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Dey S, Mohammed R, Gadde R, Abraham A, Trivedi V, Unnithan A. Clinical efficacy of the virtual fracture clinic: analysis of 17,269 referrals by type of injury. Ann R Coll Surg Engl 2023; 105:441-445. [PMID: 36374286 PMCID: PMC10149252 DOI: 10.1308/rcsann.2022.0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Numerous studies have deemed the virtual fracture clinic (VFC) model to be both cost and clinically effective. However, very few of these studies have analysed the type of injuries seen in the VFC. The objectives of this study were to assess the clinical effectiveness of the VFC and analyse the types of injuries that lead to patients re-presenting in the face-to-face fracture clinic after being discharged virtually. METHODS This is a retrospective study analysing 17,269 patients referred to the VFC between September 2017 and February 2020. Data regarding the type of presenting injury were collected to understand which injuries required further management after being discharged virtually. Patient clinic letters provided data regarding the purpose and outcomes of VFC referrals as well as face-to-face appointments. Theatre lists were cross-referenced to extract data regarding surgical management. RESULTS In total, 57.37% (9,908) patients were discharged virtually. Of these patients, 92.52% were discharged successfully and 7.48% re-presented to the fracture clinic: 98.11% were managed conservatively and 1.88% required surgery. The highest number of failed discharges were for distal radius fractures (109, 14.69%). Face-to-face follow-up in fracture clinic was requested for 37.06% (6,400) of patients; 4.98% of them required surgical intervention. Some 5.56% (961) of referrals were removed from our analysis: 807 were inappropriate referrals and 154 were deemed suitable for multidisciplinary team discussion. The trust has saved an average of £702,205 annually since introduction of the VFC. CONCLUSIONS The VFC model delivers as promised in terms of clinical efficacy and cost management. Injury types showing higher numbers of unsuccessful discharges could benefit from having modified management pathways.
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Affiliation(s)
- S Dey
- Ashford and Saint Peter's Hospitals NHS Foundation Trust, UK
| | - R Mohammed
- Ashford and Saint Peter's Hospitals NHS Foundation Trust, UK
| | - R Gadde
- Ashford and Saint Peter's Hospitals NHS Foundation Trust, UK
| | - A Abraham
- Ashford and Saint Peter's Hospitals NHS Foundation Trust, UK
| | - V Trivedi
- Ashford and Saint Peter's Hospitals NHS Foundation Trust, UK
| | - A Unnithan
- Ashford and Saint Peter's Hospitals NHS Foundation Trust, UK
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Nadarassan D, Loni A, Canham LT, Scoutaris N, Trivedi V, Douroumis D. Ultrahigh nanostructured drug payloads from degradable mesoporous silicon aerocrystals. Int J Pharm 2021; 607:120840. [PMID: 34245843 DOI: 10.1016/j.ijpharm.2021.120840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/27/2021] [Accepted: 06/28/2021] [Indexed: 11/15/2022]
Abstract
Porous silicon has found increased attention as a drug delivery system due to its unique features such as high drug payloads, surface area and biodegradation. In this study supercritical fluid (SCF) assisted drying of ultrahigh porosity (>90%) silicon particles and flakes was shown to result in much higher mesopore volumes (~4.66 cm3/g) and surface areas (~680 m2/g) than with air-drying. The loading and physical state of the model drug (S)-(+)-Ibuprofen in SCF dried matrices was quantified and assessed using thermogravimetric analysis, differential scanning calorimetry, UV-Vis spectrophotometry, gravimetric analysis, gas adsorption and electron microscopy. Internal drug payloads of up to 72% were achieved which was substantially higher than values published for both conventionally dried porous silicon (17-51%) and other mesoporous materials (7-45%). In-vitro degradability kinetics of SCF-dried matrices in simulated media was also found to be faster than air-dried controls. The in-vitro release studies provided improved but sustained drug dissolution at both pH 2.0 and pH 7.4.
