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Jiao L, Bujnowski D, Liu P, Bakota E, Liu L, Ye Y, Dewangan A, Duong CN, Kviten E, Zaheer S, Zangeneh A, Roy R, Floyd J, Monroy J, Wiltz-Beckham D. Asthma and clinical outcomes of COVID-19 in a community setting. Public Health 2024; 226:84-90. [PMID: 38016200 DOI: 10.1016/j.puhe.2023.10.040] [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] [Received: 06/07/2023] [Revised: 10/16/2023] [Accepted: 10/24/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVES The association between asthma and COVID-19 mortality remains inconclusive. We examined the association between asthma and clinical outcomes of patients with COVID-19. STUDY DESIGN A case-control study based on a surveillance cohort in Harris County, Texas. METHODS Using the data of 21,765 patients who reported having at least one chronic health condition, we investigated the association between asthma and COVID-19 severity, characterized primarily by hospitalization and death. Unconditional logistic regression models were used to estimate the multivariable odds ratio (mOR) and its 95 % confidence interval (CI) of COVID-19 severity associated with asthma and other chronic lung diseases, adjusting for demographic and other comorbidities. A P-value < 0.005 was considered statistically significant after correcting multiple testing. RESULTS In total, 3034 patients (13.9 %) had asthma, and 774 (3.56 %) had other chronic lung diseases. The case death rate among patients with asthma and other chronic lung diseases was 0.75 % and 19.0 %, respectively. Compared to patients without the respective conditions, patients with asthma had lower odds of death (mOR = 0.44, 95 % CI: 0.27-0.69), while patients with other chronic lung diseases had higher odds of hospitalization (mOR = 2.02, 95 % CI: 1.68-2.42) and death (mOR = 1.95, 95 % CI: 1.52-2.49) (P-values < 0.005). Risk factors for COVID-19 mortality included older age, male gender, diabetes, obesity, hypertension, cardiovascular disease, active cancer, and chronic kidney disease. CONCLUSIONS The public health surveillance data suggested that preexisting asthma was inversely associated with COVID-19 mortality.
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Affiliation(s)
- L Jiao
- Harris County Public Health, 1111 Fannin Street, Houston, TX, 77002, USA.
| | - D Bujnowski
- Harris County Public Health, 1111 Fannin Street, Houston, TX, 77002, USA
| | - P Liu
- Harris County Public Health, 1111 Fannin Street, Houston, TX, 77002, USA
| | - E Bakota
- Harris County Public Health, 1111 Fannin Street, Houston, TX, 77002, USA
| | - L Liu
- Harris County Public Health, 1111 Fannin Street, Houston, TX, 77002, USA
| | - Y Ye
- Harris County Public Health, 1111 Fannin Street, Houston, TX, 77002, USA
| | - A Dewangan
- Harris County Public Health, 1111 Fannin Street, Houston, TX, 77002, USA
| | - C N Duong
- Harris County Public Health, 1111 Fannin Street, Houston, TX, 77002, USA
| | - E Kviten
- Harris County Public Health, 1111 Fannin Street, Houston, TX, 77002, USA
| | - S Zaheer
- Harris County Public Health, 1111 Fannin Street, Houston, TX, 77002, USA
| | - A Zangeneh
- Harris County Public Health, 1111 Fannin Street, Houston, TX, 77002, USA
| | - R Roy
- Harris County Public Health, 1111 Fannin Street, Houston, TX, 77002, USA
| | - J Floyd
- Harris County Public Health, 1111 Fannin Street, Houston, TX, 77002, USA
| | - J Monroy
- Harris County Public Health, 1111 Fannin Street, Houston, TX, 77002, USA
| | - D Wiltz-Beckham
- Harris County Public Health, 1111 Fannin Street, Houston, TX, 77002, USA
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Roy R, Cannata A, Al-Agil M, Ferone E, Jordan A, To-Dang B, Sadler M, Shamsi A, Albarjas M, Piper S, Giacca M, Shah AM, McDonagh T, Bromage DI, Scott PA. Diagnostic accuracy, clinical characteristics, and prognostic differences of patients with acute myocarditis according to inclusion criteria. European Heart Journal - Quality of Care and Clinical Outcomes 2023:qcad061. [PMID: 37930743 DOI: 10.1093/ehjqcco/qcad061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
INTRODUCTION The diagnosis of acute myocarditis (AM) is complex due to its heterogeneity and typically is defined by either Electronic Healthcare Records (EHRs) or advanced imaging and endomyocardial biopsy, but there is no consensus. We aimed to investigate the diagnostic accuracy of these approaches for AM. METHODS Data on ICD 10th Revision(ICD-10) codes corresponding to AM were collected from two hospitals and compared to CMR-confirmed or clinically suspected(CS) AM cases with respect to diagnostic accuracy, clinical characteristics, and all-cause mortality. Next, we performed a review of published AM studies according to inclusion criteria. RESULTS We identified 291 unique admissions with ICD-10 codes corresponding to AM in the first three diagnostic positions. The positive predictive value(PPV) of ICD-10 codes for CMR-confirmed or CS-AM was 36%, and patients with CMR-confirmed or CS AM had a lower all-cause mortality than those with a refuted diagnosis (P = 0.019). Using an unstructured approach, patients with CMR-confirmed and CS AM had similar demographics, comorbidity profiles and survival over a median follow-up of 52 months (P = 0.72). Our review of the literature confirmed our findings. Outcomes for patients included in studies using CMR-confirmed criteria were favourable compared to studies with EMB-confirmed AM cases. CONCLUSION ICD-10 codes have poor accuracy in identification of AM cases and should be used with caution in clinical research. There are important differences in management and outcomes of patients according to the selection criteria used to diagnose AM. Potential selection biases must be considered when interpreting AM cohorts and requires standardisation of inclusion criteria for AM studies.
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Affiliation(s)
- Roman Roy
- King's College London British Heart Foundation Centre of Excellence, School of Cardiovascular Medicine & Sciences, London, UK
- King's College Hospital NHS Foundation Trust, London, UK
| | - Antonio Cannata
- King's College London British Heart Foundation Centre of Excellence, School of Cardiovascular Medicine & Sciences, London, UK
- King's College Hospital NHS Foundation Trust, London, UK
| | | | - Emma Ferone
- King's College London British Heart Foundation Centre of Excellence, School of Cardiovascular Medicine & Sciences, London, UK
| | - Antonio Jordan
- King's College Hospital NHS Foundation Trust, London, UK
| | - Brian To-Dang
- King's College Hospital NHS Foundation Trust, London, UK
| | - Matthew Sadler
- King's College London British Heart Foundation Centre of Excellence, School of Cardiovascular Medicine & Sciences, London, UK
- King's College Hospital NHS Foundation Trust, London, UK
| | - Aamir Shamsi
- King's College Hospital NHS Foundation Trust, London, UK
| | | | - Susan Piper
- King's College Hospital NHS Foundation Trust, London, UK
| | - Mauro Giacca
- King's College London British Heart Foundation Centre of Excellence, School of Cardiovascular Medicine & Sciences, London, UK
| | - Ajay M Shah
- King's College London British Heart Foundation Centre of Excellence, School of Cardiovascular Medicine & Sciences, London, UK
| | | | - Daniel I Bromage
- King's College London British Heart Foundation Centre of Excellence, School of Cardiovascular Medicine & Sciences, London, UK
- King's College Hospital NHS Foundation Trust, London, UK
| | - Paul A Scott
- King's College Hospital NHS Foundation Trust, London, UK
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Roy R, Wilcox J, Webb AJ, O’Gallagher K. Dysfunctional and Dysregulated Nitric Oxide Synthases in Cardiovascular Disease: Mechanisms and Therapeutic Potential. Int J Mol Sci 2023; 24:15200. [PMID: 37894881 PMCID: PMC10607291 DOI: 10.3390/ijms242015200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/11/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
Nitric oxide (NO) plays an important and diverse signalling role in the cardiovascular system, contributing to the regulation of vascular tone, endothelial function, myocardial function, haemostasis, and thrombosis, amongst many other roles. NO is synthesised through the nitric oxide synthase (NOS)-dependent L-arginine-NO pathway, as well as the nitrate-nitrite-NO pathway. The three isoforms of NOS, namely neuronal (NOS1), inducible (NOS2), and endothelial (NOS3), have different localisation and functions in the human body, and are consequently thought to have differing pathophysiological roles. Furthermore, as we continue to develop a deepened understanding of the different roles of NOS isoforms in disease, the possibility of therapeutically modulating NOS activity has emerged. Indeed, impaired (or dysfunctional), as well as overactive (or dysregulated) NOS activity are attractive therapeutic targets in cardiovascular disease. This review aims to describe recent advances in elucidating the physiological role of NOS isoforms within the cardiovascular system, as well as mechanisms of dysfunctional and dysregulated NOS in cardiovascular disease. We then discuss the modulation of NO and NOS activity as a target in the development of novel cardiovascular therapeutics.
