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Deepak , Rao P, Archana , Sowmya M, Sandeep S, Suma S. A CROSS-SECTIONAL STUDY ON COVID-19 VACCINATION HESITATION AMONG UNIVERSITY STUDENTS. Georgian Med News 2024:19-23. [PMID: 38609107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
Students serve as ambassadors, conveying effective messages to encourage the adoption of promotes healthy behaviors. Recognizing their consciousness about corona illness 2019 (COVID-19), desires to utilize the COVID-19 vaccines, and other associated variables will aid in developing viable vaccination promotion tactics for the present COVID-19 pandemic. A transverse-segment internet poll of university students in the healthcare and non-healthcare industries was conducted to analyze their motivations to be vaccinated against the coronavirus. To recruit research participants, a random snowball sampling approach was utilized using digital media sites and mails. The contestants were chosen from throughout India, including several main geographic areas, between Nov-2020 and Jan-2021, prior to the release of the COVID-19 vaccination. There were descriptive metrics utilized to illustrate the research participants' socio-demographics and vaccine-related behaviors. Using logistic regression modeling, key characteristics that are expected to influence vaccination uptake among students were modeled. p 0.06 was judged substantial in each study. 656 students participated in the study, with 48.4% coming from the healthcare sector & 51.5% from other fields. Of these 655 students, 43.6 and 22.4% came from India's northern and eastern areas. Graduate students accounted for 41.1% of the total population, and graduates for around 43.2%. The age range of 56.0% of the students was 18 to 25. Women made up 62% of the population, and 69.5% of them were unmarried. Seventy-eight percent of the students were from the medium socioeconomic level. Concerns about side effects and safety, distrust of government officials, and questions about the vaccine's efficacy were among the reasons given by students in this study for their reluctance to get vaccinated. It is essential to remember that these investigations were carried out at various times and in various nations; thus, the conclusions may not apply to all college students throughout the globe. According to the findings of this research, Indian university students showed rather a great deal of motivating desire to acquire COVID-19 immunizations. The people were either doubtful or reluctant to get the vaccination, which suggests possible vaccine aversion. There is a need for information campaigns and other actions to lessen vaccine hesitancy in order to promote the usage of COVID-19 vaccines.
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Affiliation(s)
- - Deepak
- 1Naturopathy Registration Board Under the aegis of National Institute of Naturopathy, Pune, India
| | - P Rao
- 2Oral Pathology and Microbiology, Bharati Vidyapeeth (Deemed to be university) Dental College and Hospital, Pune, Maharashtra, India
| | - - Archana
- 3Department of Yoga, Alva's College of Naturopathy and Yogic Sciences, Moodbidri, India
| | - M Sowmya
- 4Government of Nature Cure and Yoga Medical College and Teaching Hospital, Mysore, India
| | - S Sandeep
- 5Department of Clinical Naturopathy & Department of Research Methodology and Recent Advances; Govt Nature Cure and Yoga Medical College and Hospital Mysore, Karnataka, India
| | - S Suma
- 6Government Nature Cure and Yoga Medical College, Mysore, India
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Liu J, Nabavizadeh P, Rao P, Derakhshandeh R, Han DD, Guo R, Murphy MB, Cheng J, Schick SF, Springer ML. Impairment of Endothelial Function by Aerosol From Marijuana Leaf Vaporizers. J Am Heart Assoc 2023; 12:e032969. [PMID: 38014661 PMCID: PMC10727338 DOI: 10.1161/jaha.123.032969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 11/02/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Marijuana leaf vaporizers, which heat plant material and sublimate Δ-9-tetrahydrocannabinol without combustion, are popular alternatives to smoking cannabis that are generally perceived to be less harmful. We have shown that smoke from tobacco and marijuana, as well as aerosol from e-cigarettes and heated tobacco products, impair vascular endothelial function in rats measured as arterial flow-mediated dilation (FMD). METHODS AND RESULTS We exposed 8 rats per group to aerosol generated by 2 vaporizer systems (Volcano and handheld Yocan) using marijuana with varying Δ-9-tetrahydrocannabinol levels, in a single pulsatile exposure session of 2 s/min over 5 minutes, and measured changes in FMD. To model secondhand exposure, we exposed rats for 1 minute to diluted aerosol approximating release of uninhaled Volcano aerosol into typical residential rooms. Exposure to aerosol from marijuana with and without cannabinoids impaired FMD by ≈50%. FMD was similarly impaired by aerosols from Yocan (237 °C), and from Volcano at both its standard temperature (185 °C) and the minimum sublimation temperature of Δ-9-tetrahydrocannabinol (157 °C), although the low-temperature aerosol condition did not effectively deliver Δ-9-tetrahydrocannabinol to the circulation. Modeled secondhand exposure based on diluted Volcano aerosol also impaired FMD. FMD was not affected in rats exposed to clean air or water vapor passed through the Volcano system. CONCLUSIONS Acute direct exposure and modeled secondhand exposure to marijuana leaf vaporizer aerosol, regardless of cannabinoid concentration or aerosol generation temperature, impair endothelial function in rats comparably to marijuana smoke. Our findings indicate that use of leaf vaporizers is unlikely to reduce the vascular risk burden of smoking marijuana.
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Affiliation(s)
- Jiangtao Liu
- Cardiovascular Research Institute, University of California, San FranciscoSan FranciscoCAUSA
- Division of CardiologyUniversity of California, San FranciscoSan FranciscoCAUSA
| | - Pooneh Nabavizadeh
- Cardiovascular Research Institute, University of California, San FranciscoSan FranciscoCAUSA
- Present address:
Division of CardiologyUniversity of CincinnatiCincinnatiOHUSA
| | - Poonam Rao
- Division of CardiologyUniversity of California, San FranciscoSan FranciscoCAUSA
- Center for Tobacco Control Research and EducationUniversity of California, San FranciscoSan FranciscoCAUSA
- Present address:
Christus Good Shepherd/Texas A&M University Internal Medicine Residency ProgramLongviewTXUSA
| | - Ronak Derakhshandeh
- Division of CardiologyUniversity of California, San FranciscoSan FranciscoCAUSA
| | - Daniel D. Han
- Division of CardiologyUniversity of California, San FranciscoSan FranciscoCAUSA
- Present address:
School of Medicine and DentistryUniversity of RochesterRochesterNYUSA
| | - Raymond Guo
- Division of CardiologyUniversity of California, San FranciscoSan FranciscoCAUSA
- Present address:
Stanford UniversityStanfordCAUSA
| | - Morgan B. Murphy
- Division of Occupational and Environmental MedicineUniversity of California, San FranciscoSan FranciscoCAUSA
- Present address:
Sutter Health California Pacific Medical CenterStanfordCAUSA
| | - Jing Cheng
- Division of Oral Epidemiology and Dental Public HealthUniversity of California, San FranciscoSan FranciscoCAUSA
| | - Suzaynn F. Schick
- Center for Tobacco Control Research and EducationUniversity of California, San FranciscoSan FranciscoCAUSA
- Division of Occupational and Environmental MedicineUniversity of California, San FranciscoSan FranciscoCAUSA
| | - Matthew L. Springer
- Cardiovascular Research Institute, University of California, San FranciscoSan FranciscoCAUSA
- Division of CardiologyUniversity of California, San FranciscoSan FranciscoCAUSA
- Center for Tobacco Control Research and EducationUniversity of California, San FranciscoSan FranciscoCAUSA
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Han DD, Rao P, Qiu H, Navabzadeh M, Wang X, Goyal N, Mohammadi L, Huang A, Perez BG, Schick SF, Springer ML. Impairment of Endothelial Function by Cigarette Smoke and e-Cigarette Aerosol Requires RAGE. Arterioscler Thromb Vasc Biol 2023; 43:2369-2371. [PMID: 37795616 PMCID: PMC10841038 DOI: 10.1161/atvbaha.123.319514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Affiliation(s)
- Daniel D. Han
- Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, CA
- Present address: School of Medicine & Dentistry, University of Rochester, Rochester, NY
| | - Poonam Rao
- Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, CA
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA
- Present address: CHRISTUS Good Shepherd/Texas A&M University Internal Medicine Residency Program, Longview, TX
| | - Huiliang Qiu
- Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, CA
- Present address: Department of Cardiovascular Diseases, Physiology and Biomedical Engineering, Mayo Clinic Arizona, Scottsdale, AZ
| | - Mina Navabzadeh
- Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, CA
| | - Xiaoyin Wang
- Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, CA
| | - Natasha Goyal
- Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, CA
| | - Leila Mohammadi
- Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, CA
| | - Abel Huang
- Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
| | - Bryanna G. Perez
- Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
| | - Suzaynn F. Schick
- Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
| | - Matthew L. Springer
- Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, CA
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA
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Wang X, Gaur M, Mounzih K, Rodriguez HJ, Qiu H, Chen M, Yan L, Cooper BA, Narayan S, Derakhshandeh R, Rao P, Han DD, Nabavizadeh P, Springer ML, John CM. Inhibition of galectin-3 post-infarction impedes progressive fibrosis by regulating inflammatory profibrotic cascades. Cardiovasc Res 2023; 119:2536-2549. [PMID: 37602717 PMCID: PMC10676456 DOI: 10.1093/cvr/cvad116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 04/02/2023] [Accepted: 05/12/2023] [Indexed: 08/22/2023] Open
Abstract
AIMS Acute myocardial infarction (MI) causes inflammation, collagen deposition, and reparative fibrosis in response to myocyte death and, subsequently, a pathological myocardial remodelling process characterized by excessive interstitial fibrosis, driving heart failure (HF). Nonetheless, how or when to limit excessive fibrosis for therapeutic purposes remains uncertain. Galectin-3, a major mediator of organ fibrosis, promotes cardiac fibrosis and remodelling. We performed a preclinical assessment of a protein inhibitor of galectin-3 (its C-terminal domain, Gal-3C) to limit excessive fibrosis resulting from MI and prevent ventricular enlargement and HF. METHODS AND RESULTS Gal-3C was produced by enzymatic cleavage of full-length galectin-3 or by direct expression of the truncated form in Escherichia coli. Gal-3C was intravenously administered for 7 days in acute MI models of young and aged rats, starting either pre-MI or 4 days post-MI. Echocardiography, haemodynamics, histology, and molecular and cellular analyses were performed to assess post-MI cardiac functionality and pathological fibrotic progression. Gal-3C profoundly benefitted left ventricular ejection fraction, end-systolic and end-diastolic volumes, haemodynamic parameters, infarct scar size, and interstitial fibrosis, with better therapeutic efficacy than losartan and spironolactone monotherapies over the 56-day study. Gal-3C therapy in post-MI aged rats substantially improved pump function and attenuated ventricular dilation, preventing progressive HF. Gal-3C in vitro treatment of M2-polarized macrophage-like cells reduced their M2-phenotypic expression of arginase-1 and interleukin-10. Gal-3C inhibited M2 polarization of cardiac macrophages during reparative response post-MI. Gal-3C impeded progressive fibrosis post-MI by down-regulating galectin-3-mediated profibrotic signalling cascades including a reduction in endogenous arginase-1 and inducible nitric oxide synthase (iNOS). CONCLUSION Gal-3C treatment improved long-term cardiac function post-MI by reduction in the wound-healing response, and inhibition of inflammatory fibrogenic signalling to avert an augmentation of fibrosis in the periinfarct region. Thus, Gal-3C treatment prevented the infarcted heart from extensive fibrosis that accelerates the development of HF, providing a potential targeted therapy.
