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Tan HS, Tan CW, Sultana R, Chen HY, Chua T, Rahman N, Gandhi M, Sia ATH, Sng BL. The association between epidural labour analgesia and postpartum depression: a randomised controlled trial. Anaesthesia 2024; 79:357-367. [PMID: 37990597 DOI: 10.1111/anae.16178] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 11/23/2023]
Abstract
There is conflicting evidence regarding the association between epidural labour analgesia and risk of postpartum depression. Most previous studies were observational trials with limited ability to account for confounders. We aimed to determine if epidural analgesia was associated with a significant change in the incidence of postpartum depression in this randomised controlled trial. We enrolled women aged 21-50 years old with a singleton fetus ≥ 36 weeks gestation. Patients were advised regarding available labour analgesic modalities during enrolment (epidural block; intramuscular pethidine; nitrous oxide; or intravenous remifentanil). On request for analgesia, patients were offered the modality that they had been allocated randomly to first. Blinded investigators recorded patient and obstetric characteristics within 24 h of delivery and assessed for postpartum depression at 6-10 weeks following delivery using the Edinburgh Postnatal Depression Scale (score ≥ 13 considered positive for postpartum depression). The modified intention-to-treat population consisted of all patients who received any form of labour analgesia, while per-protocol consisted of patients who received their randomised modality as their first form of labour analgesia. Of 881 parturients allocated randomly (epidural n = 441, non-epidural n = 440), we analysed 773 (epidural n = 389, non-epidural n = 384); 62 (15.9%) of women allocated to epidural group developed postpartum depression compared with 65 (16.9%) women allocate to the non-epidural group. There were no significant differences in the incidence of postpartum depression between the two groups (adjusted risk difference (95%CI) 1.6 (-3.0-6.3%), p = 0.49). Similar results were obtained with per-protocol analysis (adjusted risk difference (95%CI) -1.0 (-8.3-6.3%), p = 0.79). We found no significant difference in the risk of postpartum depression between patients who received epidural labour analgesia and those who utilised non-epidural analgesic modalities.
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Affiliation(s)
- H S Tan
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore, Singapore
- Anaesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - C W Tan
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore, Singapore
- Anaesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - R Sultana
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - H Y Chen
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore, Singapore
- Paediatrics Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - T Chua
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore, Singapore
- Paediatrics Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - N Rahman
- Department of Biostatistics, Singapore Clinical Research Institute, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - M Gandhi
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
- Department of Biostatistics, Singapore Clinical Research Institute, Singapore, Singapore
| | - A T H Sia
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore, Singapore
- Anaesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - B L Sng
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore, Singapore
- Anaesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
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Sathiyabama M, Boomija RV, Muthukumar S, Gandhi M, Salma S, Prinsha TK, Rengasamy B. Green synthesis of chitosan nanoparticles using tea extract and its antimicrobial activity against economically important phytopathogens of rice. Sci Rep 2024; 14:7381. [PMID: 38548964 PMCID: PMC10978976 DOI: 10.1038/s41598-024-58066-y] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 03/25/2024] [Indexed: 04/01/2024] Open
Abstract
The aim of the present work is to biosynthesize Chitosan nanoparticles (CTNp) using tea (Camellia sinensis) extract, with potent antimicrobial properties towards phytopathogens of rice. Preliminary chemical analysis of the extract showed that they contain carbohydrate as major compound and uronic acid indicating the nature of acidic polysaccharide. The structure of the isolated polysaccharide was analyzed through FTIR and 1H NMR. The CTNp was prepared by the addition of isolated tea polysaccharides to chitosan solution. The structure and size of the CTNp was determined through FTIR and DLS analyses. The surface morphology and size of the CTNp was analysed by SEM and HRTEM. The crystalinity nature of the synthesized nanoparticle was identified by XRD analysis. The CTNp exhibited the antimicrobial properties against the most devastating pathogens of rice viz., Pyricularia grisea, Xanthomonas oryzae under in vitro condition. CTNp also suppressed the blast and blight disease of rice under the detached leaf assay. These results suggest that the biosynthesized CTNp can be used to control the most devastating pathogens of rice.
