Search tips
Search criteria

Results 1-21 (21)

Clipboard (0)

Select a Filter Below

more »
Year of Publication
1.  Arthroscopic Distal Tibial Allograft Augmentation for Posterior Shoulder Instability With Glenoid Bone Loss 
Arthroscopy Techniques  2013;2(4):e405-e411.
Glenoid bone loss is commonly associated with recurrent shoulder instability. Failure to recognize and appropriately address it can lead to poor outcomes. Numerous studies have found anterior-inferior glenoid bone loss in the setting of recurrent anterior instability. Though much less common, posterior shoulder instability can be seen in the setting of acute trauma, epilepsy, electrocution, and alcoholism. Heightened awareness has led to recognition in collision athletes as well. Posterior glenoid bone loss must be addressed in a similar fashion to anterior glenoid bone loss to prevent recurrent instability. Open bone augmentation procedures have been described with successful results. In this technical note, we describe an arthroscopic technique using fresh distal tibial allograft for posterior glenoid augmentation. In addition, a current review regarding the diagnosis and management of recurrent posterior shoulder instability is provided.
PMCID: PMC3882716  PMID: 24400190
2.  Arthroscopic Bony Bankart Fixation Using a Modified Sugaya Technique 
Arthroscopy Techniques  2013;2(3):e251-e255.
Arthroscopic fixation of bony Bankart lesions in the setting of anterior shoulder instability has had successful long-term results. Key factors such as patient positioning, portal placement, visualization, mobilization of bony/soft tissues, and anatomic reduction and fixation are crucial to yield such results. We present a modified Sugaya technique that is reproducible and based on such key principles. This technique facilitates ease of anchor and suture placement to allow for anatomic reduction and fixation.
PMCID: PMC3834646  PMID: 24265994
3.  Neonatal thrombocytopenia and platelets transfusion 
Neonates often develop thrombocytopenia at some time during hospital stay. Platelet transfusion are frequently given to them and are likely to result in unnecessary transfusion.
Material and Methods:
Thus, we analyzed thrombocytopenia in neonates, its prevalence, and relationship if any, between clinical condition and platelet transfusion in neonates, which would have been helpful in developing guidelines and/or protocols for platelet transfusion (and reducing the donor exposure) in neonates.
A total of 870 neonates who were admitted in Neonatal Intensive Care Unit (NICU) with various morbidities had platelets count done; of these, 146 (16.7%) neonate revealed thrombocytopenia.
Low birth weight babies (P 0.009) and babies born with mother having hypertension (P 0.04) showed significant thrombocytopenia. Neonates with intrauterine growth retardation (IUGR) diagnosed during antenatal screening showed lower platelet count (P 0.022). Neonates having associated illness, such as sepsis, gastrointestinal, and respiratory problems, and on vasopressor drugs were found to be associated with low platelet count.
In our study, 16.40% of thrombocytopenic neonates required platelet transfusion either alone or with other blood component during their stay in NICU.
PMCID: PMC3439756  PMID: 22988382
Neonatal transfusion; platelet transfusion; thrombocytopenia
4.  Influence of Drought and Sowing Time on Protein Composition, Antinutrients, and Mineral Contents of Wheat 
The Scientific World Journal  2012;2012:485751.
The present study in a two-year experiment investigated the influence of drought and sowing time on protein composition, antinutrients, and mineral contents of wheat whole meal of two genotypes differing in their water requirements. Different thermal conditions prevailing during the grain filling period under different sowing time generated a large effect on the amount of total soluble proteins. Late sown conditions offered higher protein content accompanied by increased albumin-globulin but decreased glutenin content. Fe content was increased to 20–23%; however, tannin decreased to 18–35% under early sown rain-fed conditions as compared to irrigated timely sown conditions in both the genotypes. Activity of trypsin inhibitor was decreased under rain-fed conditions in both genotypes. This study inferred that variable sowing times and irrigation practices can be used for inducing variation in different wheat whole meal quality characteristics. Lower temperature prevailing under early sown rain-fed conditions; resulted in higher protein content. Higher Fe and lower tannin contents were reported under early sown rain-fed conditions however, late sown conditions offered an increase in phytic acid accompanied by decreased micronutrients and glutenin contents.
