1001
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Hoque H, Ahmad N, Sran H, Patel S, Gurjar S, Kulkarni D. Invasive lobular cancer and re-do surgery – extent of the problem! EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)70603-7] [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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1002
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Patel S, Peacock S, McKinley R, Carter DC, Watson PJ. GPs' experience of managing chronic pain in a South Asian community--a qualitative study of the consultation process. Fam Pract 2008; 25:71-7. [PMID: 18375527 DOI: 10.1093/fampra/cmn012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Chronic pain is one of the most common reasons for seeking primary care consultations. GPs' experience of managing patients with pain from a multicultural community has not previously been examined. OBJECTIVES We explored GPs' experiences of managing patients with chronic pain from a South Asian community in Leicester. METHODS Qualitative semi-structured interviews were conducted with GPs from practices in two primary care trusts within Leicester. Eighteen GPs (11 males and 7 females) were interviewed in this study. RESULTS Several emerging themes were identified from the data including consulting behaviour, presentation of pain, GPs personal challenges, psychosomatic interpretations and communication. Overall, GPs find that managing South Asian patients with chronic pain can be challenging as a consequence of the way in which patients present with pain. Difficulties for GPs were created not only by language differences but also by cultural differences, which were not seen in second or third generation South Asians. GPs felt that self-management was difficult to address, and compliance with medication difficult to determine. In such consultations, GPs perceived that patients were more likely to present with psychosomatic symptoms. CONCLUSIONS Cultural influences play an important role in the consultation process where patients' behaviour is often bound in their cultural view of health care. Patients' presentation of their condition makes diagnosis difficult but can also lead to miscommunication. Whether South Asian people are more likely to present mental health problems as chronic pain is not clear and warrants further investigation.
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1003
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Le-Niculescu H, McFarland MJ, Ogden CA, Balaraman Y, Patel S, Tan J, Rodd ZA, Paulus M, Geyer MA, Edenberg HJ, Glatt SJ, Faraone SV, Nurnberger JI, Kuczenski R, Tsuang MT, Niculescu AB. Phenomic, convergent functional genomic, and biomarker studies in a stress-reactive genetic animal model of bipolar disorder and co-morbid alcoholism. Am J Med Genet B Neuropsychiatr Genet 2008; 147B:134-66. [PMID: 18247375 DOI: 10.1002/ajmg.b.30707] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We had previously identified the clock gene D-box binding protein (Dbp) as a potential candidate gene for bipolar disorder and for alcoholism, using a Convergent Functional Genomics (CFG) approach. Here we report that mice with a homozygous deletion of DBP have lower locomotor activity, blunted responses to stimulants, and gain less weight over time. In response to a chronic stress paradigm, these mice exhibit a diametric switch in these phenotypes. DBP knockout mice are also activated by sleep deprivation, similar to bipolar patients, and that activation is prevented by treatment with the mood stabilizer drug valproate. Moreover, these mice show increased alcohol intake following exposure to stress. Microarray studies of brain and blood reveal a pattern of gene expression changes that may explain the observed phenotypes. CFG analysis of the gene expression changes identified a series of novel candidate genes and blood biomarkers for bipolar disorder, alcoholism, and stress reactivity.
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1004
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Patel S, Trivedi A, Dholaria P, Dholakia M, Devra A, Gupta B, Shah SA. Recurrent multifocal primary amyloidosis of urinary bladder. SAUDI JOURNAL OF KIDNEY DISEASES AND TRANSPLANTATION 2008; 19:247-249. [PMID: 18310877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Primary localized amyloidosis of bladder is rare. We report a case of recurrence of multifocal primary amyloidosis of urinary bladder. Cystoscopy revealed a diffuse left lateral wall lesion with normal surrounding mucosa. Histopathological examination of the specimen revealed urinary bladder amyloidosis with negative surgical margins. Recurrent urinary bladder amyloidosis was confirmed 3 months after the first resection. Close follow-up is recommended.
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1005
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Patel S, Adams MR. Prevention of cardiac disease: lifestyle modification or pharmacotherapy? Intern Med J 2008; 38:199-203. [DOI: 10.1111/j.1445-5994.2007.01616.x] [Citation(s) in RCA: 2] [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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1006
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Obeng K, Rumboldt Z, Tuite G, Welsh CT, Patel S, Spampinato MV. Atypical cystic meningioma of the trigeminal nerve in a pediatric patient. AJNR Am J Neuroradiol 2008; 29:398-9. [PMID: 18024574 DOI: 10.3174/ajnr.a0876] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SUMMARY We report an unusual case of atypical cystic meningioma of the trigeminal nerve proved by histology in a 15-year-old white girl. A review of the literature showed that this is only the second reported case of a meningioma of the trigeminal nerve without dural attachment and the first occurrence in a pediatric patient.