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Affiliation(s)
- M Sathiyabama
- Department of Botany, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India.
| | - R V Boomija
- Department of Botany, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India
| | - S Muthukumar
- Department of Botany, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India
| | - M Gandhi
- Department of Botany, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India
| | - S Salma
- Department of Botany, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India
| | - T Kokila Prinsha
- Department of Botany, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India
| | - B Rengasamy
- Department of Botany, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India
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Thornhill JP, Gandhi M, Orkin C. Mpox: The Reemergence of an Old Disease and Inequities. Annu Rev Med 2024; 75:159-175. [PMID: 37788486 DOI: 10.1146/annurev-med-080122-030714] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Mpox, previously known as monkeypox, is caused by an Orthopoxvirus related to the variola virus that causes smallpox. Prior to 2022, mpox was considered a zoonotic disease endemic to central and west Africa. Since May 2022, more than 86,000 cases of mpox from 110 countries have been identified across the world, predominantly in men who have sex with men, most often acquired through close physical contact or during sexual activity. The classical clinical presentation of mpox is a prodrome including fever, lethargy, and lymphadenopathy followed by a characteristic vesiculopustular rash. The recent 2022 outbreak included novel presentations of mpox with a predominance of anogenital lesions, mucosal lesions, and other features such as anorectal pain, proctitis, oropharyngeal lesions, tonsillitis, and multiphasic skin lesions. We describe the demographics and clinical spectrum of classical and novel mpox, outlining the potential complications and management.
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Affiliation(s)
- J P Thornhill
- SHARE Research Collaborative, The Blizard Institute, Queen Mary University of London, London, United Kingdom;
| | - M Gandhi
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, California, USA
| | - C Orkin
- SHARE Research Collaborative, The Blizard Institute, Queen Mary University of London, London, United Kingdom;
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Anderson JN, Deter RL, Datoc IA, Mack L, Gandhi M, Lee W, Blumenfeld YJ. Second-trimester growth velocities in twin and singleton pregnancies. Ultrasound Obstet Gynecol 2023; 61:33-39. [PMID: 36273412 DOI: 10.1002/uog.26102] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/04/2022] [Accepted: 10/14/2022] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Previous small studies used individualized growth assessment (IGA) to characterize prenatal growth velocities of singletons and twins. We aimed to compare second-trimester growth velocities of individual anatomical parameters between monochorionic diamniotic (MCDA) twins, dichorionic diamniotic (DCDA) twins and singleton fetuses in a larger study. METHODS This was a study of a novel cohort of 222 MCDA twins and previously published cohorts of 40 DCDA twins and 118 singletons with serial ultrasound data. Fetal biometric measurements of biparietal diameter, head circumference, abdominal circumference and femur diaphysis length from prenatal ultrasound examinations were used to calculate second-trimester growth velocities using direct calculation or linear regression analysis. Linear fit was assessed based on the coefficient of determination (R2 ). Mean growth velocities and variances were compared among the three groups. RESULTS The majority of cases underwent three second-trimester ultrasound examinations with fetal biometry available. All fetuses had linear growth, with R2 > 99% for all parameters. Only 1-2% of all MCDA and DCDA anatomical parameters had abnormal growth velocity scores outside the 95% reference range for singletons. There were no significant differences in mean growth velocity for any parameter between MCDA twins and singletons. Femur diaphysis length growth velocity was significantly lower in DCDA twins than in both MCDA twins and singletons. There were no other significant differences among the groups. CONCLUSIONS Expanding on prior work using IGA, we found that second-trimester growth velocity of the four major anatomical parameters overall was similar between twins and singletons and between MCDA and DCDA twins, supporting the use of singleton-derived growth standards for IGA in twins. Twin growth potential appears to be similar to that of singletons in the second trimester, suggesting that subsequent growth divergence may be due to third-trimester physiological or pathological changes in twin pregnancies. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- J N Anderson
