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Tsatsos M, Giachos I, Tsinopoulos I, Ziakas N, Jacob S. Something to SMILE about. Is small incision lenticule extraction ready to become the gold standard in laser refractive surgery? Yes. Eye (Lond) 2024; 38:636-638. [PMID: 37731050 PMCID: PMC10920690 DOI: 10.1038/s41433-023-02745-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 07/28/2023] [Accepted: 09/11/2023] [Indexed: 09/22/2023] Open
Affiliation(s)
- M Tsatsos
- 2nd Ophthalmology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - I Giachos
- Corneal Department, Dr Agarwal's Hospital, Chennai, India
| | - I Tsinopoulos
- 2nd Ophthalmology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - N Ziakas
- 2nd Ophthalmology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - S Jacob
- Corneal Department, Dr Agarwal's Hospital, Chennai, India
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Tsatsos M, Giachos I, Prousali E, Jacob S, Ziakas N. Something to SMILE about. Is small incision lenticule extraction (SMILE) ready to become the gold standard in laser refractive surgery? no. Eye (Lond) 2024; 38:633-635. [PMID: 37731051 PMCID: PMC10920905 DOI: 10.1038/s41433-023-02746-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 09/03/2023] [Accepted: 09/11/2023] [Indexed: 09/22/2023] Open
Affiliation(s)
- M Tsatsos
- 2nd Ophthalmology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - I Giachos
- Dr Agarwal's Hospital, Corneal Department, Chennai, India
| | - E Prousali
- 2nd Ophthalmology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - S Jacob
- Dr Agarwal's Hospital, Corneal Department, Chennai, India
| | - N Ziakas
- 2nd Ophthalmology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Jacob S, Nair AB, Boddu SHS, Abuhijjleh RK, Selvaraju K, Babu T, Gorain B, Shah J, Morsy MA. The emerging role of lipid nanosystems and nanomicelles in liver diseases. Eur Rev Med Pharmacol Sci 2023; 27:8651-8680. [PMID: 37782180 DOI: 10.26355/eurrev_202309_33790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Nanoparticles (NPs) exhibit remarkable potential in the diagnosis and treatment of various liver ailments, including primary liver cancer or hepatocellular carcinoma (HCC), liver cirrhosis, viral hepatitis, and alcoholic and non-alcoholic liver diseases. High surface area-to-volume ratio with distinct physicochemical and bio-pharmaceutical properties have contributed numerous benefits to NPs, such as high intracellular uptake and efficient drug delivery capabilities stemming from their ability to encapsulate a diverse range of drugs. Lipid-based nanosystems have demonstrated significant potential as reliable and efficient transport vehicles for a variety of actives, including small interfering RNA, targeting the liver, owing to their excellent in vivo compatibility, biodegradable nature, and non-toxic properties. Multiple aspects of various lipid-based materials, lipid nanosystems like solid lipid NPs, nanovesicles such as nanoemulsions, liposomes, and nanomicelles for liver-specific active targeting have been comprehensively reviewed. Ongoing and completed clinical trials of lipid nanosystems developed for HCC, hepatic fibrosis, and hepatitis are tabulated. Types of receptors and ligands typically used for active liver targeting in HCC are extensively discussed. The US FDA's recent approval for the use of Onpattro (Patisiran) injection to treat polyneuropathy in adult patients is indicative of the rapid development of lipid nanosystems employed for hepatic targeting. Nanoemulsions loaded with diagnostic imaging agents for multi-modal liver imaging were briefly discussed. Emerging technologies are being developed to integrate desirable properties of nanoparticles (NPs), including high stability, efficient drug loading, opsonization avoidance, active liver targeting, and facilitation of endosomal escape. Clinical translations of many lipid NPs for drug and gene therapy applications targeting different liver diseases are expected in the near future.
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Affiliation(s)
- S Jacob
- Department of Pharmaceutical Sciences, College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates.
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Wadiwala I, Garg P, Nativi J, Lyle M, Leoni J, Yip D, Goswami R, Patel P, Sareyyupoglu B, MM E, Jacob S, Landolfo K, Pham S. The Role of Impella 5.5 to Reduce Pulmonary Artery Pressures in Patients with Cardiac Amyloidosis with Small Ventricular Cavity as a Bridge to Heart Transplant. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Balasubramanian P, Thomas M, Makey I, Alvarez F, Narula T, Pham S, Landolfo K, Ahmed MES, Jacob S, Shah S, Mallea J. Remote vs Local Ex-Vivo Lung Perfusion, a Single Center Experience. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Hussain M, Yazji J, Garg P, Wadiwala I, Alamouti-Fard E, Alomari M, Jacob S, Edwards M, Pham S. Bariatric Surgery is Safe and Effective in Thoracic Organ Transplant Recipients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Errahmani M, Locquet M, Spoor D, Jimenez G, Camilleri J, Bernier M, Broggio D, Monceau V, Ferrières J, Thariat J, Kirova Y, Loap P, Langendijk J, Crijns A, Boveda S, Jacob S. Association between cardiac radiation exposure and the risk of arrhythmia and conduction disorders in breast cancer patients treated with radiotherapy: A case-control study. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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8
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Honaryar M, Allodji R, Locquet M, Jimenez G, Lapeyre M, Camilleri J, Broggio D, Ferrières J, De Vathaire F, Jacob S. Coronary artery calcification progression over two years in breast cancer patients treated with radiation therapy: Findings from BACCARAT study. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Behera MR, John EE, Thomas A, David VG, Alexander S, Mohapatra A, Valson AT, Jacob S, Kakde S, Koshy PM, Rajan G, Varughese S. Difficult cannulation of hemodialysis arteriovenous fistula - Role of imaging in access management (DICAF STUDY). J Vasc Access 2022; 23:877-884. [PMID: 33977819 PMCID: PMC7615862 DOI: 10.1177/11297298211015097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Difficulty in cannulation of arteriovenous fistula (AVF) can lead to inadequate dialysis, transient to permanent loss of access and increases dependency on bridging catheters. This study aimed to analyze the causes for difficult fistula cannulation, using various imaging modalities. METHODOLOGY This was a retrospective single-center observational study conducted between October 2017 and June 2018. Patients whose fistulae were difficult to cannulate were initially evaluated by physical examination followed by doppler ultrasonography or/and fistulogram as necessary. The patients were divided into two groups that is, primary difficult cannulation (within first three months of creation of fistula) or secondary difficult cannulation (after three months). RESULTS We encountered difficult cannulation in 43 patients. About 60% were primary difficult cannulations. Most common causes for difficulty in cannulation were cannulation zone (CZ) stenosis (23.3%), immature fistula (20.9%), outflow stenosis (18.6%), inflow stenosis (11.6%), anatomical abnormalities (11.6%), outflow plus CZ stenosis (9.3%) and inflow plus CZ stenosis (4.7%). Among patients with primary difficult cannulation, immature fistula (34.6%) was the most common cause, whereas CZ stenosis (47.1%) was the most common etiology for secondary difficult cannulation. Edema leading to difficult cannulation was found in 12 patients (27.9%), all of which was due to central vein stenosis. Cannulation resulted in hematoma, fistula thrombosis, failure of fistula and pseudoaneurysm in 83.7%, 27.9%, 16.3%, and 2.3% of cases respectively. Bridging temporary dialysis catheter placement was required in 67.4% patients. Ultrasound doppler had lower diagnostic value when compared to fistulogram (71.4% vs 93.9%, p = 0.014). CONCLUSION Difficulty in cannulating the arteriovenous fistula is a common problem in hemodialysis patients. We suggest that patients whose fistulae are difficult to cannulate should undergo early radiological evaluation to decrease catheter dependency and access failure.
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Affiliation(s)
| | | | - Athul Thomas
- Department of Nephrology, Christian Medical College, Vellore, TN, India
| | | | - Suceena Alexander
- Department of Nephrology, Christian Medical College, Vellore, TN, India
| | - Anjali Mohapatra
- Department of Nephrology, Christian Medical College, Vellore, TN, India
| | - Anna T Valson
- Department of Nephrology, Christian Medical College, Vellore, TN, India
| | - Shibu Jacob
- Department of Nephrology, Christian Medical College, Vellore, TN, India
| | - Shailesh Kakde
- Department of Nephrology, Christian Medical College, Vellore, TN, India
| | | | - Gautam Rajan
- Department of Nephrology, Christian Medical College, Vellore, TN, India
| | - Santosh Varughese
- Department of Nephrology, Christian Medical College, Vellore, TN, India
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Beckmann S, Fuchs E, Jacob S, Mauermann M. INFLUENCE OF STEAM-INDUCED WETTING OF FOOD- AND COSMETIC-BASED CONTAMINANTS ON THE EFFICIENCY OF CLEAN-IN-PLACE PROCESSES OF CONTAINERS. Food and Bioproducts Processing 2022. [DOI: 10.1016/j.fbp.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Furrer D, Dragic D, Droit A, Jacob S. Les altérations génomiques dans le cancer du sein HER2-positif et la réponse au traitement. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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12
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Conley AJ, Berger T, Del Razo RA, Cotterman RF, Sahagún E, Goetze LR, Jacob S, Weinstein TAR, Dufek ME, Mendoza SP, Bales KL. The onset of puberty in colony-housed male and female titi monkeys (Plecturocebus cupreus): Possible effects of oxytocin treatment during peri-adolescent development. Horm Behav 2022; 142:105157. [PMID: 35338890 PMCID: PMC9250660 DOI: 10.1016/j.yhbeh.2022.105157] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/24/2022] [Accepted: 03/11/2022] [Indexed: 12/29/2022]
Abstract
Oxytocin has been used to treat neurodevelopmental conditions in adolescent patients but possible effects on reproductive development have not been well investigated. The effects of daily intra-nasal oxytocin treatment (12-18 months of age) on puberty and fertility were studied in colony-housed, male and female titi monkeys (Plecturocebus cupreus). Body weight, urinary conjugated pregnanes and estrogens (defining cyclicity) in females, and androgens and sperm in urine of in males, were measured from 1 to 3 years of age to detect puberty. Serum testosterone was also measured in males at 13, 23 and 33 months of age and hemi-castration at 3 years of age enabled assessment of testicular morphometry and oxytocin receptor expression. An oxytocin treatment*time interaction suggested a minor, transient suppression in weight gain after treatment ended. Note that females weighed 10% less across all ages. Oxytocin-treated females exhibited early, spurious ovulations but neither regular cyclicity (≈30 months) nor pregnancies were affected by treatment. Oxytocin did not affect the pubertal increase in urinary androgen or the first appearance of sperm, which occurred as early as 15 months of age. Treatment did delay the puberty-associated rise in serum testosterone in males. All males were pubertal by 22 months and all females by 32 months of age. Although no major male or female fertility outcome was observed, oxytocin demonstrated some physiological effects through a delay of testosterone secretion in males, induction of precocious ovulation in females, and a suppression of general weight gain for the months following treatment.