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Affiliation(s)
- Xiaoyin Wang
- Division of Cardiology, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA
- Cardiovascular Research Institute, University of California, San Francisco, 555 Mission Bay Boulevard South, San Francisco, CA 94158, USA
| | - Meenakshi Gaur
- MandalMed, Inc., 665 3rd Street, Suite 250, San Francisco, CA 94107, USA
| | - Khalid Mounzih
- MandalMed, Inc., 665 3rd Street, Suite 250, San Francisco, CA 94107, USA
| | - Hilda J Rodriguez
- Division of Cardiology, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA
- Cardiovascular Research Institute, University of California, San Francisco, 555 Mission Bay Boulevard South, San Francisco, CA 94158, USA
- MandalMed, Inc., 665 3rd Street, Suite 250, San Francisco, CA 94107, USA
| | - Huiliang Qiu
- Division of Cardiology, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA
- Cardiovascular Research Institute, University of California, San Francisco, 555 Mission Bay Boulevard South, San Francisco, CA 94158, USA
| | - Ming Chen
- Division of Cardiology, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA
| | - Liqiu Yan
- Division of Cardiology, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA
| | - Brian A Cooper
- MandalMed, Inc., 665 3rd Street, Suite 250, San Francisco, CA 94107, USA
| | - Shilpa Narayan
- Division of Cardiology, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA
- Cardiovascular Research Institute, University of California, San Francisco, 555 Mission Bay Boulevard South, San Francisco, CA 94158, USA
| | - Ronak Derakhshandeh
- Division of Cardiology, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA
- Cardiovascular Research Institute, University of California, San Francisco, 555 Mission Bay Boulevard South, San Francisco, CA 94158, USA
| | - Poonam Rao
- Division of Cardiology, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA
- Cardiovascular Research Institute, University of California, San Francisco, 555 Mission Bay Boulevard South, San Francisco, CA 94158, USA
| | - Daniel D Han
- Division of Cardiology, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA
| | - Pooneh Nabavizadeh
- Cardiovascular Research Institute, University of California, San Francisco, 555 Mission Bay Boulevard South, San Francisco, CA 94158, USA
| | - Matthew L Springer
- Division of Cardiology, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA
- Cardiovascular Research Institute, University of California, San Francisco, 555 Mission Bay Boulevard South, San Francisco, CA 94158, USA
| | - Constance M John
- MandalMed, Inc., 665 3rd Street, Suite 250, San Francisco, CA 94107, USA
- Department of Laboratory Medicine, University of California, San Francisco, 185 Berry Street, Suite 100, San Francisco, CA 94143, USA
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Rao P, Undavalli C, Ghoweba M, Kanuparthy A, Vahdat K. Platypnea Orthodeoxia Syndrome Secondary to a Persistent Eustachian Valve. Cureus 2023; 15:e42900. [PMID: 37664400 PMCID: PMC10474851 DOI: 10.7759/cureus.42900] [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: 08/03/2023] [Indexed: 09/05/2023] Open
Abstract
Platypnea-Orthodeoxia syndrome (POS) is a rare and poorly understood syndrome characterized by platypnea and oxygen desaturation in the upright position that is relieved by recumbency. Here, we report a case of an 84-year-old woman who had chronic hypoxia in an upright position despite using home oxygen. The patient presented for hypoxia evaluation and was noted to have a restrictive pattern on pulmonary function tests (PFT). An echocardiogram showed a prominent eustachian valve extending from inferior to superior vena cava with contrast approaching the interatrial septum. The patient had a complete resolution of her platypnea following the closure of the patent foramen ovale.
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Affiliation(s)
- Poonam Rao
- Internal Medicine, CHRISTUS Health/Texas A&M School of Medicine Internal Medicine Residency Program, Longview, USA
| | - Chaitanya Undavalli
- Internal Medicine, CHRISTUS Health/Texas A&M School of Medicine Internal Medicine Residency Program, Longview, USA
| | - Mohamed Ghoweba
- Internal Medicine, Texas A&M College of Medicine/CHRISTUS Good Shepherd Medical Center, Longview, USA
| | - Aparna Kanuparthy
- Internal Medicine, CHRISTUS Health/Texas A&M School of Medicine Internal Medicine Residency Program, Longview, USA
| | - Khashayar Vahdat
- Cardiology, CHRISTUS Health/Texas A&M School of Medicine Internal Medicine Residency Program, Longview, USA
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Qiu H, Zhang H, Han DD, Derakhshandeh R, Wang X, Goyal N, Navabzadeh M, Rao P, Wilson EE, Mohammadi L, Olgin JE, Springer ML. Increased vulnerability to atrial and ventricular arrhythmias caused by different types of inhaled tobacco or marijuana products. Heart Rhythm 2023; 20:76-86. [PMID: 36603937 PMCID: PMC10006068 DOI: 10.1016/j.hrthm.2022.09.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/01/2022] [Accepted: 09/09/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND The emergence of a plethora of new tobacco products marketed as being less harmful than smoking, such as electronic cigarettes and heated tobacco products, and the increased popularity of recreational marijuana have raised concerns about the potential cardiovascular risk associated with their use. OBJECTIVE The purpose of this study was to investigate whether the use of novel tobacco products or marijuana can cause the development of proarrhythmic substrate and eventually lead to arrhythmias. METHODS Rats were exposed to smoke from tobacco, marijuana, or cannabinoid-depleted marijuana, to aerosol from electronic cigarettes or heated tobacco products, or to clean air once per day for 8 weeks, following by assays for blood pressure, cardiac function, ex vivo electrophysiology, and histochemistry. RESULTS The rats exposed to tobacco or marijuana products exhibited progressively increased systolic blood pressure, decreased cardiac systolic function with chamber dilation, and reduced overall heart rate variability, relative to the clean air negative control group. Atrial fibrillation and ventricular tachycardia testing by ex vivo optical mapping revealed a significantly higher susceptibility to each, with a shortened effective refractory period and prolonged calcium transient duration. Histological analysis indicated that in all exposure conditions except for air, exposure to smoke or aerosol from tobacco or marijuana products caused severe fibrosis with decreased microvessel density and higher level of sympathetic nerve innervation. CONCLUSION These pathophysiological results indicate that tobacco and marijuana products can induce arrhythmogenic substrates involved in cardiac electrical, structural, and neural remodeling, facilitating the development of arrhythmias.
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Affiliation(s)
- Huiliang Qiu
- Division of Cardiology, University of California, San Francisco, San Francisco, California
| | - Hao Zhang
- Division of Cardiology, University of California, San Francisco, San Francisco, California
| | - Daniel D Han
- Division of Cardiology, University of California, San Francisco, San Francisco, California
| | - Ronak Derakhshandeh
- Division of Cardiology, University of California, San Francisco, San Francisco, California
| | - Xiaoyin Wang
- Division of Cardiology, University of California, San Francisco, San Francisco, California
| | - Natasha Goyal
- Division of Cardiology, University of California, San Francisco, San Francisco, California
| | - Mina Navabzadeh
- Division of Cardiology, University of California, San Francisco, San Francisco, California
| | - Poonam Rao
- Division of Cardiology, University of California, San Francisco, San Francisco, California
| | - Emily E Wilson
- Division of Cardiology, University of California, San Francisco, San Francisco, California
| | - Leila Mohammadi
- Division of Cardiology, University of California, San Francisco, San Francisco, California
| | - Jeffrey E Olgin
- Division of Cardiology, University of California, San Francisco, San Francisco, California; Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California
| | - Matthew L Springer
- Division of Cardiology, University of California, San Francisco, San Francisco, California; Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California; Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, California.
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Mohammadi L, Han DD, Xu F, Huang A, Derakhshandeh R, Rao P, Whitlatch A, Cheng J, Keith RJ, Hamburg NM, Ganz P, Hellman J, Schick SF, Springer ML. Chronic E-Cigarette Use Impairs Endothelial Function on the Physiological and Cellular Levels. Arterioscler Thromb Vasc Biol 2022; 42:1333-1350. [PMID: 36288290 PMCID: PMC9625085 DOI: 10.1161/atvbaha.121.317749] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [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: 06/14/2022] [Accepted: 09/14/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The harmful vascular effects of smoking are well established, but the effects of chronic use of electronic cigarettes (e-cigarettes) on endothelial function are less understood. We hypothesized that e-cigarette use causes changes in blood milieu that impair endothelial function. METHODS Endothelial function was measured in chronic e-cigarette users, chronic cigarette smokers, and nonusers. We measured effects of participants' sera, or e-cigarette aerosol condensate, on NO and H2O2 release and cell permeability in cultured endothelial cells (ECs). RESULTS E-cigarette users and smokers had lower flow-mediated dilation (FMD) than nonusers. Sera from e-cigarette users and smokers reduced VEGF (vascular endothelial growth factor)-induced NO secretion by ECs relative to nonuser sera, without significant reduction in endothelial NO synthase mRNA or protein levels. E-cigarette user sera caused increased endothelial release of H2O2, and more permeability than nonuser sera. E-cigarette users and smokers exhibited changes in circulating biomarkers of inflammation, thrombosis, and cell adhesion relative to nonusers, but with distinct profiles. E-cigarette user sera had higher concentrations of the receptor for advanced glycation end products (RAGE) ligands S100A8 and HMGB1 (high mobility group box 1) than smoker and nonuser sera, and receptor for advanced glycation end product inhibition reduced permeability induced by e-cigarette user sera but did not affect NO production. CONCLUSIONS Chronic vaping and smoking both impair FMD and cause changes in the blood that inhibit endothelial NO release. Vaping, but not smoking, causes changes in the blood that increase microvascular endothelial permeability and may have a vaping-specific effect on intracellular oxidative state. Our results suggest a role for RAGE in e-cigarette-induced changes in endothelial function.
