Continuous glucose monitoring (CGM) has become a valuable tool for assessing glycemic control. Th... more Continuous glucose monitoring (CGM) has become a valuable tool for assessing glycemic control. The personal glycemic state (PGS)1 is a mathematical model that considers 5 CGM data elements (mean blood glucose, percent time in range, glucose variability percentage, and frequency of moderate and severe hypoglycemia) equally to generate a score representing the degree of metabolic control. Our adapted personal glycemic state for islet transplant (PGSFIT) targets normoglycemia in islet transplantation by limiting the percent time in range to 70-140mg/dl instead of commonly used 70-180mg/dl, and uses weighted components without limiting the influence of any individual component on the total score. This allowed us to account for T1D patients keeping blood glucose high to avoid hypoglycemia or low to avoid long term complications despite increased hypoglycemia. Using PGS and PGSFIT to analyze glycemic control in 16 subjects with T1D post allogenic islet transplantations showed concordance ...
Risk of hyperkalemia (HK) limits the use of RAAS inhibitors (RAASi) in pts with congestive heart ... more Risk of hyperkalemia (HK) limits the use of RAAS inhibitors (RAASi) in pts with congestive heart failure (CHF), chronic kidney disease (CKD), or diabetes. ZS-9, a nonabsorbed cation exchanger designed to preferentially entrap K + in the GI tract, significantly reduced serum K + vs placebo (PBO) over 48 hours with low rates of adverse events in CKD patients with hyperkalemia. A pre-specified subgroup analysis was conducted with CHF patients from a large Phase 3 trial of ZS-9 for HK. Pts (N=753) with K + 5.0-6.5 mmol/L were randomized (1:1:1:1:1) to ZS-9 (1.25, 2.5, 5 or 10 g) or PBO orally 3х daily for 48 hr (acute phase). At the end of this phase, pts with K + 3.5-5.0 mmol/L (n=542) were randomized 1:1 to the same ZS-9 acute phase dose or PBO once daily (QD) on Days 3-15 (extended phase); patients initially on PBO were randomized to 1.25 or 2.5g ZS-9 QD. RAASi were kept constant during the study. Serum K + in CHF pts treated with the highest ZS-9 dose (10g) was compared to PBO with ...
Introduction: RAAS inhibitors (RAASi) are limited by hyperkalemia (HK; serum K + >5.0 mEq/L), ... more Introduction: RAAS inhibitors (RAASi) are limited by hyperkalemia (HK; serum K + >5.0 mEq/L), a mortality risk factor in patients (pts) with heart failure (HF) and chronic kidney disease (CKD). Sodium zirconium cyclosilicate (ZS-9) is a nonabsorbed cation exchanger that selectively traps potassium (K + ) in the gut. ZS-9 was well tolerated and acutely reduced and maintained K + in HK pts in a Phase 3 study. We report acute phase efficacy of ZS-9 vs placebo (PBO) across prespecified subgroups of baseline (BL) K + , eGFR, HF, CKD, diabetes mellitus (DM), and RAASi use. Methods: Pts (N=753) with serum K+ 5.0-6.5 mEq/L were randomized (1:1:1:1:1) to ZS-9 (1.25, 2.5, 5 or 10g) or PBO orally 3X/day for 48 hr, after which pts with K + ≤4.9 mEq/L (n=542) were switched to ZS-9 or PBO 1x/day on Days 3-14. RAASi was kept constant. Mean serum K + (95% CIs) was recorded at BL and 48 hr. Differences between groups were compared by unpaired t-test. Results: Prevalence of subgroups were CKD 60%,...
<b>Copyright information:</b>Taken from "Increased platelet expression of FcGamm... more <b>Copyright information:</b>Taken from "Increased platelet expression of FcGammaRIIa and its potential impact on platelet reactivity in patients with end stage renal disease"http://www.thrombosisjournal.com/content/5/1/7Thrombosis Journal 2007;5():7-7.Published online 4 Jun 2007PMCID:PMC1894958. Activation of platelets was identified with the use of flow cytometry to delineate surface expression of P-selectin in response to exposure of the platelets to the collagen mimetic convulxin (1 ng/ml), PAF (1 nM), ADP (0.2 μM), or thrombin (1 nM). Expression of FcγRIIa was quantified with the use of flow cytometry by subtracting the MFI seen with secondary antibody alone from the MFI seen with both the primary and secondary antibody. Significant and similar, although modest correlations (r values ranging from approximately 0.4–0.6) were seen with each of the agonists used.