- Stanford University School of Medicine, Department of Obstetrics and Gynecology, Stanford, CA, USA
| | - R L Deter
- Baylor College of Medicine/Texas Children's Pavilion for Women, Department of Obstetrics and Gynecology, Houston, TX, USA
| | - I A Datoc
- Stanford University School of Medicine, Department of Obstetrics and Gynecology, Stanford, CA, USA
| | - L Mack
- Baylor College of Medicine/Texas Children's Pavilion for Women, Department of Obstetrics and Gynecology, Houston, TX, USA
| | - M Gandhi
- Baylor College of Medicine/Texas Children's Pavilion for Women, Department of Obstetrics and Gynecology, Houston, TX, USA
| | - W Lee
- Baylor College of Medicine/Texas Children's Pavilion for Women, Department of Obstetrics and Gynecology, Houston, TX, USA
| | - Y J Blumenfeld
- Stanford University School of Medicine, Department of Obstetrics and Gynecology, Stanford, CA, USA
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Krispin E, Danner DJ, Donepudi R, Belfort MA, Fuller M, Gandhi M. Dichorionic twin pregnancy complicated by duodenal atresia and umbilical cord ulceration with intrauterine fetal demise. Ultrasound Obstet Gynecol 2022; 59:397-398. [PMID: 34494319 DOI: 10.1002/uog.24763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/19/2021] [Accepted: 08/27/2021] [Indexed: 06/13/2023]
Affiliation(s)
- E Krispin
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
| | - D J Danner
- Department of Pathology, Baylor College of Medicine, Houston, TX, USA
| | - R Donepudi
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
| | - M A Belfort
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
| | - M Fuller
- Department of Pathology, Baylor College of Medicine, Houston, TX, USA
| | - M Gandhi
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
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Gandhi M, Jain S, Arora KK, Valecha D. Comparison of Nalbuphine and Dexmedetomidine versus Nalbuphine and Propofol for Monitored Anaesthesia Care in Tympanoplasty: A Randomised Double-blind Study. J Clin Diagn Res 2022. [DOI: 10.7860/jcdr/2022/56308.16618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction: Tymanoplasty, a middle ear surgery, is done either under Local Anaesthesia (LA), General Anaesthesia (GA) or sedation with local anaesthesia. It is usually performed under Monitored Anesthesia Care (MAC) providing advantages of rapid onset, allowing hearing test intraoperatively and early mobilisation of the patient. Aim: To study the effect of nalbuphine/dexmedetomidine with nalbuphine/propofol on sedation and analgesia in tympanoplasties performed under MAC. Materials and Methods: This randomised, double-blind, clinical study was conducted from June 2020 to June 2021 in the Department of Anaesthesiology at Mahatma Gandhi Memorial Medical College and MY Hospital, Indore, Madhya Pradesh, India. Total 60 adult patients, of American Society of Anesthesiologists (ASA) grade I and II undergoing tympanoplasty under MAC, were randomly allocated into two groups. All patients received injection nalbuphine 50 μg/kg intravenously. Group D received a bolus dose of injection dexmedetomidine 1 μg/kg i.v. over 10 min followed by an infusion at 0.3 μg/kg/h i.v. Group P received a bolus dose of injection propofol 0.75 mg/ kg followed by an infusion at 0.025 mg/kg/min i.v. Sedation and analgesia were titrated to Ramsay Sedation Score (RSS) and Visual Analog Scale (VAS) of 3 each. The vital parameters and need for intraoperative rescue sedation/analgesia were recorded and compared. Results: Mean RSS was significantly more in group D (3.11±0.055) than group P (2.80±0.350). Overall, VAS score was significantly less in group D (1.60±0.670) than group P (2.70±0.691). In group D, 2 (6%) patients and in group P, 4 (12%) patients required inj. midazolam. Similarly, the requirement of inj. paracetamol in group D was in 3 (10%) patients, and in Group P it was 10 (33%) patients. Bradycardia (23.3% in group D and 13.3% in group P) and hypotension (20% in group D and 13.3% in group P) were the major side-effects seen in the study. Conclusion: Nalbuphine/dexmedetomidine is superior to nalbuphine/propofol in producing sedation and decreasing VAS in patients undergoing tympanoplasty under MAC.
