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Steve Taylor, Kimberly Eisenstein, Vanessa Gildenstern, Harper Price, Pooja Hingorani, Apurvi Patel, Nathan Page, Smita Bailey, David Carpentieri
Infantile choriocarcinoma (ICC) is a rare, highly malignant form of gestational trophoblastic neoplasia. Rapid diagnosis and initiation of treatment are paramount in reaching a successful outcome. Patients with these tumors typically present with a triad of anemia, hepatomegaly, and precocious puberty. Cutaneous manifestations of ICC are extraordinarily rare with few documented cases. Here, we describe a male neonate who presented to our Dermatology clinic with a rapidly growing, markedly vascular glabellar mass associated with abnormal laboratory values suggestive of Kasabach-Merritt phenomenon...
January 1, 2018: Pediatric and Developmental Pathology
Afsha Aurshina, Anil Hingorani, Ahmad Alsheekh, Pavel Kibrik, Natalie Marks, Enrico Ascher
OBJECTIVE: It has been a widely accepted practice that a previous placed pacemaker, automatic implantable cardioverter defibrillators, or central line can be a contraindication to placing a hemodialysis catheter in the ipsilateral jugular vein. Fear of dislodging pacing wires, tunneling close to the battery site or causing venous obstruction has been a concern for surgeons and interventionalists alike. We suggest that this phobia may be unfounded. METHODS: A retrospective review was conducted of patients in whom hemodialysis catheters were placed over a period of 10 years...
March 1, 2018: Journal of Vascular Access
Afsha Aurshina, Anil Hingorani, Eleanor Iadagarova, Enrico Ascher, Natalie Marks, Amrit Hingorani, Sheila N Blumberg
OBJECTIVE: Vascular surgery training and practice have been constantly evolving in the last two decades.The goal of this study is to report the changing trends in perspectives of vascular surgery trainees on current training program and issues that need redressal in vascular training and practice. METHODS: Vascular surgery trainees in the US who attended the Society of Clinical Vascular Surgery meeting from 2004-2015 were surveyed annually with an anonymous questionnaire during the meet...
March 6, 2018: Annals of Vascular Surgery
Afsha Aurshina, Anil Hingorani, Amrit Hingorani, Natalie Marks, Enrico Ascher
OBJECTIVE: We hypothesized that there may be significant differences between academic productivity of the vascular training programs in the United States (US) and Europe. In an effort to explore theory, we reviewed the number of vascular publications listed in PubMed from 2010 to 2015 for US and European directors in vascular surgery. METHODS: The list of program directors from the Association of Program directors in Vascular Surgery (APDVS) and the European Union of Medical Specialists (EUMS) were queried for the names of the directors of vascular surgical training programs at the end of 2015...
February 24, 2018: Annals of Vascular Surgery
Ahmad Alsheekh, Anil Hingorani, Afsha Aurshina, Pavel Kibrik, Natalie Marks, Yuriy Ostrozhynskyy, Enrico Ascher
Background There have been well-documented implications of race/ethnicity on the outcome of various vascular diseases, yet there are limited data on risk factors and outcome of lower limb swelling. While many patients improve with endovenous therapy (thermal ablation or iliac vein stenting), some patients' symptoms persist. The goal of this study was to identify clinical factors including race/ethnicity related to persistent leg swelling after treatment with both iliac vein stenting and thermal ablation. Methods From February 2012 to February 2014, this observational study analyzed data for 173 patients with chronic venous insufficiency who underwent both iliac vein stent placement as well as thermal ablation (radiofrequency ablation or endovenous laser ablation)...
January 1, 2018: Vascular
David Parizh, Syed Ali Raza Rizvi, Enrico Ascher, Anil Hingorani
This study is a case series describing the management of complex aneurysmal disease using the principles of both open and endovascular techniques.
January 1, 2018: Vascular
Bo Song, Samir M Hamdan, Manju M Hingorani
Flap endonucleases catalyze cleavage of single-stranded DNA flaps formed during replication, repair and recombination, and are therefore essential for genome processing and stability. Recent crystal structures of DNA-bound human flap endonuclease (hFEN1) offer new insights into how conformational changes in the DNA and hFEN1 may facilitate the reaction mechanism. For example, previous biochemical studies of DNA conformation performed under non-catalytic conditions with Ca2+ have suggested that base unpairing at the 5'-flap:template junction is an important step in the reaction, but the new structural data suggest otherwise...
February 9, 2018: Journal of Biological Chemistry
Michelle C Starr, Sangeeta R Hingorani
PURPOSE OF REVIEW: The purpose of this review is to describe the role prematurity plays in the development of chronic kidney disease (CKD) and to discuss potential reasons for this association including decreased nephron mass, as well as postnatal insults such as neonatal acute kidney injury (nAKI). RECENT FINDINGS: New observational studies in humans and experimental studies in animal models have strengthened the association between prematurity, low birth weight and CKD...
