451
|
Parker K, Patel J. Post placement. Br Dent J 2013; 214:93-4. [PMID: 23392002 DOI: 10.1038/sj.bdj.2013.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
452
|
Alrawi YA, Parker RA, Harvey RC, Sultanzadeh SJ, Patel J, Mallinson R, Potter JF, Trepte NJB, Myint PK. Predictors of early mortality among hospitalized nursing home residents. QJM 2013; 106:51-7. [PMID: 23064829 DOI: 10.1093/qjmed/hcs188] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Emergency admissions from nursing homes (NHs) are associated with high mortality. Understanding the predictors of early mortality in these patients may guide clinicians in choosing appropriate site and level of care. METHODS We identified all consecutive admissions from NHs (all ages) to an Acute Medical Assessment Unit between January 2005 and December 2007. Analysis was performed at the level of the admission. The predictors of in-patient mortality at 7 days were examined using a generalized estimating equations analysis. RESULTS A total of 314 patients [32% male, mean age: 84.2 years (SD: 8.3 years)] were admitted during the study period constituting 410 emergency episodes. Twenty-three percent of admissions resulted in hospital mortality with 73% of deaths occurring within 1 week (50% within the first 3 days). For 7-day mortality outcome, patients with a modified early warning score (MEWS) of 4-5 on admission had 12 times the odds of death [95% confidence interval (CI) 1.40-103.56], whereas those with a score of ≥6 had 21 times the odds of death (95% CI 2.71-170.57) compared with those with a score of ≤1. An estimated glomerular filtration rate (eGFR) of 30-60 and <30 ml/min/m(2) was associated with nearly a 3-fold increase in the odds of death at 1 week (95% CI 1.10-7.97) and a 5-fold increase in the odds of death within 1 week (95% CI 1.75-14.96), respectively, compared with eGFR > 60 ml/min/m(2). C-reactive protein (CRP) >100 mg/l on admission was also associated with a 2.5 times higher odds of death (95% CI 1.23-4.95). Taking eight or more different medication items per day was associated with only a third of the odds of death (95% CI 0.09-0.98) compared with patients taking only three or fewer per day. CONCLUSION In acutely ill NH residents, MEWS is an important predictor of early hospital mortality and can be used in both the community and the hospital settings to identify patients whose death maybe predictable or unavoidable, thus allowing a more holistic approach to management with discussion with patient and relatives for planning of immediate care. In addition, CRP and eGFR levels on admission have also been shown to predict early hospital mortality in these patients and can be used in conjunction with MEWS in the same way to allow decision making on the appropriate level of care at the point of hospital admission.
Collapse
|
453
|
Li H, Patel J, Mortimer R, Richard K. Ontogenic changes in human placental sodium iodide symporter expression. Placenta 2012; 33:946-8. [DOI: 10.1016/j.placenta.2012.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Revised: 07/25/2012] [Accepted: 08/17/2012] [Indexed: 10/27/2022]
|
454
|
Patel J, Sheth B, Tran QT, Ogmen H. Perceiving Statistical Significance. J Vis 2012. [DOI: 10.1167/12.9.894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
455
|
Sheth B, Patel J, Tran QT. Do We See a Least Squares World Around Us? J Vis 2012. [DOI: 10.1167/12.9.895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
456
|
Berbeco R, Korideck H, Ngwa W, Kumar R, Patel J, Sridhar S, Johnson S, Price B, Kimmelman A, Makrigiorgos M. TU-C-BRB-11: In Vitro Dose Enhancement from Gold Nanoparticles under Different Clinical MV Photon Beam Configurations. Med Phys 2012. [DOI: 10.1118/1.4735923] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
457
|
