Browsing by Author "Hashemi, M."

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    A Comparative international study on the management of acute appendicitis between a developed country and a middle income country
    (Elsevier, 2014) Markar, S.R.; Pinto, D.; Penna, M.; Karthikesalingam, A.; Bulathsinhala, B.K.S.; Kumaran, K.; Hashemi, M.; Fernando, R.
    BACKGROUND: In the past decade there has been an exponential increase in the use of Computerised Tomography (CT) imaging in the assessment of patients with acute appendicitis. The aim of this study was to compare management approaches and clinical outcomes of acute appendicitis in Sri Lanka and the United Kingdom. METHODS: Data was collected prospectively from 400 patients referred to the General Surgical department with a differential diagnosis of acute appendicitis, 200 at University Kelaniya Sri Lanka (SL group), and 200 at University College London Hospital (UK group). RESULTS: The groups were similar with respect to gender, but the SL group was younger. Preoperative work-up included ultrasound more commonly in SL patients, and CT more commonly in UK patients. More patients underwent appendicectomy in the SL group, however a laparoscopic approach was utilised more often in the UK group (50.5% vs. 11.9%). Post-operative complications were similarly represented in both groups, but re-admission occurred with greater frequency in the UK group (16.2% vs. 0%). Histologically confirmed appendicitis was seen in a significantly greater proportion of SL patients (93.1% vs. 79.8%). Multivariate analysis confirmed male gender, and diagnosis and treatment in Sri Lanka to be only factors significantly associated with positive appendicitis. DISCUSSION: Expensive investigations such as CT do not appear to improve the diagnostic accuracy of appendicitis or prevent complications. This study suggests diagnostic and treatment algorithms in the SL hospital are more accurate and efficient in confirming appendicitis than those seen in the UK hospital under investigation. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
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    Epigenome-wide association study of body mass index, and the adverse outcomes of adiposity
    (Nature Publishing Group, 2017) Whal, S.; Drong, A.; Lehne, B.; Loh, M.; Scott, W.R.; Kunze, S.; Tsai, P.C.; Ried, J.S.; Zhang, W.; Yang, Y.; Tan, S.; Fiorito, G.; Franke, L.; Guarrera, S.; Kasela, S.; Kriebel, J.; Richmond, R.C.; Adamo, M.; Afzal, U.; Ala-Korpela, M.; Albeetti, B.; Ammerpohl, O.; Apperley, J.F.; Beekman, M.; Bertazzi, P.A.; Black, S.L.; Blancher, C.; Bonder, M.J.; Brosch, M.; Carstensen-Kirberg, M.; de Craen, A.J.; de Lusignan, S.; Dehghan, A.; Elkalaawy, M.; Fischer, K.; Franco, O.H.; Gaunt, T.R.; Hampe, J.; Hashemi, M.; Isaacs, A.; Jenkinson, A.; Jha, S.; Kato, N.; Krogh, V.; Laffan, M.; Meisinger, C.; Meitinger, T.; Mok, Z.Y.; Motta, V.; Ng, H.K.; Nikolakopoulou, Z.; Nteliopoulos, G.; Panico, S.; Pervjakova, N.; Prokisch, H.; Rathmann, W.; Roden, M.; Rota, F.; Rozario, M.A.; Sandling, J.K.; Schafmayer, C.; Schramm, K.; Siebert, R.; Slagboom, P.E.; Soininen, P.; Stolk, L.; Strauch, K.; Tai, E.S.; Tarantini, L.; Thorand, B.; Tigchelaar, E.F.; Tumino, R.; Uitterlinden, A.G.; van Duijn, C.; van Meurs, J.B.; Vineis, P.; Wickremasinghe, A.R.; Wijmenga, C.; Yang, T.P.; Yuan, W.; Zhernakova, A.; Batterham, R.L.; Smith, G.D.; Deloukas, P.; Heijmans, B.T.; Herder, C.; Hofman, A.; Lindgren, C.M.; Milani, L.; van der Harst, P.; Peters, A.; Illig, T.; Relton, C.L.; Waldenberger, M.; Järvelin, M.R.; Bollati, V.; Soong, R.; Spector, T.D.; Scott, J.; McCarthy, M.I.; Elliott, P.; Bell, J.T.; Matullo, G.; Gieger, C.; Kooner, J.S.; Grallert, H.; Chambers, J.C.
    Approximately 1.5 billion people worldwide are overweight or affected by obesity, and are at risk of developing type 2 diabetes, cardiovascular disease and related metabolic and inflammatory disturbances. Although the mechanisms linking adiposity to associated clinical conditions are poorly understood, recent studies suggest that adiposity may influence DNA methylation, a key regulator of gene expression and molecular phenotype. Here we use epigenome-wide association to show that body mass index (BMI; a key measure of adiposity) is associated with widespread changes in DNA methylation (187 genetic loci with P < 1 × 10-7, range P = 9.2 × 10-8 to 6.0 × 10-46; n = 10,261 samples). Genetic association analyses demonstrate that the alterations in DNA methylation are predominantly the consequence of adiposity, rather than the cause. We find that methylation loci are enriched for functional genomic features in multiple tissues (P < 0.05), and show that sentinel methylation markers identify gene expression signatures at 38 loci (P < 9.0 × 10-6, range P = 5.5 × 10-6 to 6.1 × 10-35, n = 1,785 samples). The methylation loci identify genes involved in lipid and lipoprotein metabolism, substrate transport and inflammatory pathways. Finally, we show that the disturbances in DNA methylation predict future development of type 2 diabetes (relative risk per 1 standard deviation increase in methylation risk score: 2.3 (2.07-2.56); P = 1.1 × 10-54). Our results provide new insights into the biologic pathways influenced by adiposity, and may enable development of new strategies for prediction and prevention of type 2 diabetes and other adverse clinical consequences of obesity.