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Jose S, Geller G, Bollinger J, Mathews D, Kahn J, Garibaldi BT. The ethics of using COVID-19 host genomic information for clinical and public health decision-making: A survey of US health professionals. HGG Adv 2024; 5:100255. [PMID: 37978805 PMCID: PMC10746522 DOI: 10.1016/j.xhgg.2023.100255] [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: 07/12/2023] [Revised: 11/09/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023] Open
Abstract
Several genetic variants linked to COVID-19 have been identified by host genomics researchers. Further advances in this research will likely play a role in the clinical management and public health control of future infectious disease outbreaks. The implementation of genetic testing to identify host genomic risk factors associated with infectious diseases raises several ethical, legal, and social implications (ELSIs). As an important stakeholder group, health professionals can provide key insights into these ELSI issues. In 2021, a cross-sectional online survey was fielded to US health professionals. The survey explored how they view the value and ethical acceptability of using COVID-19 host genomic information in three main decision-making settings: (1) clinical, (2) public health, and (3) workforce. The survey also assessed participants' personal and professional experience with genomics and infectious diseases and collected key demographic data. A total of 603 participants completed the survey. A majority (84%) of participants agreed that it is ethically acceptable to use host genomics to make decisions about clinical care and 73% agreed that genetic screening has an important role to play in the public health control of COVID-19. However, more than 90% disagreed that it is ethically acceptable to use host genomics to deny resources or admission to individuals when hospital resources are scarce. Understanding stakeholder perspectives and anticipating ELSI issues will help inform policies for hospitals and public health departments to evaluate and perhaps adopt host genomic technologies in an ethically and socially responsible manner during future infectious disease outbreaks.
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Affiliation(s)
- Sheethal Jose
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Gail Geller
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Juli Bollinger
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Debra Mathews
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205, USA; Department of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Jeffrey Kahn
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Brian T Garibaldi
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
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Linder JE, Tao R, Chung WK, Kiryluk K, Liu C, Weng C, Connolly JJ, Hakonarson H, Harr M, Leppig KA, Jarvik GP, Veenstra DL, Aufox S, Chisholm RL, Gordon AS, Hoell C, Rasmussen-Torvik LJ, Smith ME, Holm IA, Miller EM, Prows CA, Elskeally O, Kullo IJ, Lee C, Jose S, Manolio TA, Rowley R, Padi-Adjirackor NA, Wilmayani NK, City B, Wei WQ, Wiesner GL, Rahm AK, Williams JL, Williams MS, Peterson JF. Prospective, multi-site study of healthcare utilization after actionable monogenic findings from clinical sequencing. Am J Hum Genet 2023; 110:1950-1958. [PMID: 37883979 PMCID: PMC10645563 DOI: 10.1016/j.ajhg.2023.10.006] [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: 07/05/2023] [Revised: 10/05/2023] [Accepted: 10/08/2023] [Indexed: 10/28/2023] Open
Abstract
As large-scale genomic screening becomes increasingly prevalent, understanding the influence of actionable results on healthcare utilization is key to estimating the potential long-term clinical impact. The eMERGE network sequenced individuals for actionable genes in multiple genetic conditions and returned results to individuals, providers, and the electronic health record. Differences in recommended health services (laboratory, imaging, and procedural testing) delivered within 12 months of return were compared among individuals with pathogenic or likely pathogenic (P/LP) findings to matched individuals with negative findings before and after return of results. Of 16,218 adults, 477 unselected individuals were found to have a monogenic risk for arrhythmia (n = 95), breast cancer (n = 96), cardiomyopathy (n = 95), colorectal cancer (n = 105), or familial hypercholesterolemia (n = 86). Individuals with P/LP results more frequently received services after return (43.8%) compared to before return (25.6%) of results and compared to individuals with negative findings (24.9%; p < 0.0001). The annual cost of qualifying healthcare services increased from an average of $162 before return to $343 after return of results among the P/LP group (p < 0.0001); differences in the negative group were non-significant. The mean difference-in-differences was $149 (p < 0.0001), which describes the increased cost within the P/LP group corrected for cost changes in the negative group. When stratified by individual conditions, significant cost differences were observed for arrhythmia, breast cancer, and cardiomyopathy. In conclusion, less than half of individuals received billed health services after monogenic return, which modestly increased healthcare costs for payors in the year following return.
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Affiliation(s)
- Jodell E Linder
- Vanderbilt University Medical Center, Nashville, TN 37203, USA.
| | - Ran Tao
- Vanderbilt University Medical Center, Nashville, TN 37203, USA
| | | | | | - Cong Liu
- Columbia University, New York, NY 10032, USA
| | | | - John J Connolly
- Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Hakon Hakonarson
- Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Margaret Harr
- Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Kathleen A Leppig
- Genetic Services, Kaiser Permanente of Washington, Seattle, WA 98195, USA
| | - Gail P Jarvik
- University of Washington Medical Center, Departments of Medicine (Medical Genetics) and Genome Sciences, Seattle, WA 98195, USA
| | - David L Veenstra
- University of Washington, Department of Pharmacy, Seattle, WA 98195, USA
| | - Sharon Aufox
- Northwestern University, Center for Genetic Medicine, Chicago, IL 60611, USA
| | - Rex L Chisholm
- Northwestern University, Center for Genetic Medicine, Chicago, IL 60611, USA
| | - Adam S Gordon
- Northwestern University, Center for Genetic Medicine, Chicago, IL 60611, USA
| | - Christin Hoell
- Northwestern University, Center for Genetic Medicine, Chicago, IL 60611, USA
| | | | - Maureen E Smith
- Northwestern University, Center for Genetic Medicine, Chicago, IL 60611, USA
| | | | - Erin M Miller
- Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH, USA
| | - Cynthia A Prows
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | | | | | | | - Sheethal Jose
- National Human Genome Research Institute, Bethesda, MD 20892, USA
| | - Teri A Manolio
- National Human Genome Research Institute, Bethesda, MD 20892, USA
| | - Robb Rowley
- National Human Genome Research Institute, Bethesda, MD 20892, USA
| | | | | | - Brittany City
- Vanderbilt University Medical Center, Nashville, TN 37203, USA
| | - Wei-Qi Wei
- Vanderbilt University Medical Center, Nashville, TN 37203, USA
| | | | | | - Janet L Williams
- Department of Genomic Health, Geisinger, Danville, PA 17822, USA
| | - Marc S Williams
- Department of Genomic Health, Geisinger, Danville, PA 17822, USA
| | - Josh F Peterson
- Vanderbilt University Medical Center, Nashville, TN 37203, USA
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Huber A, Jose S, Kassam A, Weghorn KN, Powers-Fletcher M, Sharma D, Mukherjee A, Mathew A, Kulkarni N, Chandramouli S, Alder MN, Madan R. Olfactomedin-4 + neutrophils exacerbate intestinal epithelial damage and worsen host survival after Clostridioides difficile infection. bioRxiv 2023:2023.08.21.553751. [PMID: 37662327 PMCID: PMC10473617 DOI: 10.1101/2023.08.21.553751] [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] [Indexed: 09/05/2023]
Abstract
Neutrophils are key first responders to Clostridioides difficile infection (CDI). Excessive tissue and blood neutrophils are associated with worse histopathology and adverse outcomes, however their functional role during CDI remains poorly defined. Utilizing intestinal epithelial cell (IEC)-neutrophil co-cultures and a pre-clinical animal model of CDI, we show that neutrophils exacerbate C. difficile -induced IEC injury. We utilized cutting-edge single-cell transcriptomics to illuminate neutrophil subtypes and biological pathways that could exacerbate CDI-associated IEC damage. As such, we have established the first transcriptomics atlas of bone marrow (BM), blood, and colonic neutrophils after CDI. We found that CDI altered the developmental trajectory of BM and blood neutrophils towards populations that exhibit gene signatures associated with pro-inflammatory responses and neutrophil-mediated tissue damage. Similarly, the transcriptomic signature of colonic neutrophils was consistent with hyper-inflammatory and highly differentiated cells that had amplified expression of cytokine-mediated signaling and degranulation priming genes. One of the top 10 variable features in colonic neutrophils was the gene for neutrophil glycoprotein, Olfactomedin 4 (OLFM4). CDI enhanced OLFM4 mRNA and protein expression in neutrophils, and OLFM4 + cells aggregated to areas of severe IEC damage. Compared to uninfected controls, both humans and mice with CDI had higher concentrations of circulating OLFM4; and in mice, OLFM4 deficiency resulted in faster recovery and better survival after infection. Collectively, these studies provide novel insights into neutrophil-mediated pathology after CDI and highlight the pathogenic role of OLFM4 + neutrophils in regulating CDI-induced IEC damage. One Sentence Summary Utilizing single-cell transcriptomics, IEC-epithelial co-cultures, and pre-clinical models of CDI, we have identified a subset of neutrophils that are marked by OLFM4 expression as pathogenic determinants of IEC barrier damage after CDI.
