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Cheneler ML, Qureshi K, Bahrami C. A case of diabetic striatopathy due to uncontrolled type 2 diabetes. Endocrinol Diabetes Metab Case Rep 2024; 2024:23-0082. [PMID: 38744315 DOI: 10.1530/edm-23-0082] [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: 06/29/2023] [Accepted: 04/23/2024] [Indexed: 05/16/2024] Open
Abstract
Summary Hemichorea-hemiballismus (HCHB) syndrome is a syndrome characterized by choreic movements which are irregular, nonrepetitive, and random movements, and ballismus which are spontaneous and violent movements. HCHB syndrome with a metabolic cause is a rare presentation that can be precipitated by uncontrolled diabetes. Presented here is a case of HCHB syndrome with right-sided neuroimaging findings and contralateral chorea due to uncontrolled type 2 diabetes mellitus. This patient was found to be obtunded with a blood glucose of greater than 500 mg/dL by EMS. After the administration of insulin, she was able to answer clarifying questions of noncompliance with her antihyperglycemic medications. She had a computed tomography without contrast of the head which showed hyperdense lesions in the right caudate nucleus and putamen consistent with HCHB syndrome. She was started on treatment for nonketotic hyperglycemia with insulin. As her mentation improved, she was able to cooperate with physical examination, which revealed irregular and violent movements in the left upper and lower extremities. Her hemichorea and hemiballismus improved with strict glycemic control, and she was able to be discharged to a skilled nursing facility for further rehabilitation. She would later have repeated hospitalizations for poor glycemic control, and repeat neuroimaging would reveal the resolution of hyperdensities after 4 months. HCHB syndrome due to uncontrolled diabetes has been termed diabetic striatopathy and is characterized by poor glycemic control, unilateral striatal hyperdensity on CT imaging, and contralateral choreic movements. Diabetic striatopathy remains a poorly understood disease, and the exact pathophysiologic mechanism has not been definitively elucidated. Learning points Diabetic striatopathy is a relatively new term for metabolic etiology of hemichorea-hemiballismus syndrome and was coined in 2009. The triad for diabetic striatopathy is poor glycemic control, unilateral striatal hyperdensity on CT imaging, and contralateral choreic movements. Multiple etiologies have been suggested for the cause of diabetic striatopathy including petechial hemorrhage, mineral deposition, myelin destruction, and infarction with reactive astrocytosis; however, the exact mechanism has yet to be determined. Antidopaminergic medications may be used to control the choreic movements of diabetic striatopathy; however, the mainstay of treatment is glycemic control, often with insulin therapy.
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Affiliation(s)
- M L Cheneler
- Department of Internal Medicine, Medical City Weatherford, Weatherford, Texas, USA
| | - K Qureshi
- Department of Internal Medicine, Medical City Weatherford, Weatherford, Texas, USA
| | - C Bahrami
- Department of Internal Medicine, Medical City Weatherford, Weatherford, Texas, USA
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Santollani L, Zhang YJ, Maiorino L, Palmeri JR, Stinson JA, Duhamel LR, Qureshi K, Suggs JR, Porth OT, Pinney W, Msari RA, Wittrup KD, Irvine DJ. Local delivery of cell surface-targeted immunocytokines programs systemic anti-tumor immunity. bioRxiv 2024:2024.01.03.573641. [PMID: 38260254 PMCID: PMC10802272 DOI: 10.1101/2024.01.03.573641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Cytokine therapies are potent immunotherapy agents but exhibit severe dose-limiting toxicities. One strategy to overcome this involves engineering cytokines for intratumoral retention following local delivery. Here, we develop a localized cytokine therapy that elicits profound anti-tumor immunity by engineered targeting to the ubiquitous leukocyte receptor CD45. We designed CD45-targeted immunocytokines (αCD45-Cyt) that, upon injection, decorated the surface of leukocytes in the tumor and tumor-draining lymph node (TDLN) without systemic exposure. αCD45-Cyt therapy eradicated both directly treated tumors and untreated distal lesions in multiple syngeneic mouse tumor models. Mechanistically, αCD45-Cyt triggered prolonged pSTAT signaling and reprogrammed tumor-specific CD8+ T cells in the TDLN to exhibit an anti-viral transcriptional signature. CD45 anchoring represents a broad platform for protein retention by host immune cells for use in immunotherapy.
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Affiliation(s)
- Luciano Santollani
- Department of Chemical Engineering, Massachusetts Institute of Technology; Cambridge, MA, USA
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge; MA, USA
| | - Yiming J. Zhang
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge; MA, USA
- Department of Biological Engineering, Massachusetts Institute of Technology; Cambridge, MA, USA
| | - Laura Maiorino
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge; MA, USA
- Howard Hughes Medical Institute; Chevy Chase, MD, USA
| | - Joseph R. Palmeri
- Department of Chemical Engineering, Massachusetts Institute of Technology; Cambridge, MA, USA
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge; MA, USA
| | - Jordan A. Stinson
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge; MA, USA
- Department of Biological Engineering, Massachusetts Institute of Technology; Cambridge, MA, USA
| | - Lauren R. Duhamel
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge; MA, USA
- Department of Biological Engineering, Massachusetts Institute of Technology; Cambridge, MA, USA
| | - Kashif Qureshi
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge; MA, USA
| | - Jack R. Suggs
- Department of Chemical Engineering, Massachusetts Institute of Technology; Cambridge, MA, USA
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge; MA, USA
| | - Owen T. Porth
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge; MA, USA
- Department of Biological Engineering, Massachusetts Institute of Technology; Cambridge, MA, USA
| | - William Pinney
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge; MA, USA
- Department of Biological Engineering, Massachusetts Institute of Technology; Cambridge, MA, USA
| | - Riyam Al Msari
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge; MA, USA
- Department of Biological Engineering, Massachusetts Institute of Technology; Cambridge, MA, USA
| | - K. Dane Wittrup
- Department of Chemical Engineering, Massachusetts Institute of Technology; Cambridge, MA, USA
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge; MA, USA
- Department of Biological Engineering, Massachusetts Institute of Technology; Cambridge, MA, USA
| | - Darrell J. Irvine
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge; MA, USA
- Department of Biological Engineering, Massachusetts Institute of Technology; Cambridge, MA, USA
- Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University; Cambridge, MA, USA
- Howard Hughes Medical Institute; Chevy Chase, MD, USA
- Department of Materials Science and Engineering; Massachusetts Institute of Technology, Cambridge, MA, USA
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3
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Ma L, Hostetler A, Morgan DM, Maiorino L, Sulkaj I, Whittaker CA, Neeser A, Pires IS, Yousefpour P, Gregory J, Qureshi K, Dye J, Abraham W, Suh H, Li N, Love JC, Irvine DJ. Vaccine-boosted CAR T crosstalk with host immunity to reject tumors with antigen heterogeneity. Cell 2023; 186:3148-3165.e20. [PMID: 37413990 PMCID: PMC10372881 DOI: 10.1016/j.cell.2023.06.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 03/30/2023] [Accepted: 06/02/2023] [Indexed: 07/08/2023]
Abstract
Chimeric antigen receptor (CAR) T cell therapy effectively treats human cancer, but the loss of the antigen recognized by the CAR poses a major obstacle. We found that in vivo vaccine boosting of CAR T cells triggers the engagement of the endogenous immune system to circumvent antigen-negative tumor escape. Vaccine-boosted CAR T promoted dendritic cell (DC) recruitment to tumors, increased tumor antigen uptake by DCs, and elicited the priming of endogenous anti-tumor T cells. This process was accompanied by shifts in CAR T metabolism toward oxidative phosphorylation (OXPHOS) and was critically dependent on CAR-T-derived IFN-γ. Antigen spreading (AS) induced by vaccine-boosted CAR T enabled a proportion of complete responses even when the initial tumor was 50% CAR antigen negative, and heterogeneous tumor control was further enhanced by the genetic amplification of CAR T IFN-γ expression. Thus, CAR-T-cell-derived IFN-γ plays a critical role in promoting AS, and vaccine boosting provides a clinically translatable strategy to drive such responses against solid tumors.
