1
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Little AK, Patmon DL, Sandhu H, Armstrong S, Anderson D, Sommers M. Inpatient versus Outpatient Immediate Alloplastic Breast Reconstruction: Recent Trends, Outcomes, and Safety. Plast Reconstr Surg Glob Open 2023; 11:e5135. [PMID: 37744774 PMCID: PMC10513287 DOI: 10.1097/gox.0000000000005135] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 06/06/2023] [Indexed: 09/26/2023]
Abstract
Background Immediate alloplastic breast reconstruction was traditionally performed as an inpatient procedure. Despite several reports in the literature demonstrating comparable safety outcomes, there remains hesitancy to accept breast reconstruction performed as an outpatient procedure. Methods A retrospective review of National Surgical Quality Improvement Program data from 2014 to 2018 was utilized to evaluate recent trends and 30-day postoperative complication rates for inpatient versus outpatient immediate prosthetic-based breast reconstruction. Propensity score matching was used to obtain comparable groups. Results During the study period, 33,587 patients underwent immediate alloplastic breast reconstruction. Of those, 67.5% of patients were discharged within 24 hours, and 32.4% of patients had a hospital stay of more than 24 hours. Immediate alloplastic reconstruction had an overall growth rate of 16.9% from 2014 to 2018. After propensity score matching, intraoperative variables that correlated with significantly increased inpatient status included increased work relative value units (16.3 ± 2.3 versus 16.2 ± 2.6; P < 0.001), longer operative times (228 ± 86 versus 206 ± 77; P < 0.001), and bilateral procedure (44.0% versus 43.5%; P < 0.001). There were higher rates of pulmonary embolism, wound dehiscence, urinary tract infection, transfusions, sepsis, readmissions, and reoperations in the group with the longer hospital stay. Conclusion Based on increased complication rates and costs in the inpatient setting, we propose outpatient reconstructive surgery as a safe and cost-effective alternative for immediate alloplastic breast reconstruction.
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Affiliation(s)
- Andrea K. Little
- From the Division of Plastic and Reconstructive Surgery, Spectrum Health Michigan State University Plastic Surgery Residency, Grand Rapids, Mich
| | - Darin L. Patmon
- Michigan State University College of Human Medicine, Grand Rapids, Mich
| | - Harminder Sandhu
- Michigan State University College of Human Medicine, Grand Rapids, Mich
| | | | - Daniella Anderson
- From the Division of Plastic and Reconstructive Surgery, Spectrum Health Michigan State University Plastic Surgery Residency, Grand Rapids, Mich
| | - Megan Sommers
- From the Division of Plastic and Reconstructive Surgery, Spectrum Health Michigan State University Plastic Surgery Residency, Grand Rapids, Mich
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2
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Patmon D, Sandhu H, Girotto J, Ford R. Legal Ramifications of Publishing Patient Photographs: A Review of Legal Cases. Plast Reconstr Surg Glob Open 2023; 11:e5162. [PMID: 37547352 PMCID: PMC10400045 DOI: 10.1097/gox.0000000000005162] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 06/12/2023] [Indexed: 08/08/2023]
Abstract
The use of photography in plastic surgery has become standard of practice in recent years. Patient photographs have diverse utility and can be used to visualize medical progression, and as an educational and marketing tool. With increased publication of patient photographs outside the healthcare records, it is important to understand patient privacy rights and how they pertain to images. Additionally, it is valuable to understand the legal consequences associated with dissemination of patient photographs without proper consent. Methods A retrospective analysis of the Lexis+ legal database was conducted to obtain cases that involved the improper dissemination of patient photographs or videos by surgeons. Inclusion criteria included civil cases in which the defendant was a surgeon being sued for the improper use of patient photographs. Criminal cases were excluded from analysis. Results A total of 23 cases met the inclusion criteria for our study. On average, 2.13 defendants were listed per case, often including the accused surgeon and their employer. Prior photographic consent was obtained in 69.57% (n = 16) of cases. In the remaining seven cases, the defendant did not obtain consent. In all seven of these cases, either the court ruled in favor of the plaintiff or both parties reached a settlement outside court. Conclusions To mitigate risk, surgeons should maintain two separate photographic consent forms for internal and external use. Additionally, a formal audit process should be established to ensure proper consent has been established before publishing patient photographs external to the electronic medical records.
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Affiliation(s)
- Darin Patmon
- From the Michigan State University College of Human Medicine, Grand Rapids, Mich
| | - Harminder Sandhu
- From the Michigan State University College of Human Medicine, Grand Rapids, Mich
| | - John Girotto
- Helen DeVos Children’s Hospital, Grand Rapids, Mich
| | - Ronald Ford
- Plastic Surgery, Spectrum Health/Michigan State University Plastic Surgery Integrated Residency, Grand Rapids, Mich
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3
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Oldfield LE, Jones V, Gill B, Kodous N, Fazelzad R, Rodin D, Sandhu H, Umakanthan B, Papadakos J, Giuliani ME. Synthesis of Existent Oncology Curricula for Primary Care Providers: A Scoping Review With a Global Equity Lens. JCO Glob Oncol 2023; 9:e2200298. [PMID: 37141562 DOI: 10.1200/go.22.00298] [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] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
PURPOSE Global increases in cancer, coupled with a shortage of cancer specialists, has led to an increasing role for primary care providers (PCP) in cancer care. This review aimed to examine all extant cancer curricula for PCPs and to analyze the motivations for curriculum development. METHODS A comprehensive literature search was conducted from inception to October 13, 2021, with no language restrictions. The initial search yielded 11,162 articles and 10,902 articles underwent title and abstract review. After full-text review, 139 articles were included. Numeric and thematic analyses were conducted and education programs were evaluated using Bloom's taxonomy. RESULTS Most curricula were developed in high-income countries (HICs), with 58% in the United States. Cancer-specific curricula focused on HIC priority cancers, such as skin/melanoma, and did not represent the global cancer burden. Most (80%) curricula were developed for staff physicians and 73% focused on cancer screening. More than half (57%) of programs were delivered in person, with a shift toward online delivery over time. Less than half (46%) of programs were codeveloped with PCPs and 34% did not involve PCPs in the program design and development. Curricula were primarily developed to improve cancer knowledge, and 72 studies assessed multiple outcome measures. No studies included the top two levels of Bloom's taxonomy of learning (evaluating; creating). CONCLUSION To our knowledge, this is the first review to assess the current state of cancer curricula for PCPs with a global focus. This review shows that extant curricula are primarily developed in HICs, do not represent the global cancer burden, and focus on cancer screening. This review lays a foundation to advance the cocreation of curricula that are aligned to the global cancer burden.
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Affiliation(s)
| | - Vivien Jones
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Bhajan Gill
- Cancer Education, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Nardeen Kodous
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Rouhi Fazelzad
- Library and Information Services, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Danielle Rodin
- Royal College of Surgeons in Ireland, Dublin, Ireland
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | | | - Ben Umakanthan
- Cancer Education, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Janet Papadakos
- Cancer Education, Princess Margaret Cancer Centre, Toronto, ON, Canada
- The Institute for Education Research, University Health Network, Toronto, ON, Canada
| | - Meredith Elana Giuliani
- Cancer Education, Princess Margaret Cancer Centre, Toronto, ON, Canada
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
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4
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Maduka RC, Broderick M, White EM, Ballouz D, Sandhu H, Kwakye G, Chen H, Sandhu G. The Reporting of Race and Ethnicity in Surgery Literature. JAMA Surg 2021; 156:1036-1041. [PMID: 34406343 DOI: 10.1001/jamasurg.2021.3752] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Importance The reporting of race provides transparency to the representativeness of data and helps inform health care disparities. The International Committee of Medical Journal Editors (ICMJE) developed recommendations to promote quality reporting of race; however, the frequency of reporting continues to be low among most medical journals. Objective To assess the frequency as well as quality of race reporting among publications from high-ranking broad-focused surgical research journals. Design, Setting, and Participants A literature review and bibliometric analysis was performed examining all human-based primary research articles published in 2019 from 7 surgical journals: JAMA Surgery, Journal of the American College of Surgeons, Annals of Surgery, Surgery, American Journal of Surgery, Journal of Surgical Research, and Journal of Surgical Education. The 5 journals that stated they follow the ICMJE recommendations were analyzed against the 2 journals that did not explicitly claim adherence. Main Outcomes and Measures Measured study outcomes included race reporting frequency and use of the ICMJE recommendations for quality reporting of race. Results A total of 2485 publications were included in the study. The mean (SD) frequency of reporting of race and ethnicity in publications of ICMJE vs non-ICMJE journals was 32.8% (8.4) and 32.0% (20.9), respectively (P = .72). Adherence to ICMJE recommendations for reporting race was more frequent in ICMJE journals than non-ICMJE journals (mean [SD] of 73.1% [17.8] vs 37.0% [10.2]; P < .001). Conclusions and Relevance The frequency of race and ethnicity reporting among surgical journals is low. A journal's statement of adherence to ICMJE recommendations did not affect the frequency of race and ethnicity reporting; however, there was an increase in the use of ICMJE quality metrics. These findings suggest the need for increased and more standardized reporting of racial and ethnic demographic data among surgical journals.
