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De Haes J, Catarinella C, Kaul S, Soliman Aboumarie H. Superior vena cava syndrome post heart transplantation diagnosed by transoesophageal echocardiography. Eur Heart J Cardiovasc Imaging 2024; 25:e138. [PMID: 37947210 DOI: 10.1093/ehjci/jead294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Indexed: 11/12/2023] Open
Affiliation(s)
- Jeroen De Haes
- Department of Anaesthetics and Critical Care, Harefield Hospital, Royal Brompton and Harefield Hospitals, Hill End Road, Uxbridge, London UB96JH, UK
| | - Claudia Catarinella
- Department of Internal Medicine Consultant and ICU Fellow, Hospital Calderon Guardia, San Jose, Costa Rica
| | - Sundeep Kaul
- Department of Anaesthetics and Critical Care, Harefield Hospital, Royal Brompton and Harefield Hospitals, Hill End Road, Uxbridge, London UB96JH, UK
| | - Hatem Soliman Aboumarie
- Department of Anaesthetics and Critical Care, Harefield Hospital, Royal Brompton and Harefield Hospitals, Hill End Road, Uxbridge, London UB96JH, UK
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2
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Sharma D, Koul A, Bhushan S, Gupta S, Kaul S, Dhar MK. Insights into microRNA-mediated interaction and regulation of metabolites in tomato. Plant Biol (Stuttg) 2023; 25:1142-1153. [PMID: 37681459 DOI: 10.1111/plb.13572] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/23/2023] [Indexed: 09/09/2023]
Abstract
microRNAs direct regulation of various metabolic pathways in plants and animals. miRNAs may be useful in developing novel/elite genotypes, with enhanced metabolites and disease resistance. We examined miRNAs in tomato. In tomato, miRNAs in the carotenoid pathway have not been fully elucidated. We examined the potential role of miRNAs in biosynthesis of carotenoids, transcript profiling of miRNAs and their possible targets (genes and transcription factors) at different development stages of tomato using stem-loop PCR and RT-qPCR. We also identified miRNAs targeting key flavonoid genes, such as chalcone isomerase (CHI), and dihydroflavonol-4-reductase (DFR). Distinct expression profiles of miRNAs and their targets were found in fruits of three tomato accessions, suggesting carotenoid regulation by miRNAs at various stages of fruit development. This was also confirmed using HPLC of the carotenoids. The present study may help in understanding possible regulation of carotenoid biosynthesis. The identified miRNAs can be exploited to enhance biosynthesis of different carotenoids in plants.
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Affiliation(s)
- D Sharma
- Genome Research Laboratory, School of Biotechnology, University of Jammu, Jammu, India
| | - A Koul
- Department of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB, Canada
| | - S Bhushan
- Department of Botany, Central University of Jammu, Bagla (Rahya Suchani), Samba, Jammu, India
| | - S Gupta
- Genome Research Laboratory, School of Biotechnology, University of Jammu, Jammu, India
| | - S Kaul
- Genome Research Laboratory, School of Biotechnology, University of Jammu, Jammu, India
| | - M K Dhar
- Genome Research Laboratory, School of Biotechnology, University of Jammu, Jammu, India
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3
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George PM, Reed A, Desai SR, Devaraj A, Faiez TS, Laverty S, Kanwal A, Esneau C, Liu MKC, Kamal F, Man WDC, Kaul S, Singh S, Lamb G, Faizi FK, Schuliga M, Read J, Burgoyne T, Pinto AL, Micallef J, Bauwens E, Candiracci J, Bougoussa M, Herzog M, Raman L, Ahmetaj-Shala B, Turville S, Aggarwal A, Farne HA, Dalla Pria A, Aswani AD, Patella F, Borek WE, Mitchell JA, Bartlett NW, Dokal A, Xu XN, Kelleher P, Shah A, Singanayagam A. A persistent neutrophil-associated immune signature characterizes post-COVID-19 pulmonary sequelae. Sci Transl Med 2022; 14:eabo5795. [PMID: 36383686 DOI: 10.1126/scitranslmed.abo5795] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Interstitial lung disease and associated fibrosis occur in a proportion of individuals who have recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection through unknown mechanisms. We studied individuals with severe coronavirus disease 2019 (COVID-19) after recovery from acute illness. Individuals with evidence of interstitial lung changes at 3 to 6 months after recovery had an up-regulated neutrophil-associated immune signature including increased chemokines, proteases, and markers of neutrophil extracellular traps that were detectable in the blood. Similar pathways were enriched in the upper airway with a concomitant increase in antiviral type I interferon signaling. Interaction analysis of the peripheral phosphoproteome identified enriched kinases critical for neutrophil inflammatory pathways. Evaluation of these individuals at 12 months after recovery indicated that a subset of the individuals had not yet achieved full normalization of radiological and functional changes. These data provide insight into mechanisms driving development of pulmonary sequelae during and after COVID-19 and provide a rational basis for development of targeted approaches to prevent long-term complications.
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Affiliation(s)
- Peter M George
- Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London SW3 6NR, UK
- National Heart and Lung Institute, Imperial College London, London SW3 6LY, UK
| | - Anna Reed
- Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London SW3 6NR, UK
- National Heart and Lung Institute, Imperial College London, London SW3 6LY, UK
| | - Sujal R Desai
- Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London SW3 6NR, UK
- National Heart and Lung Institute, Imperial College London, London SW3 6LY, UK
| | - Anand Devaraj
- Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London SW3 6NR, UK
- National Heart and Lung Institute, Imperial College London, London SW3 6LY, UK
| | - Tasnim Shahridan Faiez
- Centre for Molecular Bacteriology and Infection, Department of Infectious Disease, Imperial College London, London SW7 2DD, UK
| | - Sarah Laverty
- Section of Virology, Department of Infectious Disease, Imperial College London, London W2 1PG, UK
| | - Amama Kanwal
- Faculty of Health, Medicine and Wellbeing, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Camille Esneau
- Faculty of Health, Medicine and Wellbeing, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Michael K C Liu
- Section of Virology, Department of Infectious Disease, Imperial College London, London W2 1PG, UK
| | | | - William D-C Man
- Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London SW3 6NR, UK
- National Heart and Lung Institute, Imperial College London, London SW3 6LY, UK
- Faculty of Life Sciences and Medicine, King's College London, London WC2R 2LS, UK
| | - Sundeep Kaul
- Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London SW3 6NR, UK
| | - Suveer Singh
- Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London SW3 6NR, UK
| | - Georgia Lamb
- Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London SW3 6NR, UK
| | - Fatima K Faizi
- Centre for Molecular Bacteriology and Infection, Department of Infectious Disease, Imperial College London, London SW7 2DD, UK
| | - Michael Schuliga
- Faculty of Health, Medicine and Wellbeing, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Jane Read
- Faculty of Health, Medicine and Wellbeing, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Thomas Burgoyne
- Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London SW3 6NR, UK
- UCL Institute of Ophthalmology, University College London, London EC1V 9EL, UK
| | - Andreia L Pinto
- Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London SW3 6NR, UK
| | - Jake Micallef
- Belgian Volition SRL, 22 rue Phocas Lejeune, Parc Scientifique Créalys, Isnes 5032, Belgium
| | - Emilie Bauwens
- Belgian Volition SRL, 22 rue Phocas Lejeune, Parc Scientifique Créalys, Isnes 5032, Belgium
| | - Julie Candiracci
- Belgian Volition SRL, 22 rue Phocas Lejeune, Parc Scientifique Créalys, Isnes 5032, Belgium
| | - Mhammed Bougoussa
- Belgian Volition SRL, 22 rue Phocas Lejeune, Parc Scientifique Créalys, Isnes 5032, Belgium
| | - Marielle Herzog
- Belgian Volition SRL, 22 rue Phocas Lejeune, Parc Scientifique Créalys, Isnes 5032, Belgium
| | - Lavanya Raman
- National Heart and Lung Institute, Imperial College London, London SW3 6LY, UK
| | | | - Stuart Turville
- The Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia
| | - Anupriya Aggarwal
- The Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia
| | - Hugo A Farne
- National Heart and Lung Institute, Imperial College London, London SW3 6LY, UK
- The Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia
- Chest and Allergy Department, St Mary's Hospital, Imperial College NHS Trust, London W2 1NY, UK
| | - Alessia Dalla Pria
- Section of Virology, Department of Infectious Disease, Imperial College London, London W2 1PG, UK
- Department of HIV and Genitourinary Medicine, Chelsea and Westminster NHS Foundation Trust, London SW10 9NH, UK
| | - Andrew D Aswani
- Department of Intensive Care Medicine, Guy's and St Thomas' NHS Foundation Trust, London SE1 7EH, UK
- Santersus AG, Buckhauserstrasse 34, Zurich 8048, Switzerland
| | - Francesca Patella
- Kinomica Ltd, Biohub, Alderley Park, Alderley Edge, Macclesfield, Cheshire SK10 4TG, UK
| | - Weronika E Borek
- Kinomica Ltd, Biohub, Alderley Park, Alderley Edge, Macclesfield, Cheshire SK10 4TG, UK
| | - Jane A Mitchell
- National Heart and Lung Institute, Imperial College London, London SW3 6LY, UK
| | - Nathan W Bartlett
- Faculty of Health, Medicine and Wellbeing, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Arran Dokal
- Kinomica Ltd, Biohub, Alderley Park, Alderley Edge, Macclesfield, Cheshire SK10 4TG, UK
| | - Xiao-Ning Xu
- Section of Virology, Department of Infectious Disease, Imperial College London, London W2 1PG, UK
| | - Peter Kelleher
- Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London SW3 6NR, UK
- Department of HIV and Genitourinary Medicine, Chelsea and Westminster NHS Foundation Trust, London SW10 9NH, UK
- Immunology of Infection Section, Department of Infectious Disease, Imperial College London, London W2 1PG, UK
- Department of Infection and Immunity Sciences, North West London Pathology NHS Trust, London W2 1NY, UK
| | - Anand Shah
- Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London SW3 6NR, UK
- MRC Centre of Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London W2 1PG, UK
| | - Aran Singanayagam
- Centre for Molecular Bacteriology and Infection, Department of Infectious Disease, Imperial College London, London SW7 2DD, UK
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Di Nubila F, Kaul S, Buhain R, Sarwary S, Shatkar V. P-054 STANDARDIZATION OF HERNIA REGISTRY IN A HIGH-VOLUME LOW-COMPLEXITY CENTRE. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Our surgical department performs an average of 350 cases per year, performed by general surgeons of various seniority. These are predominantly in a post-pandemic period, where a backlog of patients are awaiting surgery in the NHS. It is not always possible for the same professional to provide continuity of care. An easy and reproducible classification of hernias is necessary to facilitate universal communication among surgeons.
Methods
We implemented a surgical proforma for the pre-assessment and operation note, based on the European Hernia Society (EHS) for inguinal and ventral hernias. The pre-assessment and operation note proforma were trialled on an elective basis on a week designated for hernia surgery. The proforma was then rolled out to both elective and emergency hernia repair surgery with the collaboration of all surgeons from our department.
Results
The use of designated hernia week was beneficial to learning and led to acceptance of the new proforma amongst all our surgeons. Hence, the reproducibility in non-dedicated elective lists and emergency cases could be achieved.
Conclusion
The adoption of a single classification accepted internationally, as proposed by the EHS, improves the continuity of patients’ care from pre-assessment to post-operative follow-up. The registry will benefit from better planning of theatre lists, improved productivity, understanding of recurrence rates, types of complications, and lead to improved quality of life. Long-term data collection and further studies can be uniformly compared inside the surgical department, and in collaboration with multinational studies with this initiative.
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Affiliation(s)
- F Di Nubila
- General Surgery, Barking, Havering and Redbridge University Hospitals , London , United Kingdom
| | - S Kaul
- General Surgery, Barking, Havering and Redbridge University Hospitals , London , United Kingdom
| | - R Buhain
- General Surgery, Barking, Havering and Redbridge University Hospitals , London , United Kingdom
| | - S Sarwary
- General Surgery, Barking, Havering and Redbridge University Hospitals , London , United Kingdom
| | - V Shatkar
- General Surgery, Barking, Havering and Redbridge University Hospitals , London , United Kingdom
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5
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Al Aaraj M, Abdeen B, Alkilani Y, Kaul S, Yang Y, Wain M. 48 Consenting Surgical Patients for the Risk Associated with Contracting COVID-19 During Their Stay at the Hospital. Br J Surg 2022. [PMCID: PMC9383532 DOI: 10.1093/bjs/znac039.024] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Aim Literature is suggesting significant perioperative mortality and morbidity associated with COVID-19. Therefore, the Royal College of Surgeons (RCS) has produced guidance detailing additional considerations in consenting for surgery whilst COVID-19 is prevalent within society. Section 3A of this document emphasizes the need to discuss the risk of contracting COVID-19 while patients are in hospital. We conducted a multi-cycle closed-loop audit to examine the adherence to this guidance. Method We completed four audit cycles, each comprising data collection and educational intervention to disseminate the guidance. Data was obtained from consent forms for patients who had consented to both emergency and elective surgery over a two-month period at a large NHS Trust in London. The intervention consisted of teaching sessions, regular emails to the general surgical department, and posters displayed in common areas. Results Consent forms from 139 patients were reviewed over the four cycles (n = 38, 41, 28, and 32). The proportion of patients consented for the risk of contracting COVID-19 during the perioperative period rose serially between the cycles (37%, 61%, 71%, and 85% respectively), and was significantly increased between the first and last cycle (p < 0.01, two-sided Z-test). The interventions proved most effective for senior house officers who improved from consenting 8% initially to 100% on completion of the audit. Conclusions We demonstrate the marked effectiveness of simple interventions combined with serial auditing to disseminate this message. The same practice may help improve consenting practice at other centres whilst COVID-19 is prevalent in society.