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Affiliation(s)
- Leila Mohammadi
- Division of Cardiology (L.M., D.D.H., R.D., P.R., P.G., M.L.S.), University of California, San Francisco
| | - Daniel D Han
- Division of Cardiology (L.M., D.D.H., R.D., P.R., P.G., M.L.S.), University of California, San Francisco
- Now with School of Medicine and Dentistry, University of Rochester, NY (D.D.H.)
| | - Fengyun Xu
- Department of Anesthesia and Perioperative Care (F.X., J.H.), University of California, San Francisco
| | - Abel Huang
- Division of Occupational and Environmental Medicine (A.H., A.W., S.F.S.), University of California, San Francisco
| | - Ronak Derakhshandeh
- Division of Cardiology (L.M., D.D.H., R.D., P.R., P.G., M.L.S.), University of California, San Francisco
| | - Poonam Rao
- Division of Cardiology (L.M., D.D.H., R.D., P.R., P.G., M.L.S.), University of California, San Francisco
- Now with CHRISTUS Good Shepherd Internal Medicine Residency Program, Longview, TX (P.R.)
| | - Adam Whitlatch
- Division of Occupational and Environmental Medicine (A.H., A.W., S.F.S.), University of California, San Francisco
| | - Jing Cheng
- Division of Oral Epidemiology and Dental Public Health (J.C.), University of California, San Francisco
| | - Rachel J Keith
- Department of Medicine, University of Louisville Medical School, KY (R.J.K.)
| | - Naomi M Hamburg
- Department of Medicine, Boston University School of Medicine, MA (N.M.H.)
| | - Peter Ganz
- Division of Cardiology (L.M., D.D.H., R.D., P.R., P.G., M.L.S.), University of California, San Francisco
| | - Judith Hellman
- Department of Anesthesia and Perioperative Care (F.X., J.H.), University of California, San Francisco
| | - Suzaynn F Schick
- Division of Occupational and Environmental Medicine (A.H., A.W., S.F.S.), University of California, San Francisco
- Center for Tobacco Control Research and Education (S.F.S., M.L.S.), University of California, San Francisco
| | - Matthew L Springer
- Division of Cardiology (L.M., D.D.H., R.D., P.R., P.G., M.L.S.), University of California, San Francisco
- Center for Tobacco Control Research and Education (S.F.S., M.L.S.), University of California, San Francisco
- Cardiovascular Research Institute (M.L.S.), University of California, San Francisco
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Nabavizadeh P, Liu J, Rao P, Ibrahim S, Han DD, Derakhshandeh R, Qiu H, Wang X, Glantz SA, Schick SF, Springer ML. Impairment of Endothelial Function by Cigarette Smoke Is Not Caused by a Specific Smoke Constituent, but by Vagal Input From the Airway. Arterioscler Thromb Vasc Biol 2022; 42:1324-1332. [PMID: 36288292 PMCID: PMC9616206 DOI: 10.1161/atvbaha.122.318051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Exposure to tobacco or marijuana smoke, or e-cigarette aerosols, causes vascular endothelial dysfunction in humans and rats. We aimed to determine what constituent, or class of constituents, of smoke is responsible for endothelial functional impairment. METHODS We investigated several smoke constituents that we hypothesized to mediate this effect by exposing rats and measuring arterial flow-mediated dilation (FMD) pre- and post-exposure. We measured FMD before and after inhalation of sidestream smoke from research cigarettes containing normal and reduced nicotine level with and without menthol, as well as 2 of the main aldehyde gases found in both smoke and e-cigarette aerosol (acrolein and acetaldehyde), and inert carbon nanoparticles. RESULTS FMD was reduced by all 4 kinds of research cigarettes, with extent of reduction ranging from 20% to 46% depending on the cigarette type. While nicotine was not required for the impairment, higher nicotine levels in smoke were associated with a greater percent reduction of FMD (41.1±4.5% reduction versus 19.2±9.5%; P=0.047). Lower menthol levels were also associated with a greater percent reduction of FMD (18.5±9.8% versus 40.5±4.8%; P=0.048). Inhalation of acrolein or acetaldehyde gases at smoke-relevant concentrations impaired FMD by roughly 50% (P=0.001). However, inhalation of inert carbon nanoparticles at smoke-relevant concentrations with no gas phase also impaired FMD by a comparable amount (P<0.001). Bilateral cervical vagotomy blocked the impairment of FMD by tobacco smoke. CONCLUSIONS There is no single constituent or class of constituents responsible for acute impairment of endothelial function by smoke; rather, we propose that acute endothelial dysfunction by disparate inhaled products is caused by vagus nerve signaling initiated by airway irritation.
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Affiliation(s)
- Pooneh Nabavizadeh
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California
| | - Jiangtao Liu
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California
| | - Poonam Rao
- Division of Cardiology, University of California, San Francisco, San Francisco, California
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, California
| | - Sharina Ibrahim
- Division of Cardiology, University of California, San Francisco, San Francisco, California
| | - Daniel D. Han
- Division of Cardiology, University of California, San Francisco, San Francisco, California
| | - Ronak Derakhshandeh
- Division of Cardiology, University of California, San Francisco, San Francisco, California
| | - Huiliang Qiu
- Division of Cardiology, University of California, San Francisco, San Francisco, California
| | - Xiaoyin Wang
- Division of Cardiology, University of California, San Francisco, San Francisco, California
| | - Stanton A. Glantz
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California
- Division of Cardiology, University of California, San Francisco, San Francisco, California
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, California
| | - Suzaynn F. Schick
- Division of Occupational and Environmental Medicine, University of California, San Francisco, San Francisco, California
| | - Matthew L. Springer
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California
- Division of Cardiology, University of California, San Francisco, San Francisco, California
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, California
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9
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Shanthikumar S, Kim S, Giacalone V, Rao P, Ranganathan S, Karpievitch Y, Stick S, Boucher R, Tirouvanziam R, Chandler J, Esther C. 446 Metabolites in early life bronchoalveolar fluid associate with future bronchiectasis risk in children with cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01136-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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10
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Sharma S, Rao P. A study on Environment-friendly Lifestyle and other major factors influencing household recycling in India. CM 2022. [DOI: 10.18137/cardiometry.2022.23.489498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Waste Management in India has always been a severe problem, and tackling this issue would require a social mindset towards adopting green practices. This study aims to understand the consumer mindset and awareness of recycling in India and explore factors that could influence India’s recycling behavior. The data for this study has been obtained through a primary research – survey questionnaire. Correlation analysis and regression have been applied to understand the result of the questionnaire data. Promoting recycling amongst people takes into consideration many factors. The results suggest that recycling behavior is mostly influenced by factors, such as willingness to adopt environment-friendly behavior, awareness towards recycling, and providing incentives. This study aimed to explore recycling in India and study the major factors that can influence people to adopt recycling. It also explored a possible relationship between providing incentives and influencing recycling behavior. These findings will help to analyze and develop strategies to boost the recycling rate in India.
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11
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Rao P, Han DD, Tan K, Mohammadi L, Derakhshandeh R, Navabzadeh M, Goyal N, Springer ML. Comparable Impairment of Vascular Endothelial Function by a Wide Range of Electronic Nicotine Delivery Devices. Nicotine Tob Res 2022; 24:1055-1062. [PMID: 35100430 PMCID: PMC9199952 DOI: 10.1093/ntr/ntac019] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 09/28/2021] [Revised: 12/29/2021] [Accepted: 01/28/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Electronic nicotine delivery systems (ENDS; ie, vaping devices) such as e-cigarettes, heated tobacco products, and newer coil-less ultrasonic vaping devices are promoted as less harmful alternatives to combustible cigarettes. However, their cardiovascular effects are understudied. We investigated whether exposure to aerosol from a wide range of ENDS devices, including a new ultrasonic vaping device, impairs endothelial function. AIMS AND METHODS We measured arterial flow-mediated dilation (FMD) in rats (n = 8/group) exposed to single session of 10 cycles of pulsatile 5-second exposure over 5 minutes to aerosol from e-liquids with and without nicotine generated from a USONICIG ultrasonic vaping device, previous generation e-cigarettes, 5% nicotine JUUL pods (Virginia Tobacco, Mango, Menthol), and an IQOS heated tobacco product; with Marlboro Red cigarette smoke and clean air as controls. We evaluated nicotine absorption and serum nitric oxide levels after exposure, and effects of different nicotine acidifiers on platelet aggregation. RESULTS Aerosol/smoke from all conditions except air significantly impaired FMD. Serum nicotine varied widely from highest in the IQOS group to lowest in USONICIG and previous generation e-cig groups. Nitric oxide levels were not affected by exposure. Exposure to JUUL and similarly acidified nicotine salt e-liquids did not affect platelet aggregation rate. Despite lack of heating coil, the USONICIG under airflow conditions heated e-liquid to ~77°C. CONCLUSIONS A wide range of ENDS, including multiple types of e-cigarettes with and without nicotine, a heated tobacco product, and an ultrasonic vaping device devoid of heating coil, all impair FMD after a single vaping session comparably to combusted cigarettes. IMPLICATIONS The need to understand the cardiovascular effects of various ENDS is of timely importance, as we have seen a dramatic increase in the use of these products in recent years, along with the growing assumption among its users that these devices are relatively benign. Our conclusion that a single exposure to aerosol from a wide range of ENDS impairs endothelial function comparably to cigarettes indicates that vaping can cause similar acute vascular functional impairment to smoking and is not a harmless activity.
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Affiliation(s)
- Poonam Rao
- Division of Cardiology, University of California, San Francisco, San Francisco, CA, USA
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA, USA
| | - Daniel D Han
- Division of Cardiology, University of California, San Francisco, San Francisco, CA, USA
| | - Kelly Tan
- Division of Cardiology, University of California, San Francisco, San Francisco, CA, USA
| | - Leila Mohammadi
- Division of Cardiology, University of California, San Francisco, San Francisco, CA, USA
| | - Ronak Derakhshandeh
- Division of Cardiology, University of California, San Francisco, San Francisco, CA, USA
| | - Mina Navabzadeh
- Division of Cardiology, University of California, San Francisco, San Francisco, CA, USA
| | - Natasha Goyal
- Division of Cardiology, University of California, San Francisco, San Francisco, CA, USA
| | - Matthew L Springer
- Division of Cardiology, University of California, San Francisco, San Francisco, CA, USA
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA, USA
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA
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12
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Han DD, Qiu H, Wang X, Rao P, Navabzadeh M, Goyal N, Mohammadi L, Springer ML. Abstract 136: Vascular Impairment From Acute Exposure To E-cigarette Aerosol Is Rescued By Inhibition Of The Receptor For Advanced Glycation End Products (RAGE). Arterioscler Thromb Vasc Biol 2022. [DOI: 10.1161/atvb.42.suppl_1.136] [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: 12/02/2022]
Abstract
Introduction:
E-cigarette use is known to induce vascular impairment by altering vasomotor and cellular functions of the vascular wall, but the molecular mechanism of e-cigarette-induced vascular impairment is largely unexplored. We investigated whether inhibition of RAGE prevents impairment of vasomotor function from acute e-cigarette exposure
Hypothesis:
Impairment of endothelial vasodilatory function requires the activation of RAGE.