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Affiliation(s)
- D Nadarassan
- pSiMedica Ltd, Malvern Hills Science Park, Geraldine Road, Malvern, Worcestershire WR14 3SZ, UK
| | - A Loni
- pSiMedica Ltd, Malvern Hills Science Park, Geraldine Road, Malvern, Worcestershire WR14 3SZ, UK
| | - L T Canham
- pSiMedica Ltd, Malvern Hills Science Park, Geraldine Road, Malvern, Worcestershire WR14 3SZ, UK; School of Physics and Astronomy, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom
| | - N Scoutaris
- Faculty of Engineering of Science, University of Greenwich, Central Avenue, Chatham Maritime, Kent ME4 4TB, UK
| | - V Trivedi
- Medway School of Pharmacy, University of Kent, Medway Campus, Central Avenue, Chatham Maritime, Chatham, Kent ME4 4TB, United Kingdom
| | - D Douroumis
- Faculty of Engineering of Science, University of Greenwich, Central Avenue, Chatham Maritime, Kent ME4 4TB, UK
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Lebwohl M, Deodhar A, Griffiths CEM, Menter MA, Poddubnyy D, Bao W, Jehl V, Marfo K, Primatesta P, Shete A, Trivedi V, Mease PJ. The risk of malignancy in patients with secukinumab-treated psoriasis, psoriatic arthritis and ankylosing spondylitis: analysis of clinical trial and postmarketing surveillance data with up to five years of follow-up. Br J Dermatol 2021; 185:935-944. [PMID: 33829482 DOI: 10.1111/bjd.20136] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Data on the use of biologic therapy and malignancy risk are inconsistent due to limited long-term robust studies. OBJECTIVES To assess the malignancy risk in patients with secukinumab-treated psoriasis, psoriatic arthritis (PsA) and ankylosing spondylitis (AS). METHODS This integrated safety analysis from both the secukinumab clinical trial programme and postmarketing safety surveillance data included any patient receiving at least one approved dose of secukinumab with a maximum of 5 years of follow-up. Safety analyses evaluated the rate of malignancy using exposure-adjusted incidence rates [EAIR; incidence rates per 100 patient treatment-years (PTY)]. Standardized incidence ratios (SIRs) were reported using the Surveillance, Epidemiology, and End Results Program (SEER) database as a reference population. Crude incidence of malignancy was also reported using postmarketing surveillance data. RESULTS Safety data from 49 clinical trials with secukinumab-treated patients were included: 10 685 patients with psoriasis, 2523 with PsA and 1311 with AS. Across indications over a 5-year period, the EAIR of malignancy was 0·85 per 100 PTY [95% confidence interval (CI) 0·74-0·98] in secukinumab-treated patients, corresponding to 204 patients per 23 908 PTY. Overall, the observed vs. expected number of malignancies from secukinumab clinical trial data were comparable, as indicated by an SIR of 0·99 (95% CI 0·82-1·19) across indications. The estimated crude cumulative incidence reporting rate per 100 PTY for malignancy was 0·27 in the postmarketing surveillance data across indications with a cumulative exposure of 285 811 PTY. CONCLUSIONS In this large safety analysis, the risk of malignancy was low for up to 5 years of secukinumab treatment. These data support the long-term use of secukinumab in these indications.
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Affiliation(s)
- M Lebwohl
- Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - A Deodhar
- Oregon Health & Science University, Portland, OR, USA
| | - C E M Griffiths
- The Dermatology Centre, The University of Manchester, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester, UK
| | - M A Menter
- Division of Dermatology, Baylor Scott & White Health, Dallas, TX, USA
| | - D Poddubnyy
- Division of Gastroenterology, Infectious Diseases and Rheumatology, Charité, Universitätsmedizin Berlin, Germany, and Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany
| | - W Bao
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - V Jehl
- Novartis Pharma AG, Basel, Switzerland
| | - K Marfo
- Novartis Pharma AG, Basel, Switzerland
| | | | - A Shete
- Novartis Pharma AG, Basel, Switzerland
| | - V Trivedi
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - P J Mease
- Department of Rheumatology, Swedish Health Services/Providence St Joseph Health and University of Washington, Seattle, WA, USA
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Daveson AJM, Popp A, Taavela J, Goldstein KE, Isola J, Truitt KE, Mäki M, Anderson RP, Adams A, Andrews J, Behrend C, Brown G, Chen Yi Mei S, Coates A, Daveson A, DiMarino A, Elliott D, Epstein R, Feyen B, Fogel R, Friedenberg K, Gearry R, Gerdis M, Goldstein M, Gupta V, Holmes R, Holtmann G, Idarraga S, James G, King T, Klein T, Kupfer S, Lebwohl B, Lowe J, Murray J, Newton E, Quinn D, Radin D, Ritter T, Stacey H, Strout C, Stubbs R, Thackwray S, Trivedi V, Tye‐Din J, Weber J, Wilson S. Baseline quantitative histology in therapeutics trials reveals villus atrophy in most patients with coeliac disease who appear well controlled on gluten‐free diet. ACTA ACUST UNITED AC 2020. [DOI: 10.1002/ygh2.380] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
| | - Alina Popp
- Tampere Centre for Child Health Research Faculty of Medicine and Health Technology Tampere University and Tampere University Hospital Tampere Finland
- University of Medicine and Pharmacy "Carol Davila" and National Institute for Mother and Child Health "Alessandrescu‐Rusescu" Bucharest Romania
| | - Juha Taavela
- Tampere Centre for Child Health Research Faculty of Medicine and Health Technology Tampere University and Tampere University Hospital Tampere Finland