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Affiliation(s)
| | | | | | - S. Kaul
- BHRUT, London, United Kingdom
| | | | - M. Wain
- BHRUT, London, United Kingdom
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6
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Zimmer J, Schmidt S, Klos J, Döring S, Strecker D, Vieths S, Kaul S. The Method makes the Extract: Comparative Analysis of Birch Pollen Allergen Extracts. Clin Exp Allergy 2022; 52:784-787. [DOI: 10.1111/cea.14096] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 11/28/2022]
Affiliation(s)
- J Zimmer
- Paul‐Ehrlich‐Institut Paul‐Ehrlich‐Str. 51‐59 63225 Langen Germany
| | - S Schmidt
- Paul‐Ehrlich‐Institut Paul‐Ehrlich‐Str. 51‐59 63225 Langen Germany
| | - J Klos
- Paul‐Ehrlich‐Institut Paul‐Ehrlich‐Str. 51‐59 63225 Langen Germany
| | - S Döring
- Paul‐Ehrlich‐Institut Paul‐Ehrlich‐Str. 51‐59 63225 Langen Germany
| | - D Strecker
- Paul‐Ehrlich‐Institut Paul‐Ehrlich‐Str. 51‐59 63225 Langen Germany
| | - S Vieths
- Paul‐Ehrlich‐Institut Paul‐Ehrlich‐Str. 51‐59 63225 Langen Germany
| | - S Kaul
- Paul‐Ehrlich‐Institut Paul‐Ehrlich‐Str. 51‐59 63225 Langen Germany
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7
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O'Driscoll J, Hawkes W, Beqiri A, Mumith A, Parker A, Upton R, McCourt A, Woodward W, Dockerill C, Heitner S, Yadava M, Kaul S, Sharma R, Leeson P, Woodward G. Fully automated left ventricular ejection fraction and global longitudinal strain predicts obstructive coronary artery disease in patients undergoing stress echocardiography: a multi-centre study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Assessment of LVEF and myocardial deformation with GLS has shown promise in predicting CAD, which may add prognostic information for patients undergoing SE. However, selection bias precludes an accurate assessment of routine clinical SE workflow due to the exclusion of poor image quality and contrast enhanced studies. We hypothesise that an artificial intelligence (AI) pipeline capable of fully automated contouring of the left ventricle and GLS analysis of both non-contrast and contrast SE images is feasible and can predict CAD.
Purpose
The aim of this study was to evaluate the prediction of obstructive coronary artery disease (CAD) from fully automated left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) measures in a large multicentre population of patients undergoing stress echocardiography (SE).
Methods
500 patients from five medical centres undergoing SE for the clinical evaluation of ischaemic heart disease were included in this study. LVEF and GLS was automatically calculated using AI in non-contrast and contrast images at rest and peak stress. The primary endpoint was CAD assessed using invasive coronary angiography.
Results
Patients with significant CAD demonstrated significantly reduced LVEF and GLS at rest and peak stress (all p<0.001) compared to those without CAD. Of the 130 patients who exhibited myocardial ischaemia at peak stress, patients without significant CAD (37%) had significantly reduced LVEF and GLS when compared to those who did. Multivariate analysis demonstrated that a peak LVEF (0.93; 95% CI 0.9–0.96) and peak GLS (1.15; 95% CI 1.07–1.24) were significant independent predictors of CAD. The addition of automated LVEF and GLS to basic models significantly improved the C statistic from 0.78 to 0.83 and 0.85 (both p<0.001), respectively.
Conclusions
Fully automated LVEF and GLS in non-contrast and contrast SE images is feasible and independently augment the prediction of obstructive CAD above and beyond traditional SE indexes.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J O'Driscoll
- Canterbury Christ Church University, Canterbury, United Kingdom
| | - W Hawkes
- Ultromics, Oxford, United Kingdom
| | - A Beqiri
- Ultromics, Oxford, United Kingdom
| | - A Mumith
- Ultromics, Oxford, United Kingdom
| | - A Parker
- Ultromics, Oxford, United Kingdom
| | - R Upton
- Ultromics, Oxford, United Kingdom
| | - A McCourt
- John Radcliffe Hospital, Cardiovascular Clinical Research Facility, Oxford, United Kingdom
| | - W Woodward
- John Radcliffe Hospital, Cardiovascular Clinical Research Facility, Oxford, United Kingdom
| | - C Dockerill
- John Radcliffe Hospital, Cardiovascular Clinical Research Facility, Oxford, United Kingdom
| | - S Heitner
- Oregon Health and Science University, Portland, United States of America
| | - M Yadava
- Oregon Health and Science University, Portland, United States of America
| | - S Kaul
- Oregon Health and Science University, Portland, United States of America
| | - R Sharma
- St George's Hospital, Department of Cardiology, London, United Kingdom
| | - P Leeson
- John Radcliffe Hospital, Cardiovascular Clinical Research Facility, Oxford, United Kingdom
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Kaul S, Rao C, Mane R, Tan KL, Khan AHA, Hussain MS, Shafi MA, Buettner F, Banerjee S, Boulton R, Bhargava A, Huang J, Hanson M, Raouf S, Ball S, Rajendran N. Is the Management of Rectal Cancer Using a Watch and Wait Approach Feasible, Safe and Effective in a Publicly Funded General Hospital? Clin Oncol (R Coll Radiol) 2021; 34:e25-e34. [PMID: 34454807 DOI: 10.1016/j.clon.2021.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/03/2021] [Accepted: 08/09/2021] [Indexed: 11/29/2022]
Abstract
AIMS Although there is emerging evidence to suggest equivalent oncological outcomes using a watch and wait approach compared with primary total mesorectal excision surgery, there is a paucity of evidence about the safety and efficacy of this approach in routine clinical practice. Here we report the long-term outcomes and quality of life from patients managed with watch and wait following a clinical complete response (cCR) to neoadjuvant therapy. MATERIALS AND METHODS Patients with adenocarcinoma of the rectum with cCR following neoadjuvant therapy managed using watch and wait were retrospectively identified. Demographic data, performance status, pretreatment staging information, oncological and surgical outcomes were obtained from routinely collected clinical data. Quality of life was measured by trained clinicians during telephone interviews. RESULTS Over a 7-year period, 506 patients were treated for rectal cancer, 276 had neoadjuvant therapy and 72 had a cCR (26.1%). Sixty-three were managed with watch and wait. Thirteen patients had mucosal regrowth. There was no significant difference in the incidence of metastatic disease between the surgical and watch and wait cohorts (P = 0.38). The 13 patients with mucosal regrowth underwent salvage surgery. Eleven of the patients who underwent surgical resection had R0 resections. There was also a statistically and clinically significant improvement in the Functional Assessment of Cancer Therapy - Colorectal (FACT-C) trial outcome index (P = 0.022). CONCLUSION This study shows that watch and wait is safe and effective outside of tertiary referral centres. It suggests that an opportunistic cCR is durable and when mucosal regrowth occurs it can be salvaged. Finally, we have shown that quality of life is probably improved if a watch and wait approach is adopted.
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Affiliation(s)
- S Kaul
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - C Rao
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK; Department of Surgery and Cancer, Imperial College London, London, UK; North Cumbria Integrated Care NHS Foundation Trust, UK.
| | - R Mane
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - K L Tan
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - A H A Khan
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - M S Hussain
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - M A Shafi
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - F Buettner
- German Cancer Consortium (DKTK), Heidelberg, Germany; German Cancer Research Centre (DKFZ), Heidelberg, Germany; Department of Medicine, Johann Wolfgang Goethe University, Frankfurt, Germany
| | - S Banerjee
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - R Boulton
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - A Bhargava
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK; Institute of Health, Barts and London Medical School, Queen Mary University of London (QMUL), London, UK
| | - J Huang
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - M Hanson
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - S Raouf
- Barts Health NHS Trust, London, UK
| | - S Ball
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - N Rajendran
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK.
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9
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Jakhar D, Das A, Kaul S, Kaur I, Madke B, Dalal A. Prevalence and characteristics of dermatological manifestations in COVID-19 positive dermatologists: Report from a web-based survey in India. J Eur Acad Dermatol Venereol 2021; 35:e832-e833. [PMID: 34297886 PMCID: PMC8447020 DOI: 10.1111/jdv.17532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/07/2021] [Accepted: 07/06/2021] [Indexed: 01/08/2023]
Affiliation(s)
- D Jakhar
- Dermosphere clinic, New Delhi, India
| | - A Das
- Department of Dermatology, KPC Medical College & Hospital, Kolkata, India
| | - S Kaul
- Department of Internal Medicine, John H Stroger Hospital of Cook county, Chicago, USA
| | - I Kaur
- Department of Dermatology, North Delhi Municipal Corporation Medical College & Hindu Rao Hospital, New Delhi, India
| | - B Madke
- Department of Dermatology, Venereology and Leprology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Sawangi Meghe, Wardha, Maharashtra, India
| | - A Dalal
- Department of Dermatology, Saheed Hasan Khan Mewati Government Medical College and Hospital, Nuh, India
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10
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Krishna V, Morjaria J, Jalandari R, Omar F, Kaul S. Autoptic identification of disseminated mucormycosis in a young male presenting with cerebrovascular event, multi-organ dysfunction and COVID-19 infection. IDCases 2021; 25:e01172. [PMID: 34075329 PMCID: PMC8161734 DOI: 10.1016/j.idcr.2021.e01172] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 12/13/2022] Open
Abstract
Among the secondary fungal infections in Coronavirus-19 (COVID-19) infection, Aspergillosis has been reported more often than Mucormycosis. Disseminated mucormycosis is almost always a disease of severely immunosuppressed hosts. We report a young obese Asian male who was admitted with an acute anterior cerebral artery (ACA) territory infarct and severe COVID-19 pneumonitis to the intensive care unit (ICU). He had a complicated stay with recurrent episodes of vasoplegic shock and multi-organ dysfunction. At autopsy, he was confirmed to have disseminated mucormycosis. We believe this to be the first documented case of disseminated mucormycosis in an immunocompetent host with COVID-19 infection. The lack of sensitive non-invasive modalities and biomarkers to diagnose mucormycosis, along with the extremely high mortality in untreated cases, present a unique challenge to clinicians dealing with critically ill patients with COVID-19.