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Affiliation(s)
- Leyuan Ma
- David H. Koch Institute for Integrative Cancer Research, MIT, Cambridge, MA 02139, USA; Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; The Raymond G. Perelman Center for Cellular and Molecular Therapeutics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
| | - Alexander Hostetler
- David H. Koch Institute for Integrative Cancer Research, MIT, Cambridge, MA 02139, USA
| | - Duncan M Morgan
- David H. Koch Institute for Integrative Cancer Research, MIT, Cambridge, MA 02139, USA; Department of Chemical Engineering, MIT, Cambridge, MA, USA
| | - Laura Maiorino
- David H. Koch Institute for Integrative Cancer Research, MIT, Cambridge, MA 02139, USA
| | - Ina Sulkaj
- David H. Koch Institute for Integrative Cancer Research, MIT, Cambridge, MA 02139, USA
| | - Charles A Whittaker
- David H. Koch Institute for Integrative Cancer Research, MIT, Cambridge, MA 02139, USA
| | - Alexandra Neeser
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ivan Susin Pires
- David H. Koch Institute for Integrative Cancer Research, MIT, Cambridge, MA 02139, USA
| | - Parisa Yousefpour
- David H. Koch Institute for Integrative Cancer Research, MIT, Cambridge, MA 02139, USA
| | - Justin Gregory
- David H. Koch Institute for Integrative Cancer Research, MIT, Cambridge, MA 02139, USA
| | - Kashif Qureshi
- David H. Koch Institute for Integrative Cancer Research, MIT, Cambridge, MA 02139, USA
| | - Jonathan Dye
- David H. Koch Institute for Integrative Cancer Research, MIT, Cambridge, MA 02139, USA
| | - Wuhbet Abraham
- David H. Koch Institute for Integrative Cancer Research, MIT, Cambridge, MA 02139, USA
| | - Heikyung Suh
- David H. Koch Institute for Integrative Cancer Research, MIT, Cambridge, MA 02139, USA
| | - Na Li
- David H. Koch Institute for Integrative Cancer Research, MIT, Cambridge, MA 02139, USA
| | - J Christopher Love
- David H. Koch Institute for Integrative Cancer Research, MIT, Cambridge, MA 02139, USA; Department of Chemical Engineering, MIT, Cambridge, MA, USA; Ragon Institute of Massachusetts General Hospital, Cambridge, MA 02139, USA; Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Darrell J Irvine
- David H. Koch Institute for Integrative Cancer Research, MIT, Cambridge, MA 02139, USA; Department of Materials Science and Engineering, MIT, Cambridge, MA 02139, USA; Department of Biological Engineering, MIT, Cambridge, MA 02139, USA; Ragon Institute of Massachusetts General Hospital, Cambridge, MA 02139, USA; Howard Hughes Medical Institute, Chevy Chase, MD 20815, USA.