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1007
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Burdan F, Szumiło J, Gajjar B, Dudka J, Korobowicz A, Patel S, Nat A, Nat AS, Dworzański W, Kwaśniewski W. Immunoexpression of constitutive and inducible cyclo-oxygenase isoforms in the rat foetal and maternal digestive tract. Folia Morphol (Warsz) 2008; 67:24-31. [PMID: 18335410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Cyclo-oxygenase (COX), which catalyses the conversion of arachidonic acid to prostaglandin endoperoxide and prostanoids, is widely expressed in mammalian organs. The aim of the study was to evaluate the immunoexpression of the constitutive and inducible cyclo-oxygenase isoforms (COX-1 and COX-2 respectively) in the oesophagus, stomach and the small and large bowels of untreated rat dams and foetuses on gestational day 21. The localisation of the COX isoforms was similar in the maternal and foetal organs, although the intensity of the reaction for COX-2 was stronger in the foetuses. Cytoplasmic COX-1 immunostaining was found in myocytes of the muscularis propria, muscularis mucosae and the blood vessels. It was also positive in the endothelial cells, scattered stromal cells of the lamina propria and the ganglion cells of the nerve plexus in the bowels. Apart from the keratinised layer, a strong reaction was revealed in the stratified squamous epithelium of the oesophagus and forestomach. Negative or weakly positive staining was found in the mucus-secreting cells covering the surface, gastric pits and pyloric glands, as well as in the parietal cells and the chief cells. Weakly positive COX-1 immunostaining was observed in epithelial cells of the small intestine crypts, but in some cases enterocytes and goblet cells covering villi were also positive. In the colonic mucosa weak COX-1 staining was typical of the absorptive, and goblet cells. The COX-2 immunostaining was nuclear and/or cytoplasmic. An inconsistent positive reaction was seen in the muscle of the muscularis mucosae, muscularis propria and the blood vessels. Positive staining was also found in scattered stromal cells of the lamina propria and adventitia and the ganglion cells. Weak nuclear staining was found in the stratified squamous epithelium of the oesophagus and forestomach. Unlike the strong foetal reactivity in the epithelial cells of the glandular stomach, a negative or weakly positive reaction was seen in the maternal parietal and/or mucous-secreting surface stomach cells. Some epithelial cells of the crypts both in the small and large bowel were also COX-2 positive. In conclusion, constitutive and inducible COX isoforms were detected in the digestive tract of pregnant female and in foetuses. COX-1 was the predominant isoform in both the adult and foetal organs.
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1008
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Abstract
BACKGROUND Multiple sclerosis (MS) is associated with Epstein-Barr virus (EBV) infection, but the relationship between the virus and the disease is not clear. As many different types of EBV exist, it is possible that MS is caused by one particular type of EBV. Objectives - The aim of this study was to determine whether MS is associated with a particular genotype of EBV. MATERIALS AND METHODS We collected blood from MS patients and controls, amplified and sequenced the latent membrane protein-1 (LMP-1) gene, and compared the groups. RESULTS We found a variety of LMP-1 sequences in both MS and controls, with no significant differences between the groups. Conclusion - We conclude that MS is not associated with a particular genotype of EBV.