PMCID: PMC3354446  PMID: 22629143
5.  A double-blind, randomized, multicentric, placebo-controlled clinical trial of antarth, a phytomedicine, in the treatment of osteoarthritis 
Indian Journal of Pharmacology  2011;43(1):69-72.
To test Antarth, a polyherbal phytomedicine, for its efficacy and safety in patients with osteoarthritis (OA) and compared with placebo.
Material and Methods:
A total of 90 male or female adult patients who were diagnosed clinically and radiologically with OA were recruited in the study. Antarth or placebo was given 2 capsules b.i.d. for 3 months and the patients were assessed every month for its efficacy. Diclofenac sodium was allowed to be taken as rescue medication.
After 3 months of treatment, the reduction in severity of pain on Visual Analog Scale (VAS) was more in Antarth group compared to placebo but the difference between the two groups was not significant. However, pain during functioning of disabled joints while walking distance, squatting, sitting cross-legged and climbing steps were significantly reduced in Antarth group compared to placebo (P < 0.05). Reduction in consumption of rescue medication, diclofenac sodium, was more in Antarth than in placebo group.
In Patients’ Global Assessment, patients treated with Antarth were more satisfied than the ones treated with placebo. Observations were similar in Physicians’ Global Assessment too. There were no adverse events in both the groups.
PMCID: PMC3062126  PMID: 21455426
Functional disability; global assessment; rescue medication; Visual Analog Scale
6.  Essential fatty acids as functional components of foods- a review 
Journal of Food Science and Technology  2012;51(10):2289-2303.
During the recent decades, awareness towards the role of essential fatty acids in human health and disease prevention has been unremittingly increasing among people. Fish, fish oils and some vegetable oils are rich sources of essential fatty acids. Many studies have positively correlated essential fatty acids with reduction of cardiovascular morbidity and mortality, infant development, cancer prevention, optimal brain and vision functioning, arthritis, hypertension, diabetes mellitus and neurological/neuropsychiatric disorders. Beneficial effects may be mediated through several different mechanisms, including alteration in cell membrane composition, gene expression or eicosanoid production. However, the mechanisms whereby essential fatty acids affect gene expression are complex and involve multiple processes. Further understanding of the molecular aspects of essential fatty acids will be the key to devising novel approaches to the treatment and prevention of many diseases.
PMCID: PMC4190204  PMID: 25328170
Essential fatty acids; Omega-3 fatty acids; α-Linolenic acid; Docosapentaenoic acid; Functional foods
7.  What’s New in Femoroacetabular Impingement Surgery 
Sports Health  2014;6(2):162-170.
Femoroacetabular impingement (FAI) has been described as a common cause of hip pain in young adults. This leads to abnormal hip joint mechanics and contact pressures. The associated pathomechanics can lead to the development of early osteoarthritis. Better understanding of the anatomy and pathophysiology, biomechanics, and diagnostic and therapeutic advances has led to improved clinical outcomes. A growing body of evidence has set the foundation for future progress in the treatment of this commonly encountered condition.
Evidence Acquisition:
The PubMed database was searched for English-language articles pertaining to FAI over the past 15 years (1998-2013).
Study Design:
Retrospective literature review.
Level of Evidence:
Level 4.
The authors evaluated and discussed the current evidence regarding the anatomy, physiology, biomechanics, imaging, and clinical outcomes of surgical intervention for FAI. Based on this information, future directions for improving the diagnosis and management of FAI are proposed.
There remains a diverse approach to the diagnosis and management of cam- and/or pincer-type FAI. Recent advances in clinical diagnosis, imaging, indications, and arthroscopic techniques have led to improved outcomes and have set the foundation for future progress in the management of this condition.
Strength of Recommendation Taxonomy (SORT):
PMCID: PMC3931340  PMID: 24587868
femoroacetabular impingement; surgical; biomechanics; imaging
8.  Return-to-Sport and Performance After Anterior Cruciate Ligament Reconstruction in National Basketball Association Players 
Sports Health  2013;5(6):562-568.
