sandell MA, Sorokowska A, Vodicka J, Hummel T, Gellrich J. Hedonic perception of odors in children aged 5-8 years is similar across 18 countries: Preliminary data. Int J Pediatr Otorhinolaryngol 2022; 157:111129. [PMID: 35443229 DOI: 10.1016/j.ijporl.2022.111129] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 02/21/2022] [Revised: 03/27/2022] [Accepted: 04/08/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Olfactory preference emerges very early in life, and the sense of smell in children rapidly develops until the second decade of life. It is still unclear whether hedonic perception of odors is shared in children inhabiting different regions of the globe. METHODS Five-hundred ten healthy children (N = 510; ngirls = 256; nboys = 254) aged from 5 to 8 years from 18 countries rated the pleasantness of 17 odors. RESULTS The hedonic perception of odors in children aged between 5 and 8 years was rather consistent across 18 countries and mainly driven by the qualities of an odor and the overall ability of children to label odorants. CONCLUSION Conclusions from this study, being a secondary analysis, are limited to the presented set of odors that were initially selected for the development of U-Sniff test and present null findings for the cross-cultural variability in hedonic perception of odors across 18 countries. These two major issues should be addressed in the future to either contradict or replicate the results presented herewith. This research lays fundament for posing further research questions about the developmental aspects of hedonic perception of odors and opens a new door for investigating cross-cultural differences in chemosensory perception of children.
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Affiliation(s)
- A Oleszkiewicz
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany; Institute of Psychology, University of Wroclaw, Poland.
| | - V A Schriever
- Abteilung Neuropädiatrie, Medizinische Fakultät Carl Gustav Carus, Technische Universität, Dresden, Germany; Charité - Universitätsmedizin Berlin, Center for Chronically Sick Children (Sozialpädiatrisches Zentrum, SPZ), Berlin, Germany.
| | - C Valder
- Systema Natura GmbH, Flintbek, Germany.
| | - E Agosin
- College of Engineering, Pontifical Catholic University of Chile, Santiago, Chile.
| | - A Altundag
- Otorhinolaryngology Department of Biruni University Medical Faculty, Acibadem Taksim Hospital Otorhinolaryngology Department, Istanbul, Turkey.
| | - H Avni
- Pediatric Feeding Disorders Clinic, Dana Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel.
| | - H Cao Van
- Pediatric ENT Unit, Department of Otorhinolaryngologie Head and Neck Surgery, University Hospital of Geneva, Switzerland.
| | - C Cornejo
- Escuela de Psicología, Pontificia Universidad Católica de Chile, Santiago, Chile.
| | - G Fishman
- Pediatric Otolaryngology, Dana Children's Hospital, Tel-Aviv Medical Center, Sackler School of Medicine, Tel-Aviv, Israel.
| | - M Guarneros
- Departamento de Biología Celular y Fisiología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico.
| | - N Gupta
- Department of Otorhinolaryngology, University College of Medical Sciences and GTB Hospital, Delhi, India.
| | - R Kamel
- Department of Otorhinolaryngology, Head and Neck Surgery, Cairo University, Cairo, Egypt.
| | - A Knaapila
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland.
| | - I Konstantinidis
- 2nd Otorhinolaryngology Department of Aristotle University, Thessaloniki, Greece.
| | - B N Landis
- Rhinology-Olfactology Unit, Department of Otorhinolaryngologie Head and Neck Surgery, University Hospital of Geneva, Switzerland.
| | - M Larsson
- Gösta Ekman Laboratory, Department of Psychology, Stockholm University, Stockholm, Sweden.
| | - J N Lundström
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - A Macchi
- ENT Clinic, University of Insubriae Varese, ASST Settelaghi, Italy.
| | - F Marino-Sanchez
- Unidad de Rinología y Cirugía de Base de Cráneo, Servicio de Otorrinolaringología. Hospital Universitario Ramón y Cajal, Madrid, Spain.
| | - E Mori
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan.
| | - J Mullol
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, IDIBAPS, Universitat de Barcelona, CIBERES, Barcelona, Catalonia, Spain.
| | - V Parma
- Temple University, Department of Psychology, Philadelphia, USA; Monell Chemical Senses Center, Philadelphia, USA.
| | - E J Propst
- Department of Otolaryngology - Head & Neck Surgery, Hospital for Sick Children, University of Toronto, Canada.
| | - M A Sandell
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland.
| | - A Sorokowska
- Institute of Psychology, University of Wroclaw, Poland.
| | - J Vodicka
- Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic.