Methods:
Anesthetized rats (n=8/group) were exposed to aerosols from flavorless tank style e-cigarettes with and without freebase nicotine (12 mg/ml) or air in a single session of 10 cycles of pulsatile 5s exposure over 5 minutes. For each exposure condition, groups received either 1 mg/kg of RAGE inhibitor FPS-ZM1 or vehicle i.p. 1 hour before exposure (i.e., total of 6 groups). Femoral artery flow-mediated dilation (FMD) was measured using micro-ultrasound before and after exposure.
Results:
Exposure to e-cigarette aerosol with and without nicotine impaired FMD in vehicle groups (8.3±2.7% pre-exposure vs 4.7±2.4% post-exposure, p=0.01; 9.3±4.6% pre- vs 4.8±2.7% post-, p=0.03, respectively), with no change in air control (9.7±3.2% pre- vs 9.3±3.5% post-, p=0.81). Post-exposure FMD in both aerosol groups with vehicle was lower than that in the air group with vehicle (p=0.01 for each aerosol vs air). However, FPS-ZM1 prevented the FMD impairment by aerosol exposure (with nicotine 9.1±3.5% pre- vs 8.9±2.1% post-, p=0.90; without nicotine 9.5±4.3% pre- vs 7.1±2.0% post-, p=0.17), with no change in air control (7.6±2.7% pre- vs 7.4±3.1% post-, p=0.86). Post-exposure FMD values in both aerosol groups receiving FPS-ZM1 were comparable to the air control (p=0.4 and 0.8, respectively). There were no significant difference in post-exposure FMD in the air groups receiving FPS-ZM1 or vehicle (p>0.99).
Conclusions:
RAGE mediates e-cigarette-induced acute impairment of endothelial vasodilatory function.
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13
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Eldoadoa M, Aldarragi A, Rao P, Sian P, Kapoor V, Mazarakis N. 216 Open Versus Minimally Invasive Surgery (MIS) Transforaminal Lumbar Interbody Fusion (TLIF): A Single-Centre Experience. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Transforaminal Lumbar Interbody Fusion (TLIF) is a technique used for the management of various pathologies such as degenerative disc disease, recurrent disc herniations and spondylolisthesis, to mention the most common indications. There is an ongoing debate regarding the use of open versus minimally invasive techniques for TLIF. Each has its own advantages and disadvantages. In the present study, we aim to present our experience regarding the use of open vs MIS TLIF at Stepping Hill Hospital in Manchester.
Method
A retrospective observational cohort study involving 60 patients was conducted at Stepping Hill Hospital in the UK. Patients who had TLIF surgery between 2019 and 2020 were included. Patients were consecutively allocated to either the open TLIF or the MIS TLIF group. Data were collected from hospital records including pre- and post-operative follow up notes. We also assessed pain score using the visual analogue scale.
Results
26 patients underwent MIS TLIF whereas 34 patients underwent an open procedure. The MIS group showed better outcomes compared to the open group in terms of post-operative complications, improvement of symptoms and the average hospital stay: 7.6% vs 8.8%, 73.7% vs 58.8% and 1.82 vs 2.76 days, however, the open group had a lower rate of metalwork failure 8.8% vs 11.5% in the MIS.
Conclusions
Our study showed that MIS TLIF at our unit seems to result in better outcomes related to symptoms alleviation, post-operative complications and less hospital stay despite having a slightly higher rate of metalwork failure.
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Affiliation(s)
- M. Eldoadoa
- Department of Trauma & Orthopaedics, Stepping Hill Hospital, Stockport NHS Foundation Trust, Manchester, United Kingdom
| | - A. Aldarragi
- Department of Trauma & Orthopaedics, Stepping Hill Hospital, Stockport NHS Foundation Trust, Manchester, United Kingdom
| | - P. Rao
- Department of Trauma & Orthopaedics, Stepping Hill Hospital, Stockport NHS Foundation Trust, Manchester, United Kingdom
| | - P. Sian
- Department of Trauma & Orthopaedics, Stepping Hill Hospital, Stockport NHS Foundation Trust, Manchester, United Kingdom
| | - V. Kapoor
- Department of Trauma & Orthopaedics, Stepping Hill Hospital, Stockport NHS Foundation Trust, Manchester, United Kingdom
| | - N.K. Mazarakis
- Department of Trauma & Orthopaedics, Stepping Hill Hospital, Stockport NHS Foundation Trust, Manchester, United Kingdom
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14
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Ismael S, Manoharan G, Al-Kaisi K, George A, Abas S, Al Musabi M, Rao P, Singh R. 824 UK CoPACK Study: Health Care Workers Knowledge and Confidence in Using Personal Protective Equipment (PPE) And Related Anxiety Levels During The COVID-19 Pandemic. Br J Surg 2021. [PMCID: PMC8524503 DOI: 10.1093/bjs/znab259.479] [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: 11/15/2022]
Abstract
Abstract
Aim
The COVID-19 pandemic has resulted in significant pressures on the NHS. Healthcare workers (HCWs) are at increased risk of infection. Personal protective equipment (PPE) lowers the risk of infection transmission. However, during the early phases of the pandemic, the information available regarding COVD-19 and the use of PPE has been unclear, with constantly changing guidelines. The aim of this study was to determine the knowledge and confidence about PPE usage among HCWs, in addition to measuring their anxiety levels during the COVID pandemic.
Method
A validated questionnaire was distributed among HCWs in as many UK hospitals as possible, during April 2020. The questionnaire consisted of 13 questions regarding demographics, knowledge on PPE guidance, HCW training and confidence levels in PPE usage and finally anxiety levels measured using the GAD-7 psychometric tool.
Results
1055 responses were received. Nurses (49%), Healthcare Assistants (HCA - 20%), Doctors (17%), Physios (8%) and other (6%). 99% of respondents indicated they were familiar with PPE guidance, but only 1.6% answered all 3 questions on PPE guidance accurately. 86.4% of respondents received mask-fitting checks. 79.7% received donning-doffing training. Despite this, only 46.8% were confident on their familiarity with PPE. 32.5% felt that their hospital communication regarding PPE policy during COVID-19 pandemic was poor or very poor. 30% HCWs experienced severe anxiety.
Conclusions
National guidance and local training on PPE usage during the COVID-19 pandemic has been unsatisfactory, leading to higher anxiety among HCWs. Improved information delivery and training are essential in preparation for the second wave and future pandemics.
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Affiliation(s)
- S Ismael
- Robert Jones Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom
| | - G Manoharan
- Robert Jones Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom
| | - K Al-Kaisi
- University Hospitals North Midlands, Stoke on Trent, United Kingdom
| | - A George
- Robert Jones Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom
| | - S Abas
- Robert Jones Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom
| | - M Al Musabi
- Worcester Royal Hospital, Worcester, United Kingdom
| | - P Rao
- Robert Jones Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom
| | - R Singh
- Robert Jones Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom
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15
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Rao P, Tan K, Han DD, Derakhshandeh R, Springer ML. Abstract P355: Comparable Impairment Of Vascular Endothelial Function By A Wide Range Of Electronic Nicotine Delivery Devices. Circ Res 2021. [DOI: 10.1161/res.129.suppl_1.p355] [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: 11/16/2022]
Abstract
Introduction:
Electronic nicotine delivery systems (ENDS; i.e., vaping devices) such as e-cigarettes, heated tobacco products, and newer coil-less ultrasonic vaping devices are promoted as less harmful alternatives to combustible cigarettes. However, the cardiovascular health effects of these devices are understudied. We investigated whether exposure to aerosol from a wide range of ENDS devices with and without nicotine, including a new ultrasonic vaping device, impairs endothelial function.
Hypothesis:
ENDS aerosols irrespective of nicotine, flavors, and heating coil impair endothelial function comparably to smoke from cigarettes.
Methods:
We exposed 11 groups (n=8), of anaesthetized rats to aerosol from propylene glycol (PG), vegetable glycerin (VG), PG+VG without nicotine, a USONICIG Zip ultrasonic vaping device, previous generation e-cigarettes (tank style with freebase nicotine), 5% nicotine JUUL pods of three flavors (Virginia tobacco, Mango, and Menthol), and an IQOS heated tobacco product; with Marlboro Red cigarette smoke and clean air as controls, to a single session of 10 cycles of pulsatile 5s exposure over 5 minutes. Endothelial function was quantified as arterial flow-mediated dilation (FMD) using micro-ultrasound.
Results:
Aerosol/smoke from all conditions except air significantly impaired FMD (Figure: each colored line denotes one rat, black horizontal bars denote means). The extent of impairment ranged from 40%-67% although there were no significant differences between groups. Nicotine absorption into the blood varied widely from these undiluted aerosols (those containing nicotine), with IQOS being the highest, and USONICIG and previous generation e-cig being the lowest.
Conclusions:
A single session of exposure to aerosol from a wide range of ENDS, including multiple types of e-cigarettes, a heated tobacco product, and an ultrasonic vaping device, all impair endothelial vascular function comparably to combusted cigarettes.
Key words:
JUUL, IQOS, ultrasonic vaping device, e-liquids, flow-mediated dilation
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16
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Khandaker M, Kotturi H, Progri H, Tummala S, Nikfarjam S, Rao P, Hosna A, Arasu DT, Williams W, Haleem AM. In vitroand in vivoeffect of polycaprolactone nanofiber coating on polyethylene glycol diacrylate scaffolds for intervertebral disc repair. Biomed Mater 2021; 16. [PMID: 33915528 DOI: 10.1088/1748-605x/abfd12] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/29/2021] [Indexed: 12/11/2022]
Abstract
Polyethylene glycol diacrylate (PEGDA) is an important class of photosensitive polymer with many tissue engineering applications. This study compared PEGDA and polycaprolactone (PCL) nanofiber matrix (NFM) coated PEGDA, referred to as PCL-PEGDA, scaffolds for their application in multiple tissue repair such as articular cartilage, nucleus pulposus of the intervertebral disc (IVD). We examined each scaffold morphology, porosity, swelling ratio, degradation, mechanical strength, andin vitrocytocompatibility properties. A defect was created in Sprague Dawley rat tail IVD by scraping native cartilage tissue and disc space, then implanting the scaffolds in the disc space for 4 weeks to evaluatein vivoefficacy of multi-tissue repair. Maintenance of disc height and creation of a new cell matrix was assessed to evaluate each scaffold's ability to repair the tissue defect. Although both PEGDA and PCL-PEGDA scaffolds showed similar porosity ∼73%, we observed distinct topographical characteristics and a higher effect of degradation on the water-absorbing capacity for PEGDA compared to PCL-PEGDA. Mechanical tests showed higher compressive strength and modulus of PCL-PEGDA compared to PEGDA.In vitrocell studies show that the PCL NFM layer covering PEGDA improved osteoblast cell adhesion, proliferation, and migration into the PEGDA layer.In vivostudies concluded that the PEGDA scaffold alone was not ideal for implantation in rat caudal disc space without PCL nanofiber coating due to low compressive strength and modulus.In vivoresults confirm that the PCL-PEGDA scaffold-maintained disc space and created a proteoglycan and collagen-rich new tissue matrix in the defect site after 4 weeks of scaffold implantation. We concluded that our developed PCL-PEGDA has the potential to be used in multi-tissue defect site repair.