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4
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Qureshi K. A Review Paper on Cloud Computer Architecture. Samvakti Journal of Research in Business Management 2021. [DOI: 10.46402/2021.02.12] [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: 05/08/2023]
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Qureshi K. Secure Integration of IoT and Cloud Computing. Samvakti Journal of Research in Business Management 2021. [DOI: 10.46402/2021.02.10] [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: 05/08/2023]
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Qureshi K. Analysing expression data using fuzzy logic algorithm. Asian Journal of Multidimensional Research 2021. [DOI: 10.5958/2278-4853.2021.00874.0] [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: 05/08/2023]
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Qureshi K. A survey of cloud security challenges in higher educational institutions. Asian Journal of Research in Social Sciences and Humanities 2021. [DOI: 10.5958/2249-7315.2021.00092.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
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8
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Qureshi K. A review on machine learning and IT's algorithms. Asian Journal of Multidimensional Research 2021. [DOI: 10.5958/2278-4853.2021.00866.1] [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: 05/08/2023]
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9
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Qureshi K. A glance at the security risks associated with cloud computing. Asian Journal of Multidimensional Research 2021. [DOI: 10.5958/2278-4853.2021.00854.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
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Caesar S, Layer G, Alexander R, Banks V, Barasi S, Bews S, Chaudhury B, Cockman P, Conlon M, Dasan S, Feltbower T, Fox D, Hughes S, Jani B, Jelley D, Lewis-Barned N, Mead S, Qureshi K, Twomey P, van Woerden H, Woodhouse J, Yuille F. Appraisal needs to re-start now so doctors can reflect on coronavirus experiences. BMJ 2020; 371:m3987. [PMID: 33077426 DOI: 10.1136/bmj.m3987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Susi Caesar
- Professional Development Committee, Academy of Medical Royal Colleges, 10 Dallington Street, London EC1V 0DB, UK
- Medical Appraisal 2020 Task and Finish Group, Academy of Medical Royal Colleges, London, UK
| | - Graham Layer
- Professional Development Committee, Academy of Medical Royal Colleges, 10 Dallington Street, London EC1V 0DB, UK
| | - Regi Alexander
- Royal College of Psychiatrists, 21 Prescot Street, London E1 8BB, UK
| | - Vicky Banks
- Faculty of Medical Leadership and Management, 6 St Andrews Place, London NW1 4LB, UK
| | | | - Susan Bews
- Faculty of Pharmaceutical Medicine, 19 Angel Gate, 326a City Road, London EC1V 2PT, UK
| | - Basant Chaudhury
- Royal College of Physicians of Edinburgh, 9 Queen Street, Edinburgh EH2 1JQ, UK
| | - Philippa Cockman
- NHS England and Improvement London, London, UK
- St Stephen's Health Centre, London E3 5ED, UK
| | - Maurice Conlon
- Professional Standards Team, NHS England and Improvement, Quarry House, Quarry Hill, Leeds LS2 7UE, UK
| | - Sunil Dasan
- Sustainable Working Practices Committee, Royal College of Emergency Medicine, 7-9 Bream's Buildings, Chancery Lane, London EC4A 1DT, UK
| | - Tony Feltbower
- Association of Surgeons in Primary Care and Faculty of Sexual and Reproductive Health, 27 Sunningdale Avenue, Kenilworth, Warwickshire CV82BY, UK
| | - David Fox
- Faculty of Occupational Medicine, 2 Lovibond Lane, London SE10 9FY, UK
| | - Steph Hughes
- Health Education England, Wessex Appraisal Service, Southern House, Otterbourne, Hampshire SO21 2RU, UK
| | - Bov Jani
- Royal College of Paediatrics and Child Health, 5-11 Theobalds Road, London WC1X 8SH, UK
| | - Di Jelley
- NHS England and Improvement Cumbria and North East, UK
- Health Education England (North East and Cumbria), Continuing Practice Department, Waterfront, 4 Goldcrest Way, Newburn Riverside, Newcastle Upon Tyne NE15 8NY, UK
| | - Nick Lewis-Barned
- Patient Feedback Project, Academy of Medical Royal Colleges, 10 Dallington Street, London EC1V 0DB, UK
| | | | - Kashif Qureshi
- Royal College of Ophthalmologists, 18 Stephenson Way, London NW1 2HD, UK
| | - Paul Twomey
- NHS England and Improvement North East and Yorkshire, Health House, Grange Park Lane, Willerby HU10 6DT, UK
| | - Hugo van Woerden
- Public Health Agency, 12-22 Linenhall Street, Belfast BT2 8BS, UK
| | - John Woodhouse
- Faculty of Public Health, 4 St Andrews Place, London NW1 4LB, UK
| | - Frances Yuille
- Royal College of Radiologists, 63 Lincoln's Inn Fields, London WC2A 3JW, UK
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11
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Qureshi K. Artificial Intelligence – the EHR savior? Mcgill J Med 2020. [DOI: 10.26443/mjm.v18i1.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Not required for reflection. [Essay Format]
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12
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Ahmad M, Bhatti I, Qureshi K, Ahmad N, Nisar J, Zuber M, Ashar A, Khan M, Iqbal M. Graphene oxide supported Fe2(MoO4)3 nano rods assembled round-ball fabrication via hydrothermal route and photocatalytic degradation of nonsteroidal anti-inflammatory drug. J Mol Liq 2020. [DOI: 10.1016/j.molliq.2019.112343] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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13
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Qureshi K. Selection of Representative Models: An Example of a Fluvial Sandstone Reservoir. 81st EAGE Conference and Exhibition 2019 2019. [DOI: 10.3997/2214-4609.201902011] [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: 05/08/2023]
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14
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Patel P, Sumod CB, Thakkar DP, Gupta LN, Patel VB, Bansal LK, Qureshi K, Vadher V, Baruah UK, Singh NP. Fault Protection and Overload Diagnosis in a Regulated High-Voltage Power Supply. Fusion Science and Technology 2017. [DOI: 10.13182/fst13-a17045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Paresh Patel
- Institute for Plasma Research, Gandhinagar, India 382428
| | - C. B. Sumod
- Institute for Plasma Research, Gandhinagar, India 382428
| | - D. P. Thakkar
- Institute for Plasma Research, Gandhinagar, India 382428
| | - L. N. Gupta
- Institute for Plasma Research, Gandhinagar, India 382428
| | - V. B. Patel
- Institute for Plasma Research, Gandhinagar, India 382428
| | - L. K. Bansal
- Institute for Plasma Research, Gandhinagar, India 382428
| | - K. Qureshi
- Institute for Plasma Research, Gandhinagar, India 382428
| | - V. Vadher
- Institute for Plasma Research, Gandhinagar, India 382428
| | - U. K. Baruah
- Institute for Plasma Research, Gandhinagar, India 382428
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Salji M, Payne S, Fraser S, Lamb C, Wallace J, Qureshi K, Duff M, Hendry D, Leung HY. Basaloid carcinoma of prostate (BCP) in a patient with previous history of pelvic radiotherapy treated with total pelvic exenteration and abdominoperineal resection. Journal of Clinical Urology 2016. [DOI: 10.1177/2051415814531575] [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: 11/17/2022]
Affiliation(s)
- M Salji
- Department of Urology, Gartnaval General Hospital, Glasgow, UK
| | - S Payne
- Department of Urology, Gartnaval General Hospital, Glasgow, UK
| | - S Fraser
- Department of Oncology, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - C Lamb
- Department of Oncology, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - J Wallace
- Department of Oncology, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - K Qureshi
- Department of Urology, Gartnaval General Hospital, Glasgow, UK
| | - M Duff
- Department of Urology, Gartnaval General Hospital, Glasgow, UK
| | - D Hendry
- Department of Urology, Gartnaval General Hospital, Glasgow, UK
| | - HY Leung
- Department of Urology, Gartnaval General Hospital, Glasgow, UK
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Trakroo S, Qureshi K. Successful Treatment of Chronic Hepatitis C Infection With Direct-Acting Antivirals in a Heart Transplant Recipient: A Case Report. Transplant Proc 2016; 47:2295-7. [PMID: 26361703 DOI: 10.1016/j.transproceed.2015.06.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 05/10/2015] [Accepted: 06/02/2015] [Indexed: 01/14/2023]
Abstract
BACKGROUND Heart transplant (HT) recipients with chronic hepatitis C virus (HCV) infection are noted to have higher rates of HCV related morbidity and mortality. Treatment of HCV in the past was fraught with low cure rates, increased risk of graft rejection, and medication-related side effects. CASE REPORT We report a case of successful treatment of HCV infection in a HT recipient. The patient was found to have HCV during his pretransplant workup. He underwent uneventful orthotopic HT in 2000. The HCV infection was monitored with regular liver enzymes and the surveillance liver biopsies at 2 and 5 years after HT showed mild but stable liver disease, and he stayed on chronic immunosuppression. He was not offered interferon-based HCV therapy because of the risk of steroid-resistant graft failure and cardiac decompensation. With the availability of the new direct-acting antivirals (DAA) for HCV infection, and worsening of liver fibrosis on noninvasive testing, we treated him with sofosbuvir and simeprevir for 12 weeks. During treatment, he remained clinically stable from a cardiac standpoint and he showed biochemical improvement in his liver and renal functions. Tacrolimus levels remained stable and did not require any dose adjustment. He showed rapid virologic response and subsequently achieved sustained virologic response at 12 weeks. CONCLUSION DAA use was safe and effective in treating HCV infection in a HT recipient.