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Affiliation(s)
- Roman Roy
- Cardiovascular Department, King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK;
| | - Joshua Wilcox
- Cardiovascular Department, Guy’s and St. Thomas’ NHS Foundation Trust, London SE1 7EH, UK;
| | - Andrew J. Webb
- Department of Clinical Pharmacology, British Heart Foundation Centre, School of Cardiovascular and Metabolic Medicine and Sciences, King’s College London, London SE1 7EH, UK;
| | - Kevin O’Gallagher
- Cardiovascular Department, King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK;
- British Heart Foundation Centre of Research Excellence, School of Cardiovascular and Metabolic Medicine & Sciences, Faculty of Life Sciences & Medicine, King’s College London, London SE5 9NU, UK
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Aldous R, Roy R, Cannata A, Abdrazak M, Mohanan S, Beckley-Hoelscher N, Stahl D, Kanyal R, Kordis P, Sunderland N, Parczewska A, Kirresh A, Nevett J, Fothergill R, Webb I, Dworakowski R, Melikian N, Kalra S, Johnson TW, Sinagra G, Rakar S, Noc M, Patel S, Auzinger G, Gruchala M, Shah AM, Byrne J, MacCarthy P, Pareek N. MIRACLE 2 Score Compared With Downtime and Current Selection Criterion for Invasive Cardiovascular Therapies After OHCA. JACC Cardiovasc Interv 2023; 16:2439-2450. [PMID: 37609699 DOI: 10.1016/j.jcin.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 08/01/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND The MIRACLE2 score is the only risk score that does not incorporate and can be used for selection of therapies after out-of-hospital cardiac arrest (OHCA). OBJECTIVES This study sought to compare the discrimination performance of the MIRACLE2 score, downtime, and current randomized controlled trial (RCT) recruitment criteria in predicting poor neurologic outcome after out-of-hospital cardiac arrest (OHCA). METHODS We used the EUCAR (European Cardiac Arrest Registry), a retrospective cohort from 6 centers (May 2012-September 2022). The primary outcome was poor neurologic outcome on hospital discharge (cerebral performance category 3-5). RESULTS A total of 1,259 patients (total downtime = 25 minutes; IQR: 15-36 minutes) were included in the study. Poor outcome occurred in 41.8% with downtime <30 minutes and in 79.3% for those with downtime >30 minutes. In a multivariable logistic regression analysis, MIRACLE2 had a stronger association with outcome (OR: 2.23; 95% CI: 1.98-2.51; P < 0.0001) than zero flow (OR: 1.07; 95% CI: 1.01-1.13; P = 0.013), low flow (OR: 1.04; 95% CI: 0.99-1.09; P = 0.054), and total downtime (OR: 0.99; 95% CI: 0.95-1.03; P = 0.52). MIRACLE2 had substantially superior discrimination for the primary endpoint (AUC: 0.877; 95% CI: 0.854-0.897) than zero flow (AUC: 0.610; 95% CI: 0.577-0.642), low flow (AUC: 0.725; 95% CI: 0.695-0.754), and total downtime (AUC: 0.732; 95% CI: 0.701-0.760). For those modeled for exclusion from study recruitment, the positive predictive value of MIRACLE2 ≥5 for poor outcome was significantly higher (0.92) than the CULPRIT-SHOCK (Culprit lesion only PCI Versus Multivessel PCI in Cardiogenic Shock) (0.80), EUROSHOCK (Testing the value of Novel Strategy and Its Cost Efficacy In Order to Improve the Poor Outcomes in Cardiogenic Shock) (0.74) and ECLS-SHOCK (Extra-corporeal life support in Cardiogenic shock) criteria (0.81) (P < 0.001). CONCLUSIONS The MIRACLE2 score has superior prediction of outcome after OHCA than downtime and higher discrimination of poor outcome than the current RCT recruitment criteria. The potential for the MIRACLE2 score to improve the selection of OHCA patients should be evaluated formally in future RCTs.
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Affiliation(s)
- Robert Aldous
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Roman Roy
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Antonio Cannata
- King's College Hospital NHS Foundation Trust, London, United Kingdom; School of Cardiovascular and Metabolic Medicine and Sciences, British Heart Foundation Centre of Excellence, King's College London, London, United Kingdom
| | - Muhamad Abdrazak
- King's College Hospital NHS Foundation Trust, London, United Kingdom; School of Cardiovascular and Metabolic Medicine and Sciences, British Heart Foundation Centre of Excellence, King's College London, London, United Kingdom
| | - Shamika Mohanan
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | | | - Daniel Stahl
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Ritesh Kanyal
- School of Cardiovascular and Metabolic Medicine and Sciences, British Heart Foundation Centre of Excellence, King's College London, London, United Kingdom
| | - Peter Kordis
- Centre for Intensive Internal Medicine, University Medical Center, Ljubljana, Slovenia
| | - Nicholas Sunderland
- Bristol Heart Institute, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | | | - Ali Kirresh
- Royal Free Hospital NHS Foundation Trust, London, United Kingdom
| | - Joanne Nevett
- London Ambulance Service NHS Trust, London, United Kingdom
| | | | - Ian Webb
- King's College Hospital NHS Foundation Trust, London, United Kingdom; School of Cardiovascular and Metabolic Medicine and Sciences, British Heart Foundation Centre of Excellence, King's College London, London, United Kingdom
| | - Rafal Dworakowski
- King's College Hospital NHS Foundation Trust, London, United Kingdom; School of Cardiovascular and Metabolic Medicine and Sciences, British Heart Foundation Centre of Excellence, King's College London, London, United Kingdom
| | - Narbeh Melikian
- King's College Hospital NHS Foundation Trust, London, United Kingdom; School of Cardiovascular and Metabolic Medicine and Sciences, British Heart Foundation Centre of Excellence, King's College London, London, United Kingdom
| | - Sundeep Kalra
- Royal Free Hospital NHS Foundation Trust, London, United Kingdom
| | - Thomas W Johnson
- Bristol Heart Institute, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | | | - Serena Rakar
- Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Marko Noc
- Centre for Intensive Internal Medicine, University Medical Center, Ljubljana, Slovenia
| | - Sameer Patel
- Faculty of Life Science and Medicine, King's College London, London, United Kingdom
| | - Georg Auzinger
- Faculty of Life Science and Medicine, King's College London, London, United Kingdom
| | - Marcin Gruchala
- Department of Cardiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Ajay M Shah
- King's College Hospital NHS Foundation Trust, London, United Kingdom; School of Cardiovascular and Metabolic Medicine and Sciences, British Heart Foundation Centre of Excellence, King's College London, London, United Kingdom
| | - Jonathan Byrne
- King's College Hospital NHS Foundation Trust, London, United Kingdom; School of Cardiovascular and Metabolic Medicine and Sciences, British Heart Foundation Centre of Excellence, King's College London, London, United Kingdom
| | - Philip MacCarthy
- King's College Hospital NHS Foundation Trust, London, United Kingdom; School of Cardiovascular and Metabolic Medicine and Sciences, British Heart Foundation Centre of Excellence, King's College London, London, United Kingdom
| | - Nilesh Pareek
- King's College Hospital NHS Foundation Trust, London, United Kingdom; School of Cardiovascular and Metabolic Medicine and Sciences, British Heart Foundation Centre of Excellence, King's College London, London, United Kingdom.
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Roy R, Kanyal R, Abd Razak M, To-Dang B, Chotai S, Abu-Own H, Cannata A, Dworakowski R, Webb I, Pareek M, Shah AM, MacCarthy P, Byrne J, Melikian N, Pareek N. The effect of ethnicity and socioeconomic status on outcomes after resuscitated out-of-hospital cardiac arrest - Findings from a tertiary centre in South London. Resusc Plus 2023; 14:100388. [PMID: 37125005 PMCID: PMC10130337 DOI: 10.1016/j.resplu.2023.100388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 05/02/2023] Open
Abstract
Background Out-of-hospital cardiac arrest is a common cause of morbidity and mortality, and ethnic variation in outcomes is recognised. We investigated ethnic and socioeconomic differences in arrest circumstances, rates of coronary artery disease, treatment, and outcomes in resuscitated OOHCA. Methods Patients with resuscitated OOHCA of suspected cardiac aetiology were included in the King's Out-of-Hospital Cardiac Arrest Registry between 1-May-2012 and 31-December-2020. Results Of 526 patients (median age 62.0 years, IQR 21.1, 74.1% male), 414 patients (78.7%) were White, 35 (6.7%) were Asian, and 77 (14.6%) were Black. Black patients had more co-existent hypertension (p = 0.007) and cardiomyopathy (p = 0.003), but less prior coronary revascularisation (p = 0.026) compared with White/Asian patients. There were no ethnic differences in location, witnesses, or bystander CPR, but Black patients had more non-shockable rhythms (p < 0.001). Black patients received less immediate coronary angiography (p < 0.001) and percutaneous coronary intervention (p < 0.001) but had lower rates of CAD (p = 0.004) than White/Asian patients. All-cause mortality at 12 months was highest amongst Black patients, followed by Asian and then White patients (57.1% vs 48.6% vs 41.3%, p = 0.032). In Black patients, excess mortality was driven by higher rates of multi-organ dysfunction but lower cardiac death than White/Asian patients, with cardiac death highest amongst Asian patients (p = 0.009). Socioeconomic status had no effect on mortality, and in a multivariable logistic regression, age, location, witnesses, and Black compared to White ethnicity were independent predictors of mortality, whilst social deprivation was not. Conclusion In this single-centre study, Black patients had higher mortality after resuscitated OOHCA than White/Asian patients. This may be in part due to differing underlying aetiology rather than differences in arrest circumstances or social deprivation.
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Affiliation(s)
- Roman Roy
- King’s College Hospital NHS Foundation Trust, London, UK
- School of Cardiovascular Medicine and Sciences, BHF Centre of Excellence, King’s College London, UK
| | - Ritesh Kanyal
- King’s College Hospital NHS Foundation Trust, London, UK
- School of Cardiovascular Medicine and Sciences, BHF Centre of Excellence, King’s College London, UK
| | - Muhamad Abd Razak
- King’s College Hospital NHS Foundation Trust, London, UK
- School of Cardiovascular Medicine and Sciences, BHF Centre of Excellence, King’s College London, UK
| | - Brian To-Dang
- King’s College Hospital NHS Foundation Trust, London, UK
| | - Shayna Chotai
- King’s College Hospital NHS Foundation Trust, London, UK
| | - Huda Abu-Own
- King’s College Hospital NHS Foundation Trust, London, UK
- School of Cardiovascular Medicine and Sciences, BHF Centre of Excellence, King’s College London, UK
| | - Antonio Cannata
- King’s College Hospital NHS Foundation Trust, London, UK
- School of Cardiovascular Medicine and Sciences, BHF Centre of Excellence, King’s College London, UK
| | - Rafal Dworakowski
- King’s College Hospital NHS Foundation Trust, London, UK
- School of Cardiovascular Medicine and Sciences, BHF Centre of Excellence, King’s College London, UK
| | - Ian Webb
- King’s College Hospital NHS Foundation Trust, London, UK
- School of Cardiovascular Medicine and Sciences, BHF Centre of Excellence, King’s College London, UK
| | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Ajay M Shah
- King’s College Hospital NHS Foundation Trust, London, UK
- School of Cardiovascular Medicine and Sciences, BHF Centre of Excellence, King’s College London, UK
| | - Philip MacCarthy
- King’s College Hospital NHS Foundation Trust, London, UK
- School of Cardiovascular Medicine and Sciences, BHF Centre of Excellence, King’s College London, UK
| | - Jonathan Byrne
- King’s College Hospital NHS Foundation Trust, London, UK
- School of Cardiovascular Medicine and Sciences, BHF Centre of Excellence, King’s College London, UK
| | - Narbeh Melikian
- King’s College Hospital NHS Foundation Trust, London, UK
- School of Cardiovascular Medicine and Sciences, BHF Centre of Excellence, King’s College London, UK
| | - Nilesh Pareek
- King’s College Hospital NHS Foundation Trust, London, UK
- School of Cardiovascular Medicine and Sciences, BHF Centre of Excellence, King’s College London, UK
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Tam To B, Roy R, Melikian N, Gaughran FP, O’Gallagher K. Coronary Artery Disease in Patients with Severe Mental Illness. Interv Cardiol 2023; 18:e16. [PMID: 37398869 PMCID: PMC10311395 DOI: 10.15420/icr.2022.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/23/2022] [Indexed: 07/04/2023] Open
Abstract
Severe mental illnesses (SMI), such as schizophrenia and bipolar disorder, are associated with a decrease in life expectancy of up to two decades compared with the general population, with cardiovascular disease as the leading cause of death. SMI is associated with increased cardiovascular risk profile and early onset of incident cardiovascular disease. Following an acute coronary syndrome, patients with SMI have a worse prognosis, but are less likely to receive invasive treatment. In this narrative review, the management of coronary artery disease in patients with SMI is discussed, and avenues for future research are highlighted.
