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  1. Article ; Online: Broadening the differential: pneumomediastinum and COVID-19 infection.

    Pooni, Rajan / Pandey, Gargi / Akbar, Saniath

    BMJ case reports

    2020  Volume 13, Issue 8

    Abstract: The novel coronavirus (COVID-19) has emerged as a new pathogen responsible for an atypical viral pneumonia, with severe cases progressing to an acute respiratory distress syndrome. In our practice, we have observed patients admitted with COVID-19 ... ...

    Abstract The novel coronavirus (COVID-19) has emerged as a new pathogen responsible for an atypical viral pneumonia, with severe cases progressing to an acute respiratory distress syndrome. In our practice, we have observed patients admitted with COVID-19 pneumonia developing worsening hypoxaemic respiratory failure prompting the need for urgent endotracheal intubation. Here, we present a case of a patient admitted with severe COVID-19 pneumonia who required continuous positive airway pressure support following acute deterioration. However, with the patient requiring an increasing fraction of inspired oxygen (FiO
    MeSH term(s) Betacoronavirus/isolation & purification ; COVID-19 ; Computed Tomography Angiography/methods ; Coronavirus Infections/complications ; Humans ; Lung/diagnostic imaging ; Male ; Mediastinal Emphysema/complications ; Mediastinal Emphysema/diagnostic imaging ; Middle Aged ; Pandemics ; Pneumonia, Viral/complications ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-08-11
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2020-237938
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Broadening the differential: pneumomediastinum and COVID-19 infection

    Pooni, Rajan / Pandey, Gargi / Akbar, Saniath

    BMJ case reports

    Abstract: The novel coronavirus (COVID-19) has emerged as a new pathogen responsible for an atypical viral pneumonia, with severe cases progressing to an acute respiratory distress syndrome. In our practice, we have observed patients admitted with COVID-19 ... ...

    Abstract The novel coronavirus (COVID-19) has emerged as a new pathogen responsible for an atypical viral pneumonia, with severe cases progressing to an acute respiratory distress syndrome. In our practice, we have observed patients admitted with COVID-19 pneumonia developing worsening hypoxaemic respiratory failure prompting the need for urgent endotracheal intubation. Here, we present a case of a patient admitted with severe COVID-19 pneumonia who required continuous positive airway pressure support following acute deterioration. However, with the patient requiring an increasing fraction of inspired oxygen (FiO2), a prompt CT pulmonary angiogram scan was performed to exclude an acute pulmonary embolism. Surprisingly, this revealed a pneumomediastinum. Following a brief admission to the intensive care unit, the patient made a full recovery and was discharged 18 days post admission.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #714062
    Database COVID19

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  3. Article ; Online: Broadening the differential

    Pooni, Rajan / Pandey, Gargi / Akbar, Saniath

    BMJ Case Reports

    pneumomediastinum and COVID-19 infection

    2020  Volume 13, Issue 8, Page(s) e237938

    Abstract: The novel coronavirus (COVID-19) has emerged as a new pathogen responsible for an atypical viral pneumonia, with severe cases progressing to an acute respiratory distress syndrome. In our practice, we have observed patients admitted with COVID-19 ... ...

    Abstract The novel coronavirus (COVID-19) has emerged as a new pathogen responsible for an atypical viral pneumonia, with severe cases progressing to an acute respiratory distress syndrome. In our practice, we have observed patients admitted with COVID-19 pneumonia developing worsening hypoxaemic respiratory failure prompting the need for urgent endotracheal intubation. Here, we present a case of a patient admitted with severe COVID-19 pneumonia who required continuous positive airway pressure support following acute deterioration. However, with the patient requiring an increasing fraction of inspired oxygen (FiO 2 ), a prompt CT pulmonary angiogram scan was performed to exclude an acute pulmonary embolism. Surprisingly, this revealed a pneumomediastinum. Following a brief admission to the intensive care unit, the patient made a full recovery and was discharged 18 days post admission.
    Keywords covid19
    Language English
    Publisher BMJ
    Publishing country uk
    Document type Article ; Online
    ISSN 1757-790X
    DOI 10.1136/bcr-2020-237938
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: UK Patients of Bangladeshi Descent with Crohn's Disease Respond Less Well to TNF Antagonists Than Caucasian Patients.

    Gadhok, Radha / Gordon, Hannah / Sebepos-Rogers, Gregory / Baillie, Samantha / Akbar, Saniath / Abbott, Jane E / Michael, Emma / Ahmad, Omer F / Cooper, Ben / Lindsay, James O

    Digestive diseases and sciences

    2019  Volume 65, Issue 6, Page(s) 1790–1799

    Abstract: Background: Patients with inflammatory bowel disease are currently managed with the assumption that trial data are applicable to all ethnic groups. Previous studies demonstrate differences in disease severity and phenotype of Asian patients with Crohn's ...

