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Uppugunduri, Srinivas
Publications (10 of 24) Show all publications
Tufvesson Stiller, H., Mikiver, R., Uppugunduri, S., Lindholm, C., Mansson Brahme, E. & Schmitt-Egenolf, M. (2020). Health-related quality of life in patients with melanoma - characterization of a Swedish cohort [Letter to the editor]. British Journal of Dermatology, 182(2), 506-508
Open this publication in new window or tab >>Health-related quality of life in patients with melanoma - characterization of a Swedish cohort
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2020 (English)In: British Journal of Dermatology, ISSN 0007-0963, E-ISSN 1365-2133, Vol. 182, no 2, p. 506-508Article in journal, Letter (Other academic) Published
Abstract [en]

Abstract not available.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
National Category
Dermatology and Venereal Diseases Cancer and Oncology Nursing
Identifiers
urn:nbn:se:liu:diva-161604 (URN)10.1111/bjd.18486 (DOI)000492379400001 ()31487398 (PubMedID)
Available from: 2019-11-06 Created: 2019-11-06 Last updated: 2024-02-07
Heenkenda, M. K., Malmström, A., Lysiak, M., Mudaisi, M., Bratthall, C., Milos, P., . . . Osman, A. (2019). Assessment of genetic and non-genetic risk factors for venous thromboembolism in glioblastoma - The predictive significance of B blood group. Thrombosis Research, 183, 136-142
Open this publication in new window or tab >>Assessment of genetic and non-genetic risk factors for venous thromboembolism in glioblastoma - The predictive significance of B blood group
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2019 (English)In: Thrombosis Research, ISSN 0049-3848, E-ISSN 1879-2472, Vol. 183, p. 136-142Article in journal (Refereed) Published
Abstract [en]

Introduction: Venous thromboembolism (VTE) is a common problem among patients with glioblastoma multi-forme (GBM) and with some other cancers. Here, we evaluated genetic and non-genetic potential risk factors for VTE among GBM patients. Materials and methods: A cohort of 139 patients treated with concomitant radiotherapy and temozolomide were included in the study. Next generation sequencing and genotyping approaches were applied to assess genetic risk factors in the haemostatic system. Clinical data including surgery, reoperation as well as blood group and patient information such as age and gender were available from patient records. Logistic regression analysis was performed to asses VTE risk. Results: In the study 47 patients (34%) were diagnosed for VTE during the course of their disease. When genetic and non-genetic potential risk factors were evaluated, only B blood group was found to be significantly associated with VTE incidence (odds ratio [OR] = 6.91; confidence interval [CI] = 2.19-24.14; P = 0.001). In contrast, A and O blood groups did not correlate with VTE risk. Frontal lobe tumor location also seemed to slightly increase VTE risk compared to other brain sites (OR = 3.14; CI = 1.1-10.7) although the significance level was at borderline (P = 0.05). Current study identified B blood group as the component in non-O blood groups that is responsible for increased VTE risk. Conclusion: In conclusion, these results suggest for the first time that B blood group is predictive for VTE incidence among patients with glioblastoma, information that may be potentially valuable when selecting GBM patients who are at risk for VTE for anticoagulant prophylaxis.

Place, publisher, year, edition, pages
PERGAMON-ELSEVIER SCIENCE LTD, 2019
Keywords
ABO blood groups; Glioblastoma; Sequence analysis; DNA; Surgery; Tumor location; Venous thromboembolism
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-162537 (URN)10.1016/j.thromres.2019.10.009 (DOI)000497805700024 ()31677594 (PubMedID)
Note

Funding Agencies|Medical Research Council of Southeast Sweden (FORSS); County Council of Region Ostergotland, Sweden

Available from: 2019-12-09 Created: 2019-12-09 Last updated: 2022-04-19
Liest, L., Omran, A. S., Mikiver, R., Rosenberg, P. & Uppugunduri, S. (2019). RMI and ROMA are equally effective in discriminating between benign and malignant gynecological tumors: A prospective population-based study. Acta Obstetricia et Gynecologica Scandinavica, 98(1), 24-33
Open this publication in new window or tab >>RMI and ROMA are equally effective in discriminating between benign and malignant gynecological tumors: A prospective population-based study
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2019 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 98, no 1, p. 24-33Article in journal (Refereed) Published
Abstract [en]