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany.
| | - J Gellrich
- Abteilung Neuropädiatrie, Medizinische Fakultät Carl Gustav Carus, Technische Universität, Dresden, Germany; Klinik und Poliklinik für Kinder- und Jugendheilkunde, Medizinische Fakultät Carl Gustav Carus, Technische Universität, Dresden, Germany.
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Prasanth T, Manandhar S, Satisha T, Gupta N, Kumar P. Revisiting failures in mucogingival surgery. Med J Armed Forces India 2022. [DOI: 10.1016/j.mjafi.2022.04.007] [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: 11/17/2022] Open
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Gupta N, Leung C. The effect of post-amputation pain on health-related quality of life in lower limb amputees. Disabil Rehabil 2022; 44:2325-2331. [DOI: 10.1080/09638288.2020.1832589] [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: 10/23/2022]
Affiliation(s)
- N. Gupta
- Rehabilitation Medicine Department, Westmead Hospital, Sydney, Australia
| | - C. Leung
- Rehabilitation Medicine Department, Westmead Hospital, Sydney, Australia
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Loeb S, Salter C, Nelson CJ, Mulhall JP, Byrne N, Sanchez Nolasco T, Ness M, Gupta N, Cassidy C, Crisostomo-Wynne T, Li R, Wittmann D. Comparison of Sexual Concerns Between Patients with Prostate Cancer and Their Partners. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.111] [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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Gupta N, Matsumoto T, Hiratsuka K, Saiz EG, Zhang C, Galichon P, Miyoshi T, Susa K, Tatsumoto N, Yamashita M, Morizane R. Modeling injury and repair in kidney organoids reveals that homologous recombination governs tubular intrinsic repair. Sci Transl Med 2022; 14:eabj4772. [PMID: 35235339 PMCID: PMC9161367 DOI: 10.1126/scitranslmed.abj4772] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Kidneys have the capacity for intrinsic repair, preserving kidney architecture with return to a basal state after tubular injury. When injury is overwhelming or repetitive, however, that capacity is exceeded and incomplete repair results in fibrotic tissue replacing normal kidney parenchyma. Loss of nephrons correlates with reduced kidney function, which defines chronic kidney disease (CKD) and confers substantial morbidity and mortality to the worldwide population. Despite the identification of pathways involved in intrinsic repair, limited treatments for CKD exist, partly because of the limited throughput and predictivity of animal studies. Here, we showed that kidney organoids can model the transition from intrinsic to incomplete repair. Single-nuclear RNA sequencing of kidney organoids after cisplatin exposure identified 159 differentially expressed genes and 29 signal pathways in tubular cells undergoing intrinsic repair. Homology-directed repair (HDR) genes including Fanconi anemia complementation group D2 (FANCD2) and RAD51 recombinase (RAD51) were transiently up-regulated during intrinsic repair but were down-regulated in incomplete repair. Single cellular transcriptomics in mouse models of obstructive and hemodynamic kidney injury and human kidney samples of immune-mediated injury validated HDR gene up-regulation during tubular repair. Kidney biopsy samples with tubular injury and varying degrees of fibrosis confirmed loss of FANCD2 during incomplete repair. Last, we performed targeted drug screening that identified the DNA ligase IV inhibitor, SCR7, as a therapeutic candidate that rescued FANCD2/RAD51-mediated repair to prevent the progression of CKD in the cisplatin-induced organoid injury model. Our findings demonstrate the translational utility of kidney organoids to identify pathologic pathways and potential therapies.