- Department of Internal Medicine Central Finland Central Hospital Jyväskylä Finland
| | | | - Jorma Isola
- Laboratory of Cancer Biology Faculty of Medicine and Health Technology Tampere University Tampere Finland
- Jilab Inc. Tampere Finland
| | | | - Markku Mäki
- Tampere Centre for Child Health Research Faculty of Medicine and Health Technology Tampere University and Tampere University Hospital Tampere Finland
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Kate S, Choughule A, Joshi A, Noronha V, Patil V, Dusane R, Tiwrekar P, Solanki L, Trivedi V, Prabhash K. P1.01-44 Outcome of Uncommon EGFR Mutation Positive Newly Diagnosed Advanced NSCLC Patients: A Single-Centre Retrospective Analysis. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Ghosh M, Shubham S, Mandal K, Trivedi V, Chauhan R, Naseera S. Survival and prognostic factors for glioblastoma multiforme: Retrospective single-institutional study. Indian J Cancer 2018; 54:362-367. [PMID: 29199724 DOI: 10.4103/ijc.ijc_157_17] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumor in adults. The standard management has been maximum surgical resection followed by adjuvant radiotherapy with concurrent chemotherapy followed by adjuvant chemotherapy. Although the survival rate of patients with GBM has improved with recent advancements in treatment, the prognosis remains generally poor. The median survival rates are in the range of 9-12 months and 2-year survival rates are in the range of 8%-12%. MATERIALS AND METHODS A single-institution retrospective review of 61 patients of GBM from 2012 to 2014. Data regarding patient factors, disease factors, and treatment factors were collected and survival has been calculated. RESULTS A total of 61 patients with GBM were analyzed. GBM is commonly seen in sixth decade of life. Male to female ratio is 2.6:1. The right side of the brain is commonly involved with right frontal lobe being the most common site. The median follow-up was 4.6 months. The median survival of our patients was 8 months. The 1-year and 2-year survival rates were 20% and 3.27%, respectively. CONCLUSIONS The overall survival and prognosis in patients with GBM remains poor despite of constant research and studies. Concurrent chemoradiotherapy followed by adjuvant chemotherapy with temozolomide should be used after maximal resection to improve the survival.
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Affiliation(s)
- M Ghosh
- Department of Radiation Oncology, Mahavir Cancer Sansthan, Patna, Bihar, India
| | - S Shubham
- Department of Radiation Oncology, Mahavir Cancer Sansthan, Patna, Bihar, India
| | - K Mandal
- Department of Radiation Oncology, Mahavir Cancer Sansthan, Patna, Bihar, India
| | - V Trivedi
- Department of Radiation Oncology, Mahavir Cancer Sansthan, Patna, Bihar, India
| | - R Chauhan
- Department of Radiation Oncology, Mahavir Cancer Sansthan, Patna, Bihar, India
| | - S Naseera
- Department of Radiation Oncology, Mahavir Cancer Sansthan, Patna, Bihar, India
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Hajibandeh S, Melhado R, Akhtar K, Hajibandeh S, Trivedi V, Asaad P. Landiolol hydrochloride for preventing postoperative atrial fibrillation. Anaesthesia 2018; 73:910-911. [DOI: 10.1111/anae.14337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | - R. Melhado
- Salford Royal Foundation Trust; Salford UK
| | - K. Akhtar
- Salford Royal Foundation Trust; Salford UK
| | | | - V. Trivedi
- North Manchester General Hospital; Manchester UK
| | - P. Asaad
- North Manchester General Hospital; Manchester UK
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Deka SJ, Gorai S, Manna D, Trivedi V. Evidence of PKC Binding and Translocation to Explain the Anticancer Mechanism of Chlorogenic Acid in Breast Cancer Cells. Curr Mol Med 2018; 17:79-89. [PMID: 28190385 DOI: 10.2174/1566524017666170209160619] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 01/07/2017] [Accepted: 01/20/2017] [Indexed: 11/22/2022]
Abstract
Chlorogenic acid (CGA) exhibits potentials towards liver, breast and skin cancer. Cancer cells stimulated with CGA exhibits differential expression of transcriptional factors and regulatory molecules but the molecular target of the molecule is not known. Superposition of biophoric elements of CGA with Curcumin gives maximum common substructure score of 0.90. Molecular modeling studies further suggest that CGA fits into the C1b domain of PKC with extensive interaction with residues lining binding site. It binds PKC in a concentration dependent manner with dissociation constant KD, 28.84±3.95 μM. PKC-CGA complex is stable with minimal distortion to the 3-D structure and maintains the hydrogen bonding between ligand and receptor during simulation period. Cells stimulated with CGA causes 12.1 ± 0.56% PKC translocation from the cytosol to the plasma membrane. It disturbs the cell cycle and arrest the cancer cell at the G1 phase with a reduction in S-phase. Chlorogenic acid exhibits killing of cancer cells in a dose-dependent manner with an IC50 of 75.88 ± 4.54μg/ml and 52.5 ± 4.72μg/ml towards MDAMB-231 and MCF-7 cells respectively. It induces apoptosis in cancer cells as evident by AO/EtBr staining and degradation of genomic DNA to give a laddering pattern. Apoptosis in cancer cells involves mitochondrial pathway as supported by a reduction in mitochondrial potentials and release of cyt-C into the cytosol. Hence, the current study has established PKC as an important signaling molecule to the observed anti-cancer effects of CGA and provides the impetus to design better CGA analogs for improved anti-cancer potential against the malignant tumor.
