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Banh L, Cheung KK, Chan MWY, Young EWK, Viswanathan S. Corrigendum to 'Advances in organ-on-a-chip systems for modelling joint tissue and osteoarthritic diseases' Osteoarthritis Cartilage 30 (2022) 1050-1061. Osteoarthritis Cartilage 2024:S1063-4584(24)01154-3. [PMID: 38657681 DOI: 10.1016/j.joca.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Affiliation(s)
- L Banh
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, University Health Network, Canada; Krembil Research Institute, University Health Network, Canada; Institute of Biomedical Engineering, University of Toronto, Canada.
| | - K K Cheung
- Department of Mechanical & Industrial Engineering, University of Toronto, Canada.
| | - M W Y Chan
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, University Health Network, Canada; Krembil Research Institute, University Health Network, Canada; Institute of Biomedical Engineering, University of Toronto, Canada.
| | - E W K Young
- Institute of Biomedical Engineering, University of Toronto, Canada; Department of Mechanical & Industrial Engineering, University of Toronto, Canada.
| | - S Viswanathan
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, University Health Network, Canada; Krembil Research Institute, University Health Network, Canada; Institute of Biomedical Engineering, University of Toronto, Canada; Division of Hematology, Department of Medicine, University of Toronto, Canada.
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Thompson DA, Bach M, McAnany JJ, Šuštar Habjan M, Viswanathan S, Robson AG. ISCEV standard for clinical pattern electroretinography (2024 update). Doc Ophthalmol 2024; 148:75-85. [PMID: 38488946 PMCID: PMC10954931 DOI: 10.1007/s10633-024-09970-1] [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: 02/14/2024] [Accepted: 02/18/2024] [Indexed: 03/17/2024]
Abstract
The pattern electroretinogram (PERG) is a localized retinal response evoked by a contrast-reversing pattern, usually a black and white checkerboard, which provides information about macular and retinal ganglion cell function. This document, from the International Society for Clinical Electrophysiology of Vision (ISCEV; www.iscev.org ) presents an updated and revised Standard for clinical PERG testing. This replaces the 2013 and all earlier versions. Minimum protocols for basic PERG stimuli, recording methods and reporting are specified, to promote consistency of methods for diagnosis and monitoring purposes, while responding to evolving clinical practices and technology. The main changes in the updated ISCEV Standard for clinical PERG include expanded guidance about large stimulus fields, stimulus parameters for simultaneous PERG and pattern visual evoked potential recording, baseline drift correction, and use of consistent ambient room lighting. These changes aim to provide a clinically relevant document about current practice which will facilitate good quality recordings and inter-laboratory comparisons.
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Affiliation(s)
- D A Thompson
- The Tony Kriss Visual Electrophysiology Unit, Clinical and Academic Department of Ophthalmology, Sight and Sound Centre, Great Ormond Street Hospital for Children NHS Trust, London, WC1N 3AJ, UK.
- Great Ormond Street Institute for Child Health, University College London, London, UK.
| | - M Bach
- Eye Center, Medical Center - Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - J J McAnany
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, USA
| | - M Šuštar Habjan
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva ulica 46, 1000, Ljubljana, Slovenia
| | - S Viswanathan
- Department of Biological and Vision Sciences, State University of New York College of Optometry, New York, NY, USA
| | - A G Robson
- Department of Electrophysiology, Moorfields Eye Hospital, 162 City Road, London, EC1V 2PD, UK
- Institute of Ophthalmology, University College London, London, UK
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Yaparpalvi R, Rivera A, Viswanathan S, Tang J, Tome WA, Mehta KJ. Total Reference Air Kerma (TRAK) is Associated with Dosimetric Parameters in Template-Based High Dose-Rate (HDR) Interstitial Brachytherapy in Advanced Gynecologic Cancers. Int J Radiat Oncol Biol Phys 2023; 117:e557. [PMID: 37785709 DOI: 10.1016/j.ijrobp.2023.06.1870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To study TRAK and its association with dosimetric parameters in template-based high dose-rate interstitial brachytherapy in advanced gynecologic cancers. MATERIALS/METHODS Brachytherapy treatment plans of 53 patients treated between 2012 and 2022 at our institution with template-based Iridium-192 HDR brachytherapy, post-external beam RT, for locally advanced cancers of the cervix and vagina were retrospectively reviewed. Brachytherapy dose ranged from 25 to 30-Gy delivered in 4 to 6 fractions. The median number of flexi-guide catheters implanted was 18 (range 10-30). Clinical Target Volume (CTV) values were mean (±SD): 72.2 (±40.4) cm3 (high-risk, HR) and 182.2 (±73.7) cm3 (intermediate-risk, IR) respectively. TRAK per fraction (cGy at 1m), dose-volume information for the implant, target, and organ-at-risk (OAR) were recorded. Indices for dose coverage (CI), homogeneity (DHI), non-uniformity (DNR), overdose volume (ODI) were computed. Regression and correlation tests were used to study the TRAK relationship with various dosimetric parameters. The false discovery rate at a 5% level was corrected using the Benjamini-Hochberg procedure. RESULTS The average TRAK per fraction was 0.365 (±0.12) cGy. Mean and range values of plan quality indices were - CI 0.92 (0.7- 1.0), DHI 0.57 (0.41 - 0.77), DNR 0.43 (0.23 - 0.59) and ODI 0.22 (0.11 - 0.38), respectively Correlation results for TRAK with various dosimetric indices are presented in Table 1. TRAK showed a weak correlation with the number of flexi-guide catheters implanted (r = 0.35, p = 0.013). TRAK correlated strongly with target volumes (CTV_HR and CTV_IR and CTV_HR V100%) and with isodose volumes at both high (V300, V200, V150), and low dose levels (V90, V85, V50) (p<0.00001). TRAK correlated moderately with OAR 2-cm3 doses (p<0.00001). A weak correlation was observed between TRAK and plan quality indices. CONCLUSION TRAK correlates positively with target volume and volumes enclosed by isodoses at various dose levels in interstitial HDR brachytherapy of advanced Gynecologic Cancers. Interestingly, our study observed a comparatively stronger positive correlation between TRAK and Sigmoid 2-cm3 dose, equated to TRAK correlation with bladder, rectum, and small bowel 2-cm3 doses. This finding could interest future studies utilizing TRAK as a surrogate for treatment outcome and toxicity.