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Affiliation(s)
- S Trakroo
- Department of Transplantation, Temple University Hospital, Philadelphia, Pennsylvania
| | - K Qureshi
- Section of Gastroenterology and Hepatology, Temple University School of Medicine, Philadelphia, Pennsylvania.
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Qureshi K, Abrams GA. Prevalence of biopsy-proven non-alcoholic fatty liver disease in severely obese subjects without metabolic syndrome. Clin Obes 2016; 6:117-23. [PMID: 26856683 DOI: 10.1111/cob.12132] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 10/26/2015] [Accepted: 11/24/2015] [Indexed: 01/21/2023]
Abstract
Obesity is a major risk factor for non-alcoholic fatty liver disease (NAFLD). NAFLD encompasses simple fatty liver (FL) and non-alcoholic steatohepatitis (NASH) in its spectrum. NASH can progress to liver cirrhosis and is associated with liver cancer. Not all obese subjects have insulin resistance (IR) or develop metabolic syndrome (MS). This study evaluates the prevalence of NAFLD in severely obese subjects without MS. We retrospectively reviewed 445 charts from our database of severely obese subjects with clinical suspicion of NAFLD and who were selected for laparoscopic Roux-en-Y gastric bypass surgery. One hundred five subjects who did not have MS, as defined by the International Diabetes Foundation, based on comprehensive pre-operative metabolic evaluation were included. Liver biopsy specimens were evaluated for NAFLD. 24% of morbidly obese (mean body mass index [BMI] 48 kg m(-2) ) adult subjects (mean age 38 years) who underwent bariatric surgery did not have MS. NAFLD was identified in 77 (73%) on liver biopsy, out of which 59 (56%) were labelled as FL and 18 (17%) had histological diagnosis of NASH. Age, gender, race and BMI were the same among all groups. Among NAFLD subjects, 22% did not have any additional metabolic component of MS, while 36% had low high-density lipoprotein, 27% had hypertension, 8% had high triglycerides and 6% had hyperglycaemia. IR calculated by HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) and diagnosis of hyperglycaemia was statistically higher in NASH group compared to those who did not have NASH. NAFLD is highly prevalent in morbidly obese individuals who undergo bariatric surgery despite the absence of MS. Diagnosis of hyperglycaemia in such subjects suggests the presence of IR and may have underlying NASH, which is a progressive form of NAFLD.
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Affiliation(s)
- K Qureshi
- Section of Gastroenterology and Hepatology, Department of Medicine, Temple University School of Medicine, Philadelphia, PA, USA
| | - G A Abrams
- Gastroenterology & Liver Center, Greenville Health System, Greenville, SC, USA
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McLafferty S, Trakroo S, Bonshock R, Qureshi K, Fisher S, Ramsey F, Cohen G. Treatment response evaluation by modified RECIST after locoregional therapy in patients with hepatocellular carcinoma: correlation with explant pathology and post-liver transplant survival. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.636] [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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Sharma SK, Bharathi P, Prahlad V, Patel PJ, Choksi B, Jana MR, Bansal LK, Qureshi K, Sumod CB, Vadher V, Thakkar D, Gupta LN, Rambabu S, Parmar S, Contractor N, Sahu AK, Pandya B, Sridhar B, Pandya S, Baruah UK. Characteristics of the positive ion source at reduced gas feed. Rev Sci Instrum 2014; 85:113504. [PMID: 25430113 DOI: 10.1063/1.4901596] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The neutral beam injector of steady state superconducting tokamak (SST1-NBI) at IPR is designed for injecting upto 1.7 MW of neutral beam (Hº, 30-55 keV) power to the tokamak plasma for heating and current drive. Operations of the positive ion source (PINI or Plug-In-Neutral-Injector) of SST1-NBI were carried out on the NBI test stand. The PINI was operated at reduced gas feed rate of 2-3 Torr l/s, without using the high speed cryo pumps. Experiments were conducted to achieve a stable beam extraction by optimizing operational parameters namely, the arc current (120-300 A), acceleration voltage (16-40 kV), and a suitable control sequence. The beam divergence, power density profiles, and species fractions (H(+):H2(+):H3(+)) were measured by using the diagnostics such as thermal calorimetry, infrared thermography, and Doppler shift spectroscopy. The maximum extracted beam current was about 18 A. A further increase of beam current was found to be limited by the amount of gas feed rate to the ion source.
