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Shah K, Cavallo E, Kurobe A, Paisley J, Newman D. 235: Can We Defer a Type and Screen for Pregnant Patients With Vaginal Bleeding Who “Know” Their Blood Type? Ann Emerg Med 2009. [DOI: 10.1016/j.annemergmed.2009.06.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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277
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Yang GF, Zhang LJ, Lu GM, Wu SY, Tian W, Shah K. Reply:. AJNR Am J Neuroradiol 2009. [DOI: 10.3174/ajnr.a1710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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278
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Shackleton SD, O’neill CJ, Shah K, Wills VL. GS22�*THE PROVISION OF A DEDICATED ACUTE GENERAL SURGICAL UNIT IMPROVES THE MANAGEMENT OF PATIENTS WITH ACUTE GALL BLADDER DISEASE. ANZ J Surg 2009. [DOI: 10.1111/j.1445-2197.2009.04917_22.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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279
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Debnam JM, Schellingerhout D, Kumar AJ, Ketonen L, Shah K, Hamberg LM, Hunter GJ. Multidetector CT-Guided Lumbar Puncture in Patients with Cancer. Interv Neuroradiol 2009; 15:61-6. [PMID: 20465930 DOI: 10.1177/159101990901500109] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2008] [Accepted: 01/03/2009] [Indexed: 11/15/2022] Open
Abstract
SUMMARY Lumbar puncture can be performed for therapeutic purposes, to instill intrathecal chemotherapy for leptomeningeal cancer treatment or prophylaxis. This technique is generally performed blindly or under fluoroscopic guidance. However, in certain situations, lumbar puncture using multidetector CT (MDCT)-guided imaging may be beneficial, when other options have been exhausted or depending on the requirements of the performing radiologist's institution. The purpose of this article is to describe the technique and to evaluate outcomes of MDCT-guided lumber puncture for diagnostic and therapeutic purposes in patients with cancer. We conclude that MDCT-guided lumbar puncture is an effective and safe guiding modality for thecal sac access in patients with cancer, particularly where other methods of intrathecal access have failed.
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Pfaar O, Klimek L, Fischer I, Sieber J, Amoroso S, Moreno Aguilar C, Shah K, Mösges R. Safety of two cluster schedules for subcutaneous immunotherapy in allergic rhinitis or asthma patients sensitized to inhalant allergens. Int Arch Allergy Immunol 2009; 150:102-8. [PMID: 19339808 DOI: 10.1159/000210436] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2008] [Accepted: 12/16/2008] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Subcutaneous immunotherapy (SCIT) usually requires a long titration phase, which can be associated with various adverse events (AEs). OBJECTIVES It was the aim of this study to determine the safety of 2 cluster regimens for SCIT in patients with allergic rhinitis, with or without mild or moderate allergic asthma, who were sensitized to grass and/or tree pollen, or house dust mites (HDM). PATIENTS AND METHODS Adult patients were included in a European, open-label, prospective trial. Pollen-allergic patients received grass pollen, grass and olive pollen, or hazel, alder and birch pollen according to a 3-week titration cluster. HDM-allergic patients received HDM extract according to a 2-week titration cluster. The safety of the titration phase was assessed in terms of local and systemic AEs. RESULTS The safety analysis included 157 patients: 110 received pollen and 47 HDM extract. During the cluster titration, 248 AE episodes were reported in the pollen group and 113 in the HDM group; these were mainly local reactions. Around one third of patients (30.9% pollen and 38.3% HDM) did not experience any AE. In most cases (67.1% of pollen and 71.1% of HDM patients), AEs did not lead to a change in titration schedule. No anaphylactic reaction or other serious life-threatening systemic AEs were reported. Only 2 patients in the HDM group discontinued treatment because of AEs. CONCLUSIONS Rapid cluster titration was well tolerated in adults with allergic rhinitis, with or without mild to moderate allergic asthma, due to pollen or HDM. This short-titration, high-dose cluster regime may allow better patient compliance and cost savings.
