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Jairath V, Yarur A, Osterman MT, James A, Balma D, Mehrotra S, Yang L, Yajnik V, Qasim Khan RM. ENTERPRET: A Randomized Controlled Trial of Vedolizumab Dose Optimization in Patients With Ulcerative Colitis Who Have Early Nonresponse. Clin Gastroenterol Hepatol 2023:S1542-3565(23)00912-6. [PMID: 37951560 DOI: 10.1016/j.cgh.2023.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/23/2023] [Accepted: 10/31/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND & AIMS Patients with ulcerative colitis (UC) may experience nonresponse to biologics, possibly as a result of low drug exposure. This trial assessed the efficacy of dose optimization in patients with UC who have early nonresponse to vedolizumab and high drug clearance. METHODS ENTERPRET was a phase 4, open-label, randomized, controlled trial that included patients with moderate to severe UC who had high drug clearance at week 5 (serum concentration, <50 μg/mL) and nonresponse to standard vedolizumab treatment at week 6. At week 6, eligible patients were randomized 1:1 to receive standard dosing (300 mg every 8 weeks) or dose-optimized vedolizumab (600 mg at week 6, then 300 mg every 4 weeks; or 600 mg at week 6, then 600 mg every 4 weeks [based on week 5 serum concentration]). The primary end point was endoscopic improvement at week 30. RESULTS Of 278 enrolled patients, 132 (47.5%) had a clinical response at week 6. From week 6, 108 patients received standard (n = 53) or dose-optimized vedolizumab (n = 55); among patients with nonresponse at week 6, 86.5% had high drug clearance. At week 30, 10 patients (18.9%) who received standard vedolizumab had endoscopic improvement vs 8 patients (14.5%) who received dose-optimized vedolizumab. Five patients (9.4%) who received standard vedolizumab had clinical remission at week 30 vs 5 patients (9.1%) who received dose-optimized vedolizumab; clinical response was observed in 17 (32.1%) and 17 patients (30.9%), respectively. Safety event rates were similar among treatment groups. CONCLUSIONS In patients with early nonresponse and high drug clearance, vedolizumab dose optimization is probably not required. A proportion of patients benefited from continued treatment irrespective of the dose received. CLINICALTRIALS gov: NCT03029143.
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Affiliation(s)
- Vipul Jairath
- Division of Gastroenterology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
| | - Andres Yarur
- Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California.
| | - Mark T Osterman
- Division of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Alexandra James
- Takeda Pharmaceuticals U.S.A., Inc, Lexington, Massachusetts
| | - Diane Balma
- Takeda Pharmaceuticals U.S.A., Inc, Lexington, Massachusetts
| | | | - Lili Yang
- Takeda Pharmaceuticals U.S.A., Inc, Lexington, Massachusetts
| | - Vijay Yajnik
- Takeda Pharmaceuticals U.S.A., Inc, Lexington, Massachusetts
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Tack J, McCallum R, Kuo B, Huh SY, Zhang Y, Chen YJ, Mehrotra S, Parkman HP. Randomized clinical trial: A phase 2b controlled study of the efficacy and safety of trazpiroben (TAK-906) for idiopathic or diabetic gastroparesis. Neurogastroenterol Motil 2023; 35:e14652. [PMID: 37533380 DOI: 10.1111/nmo.14652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/25/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Previous clinical studies of trazpiroben, a dopamine D2 /D3 receptor antagonist for long-term treatment of moderate-to-severe idiopathic and diabetic gastroparesis, have shown improved symptoms of fullness. This study assessed trazpiroben efficacy, safety, and tolerability in adults with idiopathic and diabetic gastroparesis versus placebo. METHODS This global, multicenter, double-blind, parallel-group, phase 2b study (NCT03544229) enrolled eligible adults aged 18-85 years with symptomatic idiopathic or diabetic gastroparesis. Randomized participants received either oral placebo or trazpiroben 5, 25, or 50 mg, administered twice daily over 12 weeks, and completed the American Neurogastroenterology and Motility Society Gastroparesis Cardinal Symptom Index-Daily Diary. Change in weekly composite score from baseline to week 12 (primary endpoint) and treatment-emergent adverse events were assessed. Data were summarized descriptively. KEY RESULTS Overall, 242 participants were enrolled (mean [standard deviation] age 55.7 [14.2] years; 75.6% female); 193 completed the study. No significant differences in change from baseline in weekly average of the daily diary composite score occurred at week 12 between placebo (least-squares mean [standard error] -1.19 [0.12]) and trazpiroben (5, 25, and 50 mg: -1.11 [0.22], -1.17 [0.12], and -1.21 [0.12], respectively). Overall, 41.4% of participants receiving trazpiroben reported treatment-emergent adverse events (placebo, 39.7%). No serious events were considered trazpiroben-related; no life-threatening or fatal events were reported. CONCLUSIONS & INFERENCES There was no clinically meaningful difference in efficacy between trazpiroben and placebo in treating gastroparesis, based on the primary endpoint analysis. Trazpiroben was well tolerated with no new safety concerns identified, strengthening evidence supporting its favorable safety profile. NCT number: NCT03544229.
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Affiliation(s)
- Jan Tack
- Department of Gastroenterology, University of Leuven, Leuven, Belgium
| | | | - Braden Kuo
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Susanna Y Huh
- Takeda Development Center Americas, Inc., Cambridge, Massachusetts, USA
| | - Yanwei Zhang
- Takeda Development Center Americas, Inc., Cambridge, Massachusetts, USA
| | - Yaozhu J Chen
- Takeda Development Center Americas, Inc., Cambridge, Massachusetts, USA
| | - Shailly Mehrotra
- Takeda Development Center Americas, Inc., Cambridge, Massachusetts, USA
| | - Henry P Parkman
- Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania, USA
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Carlson M, Mehrotra S, Chang M. Intentional Designing: Qualitative polling of stakeholders to build a medical university YouTube channel. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00699-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Matuskey D, Gallezot JD, Nabulsi N, Henry S, Torres K, Dias M, Angarita GA, Huang Y, Shoaf SE, Carson RE, Mehrotra S. Neurotransmitter transporter occupancy following administration of centanafadine sustained-release tablets: A phase 1 study in healthy male adults. J Psychopharmacol 2023; 37:164-171. [PMID: 36515395 PMCID: PMC9912308 DOI: 10.1177/02698811221140008] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Centanafadine is an inhibitor of reuptake transporters for norepinephrine (NET), dopamine (DAT) and serotonin (SERT). AIMS This phase 1, adaptive-design positron emission tomography study investigated the occupancy time course of NET, DAT, and SERT and the relationship to centanafadine plasma concentrations. METHODS Healthy adult males received centanafadine sustained-release 400 mg/day for 4 days (N = 6) or 800 mg in a single day (N = 4). Assessments included safety monitoring; time course of occupancy of NET, DAT, and SERT; and centanafadine plasma concentrations. RESULTS Transporter occupancy was numerically higher for NET versus DAT or SERT. For NET, estimated (mean ± standard error [SE]) maximal observable target occupancy (TOmax) and concentration at half maximal occupancy (IC50) were 64 ± 7% and 132 ± 65 ng/mL, respectively, for all regions and 82 ± 13% and 135 ± 97 ng/mL after excluding the thalamus, which showed high nonspecific binding. For DAT and SERT, TOmax could not be established and was assumed to be 100%; estimated IC50 (mean ± SE) values were 1580 ± 186 ng/mL and 1,760 ± 309 ng/mL, respectively. For centanafadine, the estimated in vivo affinity ratio was 11.9 ± 6.0 (mean ± SE) for NET/DAT, 13.3 ± 7.0 for NET/SERT, and 1.1 ± 0.2 for DAT/SERT. DAT and SERT occupancies at a plasma concentration of 1400 ng/mL were estimated to be 47 and 44%, respectively. CONCLUSIONS High occupancy at NET and moderate occupancy at DAT and SERT was observed at peak concentrations achieved following 400 mg total daily doses of centanafadine.
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Affiliation(s)
- David Matuskey
- Department of Radiology and Biomedical
Imaging, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Yale
University School of Medicine, New Haven, CT, USA
- Department of Neurology, Yale
University School of Medicine, New Haven, CT, USA
| | - Jean-Dominique Gallezot
- Department of Radiology and Biomedical
Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Nabeel Nabulsi
- Department of Radiology and Biomedical
Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Shannan Henry
- Department of Radiology and Biomedical
Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Kristen Torres
- Department of Radiology and Biomedical
Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Mark Dias
- Department of Radiology and Biomedical
Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Gustavo A Angarita
- Department of Psychiatry, Yale
University School of Medicine, New Haven, CT, USA
| | - Yiyun Huang
- Department of Radiology and Biomedical
Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Susan E Shoaf
- Otsuka Pharmaceutical Development &
Commercialization, Inc., Princeton, NJ, USA
- Susan E Shoaf, Otsuka Pharmaceutical
Development & Commercialization, Inc., 508 Carnegie Center, Princeton, NJ
08540, USA.
| | - Richard E Carson
- Department of Radiology and Biomedical
Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Shailly Mehrotra
- Otsuka Pharmaceutical Development &
Commercialization, Inc., Princeton, NJ, USA
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Mehrotra S, Bhattaram A, Krudys K, Bewernitz M, Uppoor R, Mehta M, Liu T, Sheridan P, Hershkowitz N, Kozauer N, Bastings E, Dunn B, Men AY. Extrapolation of Efficacy from Adults to Pediatric Patients of Drugs for Treatment of Partial Onset Seizures (POS): A Regulatory Perspective. Clin Pharmacol Ther 2022; 112:853-863. [PMID: 35678047 DOI: 10.1002/cpt.2681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/17/2022] [Indexed: 11/06/2022]
Abstract
The FDA has concluded that the efficacy of drugs approved for the treatment of partial onset seizures (POS) in adults can be extrapolated to pediatric patients 1 month of age and above and that independent efficacy trials in this pediatric population are no longer needed. This manuscript focuses on the dosing, pharmacokinetic, exposure-response, and clinical information that were leveraged from the approved drugs for the treatment of POS to conduct analyses that supported extrapolation of efficacy in pediatric patients. Clinical data from trials for 8 drugs (levetiracetam, oxcarbazepine, topiramate, lamotrigine, gabapentin, perampanel, tiagabine, and vigabatrin) approved in both adults and pediatric patients for the treatment of POS were analyzed. Comparisons of exposures at approved doses, placebo response, and model-based exposure-response relationships were performed. Based on disease similarity, similar response to intervention, and similar exposure-response relationships in adults and pediatric patients, it was concluded that extrapolation of efficacy in pediatric patients aged 1 month and above is acceptable. PK analysis to determine pediatric dose and regimens that provide drug exposure similar to that known to be effective in adult patients with POS will be required, along with long-term open-label safety data in pediatric patients.
