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Kumari P, Tiwari SK, Vasu N, Joshi P, Mehra M. Factors Associated with Nursing Professionalism: Insights from Tertiary Care Center in India. BMC Nurs 2024; 23:162. [PMID: 38448868 PMCID: PMC10916031 DOI: 10.1186/s12912-024-01820-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 02/22/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Professionalism among nurses plays a critical role in ensuring patient safety and quality care and involves delivering competent, safe, and ethical care while also working with clients, families, communities, and healthcare teams. AIMS AND OBJECTIVES To assess the level of nursing professionalism and the factors affecting professionalism among nurses working at a tertiary care center in India. METHODS A descriptive cross-sectional study was conducted from October 2022 to March 2023 using a total enumeration sampling technique. Following institutional ethics committee approval, standardized tools were administered consisting of Nursing Professionalism Scale and socio-demographic, personal, and organizational characteristics. RESULTS A total of 270 nurses participated, with a response rate of 93.7%. The mean age of the participants was 27.33 ± 2.75 years, with the majority being female (82.6%) and belonged to the age group of 23-27 years (59.6%). More than half of the nurses exhibited high professionalism (53%), with the highest and lowest median scores for professional responsibility (29.0) and valuing human beings (13.0) respectively. Multivariate regression analysis demonstrated that, compared with their counterparts, nurses with a graduate nursing qualification (AOR = 4.77, 95% CI = 1.16-19.68), up-to-date training (AOR = 4.13, 95% CI = 1.88-9.06), and adequate career opportunity (AOR = 33.91, 95% CI = 14.48-79.39) had significant associations with high nursing professionalism. CONCLUSION/IMPLICATIONS FOR PRACTICE The majority of the nurses had high professionalism, particularly in the domains of professional responsibility and management. Hospitals and healthcare institutions can use these findings to develop policies and prioritize opportunities for nurses to attend conferences and workshops to enhance their professional values, ultimately leading to improved patient care outcomes. PATIENT AND PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Poonam Kumari
- Department of Nursing Services, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Surya Kant Tiwari
- College of Nursing, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India.
| | - Nidhin Vasu
- Department of Nursing Services, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Poonam Joshi
- College of Nursing, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Manisha Mehra
- College of Nursing, All India Institute of Medical Sciences, Patna, Bihar, India.
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Kyriakopoulos C, Taleb I, Wever-Pinzon O, Selzman C, Bonios M, Dranow E, Wever-Pinzon J, Yin M, Tseliou E, Stehlik J, Alharethi R, Kfoury A, Hanff T, Fang J, Koliopoulou A, Sideris K, Krauspe E, Nelson M, Elmer A, Singh R, Psotka M, Birks E, Slaughter M, Koenig S, Kyvernitakis A, Hoffman K, Guglin M, Kotter J, Campbell K, Silvestry S, Vidic A, Raval N, Mehra M, Cowger J, Kanwar M, Shah P, Drakos S. Multicenter Development and Validation of a Machine Learning Model to Predict Myocardial Recovery During LVAD Support: The UCAR Score. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1519] [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: 04/05/2023] Open
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Tucanova Z, Ivak P, Gregor S, Hegarová M, Dorazilova Z, Marek T, Melenovsky V, Riha H, Crandall D, Connors J, Mehra M, Netuka I. The Magentum 2 Study: Long-Term Analysis of Complete Withdrawal of Anticoagulation Therapy with the Heartmate 3 LVAD. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.132] [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: 04/05/2023] Open
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Mehra M, Yadav RK, Rajora MAK, Dahiya U, Agarwal SK. Factors affecting quality of daytime and nighttime sleep among dialysis patients: A single center experience. Semin Dial 2022; 36:231-239. [PMID: 36167309 DOI: 10.1111/sdi.13125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 06/02/2022] [Accepted: 09/01/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Hemodialysis is the most common treatment modality for patients with chronic kidney disease (CKD). Excessive daytime sleepiness and poor nighttime sleep is a common problem among these patients. Patients on maintenance hemodialysis (MHD) are regularly exposed to impaired fluid balance, which may cause overhydration of varying degree. However, the role of hydration status in sleep quality has not been explored in Indian setting. Hence, this study was undertaken to assess the factors affecting sleep quality among patients on MHD in a tertiary care hospital. MATERIAL AND METHODS Patients (N = 55) were enrolled if they aged above18 years, on MHD for at least 3 months, and gave consent. The daytime sleep quality was assessed using Epworth Sleepiness Scale (ESS) and Insomnia Severity Index (ISI). The data were analyzed using SPSS version 20 and STATA software. RESULTS The mean age of the patients was 40.4 ± 14.7 years. The prevalence rate of predialysis fluid overload was 85.4%. The median ESS score was 7 and ISI score was 3 indicating normal daytime sleep and not significant insomnia. Multivariate regression with variables adjustment showed that interdialytic weight gain (P = 0.33), tingling sensation (P = 0.36) and numbness (P = 0.35) were significant predictive factors for quality of sleep. CONCLUSION The major factors affecting sleep quality were numbness, tingling sensation, and interdialytic weight gain. Fluid overload did not play any role in sleep quality. Another study may be carried out on assessment of pattern, duration, quality of sleep in multiple dialysis sessions, and effect of optimizing fluid status on the sleep parameters.