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Affiliation(s)
- Vidya Krishna
- Department of Infectious Diseases, Immunology and BMT, Great Ormond Street Hospital, London, United Kingdom
| | - Jaymin Morjaria
- Department of Respiratory Medicine, Royal Brompton and Harefield Hospital, Guy’s and St.Thomas Hospital NHS Foundation Trust, London, United Kingdom
| | - Rona Jalandari
- Department of Cardiology, Royal Brompton and Harefield Hospital, Guy’s and St.Thomas Hospital NHS Foundation Trust, London, United Kingdom
| | - Fatima Omar
- Department of Cardiology, Royal Brompton and Harefield Hospital, Guy’s and St.Thomas Hospital NHS Foundation Trust, London, United Kingdom
| | - Sundeep Kaul
- Department of Respiratory Medicine, Royal Brompton and Harefield Hospital, Guy’s and St.Thomas Hospital NHS Foundation Trust, London, United Kingdom
- Department of Intensive Care, Royal Brompton and Harefield Hospital, Guy’s and St.Thomas Hospital NHS Foundation Trust, London, United Kingdom
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11
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Edigin E, Kaul S, Eseaton P, Albrecht J. 284 Rates, characteristics, and comparison of hidradenitis suppurativa readmissions in the united states: A national population-based study. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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12
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Edigin E, Kaul S, Eseaton P, Ojemolon P, Shaka H. 385 Incidence, racial profile, and co-morbidity burden of hidradenitis suppurativa hospitalization has changed in the last decade: A longitudinal study of the national inpatient sample. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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13
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Jakhar D, Kaul S, Kaur I, Kumar S. Wifi-enabled dermoscopy: what is the potential in clinical practice and education? Clin Exp Dermatol 2021; 46:1317-1319. [PMID: 33872396 DOI: 10.1111/ced.14692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2021] [Indexed: 11/28/2022]
Affiliation(s)
- D Jakhar
- Department of Dermatology and STD, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - S Kaul
- Department of internal Medicine, John H Stroger Hospital of Cook County, Chicago, IL, USA
| | - I Kaur
- Department of Dermatology and STD, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - S Kumar
- Department of Dermatology and STD, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
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14
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Soriano A, Puzniak LA, Bassetti M, Kaul S, Moise P, Paterson D, Paterson D. 1612. Evaluation of the Use of Ceftolozane/Tazobactam for the Treatment of ESBL-producing Enterobacterales Infections Using International Data from SPECTRA (Study of Prescribing Patterns and Effectiveness of Ceftolozane/Tazobactam Real World Analysis). Open Forum Infect Dis 2020. [PMCID: PMC7778033 DOI: 10.1093/ofid/ofaa439.1792] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background There is a paucity of data on outcomes of patients with severe ESBL-producing Enterobacterales infections treated with empiric or directed ceftolozane/tazobactam (C/T). This study looked at the treatment patterns and outcomes associated with C/T use in the treatment of ESBL-producing Enterobacterales. Methods Data were collected from an international cohort of 32 hospitals in 6 countries as part of SPECTRA, a retrospective multicenter database of C/T use globally, from 2016 – 2019. All adult patients with an ESBL positive Enterobacterales sterile site culture and treated with ≥ 48 hours of C/T were eligible. Outcomes assessed were clinical success, 30-day mortality from index event and readmission. Results There were 59 patients with 121 ESBL positive isolates. Blood and urine were the most common sites of infection at 19.8% each, followed by respiratory (18.2%). E. coli (50%) and K. pneumoniae (30%) were the most common pathogens. On average patients had 2 positive ESBL isolates; median 1; range 1-15. Most patients had the same infection site and ESBL pathogen, however 13 had multi-site ESBL pathogens identified and only 2 had polymicrobial ESBL pathogens. Septic shock was observed in 14 (24%) patients; 29 (49%) were in the ICU at the onset of infection. The most common comorbid conditions were immunocompromised hosts (37%) and cardiac disease (32%). 29% of patients were transplant recipients, and 28% had a CrCl < 50 ml/min. In most patients (71%), C/T was given as directed therapy (i.e., once culture results were available). C/T was given prior to culture results (i.e., as empiric therapy) in 17 (29%) patients, of which 77% had clinical success. C/T dose was 1.5 g in 49%. Only 2 of 10 patients with a respiratory source received the currently licensed 3 g dose. Overall, clinical success was observed in 36 (61%) patients. 30-day mortality was 12%. Readmissions occurred in 5%, of which 2 were infection related. Conclusion The role of newer non-carbapenem antibiotics in the treatment of severe ESBL infections is currently undefined. In a multinational patient database, C/T was found to be effective in severe infections caused by ESBL-producing Enterobacterales. Prospective studies are needed to further define the role of C/T in the setting of frequent drug-resistant Gram-negative pathogens. Disclosures Laura A. Puzniak, PhD, Merck (Employee) Matteo Bassetti, MD, Shionogi Inc. (Advisor or Review Panel member) Pamela Moise, PharmD, Merck & Co., Inc. (Employee, Shareholder) David Paterson, Accelerate (Speaker’s Bureau)BioMerieux (Speaker’s Bureau)BioMerieux (Advisor or Review Panel member)Entasis (Advisor or Review Panel member)Merck (Advisor or Review Panel member)Merck (Grant/Research Support)Merck (Speaker’s Bureau)Pfizer (Speaker’s Bureau)Shionogi & Co., Ltd. (Grant/Research Support)VenatoRx (Advisor or Review Panel member)
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Affiliation(s)
- Alex Soriano
- Hospital Clinic de Barcelona, Barcelona, Catalonia, Spain
| | | | - Matteo Bassetti
- University of Genoa and Ospedale Policlinico San Martino, Udine, Friuli-Venezia Giulia, Italy
| | - Sundeep Kaul
- Harefield hospital, london, England, United Kingdom
| | - Pamela Moise
- Merck Research Labs, Merck & Co., Inc., Kenilworth, New Jersey
| | - David Paterson
- Hospital Clinic de Barcelona, Barcelona, Catalonia, Spain
| | - David Paterson
- Hospital Clinic de Barcelona, Barcelona, Catalonia, Spain
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15
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St Claire K, Kaul S, Caldito EG, Kramer ON, Griffin T, Albrecht J. Dapsone-induced agranulocytosis: symptoms may alert more reliably than the current blood monitoring protocol. Br J Dermatol 2020; 184:962-963. [PMID: 33270224 DOI: 10.1111/bjd.19708] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/29/2020] [Accepted: 11/30/2020] [Indexed: 12/01/2022]
Affiliation(s)
- K St Claire
- University of Illinois College of Medicine, Chicago, IL, USA.,Department of Dermatology, Wayne State University, Detroit, MI, USA
| | - S Kaul
- Department of Medicine, Cook County Health, Chicago, IL, USA
| | - E G Caldito
- Department of Medicine, Cook County Health, Chicago, IL, USA
| | - O N Kramer
- Department of Dermatology, University of Illinois, Chicago, IL, USA
| | - T Griffin
- Library of the Health Sciences, University of Illinois, Chicago, IL, USA
| | - J Albrecht
- Division of Dermatology, Department of Medicine, Cook County Health, Chicago, IL, USA.,Department of Otolaryngology, Division of Dermatology, Rush Medical College, Chicago, IL, USA
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16
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Bagheri I, Shan Y, Klaassen Z, Kamat AM, Konety B, Mehta HB, Baillargeon JG, Srinivas S, Tyler DS, Swanson TA, Kaul S, Hollenbeck BK, Williams SB. Comparing Costs of Radical Versus Partial Cystectomy for Patients Diagnosed with Localized Muscle-Invasive Bladder Cancer: Understanding the Value of Surgical Care. Urol Oncol 2020. [DOI: 10.1016/j.urolonc.2020.10.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Kaul S, Esfandiari N, Scheunemann M, Cornelissen G. Black box modeling approaches to judge the influence of a yeast extract on microbial growth and production. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- S. Kaul
- HAW Hamburg Life Science Ulmenliet 20 21033 Hamburg Germany
| | - N. Esfandiari
- HAW Hamburg Life Science Ulmenliet 20 21033 Hamburg Germany
| | - M. Scheunemann
- HAW Hamburg Life Science Ulmenliet 20 21033 Hamburg Germany
| | - G. Cornelissen
- HAW Hamburg Life Science Ulmenliet 20 21033 Hamburg Germany
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18
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Kaul S, Steinhart J, Michel L, Esfandiari N, Cornelissen G. Identification of active and inactive phases of
Bacillus licheniformis
grown on yeast extract media via Raman spectroscopy. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- S. Kaul
- HAW Hamburg Life Science Ulmenliet 20 21033 Hamburg Germany
| | - J. Steinhart
- HAW Hamburg Life Science Ulmenliet 20 21033 Hamburg Germany
| | - L. Michel
- HAW Hamburg Life Science Ulmenliet 20 21033 Hamburg Germany
| | | | - G. Cornelissen
- HAW Hamburg Life Science Ulmenliet 20 21033 Hamburg Germany
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19
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Morjaria JB, Omar F, Polosa R, Gulli G, Dalal PU, Kaul S. Bilateral lower limb weakness: a cerebrovascular consequence of covid-19 or a complication associated with it? Intern Emerg Med 2020; 15:901-905. [PMID: 32617903 PMCID: PMC7330002 DOI: 10.1007/s11739-020-02418-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/22/2020] [Indexed: 01/04/2023]
Affiliation(s)
- J B Morjaria
- Dept of Respiratory Medicine, Royal Brompton and Harefield Hospital Foundation Trust, Harefield Hospital, Hill End Road, Harefield, UB9 6JH, UK.
- Honorary Senior Clinical Lecturer, Respiratory Medicine, Imperial College, Royal Brompton and Harefield Hospital Foundation Trust, Harefield Hospital, Harefield, UB9 6JH, UK.
| | - F Omar
- Dept of Respiratory Medicine, Royal Brompton and Harefield Hospital Foundation Trust, Harefield Hospital, Hill End Road, Harefield, UB9 6JH, UK
| | - R Polosa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), Policlinico-V. Emanuele", Teaching Hospital, University of Catania, Catania, Italy
- Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), Università di Catania, Catania, Italy
| | - G Gulli
- Department of Stroke Medicine, Ashford and St Peter's Hospitals NHS Foundation Trust, Guildford Rd, Lyne, Chertsey, KT16 0PZ, UK
| | - P U Dalal
- Dept of Radiology, Royal Brompton and Harefield Hospital Foundation Trust, Harefield Hospital, Harefield, UB9 6JH, UK
| | - S Kaul
- Dept of Respiratory Medicine, Royal Brompton and Harefield Hospital Foundation Trust, Harefield Hospital, Hill End Road, Harefield, UB9 6JH, UK
- Dept of Intensive Care Medicine, Royal Brompton and Harefield Hospital Foundation Trust, Harefield Hospital, Harefield, UB9 6JH, UK
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20
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Papp Z, Agostoni P, Alvarez J, Bettex D, Bouchez S, Brito D, Černý V, Comin-Colet J, Crespo-Leiro MG, Delgado JF, Édes I, Eremenko AA, Farmakis D, Fedele F, Fonseca C, Fruhwald S, Girardis M, Guarracino F, Harjola VP, Heringlake M, Herpain A, Heunks LM, Husebye T, Ivancan V, Karason K, Kaul S, Kivikko M, Kubica J, Masip J, Matskeplishvili S, Mebazaa A, Nieminen MS, Oliva F, Papp JG, Parissis J, Parkhomenko A, Põder P, Pölzl G, Reinecke A, Ricksten SE, Riha H, Rudiger A, Sarapohja T, Schwinger RH, Toller W, Tritapepe L, Tschöpe C, Wikström G, von Lewinski D, Vrtovec B, Pollesello P. Levosimendan Efficacy and Safety: 20 years of SIMDAX in Clinical Use. Card Fail Rev 2020; 6:e19. [PMID: 32714567 PMCID: PMC7374352 DOI: 10.15420/cfr.2020.03] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 03/16/2020] [Indexed: 12/12/2022] Open
Abstract
Levosimendan was first approved for clinic use in 2000, when authorisation was granted by Swedish regulatory authorities for the haemodynamic stabilisation of patients with acutely decompensated chronic heart failure. In the ensuing 20 years, this distinctive inodilator, which enhances cardiac contractility through calcium sensitisation and promotes vasodilatation through the opening of adenosine triphosphate-dependent potassium channels on vascular smooth muscle cells, has been approved in more than 60 jurisdictions, including most of the countries of the European Union and Latin America. Areas of clinical application have expanded considerably and now include cardiogenic shock, takotsubo cardiomyopathy, advanced heart failure, right ventricular failure and pulmonary hypertension, cardiac surgery, critical care and emergency medicine. Levosimendan is currently in active clinical evaluation in the US. Levosimendan in IV formulation is being used as a research tool in the exploration of a wide range of cardiac and non-cardiac disease states. A levosimendan oral form is at present under evaluation in the management of amyotrophic lateral sclerosis. To mark the 20 years since the advent of levosimendan in clinical use, 51 experts from 23 European countries (Austria, Belgium, Croatia, Cyprus, Czech Republic, Estonia, Finland, France, Germany, Greece, Hungary, Italy, the Netherlands, Norway, Poland, Portugal, Russia, Slovenia, Spain, Sweden, Switzerland, UK and Ukraine) contributed to this essay, which evaluates one of the relatively few drugs to have been successfully introduced into the acute heart failure arena in recent times and charts a possible development trajectory for the next 20 years.
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Affiliation(s)
- Zoltán Papp
- Department of Cardiology, Faculty of Medicine, University of Debrecen Debrecen, Hungary
| | - Piergiuseppe Agostoni
- Department of Clinical Sciences and Community Health, Centro Cardiologico Monzino, IRCCS Milan, Italy
| | - Julian Alvarez
- Department of Surgery, School of Medicine, University of Santiago de Compostela Santiago de Compostela, Spain
| | - Dominique Bettex
- Institute of Anaesthesiology, University Hospital of Zurich Zurich, Switzerland
| | - Stefan Bouchez
- Department of Anaesthesiology, University Hospital Ghent, Belgium
| | - Dulce Brito
- Cardiology Department, Centro Hospitalar Universitario Lisboa Norte, CCUI, Faculdade de Medicina, Universidade de Lisboa Lisbon, Portugal
| | - Vladimir Černý
- Department of Anaesthesiology, Perioperative Medicine and Intensive Care, Masaryk Hospital, J.E. Purkinje University Usti nad Labem, Czech Republic
| | - Josep Comin-Colet
- Heart Diseases Institute, Hospital Universitari de Bellvitge Barcelona, Spain
| | - Marisa G Crespo-Leiro
- Complexo Hospitalario Universitario A Coruña (CHUAC), CIBERCV, Instituto de Investigacion Biomedica A Coruña (INIBIC), Universidad de a Coruña (UDC) La Coruña, Spain
