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  1. Article ; Online: COVID-19 patients for tracheostomy: Anesthetic and team considerations.

    Parekh, Raj M / Lai, Yan H

    Journal of clinical anesthesia

    2020  Volume 65, Page(s) 109883

    MeSH term(s) Anesthetics ; Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Humans ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2 ; Tracheostomy
    Chemical Substances Anesthetics
    Keywords covid19
    Language English
    Publishing date 2020-05-19
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1011618-7
    ISSN 1873-4529 ; 0952-8180
    ISSN (online) 1873-4529
    ISSN 0952-8180
    DOI 10.1016/j.jclinane.2020.109883
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  3. Article ; Online: COVID-19 patients for tracheostomy

    Parekh, Raj M. / Lai, Yan H.

    Journal of Clinical Anesthesia

    Anesthetic and team considerations

    2020  Volume 65, Page(s) 109883

    Keywords Anesthesiology and Pain Medicine ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 1011618-7
    ISSN 1873-4529 ; 0952-8180
    ISSN (online) 1873-4529
    ISSN 0952-8180
    DOI 10.1016/j.jclinane.2020.109883
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Altered IgG4 antibody response to repeated mRNA versus recombinant protein SARS-CoV-2 vaccines.

    Kalkeri, Raj / Zhu, Mingzhu / Cloney-Clark, Shane / Plested, Joyce S / Parekh, Anand / Gorinson, Drew / Cai, Rongman / Mahato, Soham / Ramanathan, Pradhipa / Aurelia, Lidwina Carissa / Selva, Kevin John / Marchese, Anthony M / Fries, Louis / Chung, Amy W / Dunkle, Lisa M

    The Journal of infection

    2024  Volume 88, Issue 3, Page(s) 106119

    MeSH term(s) Humans ; Antibody Formation ; COVID-19/prevention & control ; COVID-19 Vaccines ; SARS-CoV-2/genetics ; Antibodies, Viral
    Chemical Substances COVID-19 Vaccines ; Antibodies, Viral
    Language English
    Publishing date 2024-02-13
    Publishing country England
    Document type Letter
    ZDB-ID 424417-5
    ISSN 1532-2742 ; 0163-4453
    ISSN (online) 1532-2742
    ISSN 0163-4453
    DOI 10.1016/j.jinf.2024.106119
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  5. Article ; Online: Airway Collapsibility during Drug-Induced Sleep Endoscopy Relates with Clinical Features of Obstructive Sleep Apnea.

    Parekh, Manan / Triantafillou, Vasiliki / Keenan, Brendan T / Seay, Everett G / Thuler, Eric / Schwartz, Alan R / Dedhia, Raj C

    The Laryngoscope

    2023  Volume 134, Issue 4, Page(s) 1978–1985

    Abstract: ... overweight/obese (BMI 29.9 ± 4.5 kg/m: Conclusion: Objective assessment of passive and active airway ...

    Abstract Introduction: Increased pharyngeal collapsibility leads to obstructive sleep apnea (OSA). Positive airway pressure titration during drug-induced sleep endoscopy (DISE-PAP) provides objective collapsibility metrics, the pharyngeal opening pressure (PhOP), and active pharyngeal critical pressure (Pcrit
    Methods: This is a cross-sectional analysis of consecutive OSA patients undergoing DISE-PAP. Nasal PAP was increased stepwise until inspiratory flow limitation was abolished, signifying PhOP. Pcrit
    Results: On average, the 164 patients meeting inclusion criteria were middle-aged (54.2 ± 14.7 years), overweight/obese (BMI 29.9 ± 4.5 kg/m
    Conclusion: Objective assessment of passive and active airway mechanics during DISE relates with clinical risk factors for OSA. Quantitative measures of collapsibility provide accessible and meaningful data, enhancing the standard sleep surgery evaluation.
    Level of evidence: 4 Laryngoscope, 134:1978-1985, 2024.
    MeSH term(s) Middle Aged ; Humans ; Male ; Cross-Sectional Studies ; Sleep Apnea, Obstructive/diagnosis ; Sleep ; Pharynx ; Endoscopy
    Language English
    Publishing date 2023-10-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80180-x
    ISSN 1531-4995 ; 0023-852X
    ISSN (online) 1531-4995
    ISSN 0023-852X
    DOI 10.1002/lary.31114
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  6. Article: Altered IgG4 Antibody Response to Repeated mRNA versus Protein COVID Vaccines.

