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Sinha SK, Calkins HG. To The Editor—Response. Heart Rhythm 2006. [DOI: 10.1016/j.hrthm.2006.09.009] [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: 11/27/2022]
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Sinha SK, Calkins HG. Cardiac contractility modulation: A new technologically advanced placebo? Heart Rhythm 2006; 3:1148-9. [PMID: 17018341 DOI: 10.1016/j.hrthm.2006.07.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2006] [Indexed: 11/25/2022]
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128
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Singh J, Sinha SK, Clarke P, Byrne S, Donn SM. Mechanical ventilation of very low birth weight infants: is volume or pressure a better target variable? J Pediatr 2006; 149:308-13. [PMID: 16939738 DOI: 10.1016/j.jpeds.2006.01.044] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2005] [Revised: 12/16/2005] [Accepted: 01/23/2006] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To compare the efficacy and safety of volume-controlled (VC) ventilation to time-cycled pressure-limited (TCPL) ventilation in very low birth weight infants with respiratory distress syndrome (RDS). STUDY DESIGN Newborns weighing between 600 and 1500 g and with a gestational age of 24 to 31 weeks who had RDS were randomized to receive either VC or TCPL ventilation and treated with a standardized protocol. The 2 modalities were compared by determining the time required to achieve a predetermined success criterion, on the basis of either the alveolar-arterial oxygen gradient <100 mm Hg or the mean airway pressure <8 cm H(2)O. Secondary outcomes included mortality, duration of mechanical ventilation, and complications commonly associated with ventilation. RESULTS The mean time to reach the success criterion was 23 hours in the VC group versus 33 hours in the TCPL group (P = .15). This difference was more striking in babies weighing <1000g (21 versus 58 hours; P = .03). Mean duration of ventilation with VC was 255 hours versus 327 hours with TCPL (P = .60). There were 5 deaths in the VC group and 10 deaths in the TCPL group (P = .10). The incidence of other complications was similar. CONCLUSION VC ventilation is safe and efficacious in very low birth weight infants and may have advantages when compared with TCPL, especially in smaller infants.
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Sinha SK. Probing dynamics at surfaces with X-rays and neutrons. JOURNAL OF NEUTRON RESEARCH 2006. [DOI: 10.1080/10238160600974336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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130
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Hu X, Jiang Z, Narayanan S, Jiao X, Sandy AR, Sinha SK, Lurio LB, Lal J. Observation of a low-viscosity interface between immiscible polymer layers. PHYSICAL REVIEW. E, STATISTICAL, NONLINEAR, AND SOFT MATTER PHYSICS 2006; 74:010602. [PMID: 16907050 DOI: 10.1103/physreve.74.010602] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2006] [Revised: 06/07/2006] [Indexed: 05/11/2023]
Abstract
X-ray photon correlation spectroscopy was employed in a surface standing wave geometry in order to resolve the thermally driven in-plane dynamics at both the surface/vacuum (top) and polymer/polymer (bottom) interfaces of a thin polystyrene (PS) film on top of Poly(4-bromo styrene) (PBrS) and supported on a Si substrate. The top vacuum interface shows two relaxation modes: one fast and one slow, while the buried polymer-polymer interface shows a single slow mode. The slow mode of the top interface is similar in magnitude and wave vector dependence to the single mode of the buried interface. The dynamics are consistent with a low-viscosity mixed layer between the PS and PBrS and coupling of the capillary wave fluctuations between this layer and the PS.