| | - Juan F Delgado
- Heart Failure and Transplant Program, Cardiology Department, University Hospital 12 Octubre Madrid, Spain
| | - Istvan Édes
- Department of Cardiology, Faculty of Medicine, University of Debrecen Debrecen, Hungary
| | - Alexander A Eremenko
- Department of Cardiac Intensive Care, Petrovskii National Research Centre of Surgery, Sechenov University Moscow, Russia
| | - Dimitrios Farmakis
- Department of Cardiology, Medical School, University of Cyprus Nicosia, Cyprus
| | - Francesco Fedele
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, La Sapienza University of Rome Rome, Italy
| | - Cândida Fonseca
- Heart Failure Clinic, São Francisco Xavier Hospital, CHLO Lisbon, Portugal
| | - Sonja Fruhwald
- Department of Anaesthesiology and Intensive Care Medicine, Division of Anaesthesiology for Cardiovascular Surgery and Intensive Care Medicine, Medical University of Graz Graz, Austria
| | - Massimo Girardis
- Struttura Complessa di Anestesia 1, Policlinico di Modena Modena, Italy
| | - Fabio Guarracino
- Dipartimento di Anestesia e Terapie Intensive, Azienda Ospedaliero-Universitaria Pisana Pisa, Italy
| | - Veli-Pekka Harjola
- Emergency Medicine, Meilahti Central University Hospital, University of Helsinki Helsinki, Finland
| | - Matthias Heringlake
- Department of Anaesthesiology and Intensive Care Medicine, University of Lübeck Lübeck, Germany
| | - Antoine Herpain
- Department of Intensive Care, Hôpital Erasme Brussels, Belgium
| | - Leo Ma Heunks
- Department of Intensive Care Medicine, Amsterdam UMC Amsterdam, the Netherlands
| | - Tryggve Husebye
- Department of Cardiology, Oslo University Hospital Ullevaal Oslo, Norway
| | - Višnja Ivancan
- Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Zagreb, Croatia
| | - Kristjan Karason
- Departments of Cardiology and Transplantation, Sahlgrenska University Hospital Gothenburg, Sweden
| | - Sundeep Kaul
- Intensive Care Unit, National Health Service Leeds, UK
| | - Matti Kivikko
- Global Medical Affairs, R&D, Orion Pharma Espoo, Finland
| | - Janek Kubica
- Department of Cardiology and Internal Medicine, Nicolaus Copernicus University Torun, Poland
| | - Josep Masip
- Intensive Care Department, Consorci Sanitari Integral, University of Barcelona Barcelona, Spain
| | | | - Alexandre Mebazaa
- Department of Anaesthesiology and Critical Care Medicine, AP-HP, Saint Louis and Lariboisière University Hospitals Paris, France
| | | | - Fabrizio Oliva
- Department of Cardiology, Niguarda Ca'Granda Hospital Milan, Italy
| | - Julius-Gyula Papp
- MTA-SZTE Research Group of Cardiovascular Pharmacology, Hungarian Academy of Sciences, University of Szeged Szeged, Hungary
| | - John Parissis
- Second Department of Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens Athens, Greece
| | - Alexander Parkhomenko
- Emergency Cardiology Department, National Scientific Centre MD Strazhesko Institute of Cardiology Kiev, Ukraine
| | - Pentti Põder
- Department of Cardiology, North Estonia Medical Centre Tallinn, Estonia
| | - Gerhard Pölzl
- Department of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck Innsbruck, Austria
| | - Alexander Reinecke
- Klinik für Innere Medizin III, Kardiologie, Universitätsklinikum Schleswig-Holstein Kiel, Germany
| | - Sven-Erik Ricksten
- Department of Anaesthesiology and Intensive Care, Sahlgrenska University Hospital Gothenburg, Sweden
| | - Hynek Riha
- Cardiothoracic Anaesthesiology and Intensive Care, Department of Anaesthesiology and Intensive Care Medicine, Institute for Clinical and Experimental Medicine Prague, Czech Republic
| | - Alain Rudiger
- Department of Medicine, Spittal Limmattal Schlieren, Switzerland
| | | | - Robert Hg Schwinger
- Medizinische Klinik II, Klinikum Weiden, Teaching Hospital of University of Regensburg Weiden, Germany
| | - Wolfgang Toller
- Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz Graz, Austria
| | - Luigi Tritapepe
- Anaesthesia and Intensive Care Division, San Camillo-Forlanini Hospital Rome, Italy
| | - Carsten Tschöpe
- Department of Cardiology, Campus Virchow Klinikum, Charité - University Medicine Berlin Berlin, Germany
| | - Gerhard Wikström
- Institute of Medical Sciences, Uppsala University Uppsala, Sweden
| | - Dirk von Lewinski
- Department of Cardiology, Myokardiale Energetik und Metabolismus Research Unit, Medical University of Graz Graz, Austria
| | - Bojan Vrtovec
- Advanced Heart Failure and Transplantation Centre, Department of Cardiology, University Clinical Centre Ljubljana, Slovenia
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21
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Papp Z, Agostoni P, Alvarez J, Bettex D, Bouchez S, Brito D, Černý V, Comin-Colet J, Crespo-Leiro MG, Delgado JF, Édes I, Eremenko AA, Farmakis D, Fedele F, Fonseca C, Fruhwald S, Girardis M, Guarracino F, Harjola VP, Heringlake M, Herpain A, Heunks LMA, Husebye T, Ivancan V, Karason K, Kaul S, Kivikko M, Kubica J, Masip J, Matskeplishvili S, Mebazaa A, Nieminen MS, Oliva F, Papp JG, Parissis J, Parkhomenko A, Põder P, Pölzl G, Reinecke A, Ricksten SE, Riha H, Rudiger A, Sarapohja T, Schwinger RHG, Toller W, Tritapepe L, Tschöpe C, Wikström G, von Lewinski D, Vrtovec B, Pollesello P. Levosimendan Efficacy and Safety: 20 Years of SIMDAX in Clinical Use. J Cardiovasc Pharmacol 2020; 76:4-22. [PMID: 32639325 PMCID: PMC7340234 DOI: 10.1097/fjc.0000000000000859] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 05/28/2020] [Indexed: 12/12/2022]
Abstract
Levosimendan was first approved for clinical use in 2000, when authorization was granted by Swedish regulatory authorities for the hemodynamic stabilization of patients with acutely decompensated chronic heart failure (HF). In the ensuing 20 years, this distinctive inodilator, which enhances cardiac contractility through calcium sensitization and promotes vasodilatation through the opening of adenosine triphosphate-dependent potassium channels on vascular smooth muscle cells, has been approved in more than 60 jurisdictions, including most of the countries of the European Union and Latin America. Areas of clinical application have expanded considerably and now include cardiogenic shock, takotsubo cardiomyopathy, advanced HF, right ventricular failure, pulmonary hypertension, cardiac surgery, critical care, and emergency medicine. Levosimendan is currently in active clinical evaluation in the United States. Levosimendan in IV formulation is being used as a research tool in the exploration of a wide range of cardiac and noncardiac disease states. A levosimendan oral form is at present under evaluation in the management of amyotrophic lateral sclerosis. To mark the 20 years since the advent of levosimendan in clinical use, 51 experts from 23 European countries (Austria, Belgium, Croatia, Cyprus, Czech Republic, Estonia, Finland, France, Germany, Greece, Hungary, Italy, the Netherlands, Norway, Poland, Portugal, Russia, Slovenia, Spain, Sweden, Switzerland, the United Kingdom, and Ukraine) contributed to this essay, which evaluates one of the relatively few drugs to have been successfully introduced into the acute HF arena in recent times and charts a possible development trajectory for the next 20 years.
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Affiliation(s)
- Zoltán Papp
- Department of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Piergiuseppe Agostoni
- Department of Clinical Sciences and Community Health, Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Julian Alvarez
- Department of Surgery, School of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Dominique Bettex
- Institute of Anaesthesiology, University Hospital of Zurich, Zurich, Switzerland
| | - Stefan Bouchez
- Department of Anaesthesiology, University Hospital, Ghent, Belgium
| | - Dulce Brito
- Cardiology Department, Centro Hospitalar Universitario Lisboa Norte, CCUI, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Vladimir Černý
- Department of Anaesthesiology, Perioperative Medicine and Intensive Care, Masaryk Hospital, J.E. Purkinje University, Usti nad Labem, Czech Republic
| | - Josep Comin-Colet
- Heart Diseases Institute, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Marisa G. Crespo-Leiro
- Complexo Hospitalario Universitario A Coruña (CHUAC), CIBERCV, Instituto de Investigacion Biomedica A Coruña (INIBIC), Universidad de a Coruña (UDC), La Coruña, Spain
| | - Juan F. Delgado
- Heart Failure and Transplant Program, Cardiology Department, University Hospital 12 Octubre, Madrid, Spain
| | - István Édes
- Department of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Alexander A. Eremenko
- Department of Cardiac Intensive Care, Petrovskii National Research Centre of Surgery, Sechenov University, Moscow, Russia
| | - Dimitrios Farmakis
- Department of Cardiology, Medical School, University of Cyprus, Nicosia, Cyprus
| | - Francesco Fedele
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, La Sapienza University of Rome, Rome, Italy
| | - Cândida Fonseca
- Heart Failure Clinic, São Francisco Xavier Hospital, CHLO, Lisbon, Portugal
| | - Sonja Fruhwald
- Department of Anaesthesiology and Intensive Care Medicine, Division of Anaesthesiology for Cardiovascular Surgery and Intensive Care Medicine, Medical University of Graz, Graz, Austria
| | - Massimo Girardis
- Struttura Complessa di Anestesia 1, Policlinico di Modena, Modena, Italy
| | - Fabio Guarracino
- Dipartimento di Anestesia e Terapie Intensive, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Veli-Pekka Harjola
- Emergency Medicine, Meilahti Central University Hospital, University of Helsinki, Helsinki, Finland
| | - Matthias Heringlake
- Department of Anaesthesiology and Intensive Care Medicine, University of Lübeck, Lübeck, Germany
| | - Antoine Herpain
- Department of Intensive Care, Hôpital Erasme, Brussels, Belgium
| | - Leo M. A. Heunks
- Department of Intensive Care Medicine, Amsterdam UMC, Amsterdam, the Netherlands
| | - Tryggve Husebye
- Department of Cardiology, Oslo University Hospital Ullevaal, Oslo, Norway
| | - Višnja Ivancan
- Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre, Zagreb, Croatia
| | - Kristjan Karason
- Departments of Cardiology and Transplantation, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Sundeep Kaul
- Intensive Care Unit, National Health Service, Leeds, United Kingdom
| | - Matti Kivikko
- Global Medical Affairs, R&D, Orion Pharma, Espoo, Finland
| | - Janek Kubica
- Department of Cardiology and Internal Medicine, Nicolaus Copernicus University, Torun, Poland
| | - Josep Masip
- Intensive Care Department, Consorci Sanitari Integral, University of Barcelona, Barcelona, Spain
| | | | - Alexandre Mebazaa
- Department of Anaesthesiology and Critical Care Medicine, AP-HP, Saint Louis and Lariboisière University Hospitals, Paris, France
| | | | - Fabrizio Oliva
- Department of Cardiology, Niguarda Ca'Granda Hospital, Milan, Italy
| | - Julius G. Papp
- MTA-SZTE Research Group of Cardiovascular Pharmacology, Hungarian Academy of Sciences, University of Szeged, Szeged, Hungary
| | - John Parissis
- Second Department of Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexander Parkhomenko
- Emergency Cardiology Department, National Scientific Centre MD Strazhesko Institute of Cardiology, Kiev, Ukraine
| | - Pentti Põder
- Department of Cardiology, North Estonia Medical Centre, Tallinn, Estonia
| | - Gerhard Pölzl
- Department of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alexander Reinecke
- Klinik für Innere Medizin III, Kardiologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Sven-Erik Ricksten
- Department of Anaesthesiology and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hynek Riha
- Department of Anaesthesiology and Intensive Care Medicine, Cardiothoracic Anaesthesiology and Intensive Care, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Alain Rudiger
- Department of Medicine, Spittal Limmattal, Schlieren, Switzerland
| | | | - Robert H. G. Schwinger
- Medizinische Klinik II, Klinikum Weiden, Teaching Hospital of University of Regensburg, Weiden, Germany
| | - Wolfgang Toller
- Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
| | - Luigi Tritapepe
- Anaesthesia and Intensive Care Division, San Camillo-Forlanini Hospital, Rome, Italy
| | - Carsten Tschöpe
- Department of Cardiology, Campus Virchow Klinikum, Charité—University Medicine Berlin, Berlin, Germany
| | - Gerhard Wikström
- Institute of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Dirk von Lewinski
- Department of Cardiology, Myokardiale Energetik und Metabolismus Research Unit, Medical University of Graz, Graz, Austria
| | - Bojan Vrtovec
- Department of Cardiology, Advanced Heart Failure and Transplantation Centre, University Clinical Centre, Ljubljana, Slovenia
| | - Piero Pollesello
- Critical Care Proprietary Products, Orion Pharma, Espoo, Finland.
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Mahler V, Mentzer D, Bonertz A, Muraro A, Eigenmann P, Bousquet J, Halken S, Pfaar O, Jutel M, Wahn U, Vieths S, Kaul S. Allergen Immunotherapy (AIT) in children: a vulnerable population with its own rights and legislation - summary of EMA-initiated multi-stakeholder meeting on Allergen Immunotherapy (AIT) for children, held at Paul-Ehrlich-Institut, Langen, Germany, 16.1.2019. Clin Transl Allergy 2020; 10:28. [PMID: 32612805 PMCID: PMC7325268 DOI: 10.1186/s13601-020-00327-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/30/2020] [Indexed: 12/15/2022] Open
Abstract
Concerning development of medicinal products, children belong to a so-called "special population" for which additional legislation applies: Regulation (EC) No 1901/2006 on medicinal products for paediatric use sets up a system of requirements, rewards and incentives to ensure that medicinal products are researched, developed and authorized to meet the therapeutic needs of children. Allergen Immunotherapy (AIT) is believed to contain a strong potential for immunomodulatory effects inducing sustained clinical efficacy after cessation of treatment (disease modifying effect) and thereby may prevent the progression of the atopic march towards asthma manifestation. However, to this day only few data on long-term effects in general exist and even fewer in children. These are predominantly data from open studies, which are strongly influenced in their validity by the known placebo effect of AIT. Furthermore, there are no studies allowing for the conclusion that efficacy in adults are mirrored by a similar efficacy in children and thus, up to now, it is not possible to extrapolate data from adults to children. The Paediatric Committee (PDCO)-European Medicines Agency's (EMA) scientific committee responsible for activities on medicines for children-initiated a Multi-Stakeholder Meeting on AIT for Children held at the Paul-Ehrlich-Institut in Langen, Germany, to provide a platform for discussion and exchange of thoughts to this topic between allergy experts from academia, regulators and AIT-manufacturers. The consented meeting minutes, conclusions and participants are presented.