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Affiliation(s)
- Shailly Mehrotra
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA.,Takeda
| | - Atul Bhattaram
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Kevin Krudys
- Office of Neuroscience, Office of New Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Michael Bewernitz
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Ramana Uppoor
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Mehul Mehta
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Tao Liu
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Philip Sheridan
- Division of Neurology 2, Office of New Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Norman Hershkowitz
- Division of Neurology 2, Office of New Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Nicholas Kozauer
- Division of Neurology 2, Office of New Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Eric Bastings
- Office of Neuroscience, Office of New Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Billy Dunn
- Office of Neuroscience, Office of New Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Angela Yuxin Men
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA.,Haichang Biotech/The WhiteOak Group
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Khong YM, Liu J, Cook J, Purohit V, Thompson K, Mehrotra S, Cheung SYA, Hay JL, Fletcher EP, Wang J, Sachs HC, Zhu H, Siddiqui A, Cunningham L, Selen A. Harnessing formulation and clinical pharmacology knowledge for efficient pediatric drug development: Overview and discussions from M-CERSI pediatric formulation workshop 2019. Eur J Pharm Biopharm 2021; 164:66-74. [PMID: 33878434 DOI: 10.1016/j.ejpb.2021.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/11/2020] [Accepted: 04/12/2021] [Indexed: 11/19/2022]
Abstract
A pediatric formulation workshop entitled "Pediatric Formulations: Challenges of Today and Strategies for Tomorrow" was held to advance pediatric drug product development efforts in both pre-competitive and competitive environments. The workshop had four main sessions discussing key considerations of Formulation, Analytical, Clinical and Regulatory. This paper focuses on the clinical session of the workshop. It provides an overview of the discussion on the interconnection of pediatric formulation design and development, clinical development strategy and pediatric clinical pharmacology. The success of pediatric drug product development requires collaboration of multi-disciplinary teams across the pharmaceutical industry, consortiums, foundations, academia and global regulatory agencies. Early strategic planning is essential to ensure alignment among major stakeholders of different functional teams. Such an alignment is particularly critical in the collaboration between formulators and clinical pharmacology teams.
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Affiliation(s)
| | - Jing Liu
- Pfizer Inc, Groton, CT 06340, USA.
| | | | | | | | - Shailly Mehrotra
- Otsuka Pharmaceutical Development & Commercialization, Princeton, NJ 08540, USA
| | | | - Justin L Hay
- Medicines and Healthcare Products Regulatory Agency (MHRA), Canary Wharf, London E14 4PU, UK
| | | | - Jian Wang
- U.S. Food and Drug Administration (FDA), Silver Spring, MD 20993, USA
| | - Hari Cheryl Sachs
- U.S. Food and Drug Administration (FDA), Silver Spring, MD 20993, USA
| | - Hao Zhu
- U.S. Food and Drug Administration (FDA), Silver Spring, MD 20993, USA
| | - Akhtar Siddiqui
- U.S. Food and Drug Administration (FDA), Silver Spring, MD 20993, USA
| | - Lea Cunningham
- U.S. Food and Drug Administration (FDA), Silver Spring, MD 20993, USA
| | - Arzu Selen
- U.S. Food and Drug Administration (FDA), Silver Spring, MD 20993, USA
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Sharma MR, Mehrotra S, Gray E, Wu K, Barry WT, Hudis C, Winer EP, Lyss AP, Toppmeyer DL, Moreno-Aspitia A, Lad TE, Velasco M, Overmoyer B, Rugo HS, Ratain MJ, Gobburu JV. Personalized Management of Chemotherapy-Induced Peripheral Neuropathy Based on a Patient Reported Outcome: CALGB 40502 (Alliance). J Clin Pharmacol 2019; 60:444-452. [PMID: 31802506 DOI: 10.1002/jcph.1559] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 10/29/2019] [Indexed: 01/01/2023]
Abstract
Chemotherapy-induced peripheral neuropathy (henceforth, neuropathy) is often dose limiting and is generally managed by empirical dose modifications. We aimed to (1) identify an early time point that is predictive of future neuropathy using a patient-reported outcome and (2) propose a dose-adjustment algorithm based on simulated data to manage neuropathy. In previous work, a dose-neuropathy model was developed using dosing and patient-reported outcome data from Cancer and Leukemia Group B 40502 (Alliance), a randomized phase III trial of paclitaxel, nanoparticle albumin-bound paclitaxel or ixabepilone as first-line chemotherapy for locally recurrent or metastatic breast cancer. In the current work, an early time point that is predictive of the future severity of neuropathy was identified based on predictive accuracy of the model. Using the early data and model parameters, simulations were conducted to propose a dose-adjustment algorithm for the prospective management of neuropathy in individual patients. The end of the first 3 cycles (12 weeks) was identified as the early time point based on a predictive accuracy of 75% for the neuropathy score after 6 cycles. For paclitaxel, nanoparticle albumin-bound paclitaxel, and ixabepilone, simulations with the proposed dose-adjustment algorithm resulted in 61%, 48%, and 35% fewer patients, respectively, with neuropathy score ≥8 after 6 cycles compared to no dose adjustment. We conclude that early patient-reported outcome data on neuropathy can be used to guide dose adjustments in individual patients that reduce the severity of future neuropathy. Prospective validation of this approach should be undertaken in future studies.
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Affiliation(s)
| | - Shailly Mehrotra
- Center for Translational Medicine, University of Maryland, Baltimore, Maryland, USA
| | | | - Kehua Wu
- The University of Chicago, Chicago, Illinois, USA
| | - William T Barry
- Alliance Statistics and Data Center, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Clifford Hudis
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Eric P Winer
- Dana-Farber/Partners CancerCare/Harvard Cancer Center, Boston, Massachusetts, USA
| | - Alan P Lyss
- Heartland Cancer Research NCORP, St. Louis, Missouri, USA
| | | | | | - Thomas E Lad
- John H. Stroger Jr Hospital of Cook County, Chicago, Illinois, USA
| | - Mario Velasco
- Decatur Memorial Hospital/Cancer Care Specialists of Illinois/Heartland Cancer Research NCORP, Decatur, Illinois, USA
| | - Beth Overmoyer
- Dana-Farber/Partners CancerCare/Harvard Cancer Center, Boston, Massachusetts, USA
| | - Hope S Rugo
- University of California San Francisco, San Francisco, California, USA
| | | | - Jogarao V Gobburu
- Center for Translational Medicine, University of Maryland, Baltimore, Maryland, USA
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Hoegh-Guldberg O, Jacob D, Taylor M, Guillén Bolaños T, Bindi M, Brown S, Camilloni IA, Diedhiou A, Djalante R, Ebi K, Engelbrecht F, Guiot J, Hijioka Y, Mehrotra S, Hope CW, Payne AJ, Pörtner HO, Seneviratne SI, Thomas A, Warren R, Zhou G. The human imperative of stabilizing global climate change at 1.5°C. Science 2019. [PMID: 31604209 DOI: 10.1016/b978-1-78548-051-5.50007-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Increased concentrations of atmospheric greenhouse gases have led to a global mean surface temperature 1.0°C higher than during the pre-industrial period. We expand on the recent IPCC Special Report on global warming of 1.5°C and review the additional risks associated with higher levels of warming, each having major implications for multiple geographies, climates, and ecosystems. Limiting warming to 1.5°C rather than 2.0°C would be required to maintain substantial proportions of ecosystems and would have clear benefits for human health and economies. These conclusions are relevant for people everywhere, particularly in low- and middle-income countries, where the escalation of climate-related risks may prevent the achievement of the United Nations Sustainable Development Goals.
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Affiliation(s)
- O Hoegh-Guldberg
- Global Change Institute, University of Queensland, St. Lucia, QLD 4072, Australia.