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Affiliation(s)
- Brian Tam To
- Cardiovascular Department, King’s College Hospital NHS Foundation TrustLondon, UK
| | - Roman Roy
- Cardiovascular Department, King’s College Hospital NHS Foundation TrustLondon, UK
| | - Narbeh Melikian
- Cardiovascular Department, King’s College Hospital NHS Foundation TrustLondon, UK
- School of Cardiovascular and Metabolic Medicine & Sciences, British Heart Foundation Centre of Research Excellence, King’s College LondonLondon, UK
| | - Fiona P Gaughran
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonLondon, UK
- National Psychosis Service, South London and Maudsley NHS Foundation TrustLondon, UK
| | - Kevin O’Gallagher
- Cardiovascular Department, King’s College Hospital NHS Foundation TrustLondon, UK
- School of Cardiovascular and Metabolic Medicine & Sciences, British Heart Foundation Centre of Research Excellence, King’s College LondonLondon, UK
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Abu-Own H, Pillai K, Roy R, Hussain A, Jakaj G, Mohamed S, Narayana A, Khan H, Deshpande R, Whitaker D, Baghai M, Wendler O, Okonko DO. CARDIAC MITOCHONDRIAL INJURY DURING ON-PUMP CARDIAC SURGERY PRINCIPALLY INVOLVES COMPLEX I OF THE ELECTRON TRANSPORT CHAIN AND RELATES TO POSTOPERATIVE INOTROPIC REQUIREMENTS. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)01006-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Abu-Own H, JAKAJ G, Roy R, Hussain A, MOHAMED SAMEH, Pillai K, Thapliyal P, Narayana A, Khan H, Whitaker D, Deshpande R, Baghai M, Wendler O. BLUNTED TEMPORAL IMPROVEMENTS IN SURVIVAL IN PATIENTS WITH LEFT VENTRICULAR SYSTOLIC DYSFUNCTION UNDERGOING CARDIAC SURGERY. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)01059-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Roy R, McDonaugh B, O'Gallagher K. COVID-19 and the heart. Br Med Bull 2022; 144:4-11. [PMID: 36155748 PMCID: PMC9619476 DOI: 10.1093/bmb/ldac022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 08/26/2022] [Accepted: 09/02/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND There is evidence for a bi-directional relationship between COVID-19 and the cardiovascular (CV) system. SOURCE OF DATA Published literature. AREAS OF AGREEMENT Pre-existing heart failure (HF) increases the risk of mortality with COVID-19. CV complications are recognized, including increased rates of acute coronary syndromes, HF, arrhythmia and myocarditis. Drugs targeting the angiotensin system are safe and may provide prognostic benefit. AREAS OF CONTROVERSY Vaccination as a cause of myocarditis remains a key area of contention. GROWING POINTS As the pandemic progresses, we are gaining more data about the long-term effects of COVID-19 on the CV system: long COVID, and medium-to-long-term increases in CV risk. AREAS TIMELY FOR DEVELOPING RESEARCH Large-scale longitudinal studies will shed light on long-term CV outcomes with COVID-19. Furthermore, the differential effects of COVID-19 variants on the CV system must be investigated.
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Affiliation(s)
- Roman Roy
- Cardiovascular Department, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK
| | | | - Kevin O'Gallagher
- Cardiovascular Department, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.,British Heart Foundation Centre of Research Excellence, School of Cardiovascular and Metabolic Medicine & Sciences, Faculty of Life Sciences & Medicine, King's College London, London SE5 9NU, UK
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O’Gallagher K, Rosentreter RE, Elaine Soriano J, Roomi A, Saleem S, Lam T, Roy R, Gordon GR, Raj SR, Chowienczyk PJ, Shah AM, Phillips AA. The Effect of a Neuronal Nitric Oxide Synthase Inhibitor on Neurovascular Regulation in Humans. Circ Res 2022; 131:952-961. [PMID: 36349758 PMCID: PMC9770134 DOI: 10.1161/circresaha.122.321631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Neurovascular coupling (NVC) is a key process in cerebral blood flow regulation. NVC ensures adequate brain perfusion to changes in local metabolic demands. Neuronal nitric oxide synthase (nNOS) is suspected to be involved in NVC; however, this has not been tested in humans. Our objective was to investigate the effects of nNOS inhibition on NVC in humans. METHODS We performed a 3-visit partially randomized, double-blinded, placebo-controlled, crossover study in 12 healthy subjects. On each visit, subjects received an intravenous infusion of either S-methyl-L-thiocitrulline (a selective nNOS-inhibitor), 0.9% saline (placebo control), or phenylephrine (pressor control). The NVC assessment involved eliciting posterior circulation hyperemia through visual stimulation while measuring posterior and middle cerebral arteries blood velocity. RESULTS nNOS inhibition blunted the rapidity of the NVC response versus pressor control, evidenced by a reduced initial rise in mean posterior cerebral artery velocity (-3.3% [-6.5, -0.01], P=0.049), and a reduced rate of increase (ie, acceleration) in posterior cerebral artery velocity (slope reduced -4.3% [-8.5, -0.1], P=0.045). The overall magnitude of posterior cerebral artery response relative to placebo control or pressor control was not affected. Changes in BP parameters were well-matched between the S-methyl-L-thiocitrulline and pressor control arms. CONCLUSIONS Neuronal NOS plays a role in dynamic cerebral blood flow control in healthy adults, particularly the rapidity of the NVC response to visual stimulation. This work opens the way to further investigation of the role of nNOS in conditions of impaired NVC, potentially revealing a therapeutic target.
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Affiliation(s)
- Kevin O’Gallagher
- School of Cardiovascular and Metabolic Medicine & Sciences, King’s College London British Heart Foundation Centre of Research Excellence, London, UK (K.O., A.R., R.R., P.J.C., A.M.S.).,NIHR Biomedical Research Centre, Clinical Research Facility, Guy’s and St Thomas NHS Foundation Trust, London, UK (K.O., A.R., P.J.C., A.M.S.)
| | - Ryan E. Rosentreter
- Departments of Physiology and Pharmacology, Clinical Neurosciences, Cardiac Sciences, Hotchkiss Brain Institute, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Alberta, Canada (R.E.R, J.E.S., T.L., G.R.G., S.R.R., A.A.P.)
| | - Jan Elaine Soriano
- Departments of Physiology and Pharmacology, Clinical Neurosciences, Cardiac Sciences, Hotchkiss Brain Institute, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Alberta, Canada (R.E.R, J.E.S., T.L., G.R.G., S.R.R., A.A.P.)
| | - Ali Roomi
- School of Cardiovascular and Metabolic Medicine & Sciences, King’s College London British Heart Foundation Centre of Research Excellence, London, UK (K.O., A.R., R.R., P.J.C., A.M.S.).,NIHR Biomedical Research Centre, Clinical Research Facility, Guy’s and St Thomas NHS Foundation Trust, London, UK (K.O., A.R., P.J.C., A.M.S.)
| | - Saqib Saleem
- Department of Electrical and Computer Engineering, COMSATS University, Sahiwal, Pakistan (S.S.)
| | - Tyler Lam
- Departments of Physiology and Pharmacology, Clinical Neurosciences, Cardiac Sciences, Hotchkiss Brain Institute, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Alberta, Canada (R.E.R, J.E.S., T.L., G.R.G., S.R.R., A.A.P.)
| | - Roman Roy
- School of Cardiovascular and Metabolic Medicine & Sciences, King’s College London British Heart Foundation Centre of Research Excellence, London, UK (K.O., A.R., R.R., P.J.C., A.M.S.)
| | - Grant R. Gordon
- Departments of Physiology and Pharmacology, Clinical Neurosciences, Cardiac Sciences, Hotchkiss Brain Institute, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Alberta, Canada (R.E.R, J.E.S., T.L., G.R.G., S.R.R., A.A.P.)
| | - Satish R. Raj
- Departments of Physiology and Pharmacology, Clinical Neurosciences, Cardiac Sciences, Hotchkiss Brain Institute, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Alberta, Canada (R.E.R, J.E.S., T.L., G.R.G., S.R.R., A.A.P.)
| | - Philip J. Chowienczyk
- School of Cardiovascular and Metabolic Medicine & Sciences, King’s College London British Heart Foundation Centre of Research Excellence, London, UK (K.O., A.R., R.R., P.J.C., A.M.S.).,NIHR Biomedical Research Centre, Clinical Research Facility, Guy’s and St Thomas NHS Foundation Trust, London, UK (K.O., A.R., P.J.C., A.M.S.)
| | - Ajay M. Shah
- School of Cardiovascular and Metabolic Medicine & Sciences, King’s College London British Heart Foundation Centre of Research Excellence, London, UK (K.O., A.R., R.R., P.J.C., A.M.S.).,NIHR Biomedical Research Centre, Clinical Research Facility, Guy’s and St Thomas NHS Foundation Trust, London, UK (K.O., A.R., P.J.C., A.M.S.)
| | - Aaron A. Phillips
- Departments of Physiology and Pharmacology, Clinical Neurosciences, Cardiac Sciences, Hotchkiss Brain Institute, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Alberta, Canada (R.E.R, J.E.S., T.L., G.R.G., S.R.R., A.A.P.)