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Paul S, Jose S, Hori S, Krishna A. 1331P Regional variation in early diagnosis, multimorbidity and death in English males and females of different ethnicity with incident lung cancer from 2014-2019. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1464] [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] Open
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Jose S, Vishal V, AT R, Cardoza F, KM D. 091 Novel Indices for the Evaluation of Obesity in patients with Erectile Dysfunction. J Sex Med 2021. [DOI: 10.1016/j.jsxm.2021.01.061] [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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Jose S, AT R, Jithin A, Cardoza F, KM D. 087 Study on the prevalence of Sleep Disorders in patients with Erectile Dysfunction. J Sex Med 2021. [DOI: 10.1016/j.jsxm.2021.01.057] [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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Wernery U, Kinne J, Jose S, Gupta AD, Taha A, Ismail AA, Joseph M, Nagy P, Juhasz J. ‘Alpaca Fever’ in Dromedary Camel Calves–A Case Report. J CAMEL PRACT RES 2021. [DOI: 10.5958/2277-8934.2021.00045.x] [Citation(s) in RCA: 1] [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: 10/19/2022]
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9
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Al-Maashani M, Al-Balushi N, Al-Alawi M, Mirza H, Al-Huseini S, Al-Balushi M, Obeid Y, Jose S, Al-Sibani N, Al-Adawi S. Prevalence and Correlates of Depressive Symptoms among Medical Students: a Cross-sectional Single-centre Study. East Asian Arch Psychiatry 2020; 30:28-31. [PMID: 32229644 DOI: 10.12809/eaap1882] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Depressive symptoms are common among medical students. The aim of the present study was to determine the prevalence and risk factors of depressive symptoms among medical students in Sultan Qaboos University in Oman. METHOD A cross-sectional study was conducted among a random sample selected from 1041 medical students at Sultan Qaboos University, Oman. The Patient Health Questionnaire-9 (PHQ-9) was used to screen for depressive symptoms. A logistic regression model was used to determine risk factors for depressive symptoms. RESULTS Of 197 medical students selected, 189 (61 men and 128 women) responded. The PHQ-9 results showed that the prevalence of depressive symptoms was 41.3%. In multivariate analysis, female students were more likely than male students to develop depression (adjusted odds ratio = 2.866, p = 0.004). Medical students with a family history of depression were more likely to develop depression than those without a family history of depression (adjusted odds ratio = 4.150, p = 0.014). CONCLUSIONS Depressive symptoms are common among medical students in Sultan Qaboos University. Risk factors for depressive symptoms are female sex and family history of depression.
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Affiliation(s)
- M Al-Maashani
- Psychiatry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | - N Al-Balushi
- Psychiatry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | - M Al-Alawi
- Psychiatry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - H Mirza
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - S Al-Huseini
- Psychiatry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | - M Al-Balushi
- Psychiatry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | - Y Obeid
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - S Jose
- Research and Statistics, Oman Medical Specialty Board, Muscat, Oman
| | - N Al-Sibani
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - S Al-Adawi
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
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Wernery U, Schuster RK, Kinne J, Jose S. Lumpy jaw and wooden tongue in an adult dromedary camel: Case report. J CAMEL PRACT RES 2020. [DOI: 10.5958/2277-8934.2020.00048.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Zouk H, Venner E, Lennon NJ, Muzny DM, Abrams D, Adunyah S, Albertson-Junkans L, Ames DC, Appelbaum P, Aronson S, Aufox S, Babb LJ, Balasubramanian A, Bangash H, Basford M, Bastarache L, Baxter S, Behr M, Benoit B, Bhoj E, Bielinski SJ, Bland HT, Blout C, Borthwick K, Bottinger EP, Bowser M, Brand H, Brilliant M, Brodeur W, Caraballo P, Carrell D, Carroll A, Almoguera B, Castillo L, Castro V, Chandanavelli G, Chiang T, Chisholm RL, Christensen KD, Chung W, Chute CG, City B, Cobb BL, Connolly JJ, Crane P, Crew K, Crosslin D, De Andrade M, De la Cruz J, Denson S, Denny J, DeSmet T, Dikilitas O, Friedrich C, Fullerton SM, Funke B, Gabriel S, Gainer V, Gharavi A, Glazer AM, Glessner JT, Goehringer J, Gordon AS, Graham C, Green RC, Gundelach JH, Dayal J, Hain HS, Hakonarson H, Harden MV, Harley J, Harr M, Hartzler A, Hayes MG, Hebbring S, Henrikson N, Hershey A, Hoell C, Holm I, Howell KM, Hripcsak G, Hu J, Jarvik GP, Jayaseelan JC, Jiang Y, Joo YY, Jose S, Josyula NS, Justice AE, Kalla SE, Kalra D, Karlson E, Kelly MA, Keating BJ, Kenny EE, Key D, Kiryluk K, Kitchner T, Klanderman B, Klee E, Kochan DC, Korchina V, Kottyan L, Kovar C, Kudalkar E, Kullo IJ, Lammers P, Larson EB, Lebo MS, Leduc M, Lee MT(M, Leppig KA, Leslie ND, Li R, Liang WH, Lin CF, Linder J, Lindor NM, Lingren T, Linneman JG, Liu C, Liu W, Liu X, Lynch J, Lyon H, Macbeth A, Mahadeshwar H, Mahanta L, Malin B, Manolio T, Marasa M, Marsolo K, Dinsmore MJ, Dodge S, Hynes ED, Dunlea P, Edwards TL, Eng CM, Fasel D, Fedotov A, Feng Q, Fleharty M, Foster A, Freimuth R, McGowan ML, McNally E, Meldrim J, Mentch F, Mosley J, Mukherjee S, Mullen TE, Muniz J, Murdock DR, Murphy S, Murugan M, Myers MF, Namjou B, Ni Y, Obeng AO, Onofrio RC, Taylor CO, Person TN, Peterson JF, Petukhova L, Pisieczko CJ, Pratap S, Prows CA, Puckelwartz MJ, Rahm AK, Raj R, Ralston JD, Ramaprasan A, Ramirez A, Rasmussen L, Rasmussen-Torvik L, Rasouly HM, Raychaudhuri S, Ritchie MD, Rives C, Riza B, Roden D, Rosenthal EA, Santani A, Schaid D, Scherer S, Scott S, Scrol A, Sengupta S, Shang N, Sharma H, Sharp RR, Singh R, Sleiman PM, Slowik K, Smith JC, Smith ME, Smoller JW, Sohn S, Stanaway IB, Starren J, Stroud M, Su J, Tolwinski K, Van Driest SL, Vargas SM, Varugheese M, Veenstra D, Verbitsky M, Vicente G, Wagner M, Walker K, Walunas T, Wang L, Wang Q, Wei WQ, Weiss ST, Wiesner GL, Wells Q, Weng C, White PS, Wiley KL, Williams JL, Williams MS, Wilson MW, Witkowski L, Woods LA, Woolf B, Wu TJ, Wynn J, Yang Y, Yi V, Zhang G, Zhang L, Rehm HL, Gibbs RA. Harmonizing Clinical Sequencing and Interpretation for the eMERGE III Network. Am J Hum Genet 2019; 105:588-605. [PMID: 31447099 PMCID: PMC6731372 DOI: 10.1016/j.ajhg.2019.07.018] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 07/26/2019] [Indexed: 12/25/2022] Open
Abstract
The advancement of precision medicine requires new methods to coordinate and deliver genetic data from heterogeneous sources to physicians and patients. The eMERGE III Network enrolled >25,000 participants from biobank and prospective cohorts of predominantly healthy individuals for clinical genetic testing to determine clinically actionable findings. The network developed protocols linking together the 11 participant collection sites and 2 clinical genetic testing laboratories. DNA capture panels targeting 109 genes were used for testing of DNA and sample collection, data generation, interpretation, reporting, delivery, and storage were each harmonized. A compliant and secure network enabled ongoing review and reconciliation of clinical interpretations, while maintaining communication and data sharing between clinicians and investigators. A total of 202 individuals had positive diagnostic findings relevant to the indication for testing and 1,294 had additional/secondary findings of medical significance deemed to be returnable, establishing data return rates for other testing endeavors. This study accomplished integration of structured genomic results into multiple electronic health record (EHR) systems, setting the stage for clinical decision support to enable genomic medicine. Further, the established processes enable different sequencing sites to harmonize technical and interpretive aspects of sequencing tests, a critical achievement toward global standardization of genomic testing. The eMERGE protocols and tools are available for widespread dissemination.