Melchior RW, Schiavo K, Frey T, Rogers D, Patel J, Chelnik K, Rosenthal T. Evaluation of the Maquet Neonatal and Pediatric Quadrox I with an integrated arterial line filter during cardiopulmonary bypass. Perfusion 2012; 27:399-406. [PMID: 22717608 DOI: 10.1177/0267659112450059] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Perfusion equipment has evolved since its introduction into clinical practice more than fifty years ago to include smaller cardiopulmonary bypass (CPB) circuits and components. Perfusionists are now exploring the function of new oxygenators with an integrated arterial line filter (IALF). The purpose of this trial was to examine the Maquet Quadrox-I Neonatal and Pediatric oxygenators with IALF in a clinical setting, with respect to gas transfer, heat exchange co-efficiency (HEC), trans-membrane pressure (TMP) gradient and clinical experience. METHODS The Maquet Quadrox-I Neonatal oxygenator was used on 30 patients ranging from 2.2-13.1 kg. The Maquet Quadrox-I Pediatric oxygenator was used on 15 patients ranging from 12.7-24.5 kg. Arterial and venous blood gases were taken once the patient was stable on CPB and, subsequently, every 30 minutes afterwards, as per institution protocol. The values for gas transfer rates, HEC and TMP gradient were stratified into three main categories with each oxygenator: normothermia, cooling and re-warming. RESULTS During all conditions, the gas transfer rate with both oxygenators was efficient. The HEC values showed efficient heat exchanger performance during all conditions with both oxygenators. While maintaining CPB flow within the manufacturer's recommended flow rate for each oxygenator, the TMP gradient range for the Neonatal Quadrox-I was 10-40 mmHg and the Pediatric Quadrox-I was 10-60 mmHg. During the clinical trial, foam was shown to break through the cardiotomy on several occasions when high sucker return was required. CONCLUSION This new line of oxygenators performed well with regards to gas transfer, HEC and TMP gradient, but there were clinical experiences that did not meet expectations. There were repeated incidences with the venous reservoir which ultimately cast a negative light on the design of this new product from Maquet. In the future, the authors would like to evaluate updated versions of this product from Maquet and any other pediatric perfusion devices that could help the patient in the clinical arena.
Collapse
|
458
|
Patel J, Burnham R, Martin T, Parmar S. Complications related to the composite fibula flap and its acceptability to patients as a donor site. Br J Oral Maxillofac Surg 2012. [DOI: 10.1016/j.bjoms.2012.04.247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
459
|
Patel J, Song JM, Shashidharamurthy R, Compans R, Kang SM, Selvaraj P. Stable incorporation of functionally active purified GPI-anchored immunostimulatory molecules on H5 influenza VLP surfaces by protein transfer. (113.33). THE JOURNAL OF IMMUNOLOGY 2012. [DOI: 10.4049/jimmunol.188.supp.113.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
H5N1 influenza, a bilayered lipid enveloped virus, is highly pathogenic and can lead to a pandemic threat; therefore, a potent vaccine is required. The use of virus-like particles (VLPs) as a vaccine has recently gained importance as they are safe and highly immunogenic. VLPs are similar in size and structure to their viral counterparts but do not contain the viral genome required for replication. Although VLPs are immunogenic, full protection and cross-reactivity to other influenza strains does not always occur; therefore, we aim to modify H5 influenza VLPs to incorporate immunostimulatory molecules (ISMs) by using a protein transfer method. Previously, we have shown that GPI-anchored ISMs (ICAM-1 and IL-12) are able to incorporate onto H5 influenza VLPs by a simple and easy protein transfer method. In this study, we show that purification of GPI-IL-12 does not alter the functionality of the protein in stimulating proliferation of ConA-activated splenocytes suggesting that purified GPI-ISMs remain functionally active. Furthermore, the detection of incorporated GPI-ISMs onto the surface of H5 influenza VLPs by protein transfer was conducted by using immunogold staining electron microscopy and incorporation occurred uniformly as detected by flow cytometry analysis. Moreover, these GPI-ISMs remain stably expressed on the VLP surface for at least a week at 4oC. This study suggests that H5 influenza VLPs can be modified to stably express ISMs on its surface by protein transfer.
