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  1. Article ; Online: Radiometal chelators for infection diagnostics.

    Akter, Asma / Lyons, Oliver / Mehra, Varun / Isenman, Heather / Abbate, Vincenzo

    Frontiers in nuclear medicine (Lausanne, Switzerland)

    2023  Volume 2, Page(s) 1058388

    Abstract: Infection of native tissues or implanted devices is common, but clinical diagnosis is frequently difficult and currently available noninvasive tests perform poorly. Immunocompromised individuals (for example transplant recipients, or those with cancer) ... ...

    Abstract Infection of native tissues or implanted devices is common, but clinical diagnosis is frequently difficult and currently available noninvasive tests perform poorly. Immunocompromised individuals (for example transplant recipients, or those with cancer) are at increased risk. No imaging test in clinical use can specifically identify infection, or accurately differentiate bacterial from fungal infections. Commonly used [
    Language English
    Publishing date 2023-06-28
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2673-8880
    ISSN (online) 2673-8880
    DOI 10.3389/fnume.2022.1058388
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Aspergillus Infections.

    Ceesay, M Mansour / Mehra, Varun / Pagliuca, Antonio

    The New England journal of medicine

    2022  Volume 386, Issue 2, Page(s) 198

    MeSH term(s) Aspergillosis/diagnosis ; Humans
    Language English
    Publishing date 2022-01-12
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/NEJMc2117819
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: A rapidly expanding cutaneous tumour in the context of a Janus kinase inhibitor agent following allogeneic stem cell transplant.

    Davies, Anna / Salisbury, Jon / Mehra, Varun / Papa, Sophie / Basu, Tanya

    Clinical and experimental dermatology

    2022  Volume 47, Issue 11, Page(s) 2059–2064

    Abstract: Ruxolitinib is a selective, Janus kinase (JAK)1 and JAK2 inhibitor, which is effective in management of chronic graft-versus-host disease (cGvHD). However, the ensuing immunosuppressive effects can give rise to aggressive cutaneous tumours, including ... ...

    Abstract Ruxolitinib is a selective, Janus kinase (JAK)1 and JAK2 inhibitor, which is effective in management of chronic graft-versus-host disease (cGvHD). However, the ensuing immunosuppressive effects can give rise to aggressive cutaneous tumours, including Merkel cell carcinoma. We present this case to highlight the development of cutaneous tumours with ruxolitinib, an increasingly used therapy, and the challenge of managing such tumours in the context of refractory cGvHD. Click here for the corresponding questions to this CME article.
    MeSH term(s) Humans ; Janus Kinase Inhibitors/therapeutic use ; Hematopoietic Stem Cell Transplantation/adverse effects ; Graft vs Host Disease/drug therapy ; Stem Cell Transplantation ; Skin Neoplasms/drug therapy
    Chemical Substances ruxolitinib (82S8X8XX8H) ; Janus Kinase Inhibitors
    Language English
    Publishing date 2022-08-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 195504-4
    ISSN 1365-2230 ; 0307-6938
    ISSN (online) 1365-2230
    ISSN 0307-6938
    DOI 10.1111/ced.15305
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Rising incidence of Pneumocystis pneumonia: A population-level descriptive ecological study in England.

    Pates, Katharine / Periselneris, Jimstan / Russell, Mark D / Mehra, Varun / Schelenz, Silke / Galloway, James B

    The Journal of infection

    2023  Volume 86, Issue 4, Page(s) 385–390

    Abstract: Objectives: Pneumocystis pneumonia (PCP) is an opportunistic infection that causes significant morbidity and mortality in the immunocompromised population. This population is growing and diversifying, yet contemporary epidemiology is lacking. We ... ...