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Bhatt K, Cherian S, Agarwal R, Jose S, Cherian KM. Perioperative Management of Sickle Cell Disease in Paediatric Cardiac Surgery. Anaesth Intensive Care 2019; 35:792-5. [DOI: 10.1177/0310057x0703500524] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In sickle cell disease, cardiopulmonary bypass may induce red cell sickling. Partial exchange transfusion reduces the circulating haemoglobin S level. We report the management of a child with sickle cell disease who required surgical closure of a ventricular septal defect. Preoperative exchange transfusion of 50% of the total blood volume was performed with fresh packed red cells over three days. Further exchange transfusion was performed as cardiopulmonary bypass commenced. The haemoglobin S level was reduced from 76% to 37%. The blood removed from the patient during the exchanges was processed allowing storage and re-infusion of the patient's plasma and platelets. Combined preoperative and intraoperative exchange transfusions, instead of a single stage 50% volume exchange, was effective and potentially avoids larger haemodynamic effects. Cardiopulmonary bypass was conducted at normothermia and cold cardioplegia was avoided (fibrillatory arrest was used during the surgical repair).
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Affiliation(s)
- K. Bhatt
- Departments of Cardiac Anaesthesiology and Critical Care Medicine, Frontier Lifeline, Chennai, India
- Department of Cardiac Anaesthesiology
| | - S. Cherian
- Departments of Cardiac Anaesthesiology and Critical Care Medicine, Frontier Lifeline, Chennai, India
- Department of Cardiac Surgery
| | - R. Agarwal
- Departments of Cardiac Anaesthesiology and Critical Care Medicine, Frontier Lifeline, Chennai, India
- Department of Cardiac Surgery
| | - S. Jose
- Departments of Cardiac Anaesthesiology and Critical Care Medicine, Frontier Lifeline, Chennai, India
- Department of Perfusion Technology
| | - K. M. Cherian
- Departments of Cardiac Anaesthesiology and Critical Care Medicine, Frontier Lifeline, Chennai, India
- Chairman and CEO, Chief Cardiac Surgeon, Frontier Lifeline
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Juhasz J, Jose S, Kinne J, Johnson B, Raja S, Maio E, Alkhatib R, Premasuthan A, Felde O, Gyuranecz M, Nagy P, Barua R, Wernery U. Brucella melitensis caused abortion in a serologically positive dromedary camel. J CAMEL PRACT RES 2019. [DOI: 10.5958/2277-8934.2019.00001.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kullo IJ, Olson J, Fan X, Jose M, Safarova M, Radecki Breitkopf C, Winkler E, Kochan DC, Snipes S, Pacyna JE, Carney M, Chute CG, Gupta J, Jose S, Venner E, Murugan M, Jiang Y, Zordok M, Farwati M, Philogene M, Smith E, Shaibi GQ, Caraballo P, Freimuth R, Lindor NM, Sharp R, Thibodeau SN. The Return of Actionable Variants Empirical (RAVE) Study, a Mayo Clinic Genomic Medicine Implementation Study: Design and Initial Results. Mayo Clin Proc 2018; 93:1600-1610. [PMID: 30392543 PMCID: PMC6652203 DOI: 10.1016/j.mayocp.2018.06.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 05/04/2018] [Accepted: 06/08/2018] [Indexed: 12/02/2022]
Abstract
OBJECTIVES To identify clinically actionable genetic variants from targeted sequencing of 68 disease-related genes, estimate their penetrance, and assess the impact of disclosing results to participants and providers. PATIENTS AND METHODS The Return of Actionable Variants Empirical (RAVE) Study investigates outcomes following the return of pathogenic/likely pathogenic (P/LP) variants in 68 disease-related genes. The study was initiated in December 2016 and is ongoing. Targeted sequencing was performed in 2533 individuals with hyperlipidemia or colon polyps. The electronic health records (EHRs) of participants carrying P/LP variants in 36 cardiovascular disease (CVD) genes were manually reviewed to ascertain the presence of relevant traits. Clinical outcomes, health care utilization, family communication, and ethical and psychosocial implications of disclosure of genomic results are being assessed by surveys, telephone interviews, and EHR review. RESULTS Of 29,208 variants in the 68 genes, 1915 were rare (frequency <1%) and putatively functional, and 102 of these (60 in 36 CVD genes) were labeled P/LP based on the American College of Medical Genetics and Genomics framework. Manual review of the EHRs of participants (n=73 with P/LP variants in CVD genes) revealed that 33 had the expected trait(s); however, only 6 of 45 participants with non-familial hypercholesterolemia (FH) P/LP variants had the expected traits. CONCLUSION Expected traits were present in 13% of participants with P/LP variants in non-FH CVD genes, suggesting low penetrance; this estimate may change with additional testing performed as part of the clinical evaluation. Ongoing analyses of the RAVE Study will inform best practices for genomic medicine.
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Affiliation(s)
- Iftikhar J Kullo
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.
| | - Janet Olson
- Department of Health Sciences Research, Biomedical Ethics Program, Mayo Clinic, Rochester, MN
| | - Xiao Fan
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Merin Jose
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Maya Safarova
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | | | - Erin Winkler
- Center for Individualized Medicine-Genomics, Mayo Clinic, Rochester, MN
| | - David C Kochan
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Sara Snipes
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Joel E Pacyna
- Department of Health Sciences Research, Biomedical Ethics Program, Mayo Clinic, Rochester, MN
| | - Meaghan Carney
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Christopher G Chute
- Johns Hopkins University, Schools of Medicine, Public Health and Nursing, Baltimore, MD
| | - Jyoti Gupta
- National Human Genome Research Institute, Bethesda, MD
| | - Sheethal Jose
- National Human Genome Research Institute, Bethesda, MD
| | - Eric Venner
- Baylor College of Medicine Human Genome Sequencing Center, Houston, TX
| | - Mullai Murugan
- Baylor College of Medicine Human Genome Sequencing Center, Houston, TX
| | - Yunyun Jiang
- Baylor College of Medicine Human Genome Sequencing Center, Houston, TX
| | - Magdi Zordok
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Medhat Farwati
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | | | - Erica Smith
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Gabriel Q Shaibi
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, AZ
| | | | - Robert Freimuth
- Department of Health Sciences Research, Biomedical Ethics Program, Mayo Clinic, Rochester, MN
| | | | - Richard Sharp
- Department of Health Sciences Research, Biomedical Ethics Program, Mayo Clinic, Rochester, MN
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Gompels M, Michael S, Jose S, Hill T, Trevelion R, Sabin CA, May MT. The use of funnel plots with regression as a tool to visually compare HIV treatment outcomes between centres adjusting for patient characteristics and size: a UK Collaborative HIV Cohort study. HIV Med 2018; 19:386-394. [PMID: 29656588 PMCID: PMC6032937 DOI: 10.1111/hiv.12604] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2018] [Indexed: 11/30/2022]
Abstract
Objectives A measure used for assessing the effectiveness of HIV care and comparing clinical centres is the proportion of people starting antiretroviral therapy (ART) with viral suppression (VS) after 1 year. We propose a method that adjusts for patients’ demographic characteristics, and visually compares this measure between different sites accounting for centre size. Methods We analysed viral load measurements for UK Collaborative HIV Cohort (UK CHIC) patients starting ART between 2006 and 2013. We used logistic regression to estimate the proportion with VS after 1 year of ART adjusted for patient mix (in terms of age and a combined gender/ethnicity/acquisition mode variable) and calendar year. We compared outcomes between centres using funnel plots which account for centre size. Results The overall proportion of the cohort with VS 1 year after starting ART was 90% and increased from 83% to 93% between 2006 and 2013. VS was lower in younger individuals. White men who have sex with men (MSM) had the highest (94%), and black African (81%) and white (82%) heterosexual women the lowest proportions achieving VS. Comparing the unadjusted funnel plot with the adjusted, there were movements of some centres from outside to inside the 95% contour limits, which was largely explained by the patient mix of these centres. Conclusions VS 1 year after ART start was associated with demographic characteristics and centre size; therefore, to compare the performances of centres, adjustment for these factors is required. Adjusted funnel plot is an effective tool which accounts for both the demographic characteristics and the centre size. Social factors, rather than treatment decisions within the control of the centres, may drive differences in outcomes.