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Affiliation(s)
- R Yaparpalvi
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - A Rivera
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - S Viswanathan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - J Tang
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - W A Tome
- Institute for Onco-Physics, Albert Einstein College of Medicine, Bronx, NY
| | - K J Mehta
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
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Lubin J, Haynes-Lewis H, Viswanathan S, Xie X, Kamara A, Tang J, Kalnicki S, Jariwala S, Garg MK, Klein J. Assessment of Electronic Health Literacy among Patients in an Urban, Academic Radiation Therapy Department. Int J Radiat Oncol Biol Phys 2023; 117:e39. [PMID: 37785310 DOI: 10.1016/j.ijrobp.2023.06.734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The COVID-19 pandemic dramatically affected health outcomes and healthcare access, especially with the abrupt transition to virtual care. Cancer patients in the New York City borough of the Bronx, a potentially marginalized community with high rates of poverty and non-English speakers, may be particularly vulnerable to healthcare disparities, given their advanced age and possible difficulty navigating telemedicine appointments due to decreased electronic health literacy (EHL). We investigated EHL levels using both subjective and objective measures and associated predictors of EHL in patients within an academic, urban radiation oncology department. MATERIALS/METHODS We conducted a prospective IRB-approved study of patients aged ≥18 presenting for care in our department. Patients' internet access and established habits were surveyed via Health Information National Trends Survey (HINTS). Subjective EHL, self-reported comfort using the internet for health information, was assessed via the eHealth Literacy Scale (eHEALS), which calculates a score by adding participants' answers for 8 questions (each on a 1 to 5-point Likert scale). Subjective EHL was categorized as low (8-23), moderate (24-31), or good (32-40). Objective EHL was determined by the eHealth Literacy Objective Scale (eHeLiOS), which tests responses to 9 common scenarios on gathering and assessing electronic health information via multiple-choice questions. The numbers of correct answers were totaled and categorized into low (1-4), moderate (5-7), or good (8-9) EHL. RESULTS Patients were enrolled between December 2020 and December 2022. 56 patients completed the subjective eHEALS assessment, while 49 completed the eHeLiOS objective test. 52% and 27% of patients identified as Black and Hispanic, respectively; 66% were male, and the median age was 67 (range 28-86). 76% reported accessing the internet regularly, of which 92% reported doing so via broadband network. The prevalence of good EHL was 10% using objective and 29% using subjective surveys. Using a proportional odds logistic model, only age was associated with EHL. For every increased year of age, there was an 11% decrease in objective (OR 0.89, p = 0.02) and 5% decrease in subjective (OR 0.95, p = 0.08) EHL odds, respectively. Gender, race/ethnicity, income, insurance, and employment status were not significantly associated with EHL. CONCLUSION Few study patients, who represent an older and potentially marginalized population, showed good EHL levels; more perceived good EHL via subjective testing than we observed using our objective measure. These data suggest implementation of an objective EHL assessment would aid in identifying patients who may benefit from learning activities to improve EHL and support to navigate telehealth visits effectively. Further research is needed to optimize telemedicine strategies for older cancer patients with low EHL.
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Affiliation(s)
- J Lubin
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - H Haynes-Lewis
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - S Viswanathan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - X Xie
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - A Kamara
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - J Tang
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - S Kalnicki
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - S Jariwala
- Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - M K Garg
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - J Klein
- Department of Radiation Oncology, State University of New York (SUNY) Downstate Medical Sciences University and Maimonides Medical Center, Brooklyn, NY
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Davis T, Krivacsy S, Viswanathan S, English KK, Xie X, Anastos K, Kabarriti R, Rubagumya F, Murenzi G, Mugenzi P. Radiotherapy Access and Treatment in Rwanda: Demographics and Clinical Characteristics of Cervical Cancer Patients. Int J Radiat Oncol Biol Phys 2023; 117:S127. [PMID: 37784326 DOI: 10.1016/j.ijrobp.2023.06.471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Nearly all cervical cancer deaths occur in low- and middle-income countries (LMIC), and in Rwanda, cervical cancer is the leading cause of cancer mortality among women. In 2018, Rwanda Cancer Center (RCC) opened as the first place to offer radiotherapy (RT) for cervical cancer treatment in the country. This study aims to characterize patient demographic and clinical characteristics, access to care, and predictors associated with treatment initiation. MATERIALS/METHODS This study was conducted at RCC in Kigali. Between 2019 and 2022, patients who received radiotherapy were included; data were extracted from electronic medical records, including demographics, medical history, cancer information, pre-RT imaging, RT information, and toxicities. Descriptive statistics were used to summarize patient characteristics; chi-square and t-tests were used to test any distribution differences. Time to treatment initiation (TTI, time from biopsy to first RT session) was dichotomized as ≤45 vs. >45 days) and multivariable logistic regression was used to find predictors of TTI. RESULTS Of the 620 women who presented with cervical cancer, 428 (69%) were treated with radiotherapy (External Beam Radiotherapy using Volumetric Modulated Arc Therapy). The average patient's age was 55.4 years (+/-11.4), and the median distance traveled was 87.7 km (IQR: 37.0-140.0). Nearly 88% used community-based (government) insurance (CBHI, either 0% and 10% copay category); 21.9% were known to be living with HIV. 66.9% of patients presented with stage 3 or 4 disease. Of the patients receiving RT, 357 (83%) received chemotherapy. Predictors of TTI (≤45 days) were travel distance and insurance type. The odds of early TTI (≤45 days) decreased by 27% per 1 log kilometer increase. Patients using CBHI insurance had 54% lesser odds of early TTI than others. CONCLUSION RCC has built a capacity to provide advanced radiation treatment to cancer patients in Rwanda and surrounding LMIC countries. Despite the COVID-19 pandemic, RCC has treated nearly 500 patients already. This study is the first to document these patient characteristics; results suggest that longer travel distance and public insurance are major factors for longer treatment initiation. Strategies to identify barriers to screening for early cancer detection and expediting treatment initiation are ongoing.
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Affiliation(s)
- T Davis
- Albert Einstein College of Medicine, Bronx, NY
| | - S Krivacsy
- Albert Einstein College of Medicine, Bronx, NY
| | - S Viswanathan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - K K English
- Albert Einstein College of Medicine, Bronx, NY; Johns Hopkins University, Baltimore, MD
| | - X Xie
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - K Anastos
- Department of Epidemiology, and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - R Kabarriti
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - F Rubagumya
- Rwanda Cancer Center, Kigali, Dar es Sal, Rwanda
| | - G Murenzi
- Research for Development Rwanda, Kigali, Rwanda; Rwanda Military Hospital, Kigali, Rwanda
| | - P Mugenzi
- Rwanda Cancer Center, Kigali, Rwanda
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Albart SA, Yusof Khan AHK, Wan Zaidi WA, Muthuppalaniappan AM, Kandavello G, Koh GT, Leong MC, Liew HB, Ong BH, Viswanathan S, Hoo FK, Looi I, Yap YG, Law WC. Management of patent foramen ovale in embolic stroke of undetermined source patients: Malaysian experts' consensus. Med J Malaysia 2023; 78:389-403. [PMID: 37271850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION About 20 to 40% of ischaemic stroke causes are cryptogenic. Embolic stroke of undetermined source (ESUS) is a subtype of cryptogenic stroke which is diagnosed based on specific criteria. Even though patent foramen ovale (PFO) is linked with the risk of stroke, it is found in about 25% of the general population, so it might be an innocent bystander. The best way to treat ESUS patients with PFO is still up for discussion. MATERIALS AND METHODS Therefore, based on current evidence and expert opinion, Malaysian expert panels from various disciplines have gathered to discuss the management of ESUS patients with PFO. This consensus sought to educate Malaysian healthcare professionals to diagnose and manage PFO in ESUS patients based on local resources and facilities. RESULTS Based on consensus, the Malaysian expert recommended PFO closure for embolic stroke patients who were younger than 60, had high RoPE scores and did not require long-term anticoagulation. However, the decision should be made after other mechanisms of stroke have been ruled out via thorough investigation and multidisciplinary evaluation. The PFO screening should be made using readily available imaging modalities, ideally contrasttransthoracic echocardiogram (c-TTE) or contrasttranscranial Doppler (c-TCD). The contrast-transesophageal echocardiogram (c-TEE) should be used for the confirmation of PFO diagnosis. The experts advised closing PFO as early as possible because there is limited evidence for late closure. For the post-closure follow-up management, dual antiplatelet therapy (DAPT) for one to three months, followed by single antiplatelet therapy (APT) for six months, is advised. Nonetheless, with joint care from a cardiologist and a neurologist, the multidisciplinary team will decide on the continuation of therapy.