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Affiliation(s)
- V Mahler
- Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225 Langen, Germany
| | - D Mentzer
- Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225 Langen, Germany
| | - A Bonertz
- Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225 Langen, Germany
| | - A Muraro
- Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy
| | - P Eigenmann
- Pediatric Allergy Unit, University Hospitals of Geneva, Geneva, Switzerland
| | - J Bousquet
- Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, Germany.,University Hospital Montpellier, Montpellier, France.,MACVIA-France, Montpellier, France
| | - S Halken
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - O Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Phillipps-Universität Marburg, Marburg, Germany
| | - M Jutel
- Department of Clinical Immunology, Wrocław Medical University, Wrocław, Poland.,ALL-MED Medical Research Institute, Wrocław, Poland
| | - U Wahn
- Pediatric Department, Charité, Berlin, Germany
| | - S Vieths
- Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225 Langen, Germany
| | - S Kaul
- Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225 Langen, Germany
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Jakhar D, Kaur I, Kaul S. Screen mirroring, screen casting and screen sharing during COVID-19: what dermatologists should know. Clin Exp Dermatol 2020; 45:750-751. [PMID: 32304574 PMCID: PMC7264592 DOI: 10.1111/ced.14247] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/15/2020] [Indexed: 12/02/2022]
Affiliation(s)
- D Jakhar
- Department of Dermatology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - I Kaur
- Department of Dermatology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - S Kaul
- Department of Internal Medicine, John H. Stroger Hospital of Cook County, Chicago, IL, USA
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Jakhar D, Kaul S, Kaur I. WhatsApp messenger as a teledermatology tool during coronavirus disease (COVID‐19): from bedside to phone‐side. Clin Exp Dermatol 2020; 45:739-740. [PMID: 32243612 PMCID: PMC9213937 DOI: 10.1111/ced.14227] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2020] [Indexed: 11/27/2022]
Affiliation(s)
- D. Jakhar
- Department of Dermatology North Delhi Municipal Corporation Medical College & Hindu Rao Hospital New Delhi India
| | - S. Kaul
- Department of Internal Medicine John H. Stroger Hospital of Cook County Chicago IL USA
| | - I. Kaur
- Department of Dermatology North Delhi Municipal Corporation Medical College & Hindu Rao Hospital New Delhi India
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Jakhar D, Kaur I, Kaul S. Art of performing dermoscopy during the times of coronavirus disease (COVID-19): simple change in approach can save the day! J Eur Acad Dermatol Venereol 2020; 34:e242-e244. [PMID: 32223004 DOI: 10.1111/jdv.16412] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- D Jakhar
- Department of Dermatology, North Delhi Municipal Corporation Medical College & Hindu Rao Hospital, New Delhi, India
| | - I Kaur
- Department of Dermatology, North Delhi Municipal Corporation Medical College & Hindu Rao Hospital, New Delhi, India
| | - S Kaul
- Department of internal Medicine, John H Stroger Hospital of Cook County, Chicago, IL, USA
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Pollesello P, Ben Gal T, Bettex D, Cerny V, Comin-Colet J, Eremenko AA, Farmakis D, Fedele F, Fonseca C, Harjola VP, Herpain A, Heringlake M, Heunks L, Husebye T, Ivancan V, Karason K, Kaul S, Kubica J, Mebazaa A, Mølgaard H, Parissis J, Parkhomenko A, Põder P, Pölzl G, Vrtovec B, Yilmaz MB, Papp Z. Short-Term Therapies for Treatment of Acute and Advanced Heart Failure-Why so Few Drugs Available in Clinical Use, Why Even Fewer in the Pipeline? J Clin Med 2019; 8:jcm8111834. [PMID: 31683969 PMCID: PMC6912236 DOI: 10.3390/jcm8111834] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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] [Received: 10/03/2019] [Revised: 10/24/2019] [Accepted: 10/28/2019] [Indexed: 01/10/2023] Open
Abstract
Both acute and advanced heart failure are an increasing threat in term of survival, quality of life and socio-economical burdens. Paradoxically, the use of successful treatments for chronic heart failure can prolong life but-per definition-causes the rise in age of patients experiencing acute decompensations, since nothing at the moment helps avoiding an acute or final stage in the elderly population. To complicate the picture, acute heart failure syndromes are a collection of symptoms, signs and markers, with different aetiologies and different courses, also due to overlapping morbidities and to the plethora of chronic medications. The palette of cardio- and vasoactive drugs used in the hospitalization phase to stabilize the patient's hemodynamic is scarce and even scarcer is the evidence for the agents commonly used in the practice (e.g. catecholamines). The pipeline in this field is poor and the clinical development chronically unsuccessful. Recent set backs in expected clinical trials for new agents in acute heart failure (AHF) (omecamtiv, serelaxine, ularitide) left a field desolately empty, where only few drugs have been approved for clinical use, for example, levosimendan and nesiritide. In this consensus opinion paper, experts from 26 European countries (Austria, Belgium, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Israel, Italy, The Netherlands, Norway, Poland, Portugal, Russia, Slovenia, Spain, Sweden, Switzerland, Turkey, U.K. and Ukraine) analyse the situation in details also by help of artificial intelligence applied to bibliographic searches, try to distil some lesson-learned to avoid that future projects would make the same mistakes as in the past and recommend how to lead a successful development project in this field in dire need of new agents.
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Affiliation(s)
| | - Tuvia Ben Gal
- Heart Failure Unit, Rabin Medical Center, Tel Aviv University, Petah Tikva 4941492d, Israel.
| | - Dominique Bettex
- Institute of Anaesthesiology, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland.
| | - Vladimir Cerny
- Department of Anesthesiology, Perioperative Medicine and Intensive Care, Masaryk Hospital, J.E. Purkinje University, 400 96 Usti nad Labem, Czech Republic.
| | - Josep Comin-Colet
- Heart Diseases Institute, Hospital Universitari de Bellvitge, 08015 Barcelona, Spain.
| | - Alexandr A Eremenko
- Department of Cardiac Intensive Care, Petrovskii National Research Centre of Surgery, Sechenov University, 119146 Moscow, Russia.
| | - Dimitrios Farmakis
- Department of Cardiology, Medical School, University of Cyprus, 1678 Nicosia, Cyprus.
| | - Francesco Fedele
- Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, 'La Sapienza' University of Rome, 00185 Rome, Italy.
| | - Cândida Fonseca
- Heart Failure Clinic of S. Francisco Xavier Hospital, CHLO, 1449-005 Lisbon, Portugal.
| | - Veli-Pekka Harjola
- Emergency Medicine, Department of Emergency Medicine and Services, Helsinki University Hospital, University of Helsinki, 00014 Helsinki, Finland.
| | - Antoine Herpain
- Department of Intensive Care, Experimental Laboratory of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, 1050 Bruxelles, Belgium.
| | - Matthias Heringlake
- Department of Anesthesiology and Intensive Care Medicine, University of Lübeck, 23562 Lübeck, Germany.
| | - Leo Heunks
- Department of Intensive Care Medicine, Amsterdam UMC, location VUmc 081 HV, The Netherlands.
| | - Trygve Husebye
- Department of Cardiology, Oslo University Hospital Ullevaal, 0372 Oslo, Norway.
| | - Visnja Ivancan
- Department of Anesthesiology, Reanimatology and Intensive Care, University Hospital Centre, 10000 Zagreb, Croatia.
| | - Kristian Karason
- Transplant Institute, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden.
| | - Sundeep Kaul
- Intensive Care Unit, National Health Service, Leeds LS2 9JT, UK.
| | - Jacek Kubica
- Department of Cardiology and Internal Medicine, Nicolaus Copernicus University, 87-100 Torun, Poland.
| | - Alexandre Mebazaa
- Department of Anaesthesiology and Critical Care Medicine, AP-HP, Saint Louis and Lariboisière University Hospitals, Université de Paris and INSERM UMR-S 942-MASCOT, 75010 Paris, France.
| | - Henning Mølgaard
- Department of Cardiology, Århus University Hospital, 8200 Århus, Denmark.
| | - John Parissis
- Emergency Department, Attikon University Hospital, National and Kapodistrian University of Athens, 157 72 Athens, Greece.
| | - Alexander Parkhomenko
- Emergency Cardiology Department, National Scientific Center M.D. Strazhesko Institute of Cardiology, 02000 Kiev, Ukraine.
| | - Pentti Põder
- Department of Cardiology, North Estonia Medical Center, 13419 Tallinn, Estonia.
| | - Gerhard Pölzl
- Department of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
| | - Bojan Vrtovec
- Advanced Heart Failure and Transplantation Center, Department of Cardiology, Ljubljana University Medical Center, SI-1000 Ljubljana, Slovenia.
| | - Mehmet B Yilmaz
- Department of Cardiology, Dokuz Eylul University Faculty of Medicine, 35340 Izmir, Turkey.
| | - Zoltan Papp
- Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary.
- HAS-UD Vascular Biology and Myocardial Pathophysiology Research Group, Hungarian Academy of Sciences, 4001 Debrecen, Hungary.
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Le T, Kaul S, Cappelli L, Naidoo J, Kwatra S. 632 Cutaneous immune-related adverse events in 1,857 patients treated with anti-PD-1 therapy at an academic center. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Masding A, Kaul S. Opioid-induced constipation in intensive care – how big is the problem, and can we solve it? Clin Med (Lond) 2019. [DOI: 10.7861/clinmedicine.19-2-s23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kaul S, Kaur H, Vats SKS, Chawla J, Jindal R, Khetarpal P. Identification of novel translocation between short arm of chromosome 4 and long arm of chromosome 6 in an infertile man using Interphase Chromosome Profiling (ICP). Andrologia 2018; 50:e12954. [PMID: 29411892 DOI: 10.1111/and.12954] [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] [Accepted: 11/15/2017] [Indexed: 11/27/2022] Open
Abstract
Conventional cytogenetics has always been a favourite to detect chromosomal aberrations. Carriers of chromosomal translocation are often phenotypically normal but are infertile. Couples are often advised to go for karyotyping, but culture failure or improper metaphase spread with poor banding often makes the analysis difficult. We report here a novel translocation between short arm of chromosome 4 and long arm of chromosome 6 in an infertile man using an advanced molecular cytogenetic technique of Interphase Chromosome Profiling (ICP).
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Affiliation(s)
- S Kaul
- Centre for Human Genetics and Molecular Medicine, School of Health Science, Central University of Punjab, Bathinda, India
| | - H Kaur
- Adesh University, Bathinda, India
| | - S K S Vats
- Dss Imagetech Pvt. ltd, New Delhi, India
| | - J Chawla
- Jindal Heart Hospital, Jindal heart institute and IVF centre, Bathinda, India
| | - R Jindal
- Jindal Heart Hospital, Jindal heart institute and IVF centre, Bathinda, India
| | - P Khetarpal
- Centre for Human Genetics and Molecular Medicine, School of Health Science, Central University of Punjab, Bathinda, India
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Abstract
Background Work-family conflict (WFC) and job insecurity are important determinants of workers' mental health. Aims To examine the relationship between WFC and psychological distress, and the co-occurring effects of WFC and job insecurity on distress in US working adults. Methods This study used cross-sectional data from the 2010 National Health Interview Survey (NHIS) for adults aged 18-64 years. The 2010 NHIS included occupational data from the National Institute for Occupational Safety and Health (NIOSH) sponsored Occupational Health Supplement. Logistic regression models were used to examine the independent and co-occurring effects of WFC and job insecurity on distress. Results The study group consisted of 12059 participants. In the model fully adjusted for relevant occupational, behavioural, sociodemographic and health covariates, WFC and job insecurity were independently significantly associated with increased odds of psychological distress. Relative to participants reporting WFC only, participants reporting no WFC and no job insecurity had lower odds of moderate and severe distress. Co-occurring WFC and job insecurity was associated with significantly higher odds of both moderate [odds ratio (OR) = 1.55; 95% confidence interval (CI) 1.25-1.9] and severe (OR = 3.57; 95% CI 2.66-4.79) distress. Conclusions Rates of WFC and job insecurity were influenced by differing factors in working adults; however, both significantly increased risk of adverse mental health outcomes, particularly when experienced jointly. Future studies should explore the temporal association between co-occurring WFC and job insecurity and psychological distress.
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Affiliation(s)
- M Mutambudzi
- Department of Preventive Medicine & Community Health, University of Texas Medical Branch, USA
| | - Z Javed
- Department of Preventive Medicine & Community Health, University of Texas Medical Branch, USA
| | - S Kaul
- Department of Preventive Medicine & Community Health, University of Texas Medical Branch, USA
| | - J Prochaska
- Department of Preventive Medicine & Community Health, University of Texas Medical Branch, USA
| | - M K Peek
- Department of Preventive Medicine & Community Health, University of Texas Medical Branch, USA
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Lindley RI, Anderson CS, Billot L, Forster A, Hackett ML, Harvey LA, Jan S, Li Q, Liu H, Langhorne P, Maulik PK, Murthy GVS, Walker MF, Pandian JD, Alim M, Felix C, Syrigapu A, Tugnawat DK, Verma SJ, Shamanna BR, Hankey G, Thrift A, Bernhardt J, Mehndiratta MM, Jeyaseelan L, Donnelly P, Byrne D, Steley S, Santhosh V, Chilappagari S, Mysore J, Roy J, Padma MV, John L, Aaron S, Borah NC, Vijaya P, Kaul S, Khurana D, Sylaja PN, Halprashanth DS, Madhusudhan BK, Nambiar V, Sureshbabu S, Khanna MC, Narang GS, Chakraborty D, Chakraborty SS, Biswas B, Kaura S, Koundal H, Singh P, Andrias A, Thambu DS, Ramya I, George J, Prabhakar AT, Kirubakaran P, Anbalagan P, Ghose M, Bordoloi K, Gohain P, Reddy NM, Reddy KV, Rao TNM, Alladi S, Jalapu VRR, Manchireddy K, Rajan A, Mehta S, Katoch C, Das B, Jangir A, Kaur T, Sreedharan S, Sivasambath S, Dinesh S, Shibi BS, Thangaraj A, Karunanithi A, Sulaiman SMS, Dehingia K, Das K, Nandini C, Thomas NJ, Dhanya TS, Thomas N, Krishna R, Aneesh V, Krishna R, Khullar S, Thouman S, Sebastian I. Family-led rehabilitation after stroke in India (ATTEND): a randomised controlled trial. Lancet 2017; 390:588-599. [PMID: 28666682 DOI: 10.1016/s0140-6736(17)31447-2] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 03/17/2017] [Accepted: 04/04/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Most people with stroke in India have no access to organised rehabilitation services. The effectiveness of training family members to provide stroke rehabilitation is uncertain. Our primary objective was to determine whether family-led stroke rehabilitation, initiated in hospital and continued at home, would be superior to usual care in a low-resource setting. METHODS The Family-led Rehabilitation after Stroke in India (ATTEND) trial was a prospectively randomised open trial with blinded endpoint done across 14 hospitals in India. Patients aged 18 years or older who had had a stroke within the past month, had residual disability and reasonable expectation of survival, and who had an informal family-nominated caregiver were randomly assigned to intervention or usual care by site coordinators using a secure web-based system with minimisation by site and stroke severity. The family members of participants in the intervention group received additional structured rehabilitation training-including information provision, joint goal setting, carer training, and task-specific training-that was started in hospital and continued at home for up to 2 months. The primary outcome was death or dependency at 6 months, defined by scores 3-6 on the modified Rankin scale (range, 0 [no symptoms] to 6 [death]) as assessed by masked observers. Analyses were by intention to treat. This trial is registered with Clinical Trials Registry-India (CTRI/2013/04/003557), Australian New Zealand Clinical Trials Registry (ACTRN12613000078752), and Universal Trial Number (U1111-1138-6707). FINDINGS Between Jan 13, 2014, and Feb 12, 2016, 1250 patients were randomly assigned to intervention (n=623) or control (n=627) groups. 33 patients were lost to follow-up (14 intervention, 19 control) and five patients withdrew (two intervention, three control). At 6 months, 285 (47%) of 607 patients in the intervention group and 287 (47%) of 605 controls were dead or dependent (odds ratio 0·98, 95% CI 0·78-1·23, p=0·87). 72 (12%) patients in the intervention group and 86 (14%) in the control group died (p=0·27), and we observed no difference in rehospitalisation (89 [14%]patients in the intervention group vs 82 [13%] in the control group; p=0·56). We also found no difference in total non-fatal events (112 events in 82 [13%] intervention patients vs 110 events in 79 [13%] control patients; p=0·80). INTERPRETATION Although task shifting is an attractive solution for health-care sustainability, our results do not support investment in new stroke rehabilitation services that shift tasks to family caregivers, unless new evidence emerges. A future avenue of research should be to investigate the effects of task shifting to health-care assistants or team-based community care. FUNDING The National Health and Medical Research Council of Australia.