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Affiliation(s)
- A J Conley
- Department of Population Health & Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616, United States of America.
| | - T Berger
- Department of Animal Science, University of California, Davis, CA 95616, United States of America
| | - R Arias Del Razo
- Department of Psychology, University of California, Davis, CA 95616, United States of America; California National Primate Research Center, University of California, Davis, CA 95616, United States of America
| | - R F Cotterman
- Department of Population Health & Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616, United States of America
| | - E Sahagún
- Department of Psychology, University of California, Davis, CA 95616, United States of America
| | - L R Goetze
- California National Primate Research Center, University of California, Davis, CA 95616, United States of America
| | - S Jacob
- Department of Psychology, University of California, Davis, CA 95616, United States of America
| | - T A R Weinstein
- Department of Psychology, University of California, Davis, CA 95616, United States of America
| | - M E Dufek
- California National Primate Research Center, University of California, Davis, CA 95616, United States of America
| | - S P Mendoza
- Department of Psychology, University of California, Davis, CA 95616, United States of America; California National Primate Research Center, University of California, Davis, CA 95616, United States of America
| | - K L Bales
- Department of Psychology, University of California, Davis, CA 95616, United States of America; California National Primate Research Center, University of California, Davis, CA 95616, United States of America; Department of Neurobiology, Physiology, and Behavior, University of California, Davis, CA 95616, United States of America.
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Spoor D, van Leeuwen F, Russell N, Boekel N, Jacob S, Combs S, Borm K, Vliegenthart R, Sikkema G, Sijtsema M, van der Schaaf A, Maduro J, Langendijk H, Schuit E, Crijns A. MO-0803 External Validation of NTCP-models for Acute Coronary Events after Breast Cancer Radiotherapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02439-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pretzsch E, Nieß H, Bösch F, Westphalen C, Jacob S, Neumann J, Werner J, Heinemann V, Angele M. Age and metastasis – How age influences metastatic spread in cancer. Colorectal cancer as a model. Cancer Epidemiol 2022; 77:102112. [DOI: 10.1016/j.canep.2022.102112] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 01/15/2022] [Accepted: 01/17/2022] [Indexed: 12/12/2022]
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Errahmani MY, Thariat J, Ferrières J, Panh L, Locquet M, Lapeyre-Mestre M, Guernec G, Bernier MO, Boveda S, Jacob S. Risk of pacemaker implantation after radiotherapy for breast cancer: A study based on French nationwide health care database sample. Int J Cardiol Heart Vasc 2022; 38:100936. [PMID: 35005214 PMCID: PMC8717594 DOI: 10.1016/j.ijcha.2021.100936] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/19/2021] [Indexed: 11/12/2022]
Abstract
Background Among cardiac complications of breast cancer radiotherapy (BC RT), there are very limited data on arrhythmia and conduction disorders, in particular severe cases requiring permanent pacemaker implantation (PPMI). Therefore, this exploratory study aimed to evaluate the risk of PPMI for BC patients treated with RT, compared with the general population and with BC patients not treated with RT. Methods The study was performed on a 1/97 representative sample of the French health care database (EGB database). Adult women with a first BC treated with or without RT between 2008 and 2016 were included, followed until 2018, and de novo PPMI were identified. We compared the PPMI incidence in BC cohort relative to the general population with standardized incidence ratio (SIR) and evaluated the risk of PPMI in RT patients compared to patients without RT with a competing risk survival analysis. Results A total of 3853 BCE patients were included. Among BC patients treated with RT, 28 PPMI cases were observed compared with 13 expected cases, corresponding to a SIR of 2.18 [95% CI: 1.45-3.06]. For BC patients not treated with RT, the SIR was 1.01 [95% CI: 0.40-1.90]. Patients treated with RT showed a borderline significant higher risk of PPMI compared with those not treated with RT (subdistribution Hazard Ratio = 2.08, 95% CI 0.87-4.97, p = 0.09). Conclusions Our exploratory findings indicate that, over the last decade in France, BC patients treated with RT appeared to be at higher risk of PPMI than general population. Further studies are needed to expand on this topic.
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Affiliation(s)
- M Y Errahmani
- Laboratory of Epidemiology, Institute for Radiation Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France.,University Paris-Saclay, Gif-sur-Yvette, France
| | - J Thariat
- Department of Radiotherapy, Centre de Lutte Contre le Cancer A. Baclesse, University of Caen Normandie, Caen, France
| | - J Ferrières
- INSERM, UMR 1295 - CERPOP Centre d'Epidémiologie et de Recherche en santé des POPulations, Toulouse, France.,Department of Cardiology, Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - L Panh
- Heart Rhythm Management Department, Clinique Pasteur, Toulouse, France
| | - M Locquet
- Laboratory of Epidemiology, Institute for Radiation Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - M Lapeyre-Mestre
- Department of Medical and Clinical Pharmacology, CIC 1436, University of Toulouse 3, Toulouse, France
| | - G Guernec
- INSERM, UMR 1295 - CERPOP Centre d'Epidémiologie et de Recherche en santé des POPulations, Toulouse, France
| | - M O Bernier
- Laboratory of Epidemiology, Institute for Radiation Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - S Boveda
- Heart Rhythm Management Department, Clinique Pasteur, Toulouse, France
| | - S Jacob
- Laboratory of Epidemiology, Institute for Radiation Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
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Panh L, Jacob S, Van Rothem J, Lapeyre-Mestre M, Marijon E, Boveda S. Impact of transcatheter aortic valve implantations on temporal trend in pacemaker implantations over the last decade using the French National Healthcare database. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Agrawal V, Valson AT, Bakthavatchalam YD, Kakde S, Mohapatra A, David VG, Alexander S, Jacob S, Jude Prakash JA, Veeraraghavan B, Varughese S. Skin Colonizers and Catheter Associated Blood Stream Infections in Incident Indian Dialysis Patients. Indian J Nephrol 2022; 32:34-41. [PMID: 35283564 PMCID: PMC8916144 DOI: 10.4103/ijn.ijn_400_20] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/11/2020] [Accepted: 02/03/2021] [Indexed: 11/04/2022] Open
Abstract
Introduction Skin colonization is a risk factor for multi-drug resistant (MDR) catheter-associated bloodstream infections (CABSI). This study aimed to determine the prevalence and spectrum of skin colonizing MDR organisms in incident HD patients and their correlation with CABSI. Methods This single-center prospective cohort study included consecutive adult incident HD patients who underwent tunneled or non-tunneled internal jugular vein HD catheter insertion between June 1, 2017 and October 31, 2017. Nasal, axillary, and exit site swabs were obtained prior to catheter insertion, at 14-21 days, and 28-35 days after catheter insertion. Results Forty-three patients (69.7% male, 32.5% diabetic) were included and provided baseline swabs, while 29 and 10 patients respectively were available for follow-up swabs. MDR bacterial colonization, MRSA colonization, and MDR gram-negative colonization on the baseline set of swabs were seen in 76.7%, 69.7%, and 9.3% patients respectively. Of the 29 patients with at least two consecutive sets of swabs, 79.3% showed persistent colonization by MDR gram-positive organisms, most commonly by MRSA. Six patients developed a CABSI during the follow-up period (incidence rate 3.7 per 1000 patient days), 83.4% were gram negative, and in only one instance (16.6%) was the bacterial strain identical to that which had previously colonized the skin. Conclusions Three-fourths of HD patients were colonized by MDR bacteria prior to HD initiation. Despite the majority being persistently colonized by MDR gram-positive organisms, CABSIs were predominantly gram negative.
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Affiliation(s)
- Varun Agrawal
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anna T. Valson
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Shailesh Kakde
- Department of Nephrology, Jupiter Hospital, Baner, Pune, Maharashtra, India
| | - Anjali Mohapatra
- Division of Nephrology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vinoi George David
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Suceena Alexander
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Shibu Jacob
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Balaji Veeraraghavan
- Department of Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Santosh Varughese
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
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Errahmani MY, Thariat J, Ferrieres J, Bernier MO, Boveda S, Jacob S. Breast cancer radiotherapy and risk of pacemaker implantation: an epidemiologic analysis using the French nationwide claims database. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Radiotherapy (RT) is a major treatment for breast cancer (BC), but it is also associated with an increased long-term (>5–10 years) risk of cardiac complications. Specific data on cardiac arrhythmias and conduction disorders are warranted.
Purpose
To evaluate whether pacemaker (PM) implantation risk is higher in BC patients treated with RT compared to the general population or population of BC patients treated without RT.
Methods
Our study was based on the Echantillon Généraliste de Bénéficiaires (EGB), the 1/97 random sample of the French nationwide health insurance claims database. The population of patients treated for BC consisted of adult women with a first BC identified by the ICD-10 diagnosis codes between 2008 and 2016, and followed through 2018. PM implantations and RT were identified with medical procedures codes in the french Common Classification of Medical Procedures (CCAM). For each year from 2008 to 2018, the reference population included all adult women of the EGB database. History of PM or BC was an exclusion criteria. Annual incidence rates of PM implantations were evaluated between 2008 and 2018 in the reference populations. The number of PM cases observed in BC patients at least one year after BC diagnosis was compared with the expected number of PM cases calculated by using reference incidence rates with age standardization. We then computed the standardized incidence ratio (SIR) as the ratio of the observed number of PM to the expected number of PM, with 95% confidence intervals (CIs). Thereafter, a survival analysis was performed in BC patients using a Cox regression model (Hazard Ratio – HR) in order to evaluate the risk of PM associated with treatment including RT (RT) compared with treatment not including RT (no RT).
Results
A total of 3,853 patients were included in the population of patients treated for BC between 2008 and 2016 with a mean age of 60 years old and a mean follow-up of 5.6 years. In this population, 35 cases of PM were observed, compared with 19.9 expected cases of PM, corresponding to a significant SIR=1.76 (95% CI: 1.22 - 2.39). This excess risk was carried by the RT group of 2973 patients (77% of BC population): 28 observed PM vs 12.9 expected, SIR=2.18 (95% CI: 1.45–3.06). In Cox regression analysis, after adjustment on age, RT was associated with an increased risk of PM compared with no RT, but this result did not reach statistical significance (HR=1.73; p-value=0.21).