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Affiliation(s)
- Navin Gupta
- Nephrology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Harvard Stem Cell Institute (HSCI), Cambridge, MA, USA
- Nephrology Division, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Takuya Matsumoto
- Nephrology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Nephrology Division, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Ken Hiratsuka
- Nephrology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
- Nephrology Division, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Edgar Garcia Saiz
- Harvard Medical School, Boston, MA, USA
- Nephrology Division, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Chengcheng Zhang
- Nephrology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Pierre Galichon
- Harvard Stem Cell Institute (HSCI), Cambridge, MA, USA
- Nephrology Division, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Tomoya Miyoshi
- Nephrology Division, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Koichiro Susa
- Nephrology Division, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Narihito Tatsumoto
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Michifumi Yamashita
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Ryuji Morizane
- Nephrology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Harvard Stem Cell Institute (HSCI), Cambridge, MA, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
- Nephrology Division, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
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Polkoff K, Gupta N, Chung J, Gleason K, Marquez Y, Piedrahita J. 4 Transgenic porcine model reveals two roles for LGR5 in lung development and homeostasis. Reprod Fertil Dev 2021; 34:235-236. [PMID: 35231293 DOI: 10.1071/rdv34n2ab4] [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: 11/23/2022] Open
Affiliation(s)
- K Polkoff
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA
| | - N Gupta
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - J Chung
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA
| | - K Gleason
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Y Marquez
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - J Piedrahita
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA
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Guilliams KP, Gupta N, Srinivasan S, Binkley MM, Ying C, Couture L, Gross J, Wallace A, McKinstry RC, Vo K, Lee JM, An H, Goyal MS. MR Imaging Differences in the Circle of Willis between Healthy Children and Adults. AJNR Am J Neuroradiol 2021; 42:2062-2069. [PMID: 34556478 PMCID: PMC8583273 DOI: 10.3174/ajnr.a7290] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 07/19/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Asymmetries in the circle of Willis have been associated with several conditions, including migraines and stroke, but they may also be age-dependent. This study examined the impact of age and age-dependent changes in cerebral perfusion on circle of Willis anatomy in healthy children and adults. MATERIALS AND METHODS We performed an observational, cross-sectional study of bright and black-blood imaging of the proximal cerebral vasculature using TOF-MRA and T2 sampling perfection with application-optimized contrasts by using different flip angle evolution (T2-SPACE) imaging at the level of the circle of Willis in 23 healthy children and 43 healthy adults (4-74 years of age). We compared arterial diameters measured manually and cerebral perfusion via pseudocontinuous arterial spin-labeling between children and adults. RESULTS We found that the summed cross-sectional area of the circle of Willis is larger in children than in adults, though the effect size was smaller with T2-SPACE-based measurements than with TOF-MRA. The circle of Willis is also more symmetric in children, and nonvisualized segments occur more frequently in adults than in children. Moreover, the size and symmetry of the circle of Willis correlate with cerebral perfusion. CONCLUSIONS Our results demonstrate that the circle of Willis is different in size and symmetry in healthy children compared with adults, likely associated with developmental changes in cerebral perfusion. Further work is needed to understand why asymmetric vasculature develops in some but not all adults.
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Affiliation(s)
- K P Guilliams
- From the Department of Neurology (K.P.G., M.M.B., J.-M.L., M.S.G.)
- Department of Pediatrics (K.P.G., R.C.M.)
- Mallinckrodt Institute of Radiology (K.P.G., N.G., S.S., C.Y., L.C., R.C.M., K.V., J.-M.L., H.A., M.S.G.)
| | - N Gupta
- Mallinckrodt Institute of Radiology (K.P.G., N.G., S.S., C.Y., L.C., R.C.M., K.V., J.-M.L., H.A., M.S.G.)
| | - S Srinivasan
- Mallinckrodt Institute of Radiology (K.P.G., N.G., S.S., C.Y., L.C., R.C.M., K.V., J.-M.L., H.A., M.S.G.)
| | - M M Binkley
- From the Department of Neurology (K.P.G., M.M.B., J.-M.L., M.S.G.)
| | - C Ying
- Mallinckrodt Institute of Radiology (K.P.G., N.G., S.S., C.Y., L.C., R.C.M., K.V., J.-M.L., H.A., M.S.G.)
| | - L Couture
- Mallinckrodt Institute of Radiology (K.P.G., N.G., S.S., C.Y., L.C., R.C.M., K.V., J.-M.L., H.A., M.S.G.)
| | - J Gross
- Division of Neuroradiology (J.G.), Midwest Radiology, St. Paul, Minnesota
| | - A Wallace
- Department of Neurointerventional Surgery (A.W.), Ascension Columbia St. Mary's Hospital, Milwaukee, Wisconsin
| | - R C McKinstry
- Department of Pediatrics (K.P.G., R.C.M.)
- Mallinckrodt Institute of Radiology (K.P.G., N.G., S.S., C.Y., L.C., R.C.M., K.V., J.-M.L., H.A., M.S.G.)
| | - K Vo
- Mallinckrodt Institute of Radiology (K.P.G., N.G., S.S., C.Y., L.C., R.C.M., K.V., J.-M.L., H.A., M.S.G.)
| | - J-M Lee
- From the Department of Neurology (K.P.G., M.M.B., J.-M.L., M.S.G.)