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Affiliation(s)
- S K Sharma
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - P Bharathi
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - V Prahlad
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - P J Patel
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - B Choksi
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - M R Jana
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - L K Bansal
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - K Qureshi
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - C B Sumod
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - V Vadher
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - D Thakkar
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - L N Gupta
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - S Rambabu
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - S Parmar
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - N Contractor
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - A K Sahu
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - B Pandya
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - B Sridhar
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - S Pandya
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - U K Baruah
- Institute for Plasma Research, Bhat, Gandhinagar, India
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Abstract
PROBLEM STATEMENT: Rigorous evaluation assures that research endeavors meet their purpose and achieve stated goals. This is especially true for federally funded exploratory research centers, which tend to be more complex due to the involvement of multiple, interdisciplinary investigators. This study provides an overview of the approach used to develop an evaluation strategy and reports the lessons learned during the initial development of the Center for Ohana Self-Management of Chronic Illness (COSMCI) at the University of Hawai'i at Mānoa School of Nursing and Dental Hygiene. The COSMCI is composed of an interdisciplinary team of researchers and practitioners and aims to advance knowledge in the field of self management of chronic disease in the community setting. APPROACH: A systematic approach was utilized that included formative and summative strategies for ongoing evaluation. The problem was solved by addressing five key concerns: (1) development of research structure, (2) observing the process of the research pilot projects, (3) scholarly activity of COSMCI faculty, (4) dissemination and translation and (5) sustainability prospects. The method of research included formulating process strategies and determine if the plans for developing the Center were followed and whether these plans were effective. Interviews were also conducted at year one and at mid-point though the project. RESULTS: Themes that emerged from our evaluation included inclusion, timelines, realistic expectations, ongoing evaluation and preparing for changes in the team. This provided timely recognition of successes and challenges and facilitated a rapid response for interventions especially during the early development stage of the center. CONCLUSION/RECOMMENDATIONS: Effective development of a successful Center is highly dependent upon having a strong evaluation process in place that can inform ongoing development. An exploratory research center requires ongoing evaluation that allows for celebration of successes, as well as early identification of problems and rapid response.
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Affiliation(s)
- C R Nigg
- Department of Public Health Sciences, John A Burns School of Medicine, University of Hawaii at Manoa, USA
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Kelly SP, Wallwork I, Haider D, Qureshi K. Teleophthalmology with optical coherence tomography imaging in community optometry. Evaluation of a quality improvement for macular patients. Clin Ophthalmol 2011; 5:1673-8. [PMID: 22174576 PMCID: PMC3236713 DOI: 10.2147/opth.s26753] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [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] [Indexed: 11/24/2022] Open
Abstract
Purpose To describe a quality improvement for referral of National Health Service patients with macular disorders from a community optometry setting in an urban area. Methods Service evaluation of teleophthalmology consultation based on spectral domain optical coherence tomography images acquired by the community optometrist and transmitted to hospital eye services. Results Fifty patients with suspected macular conditions were managed via telemedicine consultation over 1 year. Responses were provided by hospital eye service-based ophthalmologists to the community optometrist or patient within the next day in 48 cases (96%) and in 34 (68%) patients on the same day. In the consensus opinion of the optometrist and ophthalmologist, 33 (66%) patients required further “face-to-face” medical examination and were triaged on clinical urgency. Seventeen cases (34%) were managed in the community and are a potential cost improvement. Specialty trainees were supervised in telemedicine consultations. Conclusion Innovation and quality improvement were demonstrated in both optometry to ophthalmology referrals and in primary optometric care by use of telemedicine with spectral domain optical coherence tomography images. E-referral of spectral domain optical coherence tomography images assists triage of macular patients and swifter care of urgent cases. Teleophthalmology is also, in the authors’ opinion, a tool to improve interdisciplinary professional working with community optometrists. Implications for progress are discussed.
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Affiliation(s)
- Simon P Kelly
- Ophthalmology Department, Royal Bolton Hospital National Health Service Foundation Trust, Bolton, UK
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22
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Shafique K, McLoone P, Qureshi K, Leung H, Hart C, Morrison D. P2-275 Cholesterol and the risk of grade-specific prostate cancer incidence: evidence from a large prospective cohort with 37 years follow-up. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976k.8] [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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23
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Hussain MI, Wani SA, Nagamani K, Fayaz I, Mir MA, Nabi A, Qureshi K, Khan MA, Nishikawa Y. Isolation and characterization of enteroaggregative, enterotoxigenic, diffusely adherent Escherichia coli and Salmonella Worthington from human diarrhoeic faecal samples in Kashmir and Secunderabad, India. World J Microbiol Biotechnol 2010. [DOI: 10.1007/s11274-010-0370-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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24
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Patel RK, Brown MC, Seywright M, Qureshi K, Geddes CC. Acute renal infarction due to renal fibromuscular dyplasia: a case of mistaken identity. Scott Med J 2008. [DOI: 10.1258/rsmsmj.53.2.65g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A 53 year old male presented with right sided loin pain in the absence of other distinguishing symptoms, past medical history or examination findings. Investigation, a week later, revealed a right sided renal mass. He underwent laparascopic nephrectomy for presumed renal malignancy. Surprisingly, the mass was an area of infarction and the renal artery had intimal-type fibromuscular dysplasia (FMD). This case demonstrates three important points. Firstly, renal infarction is a cause of acute loin pain. Secondly, delayed investigation can alter the radiological appearance of renal infarction. Lastly, FMD is a rare condition, particularly in men, and can cause renal infarction.
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Affiliation(s)
- RK Patel
- Renal Unit, Western Infirmary, Dumbarton Road, Glasgow, UK
| | - MC Brown
- Renal Unit, Western Infirmary, Dumbarton Road, Glasgow, UK
| | - M Seywright
- Pathology Dept., Western Infirmary, Dumbarton Road, Glasgow, UK
| | - K Qureshi
- Urology Dept., Gartnavel General Hospital, Great Western Road, Glasgow, UK
| | - CC Geddes
- Renal Unit, Western Infirmary, Dumbarton Road, Glasgow, UK
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25
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Robbie SJ, Muhtaseb M, Qureshi K, Bunce C, Wen X, Ionides AA. Authors' response to Konstantopoulos et al. Br J Ophthalmol 2007. [DOI: 10.1136/bjo.2007.115519] [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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26
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Lewis HC, Ethelberg S, Lisby M, Madsen SB, Olsen KEP, Rasmussen P, Kjelsø C, Vestergaard LS, Qureshi K, Howitz M, Mølbak K. Outbreak of shigellosis in Denmark associated with imported baby corn, August 2007. ACTA ACUST UNITED AC 2007; 12:E070830.1. [PMID: 17868617 DOI: 10.2807/esw.12.35.03257-en] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
On 16 August 2007, the Danish regional food authority (Fødevareregion Øst) and the Statens Serum Institut (SSI) became aware of an outbreak of Shigella sonnei infections.
