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Belaloui K, Malifarge E, Bohm J, Bossard C, Dienstmann R, Garcia S, Geppert C, Gogenur I, Hartmann A, Hatzibougias D, Landolfi S, Mishaeli M, Paez D, Patel P, Rodriguez-Justo M, Szafranska J, van den Eynde M, Zavadova E, Turcan S, Hermitte F. Immunoscore feasibility study in routine postsurgical pathologic review for early-stage colon cancer (CC) cases risk-assessment. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy431.031] [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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152
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De Mattos-Arruda L, Weigelt B, Cortes J, Won HH, Ng CKY, Nuciforo P, Bidard FC, Aura C, Saura C, Peg V, Piscuoglio S, Oliveira M, Smolders Y, Patel P, Norton L, Tabernero J, Berger MF, Seoane J, Reis-Filho JS. Capturing intra-tumor genetic heterogeneity by de novo mutation profiling of circulating cell-free tumor DNA: a proof-of-principle. Ann Oncol 2018; 29:2268. [PMID: 29718117 DOI: 10.1093/annonc/mdx804] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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153
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Liauw S, Kauffmann G, Patel P, Oto A. Largest Axial Dimension of Tumor on T2W Endorectal MRI is Associated with Biochemical Outcome in Men Treated with External Beam Radiation Therapy for Prostate Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.336] [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]
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154
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Paudyal P, Patel P, Gilchrist K. Health and wellbeing of young migrants: an analysis of school survey data in South East England. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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155
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Viana JD, Ferreira SC, Matana SR, Rossi F, Patel P, Garson JA, Rocha V, Tedder R, Mendrone-Júnior A, Levi JE. Detection of bacterial contamination in platelet concentrates from Brazilian donors by molecular amplification of the ribosomal 16S gene. Transfus Med 2018; 28:420-426. [PMID: 30304760 DOI: 10.1111/tme.12561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 08/09/2018] [Accepted: 09/12/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of our work was to establish a semi-automated high-throughput DNA amplification method for the universal screening of bacteria in platelet concentrates (PCs). BACKGROUND Among cases of transfusion transmission of infectious agents, bacterial contamination ranks first in the number of events, morbidity and mortality. Transmission occurs mainly by transfused PCs. Automated culture is adopted by some blood banks for screening of bacterial contamination, but this procedure is expensive and has a relatively long turnaround time. METHODS PCs were spiked with suspensions of five different bacterial species in a final concentration of 1 and 10 colony-forming units (CFU) per millilitre. After incubation, the presence of bacteria was investigated by real-time polymerase chain reaction (PCR) and by the Enhanced Bacterial Detection System (eBDS, Pall) assay as a reference method. Real-time PCR amplification was performed with a set of universal primers and probes targeting the 16S rRNA gene. Co-amplification of human mitochondrial DNA served as an internal control. RESULTS Using the real-time PCR method, it was possible to detect the presence of all bacterial species tested with an initial concentration of 10 CFU mL-1 24 h after contamination, except for Staphylococcus hominis. The PCR assay also detected, at 24 h, the presence of Serratia marcescens and Enterobacter cloacae with an initial concentration of 1 CFU mL-1 . CONCLUSIONS The real-time PCR assay may be a reliable alternative to conventional culture methods in the screening of bacterial contamination of PCs, enabling bacterial detection even with a low initial concentration of microorganisms.
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Bauml J, Mick R, Ciunci C, Aggarwal C, Davis C, Evans T, Deshpande C, Miller L, Patel P, Alley E, Knepley C, Mutale F, Cohen R, Langer C. OA07.01 Phase II Study of Pembrolizumab for Oligometastatic Non-Small Cell Lung Cancer (NSCLC) Following Completion of Locally Ablative Therapy (LAT). J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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157
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Tian S, Schreibmann E, Goyal S, Rupji M, Cassidy R, Escott C, Ferris M, Patel P, Curran W, Higgins K. P2.03-07 Radiomic Signatures Linked to Genetic Alterations as Detected by Next-Generation Sequencing: A Radiogenomics Analysis of Early-Stage NSCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1194] [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]
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158
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Fragkos K, Murray K, Obbard S, Shepherd T, Barragry J, Nwaogu A, Rogers J, Ajibodu S, Keane N, Patel P, MacRae M, Mehta S, Di Caro S, Rahman F. Risk factors for catheter related bloodstream infections in patients on home parenteral nutrition: An audit from a tertiary center in 2017. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.2041] [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]
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159
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Patel P, Golla K, Naik UP. PDK1 governs thromboxane generation and thrombosis in platelets by regulating activation of Raf1 in the MAPK pathway: comment. J Thromb Haemost 2018; 16:1901-1904. [PMID: 29983001 PMCID: PMC6159878 DOI: 10.1111/jth.14232] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Indexed: 01/31/2023]
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Adams L, Rice T, Harris A, Patel P. A - 24Neuropsychological Assessment of Dementia in Individuals with an Intellectual Disability. Arch Clin Neuropsychol 2018. [DOI: 10.1093/arclin/acy061.24] [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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161