Conclusion
Based on our study, BC patients receiving RT appeared to be at higher risk of PM implantation than general female population and BC patients without RT, illustrating a potential association between cardiac exposure during BC RT and conduction disorders.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Y Errahmani
- Institut de radioprotection et de sureté nucléaire (IRSN), Université Paris Saclay, Epidémiologie, Fontenay-Aux-Roses, France
| | - J Thariat
- Centre de Lutte Contre le Cancer, A. Baclesse, Caen, France
| | - J Ferrieres
- INSERM, UMR 1295 - CERPOP Centre d'Epidémiologie et de Recherche en santé des POPulations, Toulouse, France
| | - M O Bernier
- Institut de radioprotection et de sureté nucléaire (IRSN), Fontenay-Aux-Roses, France
| | - S Boveda
- CLINIC PASTEUR, Cardiology - Heart Rhythm Management Department, Toulouse, France
| | - S Jacob
- Institut de radioprotection et de sureté nucléaire (IRSN), Fontenay-Aux-Roses, France
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19
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Jacob S, Van Rothen J, Combes S, Errahmani M, Cardin C, Combes N, Albenque J, Boveda S. Impact of transcatheter aortic valve implantations on temporal trends of pacemaker implantations among French octogenarians: a nation-wide cohort study over the period 2008–2018. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The indications for permanent pacemaker implantation (PPMI) are strongly associated with age, with the highest rates for octogenarians (>80 years old). Over the last decade, impact of aging on temporal trends in PPMI rates among octogenarians is questionable. In the 2010's, transcatheter aortic valve implantation (TAVI) has emerged for inoperable or high-risk patients, mainly octogenarians, with an exponential increase over years. PPMI is a common short-term complication after TAVI procedure. Many studies have explored these post-TAVI PPMI in terms of incidence, timing and outcomes of PPMI following TAVI, but there are no data on the impact of TAVI on PPMI temporal trend at a nationwide scale.
Purpose
To evaluate whether PPMI in octogenarians have increased during the last decade, independently from age and sex, on a nationwide scale. Eventually, to estimate the potential contribution of TAVI in PPMI increase in this setting.
Methods
Our study was based on octogenarians from the Echantillon Généraliste de Bénéficiaires, the 1/97 random sample of the French nationwide health insurance claims database. Between 2008 and 2018, we identified de novo PPMI and TAVI with medical procedures codes in the French Common Classification of Medical Procedures (CCAM). Annual incidence rates of PPMI were evaluated between 2008 and 2012 (preTAVI-period). The number of observed PPMI cases, O, in the period 2013–2018 (TAVI-period) was compared with the expected number of PPMI cases, E, calculated by using 2008–2012 incidence rates with age and sex standardization. We then computed the standardized incidence ratio (SIR) of the observed number of PPMI to the expected number of PPMI (O/E), with 95% confidence intervals (CIs). Thereafter, we evaluated the contribution of post-TAVI PPMI in the number of excess cases of PPMI (O-E) for the period 2013–2018.
Results
The population of octogenarians increased from 23,822 in 2008 to 33,752 in 2018. In 2008, 130 PPMI were observed (546/100,000 inhabitants) reaching 228 PPMI (676/100,000) in 2018 with a marked increase in rates from the year 2012. During the period 2013–2018, for all octogenarians, 1242 cases of PPMI were observed, compared with 1171.3 expected cases of PPMI, corresponding to a significant SIR=1.06 (95% CI: 1.01–1.12). For the subpopulation of octogenarians without TAVI, no excess risk was observed with a SIR=1.01 (95% CI: 0.95–1.06). Among the excess cases of PPMI observed in 2013–2018 in all octogenarians, 72% were post-TAVI PPMI.
Conclusion
Based on our study, the number of observed PPMI in octogenarians in period 2013–2018 is 6% higher than the number we would expect. Nearly three-quarter of these excess cases are attributable to TAVI complication.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Jacob
- Institute for Radiation Protection and Nuclear Safety IRSN, Fontenay-aux-Roses, France
| | - J Van Rothen
- CLINIC PASTEUR, Cardiology - Heart Rhythm Management Department, Toulouse, France
| | - S Combes
- CLINIC PASTEUR, Cardiology - Heart Rhythm Management Department, Toulouse, France
| | - M.Y Errahmani
- Institute for Radiation Protection and Nuclear Safety IRSN, Fontenay-aux-Roses, France
| | - C Cardin
- CLINIC PASTEUR, Cardiology - Heart Rhythm Management Department, Toulouse, France
| | - N Combes
- CLINIC PASTEUR, Cardiology - Heart Rhythm Management Department, Toulouse, France
| | - J.P Albenque
- CLINIC PASTEUR, Cardiology - Heart Rhythm Management Department, Toulouse, France
| | - S Boveda
- CLINIC PASTEUR, Cardiology - Heart Rhythm Management Department, Toulouse, France
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20
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Mohapatra A, Valson AT, Annapandian VM, David VG, Alexander S, Jacob S, Kakde S, Kumar S, Devasia A, Vijayakumar TS, Tamilarasi V, Jacob CK, Basu G, John GT, Varughese S. Post-transplant complications, patient, and graft survival in pediatric and adolescent kidney transplant recipients at a tropical tertiary care center across two immunosuppression eras. Pediatr Transplant 2021; 25:e13973. [PMID: 33463876 PMCID: PMC7615901 DOI: 10.1111/petr.13973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 12/21/2020] [Accepted: 12/24/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND We report pediatric PAKT patient and graft outcomes at a large tropical tertiary center spanning two transplant eras. METHODS In this retrospective cohort study, all children ≤18 years who underwent kidney transplantation at our center between 1991 and 2016 were included. Data pertaining to their baseline characteristics, post-transplant events, and outcome were retrieved from transplant records and compared between transplant eras (1991-2005 and 2006-2016). RESULTS A total of 139 children (mean age 15.2 ± 2.9 years) underwent PAKT during this period. The incidence of UTIs, CMV disease, BKVN, invasive fungal infections, new-onset diabetes after transplant, leucopenia, and recurrent NKD was higher in the 2006-2016 era (P < .001 for all), while 1-year cumulative BPAR was comparable (P = .100). Five-year graft and patient survival in the two eras were 89.9% and 94.2% (P = .365) and 92.1% and 95.3% (P = .739), respectively. Incidence of CMV disease, BKVN, graft loss, and death was lower in the calcineurin withdrawal group. Non-adherence accounted for 36% of graft loss; infections caused 43.7% of deaths. On multivariate Cox proportional hazards analysis, independent predictors for graft loss were UTIs and blood transfusion naïve status and for death were serious infections and glomerular NKD. CONCLUSIONS PAKT in India has excellent long-term graft outcomes, though patient outcomes remain suboptimal owing to a high burden of infections. Current immunosuppression protocols need to be re-examined to balance infection risk, graft, and patient survival.
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Affiliation(s)
- Anjali Mohapatra
- Department of Nephrology, Christian Medical College, Vellore, India
| | - Anna T. Valson
- Department of Nephrology, Christian Medical College, Vellore, India
| | | | | | | | - Shibu Jacob
- Department of Nephrology, Christian Medical College, Vellore, India
| | - Shailesh Kakde
- Department of Nephrology, Christian Medical College, Vellore, India
| | - Santosh Kumar
- Department of Urology, Christian Medical College, Vellore, India
| | - Antony Devasia
- Department of Urology, Christian Medical College, Vellore, India
| | | | | | | | - Gopal Basu
- Department of Nephrology, Christian Medical College, Vellore, India
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21
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Asad RA, Valson AT, Kavitha V, Korula A, Eapen A, Rebekah G, Jacob S, Pathak H, Alexander S, Mohapatra A, David VG, Varughese S, Tamilarasi V, Basu G. Safety and utility of kidney biopsy in patients with estimated glomerular filtration rate < 30 ml/min/1.73 m 2. Nephrology (Carlton) 2021; 26:659-668. [PMID: 33779021 PMCID: PMC7615903 DOI: 10.1111/nep.13879] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/20/2021] [Accepted: 03/20/2021] [Indexed: 01/28/2023]
Abstract
AIM Kidney biopsy (KBx) is the gold standard for evaluation of kidney disease, but is associated with a higher risk of complications in patients with reduced glomerular filtration rate (GFR). We studied the safety and utility of KBx in patients with eGFR <30 ml/min/1.73 m2 . METHODS Consecutive adult patients with eGFR <30 ml/min/1.73 m2 , who were planned for a KBx and consented to participate were prospectively enrolled. Patients with solitary/transplant kidney or acute kidney injury were excluded. Haemoglobin was checked on the day of KBx and repeated 18-24 h later along with a screening ultrasound. Post-KBx complications were noted and their risk-factors analysed. The utility of the KBx was graded as effecting significant, some, or no change to subsequent management. RESULTS Of the 126 patients included, 75% were male, 27.7% were diabetic, and the median eGFR was 13.5 ml/min/1.73m2 . Major complications occurred in 5.6%. Peri-renal haematomas were detected in 37.3%, and haematomas ≥2 cm were significantly more frequent in those with eGFR <15 ml/min/1.73 m2 (29.2% vs. 13%, p = .032). Dialysis was a risk factor, while pre KBx blood transfusion, diabetes and higher serum albumin were protective against any complication. KBx was more likely to make a significant difference in management in those with eGFR 15-29 ml/min/1.73m2 (44.1% vs. 11.1%, p < .001). Increasing age, lower serum creatinine and albumin were independently associated with KBx utility. CONCLUSION KBx is relatively safe in severe kidney disease but its risk to benefit balance needs to be carefully considered when eGFR is <15 ml/min/1.73m2 .
