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Sarma D, Chiu DT, Kimball AB. Gender and Clinical Status in Burnout in Medicine. JAMA Netw Open 2024; 7:e246575. [PMID: 38602680 PMCID: PMC11009818 DOI: 10.1001/jamanetworkopen.2024.6575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/15/2024] [Indexed: 04/12/2024] Open
Abstract
This survey study assesses feelings of satisfaction, stress, and burnout by gender and clinical status among health care workers at a single academic center.
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Affiliation(s)
- Deesha Sarma
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - David T. Chiu
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Alexa B. Kimball
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
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Sarma D, Stenson B, MacDougall G, Mangino A, Sanchez LD, Chiu DT. Comparison of nurse and resident physician paging frequency by sex in the emergency department. AEM Educ Train 2024; 8:e10948. [PMID: 38510726 PMCID: PMC10950017 DOI: 10.1002/aet2.10948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/20/2023] [Accepted: 12/13/2023] [Indexed: 03/22/2024]
Abstract
Objectives The role of biological sex in interprofessional relationships is an important factor in collaborative health care settings such as the emergency department (ED) but one that has been sparsely studied. While there is anecdotal evidence on gender-based differences in communication, little research has focused on this topic. The goal of this study was to determine whether there are differences in paging frequency between nurses and male and female residents. Methods We conducted a retrospective review of patient visits to our urban, tertiary care academic ED between January 1 and April 1, 2021. Only pages from nurses to emergency medicine (EM) residents were included. Outcome variables included number of pages received by sex, number of unique ED visits, and mean number of pages per unique visit. Pearson's chi-square tests were used to analyze differences between observed and expected results. Results A total of 15,617 pages from nurses to residents over 6843 unique patient visits to the ED were analyzed. This included 187 nurses, 162 (87%) of whom were female and 25 (13%) were male. Of the 39 residents, 12 (31%) were female and 27 (69%) were male. Female residents received 4500 pages over 2228 unique patient ED visits, or a mean of two pages per patient with a mean of 186 unique ED visits per female resident. Male residents received 11,117 pages over 4615 unique patient ED visits, or a mean of 2.4 pages per patient, with a mean of 171 unique ED visits per male resident. This difference in pages per patient was statistically significant (χ2(1) = 369, p < 0.001). Conclusions We found that male residents received significantly more pages per patient than their female colleagues. Overall, further research is required to understand the factors, such as characteristics of patients or preferred communication methods of providers, that drive this disparity and what the implications are for patient outcomes.
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Affiliation(s)
- Deesha Sarma
- Department of Emergency MedicineBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | - Bryan Stenson
- Department of Emergency MedicineBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | - Gordon MacDougall
- Department of Emergency MedicineBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | - Alyssa Mangino
- Department of Emergency MedicineBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | - Leon D. Sanchez
- Department of Emergency MedicineBrigham and Women's Faulkner HospitalBostonMassachusettsUSA
| | - David T. Chiu
- Department of Emergency MedicineBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
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Mangino A, Stenson BA, Leventhal EL, Sarma D, Antkowiak PS, Chiu DT. Does the number of pages received per hour affect resident productivity? J Am Coll Emerg Physicians Open 2023; 4:e13071. [PMID: 38045014 PMCID: PMC10689889 DOI: 10.1002/emp2.13071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/20/2023] [Accepted: 11/07/2023] [Indexed: 12/05/2023] Open
Abstract
Background Workflow interruptions are common for emergency physicians and are shown to have downstream consequences such as patient dissatisfaction, delay in clinical response, and increase in medical error. However, the impact of passive interruptions on physician productivity is unclear and has not been well studied. We sought to evaluate if the number of pages received per hour significantly affects the number of patients seen per hour. Methods Retrospective data was collected on resident physician (RP) emergency department shifts from July 1st, 2021 to June 30th, 2022 at an academic medical center with an annual census of 55,000 patients. A total of 2865 RP shifts were collected among the 26 postgraduate year (PGY) 1 and PGY2 residents. For each RP shift, we identified the number of pages received per hour and the number of new patients seen per hour. Pages consist of any transmitted message that was sent to the RP's personal pager, which includes both automatic (eg, bed assignments, abnormal lab values) and personalized pages from other healthcare practicioners (eg, nursing, consultants). Data were analyzed using Poisson regression controlling for clustering at the physician level to determine if the number of patients seen per hour is significantly affected by the number of pages (divided into quartiles) received. Results We found the number of pages received per hour did not decrease the number of patients seen per hour. Contrary to our hypothesis, there was a strong positive relationship between the number of pages received per hour and the number of patients seen by RPs in that hour and subsequent hours. During the middle of a shift (hours 3, 4, and 5), RPs receiving pages in the third and fourth quartile (top 50% of pages) saw significantly more patients during that same hour and the next hour (p <0.001). Conclusion The number of pages received by RPs per hour did not decrease the number of patients seen per hour. When RPs receive a higher number of pages, there is a positive association with the number of patients they see in that hour and subsequent hours. Further studies will be needed to determine whether the content of pages affects resident productivity.
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Affiliation(s)
- Alyssa Mangino
- Department of Emergency MedicineHarvard Medical School, Beth Israel Deaconess Medical Center BostonBostonMassachusettsUSA
| | - Bryan A. Stenson
- Department of Emergency MedicineHarvard Medical School, Beth Israel Deaconess Medical Center BostonBostonMassachusettsUSA
| | - Evan L. Leventhal
- Department of Emergency MedicineHarvard Medical School, Beth Israel Deaconess Medical Center BostonBostonMassachusettsUSA
| | - Deesha Sarma
- Department of Emergency MedicineHarvard Medical School, Beth Israel Deaconess Medical Center BostonBostonMassachusettsUSA
| | - Peter S. Antkowiak
- Department of Emergency MedicineHarvard Medical School, Beth Israel Deaconess Medical Center BostonBostonMassachusettsUSA
| | - David T. Chiu
- Department of Emergency MedicineHarvard Medical School, Beth Israel Deaconess Medical Center BostonBostonMassachusettsUSA
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Agarwal I, Sarma D, Burke RC, Babineau M, Benson S, Strout T, Bilello LA, Sanchez LD. Resident Attitudes Toward Performing Pelvic Examinations in the Emergency Department. Womens Health Rep (New Rochelle) 2023; 4:89-93. [PMID: 36874233 PMCID: PMC9983135 DOI: 10.1089/whr.2022.0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 02/19/2023]
Abstract
Mounting evidence suggests that emergency physicians tend to avoid patients with gynecologic chief complaints, and that avoidance may be higher for male physicians compared to females. One underlying reason could be discomfort with performing pelvic examinations. The goal of this study was to assess whether male residents report greater discomfort with pelvic examinations than females. We performed a cross-sectional, Institutional Review Board-approved survey of residents at 6 academic emergency medicine programs. Of 100 residents who completed the survey, 63 self-identified as male, 36 female, and one selected "prefer not to say" and was excluded. Responses were compared between male and females using chi-square tests. In secondary analysis, t-tests were used to compare preferences for various chief complaints. Self-reported comfort with pelvic examinations did not differ significantly between males and females (p = 0.4249). Barriers for male respondents in performing pelvic examinations included lack of training, general dislike, and concern the patient would prefer female providers. Male residents had a statistically significant higher aversion ranking towards patients with vaginal bleeding than female residents (mean difference = 0.48, confidence interval = 0.11-0.87). Aversion ranking was the same between males and females on other chief complaints. There is a gender disparity among male and female residents in attitudes towards patients with vaginal bleeding. However, the results from this study do not demonstrate a significant difference in self-reported comfort amongst male and female residents in performing pelvic examinations. This disparity may be driven by other barriers, including self-reported lack of training and concern about patients' physician gender preferences.
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Affiliation(s)
- Isha Agarwal
- Department of Emergency Medicine, Maine Medical Center, Portland, Maine, USA.,Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Deesha Sarma
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Ryan C Burke
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Matthew Babineau
- Department of Emergency Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Scarlet Benson
- Department of Emergency Medicine, Aventura Hospital and Medical Center, Aventura, Florida, USA
| | - Tania Strout
- Department of Emergency Medicine, Maine Medical Center, Portland, Maine, USA
| | - Leslie A Bilello
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Leon D Sanchez
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Department of Emergency Medicine, Brigham and Women's Faulkner Hospital, Boston, Massachusetts, USA
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Almakadma A, Simard TJ, Sarma D, Hassett L, Alkhouli M, Packer DL, Holmes DR. Pulmonary vein stenosis – ballooning vs. stenting: a systematic review and meta-analysis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Pulmonary vein stenosis (PVS), which is often unrecognized, may arise from a variety of conditions resulting in major morbidity and mortality. In some patients, pharmacological therapy may help but more often in advance stages, mechanical treatment must be considered. Transcatheter approaches, both balloon angioplasty (BA) and stent implantation have been applied. While both may be effective, they continue to be limited by restenosis. Herein, we compare the outcomes following BA and stenting for PVS.
Purpose
PVS presents a challenge for both diagnosis and therapy, with BA and stenting being primarily limited by restenosis. Stenting is performed in most cases and is associated with improved patency rates. Historical comparisons of BA and stenting for PVS have yielded similar results. Our analysis incorporates more conventional studies (2010–2021) and provides a larger stent (N=361) versus BA (N=229) contemporary analysis of the current state of PV intervention practice.
Methods
From January 1, 2010 to August 2, 2021, studies, limited to English language and humans, were assessed in Ovid MEDLINE®, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. Two independent reviewers screened articles including those in which balloon angioplasty or stenting was performed for pulmonary vein stenosis with reporting of restenosis outcomes and data was independently extracted. Systematic review was performed, and overall restenosis rates were reported across all included studies. Meta-analysis was then performed using RevMan 5.4 assessing rates of restenosis and restenosis requiring repeat intervention.
Results
Our systematic review yielded 34 studies reporting on BA and/or stenting for PVS. Of these, 7 studies (1–7), treating a total of 343 patients with 590 PV interventions (229 BA and 361 Stents) reported restenosis rates with mean follow-up ranging from 10 to 60 months. Stenting was associated with a lower risk of restenosis compared to balloon angioplasty [risk ratio 0.35, 95% CI (0.18, 0.64), p=0.0008] (Figure 1). Restenosis requiring repeat intervention was reported in 5 studies, including 303 patients with 502 PV interventions (160 BA and 342 Stents) with stenting similarly associated with a lower risk of restenosis requiring re-intervention [risk ratio 0.34, 95% CI (0.16, 0.72), p=0.005].
Conclusion
Stenting for pulmonary vein stenosis is associated with reduced risk of restenosis and re-intervention as compared to balloon angioplasty.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Almakadma
- Mayo Clinic, Cardiovascular Diseases , Rochester , United States of America
| | - T J Simard
- Mayo Clinic, Cardiovascular Diseases , Rochester , United States of America
| | - D Sarma
- Mayo Clinic, Cardiovascular Diseases , Rochester , United States of America
| | - L Hassett
- Mayo Clinic, Mayo Clinic Libraries , Rochester , United States of America
| | - M Alkhouli
- Mayo Clinic, Cardiovascular Diseases , Rochester , United States of America
| | - D L Packer
- Mayo Clinic, Cardiovascular Diseases , Rochester , United States of America
| | - D R Holmes
- Mayo Clinic, Cardiovascular Diseases , Rochester , United States of America
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6
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Kanyal R, Pareek N, Sarma D, Bharucha A, Dworakowski R, Melikian N, Webb I, Shah A, MacCarthy P, Byrne J. Complete Revascularisation is associated with Improved Survival after Out of Hospital Cardiac Arrest. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Coronary artery disease (CAD) is common in patients with Out of Hospital Cardiac Arrest (OOHCA) but the clinical relevance of burden of CAD and evidence for revascularisation strategies in relation to outcomes and modes of death remains unclear.