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Affiliation(s)
- Richard C Maduka
- Department of Surgery, Yale University School of Medicine, New Haven, Connecticut
| | | | - Erin M White
- Department of Surgery, Yale University School of Medicine, New Haven, Connecticut
| | - Dena Ballouz
- University of Michigan School of Medicine, Ann Arbor
| | - Harminder Sandhu
- Michigan State University College of Human Medicine, East Lansing
| | - Gifty Kwakye
- Department of Surgery, University of Michigan School of Medicine, Ann Arbor
| | - Herbert Chen
- Department of Surgery, University of Alabama at Birmingham School of Medicine, Birmingham
| | - Gurjit Sandhu
- Department of Surgery, University of Michigan School of Medicine, Ann Arbor
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5
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Collard VEJ, Moore C, Nichols V, Ellard DR, Patel S, Sandhu H, Parsons H, Sharma U, Underwood M, Madan J, Tang NKY. Challenges and visions for managing pain-related insomnia in primary care using the hybrid CBT approach: a small-scale qualitative interview study with GPs, nurses, and practice managers. BMC Fam Pract 2021; 22:210. [PMID: 34666682 PMCID: PMC8527665 DOI: 10.1186/s12875-021-01552-3] [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] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 09/01/2021] [Indexed: 08/30/2023]
Abstract
Background Chronic pain and insomnia have a complex, bidirectional relationship – addressing sleep complaints alongside pain may be key to alleviating patient-reported distress and disability. Healthcare professionals have consistently reported wanting to offer psychologically informed chronic pain management at the primary care level. Research in secondary care has demonstrated good treatment efficacy of hybrid CBT for chronic pain and insomnia. However, primary care is typically the main point of treatment entry, hence may be better situated to offer treatments using a multidisciplinary approach. In this study, primary care service providers’ perception of feasibility for tackling pain-related insomnia in primary care was explored. Methods The data corpus originates from a feasibility trial exploring hybrid CBT for chronic pain and insomnia delivered in primary care. This formed three in-depth group interviews with primary care staff (n = 9) from different primary care centres from the same NHS locale. All interviews were conducted on-site using a semi-structured approach. Verbal data was recorded, transcribed verbatim and analysed using the thematic analysis process. Results Eight themes were identified – 1) Discrepant conceptualisations of the chronic pain-insomnia relationship and clinical application, 2) Mismatch between patients’ needs and available treatment offerings, 3) Awareness of psychological complexities, 4) Identified treatment gap for pain-related insomnia, 5) Lack of funding and existing infrastructure for new service development, 6) General shortage of psychological services for complex health conditions, 7) Multidisciplinary team provision with pain specialist input, and 8) Accessibility through primary care. These mapped onto four domains - Current understanding and practice, Perceived facilitators, Perceived barriers, Ideal scenarios for a new treatment service – which reflected the focus of our investigation. Taken together these provide key context for understanding challenges faced by health care professionals in considering and developing a new clinical service. Conclusions Primary care service providers from one locale advocate better, multidisciplinary treatment provision for chronic pain and insomnia. Findings suggest that situating this in primary care could be a feasible option, but this requires systemic support and specialist input as well as definitive trials for success. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01552-3.
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Affiliation(s)
- V E J Collard
- Department of Psychology, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK.
| | - C Moore
- Department of Psychology, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
| | - V Nichols
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - D R Ellard
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.,University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, UK
| | - S Patel
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - H Sandhu
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - H Parsons
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.,University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, UK
| | - U Sharma
- University/User Teaching and Research Action Partnership, University of Warwick, Coventry, CV4 7AL, UK
| | - M Underwood
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.,University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, UK
| | - J Madan
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - N K Y Tang
- Department of Psychology, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
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6
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Sidhom F, Sandhu H. Guillain-Barre Syndrome in a Patient With COVID-19 Infection. Cureus 2021; 13:e17052. [PMID: 34522530 PMCID: PMC8428162 DOI: 10.7759/cureus.17052] [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] [Accepted: 08/10/2021] [Indexed: 11/05/2022] Open
Abstract
Since the identification of SARS-CoV-2 or COVID-19 in Wuhan, several case reports have proposed a possible association between Guillain-Barre syndrome (GBS) and COVID-19. We describe a case of a 59-year-old female who initially presented with shortness of breath, tested positive for COVID-19, and subsequently developed acute hypoxic respiratory failure requiring mechanical ventilation. Her recovery was complicated by acute polyneuropathy. Clinical exam and lumbar puncture showing an albuminocytologic dissociation were consistent with GBS. The prevalence and association of GBS following COVID-19 infection require further research to understand the short and long-term neurological effects of COVID-19, as well as the management of these various neurological manifestations.
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Affiliation(s)
- Fady Sidhom
- Internal Medicine, Howard University Hospital, Washington, USA
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7
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Sandhu H, Wilson K, Reed N, Mihailidis A. A Mobile Phone App for the Self-Management of Pediatric Concussion: Development and Usability Testing. JMIR Hum Factors 2019; 6:e12135. [PMID: 31152527 PMCID: PMC6658289 DOI: 10.2196/12135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 04/09/2019] [Accepted: 04/15/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Concussion is a common injury among Canadian children and adolescents that leads to a range of neurobehavioral deficits. However, noticeable gaps continue to exist in the management of pediatric concussion, with poor health outcomes associated with the inadequate application of best practice guidelines. OBJECTIVE The aim of this study was to describe the development and assess the usability of a mobile phone app to aid youth in the self-management of concussion. A secondary objective was to assess the usefulness of the app. METHODS An agile user-centered design approach was used to develop the technology, followed by a formative lab-based usability study for assessment and improvement proposals. Youths aged 10 to 18 years with a history of concussion and health care professionals involved in concussion management were recruited. This study included participants performing 12 tasks with the mobile phone app while using the think aloud protocol and the administration of the System Usability Scale (SUS), posttest questionnaire, and a semistructured interview. RESULTS A mobile phone app prototype called NeuroCare, an easily accessible pediatric concussion management intervention that provides easy access to expert-informed concussion management strategies and helps guide youth in self-managing and tracking their concussion recovery, was developed. A total of 7 youths aged between 10 and 18 years with a history of concussion and 7 health care professionals were recruited. The mean SUS score was 81.9, mean task success rates were greater than 90% for 92% (11/12) of the tasks, 92% (11/12) of tasks had a total error frequency of less than 11 errors, and mean task completion times were less than 2 min for 100% of the tasks. CONCLUSIONS Results suggest that participants rated this app as highly usable, acceptable to users, and that it may be useful in helping youth self-manage concussion.
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Affiliation(s)
- Harminder Sandhu
- Institute of Biomaterials & Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Katherine Wilson
- Concussion Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Nick Reed
- Concussion Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Alex Mihailidis
- Institute of Biomaterials & Biomedical Engineering, University of Toronto, Toronto, ON, Canada.,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, ON, Canada
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8
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Affiliation(s)
- H Sandhu
- Warwick Clinical Trials Unit, Warwick Medical School, UK
| | - M Underwood
- Warwick Clinical Trials Unit, Warwick Medical School, UK
| | - A D Furlan
- Department of Medicine, University of Toronto, Canada
| | - J Noyes
- The James Cook University Hospital, Middlesbrough, UK
| | - S Eldabe
- The James Cook University Hospital, Middlesbrough, UK
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9
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Sandhu H, Maddock H. Investigating the Cardioprotective role of Metformin during Sunitinib-induced Cardiotoxicity by qRT-PCR profiling of microRNAs associated with myocardial injury. J Mol Cell Cardiol 2018. [DOI: 10.1016/j.yjmcc.2018.05.104] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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10
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McPhail P, Sandhu H, Dale J, Stewart-Brown S. Acupuncture in hospice settings: A qualitative exploration of patients' experiences. Eur J Cancer Care (Engl) 2018; 27:e12802. [PMID: 29323766 DOI: 10.1111/ecc.12802] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2017] [Indexed: 11/28/2022]
Abstract
Whilst acupuncture has the potential to impact on many aspects of health and well-being, including end-of-life care, there is little research regarding patients' experiences of its effects within the context of palliative care in hospice settings. The aim of this study was to address this gap, by exploring patients' experiences of acupuncture within this setting. In-depth, semi-structured interviews were conducted with a sample of eighteen patients who had received acupuncture as part of hospice care. Transcription of data, with thematic analysis, identified two overarching themes: (1) participant perceptions of the effects of acupuncture including pain control, improved physical and emotional health, spiritual well-being and awareness of health as a holistic phenomenon; and (2) factors which participants believed enabled acupuncture to have these effects including the quality of the practitioner relationship, engagement of participants in the process of their treatment and prior expectations that acupuncture could work. Acupuncture was found to be a highly acceptable, accessible and popular treatment with positive holistic effects reported across the domains of physical, mental and spiritual health and no serious adverse effects. By enabling awareness of the holistic nature of health and well-being, acupuncture was experienced as having the potential to contribute to a better death, an emergent theory that needs testing in further studies. In the meanwhile, the results of this study offer encouragement to hospices currently providing or considering investing in acupuncture provision.