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Pfaar O, Calderon MA, Andrews CP, Angjeli E, Bergmann KC, Bønløkke JH, de Blay F, Devillier P, Ellis AK, Gerth van Wijk R, Hohlfeld JM, Horak F, Jacobs RL, Jacobsen L, Jutel M, Kaul S, Larché M, Larenas-Linnemann D, Mösges R, Nolte H, Patel P, Peoples L, Rabin RL, Rather C, Salapatek AM, Sigsgaard T, Thaarup S, Yang J, Zieglmayer P, Zuberbier T, Demoly P. Allergen exposure chambers: harmonizing current concepts and projecting the needs for the future - an EAACI Position Paper. Allergy 2017; 72:1035-1042. [PMID: 28122133 DOI: 10.1111/all.13133] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Allergen exposure chambers (AECs) are clinical facilities allowing for controlled exposure of subjects to allergens in an enclosed environment. AECs have contributed towards characterizing the pathophysiology of respiratory allergic diseases and the pharmacological properties of new therapies. In addition, they are complementary to and offer some advantages over traditional multicentre field trials for evaluation of novel therapeutics. To date, AEC studies conducted have been monocentric and have followed protocols unique to each centre. Because there are technical differences among AECs, it may be necessary to define parameters to standardize the AECs so that studies may be extrapolated for driving basic immunological research and for marketing authorization purposes by regulatory authorities. METHODS For this task force initiative of the European Academy of Allergy and Clinical Immunology (EAACI), experts from academia and regulatory agencies met with chamber operators to list technical, clinical and regulatory unmet needs as well as the prerequisites for clinical validation. RESULTS The latter covered the validation process, standardization of challenges and outcomes, intra- and interchamber variability and reproducibility, in addition to comparability with field trials and specifics of paediatric trials and regulatory issues. CONCLUSION This EAACI Position Paper aims to harmonize current concepts in AECs and to project unmet needs with the intent to enhance progress towards use of these facilities in determining safety and efficacy of new therapeutics in the future.
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Affiliation(s)
- O. Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery; Universitätsmedizin Mannheim; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
- Center for Rhinology and Allergology; Wiesbaden Germany
| | - M. A. Calderon
- Section of Allergy and Clinical Immunology; Imperial College London; London UK
- National Heart & Lung Institute; Royal Brompton Hospital; London UK
| | | | | | - K. C. Bergmann
- Allergy-Centre-Charité; Charité Universitätsmedizin Berlin; Berlin Germany
| | - J. H. Bønløkke
- Department of Public Health; Section for Environment, Occupation and Health; Danish Ramazzini Center; Aarhus University; Aarhus Denmark
| | - F. de Blay
- ALYATEC; Strasbourg France
- Chest Disease Department; University Hospital of Strasbourg and Federation of Translational Medicine, EA3072; Strasbourg University; Strasbourg France
| | - P. Devillier
- UPRES EA 220; Airway Diseases Department; Hôpital Foch; Université Versailles Saint Quentin; University Paris Saclay; Suresnes France
| | - A. K. Ellis
- Department of Medicine; Queen's University; Kingston ON Canada
- Environmental Exposure Unit; Kingston General Hospital; Kingston ON Canada
| | - R. Gerth van Wijk
- Section of Allergology; Department of Internal Medicine; Erasmus MC; Rotterdam The Netherlands
| | - J. M. Hohlfeld
- Department of Clinical Airway Research; Fraunhofer Institute of Toxicology and Experimental Medicine (ITEM); Hannover Germany, Member of the German Center for Lung Research
| | - F. Horak
- Vienna Challenge Chamber; Vienna Austria
| | - R. L. Jacobs
- Biogenics Research Chamber LLC; San Antonio TX USA
| | - L. Jacobsen
- Allergy Learning and Consulting (ALC); Copenhagen Denmark
| | - M. Jutel
- ALL-MED Medical Research Institute; Wrocław Poland
- Wroclaw Medical University; Wrocław Poland
| | - S. Kaul
- Division of Allergology; Paul-Ehrlich-Institut; Federal Institute for Vaccines and Biomedicines; Langen Germany
| | - M. Larché
- Firestone Institute for Respiratory Health; Department of Medicine; St. Joseph's Hospital Healthcare; McMaster University; Hamilton ON Canada
| | - D. Larenas-Linnemann
- Department of Investigation; Hospital Médica Sur; Mexico City Mexico
- Center for Excellence in Asthma and Allergy; Mexico City Mexico
| | - R. Mösges
- Institute of Medical Statistics, Informatics and Epidemiology (IMSIE); University Hospital of Cologne; University at Cologne; Cologne Germany
| | | | - P. Patel
- Inflamax Research Inc.; Mississauga ON Canada
| | | | - R. L. Rabin
- Center for Biologics Evaluation and Research; United States Food and Drug Administration; Silver Spring MD USA
| | - C. Rather
- Biogenics Research Chamber LLC; San Antonio TX USA
| | | | - T. Sigsgaard
- Department of Public Health; Section for Environment, Occupation and Health; Danish Ramazzini Center; Aarhus University; Aarhus Denmark
| | - S. Thaarup
- Mobile Chamber Experts GmbH (MCX); Berlin Germany
| | - J. Yang
- Red Maple Trials; Ottawa ON Canada
| | | | - T. Zuberbier
- Global Allergy and Asthma European Network (GA LEN); Department of Dermatology & Allergy; Charité Universitätsmedizin Berlin; Berlin Germany
| | - P. Demoly
- Département de Pneumologie et Addictologie; Hôpital Arnaud de Villeneuve; University Hospital of Montpellier; Montpellier France
- UPMC Paris 06; UMR-S 1136; IPLESP; Equipe EPAR; Sorbonne Universités; Paris France
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Zimmer J, Döring S, Strecker D, Trösemeier JH, Hanschmann KM, Führer F, Vieths S, Kaul S. Minor allergen patterns in birch pollen allergen products-A question of pollen? Clin Exp Allergy 2017; 47:1079-1091. [PMID: 28493312 DOI: 10.1111/cea.12955] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 12/14/2016] [Revised: 03/29/2017] [Accepted: 04/19/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Contrary to the scientific differentiation between major and minor allergens, the regulatory framework controlling allergen products in the EU distinguishes relevant and non-relevant allergens. Given the lack of knowledge on their clinical relevance, minor allergens are usually not controlled by allergen product specifications. Especially, in birch pollen (BP) allergen products, minor allergens are commonly disregarded. OBJECTIVES To quantify three minor allergens in BP allergen products from different manufacturers and to assess the influence of the utilized BP on minor allergen patterns. METHODS Apart from common quality parameters such as Bet v 1 content, Bet v 4, Bet v 6 and Bet v 7 were quantified in 70 BP allergen product batches from six manufacturers, using ELISA systems developed in-house. Batch-to-batch variability was checked for agreement with a variability margin of 50%-200% from mean of the given batches for individual allergen content. Subsequently, minor allergen patterns were generated via multidimensional scaling and related to information on the pollen lots used in production of the respective product batches. RESULTS Like the already established Bet v 4 ELISA, the ELISA systems for quantification of Bet v 6 and Bet v 7 were successfully validated. Differences in minor allergen content between products and batch-to-batch consistency were observed. Correlations between minor and major allergen content were low to moderate. About 20% of batches exceeded the variability margin for at least one minor allergen. Interestingly, these fluctuations could not in all cases be linked to the use of certain BP lots. CONCLUSIONS AND CLINICAL RELEVANCE The impact of the observed minor allergen variability on safety and efficacy of BP allergen products can currently not be estimated. As the described differences could only in few cases be related to the used pollen lots, it is evident that additional factors influence minor allergens in BP allergen products.
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Affiliation(s)
- J Zimmer
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - S Döring
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - D Strecker
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - J H Trösemeier
- Division of Microbiology, Paul-Ehrlich-Institut, Langen, Germany
| | - K M Hanschmann
- Division of Microbiology, Paul-Ehrlich-Institut, Langen, Germany
| | - F Führer
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - S Vieths
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - S Kaul
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
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Sarin R, Khandrika L, Hanitha R, Avula A, Batra M, Kaul S, Raj H, Shivkumar S, Gupta S, Khan E, Bhandari T, Prasad S, Reddy VA, Swarnalata G, Bakre M, Chatterjee S, Jain J. Epidemiological and survival analysis of triple-negative breast cancer cases in a retrospective multicenter study. Indian J Cancer 2017; 53:353-359. [PMID: 28244455 DOI: 10.4103/0019-509x.200682] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION This is a retrospective study with data collected from breast cancer cases from five major Apollo Hospitals across India, as part of a biobanking process. One aspect of our study focused specifically on data from triple-negative breast cancer (TNBC) cases. The aim of this study was to analyze epidemiology, treatment options, and survival of the patients with TNBC. Our goal was to draw conclusions on the preponderance of the disease and also to understand the outcomes using the existing therapy options. MATERIALS AND METHODS Data were collected after due ethical clearances and were coded with regard to patient identifiers to protect patient privacy. Data were not only from the various departments of the respective hospitals and the treating physicians but also from the follow-up made by hospital staff and social workers. RESULTS About 20% of all cases of breast cancer comprised TNBC. Although the disease is generally thought to be an early onset disease, there was no major difference in the median age of diagnosis of TNBC compared to other breast cancer cases. More than 85% of the TNBC cases were of early stage disease with <4% of the cases of metastatic cancer. Data on follow-up were somewhat sporadic as a good number of cases were lost to follow-up, but from the available data, recurrence rate was about 11%. Death, when it occurred, was mostly in the early periods of treatment with 35% of the events occurring before 3 years. The overall survival rates beyond 3 years were more than 86%. CONCLUSIONS Data and sample collection are an ongoing process, so we expect this data set to be enriched with more cases and longer duration of follow-up in a year. Preliminary analysis sheds light on the potential of such a collection both for understanding the epidemiology of the disease and also for conducting future studies with an eye toward improving treatment outcomes.
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Affiliation(s)
- R Sarin
- Indraprastha Apollo Hospitals, New Delhi, India
| | - L Khandrika
- Sapien Biosciences Pvt. Ltd., Hyderabad, Telangana, India
| | - Rnm Hanitha
- Sapien Biosciences Pvt. Ltd., Hyderabad, Telangana, India
| | - A Avula
- Sapien Biosciences Pvt. Ltd., Hyderabad, Telangana, India
| | - M Batra
- Sapien Biosciences Pvt. Ltd., Hyderabad, Telangana, India
| | - S Kaul
- Indraprastha Apollo Hospitals, New Delhi, India
| | - H Raj
- Apollo Speciality Hospital, Chennai, Tamil Nadu, India
| | - S Shivkumar
- Apollo Hospital Enterprises, Bengaluru, Karnataka, India
| | - S Gupta
- Apollo Gleneagles Hospitals, Kolkata, West Bengal, India
| | - E Khan
- Apollo Gleneagles Hospitals, Kolkata, West Bengal, India
| | - Tps Bhandari
- Apollo Hospital Enterprises, Hyderabad, Telangana, India
| | - Svss Prasad
- Apollo Hospital Enterprises, Hyderabad, Telangana, India
| | - V A Reddy
- Apollo Hospital Enterprises, Hyderabad, Telangana, India
| | - G Swarnalata
- Apollo Hospital Enterprises, Hyderabad, Telangana, India
| | - M Bakre
- OncoStem Diagnostics Pvt. Ltd., Bengaluru, Karnataka, India
| | | | - J Jain
- Indraprastha Apollo Hospitals, New Delhi, India
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Kaul S, Zimmer J, Dehus O, Constanzo A, Daas A, Buchheit KH, Asturias J, Arilla MC, Barber D, Bertocchi A, Brunetto B, Carnes JA, Chapman M, Chaudemanche G, Dayan-Kenigsberg J, Döring S, Führer F, Gallego MT, Iacovacci P, Hanschmann KM, Holzhauser T, Hrabina M, Ledesma A, Moingeon P, Nony E, Pini C, Plunkett G, Raulf M, Reese G, Sandberg E, Sander I, Smith B, Strecker D, Valerio C, van Ree R, Weber B, Vieths S. Validation of ELISA methods for quantification of the major birch allergen Bet v 1 (BSP090). Pharmeur Bio Sci Notes 2017; 2017:69-87. [PMID: 29143737] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
To date, the potency of allergen products in Europe is expressed in manufacturer-specific units relative to a product-specific in-house reference. Consequently, cross-product comparability of allergen products from different manufacturers with respect to strength and efficacy is impossible. The Biological Standardisation Programme (BSP) project BSP090 addresses this issue via the establishment of reference standards in conjunction with ELISA methods for the quantification of major allergens in allergen products. Since the initiation of BSP090, the recombinant major allergen Bet v 1 has been adopted by the European Pharmacopoeia Commission as a Chemical Reference Substance (CRS). In parallel, two sandwich ELISA systems for quantification of Bet v 1 were found suitable in preliminary phases of BSP090 to be validated in a large collaborative study. In this study, the candidate ELISA systems were compared with respect to accuracy, precision and variability. Thirteen participating laboratories tested model samples containing the CRS as well as spiked and unspiked birch pollen extracts. Both in pre-testing and in the collaborative study, the 2 candidate ELISA systems confirmed their suitability to quantify recombinant and native Bet v 1. As no clear-cut decision for one of the ELISA systems could be made based on the results of the collaborative study, a post-study testing was performed. Bet v 1 content of 30 birch pollen allergen products was determined in parallel in both ELISA systems. Consequently, 1 candidate ELISA system was selected to be proposed as the future European Pharmacopoeia standard method for Bet v 1 quantification.