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Affiliation(s)
- S J Deka
- Malaria Research Group, Department of Biosciences and Bioengineering, Indian Institute of Technology- Guwahati, Guwahati-781039, Assam. India
| | - S Gorai
- Department of Chemistry, Indian Institute of Technology- Guwahati, Guwahati-781039, Assam. India
| | - D Manna
- Department of Chemistry, Indian Institute of Technology- Guwahati, Guwahati-781039, Assam. India
| | - V Trivedi
- Malaria Research Group, Department of Biosciences and Bioengineering, Indian Institute of Technology-Guwahati, Guwahati-781039, Assam. India
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Trivedi V, Zinchuk A, Qin L, Bravata DM, Strohl KP, Selim BJ, Yaggi HK. 0574 A Composite Model of Commonly Derived Polysomnographic Variables Predicts Risk of Cardiovascular Outcomes Better than the Apnea Hypopnea Index Alone. Sleep 2018. [DOI: 10.1093/sleep/zsy061.573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- V Trivedi
- Yale New Haven Hospital, New Haven, CT
| | - A Zinchuk
- Yale New Haven Hospital, New Haven, CT
| | - L Qin
- Yale New Haven Hospital, New Haven, CT
| | - D M Bravata
- Indiana University Center for Health Services, Indianapolis, IN
| | - K P Strohl
- Case Western Reserve University, Cleveland, OH
| | | | - H K Yaggi
- Yale New Haven Hospital, New Haven, CT
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10
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Bishay K, Chaudhuri D, Tandon P, Trivedi V, James PD, Kelly EM, Thavorn K, Kyeremanteng K. A48 PROPHYLACTIC ENDOTRACHEAL INTUBATION IN CRITICALLY ILL PATIENTS WITH UPPER GASTROINTESTINAL BLEED: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy009.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- K Bishay
- Gastroenterology and Hepatology, University of Ottawa, Ottawa, ON, Canada
| | - D Chaudhuri
- Gastroenterology and Hepatology, University of Ottawa, Ottawa, ON, Canada
| | - P Tandon
- Gastroenterology and Hepatology, University of Ottawa, Ottawa, ON, Canada
| | - V Trivedi
- Gastroenterology and Hepatology, University of Ottawa, Ottawa, ON, Canada
| | - P D James
- Gastroenterology and Hepatology, University of Ottawa, Ottawa, ON, Canada
| | - E M Kelly
- Gastroenterology and Hepatology, University of Ottawa, Ottawa, ON, Canada
| | - K Thavorn
- Gastroenterology and Hepatology, University of Ottawa, Ottawa, ON, Canada
| | - K Kyeremanteng
- Gastroenterology and Hepatology, University of Ottawa, Ottawa, ON, Canada
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Jauhal A, Harenberg S, Crawford JJ, Bare I, Prasad B, Zahorski L, Ollenberger G, Trivedi V, Chopra V, Shoker A, Lavoie A, Dehghani P. Myocardial Perfusion Scans and Mortality in Asymptomatic Patients Awaiting Renal Transplantation. Transplant Proc 2017; 49:2011-2017. [PMID: 29149953 DOI: 10.1016/j.transproceed.2017.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Accepted: 07/30/2017] [Indexed: 11/16/2022]
Abstract
Cardiac risk assessment for asymptomatic patients awaiting renal transplantation is controversial. Patients awaiting renal transplantation in Southern Saskatchewan from 2005 to 2015 were retrospectively reviewed. Patients underwent cardiac risk stratification with stress myocardial perfusion scan. Baseline clinical characteristics, nuclear scan results, all-cause mortality, and cardiovascular events were analyzed. Abnormal scans were defined as studies with reversible defects, wall motion abnormalities, lung uptake, or transient ischemic dilation. Descriptive statistics and survival analysis were calculated. Charts from 285 consecutive patients with 608 nuclear scans were analyzed. Mean age was 55.2 ± 11.7 years and 34.7% were female. Forty-three (15.1%) patients were transplanted and 99 (40.9%) patients died while awaiting renal transplantation. One hundred fifty-three patients (63.2%) had at least one abnormal scan. The mean follow-up period was 5.47 ± 3.11 years. An abnormal scan was not associated with decreased survival and/or coronary events (hazard ratio: 0.94, P = .77; 95% confidence intervals: 0.62 to 1.43). Patients awaiting renal transplantation in Saskatchewan with abnormal myocardial perfusion scans were not at greater risk of death or coronary events.
