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Shah J, Dubb S, Agar S, Shah P, Mirza T. Computed tomographic indications for occult skull fractures in paediatric head trauma diagnosed at the time of wound closure under general anaesthesia. Br J Oral Maxillofac Surg 2020; 59:35-38. [PMID: 32747033 DOI: 10.1016/j.bjoms.2020.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 07/02/2020] [Indexed: 11/18/2022]
Abstract
Children with head injuries commonly present to the emergency department with forehead lacerations, and are frequently referred to the oral and maxillofacial team. Assessing the Glasgow coma scale (GCS) and neurological status of these patients is particularly challenging and there remains marked ambiguity regarding the use of computed tomographic (CT) imaging in children who have no obvious signs of traumatic brain injury. We present a case series of three patients who presented to our unit with forehead lacerations following a fall. All had a normal GCS, no obvious neurological signs, and all were listed for wound closure under general anaesthesia. Intraoperatively they were found to have underlying skull fractures that necessitated emergency CT whilst under general anaesthesia. Retrospective analysis was performed. Current guidelines and the literature were reviewed to identify factors that may help to identify occult skull fractures in the context of paediatric head trauma. Despite the subsequent discovery of skull fractures under general anaesthesia, none of our patients would have satisfied the present absolute indications for CT in the current guidelines. A number of helpful factors are not common in the UK guidelines but are present in others, including the presence of an appreciable haematoma and lacerations greater than 5 cm, amongst others. The assessment of paediatric patients with head trauma often remains a challenge when assessing for features such as headache, focal neurology, and amnesia. A high index of suspicion, formal examination under anaesthesia, and communication with the radiology department, are imperative if we are to avoid missing an occult injury that could potentially result in brain injury.
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102
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Shah P, Bajaj S, Polsky D. 646 Late-stage melanoma diagnosis in New York State (NYS). J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.658] [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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103
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Kalra S, Ghosh S, Das AK, Nair T, Bajaj S, Priya G, Mehrotra RN, Das S, Shah P, Deshmukh V, Chawla M, Sanyal D, Chandrasekaran S, Khandelwal D, Joshi A, Eliana F, Permana H, Fariduddin MD, Shrestha PK, Shrestha D, Kahandawa S, Sumanathilaka M, Shaheed A, Rahim AA, Orabi A, Al-Ani A, Hussein W, Kumar D, Shaikh K. Unravelling the utility of modern sulfonylureas from cardiovascular outcome trials and landmark trials: expert opinion from an international panel. Indian Heart J 2020; 72:7-13. [PMID: 32423565 PMCID: PMC7231843 DOI: 10.1016/j.ihj.2020.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/25/2019] [Accepted: 01/05/2020] [Indexed: 12/13/2022] Open
Abstract
AIM The primary objective of this review is to develop practice-based expert group opinions on the cardiovascular (CV) safety and utility of modern sulfonylureas (SUs) in cardiovascular outcome trials (CVOTs). BACKGROUND The United States Food and Drug Administration issued new guidance to the pharmaceutical industry in 2008 regarding the development of new antihyperglycemic drugs. The guidance expanded the scope for the approval of novel antihyperglycemic drugs by mandating CVOTs for safety. A few long-term CVOTs on dipeptidyl peptidase 4 inhibitors, glucagon-like peptide 1 receptor agonists, and sodium-glucose cotransporter 2 inhibitors have been completed, while others are ongoing. SUs, which constitute one of the key antihyperglycemic agents used for the management of type 2 diabetes mellitus (T2DM), have been used as comparator agents in several CVOTs. However, the need for CVOTs on modern SUs remains debatable. In this context, a multinational group of endocrinologists convened for a meeting and discussed the need for CVOTs of modern SUs to evaluate their utility in the management of patients with T2DM. At the meeting, CVOTs of modern SUs conducted to date and the hypotheses derived from the results of these trials were discussed. REVIEW RESULTS The expert group analyzed the key trials emphasizing the CV safety of modern SUs and also reviewed the results of various CVOTs in which modern SUs were used as comparators. Based on literature evidence and individual clinical insights, the expert group opined that modern SUs are cardiosafe and that since they have been used as comparators in other CVOTs, CVOTs of SUs are not required. CONCLUSION Modern SUs can be considered a cardiosafe option for the management of patients with diabetes mellitus and CV disease; thus CVOTs among individuals with T2DM are not required.