    Kalkeri, Raj / Zhu, Mingzhu / Cloney-Clark, Shane / Plested, Joyce S / Parekh, Anand / Gorinson, Drew / Cai, Rongman / Mahato, Soham / Ramanathan, Pradhipa / Aurelia, L Carissa / Selva, Kevin John / Marchese, Anthony M / Fries, Louis / Chung, Amy W / Dunkle, Lisa M

    medRxiv : the preprint server for health sciences

    2024  

    Abstract: Repeated mRNA SARS-CoV-2 vaccination has been associated with increases in the proportion of IgG4 in spike-specific antibody responses and concurrent reductions in Fcγ-mediated effector functions that may limit control of viral infection. Here, we ... ...

    Abstract Repeated mRNA SARS-CoV-2 vaccination has been associated with increases in the proportion of IgG4 in spike-specific antibody responses and concurrent reductions in Fcγ-mediated effector functions that may limit control of viral infection. Here, we assessed anti-Spike total IgG, IgG1, IgG2, IgG3 and IgG4, and surrogate markers for antibody-dependent cellular phagocytosis (ADCP, FcγRIIa binding), antibody-dependent cellular cytotoxicity (ADCC, FcγRIIIa binding), and antibody-dependent complement deposition (ADCD, C1q binding) associated with repeated SARS-CoV-2 vaccination with NVX-CoV2373 (Novavax Inc., Gaithersburg, MD). The NVX-CoV2373 protein vaccine did not induce notable increases in spike-specific IgG4 or negatively impact surrogates for Fcγ effector responses. Conversely, repeated NVX-CoV2373 vaccination uniquely enhanced IgG3 responses which are known to exhibit strong affinity for FcγRIIIa and have previously been linked to potent neutralization of SARS-CoV-2. Subsequent investigations will help to understand the immunological diversity generated by different SARS-CoV-2 vaccine types and have the potential to reshape public health strategies.
    Language English
    Publishing date 2024-01-18
    Publishing country United States
    Document type Preprint
    DOI 10.1101/2024.01.17.24301374
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  7. Article ; Online: Altered IgG4 Antibody Response to Repeated mRNA versus Protein COVID Vaccines

    Kalkeri, Raj / Zhu, Mingzhu / Cloney-Clark, Shane / Plested, Joyce S. / Parekh, Anand / Gorinson, Drew / Cai, Rongman / Mahato, Soham / Ramanathan, Pradhipa / Aurelia, L. Carissa / Selva, Kevin John / Marchese, Anthony M. / Fries, Louis / Chung, Amy W. / Dunkle, Lisa M.

    medRxiv

    Abstract: Repeated mRNA SARS-CoV-2 vaccination has been associated with increases in the proportion of IgG4 in spike-specific antibody responses and concurrent reductions in Fcγ-mediated effector functions that may limit control of viral infection. Here, we ... ...

