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Vogelbaum MA, Berkey B, Peereboom D, Giannini C, Suh J, Brown P, Blumenthal D, Biggs C, Schultz C, Mehta M. RTOG 0131: Phase II trial of pre-irradiation and concurrent temozolomide in patients with newly diagnosed anaplastic oligodendrogliomas and mixed anaplastic oligodendrogliomas. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.1520] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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177
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Soisson E, Richards G, Mehta M, Tome W. SU-FF-T-67: Comparison of Linac Based Fractionated Stereotactic Radiotherapy and Tomotherapy for Treatment of Skull-Base Tumors. Med Phys 2005. [DOI: 10.1118/1.1997738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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178
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Cardinale R, Won M, Choucair A, Gillin M, Chakravarti A, Schultz C, Souhami L, Chen A, Pham H, Mehta M. A phase II trial of accelerated radiotherapy using weekly stereotactic conformal boosts for supratentorial glioblastoma multiforme. RTOG-0023. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.1511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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179
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Westerly D, Aoyama H, Patel R, Jaradat H, Olivera G, Tome W, Ritter M, Mehta M, Mackie T. SU-FF-T-82: Non-Tumor Integral Dose in Conformal, External Beam Radiation Therapy. Med Phys 2005. [DOI: 10.1118/1.1997753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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180
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Jaradat H, Paliwal B, Mehta M. SU-FF-T-170: Tomotherapy Daily Quality Assurance Phantom. Med Phys 2005. [DOI: 10.1118/1.1997841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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181
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Jaradat H, Tome W, Mehta M. SU-FF-T-412: The Feasibility of Using Tomotherapy Hi-Art Machine for Stereotactic Radiosurgery. Med Phys 2005. [DOI: 10.1118/1.1998211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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182
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Mehta M, Bhagwanjee A, Kubheka B, Penchaliah A, Jadwat R. A preliminary evaluation of optometric management and referral protocols for pa-tients with diabetic retinopathy. AFRICAN VISION AND EYE HEALTH 2005. [DOI: 10.4102/aveh.v64i4.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Aim: The purpose of this pilot study was to investigate the assessment, management and referral practices of South African optometrists in the care of patients with diabetic retinop-athy (DR) and to recommend strategies to improve and standardize patient management as required. Methods: The study design incorporated quantitative, qualitative and clinical measures that were administered to fourteen experienced optometrists from the Durban area. The quan-titative measure, the questionnaire in appendix I, evaluated the optometrists’ management pro-tocols of patients with diabetes mellitus (DM). These included the optometrists’ referral and co-management practices, their awareness and usage of appropriate guidelines in the man-agement and referral of these patients, their perceived levels of competence and confidence in their education, levels of service offered to the patients and finally the role of Continuous Professional Development (CPD). This self-report information was supplemented by a set of clinical measures where the study sample grad-ed levels of DR, chose appropriate management options and indicated prognosis for disease progression based on a set of slides presented to them. Finally the fourteen optometrists, as well as two ophthalmologists, were interviewed using tailored, semi-structured interview sched-ules. These interviews were used to elaborate and corroborate information obtained from the other two research approaches. Results: Descriptive analysis was used to analyse the data from the quantitative and clinical measures, whilst the interviews were analysed thematically. Although 86% of the sample routinely screened for ocular manifesta-tions of DM, there was no standardization in the criteria used by the fourteen optometrists. Only 15% of the sample reportedly assessed their patients using dilated fundus examina-tions (DFE), which is the internationally rec-ommended standard of care. The results of the clinical measures indicated that there was a lack of standardization in the management and refer-ral of patients with DR by the study sample, contrary to their own levels of confidence in their educational competencies regarding DR and their perception of the level of service that they offered to their patients. The interviews with the optometrists provided crucial insights into this lack of standardised care of patients with DR, with the ophthalmologists confirming the urgent need for CPD aimed at enhancing clinical skills and ensuring standardization in the management and referral of patients with DR. This finding was particularly relevant for co-management models.Conclusion: This pilot study indicates that the performance of the optometrists (albeit a relatively small group) in the assessment, man-agement and referral of patients with DR was inconsistent and not in keeping with interna-tionally recommended guidelines. It is recom-mended that CPD programmes focus on the improvement of clinical skills and on the imple-mentation of existing standardised management protocols for patients with DR. This should result in improved patient care, patient confi-dence and loyalty with regard to care received, efficient and effective models of management and co-management and decreased costs to patients and the health care system.