April 2018: Current Opinion in Pediatrics
Manal S Zaher, Fahad Rashid, Bo Song, Luay I Joudeh, Mohamed A Sobhy, Muhammad Tehseen, Manju M Hingorani, Samir M Hamdan
RNA-DNA hybrid primers synthesized by low fidelity DNA polymerase α to initiate eukaryotic lagging strand synthesis must be removed efficiently during Okazaki fragment (OF) maturation to complete DNA replication. In this process, each OF primer is displaced and the resulting 5'-single-stranded flap is cleaved by structure-specific 5'-nucleases, mainly Flap Endonuclease 1 (FEN1), to generate a ligatable nick. At least two models have been proposed to describe primer removal, namely short- and long-flap pathways that involve FEN1 or FEN1 along with Replication Protein A (RPA) and Dna2 helicase/nuclease, respectively...
February 6, 2018: Nucleic Acids Research
Almadani A, Dixit S, Rowland-Hill C, Achawal S, Rajaraman Cr, Gerry Go, R Highley, Hussain Masood, Baker L, Gill L, Morris H, Hingorani M
The management of elderly patients with glioblastoma-multiforme (GBM) remains poorly defined with many experts advocating best supportive care in view of limited evidence on efficacy of more aggressive treatment protocols. There is randomised evidence (NORDIC and NA-O8 studies) to support the use of surgery followed by adjuvant monotherapy with either radiotherapy (RT) using hypo-fractionated regimes (e.g. 36 Gy in 6 fractions OR 40 Gy in 15 fractions) or chemotherapy with temozolomide (TMZ) in patients expressing methylation of promoter for O6-methylguanine-DNA methyltransferase (MGMT) enzyme...
January 29, 2018: British Journal of Radiology
S Goya Wannamethee, Barbara J Jefferis, Lucy Lennon, Olia Papacosta, Peter H Whincup, Aroon D Hingorani
BACKGROUND: Evidence largely from animal studies suggests that conjugated linoleic acid (CLA) may have cardiovascular health benefits. However, few prospective studies have examined the association between CLA and cardiovascular disease. We have prospectively examined the association between serum CLA and incident coronary heart disease and heart failure (HF) in older men. METHODS AND RESULTS: Prospective study of 3806 men, aged 60 to 79 years, without prevalent HF followed up for an average of 13 years, during which there were 295 incident HF cases...
January 6, 2018: Journal of the American Heart Association
Monica Michelotti, Dirk F de Korne, Jennifer S Weizer, Paul P Lee, Declan Flanagan, Simon P Kelly, Anne Odergren, Sukhpal S Sandhu, Charity Wai, Niek Klazinga, Aravind Haripriya, Joshua D Stein, Melanie Hingorani
BACKGROUND: To determine alignment of proposed international standard outcomes sets for ophthalmic conditions to metrics currently reported by eye hospitals. METHODS: Mixed methods comparative benchmark study, including eight eye hospitals in Australia, India, Singapore, Sweden, U.K., and U.S. All are major international tertiary care and training centers in ophthalmology. Main outcome measure is consistency of ophthalmic outcomes measures reported. RESULTS: International agreed standard outcomes (ICHOM) sets are available for cataract surgery (10 metrics) and macular degeneration (7 metrics)...
December 29, 2017: BMC Ophthalmology
Afsha Aurshina, Enrico Ascher, Jesse Victory, Dmitriy Rybitskiy, Anjeza Zholanji, Natalie Marks, Anil Hingorani
OBJECTIVE: Endovenous thermal ablation has become the primary modality of treatment for patients with venous insufficiency. Previous literature has provided reviews of radiofrequency ablation (RFA) or endovenous laser ablation (EVLA) that mostly focus on the great saphenous vein (GSV) and small saphenous vein (SSV). Data with an extended review including the anterior accessory saphenous vein (ASV) and perforator veins (PVs) have been limited. This study examines the treatment of venous insufficiency with RFA and EVLA of these multiple veins to identify clinical and demographic predictors of both the early success and thrombotic complications of endovenous thermal ablation...
January 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
C A Parisinos, A D Hingorani
No abstract text is available yet for this article.