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Shrestha S, Yoon S, Erickson MH, Guo F, Mehra M, Bui AAT, Schulze BC, Kotsakis A, Daube C, Herndon SC, Yacovitch TI, Alvarez S, Flynn JH, Griffin RJ, Cobb GP, Usenko S, Sheesley RJ. Traffic, transport, and vegetation drive VOC concentrations in a major urban area in Texas. Sci Total Environ 2022; 838:155861. [PMID: 35568171 DOI: 10.1016/j.scitotenv.2022.155861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/06/2022] [Accepted: 05/07/2022] [Indexed: 06/15/2023]
Abstract
The population of Texas has increased rapidly in the past decade. The San Antonio Field Study (SAFS) was designed to investigate ozone (O3) production and precursors in this rapidly changing, sprawling metropolitan area. There are still many questions regarding the sources and chemistry of volatile organic compounds (VOCs) in urban areas like San Antonio which are affected by a complex mixture of industry, traffic, biogenic sources and transported pollutants. The goal of the SAFS campaign in May 2017 was to measure inorganic trace gases, VOCs, methane (CH4), and ethane (C2H6). The SAFS field design included two sites to better assess air quality across the metro area: an urban site (Traveler's World; TW) and a downwind/suburban site (University of Texas at San Antonio; UTSA). The results indicated that acetone (2.52 ± 1.17 and 2.39 ± 1.27 ppbv), acetaldehyde (1.45 ± 1.02 and 0.93 ± 0.45 ppbv) and isoprene (0.64 ± 0.49 and 1.21 ± 0.85 ppbv; TW and UTSA, respectively) were the VOCs with the highest concentrations. Additionally, positive matrix factorization showed three dominant factors of VOC emissions: biogenic, aged urban mixed source, and acetone. Methyl vinyl ketone and methacrolein (MVK + MACR) exhibited contributions from both secondary photooxidation of isoprene and direct emissions from traffic. The C2H6:CH4 demonstrated potential influence of oil and gas activities in San Antonio. Moreover, the high O3 days during the campaign were in the NOx-limited O3 formation regime and were preceded by evening peaks in select VOCs, NOx and CO. Overall, quantification of the concentration and trends of VOCs and trace gases in a major city in Texas offers vital information for general air quality management and supports strategies for reducing O3 pollution. The SAFS campaign VOC results will also add to the growing body of literature on urban sources and concentrations of VOCs in major urban areas.
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Affiliation(s)
- Sujan Shrestha
- Department of Environmental Science, Baylor University, Waco, TX, USA
| | - Subin Yoon
- Department of Environmental Science, Baylor University, Waco, TX, USA; Department of Earth and Atmospheric Sciences, University of Houston, Houston, TX, USA
| | - Matthew H Erickson
- Department of Earth and Atmospheric Sciences, University of Houston, Houston, TX, USA; TerraGraphics Environmental Engineering, Pasco, WA, USA
| | - Fangzhou Guo
- Department of Civil and Environmental Engineering, Rice University, TX, USA
| | - Manisha Mehra
- Department of Environmental Science, Baylor University, Waco, TX, USA
| | - Alexander A T Bui
- Department of Civil and Environmental Engineering, Rice University, TX, USA
| | - Benjamin C Schulze
- Department of Civil and Environmental Engineering, Rice University, TX, USA; Department of Environmental Science and Engineering, California Institute of Technology, Pasadena, CA, USA
| | - Alexander Kotsakis
- Department of Earth and Atmospheric Sciences, University of Houston, Houston, TX, USA; Universities Space Research Association, NASA/GSFC, Columbia, MD, USA
| | | | | | | | - Sergio Alvarez
- Department of Earth and Atmospheric Sciences, University of Houston, Houston, TX, USA
| | - James H Flynn
- Department of Earth and Atmospheric Sciences, University of Houston, Houston, TX, USA
| | - Robert J Griffin
- Department of Civil and Environmental Engineering, Rice University, TX, USA
| | - George P Cobb
- Department of Environmental Science, Baylor University, Waco, TX, USA
| | - Sascha Usenko
- Department of Environmental Science, Baylor University, Waco, TX, USA
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Moffett CE, Mehra M, Barrett TE, Gunsch MJ, Pratt KA, Sheesley RJ. Contemporary sources dominate carbonaceous aerosol on the North Slope of Alaska. Sci Total Environ 2022; 831:154641. [PMID: 35307446 DOI: 10.1016/j.scitotenv.2022.154641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 03/09/2022] [Accepted: 03/14/2022] [Indexed: 06/14/2023]
Abstract
As the Arctic continues to change and warm rapidly, it is increasingly important to understand the organic carbon (OC) contribution to Arctic aerosol. Biogenic sources of primary and secondary OC in the Arctic will be impacted by climate change, including warming temperatures and earlier snow and ice melt. This study focuses on identifying potential sources and regional influences on the seasonal concentration of organic aerosol through analysis of chemical and isotopic composition. Aerosol samples were collected at two sites on the North Slope of Alaska (Utqiaġvik, UQK, and Oliktok Point, OLK, which is in an Arctic oilfield) over three summers from 2015 to 2017. The elemental carbon (EC) trends at each site were used to understand local combustion influences. Local sources drove EC concentrations at Oliktok Point, where high EC was attributed to oil and gas extraction activity, including diesel combustion emissions. Utqiaġvik had very low EC in the summer. OC was more similar in concentration and well correlated between the two sites with high contributions of contemporary carbon by radiocarbon apportionment (UQK = 74%, OLK = 63%), which could include both marine and terrestrial sources of contemporary carbon (e.g. primary and secondary biogenic, biomass burning and/or associated SOA, and bioaerosols). OC concentrations are strongly correlated to maximum ambient temperatures on the NSA during the summer, which may have implications for predicting future OC aerosol concentrations in a warming Arctic. Biomass burning was determined to be an episodic influence at both sites, based on interpretation of combined aerosol composition, air mass trajectories, and remote sensing of smoke plumes. The results from this study overall strongly suggests contribution from regional sources of contemporary organic aerosol on the NSA, but additional analysis is needed to better constrain contributions from both biogenic sources (terrestrial and/or marine) and bioaerosol to better understand temperature-related aerosol processes in the Arctic.