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Gupta P, Mohamed A, Patel P, Burns A, Saeed M, Lane D, Seidu S, Khunti K. High rates of non-adherence to antidiabetic, antihypertensive and lipid lowering treatment in patients with type 2 diabetes revealed liquid chromatography-tandem mass spectrometry (lc-ms/ms) urine analysis. ATHEROSCLEROSIS SUPP 2018. [DOI: 10.1016/j.atherosclerosissup.2018.07.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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162
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Agnihotri K, Charilaou P, Patel P, Baser K, Baser HD, Patel N, Paydak H, Mehta JL. P6654Trends and predictors of cardiac implantable electronic device implantation after cardiac surgery - results from the largest inpatient sample. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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163
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Patel P, Kannangara D, Sindhu S, Toshniwal R, Amit P, Samia H, Kozinn W. A Case Series of Unusual Presentations Associated with Arthropod Bites: Cutaneous, Cardiac, Articular and other manifestations. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.4302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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164
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Patel P, Agnihotri K, Baser K, Patel H, Kaneria A, Baser HD, Patel N, Paydak H, Mehta JL. P969Impact of atrial fibrillation on patients admitted with hip fracture undergoing surgery: outcomes in the US (2005-2014). Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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165
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Mohamed AA, Gupta P, Patel P, Burns A, Saeed M, Lane D, Seidu S, Khunti K. P6187High rates of non-adherence to antidiabetic, antihypertensive and lipid lowering treatment in patients with Type 2 diabetes revealed by liquid chromatography-tandem mass spectrometry urine analysis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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166
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Le Pape S, Berzak Hopkins LF, Divol L, Pak A, Dewald EL, Bhandarkar S, Bennedetti LR, Bunn T, Biener J, Crippen J, Casey D, Edgell D, Fittinghoff DN, Gatu-Johnson M, Goyon C, Haan S, Hatarik R, Havre M, Ho DDM, Izumi N, Jaquez J, Khan SF, Kyrala GA, Ma T, Mackinnon AJ, MacPhee AG, MacGowan BJ, Meezan NB, Milovich J, Millot M, Michel P, Nagel SR, Nikroo A, Patel P, Ralph J, Ross JS, Rice NG, Strozzi D, Stadermann M, Volegov P, Yeamans C, Weber C, Wild C, Callahan D, Hurricane OA. Fusion Energy Output Greater than the Kinetic Energy of an Imploding Shell at the National Ignition Facility. PHYSICAL REVIEW LETTERS 2018; 120:245003. [PMID: 29956968 DOI: 10.1103/physrevlett.120.245003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 05/04/2018] [Indexed: 06/08/2023]
Abstract
A series of cryogenic, layered deuterium-tritium (DT) implosions have produced, for the first time, fusion energy output twice the peak kinetic energy of the imploding shell. These experiments at the National Ignition Facility utilized high density carbon ablators with a three-shock laser pulse (1.5 MJ in 7.5 ns) to irradiate low gas-filled (0.3 mg/cc of helium) bare depleted uranium hohlraums, resulting in a peak hohlraum radiative temperature ∼290 eV. The imploding shell, composed of the nonablated high density carbon and the DT cryogenic layer, is, thus, driven to velocity on the order of 380 km/s resulting in a peak kinetic energy of ∼21 kJ, which once stagnated produced a total DT neutron yield of 1.9×10^{16} (shot N170827) corresponding to an output fusion energy of 54 kJ. Time dependent low mode asymmetries that limited further progress of implosions have now been controlled, leading to an increased compression of the hot spot. It resulted in hot spot areal density (ρr∼0.3 g/cm^{2}) and stagnation pressure (∼360 Gbar) never before achieved in a laboratory experiment.
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Stolnicu S, Barsan I, Hoang L, Patel P, Terinte C, Pesci A, Aviel-Ronen S, Kiyokawa T, Alvarado-Cabrero I, Oliva E, Park KJ, Abu-Rustum NR, Pike MC, Soslow RA. Stromal invasion pattern identifies patients at lowest risk of lymph node metastasis in HPV-associated endocervical adenocarcinomas, but is irrelevant in adenocarcinomas unassociated with HPV. Gynecol Oncol 2018; 150:56-60. [PMID: 29859673 DOI: 10.1016/j.ygyno.2018.04.570] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 04/24/2018] [Accepted: 04/28/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The Silva invasion pattern-based classification system stratifies endocervical adenocarcinomas (ECAs) into 3 categories corresponding to risk of metastasis and recurrence, but has only been evaluated for HPV-associated ECAs of usual type. We examined whether the Silva system is applicable to all endocervical adenocarcinomas, especially those not associated with HPV. METHODS Complete slide sets from 341 surgical specimens of ECA were collected from 7 institutions worldwide. All specimens were associated with clinical records covering at least 5 years of follow-up. Tumors were classified as HPV-associated (HPVA) or not (NHPVA) by both morphology and detection of HPV using in situ hybridization. Recurrence and survival were analyzed by multivariate Mantel-Haenszel methods. RESULTS Most specimens (292; 85.6%) were HPVA, while 49 (14.3%) were NHPVA. All NHPVAs were Silva pattern C, while 76.0% of HPVAs were pattern C, 14.7% pattern A, and 9.3% pattern B. Including both HPVAs and NHPVAs, lymphovascular invasion (LVI) was detected in 0% of pattern A, 18.5% of pattern B and 62.6% of pattern C cases (p < 0.001). None of the pattern A or B cases were associated with lymph node metastases (LNM), in contrast to pattern C cases (21.8%). Among patients with Silva pattern C ECA, those with HPVA tumors had a lower recurrence rate and better survival than those with NHPVA; however, when adjusted for stage at diagnosis, the difference in recurrence and mortality was small and not statistically significant. CONCLUSIONS Application of the Silva system is only relevant in HPVA cervical adenocarcinoma.