    Abstract Background: Patients with inflammatory bowel disease are currently managed with the assumption that trial data are applicable to all ethnic groups. Previous studies demonstrate differences in disease severity and phenotype of Asian patients with Crohn's disease (CD), including Bangladeshi Asians within the UK. No study has evaluated the impact of ethnicity on response to anti-TNFs.
    Aim: Our primary endpoint was a comparison of failure-free survival on first prescribed anti-TNF (anti-tumor necrosis factor) therapy in UK Bangladeshi and Caucasian patients with CD. Our secondary aims were to evaluate disease phenotype, indication for anti-TNF prescription, and duration from diagnosis until first anti-TNF prescribed between groups.
    Methods: The records of consecutive outpatient appointments over a 12-month period were used to identify Caucasian and Bangladeshi patients prescribed an anti-TNF for CD. Information on patient demographics, ethnicity, disease phenotype, immunomodulator use, outcome from first biologic, duration of therapy, and reason for cessation was recorded.
    Results: In total, 224 Caucasian and Bangladeshi patients were prescribed an anti-TNF for CD. Bangladeshi patients started an anti-TNF 4.3 years earlier after diagnosis than Caucasian patients (3.9 years vs. 8.2 years: p < 0.01). Bangladeshi patients experienced shorter failure-free survival than Caucasian patients (1.8 vs. 4.8 years p < 0.01). By 2 years, significantly more Bangladeshi patients had stopped anti-TNF due to loss of response (OR 6.35, p < 0.01).
    Conclusions: This is the first study to suggest that Bangladeshi patients resident in the UK with CD respond less well to treatment with TNF antagonists than Caucasian patients.
    MeSH term(s) Adolescent ; Adult ; Asian Continental Ancestry Group ; Bangladesh ; Biomarkers ; Crohn Disease/drug therapy ; Crohn Disease/genetics ; European Continental Ancestry Group ; Humans ; Inflammation/drug therapy ; Inflammation/metabolism ; Male ; Retrospective Studies ; Treatment Outcome ; Tumor Necrosis Factor-alpha/antagonists & inhibitors ; United Kingdom ; Young Adult
    Chemical Substances Biomarkers ; Tumor Necrosis Factor-alpha
    Language English
    Publishing date 2019-10-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 304250-9
    ISSN 1573-2568 ; 0163-2116
    ISSN (online) 1573-2568
    ISSN 0163-2116
    DOI 10.1007/s10620-019-05907-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: 4-1BB ligand activates bystander dendritic cells to enhance immunization in trans.

    Macdonald, Douglas C / Hotblack, Alastair / Akbar, Saniath / Britton, Gary / Collins, Mary K / Rosenberg, William C

    Journal of immunology (Baltimore, Md. : 1950)

    2014  Volume 193, Issue 10, Page(s) 5056–5064

    Abstract: Expression of the costimulatory receptor 4-1BB is induced by TCR recognition of Ag, whereas 4-1BB ligand (4-1BBL) is highly expressed on activated APC. 4-1BB signaling is particularly important for survival of activated and memory CD8(+) T cells. We ... ...

    Abstract Expression of the costimulatory receptor 4-1BB is induced by TCR recognition of Ag, whereas 4-1BB ligand (4-1BBL) is highly expressed on activated APC. 4-1BB signaling is particularly important for survival of activated and memory CD8(+) T cells. We wished to test whether coexpression of Ag and 4-1BBL by dendritic cells (DC) would be an effective vaccine strategy. Therefore, we constructed lentiviral vectors (LV) coexpressing 4-1BBL and influenza nucleoprotein (NP). Following s.c. immunization of mice, which targets DC, we found superior CD8(+) T cell responses against NP and protection from influenza when 4-1BBL was expressed. However, functionally superior CD8(+) T cell responses were obtained when two LV were coinjected: one expressing 4-1BBL and the other expressing NP. This surprising result suggested that 4-1BBL is more effective when expressed in trans, acting on adjacent DC. Therefore, we investigated the effect of LV expression of 4-1BBL in mouse DC cultures and observed induced maturation of bystander, untransduced cells. Maturation was blocked by anti-4-1BBL Ab, required cell-cell contact, and did not require the cytoplasmic signaling domain of 4-1BBL. Greater maturation of untransduced cells could be explained by LV expression of 4-1BBL, causing downregulation of 4-1BB. These data suggest that coexpression of 4-1BBL and Ag by vaccine vectors that target DC may not be an optimal strategy. However, 4-1BBL LV immunization activates significant numbers of bystander DC in the draining lymph nodes. Therefore, transactivation by 4-1BBL/4-1BB interaction following DC-DC contact may play a role in the immune response to infection or vaccination.
    MeSH term(s) 4-1BB Ligand/genetics ; 4-1BB Ligand/immunology ; Animals ; Antigens, Viral/genetics ; Antigens, Viral/immunology ; Bystander Effect ; CD8-Positive T-Lymphocytes/immunology ; Cell Communication ; Dendritic Cells/immunology ; Female ; Genetic Vectors ; Immunization ; Influenza Vaccines/administration & dosage ; Influenza Vaccines/genetics ; Influenza Vaccines/immunology ; Lentivirus/genetics ; Mice ; Mice, Inbred BALB C ; Orthomyxoviridae/immunology ; Orthomyxoviridae Infections/immunology ; Orthomyxoviridae Infections/prevention & control ; Signal Transduction ; Transcriptional Activation ; Tumor Necrosis Factor Receptor Superfamily, Member 9/genetics ; Tumor Necrosis Factor Receptor Superfamily, Member 9/immunology ; Viral Core Proteins/genetics ; Viral Core Proteins/immunology
    Chemical Substances 4-1BB Ligand ; Antigens, Viral ; Influenza Vaccines ; Tumor Necrosis Factor Receptor Superfamily, Member 9 ; Viral Core Proteins
    Language English
    Publishing date 2014-10-10
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 3056-9
    ISSN 1550-6606 ; 0022-1767 ; 1048-3233 ; 1047-7381
    ISSN (online) 1550-6606
    ISSN 0022-1767 ; 1048-3233 ; 1047-7381
    DOI 10.4049/jimmunol.1301723
    Database MEDical Literature Analysis and Retrieval System OnLINE

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