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Affiliation(s)
- A Jauhal
- College of Medicine, University of Saskatchewan, Regina, Saskatchewan, Canada
| | - S Harenberg
- Regina Qu'Apelle Health Region, Regina, Saskatchewan, Canada
| | - J J Crawford
- Regina Qu'Apelle Health Region, Regina, Saskatchewan, Canada
| | - I Bare
- College of Medicine, University of Saskatchewan, Regina, Saskatchewan, Canada
| | - B Prasad
- College of Medicine, University of Saskatchewan, Regina, Saskatchewan, Canada; Regina Qu'Apelle Health Region, Regina, Saskatchewan, Canada
| | - L Zahorski
- Regina Qu'Apelle Health Region, Regina, Saskatchewan, Canada
| | - G Ollenberger
- College of Medicine, University of Saskatchewan, Regina, Saskatchewan, Canada; Regina Qu'Apelle Health Region, Regina, Saskatchewan, Canada; Department of Medical Imaging, University of Saskatchewan, Regina, Saskatchewan, Canada
| | - V Trivedi
- College of Medicine, University of Saskatchewan, Regina, Saskatchewan, Canada; Regina Qu'Apelle Health Region, Regina, Saskatchewan, Canada; Department of Medical Imaging, University of Saskatchewan, Regina, Saskatchewan, Canada
| | - V Chopra
- Prairie Vascular Research Network, University of Saskatchewan, Regina, Saskatchewan, Canada
| | - A Shoker
- College of Medicine, University of Saskatchewan, Regina, Saskatchewan, Canada; Regina Qu'Apelle Health Region, Regina, Saskatchewan, Canada
| | - A Lavoie
- College of Medicine, University of Saskatchewan, Regina, Saskatchewan, Canada; Regina Qu'Apelle Health Region, Regina, Saskatchewan, Canada; Prairie Vascular Research Network, University of Saskatchewan, Regina, Saskatchewan, Canada
| | - P Dehghani
- College of Medicine, University of Saskatchewan, Regina, Saskatchewan, Canada; Regina Qu'Apelle Health Region, Regina, Saskatchewan, Canada; Prairie Vascular Research Network, University of Saskatchewan, Regina, Saskatchewan, Canada.
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Eichorn D, Ali M, Lesenskyj A, Potts A, Trivedi V, Patchell R, Chen T, Williamson S, Maxwell C, Mintz A. Retrospective Analysis to Determine the Frequency of Symptomatic New Brain Metastases During Routine Magnetic Resonance Imaging Surveillance Following Stereotactic Radiosurgery or Whole-Brain Radiation Therapy. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Witharana WKL, Cardiff J, Chawla MK, Xie JY, Alme CB, Eckert M, Lapointe V, Demchuk A, Maurer AP, Trivedi V, Sutherland RJ, Guzowski JF, Barnes CA, McNaughton BL. Nonuniform allocation of hippocampal neurons to place fields across all hippocampal subfields. Hippocampus 2016; 26:1328-44. [PMID: 27273259 DOI: 10.1002/hipo.22609] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2016] [Indexed: 11/09/2022]
Abstract
The mechanisms governing how the hippocampus selects neurons to exhibit place fields are not well understood. A default assumption in some previous studies was the uniform random draw with replacement (URDWR) model, which, theoretically, maximizes spatial "pattern separation", and predicts a Poisson distribution of the numbers of place fields expressed by a given cell per unit area. The actual distribution of mean firing rates exhibited by a population of hippocampal neurons, however, is approximately exponential or log-normal in a given environment and these rates are somewhat correlated across multiple places, at least under some conditions. The advantage of neural activity-dependent immediate-early gene (IEG) analysis, as a proxy for electrophysiological recording, is the ability to obtain much larger samples of cells, even those whose activity is so sparse that they are overlooked in recording studies. Thus, a more accurate representation of the activation statistics can potentially be achieved. Some previous IEG studies that examined behavior-driven IEG expression in CA1 appear to support URDWR. There was, however, in some of the same studies, an under-recruitment of dentate gyrus granule cells, indicating a highly skewed excitability distribution, which is inconsistent with URDWR. Although it was suggested that this skewness might be related to increased excitability of recently generated granule cells, we show here that CA1, CA3, and subiculum also exhibit cumulative under-recruitment of neurons. Thus, a highly skewed excitability distribution is a general principle common to all major hippocampal subfields. Finally, a more detailed analysis of the frequency distributions of IEG intranuclear transcription foci suggests that a large fraction of hippocampal neurons is virtually silent, even during sleep. Whether the skewing of the excitability distribution is cell-intrinsic or a network phenomenon, and the degree to which this excitability is fixed or possibly time-varying are open questions for future studies. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- W K L Witharana