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Jiang Z, Kim H, Mochrie SGJ, Lurio LB, Sinha SK. Surface and interfacial dynamics of polymeric bilayer films. PHYSICAL REVIEW. E, STATISTICAL, NONLINEAR, AND SOFT MATTER PHYSICS 2006; 74:011603. [PMID: 16907103 DOI: 10.1103/physreve.74.011603] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2006] [Indexed: 05/11/2023]
Abstract
The theory for surface dynamics of the thermally excited fluctuations on a homogenous single-layer film of arbitrary depth is generalized to describe surface and interfacial dynamics of polymeric liquid bilayer films in terms of susceptibilities, power spectra, and characteristic relaxation time constants. The effects on surface dynamics originating from viscosity inhomogeneities close to the surface and interfacial regions are investigated by the bilayer theory and compared with the surface dynamics of homogeneous single-layer films under nonslip and slip boundary conditions. Our bilayer theory can also be extended to study interfacial dynamics of more generalized multilayer systems. The effects of viscoelasticity and van der Waals interactions on surface and interfacial dynamics are also briefly discussed.
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Abstract
Although the majority of newly born babies will establish normal respiratory and circulatory function without help, 1-2% might run into difficulties because of a disturbance in the normal adaptive processes required for a smooth transition from intrauterine to extrauterine life. An understanding of the normal and abnormal perinatal physiology is important to appreciate the practical differences in the approach to caring for such babies, and also for avoiding actions that might be detrimental in the longer term.
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Abstract
Ventilator induced lung injury continues to occur at an unacceptably high rate, which is inversely related to gestational age. Although the "new BPD" may not be entirely avoidable in the extremely premature infant, recognition of risk factors and adoption of an appropriate ventilatory strategy, along with continuous real time monitoring, may help to minimise lung damage. This paper will review the pathogenesis of ventilator induced lung injury and strategies that may mitigate it.
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Kochhar R, Saluja H, Singh RS, Dutta U, Sinha SK. Endoscopic clip application for postoperative residual esophageal duplication cyst. Endoscopy 2006; 38:424-5. [PMID: 16680647 DOI: 10.1055/s-2006-925023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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Abstract
The risk for colorectal carcinoma in acromegaly remains controversial. In our earlier study, we have demonstrated that the risk of colorectal carcinoma in Asian Indians with acromegaly is not increased and after this report, routine colonoscopy in our patients with acromegaly was abandoned. Subsequently, two consecutive young men aged 30 and 35, one 6 years after and other at the time of diagnosis of acromegaly had colorectal carcinoma respectively. None of them had family history of colonic neoplasm. These two younger patients with no other predisposition for colorectal neoplasm suggests that colonoscopy should be done in all patients with acromegaly at diagnosis and they should remain under surveillance.
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Dutta U, Nagi B, Garg PK, Sinha SK, Singh K, Tandon RK. Patients with gallstones develop gallbladder cancer at an earlier age. Eur J Cancer Prev 2005; 14:381-5. [PMID: 16030429 DOI: 10.1097/00008469-200508000-00011] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Significant proportions of Indian patients with gallbladder cancer are young. Multiple risk factors for gallbladder cancer are recognized among Indian patients. The effect of these risk factors on the age of development of gallbladder cancer is not known. We conducted a study to determine the influence of risk factors on the age at diagnosis of patients with gallbladder cancer and to assess the interactions between these risk factors. Patients with gallbladder cancer from two tertiary care institutions during the period 1994-2001 were prospectively studied. An ultrasound examination was done to look for the presence of gallstones. The influence of gender, gallstones, socio-economic status, smoking, residence in rural areas and in the Gangetic belt on the age at presentation was analysed using univariate analysis, logistic and linear regression analyses. The mean age of the 121 patients studied was 55+/-11.7 (SD) years. There were 51 (42%) patients aged less than 50 years. The younger patients (age < or =50 years) were more likely to have gallstones (88 versus 66%; P=0.008) and to have come from a lower socio-economic background (88 versus 71%; P=0.02) in comparison with older patients. However, there was no effect of the other risk factors. The independent determinants for younger age of patients with gallbladder cancer on logistic regression analysis were gallstones [odds ratio (OR) 4, 95% confidence interval (CI) 1.5-11; P=0.006] and lower socio-economic status (OR 3.1, 95% CI 1.1-8.6; P=0.03). On linear regression analysis, age at presentation was lowered by 5.6 years if there were associated gallstones. The mean age of patients with these two risk factors was significantly lower than that of those with one risk factor or no risk factor (52+/-12 years versus 57+/-11 years versus 61+/-9 years; P=0.007). In conclusion, the presence of gallstones and lower socio-economic status were both independently associated with a younger age at diagnosis of gallbladder cancer and their effect was additive.