Introduction Our primary objective was to test the hypothesis that human epididymal protein 4 (HE4) and risk of ovarian malignancy index outperform the CA 125 and risk of malignancy index tests in categorizing a pelvic mass into high or low risk of malignancy in a Swedish population. Furthermore, cut-off values needed to be defined for HE4 and ROMA in premenopausal and postmenopausal women prior to their introduction to clinical practice. A third objective was to investigate the correlation between HE4 levels in serum and urine. Material and methods Women with a pelvic mass scheduled for surgery were recruited from nine hospitals in south-east Sweden. Preoperative blood samples were taken for analyzing CA125 and HE4 as well as urine samples for analyzing HE4. Results We enrolled a total of 901 women, of whom 784 were evaluable. In the premenopausal and postmenopausal groups, no significant differences were found for sensitivity, positive and negative predictive value, either for RMI vs ROMA or for CA125 vs HE4 using a fixed specificity of 75%. Cut-off values indicating malignancy were established for HE4 and ROMA in premenopausal and postmenopausal women. We found no correlation between HE4 concentration in serum and urine. Conclusions We could not confirm that ROMA had diagnostic superiority over RMI in categorizing women with a pelvic mass into low-risk or high-risk groups for malignancy in a Swedish population. We have defined cut-off values for HE4 and ROMA. The lack of correlation between serum and urine HE4 obviates the introduction of urine HE4 analysis in clinical diagnostics.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
CA125; EOC; HE4; ovarian cancer; pelvic mass; RMI; ROMA; urine-HE4
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-153646 (URN)10.1111/aogs.13462 (DOI)000453833400005 ()30216407 (PubMedID)2-s2.0-85055666056 (Scopus ID)
Note

Funding Agencies|FORSS (Medical Research Council of Southeast Sweden); County Council of Ostergotland; Ostgotaregionens cancerfond

Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2020-05-06Bibliographically approved
Chenna Narendra, S., Prakash Chalise, J., Magnusson, M. & Uppugunduri, S. (2015). Local but Not Systemic Administration of Uridine Prevents Development of Antigen-Induced Arthritis. PLOS ONE, 10(10), e0141863
Open this publication in new window or tab >>Local but Not Systemic Administration of Uridine Prevents Development of Antigen-Induced Arthritis
2015 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 10, no 10, p. e0141863-Article in journal (Refereed) Published
Abstract [en]

Objective Uridine has earlier been show to down modulate inflammation in models of lung inflammation. The aim of this study was to evaluate the anti-inflammatory effect of uridine in arthritis. Methods Arthritis was induced by intra-articular injection of mBSA in the knee of NMRI mice preimmunized with mBSA. Uridine was either administered locally by direct injection into the knee joint or systemically. Systemic treatment included repeated injections or implantation of a pellet continuously releasing uridine during the entire experimental procedure. Anti-mBSA specific immune responses were determined by ELISA and cell proliferation and serum cytokine levels were determined by Luminex. Immunohistochemistry was used to identify cells, study expression of cytokines and adhesion molecules in the joint. Results Local administration of 25-100 mg/kg uridine at the time of arthritis onset clearly prevented development of joint inflammation. In contrast, systemic administration of uridine (max 1.5 mg uridine per day) did not prevent development of arthritis. Protection against arthritis by local administration of uridine did not affect the anti-mBSA specific immune response and did not prevent the rise in serum levels of pro-inflammatory cytokines associated with the triggering of arthritis. In contrast, local uridine treatment efficiently inhibited synovial expression of ICAM-1 and CD18, local cytokine production and recruitment of leukocytes to the synovium. Conclusion Local, but not systemic administration of uridine efficiently prevented development of antigen- induced arthritis. The protective effect did not involve alteration of systemic immunity to mBSA but clearly involved inhibition of synovial expression of adhesion molecules, decreased TNF and IL-6 production and prevention of leukocyte extravasation. Further, uridine is a small, inexpensive molecule and may thus be a new therapeutic option to treat joint inflammation in RA.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE, 2015
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-123070 (URN)10.1371/journal.pone.0141863 (DOI)000363920300089 ()26512984 (PubMedID)
Note

Funding Agencies|Vetenskapsradet-Grant [521-2011-3095]; Reumatikerforbundet Grant [155261]; County Council of Ostergotland, Sweden; Linkoping University

