31 results on '"Mallia M"'
Search Results
2. Acute Cerebrovascular Disease in the Young: The Stroke in Young Fabry Patients Study
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Rolfs, Arndt, Fazekas, Franz, Grittner, Ulrike, Dichgans, Martin, Martus, Peter, Holzhausen, Martin, Böttcher, Tobias, Heuschmann, Peter U., Tatlisumak, Turgut, Tanislav, Christian, Jungehulsing, Gerhard J., Giese, Anne-Katrin, Putaala, Jukaa, Huber, Roman, Bodechtel, Ulf, Lichy, Christoph, Enzinger, Christian, Schmidt, Reinhold, Hennerici, Michael G., Kaps, Manfred, Kessler, Christof, Lackner, Karl, Paschke, Eduard, Meyer, Wolfgang, Mascher, Hermann, Riess, Olaf, Kolodny, Edwin, Norrving, Bo, Rolfs, A, Ginsberg, M, Hennerici, MG, Kessler, C, Kolodny, E, Martus, P, Norrving, B, Ringelstein, EB, Rothwell, PM, Venables, G, Bornstein, N, deDeyn, P, Dichgans, M, Fazekas, F, Markus, H, Rie, O, Biedermann, C, Böttcher, T, Brüderlein, K, Burmeister, J, Federow, I, König, F, Makowei, G, Niemann, D, Rolfs, A, Rösner, S, Zielke, S, Grittner, U, Martus, P, Holzhausen, M, Fazekas, F, Enzinger, C, Schmidt, R, Ropele, S, Windisch, M, Sterner, E, Bodamer, O, Fellgiebel, A, Hillen, U, Jonas, L, Kampmann, C, Kropp, P, Lackner, K, Laue, M, Mascher, H, Meyer, W, Paschke, E, Weidemann, F, Berrouschot, J, Stoll, A, Rokicha, A, Sternitzky, C, Thomä, M, DeDeyn, PP, Sheorajpanday, R, De Brabander, I, Yperzeele, L, Brouns, R, Oschmann, P, Pott, M, Schultes, K, Schultze, C, Hirsekorn, J, Jungehulsing, GJ, Villringer, A, Schmidt, W, Liman, T, Nowe, T, Ebinger, M, Wille, A, Loui, H, Objartel, A, übelacker, A, Mette, R, Jegzentis, K, Nabavi, DG, Crome, O, Bahr, D, Ebke, M, Platte, B, Kleinen, C, Mermolja Gunther, K, Heide, W, Pape, O, Hanssen, JR, Stangenberg, D, Klingelhofer, J, Schmidt, B, Schwarz, S, Schwarze, J, Frandlih, L, Iwanow, J, Steinbach, I, Krieger, D, Boysen, G, Leth Jeppesen, L, Petersen, A, Reichmann, H, Becker, U, Dzialkowski, I, Hentschel, H, Lautenschlager, C, Hanso, H, Gahn, G, Ziemssen, T, Fleischer, K, Sehr, B, McCabe, DJH, Tobin, O, Kinsella, J, Murphy, RP, Jander, S, Hartung, HP, Siebler, M, Bottcher, C, Kohne, A, Platzen, J, Brosig, TC, Rothhammer, V, Henseler, C, Neumann-Haefelin, T, Singer, OC, Ermis, U, dos Santos, IMRM, Schuhmann, C, van de Loo, S, Kaps, M, Allendorfer, J, Tanislav, C, Brandtner, M, Muir, K, Dani, K, MacDougall, N, Smith, W, Rowe, A, Welch, A, Fazekas, F, Schrotter, G, Krenn, U, Horner, S, Pendl, B, Pluta-Fuerst, A, Trummer, U, Kessler, C, Chatzopoulos, M, v Sarnowski, Bettina, Schminke, Ulf, Link, T, Khaw, A, Nieber, E, Zierz, S, Muller, T, Wegener, N, Wartenberg, K, Gaul, C, Richter, D, Rosenkranz, M, Krützelmann, AC, Hoppe, J, Choe, CU, Narr, S, Magnus, TU, Thomalla, G, Leypoldt, F, Otto, D, Lichy, C, Hacke, W, Barrows, RJ, Tatlisumak, T, Putaala, J, Curtze, S, Metso, M, Willeit, J, Furtner, M, Spiegel, M, Knoflach, MH, Prantl, B, Witte, OW, Brämer, D, Günther, A, Prell, T, Herzau, C, Aurich, K, Deuschl, G, Wodarg, F, Zimmermann, P, Eschenfelder, CC, Levsen, M, Weber, JR, Marecek, SM, Schneider, D, Michalski, D, Kloppig, W, Küppers-Tiedt, L, Schneider, M, Schulz, A, Matzen, P, Weise, C, Hobohm, C, Meier, H, Langos, R, Urban, D, Gerhardt, I, Thijs, V, Lemmens, R, Marcelis, E, Hulsbosch, C, Aichner, F, Haring, HP, Bach, E, Machado Candido, J, e Silva, AA, Lourenco, M, de Sousa, AIM, Derex, L, Cho, TH, Díez-Tejedor, E, Fuentes, B, Martínez-Sanchez, P, Pérez-Guevara, MI, Hamer, H, Metz, A, Hallenberger, K, Müller, P, Baron, P, Bersano, A, Gattinoni, M, Vella, N, Mallia, M, Jauss, M, Adam, L, Heidler, F, Gube, C, Kiszka, M, Dichgans, M, Karpinska, A, Mewald, Y, Straub, V, Dörr, A, Zollver, A, Ringelstein, EB, Schilling, M, Borchert, A, Preuth, N, Duning, T, Kuhlenbäumer, G, Schulte, D, Rothwell, PM, Marquardt, L, Schlachetzki, F, Boy, S, Mädl, J, Ertl, GM, Fehm, NPR, Stadler, C, Benecke, R, Dudesek, A, Kolbaske, S, Lardurner, G, Sulzer, C, Zerbs, A, Lilek, S, Walleczek, AM, Sinadinowska, D, Janelidze, M, Beridze, M, Lobjanidze, N, Dzagnidze, A, Melms, A, Horber, K, Fink, I, Liske, B, Ludolph, AC, Huber, R, Knauer, K, Hendrich, C, Raubold, S, Czlonkowska, A, Baranowska, A, Blazejewska-Hyzorek, B, Lang, W, Kristoferitsch, W, Ferrari, J, Ulrich, E, Flamm-Horak, A, Lischka-Lindner, A, Schreiber, W, Demarin, V, Tranjec, Z, Bosner-Puretic, M, Jurašić, MJ, Basic Kes, V, Budisic, M, and Kopacevic, L more...