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1009
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Shaw S, Fildes J, Khan N, Patel S, Leonard C, Williams S, Yonan N. 419: The Immunomodulation of Circulating CD4+ CD25bright Regulatory T Cells by Pravastatin in a Heart Transplant Cohort. J Heart Lung Transplant 2008. [DOI: 10.1016/j.healun.2007.11.431] [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
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1010
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Eckardt AJ, Swales C, Bhattacharya K, Wassef WY, Phelan NP, Zubair S, Martins N, Patel S, Moquin B, Anwar N, Leung K, Levey JM. Open access colonoscopy in the training setting: which factors affect patient satisfaction and pain? Endoscopy 2008; 40:98-105. [PMID: 18253904 DOI: 10.1055/s-2007-995469] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND STUDY AIM Patient satisfaction with colonoscopy is important for quality assurance; it may be affected by various factors, including patient characteristics, physician training level, and procedural or organizational features. We aimed to analyze how these factors influenced patient satisfaction and pain in an outpatient training setting. METHODS Consecutive patients for open access colonoscopy (OAC) were enrolled in a prospective, single-blinded, controlled study. Primary and secondary outcomes were satisfaction and pain scores with and without trainee participation. A multivariate analysis was designed to achieve an 80 % power with an alpha value of 0.05. RESULTS 368 patients were enrolled. Satisfaction with the procedure was high (mean score 1.36; 1 = best to 5 = worst). In the multivariate analysis only waiting time in the endoscopy suite was significantly associated with lower satisfaction scores ( P = 0.024). Satisfaction was unaffected by patient factors (gender, American Society of Anesthesiologists' [ASA] score, anxiety, etc). Higher pain scores were associated with higher anxiety levels ( P = 0.02), female gender ( P = 0.02), longer procedure ( P< 0.001), and lower sedation levels ( P = 0.001); trainee involvement (49 % of procedures) did not adversely affect satisfaction or pain scores. CONCLUSIONS Patient satisfaction with OAC using sedation appears to depend primarily on organizational factors (waiting time beforehand). In contrast, pain is associated with patient characteristics (female gender, anxiety) and procedural factors (lower sedation, longer procedure). Trainee participation did not affect satisfaction or pain scores, a finding which may help to reassure patients undergoing OAC with trainee participation.
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1011
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van den Berg M, Sackley C, Hoppitt T, Patel S, Lett K, Hollands K, Wright C, Brittle N. P2.052 USE of the TUG in cognitively impaired care home residents. Parkinsonism Relat Disord 2008. [DOI: 10.1016/s1353-8020(08)70282-7] [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: 11/29/2022]
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1012
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Esposito M, Grusovin MG, Patel S, Worthington HV, Coulthard P. Interventions for replacing missing teeth: hyperbaric oxygen therapy for irradiated patients who require dental implants. Cochrane Database Syst Rev 2008:CD003603. [PMID: 18254025 DOI: 10.1002/14651858.cd003603.pub2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Dental implants offer one way to replace missing teeth. Patients who have undergone radiotherapy and those that have also undergone surgery for cancer in the head and neck region may benefit particularly from reconstruction with implants. Hyperbaric oxygen therapy (HBO) has been advocated to improve the success of implant treatment in patients who have undergone radiotherapy but this remains a controversial issue. OBJECTIVES To compare success, morbidity, patient satisfaction and cost effectiveness of dental implant treatment carried out with and without HBO in irradiated patients. SEARCH STRATEGY We searched the Cochrane Oral Health Group's Trials Register, The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. Handsearching included several dental journals. We checked the bibliographies of relevant clinical trials and review articles for studies outside the handsearched journals. We wrote to authors of the identified randomised controlled trials (RCTs), to more than 55 oral implant manufacturers; we used personal contacts and we asked on an internet discussion group in an attempt to identify unpublished or ongoing RCTs. No language restriction was applied. The last electronic search was conducted on 13 June 2007. SELECTION CRITERIA Randomised controlled trials of HBO therapy for irradiated patients requiring dental implants. DATA COLLECTION AND ANALYSIS Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two review authors. Results were expressed as random-effects models using mean differences for continuous outcomes and risk ratios for dichotomous outcomes with 95% confidence intervals. MAIN RESULTS Only one RCT was identified and included. Thirteen patients received HBO therapy while other 13 did not. Two to six implants were placed in fully edentulous mandibles to be rehabilitated with bar-retained overdentures. One year after implant loading four patients died from each group. One patient, treated with HBO, developed an osteoradionecrosis and lost all implants so the prosthesis could not be provided. Five patients in the HBO group had at least one implant failure versus two in the control group. There were no statistically significant differences for prosthesis and implant failures, postoperative complications and patient satisfaction between the two groups. AUTHORS' CONCLUSIONS Despite the limited amount of clinical research available, it appears that HBO therapy in irradiated patients requiring dental implants may not offer any appreciable clinical benefits. There is a definite need for more RCTs to ascertain the effectiveness of HBO in irradiated patients requiring dental implants. These trials ought to be of a high quality and reported as recommended by the CONSORT statement (http://www.consort-statement.org/). Each clinical centre may have limited numbers of patients and it is likely that trials will need to be multicentred.
