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Sökning: WFRF:(Ramanathan S)

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1.
  • Ruilope, LM, et al. (författare)
  • Design and Baseline Characteristics of the Finerenone in Reducing Cardiovascular Mortality and Morbidity in Diabetic Kidney Disease Trial
  • 2019
  • Ingår i: American journal of nephrology. - : S. Karger AG. - 1421-9670 .- 0250-8095. ; 50:5, s. 345-356
  • Tidskriftsartikel (refereegranskat)abstract
    • <b><i>Background:</i></b> Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. <b><i>Patients and</i></b> <b><i>Methods:</i></b> The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate ≥25 mL/min/1.73 m<sup>2</sup> and albuminuria (urinary albumin-to-creatinine ratio ≥30 to ≤5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level α = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. <b><i>Conclusions:</i></b> FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049.
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2.
  • Kumar, M., et al. (författare)
  • Groundwater evolution and its utility in upper Ganges-Yamuna Alluvial plain of Northern India, India : Evidence from solute chemistry and stable isotopes
  • 2018
  • Ingår i: Groundwater for Sustainable Development. - : Elsevier BV. - 2352-801X. ; 7, s. 400-409
  • Tidskriftsartikel (refereegranskat)abstract
    • The current study was focused on the characterization of recharge, weathering processes and to check the aptness of groundwater for household and agriculture utility in the Chhaprola industrial area located in Gautam Buddha Nagar district of Uttar Pradesh, India. Groundwater samples (n = 33) were analyzed for major cations and anions from which (n = 22) were analyzed for stable isotopic records (δ2H and δ18O). Solute chemistry revealed neutral to moderately basic nature (pH ranged 6.4–8.8) and showed a higher (ranged 552–3130 µS/cm) of electrical conductivity. Isotopic signals ranged from − 8.7 to − 3.3‰ for δ18O and − 60.1 to − 37‰ for δ2H. Bivariate plot of stable isotopes (δ18O and δ2H) showed that majority of the samples fell below the global meteoric water line (GMWL) and local meteoric water line (LMWL) of New Delhi, indicating enrichment of heavier isotopes in the aquifers, which explain that recharging water, has undergone evaporation before recharging the aquifer. Monsoonal precipitation was observed as the major source of aquifer recharge in the surveyed area. Vertical hydraulic connectivity of the aquifer layers was traced with the help of isotopic record which exhibited a more negative intercept for shallow depth tube well than the middle depth tube well. About 76% of the samples exhibited negative Schoeller index thereby indicated cation-anion exchange reactions while the remaining samples depicted the Base Exchange Reactions. Sodium-normalized Ca versus Na-normalized Mg and HCO3, indicated an equal contribution of silicate and carbonate type weathering on global-average weathering system. About 52% of the groundwater samples fell into the Ca-HCO3 - water type while remaining samples fell into 33% and 15% of Na-HCO3 and Mg-HCO3 type, respectively. Water quality indices (viz. residual sodium carbonate, Kelly index, permeability index, magnesium hazard, and Chloroalkaline indices) revealed unsuitability of the groundwater for drinking and irrigation purpose at few locations. 
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3.
  • Uy, G. L., et al. (författare)
  • Contribution of chemotherapy mobilization to disease control in multiple myeloma treated with autologous hematopoietic cell transplantation
  • 2015
  • Ingår i: Bone Marrow Transplantation. - : Springer Science and Business Media LLC. - 0268-3369 .- 1476-5365. ; 50:12, s. 1513-1518
  • Tidskriftsartikel (refereegranskat)abstract
    • In patients with multiple myeloma (MM) undergoing autologous hematopoietic cell transplantation (auto-HCT), peripheral blood progenitor cells may be collected following mobilization with growth factor alone (GF) or cytotoxic chemotherapy plus GF (CC+GF). It is uncertain whether the method of mobilization affects post-transplant outcomes. We compared these mobilization strategies in a retrospective analysis of 968 patients with MM from the Center for International Blood and Marrow Transplant Research database who received an auto-Ha in the US and Canada between 2007 and 2012. The kinetics of neutrophil engraftment (>= 0.5 x 10(9)/L) was similar between groups (13 vs 13 days, P=0.69) while platelet engraftment (>= 20 x 10(9)/L) was slightly faster with CC+GF (19 vs 18 days, P=0.006). Adjusted 3-year PFS was 43% (95% confidence interval (CI) 38-48) in GF and 40% (95% CI 35-45) in CC+GF, P=0.33. Adjusted 3-year OS was 82% (95% CI 78-86) vs 80% (95% CI 75-84), P=0.43 and adjusted 5-year OS was 62% (95% CI 54-68) vs 60% (95% CI 52-67), P=0.76, for GF and CC+GF, respectively. We conclude that MM patients undergoing auto-Ha have similar outcomes irrespective of the method of mobilization and found no evidence that the addition of chemotherapy to mobilization contributes to disease control.