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Affiliation(s)
- M Gompels
- Southmead Hospital, North Bristol NHS Trust, Department of Immunology, Bristol, UK
| | - S Michael
- School of Mathematics, University of Bristol, Bristol, UK
| | - S Jose
- Research Department of Infection and Population Health, Institute for Global Health, University College London, London, UK.,National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Blood Borne and Sexually Transmitted Infections at University College London, London, UK
| | - T Hill
- Research Department of Infection and Population Health, Institute for Global Health, University College London, London, UK.,National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Blood Borne and Sexually Transmitted Infections at University College London, London, UK
| | | | - C A Sabin
- Research Department of Infection and Population Health, Institute for Global Health, University College London, London, UK.,National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Blood Borne and Sexually Transmitted Infections at University College London, London, UK
| | - M T May
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,National Institute of Health Research (NIHR) Health Protection Research Unit (HPRU) in Evaluation of Interventions at University of Bristol, Bristol, UK
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Stremska ME, Jose S, Sabapathy V, Huang L, Bajwa A, Kinsey GR, Sharma PR, Mohammad S, Rosin DL, Okusa MD, Sharma R. IL233, A Novel IL-2 and IL-33 Hybrid Cytokine, Ameliorates Renal Injury. J Am Soc Nephrol 2017; 28:2681-2693. [PMID: 28539382 DOI: 10.1681/asn.2016121272] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [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: 12/01/2016] [Accepted: 04/07/2017] [Indexed: 12/17/2022] Open
Abstract
CD4+Foxp3+ regulatory T cells (Tregs) protect the kidney during AKI. We previously found that IL-2, which is critical for Treg homeostasis, upregulates the IL-33 receptor (ST2) on CD4+ T cells, thus we hypothesized that IL-2 and IL-33 cooperate to enhance Treg function. We found that a major subset of Tregs in mice express ST2, and coinjection of IL-2 and IL-33 increased the number of Tregs in lymphoid organs and protected mice from ischemia-reperfusion injury (IRI) more efficiently than either cytokine alone. Accordingly, we generated a novel hybrid cytokine (IL233) bearing the activities of IL-2 and IL-33 for efficient targeting to Tregs. IL233 treatment increased the number of Tregs in blood and spleen and prevented IRI more efficiently than a mixture of IL-2 and IL-33. Injection of IL233 also increased the numbers of Tregs in renal compartments. Moreover, IL233-treated mice had fewer splenic Tregs and more Tregs in kidneys after IRI. In vitro, splenic Tregs from IL233-treated mice suppressed CD4+ T cell proliferation better than Tregs from saline-treated controls. IL233 treatment also improved the ability of isolated Tregs to inhibit IRI in adoptive transfer experiments and protected mice from cisplatin- and doxorubicin-induced nephrotoxic injury. Finally, treatment with IL233 increased the proportion of ST2-bearing innate lymphoid cells (ILC2) in blood and kidneys, and adoptive transfer of ILC2 also protected mice from IRI. Thus, the novel IL233 hybrid cytokine, which utilizes the cooperation of IL-2 and IL-33 to enhance Treg- and ILC2-mediated protection from AKI, bears strong therapeutic potential.
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Affiliation(s)
- Marta E Stremska
- Division of Nephrology and Center for Immunity, Inflammation and Regenerative Medicine, Department of Medicine, and.,Departments of Pharmacology.,Microbiology, Immunology and Cancer Biology, and
| | - Sheethal Jose
- Division of Nephrology and Center for Immunity, Inflammation and Regenerative Medicine, Department of Medicine, and
| | - Vikram Sabapathy
- Division of Nephrology and Center for Immunity, Inflammation and Regenerative Medicine, Department of Medicine, and
| | - Liping Huang
- Division of Nephrology and Center for Immunity, Inflammation and Regenerative Medicine, Department of Medicine, and
| | - Amandeep Bajwa
- Division of Nephrology and Center for Immunity, Inflammation and Regenerative Medicine, Department of Medicine, and
| | - Gilbert R Kinsey
- Division of Nephrology and Center for Immunity, Inflammation and Regenerative Medicine, Department of Medicine, and
| | - Poonam R Sharma
- Biomedical Engineering, University of Virginia, Charlottesville, Virginia
| | - Saleh Mohammad
- Division of Nephrology and Center for Immunity, Inflammation and Regenerative Medicine, Department of Medicine, and
| | | | - Mark D Okusa
- Division of Nephrology and Center for Immunity, Inflammation and Regenerative Medicine, Department of Medicine, and
| | - Rahul Sharma
- Division of Nephrology and Center for Immunity, Inflammation and Regenerative Medicine, Department of Medicine, and
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Patterson S, Jose S, Samji H, Cescon A, Ding E, Zhu J, Anderson J, Burchell AN, Cooper C, Hill T, Hull M, Klein MB, Loutfy M, Martin F, Machouf N, Montaner J, Nelson M, Raboud J, Rourke SB, Tsoukas C, Hogg RS, Sabin C. A tale of two countries: all-cause mortality among people living with HIV and receiving combination antiretroviral therapy in the UK and Canada. HIV Med 2017; 18:655-666. [PMID: 28440036 PMCID: PMC5600099 DOI: 10.1111/hiv.12505] [Citation(s) in RCA: 2] [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] [Accepted: 01/17/2017] [Indexed: 01/13/2023]
Abstract
Objectives We sought to compare all‐cause mortality of people living with HIV and accessing care in Canada and the UK. Methods Individuals from the Canadian Observational Cohort (CANOC) collaboration and UK Collaborative HIV Cohort (UK CHIC) study who were aged ≥ 18 years, had initiated antiretroviral therapy (ART) for the first time between 2000 and 2012 and who had acquired HIV through sexual transmission were included in the analysis. Cox regression was used to investigate the difference in mortality risk between the two cohort collaborations, accounting for loss to follow‐up as a competing risk. Results A total of 19 960 participants were included in the analysis (CANOC, 4137; UK CHIC, 15 823). CANOC participants were more likely to be older [median age 39 years (interquartile range (IQR): 33, 46 years) vs. 36 years (IQR: 31, 43 years) for UK CHIC participants], to be male (86 vs. 73%, respectively), and to report men who have sex with men (MSM) sexual transmission risk (72 vs. 56%, respectively) (all P < 0.001). Overall, 762 deaths occurred during 98 798 person‐years (PY) of follow‐up, giving a crude mortality rate of 7.7 per 1000 PY [95% confidence interval (CI): 7.1, 8.3 per 1000 PY]. The crude mortality rates were 8.6 (95% CI: 7.4, 10.0) and 7.5 (95% CI: 6.9, 8.1) per 1000 PY among CANOC and UK CHIC study participants, respectively. No statistically significant difference in mortality risk was observed between the cohort collaborations in Cox regression accounting for loss to follow‐up as a competing risk (adjusted hazard ratio 0.86; 95% CI: 0.72–1.03). Conclusions Despite differences in national HIV care provision and treatment guidelines, mortality risk did not differ between CANOC and UK CHIC study participants who acquired HIV through sexual transmission.