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Rathore K, Joseph B, Sharma DK, Gaurav A, Sharma SK, Milind M, Patel P, Prakash C, Singh L. Evaluation of multiplex polymerase chain reaction as an alternative to conventional antibiotic sensitivity test. Vet World 2018; 11:474-479. [PMID: 29805213 PMCID: PMC5960787 DOI: 10.14202/vetworld.2018.474-479] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 03/12/2018] [Indexed: 11/16/2022] Open
Abstract
Aim This study was designed to evaluate the potential of the use of multiplex polymerase chain reaction (PCR) as an alternative to conventional antibiotic sensitivity test. Materials and Methods Isolates of Staphylococcus aureus (total = 36) from clinical cases presented to Teaching Veterinary Clinical Complex of College of Veterinary and Animal Sciences (CVAS), Navania, Udaipur, were characterized by morphological, cultural, and biochemical methods. Then, the isolates were further subjected to molecular characterization by PCR targeting S. aureus-specific sequence (107 bp). Phenotypic antibiotic sensitivity pattern was analyzed by Kirby-Bauer disc diffusion method against 11 commonly used antibiotics in veterinary medicine in and around Udaipur region. The genotypic antibiotic sensitivity pattern was studied against methicillin, aminoglycosides, and tetracycline targeting the gene mecA, aacA-aphD, and tetK by multiplex PCR. Results There was 100% correlation between the phenotype and genotype of aminoglycoside resistance, more than 90% correlation for methicillin resistance, and 58.3% in the case tetracycline resistance. Conclusion As there is a good correlation between phenotype and genotype of antibiotic resistance, multiplex PCR can be used as an alternative to the conventional antibiotic susceptibility testing, as it can give a rapid and true prediction of antibiotic sensitivity pattern.
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Perez-Protto S, Nazemian R, Matta M, Patel P, Wagner KJ, Latifi SQ, Lebovitz DJ, Reynolds JD. The effect of inhalational anaesthesia during deceased donor organ procurement on post-transplantation graft survival. Anaesth Intensive Care 2018. [PMID: 29519220 DOI: 10.1177/0310057x1804600206] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Many deceased by neurologic criteria donors are administered inhalational agents during organ recovery surgery-a process that is characterised by warm and cold ischaemia followed by warm reperfusion. In certain settings, volatile anaesthetics (VA) are known to precondition organs to protect them from subsequent ischaemia-reperfusion injury. As such, we hypothesised that exposure to VA during organ procurement would improve post-graft survival. Lifebanc (organ procurement organisation [OPO] for NE Ohio) provided the investigators with a list of death by neurologic criteria organ donors cared for at three large tertiary hospitals in Cleveland between 2006 and 2016-details about the surgical recovery phase were extracted from the organ donors' medical records. De-identified data on graft survival were obtained from the United Network for Organ Sharing (UNOS). The collated data underwent comparative analysis based on whether or not VA were administered during procurement surgery. Records from 213 donors were obtained for analysis with 138 exposed and 75 not exposed. Demographics, medical histories, and organ procurement rates were similar between the two cohorts. For the primary endpoint, there were no significant differences observed in either early (30-day) or late (five-year) graft survival rates for kidney, liver, lung, or heart transplants. Our findings from this retrospective review of a relatively small cohort do not support the hypothesis that the use of VA during the surgical procurement phase improves graft survival. Reviews of larger datasets and/or a prospective study may be required to provide a definitive answer.