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Affiliation(s)
- M Khandaker
- Department of Engineering & Physics, University of Central Oklahoma, Edmond, OK, United States of America
| | - H Kotturi
- Department of Biology, University of Central Oklahoma, Edmond, OK, United States of America
| | - H Progri
- Department of Engineering & Physics, University of Central Oklahoma, Edmond, OK, United States of America
| | - S Tummala
- Department of Engineering & Physics, University of Central Oklahoma, Edmond, OK, United States of America
| | - S Nikfarjam
- Department of Biology, University of Central Oklahoma, Edmond, OK, United States of America
| | - P Rao
- Department of Engineering & Physics, University of Central Oklahoma, Edmond, OK, United States of America
| | - A Hosna
- Department of Engineering & Physics, University of Central Oklahoma, Edmond, OK, United States of America
| | - D T Arasu
- Department of Biology, University of Central Oklahoma, Edmond, OK, United States of America
| | - W Williams
- Department of Comparative Medicine, University of Oklahoma Health Science Center, Edmond, Ok, United States of America
| | - A M Haleem
- Department of Comparative Medicine, University of Oklahoma Health Science Center, Edmond, Ok, United States of America.,Department of Orthopedics, Cairo University College of Medicine, Cairo, Egypt
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17
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Lansford JW, Walsh TH, Hromadka TV, Rao P. Doppler radar rainfall prediction and gauge data. BMC Res Notes 2020; 13:482. [PMID: 33054846 PMCID: PMC7559437 DOI: 10.1186/s13104-020-05311-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 09/28/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The data herein represents multiple gauge sets and multiple radar sites of like-type Doppler data sets combined to produce populations of ordered pairs. Publications spanning decades yet specific to Doppler radar sites contain graphs of data pairs of Doppler radar precipitation estimates versus rain gauge precipitation readings. DATA DESCRIPTION Taken from multiple sources, the data set represents several radar sites and rain gauge sites combined for 8830 data points. The data is relevant in various applications of hydrometeorology and engineering as well as weather forecasting. Further, the importance of accuracy in radar and precipitation estimates continues to increase, necessitating the incorporation of as much data as possible.
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Affiliation(s)
- Jesse W Lansford
- Department of Mathematics, United States Military Academy, West Point, NY, USA.
| | - Tyson H Walsh
- Department of Mathematics, United States Military Academy, West Point, NY, USA
| | - T V Hromadka
- Department of Mathematics, United States Military Academy, West Point, NY, USA
| | - P Rao
- Department of Civil and Environmental Engineering, California State University, Fullerton, CA, USA
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18
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Rao P, Nabavizadeh Rafsanjani P, Han D, Schick S, Springer M. Abstract 236: Aldehydes in Cigarette Smoke Impair Vascular Endothelial Function. Circ Res 2020. [DOI: 10.1161/res.127.suppl_1.236] [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: 11/16/2022]
Abstract
Introduction:
Exposure to tobacco and marijuana smoke impairs vascular endothelial function. While the particulate phase of smoke is heavily implicated, the role of volatile constituents is unclear. Smoke contains aldehydes, which are known to cause endothelial dysfunction. We explored whether two aldehydes found in smoke, acrolein and acetaldehyde, can induce endothelial dysfunction.
Hypothesis:
Aldehydes in smoke impair endothelial function.
Methods:
We exposed 4 groups of anesthetized rats to 3 ppm acrolein and 10-11.5 ppm acetaldehyde gases (concentrations relevant to levels in secondhand smoke), Marlboro Red cigarette sidestream smoke at modest levels (600 μg/m
3
PM2.5) as a positive control, and clean air through the gas generation system as a negative control. Exposure was continuous for 10 minutes. Endothelial function (flow-mediated dilation; FMD) was quantified pre- and post-exposure by measuring femoral artery diameter with ultrasound before and after 5 min of transient ischemia and expressed as % vasodilation.
Results:
Impairment of FMD was observed for acrolein (10.8±1.7(SD)% vs. 5.8±2.9%, p=.001), acetaldehyde (8.8±2.0% vs. 6.0±2.5%, p=.001), and cigarette smoke (9.4±2.9% vs. 5.8±2.0%, p=.002), but not for air (7.9±2.0% vs. 9±3.2%, p=.44) (figure; each colored line denotes a rat pre- and post-exposure; bars denote means).
Conclusions:
Acrolein and acetaldehyde at levels found in secondhand smoke impair endothelial function. Our results suggest that despite a potential role of particles, volatile aldehydes may mediate part of the endothelial dysfunction caused by exposure to smoke.
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19
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Martel G, Baker L, Wherrett C, Fergusson DA, Saidenberg E, Workneh A, Saeed S, Gadbois K, Jee R, McVicar J, Rao P, Thompson C, Wong P, Abou Khalil J, Bertens KA, Balaa FK. Phlebotomy resulting in controlled hypovolaemia to prevent blood loss in major hepatic resections (PRICE-1): a pilot randomized clinical trial for feasibility. Br J Surg 2020; 107:812-823. [PMID: 31965573 DOI: 10.1002/bjs.11463] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/28/2019] [Accepted: 11/15/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND Major liver resection is associated with blood loss and transfusion. Observational data suggest that hypovolaemic phlebotomy can reduce these risks. This feasibility RCT compared hypovolaemic phlebotomy with the standard of care, to inform a future multicentre trial. METHODS Patients undergoing major liver resections were enrolled between June 2016 and January 2018. Randomization was done during surgery and the surgeons were blinded to the group allocation. For hypovolaemic phlebotomy, 7-10 ml per kg whole blood was removed, without intravenous fluid replacement. Co-primary outcomes were feasibility and estimated blood loss (EBL). RESULTS A total of 62 patients were randomized to hypovolaemic phlebotomy (31) or standard care (31), at a rate of 3·1 patients per month, thus meeting the co-primary feasibility endpoint. The median EBL difference was -111 ml (P = 0·456). Among patients at high risk of transfusion, the median EBL difference was -448 ml (P = 0·069). Secondary feasibility endpoints were met: enrolment, blinding and target phlebotomy (mean(s.d.) 7·6(1·9) ml per kg). Blinded surgeons perceived that parenchymal resection was easier with hypovolaemic phlebotomy than standard care (16 of 31 versus 10 of 31 respectively), and guessed that hypovolaemic phlebotomy was being used with an accuracy of 65 per cent (20 of 31). There was no significant difference in overall complications (10 of 31 versus 15 of 31 patients), major complications or transfusion. Among those at high risk, transfusion was required in two of 15 versus three of nine patients (P = 0·326). CONCLUSION Endpoints were met successfully, but no difference in EBL was found in this feasibility study. A multicentre trial (PRICE-2) powered to identify a difference in perioperative blood transfusion is justified. Registration number: NCT02548910 ( http://www.clinicaltrials.gov).
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Affiliation(s)
- G Martel
- Liver and Pancreas Unit, Department of Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - L Baker
- Liver and Pancreas Unit, Department of Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - C Wherrett
- Department of Anesthesiology and Pain Medicine, Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - D A Fergusson
- Liver and Pancreas Unit, Department of Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - E Saidenberg
- Department of Medicine, Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - A Workneh
- Liver and Pancreas Unit, Department of Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - S Saeed
- Liver and Pancreas Unit, Department of Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - K Gadbois
- Department of Anesthesiology and Pain Medicine, Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - R Jee
- Department of Anesthesiology and Pain Medicine, Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - J McVicar
- Department of Anesthesiology and Pain Medicine, Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - P Rao
- Department of Anesthesiology and Pain Medicine, Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - C Thompson
- Department of Anesthesiology and Pain Medicine, Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - P Wong
- Department of Anesthesiology and Pain Medicine, Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - J Abou Khalil
- Liver and Pancreas Unit, Department of Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - K A Bertens
- Liver and Pancreas Unit, Department of Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - F K Balaa
- Liver and Pancreas Unit, Department of Surgery, Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
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20
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Rao P, Caunt JN, Wong JWY, Moore JK, Zepf FD. Child and adolescent psychiatry training in Australia and New Zealand. Eur Child Adolesc Psychiatry 2020; 29:95-103. [PMID: 31641901 DOI: 10.1007/s00787-019-01422-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 06/19/2019] [Accepted: 10/10/2019] [Indexed: 10/25/2022]
Abstract
The specialty of Child and Adolescent Psychiatry was formally recognised in the 1930s. The Faculty of Child and Adolescent Psychiatry was established in 1964 in Australia, as a subspecialty in The Royal Australian and New Zealand College of Psychiatrists (RANZCP). The aim of the current article is first to provide a brief summary and overview of the current status of Child and Adolescent Psychiatry (CAP), followed by an outline of the requirements of the Training Program for CAP in Australia and New Zealand. The training required to become a fully qualified child and adolescent psychiatrist in Australia and New Zealand consists of different stages and takes the form of competency-based training. Information relating to assessment types, supervision and research requirements is also described. Accreditation procedures for the training program are stipulated by RANZCP to monitor standards and to ensure consistency within the programs delivered across Australia and New Zealand. Employment opportunities for trainees upon completion of the program are discussed. In summary, this article highlights the requirements of the training programs for CAP in Australia and New Zealand.
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Affiliation(s)
- P Rao
- Centre and Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Division of Psychiatry and Clinical Neurosciences and Division of Paediatrics and Child Health, School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA, 6009, Australia. .,Child and Adolescent Mental Health Service, Child and Adolescent Health Service, 52-54 Monash Avenue, Nedlands, Perth, WA, 6008, Australia. .,Telethon Kids Institute, 15 Hospital Avenue, Nedlands, Perth, WA, 6008, Australia.
| | - J N Caunt
- Child and Adolescent Mental Health Service, Child and Adolescent Health Service, 52-54 Monash Avenue, Nedlands, Perth, WA, 6008, Australia
| | - J W Y Wong
- Centre and Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Division of Psychiatry and Clinical Neurosciences and Division of Paediatrics and Child Health, School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA, 6009, Australia.,Child and Adolescent Mental Health Service, Child and Adolescent Health Service, 52-54 Monash Avenue, Nedlands, Perth, WA, 6008, Australia.,Telethon Kids Institute, 15 Hospital Avenue, Nedlands, Perth, WA, 6008, Australia
| | - J K Moore
- Centre and Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Division of Psychiatry and Clinical Neurosciences and Division of Paediatrics and Child Health, School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA, 6009, Australia.,Child and Adolescent Mental Health Service, Child and Adolescent Health Service, 52-54 Monash Avenue, Nedlands, Perth, WA, 6008, Australia
| | - F D Zepf
- Centre and Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Division of Psychiatry and Clinical Neurosciences and Division of Paediatrics and Child Health, School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA, 6009, Australia.,Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Friedrich Schiller University, Am Steiger 6, 07743, Jena, Germany.,Telethon Kids Institute, 15 Hospital Avenue, Nedlands, Perth, WA, 6008, Australia
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Stockbridge A, Agarwal S, Sudhir R, Perkins T, Savory S, Pinglay P, Rao P, Das I, Brozik J, Machin R, Deshpande A, Bajaj A, Barnes D, Agrawal S, Bennett J, Tufail M. Optimal lung cancer pathway implementation in a tertiary care centre and its impact on reducing emergency presentations. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30046-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Wang XI, Cheng Y, Rao P, Wang L. P6595The optogenetic defibrillation of ventricular arrhythmia in myocardial infarction rats in vivo. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1183] [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
Optogenetics is a low-invasive, flexible and highly selective intervention that enables electrical excitation with light on myocardium overexpressing light-sensitive proteins. Optical illumination can control the simultaneous exciting of the whole myocardium under the spot, which is more conducive to recovery from electrical disturbance to sinus rhythm.
