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  1. Article ; Online: Psychoactive Drugs Induce the SOS Response and Shiga Toxin Production in

    Crane, John K / Salehi, Mashal / Alvarado, Cassandra L

    Toxins

    2021  Volume 13, Issue 7

    Abstract: Several classes of non-antibiotic drugs, including psychoactive drugs, proton-pump inhibitors (PPIs), non-steroidal anti-inflammatory drugs (NSAIDs), and others, appear to have strong antimicrobial properties. We considered whether psychoactive drugs ... ...

    Abstract Several classes of non-antibiotic drugs, including psychoactive drugs, proton-pump inhibitors (PPIs), non-steroidal anti-inflammatory drugs (NSAIDs), and others, appear to have strong antimicrobial properties. We considered whether psychoactive drugs induce the SOS response in
    MeSH term(s) Antipsychotic Agents/pharmacology ; SOS Response, Genetics/drug effects ; Serotonin Uptake Inhibitors/pharmacology ; Shiga Toxin 2/metabolism ; Shiga-Toxigenic Escherichia coli/drug effects ; Shiga-Toxigenic Escherichia coli/genetics ; Shiga-Toxigenic Escherichia coli/metabolism ; beta-Galactosidase/genetics
    Chemical Substances Antipsychotic Agents ; Serotonin Uptake Inhibitors ; Shiga Toxin 2 ; beta-Galactosidase (EC 3.2.1.23)
    Language English
    Publishing date 2021-06-23
    Publishing country Switzerland
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2518395-3
    ISSN 2072-6651 ; 2072-6651
    ISSN (online) 2072-6651
    ISSN 2072-6651
    DOI 10.3390/toxins13070437
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Psychoactive Drugs Induce the SOS Response and Shiga Toxin Production in Escherichia coli

    John K. Crane / Mashal Salehi / Cassandra L. Alvarado

    Toxins, Vol 13, Iss 437, p

    2021  Volume 437

    Abstract: Several classes of non-antibiotic drugs, including psychoactive drugs, proton-pump inhibitors (PPIs), non-steroidal anti-inflammatory drugs (NSAIDs), and others, appear to have strong antimicrobial properties. We considered whether psychoactive drugs ... ...

    Abstract Several classes of non-antibiotic drugs, including psychoactive drugs, proton-pump inhibitors (PPIs), non-steroidal anti-inflammatory drugs (NSAIDs), and others, appear to have strong antimicrobial properties. We considered whether psychoactive drugs induce the SOS response in E. coli bacteria and, consequently, induce Shiga toxins in Shiga-toxigenic E. coli (STEC). We measured the induction of an SOS response using a recA-lacZ E. coli reporter strain, as RecA is an early, reliable, and quantifiable marker for activation of the SOS stress response pathway. We also measured the production and release of Shiga toxin 2 (Stx2) from a classic E. coli O157:H7 strain, derived from a food-borne outbreak due to spinach. Some, but not all, serotonin selective reuptake inhibitors (SSRIs) and antipsychotic drugs induced an SOS response. The use of SSRIs is widespread and increasing; thus, the use of these antidepressants could account for some cases of hemolytic-uremic syndrome due to STEC and is not attributable to antibiotic administration. SSRIs could have detrimental effects on the normal intestinal microbiome in humans. In addition, as SSRIs are resistant to environmental breakdown, they could have effects on microbial communities, including aquatic ecosystems, long after they have left the human body.
    Keywords serotonin selective reuptake inhibitors ; phenothiazines ; RecA ; hypermutation ; enterohemorrhagic E. coli ; Shiga-toxigenic E. coli ; Medicine ; R
    Language English
    Publishing date 2021-06-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article: Clinically Silent Intracardiac Metastasis with Extremely Poor Prognosis in a Patient with Hepatocellular Carcinoma.

    Salehi, Mashal / Yee, The / Alatevi, Eric / Thein, Yamin

    Case reports in gastroenterology

    2017  Volume 11, Issue 2, Page(s) 416–421

    Abstract: Intracavitary cardiac extension remains an unusual site of extrahepatic metastasis in patients with hepatocellular carcinoma. While patients can present with signs and symptoms suggestive of right-sided heart failure, it may be totally asymptomatic, ... ...

