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Mohammad HR, A'Court J, Pillai A. Extruded talus treated with reimplantation and primary tibiotalocalcaneal arthrodesis. Ann R Coll Surg Engl 2017; 99:e115-e117. [PMID: 28349756 PMCID: PMC5449685 DOI: 10.1308/rcsann.2017.0042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2017] [Indexed: 11/22/2022] Open
Abstract
Extruded talus is a rare serious result from a high-energy injury to a supinated and plantar flexed foot. Treatment remains controversial with a lack of congruent evidence for talar reimplantation. A 34-year-old woman was involved in a road traffic accident at 40 mph. Imaging revealed a left talus extruded anterolaterally with a talar neck fracture. Additional injuries included right acetabular fracture, transverse process fractures and rib fractures, which were treated conservatively. The talus was reimplanted and the talar neck fixed with a cortical screw. A hindfoot nail was used to fuse the calcaneus, talus and tibia. Follow-up at two years showed solid tibiotalocalcaneal fusion, with no evidence of avascular development, and the patient was fully weight bearing without pain. We believe this is the first published case of successful primary tibiotalocalcaneal fusion for extruded talus injuries.
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Monteiro RS, Pillai A, Choi SW, Bogod D, Yentis SM. Flow characteristics of Luer and non-Luer spinal needles. Anaesthesia 2017; 72:749-754. [DOI: 10.1111/anae.13851] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2017] [Indexed: 11/28/2022]
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53
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McDevitt J, Acosta-Torres S, Zhang N, Hu T, Odu A, Wang J, Yin X, Lamus D, Miller D, Pillai A. Determination of optimal routine exchange frequency to minimize costs associated with long-term percutaneous nephrostomy (PCN) management for patients with malignant urinary obstruction. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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54
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Motara H, Olusoga T, Russell G, Jamieson S, Ahmed S, Brindle N, Pillai A, Scarsbrook A, Patel C, Chowdhury F. Clinical impact and diagnostic accuracy of 2-[18F]-fluoro-2-deoxy-d-glucose positron-emission tomography/computed tomography (PET/CT) brain imaging in patients with cognitive impairment: a tertiary centre experience in the UK. Clin Radiol 2017; 72:63-73. [DOI: 10.1016/j.crad.2016.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 08/04/2016] [Accepted: 08/11/2016] [Indexed: 01/06/2023]
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55
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George A, Philip A, Poorna D, Makunny D, Pillai A, M.r B, Pillai R, Jose W, Pavithran K. 145P Outcomes of treatment of glioblastoma multiforme: A single institution experience from South India. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw578.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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56
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George A, Philip A, Poorna D, Makunny D, Pillai A, Mr B, Pillai R, Jose W, Pavithran K. 145P Outcomes of treatment of glioblastoma multiforme: A single institution experience from South India. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00303-3] [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] Open
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57
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Pillai A. Apnoeic oxygenation in pregnancy - a reply. Anaesthesia 2016; 71:1491-1492. [PMID: 27870187 DOI: 10.1111/anae.13718] [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]
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58
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Ahmad K, Ballal M, Somasundaram K, Pillai A. Patient reported outcome and experience measures for hallux-rigidus. Cheilectomy vs. fusion. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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59
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Pillai A, Daga V, Lewis J, Mahmoud M, Mushambi M, Bogod D. High-flow humidified nasal oxygenation vs. standard face mask oxygenation. Anaesthesia 2016; 71:1280-1283. [DOI: 10.1111/anae.13607] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2016] [Indexed: 11/27/2022]
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60
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Pillai A, Lewis J, Mahmoud M, Daga V, Mushambi M, Bogod D. Abstract PR571. Anesth Analg 2016. [DOI: 10.1213/01.ane.0000492952.72689.d6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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61
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Pillai A, Monteiro R, Choi SW, Yentis S, Bogod D. Abstract PR507. Anesth Analg 2016. [DOI: 10.1213/01.ane.0000492891.69799.5c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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62
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Pillai A, Chikhani M, Hardman JG. Apnoeic oxygenation in pregnancy: a modelling investigation. Anaesthesia 2016; 71:1077-80. [PMID: 27440389 DOI: 10.1111/anae.13563] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2016] [Indexed: 11/29/2022]
Abstract
Recent studies have shown that nasal oxygen delivery can prolong the time to desaturation during apnoea in the non-pregnant population. We investigated the benefits of apnoeic oxygenation during rapid sequence induction in the obstetric population using computational modelling. We used the Nottingham Physiology Simulator, and pre-oxygenated seven models of pregnancy for 3 min using Fi O2 1.0, before inducing apnoea. We found that increasing Fi O2 at the open glottis increased the time to desaturation, extending the time taken for Sa O2 to reach 40% from 4.5 min to 58 min in the average parturient model (not in labour). Our study suggests that a small increase in time to desaturation could be achieved at Fi O2 0.4-0.6, which could be delivered by standard nasal cannulae. The greatest increases in time to desaturation were seen at Fi O2 1.0, which could be delivered by high-flow nasal cannulae under ideal conditions.