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Affiliation(s)
- S A Albart
- Clinical Research Centre, Hospital Seberang Jaya, Ministry of Health Malaysia, Seberang Jaya, Pulau Pinang, Malaysia
| | - A H K Yusof Khan
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Neurology, Serdang, Selangor, Malaysia.
| | - W A Wan Zaidi
- Hospital Canselor Tuanku Muhriz (HCTM), Department of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | | | - G Kandavello
- Institut Jantung Negara, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - G T Koh
- Hospital Serdang, Paediatric Cardiology Unit, Kajang, Selangor, Malaysia
| | - M C Leong
- Institut Jantung Negara, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - H B Liew
- Hospital Queen Elizabeth II, Department of Cardiology, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia
| | - B H Ong
- Kedah Medical Centre, Alor Setar, Kedah, Malaysia
| | - S Viswanathan
- Hospital Kuala Lumpur, Department of Neurology, Ministry of Health Malaysia, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - F K Hoo
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Neurology, Serdang, Selangor, Malaysia
| | - I Looi
- Clinical Research Centre, Hospital Seberang Jaya, Ministry of Health Malaysia, Seberang Jaya, Pulau Pinang, Malaysia
| | - Y G Yap
- Sunway Medical Centre, Petaling Jaya, Selangor, Malaysia
| | - W C Law
- Hospital Umum Sarawak, Department of Medicine, Ministry of Health Malaysia, Kuching, Sarawak, Malaysia
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Ohri N, Jolly S, Cooper B, Kabarriti R, III WRB, Klein J, Viswanathan S, Kaufman R, Shum E, Sabari J, Cheng H, Gucalp R, Castellucci E, Qin A, Gadgeel S, Halmos B. The Selective Personalized Radio-Immunotherapy for Locally Advanced NSCLC Trial (SPRINT). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.385] [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: 11/29/2022]
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Banh L, Cheung KK, Chan MWY, Young EWK, Viswanathan S. Advances in organ-on-a-chip systems for modelling joint tissue and osteoarthritic diseases. Osteoarthritis Cartilage 2022; 30:1050-1061. [PMID: 35460872 DOI: 10.1016/j.joca.2022.03.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/24/2022] [Accepted: 03/30/2022] [Indexed: 02/07/2023]
Abstract
Joint-on-a-chip (JOC) models are powerful tools that aid in osteoarthritis (OA) research. These microfluidic devices apply emerging organ-on-a-chip technology to recapitulate a multifaceted joint tissue microenvironment. JOCs address the need for advanced, dynamic in vitro models that can mimic the in vivo tissue environment through joint-relevant biomechanical or fluidic integration, an aspect that existing in vitro OA models lack. There are existing review articles on OA models that focus on animal, tissue explant, and two-dimensional and three-dimensional (3D) culture systems, including microbioreactors and 3D printing technology, but there has been limited discussion of JOC models. The aim of this article is to review recent developments in human JOC technology and identify gaps for future advancements. Specifically, mechanical stimulation systems that mimic articular movement, multi-joint tissue cultures that enable crosstalk, and systems that aim to capture aspects of OA inflammation by incorporating immune cells are covered. The development of an advanced JOC model that captures the dynamic joint microenvironment will improve testing and translation of potential OA therapeutics.
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Affiliation(s)
- L Banh
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, University Health Network, Canada; Krembil Research Institute, University Health Network, Canada; Institute of Biomedical Engineering, University of Toronto, Canada.
| | - K K Cheung
- Department of Mechanical & Industrial Engineering, University of Toronto, Canada.
| | - M W Y Chan
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, University Health Network, Canada; Krembil Research Institute, University Health Network, Canada; Institute of Biomedical Engineering, University of Toronto, Canada.
| | - E W K Young
- Institute of Biomedical Engineering, University of Toronto, Canada; Department of Mechanical & Industrial Engineering, University of Toronto, Canada.
| | - S Viswanathan
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, University Health Network, Canada; Krembil Research Institute, University Health Network, Canada; Institute of Biomedical Engineering, University of Toronto, Canada; Division of Hematology, Department of Medicine, University of Toronto, Canada.
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Hensel L, Lange F, Tscherpel C, Viswanathan S, Freytag J, Volz L, Eickhoff S, Fink G, Grefkes C. FV 25 Interhemispheric connectivity of frontoparietal motor regions aids grasping performance after stroke. Clin Neurophysiol 2022. [DOI: 10.1016/j.clinph.2022.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rasti M, Rabani R, Chan M, Viswanathan S. Mesenchymal Stem/Stromal Cells: INVESTIGATING THE ROLE OF IL6 SIGNALING IN MESENCHYMAL STROMAL CELLS INTERACTIONS WITH MONOCYTE/MACROPHAGES IN OSTEOARTHRITIS. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00169-4] [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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Chan M, Ziyaeyan A, Rasti M, Gabrial S, Kapoor M, Mahomed N, Gandhi R, Viswanathan S. Immunotherapy: POLARIZED MACROPHAGES AS A CELL-BASED THERAPY FOR OSTEOARTHRITIS. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00343-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Viswanathan S. Mesenchymal Stem/Stromal Cells: WHAT’S MORE IMPORTANT? DONOR OR CELL PROCESSING PARAMETER HETEROGENEITY IN OPTIMIZING MESENCHYMAL STROMA CELL YIELD AND POTENCY. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00227-4] [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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Banh L, Chan M, Cheung K, Shao H, Young E, Viswanathan S. Tissue Engineering, Embryonic, Organ and Other Tissue Specific Stem Cells: DEVELOPMENT AND APPLICATION OF AN ORGAN-ON-A-CHIP SYSTEM FOR THE JOINT TO MODEL AND STUDY OSTEOARTHRITIS. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00413-3] [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: 11/29/2022]
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Koob J, Rehme A, Grefkes C, Viswanathan S, Mustin M. P 10 The effect of post-stroke depression and motor impairment on incentive motivation. Clin Neurophysiol 2022. [DOI: 10.1016/j.clinph.2022.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Thangam V, Rajalakshmi A, Chandrasekaran A, Arun B, Viswanathan S, Venkatraman B, Bera S. Determination of natural radioactivity in beach sands collected along the coastal area of Tamilnadu, India using gamma ray spectrometry. J Radioanal Nucl Chem 2022. [DOI: 10.1007/s10967-022-08193-5] [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] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Chan MWY, Gomez-Aristizábal A, Mahomed N, Gandhi R, Viswanathan S. A tool for evaluating novel osteoarthritis therapies using multivariate analyses of human cartilage-synovium explant co-culture. Osteoarthritis Cartilage 2022; 30:147-159. [PMID: 34547432 DOI: 10.1016/j.joca.2021.09.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 08/07/2021] [Accepted: 09/14/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE There is a need to incorporate multiple tissues into in vitro OA models to evaluate novel therapeutics. This approach is limited by inherent donor variability. We present an optimized research tool: a human OA cartilage-synovium explant co-culture model (OA-EXM) that employs donor-matched lower and upper limit response controls combined with statistical approaches to address variability. Multiple rapid read-outs allow for evaluation of therapeutics while cataloguing cartilage-synovium interactions. DESIGN 48-h human explant cultures were sourced from OA knee arthroplasties. An OA-like cartilage-synovium co-culture baseline was established relative to donor-matched upper limit supraphysiological pro-inflammatory cytokine and lower limit OA cartilage or synovium alone controls. 100 nM dexamethasone treatment validated possible "rescue effects" within the OA-EXM dual tissue environment. Gene expression, proteoglycan loss, MMP activity, and soluble protein concentrations were analyzed using blocking and clustering methods. RESULTS The OA-EXM demonstrates the value of the co-culture approach as the addition of OA synovium increases OA cartilage proteoglycan loss and expression of MMP1, MMP3, MMP13, CXCL8, CCL2, IL6, and PTGS2, but not to the extent of supraphysiological stimulation. Conversely, OA cartilage does not affect gene expression or MMP activity of OA synovium. Dexamethasone shows dual treatment effects on synovium (pro-resolving macrophage upregulation, protease downregulation) and cartilage (pro-inflammatory, catabolic, and anabolic downregulation), and decreases soluble CCL2 levels in co-culture, thereby validating OA-EXM utility. CONCLUSIONS The OA-EXM is representative of late-stage OA pathology, captures dual interactions between cartilage and synovium, and combined with statistical strategies provides a rapid, sensitive research tool for evaluating OA therapeutics.