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Affiliation(s)
- S Kaul
- Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, D-63225 Langen, Germany
| | - J Zimmer
- Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, D-63225 Langen, Germany
| | - O Dehus
- Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, D-63225 Langen, Germany
| | - A Constanzo
- European Directorate for the Quality of Medicines & HealthCare (EDQM), 7 allée Kastner, CS 30026, F-67081 Strasbourg, France
| | - A Daas
- European Directorate for the Quality of Medicines & HealthCare (EDQM), 7 allée Kastner, CS 30026, F-67081 Strasbourg, France
| | - K-H Buchheit
- European Directorate for the Quality of Medicines & HealthCare (EDQM), 7 allée Kastner, CS 30026, F-67081 Strasbourg, France
| | - J Asturias
- Roxall Medicina España, Parque Científico y Tecnológico de Bizkaia, Ed. 401, 48170 Zamudio, Spain
| | - M C Arilla
- Roxall Medicina España, Parque Científico y Tecnológico de Bizkaia, Ed. 401, 48170 Zamudio, Spain
| | - D Barber
- ALK-Abelló S.A., Miguel Fleta 19, ES-28037 Madrid, Spain
| | - A Bertocchi
- ANSM, 143 boulevard Anatole France, 93285 Saint Denis Cedex, France
| | - B Brunetto
- ISS CNCF, Viale Regina Elena 299, I-00161 Roma, Italy
| | - J A Carnes
- Laboratorios Leti S.L., Calle Del Sol 5, 28760 Tres Cantos, Spain
| | - M Chapman
- Indoor Biotechnologies, 700 Harris Street, 22903 Charlotteville, USA
| | - G Chaudemanche
- ANSM, 143 boulevard Anatole France, 93285 Saint Denis Cedex, France
| | | | - S Döring
- Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, D-63225 Langen, Germany
| | - F Führer
- Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, D-63225 Langen, Germany
| | - M T Gallego
- Laboratorios Leti S.L., Calle Del Sol 5, 28760 Tres Cantos, Spain
| | - P Iacovacci
- ISS CNCF, Viale Regina Elena 299, I-00161 Roma, Italy
| | - K M Hanschmann
- Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, D-63225 Langen, Germany
| | - T Holzhauser
- Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, D-63225 Langen, Germany
| | - M Hrabina
- Stallergenes Greer, 6 rue Alexis de Tocqueville, 92183 Antony Cedex, France
| | - A Ledesma
- ALK-Abelló S.A., Miguel Fleta 19, ES-28037 Madrid, Spain
| | - P Moingeon
- Stallergenes Greer, 6 rue Alexis de Tocqueville, 92183 Antony Cedex, France
| | - E Nony
- Stallergenes Greer, 6 rue Alexis de Tocqueville, 92183 Antony Cedex, France
| | - C Pini
- ISS CNCF, Viale Regina Elena 299, I-00161 Roma, Italy
| | - G Plunkett
- ALK-Abelló Inc., 1700 Royston Lane, Round Rock, Texas 78664, USA
| | - M Raulf
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, D-44789 Bochum, Germany
| | - G Reese
- Allergopharma GmbH & Co. KG, Hermann-Kröner-Str. 52, D-21465 Reinbek, Germany
| | - E Sandberg
- Danish Medicines Agency, Axel Heides Gade 1, 2300 Copenhagen S, Denmark
| | - I Sander
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, D-44789 Bochum, Germany
| | - B Smith
- Indoor Biotechnologies, 700 Harris Street, 22903 Charlotteville, USA
| | - D Strecker
- Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, D-63225 Langen, Germany
| | - C Valerio
- Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993-0002, USA
| | - R van Ree
- Academic Medical Centre, Meigbergdreef 9, 1105 AZ, Amsterdam, Netherlands
| | - B Weber
- Allergopharma GmbH & Co. KG, Hermann-Kröner-Str. 52, D-21465 Reinbek, Germany
| | - S Vieths
- Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, D-63225 Langen, Germany
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Kaul S, Zimmer J, Dehus O, Costanzo A, Daas A, Buchheit KH, Asturias JA, Barber D, Carnés J, Chapman M, Dayan-Kenigsberg J, Döring S, Führer F, Hanschmann KM, Holzhauser T, Ledesma A, Moingeon P, Nony E, Pini C, Plunkett G, Reese G, Sandberg E, Sander I, Strecker D, Valerio C, van Ree R, Vieths S. Standardization of allergen products: 3. Validation of candidate European Pharmacopoeia standard methods for quantification of major birch allergen Bet v 1. Allergy 2016; 71:1414-24. [PMID: 27018782 DOI: 10.1111/all.12898] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND The BSP090 project aims at establishing European Pharmacopoeia Reference Substances in combination with the corresponding ELISA methods for the quantification of major allergens in allergen products. Two sandwich ELISAs proved suitable for quantification of Bet v 1, the major birch pollen allergen, in preceding phases of BSP090. METHODS Two Bet v 1-specific ELISA systems were compared with respect to accuracy and precision in a ring trial including 13 laboratories. Model samples containing recombinant rBet v 1.0101 as well as native birch pollen extracts were measured independently at least three times in each facility. The assessment was completed with a comparative quantification of Bet v 1 in 30 marketed birch allergen products in one laboratory, simulating the future use as reference method. RESULTS In the collaborative study, both candidate ELISAs confirmed their suitability to quantify recombinant and native Bet v 1. ELISA-A showed higher precision and lower interlaboratory variability, yet ELISA-B exhibited slightly higher accuracy. Subsequent parallel measurement of Bet v 1 in a panel of 'real-life' birch allergen products indicated better repeatability of ELISA-B. Both systems detected substantial differences in Bet v 1 content between allergen products, but the effect was more pronounced using ELISA-B due to persistently higher values compared to ELISA-A. CONCLUSIONS In the collaborative study, no deciding differences were observed between the two candidate ELISAs. Further comparison under conditions simulating the intended use combined with the criterion of long-term availability enabled the selection of one Bet v 1-specific ELISA for proposal as European Pharmacopoeia standard method.
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Affiliation(s)
- S. Kaul
- Paul-Ehrlich-Institut; Langen Germany
| | - J. Zimmer
- Paul-Ehrlich-Institut; Langen Germany
| | - O. Dehus
- Paul-Ehrlich-Institut; Langen Germany
| | - A. Costanzo
- European Directorate for the Quality of Medicines & HealthCare (EDQM); Strasbourg France
| | - A. Daas
- European Directorate for the Quality of Medicines & HealthCare (EDQM); Strasbourg France
| | - K. H. Buchheit
- European Directorate for the Quality of Medicines & HealthCare (EDQM); Strasbourg France
| | | | | | - J. Carnés
- Laboratorios Leti S.L.; Tres Cantos Spain
| | - M. Chapman
- Indoor Biotechnologies; Charlottesville VA USA
| | | | - S. Döring
- Paul-Ehrlich-Institut; Langen Germany
| | - F. Führer
- Paul-Ehrlich-Institut; Langen Germany
| | | | | | | | | | - E. Nony
- Stallergenes Greer; Antony Cedex France
| | | | | | - G. Reese
- Allergopharma GmbH & Co. KG; Reinbek Germany
| | - E. Sandberg
- Danish Medicines Agency; Copenhagen S Denmark
| | - I. Sander
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance; Ruhr-Universität Bochum (IPA); Bochum Germany
| | | | - C. Valerio
- Food and Drug Administration; Silver Spring MD USA
| | - R. van Ree
- Academic Medical Centre; Amsterdam The Netherlands
| | - S. Vieths
- Paul-Ehrlich-Institut; Langen Germany
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Sutrisna A, Soebjakto O, Wignall FS, Kaul S, Limnios EA, Ray S, Nguyen NL, Tapsall JW. Increasing resistance to ciprofloxacin and other antibiotics in Neisseria gonorrhoeae from East Java and Papua, Indonesia, in 2004 – implications for treatment. Int J STD AIDS 2016; 17:810-2. [PMID: 17212856 DOI: 10.1258/095646206779307595] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We examined gonococci isolated in 2004, in East Java and Papua, Indonesia, to review the suitability of ciprofloxacin-based and other treatment regimens. Gonococci from the two provinces were tested in Sydney for susceptibility to penicillin, tetracycline, spectinomycin, ceftriaxone, ciprofloxacin, gentamicin, azithromycin and rifampicin. Of 163 gonococcal isolates from East Java (91) and Papua (72), 120 (74%) of gonococci, 62 (68%) and 58 (80%) from East Java and Papua, respectively, were penicillinase-producing gonococci and 162 displayed high-level tetracycline resistance. Eighty-seven isolates (53%) were ciprofloxacin resistant, 44 (48%) from East Java and 43 (60%) from Papua. All isolates were sensitive to cefixime/ceftriaxone, spectinomycin and azithromycin. Minimum inhibitory concentrations of gentamicin were in the range 0.05–8 mg/L. Sixty-nine gonococci (42%) showed combined resistance, to penicillin, tetracycline and quinolones. Quinolone resistance has now reached unacceptable levels, and their use for the treatment of gonorrhoea in Indonesia should be reconsidered.
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Affiliation(s)
- A Sutrisna
- Family Health International, Jakarta, Indonesia and Bangkok, Thailand
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Nieminen MS, Buerke M, Cohen-Solál A, Costa S, Édes I, Erlikh A, Franco F, Gibson C, Gorjup V, Guarracino F, Gustafsson F, Harjola VP, Husebye T, Karason K, Katsytadze I, Kaul S, Kivikko M, Marenzi G, Masip J, Matskeplishvili S, Mebazaa A, Møller JE, Nessler J, Nessler B, Ntalianis A, Oliva F, Pichler-Cetin E, Põder P, Recio-Mayoral A, Rex S, Rokyta R, Strasser RH, Zima E, Pollesello P. The role of levosimendan in acute heart failure complicating acute coronary syndrome: A review and expert consensus opinion. Int J Cardiol 2016; 218:150-157. [PMID: 27232927 DOI: 10.1016/j.ijcard.2016.05.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 04/18/2016] [Accepted: 05/12/2016] [Indexed: 01/09/2023]
Abstract
Acute heart failure and/or cardiogenic shock are frequently triggered by ischemic coronary events. Yet, there is a paucity of randomized data on the management of patients with heart failure complicating acute coronary syndrome, as acute coronary syndrome and cardiogenic shock have frequently been defined as exclusion criteria in trials and registries. As a consequence, guideline recommendations are mostly driven by observational studies, even though these patients have a particularly poor prognosis compared to heart failure patients without signs of coronary artery disease. In acute heart failure, and especially in cardiogenic shock related to ischemic conditions, vasopressors and inotropes are used. However, both pathophysiological considerations and available clinical data suggest that these treatments may have disadvantageous effects. The inodilator levosimendan offers potential benefits due to a range of distinct effects including positive inotropy, restoration of ventriculo-arterial coupling, increases in tissue perfusion, and anti-stunning and anti-inflammatory effects. In clinical trials levosimendan improves symptoms, cardiac function, hemodynamics, and end-organ function. Adverse effects are generally less common than with other inotropic and vasoactive therapies, with the notable exception of hypotension. The decision to use levosimendan, in terms of timing and dosing, is influenced by the presence of pulmonary congestion, and blood pressure measurements. Levosimendan should be preferred over adrenergic inotropes as a first line therapy for all ACS-AHF patients who are under beta-blockade and/or when urinary output is insufficient after diuretics. Levosimendan can be used alone or in combination with other inotropic or vasopressor agents, but requires monitoring due to the risk of hypotension.
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Affiliation(s)
| | - Michael Buerke
- Department of Internal Medicine II, St. Marien Hospital Siegen, Siegen, Germany
| | | | - Susana Costa
- Department of Cardiology, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - István Édes
- Department of Cardiology, University of Debrecen, Debrecen, Hungary
| | - Alexey Erlikh
- Laboratory of Clinical Cardiology, Scientific Research Institute of Physical-Chemical Medicine, Moscow, Russia
| | - Fatima Franco
- Department of Cardiology, Coimbra Hospital and University Centre, Coimbra, Portugal
| | | | - Vojka Gorjup
- Department of Intensive Internal Medicine, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Fabio Guarracino
- Department of Cardiothoracic Anesthesia and Intensive Care, University Hospital of Pisa, Pisa, Italy
| | | | - Veli-Pekka Harjola
- Department of Emergency Medicine and Services, Helsinki University Hospital, Helsinki, Finland
| | - Trygve Husebye
- Department of Cardiology, Oslo University Hospital, Oslo, Norway
| | - Kristjan Karason
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Igor Katsytadze
- Cardiological Intensive Care Unit, Alexandrovski Central Clinical Hospital, Kiev, Ukraine
| | - Sundeep Kaul
- Department of Intensive Care and Respiratory Medicine, The Royal Brompton & Harefield Hospitals NHS Trust, London, UK
| | - Matti Kivikko
- Critical Care Proprietary Products, Orion Pharma, Espoo, Finland
| | - Giancarlo Marenzi
- Cardiological Intensive Care Unit, Cardiological Center Monzino, Milan, Italy
| | - Josep Masip
- Department of Intensive Care Medicine, Consorci Sanitari Integral, University of Barcelona, Barcelona, Spain
| | - Simon Matskeplishvili
- Department of Cardiology, University Clinic, Lomonosov Moscow State University, Moscow, Russia
| | - Alexandre Mebazaa
- Department of Anaesthesia and Burn and Critical Care, Saint-Louis-Lariboisière Hospital, AP-HP, University Paris-Diderot, Paris, France
| | - Jacob E Møller
- Department of Cardiology, Odense University Hospital, Denmark
| | - Jadwiga Nessler
- Jagiellonian University Medical College, Faculty of Medicine, Institute of Cardiology, Department of Coronary Heart Disease and Heart Failure, John Paul II Hospital, Cracow, Poland
| | - Bohdan Nessler
- Jagiellonian University Medical College, Faculty of Health Sciences, Division of Rescue Medicine, Department of Coronary Heart Disease and Heart Failure, John Paul II Hospital, Cracow, Poland
| | - Argyrios Ntalianis
- Department of Cardiology, Alexandra General Hospital of Athens, Athens, Greece
| | - Fabrizio Oliva
- Department of Cardiology II, Niguarda Ca' Granda Hospital, Milan, Italy
| | | | - Pentti Põder
- Department of Cardiology, North Estonia Medical Center, Tallinn, Estonia
| | | | - Steffen Rex
- Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium
| | - Richard Rokyta
- Department of Cardiology, University Hospital and Faculty of Medicine Pilsen, Charles University Prague, Czech Republic
| | - Ruth H Strasser
- University of Dresden, Heart Center Dresden, University Hospital, Dresden, Germany
| | - Endre Zima
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Piero Pollesello
- Critical Care Proprietary Products, Orion Pharma, Espoo, Finland
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Thakuria L, Davey R, Romano R, Carby MR, Kaul S, Griffiths MJ, Simon AR, Reed AK, Marczin N. Mechanical ventilation after lung transplantation. J Crit Care 2016; 31:110-8. [DOI: 10.1016/j.jcrc.2015.09.021] [Citation(s) in RCA: 16] [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] [Received: 04/21/2015] [Revised: 07/30/2015] [Accepted: 09/21/2015] [Indexed: 11/17/2022]
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Kaushik M, Kaul S, Wadhwa R, Urade Y. Identification of somnogenic component of ashwagandha (Withania somnifera) leaf. Sleep Med 2015. [DOI: 10.1016/j.sleep.2015.02.1520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Windberger A, Crespo López-Urrutia JR, Bekker H, Oreshkina NS, Berengut JC, Bock V, Borschevsky A, Dzuba VA, Eliav E, Harman Z, Kaldor U, Kaul S, Safronova UI, Flambaum VV, Keitel CH, Schmidt PO, Ullrich J, Versolato OO. Identification of the predicted 5s-4f level crossing optical lines with applications to metrology and searches for the variation of fundamental constants. Phys Rev Lett 2015; 114:150801. [PMID: 25933300 DOI: 10.1103/physrevlett.114.150801] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Indexed: 06/04/2023]
Abstract
We measure optical spectra of Nd-like W, Re, Os, Ir, and Pt ions of particular interest for studies of a possibly varying fine-structure constant. Exploiting characteristic energy scalings we identify the strongest lines, confirm the predicted 5s-4f level crossing, and benchmark advanced calculations. We infer two possible values for optical M2/E3 and E1 transitions in Ir^{17+} that have the highest predicted sensitivity to a variation of the fine-structure constant among stable atomic systems. Furthermore, we determine the energies of proposed frequency standards in Hf^{12+} and W^{14+}.