- School of Biological Sciences, University of Queensland, St. Lucia, QLD 4072, Australia
| | - D Jacob
- Climate Service Center Germany (GERICS), Helmholtz-Zentrum Geesthacht, Hamburg, Germany
| | - M Taylor
- Department of Physics, University of the West Indies, Kingston, Jamaica
| | - T Guillén Bolaños
- Climate Service Center Germany (GERICS), Helmholtz-Zentrum Geesthacht, Hamburg, Germany
| | - M Bindi
- Department of Agriculture, Food, Environment and Forestry (DAGRI), University of Florence, 50144 Firenze, Italy
| | - S Brown
- Faculty of Engineering and Physical Sciences, University of Southampton, Boldrewood Innovation Campus, Southampton SO16 7QF, UK
- Department of Life and Environmental Sciences, Faculty of Science and Technology, Bournemouth University, Fern Barrow, Poole, Dorset BH12 5BB, UK
| | - I A Camilloni
- Centro de Investigaciones del Mar y la Atmósfera (UBA-CONICET), UMI-IFAECI/CNRS, and Departamento de Ciencias de la Atmósfera y los Océanos (FCEN), University of Buenos Aires, Buenos Aires, Argentina
| | - A Diedhiou
- Université Grenoble Alpes, French National Research Institute for Sustainable Development (IRD), CNRS, Grenoble INP, IGE, F-38000 Grenoble, France
| | - R Djalante
- United Nations University-Institute for the Advanced Study of Sustainability (UNU-IAS), Tokyo, Japan
- Halu Oleo University, Kendari, South East Sulawesi, Indonesia
| | - K Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA
| | - F Engelbrecht
- Global Change Institute, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - J Guiot
- Aix Marseille University, CNRS, IRD, INRA, Collège de France, CEREGE, Aix-en-Provence, France
| | - Y Hijioka
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Onogawa, Tsukuba, Ibaraki 305-8506, Japan
| | | | - C W Hope
- Cambridge Judge Business School, University of Cambridge, Cambridge, UK
| | | | - H-O Pörtner
- Alfred Wegener Institute, Helmholtz Centre for Polar and Marine Research, Bremerhaven, Germany
| | - S I Seneviratne
- Institute for Atmospheric and Climate Science, ETH Zurich, Zurich, Switzerland
| | - A Thomas
- Climate Analytics, 10961 Berlin, Germany
- Environmental and Life Sciences, University of the Bahamas, Nassau 76905, Bahamas
| | - R Warren
- Tyndall Centre for Climate Change Research and School of Environmental Sciences, University of East Anglia, Norwich NR4 7TJ, UK
| | - G Zhou
- State Key Laboratory of Severe Weather, Chinese Academy of Meteorological Sciences, Beijing 100081, China
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Hoegh-Guldberg O, Jacob D, Taylor M, Guillén Bolaños T, Bindi M, Brown S, Camilloni IA, Diedhiou A, Djalante R, Ebi K, Engelbrecht F, Guiot J, Hijioka Y, Mehrotra S, Hope CW, Payne AJ, Pörtner HO, Seneviratne SI, Thomas A, Warren R, Zhou G. The human imperative of stabilizing global climate change at 1.5°C. Science 2019; 365:365/6459/eaaw6974. [DOI: 10.1126/science.aaw6974] [Citation(s) in RCA: 271] [Impact Index Per Article: 54.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 08/01/2019] [Indexed: 12/13/2022]
Abstract
Increased concentrations of atmospheric greenhouse gases have led to a global mean surface temperature 1.0°C higher than during the pre-industrial period. We expand on the recent IPCC Special Report on global warming of 1.5°C and review the additional risks associated with higher levels of warming, each having major implications for multiple geographies, climates, and ecosystems. Limiting warming to 1.5°C rather than 2.0°C would be required to maintain substantial proportions of ecosystems and would have clear benefits for human health and economies. These conclusions are relevant for people everywhere, particularly in low- and middle-income countries, where the escalation of climate-related risks may prevent the achievement of the United Nations Sustainable Development Goals.
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Boyes S, Nigdelioglu R, Mehrotra S, Pambuccian S, Walsh M, Ananthanarayanan V. Mast Cell Expression in Heart Transplant Acute Cellular Rejection (ACR): A Retrospective Single Institution Analysis. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.615] [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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Mehrotra S, Mishra S, Paramasivam G. Imaging during percutaneous coronary intervention for optimizing outcomes. Indian Heart J 2018; 70 Suppl 3:S456-S465. [PMID: 30595307 PMCID: PMC6309719 DOI: 10.1016/j.ihj.2018.08.012] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 08/02/2018] [Accepted: 08/09/2018] [Indexed: 01/29/2023] Open
Abstract
Angiography is the current gold standard for imaging during percutaneous coronary interventions but has significant limitations. Catheter-based intravascular imaging techniques such as intravascular ultrasound and the more recent optical coherence tomography have the potential to overcome these limitations and thus optimize clinical outcomes. In this update, we discussed the current applications of the available imaging techniques, existing evidence, continuing unmet needs, and potential areas for further research.
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Affiliation(s)
| | | | - Ganesh Paramasivam
- Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
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Maharolkar AP, Murugkar A, Khirade P, Mehrotra S. Temperature Dependent Microwave Dielectric Characterization of Associated Liquids. J STRUCT CHEM+ 2018. [DOI: 10.1134/s0022476618050177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Singh R, Mehrotra S, Gopalakrishnan M, Gojo I, Karp JE, Greer JM, Chen A, Piekarz R, Kiesel BF, Gobburu J, Rudek MA, Beumer JH. Population pharmacokinetics and exposure-response assessment of veliparib co-administered with temozolomide in patients with myeloid leukemias. Cancer Chemother Pharmacol 2018; 83:319-328. [PMID: 30456480 DOI: 10.1007/s00280-018-3731-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 11/13/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE Veliparib is an oral inhibitor of poly(ADP-ribose) polymerase enzyme. Combination of veliparib and temozolomide was well-tolerated and demonstrated clinical activity in older patients with relapsed or refractory acute myeloid leukemia (AML) or AML arising from pre-existing myeloid malignancies. We aimed to perform quantitative assessments of pharmacokinetics, efficacy, and safety of veliparib in this patient population to inform future trial design. METHODS Population pharmacokinetic analysis was performed using Phoenix® NLME with pharmacokinetic data obtained from 37 subjects after oral administration of veliparib in a Phase I study with and without temozolomide. Effect of covariates (age, sex, BMI, creatinine clearance (CLCR), and co-administration of temozolomide) on the pharmacokinetics of veliparib were evaluated, as well as impact of veliparib exposure on mucositis (dose-limiting toxicity), objective response rate (ORR), and overall survival. RESULTS A two-compartment model with first-order elimination and a first-order absorption with lag-time adequately described veliparib pharmacokinetics. CLCR and body weight were clinically significant covariates for veliparib disposition. The proportion of subjects with all grade mucositis increased with veliparib exposure (AUC). However, no trend in ORR and overall survival was observed with increasing exposure. CONCLUSIONS Veliparib with temozolomide presents a promising combination for older patients with myeloid leukemias. An exposure-safety relationship was established for this combination. Further clinical investigations aimed at elucidating the veliparib exposure-efficacy/safety relationship and optimizing dosing recommendations for maximizing benefit-risk in patients with advanced myeloid malignancies should study veliparib doses ranging up to 120 mg in combination with temozolomide.
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Affiliation(s)
- Renu Singh
- Center for Translational Medicine, University of Maryland, Baltimore, MD, USA
| | - Shailly Mehrotra
- Center for Translational Medicine, University of Maryland, Baltimore, MD, USA
| | | | - Ivana Gojo
- The Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
| | - Judith E Karp
- The Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
| | - Jacqueline M Greer
- The Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
| | - Alice Chen
- Investigational Drug Branch, Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD, USA
| | - Richard Piekarz
- Investigational Drug Branch, Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD, USA
| | | | - Jogarao Gobburu
- Center for Translational Medicine, University of Maryland, Baltimore, MD, USA
| | - Michelle A Rudek
- The Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
| | - Jan H Beumer
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA.
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Kanabar K, Mehrotra S, P R. Ostial left main coronary artery chronic total occlusion presenting as chronic stable angina. Indian Heart J 2018; 70:745-749. [PMID: 30392516 PMCID: PMC6204468 DOI: 10.1016/j.ihj.2018.04.012] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 04/11/2018] [Accepted: 04/25/2018] [Indexed: 11/22/2022] Open
Abstract
Significant left main coronary artery (LMCA) disease is found in 5–6% of all patients undergoing coronary angiography. It usually presents as acute coronary syndrome and is commonly associated with multi-vessel coronary artery disease (CAD). Complete occlusion of LMCA is a much rarer finding, since these patients usually present as unstable angina, myocardial infarction and cardiogenic shock. We report a case of a young female, who presented with chronic stable angina and had an isolated chronic total occlusion (CTO) of LMCA with no lesions in the other coronary arteries. Aortogram failed to demonstrate the stump of occluded LMCA and demonstrated the filling of the left coronary system from the right coronary artery. Apart from dyslipidemia, she had no other risk factors for CAD. She was extensively evaluated for non-atherosclerotic causes of LMCA CTO including vasculitis. She underwent coronary artery bypass graft successfully without any peri-procedural complications.
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Affiliation(s)
- K Kanabar
- Department of Cardiology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
| | - S Mehrotra
- Department of Cardiology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
| | - Rajan P
- Department of Cardiology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
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Ray S, Mehta NN, Mehrotra S, Lalwani S, Mangla V, Yadav A, Nundy S. Effect of informed consent on patients undergoing gastrointestinal surgery and living donor liver transplantation and on their relatives in a developing country. BJS Open 2018; 2:34-39. [PMID: 29951627 PMCID: PMC5989942 DOI: 10.1002/bjs5.37] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 11/16/2017] [Indexed: 11/12/2022] Open
Abstract
Background Informed consent is a systematic process for obtaining permission before conducting a healthcare intervention. In a developing country, gaining informed consent is generally perceived to be a ritual only to comply with legal requirements. The present study examined this by assessing the process of informed consent in patients undergoing gastrointestinal surgery or living donor liver transplantation (LDLT) and their relatives, based on their comprehension and overall satisfaction, in India. Methods All patients undergoing any gastrointestinal surgery or LDLT procedure between August 2015 and July 2016 and their relatives were included, and were administered a structured questionnaire 5 days after the procedure. Results The majority of patients (94·2 per cent) could recall the nature of their disease, the surgery performed (81·6 per cent) and anticipated complications (55·6 per cent). Among their relatives, these proportions were 97·8, 87·3 and 58·5 per cent respectively. Recall was associated with age, occupation and education among both patients and relatives. Patients undergoing LDLT, their donors and their relatives had better recall than those who had other gastrointestinal procedures (P < 0·001). Many patients found the process of informed consent useful and reassuring. Conclusion The details and risks of an operation were understood by most of the patients, especially those undergoing liver transplantation. Patients from developing countries can generally understand ‘informed consent’, and value it.