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Roy S, Fitzsimmons MR, Park S, Dorn M, Petracic O, Roshchin IV, Li ZP, Batlle X, Morales R, Misra A, Zhang X, Chesnel K, Kortright JB, Sinha SK, Schuller IK. Depth profile of uncompensated spins in an exchange bias system. PHYSICAL REVIEW LETTERS 2005; 95:047201. [PMID: 16090835 DOI: 10.1103/physrevlett.95.047201] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2005] [Indexed: 05/03/2023]
Abstract
We have used the unique spatial sensitivity of polarized neutron and soft x-ray beams in reflection geometry to measure the depth dependence of magnetization across the interface between a ferromagnet and an antiferromagnet. The net uncompensated magnetization near the interface responds to applied field, while uncompensated spins in the antiferromagnet bulk are pinned, thus providing a means to establish exchange bias.
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Hu X, Jiao X, Narayanan S, Jiang Z, K Sinha S, Lurio LB, Lal J. Resonantly enhanced off-specular X-ray scattering from polymer/polymer interfaces. THE EUROPEAN PHYSICAL JOURNAL. E, SOFT MATTER 2005; 17:353-9. [PMID: 16025193 DOI: 10.1140/epje/i2004-10147-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2004] [Accepted: 04/26/2005] [Indexed: 05/03/2023]
Abstract
We have used measurements of the absolute intensity of diffuse X-ray scattering to extract the interfacial tension of a buried polymer/polymer interface. Diffuse scattering was excited by an X-ray standing wave whose phase was adjusted to have a high intensity at the polymer/polymer interface and simultaneously a node at the polymer/air interface. This method permits the capillary-wave-induced roughness of the interface, and hence the interfacial tension, to be measured independently of the polymer/polymer interdiffusion.
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Sinha SK, Gomes JA, Bharucha DB, Duong TD, Harnick DJ, Mehta D. Clinical utility of head-up tilt table testing in very elderly patients. Heart Rhythm 2005. [DOI: 10.1016/j.hrthm.2005.02.965] [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: 10/25/2022]
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Narayanan S, Lee DR, Guico RS, Sinha SK, Wang J. Real-time evolution of the distribution of nanoparticles in an ultrathin-polymer-film-based waveguide. PHYSICAL REVIEW LETTERS 2005; 94:145504. [PMID: 15904075 DOI: 10.1103/physrevlett.94.145504] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2004] [Indexed: 05/02/2023]
Abstract
We report a novel application of an ultrathin-polymer-film-based, resonance-enhanced x-ray waveguide as a real-time nanoprobe for elucidating dilute, yet disordered, gold nanoparticles embedded in the polymer matrix. This nanoprobe promises a sensitivity enhancement of several orders of magnitude, hence revealing in real time the lateral nanoparticle distribution with subnanometer spatial resolution. We observed that the motion of the nanoparticles is strongly anisotropic, with in-plane coalescence taking place more rapidly than out-of-plane diffusion, which can ultimately facilitate the formation of two-dimensional structures.