Purpose
This study sought to assess the extent of CAD as defined by the SYNTAX score and prognostic value of complete compared with incomplete revascularisation by evaluating the SYNTAX revascularisation index (SRI) in patients with OOHCA.
Methods
619 patients with OOHCA were admitted at our centre between 1st May 2012 and 31st December 2017. 237 were excluded for having a non-cardiac aetiology or prior neurological disability. 398 patients were included into the study and of these 272 (68.3%) had early coronary angiography (CAG) and were included in the final analysis.
The baseline SYNTAX score (bSS) and residual SYNTAX score (rSS) were determined from the coronary angiograms by a cardiologist blinded to the outcome. Patients were subdivided into 4 subgroups according to quartiles of the baseline syntax score (bSS) of 0, Group A: 1–10, Group B: 11–20 and Group C: ≥21. Complete revascularisation (CR) was defined as SRI of 1 and incomplete (IR) as SRI <1 where the SRI=(1-[rSS/bSS]) ×100 (Figure 1).
Results
Patients with a bSS of 0 were younger, had less shockable initial arrest rhythms and worse lactate and pH on arrival.Patients with bSS>0 (i.e., those with coronary artery disease) had similar cardiac arrest circumstances in terms of rates of witnessed, bystander CPR and shockable rhythms. Admission metabolic status reflected by pH and lactate and rates of ST elevation/LBBB were also identical for all three groups. However, LVEF on admission decreased significantly as coronary complexity increased (P<0.0001). While early angiography was more preferentially performed in those with higher coronary complexity, paradoxically, those with bSS 1–4 had highest rates of culprit lesions which was reflected in higher rates of PCI (Figure 1).
124 (45.4%) had CR compared with 54.2% with IR. CR was most likely to be achieved as the coronary complexity reduced (Group A – 71.7%, Group B – 41.1%, Group C - 23.3%). There was no difference in rates of cardiogenic shock between both groups (CR 61.1% vs. IR 69% p=ns), but patients with complete revascularisation were younger (58.8 vs 67.8, p<0.0001), lower rates of hypertension and previous CABG (16.2% vs 3.2%, p≤0.0001)
CR was associated with decreased mortality at 30 days (45.9% vs 34.6%, p=0.046) and 12 months (49.3% vs 35.4%, p=0.022). The lower mortality rate in CR appeared to partly be driven by lower cardiac deaths though this was not statistically significant (22% vs 7%, p=0.1) (Figure 2).
Conclusions
CR in a primary coronary aetiology OOHCA group is associated with reduced early and long-term mortality, which may be driven by a reduction in cardiac deaths. Prospective randomised trials in this population are warranted.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- R Kanyal
- King's College Hospital, London, United Kingdom
| | - N Pareek
- King's College Hospital, London, United Kingdom
| | - D Sarma
- King's College Hospital, London, United Kingdom
| | - A Bharucha
- King's College Hospital, London, United Kingdom
| | | | - N Melikian
- King's College Hospital, London, United Kingdom
| | - I Webb
- King's College Hospital, London, United Kingdom
| | - A Shah
- King's College Hospital, London, United Kingdom
| | - P MacCarthy
- King's College Hospital, London, United Kingdom
| | - J Byrne
- King's College Hospital, London, United Kingdom
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Kanyal R, Sarma D, Pareek N, Dworakowski R, Melikian N, Webb I, Shah A, MacCarthy P, Byrne J. Clinical significance of early echocardiography after out-of-hospital cardiac arrest on arrival to a heart attack centre. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Left ventricular systolic dysfunction (LVSD) is common after out of hospital cardiac arrest (OOHCA) and can manifest as global or regional change.
Purpose
We evaluated the extent of global and regional LVSD and its association with coronary artery disease (CAD) and outcome in those undergoing coronary angiography after OOHCA.
Methods
619 patients with OOHCA were admitted at our centre between 1st May 2012 and 31st December 2017. 398 patients were included. Rates of cardiogenic shock and extent of CAD, as classified by the SYNTAX score were measured. The primary endpoint was 12-month mortality. Patients with incomplete data were excluded from the analysis.
Results
Two hundred and sixty-six patients (median age 62 [53–71] 76.3% male) underwent both trans-thoracic echocardiography andcoronary angiography on arrival and were included in the final analysis. 81.6% had ventricular fibrillation, 83.5% were witnessed and 51.9% occurred at residence.
Ninety-six patients (36%) had significant LVSD (Left Ventricular Ejection Fraction [LVEF] <40%) and 139 (52.2%) patients had regional wall motion abnormalities (RWMAs) on arrival. Patients were classified into 4 groups (Group A: LVEF <40%/Global, Group B: LVEF <40%/RWMA, Group C: LVEF ≥40%/Global and Group D: LVEF ≥40%/RWMA) with frequencies of 10.9%, 25.2%, 41.4% and 22.6%).
Patients in Group D had the shortest low-flow times and lowest rates of epinephrine administration, with most favourable metabolic status on arrival, based on lactate and creatinine values. In Groups B and D (RWMAs), patients were significantly more likely to have a post-ROSC ECG demonstrating ST elevation/LBBB and absence of epinephrine administration during resuscitation with shorter low flow times. Extent of CAD was similar between the four groups. From patients with LVEF ≥40%, patients in Group C had substantially lower SYNTAX scores than compared with Group D (0.5 vs 13.5, p<0.001). However, both Group B and C (RWMA) groups had highest rates of culprit lesions compared with matched global groups which was reflected in higher PCI rates (Figure 1).
The primary endpoint of 12-month mortality was lowest in Group D and highest in the Group A group. A similar effect was observed for poor neurological outcome and 30-day mortality. Patients with regional LVSD had significantly improved survival at 12 months compared with those with global LVSD (70.5% vs 48.3%, p<0.001) vs 51). Those in Group D had highest survival at 12 months, while this was similar for Groups B and C and lowest in Group A (Figure 2). Cardiac aetiology death was significantly higher in those with LVEF <40% compared to those with LVEF ≥40% (70.5% vs 48.3%, p<0.001).
Conclusions
Patients with significant LVEF <40% have higher rates of cardiogenic shock and mortality which was driven by cardiac aetiology death, while presence of RWMAs are associated with a higher rate of culprit coronary lesions and improved outcome
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- R Kanyal
- King's College Hospital, London, United Kingdom
| | - D Sarma
- King's College Hospital, London, United Kingdom
| | - N Pareek
- King's College Hospital, London, United Kingdom
| | | | - N Melikian
- King's College Hospital, London, United Kingdom
| | - I Webb
- King's College Hospital, London, United Kingdom
| | - A Shah
- King's College Hospital, London, United Kingdom
| | - P MacCarthy
- King's College Hospital, London, United Kingdom
| | - J Byrne
- King's College Hospital, London, United Kingdom
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Peck GL, Hanna JS, Scott EM, Mehta D, Model Z, Sarma D, Ginalis EE, Berlant Z, Ferrera F, Escobar J, Ordoñez CA, Morales C, Gracias VH. A longitudinal surgical systems strengthening research program for medical students: the exploration of a model for global health education. Glob Health Res Policy 2021; 6:34. [PMID: 34556190 PMCID: PMC8459485 DOI: 10.1186/s41256-021-00214-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 07/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In response to the staggering global burden of conditions requiring emergency and essential surgery, the development of international surgical system strengthening (SSS) is fundamental to achieving universal, timely, quality, and affordable surgical care. Opportunity exists in identifying optimal collaborative processes that both promote global surgery research and SSS, and include medical students. This study explores an education model to engage students in academic global surgery and SSS via institutional support for longitudinal research. OBJECTIVES We set out to design a program to align global health education and longitudinal health systems research by creating an education model to engage medical students in academic global surgery and SSS. PROGRAM DESIGN AND IMPLEMENTATION In 2015, medical schools in the United States and Colombia initiated a collaborative partnership for academic global surgery research and SSS. This included development of two longitudinal academic tracks in global health medical education and academic global surgery, which we differentiated by level of institutional resourcing. Herein is a retrospective evaluation of the first two years of this program by using commonly recognized academic output metrics. MAIN ACHIEVEMENTS In the first two years of the program, there were 76 total applicants to the two longitudinal tracks. Six of the 16 (37.5%) accepted students selected global surgery faculty as mentors (Acute Care Surgery faculty participating in SSS with Colombia). These global surgery students subsequently spent 24 total working weeks abroad over the two-year period participating in culminating research experiences in SSS. As a quantitative measure of the program's success, the students collectively produced a total of twenty scholarly pieces in the form of accepted posters, abstracts, podium presentations, and manuscripts in partnership with Colombian research mentors. POLICY IMPLICATIONS The establishment of scholarly global health education and research tracks has afforded our medical students an active role in international SSS through participation in academic global surgery research. We propose that these complementary programs can serve as a model for disseminated education and training of the future global systems-aware surgeon workforce with bidirectional growth in south and north regions with traditionally under-resourced SSS training programs.
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Affiliation(s)
- Gregory L Peck
- Department of Surgery, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street - Suite 6300, New Brunswick, NJ, 08901, USA. .,Rutgers School of Public Health, Piscataway, NJ, USA.
| | - Joseph S Hanna
- Department of Surgery, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street - Suite 6300, New Brunswick, NJ, 08901, USA
| | - Erin M Scott
- Department of Surgery, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street - Suite 6300, New Brunswick, NJ, 08901, USA.,Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA
| | - Dhaval Mehta
- Department of Surgery, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street - Suite 6300, New Brunswick, NJ, 08901, USA.,Department of Emergency Medicine, New York Presbyterian - Brooklyn Methodist Hospital, New York, NY, USA
| | - Zina Model
- Department of Surgery, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street - Suite 6300, New Brunswick, NJ, 08901, USA.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA
| | - Deesha Sarma
- Department of Surgery, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street - Suite 6300, New Brunswick, NJ, 08901, USA.,Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Elizabeth E Ginalis
- Department of Surgery, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street - Suite 6300, New Brunswick, NJ, 08901, USA.,Department of Neurological Surgery, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA
| | - Zachary Berlant
- Department of Surgery, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street - Suite 6300, New Brunswick, NJ, 08901, USA.,Department of Pediatrics, New York Presbyterian - Columbia University Medical Center, New York, NY, USA
| | - Fernando Ferrera
- Department of Surgery, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street - Suite 6300, New Brunswick, NJ, 08901, USA.,Department of Orthopaedic Surgery, UPMC Hamot Medical Center, Pittsburgh, PA, USA
| | - Javier Escobar
- Rutgers Biomedical and Health Sciences, Rutgers University, New Brunswick, NJ, USA
| | | | - Carlos Morales
- Department of Surgery, Universidad de Antioquia, Medellín, Colombia
| | - Vicente H Gracias
- Department of Surgery, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street - Suite 6300, New Brunswick, NJ, 08901, USA.,Rutgers Biomedical and Health Sciences, Rutgers University, New Brunswick, NJ, USA
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Baig M, Sarma D, Ng V, Shortland T, Sood S. 625 Health Economics and Safety of Frontline Carers in the COVID-19 Era: Time to Abolish Routine Group and Save For Emergency Appendicectomies? Br J Surg 2021. [PMCID: PMC8135674 DOI: 10.1093/bjs/znab134.306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Face of healthcare, patient safety and protection of healthcare providers has been completely transformed with global health pandemic. However, emergency surgical procedures must still be performed, with the commonest being appendicectomy. It is common practice across National Health Service trusts to collect a group and save (G&S) sample pre-operatively which increases healthcare staff exposure to the patient and increased use of personal protective equipment in this pandemic. Method Prospective study of adult patients undergoing emergency appendicectomy since the transformation of emergency care with COVID-19 induced restrictions compared with patients undergoing the same operation before the pandemic. Results 179 adult patients underwent emergency appendicectomy over 6-months in 2019–2020, 60 patients in the 12 weeks period from the start of the transformed emergency services due to the pandemic. Pre-operative G&S samples were taken for 60(33.5%) patients in the pre COVID-19 period, whereas 7(11.6%) were taken for patients undergoing appendicectomy during the pandemic. None of the patients in either group had intra-operative blood loss of more than 500 millilitres and none of them required peri-operative blood transfusion Conclusions Our study demonstrates that the routine pre-operative G&S can safely be abandoned as a routine practice for all patients undergoing emergency appendicectomy.