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Affiliation(s)
- H C Lewis
- Department of Epidemiology, Statens Serum Institut, Copenhagen, Denmark.
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27
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Hodson PV, Qureshi K, Noble CAJ, Akhtar P, Brown RS. Inhibition of CYP1A enzymes by alpha-naphthoflavone causes both synergism and antagonism of retene toxicity to rainbow trout (Oncorhynchus mykiss). Aquat Toxicol 2007; 81:275-85. [PMID: 17257690 DOI: 10.1016/j.aquatox.2006.12.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2006] [Revised: 12/13/2006] [Accepted: 12/13/2006] [Indexed: 05/13/2023]
Abstract
Retene (7-isopropyl-1-methyl phenanthrene) is a polycyclic aromatic hydrocarbon (PAH), that causes dioxin-like toxicity to early life stages of fish, including increased rates of mortality, developmental defects characterized as blue sac disease (BSD), and induction of CYP1A enzymes. This study determined whether toxicity is associated with retene, or with its metabolism by CYP1A enzymes to hydroxylated derivatives. Larval rainbow trout (Oncorhynchus mykiss) were co-exposed to four concentrations of waterborne retene and four concentrations of waterborne alpha-naphthoflavone (ANF), a compound that antagonizes CYP1A induction and inhibits oxygenation reactions. The prevalence of mortality and BSD increased in an exposure-dependent manner for larvae exposed to retene alone. Tissue concentrations of CYP1A protein and retene metabolites also increased, but no un-metabolized retene (i.e., the parent compound) was measurable. At low concentrations of ANF, toxicity increased dramatically, while tissue concentrations of polar hydroxylated metabolites of retene decreased, and concentrations of less polar metabolites, and of parent retene, increased. At the highest concentration of ANF, retene toxicity was eliminated, and parent retene was the predominant form in tissue; no concentration of ANF was toxic by itself. The inhibition of retene hydroxylation and toxicity by ANF suggests that toxicity was caused by specific retene metabolites, and not by parent retene. The potentiation of retene toxicity at low concentrations of ANF, and the antagonism at high concentrations is a unique, non-linear interaction based on modulating CYP1A enzyme activity and retene metabolism. It demonstrates that effects on fish of different complex mixtures of hydrocarbons may not be easily predicted.
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Affiliation(s)
- Peter V Hodson
- School of Environmental Studies, Queen's University, Kingston, Ont., Canada K7L 3N6.
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29
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Ng J, Kashani S, Qureshi K, Ferguson V. Intraocular pressure measurement and goldmann calibration. An eye opening review of practice in United Kingdom. Eye (Lond) 2007; 21:851-3. [PMID: 17259916 DOI: 10.1038/sj.eye.6702706] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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30
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Robbie SJ, Qureshi K, Kashani S, Qureshi MA. Managing conjunctivitis in general practice: research into management strategies for acute infective conjunctivitis. BMJ 2006; 333:446-7. [PMID: 16931847 PMCID: PMC1553501 DOI: 10.1136/bmj.333.7565.446-c] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
AIM To identify whether the risk of an intraoperative complication of phakoemulsification cataract surgery increases with age. METHODS 1441 consecutive patients undergoing phakoemulsification cataract surgery were assessed preoperatively, and data on the occurrence of intraoperative complications were collected prospectively. Data were entered into a computerised database, and logistic regression was used to examine evidence of an association between age and the risk of an intraoperative complication. In addition, the rates of intraoperative complications were compared between patients > or =88 years and those <88 years, and between patients > or =96 years and those <96 years. RESULTS No significant association was found between age and the risk of an intraoperative complication. The authors found little evidence that patients > or =88 years were at a greater risk of an intraoperative complication than those <88 years, or that those > or =96 years are at increased risk; however, numbers were small. CONCLUSIONS These results suggest that age alone is not a major risk factor for any intraoperative complications occurring during phakoemulsification cataract surgery. This has implications not just for tailoring the risk of complications occurring to individual patients but also for meaningful comparisons between national complication rates and those of individual surgeons, and better selection of cases suitable for instruction.
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Affiliation(s)
- S J Robbie
- Moorfields Eye Hospital, Duke-Elder Diagnosis and Treatment Centre, St George's Hospital, London, UK.
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32
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Cowan SA, Bagdonaite J, Qureshi K. Universal hepatitis B screening of pregnant women in Denmark ascertains substantial additional infections: results from the first five months. ACTA ACUST UNITED AC 2006; 11:E060608.3. [PMID: 16819119 DOI: 10.2807/esw.11.23.02969-en] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- S A Cowan
- Department of Epidemiology, Statens Serum Institut, Copenhagen, Denmark.
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Qureshi K, Gershon RRM, Sherman MF, Straub T, Gebbie E, McCollum M, Erwin MJ, Morse SS. Health care workers' ability and willingness to report to duty during catastrophic disasters. J Urban Health 2005; 82:378-88. [PMID: 16000654 PMCID: PMC3456052 DOI: 10.1093/jurban/jti086] [Citation(s) in RCA: 316] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Catastrophic disasters create surge capacity needs for health care systems. This is especially true in the urban setting because the high population density and reliance on complex urban infrastructures (e.g., mass transit systems and high rise buildings) could adversely affect the ability to meet surge capacity needs. To better understand responsiveness in this setting, we conducted a survey of health care workers (HCWs) (N =6,428) from 47 health care facilities in New York City and the surrounding metropolitan region to determine their ability and willingness to report to work during various catastrophic events. A range of facility types and sizes were represented in the sample. Results indicate that HCWs were most able to report to work for a mass casualty incident (MCI) (83%), environmental disaster (81%), and chemical event (71%) and least able to report during a smallpox epidemic (69%), radiological event (64%), sudden acute respiratory distress syndrome (SARS) outbreak (64%), or severe snow storm (49%). In terms of willingness, HCWs were most willing to report during a snow storm (80%), MCI (86%), and environmental disaster (84%) and least willing during a SARS outbreak (48%), radiological event (57%), smallpox epidemic (61%), and chemical event (68%). Barriers to ability included transportation problems, child care, eldercare, and pet care obligations. Barriers to willingness included fear and concern for family and self and personal health problems. The findings were consistent for all types of facilities. Importantly, many of the barriers identified are amenable to interventions.