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11
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Cannata A, Bhatti P, Roy R, Al-Agil M, Daniel A, Ferone E, Jordan A, Cassimon B, Bradwell S, Khawaja A, Sadler M, Shamsi A, Huntington J, Birkinshaw A, Rind I, Rosmini S, Piper S, Sado D, Giacca M, Shah AM, McDonagh T, Scott PA, Bromage DI. Prognostic relevance of demographic factors in cardiac magnetic resonance-proven acute myocarditis: A cohort study. Front Cardiovasc Med 2022; 9:1037837. [PMID: 36312271 PMCID: PMC9606774 DOI: 10.3389/fcvm.2022.1037837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 09/28/2022] [Indexed: 11/15/2022] Open
Abstract
Aim Acute myocarditis (AM) is a heterogeneous condition with variable estimates of survival. Contemporary criteria for the diagnosis of clinically suspected AM enable non-invasive assessment, resulting in greater sensitivity and more representative cohorts. We aimed to describe the demographic characteristics and long-term outcomes of patients with AM diagnosed using non-invasive criteria. Methods and results A total of 199 patients with cardiac magnetic resonance (CMR)-confirmed AM were included. The majority (n = 130, 65%) were male, and the average age was 39 ± 16 years. Half of the patients were White (n = 99, 52%), with the remainder from Black and Minority Ethnic (BAME) groups. The most common clinical presentation was chest pain (n = 156, 78%), with smaller numbers presenting with breathlessness (n = 25, 13%) and arrhythmias (n = 18, 9%). Patients admitted with breathlessness were sicker and more often required inotropes, steroids, and renal replacement therapy (p < 0.001, p < 0.001, and p = 0.01, respectively). Over a median follow-up of 53 (IQR 34-76) months, 11 patients (6%) experienced an adverse outcome, defined as a composite of all-cause mortality, resuscitated cardiac arrest, and appropriate implantable cardioverter defibrillator (ICD) therapy. Patients in the arrhythmia group had a worse prognosis, with a nearly sevenfold risk of adverse events [hazard ratio (HR) 6.97; 95% confidence interval (CI) 1.87-26.00, p = 0.004]. Sex and ethnicity were not significantly associated with the outcome. Conclusion AM is highly heterogeneous with an overall favourable prognosis. Three-quarters of patients with AM present with chest pain, which is associated with a benign prognosis. AM presenting with life-threatening arrhythmias is associated with a higher risk of adverse events.
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Affiliation(s)
- Antonio Cannata
- British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King’s College London, London, United Kingdom
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Prashan Bhatti
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Roman Roy
- British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King’s College London, London, United Kingdom
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Mohammad Al-Agil
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Allen Daniel
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Emma Ferone
- British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King’s College London, London, United Kingdom
| | - Antonio Jordan
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Barbara Cassimon
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Susie Bradwell
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Abdullah Khawaja
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Matthew Sadler
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Aamir Shamsi
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Josef Huntington
- British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King’s College London, London, United Kingdom
| | | | - Irfan Rind
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Stefania Rosmini
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Susan Piper
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Daniel Sado
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Mauro Giacca
- British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King’s College London, London, United Kingdom
| | - Ajay M. Shah
- British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King’s College London, London, United Kingdom
| | - Theresa McDonagh
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Paul A. Scott
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Daniel I. Bromage
- British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King’s College London, London, United Kingdom
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
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12
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Roy R, Cannata A, Bhatti P, Daniel A, Rosmini S, Birkenshaw A, Rind I, Sado D, Piper S, Scott P, McDonagh T, Bromage D. Accuracy of ICD-10 codes for patients with acute myocarditis: a retrospective study at a large tertiary centre in London, UK. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Acute myocarditis (AM) is an inflammatory disease of the myocardium that is associated with heterogenous clinical presentations, which may be non-specific. Furthermore, several cardiac diseases can mimic its clinical phenotype. Research in AM frequently utilises ICD-10 codes from hospital admissions for case identification. We retrospectively confirmed or refuted a diagnosis of AM according to ESC Position Statement criteria in patients with an ICD-10 code for AM.
Methods
We performed a single-centre retrospective analysis of all unique admissions with ICD-10 codes corresponding to myocarditis or myopericarditis in the first three coding positions at King's College Hospital, London, United Kingdom. The diagnosis was classified as “confirmed” if proven by cardiac magnetic resonance imaging (CMR) or endomyocardial biopsy (EMB) or “suspected” in the absence of CMR or EMB if other ESC Position Statement criteria were met. To identify additional cases, we used an open-source retrieval system for unstructured clinical data (CogStack). We searched hospital and Intensive Care Unit (ICU) discharge summaries for inpatients discharged alive containing the keywords “myocarditis” or “myopericarditis”. We also searched for patients who died during the study period where the keywords “myocarditis” or “myopericarditis” were included on the death notification.
Results
We identified 308 unique admissions with an ICD-10 code for myocarditis or myopericarditis in this study, presenting between 2008 and 2020 (Figure 1). Overall, 26.0% of patients (n=80/308) could be excluded from a diagnosis of AM on review of the clinical summary. A total of 16.2% of patients (n=50/308) had insufficient evidence of AM, 1.9% (n=6/308) had not had coronary artery disease excluded as a culprit for the presentation, and 10.1% (n=31/308) had an alternative diagnosis. Only 45.8% (n=141/308) of all patients met criteria for suspected or confirmed AM. Of those, 86.5% (n=122/141) of cases were confirmed by CMR. Overall, 39.6% of patients with an ICD-10 code indicating AM had a confirmed diagnosis. An additional 46 suspected and 197 confirmed cases were identified using open-source retrieval from unstructured clinical data.
Conclusion
AM has heterogenous and sometimes non-specific clinical presentations, which may be compounded by limited access to CMR and EMB. We identified significant misclassification using ICD-10 codes. It is crucial to ensure that studies investigating AM include only patients meeting appropriate diagnostic criteria, thereby ensuring a high-quality evidence base in this disease.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R Roy
- King's College London , London , United Kingdom
| | - A Cannata
- King's College London , London , United Kingdom
| | - P Bhatti
- King's College London , London , United Kingdom
| | - A Daniel
- King's College London , London , United Kingdom
| | - S Rosmini
- King's College London , London , United Kingdom
| | | | - I Rind
- King's College London , London , United Kingdom
| | - D Sado
- King's College London , London , United Kingdom
| | - S Piper
- King's College London , London , United Kingdom
| | - P Scott
- King's College London , London , United Kingdom
| | - T McDonagh
- King's College London , London , United Kingdom
| | - D Bromage
- King's College London , London , United Kingdom
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13
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Roy R, Shah AM, MacCarthy P, Byrne J, Pareek N. Limited External Applicability of the COACT and TOMAHAWK Trials: A Multicenter Study. JACC Cardiovasc Interv 2022; 15:1388-1391. [PMID: 35798487 DOI: 10.1016/j.jcin.2022.04.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/18/2022] [Accepted: 04/26/2022] [Indexed: 11/26/2022]
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14
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Ahmed F, Roy R. A Literature Review of Diagnostic Applicability of ICD 11 Classification of Personality Disorders in Comparison with ICD 10. Eur Psychiatry 2022. [PMCID: PMC9564016 DOI: 10.1192/j.eurpsy.2022.1142] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction Personality disorders are frequently encountered by all healthcare professionals and can often pose a diagnostic dilemma due to the crossover of different traits amongst the various subtypes. The ICD 10 classification comprised of succinct parameters of the 10 subtypes of personality disorders but lacked a global approach to address the complexity of the disease. The ICD 11 classification provides a more structural approach to aid in clinical diagnosis. Objectives A literature review of the diagnostic applicability of ICD 11 classification of personality disorders is presented in comparison with the ICD 10 classification. Methods A retrospective analysis of the literature outlining the ICD 10 and 11 classifications of personality disorders, exploring the differences in evidence-based applications of both. Results The ICD 11 classification of personality disorders supersedes the ICD 10 classification in describing the severity of the personality dysfunction in conjunction with a wide range of trait domain qualifiers, thus enabling the clinician to portray the disease dynamically. The current evidence available on the utility of the ICD 11 classification gives a promising outlook for its application in clinical settings. Conclusions The ICD 11 has transformed the classification of personality disorders by projecting a dimensional description of personality functioning, aiming to overcome the diagnostic deficiencies in the ICD 10 classification. The versatility offered by the application of the ICD 11 classification can be pivotal in reshaping the focus and intensity of clinical management of the disease. Disclosure No significant relationships.
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15
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Jonniya NA, Sk MF, Roy R, Kar P. Discovery of potential competitive inhibitors against With-No-Lysine kinase 1 for treating hypertension by virtual screening, inverse pharmacophore-based lead optimization, and molecular dynamics simulations. SAR QSAR Environ Res 2022; 33:63-87. [PMID: 35078380 DOI: 10.1080/1062936x.2021.2023218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/22/2021] [Indexed: 06/14/2023]
Abstract
The With-No-Lysine (WNK) has received attention because of its involvement in hypertension. Genetic mutation in the genes of WNK, leading to its overexpression, has been reported in Familial Hyperkalaemic Hypertension, and thus WNK is considered a potential drug target. Herein, we have performed a high-throughput virtual screening of ~11,000 compounds, mainly the natural phytochemical compounds and kinase inhibitory libraries, to find potential competitive inhibitors against WNK1. Initially, candidates with a docking score of ~ -10.0 kcal/mol or less were selected to further screen their good pharmacological properties by applying absorption, distribution, metabolism, excretion, and toxicity (ADMET). Finally, six docked compounds bearing appreciable binding affinities and WNK1 selectivity were complimented with 500 ns long all-atom molecular dynamic simulations. Subsequently, the MMPBSA scheme (Molecular Mechanics Poisson Boltzmann Surface Area) suggested three phytochemical compounds, C00000947, C00020451, and C00005031, with favourable binding affinity against WNK1. Among them, C00000947 acts as the most potent competitive inhibitor of WNK1. Further, inverse pharmacophore-based lead optimization of the C00000947 leads to one potential compound, meciadanol, which shows better binding affinity and specificity than C00000947 towards WNK1, which may be further exploited to develop effective therapeutics against WNK1-associated hypertension after in vitro and in vivo validation.