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Dugal JS, Jetley V, Sharma JK, Singh C, Mehta M, Sabharwa JS, Sofat S, Bharadwaj P. Techniques in Cardiology : PDA Closure in Children. Med J Armed Forces India 2005; 61:63-5. [PMID: 27407706 DOI: 10.1016/s0377-1237(05)80123-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2003] [Accepted: 05/06/2004] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Transcatheter closure of patent ductus arteriosus (PDA) with various devices has been evaluated worldwide and in selected cases can be performed successfully, thus avoiding the morbidity associated with surgical closure. METHODS AND RESULTS A 2 year old female child presented with PDA and aortic angiography showed large PDA (tubular). This defect can be closed nonsurgically by coils and devices. The coil used are normally 0.038" having delivery system called Flipper, but this child had a large PDA and so was closed by thicker coil 0.052" using a coil-Bioptome-sheath system, which is the first reported case from the Armed Forces. CONCLUSIONS We report the initial experience at our center of closure of PDA with a new coil-Bioptome-sheath system.
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Jetley V, Duggal JS, Singh C, Datta SK, Sabharwal JS, Sofat S, Mehta M. Submitral Aneurysm of the Left Ventricle. Med J Armed Forces India 2004; 60:399-401. [PMID: 27407685 PMCID: PMC4923391 DOI: 10.1016/s0377-1237(04)80023-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2002] [Accepted: 04/02/2003] [Indexed: 11/16/2022] Open
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186
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Mehta M, Cayne N, Veith FJ, Darling RC, Roddy SP, Paty PSK, Ozsvath KJ, Kreienberg PB, Chang BB, Shah DM. Relationship of proximal fixation to renal dysfunction in patients undergoing endovascular aneurysm repair. THE JOURNAL OF CARDIOVASCULAR SURGERY 2004; 45:367-74. [PMID: 15365517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Technological advancements have lead to dramatic improvements in stentgraft device design resulting in more trackable delivery systems and transrenal uncovered stents and barbs for better fixation. Transrenal bare-stents may limit stentgraft migration, particularly in patients with short or flared proximal aortic necks. However, potential disadvantages might be in worsening renal function, particularly in patients with preexisting renal insufficiency. We retrospectively analyzed our recent 7 year experience of patients undergoing endovascular aneurysm repair (EVAR) using a variety of stentgrafts with and without transrenal bare-stent fixation. Patients were divided into 2 groups; infrarenal fixation (IRF) vs transrenal fixation (TRF), or patients with preoperative serum Cr values that were normal (= or <1.5 mg/dl) vs slightly elevated (1.6-2 mg/dl), vs markedly elevated (2.1- 3.5 mg/dl). The exclusion criteria included patients with chronic renal insufficiency (CRI) on hemodialysis, and preoperative high-grade renal artery stenoses requiring angioplasty and stenting. Of 705 patients that underwent EVAR, 496 (IRF: 385 [78%], and TRF: 111 [22%]) were available with routine evaluations of serum Cr and CT scans. Preexisting comorbidities, mean procedure contrast volume, and postprocedure follow-up were similar in both groups. In the immediate postoperative period, mean serum Cr did not change significantly in either the IRF group (1.3+/-0.7 mg/dl to 1.2+/-0.9 mg/dl) or the TRF group (1.3+/-0.5 mg/dl to 1.3+/-0.6 mg/dl). Mean serum Cr did, however, significantly increase over longer follow-up in both groups: 1.4+/-0.8 mg/dl for IRF (P<0.03), and 1.5 +/- 0.8 mg/dl for TRF (P<0.01). Cr clearance was similarly unchanged in the immediate postoperative period (58+/-23 to 61+/-25 ml/min/1.73 m2 for IRF group, 53+/-17 to 55+/-17 ml/min/1.73 m2 for TRF group), but was significantly decreased in longer follow-up (53+/-23 ml/min/1.73 m2 for IRF, p<0.02: and 48+/-16 ml/min/1.73 m2 for TRF, P<0.01). There were no significant differences in serum Cr increase (p=0.19) or Cr clearance decrease (p=0.68) between the IRF and TRF groups. Small renal infarcts were noted in 6 patients (1.6%) in the IRF group, and in 8 patients (7%) in the TRF group (p=0.37). Of patients with normal preoperative renal function, renal dysfunction developed in 7.7% of IRF group and 6.1% of TRF group (p=0.76). In patients with preexisting CRI, renal dysfunction developed in 18.2% of IRF group, and 17.1% of TRF group (p=0.95). Eight patients with postoperative renal dysfunction, 5 (1.3%) from IRF group and 3 (2.7%) from TRF group subsequently required hemodialysis, and this difference was not statistically significant (p=0.91). We also analyzed 200 consecutive patients undergoing EVAR with intra-arterial contrast agents with and without preexisting CRI not on dialysis. The groups were identified on the basis of preprocedure serum Cr: group 1 (n=108), Cr less than 1.5 mg/dL (normal range); group 2 (n=65), Cr 1.5 to 2.0 mg/dL; group 3 (n=27), Cr 2.1 to 3.5 mg/dL. Routine precautions in patients with CRI included preoperative intravenous hydration with 2 L of normal saline solution, discontinuation of all nephrotoxic drugs, intraoperative administration of mannitol (0.5 g/kg intravenously), and use of nonionic, low osmolar intra-arterial contrast agent (Omnipaque 350). One-hundred and eight patients had normal renal function (group 1), and 92 patients had preexisting CRI with baseline Cr 1.5 to 2.0 mg/dL (group 2, n=65) or 2.1 to 3.5 mg/dL (group 3, n=27). Comorbid conditions included coronary artery disease (group 1, 51%; group 2, 49%; group 3, 59%), hypertension (group 1, 39%; group 2, 46%; group 3, 52%), and diabetes mellitus (group 1, 25%; group 2, 35%; group 3, 48%). In groups 1, 2, and 3, the mean volume of low osmolar contrast agent used was 210 cc, 160 cc, 130 cc, respectively; hemodynamic instability developed in 3, 1, and 1 patient, respectively. The incidence of postoperative complications between the 3 study groups was not statistically different. In grications between the 3 study groups was not statistically different. In group 1 a transient increase in serum Cr (>30% over baseline and >1.4 mg/dL) was noted in 3 patients (2.7%), 2 of whom (1.9%) required temporary hemodialysis and 1 (0.9%) who died of renal failure. In group 2 a transient increase in serum Cr was noted in 2 patients (3.1%); both patients (3.1%) required temporary hemodialysis, and 1 patient (1.5%) died of renal failure. In group 3 a transient increase in serum Cr was noted in 2 patients (7.4%); 1 patient (3.7%) required temporary hemodialysis, and 1 patient (3.7%) died of renal failure. Perioperative hypotension significantly increased the risk for elevated serum Cr and death (p<0.05), and larger contrast volume was associated with an increase in serum Cr (p<0.05) during the postoperative period. Following EVAR renal function declines slightly with both IRF and TRF. Our data show no overall difference between patients with IRF and TRF with respect to infarcts, decline in renal function, or onset of dialysis. There were a slightly greater number of renal infarcts in the TRF group, but these infarcts were clinically inconsequential. In patients with CRI, EVAR with intra-arterial radiographic contrast agents is believed to impair renal function, and CRI is considered a relative contraindication to the procedure. Results of our investigation indicate that risk for worsening renal insufficiency, dialysis, and death is only slightly and not significantly greater in patients with CRI compared with patients with normal renal function. With appropriate precautions of avoiding perioperative hypotension and limiting the volume of nonionic contrast agents, CRI need not be a contraindication for EVAR with intra-arterial contrast agents.