Anterior cruciate ligament (ACL) rupture is a significant injury in National Basketball Association (NBA) players.
NBA players undergoing ACL reconstruction (ACLR) have high rates of return to sport (RTS), with RTS the season following surgery, no difference in performance between pre- and postsurgery, and no difference in RTS rate or performance between cases (ACLR) and controls (no ACL tear).
Study Design:
NBA players undergoing ACLR were evaluated. Matched controls for age, body mass index (BMI), position, and NBA experience were selected during the same years as those undergoing ACLR. RTS and performance were compared between cases and controls. Paired-sample Student t tests, chi-square, and linear regression analyses were performed for comparison of within- and between-group variables.
Fifty-eight NBA players underwent ACLR while in the NBA. Mean player age was 25.7 ± 3.5 years. Forty percent of ACL tears occurred in the fourth quarter. Fifty players (86%) RTS in the NBA, and 7 players (12%) RTS in the International Basketball Federation (FIBA) or D-league. Ninety-eight percent of players RTS in the NBA the season following ACLR (11.6 ± 4.1 months from injury). Two players (3.1%) required revision ACLR. Career length following ACLR was 4.3 ± 3.4 years. Performance upon RTS following surgery declined significantly (P < 0.05) regarding games per season; minutes, points, and rebounds per game; and field goal percentage. However, following the index year, controls’ performances declined significantly in games per season; points, rebounds, assists, blocks, and steals per game; and field goal and free throw percentage. Other than games per season, there was no significant difference between cases and controls.
There is a high RTS rate in the NBA following ACLR. Nearly all players RTS the season following surgery. Performance significantly declined from preinjury level; however, this was not significantly different from controls. ACL re-tear rate was low.
Clinical Relevance:
There is a high RTS rate in the NBA after ACLR, with no difference in performance upon RTS compared with controls.
PMCID: PMC3806178  PMID: 24427434
anterior cruciate ligament; ACL; National Basketball Association; NBA; knee injury
9.  Topographic Analysis of the Glenoid and Proximal Medial Tibial Articular Surfaces – A Search for the Ideal Match for Glenoid Resurfacing 
Current knowledge of the appropriate site of osteochondral allograft harvest to match glenoid morphology for the purposes of glenoid resurfacing is lacking. This has led to difficulty with adequately restoring the geometry of the glenoid using current available techniques. The purpose of this study was to quantify the articular surface topography of the glenoid and medial tibial plateau via 3-dimensional (3D) modeling to determine if the medial tibial articular surface provides an anatomic topographic match to the articular surface of the glenoid.
We hypothesized that the medial tibial plateau will provide a suitable osteochondral harvest site due to its concavity and anatomic similarity to the glenoid.
Study Design
Descriptive Laboratory Study
Materials and Methods
Computed tomography (CT) was performed on four cadaveric proximal tibias and four scapulae, allowing for 16 glenoid-tibial comparative combinations. 3D CT models were created and exported into point cloud models. A local coordinate map of the glenoid and medial tibial plateau articular surfaces was created. Two zones of the medial tibial articular surface (anterior and posterior) were quantified. The glenoid articular surface was defined as a best-fit circle of the glenoid articular surface maintaining a two millimeter bony rim. This surface was virtually placed on a point on the tibial articular surface in 3D space. The tibial surface was segmented and its 3D surface orientation was determined with respect to its surface. 3D orientation of the glenoid surface was reoriented so that the direction of the glenoid surface matched that of the tibial surface. The least distances between the point-clouds on the glenoid and tibial surfaces were calculated. The glenoid surface was rotated 360 degrees in one-degree increments and the mean least distance was determined at each rotating angle.
When the centroid of the glenoid surface was placed on the medial tibial articular surface, it covered approximately two-thirds of the anterior or posterior tibial surfaces. Overall, the mean least distance difference in articular congruity of all 16 glenoid-medial tibial surface combinations was 0.74 mm (standard deviation; ± 0.13 mm). The mean least distance difference of the anterior and posterior two-thirds of the medial tibial articular surface was 0.72 mm (± 0.13 mm) and 0.76 mm (± 0.16 mm), respectively. There was no significant difference between and the anterior and posterior two-thirds of the tibia with regard to topographic match of the glenoid (p=0.187).