Purpose
We explored optogenetic defibrillation for different illumination parameters how to affect defibrillation rates and the possible mechanism of continuous illumination defibrillation.
Methods
Systemic delivery via right jugular vein injection of (AAV9-CAG-hChR2(H134R)-mCherry) were performed in juvenile SD rats to achieve the light sensitive protein Channelrhodopsin-2 (ChR2) transfer throughout the whole heart. We intubated and ventilated rats, opened chest and recorded the ECG. After ligation of the left anterior descending coronary artery, ventricular arrhythmia was induced by electrical burst stimulation (10v, 50Hz, 2s). Cardiac epicardium illumination with 470nm blue laser was performed to investigate the effects of optogenetic defibrillation and its underlying mechanism. Every heart accepted 30 pulses of 20ms duration on 8Hz to test the light intensity threshold for 1:1 capture. Different illumination modes of multiple light intensity (2,4,8,10,20 times threshold intensity), pulse duration (20, 50, 200, 500 and 1000ms) and illumination position (RV apex, RV, RVOT, septum, LV) were applied in each attempt for 4 repetitions with 1 s interval.
Results
We demonstrated that ventricular arrhythmias could be terminated by illumination of the right ventricle at 20 times threshold intensity in 1s (figure A) with the successful defibrillation rate of 95±2.673% (mean ±SEM; N=7). Herein, the successful optogenetic defibrillation rate was strongly depending on light intensity (N=5, n=50 episodes, p=0.0118) and duration of illumination (N=5, n=50 episodes, p<0.0001) (figure B.C). Notably when there were higher intensity and longer pulse duration, the higher defibrillation rate appeared. There was no significant difference in the defibrillation rate among different illumination positions (N=5, n=25episodes per position, p=0.1177) (figure D). To explore the underlying mechanism of optogenetic defibrillation, we performed the same illumination mode during sinus rhythm in 2 rats (figure E. F. G). We observed that higher light intensity and longer pulse duration were more conducive to induce an episode of higher frequency focal excitement.
Views of optogenetic defibrillation
Conclusions
We demonstrated that optogenetic defibrillation is a highly effective intervention and the possible mechanism is partly attributed to overdrive suppression. We believe that optogenetic approach is potentially to be translated into more efficient and pain-free clinical termination of ventricular arrhythmia.
Acknowledgement/Funding
The national natural science foundation of China (81772044)
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Affiliation(s)
- X I Wang
- Renmin Hospital, Department of Cardiology, Wuhan, China
| | - Y Cheng
- Renmin Hospital, Department of Cardiology, Wuhan, China
| | - P Rao
- Renmin Hospital, Department of Cardiology, Wuhan, China
| | - L Wang
- Renmin Hospital, Department of anesthesiology, Wuhan, China
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Khan F, Dave D, Rohatgi S, Nirhale S, Rao P, Naphade P. Charot-marie-tooth disease type 2O: First case report from India. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Dave D, Khan F, Rohatgi S, Nirhale S, Rao P, Naphade P. Atypical multiple sclerosis with antibody to MOG. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1434] [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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Campbell M, Martin S, Tam A, Sheth R, Singh S, Ahrar K, Slack Tidwell B, Rao P, Karam J, Wood C, Tannir N, Jonasch E, Gao J, Shah A, Blando J, Duan F, Basu S, Allison J, Sharma P, Singh S. A pilot study of tremelimumab (treme) with or without cryoablation (cryo) in patients (pts) in metastatic renal cell carcinoma (mRCC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.059] [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: 11/14/2022] Open
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Dave D, Khan F, Rohatgi S, Nirhale S, Rao P, Naphade P. Severe 5,10‐Methylenetetrahydrofolate reductase deficiency: A rare, treatable cause of complicated hereditary spastic paraplegia. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Khan F, Dave D, Rohatgi S, Nirhale S, Rao P, Naphade P. Study of spectrum of inflammatory demyelinating disease of central nervous system. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1435] [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: 10/25/2022]
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Wang XI, Cheng Y, Rao P, Wang L. P3504Near-Infrared photoactivation via upconversion nanoparticles promotes new advances in cardiac optogenetics toolbox. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0369] [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: 11/14/2022] Open
Abstract
Abstract
Background
The optogenetics manipulation of the heart based on the visible light is limited in the therapeutic potential because of the low tissue penetration. Near-infrared (NIR) light has deeper tissue penetration capabilities but radiates at unsuitable wavelengths, while upconversion nanoparticles (UCNPs) absorb NIR light to convert visible light.
Purpose
We aimed to investigate the efficient NIR control of the rat heart in vivo via UCNPs mediated cardiac optogenetics.
Methods
Systemic delivery via jugular vein injection of (AAV9-CAG-hChR2 (H134R)-mCherry) were performed in SD rats to achieve sufficient Channelrhodopsin-2 (ChR2) transfer throughout the whole heart. UCNPs of NaYF4:Yb/Tm with optimal excitation wavelength at 975nm were chosen to emit upconverted blue light. Different concentrations of UCNPs cyclohexane solution were embed in composite polydimethylsiloxane films to make flexible substrates for cardiac optogenetics study in open-chest rats (n=3). The UCNPs film was attached to the right ventricle and the 980nm NIR illumination was applied.
Results
The upconversion luminescence spectra of four concentrations (2.5, 5, 10 and 20mg/ml) of NaYF4:Yb/Tm scanned under 980nm excitation at 0.5w showed similar peaks around 475, 645 and 695nm. Emission intensity increased with the UCNPs concentration (Figure 1). The NIR-upconverted blue light from the freestanding films embedded with 2.5 and 5mg/ml UCNPs failed to capture the heart till the peak output power of the NIR laser, and the hearts were successfully captured and paced by the upconverted blue light from 10 and 20mg/mL UCNPs films (20 pulses in 8Hz with 20ms duration were repeated 3 times with the interval of 1s). However the NIR power was lower on 10mg/mL UCNPs film than the 20mg/mL one (0.93±0.11w vs 1.71±0.75w). Therefore, UCNPs film with concentration of 10mg/mL NaYF4:Yb/Tm were used for efficient cardiac optogenetic pacing by NIR light from a 400um optical fiber. Optogenetics capture of the ventricle was achieved at different NIR power, pulse duration and flash frequency. The strength-duration curve summarized the minimal NIR irradiance power of 8Hz flash required for 100% capture at different pulse duration (2, 5, 10, 20 and 50ms). Notably the longer the pulse duration was, the lower the light intensity required. Furthermore, the increasing flash frequency (6, 7, 8 and 10Hz) of the NIR light setting at 1.66w (2-fold threshold power) and 20ms duration induced sufficient cardiac pacing (Figure 2).
The efficient NIR control of the heart
Conclusion
We demonstrated the successful NIR photo-activation of ChR2 expressed in the heart by the upconverted blue light via UCNPs, which resulted in a flexible UCNPs-assisted cardiac optogenetic approach for optical control of heart activity. We believe that these advances in cardiac optogenetic toolbox not only represent a novel practical application of UCNPs, but also open up new possibilities for remote or tissue penetrating heart control.
Acknowledgement/Funding
The national natural science foundation of China (81772044)
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Affiliation(s)
- X I Wang
- Renmin Hospital, Department of Cardiology, Wuhan, China
| | - Y Cheng
- Renmin Hospital, Department of Cardiology, Wuhan, China
| | - P Rao
- Renmin Hospital, Department of Cardiology, Wuhan, China
| | - L Wang
- Renmin Hospital, Department of anesthesiology, Wuhan, China
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Dave D, Khan F, Rohatgi S, Nirhale S, Rao P, Naphade P. A study of clinical,radiological and thrombophilia profile in cerebral venous sinus thrombosis. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Auloge P, Cazzato RL, Rousseau C, Caudrelier J, Koch G, Rao P, Chiang JB, Garnon J, Gangi A. Complications following Percutaneous Bone Cryoablation: Retrospective Analysis of 239 Consecutive Patients. Semin Musculoskelet Radiol 2019. [DOI: 10.1055/s-0039-1692561] [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: 10/26/2022]
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31
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Vidya K, Rao P, Goyal N. Priming rTMS in resistant obsessive compulsive disorder: In search of a new paradigm. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.404] [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: 10/27/2022] Open
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32
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Brahmbhatt A, Rao P, Butani D. 03:27 PM Abstract No. 241 Effects of time to visceral angiography for gastrointestinal bleeding on angiographic success. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.301] [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: 10/27/2022] Open
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Runions KC, Morandini HAE, Rao P, Wong JWY, Kolla NJ, Pace G, Mahfouda S, Hildebrandt CS, Stewart R, Zepf FD. Serotonin and aggressive behaviour in children and adolescents: a systematic review. Acta Psychiatr Scand 2019; 139:117-144. [PMID: 30446991 DOI: 10.1111/acps.12986] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The role of serotonin (5-HT) in human aggression has been the subject of a large number of studies, mostly with adults. Meta-analyses indicate a small but significant inverse relationship between central nervous 5-HT availability and aggression, but genetically informed studies suggest two pathways: one to reactive aggression and the other to proactive aggression. METHOD We conducted a systemic review on central nervous 5-HT function in children and adolescents, with attention to the function of aggression. RESULTS In total, 675 articles were screened for relevance, with 45 reviewed. These included blood assays (e.g. plasma, 5-HIAA; platelet 5-HTR2A ), epigenetic studies, retrospective PET studies and 5-HT challenge paradigms (e.g. tryptophan depletion). Overall, findings were mixed, with support both for negative and for positive associations of central nervous 5-HT function with aggression in children and adolescents. CONCLUSION We propose factors that may be blurring the picture, including problems in the conceptualization and measurement of aggression in young people, the lack of prospective designs and the bias towards clinical samples of boys. Research needs to account for variance in the both motivation for and implementation of aggression, and look to the behavioural economics literature to consider the roles of reward, vengeance and self-control more clearly.