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Affiliation(s)
- M Baig
- University Hospital Coventry and Warwickshire, Coventry, United Kingdom
| | - D Sarma
- University Hospital Coventry and Warwickshire, Coventry, United Kingdom
| | - V Ng
- University Hospital Coventry and Warwickshire, Coventry, United Kingdom
| | - T Shortland
- University Hospital Coventry and Warwickshire, Coventry, United Kingdom
| | - S Sood
- University Hospital Coventry and Warwickshire, Coventry, United Kingdom
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Bhattacharya P, Zakaria R, Stonelake S, Butler B, Sarma D, Maheswari M, Zaman S. Haemorrhagic shock from solid tumours of the adrenal gland: a case of bleeding primary adrenal lymphoma. Ann R Coll Surg Engl 2021; 103:e101-e105. [PMID: 33645269 DOI: 10.1308/rcsann.2020.7040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Suprarenal or adrenal gland haemorrhage is an uncommon but potentially lethal condition if unrecognised. Adrenal masses rarely present with haemorrhage, but they remain an important differential aetiology for adrenal bleeding. We present a novel case of primary adrenal lymphoma with adrenal haemorrhage in a middle-aged woman who presented with right-sided abdominal pain and class 1 haemorrhagic shock. She was found to have spontaneous unilateral adrenal gland haemorrhage in the absence of any underlying previous pathology. Presenting features, diagnosis and subsequent oncological management are reported.
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Affiliation(s)
- P Bhattacharya
- Department of General Surgery, Sandwell and West Birmingham Hospital, West Bromwich, UK
| | - R Zakaria
- Department of General Surgery, Sandwell and West Birmingham Hospital, West Bromwich, UK
| | - S Stonelake
- Department of General Surgery, Sandwell and West Birmingham Hospital, West Bromwich, UK
| | - B Butler
- Department of General Surgery, Sandwell and West Birmingham Hospital, West Bromwich, UK
| | - D Sarma
- Department of Colorectal Surgery, University Hospital Coventry and Warwickshire, Coventry, UK
| | - M Maheswari
- Department of General Surgery, Sandwell and West Birmingham Hospital, West Bromwich, UK
| | - S Zaman
- Department of General Surgery, Sandwell and West Birmingham Hospital, West Bromwich, UK
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Sarma D, Bilello LA. A Case Report of Acute Transverse Myelitis Following Novel Coronavirus Infection. Clin Pract Cases Emerg Med 2020; 4:321-323. [PMID: 32926676 PMCID: PMC7434287 DOI: 10.5811/cpcem.2020.5.47937] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION During the coronavirus disease 2019 (COVID-19) pandemic, emergency providers are not only seeing an increasing number of patients with COVID-19 infections, but also associated complications and sequelae of this viral illness. CASE REPORT We present the case of a 28-year-old female patient who presented after a confirmed COVID-19 infection with lower back pain, bilateral symmetric upper and lower extremity numbness, and urinary retention. The patient was diagnosed with acute transverse myelitis. She required intravenous corticosteroids and plasma exchange with significant improvement in symptoms and minimal residual effects. CONCLUSION This case illustrates the importance of prompt recognition and treatment of sequelae of COVID-19 infections.
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Affiliation(s)
- Deesha Sarma
- Harvard Medical School, Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts
| | - Leslie A Bilello
- Harvard Medical School, Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts
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12
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Gupta R, Das MK, Mohanan PP, Deb PK, Parashar SK, Chopra HK, Shrivastava S, Guha S, Goswami KC, Yadav R, Alagesan R, Amuthan V, Bansal M, Chakraborty RN, Chakraborti N, Chandra S, Chatterjee A, Chatterjee D, Chatterjee SS, Dutta AL, De A, Garg A, Garg VK, Goyal A, Goyal NK, Govind SC, Gupta VK, Hasija PK, Jabir A, Jain P, Jain V, Jayagopal PB, Kasliwal RR, Katyal VK, Kerkar PG, Khan AK, Khanna NN, Mandal M, Majumder B, Mishra SS, Meena CB, Naik N, Narain VS, Pancholia AK, Pathak LA, Ponde CK, Raghu K, Ray S, Roy D, Sarma D, Shanmugasundarum S, Singh BP, Tyagi S, Vijayaraghavan G, Wander GS, Wardhan H, Nanda NC. Cardiological society of India document on safety measure during echo evaluation of cardiovascular disease in the time of COVID-19. Indian Heart J 2020; 72:145-150. [PMID: 32768012 PMCID: PMC7250084 DOI: 10.1016/j.ihj.2020.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 01/08/2023] Open
Abstract
An echocardiographic investigation is one of the key modalities of diagnosis in cardiology. There has been a rising presence of cardiological comorbidities in patients positive for COVID-19. Hence, it is becoming extremely essential to look into the correct safety precautions, healthcare professionals must take while conducting an echo investigation. The decision matrix formulated for conducting an echocardiographic evaluation is based on presence or absence of cardiological comorbidity vis-à-vis positive, suspected or negative for COVID-19. The safety measures have been constructed keeping in mind the current safety precautions by WHO, CDC and MoHFW, India.
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Affiliation(s)
- Rakesh Gupta
- JROP Institute of Echocardiography, Ultrasound & Vascular Doppler, JROP Healthcare Pvt. Ltd., C-1/16, Ashok Vihar-II, Delhi, 110052, India; JROP Charak Heart City, MD City Hospital, Model Town Northex, Delhi, 110009, India.
| | - Mrinal Kanti Das
- C K Birla Group of Hospitals (BMB and CMRI), Kolkata, West Bengal, India
| | - P P Mohanan
- Westfort Hi-Tech Hospital, Thrissur, Kerala, India
| | | | - S K Parashar
- Metro Heart Hospital, Lajpat Nagar, New Delhi, India
| | | | | | - Santanu Guha
- Calcutta Medical College Hospital, Kolkata, West Bengal, India
| | | | - Rakesh Yadav
- All India Institute of Medical Sciences, New Delhi, India
| | | | - V Amuthan
- Jeyalakshmi Heart Center, Madurai, Tamilnadu, India
| | - M Bansal
- Medanta, The Medicity, New Delhi, India
| | - R N Chakraborty
- Medica Group of Superspeciality Hospitals, Kolkata, West Bengal, India
| | - N Chakraborti
- Medica Group of Superspeciality Hospitals, Kolkata, West Bengal, India
| | - S Chandra
- King George's Medical University, Lucknow, India
| | | | - D Chatterjee
- Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India
| | | | | | - A De
- Apollo Gleneagles Hospital, Kolkata, India
| | - A Garg
- Jaipur Heart Institute, Jaipur, India
| | - V K Garg
- R D Gardi Medical College, Ujjain, India
| | - A Goyal
- Bani Park Hospital, Jaipur, India
| | - N K Goyal
- BLK Superspeciality Hospital, New Delhi, India
| | | | - V K Gupta
- Kishori Ram Hospital & Diabetes Care Centre, Bhatinda, India
| | | | - A Jabir
- Lisie Hospital Kochi, Kerala, India
| | - P Jain
- Lifeline Superspeciality Hospital, Jhansi, India
| | - V Jain
- Choithram Hospital &R.C., Indore, India
| | | | | | | | | | | | | | - M Mandal
- NRS Medical College, Kolkata, India
| | - B Majumder
- R.G. Kar Medical College & Hospital, Kolkata, India
| | - S S Mishra
- Hi-Tech Medical College and Hospital, Bhubaneshwar, India
| | - C B Meena
- SMS Medical College, Jaipur, Rajasthan
| | | | - V S Narain
- King George's Medical University, Lucknow, India
| | | | - L A Pathak
- Nanavati Heart Institute, Nanavati Superspeciality Hospital, Mumbai, India
| | - C K Ponde
- PD Hinduja National Hospital & RC, Mumbai, India
| | - K Raghu
- Care Hospital, Hyderabad, India
| | - S Ray
- Vivekananda Institute of Medical Sciences, Kolkata, India
| | - D Roy
- Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India
| | - D Sarma
- Jorhat Christian Medical Centre Hospital, Jorhat, Assam, India
| | | | | | - S Tyagi
- GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | | | - G S Wander
- Hero DMC Heart Institute, Ludhiana, India
| | - Harsh Wardhan
- Mahatma Gandhi Medical College and Hospital, Jaipur, India
| | - N C Nanda
- University of Alabama at Birmingham, Birmingham, AL, USA
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Harikrishnan S, Mohanan PP, Chopra VK, Ambuj R, Sanjay G, Bansal M, Chakraborty RN, Chandra S, Chattarjee SS, Chopra HK, Mathew C, Deb PK, Goyal A, Goswami KC, Gupta R, Guha S, Gupta V, Hasija PK, Wardhan H, Jabir A, Jayagopal PB, Kahali D, Katyal VK, Kerkar PG, Khanna NN, Majumder B, Mandal M, Meena CB, Naik N, Narain VK, Pathak LA, Ray S, Roy D, Routray SN, Sarma D, Shanmugasundaram S, Singh BP, Tyagi SK, Venugopal K, Wander GS, Yadav R, Das MK. Cardiological society of India position statement on COVID-19 and heart failure. Indian Heart J 2020; 72:75-81. [PMID: 32405088 PMCID: PMC7219407 DOI: 10.1016/j.ihj.2020.04.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 04/29/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
- S Harikrishnan
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
| | | | | | | | - G Sanjay
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | | | | | | | | | | | | | - P K Deb
- Daffodil Hospitals, Kolkata, India
| | - A Goyal
- Bani Park Hospital, D-9, Kabir Marg, Bani Park, JAIPUR, 302016, Rajasthan, India
| | | | - R Gupta
- JROP Institute of Echocardiography, New Delhi, India
| | - S Guha
- Medical College, Kolkata, India
| | - V Gupta
- Kishori Ram Hospital & Diabetes Care Centre, Bhatinda, Punjab, India
| | - P K Hasija
- MH Chennai, Armed Forces Medical Services, India
| | - Harsh Wardhan
- Mahatma Gandhi Medical College and Hospital, Jaipur, India
| | | | | | - D Kahali
- C.K.Birla Group of Hospitals (BMB), Kolkata, India
| | | | | | - N N Khanna
- Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, India
| | - B Majumder
- R.G. Kar Medical College, Kolkata, India
| | - M Mandal
- NRS Medical College, Kolkata, India
| | - C B Meena
- SMS Medical College, Jaipur, Rajasthan, India
| | | | - V K Narain
- King George's Medical University, Lucknow, India
| | - L A Pathak
- Nanavati Superspeciality Hospital, Mumbai, India
| | - S Ray
- Vivekananda Institute of Medical Sciences, Kolkata, India
| | - D Roy
- Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India
| | | | - D Sarma
- Jorhat Christian Medical Centre Hospital, Jorhat, Assam, India
| | | | | | - S K Tyagi
- GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | | | | | | | - M K Das
- C.K. Birla Group of Hospitals (BMB/CMRI), Kolkata, India
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14
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Bashford L, Wu J, Sarma D, Collins K, Rao RPN, Ojemann JG, Mehring C. Concurrent control of a brain-computer interface and natural overt movements. J Neural Eng 2018; 15:066021. [PMID: 30303130 DOI: 10.1088/1741-2552/aadf3d] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE A primary control signal in brain-computer interfaces (BCIs) have been cortical signals related to movement. However, in cases where natural motor function remains, BCI control signals may interfere with other possibly simultaneous activity for useful ongoing movement. We sought to determine if the brain could learn to control both a BCI and concurrent overt movement execution in such cases. APPROACH We designed experiments where BCI and overt movements must be used concurrently and in coordination to achieve a 2D centre out control. Power in the 70-90 Hz band of human electrocorticography (ECoG) signals, was used to generate BCI control commands for vertical movement of the cursor. These signals were deliberately recorded from the same human cortical site that produced the strongest movement related activity associated with the concurrent overt finger movements required for the horizontal movement of the cursor. MAIN RESULTS We demonstrate that three subjects were able to perform the concurrent BCI task, controlling BCI and natural movements simultaneously and to a large extent independently. We conclude that the brain is capable of dissociating the original control signal dependency on movement, producing specific BCI control signals in the presence of motor related responses from the ongoing overt behaviour with which the BCI signal was initially correlated. SIGNIFICANCE We demonstrate a novel human brain-computer interface (BCI) which can be used to control movement concurrently and in coordination with movements of the natural limbs. This demonstrates the dissociation of cortical activity from the behaviour with which it was originally associated despite the ongoing behaviour and shows the feasibility of achieving simultaneous BCI control of devices with natural movements.