We describe a novel methodology to quantify the topography of the tibial and glenoid articular surfaces. The findings suggest that the medial tibial articular surface provides an appropriate anatomic match to the glenoid articular surface. Both the anterior and posterior two-thirds of the medial tibial articular surface can serve as potential sites for osteochondral graft harvest. This methodology can be applied to future studies evaluating the ideal sites of graft harvest to treat zonal glenoid bone wear and/or loss.
Clinical Relevance
This study provides evidence of a near anatomic topographic match between the medial tibial plateau and glenoid articular surfaces, which has direct clinical application for future biologic osteochondral glenoid resurfacing. This concept has not been described in the literature to date.
PMCID: PMC4074354  PMID: 23857887
Glenoid; topography; glenoid resurfacing; articular surfaces
10.  Return to Sport Following Shoulder Surgery in the Elite Pitcher 
Sports Health  2013;5(4):367-376.
The ability to return to elite pitching, performance, and clinical outcomes of shoulder surgery in elite baseball pitchers are not definitively established.
To determine (1) the rate of return to sport (RTS) in elite pitchers following shoulder surgery, (2) postoperative clinical outcomes upon RTS, and (3) performance upon RTS and to compare RTS rates in different types of shoulder surgery.
Data Sources:
Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and checklist, Medline, SciVerse Scopus, SportDiscus, and Cochrane Central Register of Controlled Trials were searched.
Study Selection:
Levels I-IV evidence were eligible for inclusion if performance-based (eg, RTS) and/or clinical outcome–based reporting of outcomes were reported following surgical treatment of shoulder pathology in elite pitchers (major or minor league or collegiate).
Data Extraction:
Subject, shoulder, and pre- and postoperative performance-based variables of interest were extracted. All shoulder surgery types were potentially inclusive (eg, open, arthroscopic, rotator cuff, labrum, biceps, acromioclavicular joint, fracture). Study methodological quality was analyzed using the Modified Coleman Methodology Score (MCMS).
Six studies were analyzed (287 elite male pitchers [mean age, 27 years] who underwent shoulder surgery, with 99% on the dominant, throwing shoulder). MCMS was 38 (poor). Most pitchers were professional, with a mean career length of 6.58 years and postoperative clinical follow-up of 3.62 years. In 5 of 6 studies, multiple diagnoses were addressed concomitantly at surgery. Rate of RTS was 68% at mean 12 months following surgery. Twenty-two percent of Major League Baseball (MLB) pitchers never RTS in MLB. Overall performance did improve following surgery; however, this did not improve to pre-injury levels.
In this systematic review, the rate of return to elite baseball pitching following surgery was established. Performance tended to decrease prior to surgery and gradually improve postoperatively, though not reaching pre-injury levels of pitching.
Level of Evidence:
IV (systematic review of studies level I-IV evidence), therapeutic.
PMCID: PMC3899910  PMID: 24459557
shoulder; surgery; arthroscopy; pitcher; Major League Baseball
11.  Effect of exogenous lead on growth and carbon metabolism of pea (Pisum sativum L) seedlings 
The present study investigated the effect of exogenous lead (Pb) on seedling growth, carbohydrate composition and vital enzymes of sucrose metabolism, starch degradation, pentose phosphate pathway and glycolysis in pea seedlings. With 0.5 mM Pb, reduction of about 50 % in shoot and 80 % in root lengths was observed. At 5 and 7 days of seedling growth, cotyledons of Pb-stressed seedlings had about 25–50 % lower α- and β-amylase activities resulting in their higher starch content. Low starch content in the cotyledons of control seedlings at days 1, 3, 5 and 7 may be due to higher investment of carbon for seedling growth. Seedlings exposed to Pb showed significant inhibition of about 30–50 % in acid invertase activity in the growing tissues i.e. roots and shoots. Sucrose content increased by 10–20 % in shoots with much larger increase in cotyledons at 5–7 days of growth in Pb-stressed seedlings. In stressed seedlings, sucrose synthase (SS) and sucrose-6-phosphate synthase (SPS) enzymes were down regulated in the roots but SS activity was up regulated in the cotyledons leading to increased sucrose content. Exogenous Pb increased the activities of glucose-6-phosphate dehydrogenase (G6PDH) and 6-phosphogluconate dehydrogenase (6PGDH) in the cotyledons. Down regulation of G6PDH and up regulation of hexokinase (HXK) in the roots and shoots of stressed seedlings indicated that hexoses could be utilised preferably for glycolysis rather than pentose phosphate pathway in these tissues. Due to limited supply of sugars to growing tissues in the stressed seedlings, increased HXK may play a role in sugar sensing. Phosphoglucomutase (PGM) activity was maximum in the cotyledons and minimum in roots showing its importance in the conversion of glucose-1-phosphate into glucose-6-phosphate. Reduced seedling growth observed in the presence of exogenous Pb was mainly due to the decrease in the activities of amylases and invertases in the cotyledons and growing tissues respectively. Further biosynthetic capacity of the roots and shoots was down regulated in the pea seedlings due to reduced efficiency of pentose phosphate pathway under Pb toxicity.