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Affiliation(s)
- Claire E Moffett
- Department of Environmental Science, Baylor University, Waco, TX, USA
| | - Manisha Mehra
- Department of Environmental Science, Baylor University, Waco, TX, USA
| | - Tate E Barrett
- Department of Environmental Science, Baylor University, Waco, TX, USA; The Institute of Ecological, Earth, and Environmental Sciences, Baylor University, Waco, TX, USA
| | - Matthew J Gunsch
- Department of Chemistry, University of Michigan, Ann Arbor, MI, USA
| | - Kerri A Pratt
- Department of Chemistry, University of Michigan, Ann Arbor, MI, USA
| | - Rebecca J Sheesley
- Department of Environmental Science, Baylor University, Waco, TX, USA; The Institute of Ecological, Earth, and Environmental Sciences, Baylor University, Waco, TX, USA.
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Harms HJ, Bravo PE, Bajaj NS, Zhou W, Gupta A, Tran T, Taqueti VR, Hainer J, Bibbo C, Dorbala S, Blankstein R, Mehra M, Sörensen J, Givertz MM, Di Carli MF. Cardiopulmonary transit time: A novel PET imaging biomarker of in vivo physiology for risk stratification of heart transplant recipients. J Nucl Cardiol 2022; 29:1234-1244. [PMID: 33398793 PMCID: PMC8254830 DOI: 10.1007/s12350-020-02465-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 10/12/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Myocardial blood flow (MBF) can be quantified using dynamic PET studies. These studies also inherently contain tomographic images of early bolus displacement, which can provide cardiopulmonary transit times (CPTT) as measure of cardiopulmonary physiology. The aim of this study was to assess the incremental prognostic value of CPTT in heart transplant (OHT) recipients. METHODS 94 patients (age 56 ± 16 years, 78% male) undergoing dynamic 13N-ammonia stress/rest studies were included, of which 68 underwent right-heart catherization. A recently validated cardiac allograft vasculopathy (CAV) score based on PET measures of regional perfusion, peak MBF and left-ventricular (LV) ejection fraction (LVEF) was used to identify patients with no, mild or moderate-severe CAV. Time-activity curves of the LV and right ventricular (RV) cavities were obtained and used to calculate the difference between the LV and RV bolus midpoint times, which represents the CPTT and is expressed in heartbeats. Patients were followed for a median of 2.5 years for the occurrence of major adverse cardiac events (MACE), including cardiovascular death, hospitalization for heart failure or acute coronary syndrome, or re-transplantation. RESULTS CPTT was significantly correlated with cardiac filling pressures (r = .434, P = .0002 and r = .439, P = .0002 for right atrial and pulmonary wedge pressure), cardiac output (r = - .315, P = .01) and LVEF (r = - .513, P < .0001). CPTT was prolonged in patients with MACE (19.4 ± 6.0 vs 14.5 ± 3.0 heartbeats, P < .001, N = 15) with CPTT ≥ 17.75 beats showing optimal discriminatory value in ROC analysis. CPTT ≥ 17.75 heartbeats was associated with a 10.1-fold increased risk (P < .001) of MACE and a 7.3-fold increased risk (P < .001) after adjusting for PET-CAV, age, sex and time since transplant. CONCLUSION Measurements of cardiopulmonary transit time provide incremental risk stratification in OHT recipients and enhance the value of multiparametric dynamic PET imaging, particularly in identifying high-risk patients.
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Affiliation(s)
- H J Harms
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
- Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - P E Bravo
- Division of Cardiovascular Medicine, Department of Medicine; and Division of Nuclear Medicine, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - N S Bajaj
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - W Zhou
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - A Gupta
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - T Tran
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - V R Taqueti
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - J Hainer
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - C Bibbo
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - S Dorbala
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - R Blankstein
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - M Mehra
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - J Sörensen
- Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Surgical Sciences, Nuclear Medicine and PET, Uppsala University, Uppsala, Sweden
| | - M M Givertz
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - M F Di Carli
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA.
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Kostick-Quenet K, Blumenthal-Barby J, Mehra M, Lang B, Dorfman N, Bhimaraj A, Civitello A, Jorde U, Trachtenberg B, Uriel N, Kaplan H, Gilmore-Szott E, Volk R, Estep J. Integrating Personalized Risk Scores in Decision Making About Left Ventricular Assist Device (LVAD) Therapy: Clinician and Patient Perspectives. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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9
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Snipelisky D, Ivak P, Stewart G, Givertz M, Pfeffer M, Groarke J, Singh S, Netuka I, Mehra M. Stroke Patterns and Implications for Ventricular Functional Remodeling in Left Ventricular Assist Systems. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Mehra M, Kambili C, Potluri R, Rhines A, Singh V, Thomas A. Modeling the impact of bedaquiline treatment strategies on the multidrug-resistant tuberculosis burden in India. Int J Tuberc Lung Dis 2017; 21:902-909. [DOI: 10.5588/ijtld.16.0717] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- M. Mehra
- Janssen Global Commercial Strategy Organization, Raritan, New Jersey, USA
| | - C. Kambili
- Johnson & Johnson Global Public Health, Raritan, New Jersey, USA
| | - R. Potluri
- SmartAnalyst Inc, New York, New York, USA
| | - A. Rhines
- Johnson & Johnson Global Public Health, Raritan, New Jersey, USA
| | - V. Singh
- Johnson & Johnson India Pvt Limited, Mumbai, India
| | - A. Thomas
- Johnson & Johnson Global Public Health, Raritan, New Jersey, USA