    Abstract Objectives: Pneumocystis pneumonia (PCP) is an opportunistic infection that causes significant morbidity and mortality in the immunocompromised population. This population is growing and diversifying, yet contemporary epidemiology is lacking. We investigated the population-level incidence of PCP over the past decade.
    Methods: We conducted a descriptive study of all hospital admissions in England from April 2012 to March 2022. PCP episodes, age, median length of stay, gender and episodes of other respiratory fungal infections were collected. Consumption of Trimethoprim-Sulfamethoxazole was obtained between January 2019 and May 2022.
    Results: The incidence of PCP increased from 2·2-4·5/100,000 population between 2012/2013 and 2019/2020 (p < 0·0001). There was a drop in 2020/2021 to 2·7/100,000 before returning to 3.9/100,000 in 2021/2022. PCP episodes rose as a proportion of all-cause admissions as well as a proportion of episodes due to other fungal infections. The proportion of PCP patients aged 75+ increased from 14% to 26%. The median length of stay was 13.5 days. Consumption of intravenous Trimethoprim-Sulfamethoxazole increased from 0.24 × 100,000 to 0.30 × 100,000 defined daily doses.
    Conclusions: The incidence of PCP is rising rapidly and represents a significant burden to the healthcare system. Further study into who is at risk of PCP is needed to better determine who should be given prophylaxis.
    MeSH term(s) Humans ; Pneumonia, Pneumocystis/epidemiology ; Pneumonia, Pneumocystis/microbiology ; Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use ; Incidence ; Opportunistic Infections ; England/epidemiology ; Retrospective Studies
    Chemical Substances Trimethoprim, Sulfamethoxazole Drug Combination (8064-90-2)
    Language English
    Publishing date 2023-02-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 424417-5
    ISSN 1532-2742 ; 0163-4453
    ISSN (online) 1532-2742
    ISSN 0163-4453
    DOI 10.1016/j.jinf.2023.02.014
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Effect of customized vibratory device on orthodontic tooth movement: A prospective randomized control trial.

    Khera, Amit K / Raghav, Pradeep / Mehra, Varun / Wadhawan, Ashutosh / Gupta, Navna / Phull, Tarun S

    Journal of orthodontic science

    2022  Volume 11, Page(s) 18

    Abstract: Aims: The primary purpose of the present trial was to evaluate the effect of low-frequency (30Hz) vibrations on the rate of canine retraction.: Setting and design: Single-center, split mouth prospective randomized controlled clinical trial.: ... ...

    Abstract Aims: The primary purpose of the present trial was to evaluate the effect of low-frequency (30Hz) vibrations on the rate of canine retraction.
    Setting and design: Single-center, split mouth prospective randomized controlled clinical trial.
    Methods and material: 100 screened subjects (aged18-25 years) were selected; out of which 30 subjects having Class I bimaxillary protrusion or Class II div 1 malocclusion, requiring upper 1
    Statistical analysis used: Independent "t" test.
    Results: There was no statistically significant differencein the rate of individual canine retraction among the experimental and control groups when the intergroup comparison was done using independent "t" test at T1-T0, (
    Conclusion: The low-frequency vibratory stimulation of 30 Hz using a customized vibratory device did not significantly accelerate the rate of orthodontic tooth movement.
    Trial registration: Registered at ctri.nic.in (CTRI/2019/05/019043).
    Language English
    Publishing date 2022-05-04
    Publishing country India
    Document type Journal Article
    ZDB-ID 2733594-X
    ISSN 2278-0203 ; 2278-1897
    ISSN (online) 2278-0203
    ISSN 2278-1897
    DOI 10.4103/jos.jos_127_21
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Haploidentical Transplant with Post-Transplant Cyclophosphamide for Acute Myeloid Leukaemia and Myelodysplastic Syndromes Patients: The Role of Previous Lines of Therapy.

    Avenoso, Daniele / Serpenti, Fabio / Slonim, Liron Barnea / Bouziana, Styliani / Dazzi, Francesco / Hannah, Guy / Kenyon, Michelle / Mehra, Varun / Kulasekararaj, Austin / Krishamurthy, Pramila / Shah, Mili Naresh / Lionel, Sharon / Pagliuca, Antonio / Potter, Victoria

    Mediterranean journal of hematology and infectious diseases

    2024  Volume 16, Issue 1, Page(s) e2024002

    Abstract: Background: Allogeneic haematopoietic stem-cell transplant is an option, potentially curative, for high-risk acute myeloid leukaemia (AML) and myelodysplastic syndrome (MDS) patients. Post-transplant cyclophosphamide administration allows for the ... ...