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63
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Alian A, McLennan G, Bennett S, Kapoor B, Gill A, Levitin A, Sands M, Obuchowski N, Aucejo F, Menon K, Estfan B, Pillai A, Kalva S. Yttrium-90 radioembolization versus doxorubicin-eluting beads chemoembolization in patients with infiltrative hepatocellular carcinoma: single center comparison of survival and toxicity. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.223] [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
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64
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Patel A, Chamarthy M, Pillai A, Sutphin P, Reddick M, Kalva S. Above and beyond TIPS: procedural challenges and alternative techniques. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.707] [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] Open
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65
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Khosla A, Ahn R, Toomay S, Pillai A, Trimmer C, Kalva S, Sutphin P, Menon K. Dialysis fistula repair reimbursement variations: are some people getting paid more than others? J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.427] [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] Open
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66
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Toliyat M, Singh K, Sibley R, Reis S, Kalva S, Pillai A. Growing role of interventional radiology in managing thoracic duct injuries: a pictorial essay depicting the latest developments and interventional approaches. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.615] [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
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67
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Hu T, Zhang N, Kovoor J, Sutphin P, Kalva S, Pillai A. Comparative evaluation of non-procedural nephrostomy tube related complications in patients with ureteric obstruction due to cancer versus other causes: is 3 month nephrostomy tube (PCN) exchanges optimal for both disease processes? J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.348] [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] Open
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68
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Pillai A, Andring B, Iyamu I. Conventional vs. intravascular ultrasound (IVUS) guided transjugular intrahepatic portosystemic shunt (TIPS) creation: a comparison of success, efficiency, complications, and radiation dose. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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69
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Redda YT, Venkatesh G, Kalaiyarasu S, Bhatia S, Kumar DS, Nagarajan S, Pillai A, Tripathi S, Kulkarni DD, Dubey SC. Expression and purification of recombinant H5HA1 protein of H5N1 avian influenza virus in E. coli and its application in indirect ELISA. J Immunoassay Immunochem 2016; 37:346-58. [PMID: 26829111 DOI: 10.1080/15321819.2015.1135160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The PCR amplified HA1 fragment of H5N1 (H5HA1) avian influenza virus (AIV) hemagglutinin gene was cloned into pET28a (+) expression vector and expressed in Rosetta Blue (DE3) pLysS cells. The recombinant H5HA1 (rH5HA1) protein purified by passive gel elution after SDS-PAGE of the inclusion bodies reacted specifically with H5N1 serum in Western blot analysis. A subtype specific indirect enzyme linked immunosorbent assay (iELISA) using the rH5HA1 protein as the coating antigen was developed for detecting antibodies to H5 subtype of AIV. The assay had 89.04% sensitivity and 95.95% specificity when compared with haemagglutination inhibition test. The Kappa value of 0.842 indicated a perfect agreement between the tests. The iELISA developed can be used for serosurveillance of avian influenza in chickens.
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70
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Sadighi Z, Sabin ND, Hayden R, Stewart E, Pillai A. Diagnostic Clues to Human Herpesvirus 6 Encephalitis and Wernicke Encephalopathy After Pediatric Hematopoietic Cell Transplantation. J Child Neurol 2015; 30:1307-14. [PMID: 25564483 PMCID: PMC4692275 DOI: 10.1177/0883073814560628] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 10/27/2014] [Indexed: 11/17/2022]
Abstract
Human herpesvirus 6 (HHV6) encephalitis and Wernicke encephalopathy are treatable yet frequently undiagnosed causes of encephalopathy in pediatric recipients of allogeneic and autologous hematopoietic cell transplantation. Here we review representative cases of both conditions to highlight specific and relevant neurologic features that prompted effective diagnosis and treatment. Two patients with confusion accompanied by seizures, memory changes, or specific visual hallucinations and HHV6 detectable by polymerase chain reaction (PCR) in cerebrospinal fluid had improvement in viral load with ganciclovir or foscarnet treatment. Two patients had confusion, ataxia, or ocular changes and low serum thiamine levels, which resolved with parenteral thiamine. In all cases, definitive diagnosis and treatment were facilitated by a high index of suspicion and search for specific pathognomonic neurologic deficits accompanying the confusional state. It is critical to clinically differentiate these 2 conditions from other common neurologic syndromes occurring after transplant, allowing potentially improved patient outcomes by prompt diagnosis and effective treatment.