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Affiliation(s)
- S Patterson
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - S Jose
- Research Department of Infection and Population Health, University College London, London, UK
| | - H Samji
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.,British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - A Cescon
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.,Northern Ontario School of Medicine, Sudbury, ON, Canada
| | - E Ding
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - J Zhu
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - J Anderson
- Homerton University Hospital NHS Trust, London, UK
| | - A N Burchell
- Department of Family and Community Medicine, St Michael's Hospital, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - C Cooper
- The Ottawa Hospital Division of Infectious Diseases, University of Ottawa, Ottawa, ON, Canada
| | - T Hill
- Research Department of Infection and Population Health, University College London, London, UK
| | - M Hull
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - M B Klein
- Faculty of Medicine, McGill University, Montreal, QC, Canada.,The Montreal Chest Institute, McGill University Health Centre, Montreal, QC, Canada
| | - M Loutfy
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Maple Leaf Medical Clinic, Toronto, ON, Canada.,Women's College Research Institute, Toronto, ON, Canada
| | - F Martin
- York Teaching Hospital NHS Foundation Trust, York, UK
| | - N Machouf
- Clinique Medicale l'Actuel, Montreal, QC, Canada
| | - Jsg Montaner
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - M Nelson
- Chelsea and Westminster Hospital NHS Trust, London, UK
| | - J Raboud
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Toronto General Research Institute, University Health Network, Toronto, ON, Canada
| | - S B Rourke
- Ontario HIV Treatment Network, Toronto, ON, Canada
| | - C Tsoukas
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - R S Hogg
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - C Sabin
- Research Department of Infection and Population Health, University College London, London, UK
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Howarth AR, Burns FM, Apea V, Jose S, Hill T, Delpech VC, Evans A, Mercer CH, Michie S, Morris S, Sachikonye M, Sabin C. Development and application of a new measure of engagement in out-patient HIV care. HIV Med 2017; 18:267-274. [PMID: 27535219 PMCID: PMC5347876 DOI: 10.1111/hiv.12427] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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] [Accepted: 05/23/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Commonly used measures of engagement in HIV care do not take into account that the frequency of attendance is related to changes in treatment and health status. This study developed a new measure of engagement in care (EIC) incorporating clinical factors. METHODS We conducted semi-structured interviews with eight HIV physicians to identify factors associated with the timing of patients' next scheduled appointments. These factors informed the development of an algorithm to classify each month of follow-up as "in care" (on or before the time of the next expected attendance) or "out of care" (after the time of the next expected attendance). The EIC algorithm was applied to data from the UK Collaborative HIV Cohort (UK CHIC) study, a large clinical cohort study. RESULTS The interviews indicated that time to next appointment varied depending on psychosocial and physical comorbidities, and clinical factors (time since diagnosis, AIDS diagnosis, treatment status, CD4 count and viral load). The resulting EIC algorithm was applied to 44 432 patients; 83.9% of the 3 021 224 person-months were "in care". Greater EIC was independently associated with older age, white ethnicity, HIV acquisition through sex between men, current use of antiretroviral therapy (ART), a higher nadir CD4 count, later calendar year and being seen at the clinic for the first time within the last year. CONCLUSIONS This algorithm describing engagement in HIV care incorporates a time-updated measure of patients' treatment and health status. It adds to the options available for measuring this key performance indicator.
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Affiliation(s)
- AR Howarth
- Research Department of Infection and Population HealthUniversity College LondonLondonUK
| | - FM Burns
- Research Department of Infection and Population HealthUniversity College LondonLondonUK
- Royal Free London NHS Foundation TrustLondonUK
| | - V Apea
- Barts Health NHS TrustLondonUK
| | - S Jose
- Research Department of Infection and Population HealthUniversity College LondonLondonUK
| | - T Hill
- Research Department of Infection and Population HealthUniversity College LondonLondonUK
| | | | - A Evans
- Royal Free London NHS Foundation TrustLondonUK
| | - CH Mercer
- Research Department of Infection and Population HealthUniversity College LondonLondonUK
| | - S Michie
- Centre for Behaviour ChangeUniversity College LondonLondonUK
| | - S Morris
- Department of Applied Health ResearchUniversity College LondonLondonUK
| | | | - C Sabin
- Research Department of Infection and Population HealthUniversity College LondonLondonUK
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Hamzah L, Jose S, Booth JW, Hegazi A, Rayment M, Bailey A, Williams DI, Hendry BM, Hay P, Jones R, Levy JB, Chadwick DR, Johnson M, Sabin CA, Post FA. Treatment-limiting renal tubulopathy in patients treated with tenofovir disoproxil fumarate. J Infect 2017; 74:492-500. [PMID: 28130143 DOI: 10.1016/j.jinf.2017.01.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [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: 08/22/2016] [Revised: 10/07/2016] [Accepted: 01/17/2017] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Tenofovir disoproxil fumarate (TDF) is widely used in the treatment or prevention of HIV and hepatitis B infection. TDF may cause renal tubulopathy in a small proportion of recipients. We aimed to study the risk factors for developing severe renal tubulopathy. METHODS We conducted an observational cohort study with retrospective identification of cases of treatment-limiting tubulopathy during TDF exposure. We used multivariate Poisson regression analysis to identify risk factors for tubulopathy, and mixed effects models to analyse adjusted estimated glomerular filtration rate (eGFR) slopes. RESULTS Between October 2002 and June 2013, 60 (0.4%) of 15,983 patients who had received TDF developed tubulopathy after a median exposure of 44.1 (IQR 20.4, 64.4) months. Tubulopathy cases were predominantly male (92%), of white ethnicity (93%), and exposed to antiretroviral regimens that contained boosted protease inhibitors (PI, 90%). In multivariate analysis, age, ethnicity, CD4 cell count and use of didanosine or PI were significantly associated with tubulopathy. Tubulopathy cases experienced significantly greater eGFR decline while receiving TDF than the comparator group (-6.60 [-7.70, -5.50] vs. -0.34 [-0.43, -0.26] mL/min/1.73 m2/year, p < 0.0001). CONCLUSIONS Older age, white ethnicity, immunodeficiency and co-administration of ddI and PI were risk factors for tubulopathy in patients who received TDF-containing antiretroviral therapy. The presence of rapid eGFR decline identified TDF recipients at increased risk of tubulopathy.
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Affiliation(s)
- L Hamzah
- Kings College Hospital NHS Foundation Trust, London, UK; King's College London, London, UK.
| | - S Jose
- University College London, London, UK
| | - J W Booth
- Royal Free Hospital NHS Foundation Trust, London, UK
| | - A Hegazi
- St George's Healthcare NHS Trust, London, UK
| | - M Rayment
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - A Bailey
- Imperial College Healthcare NHS Trust, London, UK
| | - D I Williams
- Brighton and Sussex University Hospitals, Brighton, UK
| | | | - P Hay
- St George's Healthcare NHS Trust, London, UK
| | - R Jones
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - J B Levy
- Imperial College Healthcare NHS Trust, London, UK
| | - D R Chadwick
- South Tees Hospital NHS Foundation Trust, Middlesbrough, UK
| | - M Johnson
- Royal Free Hospital NHS Foundation Trust, London, UK
| | - C A Sabin
- University College London, London, UK
| | - F A Post
- Kings College Hospital NHS Foundation Trust, London, UK
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Jose S, Odetto D, Noll F, Saraniti G, Perrotta M. Infrarenal Minimally Invasive Para-Aortic Lymphadenectomy in Gynecologic Cancer. A Report of the First 100 Cases in Argentina. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.555] [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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Marfatia YS, Menon DS, Jose S, Patel BK. Nonhealing genital ulcer in AIDS: A diagnostic dilemma! Indian J Sex Transm Dis AIDS 2016. [PMID: 27890958 PMCID: PMC5111309 DOI: 10.4103/2589-0557.192130] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
HIV/AIDS-related immune alteration poses many diagnostic and therapeutic challenges. HIV-positive 44-year-old male, on second-line antiretroviral therapy (ART) presented with asymptomatic non healing, well-defined, erythematous ulcer over penis since 8 months with serosanguinous discharge. Inguinal lymph nodes were not palpable. Tzanck smear was negative. Biopsy was not done as the patient was not willing for the same. Acyclovir was given considering herpes infection to which there was no response, and hence azithromycin and metronidazole were given, without improvement. Minocycline was given to take care of possible atypical mycobacterial infection. Due to lack of response, corticosteroid was given for 2 weeks keeping in mind possibility of vasculitis, but there was no improvement. Although investigations to rule out tuberculous etiology were negative, empirical anti-Koch's therapy Category 2 was given without response even after 3 months. Finally, a biopsy was taken from lesion which was suggestive of donovanosis. Trimethoprim Sulfamethoxazole in higher dose was started to which he responded after 2 weeks, and therapy was continued till complete response. Patient is on second-line ART for last 7 years. He is clinically stable, but his CD4 count is hovering at around 250-300 suggestive of ART failure. Virological evaluation was not feasible. Diagnostic challenges posed include possibility of resistant bacterial, viral infection, vasculitis, or drug reaction in a setting of probable ART failure.