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Gothelf Y, Cudkowicz M, Berry J, Windebank A, Staff N, Owegi M, Levy Y, Aricha R, Mehra M, Lebovits C, Brown R. Safety and efficacy of transplantation of nurown (autologous mesenchymal stromal cells secreting neurotrophic factors) in patients with ALS: A phase 2 randomized double blind placebo controlled trial. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Schurr J, Stevens C, Coakley L, Mehra M. Does Angiotensin Pathway Inhibition Influence Non-Surgical Bleeding in Durable Mechanical Circulatory Support? J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.674] [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: 11/17/2022] Open
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Hannan M, Xie R, Kusne S, Merry C, Grossi P, Stosor V, Sivathasan C, Mehra M, Jorde U, Netuka I, Huprikar S, Kirklin J. Antimicrobial Surgical Prophylaxis in MCS Implant Surgery and Surgical Site Infection, IMACS January 2013 to December 2015. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Reed R, Mehra M, Kirshblum S, Maier D, Lammertse D, Blight A, Rupp R, Jones L, Abel R, Weidner N, Curt A, Steeves J. Spinal cord ability ruler: an interval scale to measure volitional performance after spinal cord injury. Spinal Cord 2017; 55:730-738. [DOI: 10.1038/sc.2017.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Revised: 12/16/2016] [Accepted: 12/21/2016] [Indexed: 12/22/2022]
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Carnicelli A, Thakkar A, Deicicchi D, Storm A, Connors J, Couper G, Mehra M, Groarke J, Givertz M. Resource Utilization and Hospital Readmission Rates Associated with Gastrointestinal Bleeding in Patients with Continuous Flow Left Ventricular Assist Devices. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.356] [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] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Flaig T, Mehra M, Potluri R, Ng Y, Todd M, Higano C. Real World Data Analysis of Incident Metastatic (M1) Prostate Cancer (Pc) Patients (Pts): Us Claims Database Analysis. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu336.42] [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: 11/14/2022] Open
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Bhanja SK, Goel A, Pandey N, Mehra M, Majumdar S, Mandal AB. In ovo carbohydrate supplementation modulates growth and immunity-related genes in broiler chickens. J Anim Physiol Anim Nutr (Berl) 2014; 99:163-173. [PMID: 24797673 DOI: 10.1111/jpn.12193] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 03/27/2014] [Indexed: 12/28/2022]
Abstract
A study was undertaken to investigate the role of in ovo administrated carbohydrates on the expression pattern of growth and immune-related genes. In ovo injections (n = 400) were carried out on the 14th day of incubation into the yolk sac/amnion of the broiler chicken embryos. Expression of growth-related genes: chicken growth hormone (cGH), insulin-like growth factor-I & II (IGF-I & II) and mucin were studied in hepatic and jejunum tissues of late-term embryo and early post-hatch chicks. Expression of candidate immune genes: Interleukin-2, 6, 10 and 12 (IL-2, IL-6, IL-10 and IL-12), Tumour necrosis factor-alpha (TNF-α) and Interferon gamma (IFN-γ) were studied in peripheral blood monocyte cells of in ovo-injected and control birds following antigenic stimulation with sheep RBC (SRBC) or mitogen concanavalin A (Con-A). Glucose injection significantly increased the expression of IGF-II gene during embryonic period and both cGH and IGF-II in early post-hatch period, while ribose-injected chicks had higher expression of IGF-II gene during embryonic stage. Enhanced mucin gene expression was also observed in fructose-injected chicks during embryonic age. Glucose-injected chicks had higher expression of IL-6 or IL-10, while those injected with fructose or ribose had higher expression of IL-2, IL-12 and IFN gamma. It is concluded that in ovo supplementation of carbohydrates might help in improving the growth of late-term embryos and chicks. In ovo glucose could modulate humoral-related immunity, while fructose or ribose might help in improving the cellular immunity in broiler chickens.
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Affiliation(s)
- S K Bhanja
- Central Avian Research Institute, Izatnagar, UP, India
| | - A Goel
- Central Avian Research Institute, Izatnagar, UP, India
| | - N Pandey
- Central Avian Research Institute, Izatnagar, UP, India
| | - M Mehra
- Central Avian Research Institute, Izatnagar, UP, India
| | - S Majumdar
- Central Avian Research Institute, Izatnagar, UP, India
| | - A B Mandal
- Central Avian Research Institute, Izatnagar, UP, India
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Mehra M, Cossrow N, Kambili C, Underwood R, Makkar R, Potluri R. Assessment of tuberculosis burden in China using a dynamic disease simulation model. Int J Tuberc Lung Dis 2013; 17:1186-94. [PMID: 23827732 DOI: 10.5588/ijtld.12.0959] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Although a preventable and treatable disease, tuberculosis (TB) is among the top 10 causes of death worldwide. A consequence of inadequately treated drug-susceptible TB (DS-TB) is multidrug-resistant TB (MDR-TB). OBJECTIVES To improve our understanding of the primary drivers of incidence and prevalence of DS- and MDR-TB in China. METHODS The Tuberculosis Disease Transmission Model (TBDTM) uses historical and current disease epidemiology and transmission trends and treatment effectiveness, and accounts for annual changes to these to estimate future DS-TB and MDR-TB burden. RESULTS The model shows that in China, by 2050, incidence, prevalence and mortality of DS-TB will decrease by 32%, 50% and 41%, respectively, whereas MDR-TB will increase by respectively 60%, 48% and 35%. Reduction in DS-TB is a result of high treatment and cure rates leading to a decrease in the prevalence of latent tuberculous infection (LTBI), while the increase in MDR-TB is attributed to inappropriate treatment, leading to high transmission of infection and increased LTBI prevalence. CONCLUSIONS These results demonstrate a reduction in DS-TB in China over the next 40 years, while MDR-TB will increase. Improvements in the diagnosis and treatment of MDR-TB are needed to counter this threat. The TBDTM tool has potential value in public health practice by demonstrating the impact of interventions and estimating their cost-effectiveness.
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Affiliation(s)
- M Mehra
- Janssen Global Services, Raritan, New Jersey 08869, USA.