Available from: 2015-12-04 Created: 2015-12-03 Last updated: 2021-06-14
Bastami, S., Gupta, A., Zackrisson, A. L., Ahlner, J., Osman, A. & Uppugunduri, S. (2014). Influence of UGT2B7, OPRM1 and ABCB1 gene polymorphisms on morphine use. Basic & Clinical Pharmacology & Toxicology, 115(5), 423-431
Open this publication in new window or tab >>Influence of UGT2B7, OPRM1 and ABCB1 gene polymorphisms on morphine use
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2014 (English)In: Basic & Clinical Pharmacology & Toxicology, ISSN 1742-7835, E-ISSN 1742-7843, Vol. 115, no 5, p. 423-431Article in journal (Refereed) Published
Abstract [en]

Therapeutic modulation of pain with morphine and other opioids is associated with significant variation in, both, effects and adverse effects in individual patients. Many factors including gene polymorphisms have been shown to contribute to the interindividual variability in the response to opioids. The aim of this study was to investigate the significance of UGT2B7, OPRM1 and ABCB1 polymorphisms for interindividual variability in morphine induced analgesia in patients undergoing hysterectomy. The frequency of these polymorphisms was also investigated in forensic autopsy cases as morphine is also a very commonly abused drug

Blood samples were collected from 40 patients following abdominal hysterectomy, 24 hours after initiation of analgesia through a PCA pump. Samples were genotyped and analysed for morphine and its metabolites. We also genotyped approximately 200 autopsy cases found positive for morphine in routine forensic analysis.

Patients homozygous for UGT2B7 802C needed significantly lower dose of morphine for pain relief. The same trend was observed for patients homozygous for ABCB1 1236T and 3435T, as well as to OPRM1 118A. Dose of morphine in patients included in this study was significantly related to variation in UGT2B7 T802C. Age was significantly related to both dose and concentration of morphine in blood.

Regression analysis showed that 30% of differences in variation in morphine dose could be explained by SNPs in these genes. The genotype distribution was similar between the forensic cases and the patients. However, the mean concentration of morphine was higher in forensic cases compared to patients.

We conclude that gene polymorphisms contribute significantly to the variation in morphine levels observed in individual patients.

Place, publisher, year, edition, pages
Wiley, 2014
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-96791 (URN)10.1111/bcpt.12248 (DOI)000344015300008 ()24703092 (PubMedID)
Available from: 2013-08-27 Created: 2013-08-27 Last updated: 2022-04-19Bibliographically approved
Bastami, S., Haage, P., Kronstrand, R., Kugelberg, F., Zackrisson, A.-L. & Uppugunduri, S. (2014). Pharmacogenetic aspects of tramadol pharmacokinetics and pharmacodynamics after a single oral dose. Forensic Science International, 238, 125-132
Open this publication in new window or tab >>Pharmacogenetic aspects of tramadol pharmacokinetics and pharmacodynamics after a single oral dose
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2014 (English)In: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 238, p. 125-132Article in journal (Refereed) Published
Abstract [en]

The major purpose of this study was to elucidate if genotyping can facilitate interpretations of tramadol (TRA) in forensic case work, with special regard to the estimation of the time of drug intake and drug related symptoms (DRS). The association between genetic polymorphisms in CYP2D6, OPRM1 and ABCB1 and pharmacokinetic and pharmacodynamic properties of TRA was studied. Nineteen healthy volunteers were randomized into two groups receiving a single dose of either 50 or 100 mg of orally administrated TRA. Blood samples were collected prior to dosing and up to 72 h after drug intake. The subjects were asked to report DRS during the experimental day. We found a positive correlation between the metabolic ratio of O-desmethyltramadol (ODT) to TRA and the time after drug intake for both CYP2D6 intermediate metabolizers and extensive metabolizers. For the only poor metabolizer with detectable ODT levels the metabolic ratio was almost constant. Significant associations were found between the area under the concentration-time curve (AUC) and three of the investigated ABCB1 single nucleotide polymorphisms for TRA, but not for ODT and only in the 50 mg dosage group. There was great interindividual variation in DRS, some subjects exhibited no symptoms at all whereas one subject both fainted and vomited after a single therapeutic dose. However, no associations could be found between DRS and investigated polymorphisms. We conclude that the metabolic ratio of ODT/TRA may be used for estimation of the time of drug intake, but only when the CYP2D6 genotype is known and taken into consideration. The influence of genetic polymorphisms in ABCB1 and OPRM1 requires further study.