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Louie KS, de Sanjose S, Diaz M, Castellsagué X, Herrero R, Meijer CJ, Shah K, Franceschi S, Muñoz N, Bosch FX. Early age at first sexual intercourse and early pregnancy are risk factors for cervical cancer in developing countries. Br J Cancer 2009; 100:1191-7. [PMID: 19277042 PMCID: PMC2670004 DOI: 10.1038/sj.bjc.6604974] [Citation(s) in RCA: 129] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Early age at first sexual intercourse (AFSI) has long been associated with an increased risk of invasive cervical carcinoma (ICC). Age at first pregnancy (AFP) and ICC have been investigated less, although AFSI and AFP are strongly interrelated in most developing countries. A pooled analysis of case–control studies on ICC from eight developing countries with 1864 cases and 1719 controls investigated the roles of AFSI, AFP, and ICC risk. Age at first sexual intercourse, AFP and age at first marriage (AFM) were highly interrelated and had similar ICC risk estimates. Compared with women with AFSI ⩾21 years, the odds ratio (OR) of ICC was 1.80 (95% CI: 1.50–2.39) among women with AFSI 17–20 years and 2.31 (95% CI: 1.85–2.87) for AFSI ⩽16 years (P-trend <0.001). No statistical interaction was detected between AFSI and any established risk factors for ICC. The ICC risk was 2.4-fold among those who reported AFSI and AFP at ⩽16 years compared with those with AFSI and AFP at ⩾21 years. These data confirm AFSI and AFB as risk factors for ICC in eight developing countries, but any independent effects of these two events could not be distinguished.
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Shah K, Watson D, Campbell C, Meek RMD. Intra-articular injection composed of steroid, iohexol and local anaesthetic: is it stable? Br J Radiol 2008; 82:109-11. [PMID: 19001468 DOI: 10.1259/bjr/47132569] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The aim of this study is to determine the chemical stability of a suspension of steroid, radiographic contrast material and local anaesthetic. Image-guided steroid injection using a contrast material is widely used for several musculoskeletal conditions. Manufacturers of these agents do not advise mixture in a single syringe, as the chemical stability is unknown. They suggest that, if required, these agents should be injected separately. However, the agents will be mixed together when injected into a contained space within the body. It would seem unethical to continue this in clinical practice until the stability of such a mixture is established. High-performance liquid chromatographic (HPLC) analysis was used to assess the stability of combinations of steroids (triamcinolone and methylprednisolone) and Omnipaque (iohexol). Further analysis was also performed to test the stability of adding local anaesthetics (lidocaine and bupivacaine) to these mixtures. The results demonstrated that all combinations were stable when mixed together. In conclusion, these results support the continued safe use of these products in combination in clinical practice.
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Shah K, Holloway JA, Denry IL. Effect of coloring with various metal oxides on the microstructure, color, and flexural strength of 3Y-TZP. J Biomed Mater Res B Appl Biomater 2008; 87:329-37. [DOI: 10.1002/jbm.b.31107] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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284
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Desai M, Ganpule A, Shah K, Sabnis R, Muthu V. SCHU-11: Laparoscopic Radical Cystectomy in Muscle Invasive Bladder Cancer: A Single Centre Experience. Urology 2008. [DOI: 10.1016/j.urology.2008.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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285
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Yang GF, Wu SY, Zhang LJ, Lu GM, Tian W, Shah K. Imaging findings of extraventricular neurocytoma: report of 3 cases and review of the literature. AJNR Am J Neuroradiol 2008; 30:581-5. [PMID: 18842767 DOI: 10.3174/ajnr.a1279] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Extraventricular neurocytoma (EVN) is rare entity with similar biologic behavior and histopathologic characteristics to neurocytomas that occur in the lateral ventricles, according to the 2007 World Health Organization classification. We report the cases of 3 patients with extraventricular neurocytoma, which presented as large tumors in the left frontal and parietal lobes and in the sellar region. MR imaging showed cystic degeneration, calcification and/or hemorrhage, intense enhancement, and perilesional edema. EVN should be considered in the differential diagnosis for large, heterogeneous, enhancing brain tumors that occur in young people.
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286
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Provenzale JM, Shah K, Patel U, McCrory DC. Systematic review of CT and MR perfusion imaging for assessment of acute cerebrovascular disease. AJNR Am J Neuroradiol 2008; 29:1476-82. [PMID: 18583410 DOI: 10.3174/ajnr.a1161] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Perfusion imaging sequences are an important part of imaging studies designed to provide information to guide therapy for treatment of cerebrovascular disease. The purpose of this study was to perform a meta-analysis of the medical literature on perfusion imaging to determine its role in clinical decision making for patients with acute cerebral ischemia. MATERIALS AND METHODS We searched MEDLINE by using a strategy that combined terms related to perfusion imaging with terms related to acute cerebral ischemia and brain tumors. We identified 658 perfusion imaging articles and classified them according to the clinical usefulness criteria of Thornbury and Fryback. We found 59 articles with promise of indicating usefulness in clinical decision making. We devised and implemented a clinical decision making scoring scale more appropriate to the topic of acute cerebral ischemia. RESULTS Several articles provided important insights into the physiologic processes underlying acute cerebral ischemia by correlation of initial perfusion imaging deficits with clinical outcome or ultimate size of the infarct. However, most articles showed relatively low relevance to influencing decisions in implementing treatment. CONCLUSION Most perfusion imaging articles are oriented toward important topics such as optimization of imaging parameters, determination of ischemia penumbra, and prediction of outcome. However, information as to the role of perfusion imaging in clinical decision making is lacking. Studies are needed to demonstrate that use of perfusion imaging changes outcome of patients with acute cerebral ischemia.