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Affiliation(s)
- M W Y Chan
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, University Health Network, Canada; Krembil Research Institute, University Health Network, Canada; Institute of Biomedical Engineering, University of Toronto, Canada.
| | - A Gomez-Aristizábal
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, University Health Network, Canada; Krembil Research Institute, University Health Network, Canada.
| | - N Mahomed
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, University Health Network, Canada; Krembil Research Institute, University Health Network, Canada.
| | - R Gandhi
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, University Health Network, Canada; Krembil Research Institute, University Health Network, Canada.
| | - S Viswanathan
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, University Health Network, Canada; Krembil Research Institute, University Health Network, Canada; Institute of Biomedical Engineering, University of Toronto, Canada; Division of Hematology, Department of Medicine, University of Toronto, Canada.
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Krishnan D, Viswanathan S, Rose N, Benjamin HSN, Ong AM, Hiew FL. Clinical heterogeneity of low flow spinal arteriovenous fistulas; a case series. BMC Neurol 2021; 21:366. [PMID: 34548039 PMCID: PMC8456593 DOI: 10.1186/s12883-021-02394-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 09/08/2021] [Indexed: 12/22/2022] Open
Abstract
Background Spinal AVF (SAVF), a potentially treatable cause of myelopathy, remains a challenging diagnosis. Its rarity and non-specific imaging findings often result in misdiagnosis despite a high index of clinical suspicion. The classically described high T2 signal in the spinal cord or prominent vascular flow voids in the intradural space were not infrequently missed on initial imaging, only to be picked up at follow-up imaging after progression of symptoms. Additionally, small sized fistulas(< 1 mm) and SAVF involving less frequent locations like the craniocervical junction in a patient presenting with paraplegia further complicates the diagnosis. On rare occasions, acute atypical presentation following a surgery adds to the conundrum. Definite diagnosis with spinal angiography, the gold-standard modality requires the expertise of highly skilled interventionists which may otherwise lead to false negative findings. We describe four SAVF patients with unconventional presentations, highlighting less described clinical findings. Case presentation First was a 50-year-old man presented with spastic paraparesis and was found to have an AVF at the cervical region arising from the vertebral artery. Second, a 45-year-old man with acute paraplegia post-operatively, initially treated for a transverse myelitis before lumbar region AVF was detected. Thirdly, a 27-year-old man presented with subacute lower thoracic myelopathy and deteriorated after corticosteroid treatment. The last patient, who initially appeared to have conus medullaris/cauda equina syndrome had a SAVF at the mid thoracic level. Presentation varied with some exhibiting acute deterioration mimicking other spinal cord pathology such as inflammatory disorders. All patients eventually underwent endovascular treatment with successful embolization of SDAVF. None of them exhibited further neurological deterioration after embolization. Conclusion Successful treatment of SAVF is possible provided the diagnosis is made early, allowing timely intervention. Certain clues may aid the diagnosis. Firstly, arteriovenous fistula can be located distant to the clinical localization of myelopathy resulting in the unexpected longitudinally extensive spinal cord signal change. This clinical-radiological discrepancy can be a useful clue in diagnosing SAVF. Secondly, an acute myelopathic presentation immediately post-surgery may be related to SAVF. Other SAVF feature of note includes progressive myelopathy mimicking immune-mediated myelitis among young adults below 30 years of age refractory to immune therapy.
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Affiliation(s)
- D Krishnan
- Department of Neurology, Hospital Kuala Lumpur, Jalan Pahang, 50586, Kuala Lumpur, Malaysia.
| | - S Viswanathan
- Department of Neurology, Hospital Kuala Lumpur, Jalan Pahang, 50586, Kuala Lumpur, Malaysia
| | - N Rose
- Department of Radiology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - H S N Benjamin
- Department of Neurology, Hospital Kuala Lumpur, Jalan Pahang, 50586, Kuala Lumpur, Malaysia
| | - A M Ong
- Department of Neurology, Hospital Kuala Lumpur, Jalan Pahang, 50586, Kuala Lumpur, Malaysia
| | - F L Hiew
- Department of Neurology, Hospital Kuala Lumpur, Jalan Pahang, 50586, Kuala Lumpur, Malaysia
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Robb K, Audet J, Gandhi R, Viswanathan S. Desirability profiling to statistically rank the potency of enhanced mesenchymal stromal cells with consideration for donor heterogeneity. Cytotherapy 2021. [DOI: 10.1016/s1465324921004825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Gualtieri T, Ferrari M, Taboni S, Chan H, Townson J, Mattavelli D, Sahovaler A, Eu D, Dey K, Mathews S, Re F, Bernardi S, Borsani E, Viswanathan S, Nicolai P, Sartore L, Russo D, Gilbert R, Irish J. 3D-mapping of mesenchymal stem cells growth on bioengineered scaffolds for maxillofacial skeleton regeneration: a preclinical, in vitro study. Cytotherapy 2021. [DOI: 10.1016/s146532492100517x] [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]
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20
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Rabani R, Robb K, Chahal J, Mahomed N, Gandhi R, Viswanathan S. Microrna signature of mesenchymal stromal cells contributes to their therapeutic efficacy in the context of osteoarthritis. Cytotherapy 2021. [DOI: 10.1016/s1465324921002838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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21
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Rabani R, Rasti M, Chan M, Mahomed N, Gandhi R, Viswanathan S. Paradoxical role of IL6 signalling in osteoarthritis. Cytotherapy 2021. [DOI: 10.1016/s1465324921003340] [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: 11/26/2022]
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22
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Chan M, Ziyaeyan A, Rasti M, Gabrial S, Kapoor M, Mahomed N, Gandhi R, Viswanathan S. Pro-resolving macrophages as a cell-based therapy in osteoarthritis by adoptive transfer within murine in vivo and human explant ex vivo investigation. Cytotherapy 2021. [DOI: 10.1016/s1465324921004965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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23
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Arun B, Viswanathan S, Subramanian V, Jose MT, Venkatraman B. Study of Triple to Double Coincidence Method for Tritium Measurements. Radiochemistry 2021. [DOI: 10.1134/s1066362221020120] [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: 11/23/2022]
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24