- Mallinckrodt Institute of Radiology (K.P.G., N.G., S.S., C.Y., L.C., R.C.M., K.V., J.-M.L., H.A., M.S.G.)
- Department of Biomedical Engineering (J.-M.L.)
| | - H An
- Mallinckrodt Institute of Radiology (K.P.G., N.G., S.S., C.Y., L.C., R.C.M., K.V., J.-M.L., H.A., M.S.G.)
| | - M S Goyal
- From the Department of Neurology (K.P.G., M.M.B., J.-M.L., M.S.G.)
- Mallinckrodt Institute of Radiology (K.P.G., N.G., S.S., C.Y., L.C., R.C.M., K.V., J.-M.L., H.A., M.S.G.)
- Neuroscience (M.S.G.), Washington University School of Medicine, St. Louis, Missouri
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Gupta N, Balcom SA, Gulliver A, Witherspoon RL. Systematic review of health workforce surge capacity during COVID-19 and other viral pandemics. Eur J Public Health 2021. [PMCID: PMC8574250 DOI: 10.1093/eurpub/ckab165.034] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Healthcare decision-makers need comprehensive evidence to mitigate surges in the demand for human resources for health (HRH) during infectious disease outbreaks, in terms of both short- and longer-term impacts. This study aimed to assess the state of the evidence to address HRH surge capacity during COVID-19 and other outbreaks of global significance in the 21st century.
Methods
We systematically searched eight bibliographic databases to extract primary research articles published between 01/2000-06/2020, capturing temporal changes in HRH requirements and responses surrounding viral respiratory infection pandemics. A systems approach was used, considering providers in hospitals, out-of-hospital systems, emergency medical services, and public health. We narratively synthesized the evidence following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) standard.
Results
Of the 1,155 retrieved records, 16 studies met our inclusion criteria; of these, 5 focused on COVID-19, 3 on H1N1, and 8 on a hypothetical pandemic. Different training, mobilization, and redeployment options to address pandemic-time health system capacity were assessed. Few governance scenarios drew on observational HRH data allowing for comparability across contexts. Notable evidence gaps included occupational and psychosocial factors affecting healthcare workers' absenteeism and risk of burnout, gendered considerations of HRH capacity, evaluations in low- and lower-middle income countries, and policy-actionable assessments to inform post-pandemic recovery and sustainability of services for noncommunicable disease management.
Conclusions
This research emphasized the critical need for timely, internationally comparable, and equity-informative HRH data and research to enhance preparedness, response, and recovery policies for this and future pandemics. Full paper is available at: https://doi.org/10.1002/hpm.3137
Key messages
The COVID-19 pandemic has highlighted the critical need for enhanced health workforce data and research, including better tracking of demographics, exposures, infections and deaths of health workers. Although women comprise 70% of the health workforce in many countries, gender-blindness persists in the global literature on health workforce research and governance in public health emergencies./bodyt
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Affiliation(s)
- N Gupta
- University of New Brunswick, Fredericton, Canada
| | - SA Balcom
- University of New Brunswick, Fredericton, Canada
| | - A Gulliver
- University of New Brunswick, Fredericton, Canada
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Manku B, Gupta N, Ahmad J, McLaughlin E. 639 Emergency Surgical Approach to A Bleeding Pseudoaneurysm Of the Posterior Inferior Pancreaticoduodenal Artery After Failed Embolisation. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.311] [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: 11/14/2022]
Abstract
Abstract
Background
Pseudoaneurysms of visceral arteries are uncommon, with a prevalence of 0.01% to 0.2%1. Initial treatment is radiological embolisation (RE)2. If this fails, surgical access to the pseudoaneurysm is extremely difficult. They are associated with major complications such as rupture, ischaemia and shock2, with a 20-70% mortality rate3. We report the case of a patient admitted with a life-threatening bleed from an aberrant inferior pancreaticoduodenal artery (IPDA) with failed RE.
Case Summary
A 44-year-old patient presented with right upper quadrant pain, shock and low haemoglobin. His computerised tomography (CT) scan showed a large retroperitoneal haematoma with active bleeding from a 5x6mm IPDA pseudoaneurysm. After resuscitation, access to the IPDA during RE via the coeliac axis and superior mesenteric artery was unsuccessful and he deteriorated. He underwent an emergency laparotomy, which showed the retro-peritoneal haematoma had ruptured into the peritoneal cavity through the transverse mesocolon. Four-quadrant abdominal packing and supra-coeliac manual compression of the aorta was utilised. The right colon was mobilised with full kocherisation of the duodenum. The gastrocolic omentum was divided to enter the lesser sac. The haematoma was evacuated and bleeding branches from the IPDA were suture ligated. He required 26 units of blood throughout admission and underwent 24-hour damage control laparostomy on intensive care. CT mesenteric angiogram post-surgery and re-look laparotomy showed no further active bleeds. He had an uneventful recovery and discharged safely.