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Affiliation(s)
- P McPhail
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - H Sandhu
- Division of Health Sciences, Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - J Dale
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - S Stewart-Brown
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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11
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Wipper S, Kölbel T, Manzoni D, Duprée A, Tsilimparis N, Sandhu H, Estrera A, Miller C, Debus E. The SPIDER-Graft: A Modified Frozen Elephant Trunk for Thoracoabdominal Aortic Repair. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627966] [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: 10/28/2022]
Affiliation(s)
- S. Wipper
- Department of Vascular Medicine, University Heart Center Hamburg-Eppendorf, Hamburg, Germany
| | - T. Kölbel
- Department of Vascular Medicine, University Heart Center Hamburg-Eppendorf, Hamburg, Germany
| | - D. Manzoni
- Department of Vascular Medicine, University Heart Center Hamburg-Eppendorf, Hamburg, Germany
| | - A. Duprée
- Department of Vascular Medicine, University Heart Center Hamburg-Eppendorf, Hamburg, Germany
| | - N. Tsilimparis
- Department of Vascular Medicine, University Heart Center Hamburg-Eppendorf, Hamburg, Germany
| | - H. Sandhu
- Department of Cardiothoracic and Vascular Surgery, McGovern Medical School, UTHealth, Houston, United States
| | - A. Estrera
- Department of Cardiothoracic and Vascular Surgery, McGovern Medical School, UTHealth, Houston, United States
| | - C. Miller
- Department of Cardiothoracic and Vascular Surgery, McGovern Medical School, UTHealth, Houston, United States
| | - E. Debus
- Department of Vascular Medicine, University Heart Center Hamburg-Eppendorf, Hamburg, Germany
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12
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Sandhu H, Bernstein CJ, Davies G, Tang NKY, Belhag M, Tingle A, Field M, Foss J, Lindahl A, Underwood M, Ellard DR. Combined cognitive-behavioural and mindfulness programme for people living with dystonia: a proof-of-concept study. BMJ Open 2016; 6:e011495. [PMID: 27496234 PMCID: PMC4985914 DOI: 10.1136/bmjopen-2016-011495] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES To design and test the delivery of an intervention targeting the non-motor symptoms of dystonia and pilot key health and well-being questionnaires in this population. DESIGN A proof-of-concept study to test the delivery, acceptability, relevance, structure and content for a 3-day group residential programme for the management of dystonia. SETTING Participants were recruited from a single botulinum toxin clinic. The intervention was delivered in the community. PARTICIPANTS 14 participants consented to take part (2 withdrew prior to the starting of intervention). The average age was 60 years (range 44-77), 8 of whom were female. After drop-out, 9 participants completed the 3-day programme. INTERVENTION A 3-day group residential programme. PRIMARY AND SECONDARY OUTCOME MEASURES Process evaluation and interviews were carried out before and after the intervention to explore participant's views and expectations, as well as experiences of the intervention. Select questionnaires were completed at baseline, 1-month and 3-month follow-up. RESULTS Although participants were not sure what to expect from the programme, they found it informative and for many this together with being in a group with other people with dystonia legitimised their condition. Mindfulness was accepted and adopted as a coping strategy. This was reflected in the 1-month follow-up. CONCLUSIONS We successfully delivered a 3-day residential programme to help those living with dystonia manage their condition. Further improvements are suggested. The quantitative outcome measures were acceptable to this group of patients with dystonia.
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Affiliation(s)
- H Sandhu
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - C J Bernstein
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - G Davies
- University of Southampton, Southampton, UK
| | - N K Y Tang
- Department of Psychology, University of Warwick, Coventry, UK
| | - M Belhag
- Department of Neurology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - A Tingle
- The Dystonia Society (West Midlands Group), West Midlands, UK
| | - M Field
- The Dystonia Society (West Midlands Group), West Midlands, UK
| | - J Foss
- Department of Computer Science, University of Warwick, Coventry, UK
| | - A Lindahl
- Department of Neurology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - M Underwood
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - D R Ellard
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
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13
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Bernstein CJ, Ellard DR, Davies G, Hertenstein E, Tang NKY, Underwood M, Sandhu H. Behavioural interventions for people living with adult-onset primary dystonia: a systematic review. BMC Neurol 2016; 16:40. [PMID: 27000094 PMCID: PMC4802601 DOI: 10.1186/s12883-016-0562-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 10/16/2015] [Accepted: 03/15/2016] [Indexed: 11/10/2022] Open
Abstract
Background Primary dystonia is a chronic neurological movement disorder that causes abnormal muscle movements. Pain and emotional distress may accompany these physical symptoms. Behavioural interventions are used to help people with long term conditions improve their quality of life. Little is known about behavioural interventions applied to Dystonia. We report a systematic review of studies reporting current evidence of behavioural interventions for people with primary dystonia. Methods We did systematic searches of Medline, PsycINFO, AHMED and CINAHL. We assessed the methodological quality of included studies using a risk of bias tool. Any disagreements were resolved by liaising with an independent rater. Physiological outcomes such as dystonia severity and psychological outcomes such as sleep and depression were selected on the basis that primary dystonia causes motor and non-motor symptoms. No time limit was placed on the searches. A narrative synthesis of the results is presented. Results Of 1798 titles and abstracts screened, 14 full articles were retrieved and inclusion and exclusion criteria applied. Of these a final nine were eligible for the review (N = 73). Only two were Randomised Controlled Trials (RCTs). Using the Movement Disorders Society (MDS) dystonia classification, that was published after this work started, all of the included studies were of idiopathic adult onset focal dystonia without associated features. These included: blepharospasm (eye dystonia) (N = 1), cervical dystonia (neck dystonia) (N = 2), writer’s cramp (hand dystonia) (N = 3) and the yips (N = 3). No studies reported on dystonia that affects two or more body regions. Studies reported good adherence and response rates to treatment. Physiological and psychological improvements were noted in all studies at weekly, monthly and yearly follow-ups. Caution should be taken when interpreting the results because of the scarcity of RCTs identified, use of small sample sizes, and inappropriate statistical methods. Conclusion We identified few studies; mainly of poor methodological quality that all studied a focal dystonia. It is not possible to draw firm conclusions. Nevertheless, the data suggests that a combined behavioural therapy approach including relaxation practice for people with idiopathic adult onset focal dystonia merits further investigation.
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Affiliation(s)
- C J Bernstein
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - D R Ellard
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
| | - G Davies
- University of Southampton, Southampton, UK
| | - E Hertenstein
- Department of Psychiatry and Psychotherapy, University of Freiburg Medical Center, Freiburg, Germany
| | - N K Y Tang
- Department of Psychology, University of Warwick, Coventry, UK
| | - M Underwood
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - H Sandhu
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
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Haji A, Lowther S, Ngan'ga Z, Gura Z, Tabu C, Sandhu H, Arvelo W. Reducing routine vaccination dropout rates: evaluating two interventions in three Kenyan districts, 2014. BMC Public Health 2016; 16:152. [PMID: 26880141 PMCID: PMC4754928 DOI: 10.1186/s12889-016-2823-5] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 02/03/2016] [Indexed: 11/17/2022] Open
Abstract
Background Globally, vaccine preventable diseases are responsible for nearly 20 % of deaths annually among children <5 years old. Worldwide, many children dropout from the vaccination program, are vaccinated late, or incompletely vaccinated. We evaluated the impact of text messaging and sticker reminders to reduce dropouts from the vaccination program. Methods The evaluation was conducted in three selected districts in Kenya: Machakos, Langata and Njoro. Three health facilities were selected in each district, and randomly allocated to send text messages or provide stickers reminding parents to bring their children for second and third dose of pentavalent vaccine, or to the control group (routine reminder) with next appointment date indicated on the well-child booklet. Children aged <12 months presenting for their first dose of pentavalent vaccine were enrolled. A dropout was defined as not returning for vaccination ≥2 weeks after scheduled date for third dose of pentavalent vaccine. We calculated dropout rate as a percentage of the difference between first and third pentavalent dose. Results We enrolled 1,116 children; 372 in each intervention and 372 controls between February and October 2014. Median age was 45 days old (range: 31–99 days), and 574 (51 %) were male. There were 136 (12 %) dropouts. Thirteen (4 %) children dropped out among those who received text messages, 60 (16 %) among who received sticker reminders, and 63 (17 %) among the controls. Having a caregiver with below secondary education [Odds Ratio (OR) 1.8, 95 % Confidence Interval (CI) 1.1–3.2], and residing >5 km from health facility (OR 1.6, CI 1.0–2.7) were associated with higher odds of dropping out. Those who received text messages were less likely to drop out compared to controls (OR 0.2, CI 0.04–0.8). There was no statistical difference between those who received stickers and controls (OR 0.9, CI 0.5–1.6). Conclusion Text message reminders can reduce vaccination dropout rates in Kenya. We recommend the extended implementation of text message reminders in routine vaccination services.