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Viswanathan S. Regional and global perspectives on the incidence of multiple sclerosis and neuromyelitis optica and its spectrum disorders from Asia with emphasis on China. Lancet Reg Health West Pac 2020; 3:100039. [PMID: 34327387 PMCID: PMC8315615 DOI: 10.1016/j.lanwpc.2020.100039] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 09/21/2020] [Indexed: 11/24/2022]
Affiliation(s)
- S. Viswanathan
- Department of Neurology, Kuala Lumpur Hospital, Malaysia
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25
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Viswanathan S. Management of Idiopathic CNS inflammatory diseases during the COVID-19 pandemic: Perspectives and strategies for continuity of care from a South East Asian Center with limited resources. Mult Scler Relat Disord 2020; 44:102353. [PMID: 32653804 PMCID: PMC7341969 DOI: 10.1016/j.msard.2020.102353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/15/2020] [Accepted: 06/30/2020] [Indexed: 12/21/2022]
Abstract
The Covid-19 pandemic poses a grave health management challenge globally of unprecedented nature. Management of idiopathic Central Nervous system inflammatory disorders (iCNSID) such as Multiple sclerosis, Neuromyelitis optica and its spectrum disorders and related conditions during this pandemic needs to be addressed with affirmative and sustainable strategies in order to prevent disease related risks, medication related complications and possible COVID-19 disease associated effects. Global international iCNSIDs agencies and recent publications are attempting to address this but such guidance is not available in South East Asia. Here we outline prospectively qualitatively and quantitatively novel strategies at a tertiary center in Malaysia catering for neuroimmunological disorders despite modest resources during this pandemic. In this retrospective study with longitudinal follow-up, we describe stratification of patients for face to face versus virtual visits in the absence of formal teleneurology, stratification of patients for treatment according to disease activity, rescheduling, deferring initiation or extending treatment intervals of certain disease modifying therapies(DMT's) or immunosuppressants(IS), especially those producing lymphocyte depletion in MS and the continuation of IS in patients with NMO/NMOSD. Furthermore, we highlight the use off-label treatments such as Intravenous immunoglobulins/rituximab,bridging interferons/Teriflunomide temporarily replacing more potent DMT choices,supply challenges of IS/DMT's and tailoring blood watches and neuroimaging surveillance based on the current health needs to stave off the pandemic and prevent at risk patients with iCNSID/health care workers from possibly being exposed to the COVID-19.
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Affiliation(s)
- S Viswanathan
- Department of Neurology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia.
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26
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Ooi HS, Viswanathan S, Botross NP, Eow GB, Chin YT, Kanesalingam R, R Isman MA, Cheang JM, Nordin RB, Sood S. Association between Appendectomy and Demyelinating Disorders in Subjects 40 Years and Older. Neurol India 2020; 68:850-855. [PMID: 32859827 DOI: 10.4103/0028-3886.293469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background The association between appendectomy and multiple sclerosis (MS) is unknown. In this study, we explored the association between appendectomy and MS and neuromyelitis optica spectrum disorder (NMOSD). Patients and Methods MS and NMOSD patients older than 40 were identified from neurology records from hospitals in Malaysia. The diagnoses were based on the Revised McDonald (2010) and Wingerchuk (2015) criteria. Controls were sampled from Malaysia's normal population. Individuals were interviewed telephonically or face-to-face. The age inclusion criterion (over 40) differentiated high or low lifetime risk of appendicitis, as appendicitis incidence is rare after 40. Results 49 MS, 71 NMOSD, and 880 controls met the inclusion criteria. Seventy-two individuals (9 MS, 4 NMOSD, 59 control) had undergone appendectomy. Appendectomy rates were 18.37% in the MS group (95% CI 7.5-29.2%), 5.6% in the NMOSD group (0.3%, 11%), and 6.7% among controls (5.1%, 8.4%), (MS vs NMOSD P = 0.036, MS vs controls P = 0.007). Binary regression analysis showed that MS was an independent risk factor for appendectomy (OR 2.938, 95% CI 1.302, 6.633, P = 0.009). NMOSD showed no association with appendectomy. Conclusion MS is positively associated with appendectomy, unlike ulcerative colitis, which is negatively associated. We hypothesize that there is a commonality in the microflora in persons who have had these two illnesses.
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Affiliation(s)
- Hean S Ooi
- Sir Charles Gairdner Hospital, Western Australia
| | - S Viswanathan
- Department of Neurology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Nevein P Botross
- Department of Medicine, Monash University Malaysia, Johor Bahru, Malaysia
| | | | - Yen T Chin
- Department of Medicine, Hospital Sultanah Aminah, Johor Bahru, Malaysia
| | | | | | | | - Rusli Bin Nordin
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia
| | - Suneet Sood
- Department of Surgery, Monash University Malaysia, Johor Bahru, Malaysia
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27
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Berlin Grace VM, Viswanathan S, David Wilson D, Jagadish Kumar S, Sahana K, Maria Arbin EF, Narayanan J. Significant action of Tridax procumbens L. leaf extract on reducing the TNF-α and COX-2 gene expressions in induced inflammation site in Swiss albino mice. Inflammopharmacology 2020; 28:929-938. [PMID: 31487002 DOI: 10.1007/s10787-019-00634-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 08/19/2019] [Indexed: 01/04/2023]
Abstract
The leaves of traditionally used herbal plant Tridax procumbens L. contain lots of phytochemicals having potency to reduce inflammation. In this study, the ethanol extract of the leaves of Tridax procumbens L. was analysed for the phytochemicals by GC-MS. The anti-inflammatory activity was then studied with the extract of 10, 50, and 100 mg/kg b.wt in carrageenan-induced mice model by measuring the inflammatory oedema and by analysing the histopathology. The mRNA expression levels of TNF-α and COX2 genes were studied in the inflammatory site to explore the molecular action by reverse transcription PCR and qPCR analyses. A significant (P ≤ 0.01) reduction in mice paw inflammation and a recovered histology were observed in treated groups when compared to control group in 24 h. The RT-PCR results showed a significant (P ≤ 0.01) decrease in the expression levels of TNF-α and COX2 in terms of band density in treated mice compared to control group. The qPCR RQ values also were decreased in treated groups with respect to increasing doses (RQ values of 18.985 ± 0.230, 12.140 ± 1.121, 6.718 ± 0.807 for TNF-α and 15.583 ± 1.043, 7.725 ± 1.013, 5.075 ± 0.615 for COX2, respectively for the three doses) in comparison with the control group (TNF-α 27.107 ± 2.254, COX2 20.626 ± 1.477). Tridax procumbens L. can be, thus, used for the development of a safe, natural, anti-inflammatory drug as it showed a strong inhibitory action on inflammation by acting at molecular level.