Collapse
|
460
|
Patel S, Rivera A, Patel J, Saeed O, Camacho-Rivera M, Maybaum S, Goldstein D. 74 Gastrointestinal Bleeding Is Not Associated with Pump Speed and Aortic Valve Opening in Patients Supported with the HeartMate II LVAD. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
461
|
Patel J, Kittleson M, Czer L, Rafiei M, Stern L, Patel D, Hage A, Esmailian F, Kobashigawa J. 46 The Policy of Placing Older Donors into Older Recipients: Is It Worth It? J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|
462
|
Kearney B, Chai W, Patel J, Kittleson M, Rafiei M, Stern L, Czer L, Kobashigawa J. 588 Does Level of Education Affect Outcome after Heart Transplantation. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|
463
|
Saeed O, Patel S, Ravishankar S, Patel J, Fida N, Edwards P, Pullman J, Goldstein D, Maybaum S. 584 Predictors of Recovery during Combined Pharmacological and Mechanical Unloading with the Heart Mate II Continuous Flow (CF) LVAD. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
464
|
Patel J, Kittleson M, Kansara P, Rafiei M, Stern L, Chang D, Azarbal B, Czer L, Esmailian F, Kobashigawa J. 340 Outcomes Validation of the New ISHLT Cardiac Allograft Vasculopathy Coronary Angiogram Grading Scale. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
465
|
Coleman B, Patel J, Czer L, Mirocha J, Kobashigawa J. 256 Use of Thymoglobulin after Heart Transplantation: Is There a Role in African American Patients? J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.263] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
466
|
Mortimer R, Landers K, Balakrishnan B, Li H, Mitchell M, Patel J, Richard K. Secretion and transfer of the thyroid hormone binding protein transthyretin by human placenta. Placenta 2012; 33:252-6. [DOI: 10.1016/j.placenta.2012.01.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Revised: 12/26/2011] [Accepted: 01/03/2012] [Indexed: 01/21/2023]
|
467
|
Czer L, Patel J, Kittleson M, Rafiei M, Stern L, Esmailian F, Kobashigawa J. 301 Infectious Complications of Desensitization Therapy: Is the Cure Worse Than the Disease? J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|
468
|
Moriguchi J, Patel J, Kittleson M, Rafiei M, Stern L, Chai W, Chang D, Trento A, Czer L, Kobashigawa J. 684 Risk for Deep Vein Thrombosis and Pulmonary Embolism after Heart Transplantation: Characterization of an Old Problem. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
469
|
Kansara P, Kransdorf E, Kittleson M, Patel J, Coleman B, Jamero G, Runyan C, Olay C, Jocson R, Czer L, Trento A, Kass R, Esmailian F, Kobashigawa J, Moriguchi J. 785 Improved Outcomes in “Crash and Burn” Patients through BiVAD Support. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.802] [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] Open
|
470
|
Stern L, Patel J, Kittleson M, Rafiei M, Dilibero D, Hage A, Czer L, Kobashigawa J. 586 Use of Generic Immunosuppression: Does It Truly Matter? J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.599] [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] Open
|
471
|
Patel J, Kittleson M, Rafiei M, Stern L, Chang D, Czer L, Trento A, Kobashigawa J. 457 Desensitization Therapy with Immunoglobulin (IVIG) and Rituximab for Patients Awaiting Heart Transplantation. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.468] [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] Open
|
472
|
Cao K, Lai CH, Flores S, Rafiei M, Mirocha J, Haas M, Ong G, Naim M, Wang Q, Constanza L, Patel J, Reinsmoen N, Kobashigawa J. 463 Anti -Angiotensin Type 1 Receptor (AT1R) Antibodies Together with Anti-HLA Donor Specific Antibodies (HLA-DSA) Identify Patients at Risk for Immune Complication in Heart Transplant. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|
473
|
Czer L, Patel J, Kittleson M, Rafiei M, Stern L, Chang D, Azarbal B, Trento A, Kobashigawa J. 341 Distal Pruning as an Important Factor for Outcome in the New ISHLT Cardiac Allograft Vasculopathy Grading Scale. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|
474
|
Moriguchi J, Patel J, Kittleson M, Rafiei M, Stern L, Czer L, Trento A, Kobashigawa J. 677 Older Patients with Hemodynamic Compromise Rejection: What Happened to Immunosenescence? J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|
475
|
Rafiei M, Patel J, Kittleson M, Patel N, Stern L, Azarbal B, Czer L, Trento A, Kobashigawa J. 479 First -Year Rejection and Cylex Scores Suggest the Importance of Acute Events in the Development of Cardiac Allograft Vasculopathy. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|