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Affiliation(s)
- K Qureshi
- Mailman School of Public Health, Columbia University, New York, New York, USA.
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34
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Ullah N, Qureshi K, Yordanova V, Hatfield J, Sochacki P, Lawson M, Tobi M. Differential labeling by monoclonal antibodies Adnab-9 and anti-alpha-defensin 5 based on the distribution and adenomatous tissue content of colonic polyps. Dig Dis Sci 2005; 50:708-13. [PMID: 15844706 DOI: 10.1007/s10620-005-2561-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
We sought a correlation between site and morphology of colonic polyps by labeling with neoplastic and general Paneth cell markers, monoclonal antibodies Adnab-9 and anti-alpha-defensin 5, respectively. Proportions labeled by Adnab-9 and anti-alpha-defensin 5 were, respectively, 42 and 85% for adenomas, 39 and 63% for early tubular adenomas, 41 and 44% for serrated, 34 and 20% for mixed, and 11 versus 2.7% for hyperplastic polyps. Compared with hyperplastic polyps, the proportion of other polyps labeled by Adnab-9 or anti-alpha-defensin 5 was higher but this difference was more significant for distal (P = 0.008 for Adnab-9 and P = 0.0001 for anti-alpha-defensin 5) than proximal (P = 0.645 and P = 0.154, respectively) polyps. While increased labeling of all proximal polyps compared to distal ones mirrored the colonic distribution of Paneth cells, distal adenomas tended to have a higher proportion labeled by Adnab-9, suggesting that Adnab-9 labels Paneth cells associated with increased neoplastic potential.
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Affiliation(s)
- Nadeem Ullah
- Departments of Internal Medicine & Pathology, John D Dingell VAMC, Detroit, Michigan 48201, USA
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35
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Affiliation(s)
- K. Qureshi
- Roswell Park Cancer Institute, Buffalo, NY
| | - S. Lee
- Roswell Park Cancer Institute, Buffalo, NY
| | - W. Lou
- Roswell Park Cancer Institute, Buffalo, NY
| | - D. Trump
- Roswell Park Cancer Institute, Buffalo, NY
| | - A. Gao
- Roswell Park Cancer Institute, Buffalo, NY
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36
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Ullah N, Qureshi K, Hatfield J, Sochacki P, David D, Albataineh H, Mejia L, Kenkre C, Lawson M, Tobi M. Small early tubular adenomas and mixed colonic polyps found on screening flexible sigmoidoscopy do not predict proximal neoplasia in males. Clin Gastroenterol Hepatol 2004; 2:246-51. [PMID: 15017609 DOI: 10.1016/s1542-3565(04)00012-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Distal colonic adenomas found on flexible sigmoidoscopy are associated with proximal neoplasias, thus requiring a complete colonoscopic examination, but data regarding the association of distal mixed polyps with proximal neoplasia are lacking. We conducted this study to elucidate the significance of distal mixed colonic polyps in predicting proximal neoplasia. METHODS We retrospectively analyzed data from patients who underwent a flexible sigmoidoscopic examination for colorectal cancer screening and a follow-up colonoscopic examination because of distal colonic polyps. Distal index polyps were classified by a pathologist as early tubular adenoma (ETA), serrated, or true mixed categories. Index polyps also were immunostained with a monoclonal antibody, Adnab-9, a marker for the colorectal adenoma carcinoma sequence. RESULTS In 636 patients with distal index polyps, 6% were malignant, 55% were adenomas, 13% were ETAs, 6% were serrated, 4% were true mixed, and 17% were hyperplastic. Compared with distal hyperplastic index polyps, distal malignant polyps (P = 0.0006) and adenomas (P = 0.001) were associated with a significantly increased number of synchronous proximal neoplasia, but the small distal mixed, serrated, or ETA did not predict the increased incidence of proximal neoplasia. Large distal polyps of each category were significantly associated with an increased number of synchronous proximal neoplasias. In support of these findings, immunostaining of distal polyps with Adnab-9 showed predictability for proximal neoplasia only in the adenoma category (P < 0.05). CONCLUSIONS Small ETAs, serrated, or mixed polyps found on flexible sigmoidoscopic examination do not increase the probability of synchronous proximal neoplasia.
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Affiliation(s)
- Nadeem Ullah
- Wayne State University School of Medicine, Detroit, Michigan, USA
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38
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Rizvi Z, Rehman T, Malik S, Qureshi A, Paul L, Qureshi K, Memon S, Rafi S, Ali A. An evaluation of topical and local anesthesia in phacoemulsification. J PAK MED ASSOC 2003; 53:167-70. [PMID: 12776905] [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: 03/02/2023]
Abstract
OBJECTIVE To assess the comparative efficacy of topical and local anesthesia in phacoemulsification. MATERIAL AND METHODS The medical records of 186 men and women between the ages of 45-85 years, who underwent elective cataract surgery by phacoemulsification technique, under the care of one surgeon, over a period of one year, from March 1999-March 2000 were reviewed. RESULTS Of 186 patients who underwent small incision, self-healing phacoemulsification cataract surgery, 124 received topical and 62 local anesthesia. The most common cataract types were nuclear sclerosis. The duration of surgery with topical anesthesia was shorter. Sutures and eye padding were more frequently applied for procedures done under local anesthesia. Uncorrected visual acuity in the first post-op week was between 20/20-20/50 for 53.6% of the cases done under topical compared to 30.9% in local anesthesia. A similar trend was noted in the visual acuity one month post operatively. CONCLUSION The uncorrected visual acuity improves faster and the duration of surgery is shorter when topical anesthesia is used.