December 11, 2017: European Heart Journal
Maria Carolina Borges, Aluísio J D Barros, Diana L Santos Ferreira, Juan Pablo Casas, Bernardo Lessa Horta, Mika Kivimaki, Meena Kumari, Usha Menon, Tom R Gaunt, Yoav Ben-Shlomo, Deise F Freitas, Isabel O Oliveira, Aleksandra Gentry-Maharaj, Evangelia Fourkala, Debbie A Lawlor, Aroon D Hingorani
BACKGROUND: Adiponectin, a circulating adipocyte-derived protein, has insulin-sensitizing, anti-inflammatory, antiatherogenic, and cardiomyocyte-protective properties in animal models. However, the systemic effects of adiponectin in humans are unknown. Our aims were to define the metabolic profile associated with higher blood adiponectin concentration and investigate whether variation in adiponectin concentration affects the systemic metabolic profile. METHODS AND RESULTS: We applied multivariable regression in ≤5909 adults and Mendelian randomization (using cis-acting genetic variants in the vicinity of the adiponectin gene as instrumental variables) for analyzing the causal effect of adiponectin in the metabolic profile of ≤37 545 adults...
December 2017: Circulation. Cardiovascular Genetics
Sunil R Hingorani, Lei Zheng, Andrea J Bullock, Tara E Seery, William P Harris, Darren S Sigal, Fadi Braiteh, Paul S Ritch, Mark M Zalupski, Nathan Bahary, Paul E Oberstein, Andrea Wang-Gillam, Wilson Wu, Dimitrios Chondros, Ping Jiang, Sihem Khelifa, Jie Pu, Carrie Aldrich, Andrew E Hendifar
Purpose Metastatic pancreatic ductal adenocarcinoma is characterized by excessive hyaluronan (HA) accumulation in the tumor microenvironment, elevating interstitial pressure and impairing perfusion. Preclinical studies demonstrated pegvorhyaluronidase alfa (PEGPH20) degrades HA, thereby increasing drug delivery. Patients and Methods Patients with previously untreated metastatic pancreatic ductal adenocarcinoma were randomly assigned to treatment with PEGPH20 plus nab-paclitaxel/gemcitabine (PAG) or nab-paclitaxel/gemcitabine (AG)...
February 1, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Martin C Whittle, Sunil R Hingorani
Recent advances in cytotoxic therapies for pancreatic ductal adenocarcinoma (PDA) are overshadowed by stalled clinical progress of more targeted strategies, the vast majority of which have failed in clinical trials. Inability to translate preclinical promise into clinical efficacy derives, in part, from imperfect disease modeling and mismatches between preclinical and clinical study design and execution. Into these gaps fall our patients who enter the clinical trial landscape expectantly and bear the brunt of its inadequacies...
November 2017: Cancer Journal
José A López-López, Jonathan A C Sterne, Howard H Z Thom, Julian P T Higgins, Aroon D Hingorani, George N Okoli, Philippa A Davies, Pritesh N Bodalia, Peter A Bryden, Nicky J Welton, William Hollingworth, Deborah M Caldwell, Jelena Savović, Sofia Dias, Chris Salisbury, Diane Eaton, Annya Stephens-Boal, Reecha Sofat
Objective  To compare the efficacy, safety, and cost effectiveness of direct acting oral anticoagulants (DOACs) for patients with atrial fibrillation. Design  Systematic review, network meta-analysis, and cost effectiveness analysis. Data sources  Medline, PreMedline, Embase, and The Cochrane Library. Eligibility criteria for selecting studies  Published randomised trials evaluating the use of a DOAC, vitamin K antagonist, or antiplatelet drug for prevention of stroke in patients with atrial fibrillation...
November 28, 2017: BMJ: British Medical Journal
Afsha Aurshina, Anil Hingorani, Natalie Marks, Enrico Ascher
Objective Endovascular stent graft repair for exclusion of pseudoaneurysm is currently being explored to replace open surgical repair as current management. The objective of the study was to evaluate the clinical safety and efficacy of endovascular stent graft intervention in pseudoaneurysms complicating arteriovenous reconstructions in patients on chronic hemodialysis. Methods A retrospective analysis of all pseudoaneurysms treated with stent grafts at our institution over a period of five years was performed...
January 1, 2017: Vascular
Beth Friedman, Michael A Whitney, Elamprakash N Savariar, Christa Caneda, Paul Steinbach, Qing Xiong, Dina V Hingorani, Jessica Crisp, Stephen R Adams, Michael Kenner, Csilla N Lippert, Quyen T Nguyen, Monica Guma, Roger Y Tsien, Maripat Corr
OBJECTIVE: Functional imaging of synovitis could improve both early detection of rheumatoid arthritis (RA) and long-term outcomes. Given the intersection of inflammation with coagulation protease activation, this study was undertaken to examine coagulation protease activities in arthritic mice with a dual-fluorescence ratiometric activatable cell-penetrating peptide (RACPP) that has a linker, norleucine (Nle)-TPRSFL, with a cleavage site for thrombin. METHODS: K/BxN-transgenic mice with chronic arthritis and mice with day 1 passive serum-transfer arthritis were imaged in vivo for Cy5:Cy7 emission ratiometric fluorescence from proteolytic cleavage and activation of RACPPNleTPRSFL ...
January 2018: Arthritis & Rheumatology
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