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Affiliation(s)
- V M Berlin Grace
- Department of Biotechnology, Karunya Institute of Technology and Sciences, Karunya Nagar, Coimbatore, Tamil Nadu, 641 114, India.
| | - S Viswanathan
- Department of Biotechnology, Karunya Institute of Technology and Sciences, Karunya Nagar, Coimbatore, Tamil Nadu, 641 114, India
| | - D David Wilson
- School of Science, Arts, Media and Management (SSAMM), Karunya Institute of Technology and Sciences, Karunya Nagar, Coimbatore, Tamil Nadu, 641 114, India
| | - S Jagadish Kumar
- Department of Biotechnology, Karunya Institute of Technology and Sciences, Karunya Nagar, Coimbatore, Tamil Nadu, 641 114, India
| | - K Sahana
- Department of Biotechnology, Karunya Institute of Technology and Sciences, Karunya Nagar, Coimbatore, Tamil Nadu, 641 114, India
| | - E F Maria Arbin
- Department of Biotechnology, Karunya Institute of Technology and Sciences, Karunya Nagar, Coimbatore, Tamil Nadu, 641 114, India
| | - Jini Narayanan
- Department of Biotechnology, Sugarcane Breeding Institute, Coimbatore, Tamil Nadu, 641007, India
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Chan M, Rabani R, Gandhi R, Tian Y, Gaudet I, Viswanathan S. Rapid 48-hour inflammation-resolving polarization of monocytes/macrophages is feasible at larger scale and shows anabolic effect in human osteoarthritic joint explant model. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.223] [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: 11/29/2022]
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Luo L, Uludag H, Sone E, Viswanathan S. Biomimetic mineralized collagen scaffolds and their effect on osteogenic differentiation. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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30
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Rabani R, Chahal J, Mahomed N, Marshall K, Gandhi R, Viswanathan S. Microrna profile of mesenchymal stromal cells: a tool to predict their therapeutic efficasy in osteoarthritis. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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31
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Deepu B, Viswanathan S. Effect of Percutaneous Coronary Intervention on Left Ventricular Function in Coronary Artery Disease Patients with LV Dysfunction. Indian Heart J 2019. [DOI: 10.1016/j.ihj.2019.11.079] [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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32
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Attumalil T, Radhakrishnan V, Viswanathan S, Koshy G, Gupta P. Platelet indices as a predictor of reperfusion outcome in primary PCI. Indian Heart J 2019. [DOI: 10.1016/j.ihj.2019.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Viswanathan S, Shi Y, Galipeau J, Krampera M, Leblanc K, Martin I, Nolta J, Phinney DG, Sensebe L. Mesenchymal stem versus stromal cells: International Society for Cell & Gene Therapy (ISCT®) Mesenchymal Stromal Cell committee position statement on nomenclature. Cytotherapy 2019; 21:1019-1024. [PMID: 31526643 DOI: 10.1016/j.jcyt.2019.08.002] [Citation(s) in RCA: 411] [Impact Index Per Article: 82.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 08/19/2019] [Indexed: 02/06/2023]
Abstract
The International Society for Cell & Gene Therapy (ISCT®) Mesenchymal Stromal Cell (ISCT MSC) committee offers a position statement to clarify the nomenclature of mesenchymal stromal cells (MSCs). The ISCT MSC committee continues to support the use of the acronym "MSCs" but recommends this be (i) supplemented by tissue-source origin of the cells, which would highlight tissue-specific properties; (ii) intended as MSCs unless rigorous evidence for stemness exists that can be supported by both in vitro and in vivo data; and (iii) associated with robust matrix of functional assays to demonstrate MSC properties, which are not generically defined but informed by the intended therapeutic mode of actions.
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Affiliation(s)
- S Viswanathan
- Arthritis Program, University Health Network, Krembil Research Institute, University Health Network, Cell Therapy Program, University Health Network, Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada.
| | - Y Shi
- The First Affiliated Hospital, Soochow University Institutes for Translational Medicine, Suzhou, China; Institute of Health Sciences, Chinese Academy of Sciences, Shanghai, China.
| | - J Galipeau
- Department of Medicine, University of Wisconsin Carbone Cancer Center, Madison, Wisconsin, USA
| | - M Krampera
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
| | - K Leblanc
- Division of Clinical Immunology and Transfusion Medicine, Karolinska Institutet, Stockholm, Sweden
| | - I Martin
- Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - J Nolta
- Department of Internal Medicine, Stem Cell Program and Institute for Regenerative Cures, University of California Davis, Sacramento, California, USA
| | - D G Phinney
- Department of Molecular Therapeutics, The Scripps Research Institute, Jupiter, Florida, USA
| | - L Sensebe
- UMR5273 STROMALab CNRS/EFS/UPS-INSERM U1031, Toulouse, France
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Arun B, Vijayalakshmi I, Ramani Y, Viswanathan S, Jose MT, Baskaran R, Venkatraman B. Optimization of 14C LSC measurement using CO2 absorption technique. RADIOCHIM ACTA 2019. [DOI: 10.1515/ract-2018-3042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Liquid Scintillation Counting (LSC) is the most commonly used technique for quantification of 14C in the environmental samples. An optimization study was carried out for the analysis of 14C with the direct carbon dioxide absorption method using LSC. The absorption capacity of CO2 in varying amounts of CO2 absorber Carbo-Sorb E to Permafluor scintillation cocktail volumes is found to be 5.33 ± 0.053 mmol/mL of Carbo-Sorb E. The optimum volume ratio of Carbo-Sorb E to Permafluor scintillation cocktail is found to be 1:1 based on the minimum detection activity (MDA) values. The effect of CO2 loading in the optimized absorption mixture shows that with an increasing CO2 amount (up to saturation) there is an increase in tSIE values which is due to an increase of Compton scattering effect in the CO2 loaded samples. The region of interest (ROI) for 14C measurement is found to be 10–96 keV based on the figure of merit values and the efficiency for detecting 14C is 83.45 % in the optimized ROI window.
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Affiliation(s)
- B. Arun
- Health, Safety and Environment Group, Indira Gandhi Centre for Atomic Research , Kalpakkam 603102, Tamilnadu , India
- Homi Bhabha National Institute, Indira Gandhi Centre for Atomic Research , Kalpakkam 603102, Tamilnadu , India
| | - I. Vijayalakshmi
- Health, Safety and Environment Group, Indira Gandhi Centre for Atomic Research , Kalpakkam 603102, Tamilnadu , India
| | - Yuvaraj Ramani
- Health, Safety and Environment Group, Indira Gandhi Centre for Atomic Research , Kalpakkam 603102, Tamilnadu , India
| | - S. Viswanathan
- Health, Safety and Environment Group, Indira Gandhi Centre for Atomic Research , Kalpakkam 603102, Tamilnadu , India
| | - M. T. Jose
- Health, Safety and Environment Group, Indira Gandhi Centre for Atomic Research , Kalpakkam 603102, Tamilnadu , India
- Homi Bhabha National Institute, Indira Gandhi Centre for Atomic Research , Kalpakkam 603102, Tamilnadu , India , Tel.: +91 44 27480352, Fax: +91 44 27480235
| | - R. Baskaran
- Health, Safety and Environment Group, Indira Gandhi Centre for Atomic Research , Kalpakkam 603102, Tamilnadu , India
- Homi Bhabha National Institute, Indira Gandhi Centre for Atomic Research , Kalpakkam 603102, Tamilnadu , India
| | - B. Venkatraman
- Health, Safety and Environment Group, Indira Gandhi Centre for Atomic Research , Kalpakkam 603102, Tamilnadu , India
- Homi Bhabha National Institute, Indira Gandhi Centre for Atomic Research , Kalpakkam 603102, Tamilnadu , India
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35
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Ravichandran R, Viswanathan S, Berlin Grace VM, Bonati L, Narayanan J. Ameliorating effect of lipo-ATRA treatment on the expression of TIG3 and its suppressing effect on PPARγ gene expression in lung cancer animal model. Mol Cell Biochem 2019; 460:105-112. [PMID: 31300983 DOI: 10.1007/s11010-019-03574-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 06/21/2019] [Indexed: 10/26/2022]
Abstract
This study aimed to find out the molecular therapeutic effect of lipo-ATRA on tumour suppressor TIG3 and cell proliferative biomarker PPARγ in B (a) P-induced lung cancer model. In RT-PCR study, ATRA- and lipo-ATRA-treated mice samples showed relatively higher TIG3 expression and decreased PPARγ expression (Band density) than cancer control. Among treatments, lipo-ATRA showed vital effect than free ATRA by enhancing TIG3 and decreasing PPARγ. The qPCR results also showed significant (p ≤ 0.05) difference in both TIG3 and PPAR (RQ values of TIG3, lipo-ATRA 23.85 ± 1.29; free ATRA 10.43 ± 1.81 and for PPARγ, lipo-ATRA 4.707 ± 1.21; free ATRA 15.78 ± 2.34). From this, we conclude that liposomal ATRA formulation is most preferable for prolonged delivery of ATRA at targeted site to favour molecular action. It implies that the therapeutic effect of lipo-ATRA in lung cancer was exhibited by ameliorating the TIG3 expression and by suppressing the expression of PPARγ.