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Shah P, Kim FJ, Mian BM. Genitourinary cancer management during a severe pandemic: Utility of rapid communication tools and evidence-based guidelines. BJUI COMPASS 2020; 1:45-59. [PMID: 32537615 PMCID: PMC7280667 DOI: 10.1002/bco2.18] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/06/2020] [Accepted: 05/06/2020] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES To determine the usefulness of social media for rapid communication with experts to discuss strategies for prioritization and safety of deferred treatment for urologic malignancies during COVID-19 pandemic, and to determine whether the discourse and recommendations made through discussions on social media (Twitter) were consistent with the current peer-reviewed literature regarding the safety of delayed treatment. METHODS We reviewed and compiled the responses to our questions on Twitter regarding the management and safety of deferred treatment in the setting of COVID-19 related constraints on non-urgent care. We chronicled the guidance published on this subject by various health authorities and professional organizations. Further, we analyzed peerreviewed literature on the safety of deferred treatment (surgery or systemic therapy) to make made evidence-based recommendations. RESULTS Due to the rapidly changing information about epidemiology and infectious characteristics of COVID-19, the health authorities and professional societies guidance required frequent revisions which by design take days or weeks to produce. Several active discussions on Twitter provided real-time updates on the changing landscape of the restrictions being placed on non-urgent care. For separate discussion threads on prostate cancer and bladder cancer, dozens of specialists with expertise in treating urologic cancers could be engaged in providing their expert opinions as well as share evidence to support their recommendations. Our analysis of published studies addressing the safety and extent to which delayed cancer care does not compromise oncological outcome revealed that most prostate cancer care and certain aspects of the bladder and kidney cancer care can be safely deferred for 2-6 months. Urothelial bladder cancer and advanced kidney cancer require a higher priority for timely surgical care. We did not find evidence to support the idea of using nonsurgical therapies, such as hormone therapy for prostate cancer or chemotherapy for bladder cancer for safer deferment of previously planned surgery. We noted that the comments and recommendations made by the participants in the Twitter discussions were generally consistent with our evidence-based recommendations for safely postponing cancer care for certain types of urologic cancers. CONCLUSION The use of social media platforms, such as Twitter, where the comments and recommendations are subject to review and critique by other specialists is not only feasible but quite useful in addressing the situations requiring urgent resolution, often supported by published evidence. In circumstances such as natural disasters, this may be a preferable approach than the traditional expert panels due to its ability to harness the collective intellect to available experts to provide responses and solutions in real-time. These real-time communications via Twitter provided sound guidance which was readily available to the public and participants, and was generally in concordance with the peerreviewed data on safety of deferred treatment.
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105
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Brusca S, Jang M, Shah P, Shah K, Hsu S, Feller E, E M, Najjar S, Fideli U, Kong H, Marishta A, Bhatti K, Yang Y, Tunc I, Solomon M, Berry G, Marboe C, Agbor-Enoh S, Valantine H. Early Donor-Derived Cell-Free DNA Predicts Peak Allograft Function in Heart Transplant. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1261] [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] Open
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106
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Krishnan A, Chidi A, Merlo C, Shah P, Ha J, Higgins R, Bush E. Lung Volume Reduction Surgery Prior to Lung Transplantation: A Propensity-Matched Analysis. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.459] [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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107
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Keller M, Shah P, Bush E, Diamond J, Matthews J, Brown A, Timofte I, Fideli U, Kong H, Marishta A, Bhatti K, Yang Y, Tunc I, Luikart H, Berry G, Marboe C, Iacono A, Nathan S, Khush K, Orens J, Jang M, Valentine H, Agbor-Enoh S. Donor-Derived-Cell-Free DNA to Identify Primary Graft Dysfunction Patients at Risk of Chronic Lung Allograft Dysfunction. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.959] [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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108
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Gerhard E, Singh R, Psotka M, Cavallo K, Genovese L, Cooper L, Edwards L, May C, Cole R, Sinha S, Desai S, Shah P. Long-Term Cardiac Remodeling after LVAD Deactivation for Myocardial Recovery. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.404] [Citation(s) in RCA: 1] [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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109
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Cochrane A, Levine D, Ponor I, Philogene M, Jang M, Tunc I, Mathew J, Luikart H, Shah P, Khush K, Marboe C, Berry G, Valentine H, Agbor-Enoh S. Outcomes of ISHLT Lung Transplant AMR. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1298] [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] Open
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110
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Braun O, Brambatti M, Shah P, Cipriani M, Veenis J, Bui Q, Hong K, de Heyning C, Perna E, Timmermans P, Cikes M, Gjesdal G, Partida C, Potena L, Masetti M, Loforte A, Jakus N, Nilsson J, De Bock D, Minto J, Brugts J, Sterken C, Van den Bossche K, Rega F, Sing R, Russo C, Pretorius V, Klein L, Frigerio M, Adler E, Ammirati E. ICD Therapy Confers No Survival Advantage in a Global LVAD Population: Insights from the Trans-Atlantic Registry on VAD and Transplant (TRAViATA). J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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111