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- 2013
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Catalog
3. Is erectile dysfunction a sentinel symptom for cardiovascular autonomic neuropathy in patients with type 2 diabetes?
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Debono, M., Cachia, E., Cassar, A., Calleja, N., Mallia, M., and Vassallo, J.
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- 2008
4. The Church Schools issue in Malta
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Vassallo, H. and Mallia, M. J.
- Published
- 1984
5. The European Seaman's Smart Card: a Prototype of a Distributed System Allowing Secure Access to a Unified Representation of Maritime Records
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Demartini, Claudio Giovanni, Bettiol, S., Fabrizio Lamberti, Mallia, M., and Andrea SANNA
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- 2008
6. Is erectile dysfunction a sentinel symptom for cardiovascular autonomic neuropathy in patients with type 2 diabetes?
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Debono, Miguel, Cachia, Elaine, Cassar, A., Calleja, Neville, Mallia, M., and Vassallo, Josanne
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Sexual disorders ,Cardiovascular system -- Diseases ,fungi ,food and beverages ,Non-insulin-dependent diabetes ,Impotence -- Prevention - Abstract
The study investigated whether there is a significant association between erectile dysfunction (ED) secondary to autonomic failure, and cardiovascular autonomic neuropathy (CAN) in male patients suffering from type 2 diabetes. Twenty‐two patients suffering from type 2 diabetes were recruited for this study after satisfying the stringent exclusion criteria used in the first stage. They had no evidence of overt cardiovascular disease, hypertension, neurological, renal or thyroid disease. Each subject was assessed for ED and CAN using standardized tests. Six patients were suffering from CAN while 10 patients were suffering from ED. There was no significant association between CAN and autonomic ED (P = 1). Three patients with normal erectile function had CAN, whilst three patients with ED had CAN. Further analysis demonstrates a significant increase in association between ED and CAN with age (P = 0.036). These results show that ED secondary to autonomic neuropathy is not significantly associated with CAN in this specific group of patients. Nonetheless, the study reveals that ED is a sentinel symptom for future development of CAN., peer-reviewed more...
- Published
- 2008
7. Student-led Online Debate, using Work Groups (myBU)
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Hopkins, D, Mallia, M, and Abbasirad, K
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edu - Abstract
Using User Groups and Discussion Boards for fully-online mature students to debate emotive subject of Globalisation.
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- 2008
8. Definition of a Formal and Unified Model for a Smart Card based European-wide Electronic Seaman's Book
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Lamberti, Fabrizio, Bettiol, S, Mallia, M, Sanna, Andrea, and Demartini, Claudio Giovanni
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- 2008
9. L''INGENIEUSE ET FECONDE' GEORGE SAND: LE REMANIEMENT GOTHIQUE DE CONSUELO (1842) DANS LA COMTESSE DE RUDOLSTADT (1843)
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Mallia, M., primary
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- 2013
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10. An unusual case of Parinaud's syndrome
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Mallia, M., primary, Chircop, C., additional, and Aquilina, J., additional
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- 2012
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11. Description of the architectural model for distributed courseware production delivery
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Kommers, Petrus A.M., Hoebink, H., Ferreira, A., Groenbaek, F., Shapiro, H., Entmer, H., Windeloev, D., and Mallia, M.
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METIS-136860 - Published
- 1992
12. Student-led Online Debate, using Work Groups (myBU).
- Author
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Hopkins, D, Mallia, M, Abbasirad, K, Hopkins, D, Mallia, M, and Abbasirad, K
- Abstract
Using User Groups and Discussion Boards for fully-online mature students to debate emotive subject of Globalisation.
13. A New Nitrotriazole Cysteine Conjugate for Asymmetric [2+2] [99mTcN(PNP)] Labeling for Possible Use in Imaging Hypoxia.
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Mathur, A., Mallia, M. B., Subramanian, S., Banerjee, S., and Venkatesh, M.
- Published
- 2007
14. A Case for Cross-Border Governance? A Comparative Trend Assessment of COVID-19 Transmission, Vaccination, and Outcomes Among 35 Nations in Europe Across 18 months.
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Cuschieri S, Cuschieri A, Farrugia E, Diacono E, Balzan E, Grupetta M, Vella A, Cutajar C, Formosa M, Barbara M, Mintoff F, Shaw C, Fleri-Soler S, Borg N, Pace G, Vella L, Pisani R, Attard-Mallia T, Gouder M, Attard R, Grixti N, Scicluna M, Borda T, Bartolo K, Chircop R, Degabrielle-Ferrante E, Mallia M, Attard M, Frendo N, Gatt G, Damato G, Riolo N, Muscat-Baron L, Galea M, and Grech E more...