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170
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Altman A, Wallace A, Jiang T, Okafor E, Lionberg A, Oladini F, Baron A, Matsumoto M, Sharma M, Patel P, Funaki B, Chang P. 3:54 PM Abstract No. 147 Prebiopsy labs for patients without conditions predisposing to coagulopathy: are they really necessary? J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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171
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Shore S, Soni M, Hilbman A, Patel P, Mazurek J, Justice C, Fox A, Tanna M, Molina M, Wald J, Atluri P, Bermudez C, Goldberg L, Rame J, Birati E. Pump Exchange after Left Ventricular Assist Device Implantation: Indications and Outcomes. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Shore S, Soni M, Hilbman A, Patel P, Mazurek J, Justice C, Guarracino D, Molina M, Wald J, Atluri P, Bermudez C, Fox A, Tanna M, Goldberg L, Rame J, Birati E. Predictors for Left Ventricular Assist Device Thrombosis. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Patel P, Kulkarni S, Shetty N, Polnaya A, Gala K, Chivate R. 3:45 PM Abstract No. 257 Role of radiofrequency ablation as a salvage treatment for recurrent fibromatosis: retrospective analysis. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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174
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Welch K, Aguilar J, Marie JS, Scheuerlein K, Patel P, Hieb R, Tutton S, Rilling W, White S, Hohenwalter E. Abstract No. 709 Quality improvement in interventional radiology: techniques to improve patient satisfaction. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.754] [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
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175
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Nazeri A, Patel P, Azka A, Ting K, Lee V, Kampangkaew J, Yin E, Stainback R. P382Prevalence of left atrial appendage thrombus in patients with atrial fibrillation/flutter: warfarin therapy versus direct oral anticoagulants. Europace 2018. [DOI: 10.1093/europace/euy015.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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176
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Haan SW, Clark DS, Weber CR, Baxamusa SH, Biener J, Berzak Hopkins L, Bunn T, Callahan DA, Carlson L, Edwards MJ, Hammel BA, Hamza A, Hinkel DE, Ho DD, Hsing W, Huang H, Hurricane OA, Johnson MA, Jones OS, Kritcher AL, Landen OL, Lindl JD, Marinak MM, MacKinnon AJ, Meezan NB, Milovich J, Nikroo A, Peterson JL, Patel P, Robey HF, Smalyuk VA, Spears BK, Stadermann M, Kline JL, Wilson DC, Simakov AN, Yi A. Update 2017 on Target Fabrication Requirements for High-Performance NIF Implosion Experiments. FUSION SCIENCE AND TECHNOLOGY 2018. [DOI: 10.1080/15361055.2017.1387014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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177
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Ali SM, Chen D, Ali A, Krecko L, Leitzel K, Vasekar M, Nagabhairu V, Marks E, Polimera H, Richardson A, May M, He W, Patel P, Lavin M, Hofsess S, Sweetman R, Hortobagyi G, Baselga J, Lipton A. Abstract P1-07-09: Serum activin A and outcomes in HR+ /HER2- metastatic breast cancer patients treated with everolimus: Results from BOLERO-2. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-07-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Everolimus (EVE) plus exemestane (EXE) doubled progression-free survival (PFS) while maintaining quality of life versus EXE alone in postmenopausal women with hormone receptor positive (HR+), HER2-negative metastatic breast cancer (mBC) (BOLERO-2 phase 3; NCT00863655). Pretreatment serum activin A was previously reported as a prognostic factor in first-line hormone therapy (letrozole vs tamoxifen) (Novartis P025) and anti-HER2 mBC (lapatinib vs trastzmab) (CCTG MA.31) trials. Here we investigate the prognostic and predictive ability of activin A in BOLERO-2.
Methods: Activin A levels were determined on pretreatment serum samples using ELISA. Cox-proportional hazards model was used to assess the efficacy of EVE in the activin A low and high subgroups (median cut-point), and the prognostic effect of activin A on PFS and overall survival (OS).
Results: Baseline activin A levels were determined in 513 patients (71% of 725 BOLERO-2 patients randomized 2:1 to EVE+EXE or EXE). Predictive and prognostic signals are shown in the table below
Predictive and prognostic signalsPredictive/PrognosticEnd-pointAct-ivin ATreatmentNEventsMedian PFSHR (95% CI); p valuepredictivePFSHEXE93832.5 (1.5-2.8)-predictivePFSHEVE+EXE1631325.4 (4.1-6.8)0.46 (0.34 - 0.60); <0.0001predictivePFSLEXE89774.2 (2.0 -5.4)-predictivePFSLEVE+EXE1681059.9 (8.1-12.5)0.38 (0.28 - 0.51); <0.0001predictiveOSHEXE936820.1 (13.8-22.6)-predictiveOSHEVE+EXE16312917.7 (15.7-22.3)1.04 (0.78 - 1.40); 0.78predictiveOSLEXE8939NA (34.7-NA)-predictiveOSLEVE+EXE1687241.4 (36.4-NA)1.02 (0.69 - 1.50); 0.93prognosticPFSH 2562154.1 (2.9-4.2)-prognosticPFSL 2571826.9 (6.7-8.5)0.54 (0.45 - 0.66); <0.0001prognosticOSH 25619718.0 (16.5-21.1)-prognosticOSL 25711142.3 (38.5-NA)0.34 (0.27 - 0.42); <0.0001
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In multivariate analysis (including sensitivity to prior hormone therapy and visceral disease), activin A remained a significant independent prognostic factor for PFS and OS [HR 0.57 (0.46-0.69) and 0.34 (0.27-0.43), respectively].