Conclusions
RE of visceral artery pseudoaneurysms is challenging. Surgery remains the last resort and should be performed by appropriately trained specialist surgeons.
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Affiliation(s)
- B Manku
- University Hospital Coventry and Warwickshire, Coventry, United Kingdom
| | - N Gupta
- University Hospital Coventry and Warwickshire, Coventry, United Kingdom
| | - J Ahmad
- University Hospital Coventry and Warwickshire, Coventry, United Kingdom
| | - E McLaughlin
- University Hospital Coventry and Warwickshire, Coventry, United Kingdom
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Huang J, Sarma A, Gupta N, Little S, Pruthi S. Noncontrast MRI Protocol for Selected Pediatric Pituitary Endocrinopathies: A Procedure with High Diagnostic Yield and Potential to Reduce Anesthesia and Gadolinium-Based Contrast Exposure. AJNR Am J Neuroradiol 2021; 42:1884-1890. [PMID: 34475192 PMCID: PMC8562761 DOI: 10.3174/ajnr.a7228] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/03/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Although many pediatric neuroradiology practices empirically use noncontrast brain and pituitary MR imaging for evaluation of growth hormone deficiency, central precocious puberty, and short stature, there are currently insufficient published data to support this practice in an evidence-based fashion. Therefore, the use of contrast-enhanced MR imaging for all pediatric pituitary endocrinopathies remains widespread. We evaluated whether noncontrast MR imaging has adequate diagnostic yield for the evaluation of pediatric growth hormone deficiency, central precocious puberty, and short stature. MATERIALS AND METHODS Pituitary MR imaging studies obtained for growth hormone deficiency, central precocious puberty, or short stature in patients 0-18 years of age from 2010 to 2019 were analyzed. Separate blinded review of noncontrast images in cases with abnormalities on the original radiology report was performed by 2 subspecialty-trained pediatric neuroradiologists, with discrepancies resolved by consensus. RESULTS Of the 134/442 MR imaging studies obtained for growth hormone deficiency, central precocious puberty, or short stature with hypothalamic-pituitary region abnormalities, there was 70% concordance with the original reports on blinded review of noncontrast images. Twenty-two of 40 discrepancies were deemed unrelated to the indication, and 9 cases originally interpreted as possible microadenoma were read as having normal findings on blinded review. Only 9 of 40 discrepancies required contrast for further characterization. CONCLUSIONS In our study, most relevant radiologic findings in patients with growth hormone deficiency, central precocious puberty, and short stature were detectable without contrast, providing evidence that contrast can be avoided in routine MR imaging evaluation of these indications. We propose a "rapid noncontrast pituitary" MR imaging protocol for pediatric patients presenting with growth hormone deficiency, central precocious puberty, or short stature, which may increase efficiency and decrease contrast and anesthesia exposure.
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Affiliation(s)
- J Huang
- From the Department of Radiology (J.H., A.S., S.L., S.P.), Vanderbilt University Medical Center, Nashville, Tennessee
| | - A Sarma
- From the Department of Radiology (J.H., A.S., S.L., S.P.), Vanderbilt University Medical Center, Nashville, Tennessee
| | - N Gupta
- Division of Pediatric Endocrinology and Diabetes (N.G.), Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - S Little
- From the Department of Radiology (J.H., A.S., S.L., S.P.), Vanderbilt University Medical Center, Nashville, Tennessee
| | - S Pruthi
- From the Department of Radiology (J.H., A.S., S.L., S.P.), Vanderbilt University Medical Center, Nashville, Tennessee
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Gupta N, Kapur S. Medical publishing: a flawed model in dire need of reform. Eur J Psychiatry 2021; 37:136-138. [PMID: 34511685 PMCID: PMC8418935 DOI: 10.1016/j.ejpsy.2020.12.001] [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] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 12/01/2020] [Indexed: 11/16/2022]
Abstract
Recently, in the midst of the Covid-19 pandemic, high-profile retractions of some papers published in prestigious medical journals have highlighted the necessity for structural reform to the current model of medical publishing. We discuss what ails the current system and what can be done to remedy it.