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Affiliation(s)
- Adam Haji
- College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya. .,Field Epidemiology and Laboratory Training Program, Kenya Ministry of Health, Nairobi, Kenya. .,Division of Vaccines and Immunization, Kenya Ministry of Health, Nairobi, Kenya.
| | - S Lowther
- Global Immunization Division, US Centers of Disease Control, and Prevention, Nairobi, Kenya
| | - Z Ngan'ga
- College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Z Gura
- Field Epidemiology and Laboratory Training Program, Kenya Ministry of Health, Nairobi, Kenya
| | - C Tabu
- Division of Vaccines and Immunization, Kenya Ministry of Health, Nairobi, Kenya
| | - H Sandhu
- Division for Global Health Protection, US Centers of Disease Control and Prevention, Nairobi, Kenya
| | - Wences Arvelo
- Field Epidemiology and Laboratory Training Program, Kenya Ministry of Health, Nairobi, Kenya.,Division for Global Health Protection, US Centers of Disease Control and Prevention, Nairobi, Kenya
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Estrera A, Jan A, Sandhu H. Outcomes of Open Repair for Chronic Descending Thoracic Aortic Dissection. J Vasc Surg 2015. [DOI: 10.1016/j.jvs.2015.10.020] [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: 11/25/2022]
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16
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Sandhu H, Olbrück H, Abel J, Unfried K. Differential Display Analysis of Fiber-Induced Carcinogenesis in Rat: Clue for Involvement of Integrin-Mediated Signal Transduction. Inhal Toxicol 2015; 12 Suppl 3:337-43. [DOI: 10.1080/08958378.2000.11463243] [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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17
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Waker AJ, Mahilrajan T, Sandhu H. Environmental microdosimetry: microdosimetric characterisation of low-dose exposures. Radiat Prot Dosimetry 2015; 166:204-209. [PMID: 25883311 DOI: 10.1093/rpd/ncv165] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A number of researchers, as well as the International Commission on Radiation Units and Measurements, have described how concepts and quantities used in microdosimetry best capture the stochastic nature of low-level exposures in terms of cell hits and the fraction of cells affected within a tissue. However, the concepts of microdosimetry are not generally intuitive to the public or indeed to health physicists. In this article, the methods of conventional internal dosimetry was applied to different forms of radioactive iodine to derive cell-hit numbers and cell fractions affected by low-level exposures, and it is shown that microdosimetric analysis is compatible with conventional dosimetry but has the advantage of underscoring the stochastic nature of ionising radiation at low dose. The microdosimetric description of low-dose exposures derived in this work could be improved with the use of Monte Carlo track structure codes and more realistic models of different tissues and their cellular structure.
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Affiliation(s)
- A J Waker
- Faculty of Energy Systems and Nuclear Science, UOIT, 2000 Simcoe Street North, Oshawa, ON, Canada L1H 7K4
| | - T Mahilrajan
- Faculty of Energy Systems and Nuclear Science, UOIT, 2000 Simcoe Street North, Oshawa, ON, Canada L1H 7K4
| | - H Sandhu
- Faculty of Energy Systems and Nuclear Science, UOIT, 2000 Simcoe Street North, Oshawa, ON, Canada L1H 7K4
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18
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Feng Y, Wratten S, Sandhu H, Keller M. Interspecific competition between two generalist parasitoids that attack the leafroller Epiphyas postvittana (Lepidoptera: Tortricidae). Bull Entomol Res 2015; 105:426-433. [PMID: 25572341 DOI: 10.1017/s0007485314000923] [Citation(s) in RCA: 3] [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] [Indexed: 06/04/2023]
Abstract
Two generalist parasitoids, Dolichogenidea tasmanica (Cameron) (Hymenoptera: Braconidae) and Therophilus unimaculatus (Turner) (Hymenoptera: Braconidae) attack early instars of tortricid moths, including the light brown apple moth, Epiphyas postvittana (Walker) (Lepidoptera: Tortricidae). The two parasitoids co-exist in natural habitats, while D. tasmanica is dominant in vineyards, whereas T. unimaculatus occurs mainly in adjacent native vegetation. This difference suggests possible competition between the two species, mediated by habitat. Here, we report on the extent of interspecific differences in host discrimination and the outcome of interspecific competition between the two parasitoids. The parasitoids did not show different behavioural responses to un-parasitized hosts or those that were parasitized by the other species. Larvae of D. tasmanica out-competed those of T. unimaculatus, irrespective of the order or interval between attacks by the two species. The host larvae that were attacked by two parasitoids died more frequently before a parasitoid completed its larval development than those that were attacked by a single parasitoid. Dissection of host larvae parasitized by both species indicated that first instars of D. tasmanica attacked and killed larval T. unimaculatus.
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Affiliation(s)
- Y Feng
- School of Agriculture, Food and Wine, University of Adelaide,Adelaide,SA 5005,Australia
| | - S Wratten
- Bio-Protection Research Centre,Lincoln University,PO Box 85084,Lincoln 7647,New Zealand
| | - H Sandhu
- School of the Environment, Flinders University,PO Box 2100 Adelaide,SA 5001,Australia
| | - M Keller
- School of Agriculture, Food and Wine, University of Adelaide,Adelaide,SA 5005,Australia
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19
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Davies AR, Sandhu H, Pillai A, Sinha P, Mattsson F, Forshaw MJ, Gossage JA, Lagergren J, Allum WH, Mason RC. Surgical resection strategy and the influence of radicality on outcomes in oesophageal cancer. Br J Surg 2014; 101:511-7. [PMID: 24615656 DOI: 10.1002/bjs.9456] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND The optimal surgical approach to tumours of the oesophagus and oesophagogastric junction remains controversial. The principal randomized trial comparing transhiatal (THO) and transthoracic (TTO) oesophagectomy showed no survival difference, but suggested that some subgroups of patients may benefit from the more extended lymphadenectomy typically conducted with TTO. METHODS This was a cohort study based on two prospectively created databases. Short- and long-term outcomes for patients undergoing THO and TTO were compared. The primary outcome measure was overall survival, with secondary outcomes including time to recurrence and patterns of disease relapse. A Cox proportional hazards model provided hazard ratios (HRs) and 95 per cent confidence intervals (c.i.), with adjustments for age, tumour stage, tumour grade, response to chemotherapy and lymphovascular invasion. RESULTS Of 664 included patients (263 THO, 401 TTO), the distributions of age, sex and histological subtype were similar between the groups. In-hospital mortality (1·1 versus 3·2 per cent for THO and TTO respectively; P = 0·110) and in-hospital stay (14 versus 17 days respectively; P < 0·001) favoured THO. In the adjusted model, there was no difference in overall survival (HR 1·07, 95 per cent c.i. 0·84 to 1·36) or time to tumour recurrence (HR 0·99, 0·76 to 1·29) between the two operations. Local tumour recurrence patterns were similar (22·8 versus 24·4 per cent for THO and TTO respectively). No subgroup could be identified of patients who had benefited from more radical surgery on the basis of tumour location or stage. CONCLUSION There was no difference in survival or tumour recurrence for TTO and THO.
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Affiliation(s)
- A R Davies
- Department of Surgery, St Thomas' Hospital, King's College London, London, UK; Department of Surgery, Royal Marsden Hospital, King's College London, London, UK; Gastrointestinal Cancer, Division of Cancer Studies, King's College London, London, UK; Unit of Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
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20
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Sandhu H, Cooper S, Eckert M, Pisula L, Chinweike C, Gharanei M, Maddock HL. 20 Cardioprotection During Chemotherapy: A Case Study to Understand Intracellular Mechanisms to Combat the Cardiotoxicity of Sunitinib. Heart 2014. [DOI: 10.1136/heartjnl-2013-305297.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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21
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Pathiraja P, Sandhu H, Instone M, Haldar K, Kehoe S. Should pelvic exenteration for symptomatic relief in gynaecology malignancies be offered? Arch Gynecol Obstet 2013; 289:657-62. [PMID: 24026090 DOI: 10.1007/s00404-013-3023-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 08/30/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To review the outcomes of pelvic exenterative surgery done with a palliative intent and evaluate its role in relapsed gynaecology malignancies. METHOD This is a retrospective cohort study between April 2009 and May 2012 in Oxford Gynaecological Cancer Centre. Patients were identified from the oncology surgical database. RESULTS 18 patients were identified with a mean age 54 (26-79) years, who underwent surgery for symptomatic recurrent cancer. All except one patient had radiotherapy prior to surgery. 12 patients had cervical cancer, five had vulval cancer and one had endometrial cancer. About half of the patients had major surgical complications; however, majority was patients satisfied with the outcome. CONCLUSION Pelvic exenteration in this context carries considerable morbidity and in this series achieved good symptom control with a mean overall survival of 11 months. Careful patient selection, adequate counselling and ongoing support are imperative of successful outcome.