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Chakravarti A, Seiferheld W, Robins HI, Guha A, Brachman D, Curran W, Choucair A, Mehta M. An update of phase I data from RTOG 0211: A phase I/II clinical study of gefitinib+ radiation for newly-diagnosed glioblastoma (GBM) patients. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.1571] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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188
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Choucair AK, Seiferheld W, Ford C, Hansen J, Dabbas B, Schultz C, Schulsinger A, Mehta M, Curran W. Long term survivors with glioblastoma multiforme (GBM) treated on RTOG protocols with irradiation and nitrosurea have higher initial expression of Ki-67. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.9661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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189
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Robins HI, Won M, Schultz C, Choucair A, Brachman D, Demas W, Mehta M. A phase II trial of conventional radiation therapy (XRT) plus high dose tamoxifen (TAM) for the treatment of supratentorial glioblastoma multiforme (GBM): RTOG protocol BR-0021. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.1529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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190
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Mañon RR, Oneill A, Mehta M, Knisely J, Werner-Wasik M, Lazarus H, Wagner H, Gilbert M. Phase II trial of radiosurgery (RS) for 1 to 3 newly diagnosed brain metastases from renal cell, melanoma, and sarcoma: An Eastern Cooperative Oncology Group Study (E6397). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.1507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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191
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Ford C, Seiferheld W, Choucair AK, Hansen J, Dabbas B, Schultz C, Schulsinger A, Mehta M, Curran W. Evaluation of expression of DNA repair molecules as a prognostic factor for long-term survivors with glioblastoma multiforme (GBM) treated on RTOG protocols with irradiation and nitrosoureas. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.1509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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192
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Narayana PA, Wolinsky JS, Rao SB, Renjie He, Mehta M, PROMiSe Trial MRSI Group. Multicentre proton magnetic resonance spectroscopy imaging of primary progressive multiple sclerosis. Mult Scler 2004. [DOI: 10.1177/135245850401000113] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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193
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Dwivedi S, Mehta M, Bhasin S, Agrawal K. M.502 Central obesity, pre-hypertension and parental history of cardiovascular allied disorders in affluent schoolgirls in Delhi. ATHEROSCLEROSIS SUPP 2004. [DOI: 10.1016/s1567-5688(04)90500-x] [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]
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194
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Mehta M, Veith FJ. Endovascular Repair of Aortic Aneurysms in Patients With Renal Insufficiency. ACTA ACUST UNITED AC 2004. [DOI: 10.1177/153100350401600105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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195
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Drobny GP, Long JR, Karlsson T, Shaw W, Popham J, Oyler N, Bower P, Stringer J, Gregory D, Mehta M, Stayton PS. Structural studies of biomaterials using double-quantum solid-state NMR spectroscopy. Annu Rev Phys Chem 2003; 54:531-71. [PMID: 12709513 DOI: 10.1146/annurev.physchem.54.011002.103903] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Proteins directly control the nucleation and growth of biominerals, but the details of molecular recognition at the protein-biomineral interface remain poorly understood. The elucidation of recognition mechanisms at this interface may provide design principles for advanced materials development in medical and ceramic composites technologies. Here, we describe both the theory and practice of double-quantum solid-state NMR (ssNMR) structure-determination techniques, as they are used to determine the secondary structures of surface-adsorbed peptides and proteins. In particular, we have used ssNMR dipolar techniques to provide the first high-resolution structural and dynamic characterization of a hydrated biomineralization protein, salivary statherin, adsorbed to its biologically relevant hydroxyapatite (HAP) surface. Here, we also review NMR data on peptides designed to adsorb from aqueous solutions onto highly porous hydrophobic surfaces with specific helical secondary structures. The adsorption or covalent attachment of biological macromolecules onto polymer materials to improve their biocompatibility has been pursued using a variety of approaches, but key to understanding their efficacy is the verification of the structure and dynamics of the immobilized biomolecules using double-quantum ssNMR spectroscopy.
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Zhang T, Keller H, Jeraj R, Manon R, Welsh J, Patel R, Fenwick J, Mehta M, Mackie T, Paliwal B. Breathing synchronized delivery — a new technique for radiation treatment of the targets with respiratory motion. Int J Radiat Oncol Biol Phys 2003. [DOI: 10.1016/s0360-3016(03)00980-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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197
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Shaw E, Seiferheld W, Scott C, Coughlin C, Leibel S, Curran W, Mehta M. Reexamining the radiation therapy oncology group (RTOG) recursive partitioning analysis (RPA) for glioblastoma multiforme (GBM) patients. Int J Radiat Oncol Biol Phys 2003. [DOI: 10.1016/s0360-3016(03)00843-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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198
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Welsh J, Bradley K, Manon R, Lock M, Patel R, Ruchala K, Mackie T, Mehta M. Megavoltage CT imaging for adaptive helical tomotherapy of lung cancer. Int J Radiat Oncol Biol Phys 2003. [DOI: 10.1016/s0360-3016(03)01387-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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199
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Manon R, Patel R, Zhang T, Henderson D, Tome W, Fenwick J, Paliwal B, Mehta M. CT-based analysis of free-breathing vs. maximum inspiratory breath hold techniques for 3-D conformal radiation therapy and intensity modulated radiation therapy in lung cancer: a potential basis for dose-escalation. Int J Radiat Oncol Biol Phys 2003. [DOI: 10.1016/s0360-3016(03)01360-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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200
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Mehta M, Mckenzie M. Advertising increases demand for vasectomy. AVSC NEWS (ASSOCIATION FOR VOLUNTARY SURGICAL CONTRACEPTION (U.S.)) 2002; 34:7. [PMID: 12321999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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