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Gandhi M, Singh S, Arora KK, Barde R. Effect of Preoperative Oral Melatonin on Postoperative Sedation and Analgesia among Patients Undergoing Elective Surgery under General Anaesthesia: A Randomised Controlled Study. J Clin Diagn Res 2022. [DOI: 10.7860/jcdr/2022/56679.16682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction: Postoperative pain is one of the major causes of dissatisfaction and prolonged hospital stay in patients undergoing surgery under general anaesthesia. Melatonin has been used for sleep regulation and Intensive Care Unit (ICU) sedation but there is limited knowledge regarding its effect postoperative analgesia and sedation. Aim: To evaluate the effects of preoperative melatonin on postoperative sedation and analgesia. Materials and Methods: This randomised controlled study was conducted from June 2020 to June 2021, at Mahatma Gandhi Memorial Medical College and M.Y. Hospital, Indore, Madhya Pradesh, India. Total 100 patients belonging to American Society of Anesthesiologists (ASA) grade I and II of either gender, of age 18 to 60 years who were planned for elective surgery under general anaesthesia were randomly divided into two groups. Group M (n=50) was given 6 mg oral melatonin (two capsules of 3 mg each), and group C (n=50) was given multivitamin capsules, 90 minutes before induction of anaesthesia. General anaesthesia was induced using standard method for both the groups. Sedation score was assessed in preoperative period as well as after giving drugs and till 4 hours postoperatively by using Ramsay Sedation score. Pain was evaluated by Visual Analogue Scale (VAS) score till 8 hours postoperatively. Time of request of first rescue analgesia was noted and compared to that of control group. Results: At preoperative time sedation score was comparable between both the groups. At postoperative time, sedation score 4 was seen in significantly higher number of patients of group M in comparison to group C, while at all the other time intervals, sedation scores were comparable between the two groups. Mean VAS score was found to be significantly higher in group C (3.2±0.4) in comparison to group M (3.02±0.14), 4 hours postoperatively. The mean time to request for first rescue analgesia in group M was 7.27±1.01 hours and in group C was 5.40±0.78 hour (p-value=0.001). Conclusion: Preoperative oral melatonin can be used to effectively reduce the postoperative pain without producing undue sedation.
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Xiang L, Fong W, Low A, Leung YY, Gandhi M, Xin X, Uy E, Hamilton L, Thumboo J. POS1411 EARLY IDENTIFICATION OF AXIAL SPONDYLOARTHRITIS IN A MULTI-ETHNIC ASIAN POPULATION. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:To facilitate earlier diagnosis of spondyloarthritis (SpA), we have previously cross-culturally adapted a self-administered screening questionnaire.Objectives:We aimed to improve the sensitivity of this questionnaire as a screening tool by comparing various scoring methods.Methods:Subjects newly referred to a rheumatology clinic self-administered the questionnaire before seeing a rheumatologist. Identification of axial SpA by the questionnaire using original scoring (Method A) and scoring based on Assessment of SpondyloArthritis International Society (ASAS) inflammatory back pain (IBP) criteria (Method B), ASAS referral criteria (Method C), ASAS classification criteria (Method D) and a combination of ASAS referral and classification criteria (Method E) were compared to classification by the ASAS classification criteria and diagnosis by rheumatologist. Since Methods B-E were based on SpA features, we compared self-reported vs rheumatologist-documented features in subjects with axial SpA.Results:Of 1418 subjects (age: 54 ± 14 years, female: 73%), 39 were classified as axial SpA cases by classification criteria. Methods A-E yielded sensitivities of 39%, 72%, 67%, 49% and 85%, respectively, among patients newly referred to the rheumatology clinic (Table 1). Rheumatologist-documented clinical SpA features exceeded self-report for IBP (62 vs 44%) and uveitis (15 vs 5%). The reverse was true for arthritis (21 vs 80%), enthesitis (28 vs 33%), dactylitis (3 vs 18%), good