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Affiliation(s)
- S Ray
- Department of Surgical Gastroenterology and Liver Transplantation Sir Ganga Ram Hospital New Delhi India
| | - N N Mehta
- Department of Surgical Gastroenterology and Liver Transplantation Sir Ganga Ram Hospital New Delhi India
| | - S Mehrotra
- Department of Surgical Gastroenterology and Liver Transplantation Sir Ganga Ram Hospital New Delhi India
| | - S Lalwani
- Department of Surgical Gastroenterology and Liver Transplantation Sir Ganga Ram Hospital New Delhi India
| | - V Mangla
- Department of Surgical Gastroenterology and Liver Transplantation Sir Ganga Ram Hospital New Delhi India
| | - A Yadav
- Department of Surgical Gastroenterology and Liver Transplantation Sir Ganga Ram Hospital New Delhi India
| | - S Nundy
- Department of Surgical Gastroenterology and Liver Transplantation Sir Ganga Ram Hospital New Delhi India
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Massa S, Mehrotra S, Cass L, Ward G, Walker R. Understanding Patient's Refusal of Laryngectomies and the Survival Implications. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2017.12.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Childress A, Mehrotra S, Gobburu J, McLean A, DeSousa NJ, Incledon B. Single-Dose Pharmacokinetics of HLD200, a Delayed-Release and Extended-Release Methylphenidate Formulation, in Healthy Adults and in Adolescents and Children with Attention-Deficit/Hyperactivity Disorder. J Child Adolesc Psychopharmacol 2018; 28:10-18. [PMID: 29039979 PMCID: PMC5771548 DOI: 10.1089/cap.2017.0044] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Current extended-release (ER) formulations of psychostimulants used for treatment of attention-deficit/hyperactivity disorder (ADHD) provide an extended duration of ADHD symptom control; however, the onset of efficacy can be protracted and variable, leaving the early morning untreated. The primary objective was to characterize the single-dose pharmacokinetics and tolerability of HLD200, an evening-dosed, delayed-release (DR) and ER formulation of methylphenidate (MPH), in healthy adults and in adolescents and children with ADHD. METHODS The pharmacokinetics and tolerability of a single, oral evening dose of HLD200 (54 mg) were evaluated in two single-center open-label studies: the first in healthy adults (n = 12) and the second in adolescents (n = 18) and children (n = 11) with ADHD. Primary pharmacokinetic endpoints were the rate and extent of MPH absorption (Cmax and area under the curve [AUC]) and time to peak concentration (Tmax). These parameters were calculated using noncompartmental analysis. RESULTS HLD200 produced a pharmacokinetic profile characterized by an 8- to 10-hour delay in MPH release, followed by a period of extended controlled release, resulting in an ascending absorption profile that coincided with the early morning and afternoon. Mean values (coefficient of variation [CV]%) of weight-adjusted pharmacokinetic parameters were similar in adults and in adolescents and children with ADHD: Cmax ([ng/mL]/[mg/kg]) was 9.1 (35.2), 8.8 (34.5), and 7.4 (30.1); AUC0-t ([ng · h/mL]/[mg/kg]) was 126.5 (35.5), 129.4 (34.8), and 129.7 (27.3); and Tmax (hours) was 15.6 (11.1), 17.1 (14.5), and 17.7 (14.1), respectively. Intersubject variability in the mean time to achieve ascending plasma MPH concentrations of 2, 3, 4, and 5 ng/mL was low (CV: 7.8%-17.7%). CONCLUSIONS Evening-dosed HLD200 produces the intended DR and ER pharmacokinetic profile that provides a consistent predictable delay in initial MPH release until the early morning, followed by extended release across the day. The body weight-adjusted pharmacokinetics of HLD200 were similar between adults and adolescents and children with ADHD.
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Affiliation(s)
- Ann Childress
- The Center for Psychiatry and Behavioral Medicine, Las Vegas, Nevada
| | - Shailly Mehrotra
- Center for Translational Medicine, School of Pharmacy, University of Maryland, Baltimore, Maryland
| | - Jogarao Gobburu
- Center for Translational Medicine, School of Pharmacy, University of Maryland, Baltimore, Maryland
| | - Angus McLean
- Ironshore Pharmaceuticals and Development, Inc., Grand Cayman, Cayman Islands
| | - Norberto J. DeSousa
- Ironshore Pharmaceuticals and Development, Inc., Grand Cayman, Cayman Islands
| | - Bev Incledon
- Ironshore Pharmaceuticals and Development, Inc., Grand Cayman, Cayman Islands
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Abstract
This article reviews fluid therapy and medications in pediatric trauma. For resuscitation in the setting of hemorrhagic shock, isotonic crystalloid solution is the first-line agent of choice. Colloid solutions offer no additional benefit, introduce possible increased risks and cost more than crystalloids. Blood products, starting with pRBCs, should be introduced after 20-40 ml/kg of crystalloid has been administered if there is ongoing need for volume replacement. The use of a massive transfusion protocol of 1:1:1 (if >30 kg) or 30:20:20 (if <30 kg) of pRBCs:FFP:platelets is suggested after an initial 30 ml/kg of pRBcs has been administered. Cryoprecipitate should be given for documented low fibrinogen or ongoing bleeding after administration of 1 round of all 3 blood components. For patients at risk of massive hemorrhage, early administration of tranexamic acid with an initial loading dose of 15 mg/kg (maximum 1 g) is recommended. Choice of medication for intubation of the patient with Traumatic Brain Injury (TBI) may best be guided by physiology: in the TBI patient with a high mean arterial pressure, premedication with lidocaine, fentanyl and use of etomidate may be most appropriate, whereas in the hemodynamically compromised patient, use of ketamine alone may be considered. If needed, norepinephrine has been recommended as a temporizing agent for vasopressor support in the setting of fluid-refractory shock. Although controversial, in the setting of significant spinal cord injury, the potential benefits of administering 24-48 hours of steroids (initial 30 mg/kg of methylprednisolone within 8 hours of injury) may outweigh the risks especially in previously healthy pediatric patients.
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Affiliation(s)
- Amita Misir
- Department of Pediatrics, Schulich School of Medicine, Western University, London, Ontario, Canada
| | - S Mehrotra
- Department of Pediatrics, Schulich School of Medicine, Western University, London, Ontario, Canada
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19
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Mehrotra S, Gopalakrishnan M, Gobburu J, Ji J, Greer JM, Piekarz R, Karp JE, Pratz KW, Rudek MA. Exposure-Response of Veliparib to Inform Phase II Trial Design in Refractory or Relapsed Patients with Hematological Malignancies. Clin Cancer Res 2017; 23:6421-6429. [PMID: 28751440 PMCID: PMC5837045 DOI: 10.1158/1078-0432.ccr-17-0143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 01/16/2017] [Revised: 05/04/2017] [Accepted: 07/18/2017] [Indexed: 11/16/2022]
Abstract
Purpose: A phase I trial of veliparib in combination with topotecan plus carboplatin (T+C) demonstrated a 33% objective response rate in patients with hematological malignancies. The objective is to perform exposure-response analysis to inform the phase II trial design.Experimental Design: Pharmacokinetic, efficacy, and safety data from 95 patients, who were administered 10 to 100 mg b.i.d. doses of veliparib for either 8, 14, or 21 days with T+C, were utilized for exposure-efficacy (objective response and overall survival) and exposure-safety (≥grade 3 mucositis) analysis. Multivariate cox proportional hazards and logistic regression analyses were conducted. The covariates evaluated were disease status, duration of treatment, and number of prior therapies.Results: The odds of having objective response were 1.08-fold with 1,000 ng/hr/mL increase in AUC, 1.8-fold with >8 days treatment, 2.8-fold in patients with myeloproliferative neoplasms (MPN), and 0.5-fold with ≥2 prior therapies. Based on analysis of overall survival, hazard of death decreased by 1.5% for 1,000 ng/hr/mL increase in AUC, 39% with >8 days treatment, 44% in patients with MPN, while increased by 19% with ≥2 prior therapies. The odds of having ≥grade 3 mucositis increased by 29% with 1,000 ng.h/mL increase in AUC.Conclusions: Despite shallow exposure-efficacy relationship, doses lower than 80 mg do not exceed veliparib single agent preclinical IC50 Shallow exposure-mucositis relationship also supports the 80-mg dose. Based on benefit/risk assessment, veliparib at a dose of 80 mg b.i.d. for at least 14 days in combination with T+C is recommended to be studied in MPN patients. Clin Cancer Res; 23(21); 6421-9. ©2017 AACR.
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Affiliation(s)
- Shailly Mehrotra
- Center for Translational Medicine, University of Maryland, Baltimore, Maryland
| | | | - Jogarao Gobburu
- Center for Translational Medicine, University of Maryland, Baltimore, Maryland
| | - Jiuping Ji
- Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Jacqueline M Greer
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
| | - Richard Piekarz
- Investigational Drug Branch, Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, Maryland
| | - Judith E Karp
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
- Department of Oncology, Johns Hopkins University, Baltimore, Maryland
| | - Keith W Pratz
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
- Department of Oncology, Johns Hopkins University, Baltimore, Maryland
| | - Michelle A Rudek
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland.
