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Sri Ratnamani M, Rao R. P290: Infection control in dialysis unit-difficult but not impossible. Antimicrob Resist Infect Control 2013. [PMCID: PMC3688121 DOI: 10.1186/2047-2994-2-s1-p290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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102
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Venturelli E, Rao R, Gipponi S, Liberini P, Padovani A. Headaches in the elderly, in an out-patient population over 60 years of age. J Headache Pain 2013. [DOI: 10.1186/1129-2377-14-s1-p229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Venturelli E, Rao R, Gipponi S, Liberini P, Padovani A. Headaches in the elderly, in an out-patient population over 60 years of age. J Headache Pain 2013. [PMCID: PMC3620179 DOI: 10.1186/1129-2377-1-s14-p229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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104
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Kanthan A, Rao R, Fahmy P, Alexander I, Thomas S, Kizana E. The Effects of the Human Germline Connexin40 Mutation A96S on Cardiac Physiology in the Intact Animal. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Sri Ratnamani M, Rao R. P282: Health care exposure prevention of tuberculosis by successful implementation of employee safety policy- our experience. Antimicrob Resist Infect Control 2013. [PMCID: PMC3688098 DOI: 10.1186/2047-2994-2-s1-p282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Collins R, Xiang D, Christie A, Leitch M, Euhus D, Rao R, Haley B, Sarode V. Abstract P1-07-04: Comparison of HER2 expression by immunohistochemistry (IHC) using automated imaging system and fluorescence in situ hybridization (FISH). A retrospective analysis of 2853 cases. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p1-07-04] [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: Accurate assessment of HER2 status is critical for selecting patients who will benefit from trastuzumab therapy. There is still no consensus regarding the optimal method to assess HER2 status. Computerized image analysis has been shown to provide a more accurate and objective way for quantification of HER2 expression by IHC than manual evaluation. It has been suggested that the use of image analysis may help to resolve some of the discrepancies between IHC and FISH assay.
We compared the results of HER2 expression by IHC using automated image analysis with fluorescent in situ hybridization (FISH) assay.
Design: Testing for HER2 expression by IHC and FISH was performed on 2853 specimens at UT Southwestern Medical Center between the years 2002 to 2011. Quantification of IHC HER2 expression was done by image analysis and scored as positive (>2.0), borderline (1.5 to 2.0) and negative. (<1.5). The PathVysion kit was used for FISH assay to evaluate HER2 amplification. Ratios >2.0, 1.8 to 2.0 and <1.8 were defined positive, borderline and negative amplification respectively.
Results: IHC compared to FISH
Conclusion: Despite improvements in IHC testing, the FISH assay may be a better method for determining HER2 status. Factors such as tissue fixation, scoring methods and choice of antibodies may contribute to the lower specificity of IHC.
In the amplified group, the gene amplification ratio correlated with protein expression, being highest in the IHC positive cases and lowest in those that were negative.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P1-07-04.
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Balusu R, Huffman N, Fiskus W, Smith J, Peth K, Hembruff S, Rao R, Ganguly S, McGuirk J, Bhalla K. 515 Superior Efficacy of Co-treatment with NPM1 Antagonist and FLT3 Inhibitor or Pan-histone Deacetylase Inhibitor Against Cultured and Primary Human AML Cells Co-expressing Mutant NPM1 and FLT3-ITD. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)72312-2] [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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Rao R, Deb U, Raghuram N, Rao NHR, Burke A, Hecht F. P02.179. Effects of an integrated yoga program on mood, perceived stress, quality of life and immune measures in HIV patients: a pilot study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012. [PMCID: PMC3373530 DOI: 10.1186/1472-6882-12-s1-p235] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Nandakumar B, Kadam A, Srikanth H, Rao R. P02.50. Naturopathy and yoga based life style intervention for cardiovascular risk reduction in patients with cardiovascular risk factors: a pilot study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012. [PMCID: PMC3373741 DOI: 10.1186/1472-6882-12-s1-p106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Riffel P, Rao R, Meyer M, Kettnaker P, Lemke A, Haneder S, Schoenberg SO, Michaely HJ. Die Implementierung der Dual-Source RF-Anrege-Technik in 3 T Systemen führt in der abdominellen Bildgebung zu annähernd identischen ADC Werten verglichen mit 1,5 T Scannern. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311273] [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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111
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Lassel EA, Rao R, Schwenke C, Schoenberg SO, Michaely HU. Evidenzbasierte Medizin: Entscheidungsfindung bezüglich der Dignität von Nierenläsionen anhand einer Metaanalyse der diffusionsgewichteten Bildgebung. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311289] [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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112
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Yavari M, Brinkley G, Klapstein KD, Hartwig WC, Rao R, Hermel E. Presence of the functional CASPASE-12 allele in Indian subpopulations. Int J Immunogenet 2012; 39:389-93. [PMID: 22471600 DOI: 10.1111/j.1744-313x.2012.01107.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Most humans lack a functional CASP12 gene, with the nonfunctional variant (CASP12p1), found in 100% of the Caucasian and east Asian population, and in approximately 80% of people of African descent. However, 20% of Africans carry an intact allele of CASP12, which produces a full-length pro-enzyme and increases the risk of sepsis. We examined CASP12 allele distribution in persons from central and southern Asia and found that CASP12 was significantly present in members of the Dravidian language group, particularly in persons from the Indian state of Tamil Nadu.