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Affiliation(s)
- L Bashford
- Department of Bioengineering, Imperial College London, London, United Kingdom. Bernstein Center and Brain-Links Brain-Tools, University of Freiburg, Freiburg, Germany
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Román LS, Menon BK, Blasco J, Hernández-Pérez M, Dávalos A, Majoie CBLM, Campbell BCV, Guillemin F, Lingsma H, Anxionnat R, Epstein J, Saver JL, Marquering H, Wong JH, Lopes D, Reimann G, Desal H, Dippel DWJ, Coutts S, du Mesnil de Rochemont R, Yavagal D, Ferre JC, Roos YBWEM, Liebeskind DS, Lenthall R, Molina C, Al Ajlan FS, Reddy V, Dowlatshahi D, Sourour NA, Oppenheim C, Mitha AP, Davis SM, Weimar C, van Oostenbrugge RJ, Cobo E, Kleinig TJ, Donnan GA, van der Lugt A, Demchuk AM, Berkhemer OA, Boers AMM, Ford GA, Muir KW, Brown BS, Jovin T, van Zwam WH, Mitchell PJ, Hill MD, White P, Bracard S, Goyal M, Berkhemer OA, Fransen PSS, Beumer D, van den Berg LA, Lingsma HF, Yoo AJ, Schonewille WJ, Vos JA, Nederkoorn PJ, Wermer MJH, van Walderveen MAA, Staals J, Hofmeijer J, van Oostayen JA, Lycklama à Nijeholt GJ, Boiten J, Brouwer PA, Emmer BJ, de Bruijn SF, van Dijk LC, Kappelle J, Lo RH, van Dijk EJ, de Vries J, de Kort PL, van Rooij WJJ, van den Berg JS, van Hasselt BA, Aerden LA, Dallinga RJ, Visser MC, Bot JC, Vroomen PC, Eshghi O, Schreuder TH, Heijboer RJ, Keizer K, Tielbeek AV, den Hertog HM, Gerrits DG, van den Berg-Vos RM, Karas GB, Steyerberg EW, Flach Z, Marquering HA, Sprengers ME, Jenniskens SF, Beenen LF, Zech M, Kowarik M, Seifert C, Schwaiger B, Puri A, Hou S, Wakhloo A, Moonis M, Henniger N, Goddeau R, van den Berg R, Massari F, Minaeian A, Lozano JD, Ramzan M, Stout C, Patel A, Tunguturi A, Onteddu S, Carandang R, Howk M, Koudstaal PJ, Ribó M, Sanjuan E, Rubiera M, Pagola J, Flores A, Muchada M, Meler P, Huerga E, Gelabert S, Coscojuela P, van Zwam WH, Tomasello A, Rodriguez D, Santamarina E, Maisterra O, Boned S, Seró L, Rovira A, Molina CA, Millán M, Muñoz L, Roos YB, Pérez de la Ossa N, Gomis M, Dorado L, López-Cancio E, Palomeras E, Munuera J, García Bermejo P, Remollo S, Castaño C, García-Sort R, van der Lugt A, Cuadras P, Puyalto P, Hernández-Pérez M, Jiménez M, Martínez-Piñeiro A, Lucente G, Dávalos A, Chamorro A, Urra X, Obach V, van Oostenbrugge RJ, Cervera A, Amaro S, Llull L, Codas J, Balasa M, Navarro J, Ariño H, Aceituno A, Rudilosso S, Renu A, Majoie CB, Macho JM, San Roman L, Blasco J, López A, Macías N, Cardona P, Quesada H, Rubio F, Cano L, Lara B, Dippel DW, de Miquel MA, Aja L, Serena J, Cobo E, Albers GW, Lees KR, Arenillas J, Roberts R, Minhas P, Al-Ajlan F, Brown MM, Salluzzi M, Zimmel L, Patel S, Eesa M, Martí-Fàbregas J, Jankowitz B, Serena J, Salvat-Plana M, López-Cancio E, Bracard S, Liebig T, Ducrocq X, Anxionnat R, Baillot PA, Barbier C, Derelle AL, Lacour JC, Richard S, Samson Y, Sourour N, Baronnet-Chauvet F, Stijnen T, Clarencon F, Crozier S, Deltour S, Di Maria F, Le Bouc R, Leger A, Mutlu G, Rosso C, Szatmary Z, Yger M, Andersson T, Zavanone C, Bakchine S, Pierot L, Caucheteux N, Estrade L, Kadziolka K, Leautaud A, Renkes C, Serre I, Desal H, Mattle H, Guillon B, Boutoleau-Bretonniere C, Daumas-Duport B, De Gaalon S, Derkinderen P, Evain S, Herisson F, Laplaud DA, Lebouvier T, Lintia-Gaultier A, Wahlgren N, Pouclet-Courtemanche H, Rouaud T, Rouaud Jaffrenou V, Schunck A, Sevin-Allouet M, Toulgoat F, Wiertlewski S, Gauvrit JY, Ronziere T, Cahagne V, van der Heijden E, Ferre JC, Pinel JF, Raoult H, Mas JL, Meder JF, Al Najjar-Carpentier AA, Birchenall J, Bodiguel E, Calvet D, Domigo V, Ghannouti N, Godon-Hardy S, Guiraud V, Lamy C, Majhadi L, Morin L, Naggara O, Trystram D, Turc G, Berge J, Sibon I, Fleitour N, Menegon P, Barreau X, Rouanet F, Debruxelles S, Kazadi A, Renou P, Fleury O, Pasco-Papon A, Dubas F, Caroff J, Hooijenga I, Godard Ducceschi S, Hamon MA, Lecluse A, Marc G, Giroud M, Ricolfi F, Bejot Y, Chavent A, Gentil A, Kazemi A, Puppels C, Osseby GV, Voguet C, Mahagne MH, Sedat J, Chau Y, Suissa L, Lachaud S, Houdart E, Stapf C, Buffon Porcher F, Pellikaan W, Chabriat H, Guedin P, Herve D, Jouvent E, Mawet J, Saint-Maurice JP, Schneble HM, Turjman F, Nighoghossian N, Berhoune NN, Geerling A, Bouhour F, Cho TH, Derex L, Felix S, Gervais-Bernard H, Gory B, Manera L, Mechtouff L, Ritzenthaler T, Riva R, Lindl-Velema A, Salaris Silvio F, Tilikete C, Blanc R, Obadia M, Bartolini MB, Gueguen A, Piotin M, Pistocchi S, Redjem H, Drouineau J, van Vemde G, Neau JP, Godeneche G, Lamy M, Marsac E, Velasco S, Clavelou P, Chabert E, Bourgois N, Cornut-Chauvinc C, Ferrier A, de Ridder A, Gabrillargues J, Jean B, Marques AR, Vitello N, Detante O, Barbieux M, Boubagra K, Favre Wiki I, Garambois K, Tahon F, Greebe P, Ashok V, Voguet C, Coskun O, Guedin P, Rodesch G, Lapergue B, Bourdain F, Evrard S, Graveleau P, Decroix JP, de Bont-Stikkelbroeck J, Wang A, Sellal F, Ahle G, Carelli G, Dugay MH, Gaultier C, Lebedinsky AP, Lita L, Musacchio RM, Renglewicz-Destuynder C, de Meris J, Tournade A, Vuillemet F, Montoro FM, Mounayer C, Faugeras F, Gimenez L, Labach C, Lautrette G, Denier C, Saliou G, Janssen K, Chassin O, Dussaule C, Melki E, Ozanne A, Puccinelli F, Sachet M, Sarov M, Bonneville JF, Moulin T, Biondi A, Struijk W, De Bustos Medeiros E, Vuillier F, Courtheoux P, Viader F, Apoil-Brissard M, Bataille M, Bonnet AL, Cogez J, Kazemi A, Touze E, Licher S, Leclerc X, Leys D, Aggour M, Aguettaz P, Bodenant M, Cordonnier C, Deplanque D, Girot M, Henon H, Kalsoum E, Boodt N, Lucas C, Pruvo JP, Zuniga P, Bonafé A, Arquizan C, Costalat V, Machi P, Mourand I, Riquelme C, Bounolleau P, Ros A, Arteaga C, Faivre A, Bintner M, Tournebize P, Charlin C, Darcel F, Gauthier-Lasalarie P, Jeremenko M, Mouton S, Zerlauth JB, Venema E, Lamy C, Hervé D, Hassan H, Gaston A, Barral FG, Garnier P, Beaujeux R, Wolff V, Herbreteau D, Debiais S, Slokkers I, Murray A, Ford G, Muir KW, White P, Brown MM, Clifton A, Freeman J, Ford I, Markus H, Wardlaw J, Ganpat RJ, Lees KR, Molyneux A, Robinson T, Lewis S, Norrie J, Robertson F, Perry R, Dixit A, Cloud G, Clifton A, Mulder M, Madigan J, Roffe C, Nayak S, Lobotesis K, Smith C, Herwadkar A, Kandasamy N, Goddard T, Bamford J, Subramanian G, Saiedie N, Lenthall R, Littleton E, Lamin S, Storey K, Ghatala R, Banaras A, Aeron-Thomas J, Hazel B, Maguire H, Veraque E, Heshmatollah A, Harrison L, Keshvara R, Cunningham J, Schipperen S, Vinken S, van Boxtel T, Koets J, Boers M, Santos E, Borst J, Jansen I, Kappelhof M, Lucas M, Geuskens R, Barros RS, Dobbe R, Csizmadia M, Hill MD, Goyal M, Demchuk AM, Menon BK, Eesa M, Ryckborst KJ, Wright MR, Kamal NR, Andersen L, Randhawa PA, Stewart T, Patil S, Minhas P, Almekhlafi M, Mishra S, Clement F, Sajobi T, Shuaib A, Montanera WJ, Roy D, Silver FL, Jovin TG, Frei DF, Sapkota B, Rempel JL, Thornton J, Williams D, Tampieri D, Poppe AY, Dowlatshahi D, Wong JH, Mitha AP, Subramaniam S, Hull G, Lowerison MW, Sajobi T, Salluzzi M, Wright MR, Maxwell M, Lacusta S, Drupals E, Armitage K, Barber PA, Smith EE, Morrish WF, Coutts SB, Derdeyn C, Demaerschalk B, Yavagal D, Martin R, Brant R, Yu Y, Willinsky RA, Montanera WJ, Weill A, Kenney C, Aram H, Stewart T, Stys PK, Watson TW, Klein G, Pearson D, Couillard P, Trivedi A, Singh D, Klourfeld E, Imoukhuede O, Nikneshan D, Blayney S, Reddy R, Choi P, Horton M, Musuka T, Dubuc V, Field TS, Desai J, Adatia S, Alseraya A, Nambiar V, van Dijk R, Wong JH, Mitha AP, Morrish WF, Eesa M, Newcommon NJ, Shuaib A, Schwindt B, Butcher KS, Jeerakathil T, Buck B, Khan