PMCID: PMC3550685  PMID: 24381440
Pb toxicity; Pisum sativum; Carbon metabolism; Glycolysis; Pentose phosphate pathway
12.  Arthroscopic-Assisted Core Decompression for Osteonecrosis of the Femoral Head 
Arthroscopy Techniques  2013;3(1):e7-e11.
The management of pre-collapse osteonecrosis of the femoral head is controversial. Core decompression is a technique that theoretically decreases the intraosseous pressure of the femoral head, resulting in a local vascularized healing response. Its efficacy has been shown in delaying early subchondral collapse. We describe the technique of arthroscopic-assisted core decompression of the femoral head for osteonecrosis. The advantages of this technique include evaluation of the presence or absence of articular cartilage injury, subchondral collapse, and guidance during reaming and curettage. It also allows the ability to address any concomitant soft-tissue or bony pathology associated with or in addition to the osteonecrotic lesion.
PMCID: PMC3986482  PMID: 24749025
13.  All-Arthroscopic Patch Augmentation of a Massive Rotator Cuff Tear: Surgical Technique 
Arthroscopy Techniques  2013;2(4):e447-e451.
Surgical management of massive rotator cuff tears remains challenging, with failure rates ranging from 20% to 90%. Multiple different arthroscopic and open techniques have been described, but there is no current gold standard. Failure after rotator cuff repair is typically multifactorial; however, failure of tendon-footprint healing is often implicated. Patch augmentation has been described as a possible technique to augment the biology of rotator cuff repair in situations of compromised tendon quality and has shown promising short-term results. The purpose of this article is to describe our preferred surgical technique for arthroscopic rotator cuff repair with patch augmentation.
PMCID: PMC3882705  PMID: 24400198
14.  Solar forcing of the Indian summer monsoon variability during the Ållerød period 
Scientific Reports  2013;3:2753.
Rapid climatic shifts across the last glacial to Holocene transition are pervasive feature of the North Atlantic as well as low latitude proxy archives. Our decadal to centennial scale record of summer monsoon proxy Globigerina bulloides from rapidly accumulating sediments from Hole 723A, Arabian Sea shows two distinct intervals of weak summer monsoon wind coinciding with cold periods within Ållerød inerstadial of the North Atlantic named here as IACP-A1 and IACP-A2 and dated (within dating uncertainties) at 13.5 and 13.3 calibrated kilo years before the present (cal kyr BP), respectively. Spectral analysis of the Globigerina bulloides time series for the segment 13.6–13.1 kyr (Ållerød period) reveals a strong solar 208-year cycle also known as de Vries or Suess cycle, suggesting that the centennial scale variability in Indian summer monsoon winds during the Ållerød inerstadial was driven by changes in the solar irradiance through stratospheric-tropospheric interactions.
PMCID: PMC3782882  PMID: 24067487
15.  BOROX Catalysis: Self-assembled AMINO-BOROX and IMINO-BOROX Chiral Brønsted Acids in a Five Component Catalyst Assembly/Catalytic Asymmetric Aziridination 
The Journal of organic chemistry  2012;77(18):7932-7944.