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Brick AJ, McDermott DF, Clement JM, Kwabi C, Shah K, Weiner JR, Duh MS, Neary MP, Oh WK, Choueiri TK. Treatment discontinuations, dose reductions, and interruptions for angiogenesis inhibitor therapies in patients with metastatic renal cell carcinoma (mRCC). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.14636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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288
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Choueiri TK, Regan MM, Brick AJ, Clement JM, Kwabi C, Shah K, Amato A, McDermott DF, Atkins MB, Signoretti S. Carbonic anhydrase IX (CA IX) and pathologic features as predictors of outcome in patients (pts) with metastatic renal cell carcinoma (mRCC) receiving VEGF-targeted therapy. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.16042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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289
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Clement JM, McDermott DF, Choueiri TK, Brick AJ, Kwabi C, Shah K, Weiner JR, Duh MS, Neary MP, Oh WK. Patients with metastatic renal cell carcinoma (mRCC) receiving sunitinib in “real-world” clinical practice: Baseline characteristics and treatment efficacy. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.16071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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290
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Reddy VA, Honavar SG, Shome D, Shah K, Murthy R, Naik M, Vemuganti GK. Demographics, clinical profile, management and outcome of retinoblastoma. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.10051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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291
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Rahman H, Murtaza N, Shah K, Qayyum A, Ullah I, Malik W. Genetic variation for stomatal conductance in upland cotton as influenced by heat-stressed and non-stressed growing regimes. ACTA ACUST UNITED AC 2008. [DOI: 10.1556/aagr.56.2008.1.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Stomatal conductance is an important heat avoidance mechanism and its association with higher yield and heat resistance has been established in Pima cotton. Experiments were carried out on upland cotton under heat-stressed and non-stressed greenhouse and field regimes, to understand the impact of heat-stressed and non-stressed environments on the genetic and combining ability variations for stomatal conductance. The experimental material comprised 8 upland cotton cultivars and their 15 F
1
cross combinations obtained in a line × tester mating arrangement. The results showed high genetic variability for stomatal conductance in a single environment, but low genetic variability across environments, due to the higher magnitude of the environmental interaction, especially that caused by temperature regimes. The interaction effect of temperature regimes also substantially modified general and specific combining ability variations for stomatal conductance. The relative contributions of general and specific combining abilities to total phenotypic variation for stomatal conductance also underwent a great change across field temperature regimes. The non-stressed regime favoured the expression of genes causing the additive type of genetic variability. The heat-stressed field regime, however, favoured the expression of both additive and non-additive types of genetic variation for stomatal conductance in upland cotton. Recurrent selection for the accumulation of favourable genes for general combining ability under non-stressed conditions was suggested for improving stomatal conductance in applied cotton breeding programmes.
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Javaid A, Hasan R, Zafar A, Ghafoor A, Pathan AJ, Rab A, Sadiq A, Akram CM, Burki I, Shah K, Ansari M, Rizvi N, Khan SU, Awan SR, Syed ZA, Iqbal ZH, Shaheen Z, ur Rehman N. Prevalence of primary multidrug resistance to anti-tuberculosis drugs in Pakistan. Int J Tuberc Lung Dis 2008; 12:326-331. [PMID: 18284840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
SETTING Pakistan ranks sixth in the world in terms of tuberculosis (TB) burden, with a World Health Organization estimated incidence of 181 per 100000, or 286000 new cases annually. Hospital-based data indicate a significant problem of multidrug-resistant TB (MDR-TB) in the country and highlight the need to assess its extent at community level. In this cross-sectional study, sputum samples from 742 untreated newly diagnosed pulmonary TB patients from all over the country were used. OBJECTIVE To assess the prevalence of primary drug resistance in Pakistan. RESULTS Of 672 culture-positive patients, 76 (11.3%) showed resistance to one or more drugs. Resistance to streptomycin (10 microg/ml) was found in 36 (5.4%) patients, isoniazid (INH) (1 microg/ml) in 51 (7.6%), rifampicin (RMP) (5 microg/ml) in 15 (2.2%), ethambutol (10 microg/ml) in 12 (1.8%) and pyrazinamide in 22 (3.3%) samples. Forty-six (6.8%) of the isolates tested were resistant to a single drug, 10 (1.5%) to two drugs, 12 (1.8%) to three drugs, and 6 (0.9%) to four drugs, while 2 (0.3%) isolates were resistant to all five first-line agents. Primary MDR-TB was 1.8% (n=12) (INH 1 microg/ml, RMP 5 microg/ml). CONCLUSION The results of this study show a prevalence of primary MDR-TB in Pakistan of <2%, which needs to be addressed through an effective DOTS strategy.