K, Naik SS, Emery DJ, Owen RJ, Kotylak TB, Ashforth RA, Yeo TA, McNally D, Siddiqui M, Saqqur M, Hussain D, Kalashyan H, Manosalva A, Kate M, Gioia L, Hasan S, Mohammad A, Muratoglu M, Williams D, Thornton J, Cullen A, Brennan P, O'Hare A, Looby S, Hyland D, Duff S, McCusker M, Hallinan B, Lee S, McCormack J, Moore A, O'Connor M, Donegan C, Brewer L, Martin A, Murphy S, O'Rourke K, Smyth S, Kelly P, Lynch T, Daly T, O'Brien P, O'Driscoll A, Martin M, Daly T, Collins R, Coughlan T, McCabe D, Murphy S, O'Neill D, Mulroy M, Lynch O, Walsh T, O'Donnell M, Galvin T, Harbison J, McElwaine P, Mulpeter K, McLoughlin C, Reardon M, Harkin E, Dolan E, Watts M, Cunningham N, Fallon C, Gallagher S, Cotter P, Crowe M, Doyle R, Noone I, Lapierre M, Coté VA, Lanthier S, Odier C, Durocher A, Raymond J, Weill A, Daneault N, Deschaintre Y, Jankowitz B, Baxendell L, Massaro L, Jackson-Graves C, Decesare S, Porter P, Armbruster K, Adams A, Billigan J, Oakley J, Ducruet A, Jadhav A, Giurgiutiu DV, Aghaebrahim A, Reddy V, Hammer M, Starr M, Totoraitis V, Wechsler L, Streib S, Rangaraju S, Campbell D, Rocha M, Gulati D, Silver FL, Krings T, Kalman L, Cayley A, Williams J, Stewart T, Wiegner R, Casaubon LK, Jaigobin C, del Campo JM, Elamin E, Schaafsma JD, Willinsky RA, Agid R, Farb R, ter Brugge K, Sapkoda BL, Baxter BW, Barton K, Knox A, Porter A, Sirelkhatim A, Devlin T, Dellinger C, Pitiyanuvath N, Patterson J, Nichols J, Quarfordt S, Calvert J, Hawk H, Fanale C, Frei DF, Bitner A, Novak A, Huddle D, Bellon R, Loy D, Wagner J, Chang I, Lampe E, Spencer B, Pratt R, Bartt R, Shine S, Dooley G, Nguyen T, Whaley M, McCarthy K, Teitelbaum J, Tampieri D, Poon W, Campbell N, Cortes M, Dowlatshahi D, Lum C, Shamloul R, Robert S, Stotts G, Shamy M, Steffenhagen N, Blacquiere D, Hogan M, AlHazzaa M, Basir G, Lesiuk H, Iancu D, Santos M, Choe H, Weisman DC, Jonczak K, Blue-Schaller A, Shah Q, MacKenzie L, Klein B, Kulandaivel K, Kozak O, Gzesh DJ, Harris LJ, Khoury JS, Mandzia J, Pelz D, Crann S, Fleming L, Hesser K, Beauchamp B, Amato-Marzialli B, Boulton M, Lopez-Ojeda P, Sharma M, Lownie S, Chan R, Swartz R, Howard P, Golob D, Gladstone D, Boyle K, Boulos M, Hopyan J, Yang V, Da Costa L, Holmstedt CA, Turk AS, Navarro R, Jauch E, Ozark S, Turner R, Phillips S, Shankar J, Jarrett J, Gubitz G, Maloney W, Vandorpe R, Schmidt M, Heidenreich J, Hunter G, Kelly M, Whelan R, Peeling L, Burns PA, Hunter A, Wiggam I, Kerr E, Watt M, Fulton A, Gordon P, Rennie I, Flynn P, Smyth G, O'Leary S, Gentile N, Linares G, McNelis P, Erkmen K, Katz P, Azizi A, Weaver M, Jungreis C, Faro S, Shah P, Reimer H, Kalugdan V, Saposnik G, Bharatha A, Li Y, Kostyrko P, Santos M, Marotta T, Montanera W, Sarma D, Selchen D, Spears J, Heo JH, Jeong K, Kim DJ, Kim BM, Kim YD, Song D, Lee KJ, Yoo J, Bang OY, Rho S, Lee J, Jeon P, Kim KH, Cha J, Kim SJ, Ryoo S, Lee MJ, Sohn SI, Kim CH, Ryu HG, Hong JH, Chang HW, Lee CY, Rha J, Davis SM, Donnan GA, Campbell BCV, Mitchell PJ, Churilov L, Yan B, Dowling R, Yassi N, Oxley TJ, Wu TY, Silver G, McDonald A, McCoy R, Kleinig TJ, Scroop R, Dewey HM, Simpson M, Brooks M, Coulton B, Krause M, Harrington TJ, Steinfort B, Faulder K, Priglinger M, Day S, Phan T, Chong W, Holt M, Chandra RV, Ma H, Young D, Wong K, Wijeratne T, Tu H, Mackay E, Celestino S, Bladin CF, Loh PS, Gilligan A, Ross Z, Coote S, Frost T, Parsons MW, Miteff F, Levi CR, Ang T, Spratt N, Kaauwai L, Badve M, Rice H, de Villiers L, Barber PA, McGuinness B, Hope A, Moriarty M, Bennett P, Wong A, Coulthard A, Lee A, Jannes J, Field D, Sharma G, Salinas S, Cowley E, Snow B, Kolbe J, Stark R, King J, Macdonnell R, Attia J, D'Este C, Saver JL, Goyal M, Diener HC, Levy EI, Bonafé A, Mendes Pereira V, Jahan R, Albers GW, Cognard C, Cohen DJ, 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M, Grande A, Hildebrandt D, Miller K, Scherber J, Hendrickson A, Jumaa M, Zaidi S, Hendrickson T, Snyder V, Killer-Oberpfalzer M, Mutzenbach J, Weymayr F, Broussalis E, Stadler K, Jedlitschka A, Malek A, Mueller-Kronast N, Beck P, Martin C, Summers D, Day J, Bettinger I, Holloway W, Olds K, Arkin S, Akhtar N, Boutwell C, Crandall S, Schwartzman M, Weinstein C, Brion B, Prothmann S, Kleine J, Kreiser K, Boeckh-Behrens T, Poppert H, Wunderlich S, Koch ML, Biberacher V, Huberle A, Gora-Stahlberg G, Knier B, Meindl T, Utpadel-Fischler D. Imaging features and safety and efficacy of endovascular stroke treatment: a meta-analysis of individual patient-level data. Lancet Neurol 2018; 17:895-904. [DOI: 10.1016/s1474-4422(18)30242-4] [Citation(s) in RCA: 213] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 06/11/2018] [Accepted: 06/12/2018] [Indexed: 11/29/2022]
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Caddick V, Sarma D, Curran F. Intramuscular hibernoma in an adult: A case report. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Porter P, Armbruster K, Adams A, Billigan J, Oakley J, Ducruet A, Jadhav A, Giurgiutiu DV, Aghaebrahim A, Reddy V, Hammer M, Starr M, Totoraitis V, Wechsler L, Streib S, Rangaraju S, Campbell D, Rocha M, Gulati D, Silver FL, Krings T, Kalman L, Cayley A, Williams J, Stewart T, Wiegner R, Casaubon LK, Jaigobin C, del Campo JM, Elamin E, Schaafsma JD, Willinsky RA, Agid R, Farb R, ter Brugge K, Sapkoda BL, Baxter BW, Barton K, Knox A, Porter A, Sirelkhatim A, Devlin T, Dellinger C, Pitiyanuvath N, Patterson J, Nichols J, Quarfordt S, Calvert J, Hawk H, Fanale C, Frei DF, Bitner A, Novak A, Huddle D, Bellon R, Loy D, Wagner J, Chang I, Lampe E, Spencer B, Pratt R, Bartt R, Shine S, Dooley G, Nguyen T, Whaley M, McCarthy K, Teitelbaum J, Tampieri D, Poon W, Campbell N, Cortes M, Dowlatshahi D, Lum C, Shamloul R, Robert S, Stotts G, Shamy M, Steffenhagen N, Blacquiere D, Hogan M, AlHazzaa M, Basir G, Lesiuk H, Iancu D, Santos M, Choe H, Weisman DC, Jonczak K, Blue-Schaller A, Shah Q, MacKenzie L, Klein B, Kulandaivel K, Kozak O, Gzesh DJ, Harris LJ, Khoury JS, Mandzia J, Pelz D, Crann S, Fleming L, Hesser K, Beauchamp B, Amato-Marzialli B, Boulton M, Lopez- Ojeda P, Sharma M, Lownie S, Chan R, Swartz R, Howard P, Golob D, Gladstone D, Boyle K, Boulos M, Hopyan J, Yang V, Da Costa L, Holmstedt CA, Turk AS, Navarro R, Jauch E, Ozark S, Turner R, Phillips S, Shankar J, Jarrett J, Gubitz G, Maloney W, Vandorpe R, Schmidt M, Heidenreich J, Hunter G, Kelly M, Whelan R, Peeling L, Burns PA, Hunter A, Wiggam I, Kerr E, Watt M, Fulton A, Gordon P, Rennie I, Flynn P, Smyth G, O'Leary S, Gentile N, Linares G, McNelis P, Erkmen K, Katz P, Azizi A, Weaver M, Jungreis C, Faro S, Shah P, Reimer H, Kalugdan V, Saposnik G, Bharatha A, Li Y, Kostyrko P, Santos M, Marotta T, Montanera W, Sarma D, Selchen D, Spears J, Heo JH, Jeong K, Kim DJ, Kim BM, Kim YD, Song D, Lee KJ, Yoo J, Bang OY, Rho S, Lee J, Jeon P, Kim KH, Cha J, Kim SJ, Ryoo S, Lee MJ, Sohn SI, Kim CH, Ryu HG, Hong JH, Chang HW, Lee CY, Rha J, Davis SM, Donnan GA, Campbell BCV, Mitchell PJ, Churilov L, Yan B, Dowling R, Yassi N, Oxley TJ, Wu TY, Silver G, McDonald A, McCoy R, Kleinig TJ, Scroop R, Dewey HM, Simpson M, Brooks M, Coulton B, Krause M, Harrington TJ, Steinfort B, Faulder K, Priglinger M, Day S, Phan T, Chong W, Holt M, Chandra RV, Ma H, Young D, Wong K, Wijeratne T, Tu H, Mackay E, Celestino S, Bladin CF, Loh PS, Gilligan A, Ross Z, Coote S, Frost T, Parsons MW, Miteff F, Levi CR, Ang T, Spratt N, Kaauwai L, Badve M, Rice H, de Villiers L, Barber PA, McGuinness B, Hope A, Moriarty M, Bennett P, Wong A, Coulthard A, Lee A, Jannes J, Field D, Sharma G, Salinas S, Cowley