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Affiliation(s)
| | - Anna T. Valson
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Vijayakumar Kavitha
- Department of Pathology, Christian Medical College, Vellore, Tamil Nadu, India
- Metropolis Healthcare Ltd., Chennai, Tamil Nadu, India
| | - Anila Korula
- Department of Pathology, Christian Medical College, Vellore, Tamil Nadu, India
- Department of Pathology, Pushpagiri Institute of Medical Sciences, Thiruvalla, Kerala, India
| | - Anu Eapen
- Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Grace Rebekah
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Shibu Jacob
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Harish Pathak
- Nephrology, Nanavati Super Specialty Hospital, Mumbai, India
| | - Suceena Alexander
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Vinoi George David
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Santosh Varughese
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Veerasamy Tamilarasi
- Institute of Kidney Disease, Medica Super Specialty Hospital, Kolkata, West Bengal, India
| | - Gopal Basu
- Renal Medicine, The Alfred Hospital, MONASH University (Central Clinical School), Melbourne, Victoria, Australia
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22
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Matthai SM, Alexander S, Jacob S, Duhli N, David VG, Varughese S. Crystals, crystals everywhere but not a clue till late… Light chain crystalline proximal tubulopathy with concomitant myeloma cast nephropathy. INDIAN J PATHOL MICR 2021; 63:463-466. [PMID: 32769341 DOI: 10.4103/ijpm.ijpm_756_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The renal diseases commonly associated with myeloma include primary amyloidosis, cast nephropathy, and light chain deposition disease. Less frequent forms of renal involvement encountered in the course of myeloma are crystalline and non-crystalline proximal tubulopathies, neoplastic plasma cell infiltration, and immunoglobulin crystallization in interstitial histiocytes and glomerular cells including podocytes. Light chain proximal tubulopathy (LCPT) caused by aggregation of non-crystalline and rarely crystalline deposits of monoclonal light chains in the cytoplasm of proximal tubular epithelial cells, accounts for less than 5% of monoclonal gammopathy-associated kidney diseases. We report the case of a 48-year-old Indian woman with multiple myeloma, who presented with acute kidney injury and nephrotic syndrome, in whom the renal biopsy revealed widespread crystalline inclusions in extraglomerular and glomerular compartments. We present illustrative light microscopic (LM) and diagnostic electron microscopic (EM) findings of this case which enabled a diagnosis of crystalline LCPT, crystal storing histiocytosis, and crystalline podocytopathy occurring synchronously with myeloma cast nephropathy. While documenting this unique juxtapositioning of multicompartmental paraproteinemic renal injury in multiple myeloma, diagnosed after EM analysis of the patient's renal biopsy, we discuss the pathogenetic pathways of this condition along with the clinical implications. Due to intrinsic structural properties of the crystals, they frequently escape detection by routine LM, necessitating EM analysis for their diagnosis. Given the prognostic implications of tubulopathies complicating myeloma, LCPT is a critically important diagnosis, highlighting the need for a comprehensive renal biopsy evaluation inclusive of EM for the practice of precision medicine in such scenarios.
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Affiliation(s)
- Smita Mary Matthai
- Department of Pathology, Central Electron Microscopy Facility, Wellcome Trust Research Laboratory, Christian Medical College, Vellore, Tamil Nadu, India
| | - Suceena Alexander
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Shibu Jacob
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Neelaveni Duhli
- Department of General Pathology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Vinoi George David
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Santosh Varughese
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
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23
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Varughese S, Alexander S, Valson AT, Mohapatra A, David VG, Jacob S, John EE, Koshy PM, Eapen JJ, Thomas A, Yusuf S. Blind Bedside Peritoneal Dialysis Catheter Repositioning: An Innovative Technique. Indian J Nephrol 2021; 31:311-313. [PMID: 34376952 PMCID: PMC8330660 DOI: 10.4103/ijn.ijn_417_19] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 02/04/2020] [Accepted: 03/10/2020] [Indexed: 11/04/2022] Open
Abstract
Catheter malfunction in peritoneal dialysis (PD) patients may lead to technique failure. Surgical repositioning is sometimes required for resumption of PD and is associated with additional costs of procedure and hospitalization. Meanwhile, patients may need hemodialysis via a temporary vascular catheter with increasing costs and risk of catheter-associated bacteremia. We describe an innovative technique of blind bedside PD catheter repositioning as a possible alternative to surgical repositioning when there is catheter malfunction. In 29 patients over a period of 3 years, we attempted blind bedside PD catheter repositioning with immediate successful inflow and outflow in all of them after repositioning. At 1 month, 21 (72.4%) patients had good catheter function and at 6 months, 19 (65.5%) patients were continuing successful PD. This bedside innovative procedure allowed for catheter salvage without constructing a new exit site or tunnel and without the requirement of a break-in period. The benefits to the patient in terms of cost and shortened hospital stay make it ideal for resource-poor settings. We suggest that this innovative technique be attempted before resorting to the open surgical method of PD catheter repositioning.
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Affiliation(s)
- Santosh Varughese
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Suceena Alexander
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anna T. Valson
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anjali Mohapatra
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Vinoi G. David
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Shibu Jacob
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Elenjickal E. John
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Pradeep M. Koshy
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Jeethu J. Eapen
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Athul Thomas
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sabina Yusuf
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
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24
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Saranya K, Ponnada SR, Cheruvathoor JJ, Jacob S, Kandukuri G, Mudigonda M, Kasabu AL, Balla SB. Assessing the probability of having attained 16 years of age in juveniles using third molar development in a sample of South Indian population. J Forensic Odontostomatol 2021; 39:16-23. [PMID: 34057154 PMCID: PMC8590846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Juvenile crime or delinquency has been increasing at an alarming rate in recent times. In many countries, including India, the minimum age for criminal responsibility is 16 years. The present study aimed to estimate the probability of a south Indian adolescent either being or being older than the legally relevant age of 16 years using Demirjian's tooth formation stages. Orthopantomograms (OPG) of 640 south Indian adolescents (320 boys and 320 girls) aged between 12 and 20 years were retrospectively analyzed. In each OPG, Demirjian's formation stage of the mandibular left third molar was recorded and the data was subjected to statistical analysis. Descriptive and Pearsons correlation statistics were performed. The empirical probabilities were provided relative to the medico-legal question of predicting 16 years of age. The distribution of age throughout the 10th, 25th, 50th, 75th and 90th percentile follows a logical distribution pattern horizontally and vertically. Pearson's correlation statistics showed a strong positive correlation between the Demirjian's stages and age for both sexes. Therefore, it can be concluded that stage "F" can be used to predict the attainment of age equal to or older than 16 years with a probability of 93.9% for boys and 96.6% for girls.
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Affiliation(s)
- K Saranya
- Department of Oral PathologyC.K.S. Teja Institute of Dental Sciences & Research Tirupathi
| | - S R Ponnada
- Department of Orthodontics & Dentofacial Orthopaedics Panineeya Mahavidyalaya Institute of Dental Sciences Hyderabad
| | - J J Cheruvathoor
- Department of Endodontics & Conservative dentistry Penang International Dental college Malaysia
| | - S Jacob
- Department of General Dentistry Penang International Dental college Malaysia
| | - G Kandukuri
- Department of Periodontics Anil Neerukonda Institute of Dental Sciences Visakhapatnam
| | - M Mudigonda
- Department of Periodontics Anil Neerukonda Institute of Dental Sciences Visakhapatnam
| | - A L Kasabu
- Department of Oral Medicine & Radiology Panineeya Mahavidyalaya Institute of Dental Sciences Hyderabad, Telangan
| | - S B Balla
- Department of Forensic Odontology Panineeya Mahavidyalaya Institute of Dental Sciences Hyderabad, Telangana
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25
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Abstract
BACKGROUND It is recognized that healthcare workers (HCWs) are at high risk of contracting Covid-19. It is incumbent on occupational health staff to recognize potential symptoms of Covid-19 among HCWs. AIMS The aims of the study were to describe the presenting symptoms of HCWs who developed Covid-19 in Ireland, and to estimate the odds of specific symptoms being associated with a positive Covid-19 polymerase chain reaction (PCR) result. METHODS A retrospective chart review of all symptomatic HCWs who self-presented for Covid-19 testing in Cork from March to May 2020 was conducted. A sex-matched case-control study was carried out to compare presenting features among those who tested positive compared to those who tested negative. Univariate and multivariable-adjusted conditional logistic regression models were run using Stata 15.0 to identify the symptoms associated with positive Covid-19 swab results. RESULTS Three hundred and six HCWs were included in the study; 102 cases and 204 controls. Common presenting features among cases were fever/chills (55%), cough (44%) and headache (35%). The symptoms which were significantly associated with a positive Covid-19 swab result were loss of taste/smell (adjusted odds ratio [aOR] 12.15, 95% confidence interval [CI] 1.36-108.79), myalgia (aOR 2.36, 95% 1.27-4.38), fatigue (aOR 2.31, 95% CI 1.12-4.74), headache (aOR 2.11, 95% CI 1.19-3.74) and fever/chills (aOR 1.88, 95% CI 1.12-3.15). CONCLUSIONS Fever, fatigue, myalgia, loss of taste/smell and headache were associated with increased odds of a Covid-19 diagnosis among symptomatic self-referred HCWs compared with those had negative swab results. Testing criteria for HCWs should reflect the broad range of possible symptoms of Covid-19.
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Affiliation(s)
- G O'Sullivan
- Occupational Health Department, Cork University Hospital, Cork, Ireland
| | - S Jacob
- Occupational Health Department, Cork University Hospital, Cork, Ireland
| | - P M Barrett
- School of Public Health, University College Cork, Cork, Ireland.,Department of Public Health HSE South, Cork, Ireland
| | - J Gallagher
- Occupational Health Department, Cork University Hospital, Cork, Ireland
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26
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Alexander S, Varughese S, Franklin R, Roy S, Rebekah G, David VG, Mohapatra A, Valson AT, Jacob S, Koshy PM, Rajan G, Daha MR, Feehally J, Barratt J, John GT. Epidemiology, baseline characteristics and risk of progression in the first South-Asian prospective longitudinal observational IgA nephropathy cohort. Kidney Int Rep 2021; 6:414-428. [PMID: 33615067 PMCID: PMC7879115 DOI: 10.1016/j.ekir.2020.11.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 11/17/2020] [Accepted: 11/19/2020] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Glomerular Research And Clinical Experiments-IgA Nephropathy in Indians (GRACE-IgANI) is the first prospective South Asian IgAN cohort with protocolized follow-up and extensive biosample collection. Here we report the baseline clinical, biochemical, and histopathologic characteristics of GRACE IgANI and calculate baseline risk of progression for the cohort. METHODS 201 incident adults with kidney biopsy-proven primary IgAN were recruited into GRACE-IgANI between March 2015 and September 2017. As of April 30, 2020, the cohort had completed a median follow-up of 30 months (interquartile range [IQR] 16-39). RESULTS The commonest clinical presentation in GRACE IgANI was hypertension, with or without proteinuria, and nephrotic-range proteinuria was present in 34%, despite <10 months of lead time to kidney biopsy. The GRACE-IgANI kidney biopsy data demonstrated a disproportionate absence of active glomerular lesions and overrepresentation of segmental sclerosing lesions and tubulointerstitial fibrosis at presentation, often coexistent with relatively well-preserved estimated glomerular filtration rate (eGFR) and low levels of proteinuria, especially in males. Baseline risk of progression was calculated for each evaluable patient using 2 different risk prediction tools. The median 5-year absolute risk of end-stage kidney disease (ESKD) was 19.8% (IQR 2.7-57.4) and median 5-year risk of progression to the combined endpoint of 50% decline in eGFR or ESKD was 35.5% using the 2 tools. CONCLUSIONS The predicted risk of progression in this cohort was considerable. Over the next 5 years, we will dissect the pathogenic pathways that underlie this severe South Asian IgAN phenotype.