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1013
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Hamill TG, Sato N, Jitsuoka M, Tokita S, Krause S, Ryan C, Gantert L, Sleph H, Zeng Z, Miller P, Patel S, Riffel K, Sanabria S, Eng W, Chen T, Renger J, Doran S, Garson S, Iannone R, Hargreaves R, Burns H. Histamine H3 inverse agonist PET tracers labelled with carbon-11 or fluorine-18. Neuroimage 2008. [DOI: 10.1016/j.neuroimage.2008.04.196] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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1014
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Scudamore KA, Baillie H, Patel S, Edwards SG. Occurrence and fate ofFusariummycotoxins during commercial processing of oats in the UK. ACTA ACUST UNITED AC 2007; 24:1374-85. [PMID: 17906998 DOI: 10.1080/02652030701509972] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The commercial processing of oats is different from that of other cereals, such as wheat and maize. In northwest Europe, oats also appear to be more susceptible to contamination with HT-2 and T-2 toxins than other cereals. Mycotoxins, such as deoxynivanol and zearalenone, in cereals are already controlled by EU legislation. With regard to additional, impending legislation, this study examined HT-2 and T-2 toxins together with zearalenone, deoxynivalenol and other related toxins in a commercial oat mill and how the concentrations varied from raw oats to the final prepared oat flakes. Concentrations of each Fusarium mycotoxin fell by 90-95% during the process, with the major loss being a physical distribution occurring at the de-hulling stage. Initial studies of losses occurring at other stages, such as kilning or de-branning of prepared oat groats, suggest these to be small. The use of colour sorting after kilning showed higher concentrations of each mycotoxin in the discoloured groats. The feasibility of developing a predictive tool for the oat industry is examined.
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1015
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Wright SE, Khaznadar R, Wang Z, Quinlin IS, Rewers-Felkins KA, Phillips CA, Patel S. Generation of MUC1-stimulated mononuclear cells using optimized conditions. Scand J Immunol 2007; 67:24-9. [PMID: 18021186 DOI: 10.1111/j.1365-3083.2007.02032.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Mucin is a glycoprotein found on the surface of cell membranes of adenocarcinomas. The purpose of these studies was to generate MUC1 multiple tandem repeat (VNTR)-stimulated mononuclear cells (M1SMC). We first determined the optimal conditions to influence the immune response. In these studies, peripheral blood mononuclear cells (PBMC), from patients with adenocarcinomas, were stimulated by different numbers of M1SMC stimulations, various concentrations of MUC1 peptide, washing of PBMC prior to stimulation and days in culture, to determine the optimal conditions to influence the immune response. The results of this study indicate that the mononuclear cells (MC) stimulated twice 1 week apart with MUC1 VNTR1 produced a greater specific killing of the breast cancer cell line MCF-7 than the 0, 1, 3 or 4 weekly stimulations. The optimal molarity for inducing cytotoxicity and cytokines (granulocyte macrophage colony-stimulating factor, gamma-interferon and interleukin-10) was 45 x 10(-8) M (1 microg/ml); except for tumour necrosis factor (TNF)-alpha which was 22 x 10(-8) M (0.5 microg/ml). The unwashed MC were superior to washing them with Ficoll-Hypaque. The optimal number of days in culture for cytotoxicity and cytokine production was after two stimulations (i.e. after day 7). Optimum conditions for generation of M1SMC identified in these studies were two stimulations with peptide, concentration of 45 x 10(-8) M (1 microg/ml) peptide, unwashed cells, and after two stimulations or after 8 days in culture. M1SMC were generated from multiple patients with breast cancer which lysed adenocarcinoma cells.
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1016
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Lindsey J, Patel S. PCR for bacterial 16S ribosomal DNA in multiple sclerosis cerebrospinal fluid. Mult Scler 2007; 14:147-52. [PMID: 17986505 DOI: 10.1177/1352458507082149] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The cause of multiple sclerosis (MS) is currently unknown. The hypothesis of this study is that MS is caused by a chronic bacterial infection of the central nervous system (CNS) and the ensuing immune response. We developed a sensitive two-stage polymerase chain reaction method using nested or semi-nested primers specific for the bacterial 16S ribosomal DNA to test for the presence of bacterial DNA in cerebrospinal fluid. We designed seven sets of primers to amplify DNA from spirochetes , Campylobacter, Mycoplasma, Chlamydia, Bartonella, Mycobacteria and Streptococcus and tested cerebrospinal fluid from patients with relapsing-remitting MS, primary progressive MS, transverse myelitis and controls. We did not detect DNA from any of the groups of bacteria in patients or controls. We conclude that we were unable to find evidence for CNS infection with any of these seven groups of bacteria in MS.