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Affiliation(s)
- Ragavi Ravichandran
- Department of Biotechnology, Karunya Institute of Technology and Sciences, Karunya Nagar, Coimbatore, Tamilnadu, 641114, India
| | - S Viswanathan
- Department of Biotechnology, Karunya Institute of Technology and Sciences, Karunya Nagar, Coimbatore, Tamilnadu, 641114, India
| | - V M Berlin Grace
- Department of Biotechnology, Karunya Institute of Technology and Sciences, Karunya Nagar, Coimbatore, Tamilnadu, 641114, India.
| | - Lucia Bonati
- Biotechnology, ETH Zurich, Hebelstrasse, 17, 4056, Basel, Switzerland
| | - Jini Narayanan
- Department of Biotechnology, Sugarcane Breeding Institute, Coimbatore, Tamil Nadu, 641007, India
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Rabani R, Chan M, Gómez-Aristizábal A, Viswanathan S. Dual role of IL6 mediated by mesenchymal stromal cell signaling to joint macrophages in osteoarthritis. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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37
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Luo L, Sone E, Viswanathan S. Generating biomimetic mineralized collagen scaffolds for bone regeneration. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Robb K, Gómez-Aristizábal A, Gandhi R, Viswanathan S. Culture enhanced mesenchymal stromal cells with increased potency. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.532] [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: 11/26/2022]
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Waseem S, Audet J, Viswanathan S. Statistical modeling to optimize the manufacturing process of mesenchymal stromal cells. Osteoarthritis Cartilage 2019. [DOI: 10.1016/j.joca.2019.02.464] [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: 02/18/2023]
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Bayly A, Dear L, Brown D, Nankivell B, Viswanathan S. 53. Monoclonal gammopathies affecting the kidney. Pathology 2019. [DOI: 10.1016/j.pathol.2018.09.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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41
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Viswanathan S, Berlin Grace VM, Danisha JP. Enhancement of tumor suppressor RAR-β protein expression by cationic liposomal-ATRA treatment in benzo(a)pyrene-induced lung cancer mice model. Naunyn Schmiedebergs Arch Pharmacol 2018; 392:415-426. [DOI: 10.1007/s00210-018-01598-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 11/27/2018] [Indexed: 12/25/2022]
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42
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Pirlamarla A, Tang J, Ohri N, Berkowitz A, Mehta K, Viswanathan S, Kuo D, Kalnicki S. Post-Treatment Neutrophil-to-Lymphocyte Ratio (NLR) As a Predictor of Outcomes and Its Association with Incidental Splenic Radiation Therapy Dose in Locally Advanced Cervical Cancer (LACC). Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lohmann P, Kocher M, Ceccon G, Bauer EK, Stoffels G, Viswanathan S, Ruge MI, Neumaier B, Shah NJ, Fink GR, Langen K, Galldiks N. P05.11 Combined FET PET/MRI radiomics for the differentiation of radiation injury from recurrent brain metastasis. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.337] [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: 11/13/2022] Open
Affiliation(s)
- P Lohmann
- Inst. of Neuroscience and Medicine, Forschungszentrum Juelich, Juelich, Germany
- Dept. of Stereotaxy and Functional Neurosurgery, University of Cologne, Cologne, Germany
| | - M Kocher
- Inst. of Neuroscience and Medicine, Forschungszentrum Juelich, Juelich, Germany
- Dept. of Stereotaxy and Functional Neurosurgery, University of Cologne, Cologne, Germany
| | - G Ceccon
- Dept. of Neurology, University of Cologne, Cologne, Germany
| | - E K Bauer
- Dept. of Neurology, University of Cologne, Cologne, Germany
| | - G Stoffels
- Inst. of Neuroscience and Medicine, Forschungszentrum Juelich, Juelich, Germany
| | - S Viswanathan
- Inst. of Neuroscience and Medicine, Forschungszentrum Juelich, Juelich, Germany
| | - M I Ruge
- Dept. of Stereotaxy and Functional Neurosurgery, University of Cologne, Cologne, Germany
| | - B Neumaier
- Inst. of Neuroscience and Medicine, Forschungszentrum Juelich, Juelich, Germany
| | - N J Shah
- Inst. of Neuroscience and Medicine, Forschungszentrum Juelich, Juelich, Germany
- Dept. of Neurology, University Hospital RWTH Aachen, Aachen, Germany
| | - G R Fink
- Inst. of Neuroscience and Medicine, Forschungszentrum Juelich, Juelich, Germany
- Dept. of Neurology, University of Cologne, Cologne, Germany
| | - K Langen
- Inst. of Neuroscience and Medicine, Forschungszentrum Juelich, Juelich, Germany
- Dept. of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - N Galldiks
- Inst. of Neuroscience and Medicine, Forschungszentrum Juelich, Juelich, Germany
- Dept. of Neurology, University of Cologne, Cologne, Germany
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Viswanathan S. Efficacy and safety of Fingolimod therapy in multi-ethnic Malaysian patients with relapsing remitting multiple sclerosis: A longitudinal observational study. J Clin Neurosci 2018; 54:25-28. [DOI: 10.1016/j.jocn.2018.04.062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 04/22/2018] [Indexed: 10/28/2022]
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Viswanathan S, Berlin Grace V. Reduced RAR-β gene expression in Benzo(a)Pyrene induced lung cancer mice is upregulated by DOTAP lipo-ATRA treatment. Gene 2018; 668:18-26. [DOI: 10.1016/j.gene.2018.05.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 04/26/2018] [Accepted: 05/15/2018] [Indexed: 01/12/2023]
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Prabhakaran KK, George Koshy A, Iype M, Viswanathan S, Nini Gupta P, Sivaprasad K, Radhakrishnan VV. P4557Incidence, predictors, prognosis, management and outcomes of coronary perforation during chronic total occlusion (CTO) interventions-a single center study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | - M Iype
- Government Medical College, Trivandrum, India
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Viswanathan S, Rose N, Arip M, Chai CH, Law WC, Sim R, Ong MC. Multiple sclerosis and neuromyelitis optica spectrum disorders in Malaysia: A comparison in different ethnic groups. Mult Scler Relat Disord 2018; 25:300-308. [PMID: 30172173 DOI: 10.1016/j.msard.2018.07.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 05/30/2018] [Accepted: 07/01/2018] [Indexed: 02/08/2023]
Abstract