response to NSAIDs (33 vs 41%) and family history for SpA (5 vs 10%).Table 1.Performance of the five scoring methods for the cross-culturally adapted Hamilton axial SpA questionnaire.Scoring methodSensitivity(95% confidence interval)Specificity(95% confidence interval)Positive predictive value(95% confidence interval)Negative predictive value(95% confidence interval)Method A38.5(23.4 – 55.4)93.7(92.3 – 94.9)14.7(8.5 – 23.1)98.2(97.3 – 98.8)Method B71.8(55.1 – 85.0)73.1(70.7 – 75.4)7.0(4.7 – 10.0)98.9(98.1 – 99.5)Method C66.7(49.8 – 80.9)77.8(75.5 – 80.0)7.8(5.2 – 11.3)98.8(98.0 – 99.4)Method D48.7(32.4 – 65.2)74.9(72.5 – 77.2)5.2(3.2 – 8.0)98.1(97.1 – 98.8)Method E84.6(69.5 – 94.1)37.2(34.6 – 39.8)3.7(2.5 – 5.1)98.8(97.5 – 99.6)Method A: the original scoring defined by the questionnaire developers; Method B: a scoring based on the ASAS IBP criteria; Method C: a scoring based on the ASAS referral criteria; Method D: a scoring based on the ASAS classification criteria for axial and peripheral SpA; Method E: a scoring based on a combination of the ASAS referral and classification criteria.Conclusion:A self-administered questionnaire scored based on a combination of ASAS referral and classification criteria achieved high sensitivity in identifying axial SpA in subjects referred to a rheumatology clinic. This supports its evaluation as a screening tool for axial SpA in the general population.References:[1]Xiang L, Teo EPS, Low AHL, Leung YY, Fong W, Xin X, et al. Cross-cultural adaptation of the Hamilton axial spondyloarthritis questionnaire and development of a Chinese version in a multi-ethnic Asian population. Int J Rheum Dis. 2019;22(9):1652-60.[2]Sieper J, Rudwaleit M, Baraliakos X, Brandt J, Braun J, Burgos-Vargas R, et al. The Assessment of SpondyloArthritis international Society (ASAS) handbook: a guide to assess spondyloarthritis. Annals of the rheumatic diseases. 2009;68 Suppl 2:ii1-44.[3]Poddubnyy D, van Tubergen A, Landewe R, Sieper J, van der Heijde D. Development of an ASAS-endorsed recommendation for the early referral of patients with a suspicion of axial spondyloarthritis. Annals of the rheumatic diseases. 2015;74(8):1483-7.[4]Rudwaleit M, van der Heijde D, Landewe R, Akkoc N, Brandt J, Chou CT, et al. The Assessment of SpondyloArthritis International Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Annals of the rheumatic diseases. 2011;70(1):25-31.Acknowledgements:This work was supported by a Health Services Research Grant (HSRG) from the Singapore Ministry of Health National Medical Research Council [grant number: NMRC/HSRG/0075/2017].Disclosure of Interests:None declared
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Xiang L, Low A, Leung YY, Fong W, Gandhi M, Yoon S, Lau TC, Koh DR, Thumboo J. POS1413 INTERVAL BETWEEN SYMPTOM ONSET AND DIAGNOSIS AMONG PATIENTS WITH AUTOIMMUNE RHEUMATIC DISEASES IN A MULTI-ETHNIC ASIAN POPULATION. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The interval between symptom onset and diagnosis can often be longer than is ideal in autoimmune rheumatic diseases (ARDs).Objectives:We aimed to characterise this interval among patients newly diagnosed with ARDs in a multi-ethnic Asian population and to identify factors associated with a longer interval.Methods:We used Scott’s model of pathways to treatment to characterise the interval between symptom onset and diagnosis into 4 intervals: #1 between symptom onset and first seeking medical attention, #2 between first medical attention and rheumatology referral, #3 between rheumatology referral and first rheumatology assessment, and #4 between first rheumatology assessment and diagnosis. Linear regression models were used to identify factors associated with a longer the overall interval between symptom onset and diagnosis and Interval #1.Results:Among 259 patients (age: 51±15 years, female: 71%, most common three ARDs: rheumatoid arthritis (n = 75), axial spondyloarthritis (n = 40) and psoriatic arthritis (n = 35)), the median overall interval was 11.5 months. Interval #1 (median = 4.9 months) was significantly longer than the other intervals (Table 1). Patients with axial spondyloarthritis had a significantly longer overall interval (median = 38.7 months) and Interval #1 (median = 26.6 months) compared