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Affiliation(s)
- P Pathiraja
- Oxford University Hospital, Headington, Oxford, OX3 7LJ, UK,
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22
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Rainey JJ, Bhatnagar P, Estivariz CF, Durrani S, Galway M, Sandhu H, Bahl S, Jafari H, Wenger J. Providing monovalent oral polio vaccine type 1 to newborns: findings from a pilot birth-dose project in Moradabad district, India. Bull World Health Organ 2009; 87:955-9. [PMID: 20454487 PMCID: PMC2789365 DOI: 10.2471/blt.08.061556] [Citation(s) in RCA: 8] [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: 11/18/2008] [Revised: 03/10/2009] [Accepted: 03/11/2009] [Indexed: 11/27/2022] Open
Abstract
PROBLEM Poliovirus transmission remained a public health challenge in western Uttar Pradesh, India in late 2005 and early 2006. In 2006, the India Expert Advisory Group for Polio Eradication concluded that, given the peak incidence of polio among children 6 to 12 months of age, a targeted birth dose of oral polio vaccine may be necessary to interrupt intense poliovirus transmission in high risk areas. APPROACH The Government of Uttar Pradesh, the National Polio Surveillance Project and the United Nations Children's Fund (UNICEF) implemented a pilot birth-dose project aimed at identifying and vaccinating all newborns with a dose of oral polio vaccine within 72 hours of birth in an effort to evaluate operational feasibility and potential impact on population immunity. LOCAL SETTING The project was piloted in Moradabad district: zone 7 in Moradabad City (urban setting), Kunderki block (rural setting) and in select birthing hospitals. RELEVANT CHANGES Between July 2006 and February 2007, 9740 newborns were identified, of which 6369 (65%) were vaccinated by project personnel within 72 hours of birth. Project coverage (for total newborns vaccinated) ranged from 39% (in zone 7) to 76% (in Kunderki block) of the estimated number of newborns vaccinated during previous supplemental immunization activities. LESSONS LEARNED Birth-dose coverage among newborns was lower than expected. Expansion costs were estimated to be high, with marginal impact. The project, however, provided opportunities to strengthen newborn tracking systems which have increased the number of newborns and young infants vaccinated during supplemental immunization activities and enrolled in routine programmes.
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Affiliation(s)
- J J Rainey
- US Centers for Disease Control and Prevention, Global Immunization Division,1600 Clifton Road (MS E-05), Atlanta, GA 30333, United States of America.
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23
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Sandhu H, Dale J, Stallard N, Crouch R, Glucksman E. Emergency nurse practitioners and doctors consulting with patients in an emergency department: a comparison of communication skills and satisfaction. Emerg Med J 2009; 26:400-4. [PMID: 19465607 DOI: 10.1136/emj.2008.058917] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Emergency nurse practitioners (ENPs) play an increasingly important role in UK emergency departments (EDs), but there is limited evidence about how this affects patient care and outcome. A study was undertaken to compare the content of, and satisfaction with, consultations made with patients presenting with problems of low acuity to an ED. METHODS Patients presenting with "primary care" problems were allocated to senior house officers (SHOs, n = 10), specialist registrars/staff grades (n = 7), sessionally-employed general practitioners (GPs, n = 12) or ENPs (n = 6) randomly rostered to work in a consulting room that had a wall-mounted video camera. At the end of each consultation the doctor/ENP and the patient were asked to complete the Physician/Patient Satisfaction Questionnaire. A stratified sample of videotaped consultations (n = 296) was analysed in depth using the Roter Interaction Analysis System. The main outcome measures were length of consultation; numbers of utterances of doctor/ENP and patient talk related to building a relationship, data gathering, activating/partnering, and patient education/counselling; doctor/ENP and patient consultation satisfaction scores. RESULTS ENPs and GPs focused more on patient education and counselling about the medical condition or therapeutic regimen than did ED doctors. There were no significant differences in consultation length. ENPs had higher levels of overall self-satisfaction with their consultations than ED doctors. Patient satisfaction with how actively they participated in the consultation was significantly associated with the amount of talk relating to building a relationship and activating and partnering, and patient satisfaction with information giving in the consultation was significantly associated with the amount of talk relating to building a relationship. CONCLUSION These findings suggest differences between ENP and ED doctor consultations which are associated with some aspects of patient satisfaction. In contrast to previous reports, consultation length was not greater for ENPs than for doctors. There is a need for further research to test the generalisability of these findings and their impact on clinical outcome.
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Affiliation(s)
- H Sandhu
- Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, UK.
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24
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Coleman C, Sandhu H, Devita M. 48: A Retrospective Review of Perioperative Management of Serum Potassium Measurements in Chronic Hemodialysis Patients. Am J Kidney Dis 2008. [DOI: 10.1053/j.ajkd.2008.02.053] [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: 11/11/2022]
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Sandhu H, Bankes MJK, Youngman J, Scott G. Failure of a "screw-in" acetabular component: ten-year results, survivorship analysis, and the prediction of failure. J Arthroplasty 2006; 21:85-91. [PMID: 16446190 DOI: 10.1016/j.arth.2005.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 07/09/2003] [Accepted: 02/20/2005] [Indexed: 02/01/2023] Open
Abstract
The Rotalok screw-in threaded acetabular component was prospectively reviewed with 10-year clinical and radiological follow-up for 60 patients. Nine patients died and 5 were lost to follow-up. Clinically, 28 patients were pain-free, 13 had mild pain, and 3 had moderate pain. Thirteen patients underwent revision for loosening and 3 required revision but were unfit. Superior migration, angular migration, and zone lucency were measured radiologically. Cumulative survival was 70.75% with revision surgery as the end point and 60% with combined clinical failure and revision as the end point. Angular migration of 3 degrees or more was a significant predictor of clinical failure and revision (P < .0001), with 5 degrees being very highly predictive with a sensitivity of 0.72 and a specificity of 1.00. Revision was associated with younger patients (P = .03) and autograft use without screw stabilization (P = .024). The high failure rate of the Rotalok necessitates careful clinical and radiological follow-up, with asymptomatic radiological angular migration often the first predictor of failure.
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Affiliation(s)
- H Sandhu
- Royal United Hospital, Bath, England, UK
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26
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Abstract
Acetabular cement extrusion (CE) is a common finding after total hip arthroplasty, but the incidence is unclear from the literature, and there is no accepted way of measuring it. We report a retrospective observational study of 100 patients (25 consecutive patients from each of 4 consultants, 112 hips) to determine the site and incidence of CE on postoperative radiographs, and to measure its area and the maximum distance of the extruded cement from the edge of the cement mantle. We found that 50 of 112 (44.6%) hips showed evidence of CE, with a 15.2% incidence of CE > 200 mm(2).
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Affiliation(s)
- William N Martin
- Trauma and Orthopaedics, Weston General Hospital, Weston-super-Mare, United Kingdom
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Abstract
Despite anecdotal stories, the potential of the arthroscope tip or the light cable end to cause thermal burns to the surgical drapes and to patients has not been investigated in orthopaedic surgery. This study shows that the arthroscopic tip registering a temperature of 41.9 degrees C, is unlikely to cause skin burns but causes singeing of drapes without combustion. The light cable end registers a temperature of 101 degrees C with the potential for causing skin burns. It has been demonstrated to cause combustion of disposable arthroscopic drapes within seconds at a distance of 0.5 cm. It is recommended that the light source should be switched on only after the light cable has been connected to the arthroscope. The light cable end must not rest on the drapes once the light source has been switched on, as thermal burns will occur within seconds. A retractable shield of 2.5 cm fitted to the light cable end may virtually avoid the potential for combustion.
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Affiliation(s)
- H Sandhu
- 5 Kensington Gardens, Bath BA1 6LH, UK.
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Martin WN, Sandhu H. Focused rigidity casting: a prospective randomised study. J R Coll Surg Edinb 2002; 47:713-4; author reply 714. [PMID: 12463715] [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: 02/27/2023]
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Bostrom MP, Yang X, Kennan M, Sandhu H, Dicarlo E, Lane JM. An unexpected outcome during testing of commercially available demineralized bone graft materials: how safe are the nonallograft components? Spine (Phila Pa 1976) 2001; 26:1425-8. [PMID: 11458144 DOI: 10.1097/00007632-200107010-00007] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [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] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Radiographic and histologic analyses of commercially available bone graft materials were performed. OBJECTIVE To compare the osteoinductive efficacy of commercially available demineralized bone matrix material. SUMMARY OF BACKGROUND DATA The relative in vivo bone formation and toxicology of the nonallograft components the make up various commercially available demineralized bone matrix products are not known. METHODS An in vivo bone formation model was used in 30 athymic rats. Six different bone grafting materials were tested in subcutaneous and intermuscular locations. After 4 weeks, radiographic and histologic testing of bone formation was performed. RESULTS Eight of nine rats implanted with Grafton demineralized bone matrix products died 1 to 4 days after implantation of the bone graft material. None of the remaining 10 animals implanted with the four other grafting materials died. The experiment was modified and completed with a lower dose of bone graft material. Pathologic analysis indicated that the cause of death was hemorrhagic necrosis of the kidneys, most likely caused by a toxic effect on the glomeruli and tubules. A possible causative factor may have been the glycerol in the graft material. CONCLUSIONS Although the volume of Grafton product per kilogram of body weight used in this study was approximately eight times the maximum volume used in humans, the authors believe that this data must be reported because this product is used substantially in clinical settings. In addition, the osteoinductive performance and relative safety of the nonallograft components in all commercially available demineralized bone grafts are not known.