E, Snow B, Kolbe J, Stark R, King J, Macdonnell R, Attia J, D'Este C, Saver JL, Goyal M, Diener HC, Levy EI, Bonafé A, Mendes Pereira V, Jahan R, Albers GW, Cognard C, Cohen DJ, Hacke W, Jansen O, Jovin TG, Mattle HP, Nogueira RG, Siddiqui AH, Yavagal DR, von Kummer R, Smith W, Turjman F, Hamilton S, Chiacchierini R, Amar A, Sanossian N, Loh Y, Devlin T, Baxter B, Hawk H, Sapkota B, Quarfordt S, Sirelkhatim A, Dellinger C, Barton K, Reddy VK, Ducruet A, Jadhav A, Horev A, Giurgiutiu DV, Totoraitis V, Hammer M, Jankowitz B, Wechsler L, Rocha M, Gulati D, Campbell D, Star M, Baxendell L, Oakley J, Siddiqui A, Hopkins LN, Snyder K, Sawyer R, Hall S, Costalat V, Riquelme C, Machi P, Omer E, Arquizan C, Mourand I, Charif M, Ayrignac X, Menjot de Champfleur N, Leboucq N, Gascou G, Moynier M, du Mesnil de Rochemont R, Singer O, Berkefeld J, Foerch C, Lorenz M, Pfeilschifer W, Hattingen E, Wagner M, You SJ, Lescher S, Braun H, Dehkharghani S, Belagaje SR, Anderson A, Lima A, Obideen M, Haussen D, Dharia R, Frankel M, Patel V, Owada K, Saad A, Amerson L, Horn C, Doppelheuer S, Schindler K, Lopes DK, Chen M, Moftakhar R, Anton C, Smreczak M, Carpenter JS, Boo S, Rai A, Roberts T, Tarabishy A, Gutmann L, Brooks C, Brick J, Domico J, Reimann G, Hinrichs K, Becker M, Heiss E, Selle C, Witteler A, Al-Boutros S, Danch MJ, Ranft A, Rohde S, Burg K, Weimar C, Zegarac V, Hartmann C, Schlamann M, Göricke S, Ringlestein A, Wanke I, Mönninghoff C, Dietzold M, Budzik R, Davis T, Eubank G, Hicks WJ, Pema P, Vora N, Mejilla J, Taylor M, Clark W, Rontal A, Fields J, Peterson B, Nesbit G, Lutsep H, Bozorgchami H, Priest R, Ologuntoye O, Barnwell S, Dogan A, Herrick K, Takahasi C, Beadell N, Brown B, Jamieson S, Hussain MS, Russman A, Hui F, Wisco D, Uchino K, Khawaja Z, Katzan I, Toth G, Cheng-Ching E, Bain M, Man S, Farrag A, George P, John S, Shankar L, Drofa A, Dahlgren R, Bauer A, Itreat A, Taqui A, Cerejo R, Richmond A, Ringleb P, Bendszus M, Möhlenbruch M, Reiff T, Amiri H, Purrucker J, Herweh C, Pham M, Menn O, Ludwig I, Acosta I, Villar C, Morgan W, Sombutmai C, Hellinger F, Allen E, Bellew M, Gandhi R, Bonwit E, Aly J, Ecker RD, Seder D, Morris J, Skaletsky M, Belden J, Baker C, Connolly LS, Papanagiotou P, Roth C, Kastrup A, Politi M, Brunner F, Alexandrou M, Merdivan H, Ramsey C, Given II C, Renfrow S, Deshmukh V, Sasadeusz K, Vincent F, Thiesing JT, Putnam J, Bhatt A, Kansara A, Caceves D, Lowenkopf T, Yanase L, Zurasky J, Dancer S, Freeman B, Scheibe-Mirek T, Robison J, Rontal A, Roll J, Clark D, Rodriguez M, Fitzsimmons BFM, Zaidat O, Lynch JR, Lazzaro M, Larson T, Padmore L, Das E, Farrow-Schmidt A, Hassan A, Tekle W, Cate C, Jansen O, Cnyrim C, Wodarg F, Wiese C, Binder A, Riedel C, Rohr A, Lang N, Laufs H, Krieter S, Remonda L, Diepers M, Añon J, Nedeltchev K, Kahles T, Biethahn S, Lindner M, Chang V, Gächter C, Esperon C, Guglielmetti M, Arenillas Lara JF, Martínez Galdámez M, Calleja Sanz AI, Cortijo Garcia E, Garcia Bermejo P, Perez S, Mulero Carrillo P, Crespo Vallejo E, Ruiz Piñero M, Lopez Mesonero L, Reyes Muñoz FJ, Brekenfeld C, Buhk JH, Krützelmann A, Thomalla G, Cheng B, Beck C, Hoppe J, Goebell E, Holst B, Grzyska U, Wortmann G, Starkman S, Duckwiler G, Jahan R, Rao N, Sheth S, Ng K, Noorian A, Szeder V, Nour M, McManus M, Huang J, Tarpley J, Tateshima S, Gonzalez N, Ali L, Liebeskind D, Hinman J, Calderon-Arnulphi M, Liang C, Guzy J, Koch S, DeSousa K, Gordon-Perue G, Haussen D, Elhammady M, Peterson E, Pandey V, Dharmadhikari S, Khandelwal P, Malik A, Pafford R, Gonzalez P, Ramdas K, Andersen G, Damgaard D, Von Weitzel-Mudersbach P, Simonsen C, Ruiz de Morales Ayudarte N, Poulsen M, Sørensen L, Karabegovich S, Hjørringgaard M, Hjort N, Harbo T, Sørensen K, Deshaies E, Padalino D, Swarnkar A, Latorre JG, Elnour E, El-Zammar Z, Villwock M, Farid H, Balgude A, Cross L, Hansen K, Holtmannspötter M, Kondziella D, Hoejgaard J, Taudorf S, Soendergaard H, Wagner A, Cronquist M, Stavngaard T, Cortsen M, Krarup LH, Hyldal T, Haring HP, Guggenberger S, Hamberger M, Trenkler J, Sonnberger M, Nussbaumer K, Dominger C, Bach E, Jagadeesan BD, Taylor R, Kim J, Shea K, Tummala R, Zacharatos H, Sandhu D, Ezzeddine M, Grande A, Hildebrandt D, Miller K, Scherber J, Hendrickson A, Jumaa M, Zaidi S, Hendrickson T, Snyder V, Killer-Oberpfalzer M, Mutzenbach J, Weymayr F, Broussalis E, Stadler K, Jedlitschka A, Malek A, Mueller-Kronast N, Beck P, Martin C, Summers D, Day J, Bettinger I, Holloway W, Olds K, Arkin S, Akhtar N, Boutwell C, Crandall S, Schwartzman M, Weinstein C, Brion B, Prothmann S, Kleine J, Kreiser K, Boeckh-Behrens T, Poppert H, Wunderlich S, Koch ML, Biberacher V, Huberle A, Gora-Stahlberg G, Knier B, Meindl T, Utpadel-Fischler D, Zech M, Kowarik M, Seifert C, Schwaiger B, Puri A, Hou S. Effect of general anaesthesia on functional outcome in patients with anterior circulation ischaemic stroke having endovascular thrombectomy versus standard care: a meta-analysis of individual patient data. Lancet Neurol 2018; 17:47-53. [DOI: 10.1016/s1474-4422(17)30407-6] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/05/2017] [Accepted: 10/11/2017] [Indexed: 10/18/2022]
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Mahendran B, Sarma D, Ramzi S. Sentinel Lymph Node Biopsy for Breast Ductal Carcinoma in Situ: Waste of Time, Money and Resources. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Talukdar B, Kalita HK, Basumatary S, Saikia DJ, Sarma D. Cytotoxic and genotoxic affects of acid mine drainage on fish Channa punctata (Bloch). Ecotoxicol Environ Saf 2017; 144:72-78. [PMID: 28601519 DOI: 10.1016/j.ecoenv.2017.06.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 05/19/2017] [Accepted: 06/02/2017] [Indexed: 06/07/2023]
Abstract
The investigation deals with the effects of Acid Mine Drainage (AMD) of coal mine on fish Channa punctata (Bloch) by examining the incidence of haematological, morphological, histological changes and DNA fragmentation in tissues of C. punctata in laboratory condition. For this study fishes were exposed to 10% of AMD for a period of 30 days. The fusion of the primary and secondary gill lamellae, distortion, loss of alignment, deposition of worn out tissues and mucous on the surface of the lamella in the gills; degeneration of morphological architecture, loss of alignment of tubules, mucous deposition in the kidney; cellular damage, cellular necrosis, extraneous deposition on the surface, pore formation in the liver are some important changes detected by scanning electron microscopy. Fishes of AMD treated group showed gradual significant decrease in TEC, Hb and, increase in TLC and DLC as compared to that of the control. DNA fragmentation observed in kidney of fishes from treated group indicates an intricate pollutant present in the AMD. The high incidence of morphological and histological alterations, haematological changes along with DNA breakage in C. punctata is an evidence of the cytotoxic and genotoxic potential of AMD of coal mines.
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Affiliation(s)
- B Talukdar
- Department of Zoology, Gauhati University, Guwahati 781014, Assam, India
| | - H K Kalita
- Department of Zoology, Gauhati University, Guwahati 781014, Assam, India
| | - S Basumatary
- Department of Zoology, Gauhati University, Guwahati 781014, Assam, India
| | - D J Saikia
- Department of Zoology, Gauhati University, Guwahati 781014, Assam, India
| | - D Sarma
- Department of Zoology, Gauhati University, Guwahati 781014, Assam, India.