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1017
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Hijal T, Rajakesari S, Patel S, Muanza T. Estrogen Receptor Status Is a Significant Predictor of Overall and Brain Metastasis-Free Survival in Patients With Breast Cancer and Brain Metastases Treated With Trastuzumab. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1192] [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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1018
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Allotey J, Davenport M, Njere I, Charlesworth P, Greenough A, Ade-Ajayi N, Patel S. Benefit of preformed silos in the management of gastroschisis. Pediatr Surg Int 2007; 23:1065-9. [PMID: 17694400 DOI: 10.1007/s00383-007-2004-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/30/2007] [Indexed: 11/26/2022]
Abstract
Gastroschisis is traditionally managed by primary closure (PC) or delayed closure after surgical silo placement. Bedside insertion of preformed silos (PFS) and delayed closure has become more widespread, although its benefits remain unclear. To identify differences in outcome of infants managed with PFS compared with traditional closure (TC) techniques. Single-centre retrospective review of 53 consecutive neonates admitted between February 2000 and January 2006. Data expressed as median (range). Non-parametric statistical analysis used with P < 0.05 regarded as significant. Forty infants underwent TC and 13 had PFS and delayed closure. Median ventilation time in both groups was 4 days (P = 0.19) however this was achieved with higher mean airway pressures (MAPs) (day 0, 10 (5-16) versus 8 (5-10) cmH(2)O; P = 0.02) and inspired oxygen (40 (21-100) versus 30 (21-60)%; P = 0.03) in TC group. Urine output on day-1 of life was significantly higher in PFS group (1.1 (0.16-3.07) versus 0.45 (0-2.8) ml/kg/h; P = 0.02). Inotrope support was required in 17/40 (43%) of TC versus 0/13 (0%) in PFS (P < 0.01). After exclusion of infants with short bowel syndrome and/or intestinal atresia (n = 9), there was a shorter time to full enteral feeds in the TC group (22 (12-36) versus 27 (17-45); P = 0.07), although there was no difference in the period of parenteral nutrition (PN) (P = 0.1) or overall hospital stay (P = 0.34). No deaths or episodes of necrotizing enterocolitis occurred. The use of PFS for gastroschisis closure is associated with a reduction in pulmonary barotrauma, better tissue perfusion and improved early renal function, consistent with a reduction in abdominal compartment syndrome.
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1019
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Winkelmann CT, Patel S, Gibson RE. CMR 2007: 12.04: Novel contrast protocol for visualization of intestinal tumors in a mouse transgenic model by MicroCT imaging. CONTRAST MEDIA & MOLECULAR IMAGING 2007. [DOI: 10.1002/cmmi.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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1020
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Patel S, Dawood A, Ford TP, Whaites E. The potential applications of cone beam computed tomography in the management of endodontic problems. Int Endod J 2007; 40:818-30. [PMID: 17697108 DOI: 10.1111/j.1365-2591.2007.01299.x] [Citation(s) in RCA: 375] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIM To provide core information on cone beam computed tomography (CBCT) technology and its potential applications in endodontic practice. SUMMARY CBCT has been specifically designed to produce undistorted three-dimensional information of the maxillofacial skeleton as well as three-dimensional images of the teeth and their surrounding tissues. This is usually achieved with a substantially lower effective dose compared with conventional medical computed tomography (CT). Periapical disease may be detected sooner using CBCT compared with periapical views, and the true size, extent, nature and position of periapical and resorptive lesions can be assessed. Root fractures, root canal anatomy and the true nature of the alveolar bone topography around teeth may be assessed. CBCT scans are desirable to assess posterior teeth prior to periapical surgery, as the thickness of the cortical and cancellous bone can be accurately determined as can the inclination of roots in relation to the surrounding jaw. The relationship of anatomical structures such as the maxillary sinus and inferior dental nerve to the root apices may also be clearly visualized. KEY LEARNING POINTS CBCT has a low effective dose in the same order of magnitude as conventional dental radiographs. CBCT has numerous potential applications in the management of endodontic problems.