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Taleb I, Wever-Pinzon O, Yin M, Kfoury A, Caine W, Stehlik J, Catino A, Wever-Pinzon J, Bonios M, McKellar S, Alharethi R, Koliopoulou A, Fang J, Selzman C, Dranow E, Shah P, Singh R, Psotka M, Zhu W, Slaughter M, Birks E, Koenig S, Kanwar M, Kyvernitakis A, Hoffman K, Guglin M, Kotter J, Campbell K, Drakos S. Predicting Cardiac Structural and Functional Improvement Induced by Mechanical Unloading in Chronic Heart Failure: A Derivation-Validation Multicenter Study. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1052] [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] Open
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112
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Doshi A, Tushak Z, Kong H, Garcia V, Jang M, Shah P, Hsu S, Feller E, Rodrigo M, Najjar S, Fideli U, Marishta A, Bhatti K, Yang Y, Tunc I, Solomon M, Berry G, Marboe C, Agbor-Enoh S, Shah K, Valantine H. Increased Cell Free DNA Levels in African American Patients Early after Heart Transplantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.922] [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] Open
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113
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Agbor-Enoh S, Ponor I, Shah P, Levine D, Cochrane A, Philogene M, Matthews J, Brown A, Timofte I, Fideli U, Kong H, Marishta A, Bhatti K, Tunc I, Yang Y, Luikart H, Marboe C, Berry G, Iacono A, Nathan S, Khush K, Orens J, Jang M, Valantine H. To Treat or Not to Treat: DSA Positive Lung Transplant Recipients. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1118] [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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114
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Bazemore K, Permpalung N, Rohly M, Timofte I, Brown A, Orens J, Iacono A, Nathan S, Avery R, Valentine H, Agbor-Enoh S, Shah P. Characterization of Respiratory Pathogens in Contemporary Lung Transplant Recipients. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.051] [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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115
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Philogene M, Massie A, Kong H, Shah P, Cochrane A, Ponor I, Levine D, Shah K, Hsu S, Feller E, Rodrigo M, Najjar S, Tunc I, Berry G, Marboe C, Jang M, Agbor-Enoh S, Valantine H. Association between Pretransplant Antibody against Angiotensin II Type 1 Receptor and Posttransplant Allograft Injury. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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116
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Cantu E, Bermudez C, Cevasco M, Suzuki Y, Buckley T, Galati V, Majeti N, Benvenuto L, Anderson M, Wille K, Weinacker A, Dhillon G, Orens J, Shah P, Lama V, McDyer J, Snyder L, Palmer S, Hartwig M, Hage C, Singer J, Calfee C, Kukreja J, Greenland J, Ware L, Hsu J, Gallop R, Diamond J, Christie J. Implications of ECMO Bridging and Salvage Strategies on Mortality and PGD. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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117
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Krishnan A, Bush E, Chidi A, Nolley E, Agbor-Enoh S, West N, Tallarico E, Orens J, Ha J, Shah P, Segev D, Massie A, Higgins R, Merlo C. The Effect of the Cystic Fibrosis Care Center on Lung Transplant Outcomes. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1013] [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] Open
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118
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Agbor-Enoh S, Jang M, Singh K, Tunc I, Pirooznia M, Seifuddin F, Ponor I, Levine D, Cochrane A, Philogene M, Mathews J, Shah P, Luikart H, Khush K, Marboe C, Berry G, Valantine H. Early and Late Pulmonary AMR Show Distinct Profiles; Clinical and Epigenetic Analyses. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1300] [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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119
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Cooper L, Cochrane A, Cherikh W, Toll A, Psotka M, Shah P, Lund L, Stehlik J, Mentz R, Zuckermann A. Induction Therapy after Heart Transplantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.608] [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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120
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PATEL U, Patel H, Darji P, Patwari D, Shah P, Mazumdar M, Mandowara B, Shah R, Chotai N. SAT-422 SPECTRUM OF ACUTE KIDNEY INJURY IN DENGUE FEVER. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.447] [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] Open
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121
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Kute V, patel H, Shah P. SUN-378 CLINICAL AND HISTOPATHOLOGIC PROFILE OF IGA NEPHROPATHY IN A TERTIARY HOSPITAL IN INDIA. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.917] [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] Open
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122
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MESHRAM H, Kute V, Shah P. SAT-357 EXPANDING DONOR POOL BY UTILISING DECEASED DONOR WITH SNAKE BITE. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.378] [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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123
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MAZUMDAR M, Mandowara B, Patil R, Darji P, Patel H, Shah P, Patwari D. SAT-433 RENAL CORTICAL NECROSIS IN NON-HEMORRHAGIC DENGUE FEVER- A RARE CASE REPORT. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.459] [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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124
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Abbott J, Shah P. Amblyopia, deprivation and health disparities research: challenges in 2020. Eye (Lond) 2020; 34:1491-1493. [PMID: 32094471 PMCID: PMC7609316 DOI: 10.1038/s41433-020-0823-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/07/2020] [Accepted: 02/11/2020] [Indexed: 11/09/2022] Open
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125
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Shah P, Dylgjeri F, Srinivasan B, Brennan P. Oral tyrosine kinase inhibitors in OMFS: a review. Br J Oral Maxillofac Surg 2020; 58:135-138. [DOI: 10.1016/j.bjoms.2019.11.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 11/25/2019] [Indexed: 01/07/2023]
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