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Affiliation(s)
- N A Jonniya
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Indore, India
| | - M F Sk
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Indore, India
| | - R Roy
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Indore, India
| | - P Kar
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Indore, India
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16
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Gutmann C, Khamina K, Theofilatos K, Diendorfer AB, Burnap SA, Nabeebaccus A, Fish M, McPhail MJW, O'Gallagher K, Schmidt LE, Cassel C, Auzinger G, Napoli S, Mujib SF, Trovato F, Sanderson B, Merrick B, Roy R, Edgeworth JD, Shah AM, Hayday AC, Traby L, Hackl M, Eichinger S, Shankar-Hari M, Mayr M. Association of cardiometabolic microRNAs with COVID-19 severity and mortality. Cardiovasc Res 2022; 118:461-474. [PMID: 34755842 PMCID: PMC8689968 DOI: 10.1093/cvr/cvab338] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 11/03/2021] [Indexed: 01/26/2023] Open
Abstract
AIMS Coronavirus disease 2019 (COVID-19) can lead to multiorgan damage. MicroRNAs (miRNAs) in blood reflect cell activation and tissue injury. We aimed to determine the association of circulating miRNAs with COVID-19 severity and 28 day intensive care unit (ICU) mortality. METHODS AND RESULTS We performed RNA-Seq in plasma of healthy controls (n = 11), non-severe (n = 18), and severe (n = 18) COVID-19 patients and selected 14 miRNAs according to cell- and tissue origin for measurement by reverse transcription quantitative polymerase chain reaction (RT-qPCR) in a separate cohort of mild (n = 6), moderate (n = 39), and severe (n = 16) patients. Candidates were then measured by RT-qPCR in longitudinal samples of ICU COVID-19 patients (n = 240 samples from n = 65 patients). A total of 60 miRNAs, including platelet-, endothelial-, hepatocyte-, and cardiomyocyte-derived miRNAs, were differentially expressed depending on severity, with increased miR-133a and reduced miR-122 also being associated with 28 day mortality. We leveraged mass spectrometry-based proteomics data for corresponding protein trajectories. Myocyte-derived (myomiR) miR-133a was inversely associated with neutrophil counts and positively with proteins related to neutrophil degranulation, such as myeloperoxidase. In contrast, levels of hepatocyte-derived miR-122 correlated to liver parameters and to liver-derived positive (inverse association) and negative acute phase proteins (positive association). Finally, we compared miRNAs to established markers of COVID-19 severity and outcome, i.e. SARS-CoV-2 RNAemia, age, BMI, D-dimer, and troponin. Whilst RNAemia, age and troponin were better predictors of mortality, miR-133a and miR-122 showed superior classification performance for severity. In binary and triplet combinations, miRNAs improved classification performance of established markers for severity and mortality. CONCLUSION Circulating miRNAs of different tissue origin, including several known cardiometabolic biomarkers, rise with COVID-19 severity. MyomiR miR-133a and liver-derived miR-122 also relate to 28 day mortality. MiR-133a reflects inflammation-induced myocyte damage, whilst miR-122 reflects the hepatic acute phase response.
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Affiliation(s)
- Clemens Gutmann
- King's College London British Heart Foundation Centre, School of Cardiovascular Medicine and Sciences, 125 Coldharbour Lane, London SE5 9NU, UK
| | | | - Konstantinos Theofilatos
- King's College London British Heart Foundation Centre, School of Cardiovascular Medicine and Sciences, 125 Coldharbour Lane, London SE5 9NU, UK
| | | | - Sean A Burnap
- King's College London British Heart Foundation Centre, School of Cardiovascular Medicine and Sciences, 125 Coldharbour Lane, London SE5 9NU, UK
| | - Adam Nabeebaccus
- King's College London British Heart Foundation Centre, School of Cardiovascular Medicine and Sciences, 125 Coldharbour Lane, London SE5 9NU, UK
- King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK
| | - Matthew Fish
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Great Maze Pond, London, SE1 9RT, UK
- Department of Intensive Care Medicine, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK
| | - Mark J W McPhail
- King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK
- Department of Inflammation Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, Newcomen Street, London SE1 1UL, UK
- Institute of Liver Studies, King's College Hospital, Denmark Hill, London SE5 9RS, UK
| | - Kevin O'Gallagher
- King's College London British Heart Foundation Centre, School of Cardiovascular Medicine and Sciences, 125 Coldharbour Lane, London SE5 9NU, UK
- King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK
| | - Lukas E Schmidt
- King's College London British Heart Foundation Centre, School of Cardiovascular Medicine and Sciences, 125 Coldharbour Lane, London SE5 9NU, UK
| | - Christian Cassel
- King's College London British Heart Foundation Centre, School of Cardiovascular Medicine and Sciences, 125 Coldharbour Lane, London SE5 9NU, UK
| | - Georg Auzinger
- King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK
- Department of Liver Intensive Care & Critical Care, King's College Hospital London, Denmark Hill, London SE5 9RS, UK
- Department of Critical Care, Cleveland Clinic London, 33 Grosvenor Place, London SW1X 7HY, UK
| | - Salvatore Napoli
- Department of Inflammation Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, Newcomen Street, London SE1 1UL, UK
| | - Salma F Mujib
- Institute of Liver Studies, King's College Hospital, Denmark Hill, London SE5 9RS, UK
| | - Francesca Trovato
- King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK
- Department of Inflammation Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, Newcomen Street, London SE1 1UL, UK
- Institute of Liver Studies, King's College Hospital, Denmark Hill, London SE5 9RS, UK
| | - Barnaby Sanderson
- Department of Intensive Care Medicine, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK
| | - Blair Merrick
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy’s and St Thomas’ NHS Foundation Trust & King’s College London, Westminster Bridge Road, London SE1 7EH, UK
| | - Roman Roy
- King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK
| | - Jonathan D Edgeworth
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Great Maze Pond, London, SE1 9RT, UK
- Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, Guy’s and St Thomas’ NHS Foundation Trust & King’s College London, Westminster Bridge Road, London SE1 7EH, UK
| | - Ajay M Shah
- King's College London British Heart Foundation Centre, School of Cardiovascular Medicine and Sciences, 125 Coldharbour Lane, London SE5 9NU, UK
- King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK
| | - Adrian C Hayday
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Great Maze Pond, London, SE1 9RT, UK
- The Francis Crick Institute, 1 Midland Road, London NW1 1AT, UK
| | - Ludwig Traby
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | | | - Sabine Eichinger
- Department of Medicine I, Division of Haematology and Hemostaseology Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Manu Shankar-Hari
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Great Maze Pond, London, SE1 9RT, UK
- Department of Intensive Care Medicine, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK
- Centre of Inflammation Research, The University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Manuel Mayr
- King's College London British Heart Foundation Centre, School of Cardiovascular Medicine and Sciences, 125 Coldharbour Lane, London SE5 9NU, UK
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17
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Sk MF, Haridev S, Roy R, Kar P. Investigating potency of TMC-126 against wild-type and mutant variants of HIV-1 protease: a molecular dynamics and free energy study. SAR QSAR Environ Res 2021; 32:941-962. [PMID: 34787532 DOI: 10.1080/1062936x.2021.1999318] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/25/2021] [Indexed: 06/13/2023]
Abstract
A detailed computational study was performed to investigate the conformational changes of flap region and the mechanism underlying the binding of the inhibitor TMC-126 to HIV-1 protease (PR1) and its mutant variants through molecular dynamics simulations in conjunction with the molecular mechanics Poisson-Boltzmann (MM-PBSA) free energy calculation. Further, we have studied the effectiveness of the inhibitor against HIV-2 protease (PR2). The MM-PBSA calculation suggests that TMC-126 loses its potency against mutant variants and PR2 compared to wild-type PR1 mainly due to the loss in intermolecular electrostatic interactions. The potency of the inhibitor decreases in the order: wild type PR1 > M46L > MDR20 > I50V > PR2 > V32I > A28S. Our study reveals that the flap of PR1 adopts a semi-open conformation due to the mutation I50V or MDR20. The dissimilar nature of the movement of the flap tip of both monomers is evident from the dynamic cross-correlation map. The protein structural network analysis displays that mutation causes structural rearrangements and changes the communication path between residues. Overall, we believe our study may help explore and accelerate the development of novel HIV-1/HIV-2 protease inhibitors with better potency.
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Affiliation(s)
- M F Sk
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Indore, India
| | - S Haridev
- Department of Physics, Indian Institute of Technology Indore, Indore, India
| | - R Roy
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Indore, India
| | - P Kar
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Indore, India
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Mukherjee S, O'Connor H, Harman R, O'Donovan M, Debiram-Beecham I, Alias B, Bailey A, Bateman A, de Caestecker J, Crosby T, Falk S, Gollins S, Hawkins M, Levy S, Radhakrishna G, Roy R, Sripadam R, Fitzgerald R. P-109 CYTOFLOC: Evaluation of a non-endoscopic immunocytological device (Cytosponge™) for post-chemo-radiotherapy surveillance in patients with oesophageal cancer – a feasibility study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.164] [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] Open
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Mandal A, Baneh H, Roy R, Notter DR. Correction to: Genetic diversity and population structure of Jamunapari goat in India using pedigree analysis. Trop Anim Health Prod 2021; 53:293. [PMID: 33909174 DOI: 10.1007/s11250-021-02710-6] [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: 11/30/2022]
Affiliation(s)
- Ajoy Mandal
- Animal Breeding Section, ICAR-National Dairy Research Institute, Eastern Regional Station, Kalyani, West Bengal, 741235, India.
| | - Hasan Baneh
- Digital Agriculture Laboratory (DAL), Skolkovo Institute of Science and Technology, 121205, Moscow, Russia
| | - R Roy
- , Shivpuri, Lalbahadur Shastri Nagar, Patna, Bihar, 800023, India
| | - D R Notter
- Department of Animal and Poultry Sciences, Virginia Tech, Blacksburg, VA, USA
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Mandal A, Baneh H, Roy R, Notter DR. Genetic diversity and population structure of Jamunapari goat in India using pedigree analysis. Trop Anim Health Prod 2021; 53:218. [PMID: 33745019 DOI: 10.1007/s11250-021-02638-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 02/22/2021] [Indexed: 11/29/2022]
Abstract
Pedigree records of 6821 Jamunapari goats of India were collected from 1980 to 2011 and used to evaluate the population structure and genetic diversity in this flock. Animals born between 2009 and 2011 represented the current reference population. The average pedigree completeness index (PCI) and numbers of equivalent complete generations (EqG) were estimated for the entire (PCI = 0.18, EqG = 2.24) and reference (PCI = 0.31, EqG = 3.45) populations. The average generation interval was 3.33 years. The average inbreeding coefficient and the average relatedness were 0.46 and 1.06%, respectively, for the entire population and 0.77 and 3.87% for the reference population. The rate of inbreeding was 0.06% per generation. The effective population size (Ne), estimated from increases in inbreeding coefficients between the first and third equivalent complete generations, was 52.65, but periodic introductions of unrelated breeding males resulted in average inbreeding levels in the reference population that were lower than those predicted from the estimate of Ne. Effective numbers of founders (fe), ancestors (fa), founder genomes equivalents (fg), and non-founder genomes (fng) were 51, 39, 25.8, and 48.2, respectively. The fe/fa ratio in the reference population was 1.31 and indicated that occasional bottlenecks had occurred in the population. The 14 most influential ancestors contributed 50% of the genetic variability in the reference population, with a maximum individual contribution of 9.25%. Approximately 1.9% of the initial heterozygosity had been lost from the population, indicating that substantial genetic diversity still exists in this flock.