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Affiliation(s)
- Yogesh S. Marfatia
- Department of Skin-VD, Baroda Medical College and SSG Hospital, Vadodara, Gujarat, India
| | - Devi Sathianadha Menon
- Department of Skin-VD, Baroda Medical College and SSG Hospital, Vadodara, Gujarat, India,Address for correspondence: Dr. Devi Sathianadha Menon, Department of Skin-VD, Medical College Baroda and SSG Hospital, Vadodara - 390 001, Gujarat, India. E-mail:
| | - Sheethal Jose
- Department of Skin-VD, Baroda Medical College and SSG Hospital, Vadodara, Gujarat, India
| | - Brijesh Kumar Patel
- Department of Skin-VD, Baroda Medical College and SSG Hospital, Vadodara, Gujarat, India
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Jose S, Quinn K, Dunn D, Cox A, Sabin C, Fidler S. Virological failure and development of new resistance mutations according to CD4 count at combination antiretroviral therapy initiation. HIV Med 2015; 17:368-72. [PMID: 26306942 PMCID: PMC4949527 DOI: 10.1111/hiv.12302] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2015] [Indexed: 11/28/2022]
Abstract
Objectives No randomized controlled trials have yet reported an individual patient benefit of initiating combination antiretroviral therapy (cART) at CD4 counts > 350 cells/μL. It is hypothesized that earlier initiation of cART in asymptomatic and otherwise healthy individuals may lead to poorer adherence and subsequently higher rates of resistance development. Methods In a large cohort of HIV‐positive individuals, we investigated the emergence of new resistance mutations upon virological treatment failure according to the CD4 count at the initiation of cART. Results Of 7918 included individuals, 6514 (82.3%), 996 (12.6%) and 408 (5.2%) started cART with a CD4 count ≤ 350, 351–499 and ≥ 500 cells/μL, respectively. Virological rebound occurred while on cART in 488 (7.5%), 46 (4.6%) and 30 (7.4%) with a baseline CD4 count ≤ 350, 351–499 and ≥ 500 cells/μL, respectively. Only four (13.0%) individuals with a baseline CD4 count > 350 cells/μL in receipt of a resistance test at viral load rebound were found to have developed new resistance mutations. This compared to 107 (41.2%) of those with virological failure who had initiated cART with a CD4 count < 350 cells/μL. Conclusions We found no evidence of increased rates of resistance development when cART was initiated at CD4 counts above 350 cells/μL.
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Affiliation(s)
- S Jose
- Research Department of Infection and Population Health, UCL, London, UK
| | - K Quinn
- Department of Medicine, Imperial College London, London, UK
| | - D Dunn
- Medical Research Council Clinical Trials Unit at UCL, London, UK
| | - A Cox
- Infection and Immunity, Imperial College Healthcare NHS Trust, London, UK
| | - C Sabin
- Research Department of Infection and Population Health, UCL, London, UK
| | - S Fidler
- Department of Medicine, Imperial College London, London, UK
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Johnson B, Joseph M, Jose S, Jose S, Kinne J, Wernery U. The microflora of teat canals and udder cisterns in non-lactating dromedaries. J CAMEL PRACT RES 2015. [DOI: 10.5958/2277-8934.2015.00008.9] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Berlin M, Joseph M, Jose S, Raghavan R, Syriac G, Paily N, Wernery U. Production of A Caseous Lymphadenitis Vaccine for Dromedaries. J CAMEL PRACT RES 2015. [DOI: 10.5958/2277-8934.2015.00026.0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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26
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Jose S, Anju S, Cinu T, Aleykutty N, Thomas S, Souto E. In vivo pharmacokinetics and biodistribution of resveratrol-loaded solid lipid nanoparticles for brain delivery. Int J Pharm 2014; 474:6-13. [DOI: 10.1016/j.ijpharm.2014.08.003] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 07/31/2014] [Accepted: 08/02/2014] [Indexed: 12/19/2022]
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Sharma R, Abaya C, Sharma P, Stremska M, Jose S. Regulation of organ-specific inflammation by CXCR5 during systemic autoimmunity (BA13P.131). The Journal of Immunology 2014. [DOI: 10.4049/jimmunol.192.supp.177.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Mice and humans deficient in the Foxp3+ T regulatory cells (Tregs) develop systemic autoimmunity affecting multiple organs and die prematurely. Mice deficient for interleukin (IL)-2 (IL2KO) have reduced Tregs and develop inflammation mainly in liver, colon, pancreas and salivary glands. We found that the CD4+ T-cells in the secondary lymphoid organs IL2KO mice highly express CXCR5, a chemokine receptor and a marker for T-follicular helper (TfH) cells. We hypothesized that CXCR5 expression may regulate inflammation by regulating T-cell recruitment and organ-specific autoantibody production. We found that CXCR5+CD4+ T-cells were highly enriched in these inflamed organs of IL2KO mice. Rendering the IL2KO mice deficient for CXCR5 led to prolonged lifespan compared to CXCR5-sufficient IL2KO mice and protection against inflammation especially in liver and colon and partial protection against inflammation in pancreas and salivary glands. This was accompanied with a reduction of activated B and T cells in the secondary lymphoid organs as well as reduced production of inflammatory cytokines by the T-cells. However, no significant correlation was observed between CXCR5 expression and antibodies to liver and pancreatic auto-antigens. The data suggests that CXCR5 expression regulates organ-specific inflammation during Treg-deficiency -induced systemic autoimmunity, through regulation of T-cell trafficking, with an undetectable contribution to autoantibody production.
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Affiliation(s)
- Rahul Sharma
- 1Division of Nephrology, Center for Immunity Inflammation and Regenerative Medicine, University of Virginia, Charlottesville, VA
| | - Christian Abaya
- 1Division of Nephrology, Center for Immunity Inflammation and Regenerative Medicine, University of Virginia, Charlottesville, VA
| | - Poonam Sharma
- 1Division of Nephrology, Center for Immunity Inflammation and Regenerative Medicine, University of Virginia, Charlottesville, VA
| | - Marta Stremska
- 1Division of Nephrology, Center for Immunity Inflammation and Regenerative Medicine, University of Virginia, Charlottesville, VA
| | - Sheethal Jose
- 1Division of Nephrology, Center for Immunity Inflammation and Regenerative Medicine, University of Virginia, Charlottesville, VA
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Samuel M, Jose S, Winston A, Nelson M, Johnson M, Chadwick D, Fisher M, Leen C, Gompels M, Gilson R, Post FA, Hay P, Sabin CA. The effects of age on associations between markers of HIV progression and markers of metabolic function including albumin, haemoglobin and lipid concentrations. HIV Med 2013; 15:311-6. [PMID: 24245861 PMCID: PMC4265250 DOI: 10.1111/hiv.12103] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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] [Accepted: 09/12/2013] [Indexed: 12/25/2022]
Abstract
OBJECTIVES We investigated whether age modified associations between markers of HIV progression, CD4 T lymphocyte count and HIV RNA viral load (VL), and the following markers of metabolic function: albumin, haemoglobin, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC). METHODS A retrospective analysis of data from the United Kingdom Collaborative HIV Cohort was carried out. Analyses were limited to antiretroviral-naïve subjects to focus on the impact of HIV disease itself. A total of 16670 subjects were included in the analysis. Multilevel linear regression models assessed associations between CD4 count/VL and each of the outcomes. Statistical tests for interactions assessed whether associations differed among age groups. RESULTS After adjustment for gender and ethnicity, there was evidence that lower CD4 count and higher VL were associated with lower TC, LDL-C, haemoglobin and albumin concentrations but higher triglyceride concentrations. Age modified associations between CD4 count and albumin (P < 0.001) and haemoglobin (P = 0.001), but not between CD4 count and HDL-C, LDL-C and TC, or VL and any outcome. Among participants aged < 30, 30-50 and > 50 years, a 50 cells/μL lower CD4 count correlated with a 2.4 [95% confidence interval (CI) 1.7-3.0], 3.6 (95% CI 3.2-4.0) and 5.1 (95% CI 4.0-6.1) g/L lower haemoglobin concentration and a 0.09 (95% CI 0.07-0.11), 0.12 (95% CI 0.11-0.13) and 0.16 (95% CI 0.13-0.19) g/L lower albumin concentration, respectively. CONCLUSIONS We present evidence that age modifies associations between CD4 count and plasma albumin and haemoglobin levels. A given reduction in CD4 count was associated with a greater reduction in haemoglobin and albumin concentrations among older people living with HIV. These findings increase our understanding of how the metabolic impact of HIV is influenced by age.