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Affiliation(s)
| | | | | | - Sanjeet Roy
- Department of General Pathology, Christian Medical College, Vellore, India
| | - Grace Rebekah
- Department of Biostatistics, Christian Medical College, Vellore, India
| | | | - Anjali Mohapatra
- Department of Nephrology, Christian Medical College, Vellore, India
| | - Anna T. Valson
- Department of Nephrology, Christian Medical College, Vellore, India
| | - Shibu Jacob
- Department of Nephrology, Christian Medical College, Vellore, India
| | | | - Gautham Rajan
- Department of Nephrology, Christian Medical College, Vellore, India
| | | | - John Feehally
- University of Leicester College of Medicine Biological Sciences and Psychology, UK
| | - Jonathan Barratt
- University of Leicester College of Medicine Biological Sciences and Psychology, UK
| | - George T. John
- Department of Nephrology, Christian Medical College, Vellore, India
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27
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Jacob S, Walker V, Fondard O, Jimenez G, Camilleri J, Panh L, Broggio D, Bernier M, Laurier D, Ferrières J, Lairez O. Myocardial deformation after radiotherapy for breast cancer: A layer-specific and territorial longitudinal strain analysis (BACCARAT study). Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.046] [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]
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28
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Jacob S, Errahmani Y, Bernier M, Thariat J, Lapeyre-Mestre M, Voglimacci-Stephanopoli Q, Ferrières J, Boveda S. Risk of pacemaker implantation in patients treated for breast cancer: A study based on French nationwide health database sample. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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29
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Linkies A, Jacob S, Zink P, Maschemer M, Maier W, Koch E. Characterization of cultural traits and fungicidal activity of strains belonging to the fungal genus Chaetomium. J Appl Microbiol 2020; 131:375-391. [PMID: 33249672 DOI: 10.1111/jam.14946] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/14/2020] [Accepted: 11/22/2020] [Indexed: 11/27/2022]
Abstract
AIMS Compare and characterize Chaetomium strains with special regard to their potentialities as biocontrol agents. METHODS AND RESULTS Twelve strains of the fungal genus Chaetomium from diverse ecological niches were identified as belonging to six different species. Large differences were observed between the strains with regard to temperature requirements for mycelial growth and pigmentation of culture filtrates. Culture filtrates and ethyl acetate extracts were assayed for fungicidal effects against important phytopathogens both on agar media and in multiwell plates. The samples from Chaetomium globosum were particularly active against Botrytis cinerea, Pyrenophora graminea and Bipolaris sorokiniana, while those from C. cochliodes and C. aureum were inhibitory towards Phytophthora infestans, and P. infestans and Fusarium culmorum respectively. To narrow down the active principle, the most promising extracts were separated by preparative HPLC and the resulting fractions tested in bioassays. Chaetoglobosins were identified as active compounds produced by C. globosum. CONCLUSIONS The bioassays revealed C. aureum and C. cochliodes as promising candidates for use in biocontrol. Both showed remarkably good activity against the prominent plant pathogen P. infestans. SIGNIFICANCE AND IMPACT OF THE STUDY We provide the first systematic study comparing six different Chaetomium species with regard to their use as biocontrol agents.
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Affiliation(s)
- A Linkies
- Julius Kühn Institute - Federal Research Centre for Cultivated Plants, Institute for Biological Control, Darmstadt, Germany.,Department of Crop Protection, Hochschule Geisenheim University, Geisenheim, Germany
| | - S Jacob
- Institut für Biotechnologie und Wirkstoff-Forschung, Kaiserslautern, Germany
| | - P Zink
- Julius Kühn Institute - Federal Research Centre for Cultivated Plants, Institute for Biological Control, Darmstadt, Germany
| | | | - W Maier
- Julius Kühn Institute - Federal Research Centre for Cultivated Plants, Institute for Epidemiology and Pathogen Diagnostics, Braunschweig, Germany
| | - E Koch
- Julius Kühn Institute - Federal Research Centre for Cultivated Plants, Institute for Biological Control, Darmstadt, Germany
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Murakonda VB, Mohapatra A, Geevar T, Vijayan R, Kakde S, Jacob S, Alexander S, David VG, Nair SC, Varughese S, Valson AT. Does Hemodialysis Need to be Initiated to Improve Platelet Function in CKD G5 Patients? A Pilot Prospective, Observational Cohort Study. Indian J Nephrol 2020; 31:43-49. [PMID: 33994687 PMCID: PMC8101674 DOI: 10.4103/ijn.ijn_232_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 12/17/2019] [Accepted: 05/06/2020] [Indexed: 11/29/2022] Open
Abstract
Introduction: We previously showed that patients with chronic kidney disease (CKD) Stage G4-5 have normal bleeding times. This made us question whether hemodialysis (HD) initiation was really necessary solely to improve platelet function. Methods: In this prospective observational study, two 5 ml citrated blood samples and one 2 ml EDTA blood sample were collected from incident HD patients fulfilling inclusion criteria prior to HD initiation (baseline sample) and after three sessions of short duration, low flow, counter-current HD. In each instance, one sample was used to perform Collagen adenosine diphosphate closure time (CADPCT) using the Platelet function analyzer (PFA 200, normal range 68-142 seconds) and the second for light transmission aggregometry (LTA) with ADP as agonist (normal ≥50%). Results: This study included 20 patients between October 2017 and February 2019. Overall, and in the subgroup with normal baseline CADPCT or LTA, there was no statistically significant improvement after HD. However, of the 30% of patients who had an abnormal baseline CADPCT, 50% attained a normal value after three HD sessions, and the overall reduction in CADPCT in this group was statistically significant (P = 0.02). Of those with a baseline normal CADPCT, 21% developed abnormal prolongation post HD. Conclusion: HD for the sole purpose of improving platelet function is only of benefit in the subgroup of patients with an abnormal CADPCT at baseline, with close to 50% normalizing their platelet function after three sessions of low flow, short duration, counter-current HD.
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Affiliation(s)
- Vinod B Murakonda
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anjali Mohapatra
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Tulasi Geevar
- Department of Transfusion Medicine and Immunohaematology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Ramya Vijayan
- Department of Transfusion Medicine and Immunohaematology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Shailesh Kakde
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Shibu Jacob
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Suceena Alexander
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Vinoi G David
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sukesh C Nair
- Department of Transfusion Medicine and Immunohaematology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Santosh Varughese
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anna T Valson
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
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Sawlani V, Scotton S, Nader K, Jen JP, Patel M, Gokani K, Denno P, Thaller M, Englezou C, Janjua U, Bowen M, Hoskote C, Veenith T, Hassan-Smith G, Jacob S. COVID-19-related intracranial imaging findings: a large single-centre experience. Clin Radiol 2020; 76:108-116. [PMID: 33023738 PMCID: PMC7491990 DOI: 10.1016/j.crad.2020.09.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [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: 08/03/2020] [Accepted: 09/08/2020] [Indexed: 01/03/2023]
Abstract
AIM To describe the neuroradiological changes in patients with coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS A retrospective review was undertaken of 3,403 patients who were confirmed positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and admitted to Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK between 1 March 2020 and 31 May 2020, and who underwent neuroimaging. Abnormal brain imaging was evaluated in detail and various imaging patterns on magnetic resonance imaging MRI were identified. RESULTS Of the 3,403 patients with COVID-19, 167 (4.9%) had neurological signs or symptoms warranting neuroimaging. The most common indications were delirium (44/167, 26%), focal neurology (37/167, 22%), and altered consciousness (34/167, 20%). Neuroimaging showed abnormalities in 23% of patients, with MRI being abnormal in 20 patients and computed tomography (CT) in 18 patients. The most consistent neuroradiological finding was microhaemorrhage with a predilection for the splenium of the corpus callosum (12/20, 60%) followed by acute or subacute infarct (5/20, 25%), watershed white matter hyperintensities (4/20, 20%), and susceptibility changes on susceptibility-weighted imaging (SWI) in the superficial veins (3/20, 15%), acute haemorrhagic necrotising encephalopathy (2/20, 10%), large parenchymal haemorrhage (2/20, 10%), subarachnoid haemorrhage (1/20, 5%), hypoxic–ischaemic changes (1/20, 5%), and acute disseminated encephalomyelitis (ADEM)-like changes (1/20, 5%). CONCLUSION Various imaging patterns on MRI were observed including acute haemorrhagic necrotising encephalopathy, white matter hyperintensities, hypoxic-ischaemic changes, ADEM-like changes, and stroke. Microhaemorrhages were the most common findings. Prolonged hypoxaemia, consumption coagulopathy, and endothelial disruption are the likely pathological drivers and reflect disease severity in this patient cohort.
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Affiliation(s)
- V Sawlani
- Department of Neuroradiology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; University of Birmingham, Birmingham, UK.
| | - S Scotton
- Department of Neurology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - K Nader
- Department of Neuroradiology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; University of Birmingham, Birmingham, UK
| | - J P Jen
- Department of Neuroradiology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - M Patel
- Department of Neuroradiology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; University of Birmingham, Birmingham, UK
| | - K Gokani
- Department of Neurology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - P Denno
- Department of Neurology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - M Thaller
- Department of Neurology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - C Englezou
- Department of Neurology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - U Janjua
- Department of Neuroradiology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - M Bowen
- Department of Neuroradiology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - C Hoskote
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, Queen Square, London, UK
| | - T Veenith
- University of Birmingham, Birmingham, UK; Department of Intensive Care, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - G Hassan-Smith
- University of Birmingham, Birmingham, UK; Department of Neurology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - S Jacob
- University of Birmingham, Birmingham, UK; Department of Neurology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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Albone E, Cheng X, Verdi A, Jacob S, Fernando S, Furuuchi K, Fulmer J, Soto A, Drozdowski B, Mano Y, Nakatani Y, Uenaka T. 579P MORAb-109: A site-specific eribulin-conjugated ADC targeting human mesothelin. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Chartier H, Fassier P, Leuraud K, Jacob S, Baudin C, Laurier D, Bernier MO. Occupational low-dose irradiation and cancer risk among medical radiation workers. Occup Med (Lond) 2020; 70:476-484. [DOI: 10.1093/occmed/kqaa130] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Abstract
Background
Medical workers are the largest group of workers occupationally exposed to low doses of ionizing radiation (IR) worldwide.