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Affiliation(s)
- M P Bostrom
- Hospital for Special Surgery, New York, New York 10021, USA.
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Lamb D, Wright J, Kharodia S, Sandhu H, Goodall A. Modulation of monocyte atherosclerotic and thrombotic antigen expression by platelets. Atherosclerosis 2000. [DOI: 10.1016/s0021-9150(00)80012-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
Human malignant mesotheliomas are induced almost exclusively by fibrous dusts. The nature of interactions between fibers and target cells, and the molecular mechanisms leading to tumorigenesis, are not yet understood. Here, the mRNA expression patterns at different stages of asbestos-induced carcinogenesis in rats were monitored by suppression subtractive hybridization (SSH) and array assay. Several genes were upregulated in pretumorous tissues from asbestos-treated rats, in asbestos-induced tumors and in cells treated with asbestos in vitro. The upregulation of the proto-oncogene c-myc, fra-1 and egfr in fiber-induced carcinogenesis was demonstrated at different stages of carcinogenesis. A possible role of Fra-1 as one of the dimeric proteins generating the AP-1 transcription factor was substantiated by its dose-dependent expression in mesothelial cells treated with asbestos in vitro. The upregulation of osteopontin (an extracellular matrix protein) and of zyxin and integrin-linked kinase (intracellular proteins associated with the focal adhesion contact), indicate that fibers may affect integrin-linked signal transduction and extracellular matrix proteins.
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Affiliation(s)
- H Sandhu
- Department of Experimental Toxicology, Medical Institute of Environmental Hygiene at the Heinrich Heine University, Auf'm Hennekamp 50,40225 Düsseldorf, Germany
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Unfried K, Sandhu H, Schürkes C, Albrecht C, Abel J. Effects of Crocidolite Fibers on the Peritoneal Mesothelium of Rats. Inhal Toxicol 2000; 12 Suppl 3:149-55. [PMID: 26368611 DOI: 10.1080/08958378.2000.11463208] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The assay of intraperitoneal (ip) injection to rats was used as experimental system to study the mechanisms of carcinogenic effects of fibrous dusts. With this test system, fibers were shown to induce mesothelioma in the peritoneal cavity. Although the data of the ip assay are discussed controversially in terms of risk assessment, it is a valuable tool to investigate the molecular mechanisms of mesothelioma carcinogenesis in vivo. This test system allows one to investigate both the effects of fibers on signal transduction and the genotoxic potential of fibers. On the level of mRNA expression, different stages of fiber-induced tumor development in the peritoneal space were examined using differential display techniques. Genes of signal transduction pathways are mainly affected by the fiber treatment; for example, the activation of genes for the AP-1 transcription factor could be observed in the tissues of the peritoneal cavity. Thus, our in vivo data confirm the findings reported from cell culture systems. Moreover, our results from the differential display assays reveal that genes involved in the integrin-linked signal transduction are upregulated. In addition, the ip assay can be applied to transgenic animals to perform mutagenicity testing. Using the Big Blue transgenic animal system, we provide data of a significant increase in mutation frequency after treatment with crocidolite asbestos.
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Affiliation(s)
- K Unfried
- a Department of Experimental Toxicology , Medical Institute of Environmental Hygiene at the Heinrich Heine University , Düsseldorf , Germany
| | - H Sandhu
- a Department of Experimental Toxicology , Medical Institute of Environmental Hygiene at the Heinrich Heine University , Düsseldorf , Germany
| | - C Schürkes
- a Department of Experimental Toxicology , Medical Institute of Environmental Hygiene at the Heinrich Heine University , Düsseldorf , Germany
| | - C Albrecht
- b Department of Fibre and Particle Toxicology , Medical Institute of Environmental Hygiene at the Heinrich Heine University , Düsseldorf , Germany
| | - J Abel
- a Department of Experimental Toxicology , Medical Institute of Environmental Hygiene at the Heinrich Heine University , Düsseldorf , Germany
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Sandhu H, Morley-Forster P, Spadafora S. Epidural Hematoma Following Epidural Analgesia in a Patient Receiving Unfractionated Heparin for Thromboprophylaxis. Reg Anesth Pain Med 2000. [DOI: 10.1097/00115550-200001000-00014] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sandhu H, Morley-Forster P, Spadafora S. Epidural hematoma following epidural analgesia in a patient receiving unfractionated heparin for thromboprophylaxis. Reg Anesth Pain Med 2000; 25:72-5. [PMID: 10660245 DOI: 10.1016/s1098-7339(00)80015-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 10/25/2022]
Abstract
BACKGROUND AND OBJECTIVES The practice of providing postoperative epidural analgesia for patients receiving deep venous thromboprophylaxis with unfractionated heparin is common. This case report is intended to heighten awareness of comorbid risk factors for epidural hematoma and to bring attention to the new ASRA consensus guidelines on the management of neuraxial anesthesia in the presence of standard heparin. CASE REPORT A 79-year-old woman with apparently normal coagulation and receiving no antiplatelet agents required an abdominoperineal resection for recurrent squamous cell carcinoma of the anus. Approximately 2 hours after her preoperative dose of 5,000 U unfractionated heparin, an epidural catheter was placed on the third attempt. Subcutaneous heparin was subsequently administered every 12 hours. Her international normalized ratio became slightly elevated during surgery while the partial thromboplastin time and platelet count remained normal. The catheter was removed on postoperative day 3, 6 hours after the last dose of heparin. The patient developed signs of an epidural hematoma requiring surgical evacuation on postoperative day 4. The presence of previously undiagnosed spinal stenosis may have contributed to her symptoms. CONCLUSION Management of postoperative epidural analgesia in the patient receiving thromboprophylaxis with unfractionated heparin requires appropriate timing of epidural insertion and removal, monitoring of coagulation status and vigilance.
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Affiliation(s)
- H Sandhu
- Department of Anesthesia, St. Joseph's Health Centre, London, Ontario, Canada
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Sandhu H. Comparison of ondansetron, dimenhydrinate versus placebo as PONV prophylaxis for outpatient gynecological laparoscopy. ACTA ACUST UNITED AC 1999. [DOI: 10.1016/s0966-6532(99)00016-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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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Sandhu H, Wiesenthal SR, MacDonald PE, McCall RH, Tchipashvili V, Rashid S, Satkunarajah M, Irwin DM, Shi ZQ, Brubaker PL, Wheeler MB, Vranic M, Efendic S, Giacca A. Glucagon-like peptide 1 increases insulin sensitivity in depancreatized dogs. Diabetes 1999; 48:1045-53. [PMID: 10331409 DOI: 10.2337/diabetes.48.5.1045] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.1] [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] [Indexed: 11/13/2022]
Abstract
To determine whether glucagon-like peptide (GLP)-1 increases insulin sensitivity in addition to stimulating insulin secretion, we studied totally depancreatized dogs to eliminate GLP-1's incretin effect. Somatostatin was infused (0.8 microg x kg(-1) x min(-1)) to inhibit extrapancreatic glucagon in dogs, and basal glucagon was restored by intraportal infusion (0.65 ng x kg(-1) x min(-1)). To simulate the residual intraportal insulin secretion in type 2 diabetes, basal intraportal insulin infusion was given to obtain plasma glucose concentrations of approximately 10 mmol/l. Glucose was clamped at this level for the remainder of the experiment, which included peripheral insulin infusion (high dose, 5.4 pmol x kg(-1) x min(-1), or low dose, 0.75 pmol x kg(-1) x min(-1)) with or without GLP-1(7-36) amide (1.5 pmol x kg(-1) x min(-1)). Glucose production and utilization were measured with 3-[3H]glucose, using radiolabeled glucose infusates. In 12 paired experiments with six dogs at the high insulin dose, GLP-1 infusion resulted in higher glucose requirements than saline (60.9+/-11.0 vs. 43.6+/-8.3 micromol x kg(-1) x min(-1), P< 0.001), because of greater glucose utilization (72.6+/-11.0 vs. 56.8+/-9.7 micromol x kg(-1) x min(-1), P<0.001), whereas the suppression of glucose production was not affected by GLP-1. Free fatty acids (FFAs) were significantly lower with GLP-1 than saline (375.3+/-103.0 vs. 524.4+/-101.1 micromol/l, P<0.01), as was glycerol (77.9+/-17.5 vs. 125.6+/-51.8 micromol/l, P<0.05). GLP-1 receptor gene expression was found using reverse transcriptase-polymerase chain reaction of poly(A)-selected RNA in muscle and adipose tissue, but not in liver. Low levels of GLP-1 receptor gene expression were also found in adipose tissue using Northern blotting. In 10 paired experiments with five dogs at the low insulin dose, GLP-1 infusion did not affect glucose utilization or FFA and glycerol suppression when compared with saline, suggesting that GLP-1's effect on insulin action was dependent on the insulin dose. In conclusion, in depancreatized dogs, GLP-1 potentiates insulin-stimulated glucose utilization, an effect that might be contributed in part by GLP-1 potentiation of insulin's antilipolytic action.