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- Humans, SARS-CoV-2, Pandemics prevention & control, COVID-19 Vaccines therapeutic use, Vaccination, Europe epidemiology, COVID-19 epidemiology, COVID-19 prevention & control
- Abstract
Objective: Coronavirus disease 2019 (COVID-19) spread globally, including across Europe, resulting in different morbidity and mortality outcomes. The aim of this study was to explore the progression of the COVID-19 pandemic over 18 mo in relation to the effect of COVID-19 vaccination at a population level across 35 nations in Europe, while evaluating the data for cross-border epidemiological trends to identify any pertinent lessons that can be implemented in the future., Methods: Epidemiological data were obtained from European Centre for Disease Prevention and Control and Our World in Data databases while Ministry of Health websites of each respective country and local newspapers were used for COVID-19-related vaccination strategies. Case, mortality, and vaccination incidence comparative analyses were made across neighboring countries., Results: Similar morbidity and mortality outcomes were evident across neighboring countries over 18 mo, with a bidirectional relationship evident between cumulative fully vaccinated population and case fatality rates., Conclusion: Countries' COVID-19 outcome is related on national mitigative measures, vaccination rollouts, and neighboring countries' actions and COVID-19 situations. Mass population vaccination appeared to be effective in reducing COVID-19 case severity and mortality rates. Vaccination equity and pan-European commitment for cross-border governance appear to be the way forward to ensure populations' return to "normality." more...
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- 2022
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15. Outcomes of endovascular treatment for acute ischaemic stroke in Mater Dei Hospital, Malta.
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Cilia K, Grech R, and Mallia M
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- Adult, Aged, Aged, 80 and over, Hospitals, Humans, Malta, Middle Aged, Prospective Studies, Retrospective Studies, Thrombectomy methods, Treatment Outcome, Brain Ischemia diagnostic imaging, Brain Ischemia surgery, Endovascular Procedures methods, Ischemic Stroke, Stroke diagnostic imaging, Stroke surgery
- Abstract
Introduction: The aim of this study was to assess the outcomes of endovascular treatment for acute ischaemic stroke in Mater Dei Hospital, Malta and compare them with international data., Methods: A prospective review of all patients who underwent mechanical thrombectomy from 2015 to the end of 2019 was performed. Eligible patients had large vessel occlusion confirmed on computed tomography angiography. Demographical data, the National Institutes of Health stroke scale at presentation, endovascular procedure details and process times were analysed. The thrombolysis in cerebral infarction score was used to assess the degree of reperfusion. A thrombolysis in cerebral infarction score of 2b-3 was considered as successful recanalisation. Functional outcome (modified Rankin scale score) and mortality at 90 days were measured. Functional independence was defined as a modified Rankin scale score of 2 or less., Results: A total of 132 patients underwent endovascular treatment, one patient was excluded due to incomplete data. The mean age was 71 (range 25-94) years, and the mean National Institutes of Health stroke scale at presentation was 14. Of the 131 patients treated, 69 received intravenous thrombolysis. Successful recanalisation (thrombolysis in cerebral infarction score 2b-3) was achieved in 80% of patients (105/131); 53% of patients (69/131) achieved functional independence at 90 days, with a mortality of 21% at 90 days. Symptomatic intracranial haemorrhage was recorded in 16 patients (12%) There was a statistical difference in the functional independence and mortality rate in favour of the successful recanalisation group., Conclusion: Our data are consistent with a favourable clinical outcome after successful recanalisation. Service in Malta is achieving favourable outcomes for patients treated with mechanical thrombectomy for acute ischaemic stroke. more...
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- 2022
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16. Sex-Specific Computed Tomography Coronary Plaque Characterization and Risk of Myocardial Infarction.
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Williams MC, Kwiecinski J, Doris M, McElhinney P, D'Souza MS, Cadet S, Adamson PD, Moss AJ, Alam S, Hunter A, Shah ASV, Mills NL, Pawade T, Wang C, Weir-McCall JR, Bonnici-Mallia M, Murrills C, Roditi G, van Beek EJR, Shaw LJ, Nicol ED, Berman DS, Slomka PJ, Newby DE, Dweck MR, and Dey D more...
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- Computed Tomography Angiography, Coronary Angiography, Coronary Vessels diagnostic imaging, Female, Humans, Male, Predictive Value of Tests, Risk Factors, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease epidemiology, Myocardial Infarction diagnostic imaging, Myocardial Infarction epidemiology, Plaque, Atherosclerotic
- Abstract
Objectives: This study was designed to investigate whether coronary computed tomography angiography assessments of coronary plaque might explain differences in the prognosis of men and women presenting with chest pain., Background: Important sex differences exist in coronary artery disease. Women presenting with chest pain have different risk factors, symptoms, prevalence of coronary artery disease and prognosis compared to men., Methods: Within a multicenter randomized controlled trial, we explored sex differences in stenosis, adverse plaque characteristics (positive remodeling, low-attenuation plaque, spotty calcification, or napkin ring sign) and quantitative assessment of total, calcified, noncalcified and low-attenuation plaque burden., Results: Of the 1,769 participants who underwent coronary computed tomography angiography, 772 (43%) were female. Women were more likely to have normal coronary arteries and less likely to have adverse plaque characteristics (p < 0.001 for all). They had lower total, calcified, noncalcified, and low-attenuation plaque burdens (p < 0.001 for all) and were less likely to have a low-attenuation plaque burden >4% (41% vs. 59%; p < 0.001). Over a median follow-up of 4.7 years, myocardial infarction (MI) occurred in 11 women (1.4%) and 30 men (3%). In those who had MI, women had similar total, noncalcified, and low-attenuation plaque burdens as men, but men had higher calcified plaque burden. Low-attenuation plaque burden predicted MI (hazard ratio: 1.60; 95% confidence interval: 1.10 to 2.34; p = 0.015), independent of calcium score, obstructive disease, cardiovascular risk score, and sex., Conclusions: Women presenting with stable chest pain have less atherosclerotic plaque of all subtypes compared to men and a lower risk of subsequent MI. However, quantitative low-attenuation plaque is as strong