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Grover R, Mehra M, Pandit IK, Srivastava N, Gugnani N, Gupta M. Clinical efficacy of various root canal obturating methods in primary teeth: a comparative study. Eur J Paediatr Dent 2013; 14:104-108. [PMID: 23758458] [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: 06/02/2023]
Abstract
AIM The purpose of this in vivo study was to evaluate and compare the efficacy of different obturating methods used in primary teeth, when obturated using a combination of zinc oxide and iodoform paste (Endoflas F.S.). MATERIALS AND METHODS A group of 29 patients aged 3-9 years and a total of 64 teeth were selected. These 64 teeth (32 anterior teeth=32 canals, and 32 posterior teeth=80 canals) were randomly divided into 4 groups. Teeth were obturated with Lentulo spiral, pressure syringe, bi-directional spiral and Pastinject. Post-operative evaluation was done for: quality of canal obturation, (underfilled, optimally filled, overfilled) and presence of voids. RESULTS Pastinject exhibited the highest number of optimally filled canals, while the highest number of underfilled canals were observed with bi-directional spiral, and the highest number of overfilled canals were observed with pressure syringe. A minimum number of voids was present in canals filled with the Pastinject technique and pressure syringe. CONCLUSION These results suggest that Pastinject was the most effective technique for obturation of primary teeth.
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Affiliation(s)
- R Grover
- Department of Pedodontics and Preventive Dentistry, Sri Guru Ram Dass Institue of Dental Sciences and Research, Amritsar, India.
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Carniato S, Mehra M, King RM, Wakhloo AK, Gounis MJ. Porcine brachial artery tortuosity for in vivo evaluation of neuroendovascular devices. AJNR Am J Neuroradiol 2013; 34:E36-8. [PMID: 22081678 DOI: 10.3174/ajnr.a2778] [Citation(s) in RCA: 6] [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] [Indexed: 11/07/2022]
Abstract
We report a novel model of arterial tortuosity in the porcine brachial artery for testing of endovascular devices in the flexed forelimb position. This provides an ideal vascular territory for an in vivo assessment of guidewires, microcatheters, and endovascular implants because it closely mimics the challenging curvature at the carotid siphon.
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Affiliation(s)
- S Carniato
- Research and Development, Stryker Neurovascular, Fremont, California, USA
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Khanna A, Guo M, Mehra M, Royal W. Inflammation and oxidative stress induced by cigarette smoke in Lewis rat brains. J Neuroimmunol 2012; 254:69-75. [PMID: 23031832 DOI: 10.1016/j.jneuroim.2012.09.006] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2012] [Revised: 09/06/2012] [Accepted: 09/07/2012] [Indexed: 01/24/2023]
Abstract
Exposure to cigarette smoke has been associated with an increased risk of neurological diseases such as stroke, Alzheimer's disease and multiple sclerosis. In these studies, serum and brain sections from Lewis rats or those exposed to cigarette smoke and control rats were examined for evidence of increased inflammation and oxidative stress. Immunocytochemical staining of brain sections from CS-exposed rats showed increased expression of class II MHC and, in ELISA, levels of IFN-gamma and TNF-α were higher than for non-exposed rats. In polymerase chain reaction assays there was increased interferon-gamma, TNF-α, IL-1α, IL-1β, IL-23, IL-6, IL-23, IL-17, IL-10, TGF-β, T-bet and FoxP3 gene expression with CS exposure. There was also markedly elevated MIP-1α/CCL3, less prominent MCP-1/CCL2 and no elevation of SDF-1α gene expression. Analysis of samples from CS-exposed and control rats for anti-oxidant expression showed no significant difference in serum levels of glutathione and, in brain, similar levels of superoxide dismutase and decreased thioredoxin gene expression. In contrast, there was increased brain gene expression for the pro-oxidants iNOS and the NADPH components NOX4, dual oxidase 1 and p22(phox). Nrf2 expression, which is typically triggered as a secondary response to oxidative stress, was also increased in brains from CS-exposed rats with nuclear translocation of this protein from cytoplasm demonstrated in astrocytes in association with increased expression of the aryl hydrocarbon receptor gene, an Nrf2 target. These studies, therefore, demonstrate that CS exposure in these animals can trigger multiple immune and oxidative responses that may have important roles in the pathogenesis of CNS inflammatory neurological diseases.
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Affiliation(s)
- A Khanna
- Department of Pathology, The University of Maryland School of Medicine, Baltimore, MD, United States
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Spilberg G, Carniato SL, King RM, van der Bom IMJ, Mehra M, Walvick RP, Wakhloo AK, Gounis MJ. Temporal evolution of susceptibility artifacts from coiled aneurysms on MR angiography: an in vivo canine study. AJNR Am J Neuroradiol 2011; 33:655-60. [PMID: 22194374 DOI: 10.3174/ajnr.a2831] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Intracranial aneurysms treated by coiling have a risk for recurrence, requiring surveillance imaging. MRA has emerged as an attractive technique for postcoiling aneurysm imaging. Previous research has evaluated MR imaging artifacts of the coil mass in vitro. Our aim in this study was to evaluate MR imaging artifacts of coiled aneurysms in vivo with time. MATERIALS AND METHODS Four sidewall aneurysms were created in each of 4 dogs. Aneurysms were embolized receiving only 1 type of coils. After embolization, the animals were transferred to MR imaging, which included axial 3D TOF MRA (TEs, 3.5, 5, and 6.9 ms), phase-contrast MRA, and coronal CE-MRA. MR imaging studies were repeated at 1, 4, 6, 8, 14, and 28 weeks. We calculated an OEF: OEF = V(A)/V(CM), where the numerator represents the volume of the MR imaging artifacts and the denominator is the true volume of the coil mass measured by 3D RA. RESULTS OEFs were largest immediately after embolization and showed a gradual decay until approximately 4 weeks, when there was stabilization of the size of the artifacts. By 4 weeks, there was mild coil compaction (average coil mass volume decrease of 7.8%); however, the OEFs decreased by 25% after 4 weeks (P < .001). CONCLUSIONS MR imaging susceptibility artifacts change with time, being maximal in the postembolization setting and decaying until 4 weeks. The clinical implications of this study are that baseline MRA for comparison with future imaging should be acquired at a minimum of 1 week after the procedure.