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Sinha SK, Lacaze-Masmonteil T, Valls i Soler A, Wiswell TE, Gadzinowski J, Hajdu J, Bernstein G, Sanchez-Luna M, Segal R, Schaber CJ, Massaro J, d'Agostino R. A multicenter, randomized, controlled trial of lucinactant versus poractant alfa among very premature infants at high risk for respiratory distress syndrome. Pediatrics 2005; 115:1030-8. [PMID: 15805381 DOI: 10.1542/peds.2004-2231] [Citation(s) in RCA: 151] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Available therapeutic surfactants are either animal-derived or non-protein-containing synthetic products. Animal-derived surfactants contain variable amounts of surfactant apoproteins, whereas the older-generation synthetic products contain only phospholipids and lack surfactant proteins (SPs). Both decrease morbidity and mortality rates associated with respiratory distress syndrome (RDS) among preterm infants, compared with placebo. However, excess mortality rates have been observed with non-protein-containing synthetic surfactants, compared with the animal-derived products. Evidence suggests that synthetic surfactants consisting solely of phospholipids can be improved with the addition of peptides that are functional analogs of SPs. Lucinactant is a new synthetic peptide-containing surfactant that contains sinapultide, a novel, 21-amino acid peptide (leucine and lysine repeating units, KL4 peptide) designed to mimic human SP-B. It is completely devoid of animal-derived components. OBJECTIVE We hypothesized that the outcomes for premature infants treated with lucinactant and poractant alfa would be similar. Therefore, we compared lucinactant (Surfaxin; Discovery Laboratories, Doylestown, PA) with porcine-derived, poractant alfa (Curosurf; Chiesi Farmaceutici, Parma, Italy) in a trial to test for noninferiority. METHODS A total of 252 infants born between 24 and 28 weeks of completed gestation, with birth weights between 600 and 1250 g, were assigned randomly in a multicenter, multinational, noninferiority, randomized, controlled study to receive either lucinactant (n = 124) or poractant alfa (n = 128) within 30 minutes of life. The primary outcome was the incidence of being alive without bronchopulmonary dysplasia (BPD) through 28 days of age. Key secondary outcomes included death at day 28 and 36 weeks postmenstrual age (PMA), air leaks, neuroimaging abnormalities, and other complications related to either prematurity or RDS. An independent, international, data and safety monitoring committee monitored the trial. RESULTS The treatment difference between lucinactant and poractant alfa for survival without BPD through 28 days was 4.75% (95% confidence interval [CI]: -7.3% to 16.8%) in favor of lucinactant, with the lower boundary of the 95% CI for the difference, ie, -7.3%, being greater than the prespecified noninferiority margin of -14.5%. At 28 days, 45 of 119 infants given lucinactant were alive without BPD (37.8%; 95% CI: 29.1-46.5%), compared with 41 of 124 given poractant alfa (33.1%; 95% CI: 24.8-41.3%); at 36 weeks PMA, the rates were 64.7% and 66.9%, respectively. The corresponding mortality rate through day 28 for the lucinactant group was lower than that for the poractant alfa group (11.8% [95% CI: 6.0-17.6%] vs 16.1% [95% CI: 9.7-22.6%]), as was the rate at 36 weeks PMA (16% and 18.5%, respectively). There were no differences in major dosing complications. In addition, no significant differences were observed in the incidences of common complications of prematurity, including intraventricular hemorrhage (grades 3 and 4) and cystic periventricular leukomalacia (lucinactant: 14.3%; poractant alfa: 16.9%). CONCLUSIONS Lucinactant and poractant alfa were similar in terms of efficacy and safety when used for the prevention and treatment of RDS among preterm infants. The ability to enhance the performance of a synthetic surfactant with the addition of a peptide that mimics the action of SP-B, such as sinapultide, brings potential advantages to exogenous surfactant therapy.