    Abstract Background: Allogeneic haematopoietic stem-cell transplant is an option, potentially curative, for high-risk acute myeloid leukaemia (AML) and myelodysplastic syndrome (MDS) patients. Post-transplant cyclophosphamide administration allows for the selection of haploidentical donors in patients who are eligible for the procedure but do not have a fully matched donor since it can overcome the HLA barrier. There is still an active debate on whether intensifying the conditioning regimen is necessary with haploidentical donors when peripheral blood stem cells are used as the graft source. Herein, we report our decennial experience of haploidentical stem-cell transplant using peripheral blood stem cells (haplo-PBSC) at King's College Hospital.
    Objectives: The primary objective was to evaluate overall survival (OS) following haplo-PBSC. Secondary objectives were total OS for patients with less than two previous lines of therapy, OS according to cytomegalovirus (CMV) reactivation, incidence of transplant-related mortality (TRM), graft-versus-host disease (GVHD) and GVHD-relapse-free survival (GRFS).
    Results: One-year and three-year total OS were 62% and 43%, respectively, with a median OS of 22 months. One-year and three-year OS for patients with ≤2 and those with >2 previous lines of therapy were 72% and 55%, and 60% and 22%, respectively (p-value=0.04). The median OS in patients with >2 previous and ≤2 lines of therapy was 16 and 49 months, respectively. Cumulative incidence (CI) of relapse was 25% with a median time to relapse of 5 months (range 1 - 38 months).
    Conclusions: Haploidentical haematopoietic stem-cell transplant is potentially curative in chemosensitive AML and MDS and offers a high rate of prolonged remission. Our cohort further confirms the role of consolidative haploidentical transplant in patients in complete remission and highlights that patients with heavily pre-treated disease may not benefit from this strategy.
    Language English
    Publishing date 2024-01-01
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2674750-9
    ISSN 2035-3006
    ISSN 2035-3006
    DOI 10.4084/MJHID.2024.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Estimating the value of demand-side management in low-cost, solar micro-grids

    Mehra, Varun / Reja Amatya / Rajeev J. Ram

    Energy. 2018 Nov. 15, v. 163

    2018  

    Abstract: Demand-side management has the potential to reduce the cost of solar based community micro-grids and solar home systems for electricity access. This paper presents a methodology for optimal least-cost sizing of generation assets while meeting explicit ... ...

    Abstract Demand-side management has the potential to reduce the cost of solar based community micro-grids and solar home systems for electricity access. This paper presents a methodology for optimal least-cost sizing of generation assets while meeting explicit reliability constraints in micro-grids that are capable of active demand management. The battery management model considers kinetic constraints on battery operation and represents dispatch in the field to regulate the depth of discharge. The model allows consideration of the trade-off between depth of discharge, cycle life, and calendar lifetime in lead-acid batteries. Separate reliability targets for disaggregated, residential load profiles at hourly timesteps are considered to evaluate the performance and cost reduction potential of demand-side management capabilities — with economic results and sensitivity analyses around key input assumptions subsequently presented. We find that demand-side management can reduce the number and cost of requisite solar panels and batteries with the integration of real-time management and controls – a key result for justifying next generation micro-grids for electricity access.
    Keywords assets ; batteries ; cost effectiveness ; electricity ; models ; solar collectors
    Language English
    Dates of publication 2018-1115
    Size p. 74-87.
    Publishing place Elsevier Ltd
    Document type Article
    ZDB-ID 2019804-8
    ISSN 0360-5442 ; 0360-5442
    ISSN (online) 0360-5442
    ISSN 0360-5442
    DOI 10.1016/j.energy.2018.07.204
    Database NAL-Catalogue (AGRICOLA)

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  8. Article: Fludarabine-Melphalan-Campath, Followed by Unmanipulated Peripheral-Blood Haematopoietic Stem Cells, Can Still Cure Lymphoma.