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4.
  • Kumar, M., et al. (författare)
  • Frontier review on the propensity and repercussion of SARS-CoV-2 migration to aquatic environment
  • 2020
  • Ingår i: Journal of Hazardous Materials Letters. - : Elsevier BV. - 2666-9110. ; 1
  • Tidskriftsartikel (refereegranskat)abstract
    • Increased concern has recently emerged pertaining to the occurrence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in aquatic environment during the current coronavirus disease 2019 (COVID-19) pandemic. While infectious SARS-CoV-2 has yet to be identified in the aquatic environment, the virus potentially enters the wastewater stream from patient excretions and a precautionary approach dictates evaluating transmission pathways to ensure public health and safety. Although enveloped viruses have presumed low persistence in water and are generally susceptible to inactivation by environmental stressors, previously identified enveloped viruses persist in the aqueous environment from days to several weeks. Our analysis suggests that not only the surface water, but also groundwater, represent SARS-CoV-2 control points through possible leaching and infiltrations of effluents from health care facilities, sewage, and drainage water. Most fecally transmitted viruses are highly persistent in the aquatic environment, and therefore, the persistence of SARS-CoV-2 in water is essential to inform its fate in water, wastewater and groundwater and subsequent human exposure.
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5.
  • Pasquini, Marcelo C., et al. (författare)
  • Hematopoietic Cell Transplantation Outcomes in Monosomal Karyotype Myeloid Malignancies
  • 2016
  • Ingår i: Biology of blood and marrow transplantation. - : Elsevier BV. - 1083-8791 .- 1523-6536. ; 22:2, s. 248-257
  • Tidskriftsartikel (refereegranskat)abstract
    • The presence of monosomal karyotype (MK+) in acute myeloid leukemia (AML) is associated with dismal outcomes. We evaluated the impact of MK+ in AML (MK+AML, n = 240) and in myelodysplastic syndrome (MDS) (MK+MDS, n = 221) on hematopoietic cell transplantation outcomes compared with other cytogenetically defined groups (AML, n = 3360; MDS, n = 1373) as reported to the Center for International Blood and Marrow Transplant Research from 1998 to 2011. MK+AML was associated with higher disease relapse (hazard ratio, 1.98; P < .01), similar transplantation-related mortality (TRM) (hazard ratio, 1.01; P = .90), and worse survival (hazard ratio, 1.67; P < .01) compared with those outcomes for other cytogenetically defined AML. Among patients with MDS, MK+ MDS was associated with higher disease relapse (hazard ratio, 2.39; P < .01), higher TRM (hazard ratio, 1.80; P < .01), and worse survival (HR, 2.02; P < .01). Subset analyses comparing chromosome 7 abnormalities (del7/7q) with or without MK+ demonstrated higher mortality for MK+ disease in for both AML (hazard ratio, 1.72; P < .01) and MDS (hazard ratio, 1.79; P < .01). The strong negative impact of MK+ in myeloid malignancies was observed in all age groups and using either myeloablative or reduced-intensity conditioning regimens. Alternative approaches to mitigate disease relapse in this population are needed.
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8.
  • Damato, V, et al. (författare)
  • Rituximab abrogates aquaporin-4-specific germinal center activity in patients with neuromyelitis optica spectrum disorders
  • 2022
  • Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences. - 1091-6490. ; 119:24, s. e2121804119-
  • Tidskriftsartikel (refereegranskat)abstract
    • By studying paired blood and deep cervical lymph node samples from patients with neuromyelitis optica spectrum disorders, our data provide evidence for a germinal center–based generation of aquaporin-4 antibodies. Frequent serum aquaporin-4 immunoglobulin Ms (IgMs) and shifts in IgG subclasses were observed alongside preferential synthesis of aquaporin-4 IgGs and aquaporin-4–reactive B cells within lymph nodes. Both intranodal synthesis of aquaporin-4 antibodies and intranodal aquaporin-4–reactive B cells were robustly eliminated with rituximab administration. This study systematically explores lymph nodes that drain the central nervous system (CNS) in patients with CNS autoimmunity and offers a potential explanation as to why rituximab is clinically highly efficacious in autoantibody-mediated diseases despite no accompanying reduction in serum autoantibody levels.