a predictor of subsequent MI in women as in men. (Scottish Computed Tomography of the HEART Trial [SCOT-HEART]; NCT01149590)., Competing Interests: Funding Support and Author Disclosures Drs. Dey, Slomka, and Berman and Mr. Cadet may receive software royalties from Cedars-Sinai Medical Center; and Drs. Dey, Slomka, and Berman have a patent. This trial was funded by The Chief Scientist Office of the Scottish Government Health and Social Care Directorates (CZH/4/588), with supplementary awards from Edinburgh and Lothian’s Health Foundation Trust and the Heart Diseases Research Fund. Drs. Williams, Mills, Newby, and Dweck are supported by the British Heart Foundation (FS/ICRF/20/26002, CH/09/002, FS/11/014, FS/16/14/32023, RG/20/10/34966, RE/18/5/34216, RG/16/10/32375, FS/14/78/31020). Dr. Williams was supported by The Chief Scientist Office of the Scottish Government Health (PCL/17/04). Dr. Newby is the recipient of a Wellcome Trust Senior Investigator Award (WT103782AIA). Dr. van Beek is supported by Scottish Imaging Network: A Platform of Scientific Excellence (SINAPSE). Dr. Adamson is supported by a National Heart Foundation of New Zealand Senior Fellowship (1844). Dr. Dweck is supported by the Sir Jules Thorn Biomedical Research Award 2015 (15/JTA). The Royal Bank of Scotland supported the provision of 320-multidetector CT for NHS Lothian and the University of Edinburgh. The Edinburgh Imaging facility QMRI (Edinburgh) is supported by the National Health Service Research Scotland (NRS) through National Health Service Lothian Health Board. The Clinical Research Facility Glasgow and Clinical Research Facility Tayside are supported by National Health Service Research Scotland (NRS). Ms. McElhinney and Dr. Dey are supported by National Institute of Health/National Heart, Lung, and Blood Institute grants (1R01HL148787-01A1 and 1R01HL151266). Mr. Cadet is supported by the Miriam and Sheldon G. Adelson Medical Research Foundation. All other authors have no reported that they have norelationships relevant to the contents of this paper to disclose., (Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.) more...
- Published
- 2021
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17. Prophylactic Faecalibacterium prausnitzii treatment prevents the acute breakdown of colonic epithelial barrier in a preclinical model of pelvic radiation disease.
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Lapiere A, Geiger M, Robert V, Demarquay C, Auger S, Chadi S, Benadjaoud M, Fernandes G, Milliat F, Langella P, Benderitter M, Chatel JM, and Sémont A
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- Animals, Cell Proliferation, Colon immunology, Colon pathology, Colon physiopathology, Gastrointestinal Microbiome, Interleukin-18 metabolism, Intestinal Mucosa immunology, Intestinal Mucosa pathology, Intestinal Mucosa physiology, Macrophages physiology, Male, Neutrophils physiology, Pelvis, Permeability, Radiation Injuries, Experimental immunology, Rats, Rats, Sprague-Dawley, Rectum radiation effects, Stem Cells physiology, Colon radiation effects, Faecalibacterium prausnitzii, Intestinal Mucosa radiation effects, Probiotics, Radiation Injuries, Experimental pathology, Radiation Injuries, Experimental prevention & control
- Abstract
Every year, millions of people around the world benefit from radiation therapy to treat cancers localized in the pelvic area. Damage to healthy tissue in the radiation field can cause undesirable toxic effects leading to gastrointestinal complications called pelvic radiation disease. A change in the composition and/or function of the microbiota could contribute to radiation-induced gastrointestinal toxicity. In this study, we tested the prophylactic effect of a new generation of probiotic like Faecalibacterium prausnitzii ( F. prausnitzii ) on acute radiation-induced colonic lesions. Experiments were carried out in a preclinical model of pelvic radiation disease. Rats were locally irradiated at 29 Gray in the colon resulting in colonic epithelial barrier rupture. Three days before the irradiation and up to 3 d after the irradiation, the F. prausnitzii A2-165 strain was administered daily (intragastrically) to test its putative protective effects. Results showed that prophylactic F. prausnitzii treatment limits radiation-induced para-cellular hyperpermeability, as well as the infiltration of neutrophils (MPO+ cells) in the colonic mucosa. Moreover, F. prausnitzii treatment reduced the severity of the morphological change of crypts, but also preserved the pool of Sox-9+ stem/progenitor cells, the proliferating epithelial PCNA+ crypt cells and the Dclk1+/IL-25+ differentiated epithelial tuft cells. The benefit of F. prausnitzii was associated with increased production of IL-18 by colonic crypt epithelial cells. Thus, F. prausnitzii treatment protected the epithelial colonic barrier from colorectal irradiation. New-generation probiotics may be promising prophylactic treatments to reduce acute side effects in patients treated with radiation therapy and may improve their quality of life. more...
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- 2020
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18. Clinical reasoning: exploring its characteristics and enhancing its learning.
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Gruppetta M and Mallia M
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- Curriculum, Humans, Learning, Clinical Competence, Clinical Reasoning
- Abstract
Clinical reasoning is an extensive and intricate field, dealing with the process of thinking and decision making in practice. Its study can be quite challenging because it is context and task dependent. Educational frameworks such as the conscious competence model and the dual process reasoning model have been developed to help its understanding. To enhance the learning of clinical reasoning, there are significant areas that can be targeted through learning processes. These include knowledge adequacy; ability to gather appropriate patient data; use of proper reasoning strategies to address specific clinical questions; and the ability to reflect and evaluate on decisions taken, together with the role of the wider practice community and the activity of professional socialisation. This article explores the characteristics of clinical reasoning and delves deeper into the various strategies that prove useful for learning. more...
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- 2020
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19. Low-Attenuation Noncalcified Plaque on Coronary Computed Tomography Angiography Predicts Myocardial Infarction: Results From the Multicenter SCOT-HEART Trial (Scottish Computed Tomography of the HEART).
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Williams MC, Kwiecinski J, Doris M, McElhinney P, D'Souza MS, Cadet S, Adamson PD, Moss AJ, Alam S, Hunter A, Shah ASV, Mills NL, Pawade T, Wang C, Weir McCall J, Bonnici-Mallia M, Murrills C, Roditi G, van Beek EJR, Shaw LJ, Nicol ED, Berman DS, Slomka PJ, Newby DE, Dweck MR, and Dey D more...