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Affiliation(s)
- G Spilberg
- Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts 01655, USA
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van der Bom IMJ, Mehra M, Walvick RP, Chueh JY, Gounis MJ. Quantitative evaluation of C-arm CT cerebral blood volume in a canine model of ischemic stroke. AJNR Am J Neuroradiol 2011; 33:353-8. [PMID: 22173756 DOI: 10.3174/ajnr.a2944] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Previous studies have shown the feasibility of assessing qualitative CBV measurements in the angiography suite by using FPD-CBCT systems. We have investigated the correlation of FPD-CBCT CBV lesion volumes to the infarct volume. MATERIALS AND METHODS Unilateral strokes were created in 7 adult dogs. MR imaging and FPD-CBCT data were obtained after MCA occlusion. FPD-CBCT CBV and ADC maps were generated for all subjects. The animals were sacrificed immediately following the last imaging study to measure infarct volume on histology. The reliability of FPD-CBCT-based lesion volume measurements was compared with those measured histologically by using regression and Bland-Altman analysis. RESULTS The best correlation (R(2) = 0.72) between lesion volumes assessed with FPD-CBCT and histology was established with a threshold of mean healthy CBV - 2.5 × SD. These results were inferior to the correlation of lesion volumes measured with ADC and histology (R(2) = 0.99). Bland-Altman analysis showed that the agreement of ADC-derived lesion volumes with histology was superior to the agreement of FPD-CBCT-derived lesion volumes with histology. CONCLUSIONS We correlated FPD-CBCT measurements of CBV and MR ADC lesion volumes with histologically assessed infarct volume. As expected, ADC is a very accurate and precise method for determining the extent of infarction. FPD-CBCT CBV lesion volumes are correlated to the size of the infarct. Improvement of FPD-CBCT image quality provides an opportunity to establish quantitative CBV measurement in the angiography suite.
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Affiliation(s)
- I M J van der Bom
- Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts 01655, USA
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Carniato S, Mehra M, King R, Wakhloo A, Gounis M. O-023 Pre-clinical model of porcine arterial tortuosity for in vivo testing of neuroendovascular devices. J Neurointerv Surg 2011. [DOI: 10.1136/neurintsurg-2011-010097.23] [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: 11/03/2022]
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26
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Gounis M, Nogueira R, Mehra M, Finol E, Yang Y, Jahrmarkt S, Migliuolo M, Wakhloo A. O-006 Pharmaco-mechanical clot disruption using a balloon infusion wire in an acute rabbit common carotid artery thromboembolic occlusion model. J Neurointerv Surg 2011. [DOI: 10.1136/neurintsurg-2011-010097.6] [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: 11/03/2022]
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Dhawan R, Wu Y, Mehra M. Docetaxel use, analgesics use, and survival in prostate cancer: Survival analysis using a large claims database (2003-2009). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15073] [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: 11/20/2022] Open
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Solo K, Mehra M, Dhawan R, Valant J, Scher HI. Prevalence of prostate cancer (PC) clinical states (CS) in the United States: Estimates using a dynamic progression model. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4637] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Mehra M, Wu Y, Dhawan R. Comparison of medical resource use and associated cost before and after docetaxel treatment among prostate cancer patients. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15068] [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: 11/20/2022] Open
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Mehra M, Hill K, Nicholl D, Schadrack J. The burden of chronic lower back pain with neuropathic components: a healthcare resource perspective. The Journal of Pain 2011. [DOI: 10.1016/j.jpain.2011.02.042] [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] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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31
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Lee M, Burke A, Huebner T, Feller E, Mehra M, Augustine S, Drachenberg C. 682 Antibody Mediated Rejection in Heart Transplant Biopsies. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.696] [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: 11/29/2022] Open
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32
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Mehra M, Wu Y, Dhawan R. Comparison of health care resource use before and after docetaxel treatment among prostate cancer patients. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.215] [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: 11/20/2022] Open
Abstract
215 Background: Docetaxel is standard of care among late-stage prostate cancer patients. We analyzed patterns of health care resource utilization (RU) among patients before and after exposure to docetaxel using a large commercial claims database. Methods: A random sample of patients (N = 336) with a diagnosis of prostate cancer (ICD 9 code: 185.X) and a claim for docetaxel (2003–2009) was identified from the PharMetrics database, a nationally representative, non-payer-owned integrated commercial U.S. claims database. All patients had ≥ 12 months of enrollment prior to initiation of docetaxel. Patients were followed from their first docetaxel claim until lost to follow-up or June 30, 2009 (censored). RU was defined as all-cause hospitalization, ER, physician, and ambulatory visits. Incidence rates were derived. Results: Mean age of patients was 67.9 years (SD 10.6); mean number of docetaxel prescriptions was 9.9 (SD 10.3). Mean time to study end/lost to follow-up was 15.41 (SD 12.49) months from the index date. The table shows health care RU for the 12 months before, and over the follow-up period after docetaxel initiation. Hospitalizations, ER, physician, and ambulatory visits were significantly higher in the follow-up period. The average length of hospital stay was significantly longer after docetaxel treatment (8.2 vs 5.5 days). Prior to docetaxel, two-thirds of the patients were on hormonal therapy; 51% on analgesics, and 31% on bisphosphonates. After docetaxel, the proportions were 62%, 58%, and 54%, respectively. Conclusions: The significantly higher RU with disease progression in prostate cancer patients suggests a need for new treatment options that can effectively manage and improve patient outcomes. [Table: see text] [Table: see text]