Conclusions: Higher serum activin A was strongly associated with shorter PFS and OS in HR+/HER2- mBC patients. Everolimus was efficacious regardless of serum activin A level. These results are similar to our previous studies in phase 3 trials of letrozole-tamoxifen (Novartis P025), and HER2-targeted therapy, lapatinib vs trastuzmab (CCTG MA.31): pretreatment serum activin A was prognostic for outcome, but was not a predictive factor for treatment arm selection.
Citation Format: Ali SM, Chen D, Ali A, Krecko L, Leitzel K, Vasekar M, Nagabhairu V, Marks E, Polimera H, Richardson A, May M, He W, Patel P, Lavin M, Hofsess S, Sweetman R, Hortobagyi G, Baselga J, Lipton A. Serum activin A and outcomes in HR+ /HER2- metastatic breast cancer patients treated with everolimus: Results from BOLERO-2 [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-07-09.
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Reynolds CA, Davison KL, Andrews N, Patel P, Kitchen A, Brailsford SR. Dissecting the decline of hepatitis C in first-time donors in England and Wales. Vox Sang 2018; 113:329-338. [PMID: 29441589 DOI: 10.1111/vox.12638] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 12/14/2017] [Accepted: 01/14/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND OBJECTIVES The rate of confirmed hepatitis C virus (HCV) cases, in first-time donors, is much lower in 2015 than 20 years ago. We investigate reasons for the decline. MATERIALS AND METHODS HCV rates were analysed by gender and birth cohort for 1996 to 2015 and ethnic group for 2006 to 2015. Variables for confirmed positive cases were compared for two ten-year periods (1996 to 2005 and 2006 to 2015) including genotyping data for 2006 to 2015. RESULTS There were 2007 confirmed HCV cases identified between 1996 and 2015. The rate per 100 000 donations fell from 78·6 in 1996 to 26·9 by 2015. By birth cohort, HCV rates were highest in donors born in the 1950s and 1960s who contributed a decreasing proportion of first-time donors. Between 2006 and 2015, there was no significant decline in HCV rate. The HCV-positive donor profile has changed in the last 10 years with increased proportions of younger donors, donors born abroad and decreased reported injecting drug use. Genotype 1a remains predominate, but genotype 1b has increased associated with this change in birth cohort and ethnicity. CONCLUSION The decline in number and rate of confirmed HCV-positive first-time donors is mainly due to a decrease in first-time donors born before 1970, with the highest rate of HCV. However, the decline has slowed and the profile of HCV-positive first-time donors is changing. A better understanding of behaviour and sources of HCV in younger and ethnic minority donors are needed.
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Bernard R, Bowsher G, Milner C, Boyle P, Patel P, Sullivan R. Intelligence and global health: assessing the role of open source and social media intelligence analysis in infectious disease outbreaks. JOURNAL OF PUBLIC HEALTH-HEIDELBERG 2018; 26:509-514. [PMID: 30294522 PMCID: PMC6153980 DOI: 10.1007/s10389-018-0899-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 01/18/2018] [Indexed: 11/28/2022]
Abstract
Purpose Open Source Intelligence (OSINT) and Signals Intelligence (SIGINT) from the clandestine intelligence sector are being increasingly employed in infectious disease outbreaks. The purpose of this article is to explore how such tools might be employed in the detection, reporting, and control of outbreaks designated as a 'threat' by the global community. It is also intended to analyse previous use of such tools during the Ebola and SARS epidemics and to discuss key questions regarding the ethics and legality of initiatives that further blur the military and humanitarian spaces. Methods We undertake qualitative analysis of current discussions on OSINT and SIGINT and their intersection with global health. We also review current literature and describe the debates. We built on quantitative and qualitative research done into current health collection capabilities. Results This article presents an argument for the use of OSINT in the detection of infectious disease outbreaks and how this might occur. Conclusion We conclude that there is a place for OSINT and SIGINT in the detection and reporting of outbreaks. However, such tools are not sufficient on their own and must be corroborated for the intelligence to be relevant and actionable. Finally, we conclude that further discussion on key ethical issues needs to take place before such research can continue. In particular, this involves questions of jurisdiction, data ownership, and ethical considerations.