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- Aged, Angina, Stable diagnosis, Angina, Stable mortality, Coronary Artery Disease complications, Coronary Artery Disease mortality, Coronary Stenosis complications, Coronary Stenosis mortality, Female, Heart Disease Risk Factors, Humans, Male, Middle Aged, Myocardial Infarction diagnosis, Myocardial Infarction mortality, Predictive Value of Tests, Prognosis, Risk Assessment, Scotland, Time Factors, Vascular Calcification complications, Vascular Calcification mortality, Angina, Stable etiology, Computed Tomography Angiography, Coronary Angiography, Coronary Artery Disease diagnostic imaging, Coronary Stenosis diagnostic imaging, Myocardial Infarction etiology, Plaque, Atherosclerotic, Vascular Calcification diagnostic imaging
- Abstract
Background: The future risk of myocardial infarction is commonly assessed using cardiovascular risk scores, coronary artery calcium score, or coronary artery stenosis severity. We assessed whether noncalcified low-attenuation plaque burden on coronary CT angiography (CCTA) might be a better predictor of the future risk of myocardial infarction., Methods: In a post hoc analysis of a multicenter randomized controlled trial of CCTA in patients with stable chest pain, we investigated the association between the future risk of fatal or nonfatal myocardial infarction and low-attenuation plaque burden (% plaque to vessel volume), cardiovascular risk score, coronary artery calcium score or obstructive coronary artery stenoses., Results: In 1769 patients (56% male; 58±10 years) followed up for a median 4.7 (interquartile interval, 4.0-5.7) years, low-attenuation plaque burden correlated weakly with cardiovascular risk score ( r =0.34; P <0.001), strongly with coronary artery calcium score ( r =0.62; P <0.001), and very strongly with the severity of luminal coronary stenosis (area stenosis, r =0.83; P <0.001). Low-attenuation plaque burden (7.5% [4.8-9.2] versus 4.1% [0-6.8]; P <0.001), coronary artery calcium score (336 [62-1064] versus 19 [0-217] Agatston units; P <0.001), and the presence of obstructive coronary artery disease (54% versus 25%; P <0.001) were all higher in the 41 patients who had fatal or nonfatal myocardial infarction. Low-attenuation plaque burden was the strongest predictor of myocardial infarction (adjusted hazard ratio, 1.60 (95% CI, 1.10-2.34) per doubling; P =0.014), irrespective of cardiovascular risk score, coronary artery calcium score, or coronary artery area stenosis. Patients with low-attenuation plaque burden greater than 4% were nearly 5 times more likely to have subsequent myocardial infarction (hazard ratio, 4.65; 95% CI, 2.06-10.5; P <0.001)., Conclusions: In patients presenting with stable chest pain, low-attenuation plaque burden is the strongest predictor of fatal or nonfatal myocardial infarction. These findings challenge the current perception of the supremacy of current classical risk predictors for myocardial infarction, including stenosis severity. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01149590. more...
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- 2020
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20. Synthesis and preliminary evaluation of 99m Tc-Hynic-fragments [F(ab') 2 and F(ab')] of Rituximab as radioimmunoscintigraphic agents for patients with Non-Hodgkin's lymphoma.
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Suman SK, Kameswaran M, Mallia M, Mittal S, and Dash A
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- Animals, Humans, Mice, Rituximab immunology, Antineoplastic Agents therapeutic use, Lymphoma, Non-Hodgkin drug therapy, Radioimmunodetection methods, Rituximab therapeutic use, Technetium administration & dosage
- Abstract
This study was to evaluate the potential of
99m Tc-Hynic-fragments of Rituximab as radioimmunoscintigraphic agents for diagnosis of patients with Non-Hodgkin's Lymphoma (NHL). Rituximab was digested with immobilized pepsin and papain to yield F(ab')2 -Rituximab and F(ab')-Rituximab fragments respectively. Purified fragments were characterized by SE-HPLC and SDS-PAGE and subsequently radiolabeled with technetium-99m using Hynic as bifunctional chelator. The99m Tc-Hynic-F(ab')2 -Rituximab and99m Tc-Hynic-F(ab')-Rituximab exhibited good in-vitro stability and specificity to Raji cells. Biodistribution studies demonstrated rapid pharmacokinetics and clearance predominantly through renal route., (Copyright © 2019. Published by Elsevier Ltd.) more...- Published
- 2019
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21. Development and Validation of a Path Length Calculation for Carotid-Femoral Pulse Wave Velocity Measurement: A TASCFORCE, SUMMIT, and Caerphilly Collaborative Venture.
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Weir-McCall JR, Brown L, Summersgill J, Talarczyk P, Bonnici-Mallia M, Chin SC, Khan F, Struthers AD, Sullivan F, Colhoun HM, Shore AC, Aizawa K, Groop L, Nilsson J, Cockcroft JR, McEniery CM, Wilkinson IB, Ben-Shlomo Y, and Houston JG more...