- Department of Oncology, Johns Hopkins University, Baltimore, Maryland
- Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins University, Baltimore, Maryland
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20
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Mehrotra S, Sharma MR, Gray E, Wu K, Barry WT, Hudis C, Winer EP, Lyss AP, Toppmeyer DL, Moreno-Aspitia A, Lad TE, Valasco M, Overmoyer B, Rugo H, Ratain MJ, Gobburu JV. Kinetic-Pharmacodynamic Model of Chemotherapy-Induced Peripheral Neuropathy in Patients with Metastatic Breast Cancer Treated with Paclitaxel, Nab-Paclitaxel, or Ixabepilone: CALGB 40502 (Alliance). AAPS J 2017; 19:1411-1423. [PMID: 28620884 PMCID: PMC5711539 DOI: 10.1208/s12248-017-0101-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 01/24/2017] [Accepted: 05/11/2017] [Indexed: 01/26/2023] Open
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting toxicity caused by several chemotherapeutic agents. Currently, CIPN is managed by empirical dose modifications at the discretion of the treating physician. The goal of this research is to quantitate the dose-CIPN relationship to inform the optimal strategies for dose modification. Data were obtained from the Cancer and Leukemia Group B (CALGB) 40502 trial, a randomized phase III trial of paclitaxel vs. nab-paclitaxel vs. ixabepilone as first-line chemotherapy for locally recurrent or metastatic breast cancer. CIPN was measured using a subset of the Functional Assessment of Cancer Therapy-Gynecologic Oncology Group Neurotoxicity (FACT-GOG-NTX) scale. A kinetic-pharmacodynamic (K-PD) model was utilized to quantitate the dose-CIPN relationship simultaneously for the three drugs. Indirect response models with linear and Smax drug effects were evaluated. The model was evaluated by comparing the predicted proportion of patients with CIPN (score ≥8 or score ≥12) to the observed proportion. An indirect response model with linear drug effect was able to describe the longitudinal CIPN data reasonably well. The proportion of patients that were falsely predicted to have CIPN or were falsely predicted not to have CIPN was 20% or less at any cycle. The model will be utilized to identify an early time point that can predict CIPN at later time points. This strategy will be utilized to inform dose adjustments to prospectively manage CIPN. Clinicaltrials.gov ID: NCT00785291.
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Affiliation(s)
- Shailly Mehrotra
- Center for Translational Medicine, School of Pharmacy, University of Maryland, Baltimore, Maryland, USA
| | | | - Elizabeth Gray
- NorthShore University Health System, Evanston, Illinois, USA
| | - Kehua Wu
- State Key Laboratory of Natural and Biomimetic Drugs (Peking University), Beijing, China
| | - William T Barry
- Alliance Statistics and Data Center, Duke University, Durham, North Carolina, USA
| | - Clifford Hudis
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Eric P Winer
- Dana-Farber/Partners CancerCare/ Harvard Cancer Center, Boston, Massachusetts, USA
| | - Alan P Lyss
- Heartland Cancer Research NCORP, St. Louis, Missouri, USA
| | | | | | - Thomas E Lad
- John H. Stroger Jr Hospital of Cook County, Chicago, Illinois, USA
| | - Mario Valasco
- Decatur Memorial Hospital/Cancer Care Specialists of Illinois/ Heartland Cancer Research NCORP, Decatur, Illinois, USA
| | - Beth Overmoyer
- Dana-Farber/Partners CancerCare/ Harvard Cancer Center, Boston, Massachusetts, USA
| | - Hope Rugo
- University of California-San Francisco, San Francisco, California, USA
| | | | - Jogarao V Gobburu
- Center for Translational Medicine, School of Pharmacy, University of Maryland, Baltimore, Maryland, USA.
- Center for Translational Medicine, School of Pharmacy, University of Maryland, 20 N Pine Street, Room 513, Baltimore, Maryland, 21201, USA.
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21
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Niu J, Scheuerell C, Mehrotra S, Karan S, Puhalla S, Kiesel BF, Ji J, Chu E, Gopalakrishnan M, Ivaturi V, Gobburu J, Beumer JH. Parent-Metabolite Pharmacokinetic Modeling and Pharmacodynamics of Veliparib (ABT-888), a PARP Inhibitor, in Patients With BRCA 1/2-Mutated Cancer or PARP-Sensitive Tumor Types. J Clin Pharmacol 2017; 57:977-987. [PMID: 28387939 DOI: 10.1002/jcph.892] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 02/16/2017] [Indexed: 01/17/2023]
Abstract
Veliparib (ABT-888) is a novel oral poly-ADP-ribose polymerase (PARP) inhibitor that is being developed for the treatment of hematologic malignancies and solid tumors. Although the pharmacokinetics of veliparib have been studied in combination with cytotoxic agents, limited information exists regarding the pharmacokinetics (PK) of chronically dosed single-agent veliparib in patients with either BRCA 1/2-mutated cancer or PARP-sensitive tumors. The objectives of the current analysis were to characterize the population pharmacokinetics of veliparib and its primary, active metabolite, M8, and to evaluate the relationship between veliparib and M8 concentrations and poly-ADP-ribose (PAR) level observed in peripheral blood mononuclear cells (PBMCs). Seventy-one subjects contributed with veliparib plasma concentrations, M8 plasma concentrations, and PAR levels in PBMCs. Veliparib and M8 concentrations were modeled simultaneously using a population PK approach. A 2-compartment model with delayed first-order absorption and the elimination parameterized as renal (CLR /F) and nonrenal clearance (CLNR /F) adequately described veliparib pharmacokinetics. The pharmacokinetics of the M8 metabolite was described with a 2-compartment model. Creatinine clearance(CLCR ) and lean body mass (LBM) were identified as significant predictors of veliparib CLR /F and central volume of distribution, respectively. For a typical subject (LBM, 48 kg; CLCR , 95 mL/min), total clearance (CLR /F + CLNR /F), and central and peripheral volume of distribution for veliparib were estimated as 17.3 L/h, 98.7 L, and 48.3 L, respectively. At least 50% inhibition of PAR levels in PBMCs was observed at dose levels ranging from 50 to 500 mg.
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Affiliation(s)
- Jing Niu
- Center for Translational Medicine, School of Pharmacy, University of Maryland, Baltimore, MD, USA
| | - Christie Scheuerell
- Center for Translational Medicine, School of Pharmacy, University of Maryland, Baltimore, MD, USA
| | - Shailly Mehrotra
- Center for Translational Medicine, School of Pharmacy, University of Maryland, Baltimore, MD, USA
| | - Sharon Karan
- Center for Translational Medicine, School of Pharmacy, University of Maryland, Baltimore, MD, USA
| | - Shannon Puhalla
- Division of Hematology-Oncology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Brian F Kiesel
- Cancer Therapeutics Program, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - Jiuping Ji
- Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Edward Chu
- Division of Hematology-Oncology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Cancer Therapeutics Program, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - Mathangi Gopalakrishnan
- Center for Translational Medicine, School of Pharmacy, University of Maryland, Baltimore, MD, USA
| | - Vijay Ivaturi
- Center for Translational Medicine, School of Pharmacy, University of Maryland, Baltimore, MD, USA
| | - Jogarao Gobburu
- Center for Translational Medicine, School of Pharmacy, University of Maryland, Baltimore, MD, USA
| | - Jan H Beumer
- Division of Hematology-Oncology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Cancer Therapeutics Program, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA.,Department of Pharmaceutical Sciences, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA
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22
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Srivastava SK, Shinde S, Singh SK, Mehrotra S, Verma MR, Singh AK, Nandi S, Srivastava N, Singh SK, Goswami TK, Bhure SK, Kumar H, Ghosh SK. Antisperm antibodies in repeat-breeding cows: Frequency, detection and validation of threshold levels employing sperm immobilization, sperm agglutination and immunoperoxidase assay. Reprod Domest Anim 2017; 52:195-202. [DOI: 10.1111/rda.12877] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 09/24/2016] [Indexed: 11/30/2022]
Affiliation(s)
- SK Srivastava
- Division of Animal Reproduction; ICAR-Indian Veterinary Research Institute; Izatnagar India
| | - S Shinde
- Division of Animal Reproduction; ICAR-Indian Veterinary Research Institute; Izatnagar India
| | - SK Singh
- Division of Animal Reproduction; ICAR-Indian Veterinary Research Institute; Izatnagar India
| | - S Mehrotra
- AI Laboratory, LPM; ICAR-Indian Veterinary Research Institute; Izatnagar India
| | - MR Verma
- Division of LES & IT; ICAR-Indian Veterinary Research Institute; Izatnagar India
| | - AK Singh
- Division of Animal Reproduction; ICAR-Indian Veterinary Research Institute; Izatnagar India
| | - S Nandi
- Centre for Animal Disease Research and Diagnosis; ICAR-Indian Veterinary Research Institute; Izatnagar India
| | - N Srivastava
- Quality Control, Semen Freezing Laboratory; ICAR-Central Institute for Research on Cattle; Meerut India
| | - SK Singh
- Division of Animal Reproduction; ICAR-Indian Veterinary Research Institute; Izatnagar India
| | - TK Goswami
- Immunology Section; Indian Veterinary Research Institute; Izatnagar India
| | - SK Bhure
- Biochemistry and Food Science Sections; Indian Veterinary Research Institute; Izatnagar India
| | - H Kumar
- Division of Animal Reproduction; ICAR-Indian Veterinary Research Institute; Izatnagar India
| | - SK Ghosh
- Division of Animal Reproduction; ICAR-Indian Veterinary Research Institute; Izatnagar India
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23
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Mehrotra S, Gopalakrishnan M, Gobburu J, Greer JM, Piekarz R, Karp JE, Pratz K, Rudek MA. Population pharmacokinetics and site of action exposures of veliparib with topotecan plus carboplatin in patients with haematological malignancies. Br J Clin Pharmacol 2017; 83:1688-1700. [PMID: 28156017 DOI: 10.1111/bcp.13253] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 01/18/2017] [Accepted: 01/30/2017] [Indexed: 11/28/2022] Open
Abstract
AIMS Veliparib is a potent inhibitor of poly(ADP-ribose) polymerase (PARP) enzyme. The objectives of the analysis were to evaluate the effect of baseline covariates and co-administration of topotecan plus carboplatin (T + C) on pharmacokinetics of veliparib in patients with refractory acute leukaemia, and compare veliparib concentration in various biological matrices. METHODS A population pharmacokinetic model was developed and effect of age, body size indices, sex, creatinine clearance (CrCL) and co-administration of T + C on the pharmacokinetics of veliparib were evaluated. The final model was qualified using bootstrap and quantitative predictive check. Linear regression was conducted to correlate concentrations of veliparib in various biological matrices. RESULTS A two compartment model with first-order absorption with Tlag described veliparib pharmacokinetics. The apparent clearance (CL/F) and volume (Vc /F) were 16.5 l h-1 and 122.7 l, respectively. The concomitant administration of T + C was not found to affect veliparib CL/F. CrCL and lean body mass (LBM) were significant covariates on CL/F and Vc/F, respectively. While a strong positive relationship was observed between veliparib concentrations in plasma and bone marrow supernatant, no correlation was observed between plasma and peripheral blood or bone marrow blasts. CONCLUSIONS Consistent with veliparib's physiochemical properties and its elimination mechanism, LBM and CrCL were found to affect pharmacokinetics of veliparib while concomitant administration of T + C did not affect veliparib's CL/F. Plasma concentrations were found to be a reasonable surrogate for veliparib concentrations in peripheral blood and bone marrow supernatant but not blasts. The current model will be utilized to conduct exposure-response analysis to support dosing recommendations.