Continuous glucose monitoring (CGM) has become a valuable tool for assessing glycemic control. Th... more Continuous glucose monitoring (CGM) has become a valuable tool for assessing glycemic control. The personal glycemic state (PGS)1 is a mathematical model that considers 5 CGM data elements (mean blood glucose, percent time in range, glucose variability percentage, and frequency of moderate and severe hypoglycemia) equally to generate a score representing the degree of metabolic control. Our adapted personal glycemic state for islet transplant (PGSFIT) targets normoglycemia in islet transplantation by limiting the percent time in range to 70-140mg/dl instead of commonly used 70-180mg/dl, and uses weighted components without limiting the influence of any individual component on the total score. This allowed us to account for T1D patients keeping blood glucose high to avoid hypoglycemia or low to avoid long term complications despite increased hypoglycemia. Using PGS and PGSFIT to analyze glycemic control in 16 subjects with T1D post allogenic islet transplantations showed concordance ...
Risk of hyperkalemia (HK) limits the use of RAAS inhibitors (RAASi) in pts with congestive heart ... more Risk of hyperkalemia (HK) limits the use of RAAS inhibitors (RAASi) in pts with congestive heart failure (CHF), chronic kidney disease (CKD), or diabetes. ZS-9, a nonabsorbed cation exchanger designed to preferentially entrap K + in the GI tract, significantly reduced serum K + vs placebo (PBO) over 48 hours with low rates of adverse events in CKD patients with hyperkalemia. A pre-specified subgroup analysis was conducted with CHF patients from a large Phase 3 trial of ZS-9 for HK. Pts (N=753) with K + 5.0-6.5 mmol/L were randomized (1:1:1:1:1) to ZS-9 (1.25, 2.5, 5 or 10 g) or PBO orally 3х daily for 48 hr (acute phase). At the end of this phase, pts with K + 3.5-5.0 mmol/L (n=542) were randomized 1:1 to the same ZS-9 acute phase dose or PBO once daily (QD) on Days 3-15 (extended phase); patients initially on PBO were randomized to 1.25 or 2.5g ZS-9 QD. RAASi were kept constant during the study. Serum K + in CHF pts treated with the highest ZS-9 dose (10g) was compared to PBO with ...
Introduction: RAAS inhibitors (RAASi) are limited by hyperkalemia (HK; serum K + >5.0 mEq/L), ... more Introduction: RAAS inhibitors (RAASi) are limited by hyperkalemia (HK; serum K + >5.0 mEq/L), a mortality risk factor in patients (pts) with heart failure (HF) and chronic kidney disease (CKD). Sodium zirconium cyclosilicate (ZS-9) is a nonabsorbed cation exchanger that selectively traps potassium (K + ) in the gut. ZS-9 was well tolerated and acutely reduced and maintained K + in HK pts in a Phase 3 study. We report acute phase efficacy of ZS-9 vs placebo (PBO) across prespecified subgroups of baseline (BL) K + , eGFR, HF, CKD, diabetes mellitus (DM), and RAASi use. Methods: Pts (N=753) with serum K+ 5.0-6.5 mEq/L were randomized (1:1:1:1:1) to ZS-9 (1.25, 2.5, 5 or 10g) or PBO orally 3X/day for 48 hr, after which pts with K + ≤4.9 mEq/L (n=542) were switched to ZS-9 or PBO 1x/day on Days 3-14. RAASi was kept constant. Mean serum K + (95% CIs) was recorded at BL and 48 hr. Differences between groups were compared by unpaired t-test. Results: Prevalence of subgroups were CKD 60%,...
<b>Copyright information:</b>Taken from "Increased platelet expression of FcGamm... more <b>Copyright information:</b>Taken from "Increased platelet expression of FcGammaRIIa and its potential impact on platelet reactivity in patients with end stage renal disease"http://www.thrombosisjournal.com/content/5/1/7Thrombosis Journal 2007;5():7-7.Published online 4 Jun 2007PMCID:PMC1894958. Activation of platelets was identified with the use of flow cytometry to delineate surface expression of P-selectin in response to exposure of the platelets to the collagen mimetic convulxin (1 ng/ml), PAF (1 nM), ADP (0.2 μM), or thrombin (1 nM). Expression of FcγRIIa was quantified with the use of flow cytometry by subtracting the MFI seen with secondary antibody alone from the MFI seen with both the primary and secondary antibody. Significant and similar, although modest correlations (r values ranging from approximately 0.4–0.6) were seen with each of the agonists used.
Uploads
Papers by Mohamed El-Shahawy