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Gonzalez N, Patel P, Han G. A dissimilar biosimilar? Lichenoid drug eruption induced by an infliximab biosimilar. Br J Dermatol 2018; 178:965-968. [DOI: 10.1111/bjd.15686] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2017] [Indexed: 11/27/2022]
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Knox JJ, Barrios CH, Kim TM, Cosgriff T, Srimuninnimit V, Pittman K, Sabbatini R, Rha SY, Flaig TW, Page RD, Beck JT, Cheung F, Yadav S, Patel P, Geoffrois L, Niolat J, Berkowitz N, Marker M, Chen D, Motzer RJ. Final overall survival analysis for the phase II RECORD-3 study of first-line everolimus followed by sunitinib versus first-line sunitinib followed by everolimus in metastatic RCC. Ann Oncol 2018; 28:1339-1345. [PMID: 28327953 PMCID: PMC5452072 DOI: 10.1093/annonc/mdx075] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background RECORD-3 compared everolimus and sunitinib as first-line therapy, and the sequence of everolimus followed by sunitinib at progression compared with the opposite (standard) sequence in patients with metastatic renal cell carcinoma (mRCC). This final overall survival (OS) analysis evaluated mature data for secondary end points. Patients and methods Patients received either first-line everolimus followed by second-line sunitinib at progression (n = 238) or first-line sunitinib followed by second-line everolimus (n = 233). Secondary end points were combined first- and second-line progression-free survival (PFS), OS, and safety. The impacts of neutrophil lymphocyte ratio (NLR) and baseline levels of soluble biomarkers on OS were explored. Results At final analysis, median duration of exposure was 5.6 months for everolimus and 8.3 months for sunitinib. Median combined PFS was 21.7 months [95% confidence interval (CI) 15.1–26.7] with everolimus-sunitinib and 22.2 months (95% CI 16.0–29.8) with sunitinib-everolimus [hazard ratio (HR)EVE-SUN/SUN-EVE, 1.2; 95% CI 0.9–1.6]. Median OS was 22.4 months (95% CI 18.6–33.3) for everolimus-sunitinib and 29.5 months (95% CI 22.8–33.1) for sunitinib-everolimus (HREVE-SUN/SUN-EVE, 1.1; 95% CI 0.9–1.4). The rates of grade 3 and 4 adverse events suspected to be related to second-line therapy were 47% with everolimus and 57% with sunitinib. Higher NLR and 12 soluble biomarker levels were identified as prognostic markers for poor OS with the association being largely independent of treatment sequences. Conclusions Results of this final OS analysis support the sequence of sunitinib followed by everolimus at progression in patients with mRCC. The safety profiles of everolimus and sunitinib were consistent with those previously reported, and there were no unexpected safety signals. Clinical Trials number ClinicalTrials.gov identifier, NCT00903175
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Abstract
Some of the highest rates of erectile dysfunction are seen in patients with renal failure, especially those on dialysis. The treatment of erectile dysfunction has been revolutionized in the last decade by the introduction of sildenafil. The literature on sildenafil in dialysis patients is here reviewed. Sildenafil seems to be both safe and effective in the treatment of sexual dysfunction in the dialysis population.
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Sinharay R, Mithra S, Patel P, Ah-Moye A, Morrow S, Khiroya R, Falzon M, Borg E, Ahmed T, Forster M, Navani N. EGFR mutation specific immunohistochemistry revolutionises time to treatment with tyrosine kinase inhibitors (TKIs). Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30085-0] [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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184
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Patel P, King N. Examining trainee awareness of dermatoses and dermatological assessments during acute admissions (A quality improvement project). Acute Med 2018; 17:137-143. [PMID: 30129946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Studies demonstrate 67% of elderly patients can have dermatoses, which could result in functional and psychological consequences. Elderly presentations are further complicated by comorbidities and polypharmacy. This combined with limited dermatology training at undergraduate and postgraduate levels creates diagnostic challenges. This project investigated dermatology assessments by trainees using the Trust's acute medical admissions proforma. 100 proforma were reviewed for skin assessments alongside nursing skin care bundles. Subsequently, a skin survey was conducted amongst trainees evaluating knowledge and confidence when diagnosing and managing common dermatoses. Successively, a dermatology teaching series was delivered. Post-intervention the above were reassessed, demonstrating improvements in most areas. The dermatology teaching series will continue alongside a Trust hospital guideline to sustain improvements in dermatological care on admission.
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Patel P, Ahmad S, Smith D. Comparison of SABR for lung cancer with or without histological diagnosis. Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30167-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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186
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Duane BG, Freeman R, Richards D, Crosbie S, Patel P, White S, Humphris G. Using the simplified case mix tool (sCMT) to identify cost in special care dental services to support commissioning. COMMUNITY DENTAL HEALTH 2017; 34:56-59. [PMID: 28561560 DOI: 10.1922/cdh_4012duane04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 08/11/2016] [Indexed: 11/11/2022]
Abstract
To commission dental services for vulnerable (special care) patient groups effectively, consistently and fairly an evidence base is needed of the costs involved. The simplified Case Mixed Tool (sCMT) can assess treatment mode complexity for these patient groups. OBJECTIVE To determine if the sCMT can be used to identify costs of service provision. CLINICAL SETTING Patients (n=495) attending the Sussex Community NHS Trust Special Care Dental Service for care were assessed using the sCMT. MAIN MEASURES sCMT score and costs (staffing, laboratory fees, etc.) besides patient age, whether a new patient and use of general anaesthetic/intravenous sedation. METHOD Statistical analysis (adjusted linear regression modelling) compared sCMT score and costs then sensitivity analyses of the costings to age, being a new patient and sedation use were undertaken. Regression tables were produced to present estimates of service costs. RESULTS Costs increased with sCMT total scale and single item values in a predictable manner in all analyses except for 'cooperation'. Costs increased with the use of IV sedation; with each rising level of the sCMT, and with complexity in every sCMT category, except cooperation. CONCLUSION Costs increased with increase in complexity of treatment mode as measured by sCMT scores. Measures such as the sCMT can provide predictions of the resource allocations required when commissioning special care dental services.