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71
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72
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Huprikar S, Danziger-Isakov L, Ahn J, Naugler S, Blumberg E, Avery RK, Koval C, Lease ED, Pillai A, Doucette KE, Levitsky J, Morris MI, Lu K, McDermott JK, Mone T, Orlowski JP, Dadhania DM, Abbott K, Horslen S, Laskin BL, Mougdil A, Venkat VL, Korenblat K, Kumar V, Grossi P, Bloom RD, Brown K, Kotton CN, Kumar D. Solid organ transplantation from hepatitis B virus-positive donors: consensus guidelines for recipient management. Am J Transplant 2015; 15:1162-72. [PMID: 25707744 DOI: 10.1111/ajt.13187] [Citation(s) in RCA: 151] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 12/08/2014] [Accepted: 12/24/2014] [Indexed: 01/25/2023]
Abstract
Use of organs from donors testing positive for hepatitis B virus (HBV) may safely expand the donor pool. The American Society of Transplantation convened a multidisciplinary expert panel that reviewed the existing literature and developed consensus recommendations for recipient management following the use of organs from HBV positive donors. Transmission risk is highest with liver donors and significantly lower with non-liver (kidney and thoracic) donors. Antiviral prophylaxis significantly reduces the rate of transmission to liver recipients from isolated HBV core antibody positive (anti-HBc+) donors. Organs from anti-HBc+ donors should be considered for all adult transplant candidates after an individualized assessment of the risks and benefits and appropriate patient consent. Indefinite antiviral prophylaxis is recommended in liver recipients with no immunity or vaccine immunity but not in liver recipients with natural immunity. Antiviral prophylaxis may be considered for up to 1 year in susceptible non-liver recipients but is not recommended in immune non-liver recipients. Although no longer the treatment of choice in patients with chronic HBV, lamivudine remains the most cost-effective choice for prophylaxis in this setting. Hepatitis B immunoglobulin is not recommended.
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73
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Klein-Geltink RI, Alves de Araujo CA, Andrews KA, Shuyu E, Neale GA, Calabrese CA, Grosveld G, Pillai A. CD3/CD28 Co-Stimulated Activation of PI3K-mTORC2-AKT Metabolic Programming Augments Granzyme B Expression and Direct Cytotoxicity in Expanded Human iNKT Cells. Biol Blood Marrow Transplant 2015. [DOI: 10.1016/j.bbmt.2014.11.549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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74
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Seth A, Shuyu E, Abdelsamed H, Vogel P, Pillai A. Non-Myeloablative TLI/ATG + Alkylator Conditioning Augments Bidirectional Immune Tolerance Via Regulatory MDSC in a Robust Murine Model of MHC-Mismatched BMT for Beta-Thalassemia. Biol Blood Marrow Transplant 2015. [DOI: 10.1016/j.bbmt.2014.11.550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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75
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Martin J, Howard SC, Pillai A, Vogel P, Naren AP, Davis S, Ringwald-Smith K, Buddington K, Buddington RK. The weaned pig as a model for Doxorubicin-induced mucositis. Chemotherapy 2014; 60:24-36. [PMID: 25341697 DOI: 10.1159/000365725] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 07/03/2014] [Indexed: 01/23/2023]
Abstract
BACKGROUND Chemotherapy-induced mucositis (CIM) complicates cancer therapy and limits maximum tolerated doses and efficacy. Rodent models do not reproducibly mimic clinical CIM, so alternative models are needed. METHODS CIM severity was assessed after weaned pigs were treated with doxorubicin (5 and 3.75 mg/kg) using clinical observations, laboratory parameters and gastrointestinal structure and functions. Bovine colostrum was provided as an experimental intervention to the pigs treated receiving the 3.75 mg/kg dose. RESULTS Doxorubin at 3.75 mg/kg decreased food intake and weight gain (p < 0.05) and caused diarrhea and vomiting that coincided with damage to the small intestine mucosa based on histological scoring (p < 0.05). It resulted in higher serum TNF-α concentrations, increased chloride secretion and reduced brush border membrane disaccharidase activities and carrier-mediated glucose uptake (all p < 0.05). The gastrointestinal damage and dysfunction resemble the clinical and laboratory features of CIM in humans; these can be partially prevented by providing cow colostrum. CONCLUSION The weaned pig is a relevant large animal for studying CIM and evaluating existing and experimental interventions for mucositis.
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