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, T1K 3M4
| | - J Cardiff
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, T1K 3M4
| | - M K Chawla
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, Arizona
| | - J Y Xie
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, T1K 3M4
| | - C B Alme
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, T1K 3M4.,Kavli Institute for System Neuroscience and Centre for Neural Computation, Norwegian University of Science and Technology, Trondheim, Norway
| | - M Eckert
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, T1K 3M4
| | - V Lapointe
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, T1K 3M4
| | - A Demchuk
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, T1K 3M4
| | - A P Maurer
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, Florida
| | - V Trivedi
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, T1K 3M4
| | - R J Sutherland
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, T1K 3M4
| | - J F Guzowski
- Center for Neurobiology of Learning and Memory, Department of Neurobiology and Behavior, University of California, Irvine
| | - C A Barnes
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, Arizona
| | - B L McNaughton
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, T1K 3M4. .,Center for Neurobiology of Learning and Memory, Department of Neurobiology and Behavior, University of California, Irvine.
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Bouledjouidja A, Masmoudi Y, Sergent M, Trivedi V, Meniai A, Badens E. Drug loading of foldable commercial intraocular lenses using supercritical impregnation. Int J Pharm 2016; 500:85-99. [DOI: 10.1016/j.ijpharm.2016.01.016] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 01/06/2016] [Accepted: 01/08/2016] [Indexed: 11/24/2022]
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15
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Choughule A, Sharma R, Trivedi V, Thavamani A, Noronha V, Joshi A, Desai S, Chandrani P, Sundaram P, Utture S, Jambhekar N, Gupta S, Aich J, Prabhash K, Dutt A. Coexistence of KRAS mutation with mutant but not wild-type EGFR predicts response to tyrosine-kinase inhibitors in human lung cancer. Br J Cancer 2014; 111:2203-4. [PMID: 25117816 PMCID: PMC4260019 DOI: 10.1038/bjc.2014.401] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- A Choughule
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Center, Mumbai, India
| | - R Sharma
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Center, Mumbai, India
- Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Center, Navi Mumbai, India
| | - V Trivedi
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Center, Mumbai, India
- Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Center, Navi Mumbai, India
| | - A Thavamani
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Center, Mumbai, India
- Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Center, Navi Mumbai, India
| | - V Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Center, Mumbai, India
| | - A Joshi
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Center, Mumbai, India
| | - S Desai
- Department of Pathology, Tata Memorial Hospital, Tata Memorial Center, Mumbai, India
| | - P Chandrani
- Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Center, Navi Mumbai, India
| | - P Sundaram
- Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Center, Navi Mumbai, India
| | - S Utture
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Center, Mumbai, India
| | - N Jambhekar
- Department of Pathology, Tata Memorial Hospital, Tata Memorial Center, Mumbai, India
| | - S Gupta
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Center, Mumbai, India
| | - J Aich
- Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Center, Navi Mumbai, India
- E-mail: or E-mail: or ; E-mail:
| | - K Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Center, Mumbai, India
- E-mail: or E-mail: or ; E-mail:
| | - A Dutt
- Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Center, Navi Mumbai, India
- E-mail: or E-mail: or ; E-mail:
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Trivedi V, Mishra P. THU0328 The Efficacy of Classical Indian Yoga in the Treatment of Fibromyalgia: A Randomized Controlled Trial. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1020] [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: 11/03/2022]
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17
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Mishra P, Trivedi V. THU0136 Acupuncture in the Treatment of Rheumatoid Arthritis: Results of A Randomized Controlled Trial. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2199] [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: 11/04/2022]