Aims
This review presents all the cohorts of medical workers exposed in the world and summarizes cancer risks associated with radiation exposure in this population.
Methods
Epidemiological studies on health professionals exposed to IR published from 1975 to 2019 were reviewed. Strength of evidence was assessed according to the modified Royal College of General Practitioners three-star system.
Results
Among the 16 epidemiological studies focusing on cancers from 11 cohorts among medical staff exposed to radiation, higher risks of cancer were observed for pre-1950 exposure and for medical workers who performed fluoroscopically guided interventional procedures or radionuclides procedures compared to those who did not. However, strength of evidence supporting the associations remains moderate as several methodological limits including the lack of dosimetry data, lifestyle factors and recent updates may obscure the link between medical occupational exposure and cancer occurrence.
Conclusions
Excess risk of cancer is suspected for high and former exposures. The more highly exposed professions, i.e. interventional physicians and nuclear medicine workers, should be monitored carefully. Collaborative projects aiming to increase the quantity and quality of information of the studied populations would be a key point
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Affiliation(s)
- H Chartier
- PSE-SANTE/SESANE/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
- Percy Hospital, Radiological Protection Service of the Armed Forces (SPRA), Clamart, France
| | - P Fassier
- PSE-SANTE/SESANE/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - K Leuraud
- PSE-SANTE/SESANE/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - S Jacob
- PSE-SANTE/SESANE/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - C Baudin
- PSE-SANTE/SESANE/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - D Laurier
- PSE-SANTE/SESANE/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - M-O Bernier
- PSE-SANTE/SESANE/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
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Kumar S, Doss SA, Jacob S, T Valson A, Alexander S, David VG, Varughese S, Daniel D. Association of prior sensitizing events with anti-human leukocyte antigen antibodies: An analysis of renal transplant recipients in a tertiary care centre in South India. Transfus Apher Sci 2020; 59:102808. [PMID: 32444280 DOI: 10.1016/j.transci.2020.102808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/22/2020] [Accepted: 04/22/2020] [Indexed: 10/24/2022]
Abstract
Traditionally, sensitizing events such as previous pregnancies, previous transfusions and prior transplants result in the production of anti-Human Leukocyte Antigen (HLA) antibodies. However, it has been observed that, anti-HLA antibodies have been detected in many patients with no prior history of sensitizing events. This retrospective study analysed the most recent 100 consecutive Single Antigen Bead (SAB) assay results performed on 100 patients. The SAB assay is used routinely to detect anti-HLA antibodies in transplant recipients. Results of the SAB assay were analyzed and subsequently studied to see if a correlation existed between sensitizing events, the type of events and presence of antibody. Analysis showed that 77% (77/100) had anti-HLA antibodies. 61 out of 100 patients had prior sensitizing events while the remaining 39 had none. Both these groups showed an almost equal percent of patients with anti-HLA antibodies 77% (47/61) and 76.9% (30/39) respectively. A single sensitizing event was seen in 54.1% (33/61) patients including previous transfusions in 29.5% (18/61), pregnancies in 11.4% (7/61) and prior transplant in 13.1% (8/61). Our study suggests that irrespective of whether patients have prior sensitizing events or not, patients run the risks of alloimmunization, and therefore appropriate screening tests should be included in the pre-transplant compatibility algorithm.
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Affiliation(s)
- Snehil Kumar
- Department of Transfusion Medicine and Immunohaematology, 5th Floor, ASHA Building, Christian Medical College, Vellore, Tamil Nadu, India.
| | - Sam Arul Doss
- Department of Transfusion Medicine and Immunohaematology, 5th Floor, ASHA Building, Christian Medical College, Vellore, Tamil Nadu, India
| | - Shibu Jacob
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anna T Valson
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Suceena Alexander
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Vinoi George David
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Santosh Varughese
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Dolly Daniel
- Department of Transfusion Medicine and Immunohaematology, 5th Floor, ASHA Building, Christian Medical College, Vellore, Tamil Nadu, India
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Ahmed MS, Shah S, Zhang N, Jarmi T, Jacob S, Makey I, Thomas M, Sareyyupoglu B, Landolfo K, Erasmus D, Pham S. Survival Outcomes of Lung Transplant Recipients from Donors with Abnormal Kidney Function. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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ALEXANDER S, Sabina Y, David George V, Valson T A, Jacob S, John Elias E, Eapen Joseph J, Athul T, Bindra M, Roy S, Varughese S. SUN-392 Crescentic Glomerulonephritis: A Single Center Observational Cohort Study On The Clinico-pathological Features And Follow-up Outcomes. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.932] [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: 11/30/2022] Open
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Valson AT, Asad RA, Radhakrishnan RC, Sinha S, Jacob S, Varughese S, Tamilarasi V. “Why I Chose Hemodialysis over Peritoneal Dialysis”: An Opinion Survey among In-Center Hemodialysis Patients. Perit Dial Int 2020; 38:305-308. [DOI: 10.3747/pdi.2017.00116] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Peritoneal dialysis (PD) penetration in India remains low despite the huge chronic kidney disease burden and unmet need for renal replacement therapy (RRT). In order to understand the socioeconomic reasons that govern patients’ preference for hemodialysis (HD), we carried out an opinion survey among prevalent in-center HD patients at our institution using a multiple response questionnaire that was verbally administered to them at the dialysis facility by the investigators. Close to 80% were self-financed and 49.5% were on twice weekly HD. Despite the majority (95%) receiving RRT education from a nephrologist, 43.4% were not aware of PD as an RRT modality. The treating nephrologist's recommendation was the most important reason given for choosing HD (77.8%) and not choosing PD (69.7%). Other reasons for not choosing PD included lack of a dedicated caregiver or “clean area” at home (15.1%), fear of infection (15.1%), disruption of work (14.1%), and the high cost of PD (7%). The perceived advantages of HD over PD were greater convenience because of need for only twice or thrice weekly sessions (61%), supervised care received in a hospital setting (28.8%), and less disruption of the patient's and family's routine (22%). We discuss the implications of these findings and what policy makers and nephrologists in India and other developing countries can do to improve PD penetration and utilization.
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Affiliation(s)
- Anna T. Valson
- Department of Nephrology Christian Medical College, Vellore, Tamil Nadu, India
| | - Riyaz A. Asad
- Department of Nephrology Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Shampa Sinha
- Department of Palliative Care Royal North Shore Hospital Sydney, New South Wales, Australia
| | - Shibu Jacob
- Department of Nephrology Christian Medical College, Vellore, Tamil Nadu, India
| | - Santosh Varughese
- Department of Nephrology Christian Medical College, Vellore, Tamil Nadu, India
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Kholakiya Y, Jose A, Rawat A, Nagori SA, Jacob S, Roychoudhury A. Surgical management of oral submucous fibrosis with "Seagull-nasolabial flap" combined with short-term oral pentoxifylline for preventing relapse. J Stomatol Oral Maxillofac Surg 2020; 121:512-516. [PMID: 31904528 DOI: 10.1016/j.jormas.2019.12.015] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 12/08/2019] [Accepted: 12/18/2019] [Indexed: 10/25/2022]
Abstract
The aim of the study was to evaluate the effectiveness of seagull-shaped nasolabial flap (NLF) along with adjunctive short-term oral pentoxifylline in the surgical reconstruction of oral sub mucous fibrosis (OSMF) following fibrotomy. We retrospectively evaluated 18 patients with grade IV oral sub mucous fibrosis treated by NLF. There were 3 females and 15 males. All patients were classified as stage IV OSMF with a mean preoperative mouth opening of 8.11±3.38mm. Postoperatively, patients were administered 400mg of pentoxifylline (PTX) thrice daily for 3 months. Patients were followed up at one month, six months and one year. Mouth opening, presence or absence of malignant transformation, relapse and complications were recorded at each follow-up. We found statistically significant increase in mouth opening from 8.11±3.3 to 37.67±3.74 in the postoperative period. The complications associated with NLF were very minimal. The PTX was well tolerated by all the patients. There was no incidence of relapse or rebound fibrosis seen in our series. To the best of our knowledge, this is the first time that oral pentoxifylline has been administered along with surgical treatment of oral submucous fibrosis to prevent relapse. The use of oral PTX as an adjunct along with surgical reconstruction in OSMF improves mouth opening, reduces burning sensation and relapse.
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Affiliation(s)
- Y Kholakiya
- Department of oral and maxillofacial surgery, All India institute of medical sciences, New Delhi, India
| | - A Jose
- Division of oral and maxillofacial surgery, Army dental centre research and referral, New Delhi, India.
| | - A Rawat
- Division of oral and maxillofacial surgery, Army dental centre research and referral, New Delhi, India
| | | | | | - A Roychoudhury
- Department of oral and maxillofacial surgery, All India institute of medical sciences, New Delhi, India
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Voglimacci-Stephanopoli Q, Jacob S, Bernier M, Thariat J, Lapeyre-Mestre M, Ferrières J, Mondoly P, Maury P, Boveda S. Cardiac arrhythmias and conduction disorders after breast cancer treatment including radiotherapy: a study based on the French nationwide health database. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Radhakrishnan RC, Varughese S, Chandran A, Jacob S, David VG, Alexander S, Mohapatra A, Valson AT, Gopal B, Palani C, Jose A, Antonisamy B, Tamilarasi V. Effects of Individualized Dialysate Sodium Prescription in Hemodialysis - Results from a Prospective Interventional Trial. Indian J Nephrol 2020; 30:3-7. [PMID: 32015592 PMCID: PMC6977377 DOI: 10.4103/ijn.ijn_391_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 03/03/2019] [Accepted: 05/07/2019] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Individualized dialysate sodium prescription does affect weight gain, blood pressure (BP), and intradialytic complications. A prospective interventional trial (Dialysate Individualised Sodium (DISO) trial) was conducted to study this issue in Indian patients. METHODS Forty patients on thrice-weekly maintenance hemodialysis (HD) for at least 6 weeks were enrolled. The study was performed in two different phases. In the first phase, 12 consecutive HD sessions were done with a standard dialysate sodium concentration of 140 mEq/L. In the second phase, 12 consecutive HD sessions were done with dialysate sodium concentration set to individualized value (mean of pre-HD sodium concentration multiplied by Donnan coefficient of 0.95). Differences in pre- and post-HD sodium, interdialytic weight gain (IDWG), pre- and post-HD BP, thirst scores, and intradialytic adverse events during both phases were assessed. RESULTS The mean age of patients was 45.65 years (24 males, 16 females). The mean serum pre-HD sodium level was 138.7 ± 1.7 meq/L in the standard phase and 138.2 ± 2.6meq/L in the individualized phase (P = 0.229). In the standard phase, the mean IDWG was 2.64 ± 1.56 kg and 2.13 ± 0.99 kg in the individualized phase (P = 0.008). The mean pre-HD systolic BP was 138 ± 18 mmHg and 134 ± 17 mmHg in the standard and individualized phases (P = 0.008). There was no difference in intradialytic symptoms, hypotensive episodes or requirement of interventions. Hypertension episodes occurred at a mean value of 2.2 and 1.2 in the standard and individualized phases, respectively (P = 0.010). CONCLUSION The use of individualized dialysate sodium level is safe and results in lower IDWG, pre-HD systolic BP, and intradialytic hypertension in patients on HD.