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Affiliation(s)
- Ajoy Mandal
- Animal Breeding Section, ICAR-National Dairy Research Institute, Eastern Regional Station, Kalyani, West Bengal, 741235, India.
| | - Hasan Baneh
- Digital Agriculture Laboratory (DAL), Skolkovo Institute of Science and Technology, Moscow 121205, Russia
| | - R Roy
- Shivpuri, Lalbahadur Shastri Nagar, Bihar, Patna, 800023, India
| | - D R Notter
- Department of Animal and Poultry Sciences, Virginia Tech, Blacksburg, VA, USA
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Lawrence C, Seckold R, Smart C, King BR, Howley P, Feltrin R, Smith TA, Roy R, Lopez P. Increased paediatric presentations of severe diabetic ketoacidosis in an Australian tertiary centre during the COVID-19 pandemic. Diabet Med 2021; 38:e14417. [PMID: 33020999 PMCID: PMC7646057 DOI: 10.1111/dme.14417] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/15/2020] [Accepted: 09/27/2020] [Indexed: 12/28/2022]
Abstract
AIMS To determine if the frequency of severe diabetic ketoacidosis at presentation of new-onset type 1 diabetes to an Australian tertiary centre increased during the initial period of restrictions resulting from the COVID-19 pandemic (March to May 2020). METHODS Data were collected on presentations of newly diagnosed type 1 diabetes as well as on all paediatric presentations to the emergency department of a tertiary centre between 2015 and 2020. Data from the period of initial COVID restrictions in Australia (March to May 2020) were compared to the period March to May of the previous 5 years (pre-pandemic periods). RESULTS The number of new diagnoses of type 1 diabetes was comparable in the pandemic period and pre-pandemic periods (11 in 2020 vs range 6-10 in 2015-2019). The frequency of severe diabetic ketoacidosis was significantly higher in the pandemic period compared to the pre-pandemic periods (45% vs 5%; P <0.003), odds ratio 16.7 (95% CI 2.0, 194.7). The overall frequency of diabetic ketoacidosis was also significantly higher during the pandemic period (73% vs 26%; P <0.007), odds ratio 7.5 (95% CI 1.7, 33.5). None of the individuals tested positive for COVID-19. Presentations of people aged <18 years to the emergency department decreased by 27% in the pandemic period compared to the average of the pre-pandemic periods (4799 vs 6550; range 6268 to 7131). CONCLUSIONS A significant increase in the frequency of severe diabetic ketoacidosis at presentation of type 1 diabetes was observed during the initial period of COVID-19 restrictions. We hypothesize that concern about presenting to hospital during a pandemic led to a delay in diagnosis. These data have important implications for advocacy of seeking healthcare for non-pandemic-related conditions during a global pandemic.
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Affiliation(s)
- C. Lawrence
- John Hunter Children’s HospitalNewcastleNSWAustralia
- School of Medicine and Public HealthUniversity of NewcastleNewcastleNSWAustralia
| | - R. Seckold
- John Hunter Children’s HospitalNewcastleNSWAustralia
- Hunter Medical Research InstituteNewcastleNSWAustralia
- School of Medicine and Public HealthUniversity of NewcastleNewcastleNSWAustralia
| | - C. Smart
- John Hunter Children’s HospitalNewcastleNSWAustralia
- Hunter Medical Research InstituteNewcastleNSWAustralia
| | - B. R. King
- John Hunter Children’s HospitalNewcastleNSWAustralia
- Hunter Medical Research InstituteNewcastleNSWAustralia
- School of Medicine and Public HealthUniversity of NewcastleNewcastleNSWAustralia
| | - P. Howley
- School of Mathematical and Physical Sciences/StatisticsUniversity of NewcastleNewcastleNSWAustralia
| | - R. Feltrin
- John Hunter Children’s HospitalNewcastleNSWAustralia
| | - T. A. Smith
- Hunter Medical Research InstituteNewcastleNSWAustralia
- School of Medicine and Public HealthUniversity of NewcastleNewcastleNSWAustralia
| | - R. Roy
- Hunter Medical Research InstituteNewcastleNSWAustralia
- School of Medicine and Public HealthUniversity of NewcastleNewcastleNSWAustralia
| | - P. Lopez
- John Hunter Children’s HospitalNewcastleNSWAustralia
- Hunter Medical Research InstituteNewcastleNSWAustralia
- School of Medicine and Public HealthUniversity of NewcastleNewcastleNSWAustralia
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Roy R. 324P COVID era: Perception of oncologists from a developing nation. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Johnston SD, López-Fernández C, Arroyo F, Roy R, Holt WV, Gosálvez J. Protamine composition of koala and wombat spermatozoa provides new insights into DNA stability following cryopreservation. Reprod Fertil Dev 2020; 31:1558-1566. [PMID: 31167697 DOI: 10.1071/rd18512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 05/02/2019] [Indexed: 11/23/2022] Open
Abstract
To investigate differences in the post-thaw DNA stability of koala and wombat spermatozoa, protamine amino acid sequences were compared and it was found that there were three more arginine residues for the wombat. Koala and wombat spermatozoa, cryopreserved using identical protocols, were examined for changes in sperm DNA fragmentation (SDF) dynamics over 24h of post-thaw incubation. Following validation of a wombat sperm chromatin dispersion test, wombat DNA showed a rate of SDF that was 6-fold higher than for koala spermatozoa (P=0.038). Finally, we examined whether expected differences in chromatin compactness, associated with protamine sequence, had an effect on restriction site accessibility of sperm DNA. Thawed spermatozoa were exposed to Alu I and EcoR1 endonuclease restriction enzymes and the SDF dynamics were observed. Koala spermatozoa exposed to Alu I showed a greater rate of SDF (P=0.01), whereas wombat spermatozoa exposed to EcoR1 showed a greater rate of SDF (P=0.032). We conclude that restriction sites in these species are differentially present or exposed and potentially account for differences in SDF dynamics. Although differences in the arginine composition of protamine may explain relative differences in SDF following cryopreservation, they do not support the hypothesis that increased arginine composition increases DNA stability; rather, increased arginine composition in the wombat may reduce post-thaw chromatin swelling.
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Affiliation(s)
- S D Johnston
- School of Agriculture and Food Sciences, The University of Queensland, Gatton, Qld 4343, Australia; and Corresponding author.
| | - C López-Fernández
- Department of Biology, Autonomous University of Madrid, Cantoblanco, Madrid, 28049, Spain
| | - F Arroyo
- Department of Biology, Autonomous University of Madrid, Cantoblanco, Madrid, 28049, Spain
| | - R Roy
- Department of Biology, Autonomous University of Madrid, Cantoblanco, Madrid, 28049, Spain
| | - W V Holt
- Academic unit of Reproductive and Developmental Medicine, University of Sheffield, Sheffield, S10 2TN, UK
| | - J Gosálvez
- Department of Biology, Autonomous University of Madrid, Cantoblanco, Madrid, 28049, Spain
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Malik F, Middleton Z, Haque F, Tambe N, Roy R. P-273 Real-world experience of definitive chemoradiation in esophageal cancer: Correlation of tumour length, toxicity and disease control. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.355] [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: 11/25/2022] Open
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25
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Swinson D, Hall P, Lord S, Marshall H, Ruddock S, Allmark C, Cairns D, Waters J, Wadsley J, Falk S, Roy R, Joseph M, Nicoll J, Kamposioras K, Tillett T, Cummins S, Grumett S, Stokes Z, Waddell T, Chatterjee A, Garcia A, Khan M, Petty R, Seymour M. OPTIMIZING CHEMOTHERAPY FOR FRAIL AND/OR ELDERLY PATIENTS WITH ADVANCED GASTROESOPHAGEAL CANCER (AGOAC): THE GO2 PHASE III TRIAL. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31133-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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26
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Tralau-Stewart L, Roy R. Radiology-guided oesophageal stenting for the palliation of dysphagia: a single center experience. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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27
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Cole R, Minto J, Flattery M, Parikh A, Dong T, Roy R, Bogar L, Morris A, Vega J, Gupta D, Bhatt K, Smith A, Laskar S, Lala A, Shah K, Shah P. Effects of Induction on the Risk of Post-Transplant De Novo DSA. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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28
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Dong T, Demoss B, Roy R, Smith A, Vega J, Laskar S, Bhatt K, Gupta D, Morris A, Cole R. Sensitization in LVAD Recipients with and without Transfusions. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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29
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Nieddu T, Ray T, Rajasree KS, Roy R, Chormaic SN. Simple, narrow, and robust atomic frequency reference at 993 nm exploiting the rubidium (Rb) 5S 1/2 to 6S 1/2 transition using one-color two-photon excitation. Opt Express 2019; 27:6528-6535. [PMID: 30876236 DOI: 10.1364/oe.27.006528] [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] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 02/05/2019] [Indexed: 06/09/2023]
Abstract
We experimentally demonstrate a one-color two-photon transition from the 5S1/2 ground state to the 6S1/2 excited state in rubidium (Rb) vapor using a continuous wave laser at 993 nm. The Rb vapor contains both isotopes (85Rb and 87Rb) in their natural abundances. The electric dipole-allowed transitions are characterized by varying the power and polarization of the excitation laser. Since the optical setup is relatively simple, and the energies of the allowed levels are impervious to stray magnetic fields, this is an attractive choice for a frequency reference at 993 nm, with possible applications in precision measurements and quantum information processing.