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Affiliation(s)
- H Sandhu
- Department of Physiology, University of Toronto, Ontario, Canada
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Fineman I, Johnson JP, Di-Patre PL, Sandhu H. Chronic renal failure causing brown tumors and myelopathy. Case report and review of pathophysiology and treatment. J Neurosurg 1999; 90:242-6. [PMID: 10199256 DOI: 10.3171/spi.1999.90.2.0242] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [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: 11/06/2022]
Abstract
Brown tumors (osteoclastomas) are histologically benign lesions that are caused by primary or secondary hyperparathyroidism. Secondary hyperparathyroidism is a frequent complication of chronic renal failure. Skeletal brown tumors are relatively uncommon, and brown tumors that involve the spine are considered very rare. The authors present the case of a 37-year-old woman with systemic lupus erythematosus and hemodialysis-dependent anuric renal failure, in whom spinal cord compression developed due to a brown tumor and pathological fracture at T-9. The patient underwent transthoracic decompressive surgery and spinal reconstruction in which cadaveric femoral allograft and instrumentation were used. Brown tumors of the vertebral column require surgical treatment if medical therapy and parathyroidectomy fail to halt their progression or if acute neurological deterioration occurs. In patients with renal failure bone healing is delayed and there is an increased risk that healing will fail because the metabolic derangements can result in severe osteoporosis. Surgical reconstruction of the spine may require the use of augmentation with instrumentation and aggressive treatment of hyperparathyroidism to achieve successful outcomes.
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Affiliation(s)
- I Fineman
- Division of Neurosurgery, University of California, Los Angeles School of Medicine, USA
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Abstract
Hyperinsulinemia is a common finding in obesity and results from insulin hypersecretion and impaired hepatic insulin extraction. In vitro studies have shown that free fatty acids (FFAs), which are often elevated in obesity, can impair insulin binding and degradation in isolated rat hepatocytes. To investigate whether FFAs impair hepatic insulin extraction (E(H)) in vivo, either saline (SAL) or 10% Intralipid (0.03 ml x kg(-1) x min(-1)) plus heparin (0.44 U x kg(-1) x min(-1)) (IH) was infused into normal dogs to elevate FFA levels. Insulin was infused intraportally at 18 pmol x kg(-1) x min(-1) for 150 min (period A, high insulin dose), and then at 2.4 pmol x kg(-1) x min(-1) for another 150 min (period B, low insulin dose). After the low portal insulin dose, additional insulin was infused peripherally at 8.4 pmol x kg(-1) x min(-1) for 120 min (period C) to assess the clearance of insulin from the peripheral plasma. In 16 paired experiments, FFA levels were 1,085 +/- 167, 1,491 +/- 240, 1,159 +/- 221 micromol/l (IH) and 221 +/- 44, 329 +/- 72, 176 +/- 44 micromol/l (SAL) in periods A, B, and C, respectively. Peripheral insulin levels were greater with IH (P < 0.001) than with SAL in all periods (1,620 +/- 114, 126 +/- 12, 1,050 +/- 72 pmol/l for IH vs. 1,344 +/- 168, 96 +/- 4.2, 882 +/- 60 pmol/l for SAL). Glucose clearance was impaired by IH in all periods (P < 0.05), whereas glucose production was slightly increased by IH during period B. Peripheral insulin clearance (Cl) and E(H) were calculated from the insulin infusion rate and insulin concentration data in each period by taking into account the nonlinearity of insulin kinetics. Cl was lower (P < 0.01) with IH (9.6 +/- 0.6, 12.0 +/- 0.9, 10.2 +/- 0.6 ml x kg(-1) x min(-1)) than with SAL (11.2 +/- 1, 13.6 +/- 0.7, 11.9 +/- 0.9 ml x kg(-1) x min(-1)) in periods A, B, and C. E(H) was also lower (P < 0.05) with IH (25 +/- 4, 40 +/- 5, 32 +/- 5%) than with SAL (30 +/- 2.8, 47 +/- 3, 38 +/- 3%). We conclude that FFAs can impair hepatic insulin extraction in vivo at high and low insulin levels, an effect that may contribute to the peripheral hyperinsulinemia of obesity.
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Affiliation(s)
- S R Wiesenthal
- Department of Physiology, University of Toronto, Ontario, Canada
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Mason TM, Goh T, Tchipashvili V, Sandhu H, Gupta N, Lewis GF, Giacca A. Prolonged elevation of plasma free fatty acids desensitizes the insulin secretory response to glucose in vivo in rats. Diabetes 1999; 48:524-30. [PMID: 10078552 DOI: 10.2337/diabetes.48.3.524] [Citation(s) in RCA: 122] [Impact Index Per Article: 4.9] [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] [Indexed: 11/13/2022]
Abstract
Prolonged exposure of pancreatic islets to free fatty acids (FFAs) inhibits glucose-stimulated insulin secretion (GSIS) in vitro. However, FFA inhibition of GSIS has not been clearly demonstrated in vivo. We examined the in vivo effect of prolonged elevation of plasma FFAs on GSIS using a two-step hyperglycemic clamp in rats treated with a 48-h intravenous infusion of either 20% Intralipid plus heparin (INT) (5 microl/min plus heparin, 0.1 U/min; n = 8), oleate (OLE) (1.3 microEq/min; n = 6), saline (SAL) (n = 6), or bovine serum albumin (BSA) (vehicle for OLE; n = 5). Because there was no difference in any of the parameters between BSA and SAL rats, these groups were combined as control rats (CONT) (n = 11). At the end of the 48-h OLE/INT/CONT infusions, after an overnight fast, plasma glucose was clamped for 2 h at 13 mmol/l and for another 2 h at 22 mmol/l. Preclamp plasma FFAs were elevated twofold (P < 0.01) versus CONT with both INT and OLE (NS, INT vs. OLE). Preclamp glucose, insulin, and C-peptide levels were higher in INT than in CONT rats (P < 0.05), suggesting insulin resistance, but they were not different in OLE and CONT rats. The insulin and C-peptide responses to the rise in plasma glucose from basal to 13 mmol/l were lower in OLE (336 +/- 72 pmol/l and 1.2 +/- 0.1 nmol/l, P < 0.01 and P < 0.05, respectively) than in CONT (552 +/- 54 and 1.9 +/- 0.1) rats, but they were not different between CONT and INT rats (648 +/- 150 and 2.0 +/- 0.4). The insulin and C-peptide responses to the rise in plasma glucose from 13 to 22 mmol/l were lower in both INT (1,188 +/- 204 pmol/l and 3.0 +/- 0.3 nmol/l, P < 0.01 and P < 0.001) and OLE (432 +/- 60 and 1.7 +/- 0.2, P < 0.001 vs. CONT or INT) rats than in CONT rats (1,662 +/- 174 and 5.0 +/- 0.6). In summary, 1) both INT and OLE decreased GSIS in vivo in rats, and 2) the impairing effect of INT on GSIS was less than that of OLE, which might be due to the different type of fatty acid (mostly polyunsaturated in INT versus monounsaturated as OLE) and/or to differential effects of INT and OLE on insulin sensitivity. In conclusion, prolonged elevation of plasma FFAs can desensitize the insulin secretory response to glucose in vivo, thus inducing a beta-cell defect that is similar to that found in type 2 diabetes.
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Affiliation(s)
- T M Mason
- Department of Physiology, University of Toronto, Ontario, Canada
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Ganguly NK, Sandhu H, Dubey ML, Mahajan RC. Biochemical changes induced by malarial parasites. Indian J Med Res 1997; 106:70-8. [PMID: 9291678] [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] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The morbidity associated with malaria plays a key role in the staggering of the social and economic development of human race. The investigations on the cellular, biochemical and molecular organisation of the malarial parasite are important to understand the host parasite interactions in a better way. The parasite induces several biochemical and biophysical alterations in the host red cells. It is well recognized that cation homeostasis is vital to basic aspects of cell functions. Though the pathogenesis of anaemia associated with Plasmodium falciparum infection is multifactorial, the complex mechanisms involving the role of oxidant stress and calcium imbalance of infected red cells plays an important role.