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9.
  • D'Souza, Anita, et al. (författare)
  • Improved Outcomes After Autologous Hematopoietic Cell Transplantation for Light Chain Amyloidosis : A Center for International Blood and Marrow Transplant Research Study
  • 2015
  • Ingår i: Journal of Clinical Oncology. - 0732-183X .- 1527-7755. ; 33:32, s. 3741-
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose Autologous hematopoietic cell transplantation, or autotransplantation, is effective in light-chain amyloidosis (AL), but it is associated with a high risk of early mortality (EM). In a multicenter randomized comparison against oral chemotherapy, autotransplantation was associated with 24% EM. We analyzed trends in outcomes after autologous hematopoietic cell transplantation for AL in North America. Patients and Methods Between 1995 and 2012, 1,536 patients with AL who underwent autotransplantation at 134 centers were identified in the Center for International Blood and Marrow Transplant Research database. EM and overall survival (OS) were analyzed in three time cohorts: 1995 to 2000 (n = 140), 2001 to 2006 (n = 596), and 2007 to 2012 (n = 800). Hematologic and renal responses and factors associated with EM, relapse and/or progression, progression-free survival and OS were analyzed in more recent subgroups from 2001 to 2006 (n = 197) and from 2007 to 2012 (n = 157). Results Mortality at 30 and 100 days progressively declined over successive time periods from 11% and 20%, respectively, in 1995 to 2000 to 5% and 11%, respectively, in 2001 to 2006, and to 3% and 5%, respectively, in 2007 to 2012. Correspondingly, 5-year OS improved from 55% in 1995 to 2000 to 61% in 2001 to 2006 and to 77% in 2007 to 2012. Hematologic response to transplantation improved in the latest cohort. Renal response rate was 32%. Centers performing more than four AL transplantations per year had superior survival outcomes. In the multivariable analysis, cardiac AL was associated with high EM and inferior progression-free survival and OS. Autotransplantation in 2007 to 2012 and use of higher dosages of melphalan were associated with a lowered relapse risk. A Karnofsky score less than 80 and creatinine levels 2 mg/m(2) or greater were associated with worsened OS. Conclusion Post-transplantation survival in AL has improved, with a dramatic reduction in early post-transplantation mortality and excellent 5-year survival. The risk-benefit ratio for autotransplantation has changed, and randomized comparison with nontransplantation approaches is again warranted.
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10.
  • Jayamani, Jayaraj, et al. (författare)
  • Studies on Corrosion of Titanium and Air-Oxidized Titanium in Fluorinated Nitric Acid
  • 2019
  • Ingår i: Transactions of the Indian Institute of Metals. - : Springer Science and Business Media LLC. - 0972-2815 .- 0975-1645. ; 72:7, s. 1917-1926
  • Tidskriftsartikel (refereegranskat)abstract
    • Titanium (Ti) is a lustrous transition metal which possesses excellent corrosion resistance in several aggressive environments but is attacked by acidic fluoride media. In this work, the addition of fluoride ion to nitric acid on the corrosion behavior of Ti and air-oxidized Ti was studied. Air oxidation of Ti at 800 °C for 5 h resulted in the formation of an intact rutile TiO2 layer with a thickness of about 35 μm. The corrosion resistance was investigated from the polarization resistance ($$R_{\text{P}}$$RP) values which were obtained from linear polarization and electrochemical impedance spectroscopy (EIS) measurements. A decrease in the $$R_{\text{P}}$$RPvalue of Ti with the addition of fluoride ion in nitric acid was observed, and this indicated the formation of an unstable layer, which resulted in accelerated dissolution. The several order increase in the $$R_{\text{P}}$$RPvalue of air-oxidized Ti in nitric acid containing fluoride ions pointed the improved resistance to corrosion. The diffusivity of species through the air-oxidized TiO2 layer was estimated from the electrochemical equivalent circuit (EEC) analysis of EIS data. Even though the diffusivity increased by several orders with the addition of fluoride ions, air-oxidized Ti provided better protection against nitric acid containing fluoride ions than Ti. The corrosion rates of Ti and air-oxidized Ti in boiling nitric acid containing fluoride ions were also estimated from weight loss experiments. Even in boiling fluorinated nitric acid, air-oxidized Ti provided better corrosion protection, with corrosion rates of about 1000 times less than that of Ti.
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