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Affiliation(s)
- A Windberger
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | | | - H Bekker
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - N S Oreshkina
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - J C Berengut
- School of Physics, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - V Bock
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - A Borschevsky
- Centre for Theoretical Chemistry and Physics, The New Zealand Institute for Advanced Study, Massey University Auckland, Private Bag 102904, 0745 Auckland, New Zealand
| | - V A Dzuba
- School of Physics, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - E Eliav
- School of Chemistry, Tel Aviv University, 69978 Tel Aviv, Israel
| | - Z Harman
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - U Kaldor
- School of Chemistry, Tel Aviv University, 69978 Tel Aviv, Israel
| | - S Kaul
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - U I Safronova
- Physics Department, University of Nevada, Reno, Nevada 89557, USA
| | - V V Flambaum
- School of Physics, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - C H Keitel
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - P O Schmidt
- Physikalisch-Technische Bundesanstalt, Bundesallee 100, 38116 Braunschweig, Germany
- Institut für Quantenoptik, Leibniz Universität Hannover, Welfengarten 1, 30167 Hannover, Germany
| | - J Ullrich
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
- Physikalisch-Technische Bundesanstalt, Bundesallee 100, 38116 Braunschweig, Germany
| | - O O Versolato
- Physikalisch-Technische Bundesanstalt, Bundesallee 100, 38116 Braunschweig, Germany
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Mohite PN, Kaul S, Sabashnikov A, Rashid N, Fatullayev J, Zych B, Popov AF, Maunz O, Patil NP, Garcia-Saez D, DeRobertis F, Bahrami T, Amrani M, Banner NR, Simon AR. Extracorporeal life support in patients with refractory cardiogenic shock: keep them awake. Interact Cardiovasc Thorac Surg 2015; 20:755-60. [DOI: 10.1093/icvts/ivv057] [Citation(s) in RCA: 10] [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] [Received: 11/30/2014] [Accepted: 02/19/2015] [Indexed: 12/26/2022] Open
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Beeson J, Kaul S, Anikin V, Dalal P. 122: Lung cancer treated using radiofrequency ablation: two year outcome data. Lung Cancer 2015. [DOI: 10.1016/s0169-5002(15)50116-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ogedegbe C, Carlisle A, Dave P, De Vinck D, Kaul S, Nyirenda T, Feldman J. 272 Efficacy of Topical Perfluoro t-butylcyclohexane, Oxygen-Saturated Gel in a Model of Delayed Wound Healing: Partial Thickness Burn Wound With Pseudomonas Infection in Swine. Ann Emerg Med 2014. [DOI: 10.1016/j.annemergmed.2014.07.299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Romano R, Wong I, Thakuria L, De Robertis F, Bahrami T, Amrani M, Kaul S, Hall D, Reed A, Carby M, Simon A, Marczin N. Impact of Minimally Invasive Lung Transplantation on Postoperative Renal Outcomes. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Mohite P, Sabashnikov A, Zych B, Saez D, Patil N, Weymann A, DeRobertis F, Bahrami T, Amrani M, Pitt T, McBrearty L, Reed A, Carby M, Kaul S, Simon A. Extracorporeal Life Support in ‘Awake’ Patients as a Bridge to Lung Transplantation. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Kaul S. Are Concerns About Reliability in the Trial to Assess Chelation Therapy Fair Grounds for a Hasty Dismissal?: An Alternative Perspective. Circ Cardiovasc Qual Outcomes 2014; 7:5-7. [DOI: 10.1161/circoutcomes.113.000714] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hopkinson N, Wallis C, Higgins B, Gaduzo S, Sherrington R, Keilty S, Stern M, Britton J, Bush A, Moxham J, Sylvester K, Griffiths V, Sutherland T, Crossingham I, Raju R, Spencer C, Safavi S, Deegan P, Seymour J, Hickman K, Hughes J, Wieboldt J, Shaheen F, Peedell C, Mackenzie N, Nicholl D, Jolley C, Crooks G, Crooks G, Dow C, Deveson P, Bintcliffe O, Gray B, Kumar S, Haney S, Docherty M, Thomas A, Chua F, Dwarakanath A, Summers G, Prowse K, Lytton S, Ong YE, Graves J, Banerjee T, English P, Leonard A, Brunet M, Chaudhry N, Ketchell RI, Cummings N, Lebus J, Sharp C, Meadows C, Harle A, Stewart T, Parry D, Templeton-Wright S, Moore-Gillon J, Stratford- Martin J, Saini S, Matusiewicz S, Merritt S, Dowson L, Satkunam K, Hodgson L, Suh ES, Durrington H, Browne E, Walters N, Steier J, Barry S, Griffiths M, Hart N, Nikolic M, Berry M, Thomas A, Miller J, McNicholl D, Marsden P, Warwick G, Barr L, Adeboyeku D, Mohd Noh MS, Griffiths P, Davies L, Quint J, Lyall R, Shribman J, Collins A, Goldman J, Bloch S, Gill A, Man W, Christopher A, Yasso R, Rajhan A, Shrikrishna D, Moore C, Absalom G, Booton R, Fowler RW, Mackinlay C, Sapey E, Lock S, Walker P, Jha A, Satia I, Bradley B, Mustfa N, Haqqee R, Thomas M, Patel A, Redington A, Pillai A, Keaney N, Fowler S, Lowe L, Brennan A, Morrison D, Murray C, Hankinson J, Dutta P, Maddocks M, Pengo M, Curtis K, Rafferty G, Hutchinson J, Whitfield R, Turner S, Breen R, Naveed SUN, Goode C, Esterbrook G, Ahmed L, Walker W, Ford D, Connett G, Davidson P, Elston W, Stanton A, Morgan D, Myerson J, Maxwell D, Harrris A, Parmar S, Houghton C, Winter R, Puthucheary Z, Thomson F, Sturney S, Harvey J, Haslam PL, Patel I, Jennings D, Range S, Mallia-Milanes B, Collett A, Tate P, Russell R, Feary J, O'Driscoll R, Eaden J, Round J, Sharkey E, Montgomery M, Vaughan S, Scheele K, Lithgow A, Partridge S, Chavasse R, Restrick L, Agrawal S, Abdallah S, Lacy-Colson A, Adams N, Mitchell S, Haja Mydin H, Ward A, Denniston S, Steel M, Ghosh D, Connellan S, Rigge L, Williams R, Grove A, Anwar S, Dobson L, Hosker H, Stableforth D, Greening N, Howell T, Casswell G, Davies S, Tunnicliffe G, Mitchelmore P, Phitidis E, Robinson L, Prowse K, Bafadhel M, Robinson G, Boland A, Lipman M, Bourke S, Kaul S, Cowie C, Forrest I, Starren E, Burke H, Furness J, Bhowmik A, Everett C, Seaton D, Holmes S, Doe S, Parker S, Graham A, Paterson I, Maqsood U, Ohri C, Iles P, Kemp S, Iftikhar A, Carlin C, Fletcher T, Emerson P, Beasley V, Ramsay M, Buttery R, Mungall S, Crooks S, Ridyard J, Ross D, Guadagno A, Holden E, Coutts I, Cullen K, O'Connor S, Barker J, Sloper K, Watson J, Smith P, Anderson P, Brown L, Nyman C, Milburn H, Clive A, Serlin M, Bolton C, Fuld J, Powell H, Dayer M, Woolhouse I, Georgiadi A, Leonard H, Dodd J, Campbell I, Ruiz G, Zurek A, Paton JY, Malin A, Wood F, Hynes G, Connell D, Spencer D, Brown S, Smith D, Cooper D, O'Kane C, Hicks A, Creagh-Brown B, Lordan J, Nickol A, Primhak R, Fleming L, Powrie D, Brown J, Zoumot Z, Elkin S, Szram J, Scaffardi A, Marshall R, Macdonald I, Lightbody D, Farmer R, Wheatley I, Radnan P, Lane I, Booth A, Tilbrook S, Capstick T, Hewitt L, McHugh M, Nelson C, Wilson P, Padmanaban V, White J, Davison J, O'Callaghan U, Hodson M, Edwards J, Campbell C, Ward S, Wooler E, Ringrose E, Bridges D, Long A, Parkes M, Clarke S, Allen B, Connelly C, Forster G, Hoadley J, Martin K, Barnham K, Khan K, Munday M, Edwards C, O'Hara D, Turner S, Pieri-Davies S, Ford K, Daniels T, Wright J, Towns R, Fern K, Butcher J, Burgin K, Winter B, Freeman D, Olive S, Gray L, Pye K, Roots D, Cox N, Davies CA, Wicker J, Hilton K, Lloyd J, MacBean V, Wood M, Kowal J, Downs J, Ryan H, Guyatt F, Nicoll D, Lyons E, Narasimhan D, Rodman A, Walmsley S, Newey A, Buxton M, Dewar M, Cooper A, Reilly J, Lloyd J, Macmillan AB, Roots D, Olley A, Voase N, Martin S, McCarvill I, Christensen A, Agate R, Heslop K, Timlett A, Hailes K, Davey C, Pawulska B, Lane A, Ioakim S, Hough A, Treharne J, Jones H, Winter-Burke A, Miller L, Connolly B, Bingham L, Fraser U, Bott J, Johnston C, Graham A, Curry D, Sumner H, Costello CA, Bartoszewicz C, Badman R, Williamson K, Taylor A, Purcell H, Barnett E, Molloy A, Crawfurd L, Collins N, Monaghan V, Mir M, Lord V, Stocks J, Edwards A, Greenhalgh T, Lenney W, McKee M, McAuley D, Majeed A, Cookson J, Baker E, Janes S, Wedzicha W, Lomas Dean D, Harrison B, Davison T, Calverley P, Wilson R, Stockley R, Ayres J, Gibson J, Simpson J, Burge S, Warner J, Lenney W, Thomson N, Davies P, Woodcock A, Woodhead M, Spiro S, Ormerod L, Bothamley G, Partridge M, Shields M, Montgomery H, Simonds A, Barnes P, Durham S, Malone S, Arabnia G, Olivier S, Gardiner K, Edwards S. Children must be protected from the tobacco industry's marketing tactics. BMJ 2013; 347:f7358. [PMID: 24324220 DOI: 10.1136/bmj.f7358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Nicholas Hopkinson
- British Thoracic Society Chronic Obstructive Pulmonary Disease Specialist Advisory Group, National Heart and Lung Institute, Imperial College, London SW3 6NP, UK
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Kour G, Kaul S, Dhar MK. Molecular characterization of repetitive DNA sequences from B chromosome in Plantago lagopus L. Cytogenet Genome Res 2013; 142:121-8. [PMID: 24296743 DOI: 10.1159/000356472] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2013] [Indexed: 11/19/2022] Open
Abstract
In Plantagolagopus the B chromosome has been reported by our laboratory to be the result of massive amplification of ribosomal DNA sequences. However, the presence of transposable elements and other repetitive DNA sequences together with rDNA could not be ruled out. The present study clearly demonstrated the presence of transposable elements in the B chromosomes. These transposable elements were characterized and their nature assessed. Physical mapping using double fluorescent in situ hybridization was performed using DNA probes for 5S and copia elements. The results clearly proved that the B chromosome is a mix of 5S, 45S rDNA and transposable elements. Based on the FISH and Fiber-FISH patterns, it can be concluded that while 45S rDNA sequences are restricted to the subtelomeric regions, the 5S rDNA sequences are interspersed with transposons in the body of the B chromosome. These results have further enhanced our understanding of the organization and evolution of B chromosomes.
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Affiliation(s)
- G Kour
- Genome Research Laboratory, School of Biotechnology, University of Jammu, Jammu, India
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