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Affiliation(s)
- Z Rizvi
- Aga Khan University Medical College, Karachi
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39
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Poulsen A, Qureshi K, Lisse I, Kofoed PE, Nielsen J, Vestergaard BF, Aaby P. A household study of chickenpox in Guinea-Bissau: intensity of exposure is a determinant of severity. J Infect 2002; 45:237-42. [PMID: 12423611 DOI: 10.1053/jinf.2002.1049] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To determinate the relative importance of state of nutrition and intensity of exposure for clinical severity of chickenpox in a developing country. METHODS A prospective household study was performed in a semi-urban area in Bissau, the capital of Guinea-Bissau, between December 1994 and June 1995. Antibodies were measured in the acute and the convalescence phase to assess validity of clinical diagnoses. The clinical severity of infection was assessed by number of pox, fever response and skin infections. Severity was compared for index cases, i.e. the first case in the house, and secondary and tertiary cases infected following exposure at home. RESULT Chickenpox was diagnosed in 165 persons. The clinician's and the mothers' diagnoses corresponded well with the serological results. Median age was 36 months (range 3 months to 30.3 years). There was no correlation between nutritional status measured by arm-circumference and severity of infection. The number of pox was higher for secondary cases than for index cases (median 106 vs. 89, P<0.01), the difference being more pronounced for girls (P=0.018) than for boys (P=0.575). The risk of skin infection as a complication was correlated with the number of pox (P<0.001). CONCLUSION Chickenpox was recognised correctly by Guinean mothers. The age distribution in Guinea-Bissau resembled the pattern in developed countries. The intensity of exposure was a major determinant of severity, especially for girls.
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Affiliation(s)
- A Poulsen
- Projecto de Saude de Bandim, Guinea-Bissau, Denmark.
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Abstract
The role of the home environment in the transmission of infectious diseases has been well described in the developing world but has received less attention in developed countries. An increasing focus on home hygiene has emerged in debates regarding the use of antimicrobial products in the home and the potential for development of resistance and in discussions regarding "when is clean too clean" and "what is clean." Studies are clearly needed to further explicate the role of the home in the spread of infectious agents, but before these can be conducted, adequate measurement tools are essential. This article describes extensive psychometric testing undertaken to develop valid and reliable methods and tools to measure home hygiene and focuses on a neighborhood that was primarily Spanish speaking in New York City. The Home Hygiene Assessment Tool described in this article can be used by clinicians and researchers to further elucidate the role of the home environment in the prevention and control of infections.
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Affiliation(s)
- E L Larson
- Pharmaceutical and Therapeutic Research, Columbia University School of Nursing, 630 W. 168th Street, New York, NY 10032, USA.
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Qureshi K. Strategies for managing staff time and attendance. Semin Nurse Manag 2000; 8:174-5; discussion 175-7. [PMID: 12029664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Affiliation(s)
- K Qureshi
- St Luke's Roosevelt Hospital Center, New York, NY, USA
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Nutt JE, Mellon JK, Qureshi K, Lunec J. Matrix metalloproteinase-1 is induced by epidermal growth factor in human bladder tumour cell lines and is detectable in urine of patients with bladder tumours. Br J Cancer 1998; 78:215-20. [PMID: 9683296 PMCID: PMC2062898 DOI: 10.1038/bjc.1998.467] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The matrix metalloproteinases are a family of enzymes that degrade the extracellular matrix and are considered to be important in tumour invasion and metastasis. The effect of epidermal growth factor (EGF) on matrix metalloproteinase-1 (MMP1) production in two human bladder tumour cell lines, RT112 and RT4, has been investigated. In the RT112 cell line, an increase in MMP1 mRNA levels was found after a 6-h incubation with EGF, and this further increased to 20-fold that of control levels at 24- and 48-h treatment with 50 ng ml(-1) of EGF. MMP2 mRNA levels remained constant over this time period, whereas in the RT4 cells no MMP2 transcripts were detectable, but MMP1 transcripts again increased with 24- and 48-h treatment with 50 ng ml(-1) of EGF. MMP1 protein concentration in the conditioned medium from both cell lines increased with 24- and 48-h treatment of the cells and the total MMP1 was higher in the medium than the cells, demonstrating that the bladder tumour cell lines synthesize and secrete MMP1 protein after continuous stimulation with EGF. MMP1 protein was detected in urine from patients with bladder tumours, with a significant increase in concentration with increased stage and grade of tumour. MMP1 urine concentrations may therefore be a useful prognostic indicator for bladder tumour progression.
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Affiliation(s)
- J E Nutt
- Cancer Research Unit, The Medical School, Framlington Place, University of Newcastle upon Tyne, UK
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Qureshi K, Rao KV, Qureshi IA. Differential inhibition by hyperammonemia of the electron transport chain enzymes in synaptosomes and non-synaptic mitochondria in ornithine transcarbamylase-deficient spf-mice: restoration by acetyl-L-carnitine. Neurochem Res 1998; 23:855-61. [PMID: 9572674 DOI: 10.1023/a:1022406911604] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.3] [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: 02/07/2023]
Abstract
Sparse-fur (spf) mouse is the ideal animal model to study the neuropathology of congenital ornithine transcarbamylase (OTC) deficiency. Our current hypothesis implies that an ammonia-induced depletion of energy metabolism in the spf mouse, could be due to a reduction in the activities of the enzymes of the electron transport chain and a treatment with acetyl-L-carnitine could normalize this abnormality. We also hypothesized that there might be a differential degree of inhibition in synaptosomal and non-synaptic mitochondria, for the enzymes of the electron transport chain, caused by congenital hyperammonemia. We have therefore measured the activities of NADH-cytochrome C oxidoreductase, succinate cytochrome C oxidoreductase and cytochrome C oxidase in synaptosomes and non-synaptic mitochondria, isolated from spf mice and CD-1 controls with and without acetyl-L-carnitine treatment. Our results indicate a significant reduction (19-34%) in the activities of these complexes in synaptosomes in untreated spf mice, whereas in non-synaptic mitochondria, there was a tendency for the activities to decrease. Acetyl-L-carnitine treatment enhanced these activities (15-64%) for all the three enzyme complexes and its effect was more prominent on succinate cytochrome C oxidoreductase activity (64%). These studies point out that: (a) ammonia-induced disturbances in the energy metabolism could be more pronounced in neuronal mitochondria, and (b) the effect of acetyl-L-carnitine on the restoration of cerebral ATP in hyperammonemia could be through an enhancement of the activities of various electron transport chain enzymes.
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Affiliation(s)
- K Qureshi
- Department of Pediatrics, University of Montreal, Hôpital Sainte-Justine, Quebec, Canada
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Swann IL, Thompson EN, Qureshi K. Domperidone or metoclopramide in preventing chemotherapeutically induced nausea and vomiting. Br Med J 1979; 2:1188. [PMID: 519355 PMCID: PMC1597274 DOI: 10.1136/bmj.2.6199.1188] [Citation(s) in RCA: 35] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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