    Abstract Intracavitary cardiac extension remains an unusual site of extrahepatic metastasis in patients with hepatocellular carcinoma. While patients can present with signs and symptoms suggestive of right-sided heart failure, it may be totally asymptomatic, which is very rare with only a few cases reported so far. Also, cardiac metastasis is of great prognostic importance as patients with intracardiac metastasis can have an extremely poor prognosis. Here, we present the case of a 52-year-old male patient with advanced hepatocellular carcinoma, with an incidentally found tumor thrombus extending from the inferior vena cava to the right atrium, protruding through the tricuspid valve into the right ventricle, on routine echocardiography. The patient did not have any signs or symptoms of heart involvement and unfortunately died on the 18th day of the hospital stay.
    Language English
    Publishing date 2017-07-11
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2440540-1
    ISSN 1662-0631
    ISSN 1662-0631
    DOI 10.1159/000477379
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Methotrexate-induced Hypersensitivity Pneumonitis appearing after 30 years of use

    Mashal Salehi / Robertha Miller / Myint Khaing

    Journal of Medical Case Reports, Vol 11, Iss 1, Pp 1-

    a case report

    2017  Volume 4

    Abstract: Abstract Background Methotrexate has been implicated in a variety of lung complications, one of which is hypersensitivity pneumonitis. Hypersensitivity pneumonitis most often occurs within the first year of starting low-dose orally administered ... ...

    Abstract Abstract Background Methotrexate has been implicated in a variety of lung complications, one of which is hypersensitivity pneumonitis. Hypersensitivity pneumonitis most often occurs within the first year of starting low-dose orally administered methotrexate. We present a case of methotrexate-induced hypersensitivity pneumonitis after 30 years of methotrexate use, which is the first case to be reported so far. Case presentation A 77-year-old African American woman with a history of rheumatoid arthritis presented with progressively worsening shortness of breath and nonproductive cough. She was on a daily dose of 2.5 mg of methotrexate that had been orally administered for the last 30 years. A physical examination was significant for fever of 38.2 °C (100.8 °F), tachycardia, bilateral basal crackles, and oxygen saturation of 88% on room air. A laboratory work up was significant for normal white blood cell count, increased eosinophil count of 18.3%, and erythrocyte sedimentation rate of 111 mm/hour. Sputum cultures were negative for any bacterial pathogens including acid-fast bacilli. Influenza and respiratory syncytial viral infection were ruled out. A (1-3)-B-D-glucan assay (Fungitell®) was within normal limits. Pulmonary embolism was ruled out and echocardiography was normal. A chest X-ray showed hazy opacity with prominent reticulation within the upper lung fields bilaterally, right greater than the left with no pleural effusion. Lung computed tomography revealed nonspecific bilateral upper lung opacification. A pulmonary function test was significant for no obstruction, normal maximum voluntary ventilation, and no restriction, with mildly decreased diffusion. Methotrexate was stopped, and our patient was started on prednisone 60 mg orally administered daily with dramatic clinical and radiologic improvement. Conclusions Methotrexate-induced hypersensitivity pneumonitis usually occurs in the initial few weeks to months of starting treatment with methotrexate; however, it can occur late during therapy too, and ...
    Keywords Hypersensitivity pneumonitis ; Methotrexate ; Rheumatoid arthritis ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2017-06-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Levamisole-Induced Leukocytoclastic Vasculitis with Negative Serology in a Cocaine User.

    Salehi, Mashal / Morgan, Michael P / Gabriel, Abigail

    The American journal of case reports

    2017  Volume 18, Page(s) 641–643

    Abstract: BACKGROUND Levamisole is a common adulterant of cocaine. It can cause agranulocytosis and cutaneous vasculitis that can possibly lead to cutaneous necrosis. In all reported cases of levamisole-induced vasculitis, it has been described as a clinical ... ...