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Patel P, Baier J, Baranov E, Khurana E, Gambrah-Sampaney C, Johnson A, Monokwane B, Bearden DR. Health beliefs regarding pediatric cerebral palsy among caregivers in Botswana: A qualitative study. Child Care Health Dev 2017; 43:861-868. [PMID: 28744889 DOI: 10.1111/cch.12490] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 06/19/2017] [Accepted: 06/22/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cerebral palsy (CP) is the most common motor disability worldwide with an incidence of 2.5 per 1,000 births globally. Health beliefs among caregivers may be major drivers of health-related behaviours and service utilization, but little is known regarding health beliefs around CP in Africa. METHODS Between July 2013 and September 2015, children with CP were identified in Gaborone, Botswana, and their caregivers were invited to participate in a qualitative study utilizing semistructured in-person one-on-one interviews. Interview questions addressed their understanding of CP, challenges of caring for a handicapped child, and community response to children with CP. RESULTS Sixty-two caregivers participated in the study. Common themes elicited were variable knowledge about CP, financial and physical burden, lack of therapies and educational resources, and the impact of stigma. Caregivers in Botswana generally subscribed to a biomedical explanation of CP but expressed concerns regarding more stigmatizing folks beliefs expressed in the community. CONCLUSION Health beliefs regarding CP in Botswana likely have a significant impact on utilization of healthcare resources. Information from this study should inform future educational interventions for caregivers of children with CP.
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Higgins K, Pillai R, Chen Z, Zhang C, Patel P, Pakkala S, Shelton J, Force S, Fernandez F, Steuer C, Owonikoko T, Ramalingam S, Bradley J, Curran W. P1.08-003 Concomitant Chemotherapy and Radiotherapy with SBRT Boost for Unresectable, Stage III Non-Small Cell Lung Cancer: A Phase I Study. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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189
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Selinger CP, Parkes GC, Bassi A, Fogden E, Hayee B, Limdi JK, Ludlow H, McLaughlin S, Patel P, Smith M, Raine T. A multi-centre audit of excess steroid use in 1176 patients with inflammatory bowel disease. Aliment Pharmacol Ther 2017; 46:964-973. [PMID: 28949018 DOI: 10.1111/apt.14334] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 06/01/2017] [Accepted: 08/31/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Corticosteroids are central to inducing remission in inflammatory bowel disease (IBD) but are ineffective maintenance agents. AIM To benchmark steroid usage in British outpatients and assess factors associated with excess exposure. METHODS We recorded steroid use in unselected IBD outpatients. Cases meeting criteria for steroid dependency or excess were blind peer reviewed to determine whether steroid prescriptions were avoidable. Associations between steroid use and patient/institutional factors were analysed. RESULTS Of 1176 patients, 30% received steroids in the prior 12 months. 14.9% had steroid dependency or excess, which was more common in moderate/severe ulcerative colitis (UC) than Crohn's disease (CD) (42.6% vs 28.1%; P = .027). Steroid dependency or excess was deemed avoidable in 49.1%. The annual incidence of inappropriate steroid excess was 7.1%. Mixed-effects logistic regression analysis revealed independent predictors of inappropriate steroid excess. The odds ratio (OR, 95%CI) for moderate/severe compared to mild/quiescent disease activity was 4.59 (1.53-20.64) for UC and 4.60 (2.21-12.00) for CD. In CD, lower rates of inappropriate steroid excess were found in centres with an IBD multi-disciplinary team (OR 0.62 [0.46-0.91]), whilst dedicated IBD clinics protected against inappropriate steroid excess in UC (OR 0.64, 95% CI 0.21-0.94). The total number of GI trainees was associated with rates of inappropriate steroid excess. CONCLUSIONS Steroid dependency or excess occurred in 14.9% of British IBD patients (in 7.1% potentially avoidable). We demonstrated positive effects of service configurations (IBD multi-disciplinary team, dedicated IBD clinics). Routine recording of steroid dependency or excess is feasible and should be considered a quality metric.