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MESH Headings
- Biological Products/administration & dosage
- Biological Products/therapeutic use
- Bronchopulmonary Dysplasia/epidemiology
- Bronchopulmonary Dysplasia/prevention & control
- Drug Combinations
- Fatty Alcohols/administration & dosage
- Fatty Alcohols/therapeutic use
- Female
- Humans
- Incidence
- Infant Mortality
- Infant, Newborn
- Infant, Premature
- Infant, Premature, Diseases/epidemiology
- Infant, Premature, Diseases/mortality
- Infant, Very Low Birth Weight
- Intracranial Hemorrhages/epidemiology
- Leukomalacia, Periventricular/epidemiology
- Male
- Phosphatidylglycerols/administration & dosage
- Phosphatidylglycerols/therapeutic use
- Phospholipids/administration & dosage
- Phospholipids/therapeutic use
- Proteins/administration & dosage
- Proteins/therapeutic use
- Pulmonary Surfactants/administration & dosage
- Pulmonary Surfactants/therapeutic use
- Respiration, Artificial
- Respiratory Distress Syndrome, Newborn/epidemiology
- Respiratory Distress Syndrome, Newborn/prevention & control
- Respiratory Distress Syndrome, Newborn/therapy
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Malhotra S, Rana SV, Sinha SK, Khurana S. Dietary fiber assessment of patients with irritable bowel syndrome from Northern India. Indian J Gastroenterol 2005; 23:217-8. [PMID: 15627661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Data on the absolute fiber intake and the source of dietary fiber intake in patients with irritable bowel syndrome (IBS) have been lacking in northern Indians. OBJECTIVE To find out the absolute fiber intake from different sources of food items in patients with IBS and healthy subjects from northern India. METHODS Using the 72-hour recall method, dietary intake of macronutrients and fiber was determined in 33 consecutive adult patients with IBS and 33 age- and gender-matched healthy controls. RESULTS The patients consumed lower amounts of macronutrients (protein 60.4 g vs 79.3 g, fat 47.7 g vs 65.7 g, and carbohydrates 294.6 g vs 339.8 g) and dietary fiber (8.1 g vs 15.7 g) than the control subjects. Though the patients consumed similar amount of pulses as the controls (46.6 [25.0] vs 46 [19.6] g/day), their fiber intake from pulses was lower (0.8 [0.7] vs 1.4 [0.9] g/day). The intake of fiber from vegetables and fruits was also significantly lower in patients (2.1 and 0.5 g/day, respectively) than in control subjects (5.8 and 3.9 g/day, respectively; p< 0.001 each). CONCLUSION Total dietary fiber intake and intake of fiber from vegetables, fruits and pulses are lower in patients with IBS from northern India than in control subjects.
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Mantri RR, Sinha SK, Mehta D. Radiofrequency ablation of Mahaim pathway during atrial fibrillation. Heart Rhythm 2005; 2:179-81. [PMID: 15851294 DOI: 10.1016/j.hrthm.2004.10.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2004] [Accepted: 10/05/2004] [Indexed: 11/21/2022]
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Santha T, Garg R, Subramani R, Chandrasekaran V, Selvakumar N, Sisodia RS, Perumal M, Sinha SK, Singh RJ, Chavan R, Ali F, Sarma SK, Sharma KM, Jagtap RD, Frieden TR, Fabio L, Narayanan PR. Comparison of cough of 2 and 3 weeks to improve detection of smear-positive tuberculosis cases among out-patients in India. Int J Tuberc Lung Dis 2005; 9:61-8. [PMID: 15675552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
SETTING Governmental health facilities in six districts of India. OBJECTIVE To estimate the prevalence of cough and to compare the detection of smear-positive tuberculosis (TB) among out-patients with cough of > or =2 or > or =3 weeks. DESIGN Trained health workers questioned each out-patient for presence of cough. Those with cough > or =2 weeks underwent sputum microscopy. RESULTS Of 55561 out-patients interviewed, 2210 (4%) had cough > or =2 weeks, of whom 267 had sputum-positive TB, compared to 182/1370 with cough > or =3 weeks. The 31% who did not spontaneously complain of cough were less likely to be sputum-positive than those who did (45/680 [7%] vs. 222/1530 [15%], P < 0.001), but they accounted for 45/267 smear-positive cases. Using cough > or =2 weeks as the screening criterion, the estimated number of smears performed per day at each primary and secondary health care facility was respectively 8 and 19, compared to 5 and 12 using cough > or =3 weeks. CONCLUSION The detection of smear-positive TB cases can be substantially improved by actively eliciting history of cough from all out-patients, and by changing the screening criterion for performing sputum microscopy among out-patients from cough > or =3 weeks to > or =2 weeks. Before implementing this change nationally, its programmatic feasibility should be assessed.