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Fahmy P, Kanthan A, Rao R, Alexander I, Kizana E. The Effects of Connexin45 Over-expression on Cardiac Physiology in the Intact Animal. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.270] [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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114
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Fahmy P, Kanthan A, Rao R, Alexander I, Kizana E. Efficient Atrial and Ventricular Transduction Following Tail Vein Injection of AAV2/9 Viral Vector. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.653] [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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115
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Noimark L, Wales J, Du Toit G, Pastacaldi C, Haddad D, Gardner J, Hyer W, Vance G, Townshend C, Alfaham M, Arkwright PD, Rao R, Kapoor S, Summerfield A, Warner JO, Roberts G. The use of adrenaline autoinjectors by children and teenagers. Clin Exp Allergy 2011; 42:284-92. [PMID: 22181034 DOI: 10.1111/j.1365-2222.2011.03912.x] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Revised: 09/24/2011] [Accepted: 10/06/2011] [Indexed: 11/27/2022]
Abstract
BACKGROUND Although adrenaline is recommended as first line treatment for anaphylaxis, it is often not utilized. There has been a debate about when adrenaline autoinjectors should be prescribed and how many should be dispensed. OBJECTIVES To see how many adrenaline autoinjectors were used during anaphylactic reactions and to determine why they were not used in situations where they were clinically indicated. METHODS Patients were recruited prospectively at 14 paediatric allergy clinics throughout UK. Participants completed a questionnaire covering demographic data, atopic status and details of allergic reactions in the previous year and reasons for using more than one device. RESULTS A total of 969 patients were recruited of whom 466 (48.1%, 95% CI: 37.9-58.2) had had at least one reaction in the previous year; 245 (25.3%, 95% CI: 16.2-34.4) of these reactions were anaphylaxis. An adrenaline autoinjector was used by 41 (16.7%, 95% CI: 11.7-21.3) participants experiencing anaphylaxis. Thirteen participants received more than one dose of adrenaline, for nine of these a health professional gave at least one. The commonest reasons for using more than one were severe breathing difficulties (40%), lack of improvement with first dose (20%) and miss-firing (13.3%). The commonest reasons for not using adrenaline in anaphylaxis were 'thought adrenaline unnecessary' (54.4%) and 'unsure adrenaline necessary' (19.1%). Many with wheeze did not use their autoinjector. CONCLUSIONS AND CLINICAL RELEVANCE Adrenaline is used by only a minority of patients experiencing anaphylaxis in the community. Thirteen of the 41 patients with anaphylaxis who used their autoinjector needed another dose of adrenaline. Further research is needed to consider how to best encourage the usage of adrenaline when clinically indicated in anaphylaxis.
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Pradeep CR, Koestler W, Lauriola M, Nair H, Rao R, Mills GB, Yarden Y. P2-03-04: Novel Pathways Underlying the Initiation and Transition of DCIS to IDC of HER2−Overexpressing Breast Cancer Model. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p2-03-04] [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: The HER2/Neu -oncogene is amplified in 20–25% percent of human primary breast cancers and this alteration is associated with disease behaviour. The HER2/neu oncogene encodes a receptor-like tyrosine kinase, whose overexpression in breast cancer predicts poor prognosis and resistance to conventional therapies. Whereas signalling pathways emanating from HER2 have been characterized, much less is known about the transcriptionally regulated genes controlled by HER2 that contribute to the initiation of Ductal Carcinoma Insitu (DCIS) and their transition to an invasive ductal carcinoma (IDC).