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Sun Myint A, Stewart A, Mills J, Sripadam R, Whitmarsh K, Roy R, Franklin A, Dhadda A. Treatment: the role of contact X-ray brachytherapy (Papillon) in the management of early rectal cancer. Colorectal Dis 2019; 21 Suppl 1:45-52. [PMID: 30809905 DOI: 10.1111/codi.14507] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 11/26/2018] [Indexed: 12/13/2022]
Affiliation(s)
- A Sun Myint
- Papillon Suite, Clatterbridge Cancer Centre, Bebington, Wirral, UK.,Translational Medicine Department, University of Liverpool, Liverpool, UK
| | - A Stewart
- St Luke's Cancer Centre, Royal Surrey County Hospital, Guildford, UK.,University of Surrey, Guildford, UK
| | - J Mills
- Nottingham University Hospital, Nottingham, UK
| | - R Sripadam
- Papillon Suite, Clatterbridge Cancer Centre, Bebington, Wirral, UK
| | - K Whitmarsh
- Papillon Suite, Clatterbridge Cancer Centre, Bebington, Wirral, UK
| | - R Roy
- Queen's Centre for Oncology and Haematology, Hull, UK
| | - A Franklin
- St Luke's Cancer Centre, Royal Surrey County Hospital, Guildford, UK
| | - A Dhadda
- Queen's Centre for Oncology and Haematology, Hull, UK
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Preyan Parekh K, Al-Dubbaisi H, Nainesh Patel V, Syed Abbas Rizvi K, Roy R. Utilizing progress testing in a competency-based medical education curriculum. Med Teach 2019; 41:119. [PMID: 30106595 DOI: 10.1080/0142159x.2018.1500685] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
| | - Halah Al-Dubbaisi
- a GKT School of Medical Education , King's College London , London , UK
| | | | | | - Roman Roy
- a GKT School of Medical Education , King's College London , London , UK
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Affiliation(s)
- Vishal N Patel
- GKT School of Medical Education; King's College London; London UK
| | | | - Kishan P Parekh
- GKT School of Medical Education; King's College London; London UK
| | | | - Roman Roy
- GKT School of Medical Education; King's College London; London UK
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Garcia-Rodriguez A, de la Casa M, Gosálvez J, Roy R. CAT-262CT Genotype shows higher catalase activity in seminal plasma and lower risk of male infertility. Meta Gene 2018. [DOI: 10.1016/j.mgene.2018.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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35
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Hung T, Gezari S, Cenko SB, van Velzen S, Blagorodnova N, Yan L, Kulkarni SR, Lunnan R, Kupfer T, Leloudas G, Kong AKH, Nugent PE, Fremling C, Laher RR, Masci FJ, Cao Y, Roy R, Petrushevska T. SIFTING FOR SAPPHIRES: SYSTEMATIC SELECTION OF TIDAL DISRUPTION EVENTS IN iPTF. Astrophys J Suppl Ser 2018; 238:15. [PMID: 31160831 PMCID: PMC6544052 DOI: 10.3847/1538-4365/aad8b1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We present results from a systematic selection of tidal disruption events (TDEs) in a wide-area (4800 deg2), g + R band, Intermediate Palomar Transient Factory (iPTF) experiment. Our selection targets typical optically-selected TDEs: bright (>60% flux increase) and blue transients residing in the center of red galaxies. Using photometric selection criteria to down-select from a total of 493 nuclear transients to a sample of 26 sources, we then use follow-up UV imaging with the Neil Gehrels Swift Telescope, ground-based optical spectroscopy, and light curve fitting to classify them as 14 Type Ia supernovae (SNe Ia), 9 highly variable active galactic nuclei (AGNs), 2 confirmed TDEs, and 1 potential core-collapse supernova. We find it possible to filter AGNs by employing a more stringent transient color cut (g - r < -0.2 mag); further, UV imaging is the best discriminator for filtering SNe, since SNe Ia can appear as blue, optically, as TDEs in their early phases. However, when UV-optical color is unavailable, higher precision astrometry can also effectively reduce SNe contamination in the optical. Our most stringent optical photometric selection criteria yields a 4.5:1 contamination rate, allowing for a manageable number of TDE candidates for complete spectroscopic follow-up and real-time classification in the ZTF era. We measure a TDE per galaxy rate of 1.7 - 1.3 + 2.9 × 10 - 4 gal - 1 yr - 1 (90% CL in Poisson statistics). This does not account for TDEs outside our selection criteria, thus may not reflect the total TDE population, which is yet to be fully mapped.
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Affiliation(s)
- T Hung
- Department of Astronomy, University of Maryland, College Park, MD 20742, USA
| | - S Gezari
- Department of Astronomy, University of Maryland, College Park, MD 20742, USA
- Joint Space-Science Institute, University of Maryland, College Park, MD 20742, USA
| | - S B Cenko
- Joint Space-Science Institute, University of Maryland, College Park, MD 20742, USA
- NASA Goddard Space Flight Center, Mail Code 661, Greenbelt, MD 20771, USA
| | - S van Velzen
- Joint Space-Science Institute, University of Maryland, College Park, MD 20742, USA
- Department of Physics, New York University, NY 10003, USA
| | - N Blagorodnova
- Department of Astronomy, California Institute of Technology, Pasadena, CA 91125, USA
| | - Lin Yan
- Caltech Optical Observatories, Cahill Center for Astronomy and Astrophysics, California Institute of Technology, Pasadena, CA 91125, USA
- Infrared Processing and Analysis Center, California Institute of Technology, Pasadena, CA 91125, USA
| | - S R Kulkarni
- Department of Astronomy, California Institute of Technology, Pasadena, CA 91125, USA
| | - R Lunnan
- The Oskar Klein Centre & Department of Astronomy, Stockholm University, AlbaNova, SE-106 91 Stockholm, Sweden
| | - T Kupfer
- Department of Astronomy, California Institute of Technology, Pasadena, CA 91125, USA
| | - G Leloudas
- Dark Cosmology Centre, Niels Bohr Institute, University of Copenhagen, Juliane Maries vej 30, 2100 Copenhagen, Denmark
| | - A K H Kong
- Institute of Astronomy, National Tsing Hua University, No. 101, Section 2, Kuang-Fu Road, Hsinchu, 30013, Taiwan
| | - P E Nugent
- Department of Astronomy, University of California, Berkeley, CA 94720-3411, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, MS 50B-4206, Berkeley, CA 94720, USA
| | - C Fremling
- Department of Astronomy, California Institute of Technology, Pasadena, CA 91125, USA
| | - Russ R Laher
- Infrared Processing and Analysis Center, California Institute of Technology, Pasadena, CA 91125, USA
| | - F J Masci
- Infrared Processing and Analysis Center, California Institute of Technology, Pasadena, CA 91125, USA
| | - Y Cao
- Department of Astronomy, University of Washington, Box 351580, U.W., Seattle, WA 98195-1580, USA
- eScience Institute, University of Washington, Box 351570, U.W., Seattle, WA 98195-1580, USA
| | - R Roy
- The Oskar Klein Centre & Department of Astronomy, Stockholm University, AlbaNova, SE-106 91 Stockholm, Sweden
| | - T Petrushevska
- Oskar Klein Centre, Department of Physics, Stockholm University, SE 106 91 Stockholm, Sweden
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Coen O, Karsera L, Tambe N, Roy R. A single centre experience of in-field recurrence following pre-operative radio(chemo)therapy in patients with rectal cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.316] [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: 11/13/2022] Open
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García-Rodríguez A, de la Casa M, Peinado H, Gosálvez J, Roy R. Human prostasomes from normozoospermic and non-normozoospermic men show a differential protein expression pattern. Andrology 2018; 6:585-596. [DOI: 10.1111/andr.12496] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 03/20/2018] [Accepted: 03/28/2018] [Indexed: 12/11/2022]
Affiliation(s)
| | | | - H. Peinado
- Microenvironment and Metastasis Group; Molecular Oncology Program; Spanish National Cancer Research Centre (CNIO); Madrid Spain
| | - J. Gosálvez
- Biology Department; University Autónoma of Madrid; Madrid Spain
| | - R. Roy
- Biology Department; University Autónoma of Madrid; Madrid Spain
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Affiliation(s)
- R. Roy
- Ecole Polytechnique de Montréal, C.P. 6079, Succursale A, Montréal, Québec H3C 3A7, Canada
| | - A. Hébert
- Ecole Polytechnique de Montréal, C.P. 6079, Succursale A, Montréal, Québec H3C 3A7, Canada
| | - G. Marleau
- Ecole Polytechnique de Montréal, C.P. 6079, Succursale A, Montréal, Québec H3C 3A7, Canada
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Affiliation(s)
- N. H. Macmillan
- The Pennsylvania State University, Materials Research Laboratory, University Park, Pennsylvania 16802
| | - R. Roy
- The Pennsylvania State University, Materials Research Laboratory, University Park, Pennsylvania 16802
| | - P. T. B. Shaffer
- The Carborundum Company, Engineered Systems Group, P.O. Box 414, Niagara Falls, New York 14302
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Affiliation(s)
- R. Roy
- Institut de Génie Énergétique, École Polytechnique de Montréal Montréal, Québec, Canada H3C 3A 7
| | - A. Hébert
- Institut de Génie Énergétique, École Polytechnique de Montréal Montréal, Québec, Canada H3C 3A 7
| | - G. Marleau
- Institut de Génie Énergétique, École Polytechnique de Montréal Montréal, Québec, Canada H3C 3A 7
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Affiliation(s)
- G. Marleau
- Ecole Polytechnique de Montréal, Institut de Génie Energétique Montreal, Québec, Canada H3C 3A 7
| | - R. Roy
- Ecole Polytechnique de Montréal, Institut de Génie Energétique Montreal, Québec, Canada H3C 3A 7
| | - A. Hébert
- Ecole Polytechnique de Montréal, Institut de Génie Energétique Montreal, Québec, Canada H3C 3A 7
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Crosby T, Hurt CN, Falk S, Gollins S, Staffurth J, Ray R, Bridgewater JA, Geh JI, Cunningham D, Blazeby J, Roy R, Maughan T, Griffiths G, Mukherjee S. Long-term results and recurrence patterns from SCOPE-1: a phase II/III randomised trial of definitive chemoradiotherapy +/- cetuximab in oesophageal cancer. Br J Cancer 2017; 116:709-716. [PMID: 28196063 PMCID: PMC5355926 DOI: 10.1038/bjc.2017.21] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 01/03/2017] [Accepted: 01/16/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The SCOPE-1 study tested the role of adding cetuximab to conventional definitive chemoradiotherapy (dCRT), and demonstrated greater toxicity and worse survival outcomes. We present the long-term outcomes and patterns of recurrence. METHODS SCOPE-1 was a phase II/III trial in which patients were randomised to cisplatin 60 mg m-2 (day 1) and capecitabine 625 mg m-2 bd (days 1-21) for four cycles +/- cetuximab 400 mg m-2 day 1 then by 250 mg m-2 weekly. Radiotherapy consisted of 50 Gy/25# given concurrently with cycles 3 and 4. Recruitment was between February 2008 and February 2012, when the IDMC recommended closure on the basis of futility. RESULTS About 258 patients (dCRT=129; dCRT+cetuximab (dCRT+C)=129) were recruited from 36 centres. About 72.9% (n=188) had squamous cell histology. The median follow-up (IQR) was 46.2 (35.9-48.3) months for surviving patients. The median overall survival (OS; months; 95% CI) was 34.5 (24.7-42.3) in dCRT and 24.7 (18.6-31.3) in dCRT+C (hazard ratio (HR)=1.25, 95% CIs: 0.93-1.69, P=0.137). Median progression-free survival (PFS; months; 95% CI) was 24.1 (15.3-29.9) and 15.9 (10.7-20.8) months, respectively (HR=1.28, 95% CIs: 0.94-1.75; P=0.114). On multivariable analysis only earlier stage, full-dose RT, and higher cisplatin dose intensity were associated with improved OS. CONCLUSIONS The mature analysis demonstrates that the dCRT regimen used in the study provided useful survival outcomes despite its use in patients who were largely unfit for surgery or who had inoperable disease. Given the competing risk of systemic and local failure, future studies should continue to focus on enhancing local control as well as optimising systemic therapy.