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Affiliation(s)
- K C Runions
- Department of Health, Child and Adolescent Mental Health Services, Bentley, WA, Australia.,Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.,Division of Psychiatry and Clinical Neurosciences and Division of Paediatrics and Child Health, Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, School of Medicine, University of Western Australia, Perth, WA, Australia
| | - H A E Morandini
- Division of Psychiatry and Clinical Neurosciences and Division of Paediatrics and Child Health, Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, School of Medicine, University of Western Australia, Perth, WA, Australia
| | - P Rao
- Department of Health, Child and Adolescent Mental Health Services, Bentley, WA, Australia.,Division of Psychiatry and Clinical Neurosciences and Division of Paediatrics and Child Health, Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, School of Medicine, University of Western Australia, Perth, WA, Australia
| | - J W Y Wong
- Department of Health, Child and Adolescent Mental Health Services, Bentley, WA, Australia.,Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.,Division of Psychiatry and Clinical Neurosciences and Division of Paediatrics and Child Health, Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, School of Medicine, University of Western Australia, Perth, WA, Australia
| | - N J Kolla
- Centre for Addictions and Mental Health, University of Toronto, Toronto, ON, Canada
| | - G Pace
- Department of Health, Child and Adolescent Mental Health Services, Bentley, WA, Australia
| | - S Mahfouda
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.,School of Psychological Sciences, Faculty of Sciences, University of Western Australia, Perth, WA, Australia
| | - C S Hildebrandt
- Jülich Aachen Research Alliance, JARA Translational Brain Medicine, Aachen, Germany.,Child and Adolescent Psychiatry and Psychotherapy, Clinics of the City Cologne GmbH, Cologne, Germany
| | - R Stewart
- Division of Psychiatry and Clinical Neurosciences and Division of Paediatrics and Child Health, Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, School of Medicine, University of Western Australia, Perth, WA, Australia
| | - F D Zepf
- Division of Psychiatry and Clinical Neurosciences and Division of Paediatrics and Child Health, Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, School of Medicine, University of Western Australia, Perth, WA, Australia.,Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Clinics of the Friedrich Schiller University, Jena, Germany
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Zibrov AA, Rao P, Kometter C, Spanton EM, Li JIA, Dean CR, Taniguchi T, Watanabe K, Serbyn M, Young AF. Emergent Dirac Gullies and Gully-Symmetry-Breaking Quantum Hall States in ABA Trilayer Graphene. Phys Rev Lett 2018; 121:167601. [PMID: 30387651 DOI: 10.1103/physrevlett.121.167601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Indexed: 06/08/2023]
Abstract
We report on quantum capacitance measurements of high quality, graphite and hexagonal boron nitride encapsulated Bernal stacked trilayer graphene devices. At zero applied magnetic field, we observe a number of electron density- and electrical displacement-tuned features in the electronic compressibility associated with changes in Fermi surface topology. At a high displacement field and low density, strong trigonal warping gives rise to three new emergent Dirac cones in each valley, which we term "gullies." The gullies are centered around the corners of a hexagonal Brillouin zone and related by threefold rotation symmetry. At low magnetic fields of B=1.25 T, the gullies manifest as a change in the degeneracy of the Landau levels from two to three. Weak incompressible states are also observed at integer filling within these triplet Landau levels, which a Hartree-Fock analysis indicates are associated with Coulomb-driven nematic phases that spontaneously break rotation symmetry.
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Affiliation(s)
- A A Zibrov
- Department of Physics, University of California, Santa Barbara, California 93106, USA
| | - P Rao
- Institute of Science and Technology, Am Campus 1, 3400 Klosterneuburg, Austria
| | - C Kometter
- Department of Physics, University of California, Santa Barbara, California 93106, USA
| | - E M Spanton
- California Nanosystems Institute, University of California, Santa Barbara, California 93106, USA
| | - J I A Li
- Department of Physics, Columbia University, New York, New York 10025, USA
| | - Cory R Dean
- Department of Physics, Columbia University, New York, New York 10025, USA
| | - T Taniguchi
- Advanced Materials Laboratory, National Institute for Materials Science, Tsukuba, Ibaraki 305-0044, Japan
| | - K Watanabe
- Advanced Materials Laboratory, National Institute for Materials Science, Tsukuba, Ibaraki 305-0044, Japan
| | - M Serbyn
- Institute of Science and Technology, Am Campus 1, 3400 Klosterneuburg, Austria
| | - A F Young
- Department of Physics, University of California, Santa Barbara, California 93106, USA
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Othman S, Rao P, Shakeel M. Preoperative prediction of Difficult Laryngeal Exposure (DLE) during Microlaryngoscopy (ML): Use of LARYNGOSCORE in a scottish teaching hospital. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.262] [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: 10/28/2022]
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Jayappa SN, Rao P, Tandon AS, Bharathy K, Sikora SS. Large cystic lympangioma of the pancreas: a case reportum. Ann R Coll Surg Engl 2017; 100:e12-e14. [PMID: 29046074 DOI: 10.1308/rcsann.2017.0178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Lymphangioma of the pancreas is rare and presents as a large cystic mass in the retroperitoneum. The pancreatic origin can be confirmed by careful evaluation of cross sectional imaging. Preoperative differentiation from other pancreatic cystic neoplasms is difficult but possible. Large symptomatic lesions warrant surgery. The diagnosis is confirmed by typical features on histopathology and immunohistochemistry. Presented here is a case report of a pancreatic lymphangioma, discussed in the context of available literature.
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Affiliation(s)
- S N Jayappa
- Department of Surgical Gastroenterology, Sakra World Hospital, Bengaluru , Karnataka , India
| | - P Rao
- Department of Pathology, Sakra World Hospital, Bengaluru , Karnataka , India
| | - A S Tandon
- Department of Radiology, Sakra World Hospital, Bengaluru , Karnataka , India
| | - Kgs Bharathy
- Department of Surgical Gastroenterology, Sakra World Hospital, Bengaluru , Karnataka , India
| | - S S Sikora
- Department of Surgical Gastroenterology, Sakra World Hospital, Bengaluru , Karnataka , India
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Bagheri A, Kumar P, Kamath A, Rao P. Association of angiogenic cytokines (VEGF-A and VEGF-C) and clinical characteristic in women with unexplained recurrent miscarriage. ACTA ACUST UNITED AC 2017; 118:258-264. [PMID: 28516786 DOI: 10.4149/bll_2017_051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Recurrent miscarriage (RM) defined as 2 or more spontaneous miscarriage before 20 weeks of gestation, affects at least 1 % of couples trying to conceive. In over 50 % of cases, the cause of the loss of pregnancy remains unexplained. Reduced expression of Angiogenic factors such as: vascular endothelial growth factor (VEGF-A) and VEGF-C has been linked with spontaneous miscarriage, likely due to defective foetal and placental angiogenesis. AIMS AND OBJECTIVES To investigate the relationships between serum level of VEGF-A and VEGF-C with clinical characteristic in women with URM and compare to pregnant and healthy women. MATERIALS AND METHODS A case-control study, which was conducted between 90 non-pregnant women with history of RM, age-matched with 70 non-pregnant women without history of recurrent abortion with at least one child (controls) and 70 pregnant women without history of recurrent abortion with at least one child (controls). Those with unexplained RM were eligible. Demographic and Anthropometric data were retrieved by pre-test questionnaire and serum level of VEGF-A and VEGF-C measured by ELISA kit. RESULTS This study showeds that maternal levels of VEGF-A and VEGF-C were distinctly lower in RSA (189.87±88.1 vs 238.8±99.6) compared to healthy (239.1±99.7 vs 275.5±133.08) and pregnant (301.5±76.4 vs 402.5±128.6) women as control groups. Univariate analysis demonstrated that clinical characteristic factors were significantly associated with concentration of VEGF-A and VEGF-C in cases and controls. CONCLUSIONS Our findings suggest that these molecules could be used as potential predictive markers of miscarriage in these women presenting with URM (Tab. 4, Fig. 5, Ref. 40).
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Malhotra A, Dhutia H, Rao P, Gati S, Keteepe-Arachi T, Finnochiaro G, Yeo T, Basu J, Parry-White G, D'Silva A, Papatheodorou S, Ensam B, Tome M, Papadakis M, Sharma S. P3244The mixed race heart: not so black and white. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Affiliation(s)
- K Runions
- Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, Dentistry and Health Sciences, School of Medicine, Division of Psychiatry and Clinical Neurosciences & Division of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Telethon Kids Institute, Perth, WA, Australia
| | - P Rao
- Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, Dentistry and Health Sciences, School of Medicine, Division of Psychiatry and Clinical Neurosciences & Division of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Department of Health in Western Australia, Community Child & Adolescent Mental Health Services, Perth, WA, Australia
| | - J W Y Wong
- Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, Dentistry and Health Sciences, School of Medicine, Division of Psychiatry and Clinical Neurosciences & Division of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Telethon Kids Institute, Perth, WA, Australia.,Department of Health in Western Australia, Specialised Child and Adolescent Mental Health Services (CAMHS), Perth, WA, Australia
| | - F D Zepf
- Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, Dentistry and Health Sciences, School of Medicine, Division of Psychiatry and Clinical Neurosciences & Division of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Telethon Kids Institute, Perth, WA, Australia.,Department of Health in Western Australia, Specialised Child and Adolescent Mental Health Services (CAMHS), Perth, WA, Australia
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Butler C, Jiang N, Rao P, Zheng Y, Gjertson D, Zhang Q, Cadeiras M, Deng M, Ray B, Reed E. Identification and Validation of Non-HLA Antibodies in Cardiac Allograft Rejection. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Borgs GP, Runions K, Biskup CS, Königschulte W, Rao P, Wong J, Moore J, Stewart RM, Zepf FD. Reactive aggression in young patients with ADHD-a critical role for small provocations. Acta Psychiatr Scand 2016; 134:566-568. [PMID: 27869991 DOI: 10.1111/acps.12661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- G P Borgs
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany
| | - K Runions
- Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, Dentistry and Health Sciences, School of Psychiatry and Clinical Neurosciences & School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Telethon Kids Institute, Perth, WA, Australia
| | - C S Biskup
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany
| | - W Königschulte
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany
| | - P Rao
- Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, Dentistry and Health Sciences, School of Psychiatry and Clinical Neurosciences & School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Department of Health in Western Australia, Community Child & Adolescent Mental Health Services, Perth, WA, Australia
| | - J Wong
- Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, Dentistry and Health Sciences, School of Psychiatry and Clinical Neurosciences & School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia
| | - J Moore
- Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, Dentistry and Health Sciences, School of Psychiatry and Clinical Neurosciences & School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Department of Health in Western Australia, Paediatric Consultation Liaison Program, Perth, WA, Australia
| | - R M Stewart
- Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, Dentistry and Health Sciences, School of Psychiatry and Clinical Neurosciences & School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia
| | - F D Zepf
- Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, Dentistry and Health Sciences, School of Psychiatry and Clinical Neurosciences & School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Telethon Kids Institute, Perth, WA, Australia.,Department of Health in Western Australia, Specialised Child and Adolescent Mental Health Services (CAMHS), Perth, WA, Australia
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Huo Y, Phan K, Zhao D, Rao P, Phan S, Mortimer A. Endovascular therapy including thrombectomy for acute ischemic stroke: a systematic review and meta-analysis with trial sequential analysis. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Runions KC, Stewart RM, Moore J, Martinez Ladino Y, Rao P, Zepf FD. Disruptive mood dysregulation disorder in ICD-11: a new disorder or ODD with a specifier for chronic irritability? Eur Child Adolesc Psychiatry 2016; 25:331-2. [PMID: 26578258 DOI: 10.1007/s00787-015-0789-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 10/22/2015] [Indexed: 10/22/2022]
Affiliation(s)
| | - R M Stewart
- Department of Child and Adolescent Psychiatry, The University of Western Australia, 35 Stirling Highway (M561), Crawley, Perth, WA, 6840, Australia
| | - J Moore
- Department of Child and Adolescent Psychiatry, The University of Western Australia, 35 Stirling Highway (M561), Crawley, Perth, WA, 6840, Australia
| | - Y Martinez Ladino
- Department of Child and Adolescent Psychiatry, The University of Western Australia, 35 Stirling Highway (M561), Crawley, Perth, WA, 6840, Australia
| | - P Rao
- Department of Child and Adolescent Psychiatry, The University of Western Australia, 35 Stirling Highway (M561), Crawley, Perth, WA, 6840, Australia
| | - F D Zepf
- Department of Child and Adolescent Psychiatry, The University of Western Australia, 35 Stirling Highway (M561), Crawley, Perth, WA, 6840, Australia. .,Specialised Child and Adolescent Mental Health Services (CAMHS), Department of Health in Western Australia, Perth, WA, Australia.