Materials and Methods: Normal and HER2 overexpressing mammary epithelial cells (MCF10A) were grown in extracellular matrix to form 3D structures, When grown in extracellular matrix as 3-dimensional spheroids, control cells developed a hollow lumen, but HER2−overexpressing cells populated the lumen by evading apoptosis. On the next step, uopon the growth factror stimulation HER2−overexpressing cells grown in extracellular matrix, which protruded invasive outgrowths. Highly variable genes were selected from the described phenotypes using RNA isolated from the 3D structures and hybridized to an Affymetrix HuGene 1.0 ST oligonucleotide array. Results: Using microarrays we analysed transcriptional events responsible for the morphological changes and found several novel sets of genes such as integral proteins, transcription factors, matrix proteases, Notch genes and chemokines were highly altered in the HER2 overexpressing group which were not appreciated before. Using gene annotation we defined molecular-pathways responsible for the phenotypical changes. More specifically, our study proposes a two hit model describes the pathways involved in the initiation of the Ductal Carcinoma Insitu and their transition to Invasive Cancer underlying the HER2 transcriptional network.
Discussion: According to the proposed model, expansion of ductal hyperplasia is limited by intraluminal apoptosis, unless they overexpress HER2, which drives proliferation and forms DCIS due to HER2 induced Notch pathways genes. Secondly, results obtained with the 3D system and their reflection in clinical outcome, we propose that neither HER2 amplification, nor the presence of GFs, is sufficient for development of IDC, but their co-occurrence can instigate metastasis by the activation of genes of integrin-adhesion signaling. The more virulent scenario combines HER2 amplification with GFs, thereby switching a robust, auto-stimulatory program.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-03-04.
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Ratnamani MS, Rao R. Importance and impact of surveillance of the microbial quality of dialysate and RO water in a tertiary health. BMC Proc 2011. [PMCID: PMC3239635 DOI: 10.1186/1753-6561-5-s6-p211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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118
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Rao R. Application of six sigma process to implement the infection control process and its impact on infection rates in a tertiary health care centre. BMC Proc 2011. [PMCID: PMC3239653 DOI: 10.1186/1753-6561-5-s6-p228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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119
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Rao R. Bedside brochoscopy a concern. BMC Proc 2011. [PMCID: PMC3239809 DOI: 10.1186/1753-6561-5-s6-p73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Khoynezhad A, Rao R, Trento A, Gewertz B. Management of acute type B aortic dissections and acute limb ischemia. THE JOURNAL OF CARDIOVASCULAR SURGERY 2011; 52:507-517. [PMID: 21792158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The aim of this study was to review the management of acute type B aortic dissection (TBAD) with acute limb ischemia. A search using the "Pubmed" resulted in 254 records by combining the Medical Subject Heading keywords (listed separately). The articles were assessed for their validity, correct pathology and patient cohort. Inclusion criteria included all patients with complicated acute TBAD who were candidates for open of thoracic endovascular aortic repair (TEVAR). The exclusion criteria included type A, asymptomatic acute or chronic TBAD, penetrating ulcer or intramural hematoma. TBAD with limb ischemia has a poor prognosis if not diagnosed, triaged and treated promptly. Clinical presentation and diagnostic strategy as well as various imaging are reviewed. Early mortality rate for complicated acute TBAD (with malperfusion to lower extremity) is 12%. The management has moved from open operation to primary TEVAR. In cases with anatomic obstruction, open surgical techniques such as femoral-femoral bypass, axillo-femoral bypass or surgical fenestration can be successful in relief of malperfusion to the affected limb. One-year-survival rates are 85%. A complete to partial reverse aortic remodeling occurred in 78% of survivors of acute TBAD, if primary TEVAR is applied. Acute TBAD with limb ischemia remains a clinical challenge that requires prompt diagnosis and treatment. TEVAR of acute TBAD is associated with relatively low morbidity and mortality, and is more often used as primary approach for patients with limb ischemia. The outcomes with TEVAR compare favorably to the open repair, and initiate reverse aortic remodeling in majority of the survivors.
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Miossec P, Verweij CL, Klareskog L, Pitzalis C, Barton A, Lekkerkerker F, Reiter S, Laslop A, Breedveld F, Abadie E, Flamion B, Dere W, Mpofu S, Goel N, Ethgen D, Mitlak B, Ormarsdóttir S, Rao R, Tsouderos Y, Reginster JY. Biomarkers and personalised medicine in rheumatoid arthritis: a proposal for interactions between academia, industry and regulatory bodies. Ann Rheum Dis 2011; 70:1713-8. [PMID: 21784723 DOI: 10.1136/ard.2011.154252] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Rheumatoid arthritis (RA) is one of the most appropriate conditions for the application of personalised medicine as a high degree of heterogeneity has been recognised, which remains to be explained. Such heterogeneity is also reflected in the large number of treatment targets and options. A growing number of biologics as well as small molecules are already in use and there are promising new drugs in development. In order to make the best use of treatment options, both targeted and non-targeted biomarkers have to be identified and validated. To this aim, new rules are needed for the interaction between academia and industry under regulatory control. Setting up multi-centre biosample collections with clear definition of access, organising early, possibly non-committing discussions with regulatory authorities, and defining a clear route for the validation, qualification and registration of the biomarker-drug combination are some of the more critical areas where effective collaboration between the drug industry, academia and regulators is needed.