    Avenoso, Daniele / Alabdulwahab, Amal / Kenyon, Michelle / Mehra, Varun / Krishnamurthy, Pramila / Dazzi, Francesco / Leung, Ye Ting / Anteh, Sandra / Shah, Mili Naresh / Kuhnl, Andrea / Sanderson, Robin / Patten, Piers / Yallop, Deborah / Pagliuca, Antonio / Potter, Victoria

    Mediterranean journal of hematology and infectious diseases

    2023  Volume 15, Issue 1, Page(s) e2023041

    Abstract: Background: The second decade of this millennium was characterized by a widespread availability of chimeric antigen receptor T-cell (CAR-T) therapies to treat relapsed and refractory lymphomas. As expected, the role and indication of allogeneic ... ...

    Abstract Background: The second decade of this millennium was characterized by a widespread availability of chimeric antigen receptor T-cell (CAR-T) therapies to treat relapsed and refractory lymphomas. As expected, the role and indication of allogeneic haematopoietic stem cell transplant (allo-HSCT) in the management of lymphoma changed. Currently, a non-neglectable proportion of patients will be considered candidate for an allo-HSCT, and the debate of which transplant platform should be offered is still active.
    Objectives: to report the outcome of patients affected with relapsed/refractory lymphoma and transplanted following reduced intensity conditioning at King's College Hospital, London, between January 2009 and April 2021.
    Methods: Conditioning was with 150mg/m2 of fludarabine and melphalan of 140mg/m2. The graft was unmanipulated G-CSF mobilized peripheral blood haematopoietic stem cells (PBSC). Graft-
    Results: One-year and five years OS were 87% and 79.9%, respectively, and median OS was not reached. The cumulative incidence of relapse was 16%. The incidence of acute GVHD was 48% (only grade I/II); no cases of grade III/IV were diagnosed. Chronic GVHD occurred in 39% of patients. TRM was 12%, with no cases developed within day 100 and 18 months after the procedure.
    Conclusions: The outcomes of heavily pretreated lymphoma patients are favorable, with median OS and survival not reached after a median of 49 months. In conclusion, even if some lymphoma subgroups cannot be treated (yet) with advanced cellular therapies, this study confirms the role of allo-HSCT as a safe and curative strategy.
    Language English
    Publishing date 2023-07-01
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2674750-9
    ISSN 2035-3006
    ISSN 2035-3006
    DOI 10.4084/MJHID.2023.041
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Guidelines for the management of Toxoplasma gondii infection and disease in patients with haematological malignancies and after haematopoietic stem-cell transplantation: guidelines from the 9th European Conference on Infections in Leukaemia, 2022.

    Aerts, Robina / Mehra, Varun / Groll, Andreas H / Martino, Rodrigo / Lagrou, Katrien / Robin, Christine / Perruccio, Katia / Blijlevens, Nicole / Nucci, Marcio / Slavin, Monica / Bretagne, Stéphane / Cordonnier, Catherine

    The Lancet. Infectious diseases

    2023  Volume 24, Issue 5, Page(s) e291–e306

    Abstract: Patients with haematological malignancies might develop life-threatening toxoplasmosis, especially after allogeneic haematopoietic stem-cell transplantation (HSCT). Reactivation of latent cysts is the primary mechanism of toxoplasmosis following HSCT; ... ...