    Abstract BACKGROUND Levamisole is a common adulterant of cocaine. It can cause agranulocytosis and cutaneous vasculitis that can possibly lead to cutaneous necrosis. In all reported cases of levamisole-induced vasculitis, it has been described as a clinical syndrome characterized by a constellation of typical clinical features and a positive serum serology for ANCA levels, especially very high-titer p-ANCA levels, in the background of cocaine abuse. However, patients may have a negative serology and here, we present the first such case. CASE REPORT A 58-year-old African American man with a history of polysubstance abuse, 4 days after last cocaine use, presented with sudden onset of painful pruritic rash and polyarthralgias. He was found to have normal vital signs, with bilateral tender knees and erythematous-purplish maculopapular lesions involving the abdomen and the left thigh. Laboratory work-up was significant for elevated CRP, negative c-ANCA, p-ANCA ANA, and RA levels, and a positive urine toxicology for cocaine. Urine analysis by high-performance liquid chromatography was positive for levamisole. Ultimately, a final diagnosis was made by skin biopsy, which revealed findings suggestive of leukocytoclastic vasculitis. CONCLUSIONS Cutaneous leukocytoclastic vasculitis can be caused by levamisole, which is used as an adulterant in cocaine. Most cases are associated with positive ANCA levels; however, a negative serology is also a possibility.
    MeSH term(s) Cocaine-Related Disorders/complications ; Drug Contamination ; Humans ; Levamisole/adverse effects ; Male ; Middle Aged ; Vasculitis, Leukocytoclastic, Cutaneous/chemically induced
    Chemical Substances Levamisole (2880D3468G)
    Language English
    Publishing date 2017-06-08
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2517183-5
    ISSN 1941-5923 ; 1941-5923
    ISSN (online) 1941-5923
    ISSN 1941-5923
    DOI 10.12659/ajcr.903917
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Exceptionally High Creatine Kinase (CK) Levels in Multicausal and Complicated Rhabdomyolysis: A Case Report.

    Luckoor, Pavan / Salehi, Mashal / Kunadu, Afua

    The American journal of case reports

    2017  Volume 18, Page(s) 746–749

    Abstract: BACKGROUND Rhabdomyolysis is a syndrome caused by muscle breakdown. It can be caused by traumatic as well as non-traumatic factors such as drugs, toxins, and infections. Although it has been initially associated with only traumatic causes, non-traumatic ... ...

    Abstract BACKGROUND Rhabdomyolysis is a syndrome caused by muscle breakdown. It can be caused by traumatic as well as non-traumatic factors such as drugs, toxins, and infections. Although it has been initially associated with only traumatic causes, non-traumatic causes now appear to be at least 5 times more frequent. In rhabdomyolysis, the CK levels can range anywhere from 10 000 to 200 000 or even higher. The higher the CK levels, the greater will be the renal damage and associated complications. We present the case of a patient with exceptionally massive rhabdomyolysis with unusually high CK levels (nearly 1 million) caused by combined etiologic factors and complicated with acute renal failure. CASE REPORT A 36-year-old African American male patient with no significant past medical history and a social history of cocaine and alcohol abuse presented with diarrhea and generalized weakness of 2 days' duration. He was found to be febrile, tachycardic, tachypneic, and hypoxic. The patient was subsequently intubated and admitted to the medical ICU. Laboratory work-up showed acute renal failure with deranged liver functions test results, and elevated creatine kinase of 701,400 U/L. CK levels were subsequently too high for the lab to quantify. Urine legionella testing was positive for L. pneumophilia serogroup 1 antigen and urine toxicology was positive for cocaine. The patient had a protracted course in the ICU. He was initially started on CVVH, and later received intermittent hemodialysis for about 1 month. CONCLUSIONS In the presence of multiple etiologic factors, rhabdomyolysis can be massive with resultant significant morbidity. Clinicians should have a high index of suspicion for rhabdomyolysis in the presence of multiple factors, as early recognition of this diseases is very important in the prevention and active management of life-threatening conditions.
    MeSH term(s) Acute Kidney Injury/etiology ; Adult ; Creatine Kinase/analysis ; Humans ; Legionellosis/complications ; Male ; Pneumonia, Bacterial/complications ; Rhabdomyolysis/complications ; Rhabdomyolysis/etiology ; Sepsis/complications ; Substance-Related Disorders/complications
    Chemical Substances Creatine Kinase (EC 2.7.3.2)
    Language English
    Publishing date 2017-07-04
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2517183-5
    ISSN 1941-5923 ; 1941-5923
    ISSN (online) 1941-5923
    ISSN 1941-5923
    DOI 10.12659/ajcr.905089
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Methotrexate-induced Hypersensitivity Pneumonitis appearing after 30 years of use: a case report.