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Zepf F, Rao P, Moore J, Stewart R, Ladino YM, Hartmann B. Human breast milk and adipokines – A potential role for the soluble leptin receptor (sOb-R) in the regulation of infant energy intake and development. Med Hypotheses 2016; 86:53-5. [DOI: 10.1016/j.mehy.2015.11.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 11/19/2015] [Indexed: 11/29/2022]
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Abstract
A 38-year-old female on Vitamin D therapy presented with hypercalcemia induced acute kidney injury. Evaluation revealed primary hyperparathyroidism (PHPT) and iatrogenic hypervitaminosis D. After medical stabilization, she underwent surgical removal of the parathyroid adenoma, and made a full recovery. This case highlights unmasking of subclinical hyperparathyroidism by vitamin D therapy leading to severe hypercalcemia.
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Affiliation(s)
- S Bala
- Department of Nephrology, Global Hospital, Mumbai, Maharashtra, India
| | - B Shah
- Department of Nephrology, Global Hospital, Mumbai, Maharashtra, India
| | - P Rajput
- Department of Nephrology, Global Hospital, Mumbai, Maharashtra, India
| | - P Rao
- Department of Surgery, Global Hospital, Mumbai, Maharashtra, India
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Garnon J, Ramamurthy N, Caudrelier J J, Erceg G, Breton E, Tsoumakidou G, Rao P, Gangi A. MRI-Guided Percutaneous Biopsy of Mediastinal Masses Using a Large Bore Magnet: Technical Feasibility. Cardiovasc Intervent Radiol 2015; 39:761-767. [PMID: 26604114 DOI: 10.1007/s00270-015-1246-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [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: 03/21/2015] [Accepted: 09/11/2015] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To evaluate the diagnostic accuracy and safety of magnetic resonance imaging (MRI)-guided percutaneous biopsy of mediastinal masses performed using a wide-bore high-field scanner. MATERIALS AND METHODS This is a retrospective study of 16 consecutive patients (8 male, 8 female; mean age 74 years) who underwent MRI-guided core needle biopsy of a mediastinal mass between February 2010 and January 2014. Size and location of lesion, approach taken, time for needle placement, overall duration of procedure, and post-procedural complications were evaluated. Technical success rates and correlation with surgical pathology (where available) were assessed. RESULTS Target lesions were located in the anterior (n = 13), middle (n = 2), and posterior mediastinum (n = 1), respectively. Mean size was 7.2 cm (range 3.6-11 cm). Average time for needle placement was 9.4 min (range 3-18 min); average duration of entire procedure was 42 min (range 27-62 min). 2-5 core samples were obtained from each lesion (mean 2.6). Technical success rate was 100%, with specimens successfully obtained in all 16 patients. There were no immediate complications. Histopathology revealed malignancy in 12 cases (4 of which were surgically confirmed), benign lesions in 3 cases (1 of which was false negative following surgical resection), and one inconclusive specimen (treated as inaccurate since repeat CT-guided biopsy demonstrated thymic hyperplasia). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in our study were 92.3, 100, 100, 66.7, and 87.5%, respectively. CONCLUSION MRI-guided mediastinal biopsy is a safe procedure with high diagnostic accuracy, which may offer a non-ionizing alternative to CT guidance.
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Affiliation(s)
- J Garnon
- Department of Interventional Radiology, Nouvel Hôpital Civil, Strasbourg, France.
| | - N Ramamurthy
- Department of Radiology, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK
| | - J Caudrelier J
- Department of Interventional Radiology, Nouvel Hôpital Civil, Strasbourg, France
| | - G Erceg
- ICube, University of Strasbourg, CNRS, Strasbourg, France
| | - E Breton
- ICube, University of Strasbourg, CNRS, Strasbourg, France
| | - G Tsoumakidou
- Department of Interventional Radiology, Nouvel Hôpital Civil, Strasbourg, France
| | - P Rao
- Department of Interventional Radiology, Nouvel Hôpital Civil, Strasbourg, France.,ICube, University of Strasbourg, CNRS, Strasbourg, France
| | - A Gangi
- Department of Interventional Radiology, Nouvel Hôpital Civil, Strasbourg, France.,ICube, University of Strasbourg, CNRS, Strasbourg, France
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Rao P, Moore JK, Stewart R, Hood SD, Runions K, Zepf FD. Diagnostic inexactitude - Reframing and relabelling Disruptive Mood Dysregulation Disorder for ICD-11 does not solve the problem. Med Hypotheses 2015; 85:1035-6. [PMID: 26545314 DOI: 10.1016/j.mehy.2015.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 09/18/2015] [Accepted: 10/11/2015] [Indexed: 11/26/2022]
Affiliation(s)
- P Rao
- Department of Child and Adolescent Psychiatry, School of Psychiatry and Clinical Neurosciences & School of Paediatrics and Child Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia (M561), Perth, WA 6009, Australia; Community Child and Adolescent Mental Health Services, Department of Health in Western Australia, Perth, WA, Australia
| | - J K Moore
- Department of Child and Adolescent Psychiatry, School of Psychiatry and Clinical Neurosciences & School of Paediatrics and Child Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia (M561), Perth, WA 6009, Australia; Paediatric Consultation-Liaison Program, Child and Adolescent Mental Health Services, Department of Health in Western Australia, Perth, WA, Australia
| | - R Stewart
- Department of Child and Adolescent Psychiatry, School of Psychiatry and Clinical Neurosciences & School of Paediatrics and Child Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia (M561), Perth, WA 6009, Australia
| | - S D Hood
- School of Psychiatry and Clinical Neurosciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, GPO Box D184, Perth, WA 6840, Australia
| | - K Runions
- Telethon Kids Institute, Perth, WA, Australia
| | - F D Zepf
- Department of Child and Adolescent Psychiatry, School of Psychiatry and Clinical Neurosciences & School of Paediatrics and Child Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia (M561), Perth, WA 6009, Australia; Specialised Child and Adolescent Mental Health Services (CAMHS), Department of Health in Western Australia, Perth, WA, Australia.
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Joon A, Rao P, Shenoy SM, Baliga S. Prevalence of Hepatitis A virus (HAV) and Hepatitis E virus (HEV) in the patients presenting with acute viral hepatitis. Indian J Med Microbiol 2015; 33 Suppl:102-5. [PMID: 25657123 DOI: 10.4103/0255-0857.150908] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Hepatitis A virus (HAV) and Hepatitis E virus (HEV) are both enterically transmitted, resulting in acute viral hepatitis (AVH) in developing countries. They pose major health problems in our country. This study was done to determine prevalence of HAV and HEV in patients presenting with AVH and the co-infection of HAV and HEV in these patients. MATERIALS AND METHODS A cross-sectional study of 2-years duration was conducted in the Department of Microbiology, KMC, Mangalore. A non-random sampling of 958 patients presenting with AVH was considered in the study. On the basis of history, serum samples were analysed for IgM anti-HAV and IgM anti-HEV for the detection of HAV and HEV, respectively using commercially available ELISA kits. Data collected was analysed by using Statistical Package for the Social Sciences (SPSS) version 11.5. RESULTS The seroprevalence of HAV- and HEV-positive patients were 19.31% and 10.54%, respectively. The seroprevalence of both HAV and HEV in patients with acute viral hepatitis was 11.5%. The prevalence of HAV and HEV among males (68% and 31%) was higher than in females (31% and 20%) and was predominantly seen among young adults. These infections were predominantly seen during end of monsoons and beginning of winter. CONCLUSION Though the prevalence of HAV is much higher than that of HEV, co-infection rate of 11.5% mandates the screening for HEV which will be of immense importance in pregnant women and improving levels of personal hygiene among higher socio-economic population. These data will be essential for planning of future vaccination strategies and for better sanitation programme in this part of the country.
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Affiliation(s)
| | | | - S M Shenoy
- Department of Microbiology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
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Kumar P, Rao T, Prasad Y, Rao C, Rajyam P, Sarma M, Ashok G, Rao P. Role of Chandipura virus in an “epidemic brain attack” in Andhra Pradesh, India. J Pediatr Neurol 2015. [DOI: 10.1055/s-0035-1557208] [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)
- P. Kumar
- Children's Brain Clinic, Secunderabad, India
| | - T. Rao
- Civil Surgeon Pediatrician, Karimnagar District Headquarters' Hospital, India
| | - Y. Prasad
- Pediatric Neurology Division of Department of Neurology, Osmania Medical College/Niloufer Hospital, Hyderabad, India
| | - C. Rao
- Department of Radiology, Elbit Medical Diagnostics Limited, Hyderabad, India
| | - P. Rajyam
- Directorate of Health, Government of Andhra Pradesh, India
| | - M.M.V. Sarma
- Department of Preventive and Social Medicine, Gandhi Medical College, Hyderabad, India
| | - Gajula Ashok
- Pediatric Neurology Division of Department of Neurology, Osmania Medical College/Niloufer Hospital, Hyderabad, India
| | - P. Rao
- Pediatric Neurology Division of Department of Neurology, Osmania Medical College/Niloufer Hospital, Hyderabad, India
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