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Peck GL, Sarma D, NeMoyer R, Schwander S, Willard S, Terregino CA, Escobar J, Lee L, Gupta R, Gracias V. Successful Global Surgery Program Implementation Contributes to Achieving Organizational Strategic Plans in Global Health. J Am Coll Surg 2017. [DOI: 10.1016/j.jamcollsurg.2017.07.590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Akhtar M, Ciji A, Sarma D, Rajesh M, Kamalam B, Sharma P, Singh A. Reproductive dysfunction in females of endangered golden mahseer ( Tor putitora ) in captivity. Anim Reprod Sci 2017; 182:95-103. [DOI: 10.1016/j.anireprosci.2017.05.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/08/2017] [Accepted: 05/14/2017] [Indexed: 11/15/2022]
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Peck G, Saluja S, Blitzer DN, Sarma D, Anderson GA, Rodas E, Foianini JE, Puyana JC, Meara J, Morales C, Ordonez C, Gracias V. Using global surgical indicators to improve trauma care in Latin America. Bull Am Coll Surg 2017; 102:11-16. [PMID: 28920641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Sarma D, Das R, Akhtar MS, Ciji A, Sharma NK, Singh AK. Morpho-histological and ultra architectural changes during early development of endangered golden mahseer Tor putitora. J Fish Biol 2016; 89:2038-2054. [PMID: 27500786 DOI: 10.1111/jfb.13109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 07/01/2016] [Indexed: 06/06/2023]
Abstract
Ultrastructural and histological changes in the embryonic and larval surface during ontogenesis of the endangered golden mahseer Tor putitora is studied here for the first time. Embryonic development was completed 91-92 h after fertilization at an ambient temperature of 23° ± 1° C (mean ± s.d.). The gastrula stage was characterized by presence of the Kupffer's vesicle, notochord, ectoderm and endoderm cells. Primordial germ cells were clearly identifiable from c. 55 h post-fertilization at the organogenesis stage. Mean total length of newly hatched larvae was 7·0 ± 0·5 mm. Scanning electron microscopy of newly hatched larvae demonstrated vitelline arteries, microridged epithelial cells and mucous gland openings over much of the body surface. Eye, oral cavity, pharyngeal arches, heart, intestinal loop, prosencephalon, cephalic vesicle and nasal epithelium were clearly distinguished in 3 day old hatched individuals. In 6 day old individuals, caudal-fin rays and internal organs were evident. The dorsal fin became prominent at this stage and larvae began swimming at the surface. The reserved yolk material was totally absorbed 8-11 days after hatching and larvae began feeding exogenously. Tor putitora exhibited a longer early developmental period than other cyprinids reared at similar temperatures.
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Affiliation(s)
- D Sarma
- ICAR-Directorate of Coldwater Fisheries Research, Bhimtal, 263136, Nainital, Uttarakhand, India
| | - R Das
- ICAR-Directorate of Coldwater Fisheries Research, Bhimtal, 263136, Nainital, Uttarakhand, India
| | - M S Akhtar
- ICAR-Directorate of Coldwater Fisheries Research, Bhimtal, 263136, Nainital, Uttarakhand, India.
| | - A Ciji
- ICAR-Directorate of Coldwater Fisheries Research, Bhimtal, 263136, Nainital, Uttarakhand, India
| | - N K Sharma
- ICAR-Directorate of Coldwater Fisheries Research, Bhimtal, 263136, Nainital, Uttarakhand, India
- Department of Zoology, Hemvati Nandan Bahuguna Garhwal University, Tehri Campus Badshahithaul, Tehri Garhwal, 249199, India
| | - A K Singh
- ICAR-Directorate of Coldwater Fisheries Research, Bhimtal, 263136, Nainital, Uttarakhand, India
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Talukdar B, Kalita HK, Baishya RA, Basumatary S, Sarma D. Evaluation of genetic toxicity caused by acid mine drainage of coal mines on fish fauna of Simsang River, Garohills, Meghalaya, India. Ecotoxicol Environ Saf 2016; 131:65-71. [PMID: 27213561 DOI: 10.1016/j.ecoenv.2016.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 05/09/2016] [Accepted: 05/12/2016] [Indexed: 06/05/2023]
Abstract
Fishery ecology of the Simsang River, Meghalaya is being threatened by large scale environmental degradation due to acid mine drainage (AMD) of coal mines. In the present paper, effort has been made to evaluate the genotoxicity caused due to AMD of coal mines on Channa punctata under laboratory condition through comet assay, micronucleus and chromosome aberration tests. Water samples were collected seasonally from affected and unaffected sites of the River and physico-chemical quality of water indicated low pH (4.6), high concentration of sulphates (270mgL(-1)) and iron (7.2mgL(-1)) beyond permissible limits. Polycyclic aromatic hydrocarbon (PAH) showed highest concentration of 4-ring PAH and Benzo[a]anthracene was the most important pollutant in the water collected from affected sites. The highest and the lowest mean concentrations of PAHs were estimated in monsoon and winter season, respectively. The index of DNA damage assessed by comet assay, micronucleus and chromosome aberration tests demonstrated significant differences season wise in different sampling sites. Frequency of DNA-damaged cells was found highest in the water samples collected from affected site in monsoon season.
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Affiliation(s)
- B Talukdar
- Department of Zoology, Gauhati University, Guwahati 781014, Assam, India
| | - H K Kalita
- Department of Zoology, Gauhati University, Guwahati 781014, Assam, India
| | - R A Baishya
- Department of Zoology, Gauhati University, Guwahati 781014, Assam, India
| | - S Basumatary
- Department of Zoology, Gauhati University, Guwahati 781014, Assam, India
| | - D Sarma
- Department of Zoology, Gauhati University, Guwahati 781014, Assam, India.
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Dmytriw A, Sarma D, Montanera W, Cusimano M, Bharatha A. E-017 endovascular management of iatrogenic anterior communication artery pseudoaneurysm. J Neurointerv Surg 2015. [DOI: 10.1136/neurintsurg-2015-011917.92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Talukdar B, Basumatary S, Kalita HK, Baishya RA, Dutta A, Srivastava SK, Sarma D. Histopathological Alternations in Liver and Kidney of Tor tor (Ham) Inhabited in Coal Mining Affected Areas of Simsang River, Garohills; Meghalaya. Natl Acad Sci Lett 2015. [DOI: 10.1007/s40009-014-0346-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sarma D, Das PD, Das P, Bisht H, Akhtar M, Ciji A. Fatty acid, amino acid and mineral composition of rainbow trout ( Oncorhynchus mykiss) of Indian Himalaya. INDIAN J ANIM RES 2015. [DOI: 10.5958/0976-0555.2015.00104.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Johnson LA, Wander JD, Sarma D, Su DK, Fetz EE, Ojemann JG. Direct electrical stimulation of the somatosensory cortex in humans using electrocorticography electrodes: a qualitative and quantitative report. J Neural Eng 2013; 10:036021. [PMID: 23665776 DOI: 10.1088/1741-2560/10/3/036021] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Recently, electrocorticography-based brain-computer interfaces have been successfully used to translate cortical activity into control signals for external devices. However, the utility of such devices would be greatly enhanced by somatosensory feedback. Direct stimulation of somatosensory cortex evokes sensory perceptions, and is thus a promising option for closing the loop. Before this can be implemented in humans it is necessary to evaluate how changes in stimulus parameters are perceived and the extent to which they can be discriminated. APPROACH Electrical stimulation was delivered to the somatosensory cortex of human subjects implanted with electrocorticography grids. Subjects were asked to discriminate between stimuli of different frequency and amplitude as well as to report the qualitative sensations elicited by the stimulation. MAIN RESULTS In this study we show that in humans implanted with electrocorticography grids, variations in the amplitude or frequency of cortical electrical stimulation produce graded variations in percepts. Subjects were able to reliably distinguish between different stimuli. SIGNIFICANCE These results indicate that direct cortical stimulation is a feasible option for sensory feedback with brain-computer interface devices.
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Affiliation(s)
- L A Johnson
- Department of Neurological Surgery, The University of Washington, Seattle, WA 98195, USA.
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Abstract
INTRODUCTION An increased prevalence of vitamin D deficiency has been reported from across the globe including India. Various studies have shown an intrinsic relation between various parameters of maternal and fetal wellbeing with maternal vitamin D status during pregnancy. AIMS To look for any association of vitamin D status during pregnancy with the modifiable factors - extent of sun exposure, sunscreen use, vegetarian diet, dietary calcium intake, and multivitamin supplementation. MATERIALS AND METHODS A total of 50 pregnant females, aged 20-40 years were studied during the first trimester of pregnancy. Fifty age and body mass index (BMI) matched females were taken as controls. Serum 25(OH)D was measured by radioimmunoassay (Diasorin). RESULT Forty-two percent of the cases were found to have vitamin D deficiency and 14% were found to have vitamin D insufficiency, whereas 20% of the controls had vitamin D deficiency and 24% had vitamin D insufficiency (P =0.0375). There was a significant association of 25(OH)D levels with extent of sun exposure, sunscreen use, and vegetarian diet. There was no association of 25(OH)D levels with multivitamin supplementation or dietary calcium intake. CONCLUSION Vitamin D deficiency was less in our study group as compared with that reported in other Indian studies. Sun exposure, sunscreen use, and vegetarian diet are important modifiable variables significantly associated with vitamin D status in pregnancy.
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Affiliation(s)
- A. Dasgupta
- Department of Endocrinology and Metabolism, Gauhati Medical College and Hospital, Guwahati, India
| | - UK Saikia
- Department of Endocrinology and Metabolism, Gauhati Medical College and Hospital, Guwahati, India
| | - D. Sarma
- Department of Endocrinology and Metabolism, Gauhati Medical College and Hospital, Guwahati, India
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Abstract
1577 Background: Venous thromboembolism (VTE) poses a significant health risk to cancer patients and is one of the leading causes of death among this population. The most effective way to prevent VTE and reduce its prominence as a public health burden is by identifying high-risk patients and administering prophylactic measures. In 2008, Khorana et al. developed a model that classified patients by risk based on clinical factors. Methods: We conducted a retrospective study to test this model’s efficacy, on 150 patients with cancer receiving chemotherapy at an outpatient oncology clinic between January 1 and August 1, 2011. We aggregated data and assigned points based on the five factors in the Khorana model: site of cancer with 2 points for very high-risk site and 1 point for high-risk site, 1 point each for leukocyte counts more than 11 x 109/L, platelet counts greater than 350 X 109/L, hemoglobin levels less than 100 g/L and/or the use of erythropoiesis-stimulating agents, and BMI greater than 35 kg/m2 (Khorana et al., Blood 2008). Based on this scoring system, patients with 0 points were grouped into the low-risk category, those with 1-2 points were considered intermediate-risk, and those with 3-4 points were classified as high-risk. Results: As shown in the table, VTE incidence for the low-risk group was 1.9%, intermediate-risk group was 3.9%, and high-risk group was 9.1%. Conclusions: High-risk patients were about 4.5 times more likely to develop a VTE than low risk patients. These results provide valuable insight in determining which patients might benefit from prophylaxis and in motivating the design of prospective clinical trials that assess the VTE predictive model in various ambulatory cancer settings. [Table: see text]
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Affiliation(s)
| | - So Yeon Kim
- Pennsylvania Oncology Hematology Associates, Philadelphia, PA
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Mathew S, Gupta S, Mendall M, Sarma D. Pancreatic cystic neoplasm presenting as a large gastric ulcer. Endoscopy 2012; 43 Suppl 2 UCTN:E363. [PMID: 22068646 DOI: 10.1055/s-0030-1256644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- S Mathew
- Department of Gastroenterology, Croydon University Hospital, Croydon, UK.
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Wilkerson P, Sarma D, Derodra J. Painful Horner syndrome. Postgrad Med J 2008; 84:142. [PMID: 18372485 DOI: 10.1136/pgmj.2007.062497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- P Wilkerson
- Department of Vascular Surgery, Mayday University Hospital, Croydon CR7 7YE, UK.
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Haw C, Sarma D, Ter Brugge K. Coexistence of Mandibular Arteriovenous Malformation and Cerebellar Arteriovenous Malformation. An Example of Cerebrofacial Arteriovenous Metameric Syndrome Type III. Interv Neuroradiol 2004; 9:71-4. [PMID: 20591306 DOI: 10.1177/159101990300900112] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2003] [Accepted: 01/20/2003] [Indexed: 11/15/2022] Open
Abstract
SUMMARY We describe a patient with cerebellar and mandibular arteriovenous malformations who initially presented with oral haemorrhage and then subsequently had a cerebellar haemorrhage. This is the second reported case of cerebrofacial arteriovenous metameric syndrome type III (CAMS III) in the literature and we discuss the role of homeobox genes in craniofacial development and angiogenesis.