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Affiliation(s)
- Shailly Mehrotra
- Center for Translational Medicine, University of Maryland, Baltimore, Maryland
| | | | - Jogarao Gobburu
- Center for Translational Medicine, University of Maryland, Baltimore, Maryland
| | - Jacqueline M Greer
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
| | - Richard Piekarz
- Investigational Drug Branch, Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, Maryland
| | - Judith E Karp
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland.,Department of Oncology, Johns Hopkins University, Baltimore, Maryland
| | - Keith Pratz
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland.,Department of Oncology, Johns Hopkins University, Baltimore, Maryland
| | - Michelle A Rudek
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland.,Department of Oncology, Johns Hopkins University, Baltimore, Maryland.,Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins University, Baltimore, Maryland
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Janakiraman H, House RP, Talwar S, Courtney SM, Hazard ES, Hardiman G, Mehrotra S, Howe PH, Gangaraju V, Palanisamy V. Repression of caspase-3 and RNA-binding protein HuR cleavage by cyclooxygenase-2 promotes drug resistance in oral squamous cell carcinoma. Oncogene 2016; 36:3137-3148. [PMID: 27941877 PMCID: PMC5453834 DOI: 10.1038/onc.2016.451] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 10/17/2016] [Accepted: 10/31/2016] [Indexed: 12/22/2022]
Abstract
A well-studied RNA-binding protein Hu Antigen-R (HuR), controls post-transcriptional gene regulation and undergoes stress-activated caspase-3 dependent cleavage in cancer cells. The cleavage products of HuR are known to promote cell death however, the underlying molecular mechanisms facilitating caspase-3 activation and HuR cleavage remains unknown. Here, we show that HuR cleavage associated with active caspase-3 in oral cancer cells treated with ionizing radiation and chemotherapeutic drug, paclitaxel. We determined that oral cancer cells overexpressing cyclooxygenase-2 (COX-2) limited the cleavage of caspase-3 and HuR, which reduced the rate of cell death in paclitaxel resistant oral cancer cells. Specific inhibition of COX-2 by celecoxib, promoted apoptosis through activation of caspase-3 and cleavage of HuR in paclitaxel-resistant oral cancer cells, both in vitro and in vivo. In addition, oral cancer cells overexpressing cellular HuR increased the half-life of COX-2 mRNA, promoted COX-2 protein expression and exhibited enhanced tumor growth in vivo in comparison with cells expressing a cleavable form of HuR. Finally, our ribonucleoprotein immunoprecipitation and sequencing (RIP-seq) analyses of HuR in oral cancer cells treated with ionizing radiation (IR), determined that HuR cleavage product-1 (HuR-CP1) bound and promoted the expression of mRNAs encoding proteins involved in apoptosis. Our results indicated that, cellular non-cleavable HuR controls COX-2 mRNA expression and enzymatic activity. In addition, overexpressed COX-2 protein repressed the cleavage of caspase-3 and HuR to promote drug resistance and tumor growth. Altogether, our observations support the use of the COX-2 inhibitor celecoxib, in combination with paclitaxel, for the management of paclitaxel resistant oral cancer cells.
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Affiliation(s)
- H Janakiraman
- Department of Oral Health Sciences and Center for Oral Health Research, College of Dental Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - R P House
- Department of Oral Health Sciences and Center for Oral Health Research, College of Dental Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - S Talwar
- Department of Oral Health Sciences and Center for Oral Health Research, College of Dental Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - S M Courtney
- Center for Genomics Medicine, Medical University of South Carolina, Charleston, SC, USA.,Department of Pathology, Medical University of South Carolina, Charleston, SC, USA
| | - E S Hazard
- Center for Genomics Medicine, Medical University of South Carolina, Charleston, SC, USA.,Library Science and Informatics, Medical University of South Carolina, Charleston, SC, USA
| | - G Hardiman
- Center for Genomics Medicine, Medical University of South Carolina, Charleston, SC, USA.,Departments of Medicine and Public Health, Medical University of South Carolina, Charleston, SC, USA
| | - S Mehrotra
- Department of Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - P H Howe
- Department of Biochemistry and Molecular Biology, Medical University of South Carolina, Charleston, SC, USA
| | - V Gangaraju
- Department of Biochemistry and Molecular Biology, Medical University of South Carolina, Charleston, SC, USA
| | - V Palanisamy
- Department of Oral Health Sciences and Center for Oral Health Research, College of Dental Medicine, Medical University of South Carolina, Charleston, SC, USA.,Department of Biochemistry and Molecular Biology, Medical University of South Carolina, Charleston, SC, USA
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Mehrotra S, Kumar B, Vijayvergiya R, Mathew S. High traffic congestion in right atrium. Indian Heart J 2016; 68 Suppl 2:S190-S193. [PMID: 27751286 PMCID: PMC5067761 DOI: 10.1016/j.ihj.2016.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 03/22/2016] [Accepted: 04/01/2016] [Indexed: 11/17/2022] Open
Abstract
A 62-year lady presented with limb swelling and heart failure due to leads induced venous fibrosis and severe tricuspid stenosis, 33 years after pacemaker implantation. After undergoing surgical removal of all leads and tricuspid valve replacement under cardiopulmonary bypass, she regained a normal functional status and tricuspid and right ventricular functions.
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Affiliation(s)
| | | | | | - S Mathew
- Cardiothoracic Surgery, PGIMER, Chandigarh, India
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26
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Henning S, Navarro F, Farhangi Oskuei P, Tobin K, Fernandez M, Eby J, Klarquist J, Chatterjee S, Mehrotra S, Clark J, Le Poole I. 033 CCL22 to divert regulatory T cells and control melanoma tumor growth. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.057] [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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Sojitra P, Muralidhar A, Quddus S, Mehrotra S, Ananthanarayanan V. Airway Centered Neutrophils in Post-Transplant Transbronchial Biopsies: A Poor Predictor of Infection. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.763] [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: 10/21/2022] Open
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28
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Kwong C, Essendrop R, Dixon E, Mehrotra S, Lowery E, Gagermeier J, Mirza K, Ananthanarayanan V. Histomorphology and C4d Expression Are Poor Predictors of Antibody-Mediated Rejection (AMR) in Lung Transplant Recipients. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.762] [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: 10/22/2022] Open
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29
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Mehrotra S, Gobburu J. Communicating to Influence Drug Development and Regulatory Decisions: A Tutorial. CPT Pharmacometrics Syst Pharmacol 2016; 5:163-72. [PMID: 27299706 PMCID: PMC4846777 DOI: 10.1002/psp4.12073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 02/24/2016] [Accepted: 02/25/2016] [Indexed: 01/07/2023] Open
Abstract
Pharmacometricians require three skills to be influential: technical, business (e.g., drug development), and soft skills (e.g., communication). Effective communication is required to translate technical and often complicated quantitative findings to interdisciplinary team members in order to influence drug development or regulatory decisions. In this tutorial, we highlight important aspects related to communicating pharmacometric analysis to influence decisions.