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1021
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Patel S, Orloff M, Tsoulfas G, Kashyap R, Jain A, Bozorgzadeh A, Abt P. Living-donor liver transplantation in the United States: identifying donors at risk for perioperative complications. Am J Transplant 2007; 7:2344-9. [PMID: 17845568 DOI: 10.1111/j.1600-6143.2007.01938.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Donor safety has been scrutinized by both the medical community and the media. Variability exists in reported donor complications and associated risk factors are ill defined. Use of administrative data can overcome the bias of single-center studies and explore variables associated with untoward events. A retrospective cohort study identifying living liver donors in two large healthcare registries yielded 433 right and left lobe donors from 13 centers between 2001 and 2005. Perioperative complications were identified using International Classification of Diseases, 9th Revision (ICD-9) coding data and classified according to the Clavien system. Logistic regression models identified factors associated with complications. There was one perioperative death (0.23%). The overall complication rate was 29.1% and major complication rate defined by a Clavien grade >or=3 was 3.5%. Center living-donor volume (OR = 0.97, 95% CI = 0.95-0.99) and the ratio of living-donors to all donors (living and deceased) (OR = 0.94, 95% CI = 0.92-0.96) were associated with a lower risk of all complications. Donor age >50 years (OR = 4.25, 95% CI = 1.22-14.87) was associated with a higher risk of major complications. Living liver donation is currently performed with a low risk of major morbidity. Use of administrative data represents an important tool to facilitate a better understanding of donor risk factors.
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1022
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Kulshreshtha R, Patel S, Arya AP, Hall S, Compson JP. Variations of the extensor pollicis brevis tendon and its insertion: a study of 44 cadaveric hands. J Hand Surg Eur Vol 2007; 32:550-3. [PMID: 17950220 DOI: 10.1016/j.jhse.2007.04.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2006] [Revised: 03/27/2007] [Accepted: 04/11/2007] [Indexed: 02/03/2023]
Abstract
The aim of this study was to describe the anatomy of the extensor pollicis brevis tendon, in particular its insertion, in 44 preserved hands from 23 cadavers. We found that only 25% of the tendons were inserted in the conventional way, viz, into the base of the proximal phalanx, and confirmed that the course and insertion of the extensor pollicis brevis tendon varies widely. The importance of these findings to the practice of hand surgery is discussed.
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1023
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Kumarasinghe AR, Flavell WR, Thomas AG, Mallick AK, Tsoutsou D, Chatwin C, Rayner S, Kirkham P, Warren S, Patel S, Christian P, O'Brien P, Grätzel M, Hengerer R. Electronic properties of the interface between p-CuI and anatase-phase n-TiO2 single crystal and nanoparticulate surfaces: A photoemission study. J Chem Phys 2007; 127:114703. [PMID: 17887866 DOI: 10.1063/1.2772249] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We present a study of the growth of the p-type inorganic semiconductor CuI on n-type TiO2 anatase single crystal (101) surfaces and on nanoparticulate anatase surfaces using synchrotron radiation photoemission spectroscopy. Core level photoemission data obtained using synchrotron radiation reveal that both the substrate (TiO2) and the overlayer (CuI) core levels shift to a lower binding energy to different degrees following the growth of CuI on TiO2. Valence band photoemission data show that the valence band maximum of the clean substrate differs from that of the dosed surface which may be interpreted qualitatively as due to the introduction of a new density of states within the band gap of TiO2 as a result of the growth of CuI. The valence band offset for the heterojunction n-TiO2p-CuI has been measured using photoemission for both nanoparticulate and single crystal TiO2 surfaces, and the band energy alignment for these heterojunction interfaces is presented. With the information obtained here, it is suggested that the interface between p-CuI and single crystal anatase-phase n-TiO2 is a type-II heterojunction interface, with significant band bending. The measured total band bending matches the work function change at the interface, i.e., there is no interface dipole. In the case of the nanoparticulate interface, an interface dipole is found, but band bending within the anatase nanoparticles remains quite significant. We show that the corresponding depletion layer may be accommodated within the dimension of the nanoparticles. The results are discussed in the context of the functional properties of dye-sensitized solid state solar cells.
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1024
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Drumheller B, Ayan J, Peress D, Song C, Dubon M, Dahlem K, Schlanger S, Patel S, Ward M, Sama A. 233: Do Acute Coronary Syndrome Patients With a Higher Body Mass Index Receive More Aggressive Treatments? Ann Emerg Med 2007. [DOI: 10.1016/j.annemergmed.2007.06.216] [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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