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Affiliation(s)
- Radhika C. Radhakrishnan
- Department of Nephrology, Christian Medical College, (Current Affiliation: Department of Pediatric Nephrology, Government Medical College, Thiruvananthapuram, Kerala), India
| | - Santosh Varughese
- Department of Nephrology, Christian Medical College, The Alfred Hospital, Melbourne, Australia), Australia
| | - Abitha Chandran
- Department of Nephrology, Christian Medical College, The Alfred Hospital, Melbourne, Australia), Australia
| | - Shibu Jacob
- Department of Nephrology, Christian Medical College, The Alfred Hospital, Melbourne, Australia), Australia
| | - Vinoi G. David
- Department of Nephrology, Christian Medical College, The Alfred Hospital, Melbourne, Australia), Australia
| | - Suceena Alexander
- Department of Nephrology, Christian Medical College, The Alfred Hospital, Melbourne, Australia), Australia
| | - Anjali Mohapatra
- Department of Nephrology, Christian Medical College, The Alfred Hospital, Melbourne, Australia), Australia
| | - Anna T. Valson
- Department of Nephrology, Christian Medical College, The Alfred Hospital, Melbourne, Australia), Australia
| | - Basu Gopal
- Department of Nephrology, Christian Medical College, (Current Affiliation: Department of Renal Medicine, The Alfred Hospital, Melbourne, Australia), Australia
| | - C. Palani
- Department of Nephrology, Christian Medical College, The Alfred Hospital, Melbourne, Australia), Australia
| | - Arun Jose
- Department of Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
| | - B. Antonisamy
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
| | - V. Tamilarasi
- Department of Nephrology, Christian Medical College, The Alfred Hospital, Melbourne, Australia), Australia
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Miossec C, Jacob S, Peipoch L, Brard M, Jolivet E, Hochedez P, Hamlat A, Desbois N. Cerebral phaeohyphomycosis due to Cladophialophora bantiana in a French Guianese child. J Mycol Med 2019; 30:100918. [PMID: 31926829 DOI: 10.1016/j.mycmed.2019.100918] [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: 12/04/2018] [Revised: 10/31/2019] [Accepted: 11/20/2019] [Indexed: 10/25/2022]
Abstract
We report a case of cerebral phaeohyphomycosis, a fungal brain infection due to a dark (dematiaceous) fungi in a 6-year-old French Guyanese boy. The child presented fever and drowsiness due to several paraventricular brain abscesses. Neurological surgeries were performed to reduce intracranial hypertension and to obtain abscess biopsies. Mycological cultures of intraoperative samples led to the diagnosis of cerebral phaeohyphomycosis due to Cladophialophora bantiana. The patient neurological status deteriorated and remained critical after several weeks of combination antifungal therapy with voriconazole 8mg/kg/day, liposomal amphotericin B 10mg/kg/day and flucytosine 200mg/kg/day. A complete surgical resection was not possible because of multiple small abscesses. A multidisciplinary ethical staff decided on home medical care with palliative ventriculoperitoneal shunt, nasogastric feeding and analgesics. One year later, the patient's neurological condition had improved and cerebral lesions had regressed, while he had not received any antifungal treatment but only traditional medicines. Cerebral phaeohyphomycosis are rare diseases affecting immunocompromised but also apparently non-immunocompromised patients, as in this case. A complete surgical resection is not always possible and mortality rates are high in spite of treatments with a combination of antifungals. The diagnosis may be difficult because of these dematiaceous fungi's slowly growing and their potential pathogenicity for laboratory staff.
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Affiliation(s)
- C Miossec
- Laboratoire de parasitologie-mycologie, hôpital Pierre-Zobda-Quitman, CHU de la Martinique, BP 632, 97261 Fort-de-France cedex, Martinique.
| | - S Jacob
- Laboratoire de parasitologie-mycologie, hôpital Pierre-Zobda-Quitman, CHU de la Martinique, BP 632, 97261 Fort-de-France cedex, Martinique
| | - L Peipoch
- Service de réanimation pédiatrique, hôpital Pierre-Zobda-Quitman, CHU de la Martinique, BP 632, 97261 Fort-de-France cedex, Martinique
| | - M Brard
- Service de réanimation pédiatrique, hôpital Pierre-Zobda-Quitman, CHU de la Martinique, BP 632, 97261 Fort-de-France cedex, Martinique
| | - E Jolivet
- Service de pédiatrie, hôpital Pierre-Zobda-Quitman, CHU de la Martinique, BP 632, 97261 Fort-de-France cedex, Martinique
| | - P Hochedez
- Service des maladies infectieuses et tropicales, hôpital Pierre-Zobda-Quitman, CHU de la Martinique, BP 632, 97261 Fort-de-France cedex, Martinique
| | - A Hamlat
- Service de neurochirurgie, hôpital Pierre-Zobda-Quitman, CHU de la Martinique, BP 632, 97261 Fort-de-France cedex, Martinique
| | - N Desbois
- Laboratoire de parasitologie-mycologie, hôpital Pierre-Zobda-Quitman, CHU de la Martinique, BP 632, 97261 Fort-de-France cedex, Martinique
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Nikles J, Tate R, Mitchell G, Perdices M, McGree J, Freeman C, Jacob S, Taing M, Sterling M. Personalised treatments for acute whiplash injuries: A pilot study of nested N-of-1 trials in a multiple baseline single-case experimental design. Contemp Clin Trials Commun 2019; 16:100480. [PMID: 31763492 PMCID: PMC6859231 DOI: 10.1016/j.conctc.2019.100480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 11/30/2018] [Revised: 10/20/2019] [Accepted: 10/24/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Whiplash associated disorder (WAD), a common and disabling condition, incurs huge burden and costs to Australia. Yet, current treatments for whiplash are not very effective; improved outcomes are urgently needed. Clinical guidelines recommend simple analgesia (paracetamol and non-steroidal anti-inflammatory drugs) but there have been no trials of guideline-recommended drugs. This study will investigate the effectiveness of evidence-based advice (EBA), paracetamol, naproxen, and both paracetamol and naproxen, in reducing daily neck pain and preventing chronic neck pain after whiplash injury. METHODS This study is a pilot series of multi-cycle, double-blinded, randomised N-of-1 trials, nested in a multiple baseline design. The design will comprise three baselines of 5, 8 or 11 days duration. Post enrolment, participants will be randomly assigned to one of the baselines. Fifteen participants with acute (<2 weeks) Grade II WAD, experiencing at least moderate pain (NRS: ≥ 5/10), and at risk of poor recovery will be recruited from hospitals in Queensland, Australia, and through local physiotherapists. Patients will receive EBA plus a randomised sequence of three cycles of ten day treatment triplets (paracetamol designated as a C phase, naproxen, designated as a D phase, and both paracetamol and naproxen, designated as an E phase). DISCUSSION We will test the effects of different treatments on the primary outcome of average neck pain intensity collected daily and at 4 and 7 months post-injury. Secondary outcomes, including disability, depression, post-traumatic stress symptoms, pain catastrophizing, and feasibility of study procedures, will also be evaluated. The results of this study will inform a larger trial aiming to strengthen the evidence on EBA and simple analgesics for WAD. TRIAL REGISTRATION Clinical Trials Primary Registry: Australian and New Zealand Clinical Trials Registry. CLINICAL TRIAL REGISTRATION NUMBER ACTRN12618001291279. DATE OF REGISTRATION 31/07/2018. PRIMARY TRIAL SPONSOR The University of Queensland, Brisbane QLD 4072 Australia. FUNDING The University of Queensland.
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Affiliation(s)
- J. Nikles
- Recover Injury Research Centre, The University of Queensland, Herston, QLD, Australia
- NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, Australia
| | - R.L. Tate
- John Walsh Centre for Rehabilitation Studies, Northern Clinical School, The University of Sydney, Sydney, Australia
| | - G. Mitchell
- Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
- Limestone Medical Centre, Ipswich, QLD, Australia
| | - M. Perdices
- Royal North Shore Hospital, Sydney, Australia
| | - J.M. McGree
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - C. Freeman
- School of Pharmacy, Faculty of Health and Behavioural Sciences, The University of Queensland, QLD, Australia
| | - S. Jacob
- Recover Injury Research Centre, The University of Queensland, Herston, QLD, Australia
| | - M.W. Taing
- School of Pharmacy, The University of Queensland, QLD, Australia
| | - M. Sterling
- Recover Injury Research Centre, The University of Queensland, Herston, QLD, Australia
- NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, Australia
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Radhakrishnan RC, Gopal B, Zachariah UG, Abraham P, Mohapatra A, Valson AT, Alexander S, Jacob S, Tulsidas KS, David VG, Varughese S. The long-term impact of hepatitis C infection in kidney transplantation in the pre-direct acting antiviral era. Saudi J Kidney Dis Transpl 2019; 29:1092-1099. [PMID: 30381505 DOI: 10.4103/1319-2442.243964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Hepatitis C virus (HCV) infection in kidney transplantation is an important issue with effects on patient and graft survival. The current standard of care involves using oral Direct Acting Antiviral drugs. Till recently, pre-transplant treatment with interferon was the only option for treatment. We studied 677 consecutive kidney transplant recipients with HCV infection. 5.2% patients had evidence of HCV infection. 2.0% were newly detected to have HCV infection after transplant (de novo HCV group). Nearly 28.6% had negative antibody tests but positive Nucleic Acid Test at the time of diagnosis. Eighty-five percent of pre-transplant HCV-positive patients were treated with interferon-based regimens. Early virologic response was seen in 66.6%. End of treatment response was achieved by 94.1%. Sustained virologic response was seen in 81.2%. Overall, patient and graft survival were not different between HCV and control groups (log-rank P = 0.154). Comparing HCV and control groups, there was a tendency toward increased fungal (11.4% vs. 5.6%, P = 0.144) and CMV infections (25.7% vs. 17.1%, P = 0.191) in the HCV group, though it did not reach statistical significance. Eighty-percent of the interferon-treated patients suffered side effects. On comparing, the pre-transplant HCV-positive group (85% treated) with the de novo HCV group (none treated), the de novo group had significantly reduced patient survival (P = 0.020) and NODAT (35.7 vs 4.8%, P = 0.028), and a tendency toward higher CMV infections (35.7% vs 19%, P = 0.432). In addition, death and hepatic complications (decompensated liver disease, fibrosing cholestatic hepatitis) occurred only in de novo HCV group. These results highlight the need for continued post-transplant treatment of HCV positive patients. The newer anti-HCV drugs are expected to fulfill this felt-need in kidney transplantation but long-term results are awaited. This study can serve as a benchmark for future studies to compare the long-term effect of Direct Acting Antiviral drugs.