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Affiliation(s)
- S Mehrotra
- Center for Translational Medicine, School of Pharmacy, University of Maryland, Baltimore, Maryland, USA
| | - J Gobburu
- Center for Translational Medicine, School of Pharmacy, University of Maryland, Baltimore, Maryland, USA
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Mehrotra S, Sharma R, Prasad N, Gupta A, Bhadauria D, Kaul A, Jain M, Rishishwar P. The importance of donor-specific anti-HLA antibodies (DSA) identification in renal transplant patients with C4d-negative biopsies. Indian Journal of Transplantation 2016. [DOI: 10.1016/j.ijt.2016.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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31
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Dar SH, Qureshi S, Palanivelu M, Muthu S, Mehrotra S, Jan MH, Chaudhary GR, Kumar H, Saravanan R, Narayanan K. Evaluating a murine model of endometritis using uterine isolates of Escherichia coli from postpartum buffalo. Iran J Vet Res 2016; 17:171-176. [PMID: 27822246 PMCID: PMC5090150] [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] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 01/23/2016] [Accepted: 02/27/2016] [Indexed: 06/06/2023]
Abstract
Ascending infection of the uterus with Gram-negative bacteria is responsible for postpartum endometritis in cattle and buffalo and can adversely affect fertility. Development of a laboratory animal model for bovine endometritis would facilitate the understanding of the pathogenesis as it is difficult to conduct controlled experimentation in the native host. In the present study, 30 virgin Swiss Albino mice (5-8 weeks old) were used to evaluate the pathogenic potential of Escherichia coli, isolated from the normally calved postpartum buffalo to induce endometritis. Mice in the diestrus phase of the estrous cycle were randomly allotted to one of the following four intravaginal inoculation (100 μL) treatments: EG (experimental group)-1: sterile normal saline; EG-2, -3 and -4: E. coli@ 1.5 × 104, 105 and 106 CFU/ml, respectively. The animals were then scarified 36 h post-inoculation to study gross and microscopical lesions. Gross changes were confined to EG-4. Acute endometritis was recorded in 50% of the EG-3 and 66.7% of the EG-4. The rate of acute endometritis development was significantly higher in EG-4 (P<0.05) as compared to the other groups. The present study demonstrated that the animal model for bubaline endometritis can be developed in mice by intravaginal inoculation of E.coli@ 1.5 × 106 CFU/ml at diestrus. Ease of intravaginal inoculation, apparent absence of systemic involvement and high infective rate are the advantages of the model over other studies.
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Affiliation(s)
- S. H. Dar
- Division of Animal Reproduction, Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - S. Qureshi
- Division of Biological Standardization, Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - M. Palanivelu
- Divsion of Pathology, Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - S. Muthu
- Division of Temperate Animal Husbandry, Indian Veterinary Research Institute, Mukteswar, Uttarakhand, 263138, India
| | - S. Mehrotra
- Division of Livestock Production and Management, Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - M. H. Jan
- Division of Animal Reproduction, Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - G. R. Chaudhary
- Ph.D. Scholar, Division of Animal Reproduction, Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - H. Kumar
- Division of Animal Reproduction, Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - R. Saravanan
- Immunology Section, Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - K. Narayanan
- Division of Animal Reproduction, Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
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Kumar A, Mehrotra S, Singh G, Maurya VP, Narayanan K, Mahla AS, Chaudhari RK, Singh M, Soni YK, Kumawat BL, Dabas SK, Srivastava N. Supplementation of Slow-Release Melatonin Improves Recovery of Ovarian Cyclicity and Conception in Summer Anoestrous Buffaloes (Bubalus bubalis). Reprod Domest Anim 2015; 51:10-7. [PMID: 26566713 DOI: 10.1111/rda.12639] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 10/10/2015] [Indexed: 11/30/2022]
Abstract
The role of melatonin as a protective neurohormone against restoring cyclicity in summer anoestrous animals in photoperiod species has gained wider acceptance. This study was designed to uncover the evidence the slow-release melatonin (MLT) has on initiation of ovarian cyclicity and conception rate (CR) in summer anoestrous buffaloes. Thus, buffaloes diagnosed as summer anoestrous (absence of overt signs of oestrus, concurrent rectal examination and radioimmunoassay for serum progesterone at 10 days interval) were grouped as untreated (Group I, sterilized corn oil, n = 8) and treated (Group II, single subcutaneous injection of MLT @18 mg/50 kg bwt in sterilized corn oil, n = 20). Animals treated and detected in oestrus were artificially inseminated (AI) followed by division into Group III (second dose of MLT on 5th day post-AI, n = 8) and Group IV (no melatonin administration, n = 10). Blood samples were collected at 4 days interval for estimation of serum MLT, progesterone and oestrogen using radioimmunoassay kit. Mean oestrous induction rate (OIR), oestrous induction interval (OII), interoestrous interval (IOI) and CR were estimated. Compared to control, concentration of melatonin was significantly (p < 0.05) higher in treated group ranging from 14.34 ± 1.72 to 412.31 ± 14.47 pg/ml whereas other two hormones did not show any concentration difference. Melatonin-administered buffaloes showed significantly (p < 0.05) higher (90%) OIR with OII of 18.06 ± 1.57 days. Results showed improvement in conception rate in buffaloes administered with post-insemination melatonin. It can be concluded from the study that slow-release melatonin supplementation restored cyclicity in summer anoestrous animals resulting in improvement in conception rate in buffaloes.
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Affiliation(s)
- A Kumar
- Division of Animal Production, ICAR Res Complex for NEH Region, Umiom, Meghalaya, India
| | - S Mehrotra
- AI Laboratory, LPM, ICAR-Indian Veterinary Research Institute, Izatnagar, UP, India
| | - G Singh
- Division of Climatology and Physiology, ICAR-Indian Veterinary Research Institute, Izatnagar, UP, India
| | - V P Maurya
- Division of Climatology and Physiology, ICAR-Indian Veterinary Research Institute, Izatnagar, UP, India
| | - K Narayanan
- Division of Animal Reproduction, ICAR-Indian Veterinary Research Institute, Izatnagar, UP, India
| | - A S Mahla
- Division of Animal Reproduction, ICAR-Indian Veterinary Research Institute, Izatnagar, UP, India
| | - R K Chaudhari
- Division of Animal Reproduction, ICAR-Indian Veterinary Research Institute, Izatnagar, UP, India
| | - M Singh
- Division of Animal Production, ICAR Res Complex for NEH Region, Umiom, Meghalaya, India
| | - Y K Soni
- Animal Physiology Laboratory, ICAR-Central Institute for Research on Cattle, Meerut, UP, India
| | - B L Kumawat
- Division of Animal Reproduction, ICAR-Indian Veterinary Research Institute, Izatnagar, UP, India
| | - S K Dabas
- Division of Animal Production, ICAR Res Complex for NEH Region, Umiom, Meghalaya, India
| | - N Srivastava
- Semen Freezing Laboratory, ICAR-Central Institute for Research on Cattle, Meerut, UP, India
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Gill N, Sirizzotti N, Kucey A, Tieu A, Urquhart B, Lim R, Rieder M, Joubert G, Mehrotra S, Poonai N. 327 Does a Single Dose of Dexamethasone for Croup Cause Adrenal Suppression?: A Prospective Study. Ann Emerg Med 2015. [DOI: 10.1016/j.annemergmed.2015.07.363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Mehrotra S, Sharma R. Role of C1q binding donor specific antibody (DSA) assay in transplantation. Indian Journal of Transplantation 2015. [DOI: 10.1016/j.ijt.2015.11.002] [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: 10/22/2022] Open
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35
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Mehrotra S, Rishishwar P, Sharma R. Evaluation of immunological barriers in transplantation: Role of transplant immunology lab. Indian Journal of Transplantation 2015. [DOI: 10.1016/j.ijt.2015.11.001] [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: 10/22/2022] Open
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36
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Mehrotra S, Schmith VD, Dumitrescu TP, Gobburu J. Pharmacometrics-guided drug development of antihyperhidrosis agents. J Clin Pharmacol 2015; 55:1256-67. [DOI: 10.1002/jcph.536] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 04/28/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Shailly Mehrotra
- Center for Translation Medicine, School of Pharmacy; University of Maryland; Baltimore MD USA
| | - Virginia D. Schmith
- Clinical Pharmacology Modeling and Simulation; GlaxoSmithKline (GSK); Research Triangle Park NC USA
- Presently at Nuventra Pharma Sciences
| | - Teodora Pene Dumitrescu
- Clinical Pharmacology Modeling and Simulation; GlaxoSmithKline (GSK); Research Triangle Park NC USA
| | - Jogarao Gobburu
- Center for Translation Medicine, School of Pharmacy; University of Maryland; Baltimore MD USA
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Kumar A, Mehrotra S, Singh G, Narayanan K, Das G, Soni Y, Singh M, Mahla A, Srivastava N, Verma M. Sustained delivery of exogenous melatonin influences biomarkers of oxidative stress and total antioxidant capacity in summer-stressed anestrous water buffalo (Bubalus bubalis). Theriogenology 2015; 83:1402-7. [DOI: 10.1016/j.theriogenology.2014.12.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 10/25/2014] [Accepted: 12/18/2014] [Indexed: 11/25/2022]
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Sharma M, Gray E, Mehrotra S, Wu K, Barry WT, Hudis CA, Winer EP, Lyss AP, Toppmeyer D, Moreno-Aspitia A, Rugo HS, Ratain MJ, Gobburu J. A model-based approach to dose optimization of neurotoxic chemotherapy for metastatic breast cancer (MBC). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.1041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | - Kehua Wu
- Peking University, Beijing, China
| | | | | | | | | | | | | | - Hope S. Rugo
- University of California, San Francisco, San Francisco, CA
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Mehrotra S, Rohit MK. Prospective study to develop surface landmarks for blind axillary vein puncture for permanent pacemaker and defibrillator lead implantation and compare it to available contrast venography guided technique. Indian Heart J 2015; 67:136-40. [PMID: 26071292 DOI: 10.1016/j.ihj.2015.04.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Revised: 08/30/2014] [Accepted: 04/09/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To develop surface landmarks for blind axillary vein puncture for pacemaker lead implantation. METHODS AND RESULTS Patients for routine coronary angiography were counseled for participating in our study. 20 patients who gave consent were taken up for axillary venogram after proper positioning at the time of coronary angiogram. The venograms of these 20 patients, were reviewed and the landmarks were used to develop a blind axillary puncture technique. Success rate of 100% was achieved with surface landmark guided axillary vein puncture. The implantation time while using surface landmark guided axillary puncture was not significantly longer than when venography based approach was used. Another interesting observation made from the study was that increasing BMI had a positive correlation with the time taken for venous access, the fluoroscopic time and the volume of contrast used, all the associations being statistically significant. Thus, the surface landmark guided technique is more safe and expeditious in non obese patients and probably in pediatric patients as well. Moreover, the new surface landmark guided approach is a significant safety step in terms of reducing the unwanted and avoidable radiation exposure to the hands. CONCLUSION The results of this study demonstrate that placement of endocardial permanent pacemaker and ICD leads via the developed surface landmarks is effective and safe and is devoid of the harmful effects of radiation and contrast exposure.