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Affiliation(s)
- M. Mehra
- Johnson and Johnson, Raritan, NJ
| | - Y. Wu
- Johnson and Johnson, Raritan, NJ
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Albert N, Curtis A, Gheorghiade M, Heywood J, Inge PJ, McBride M, Mehra M, O'Connor C, Reynolds D, Walsh M, Yancy C, Fonarow G. Documentation of QRS Duration and NYHA Class in HF Patients after a Performance Improvement Initiative: IMPROVE HF. J Card Fail 2010. [DOI: 10.1016/j.cardfail.2010.06.243] [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] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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van der Bom M, Walvick R, Mehra M, Wakhloo A, Gounis M. O-001 Assessment of CT cerebral blood volume, MR diffusion weighted imaging and histology in a canine model of acute ischemic stroke. J Neurointerv Surg 2010. [DOI: 10.1136/jnis.2010.003244.1] [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: 11/03/2022]
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Gheorghiade M, Fonarow G, Yancy C, Albert N, Curtis A, Stough WG, Heywood J, McBride M, Mehra M, O'Connor C, Reynolds D, Walsh M. BNP Levels in Outpatients with Heart Failure: Frequency of Assessment, Relationship to Symptoms, Disease Severity, and HF Quality of Care Measures. J Card Fail 2009. [DOI: 10.1016/j.cardfail.2009.06.197] [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: 11/28/2022]
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Curtis A, Fonarow G, Yancy C, Albert N, Stough WG, Gheorghiade M, Heywood J, McBride M, Mehra M, O'Connor C, Reynolds D, Walsh M. Influence of Atrial Fibrillation on the Use of CRT and ICD Therapy in Heart Failure: Findings from IMPROVE HF. J Card Fail 2009. [DOI: 10.1016/j.cardfail.2009.06.196] [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: 11/27/2022]
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37
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Heywood J, Fonarow G, Yancy C, Albert N, Curtis A, Stough WG, Gheorghiade M, McBride M, Mehra M, O'Connor C, Reynolds D, Walsh M. Prevalence and Characteristics of Prolonged QRS Duration in Outpatients with Left Ventricular Systolic Dysfunction: An IMPROVE HF Analysis. J Card Fail 2009. [DOI: 10.1016/j.cardfail.2009.06.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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38
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Albert N, Fonarow G, Yancy C, Curtis A, Stough WG, Gheorghiade M, Heywood J, McBride M, Mehra M, O'Connor C, Reynolds D, Walsh M. Influence of Advance Practice Nurse and Dedicated Heart Failure Clinics on Delivery of Recommended Therapies in Outpatient Cardiology Practices: IMPROVE HF Findings. J Card Fail 2008. [DOI: 10.1016/j.cardfail.2008.06.348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Yancy C, Fonarow G, Albert N, Curtis A, Stough WG, Gheorghiade M, Heywood J, McBride M, Mehra M, C. O, Reynolds D, Walsh M. Significant Gaps in Adherence to Guideline Recommended Adjunctive Heart Failure Therapies among Outpatient Cardiology Practices: Findings from IMPROVE HF. J Card Fail 2008. [DOI: 10.1016/j.cardfail.2008.06.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Heywood J, Fonarow G, Yancy C, Albert N, Curtis A, Stough WG, Gheorghiade M, McBride M, Mehra M, C. O, Reynolds D, Walsh M. Comparison of Medical Treatment in Outpatients Receiving Device Therapy for Systolic Dysfunction: A Report from IMPROVE HF. J Card Fail 2008. [DOI: 10.1016/j.cardfail.2008.06.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Buise M, Van Bommel J, Mehra M, Tilanus HW, Van Zundert A, Gommers D. Pulmonary morbidity following esophagectomy is decreased after introduction of a multimodal anesthetic regimen. Acta Anaesthesiol Belg 2008; 59:257-261. [PMID: 19235524] [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: 05/27/2023]
Abstract
Respiratory morbidity is the most frequent complication after esophagectomy, which can occur in 50% of the patients treated for esophageal cancer. We tested the hypothesis whether an anesthetic regimen, emphasizing intraoperative fluid restriction and early extubation could, positively influence postoperative morbidity, without affecting the gastric tube reconstruction. We introduced an anesthetic regimen, based on early extubation and a controlled intraoperative fluid management (net fluid balance < 4 L) in combination with the use of norepinephrine to maintain mean arterial blood pressure > 65 mmHg. Postoperative morbidity and mortality were compared with a similar group of patients operated one year before. From June 2005 till September 2006, 83 patients were treated according to the new regimen (NR) and compared to a similar number of patients from the same period in 2003-2005 (standard regimen: SR). Applying the NR resulted in significantly less fluid administration (balance of 3.5 +/- 0.2 L NR vs. 5.1 +/- 0.2 L SR, p < 0.05) resulting in fewer patients developing pneumonia (26% in the NR group vs. 42% in the SR group, p < 0.05). Similar per operative blood loss and urine output and occurrence of leakage or ischemia of the gastric tube anastomosis occurred in both groups. Respiratory morbidity is significantly reduced with the introduction of a new anesthetic regimen directed at intraoperative fluid restriction and early extubation, without increasing anastomotic leakage of the gastric tube reconstruction.