    Abstract Repeated mRNA SARS-CoV-2 vaccination has been associated with increases in the proportion of IgG4 in spike-specific antibody responses and concurrent reductions in Fcγ-mediated effector functions that may limit control of viral infection. Here, we assessed anti-Spike total IgG, IgG1, IgG2, IgG3 and IgG4, and surrogate markers for antibody-dependent cellular phagocytosis (ADCP, FcγRIIa binding), antibody-dependent cellular cytotoxicity (ADCC, FcγRIIIa binding), and antibody-dependent complement deposition (ADCD, C1q binding) associated with repeated SARS-CoV-2 vaccination with NVX-CoV2373 (Novavax Inc., Gaithersburg, MD). The NVX-CoV2373 protein vaccine did not induce notable increases in spike-specific IgG4 or negatively impact surrogates for Fcγ effector responses. Conversely, repeated NVX-CoV2373 vaccination uniquely enhanced IgG3 responses which are known to exhibit strong affinity for FcγRIIIa and have previously been linked to potent neutralization of SARS-CoV-2. Subsequent investigations will help to understand the immunological diversity generated by different SARS-CoV-2 vaccine types and have the potential to reshape public health strategies.
    Keywords covid19
    Language English
    Publishing date 2024-01-18
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2024.01.17.24301374
    Database COVID19

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  8. Article: A Severe Acute Respiratory Syndrome Coronavirus 2 Anti-Spike Immunoglobulin G Assay: A Robust Method for Evaluation of Vaccine Immunogenicity Using an Established Correlate of Protection.

    Zhu, Mingzhu / Cloney-Clark, Shane / Feng, Sheau-Line / Parekh, Anand / Gorinson, Drew / Silva, David / Skonieczny, Paul / Wilson, Adjele / Kalkeri, Raj / Woo, Wayne / Cai, Miranda R / Fries, Louis / Glenn, Greg / Plested, Joyce S

    Microorganisms

    2023  Volume 11, Issue 7

    Abstract: As the COVID-19 pandemic continues, variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to emerge. Immunogenicity evaluation of vaccines and identification of correlates of protection for vaccine effectiveness is critical to ...

    Abstract As the COVID-19 pandemic continues, variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to emerge. Immunogenicity evaluation of vaccines and identification of correlates of protection for vaccine effectiveness is critical to aid the development of vaccines against emerging variants. Anti-recombinant spike (rS) protein immunoglobulin G (IgG) quantitation in the systemic circulation (serum/plasma) is shown to correlate with vaccine efficacy. Thus, an enzyme-linked immunosorbent assay (ELISA)-based binding assay to detect SARS-CoV-2 (ancestral and variant strains) anti-rS IgG in human serum samples was developed and validated. This assay successfully met acceptance criteria for inter/intra-assay precision, specificity, selectivity, linearity, lower/upper limits of quantitation, matrix effects, and assay robustness. The analyte in serum was stable for up to 8 freeze/thaw cycles and 2 years in -80 °C storage. Similar results were observed for the Beta, Delta, and Omicron BA.1/BA.5/XBB.1.5 variant-adapted assays. Anti-rS IgG assay results correlated significantly with neutralization and receptor binding inhibition assays. In addition, usage of international reference standards allows data extrapolation to WHO international units (BAU/mL), facilitating comparison of results with other IgG assays. This anti-rS IgG assay is a robust, high-throughput method to evaluate binding IgG responses to S protein in serum, enabling rapid development of effective vaccines against emerging COVID-19 variants.
    Language English
    Publishing date 2023-07-11
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2720891-6
    ISSN 2076-2607
    ISSN 2076-2607
    DOI 10.3390/microorganisms11071789
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  9. Article ; Online: The Application of Ultrasound to Quantify Hyoid Motion During Drug-Induced Sleep Endoscopy.

    Parekh, Manan H / Thuler, Eric / Triantafillou, Vasiliki / Seay, Everett / Sehgal, Chandra / Schultz, Susan / Keenan, Brendan T / Schwartz, Alan R / Dedhia, Raj C

    The Laryngoscope

    2023  Volume 133, Issue 11, Page(s) 3221–3227

    Abstract: ... 10 years), overweight (29.3 ± 3.99 kg/m: Conclusion: During DISE, hyoid displacement is greater ...