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Affiliation(s)
- S Mehrotra
- Assistant Professor, Dept of Cardiology, PGIMER, Chandigarh, India.
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Krishnan BB, Kumar H, Mehrotra S, Singh S, Goswami T, Khan F, Patra M, Islam R. Effect of leukotriene B4and oyster glycogen in resolving subclinical endometritis in repeat breeding crossbred cows. INDIAN J ANIM RES 2015. [DOI: 10.5958/0976-0555.2015.00112.0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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41
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Mehrotra S, Sharma R, Mayya M, Gupta A, Prasad N, Kaul A, Bhadauria D. Pre transplant PRA (penal reactive antibody) and DSA (donor specific antibody) screening status and outcome after renal transplantation. Indian Journal of Transplantation 2015. [DOI: 10.1016/j.ijt.2015.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Dar S, Chaudhary G, Mehrotra S, Qureshi S, Sankar M, Jan M, Kumar H, Chaudhary R, Palanivelu M, Narayanan K. Association ofEscherichia coliandFusobacterium necrophorumwith subclinical endometritis in postpartum Murrah buffalo. ACTA ACUST UNITED AC 2015. [DOI: 10.5958/0973-970x.2015.00076.0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
Medicinal plants having immunomodulatory properties provide an alterna-tive potential to conventional chemotherapy for a variety of diseases espe-cially in relation to host defense mechanism. Curcumin one of major curcu-minoids of Curcuma longa, reportedly possess several pharmacological prop-erties including anti-inflammatory, anti-cancer, immunomodulatory activi-ties. Curcumin blocks inflammatory enzymes cyclooxygenase (COX), lipooxy-genase (LOX), matrix metalloproteinase (MMP). Curcumin suppresses the proliferation of a wide variety of tumour cells, including breast carcinoma, colon carcinoma, and renal cell carcinoma through cell cycle arrest. It in-duced apoptosis by downregulation of antiapoptotic protein (Bcl-2 and Bcl-xL). Curcumin modulates immune system by suppressing T-cells, proliferating number of B-cells and reducing proliferation of immature B-cell lymphoma cells. Curcumin treatment inhibited the production of cytokines (IL-8, MIP-1α, MCP-1, IL-1β, TNF-α) and dimerisation of TLR’s. Immunoregulatory activi-ty of curcumin is by inhibiting phosphorylation of IKKβ which ultimately leads to suppression of NF-κB (transcriptional activator protein). This activity of curcumin has renewed scientific interest in its potential to prevent and treat the diseases such as arthritis, allergy, asthma & cancer.
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Mehrotra S, Singh U, Gupta HP, Tandon I, Saxena P. A prospective double blind study comparing the effects of oxytocin and human chorionic gonadotrophin as trigger for ovulation. J OBSTET GYNAECOL 2013; 34:13-6. [PMID: 24359041 DOI: 10.3109/01443615.2013.822479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study was undertaken to compare the effect of oxytocin and human chorionic gonadotrophin (hCG) on ovulation and conception. A total of 100 women with anovulatory infertility were allocated into two equal groups to take clomiphene citrate plus hCG or clomiphene citrate plus oxytocin. The size and number of follicles by transvaginal sonography determined the administration of hCG or oxytocin. The serum progesterone concentration was measured to provide evidence for ovulation. The ovulation and pregnancy rate of the two groups were compared. There was no significant difference between the groups with respect to mean number of follicles, mean follicular size and rate of ovulation in three cycles. The rate of pregnancy was higher in the oxytocin group compared with the hCG group (12% vs 4%) but it failed to reach statistical difference (p = 0.140). Mild pain was the only side-effect observed in the two groups. Oxytocin was found to be a viable alternative to hCG for triggering ovulation in infertile patients.
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Affiliation(s)
- S Mehrotra
- Department of Obstetrics and Gynaecology, Chattrapati Sahuji Maharaj Medical University (Formerly King George Medical University) , Lucknow , India
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Abstract
Atypical vascular lesions (AVL) and angiosarcomas (AS) are lesions known to arise after radiation therapy. These lesions can show overlap in both their gross and histologic pictures, and distinction between the two can be extremely challenging at times. They are known most commonly to arise in the breast region after radiation therapy. We present the first unique case of post-radiation AVL/AS arising in the larynx of a 51 year old woman, occurring 8 years after she received radiation for tonsillar squamous cell carcinoma.
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Affiliation(s)
- K M Mudaliar
- Department of Pathology, Loyola University Medical Center, Loyola University Chicago, Building #110, Rm #2242, 2160 S. First Avenue, Maywood, IL, 60153, USA,
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Tilakaratna P, Mehrotra S. Entrapment of a central venous catheter guidewire. Anaesthesia 2013; 68:646. [PMID: 23662760 DOI: 10.1111/anae.12272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Srivastava N, Srivastava SK, Ghosh SK, Jerome A, Das GK, Mehrotra S. Sequestration of PDC-109 Protein by Specific Antibodies and Egg Yolk Cryoprotects Bull Spermatozoa. Reprod Domest Anim 2013; 48:724-31. [DOI: 10.1111/rda.12151] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Accepted: 01/07/2013] [Indexed: 11/30/2022]
Affiliation(s)
- N Srivastava
- Animal Reproduction Division; Indian Veterinary Research Institute; Izatnagar; UP; India
| | - SK Srivastava
- Animal Reproduction Division; Indian Veterinary Research Institute; Izatnagar; UP; India
| | - SK Ghosh
- Animal Reproduction Division; Indian Veterinary Research Institute; Izatnagar; UP; India
| | - A Jerome
- Central Institute for Research on Buffaloes; Hisar; Hariana; UP; India
| | - GK Das
- Animal Reproduction Division; Indian Veterinary Research Institute; Izatnagar; UP; India
| | - S Mehrotra
- Animal Reproduction Division; Indian Veterinary Research Institute; Izatnagar; UP; India
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Kumar A, Mehrotra S, Dangi S, Singh G, chand S, Singh L, Mahla A, Kumar S, Nehra K. Faecal steroid metabolites assay as a non-invasive monitoring of reproductive status in animals. Vet World 2013. [DOI: 10.5455/vetworld.2013.59-63] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Bhandari S, Seth A, Sethi KK, Tyagi S, Gupta R, Tiwari SC, Mehrotra S, Seth A, Guha S, Deb PK, Dasbiswas A, Mohanan PP, Venugopal K, Sinha N, Pinto B, Banerjee A, Sengottuvelu G, Mehran R, Mc Collough P. Cardiological Society of India practice guidelines for angiography in patients with renal dysfunction. Indian Heart J 2012. [PMID: 23186627 DOI: 10.1016/j.ihj.2012.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
PREAMBLE: The potential risk of contrast-induced acute kidney injury (CI-AKI) has made utilization of coronary angiography in the work-up for the diagnosis of coronary artery disease in CKD quite low.(1) This is in contrast to increasing prevalence and severity of CAD as the serum creatinine rises.(2) In fact most CKD patients will succumb to CAD and not to ESRD.(3) Thus the judicious use of CAG/PCI in this setting is of prime importance but underused. The CSI began to develop guidelines for Indian context as most guidelines are those developed by ACC/AHA or ESC. The aim was to assist the physicians in selecting the best management strategy for an individual patient under his care based on an expert committee who would review the current data and write the guidelines with relevance to the Indian context. The guidelines were developed initially in June 2010 as an initiative of Delhi CSI. Three interventional cardiologist (SB, AS, KKS), one nephrologist (SCT) and two clinical cardiologists (ST, RG) along with Dr. Roxana Mehran (New York) and Dr. Peter McCullough (Missouri), U.S.A.; were involved in a three-way teleconference to discuss/debate the data. This was presented by SB, and over the next two hours each data subset was debated/agreed/deleted and this resulted in the "Guidelines for CAG in Renal Dysfunction Patients". These were then written and re- circulated to all for final comments. Further, these guidelines were updated and additional Task Force Members nominated by Central CSI were involved in the formation of the final CSI Guidelines. Both (Roxana Mehran and Peter McCullough) reviewed these updated Guidelines in October 2012 and after incorporating the views of all the Task Force members-the final format is as it is presented in this final document.
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Singh U, Gupta H, Mehrotra S. W302 TO EVALUATE THE EFFECT OF VAGINAL PH ON EFFICACY OF PROSTAGLANDIN GEL ON CERVICAL RIPENING AND COURSE OF LABOUR. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)62025-6] [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]
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