Place, publisher, year, edition, pages
Elsevier, 2014
Keywords
Tramadol; Pharmacokinetics; Pharmacodynamics; CYP2D6; ABCB1; OPRM1
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-106838 (URN)10.1016/j.forsciint.2014.03.003 (DOI)000334580700025 ()24709712 (PubMedID)
Available from: 2014-05-28 Created: 2014-05-23 Last updated: 2020-08-18Bibliographically approved
Arbring, K., Uppugunduri, S. & Lindahl, T. (2013). Comparison of prothrombin time (INR) results and main characteristics of patients on warfarin treatment in primary health care centers and anticoagulation clinics. BMC Health Services Research, 13
Open this publication in new window or tab >>Comparison of prothrombin time (INR) results and main characteristics of patients on warfarin treatment in primary health care centers and anticoagulation clinics
2013 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 13Article in journal (Refereed) Published
Abstract [en]

Background

Oral anticoagulant therapy is used to prevent thrombosis in patients with atrial fibrillation (AF), venous thrombosis and prosthetic heart valves. The introduction of new therapies emphasizes the need to discern the best practice for the patients remaining on warfarin treatment. This study compares patient characteristics and therapeutic control in two settings managing warfarin treatment: Swedish primary health care centers (PHCC) and specialized anticoagulation clinics (ACC).

Methods

Prothrombin time (PT) test results reported as International Normalized Ratio (INR) were collected for five consecutive days from patients on warfarin treatment; 564 PHCC and 927 ACC patients. Therapeutic control was calculated as PT test results in relation to intended therapeutic range (TR). Mann–Whitney Rank Sum Test and Chi2 test were used for statistical comparisons.

Results

The PHCC patients were older than the ACC patients, 76 v. 70 years (p<0.01) with a predominance of men in both groups. The reasons for treating differed between the groups. Seventy-two percent of PHCC patients and 66% of ACC patients had a PT-INR within the intended TR (p<0.05). Men generally had better results than women (72% v. 63%, p<0.001) and particularly in the PHCC group v. the ACC group (78% v. 69%, p<0.01).

PT-INR above intended TR was significantly more common in the ACC setting, (p<0.05), for women overall (p<0.01), for women in the PHCC setting, and for ACC men (p<0.05).

Conclusions

In this study both settings achieved good therapeutic control of warfarin treatment with a minor advantage for PHCC over ACC, and better results for men, especially in the PHCC setting. As patient characteristics differ between the PHCC and ACC, it is important to conduct further randomized studies to discern the best practice locally for warfarin management also after the introduction of new drugs.

Place, publisher, year, edition, pages
BioMed Central, 2013
Keywords
Oral anticoagulants, Treatment, Quality control, Warfarin
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-90753 (URN)10.1186/1472-6963-13-85 (DOI)000315994100001 ()
Note

Funding Agencies|Medical Research Council of Southeast Sweden (FORSS)||

Available from: 2013-04-08 Created: 2013-04-05 Last updated: 2023-10-31Bibliographically approved
Arbring, K., Chaireti, R., Janzon, M., Uppugunduri, S., Jansson, K. & Lindahl, T. (2013). First experience of structured introduction of new oral anticoagulants in a Swedish health care district: dabigatran as an alternative to warfarin in atrial fibrillation. In: : . Paper presented at XXIVth Congress of the International Society of Thrombosis and Haemostasi (ISTH 2013), 29 June - 4 Juli 2013, Amsterdam, Holland.
Open this publication in new window or tab >>First experience of structured introduction of new oral anticoagulants in a Swedish health care district: dabigatran as an alternative to warfarin in atrial fibrillation
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2013 (English)Conference paper, Published paper (Refereed)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-103424 (URN)
Conference
XXIVth Congress of the International Society of Thrombosis and Haemostasi (ISTH 2013), 29 June - 4 Juli 2013, Amsterdam, Holland
Available from: 2014-01-20 Created: 2014-01-20 Last updated: 2014-08-26
Bastami, S., Norling, C., Trinks, C., Holmlund, B., Walz, T. M., Ahlner, J. & Uppugunduri, S. (2013). Inhibitory effect of opiates on LPS mediated release of TNF and IL-8. Acta Oncologica, 52(5), 1022-1033
Open this publication in new window or tab >>Inhibitory effect of opiates on LPS mediated release of TNF and IL-8
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2013 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 52, no 5, p. 1022-1033Article in journal (Refereed) Published
Abstract [en]