to patients with RA (median = 7.6 and 3.5 months, respectively), PsA (median = 7.0 and 2.6 months, respectively) and the other ARDs. Gender was the only patient-related factor significantly associated with the overall interval (reference = male, coefficient = -15.3, p = 0.033) in regression models.Conclusion:A longer than ideal interval between symptom onset and diagnosis was observed among patients with ARDs. This was primarily due to a relatively long interval between symptom onset and first seeking medical attention, and highlights the importance of interventions targeting patients prior to first medical attention in reducing the duration between symptom onset and diagnosis.References:[1]Scott SE, Walter FM, Webster A, Sutton S, Emery J. The model of pathways to treatment: conceptualization and integration with existing theory. Br J Health Psychol. 2013;18(1):45-65.Table 1.Interval between symptom onset and diagnosisOverall interval, months, median (lower and upper quartiles)†Interval #1, months, median (lower and upper quartiles)Interval #2, months, median (lower and upper quartiles)Interval #3, months, median (lower and upper quartiles)Interval #4, months, median (lower and upper quartiles)Overall(n = 259)11.5(4.7 – 36.0)4.9(1.0 – 24.0)0.3(0.0 – 3.9)1.5(0.8 – 1.8)0.0(0.0 – 1.2)RA(n = 75)7.6(3.1 – 14.8)3.5(1.3 – 11.6)0.2(0.0 – 2.5)1.3(0.6 – 1.6)0.0(0.0 – 0.2)AxSpA(n = 40)38.7(9.6 – 66.7)26.6(4.2 – 56.1)1.6(0.0 – 7.6)1.6(1.2 – 2.3)0.0(0.0 – 2.0)PsA(n = 35)7.0(3.0 – 28.4)2.6(0.2 – 11.3)0.5(0.2 – 3.9)1.6(0.6 – 1.7)0.0(0.0 – 0.0)Seronegative IA(n = 21)12.0(4.7 – 22.8)6.4(1.9 – 34.4)0.1(0.0 – 4.6)1.4(1.3 – 1.5)0.0(0.0 – 0.8)SjS(n = 27)14.2(6.0 – 48.0)4.6(0.6 – 19.0)0.3(0.0 – 3.9)1.6(0.9 – 1.9)0.8(0.0 – 2.3)UCTD(n = 27)15.7(5.1 – 39.8)2.2(0.7 – 24.0)0.8(0.1 – 8.1)1.6(0.5 – 1.8)1.2(0.0 – 2.1)Other ARDs(n = 34)8.1(5.3 – 36.0)6.3(0.9 – 31.7)0.2(0.0 – 1.1)1.5(1.2 – 1.8)0.3(0.0 – 1.1)Overall interval and Intervals #1-4: refer to abstract for definitions; RA: rheumatoid arthritis; axSpA: axial spondyloarthritis; PsA: psoriatic arthritis; IA: inflammatory arthritis; SjS: Sjögren’s syndrome; UCTD: undifferentiated connective tissue disease; other ARDs: systemic lupus erythematosus, systemic sclerosis, idiopathic inflammatory myopathies, palindromic rheumatism and overlap syndromes.†Intervals #1-4 did not sum to the overall interval mainly due to the fact that Intervals #1-4 might not available for all patients.Disclosure of Interests:None declared
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Mave V, Kadam D, Gaikwad S, Kinikar A, Aguilar D, Chavan A, Paradkar M, Yogendra SVB, Bharadwaj R, Kagal A, Suryavanshi N, Golub J, Kulkarni V, Dooley KE, Gupta A, Bacchetti P, Gerona R, Gupte N, Gandhi M. Measuring TB drug levels in the hair in adults and children to monitor drug exposure and outcomes. Int J Tuberc Lung Dis 2021; 25:52-60. [PMID: 33384045 DOI: 10.5588/ijtld.20.0574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION: Testing for anti-TB drugs in small hair samples may serve as a non-invasive tool to measure cumulative drug exposure and/or adherence, as these determine treatment success. We aimed to assess how well hair assays of TB drugs predict TB treatment outcomes.METHODS: A small thatch of hair, ~30 strands, was cut from the occipital region in adults and children from a prospective TB cohort in India. Isoniazid (INH), acetyl-INH and pyrazinamide (PZA) were extracted from the hair samples and quantified using liquid-chromatography-tandem mass spectrometry. The relationship between drug concentrations in hair and time to unfavourable outcomes was assessed using Cox-proportional hazards regression models.RESULTS: A two-fold increase in hair acetyl-INH concentrations in the 264 participants in our cohort with hair assays for TB drugs indicated a lower hazard of unfavourable TB treatment outcomes (aHR 0.67, 95%CI 0.44-1.02) and TB treatment failure (aHR 0.65, 95%CI 0.42-1.01). Higher summed concentrations (a summed measure of INH and acetyl-INH) indicated a lower hazard of treatment failure (aHR 0.69, 95%CI 0.45-1.05)CONCLUSION: Hair levels of INH and its metabolite may predict TB treatment outcomes, indicating the potential utility of this measure to assess and optimise TB treatment outcomes.