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Jegger D, Sundaram S, Shah K, Mallabiabarrena I, Mucciolo G, von Segesser LK. Using computational fluid dynamics to evaluate a novel venous cannula (Smart canula) for use in cardiopulmonary bypass operating procedures. Perfusion 2008; 22:257-65. [PMID: 18181514 DOI: 10.1177/0267659107083657] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Peripheral access cardiopulmonary bypass (CPB) is initiated with percutaneous cannulae (CTRL) and venous drainage is often impeded due to smaller vessel and cannula size. A new cannula (Smartcanula, SC) was developed which can change shape in situ and, therefore, may improve venous drainage. Its performance was evaluated using a 2-D computational fluid dynamics (CFD) model. The Navier-Stokes equations could be simplified due to the fact that we use a steady state and a 2-dimensional system while the equation of continuity (p constant) was also simplified. We compared the results of the SC to the CTRL using CFDRC (Version 6.6, CFDRC research corporation, Huntsville, USA) at two preloads (300 and 700 Pa). The SC's mass flow rate outperformed the CTRL by 12.1% and 12.2% at a pressures of 300 and 700 Pa, respectively. At 700 Pa, a pressure gradient of 50% was measured for the CTRL and 11% for the SC. The mean velocity at the 700 Pa for the CTRL was 1.0 m.s(-1) at exit while the SC showed an exit velocity of 1.3 m.s(-1). Shear rates inside the cannulae were similar between the two cannulae. In conclusion, the prototype shows greater mass flow rates compared to the classic cannula; thus, it is more efficient. This is also advocated by a better pressure gradient and higher average velocities. By reducing cannula-tip surface area or increasing hole surface area, greater flow rates are achieved.
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Kale A, Shah K, Hallikerimath S. Lesch-Nyhan syndrome: a case report. J Indian Soc Pedod Prev Dent 2008; 26 Suppl 1:S11-3. [PMID: 18974538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Lesch-Nyhan syndrome, a rare inborn error of metabolism, is characterized by mental retardation and self-destructive behavior resulting in self-mutilation through biting and scratching. It is a rare anomaly consisting of deficiency in the production of hypoxanthine phosphoribosyltransferase that leads to the overproduction of purine and accumulation of uric acid. No medical treatment exists to alleviate the symptoms of self-mutilation where direct dental intervention is the only way these behavior can be affected. A unique case of this type affecting a 6-year-old male child is reported.
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Palmer K, Thaly R, Shah K, Patel V. POD-10.01: Radiofrequency ablation of renal tumors: an alternative for patients with imperative indication for nephron-sparing surgery or those with significant co-morbidities. Urology 2007. [DOI: 10.1016/j.urology.2007.06.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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296
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Arend D, Shah K, Palmer K, Thaly R, Patel V. POS-03.125: Histopathologic outcomes of robotic-assisted laparoscopic radical prostatectomy: an analysis of positive margin status. Urology 2007. [DOI: 10.1016/j.urology.2007.06.674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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297
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Palmer K, Shah K, R. Thaly R, Patel V. VID-01.06: Early retrograde release of the neurovascular bundle during robotic-assisted laparoscopic radical prostatectomy. Urology 2007. [DOI: 10.1016/j.urology.2007.06.630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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298
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Shah K, Palmer K, Thaly R, Patel V. MP-18.03: High resolution imaging of the radical prostatectomy specimen: feasibility to predict positive margin status. Urology 2007. [DOI: 10.1016/j.urology.2007.06.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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299
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Patel A, Shah K, Thaly R, Palmer K, Patel V. POS-03.98: Operative complications of robotic assisted laparoscopic radical prostatectomy: the learning curve and beyond - a single surgeon series. Urology 2007. [DOI: 10.1016/j.urology.2007.06.644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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300
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Palmer K, Thaly R, Shah K, Patel V. VID-01.04: Robotic-assisted laparoscopic radical prostatectomy in patients with previous inguinal meshplasty: technique and perioperative outcome. Urology 2007. [DOI: 10.1016/j.urology.2007.06.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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