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- Adult, Age Factors, Aged, Analysis of Variance, Blood Pressure Determination methods, Carotid Arteries diagnostic imaging, Carotid Arteries physiology, Cohort Studies, Female, Femoral Artery diagnostic imaging, Femoral Artery physiology, Humans, Logistic Models, Male, Middle Aged, Prospective Studies, Risk Assessment, Sex Factors, Whole Body Imaging, Blood Flow Velocity physiology, Blood Pressure physiology, Magnetic Resonance Angiography methods, Pulse Wave Analysis methods, Vascular Stiffness
- Abstract
Current distance measurement techniques for pulse wave velocity (PWV) calculation are susceptible to intercenter variability. The aim of this study was to derive and validate a formula for this distance measurement. Based on carotid femoral distance in 1183 whole-body magnetic resonance angiograms, a formula was derived for calculating distance. This was compared with distance measurements in 128 whole-body magnetic resonance angiograms from a second study. The effects of recalculation of PWV using the new formula on association with risk factors, disease discrimination, and prediction of major adverse cardiovascular events were examined within 1242 participants from the multicenter SUMMIT study (Surrogate Markers of Micro- and Macrovascular Hard End-Points for Innovative Diabetes Tools) and 825 participants from the Caerphilly Prospective Study. The distance formula yielded a mean error of 7.8 mm (limits of agreement =-41.1 to 56.7 mm; P <0.001) compared with the second whole-body magnetic resonance angiogram group. Compared with an external distance measurement, the distance formula did not change associations between PWV and age, blood pressure, or creatinine ( P <0.01) but did remove significant associations between PWV and body mass index (BMI). After accounting for differences in age, sex, and mean arterial pressure, intercenter differences in PWV persisted using the external distance measurement ( F =4.6; P =0.004), whereas there was a loss of between center difference using the distance formula ( F =1.4; P =0.24). PWV odds ratios for cardiovascular mortality remained the same using both the external distance measurement (1.14; 95% confidence interval, 1.06-1.24; P =0.001) and the distance formula (1.17; 95% confidence interval, 1.08-1.28; P <0.001). A population-derived automatic distance calculation for PWV obtained from routinely collected clinical information is accurate and removes intercenter measurement variability without impacting the diagnostic utility of carotid-femoral PWV., (© 2018 The Authors.) more...
- Published
- 2018
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22. Contrast induced spinal myoclonus after percutaneous coronary intervention.
- Author
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Abela L, Magri Gatt K, Farrugia J, and Mallia M
- Abstract
We present a case of a 77-year-old man diagnosed with contrast-induced spinal myoclonus following primary percutaneous coronary intervention. After being admitted with a diagnosis of anteroseptal myocardial infarction, he underwent primary percutaneous coronary intervention to the left anterior descending artery and was prescribed aspirin, clopidogrel, and intravenous heparin. The following day he developed non-intentional irregular jerky movements confined to the truncal area. In view of rhythmic jerking confined to muscles innervated by a restricted segment of the spinal cord, resistance to supra-spinal influences and voluntary action, and no preceding electroencephalography activity in the contralateral sensorimotor cortex, a diagnosis of spinal myoclonus was made. Spinal myoclonus is a rare entity in which myoclonic movements occur in muscles originating from few (segmental), or many adjacent spinal motor roots (propriospinal). Structural lesions are found in the majority of cases but the actual pathophysiology is still unknown. Contrast-induced spinal myoclonus is an even rarer phenomenon with few published reports. We describe postulated mechanisms and the management of this phenomenon. < Learning objective: Myoclonus is a jerky movement due to abrupt involuntary contractions involving agonist and antagonist muscles. Spinal myoclonus is a rare disorder where myoclonic movements occur in muscles originating from spinal motor roots. The cause is usually a structural lesion, but in rare cases it can be induced by contrast. A video of this rare phenomenon is available with this article and the proposed pathophysiological mechanisms and treatment are discussed.>. more...
- Published
- 2017
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23. Herpes simplex encephalitis: unusual imaging appearances.
- Author
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Bonnici-Mallia M, Kanodia AK, Rae N, and Marwick C
- Subjects
- Antiviral Agents therapeutic use, Brain diagnostic imaging, Diagnosis, Differential, Encephalitis, Herpes Simplex complications, Encephalitis, Herpes Simplex drug therapy, Female, Herpesvirus 1, Human isolation & purification, Humans, Hypothermia virology, Immunosuppressive Agents therapeutic use, Middle Aged, Retinal Necrosis Syndrome, Acute virology, Encephalitis, Herpes Simplex diagnostic imaging, Hypothermia etiology, Retinal Necrosis Syndrome, Acute etiology
- Published
- 2016
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24. Radiosynovectomy of Proximal Interphalangeal Joint Synovitis in Rheumatoid Arthritis Treated with Rhenium-188 Labeled Tin-colloid and Imaging with Single-photon Emission Computerized Tomography/Computed Tomography: A First Case Report.
- Author
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Kamaleshwaran KK, Rajamani V, Krishnan B, Mallia M, Kalarikal R, Mohanan V, and Shinto AS
- Abstract
Rheumatoid arthritis (RA) is a chronic disease that is mainly characterized by the asymmetric erosive synovitis, particularly affecting peripheral joints. Radiation synovectomy or radiosynovectomy (RSV), also known as radiosynoviorthesis was first described in 1950's as an adjuvant treatment for RA. RSV is based on the irradiation of the joint synovium by the intra-articular administration of various β-emitting radiopharmaceuticals. As a generator-produced β-emitting radionuclide, the importance of rhenium-188 (Re-188) for radionuclide therapy is increasing rapidly. There are previous reports which used Re-188 tin colloid in knee joint synovitis, but use of Re-188 tin colloid in small joint is not yet reported. We describe the use of Re-188 tin colloid in a 45-year-old female who presented with right 4(th) proximal interphalangeal joint synovitis due to rheumatoid arthritis. more...
- Published
- 2015
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25. Utility of (99m)Tc-Hynic-TOC in 131I Whole-Body Scan Negative Thyroid Cancer Patients with Elevated Serum Thyroglobulin Levels.