    Salehi, Mashal / Miller, Robertha / Khaing, Myint

    Journal of medical case reports

    2017  Volume 11, Issue 1, Page(s) 174

    Abstract: Background: Methotrexate has been implicated in a variety of lung complications, one of which is hypersensitivity pneumonitis. Hypersensitivity pneumonitis most often occurs within the first year of starting low-dose orally administered methotrexate. We ...

    Abstract Background: Methotrexate has been implicated in a variety of lung complications, one of which is hypersensitivity pneumonitis. Hypersensitivity pneumonitis most often occurs within the first year of starting low-dose orally administered methotrexate. We present a case of methotrexate-induced hypersensitivity pneumonitis after 30 years of methotrexate use, which is the first case to be reported so far.
    Case presentation: A 77-year-old African American woman with a history of rheumatoid arthritis presented with progressively worsening shortness of breath and nonproductive cough. She was on a daily dose of 2.5 mg of methotrexate that had been orally administered for the last 30 years. A physical examination was significant for fever of 38.2 °C (100.8 °F), tachycardia, bilateral basal crackles, and oxygen saturation of 88% on room air. A laboratory work up was significant for normal white blood cell count, increased eosinophil count of 18.3%, and erythrocyte sedimentation rate of 111 mm/hour. Sputum cultures were negative for any bacterial pathogens including acid-fast bacilli. Influenza and respiratory syncytial viral infection were ruled out. A (1-3)-B-D-glucan assay (Fungitell®) was within normal limits. Pulmonary embolism was ruled out and echocardiography was normal. A chest X-ray showed hazy opacity with prominent reticulation within the upper lung fields bilaterally, right greater than the left with no pleural effusion. Lung computed tomography revealed nonspecific bilateral upper lung opacification. A pulmonary function test was significant for no obstruction, normal maximum voluntary ventilation, and no restriction, with mildly decreased diffusion. Methotrexate was stopped, and our patient was started on prednisone 60 mg orally administered daily with dramatic clinical and radiologic improvement.
    Conclusions: Methotrexate-induced hypersensitivity pneumonitis usually occurs in the initial few weeks to months of starting treatment with methotrexate; however, it can occur late during therapy too, and prompt diagnosis is crucial as it is a reversible condition when diagnosed early.
    Language English
    Publishing date 2017-06-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 2269805-X
    ISSN 1752-1947 ; 1752-1947
    ISSN (online) 1752-1947
    ISSN 1752-1947
    DOI 10.1186/s13256-017-1333-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Encephalitis treatment - a case report with long-term follow-up of EBV PCR in cerebrospinal fluid.

    Zarlasht, Fnu / Salehi, Mashal / Abu-Hishmeh, Mohammad / Khan, Muzammil

    International journal of general medicine

    2017  Volume 10, Page(s) 371–373

    Abstract: Background: Epstein-Barr virus (EBV) has been found to cause infectious mononucleosis multiple times, but has been associated rarely with EBV encephalitis. Also, whenever it is diagnosed, it is always treated symptomatically.: Case report: A case of ... ...

    Abstract Background: Epstein-Barr virus (EBV) has been found to cause infectious mononucleosis multiple times, but has been associated rarely with EBV encephalitis. Also, whenever it is diagnosed, it is always treated symptomatically.
    Case report: A case of confirmed EBV encephalitis is presented, which was treated with antiviral therapy resulting in complete clearance of the virus in cerebrospinal fluid and minimal neurologic symptoms after hospital discharge.
    Conclusion: The Infectious Diseases Society of America guidelines state that intravenous acyclovir is not recommended for EBV-related encephalitis. But we reviewed the literature and found similar cases, and we believe that antiviral therapy should be recommended for EBV encephalitis because it is a potentially fatal disease and if left untreated, can lead to raised intracranial pressure, craniotomy and even death.
    Language English
    Publishing date 2017-10-26
    Publishing country New Zealand
    Document type Case Reports
    ZDB-ID 2452220-X
    ISSN 1178-7074
    ISSN 1178-7074
    DOI 10.2147/IJGM.S143335
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Short-Term High-Dose Steroid Therapy in a Case of Rhabdomyolysis Refractory to Intravenous Fluids.