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Affiliation(s)
- V Mave
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India, Johns Hopkins University School of Medicine, Baltimore, MD
| | - D Kadam
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - S Gaikwad
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - A Kinikar
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - D Aguilar
- University of California, San Francisco, CA, USA
| | - A Chavan
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - M Paradkar
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - S V B Yogendra
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - R Bharadwaj
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - A Kagal
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - N Suryavanshi
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - J Golub
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - V Kulkarni
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - K E Dooley
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - A Gupta
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India, Johns Hopkins University School of Medicine, Baltimore, MD
| | - P Bacchetti
- University of California, San Francisco, CA, USA
| | - R Gerona
- University of California, San Francisco, CA, USA
| | - N Gupte
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India, Johns Hopkins University School of Medicine, Baltimore, MD
| | - M Gandhi
- University of California, San Francisco, CA, USA
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11
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Sastry AC, Gandhi M, Clark SL, Whitehead WE, Mann DG, Sutton CD. Fetal heart rate mirrors maternal temperature during posterior fossa craniotomy: a case report. Int J Obstet Anesth 2021; 47:103193. [PMID: 34144352 DOI: 10.1016/j.ijoa.2021.103193] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 04/27/2021] [Accepted: 05/19/2021] [Indexed: 11/15/2022]
Abstract
While it is well known that maternal temperature affects fetal heart rate, the exact relationship is not well described. The circumstances accompanying most cases of maternal hypothermia and rewarming (e.g. a drowning event) have precluded a precise quantitative description of this relationship. We describe hypothermia and controlled rewarming during resection of a maternal brain stem tumor in the early third trimester. Continuous electronic fetal heart rate and core temperature monitoring demonstrated a near linear relationship during the development of hypothermia and rewarming. Recognition of the close relationship between maternal temperature and fetal heart rate can help safeguard maternal and fetal health, and prevent unnecessary delivery during non-obstetric surgery in pregnancy.
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Affiliation(s)
- A C Sastry
- Department of Obstetrics and Gynecology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - M Gandhi
- Department of Obstetrics and Gynecology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - S L Clark
- Department of Obstetrics and Gynecology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - W E Whitehead
- Department of Neurosurgery, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - D G Mann
- Department of Anesthesiology, Perioperative, and Pain Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - C D Sutton
- Department of Anesthesiology, Perioperative, and Pain Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
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12
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Joshi M, Puvar A, Kumar D, Ansari A, Pandya M, Raval J, Patel Z, Trivedi P, Gandhi M, Pandya L, Patel K, Savaliya N, Bagatharia S, Kumar S, Joshi C. Genomic Variations in SARS-CoV-2 Genomes From Gujarat: Underlying Role of Variants in Disease Epidemiology. Front Genet 2021; 12:586569. [PMID: 33815459 PMCID: PMC8017293 DOI: 10.3389/fgene.2021.586569] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 02/15/2021] [Indexed: 12/19/2022] Open
Abstract