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Affiliation(s)
- N Gupta
- Speciality Trainee ST6, General Adult Community Mental Health Team, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | - S Kapur
- Pain Management & Anaesthesia, University Hospital Birmingham, Birmingham, UK
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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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Dutta A, Gupta N, Walia R, Bhansali A, Dutta P, Bhadada SK, Pivonello R, Ahuja CK, Dhandapani S, Hajela A, Simeoli C, Sachdeva N, Saikia UN. Remission in Cushing's disease is predicted by cortisol burden and its withdrawal following pituitary surgery. J Endocrinol Invest 2021; 44:1869-1878. [PMID: 33453019 DOI: 10.1007/s40618-020-01495-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 12/26/2020] [Indexed: 12/16/2022]
Abstract
AIM To ascertain the predictors of remission and relapse in patients of Cushing's disease (CD) undergoing pituitary transsphenoidal surgery (TSS). METHODS Patients with CD subjected to TSS over 35 years at a tertiary care center were included. Patients were grouped into remission and persistent disease at 1 year after surgery, and were further followed up for relapse. Demographic, clinical, biochemical, histological, radiological and post-operative follow-up parameters were analyzed. RESULTS Of the 152 patients of CD, 145 underwent TSS. Remission was achieved in 95 (65.5%) patients at 1 year. Patients in remission had shorter duration of symptoms prior to presentation (p = 0.009), more frequent presence of proximal myopathy (p = 0.038) and a tumor size of < 2.05 cm (p = 0.016) in comparison to those with persistent disease. Post-TSS, immediate post-operative 0800-h cortisol (< 159.85 nmol/L; p = 0.001), histological confirmation of tumor (p = 0.045), duration of glucocorticoid replacement (median 90 days; p = 0.001), non-visualization of tumor on MRI (p = 0.003), new-onset hypogonadism (p = 0.001), 3-month 0800-h cortisol (< 384.9 nmol/L; p = 0.001), resolution of diabetes (p = 0.001) and hypertension (p = 0.001), and recovery of hypothalamic-pituitary-adrenal axis (p = 0.018) favored remission. In logistic regression model, requirement of glucocorticoid replacement (p = 0.033), and resolution of hypertension post-TSS (p = 0.003) predicted remission. None of the parameters could predict relapse. CONCLUSION The study could ascertain the predictors of remission in CD. Apart from the tumor characteristics, surgical aspects and low post-operative 0800-h cortisol, the results suggest that baseline clinical parameters, longer glucocorticoid replacement, and resolution of metabolic complications post-TSS predict remission in CD. Long-term follow-up is essential to look for relapse.
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Affiliation(s)
- A Dutta
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Nehru Extension block, Chandigarh, 160012, India
| | - N Gupta
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Nehru Extension block, Chandigarh, 160012, India
| | - R Walia
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Nehru Extension block, Chandigarh, 160012, India.
| | - A Bhansali
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Nehru Extension block, Chandigarh, 160012, India
| | - P Dutta
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Nehru Extension block, Chandigarh, 160012, India
| | - S K Bhadada
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Nehru Extension block, Chandigarh, 160012, India
| | - R Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
| | - C K Ahuja
- Department of Radiology, PGIMER, Chandigarh, India
| | - S Dhandapani
- Department of Neurosurgery, PGIMER, Chandigarh, India
| | - A Hajela
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Nehru Extension block, Chandigarh, 160012, India
| | - C Simeoli
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
| | - N Sachdeva
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Nehru Extension block, Chandigarh, 160012, India
| | - U N Saikia
- Department of Histopathology, PGIMER, Chandigarh, India
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Alagarasu K, Patil JA, Kakade MB, More AM, Yogesh B, Newase P, Jadhav SM, Parashar D, Kaur H, Gupta N, Vijay N, Narayan J, Shah PS. Serotype and genotype diversity of dengue viruses circulating in India: a multi-centre retrospective study involving the Virus Research Diagnostic Laboratory Network in 2018. Int J Infect Dis 2021; 111:242-252. [PMID: 34428547 DOI: 10.1016/j.ijid.2021.08.045] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES A retrospective study was undertaken to investigate the circulating dengue virus (DENV) serotypes and genotypes in India in 2018. METHODS In total, 4963 samples referred to virus research diagnostic laboratories (n=21), the Indian Council of Medical Research-National Institute of Virology (ICMR-NIV) and ICMR-NIV field units (n=2) for diagnosis of dengue in 2018 were tested using a real-time reverse transcription polymerase chain reaction assay for the presence of DENV serotypes. Representative samples were sequenced for the envelope (E) gene. RESULTS Regional diversity was observed with regard to the dominant circulating serotypes. DENV-2 was found to be the most common serotype in many states. Thrombocytopenia, petechiae and malaise were associated with DENV-2 infection. Phylogenetic analyses of DENV E gene sequences revealed the circulation of genotypes I and V of DENV-1, two lineages of DENV-2 genotype IV, DENV-3 genotype III and DENV-4 genotype I. CONCLUSIONS This study found regional differences in the prevalence of circulating DENV serotypes in India, and provides baseline data for continuous molecular surveillance. Molecular surveillance may have implications for predicting large-scale outbreaks of dengue if regional shifts in the predominantly circulating serotypes and genotypes are detected during the early phase of the dengue season.