    Zarlasht, Fnu / Salehi, Mashal / Sattar, Alamgir / Abu-Hishmeh, Mohammad / Khan, Muzammil

    The American journal of case reports

    2017  Volume 18, Page(s) 1110–1113

    MeSH term(s) Adult ; Creatine Kinase/analysis ; Dose-Response Relationship, Drug ; Fluid Therapy/adverse effects ; Glucocorticoids/administration & dosage ; Humans ; Male ; Methylprednisolone/administration & dosage ; Rhabdomyolysis/drug therapy ; Treatment Failure
    Chemical Substances Glucocorticoids ; Creatine Kinase (EC 2.7.3.2) ; Methylprednisolone (X4W7ZR7023)
    Language English
    Publishing date 2017-10-17
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2517183-5
    ISSN 1941-5923 ; 1941-5923
    ISSN (online) 1941-5923
    ISSN 1941-5923
    DOI 10.12659/AJCR.905196
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Coverage and inequalities in maternal and child health interventions in Afghanistan.

    Akseer, Nadia / Bhatti, Zaid / Rizvi, Arjumand / Salehi, Ahmad S / Mashal, Taufiq / Bhutta, Zulfiqar A

    BMC public health

    2016  Volume 16 Suppl 2, Page(s) 797

    Abstract: Background: Afghanistan has made considerable gains in improving maternal and child health and survival since 2001. However, socioeconomic and regional inequities may pose a threat to reaching universal coverage of health interventions and further ... ...

    Abstract Background: Afghanistan has made considerable gains in improving maternal and child health and survival since 2001. However, socioeconomic and regional inequities may pose a threat to reaching universal coverage of health interventions and further health progress. We explored coverage and socioeconomic inequalities in key life-saving reproductive, maternal, newborn and child health (RMNCH) interventions at the national level and by region in Afghanistan. We also assessed gains in child survival through scaling up effective community-based interventions across wealth groups.
    Methods: Using data from the Afghanistan Multiple Indicator Cluster Survey (MICS) 2010/11, we explored 11 interventions that spanned all stages of the continuum of care, including indicators of composite coverage. Asset-based wealth quintiles were constructed using standardised methods, and absolute inequalities were explored using wealth quintile (Q) gaps (Q5-Q1) and the slope index of inequality (SII), while relative inequalities were assessed with ratios (Q5/Q1) and the concentration index (CIX). The lives saved tool (LiST) modeling used to estimate neonatal and post-neonatal deaths averted from scaling up essential community-based interventions by 90 % coverage by 2025. Analyses considered the survey design characteristics and were conducted via STATA version 12.0 and SAS version 9.4.
    Results: Our results underscore significant pro-rich socioeconomic absolute and relative inequalities, and mass population deprivation across most all RMNCH interventions studied. The most inequitable are antenatal care with a skilled attendant (ANCS), skilled birth attendance (SBA), and 4 or more antenatal care visits (ANC4) where the richest have between 3.0 and 5.6 times higher coverage relative to the poor, and Q5-Q1 gaps range from 32 % - 65 %. Treatment of sick children and breastfeeding interventions are the most equitably distributed. Across regions, inequalities were highest in the more urbanised East, West and Central regions of the country, while they were lowest in the South and Southeast. About 7700 newborns and 26,000 post-neonates could be saved by scaling up coverage of community outreach interventions to 90 %, with the most gains in the poorest quintiles.
    Conclusions: Afghanistan is a pervasively poor and conflict-prone nation that has only recently experienced a decade of relative stability. Though donor investments during this period have been plentiful and have contributed to rebuilding of health infrastructure in the country, glaring inequities remain. A resolution to scaling up health coverage in insecure and isolated regions, and improving accessibility for the poorest and marginalised populations, should be at the forefront of national policy and programming efforts.
    MeSH term(s) Adult ; Afghanistan/epidemiology ; Child ; Child Health Services/statistics & numerical data ; Female ; Healthcare Disparities/statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Parturition ; Pregnancy ; Prenatal Care/statistics & numerical data ; Reproductive Health ; Residence Characteristics
    Language English
    Publishing date 2016-09-12
    Publishing country England
    Document type Journal Article
    ISSN 1471-2458
    ISSN (online) 1471-2458
    DOI 10.1186/s12889-016-3406-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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