    Abstract Patients with haematological malignancies might develop life-threatening toxoplasmosis, especially after allogeneic haematopoietic stem-cell transplantation (HSCT). Reactivation of latent cysts is the primary mechanism of toxoplasmosis following HSCT; hence, patients at high risk are those who were seropositive before transplantation. The lack of trimethoprim-sulfamethoxazole prophylaxis and various immune status parameters of the patient are other associated risk factors. The mortality of toxoplasma disease-eg, with organ involvement-can be particularly high in this setting. We have developed guidelines for managing toxoplasmosis in haematology patients, through a literature review and consultation with experts. In allogeneic HSCT recipients seropositive for Toxoplasma gondii before transplant, because T gondii infection mostly precedes toxoplasma disease, we propose weekly blood screening by use of quantitative PCR (qPCR) to identify infection early as a pre-emptive strategy. As trimethoprim-sulfamethoxazole prophylaxis might fail, prophylaxis and qPCR screening should be combined. However, PCR in blood can be negative even in toxoplasma disease. The duration of prophylaxis should be a least 6 months and extended during treatment-induced immunosuppression or severe CD4 lymphopenia. If a positive qPCR test occurs, treatment with trimethoprim-sulfamethoxazole, pyrimethamine-sulfadiazine, or pyrimethamine-clindamycin should be started, and a new sample taken. If the second qPCR test is negative, clinical judgement is recommended to either continue or stop therapy and restart prophylaxis. Therapy must be continued until a minimum of two negative PCRs for infection, or for at least 6 weeks for disease. The pre-emptive approach is not indicated in seronegative HSCT recipients, after autologous transplantation, or in non-transplant haematology patients, but PCR should be performed with a high level of clinical suspicion.
    MeSH term(s) Humans ; Toxoplasmosis/diagnosis ; Toxoplasmosis/drug therapy ; Hematopoietic Stem Cell Transplantation/adverse effects ; Toxoplasma ; Hematologic Neoplasms/complications ; Hematologic Neoplasms/therapy ; Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use ; Antiprotozoal Agents/therapeutic use
    Chemical Substances Trimethoprim, Sulfamethoxazole Drug Combination (8064-90-2) ; Antiprotozoal Agents
    Language English
    Publishing date 2023-12-19
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 2061641-7
    ISSN 1474-4457 ; 1473-3099
    ISSN (online) 1474-4457
    ISSN 1473-3099
    DOI 10.1016/S1473-3099(23)00495-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Insights into horizontal acquisition patterns of dormancy and reactivation regulon genes in mycobacterial species using a partitioning-based framework.

    Mehra, Varun / Ghosh, Tarini Shankar / Mande, Sharmila S

    Journal of biosciences

    2016  Volume 41, Issue 3, Page(s) 475–485

    Abstract: Horizontal Gene Transfer (HGT) events, initially thought to be rare in Mycobacterium tuberculosis, have recently been shown to be involved in the acquisition of virulence operons in M. tuberculosis. We have developed a new partitioning framework based ... ...

    Abstract Horizontal Gene Transfer (HGT) events, initially thought to be rare in Mycobacterium tuberculosis, have recently been shown to be involved in the acquisition of virulence operons in M. tuberculosis. We have developed a new partitioning framework based HGT prediction algorithm, called Grid3M, and applied the same for the prediction of HGTs in Mycobacteria. Validation and testing using simulated and real microbial genomes indicated better performance of Grid3M as compared with other widely used HGT prediction methods. Specific analysis of the genes belonging to dormancy/reactivation regulons across 14 mycobacterial genomes indicated that horizontal acquisition is specifically restricted to important accessory proteins. The results also revealed Burkholderia species to be a probable source of HGT genes belonging to these regulons. The current study provides a basis for similar analyses investigating the functional/evolutionary aspects of HGT genes in other pathogens. A database of Grid3M predicted HGTs in completely sequenced genomes is available at https://metagenomics.atc.tcs.com/Grid3M/.
    MeSH term(s) Algorithms ; Burkholderia/genetics ; Evolution, Molecular ; Gene Transfer, Horizontal/genetics ; Genome, Bacterial ; Humans ; Mycobacterium tuberculosis/genetics ; Mycobacterium tuberculosis/pathogenicity ; Operon/genetics ; Phylogeny ; Tuberculosis/genetics ; Tuberculosis/microbiology
    Language English
    Publishing date 2016-08-23
    Publishing country India
    Document type Journal Article
    ZDB-ID 756157-x
    ISSN 0973-7138 ; 0250-5991
    ISSN (online) 0973-7138
    ISSN 0250-5991
    DOI 10.1007/s12038-016-9622-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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