A five-component catalyst assembly/aziridination reaction is described starting from an aldehyde, an amine, ethyl diazoacetate, B(OPh)3 and a molecule of a vaulted biaryl ligand (VAPOL or VANOL). A remarkable level of chemo-selectivity was observed since while 10 different products could have resulted from various reactions between the five components, an aziridine was formed in 85% yield and 98% ee and only two other products could be detected in 3% yield. Studies reveal that the first in a sequence of three reactions is an exceedingly rapid amine induced assembly of an amino-boroxinate (AMINO-BOROX) species from VAPOL and B(OPh)3 which is followed by imine formation from the amine and aldehyde and the concomitant formation of an IMINO-BOROX species, and finally the reaction of the imine with ethyl diazoacetate mediated by the IMINO-BOROX catalyst to give aziridine-2-carboxylic esters with very high diastereo- and enantioselectivity.
PMCID: PMC3605743  PMID: 22947019
16.  The Posterolateral Portal: Optimizing Anchor Placement and Labral Repair at the Inferior Glenoid 
Arthroscopy Techniques  2013;2(3):e201-e204.
The Bankart lesion is considered the critical lesion in anterior shoulder instability, in which the anteroinferior glenoid labrum separates from the glenoid rim. Technical advances in arthroscopy have ushered in a shift from open to arthroscopic Bankart repair. When one is performing an arthroscopic Bankart repair, proper portal placement is critical for success in labral preparation and anchor placement. Frequently, standard anterior portals are insufficient for inferior glenoid anchor placement and suture shuttling. The posterolateral portal—located 4 cm lateral to the posterolateral corner of the acromion—simplifies and improves anchor placement, trajectory, and anatomic capsulolabral repair of the inferior glenoid. We present our preferred technique for capsulolabral repair of the inferior glenoid.
PMCID: PMC3834628  PMID: 24265983
17.  Differentially Expressed Genes during Contrasting Growth Stages of Artemisia annua for Artemisinin Content 
PLoS ONE  2013;8(4):e60375.
Artemisia annua is the source of antimalarial phytomolecule, artemisinin. It is mainly produced and stored in the glandular secretory trichomes present in the leaves of the plant. Since, the artemisinin biosynthesis steps are yet to be worked out, in this investigation a microarray chip was strategized for the first time to shortlist the differentially expressing genes at a stage of plant producing highest artemisinin compared to the stage with no artemisinin. As the target of this study was to analyze differential gene expression associated with contrasting artemisinin content in planta and a genotype having zero/negligible artemisinin content was unavailable, it was decided to compare different stages of the same genotype with contrasting artemisinin content (seedling - negligible artemisinin, mature leaf - high artemisinin). The SCAR-marked artemisinin-rich (∼1.2%) Indian variety ‘CIM-Arogya’ was used in the present study to determine optimal plant stage and leaf ontogenic level for artemisinin content. A representative EST dataset from leaf trichome at the stage of maximal artemisinin biosynthesis was established. The high utility small scale custom microarray chip of A. annua containing all the significant artemisinin biosynthesis-related genes, the established EST dataset, gene sequences isolated in-house and strategically selected candidates from the A. annua Unigene database (NCBI) was employed to compare the gene expression profiles of two stages. The expression data was validated through semiquantitative and quantitative RT-PCR followed by putative annotations through bioinformatics-based approaches. Many candidates having probable role in artemisinin metabolism were identified and described with scope for further functional characterization.
PMCID: PMC3616052  PMID: 23573249
18.  Routine Complete Capsular Closure During Hip Arthroscopy 
Arthroscopy Techniques  2013;2(2):e89-e94.
The utility of hip arthroscopy has recently progressed beyond diagnostic to therapeutic purposes addressing central and peripheral compartment pathologies. Capsulotomy provides freedom of visualization and instrumentation. The contribution to hip stability of both dynamic and static hip structures is not fully understood. However, both basic science biomechanical and clinical outcome studies have exhibited a relevant role of the capsule in hip stability. Though rare, iatrogenic post-arthroscopy subluxation and dislocation have been reported. Therefore many surgeons have cautioned against aggressive capsulotomy or capsulectomy without repair, because of the potential for precipitation of iatrogenic hip instability. We typically perform a “T” capsulotomy and recommend complete capsular closure in conjunction with labral repair and osseous femoral and acetabular treatment. A safe, efficient, and effective method to accomplish complete capsular closure is presented to reduce iatrogenic postoperative hip instability.