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Affiliation(s)
- M Samuel
- Guy's and St Thomas' NHS Foundation Trust, London, UK
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Nila MV, Sudhir MR, Cinu TA, Aleykutty NA, Jose S. Floating microspheres of carvedilol as gastro retentive drug delivery system: 32full factorial design andin vitroevaluation. Drug Deliv 2013; 21:110-7. [DOI: 10.3109/10717544.2013.834414] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [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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Jose S, Fangueiro JF, Smitha J, Cinu TA, Chacko AJ, Premaletha K, Souto EB. Predictive modeling of insulin release profile from cross-linked chitosan microspheres. Eur J Med Chem 2012; 60:249-53. [PMID: 23313633 DOI: 10.1016/j.ejmech.2012.12.011] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Revised: 11/10/2012] [Accepted: 12/07/2012] [Indexed: 10/27/2022]
Abstract
Insulin-loaded microspheres composed of chitosan 3% (w/v), and loading 120 IU insulin were produced by emulsion cross-linking method. Cross-linking time was 5 h and glutaraldehyde 3.5% (v/v) was used as cross-linker. Swelling ratio studies were evaluated to predict release of insulin from chitosan microspheres. Bacitracin and sodium taurocholate were incorporated in the formulations as proteolytic enzyme inhibitor and absorption enhancer, respectively. In vitro insulin release studies were performed in phosphate buffer pH 7.4 and also in HCl pH 2 with and without trypsin. Activity of bacitracin was also evaluated. In vitro release showed a controlled profile up to 12 h and the formulation containing 0.15% (w/v) of bacitracin revealed a maximum biological activity of about 49.1 ± 4.1%. Mathematical modeling using Higuchi and Korsmeyer-Peppas suggested a non-Fickian diffusion as the mechanism of insulin release. Insulin-loaded chitosan microspheres for oral delivery showed to be an innovative and reliable delivery system to overcome conventional insulin therapy.
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Affiliation(s)
- S Jose
- Department of Pharmaceutical Sciences, Mahatma Gandhi University, Cheruvandoor Campus, Ettumanoor 686 631, Kerala, India
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Jose S, Ansa CR, Cinu TA, Chacko AJ, Aleykutty NA, Ferreira SV, Souto EB. Thermo-sensitive gels containing lorazepam microspheres for intranasal brain targeting. Int J Pharm 2012; 441:516-26. [PMID: 23147411 DOI: 10.1016/j.ijpharm.2012.10.049] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 10/30/2012] [Accepted: 10/31/2012] [Indexed: 11/18/2022]
Abstract
Thermo-sensitive gels containing lorazepam microspheres were developed and characterized for intranasal brain targeting. Pluronics (PF-127 and PF-68) have been selected since they are thermo-reversible polymers with the property of forming a solution at low temperatures (4-5 °C), and a gel at body temperature (37 °C). This property makes them an interesting material to work with, especially in case of controlled release formulations. The present study focuses on the development of an intranasal formulation for lorazepam, as an alternative route of drug delivery to the brain. Direct transport of drugs to the brain circumventing the brain barrier, following intranasal administration, provides a unique feature and better option to target brain. The presence of mucoadhesive microspheres in the gel vehicle via nasal route can achieve a dual purpose of prolonged drug release and enhanced bioavailability. To optimise the microsphere formulation, Box Behnken design was employed by investigating the effect of three factors, polymer concentration (chitosan), emulsifier concentration (Span 80) and cross-linking agent (glutaraldehyde) on the response variable which is the mean particle size. The concentration of 21% PF-127 and 1% PF-68 were found to be promising gel vehicles. The results showed that the release rate followed a prolonged profile dispersion of the microspheres in the viscous media, in comparison to the microspheres alone. Histopathological studies proved that the optimised formulation does not produce any toxic effect on the microscopic structure of nasal mucosa.
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Affiliation(s)
- S Jose
- Department of Pharmaceutical Sciences, Mahatma Gandhi University, Cheruvandoor Campus, Ettumanoor P.O., Kerala 686 631, India.
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Tinny T, Chacko AJ, Jose S. Formulation development and statistical optimization of chronotherapeutic tablets of indometacin. Drug Dev Ind Pharm 2012; 39:1357-63. [DOI: 10.3109/03639045.2012.715352] [Citation(s) in RCA: 5] [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: 11/13/2022]
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Jose S, Jayesh P, Sudheer NS, Poulose G, Mohandas A, Philip R, Singh ISB. Lymphoid organ cell culture system from Penaeus monodon (Fabricius) as a platform for white spot syndrome virus and shrimp immune-related gene expression. J Fish Dis 2012; 35:321-334. [PMID: 22372817 DOI: 10.1111/j.1365-2761.2012.01348.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Shrimp cell lines are yet to be reported and this restricts the prospects of investigating the associated viral pathogens, especially white spot syndrome virus (WSSV). In this context, development of primary cell cultures from lymphoid organs was standardized. Poly-l-lysine-coated culture vessels enhanced growth of lymphoid cells, while the application of vertebrate growth factors did not, except insulin-like growth factor-1 (IGF-1). Susceptibility of the lymphoid cells to WSSV was confirmed by immunofluoresence assay using monoclonal antibody against the 28 kDa envelope protein of WSSV. Expression of viral and immune-related genes in WSSV-infected lymphoid cultures could be demonstrated by RT-PCR. This emphasizes the utility of lymphoid primary cell culture as a platform for research in virus-cell interaction, virus morphogenesis, up and downregulation of shrimp immune-related genes, and also for the discovery of novel drugs to combat WSSV in shrimp culture.
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Affiliation(s)
- S Jose
- National Centre for Aquatic Animal Health, Cochin University of Science and Technology, Kochi, India
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Affiliation(s)
- S Ramadass
- Department of Perfusion & Cardiothoracic Surgery, Frontier Lifeline and Dr. K.M. Cherian Heart Foundation, Chennai, India
| | - S Jose
- Department of Perfusion & Cardiothoracic Surgery, Frontier Lifeline and Dr. K.M. Cherian Heart Foundation, Chennai, India
| | - C Dasarathan
- Department of Perfusion & Cardiothoracic Surgery, Frontier Lifeline and Dr. K.M. Cherian Heart Foundation, Chennai, India
| | - R Agarwal
- Department of Perfusion & Cardiothoracic Surgery, Frontier Lifeline and Dr. K.M. Cherian Heart Foundation, Chennai, India
| | - KM Cherian
- Department of Perfusion & Cardiothoracic Surgery, Frontier Lifeline and Dr. K.M. Cherian Heart Foundation, Chennai, India
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Jose S, Fangueiro JF, Smitha J, Cinu TA, Chacko AJ, Premaletha K, Souto EB. Cross-linked chitosan microspheres for oral delivery of insulin: Taguchi design and in vivo testing. Colloids Surf B Biointerfaces 2011; 92:175-9. [PMID: 22221459 DOI: 10.1016/j.colsurfb.2011.11.040] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Revised: 11/19/2011] [Accepted: 11/21/2011] [Indexed: 02/03/2023]
Abstract
Insulin-loaded chitosan microspheres were engineered by emulsion cross-linking method using glutaraldehyde as cross-linker. Taguchi orthogonal method was applied to optimize the production time and reduce the number of experiments required to obtain an optimized formulation. Three variables were evaluated, i.e. chitosan and glutaraldehyde concentrations, and cross-linking time at three levels. The dependent variables were the mean particle size and the encapsulation efficiency. The optimal formulation was obtained with chitosan 3% (w/v), glutaraldehyde 3.5% (v/v), and cross-linking time of 5h, characterized by microspheres with a mean particle size of 29.5 μm, and insulin encapsulation efficiency of 71.6±1.3%. In vivo studies were carried out using male Wistar albino rats, revealing a significant reduction in blood glucose level after administration of the optimized formulation, in comparison to a subcutaneous insulin injection. Chitosan microspheres were superior in terms of sustaining protein release over conventional insulin therapy.
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Affiliation(s)
- S Jose
- Department of Pharmaceutical Sciences, Mahatma Gandhi University, Ettumanoor, Kerala, India
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Ponnusamy K, Jose S, Savarimuthu I, Michael G, Redenbach M. Genetic diversity study of Chromobacterium violaceum isolated from Kolli hills by amplified ribosomal DNA restriction analysis (ARDRA) and random amplified polymorphic DNA (RAPD). Lett Appl Microbiol 2011; 53:341-9. [DOI: 10.1111/j.1472-765x.2011.03115.x] [Citation(s) in RCA: 7] [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: 11/29/2022]
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Jose S, Prema MT, Chacko AJ, Thomas AC, Souto EB. Colon specific chitosan microspheres for chronotherapy of chronic stable angina. Colloids Surf B Biointerfaces 2010; 83:277-83. [PMID: 21194900 DOI: 10.1016/j.colsurfb.2010.11.033] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Revised: 11/23/2010] [Accepted: 11/23/2010] [Indexed: 10/18/2022]
Abstract
In the present work, chitosan microspheres with a mean diameter between 6.32 μm and 9.44 μm, were produced by emulsion cross-linking of chitosan, and tested for chronotherapy of chronic stable angina. Aiming at developing a suitable colon specific strategy, diltiazem hydrochloride (DTZ) was encapsulated in the microspheres, following Eudragit S-100 coating by solvent evaporation technique, exploiting the advantages of microbiological properties of chitosan and pH dependent solubility of Eudragit S-100. Different microsphere formulations were prepared varying the ratio DTZ:chitosan (1:2 to 1:10), stirring speed (1000-2000 rpm), and the concentration of emulsifier Span 80 (0.5-1.5% (w/v)). The effect of these variables on the particle size and encapsulation parameters (production yield (PY), loading capacity (LC), encapsulation efficiency (EE)) was evaluated to develop an optimized formulation. In vitro release study of non-coated chitosan microspheres in simulated gastrointestinal (GI) fluid exhibited a burst release pattern in the first hour, whereas Eudragit S-100 coating allowed producing systems of controlled release diffusion fitting to the Higuchi model, and thus suitable for colon-specific drug delivery. DSC analysis indicated that DTZ was dispersed within the microspheres matrix. Scanning electron microscopy revealed that the microspheres were spherical and had a smooth surface. Chitosan biodegradability was proven by the enhanced release rate of DTZ in presence of rat caecal contents.