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Sinha SK, Harnick D, Gomes JA, Mehta D. Electrophysiologic interventions in patients with inferior vena cava filters: Safety and efficacy of the transfemoral approach. Heart Rhythm 2005; 2:15-8. [PMID: 15851258 DOI: 10.1016/j.hrthm.2004.09.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2004] [Accepted: 09/26/2004] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the transfemoral venous approach for electrophysiologic interventions in patients with inferior vena cava filters. BACKGROUND Reports have detailed complications associated with obtaining central venous access in patients with inferior vena cava filters. Accordingly, electrophysiologic interventions have been modified or deferred altogether in such patients. METHODS Patients requiring interventions with a transfemoral approach who were at least 3 months post filter insertion underwent fluoroscopically guided insertion and withdrawal of electrode catheters with appropriate follow-up. RESULTS Five patients underwent successful pacing, electrophysiologic study, or radiofrequency ablation using one to three catheters, with no complications attributable to filter placement. CONCLUSIONS Transfemoral electrophysiologic interventions can be safely undertaken across vena cava filters provided appropriate precautions are taken.
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Sinha SK, Mehta D, Gomes JA. Prevention of sudden cardiac death: the role of the implantable cardioverter-defibrillator. THE MOUNT SINAI JOURNAL OF MEDICINE, NEW YORK 2005; 72:1-9. [PMID: 15682255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Sudden cardiac death, usually due to fatal ventricular tachyarrhythmias, results in the loss of 300,000-400,000 lives each year in the United States. Implantable cardioverter-defibrillator therapy has revolutionized both the secondary and, increasingly, the primary prevention of sudden cardiac death. In the last decade, subcutaneous pectoral implantation with transvenous lead placement has lessened perioperative risk considerably, raising the benefit/risk ratio for many candidates. As a consequence, the list of approved indications for implantable cardioverter-defibrillator therapy has expanded rapidly in recent years. Current devices offer tiered therapy utilizing bradycardia pacing, anti-tachycardia pacing, low-energy cardioversion, and high-energy defibrillation. Hybrid therapy, combining device, drugs and radiofrequency catheter ablation as required, has become the standard of care for reducing both appropriate and inappropriate shocks. As implantation rates continue to rise, so will the number of patients presenting with electrical storm. The dilemma of how our society will cope with the enormous projected costs of implantable cardioverter-defibrillator therapy has yet to be resolved.
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Dutta U, Sinha SK, Singh P, Singh K, Aydinli B, Celebi F, Kantarci M, Ozturk G. Images of interest. Hepatobiliary and pancreatic: complications of hydatid disease. J Gastroenterol Hepatol 2004; 19:1321. [PMID: 15482544 DOI: 10.1111/j.1440-1746.2004.03628.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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149
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Islam Z, Liu X, Sinha SK, Lang JC, Moss SC, Haskel D, Srajer G, Wochner P, Lee DR, Haeffner DR, Welp U. Four-unit-cell superstructure in the optimally doped YBa2Cu3O6.92 superconductor. PHYSICAL REVIEW LETTERS 2004; 93:157008. [PMID: 15524931 DOI: 10.1103/physrevlett.93.157008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2003] [Indexed: 05/24/2023]
Abstract
Diffuse x-ray scattering measurements reveal that the optimally doped YBa2Cu3O6.92 superconductor is intrinsically modulated due to the formation of a kinetically limited 4-unit-cell superlattice, q(0)=(1/4, 0, 0), along the shorter Cu-Cu bonds. The superlattice consists of large anisotropic displacements of Cu, Ba, and O atoms, respectively, which are correlated over approximately 3-6 unit cells in the ab plane, and appears to be consistent with the presence of an O-ordered "ortho-IV" phase. Long-range strains emanating from these modulated regions generate an inhomogeneous lattice which may play a fundamentally important role in the electronic properties of yttrium-barium-copper-oxides.
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