PMCID: PMC3716194  PMID: 23875156
19.  Multi-Component Catalytic Asymmetric Aziridination of Aldehydes 
Organic letters  2011;13(21):5866-5869.
The first multi-component catalytic asymmetric aziridination reaction is developed to give aziridine-2-carboxylic esters with very high diastereo- and enantioselectivity from aromatic and aliphatic aldehydes. This new method pushes the boundary of the aziridination reaction to substrates that failed with pre-formed imines.
PMCID: PMC3212731  PMID: 21988131
20.  WR-2721 (Amifostine) Ameliorates Cisplatin-Induced Hearing Loss But Causes Neurotoxicity In Hamsters: Dose-Dependent Effects 
Chemoprotective agents reduce the toxic side effects of chemotherapy agents such as cisplatin. The conventional belief is that the chemoprotective agent WR-2721 (Amifostine), while protecting against most cisplatin-induced side effects, does not protect against cisplatin-induced ototoxicity (i.e., hearing loss). There is no knowledge, however, about the efficacy of high doses of WR-2721 (WR) in possibly protecting against cisplatin-induced ototoxicity. Thus, the dose-dependent effects of WR in possibly ameliorating cisplatin-induced ototoxicity were investigated. Hamsters were given a series of 5 cisplatin injections (3 mg/kg/injection once every other day, i.p.) either alone or in combination with 18, 40, 80, or 400 mg/kg/injection of the rescue agent WR (n = 5 or 10/group). Other groups received either 80 mg/kg/injection WR alone (n = 5) or were untreated (n = 14). Ototoxicity was assessed by auditory brain stem responses (ABR). WR provided dose-dependent rescue from cisplatin’s ototoxicity with no protection at the low dose of 18 mg/kg, moderate protection at 40 mg/kg, and nearly complete protection at 80 and 400 mg/kg. However, WR doses of 40 mg/kg or higher caused neurotoxicity as evidenced by prolongations in the ABR’s interpeak latencies. Thus, high doses of WR provided the beneficial effect of protecting against cisplatin-induced ototoxicity, but had the harmful side effect of neurotoxicity. Previous failures to find chemoprotection from cisplatin-induced ototoxicity were likely due to the use of WR doses that were too small. The clinical implications of the beneficial and harmful effects of high doses of WR are discussed.
PMCID: PMC2504549  PMID: 15185124
amifostine; auditory brain stem response (ABR); cancer therapy; chemoprotection; cisplatin; neurotoxicity; ototoxicity; sensorineural hearing loss; WR-2721
21.  Vitamin B12 deficiency. Prevalence among South Asians at a Toronto clinic. 
Canadian Family Physician  2004;50:743-747.
OBJECTIVE: To estimate the prevalence of vitamin B12 deficiency in adult South Asian patients. DESIGN: Retrospective chart review. SETTING: Family practice clinic in Toronto, Ont. PARTICIPANTS: Records of 988 South Asian patients. INTERVENTION: Of 1000 randomly selected records, we found 988 charts. From charts with at least one documented B12 level, we extracted data on age, mean corpuscular volume (MCV), hemoglobin and ferritin levels, and diet (if available). Descriptive and analytic statistics were calculated. MAIN OUTCOME MEASURES: Levels of serum B12 and factors associated with low levels of B12. RESULTS: B12 results were documented in 49% of charts; 46% of results showed deficiency. Patients older than 65 and vegetarians were more likely to be B12 deficient. Low serum B12 levels were positively correlated with low hemoglobin and ferritin levels and poorly correlated with low MCV levels. CONCLUSION: Many more South Asian patients than patients in the general population have vitamin B12 deficiency. A vegetarian diet seems a strong risk factor. A single low result, however, might not indicate true B12 deficiency.
PMCID: PMC2214606  PMID: 15171677

Results 1-21 (21)