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Rao R, Bryowsky K, Mao J, Bunton D, McPherson C, Mathur A. Gastrointestinal complications associated with ibuprofen therapy for patent ductus arteriosus. J Perinatol 2011; 31:465-70. [PMID: 21252965 DOI: 10.1038/jp.2010.199] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To review intestinal complications associated with ibuprofen treatment of patent ductus arteriosus (PDA). STUDY DESIGN Data from preterm infants treated with ibuprofen were retrospectively reviewed. χ(2) test and Fischer's exact test were used for univariate analyses. Multivariate analyses with logistic regression modeling were used to identify risk factors. RESULT One hundred and two infants were treated with ibuprofen for PDA. Nine (9/102, 8.8%) infants developed spontaneous intestinal perforation (SIP), whereas 93/102 (91.2%) did not. The mean (± s.d.) gestational age (GA) at birth in infants with and without SIP was 25.2 (± 1.3) vs 27.6 (± 2.4) weeks (P=0.02) and the median (interquartile) length of stay (LOS) was 109.5 (91.0 to 116.5) vs 75.0 (53.0 to 94.5) days (P=0.002), respectively. The mean (± s.d.) age at starting ibuprofen was 3.3 (± 1.3) vs 5.8 (± 3.5) days in infants with and without SIP, respectively (P=0.03). In logistic regression analyses, increasing GA and later initiation of ibuprofen treatment were protective against risk of SIP; odds ratio, 95% confidence interval (OR, 95% CI)=0.26 (0.09 to 0.75), P=0.01 and 0.63 (0.41 to 0.95), P=0.03, respectively. CONCLUSION Infants at lower GA are at risk of SIP when treated early with ibuprofen for symptomatic PDA.
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Lenert LA, Kirsh D, Griswold WG, Buono C, Lyon J, Rao R, Chan TC. Design and evaluation of a wireless electronic health records system for field care in mass casualty settings. J Am Med Inform Assoc 2011; 18:842-52. [PMID: 21709162 DOI: 10.1136/amiajnl-2011-000229] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND There is growing interest in the use of technology to enhance the tracking and quality of clinical information available for patients in disaster settings. This paper describes the design and evaluation of the Wireless Internet Information System for Medical Response in Disasters (WIISARD). MATERIALS AND METHODS WIISARD combined advanced networking technology with electronic triage tags that reported victims' position and recorded medical information, with wireless pulse-oximeters that monitored patient vital signs, and a wireless electronic medical record (EMR) for disaster care. The EMR system included WiFi handheld devices with barcode scanners (used by front-line responders) and computer tablets with role-tailored software (used by managers of the triage, treatment, transport and medical communications teams). An additional software system provided situational awareness for the incident commander. The WIISARD system was evaluated in a large-scale simulation exercise designed for training first responders. A randomized trial was overlaid on this exercise with 100 simulated victims, 50 in a control pathway (paper-based), and 50 in completely electronic WIISARD pathway. All patients in the electronic pathway were cared for within the WIISARD system without paper-based workarounds. RESULTS WIISARD reduced the rate of the missing and/or duplicated patient identifiers (0% vs 47%, p<0.001). The total time of the field was nearly identical (38:20 vs 38:23, IQR 26:53-1:05:32 vs 18:55-57:22). CONCLUSION Overall, the results of WIISARD show that wireless EMR systems for care of the victims of disasters would be complex to develop but potentially feasible to build and deploy, and likely to improve the quality of information available for the delivery of care during disasters.
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Biswas A, Rao R, Umashankar S, Mynampati KC, Reuben S, Parab G, Swarup S. datPAV--an online processing, analysis and visualization tool for exploratory investigation of experimental data. Bioinformatics 2011; 27:1585-6. [DOI: 10.1093/bioinformatics/btr179] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Pai VV, Hanumanthayya K, Naveen KN, Rao R, Dinesh US. Bowen's disease over the abdomen--a histological pigmented variety. Indian J Cancer 2011; 48:121-2. [PMID: 21330759 DOI: 10.4103/0019-509x.76637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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