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Affiliation(s)
- K Alagarasu
- Dengue and Chikungunya Group, ICMR-National Institute of Virology, Pune, Maharashtra, India.
| | - J A Patil
- Dengue and Chikungunya Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - M B Kakade
- Dengue and Chikungunya Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - A M More
- Dengue and Chikungunya Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - B Yogesh
- Dengue and Chikungunya Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - P Newase
- Dengue and Chikungunya Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - S M Jadhav
- Dengue and Chikungunya Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - D Parashar
- Dengue and Chikungunya Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - H Kaur
- Virology Unit, Indian Council of Medical Research, New Delhi, India
| | - N Gupta
- Virology Unit, Indian Council of Medical Research, New Delhi, India
| | - N Vijay
- Virology Unit, Indian Council of Medical Research, New Delhi, India
| | - J Narayan
- Virology Unit, Indian Council of Medical Research, New Delhi, India
| | - P S Shah
- Dengue and Chikungunya Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
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Bhardwaj SC, Kumar S, Gangwar OP, Prasad P, Kashyap PL, Khan H, Savadi S, Singh GP, Gupta N, Thakur R. Physiologic Specialization and Genetic Differentiation of Puccinia triticina Causing Leaf Rust of Wheat on the Indian Subcontinent During 2016 to 2019. Plant Dis 2021; 105:1992-2000. [PMID: 33439038 DOI: 10.1094/pdis-06-20-1382-re] [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] [Indexed: 06/12/2023]
Abstract
Wheat is the second most cultivated cereal crop in the world and is an important crop in India. Leaf (brown) rust, caused by Puccinia triticina, was the most prevalent among the three rusts found in all the wheat-growing areas of India, Bhutan, and Nepal during 2016 to 2019. Leaf rust samples from wheat crops in these countries were pathotyped using the wheat differential genotypes and binomial Indian system of nomenclature. To facilitate international communication, each pathotype identified was also tested using the North American differentials. A total of 33 pathotypes were identified from 1,086 samples, including three new pathotypes: 61R47 (162-5 = KHTPM) and 93R49 (49 = NHKTN) from India and 93R57 (20-1 = NHKTN) from Nepal. Two pathotypes, 121R60-1 (77-9/52 = MHTKL) and 121R63-1 (77-5 = THTTM), accounted for 79.46% of the population. Virulence on Lr19 was identified in 0.27% of the samples from Nepal only. The proportion of pathotype 121R60-1 (77-9 = MHTKL) increased to 57.55% during these years. Virulence was not observed on Lr9, Lr24, Lr25, Lr28, Lr32, Lr39, Lr45, and Lr47 in the population of the Indian subcontinent. Eighteen polymorphic simple sequence repeat (SSR) primer pairs tested on the isolates amplified 48 alleles with an average of 2.66 alleles per primer pair. Based on SSR genotyping, these pathotypes could be grouped into two clades with another two subclades each. Many of the Lr genes present in Indian wheat germplasm (Lr1, Lr3a, Lr10, Lr11, Lr14a, Lr15, Lr16, Lr17, Lr20, Lr23, and Lr26) were ineffective for a majority of pathotypes. Most of these varieties possessed a high degree of leaf rust resistance. The field resistance of wheat varieties could be attributed to the interaction of genes, unknown resistance, or adult plant resistance.