We performed a retrospective observational analytical study looking at the frequencies and characteristics of multiple sclerosis(MS) and neuromyelitis optica spectrum disorders(NMOSD) in consecutive patients with idiopathic inflammatory demyelinating disease (IIDDs) attending three centers (2009-2017). Of 523 patients with IIDDs, there were 173 patients with NMOSD and 230 patients with MS. The percentage of NMOSD: IIDDs was 33%. The percentage of NMOSD:Total MS and NMOSD cohort was 43%. Of 141 seropositive NMOSD patients, 134(95%) were from the three main ethnic groups. The percentage of seropositive NMOSD to IIDDs and to combined MS and NMOSD was 26.9% and 35% respectively. Ratios of MS to NMOSD were nearly equal at 1.3 to 1.0, reinforcing the high ratio of NMOSD to MS in Asia. Nearly half of the Chinese cohort were seropositive ie; 71/141 (50%) with the remainder being Malays; 56/141 (39.7%) and Indians; 7/141 (5%). Amongst the other indigenous groups seropositivity was seen in 2 each of Iban, Bajau, Kadazan descent as well as one of Bidayuh origin. Comparatively, seropositivity in NMOSD is commoner amongst the Chinese compared to the Malays (p ≤ 0.005) and Indians, p ≤ 0.05 with ratios as high as 10:1. In the MS group of 230 subjects, 123(53.5%) were Malays (ratio of MS:NMOSD of 2:1), 41(17.8%) were Chinese, (ratio of MS:NMOSD of 0.5:1.0) and 54 (23.5%)were Indians (ratios of MS:NMOSD of 5:1 amongst the Indians). The remainder from East Malaysia were made up of 2 each of Kadazans, Ibans and Bajaus including 3 each of Bidayuh and Eurasian descent. Comparatively, in the NMOSD and MS cohorts a female preponderance was noted more so amongst Chinese NMOSD patients, with rare familial occurrence in both but more in Malay MS/NMOSD patients. This study also highlighted some of the inter-ethnic differences in presentation of MS and NMOSD amongst the 3 main ethnic races in Malaysia and confirms indigenous races having MS/NMOSD which needs further research. It also reviewed current literature on similar inter-ethnic differences world wide. To conclude, MS and NMOSD are the commonest demyelinating diseases seen in Malaysia with interesting inter-ethnic differences and similarities.
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Affiliation(s)
- S Viswanathan
- Department of Neurology, Kuala Lumpur Hospital, Kuala Lumpur, Ministry of Health of Malaysia.
| | - N Rose
- Department of Radiology, Kuala Lumpur Hospital, Kuala Lumpur, Ministry of Health of Malaysia
| | - M Arip
- Department of Immunology, Medical Research Institute, Kuala Lumpur, Ministry of Health of Malaysia
| | - C H Chai
- Department of Neurology, Sarawak General Hospital, Kuching, Sarawak, Ministry of Health of Malaysia
| | - W C Law
- Department of Neurology, Sarawak General Hospital, Kuching, Sarawak, Ministry of Health of Malaysia
| | - R Sim
- Department of Neurology, Sarawak General Hospital, Kuching, Sarawak, Ministry of Health of Malaysia
| | - M C Ong
- Department of Medicine, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Ministry of Health of Malaysia
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Carol L, Tai MLS, Yusoff SM, Rose N, Rafia MH, Viswanathan S. Spinal cryptoccoma mimicking a spinal cord tumor complicated by cryptococcal meningitis in an immunocompetent patient. Neurol India 2018; 66:1181-1183. [PMID: 30038119 DOI: 10.4103/0028-3886.237012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Lai Carol
- Department of Neurology, Kuala Lumpur Hospital, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Mei-Ling Sharon Tai
- Division of Neurology, Department of Medicine, Faculty of Medicine, University Malaya, Jalan Universiti, Kuala Lumpur, Malaysia
| | - S M Yusoff
- Department of Pathology, Kuala Lumpur Hospital, Jalan Pahang, Kuala Lumpur, Malaysia
| | - N Rose
- Department of Radiology, Kuala Lumpur Hospital, Jalan Pahang, Kuala Lumpur, Malaysia
| | - M H Rafia
- Department of Neurology, Kuala Lumpur Hospital, Jalan Pahang, Kuala Lumpur, Malaysia
| | - S Viswanathan
- Department of Neurology, Kuala Lumpur Hospital, Jalan Pahang, Kuala Lumpur, Malaysia
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Turker L, Cardaci R, Rosenthal E, Viswanathan S, Van Arsdale A, Kuo D, Nevadunsky N, Goldberg G, Frimer M. Sexual dysfunction disparities in ethnically/racially diverse women with history of gynecologic malignancies. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.316] [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: 11/15/2022]
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Viswanathan S, Merheb R, Wen X, Collin M, Groh-Wargo S. Standardized slow enteral feeding protocol reduces necrotizing enterocolitis in micropremies. J Neonatal Perinatal Med 2018; 10:171-180. [PMID: 28409756 DOI: 10.3233/npm-171680] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Compared to early enteral feeds, delayed introduction and slow enteral feeding advancement to reduce necrotizing enterocolitis (NEC) is not well studied in micropremies (<750g birth weight). METHODS Pre-post case control study. Micropremies who followed a standardized slow enteral feeding (SSEF) protocol (September 2009 to March 2015) were compared with a similar group of historical controls (PreSSEF, January 2003 to July 2009). Enteral feeding withheld for first 10-14 days and advanced at <10 ml/kg/day in the SSEF group. RESULTS Ninety-two infants in the SSEF group were compared with 129 PreSSEF group. Birth weight and gestational age in SSEF and PreSSEF were similar. Breast milk initiation rate was higher in SSEF (87.0 vs. 72.0%, p = 0.01) compared to PreSSEF, but were similar at full enteral feeds. Compared with PreSSEF, feeding initiation day, full enteral feeding day, parenteral nutrition days, and total central line days were longer in SSEF. There was significant reduction in NEC (1.1 vs. 16.2%, p < 0.01), surgical NEC (0.0 vs. 7.8%, p < 0.01) and NEC/death (7.6 vs. 29.5%, p < 0.01), in SSEF compared to PreSSEF. SSEF, compared to PreSSEF, had more cholestasis (41.8 vs 28.8%, p = 0.04), higher peak serum alkaline phosphatase (638 vs. 534 IU/dL, p < 0.01), but similar rates of late-onset sepsis (39.1 vs 43.4%, p = 0.53). In infants who survived to discharge, SSEF had higher discharge weight, lower extra-uterine growth restriction, and similar length of stay, compared to PreSSEF. CONCLUSIONS A SSEF protocol significantly reduces the incidence of NEC and combined NEC/death in micropremies.
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Affiliation(s)
- S Viswanathan
- Division of Neonatology, Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, OH, USA
| | - R Merheb
- Division of Neonatology, Department of Pediatrics, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Xintong Wen
- Division of Neonatology, Department of Pediatrics, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - M Collin
- Division of Neonatology, Department of Pediatrics, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - S Groh-Wargo
- Division of Neonatology, Department of Pediatrics, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA
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