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Affiliation(s)
- T Crosby
- Velindre Cancer Centre, Velindre Hospital, Cardiff CF14 2TL, UK
| | - C N Hurt
- Wales Cancer Trials Unit, Cardiff University, Cardiff CF14 4YS, UK
| | - S Falk
- Bristol Haematology and Oncology Centre, University Hospitals Bristol NHS Foundation Trust, Bristol BS2 8ED, UK
| | - S Gollins
- North Wales Cancer Treatment Centre, Conwy and Denbighshire NHS Trust, Rhyl LL18 5UJ, UK
| | - J Staffurth
- Velindre Cancer Centre, Velindre Hospital, Cardiff CF14 2TL, UK
| | - R Ray
- Wales Cancer Trials Unit, Cardiff University, Cardiff CF14 4YS, UK
| | - J A Bridgewater
- UCL Cancer Institute, University College London, London WC1E 6BT, UK
| | - J I Geh
- Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust Birmingham B15 2GW, UK
| | - D Cunningham
- The Royal Marsden Hospital NHS Foundation Trust, London SM2 5PT, UK
| | - J Blazeby
- Centre for Surgical Research, University of Bristol, Bristol BS8 2PS, UK
| | - R Roy
- Diana Princess of Wales Hospital, Northern Lincolnshire and Goole NHS Foundation Trust, Grimsby DN33 2BA, UK
| | - T Maughan
- CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford OX3 7DQ, UK
| | - G Griffiths
- Southampton Clinical Trials Unit, University of Southampton, Southampton SO16 6YD, UK
| | - S Mukherjee
- CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford OX3 7DQ, UK
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Hall PS, Lord SR, Collinson M, Marshall H, Jones M, Lowe C, Howard H, Swinson D, Velikova G, Anthoney A, Roy R, Dent J, Cheeseman S, Last K, Seymour MT. A randomised phase II trial and feasibility study of palliative chemotherapy in frail or elderly patients with advanced gastroesophageal cancer (321GO). Br J Cancer 2017; 116:472-478. [PMID: 28095397 PMCID: PMC5318975 DOI: 10.1038/bjc.2016.442] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 11/08/2016] [Accepted: 12/05/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Elderly patients are commonly under-represented in cancer clinical trials. The 321GO was undertaken in preparation for a definitive phase three trial assessing different chemotherapy regimens in a frail and/or elderly population with advanced gastroesophageal (GO) cancer. METHODS Patients with advanced GO cancer considered unfit for conventional dose chemotherapy were randomly assigned in a 1 : 1 : 1 ratio to: epirubicin, oxaliplatin and capecitabine (EOX); oxaliplatin and capecitabine (OX); and capecitabine alone (X) (all 80% of full dose and unblinded). The primary end point was patient recruitment over an 18-month period. A registration study recorded treatment choice for all patients with advanced GO cancer at trial centres. RESULTS A total of 313 patients were considered for palliative chemotherapy for GO cancer over the 18-month period: 115 received full dose treatment, 89 less than standard treatment or entered 321GO and 111 no treatment. Within 321GO, 55 patients were randomly assigned (19 to OX and X; 17 to EOX). Progression-free survival (PFS) for all patients was 4.4 months and by arm 5.4, 5.6 and 3.0 months for EOX, OX and X, respectively. The number of patients with a good overall treatment utility (OTU), a novel patient-centred endpoint, at 12 weeks was 3 (18%), 6 (32%) and 1 (6%) for EOX, OX and X, respectively. At 6 weeks, 22 patients (41%) had experienced a non-haematologic toxicity ⩾grade 3, most commonly lethargy or diarrhoea. The OTU was prognostic for overall survival in patients alive at week 12 (logrank test P=0.0001). CONCLUSIONS It is feasible to recruit elderly and/or frail patients with advanced GO cancer to a randomised clinical trial. The OX is the preferred regimen for further study. Overall treatment utility shows promise as a comparator between treatment regimens for feasibility and randomised trials in the elderly and/or frail GO cancer population.
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Affiliation(s)
- P S Hall
- Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh EH4 2XR, UK
| | - S R Lord
- Department of Oncology, University of Oxford, Oxford, UK
| | - M Collinson
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - H Marshall
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - M Jones
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - C Lowe
- NIHR Cancer Research Network Coordinating Centre, Leeds, UK
| | - H Howard
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - D Swinson
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - G Velikova
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - A Anthoney
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - R Roy
- Department of Oncology, Castle Hill Hospital, Hull, UK
| | - J Dent
- Department of Oncology, Huddersfield Royal Infirmary, Huddersfield, UK
| | - S Cheeseman
- Department of Oncology, The York Hospital, York, UK
| | - K Last
- Department of Oncology, The York Hospital, York, UK
- Department of Oncology, Bradford Royal Infirmary, Bradford, UK
| | - M T Seymour
- NIHR Cancer Research Network Coordinating Centre, Leeds, UK
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Chautard C, Beaucaire C, Gérard M, Phrommavanh V, Nos J, Galoisy L, Calas G, Roy R, Descostes M. Geochemical Characterization of U Tailings (Bois Noirs Limouzat, France). ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.proeps.2016.12.067] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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45
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Roy R, Banerjee K, Bhattacharya R, Mukhopadhyay A. 159P Antioxidant effect of mangiferin: The potential anti-cancer therapeutic agent. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw579.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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46
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Roy R, Banerjee K, Bhattacharya R, Mukhopadhyay A. 159P Antioxidant effect of mangiferin: The potential anti-cancer therapeutic agent. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00317-3] [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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47
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Affiliation(s)
- J.P. Cheng
- Materials Research Laboratory, The Pennsylvania State University, University Park, PA 16802, USA
| | - D.K. Agrawal
- Materials Research Laboratory, The Pennsylvania State University, University Park, PA 16802, USA
| | - S. Komarneni
- Materials Research Laboratory, The Pennsylvania State University, University Park, PA 16802, USA
| | - M. Mathis
- Materials Research Laboratory, The Pennsylvania State University, University Park, PA 16802, USA
| | - R. Roy
- Materials Research Laboratory, The Pennsylvania State University, University Park, PA 16802, USA
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48
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Bharati S, Ghosal A, Datta I, Aggarwal P, Pal A, Roy R. Pundit Madhusudan Gupta – A versatile genius and forefather of modern medical education in India. J ANAT SOC INDIA 2016. [DOI: 10.1016/j.jasi.2016.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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49
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Roy R, Som P, Ghosal A, Kundu R. Bilateral multiple renal arteries with anomalous origin of ovarian arteries on both sides: A case report. J ANAT SOC INDIA 2016. [DOI: 10.1016/j.jasi.2016.08.387] [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: 11/25/2022]
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Abstract
The multifaceted nature of the pathology of dementia spectrum disorders has complicated their management and the development of effective treatments. This is despite the fact that they are far from uncommon, with Alzheimer's disease (AD) alone affecting 35 million people worldwide. The cholinergic system has been found to be crucially involved in cognitive function, with cholinergic dysfunction playing a pivotal role in the pathophysiology of dementia. The use of molecular imaging such as SPECT and PET for tagging targets within the cholinergic system has shown promise for elucidating key aspects of underlying pathology in dementia spectrum disorders, including AD or parkinsonian dementias. SPECT and PET studies using selective radioligands for cholinergic markers, such as [(11)C]MP4A and [(11)C]PMP PET for acetylcholinesterase (AChE), [(123)I]5IA SPECT for the α4β2 nicotinic acetylcholine receptor and [(123)I]IBVM SPECT for the vesicular acetylcholine transporter, have been developed in an attempt to clarify those aspects of the diseases that remain unclear. This has led to a variety of findings, such as cortical AChE being significantly reduced in Parkinson's disease (PD), PD with dementia (PDD) and AD, as well as correlating with certain aspects of cognitive function such as attention and working memory. Thalamic AChE is significantly reduced in progressive supranuclear palsy (PSP) and multiple system atrophy, whilst it is not affected in PD. Some of these findings have brought about suggestions for the improvement of clinical practice, such as the use of a thalamic/cortical AChE ratio to differentiate between PD and PSP, two diseases that could overlap in terms of initial clinical presentation. Here, we review the findings from molecular imaging studies that have investigated the role of the cholinergic system in dementia spectrum disorders.
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Affiliation(s)
- Roman Roy
- Neurodegeneration Imaging Group, Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Flavia Niccolini
- Neurodegeneration Imaging Group, Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gennaro Pagano
- Neurodegeneration Imaging Group, Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Marios Politis
- Neurodegeneration Imaging Group, Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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