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18
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Yadav M, Trivedi V, Upadhyay V, Shah G, Shah H, Upadhyay A, Goswami S, Shrivastav PS. Sensitive, selective and rapid determination of lafutidine in human plasma by solid phase extraction-liquid chromatography-tandem mass spectrometry. J Anal Chem 2014. [DOI: 10.1134/s1061934814050116] [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: 11/23/2022]
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19
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Balaji SN, Trivedi V. Suicidal inactivation of methemoglobin by generation of thiyl radical: insight into NAC mediated protection in RBC. Curr Mol Med 2014; 13:1000-9. [PMID: 23745587 DOI: 10.2174/15665240113139990054] [Citation(s) in RCA: 2] [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] [Received: 12/11/2012] [Revised: 05/23/2013] [Accepted: 05/28/2013] [Indexed: 11/22/2022]
Abstract
N-acetyl-L-cysteine (NAC) improves antioxidant potentials of RBCs to provide protection against oxidative stress induced hemolysis. The antioxidant mechanism of NAC to reduce oxidative stress in RBC, studied through inactivation of pro-oxidant MetHb. NAC causes irreversible inactivation of the MetHb in an H2O2 dependent manner, and the inactivation follows the pseudo- first- order kinetics. The kinetic constants are ki = 8.5μM, kinact = 0.706 min(-1) and t1/2 = 0.9 min. Spectroscopic studies indicate that MetHb accepts NAC as a substrate and oxidizes through a single electron transfer mechanism to the NACox. The single e- oxidation product of NAC has been identified as the 5, 5'- dimethyl-1- pyrroline N- oxide (DMPO) adduct of the sulfur centered radical (a(N) = 15.2 G and a(H)=16.78 G). Binding studies indicate that NACox interacts at the heme moiety and NAC oxidation through MetHb is essential for NAC binding. Heme-NAC adduct dissociated from MetHb and identified (m/z 1011.19) as 2:1 ratio of NAC/heme in the adduct. TEMPO and PBN treatment reduces NAC binding to MetHb and protects against inactivation confirms the role of thiyl radical in the inactivation process. Furthermore, scavenging thiyl radicals by TEMPO abolish the protective effect of NAC in hemolysis. Current work highlights antioxidant mechanism of NAC through NAC thiyl radical generation, and MetHb inactivation to exhibit protection in RBC against oxidative stress induced hemolysis.
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Affiliation(s)
- S N Balaji
- Malaria Research Group, Department of Biotechnology, Indian Institute of Technology, Guwahati, Assam, India
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20
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Bhavani S, Trivedi V, Jala VR, Subramanya HS, Kaul P, Prakash V, Appaji Rao N, Savithri HS. Role of Lys-226 in the Catalytic Mechanism of Bacillus Stearothermophilus Serine HydroxymethyltransferaseCrystal Structure and Kinetic Studies,. Biochemistry 2005; 44:6929-37. [PMID: 15865438 DOI: 10.1021/bi047800x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Serine hydroxymethyltransferase (SHMT), a pyridoxal 5'-phosphate (PLP)-dependent enzyme catalyzes the reversible conversion of l-Ser and tetrahydropteroylglutamate (H(4)PteGlu) to Gly and 5,10-methylene tetrahydropteroylglutamate (CH(2)-H(4)PteGlu). Biochemical and structural studies on this enzyme have implicated several residues in the catalytic mechanism, one of them being the active site lysine, which anchors PLP. It has been proposed that this residue is crucial for product expulsion. However, in other PLP-dependent enzymes, the corresponding residue has been implicated in the proton abstraction step of catalysis. In the present investigation, Lys-226 of Bacillus stearothermophilus SHMT (bsSHMT) was mutated to Met and Gln to evaluate the role of this residue in catalysis. The mutant enzymes contained 1 mol of PLP per mol of subunit suggesting that Schiff base formation with lysine is not essential for PLP binding. The 3D structure of the mutant enzymes revealed that PLP was bound at the active site in an orientation different from that of the wild-type enzyme. In the presence of substrate, the PLP ring was in an orientation superimposable with that of the external aldimine complex of wild-type enzyme. However, the mutant enzymes were inactive, and the kinetic analysis of the different steps of catalysis revealed that there was a drastic reduction in the rate of formation of the quinonoid intermediate. Analysis of these results along with the crystal structures suggested that K-226 is responsible for flipping of PLP from one orientation to another which is crucial for H(4)PteGlu-dependent Calpha-Cbeta bond cleavage of l-Ser.