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Affiliation(s)
- C Haw
- Diagnostic and Therapeutic Neuroradiology, Western Hospital, Toronto; Canada
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Kalita N, Sarma D, Talukdar J, Barua N, Ahmed N. Comparative performance of Khaki Campbell ducks, Desi ducks and their reciprocal crosses for certain economic traits in rural conditions. WORLD POULTRY SCI J 2004. [DOI: 10.1079/wps200423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- N. Kalita
- Department of Poultry Science College of Veterinary Science, Assam Agricultural University, Khanapara, Guwahati – 781022, Assam, India
| | - D. Sarma
- Department of Poultry Science College of Veterinary Science, Assam Agricultural University, Khanapara, Guwahati – 781022, Assam, India
| | - J.K. Talukdar
- Department of Poultry Science College of Veterinary Science, Assam Agricultural University, Khanapara, Guwahati – 781022, Assam, India
| | - N. Barua
- Department of Poultry Science College of Veterinary Science, Assam Agricultural University, Khanapara, Guwahati – 781022, Assam, India
| | - N. Ahmed
- Department of Extension Education, College of Veterinary Science, Assam Agricultural University, Khanapara, Guwahati – 781022, Assam, India
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Sarma D, Farb RI, Mikulis DJ, terBrugge KG. Reversal of restricted diffusion in cerebral venous thrombosis: case report. Neuroradiology 2004; 46:118-21. [PMID: 14726984 DOI: 10.1007/s00234-003-1121-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2003] [Accepted: 07/29/2003] [Indexed: 11/28/2022]
Abstract
We report a patient with extensive cerebral venous thrombosis who showed complete reversal of restricted diffusion on MRI, accompanied by excellent clinical recovery. The implications of these findings in relation to interpretation of diffusion changes in cerebral venous thrombosis are discussed, and differences with arterial stroke are highlighted.
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Affiliation(s)
- D Sarma
- Fell Pavilion 3-210, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON M5T 2S8, Canada
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36
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Baruah A, Sarma D, Saud J, Singh RS. In vitro regeneration of Hypericum patulum Thunb.--a medicinal plant. Indian J Exp Biol 2001; 39:947-9. [PMID: 11831384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
A protocol was developed for high frequency plant regeneration in H. patulum by shoot-tip culture. H. patulum plants were collected from a wild source growing at high altitude in the eastern Himalayas. Multiple buds were initiated from shoot-tips cultured on Murashige and Skoog's medium supplemented with BAP, kinetin. Addition of thiamin HCI, Ca-pantothenate and biotin enhanced multiple shoot formation. Upon transfer to phytohormone free liquid medium following a brief exposure to auxin, root formation occurred from the micro shoots . Rooted plants were hardened and transferred to soil. Regeneration potentiality was found to be constant throughout the year in long term cultures.
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Affiliation(s)
- A Baruah
- Plant Sciences and Ecology Division, Regional Research Laboratory, Jorhat, India.
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Affiliation(s)
- A Batra
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
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38
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Gupta AK, Sharma R, Sarma D. Imaging in epilepsy. Indian J Pediatr 2000; 67:S40-60. [PMID: 11129894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Epilepsy is a common problem in the paediatric age group. Imaging plays a vital role in identifying the seizure focus. Cross-sectional imaging modalities like CT and MRI have had a major impact on the management of seizure disorders. MRI, because of its high contrast resolution and multiplanar capability is the ideal imaging modality but its use is restricted due to high cost. Computed tomography is cheaper and is the first, and often, the only modality used, especially in the underprivileged areas of the world. In the tropical countries inflammatory granuloma are a common cause of epilepsy and CT is adequate to detect these lesions. Other causes include congenital abnormalities, neoplastic and vascular causes.
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Affiliation(s)
- A K Gupta
- Department of Radiodiagnosis, AIIMS, New Delhi
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Abstract
The authors describe the use of dual-phase intravenous CT angiography of the pelvis in two female patients, who presented with ongoing excessive vaginal bleeding, to demonstrate large adnexal and uterine arteriovenous malformations (AVMs). Power Doppler was used as the initial modality to diagnose the AVMs. CT angiography, along with 3-D rendering in the form of maximum intensity projections and shaded surface display, were especially useful for anatomical conceptualization to the gynecologist. This greatly helped in the subsequent management in the form of therapeutic embolization in both patients by reducing the time, radiation dose, and contrast required for the procedure. Subsequent surgery, which was required in both patients (due to failed embolization), was also greatly aided by the demonstration of the exact extent of the AVMs on axial CT images. Thus, CT angiography emerged as an impressive non-invasive imaging modality for the complete evaluation and management of the uterine AVMs.
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Affiliation(s)
- M S Gulati
- Department of Radiodiagnosis, All India Institute of Medical Sciences, 110 029, New Delhi, India.
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40
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Abstract
We report an unusual case of a ruptured primary hydatid cyst of the gallbladder. The sonographic appearance-a distended gallbladder containing an intraluminal mass with undulating membranes in the neck and body-led to the diagnosis of this extremely rare condition.
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Affiliation(s)
- A Kapoor
- Department of Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
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41
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Sarma D, Sarma S, Baruah A. Micropropagation and in vitro flowering of Rauvolfia tetraphylla; a potent source of anti-hypertension drugs. Planta Med 1999; 65:277-278. [PMID: 10232082 DOI: 10.1055/s-2006-960778] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
A simple protocol for in vitro mass multiplication of Rauvolfia tetraphylla (Apocynaceae) has been developed. The endophytic microflora was controlled by adopting integrated measures. Multiple shoot development was achieved on MS + Kin (0.1-0.2 mg/l) + BAP (0.4-0.5 mg/l) media. Rooting from in vitro shoots occurred on NAA containing media. In vitro flowering was induced in shoot multiplication media.
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Abstract
Abdominal tuberculosis continues to be endemic in the developing world and has shown a resurgence in the West. Computed tomography (CT) evaluation is singularly informative as it demonstrates involvement of the bowel, peritoneum, lymph nodes, and solid organs in a single examination. A spectrum of CT findings in an immunocompetent population is presented, ranging from subtle to advanced and common to rare. Genitourinary tuberculosis and tuberculosis in AIDS are excluded as they merit separate discussions.
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Affiliation(s)
- M S Gulati
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
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Chakravarty K, Sarma D, al-Jafari MS. Catastrophic hypoadrenalism in a case of Sjögren's syndrome. Int J Clin Pract 1998; 52:441-2. [PMID: 9894388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
We describe a patient with Sjögren's syndrome who died from undiagnosed adrenocortical failure. A positive test for adrenocortical antibody, performed pre-terminally, suggested the underlying diagnosis, which was subsequently confirmed at post-mortem. This case highlights the rare association of Sjögren's syndrome with occult adrenocortical failure. Perhaps a greater awareness of this association and more frequent serological screening are necessary to prevent a fatal outcome.
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Affiliation(s)
- K Chakravarty
- Department of Rheumatology, Warrington Hospital NHS Trust, Cheshire, UK
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Sarma D, Yang X, Jin G, Shindoh M, Pater MM, Pater A. Resistance to retinoic acid and altered cytokeratin expression of human papillomavirus type 16-immortalized endocervical cells after tumorigenesis. Int J Cancer 1996; 65:345-50. [PMID: 8575856 DOI: 10.1002/(sici)1097-0215(19960126)65:3<345::aid-ijc12>3.0.co;2-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Human papillomaviruses (HPVs) and cigarette smoking are epidemiologically associated with cervical cancer. We recently found that HEN-16 and HEN-16-2 HPV type 16-immortalized endocervical cells form tumors after treatment with cigarette smoke condensate and derived 2 tumor cell line cultures, HEN-16T and HEN-16-2T, respectively. Here, we examine the molecular pathologic effect of tumorigenesis. HEN-16T and HEN-16-2T exhibit unchanged status and expression of integrated HPV 16 DNA. However, the expression of the cytokeratin CK7 and CK13 endocervical cell markers is more homogeneous in monolayer and organotypic raft cultures after tumorigenesis. For the effect of retinoic acid on monolayers for growth inhibition, HEN-16T were significantly less sensitive than the normal and immortalized non-tumorigenic cells. HEN-16-2T were completely resistant. Moreover, the rafts from both tumorigenic cell line cultures were resistant to retinoic acid and continued to display thick rafts and homogeneous severe dysplasia/carcinoma in situ. In contrast, the non-malignant HEN-16 and HEN-16-2 rafts were thinner, and treatment with retinoic acid blocked the formation of severe dysplasia, reconstructing an epithelium resembling that of the normal endocervix. Our results support the significance of non-viral factors in the mechanism by which cigarette smoking induces tumorigenesis in the late stages of HPV-initiated progression to cervical cancer. Importantly, our data indicate that the sensitivity to retinoic acid of the HPV-containing endocervical cells is lost following tumorigenesis in vitro and possibly in women.
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Affiliation(s)
- D Sarma
- Division of Basic Medical Sciences, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada
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45
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Jain Y, Arya LS, Sarma D. Metastatic malignant melanoma in a child. Indian J Pediatr 1994; 61:192-4. [PMID: 7927619 DOI: 10.1007/bf02843617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Y Jain
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi
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46
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Abstract
Prostate specific antigen (PSA) has become a mainstay in the diagnosis and management of patients with prostate cancer. We have found, as have others, that it may be elevated in patients with prostatic inflammation. Ten patients had clinical evidence of prostatitis and elevated PSA levels. Six of these had persistently elevated levels after antibiotic treatment. After transrectal ultrasonography and biopsy, two had findings of adenocarcinoma, and the rest had a pathologic diagnosis of acute or chronic prostatitis. We studied this process in an experimental model of prostatitis using a nonhuman primate. We infected six cynomolgus monkeys and followed their PSA levels until resolution of the infection. The PSA peaked between 5 and 7 days after inoculation and gradually returned to baseline in 8 weeks. The dramatically elevated serum PSA levels in bacterial prostatitis can cause confusion in the diagnosis of prostatic carcinoma.
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Affiliation(s)
- D E Neal
- Department of Urology, Tulane University School of Medicine, New Orleans, Louisiana
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47
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Abstract
A fifty-five-year-old man presenting with unilateral renal colic and ureteral obstruction was found to have ureteral metastasis from a primary gallbladder carcinoma. This appears to be the second report of such a case in the English literature.
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48
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Wiener M, Sarma D, Rao M. Renal Cell Carcinoma in a Horseshoe Kidney. J Urol 1984. [DOI: 10.1016/s0022-5347(17)50129-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M. Wiener
- Department of Urology, Tulane Medical Center, New Orleans
- VA Medical Center, Alexandria
- Department of Pathology, Louisiana State University Medical Center, New Orleans, Louisiana
| | - D. Sarma
- Department of Urology, Tulane Medical Center, New Orleans
- VA Medical Center, Alexandria
- Department of Pathology, Louisiana State University Medical Center, New Orleans, Louisiana
| | - M. Rao
- Department of Urology, Tulane Medical Center, New Orleans
- VA Medical Center, Alexandria
- Department of Pathology, Louisiana State University Medical Center, New Orleans, Louisiana
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49
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Sarma D, Rohr W, Haindel C. Aspergillosis of the orbit. J La State Med Soc 1984; 136:19-20. [PMID: 6376706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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50
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Abstract
A case of renal cell carcinoma arising in a horseshoe kidney and presenting with a pathologic fracture of humerus is reported. Relevant literature is discussed.
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