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Affiliation(s)
| | - Basu Gopal
- Central Northern Adelaide Renal and Transplant Service, Royal Adelaide Hospital, Adelaide, Australia
| | - Uday G Zachariah
- Department of Hepatology, Christian Medical College, Vellore, India
| | - Priya Abraham
- Department of Clinical Virology, Christian Medical College, Vellore, India
| | - Anjali Mohapatra
- Department of Nephrology, Christian Medical College, Vellore, India
| | - Anna T Valson
- Department of Nephrology, Christian Medical College, Vellore, India
| | | | - Shibu Jacob
- Department of Nephrology, Christian Medical College, Vellore, India
| | | | - Vinoi G David
- Department of Nephrology, Christian Medical College, Vellore, India
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Galvez C, Jacob S, Zhao J, Tegtmeyer K, Finkelman B, Chae Y, Mohindra N, Jovanovic B, Behdad A, Villaflor V. P1.03-38 EGFR Mutation Status as a Prognostic Marker in Stage 1 Lung Adenocarcinoma After Definitive Surgical Resection. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Agrawal V, Valson AT, Mohapatra A, David VG, Alexander S, Jacob S, Bakthavatchalam YD, Prakash JAJ, Balaji V, Varughese S. Fast and furious: a retrospective study of catheter-associated bloodstream infections with internal jugular nontunneled hemodialysis catheters at a tropical center. Clin Kidney J 2019; 12:737-744. [PMID: 31583098 PMCID: PMC6768464 DOI: 10.1093/ckj/sfy138] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Nontunneled hemodialysis catheters (NTHCs) remain the preferred vascular access at hemodialysis (HD) initiation in developing countries. We studied the incidence, risk factors and microbiological spectrum of jugular NTHC-associated bloodstream infections (CABSIs) at a tertiary care center in South Asia. METHODS In this retrospective cohort study, all adult (≥18 years) incident patients who underwent jugular NTHC insertion for HD between January 2016 and June 2017, had no prior history of temporary vascular access insertion and were followed up for ≥14 days were included. RESULTS A total of 897 patients underwent NTHC insertion during the study period and 169 patients fulfilled the inclusion criteria and contributed 7079 patient days of follow-up. CABSI incidence was 7.34 episodes per 1000 catheter days and median infection-free survival and time to CABSI were 96 and 24.5 days, respectively. In multivariate Cox regression analysis, immunosuppressive medication {hazard ratio [HR] 2.87 [95% confidence interval (CI) 1.09-7.55]; P = 0.033} and intravenous cefazolin use [HR 0.51 (95% CI 0.28-0.94); P = 0.031] was independently associated with CABSI. The cumulative hazard of CABSI was 8.3, 13.3, 17.6 and 20.9% at Weeks 1, 2, 3 and 4, respectively. Gram-negative organisms were the most common etiological agents (54.7%) and 40.3% of CABSIs were caused by drug-resistant organisms. Gram-negative and Gram-positive CABSIs were associated with neutrophil left shift and higher procalcitonin compared with coagulase-negative staphylococcal CABSIs. CONCLUSION In South Asia, NTHC-associated CABSIs occur early and are predominantly Gram negative. We hypothesize that poor hygiene practices may play a role in this phenomenon.
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Affiliation(s)
- Varun Agrawal
- Department of Nephrology, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Anna T Valson
- Department of Nephrology, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Anjali Mohapatra
- Department of Nephrology, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Vinoi George David
- Department of Nephrology, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Suceena Alexander
- Department of Nephrology, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Shibu Jacob
- Department of Nephrology, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | | | | | - Veeraraghavan Balaji
- Department of Microbiology, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Santosh Varughese
- Department of Nephrology, Christian Medical College Hospital, Vellore, Tamil Nadu, India
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Tsatsos M, Mironidou M, Jacob S, Ziakas N. Factors influencing corneal predescemetic endothelial keratoplasty (PDEK) graft creation: It's all in a bubble. Hell J Nucl Med 2019; 22 Suppl 2:42-46. [PMID: 31802044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 11/11/2019] [Indexed: 06/10/2023]
Abstract
AIM To assess the effect of pneumatic (air) and fluidic (transport medium) injection to the type of bubble (I, II or mixed III) and the resultant dissection of corneal endothelial grafts PDEK or DMEK. MATERIALS AND METHODS All grafts were obtained from Dr Agrawal Hospital's Eye Bank. Air injection was the initial preferred mode of graft harvest. If pneumatic dissection was unsuccessful after 10 tries, fluidic dissection with transport medium was tried. SPSS 23.0 was used to statistically analyse the data. RESULTS 40 consecutive donor corneas with a mean age of 46.5 and a mean endothelial count of 2980 were analysed. Air dissection lead to the harvest of 27 endothelial grafts and fluid dissection led to the creation of 7 endothelial grafts. Statistically significant difference was found the different bubble types and the type of injection (χ2 chi square=10.02, 0=0.008). CONCLUSION In young donors pneumatic (air) graft dissection leads to PDEK in a high proportion. This percentage is reduced when transport medium is tried after unsuccessful air injection. Injection of transport medium increases the percentage of grafts harvested but also increases the ratio of Type II and III DMEK grafts created.
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Affiliation(s)
- M Tsatsos
- Dorset County Hospital NHS Trust, Ophthalmology Department, Dorchester, UK.
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Matthai SM, Jacob S, Bindra MS, David VG, Varughese S. Nephropathic cystinosis presenting with uveitis: Report of a "Can't See, Can't Pee" situation. INDIAN J PATHOL MICR 2019; 62:457-460. [PMID: 31361240 DOI: 10.4103/ijpm.ijpm_623_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Nephropathic cystinosis is a rare autosomal recessive lysosomal disease characterized by accumulation of pathognomonic cystine crystals in renal and other tissues of the body. Cystinosis is caused by mutant cystinosin, the cystine transport protein located in lysosomal membranes, leading to systemic deposits of cystine and resultant end organ damage. Cystinosis is rarer in Asians than Caucasians with only a handful of cases reported from India to date. Due to its extreme rarity and clinically insidious presentation in contrast to the infantile form, the diagnosis of juvenile nephropathic cystinosis is frequently delayed or overlooked. Moreover, routine processing and sectioning of paraffin embedded tissues dissolves cystine crystals, making it difficult to diagnose this condition on light microscopic examination alone, mandating electron microscopic (EM) analysis of renal biopsies for an accurate diagnosis of this condition. We describe a case of juvenile nephropathic cystinosis presenting with uveitis and photophobia in a 17-year-old Indian male, diagnosed after EM examination of the patient's renal biopsy for evaluation of nephrotic syndrome. While highlighting the diagnostic utility of EM, we describe a few histopathologic clues which can prompt inclusion of EM analysis of renal biopsies in this setting.
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Affiliation(s)
- Smita Mary Matthai
- Central Electron Microscopy Facility, Wellcome Trust Research Laboratory, Vellore, Tamil Nadu, India
| | - Shibu Jacob
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Mandeep S Bindra
- Department of General Pathology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Vinoi George David
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Santosh Varughese
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
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Walker V, Lairez O, Fondard O, Jimenez G, Broggio D, Laurier D, Ferrières J, Jacob S. Utilisation de l’imagerie 2D-strain du myocarde pour la détection précoce de la cardiotoxicité induite par la radiothérapie chez les patientes atteintes d’un cancer du sein (étude BACCARAT). Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.03.032] [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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Thompson DC, Bailey MS, Bowley D, Jacob S. Encephalitis on deployment in Kenya: think beyond the infections. J ROY ARMY MED CORPS 2019; 165:374-376. [PMID: 30992337 DOI: 10.1136/jramc-2018-001115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 03/12/2019] [Accepted: 03/14/2019] [Indexed: 11/04/2022]
Abstract
A 34-year-old female soldier presented with fever and behavioural changes while deployed in Kenya and was diagnosed with encephalitis. The patient underwent urgent aeromedical evacuation to the Queen Elizabeth Hospital, Birmingham for further management. Microbiology tests excluded common infectious causes that are endemic in the East Africa region. However, an autoantibody screen was positive for antibodies against the N-methyl-D-aspartate receptor (NMDAR). Full body imaging confirmed the presence of limbic encephalitis and an ovarian mass suggestive of a teratoma. The patient was diagnosed with ovarian teratoma-associated anti-NMDAR encephalitis, a potentially fatal disease. The patient underwent surgery to remove the teratoma and commenced immunotherapy with steroids, plasma exchange and rituximab. This case highlights the diagnostic challenges of fever with behavioural changes in military personnel deployed in a tropical environment.
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Affiliation(s)
| | - M S Bailey
- Department of Infection and Tropical Medicine, Birmingham Heartlands Hospital, Birmingham, UK.,Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK
| | - D Bowley
- Department of Surgery, 16 Medical Regiment, Colchester, UK.,Department of Surgery, Birmingham Heartlands Hospital, Birmingham, UK
| | - S Jacob
- Department of Neurology, Queen Elizabeth Hospital Birmingham, Birmingham, UK
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Walker V, Broggio D, Derreumaux S, Camilleri J, Bruguière E, Lapeyre M, Fondard O, Lairez O, Bernier M, Laurier D, Chevelle C, Jimenez G, Ferrières J, Jacob S. Cardiac radiation exposure associated with breast cancer radiotherapy: Dose distribution to the heart substructures and coronary arteries (BACCARAT study). Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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