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Affiliation(s)
- Siddegowda Bhavani
- Department of Biochemistry, Indian Institute of Science, Bangalore, India
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Trivedi H, Vanikar A, Shah V, Mehta A, Shah S, Shah T, Visana K, Modi P, Sinha P, Trivedi V. Mega dose unfractionated donor bone marrow-derived cell infusion in thymus and periphery-an integrated clinical approach for tolerance in living related renal allografts. Transplant Proc 2003; 35:203-6. [PMID: 12591366 DOI: 10.1016/s0041-1345(02)03901-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- H Trivedi
- Institute of Kidney Diseases & Research Centre, Institute of Transplantation Sciences, Civil Hospital Campus, 16, Gujarat, Ahmedabad, India
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Lobo Gajiwala A, Trivedi V, Deshpande S. The use of Irradiated Allografts in Posterior Spinal Fusion for Healed Tubercular Kyphosis in Children. Cell Tissue Bank 2003; 4:119-23. [PMID: 15256848 DOI: 10.1023/b:catb.0000007027.94284.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Post-tubercular spinal kyphosis in children is not only cosmetically unacceptable but functionally disabling as well, as with the progression of the deformity there is a very significant risk of late onset paraplegia. We present our preliminary results in a prospective study of 12 cases of healed post-tubercular kyphosis in children treated with isolated posterior spinal fusion using irradiated allografts and autogenous cancellous grafts.The study included 12 patients of healed post-tubercular kyphosis documented by clinical, radiological and haematological criteria, with >2 spine at risk signs radiologically. The mean age was 7 years. In situ posterior spinal fusion with irradiated allografts and autogenous cancellous bone graft without any instrumentation was done for all the patients. The total follow-up is 5 years (mean 2.8 years).Eight patients (66%) showed a correction of the kyphosis, 3 patients (25%) were static and only 1 patient showed worsening of the deformity. Eleven patients had sound fusion and 1 patient had good fusion but a pseudoarthrosis at the lower vertebral level.Good posterior fusion was achieved because of the judicious use of morcellised, irradiated cancellous allografts with autogenous cancellous grafts. The proposed mechanism of correction is selective anterior column growth vis-à-vis posterior fused mass leading to gradual self-correction and remodelling.Conclusion. In situ posterior spinal fusion with irradiated allografts is a simple, safe, easily reproducible, less morbid surgical procedure with good results which may alter the long term disability of the patients.
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Trivedi H, Shah V, Shah P, Darji P, Sane A, Vanikar A, Trivedi V, Savani H, Narayanan K, Velusami S, Dalal S, Shah S, Shah T, Pancholi N, Visana K. High dose DBMC associated tolerance in live-related renal allograft recipients. Transplant Proc 2000; 32:2001-2. [PMID: 11120039 DOI: 10.1016/s0041-1345(00)01531-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- H Trivedi
- Institute of Kidney Diseases and Research Centre and Institute of Transplantation, Ahmedabad, India
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Patel B, Trivedi V. Threatened abortion outcome in relation to intrauterine clot site and not only volume. Int J Gynaecol Obstet 2000. [DOI: 10.1016/s0020-7292(00)81795-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kakuda JT, Stuntz M, Trivedi V, Klein SR, Vargas HI. Objective assessment of axillary morbidity in breast cancer treatment. Am Surg 1999; 65:995-8. [PMID: 10515551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Historically, axillary lymph node dissection (ALND) was a critical aspect of the operative management of breast cancer. Recently, the role of ALND has been questioned, with postoperative morbidity possibly overshadowing patient benefit. Our objective was to quantitatively assess the long-term morbidity of ALND in patients with breast cancer. We conducted a cross-sectional study of patients being followed by the Breast Surgery Clinic at a university-affiliated urban hospital. Ninety-five patients with unilateral breast cancer who had undergone ALND were evaluated at routine follow-up visits in the latter half of 1998. A questionnaire was used to quantify the degree of subjective findings, including arm swelling, chest wall pain, decreased mobility, and weakness. Upper extremity strength, active range of motion, and circumference were measured. Overall, 70 per cent of patients had at least one complaint, with 18 per cent having moderate to severe symptoms. Twenty-one per cent had notable decrements in strength or range of motion, 9.3 per cent of patients required chronic compression garments for lymphedema, and 6.4 per cent changed their vocational status because of surgical morbidity. We conclude that adverse effects from ALND occur commonly. Objective findings are less common, perhaps causing clinicians to underappreciate postoperative morbidity. A significant subset of patients had enduring disability.
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Affiliation(s)
- J T Kakuda
- Department of Surgery at Harbor-UCLA Medical Center, Torrance, California, USA
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Affiliation(s)
- A S Ali
- Department of Internal Medicine, Henry Ford Hospital, Detroit, MI 48202
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Trivedi DR, Kale CH, Trivedi V, Patkar AP, Dubash C. Sclerotherapy for esophageal varices--a prospective study. Indian J Gastroenterol 1986; 5:293. [PMID: 3781587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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