    Abstract Introduction: The significance of hyoid dynamics in OSA pathophysiology remains unclear. Drug-induced sleep endoscopy (DISE) is often used for evaluating patients intolerant to positive airway pressure (PAP) therapy. We performed DISE with concurrent hyoid-focused ultrasonography to quantify hyoid dynamics during obstructive and non-obstructive breathing.
    Methods: A cross-sectional analysis from a prospective cohort of patients undergoing DISE with PAP titration (DISE-PAP) and hyoid-focused ultrasound was conducted. Hyoid ultrasound was performed during obstructive breathing, and non-obstructive breathing after PAP administration. Motion was quantified by generating displacement curves based on echo-tracking hyoid movement. The image analysis protocol for quantifying hyoid displacement was performed independently by two researchers, and reliability of measures was assessed. Univariate and multivariate regressions were performed for various clinical data and hyoid displacement during obstructive breathing.
    Results: Twenty patients met inclusion criteria. On average, the cohort was male (75%), elderly (65.9 ± 10 years), overweight (29.3 ± 3.99 kg/m
    Conclusion: During DISE, hyoid displacement is greater during obstructive breathing with significant variability amongst patients. Further, these ultrasonographic measurements had excellent intra- and inter-rater reliability. Additional, larger studies are needed to understand contributors to hyoid mobility.
    Level of evidence: 4 Laryngoscope, 133:3221-3227, 2023.
    MeSH term(s) Humans ; Male ; Aged ; Sleep Apnea, Obstructive/therapy ; Polysomnography/methods ; Prospective Studies ; Cross-Sectional Studies ; Reproducibility of Results ; Endoscopy/methods ; Ultrasonography ; Sleep
    Language English
    Publishing date 2023-06-07
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 80180-x
    ISSN 1531-4995 ; 0023-852X
    ISSN (online) 1531-4995
    ISSN 0023-852X
    DOI 10.1002/lary.30805
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  10. Article ; Online: Association Between Soft Tissue Measures From Computed Tomography and Upper Airway Collapsibility on Drug-Induced Sleep Endoscopy.

    Thuler, Eric R / Parekh, Manan H / Rodin, Jules G / Seay, Everett G / Wiemken, Andrew / Keenan, Brendan T / Schwab, Richard J / Schwartz, Alan R / Dedhia, Raj C

    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

    2024  

    Abstract: ... 70.5%), white (84.2%), middle-aged (56.6 ± 13.5 years), and overweight (29.6 ± 4.7 kg/m: Conclusion ...

    Abstract Objective: Positive airway pressure (PAP) titration during drug-induced sleep endoscopy (DISE) provides objective measures of upper airway collapsibility. While skeletal measurements relate to collapsibility measures on DISE, the influence of soft tissue dimensions on upper airway collapsibility is not known. We analyzed the relationship of measures of upper airway soft tissue volumes, specifically soft palate, pharyngeal lateral walls, and tongue, with metrics of collapsibility.
    Study design: Cross-sectional analysis from a prospective cohort.
    Setting: Academic medical center.
    Methods: Patients seeking PAP alternative therapies for obstructive sleep apnea (OSA) underwent standardized supine computed tomography (CT) acquisition and DISE protocols. The CT analysis primarily focused on soft tissue volumes and, secondarily, on airway and skeletal volumetric measures. DISE with PAP administration (DISE-PAP) enabled the determination of the pressure at which inspiratory airflow first commenced (pharyngeal critical pressure, Pcrit
    Results: One hundred thirty-nine subjects completed both CT and DISE-PAP. On average, patients were male (70.5%), white (84.2%), middle-aged (56.6 ± 13.5 years), and overweight (29.6 ± 4.7 kg/m
    Conclusion: After controlling for clinical factors and skeletal volume, greater tongue volume was associated with more severe collapsibility during DISE. These results, in concert with previous work, suggest that greater tongue volume in a smaller skeletal dimensions contribute to the severity of airway collapsibility, a key driver of OSA pathogenesis.
    Language English
    Publishing date 2024-04-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 392085-9
    ISSN 1097-6817 ; 0161-6439 ; 0194-5998
    ISSN (online) 1097-6817
    ISSN 0161-6439 ; 0194-5998
    DOI 10.1002/ohn.772
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