- Author
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Shinto AS, Kamaleshwaran KK, Mallia M, Korde A, Samuel G, Banerjee S, Velayutham P, Damodharan S, and Sairam M
- Abstract
Several studies have reported on the expression of somatostatin receptors (SSTRs) in patients with differentiated thyroid cancer (DTC). The aim of this study was to evaluate the imaging abilities of a recently developed Technetium-99m labeled somatostatin analog, (99m)Tc-Hynic-TOC, in terms of precise localization of the disease. The study population consisted of 28 patients (16 men, 12 women; age range: 39-72 years) with histologically confirmed DTC, who presented with recurrent or persistent disease as indicated by elevated serum thyroglobulin (Tg) levels after initial treatment (serum Tg > 10 ng/ml off T4 suppression for 4-6 weeks). All patients were negative on the Iodine-131 posttherapy whole-body scans. Fluorine-18 fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) was performed in all patients. SSTR scintigraphy was true positive in 23 cases (82.1%), true negative in two cases (7.1%) and false negative in three cases (10.7%) which resulted in a sensitivity of 88.46%, specificity of 100% and an accuracy of 89.2%. Sensitivity of (99m)Tc-Hynic-TOC scan was higher (93.7%) for patients with advanced stages, that is stages III and IV. (18)F-FDG showed a sensitivity of 93.7%, a specificity of 50% and an accuracy of 89.3%. (18)F-FDG PET was found to be more sensitive, with lower specificity due to false positive results in 2 patients. Analysis on a lesion basis demonstrated substantial agreement between the two imaging techniques with a Cohen's kappa of 0.66. Scintigraphy with (99m)Tc-Hynic-TOC might be a promising tool for treatment planning; it is easy to perform and showed sufficient accuracy for localization diagnostics in thyroid cancer patients with recurrent or metastatic disease. more...
- Published
- 2015
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26. Improved kit formulation for preparation of (99m)Tc-HYNIC-TOC: results of preliminary clinical evaluation in imaging patients with neuroendocrine tumors.
- Author
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Korde A, Mallia M, Shinto A, Sarma HD, Samuel G, and Banerjee S
- Subjects
- Animals, Drug Stability, Freeze Drying, Mice, Neuroendocrine Tumors metabolism, Octreotide chemical synthesis, Octreotide chemistry, Octreotide pharmacokinetics, Organotechnetium Compounds chemical synthesis, Organotechnetium Compounds pharmacokinetics, Radionuclide Imaging, Radiopharmaceuticals chemical synthesis, Radiopharmaceuticals pharmacokinetics, Receptors, Somatostatin biosynthesis, Tissue Distribution, Neuroendocrine Tumors diagnostic imaging, Octreotide analogs & derivatives, Organotechnetium Compounds chemistry, Radiopharmaceuticals chemistry
- Abstract
(99m)Tc-HYNIC-TOC is a cost-effective and logistically viable agent for scintigraphy of neuroendocrine tumors overexpressing somatostatin receptors as compared with [(111)In-DTPA-D-Phe(1)] Octreotide (Octreoscan(®)). Several studies have been reported, wherein the efficacy of this agent is demonstrated. In the present article, the authors report the preparation of a single-vial HYNIC-TOC kit suitable for the preparation of 4-5 patient doses (15 mCi/patient) of (99m)Tc-HYNIC-TOC. The kits were tested for sterility and bacterial endotoxins to assure safety of the product. A significant modification in this kit is the inclusion of buffer in the kit itself, unlike in commercially available kits where the buffer solution has to be added during preparation. (99m)Tc-HYNIC-TOC was prepared by adding 20-80 mCi (740-2960 MBq) of freshly eluted Na(99m)TcO4 in 1-3 mL of sterile saline directly into the kit vial and heating the vial in a water bath at 100°C for 20 minutes. The labeling yield and radiochemical purity of (99m)Tc-HYNIC-TOC, prepared using the lyophilized cold kit, were consistently >90%. The kits were evaluated over a period of 9 months and found to be stable when stored at -20°C. Limited clinical studies performed with the (99m)Tc-HYNIC-TOC, formulated using the kit, showed adequate sensitivity and specificity for the detection of gasteroenteropancreatic neuroendocrine tumors. more...
- Published
- 2014
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27. Clinical utility of indigenously formulated single-vial lyophilized HYNIC-TOC kit in evaluating Gastro-entero Pancreatic neuro endocrine tumours.
- Author
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Shinto AS, Kamaleshwaran K, Vyshak K, Sudhakar N, Banerjee S, Korde A, Samuel G, and Mallia M
- Abstract
Objectives: The objective of this study was to evaluate the performance and utility of (99m)Tc HYNIC-TOC planar scintigraphy and SPECT/CT in the diagnosis, staging and management of gastroenteropancreatic neuroendocrine tumors (GPNETs)., Methods: 22 patients (median age, 46 years) with histologically proven gastro- entero- pancreatic NETs underwent (99m)Tc HYNIC-TOC whole body scintigraphy and regional SPECT/CT as indicated. Scanning was performed after injection of 370-550 MBq (10-15 mCi) of (99m)Tc HYNIC-TOC intravenously. Images were evaluated by two experienced nuclear medicine physicians both qualitatively as well as semi quantitatively (tumor to background and tumor to normal liver ratios on SPECT -CT images). Results of SPECT/CT were compared with the results of conventional imaging. Histopathology results and follow-up somatostatin receptor scintigraphy with (99m)Tc HYNIC TOC or conventional imaging with biochemical markers were considered to be the reference standards., Results: (99m)Tc HYNIC TOC showed sensitivity and specificity of 87.5% and 85.7%, respectively, for primary tumor and 100% and 86% for metastases. It was better than conventional imaging modalities for the detection of both primary tumor (P<0.001) and metastases (P<0.0001). It changed the management strategy in 6 patients (31.8%) and supported management decisions in 8 patients (36.3%)., Conclusion: (99m)Tc HYNIC TOC SPECT/CT appears to be a highly sensitive and specific modality for the detection and staging of GPNETs. It is better than conventional imaging for the evaluation of GPNETs and can have a significant impact on patient management and planning further therapeutic options. more...
- Published
- 2014
28. Gratifying clinical experience with an indigenously formulated single-vial lyophilized HYNIC-TOC kit at the radiopharmaceutical division of BARC: a pivotal boost for building up a peptide receptor radionuclide therapy programme in an Indian setting.