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Boch K, Kasmire K, Waynik I, Hoppa E, Patel P. 248 A Clinical Pathway for the Management of Febrile Infants Ages 29-60 Days Improves Antimicrobial Stewardship. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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191
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Bhave S, Koshy M, Akthar A, Sengul A, Weichselbaum R, Patel P, Rondelli D, Aydogan B. Long-Term Toxicities Using Intensity Modulated Total Marrow Irradiation as a Conditioning Regimen for Advanced Hematologic Malignancies. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1624] [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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Trivedi L, Tumati V, Li J, Patel P, Vusirikala M, Sadeghi N, Rizvi S, Chen W, Wachsmann J, Scaglioni P, Collins R, Desai N. Patterns of Failure Analysis of Patients With Double Hit or Double Expressor Lymphomas: Implications for Radiation Therapy. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.449] [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]
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193
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Pantoja F, Patel P, Keane N, Fragkos K, Samaan M, Barnova I, Di Caro S, Mehta S, Rahman F. PT10.2: Re-Feeding Syndrome in Adults Receiving Total Parenteral Nutrition: An Audit in a Highly Specialized Intestine Failure Unit. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30664-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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194
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Kelly-Morland C, Zhong J, Goh V, Wah T, Ralph C, Thistlethwaite F, Patel P, Nathan P, Eisen T, Gregory W, McParland L, Cool H, Royle KL, Best E, Whincup L, Collinson F, Brown J. Prospective comparison of RECIST and alternative response assessment criteria in the evaluation of metastatic renal cell cancer patients from phase II of the multi-centre randomised STAR trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx371.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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195
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Lewis PO, Khan I, Patel P. Successful stepdown treatment of pulmonary histoplasmosis with thrice-weekly liposomal amphotericin B in a hospital-associated, outpatient infusion centre: A case report. J Clin Pharm Ther 2017; 43:269-272. [PMID: 28806478 DOI: 10.1111/jcpt.12609] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 07/20/2017] [Indexed: 12/31/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Amphotericin is the preferred treatment for pulmonary histoplasmosis during pregnancy. The long half-life of amphotericin supports less than daily administration. CASE SUMMARY A 28-year-old pregnant woman diagnosed with recurrent pulmonary histoplasmosis was initiated on liposomal amphotericin 250 mg (4 mg/kg) intravenously daily. After 2 weeks, the patient was discharged and successfully received 250 mg thrice weekly at a hospital-associated outpatient infusion centre. After 6 weeks of outpatient treatment, a chest X-ray demonstrated no remaining disease and therapy was discontinued. WHAT IS NEW AND CONCLUSION Administration of thrice-weekly liposomal amphotericin in a hospital-associated, outpatient infusion centre may be a promising option for stepdown treatment in patients unable to take itraconazole.
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Gupta P, Patel P, Strauch B, Lai F, Akbarov A, Gulsin G, Maresova V, Rosa J, Cole R, Smith P, Widimsky J, Samani N, Williams B, Tomaszewski M. 3894Predictors of non-adherence to antihypertensive treatment: insights from liquid chromatography tandem mass spectrometry based analysis. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.3894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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197
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Patel P, Rebollo-Mesa I, Ryan E, Sinha MD, Marks SD, Banga N, Macdougall IC, Webb MC, Koffman G, Olsburgh J. Prophylactic Ureteric Stents in Renal Transplant Recipients: A Multicenter Randomized Controlled Trial of Early Versus Late Removal. Am J Transplant 2017; 17:2129-2138. [PMID: 28188678 DOI: 10.1111/ajt.14223] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 01/19/2017] [Accepted: 01/31/2017] [Indexed: 01/25/2023]
Abstract
Prophylactic ureteric stenting in renal transplantation reduces major urological complications; however, morbidity is related to the indwelling duration of a stent. We aimed to determine the optimal duration for stents in this clinical setting. Patients (aged 2-75 years) from six UK hospitals who were undergoing renal transplantation were recruited and randomly assigned to either early stent removal at 5 days (without cystoscopy) or late removal at 6 weeks after transplantation (with cystoscopy). The primary outcome was a composite of stent-related complications defined as pain, visible hematuria, migration, fragmentation, and urinary tract infections (UTIs) within 3 mo of transplantation. Between May 2010 and Nov 2013, we randomly assigned 227 participants, with 205 included in the final analysis of the primary outcome. Stent-related complications were significantly higher in the late versus early stent removal groups (36 of 126 [28.6%] vs. 6 of 79 [7.6%]; p < 0.001). The majority of stent complications consisted of UTIs, with an incidence of 31 of 126 (24.6%) in the late group compared with 6 of 79 (7.6%) in the early group (p = 0.004). We found early stent removal on day 5 significantly reduced stent-related complications and improved quality of life in the first 3 mo after transplantation (ISRCTN09184595).
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Bhatia S, Patel P, Bhatia S, Arora S, Deshmukh A. P808Utilization and safety profile of catheter ablation for non-ischemic ventricular tachycardia. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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199
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Kanagala P, Cheng A, McAdam J, Marsh A, Patel P, Gupta P, Arnold J, Squire I, Ng L, McCann G. P3379Prevalence and prognostic significance of right ventricular dysfunction in heart failure with preserved ejection fraction. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bhatia S, Bhatia S, Patel P, Arora S, Deshmukh A. P209Quality of care outcomes among NSTEMI patients with chronic kidney disease undergoing PCI. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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