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Affiliation(s)
- M Buise
- Erasmus Medical Centre, Department of Anesthesiology, Rotterdam, The Netherlands
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Fonarow G, Yancy C, Albert N, Curtis A, Stough WG, Gheorghiade M, Heywood J, McBride M, Mehra M, O'Connor C, Reynolds D, Walsh M. Heart Failure Quality of Care in the Outpatient Cardiology Practice Setting: A Report from IMPROVE HF. J Card Fail 2007. [DOI: 10.1016/j.cardfail.2007.06.655] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Yancy C, Fonarow G, Albert N, Curtis A, Stough WG, Gheorghiade M, Heywood J, McBride M, Mehra M, O'Connor C, Reynolds D, Walsh M. Outpatient Documentation of NYHA Functional Class and/or Activity Level in HF Patients: A Report from IMPROVE HF. J Card Fail 2007. [DOI: 10.1016/j.cardfail.2007.06.671] [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: 11/17/2022]
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Mehra M, Deng M, Starling R, Murali S, Pauly D, Lal P, Cadeiras M, Baron H, Rosenberg S, Eisen H. 171: Does induction therapy influence the utility of gene expression testing for cardiac allograft rejection? J Heart Lung Transplant 2007. [DOI: 10.1016/j.healun.2006.11.188] [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: 11/24/2022] Open
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Hunt J, Bedánová H, Starling R, Rabágo G, Banner N, Kobashigawa J, Keogh A, Kormos R, Mehra M, Wahlers T, Noeldeke J. 398: Premature termination of a prospective, open label, randomized, multicenter study of sirolimus to replace calcineurin inhibitors (CNI) in a standard care regimen of CNI, MMF and corticosteroids early after heart transplantation. J Heart Lung Transplant 2007. [DOI: 10.1016/j.healun.2006.11.419] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Abstract
BACKGROUND Idiosyncratic terminology and frameworks in the study of patient safety have been tolerated but are increasingly problematic. Agreement on standard language and frameworks is needed for optimal improvement and dissemination of knowledge about patient safety. METHODS Patient safety events were assessed using critical incident analysis, a method used to classify risks that has been more recently applied to medicine. Clinician interviews and clinician reports to a web based reporting system were used for analysis of hospital based and ambulatory care events, respectively. Events were classified independently by three investigators. RESULTS A pediatric patient safety taxonomy, relevant to both hospital based and ambulatory pediatric care, was developed from the analysis of 122 hospital based and 144 ambulatory care events. It is composed of four main categories: (1) problem type; (2) domain of medicine; (3) contributing factors in the patient (child-specific), environment (latent conditions) and care providers (human factors); and (4) outcome or result of the event and level of harm. A classification of preventive mechanisms was also developed. Inter-rater reliability of classifications ranged from 72% to 86% for sub-categories of the taxonomy. CONCLUSIONS This patient safety taxonomy reflects the nature of events that occur in both pediatric hospital based and ambulatory care settings. It is flexible in its construction, permits analysis to begin at any point, and depicts the relationships and interactions of elements of an event.
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Affiliation(s)
- D M Woods
- Institute for Healthcare Studies, Feinberg School of MedicineNorthwestern University, Chicago, IL, USA.
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Kumar R, Mehra M, Dabas P, Raha R. A study of ocular infections amongst primary school children in Delhi. J Commun Dis 2004; 36:121-6. [PMID: 16295674] [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: 05/05/2023]
Abstract
The present study of ocular infections was conducted amongst primary school children residing in an urban slum and rural area of Delhi. A total of four schools were selected, two from urban slum in Central Delhi Rouse Avenue and two from a peripheral village on the outskirts of Delhi. All the children studying in the above mentioned schools and residing in the same area were covered. All the study subjects were interviewed, clinically examined and given a proforma to be filled by their parents. Of the total 775 subjects only 91 (11.74%) had ocular infections. Conjunctivitis was the most prevalent infection followed by trachoma, stye, blepharitis and chalazion. The type and prevalence of infection was similar, in both sexes and both areas, rural and urban. There was a significant rising trend of ocular infection with increase in age. A significant association was found between ocular infections and religion but the association with per capita income was not significant.
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Affiliation(s)
- Rajesh Kumar
- Deptt. of Community Medicine, Maulana Azad Medical College, Delhi
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48
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Khokhar A, Singh S, Talwar R, Rasania SK, Badhan SR, Mehra M. A study of malnutrition among children aged 6 months to 2 years from a resettlement colony of Delhi. Indian J Med Sci 2003; 57:286-9. [PMID: 12928554] [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: 03/04/2023]
Abstract
Nutritional status of 1661 children aged 6 months to 2 years who attended the Well Baby Clinic of UHC Gokulpuri, Delhi during the year 2000 was studied. 60.7% of them were malnourished. Undesirable practices of discarding the colostrum, not exclusively breast feeding the child till at least 4 months of age, delayed weaning, dilution of top milk, use of bottle and nipple for feeding the children are still widely prevalent.
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Affiliation(s)
- A Khokhar
- Department of Community Medicine, VMMC & Safdarjang Hospital, 374-A Pocket-II, Mayur Vihar, Phase-I, Delhi 110091, India
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Eisen H, Deng M, Mehra M, Hunt S, Johnson F, Robbins R, Autieri M, Itescu S, Giacomini J, Ahern D, Berry G, Marboe C, Mahmood I, Woodward R, Wohlgemuth J. Non-invasive molecular screening for acute cardiac rejection: a multicenter prospective clinical study. J Heart Lung Transplant 2003. [DOI: 10.1016/s1053-2498(02)00677-0] [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: 11/16/2022] Open
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50
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Singh MM, Bano T, Pagare D, Sharma N, Devi R, Mehra M. Knowledge and attitude towards tuberculosis in a slum community of Delhi. J Commun Dis 2002; 34:203-14. [PMID: 14703055] [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: 04/27/2023]
Abstract
A cross-sectional study was conducted among 208 adults (114 males and 94 females) aged 16-70 years, selected by systematic random sampling method in Lok Nayak Colony, Delhi to assess the knowledge and attitude towards tuberculosis (TB). Literacy rate was 28.4%. Only 174 (83.6%) heard of tuberculosis mainly from neighbours (64.9%) and friends (62.1%). Only 2.3% knew that TB was caused by a germ. Literates were more aware than illiterates regarding some signs and symptoms of TB i.e breathlessness (p=0.002), low grade fever (p=0.02), loss of appetite (p<0.001) and factors favouring TB e.g. overcrowding (56.4%) and poor diet (45.4%). Only 12.6% knew about the duration of treatment for 6-8 months and 1.7% knew about preventive role of BCG. Tendency to discriminate TB patients was evident from the findings e.g 71% respondents agreed upon isolating TB patients from the family, 74.1% on avoiding the patient in food sharing, on quitting job by the patient (33%), prohibiting marriage of the patient (27.6%), shunning him from attending social functions (18%), etc. Extensive health education directing towards attitudinal change by community involvement is needed to create awareness and remove myths about TB in such colonies.
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