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Affiliation(s)
- S C Bhardwaj
- ICAR-Indian Institute of Wheat and Barley Research, Regional Station, Flowerdale, Shimla, Himachal Pradesh 171002, India
| | - S Kumar
- ICAR-Indian Institute of Wheat and Barley Research, Regional Station, Flowerdale, Shimla, Himachal Pradesh 171002, India
| | - O P Gangwar
- ICAR-Indian Institute of Wheat and Barley Research, Regional Station, Flowerdale, Shimla, Himachal Pradesh 171002, India
| | - P Prasad
- ICAR-Indian Institute of Wheat and Barley Research, Regional Station, Flowerdale, Shimla, Himachal Pradesh 171002, India
| | - P L Kashyap
- ICAR-Indian Institute of Wheat and Barley Research, Karnal, Haryana 132001, India
| | - H Khan
- ICAR-Indian Institute of Wheat and Barley Research, Karnal, Haryana 132001, India
| | - S Savadi
- ICAR-Directorate of Cashew Research, Karnataka 574202, India
| | - G P Singh
- ICAR-Indian Institute of Wheat and Barley Research, Karnal, Haryana 132001, India
| | - N Gupta
- ICAR-Indian Institute of Wheat and Barley Research, Regional Station, Flowerdale, Shimla, Himachal Pradesh 171002, India
| | - R Thakur
- ICAR-Indian Institute of Wheat and Barley Research, Regional Station, Flowerdale, Shimla, Himachal Pradesh 171002, India
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Pal R, Bhadada SK, Gupta N, Behera A, Aggarwal N, Aggarwal A, Raviteja KV, Saikia UN, Kaur G, Arvindbhai SM, Walia R. Primary hyperparathyroidism in pregnancy: observations from the Indian PHPT registry. J Endocrinol Invest 2021; 44:1425-1435. [PMID: 33037580 DOI: 10.1007/s40618-020-01441-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/29/2020] [Indexed: 01/12/2023]
Abstract
PURPOSE To present the data on primary hyperparathyroidism (PHPT) in pregnancy from India obtained from a large database maintained over 15 years. METHODS We retrieved data of all women with gestational PHPT from the Indian PHPT registry between July 2005 and January 2020, and compared their clinical, biochemical, and other characteristics with age-matched non-pregnant women with PHPT. RESULTS Out of 386 women, eight had gestational PHPT (2.1%). The common presenting manifestations were acute pancreatitis (50%) and renal stone disease (50%); two were asymptomatic. Five women (62.5%) had a history of prior miscarriages. Seven patients (88%) had preeclampsia during the present gestation. Serum calcium and intact parathyroid hormone (iPTH) were not statistically different from the age-matched non-pregnant PHPT group. Six patients with mild-to-moderate hypercalcemia were medically managed with hydration with/without cinacalcet while one patient underwent percutaneous ethanol ablation of the parathyroid adenoma; none underwent surgery during pregnancy. Mean serum calcium maintained from treatment initiation till delivery was 10.5 ± 0.4 mg/dl. One patient had spontaneous preterm delivery at 36 weeks; the remaining patients had normal vaginal delivery at term. None had severe preeclampsia/eclampsia. Fetal outcomes included low birth weight in three newborns (37.5%); two of them had hypocalcemic seizures. CONCLUSION The prevalence of gestational PHPT was 2.1% in this largest Indian PHPT cohort, which is higher than that reported from the West (< 1%). Gestational PHPT can lead to preeclampsia and miscarriage. Pregnant PHPT patients with mild-to-moderate hypercalcemia can be managed with hydration/cinacalcet; however, long-term safety data and large-scale randomized controlled trials are required.
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Affiliation(s)
- R Pal
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - S K Bhadada
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
| | - N Gupta
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - A Behera
- Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - N Aggarwal
- Department of Gynecology and Obstetrics, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - A Aggarwal
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - K V Raviteja
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - U N Saikia
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - G Kaur
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - S M Arvindbhai
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - R Walia
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
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Gupta N, Cullison C, Mally A, Xiang L, Hill ST, Beveridge MG. Certain public-reported immune-mediated adverse events for PD-1 inhibitors in melanoma occur at higher rates than in clinical trials. J Eur Acad Dermatol Venereol 2021; 35:e667-e670. [PMID: 34014567 DOI: 10.1111/jdv.17373] [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] [Received: 01/18/2021] [Revised: 03/30/2021] [Accepted: 04/28/2021] [Indexed: 11/29/2022]
Affiliation(s)
- N Gupta
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - C Cullison
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - A Mally
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - L Xiang
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - S T Hill
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - M G Beveridge
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
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