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Affiliation(s)
- N K Ganguly
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education & Research, Chandigarh
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Kavanagh BP, Ngo C, Raymer K, Yang H, Alhashemi JA, Lui ACP, Reid D, Cicutti N, Krepski B, Wood G, Heyland DK, Badner NH, Murkin JM, Mohr J, McKenzie FN, van der Starre PJA, van Rooyen-Butijn WT, Wilson-Yang K, Teoh K, Lee RMKW, Hossain I, Cheng D, Karski J, Asokumar B, Sandier A, St-Amand MA, Murkin JM, Menkis AH, Downey DB, Nantau W, Adams S, Dowd N, Cheng D, Wong D, Carroll-Munro J, Trachuk C, Cregg N, Cheng DCH, Williams WG, Karski JM, Siu S, Webb G, Cheng DCH, Wong DT, Kustra R, Karski J, Tibshirani RJ, Côté DL, Lacey DE, LeDez KM, Smith JA, Crosby ET, Orkin FK, Fisher A, Volgyesi G, Silverman J, Edelstein S, Rucker J, Sommer L, Dunington S, Roy L, Crochetière C, Arsenault MY, Villeneuve E, Lortie L, Grange CS, Douglas MJ, Adams TJ, Merrick PM, Lucas SB, Morgan PJ, Halpern S, Lo J, Giesinger CL, Halpern SH, Breen TW, Vishnubala S, Shetty GR, De Kock M, Lagmiche A, Scholtes JL, Grodecki W, Duffy PJ, Hull KA, Hawboldt GS, Clark AJ, Smith JB, Norman RW, Beattie WS, Sandier A, Jewett M, Valiquette L, Katz J, Fradet Y, Redelmeier D, Sampson H, Cole J, Chedore T, Snedden W, Green RG, Sosis MB, Robles PI, Lazar ER, Jolly DT, Tarn YK, Tawfik SR, Clanachan AS, Milne A, Beamish T, Cuillerier DJ, Sharpe MD, Lee JK, Basta M, Krahn AD, Klein GJ, Yee R, Vakharia N, Francis H, Scheepers L, Vaghadia H, Carrier J, Martin R, Pirlet M, Claprood Y, Tétrault JP, Wong TD, Ryner L, Kozlowski P, Scarth G, Warrian RK, Lefevre G, Thiessen D, Girling L, Doiron L, McCudden C, Saunders J, Mutch WAC, Duffy PJ, Langevin S, Lessard MR, Trépanier CA, Hare GMT, Ngan JCS, Viskari D, Berrill A, Jodoin C, Couture J, Bellemare F, Farmer S, Muir H, Money P, Milne B, Parlow J, Raymond J, Williams JM, Craen RA, Novick T, Komar W, Frenette L, Cox J, Lockhart B, McArdle P, Eckhoff D, Bynon S, Dobkowski WB, Grant DR, Wall WJ, Chedrawy EG, Hall RI, Nedelcu V, Parlow J, Viale JP, Bégou G, Sagnard P, Hughson R, Quintin L, Troncy É, Collet JP, Shapiro S, Guimond JG, Blair L, Ducruet T, Francœur M, Charbonneau M, Blaise G, Snedden W, Bernadska E, Manson HI, Kutt JL, Mezon BY, Nishida O, Arellano R, Boylen P, DeMajo W, Archer DP, Roth SH, Raman S, Manninen P, Boyle K, Cenic A, Lee TY, Gelb AW, Reinders FX, Brown JIM, Baker AJ, Moulton RJ, Schlichtert L, Schwarz SKW, Puil E, Finegan BA, Finucane BT, Kurrek MM, Devitt JH, Morgan PJ, Cleave-Hogg D, Bradley J, Byrick R, Spadafora SM, Fuller JG, Gelula MH, Mayson K, Forster B, Byrick RJ, McKnight DJ, Kurrek M, Kolton M, Cleave-Hogg D, Haughton J, Halpern S, Kronberg J, Shysh S, Eagle C, Dagnone AJ, Parlow JL, Blaise G, Yang F, Nguyen H, Troncy E, Czaika G, Wachowski I, Basta M, Krahn AD, Yee R, Deladrière H, Cambier C, Pendeville P, Hung OR, Coonan E, Whynot SC, Mezei M, Coonan E, Whynot SC, Ho AMH, Luchsinger IS, Ling E, Mashava D, Chinyanga HM, Cohen MM, Shaw M, Robblee JA, Labow RS, Rubens FD, Diemunsch AM, Gervais R, Rose DK, Cohen MM, O’Brien-Pallas L, Copplestone C, Rose DK, Karkouti K, Sykora K, Cheung SLW, Booker PD, Franks R, Pozzi M, Guard B, Sikich N, Lerman J, Levine M, Swan H, Cox P, Montgomery C, Dunn G, Bourne R, Kinahan A, McCormack J, Dunn GS, Reimer EJ, Sanderson P, Sanderson PM, Montgomery CJ, Betts TA, Orlay GR, Wong DH, Cohen M, Al-Kaisy AA, Chan V, Peng P, Perlas A, Miniad A, Cushing EV, Mills KR, El-Beheiry H, Jahromi SS, Weaver J, Morris M, Carien PL, Cowan RM, Manninen P, Richards J, Robblee JA, Labow RS, Rubens FD, Menkis AH, Adams S, Henderson BT, Hudson RJ, Thomson IR, Moon M, Peterson MD, Rosenbloom M, Davison PJ, Ali M, Ali NS, Searle NR, Thomson I, Roy M, Gagnon L, Lye A, Walsh F, Middleton W, Wong D, Langer A, Errett L, Mazer CD, Karski J, Tibshirani RJ, Williamson KM, Smith G, Gnanendran KP, Bignell SJ, Jones S, Sleigh J, Arnell M, Schultz JAI, Fear DW, Ganapathy S, Moote C, Wassermann R, Watson J, Armstrong K, Calikyan AO, Yilmaz O, Kose Y, Peng P, Chan V, Chung F, Claxton AR, Krishnathas A, Mezei G, Badner NH, Paul TL, Doyle JA, Mehta M, DeLima LGR, Silva LEO, May WL, Maliakkal RJ, Mehta M, Kolesar R, Arellano R, Rafuse S, Fletcher M, Dunn G, Curran M, Bragg P, Chamberlain W, Crossan M, Ganapathy S, Sandhu H, Spadafora S, Mian R, Evans B, Hurst L, Katsiris S. Abstracts. Can J Anaesth 1997. [DOI: 10.1007/bf03022274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Sandhu H, Lemaire L, Heinlein UA. Male germ cell extracts contain proteins binding to the conserved 3'-end of mouse p68 RNA helicase mRNA. Biochem Biophys Res Commun 1995; 214:632-8. [PMID: 7677776 DOI: 10.1006/bbrc.1995.2333] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [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: 01/26/2023]
Abstract
The 3'-untranslated regions of human and mouse p68 RNA helicase mRNA are highly conserved, suggesting a functional role of the nucleic acid sequence itself in regulation of p68 RNA helicase expression. Secondary structure evaluations revealed no indications for a predominant folding pattern within the 3'-UTR. To test the potential of the 3'-sequence to serve as a target for specific binding proteins, gel shift assays were performed. In vitro-synthesized RNA was incubated with cytoplasmic as well as nuclear extracts from mouse male germ cells. Evidence was obtained that such specific proteins exist in germ cell extracts. Photo-crosslinking experiments suggested that a 30 kDa protein was involved in these binding events.
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Affiliation(s)
- H Sandhu
- Institut für Genetik, Heinrich-Heine-Universität, Düsseldorf, Germany
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Sandhu SK, Sandhu H. Psychosocial aspect of planned induction of labour. J Indian Med Assoc 1995; 93:297-8. [PMID: 8713242] [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: 02/01/2023]
Abstract
One hundred patients of planned induction and 25 cases of spontaneous delivery were interviewed on the various aspects of labour care in the postpartum period. Majority were satisfied with overall care and 65% were of the opinion of opting for induction next time.
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Affiliation(s)
- S K Sandhu
- Department of Obstetrics and Gynaecology, Medical College, Amritsar
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Bergman M, Tornetta P, Kerina M, Sandhu H, Simon G, Deysine G, Alcindor F. Femur fractures caused by gunshots: treatment by immediate reamed intramedullary nailing. J Trauma 1993; 34:783-5. [PMID: 8315670] [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: 01/29/2023]
Abstract
Fractures of the femur caused by gunshots are increasingly common. There is no standard treatment of these fractures since there are no clear guidelines relating these injuries to open fracture classification. We reviewed our experience with such fractures, which included 65 patients who had an immediate reamed intramedullary nail placed as treatment. The soft-tissue injury, vascular injury, missile velocity, and length of hospital stay were evaluated. We found that all patients healed with no infections. The overall morbidity and average hospital stay were decreased compared with studies advocating delayed intramedullary nailing and prolonged intravenous antibiotics. We recommend that patients with fractures of the femur caused by gunshots are candidates for immediate reamed intramedullary nailing providing that there is only mild to moderate soft-tissue contamination and no evidence of major devitalization.
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Affiliation(s)
- M Bergman
- Department of Orthopedic Surgery, Kings County Hospital Center, Brooklyn
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Sheu K, Lavigne G, Sandhu H, Koenig M, Moebus G, Johnson JF. USE OF COMBINED MICRO EXTRACTOR SFC INTERFACE AND MICRO FOURIER TRANSFORM INFRARED SPECTROSCOPY FOR CHARACTERIZATION OF THE LOW MOLECULAR WEIGHT FRACTIONS OF ASPHALT. ACTA ACUST UNITED AC 1992. [DOI: 10.1080/08843759208916023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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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Szelc CM, Sandhu H, Kobayashi RH, Glovsky MM. Respiratory failure in a seven-month-old baby: an unusual presentation of severe immunologic disease. Ann Allergy 1991; 66:115-20. [PMID: 1994781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- C M Szelc
- UCLA Center for the Health Sciences, Division of Pediatric Allergy-Immunology
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Yanover L, Banting D, Grainger R, Sandhu H. Effect of a daily 0.2% chlorhexidine rinse on the oral health of an institutionalized elderly population. J Can Dent Assoc 1988; 54:595-8. [PMID: 3048596] [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: 01/03/2023]
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