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Affiliation(s)
- S Jose
- Department of Pharmaceutical Sciences, Mahatma Gandhi University, Cheruvandoor Campus, Ettumanoor-686 631, Kerala, India
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Kinne J, Madarame H, Takai S, Jose S, Wernery U. Disseminated Rhodococcus equi infection in dromedary camels (Camelus dromedarius). Vet Microbiol 2010; 149:269-72. [PMID: 21035967 DOI: 10.1016/j.vetmic.2010.09.037] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2010] [Revised: 09/29/2010] [Accepted: 09/30/2010] [Indexed: 11/16/2022]
Abstract
Rhodococcus (R). equi, a recognized pathogen in horses, is emerging as a human opportunistic pathogen, especially in immunocompromized people. It affects also New World camelids, but there are no reports of R. equi infection in Old World camelids yet. Four cases of disseminated R. equi infection in adult breeding dromedaries occurred at one camel farm near Dubai within 16 months of each other. At necropsy the lungs were diffusely consolidated with large caseous areas. Histology revealed severe suppurative to necrotising pneumonia with multiple encapsulated abscesses. Immunohistochemistry enabled the detection of 15- to 17-kDa antigens (VapA) of R. equi in the lung sections. High numbers of R. equi were isolated from the lung lesions as well as from liver, spleen and mediastinal lymph nodes, indicative of septicaemia. The isolated strains were PCR-positive for the specific virulence plasmid (VapA-Gen) of R. equi, indicating virulent strains and containing an 85-kb type I plasmid. This is the first report of disseminated R. equi infection in Old World camelids. Since adult camels in general do not suffer from bacterial caused pneumonia (except tuberculosis), this is a new emerging disease for camels.
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Affiliation(s)
- J Kinne
- Central Veterinary Research Laboratory (CVRL), POB 597, Dubai, United Arab Emirates.
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Holzmueller E, Jose S. Response of Cogongrass to Imazapyr Herbicides on a Reclaimed Phosphate-Mine Site in Central Florida, USA. ECOL RESTOR 2010. [DOI: 10.3368/er.28.3.300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Jose S, Dhanya K, Cinu TA, Aleykutty NA. Multiparticulate system for colon targeted delivery of ondansetron. Indian J Pharm Sci 2010; 72:58-64. [PMID: 20582191 PMCID: PMC2883228 DOI: 10.4103/0250-474x.62237] [Citation(s) in RCA: 24] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2009] [Revised: 10/09/2009] [Accepted: 12/25/2009] [Indexed: 11/29/2022] Open
Abstract
Targeted delivery of drugs to colon has the potential for local treatment of a variety of colonic diseases. The main objective of the study was to develop a multiparticulate system containing chitosan microspheres for the colon targeted delivery of ondansetron for the treatment of irritable bowel syndrome. This work combines pH-dependent solubility of eudragit S-100 polymers and microbial degradability of chitosan polymers. Chitosan microspheres containing ondansetron were prepared by emulsion cross linking method. The effect of process variables like chitosan concentration, drug-polymer ratio, emulsifier concentration and stirring speed were studied on particle size and entrapment efficiency of chitosan microspheres. In vitro drug release studies in simulated gastro intestinal fluids showed a burst drug release pattern in the initial hour necessitating microencapsulation around the chitosan microspheres. The optimized formulation was then subjected to microencapsulation with eudragit S-100 by solvent evaporation technique. The effect of different coat/core ratio on particle size, drug entrapment efficiency and in vitro drug release were studied. Formulation which contain 1:10 core/coat ratio released lesser amount of drug in the upper gastro intestinal conditions and so selected as best formulation and then subjected to in vitro drug release studies in presence of rat ceacal contents to assess biodegradability of chitosan microspheres in colon. In order to study the drug release mechanism in vitro drug release data was fitted into various kinetic models. Analysis of regression values suggested that the possible drug release mechanism was Peppas model.
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Affiliation(s)
- S. Jose
- Department of Pharmaceutical Sciences, Cheruvandoor campus, Mahatma Gandhi University, Ettumanoor, Kottayam-686 631, India
| | - K. Dhanya
- Department of Pharmaceutical Sciences, Cheruvandoor campus, Mahatma Gandhi University, Ettumanoor, Kottayam-686 631, India
| | - T. A. Cinu
- Department of Pharmaceutical Sciences, Cheruvandoor campus, Mahatma Gandhi University, Ettumanoor, Kottayam-686 631, India
| | - N. A. Aleykutty
- Department of Pharmaceutical Sciences, Cheruvandoor campus, Mahatma Gandhi University, Ettumanoor, Kottayam-686 631, India
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Daneshgar P, Jose S. Broomsedge Communities Are Resistant to Invasion by Cogongrass (Florida). ECOL RESTOR 2009. [DOI: 10.3368/er.27.4.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Suman E, Jose S, D'Souza J, Kotian S. Does vancomycin inhibit biofilm production by coagulase-negative staphylococci? J Hosp Infect 2009; 73:86-7. [DOI: 10.1016/j.jhin.2009.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2009] [Accepted: 06/19/2009] [Indexed: 11/26/2022]
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Ruth AD, Jose S, Miller DL. Seed Bank Dynamics of Sand Pine Scrub and Longleaf Pine Flatwoods of the Gulf Coastal Plain (Florida). ECOL RESTOR 2008. [DOI: 10.3368/er.26.1.19] [Citation(s) in RCA: 6] [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: 11/03/2022]
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Jose S, Beegum GRJ. In vitro susceptibility of viridans streptococci to leaf extracts of Mangifera Indica. Indian J Microbiol 2007; 47:160-3. [PMID: 23100659 PMCID: PMC3450110 DOI: 10.1007/s12088-007-0030-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: 12/22/2006] [Revised: 03/15/2007] [Accepted: 04/23/2007] [Indexed: 11/24/2022] Open
Abstract
The susceptibility of Viridans streptococci to leaf extracts of Mangifera indica was studied on 53 clinical isolates from 39 patients. All the isolates were found to be susceptible to both water and methanol extract of M. indica leaves. Minimum inhibitory concentration (MIC) of methanol extract for all isolates were <50 mg/mL and MIC of water extract for all isolates were <200 mg/mL. Methanol extract was found to have better action against Viridans streptococci than water extract.
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Affiliation(s)
- S. Jose
- Department of Biotechnology, St Thomas College, Pala, Kerala India
| | - G. R. J. Beegum
- Department of Biotechnology, St Thomas College, Pala, Kerala India
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Jose S, Francis B, Thomas S, Karger-Kocsis J. Morphology and mechanical properties of polyamide 12/polypropylene blends in presence and absence of reactive compatibiliser. POLYMER 2006. [DOI: 10.1016/j.polymer.2006.03.046] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [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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Jose S, Thomas S, Lievana E, Karger-Kocsis J. Morphology and mechanical properties of polyamide 12 blends with styrene/ethylene-butylene/styrene rubbers with and without maleation. J Appl Polym Sci 2005. [DOI: 10.1002/app.21362] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Jose S, Nair SV, Thomas S, Karger-Kocsis J. Effect of reactive compatibilisation on the phase morphology and tensile properties of PA12/PP blends. J Appl Polym Sci 2005. [DOI: 10.1002/app.22806] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Jose S, Aprem A, Francis B, Chandy M, Werner P, Alstaedt V, Thomas S. Phase morphology, crystallisation behaviour and mechanical properties of isotactic polypropylene/high density polyethylene blends. Eur Polym J 2004. [DOI: 10.1016/j.eurpolymj.2004.02.026] [Citation(s) in RCA: 125] [Impact Index Per Article: 6.3] [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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