- Author
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Basu S, Kand P, Mallia M, Korde A, and Shimpi H
- Subjects
- Humans, India, Octreotide economics, Octreotide supply & distribution, Octreotide therapeutic use, Organotechnetium Compounds economics, Organotechnetium Compounds supply & distribution, Radiopharmaceuticals economics, Radiopharmaceuticals supply & distribution, Tomography, Emission-Computed, Single-Photon, Octreotide analogs & derivatives, Organotechnetium Compounds therapeutic use, Radiopharmaceuticals therapeutic use, Reagent Kits, Diagnostic
- Published
- 2013
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29. An unusual case of Parinaud's syndrome.
- Author
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Mallia M, Chircop C, and Aquilina J
- Subjects
- Adult, Autoantibodies blood, Brain pathology, Diagnosis, Differential, Diarrhea etiology, Dizziness etiology, Gangliosides immunology, Headache etiology, Humans, Magnetic Resonance Imaging, Male, Miller Fisher Syndrome immunology, Ocular Motility Disorders immunology, Vision Disorders etiology, Miller Fisher Syndrome diagnosis, Ocular Motility Disorders diagnosis
- Abstract
A 25-year-old man presented with blurred vision, headache and dizziness. On questioning, there was also a history of a preceding diarrhoeal illness. Initial investigations were normal. However, after a week, he represented with a Parinaud's syndrome. In view of the preceding diarrhoea, the transient unsteadiness and the areflexia on examination, anti-GQ1b antibodies were requested. The resulting titre was positive confirming the suspected diagnosis of Miller Fisher syndrome. He responded to intravenous immunoglobulins with full resolution of his symptoms and signs. Although various unusual neuro-ophthalmological signs have been reported localising to the brainstem, to our knowledge, this is the first case report of Parinaud's syndrome being the presenting symptom of Miller Fisher syndrome. more...
- Published
- 2012
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30. Adsorption of uranium from aqueous solution using chitosan-tripolyphosphate (CTPP) beads.
- Author
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Sureshkumar MK, Das D, Mallia MB, and Gupta PC
- Subjects
- Adsorption, Hydrogen-Ion Concentration, Solutions, Spectroscopy, Fourier Transform Infrared, Thermodynamics, Chitosan chemistry, Uranium chemistry, Water chemistry
- Abstract
Chitosan-tripolyphosphate (CTPP) beads were prepared using in-liquid curing method and used for the adsorption of uranium from aqueous solution. Beads were prepared at two different cross-linking densities by adjusting the pH of the tripolyphosphate solution. The synthesized beads were characterized using FTIR spectroscopy before and after adsorption of uranium. Beads having higher cross-linking are found to have better adsorption capacity for uranium. Factors that influence the uranium adsorption onto CTPP beads such as solution pH, contact time and initial uranium concentration were studied in detail. The experimental results were fitted into Langmuir and Freundlich adsorption isotherms. From Langmuir adsorption model the adsorption capacity of CTPP beads for uranium is estimated as 236.9 mg/g. Pseudo-first order, pseudo-second order and intraparticle diffusion model were applied to the observed kinetics data and the results shows that the pseudo-second order model is more suitable to explain the kinetics of adsorption of uranium on CTPP beads. FTIR spectroscopic characterization of the beads showed that the phosphate groups may be more responsible for the adsorption of uranium on CTPP beads., (Copyright © 2010 Elsevier B.V. All rights reserved.) more...
- Published
- 2010
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31. 99mTc-labeling of colchicine using [99mTc(CO)3(H2O)3]+ and [99mTc triple bond N]2+ core for the preparation of potential tumor-targeting agents.
- Author
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Korde A, Satpati D, Mathur A, Mallia M, Banerjee S, Kothari K, Sarma HD, Choudhari P, and Venkatesh M
- Subjects
- Animals, Cell Line, Tumor, Colchicine chemical synthesis, Colchicine chemistry, Drug Resistance, Multiple, Drug Resistance, Neoplasm, Fibrosarcoma diagnostic imaging, Melanoma, Experimental diagnostic imaging, Mice, Radionuclide Imaging, Tissue Distribution, Colchicine analogs & derivatives, Neoplasms, Experimental diagnostic imaging, Organotechnetium Compounds chemical synthesis, Organotechnetium Compounds chemistry, Radiopharmaceuticals chemical synthesis, Radiopharmaceuticals chemistry
- Abstract
Multidrug resistance (MDR) mediated by over-expression of P-glycoprotein (Pgp) is one of the major causes of failure of chemotherapy in cancer treatment. Colchicine, a naturally occurring alkaloid, is a Pgp substrate and acts as an antimitotic agent by binding to microtubules. Hence, Colchicine and its analogues radiolabeled with 99mTc may have potential for visualization of MDR in tumors. Here we report 99mTc-labeling of colchicine derivatives using [99mTc(CO)3(H2O)3]+ and [99mTc triple bond N]2+ cores. Trimethylcolchicinic acid synthesized from colchicine was used as the precursor to prepare iminodiacetic acid and dithiocarbamate derivatives which were then radiolabeled with [99mTc(CO)3(H2O)3]+ and [99mTc triple bond N]2+ cores, respectively. Radiolabeling yield for both the complexes was > 98% as observed by HPLC and TLC patterns. In vitro studies in tumor cell lines showed significant uptake for 99mTc-carbonyl as well as for 99mTc-nitrido colchicine complexes. Biodistribution studies in Swiss mice bearing fibrosarcoma tumor showed 4.1 +/- 1.2% ID/g of uptake at 30 min pi for 99mTc(CO)3-complex as against 0.42 +/- 0.24% ID/g for the 99mTcN-complex. 99mTc(CO)3-colchicine complex exhibited better pharmacokinetics with lower liver accumulation as compared to the 99mTcN-complex. Thus, colchicine radiolabeled with [99mTc(CO)3(H2O)3]+ core is more promising with respect to in vivo distribution characteristics in tumor model. more...
- Published
- 2006
- Full Text
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