Most patients with advanced cancer experience severe pain and are often treated with opiates. Cancer patients are especially susceptible to opportunistic infections due to treatment with immunosuppressive and cytostatic drugs. Since opiates have been demonstrated to have immunomodulatory effects, it is of clinical importance to evaluate potential differences between commonly used opiates with regard to their effect on the immune system. The aim of this study was to evaluate the effect of morphine, tramadol, fentanyl and ketobemidone on the functioning of the immune system with special reference to TNF and IL-8 release. Method. U-937 cells were preincubated with different concentrations of opioids followed by stimulation with LPS 100 μg/ml for three hours. The effect of opioids on the levels of cytokine mRNA was studied using RT-PCR. Erk and Akt phosphorylation was also measured by Western blot. Results. All opioids with the exception of fentanyl were capable of inhibiting TNF release from U-937 cells. Morphine had no effect on IL-8 release but the effect of other opiates was almost the same as the effect on TNF. All opioids with the exception of fentanyl were capable of inhibiting production of mRNA for TNF and IL-8. The observed effects of opiates were not always reversible by naloxone, suggesting that the effects might be mediated by other receptors or through a non-receptor mediated direct effect. Although preliminary evidence suggests the involvement of Erk and Akt pathways, further studies are needed to unravel the intracellular pathways involved in mediating the effects of opiates. Our data suggests that the order of potency with regard to inhibition of cytokine release is as follows: tramadol > ketobemidone > morphine > fentanyl. Conclusion. Further studies are needed to understand the clinical implications of the observed immunosuppressive effects of tramadol and ketobemidone and to improve opioid treatment strategies in patients with cancer.

Place, publisher, year, edition, pages
Informa Healthcare, 2013
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-89960 (URN)10.3109/0284186X.2012.737932 (DOI)23145506 (PubMedID)
Available from: 2013-03-12 Created: 2013-03-12 Last updated: 2017-12-06
Bastami, S., Frödin, T., Ahlner, J. & Uppugunduri, S. (2012). Topical morphine gel in the treatment of painful leg ulcers, a double-blind, placebo-controlled clinical trial: a pilot study. International Wound Journal, 9(4), 419-427
Open this publication in new window or tab >>Topical morphine gel in the treatment of painful leg ulcers, a double-blind, placebo-controlled clinical trial: a pilot study
2012 (English)In: International Wound Journal, ISSN 1742-4801, E-ISSN 1742-481X, Vol. 9, no 4, p. 419-427Article in journal (Refereed) Published
Abstract [en]

Chronic painful wounds, a major health problem, have a detrimental impact on the quality of life due to associated pain. Some clinical reports have suggested that local administration of morphine could be beneficial. The aim of this study was to evaluate the analgesic effect of topically applied morphine on chronic painful leg ulcers. Twenty-one patients were randomly assigned to receive either morphine or placebo in a randomised, placebo-controlled, crossover pilot study. Each patient was treated four times in total. Pain was measured by the visual analogue score (VAS) before application of gel, directly after and after 2, 6, 12 and 24 hours. Although an overall, clinically relevant, reduction of pain was observed upon treatment with morphine, the difference was not statistically significant. Morphine reduced pain scores more than placebo on treatment occasions 1 and 2. The difference was statistically significant only 2 hours after dressing on the first treatment occasion. Thus, our study did not demonstrate a consistent and globally significant difference in nociception in patients treated with morphine. However, the relatively small number of patients included in our study and other methodological limitations makes it difficult for us to draw general conclusions regarding efficacy of topically applied morphine as an effective treatment for some painful ulcers. Further studies are warranted to evaluate the value of topically applied morphine in the treatment of patients with chronic painful leg ulcers.

Place, publisher, year, edition, pages
Blackwell Publishing, 2012
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-75512 (URN)10.1111/j.1742-481X.2011.00901.x (DOI)000306406000011 ()22151619 (PubMedID)
Available from: 2012-03-05 Created: 2012-03-05 Last updated: 2017-12-07
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