Humanity has seen numerous pandemics during its course of evolution. The list includes several incidents from the past, such as measles, Ebola, severe acute respiratory syndrome (SARS), and Middle East respiratory syndrome (MERS), etc. The latest edition to this is coronavirus disease 2019 (COVID-19), caused by the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As of August 18, 2020, COVID-19 has affected over 21 million people from 180 + countries with 0.7 million deaths across the globe. Genomic technologies have enabled us to understand the genomic constitution of pathogens, their virulence, evolution, and rate of mutation, etc. To date, more than 83,000 viral genomes have been deposited in public repositories, such as GISAID and NCBI. While we are writing this, India is the third most affected country by COVID-19, with 2.7 million cases and > 53,000 deaths. Gujarat is the 11th highest affected state with a 3.48% death rate compared to the national average of 1.91%. In this study, a total of 502 SARS-CoV-2 genomes from Gujarat were sequenced and analyzed to understand its phylogenetic distribution and variants against global and national sequences. Further variants were analyzed from diseased and recovered patients from Gujarat and the world to understand its role in pathogenesis. Among the missense mutations present in the Gujarat SARS-CoV-2 genomes, C28854T (Ser194Leu) had an allele frequency of 47.62 and 7.25% in deceased patients from the Gujarat and global datasets, respectively. In contrast, the allele frequency of 35.16 and 3.20% was observed in recovered patients from the Gujarat and global datasets, respectively. It is a deleterious mutation present in the nucleocapsid (N) gene and is significantly associated with mortality in Gujarat patients with a p-value of 0.067 and in the global dataset with a p-value of 0.000924. The other deleterious variant identified in deceased patients from Gujarat (p-value of 0.355) and the world (p-value of 2.43E-06) is G25563T, which is located in Orf3a and plays a potential role in viral pathogenesis. SARS-CoV-2 genomes from Gujarat are forming distinct clusters under the GH clade of GISAID. This study will shed light on the viral haplotype in SARS-CoV-2 samples from Gujarat, India.
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Affiliation(s)
- Madhvi Joshi
- Gujarat Biotechnology Research Centre (GBRC), Department of Science & Technology (DST), Gandhinagar, India
| | - Apurvasinh Puvar
- Gujarat Biotechnology Research Centre (GBRC), Department of Science & Technology (DST), Gandhinagar, India
| | - Dinesh Kumar
- Gujarat Biotechnology Research Centre (GBRC), Department of Science & Technology (DST), Gandhinagar, India
| | - Afzal Ansari
- Gujarat Biotechnology Research Centre (GBRC), Department of Science & Technology (DST), Gandhinagar, India
| | - Maharshi Pandya
- Gujarat Biotechnology Research Centre (GBRC), Department of Science & Technology (DST), Gandhinagar, India
| | - Janvi Raval
- Gujarat Biotechnology Research Centre (GBRC), Department of Science & Technology (DST), Gandhinagar, India
| | - Zarna Patel
- Gujarat Biotechnology Research Centre (GBRC), Department of Science & Technology (DST), Gandhinagar, India
| | - Pinal Trivedi
- Gujarat Biotechnology Research Centre (GBRC), Department of Science & Technology (DST), Gandhinagar, India
| | - Monika Gandhi
- Gujarat Biotechnology Research Centre (GBRC), Department of Science & Technology (DST), Gandhinagar, India
| | - Labdhi Pandya
- Gujarat Biotechnology Research Centre (GBRC), Department of Science & Technology (DST), Gandhinagar, India
| | - Komal Patel
- Gujarat Biotechnology Research Centre (GBRC), Department of Science & Technology (DST), Gandhinagar, India
| | - Nitin Savaliya
- Gujarat Biotechnology Research Centre (GBRC), Department of Science & Technology (DST), Gandhinagar, India
| | | | - Sachin Kumar
- Indian Institute of Technology Guwahati, Guwahati, India
| | - Chaitanya Joshi
- Gujarat Biotechnology Research Centre (GBRC), Department of Science & Technology (DST), Gandhinagar, India
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13
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Almaghrabi MM, Gandhi M, Guizzetti L, Iansavitchene A, Oakland K, Jairath V, Sey M. A115 A SYSTEMATIC REVIEW AND META-ANALYSIS OF LOWER GASTROINTESTINAL BLEEDING RISK SCORES TO PREDICT ADVERSE OUTCOMES. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Acute lower gastrointestinal bleeding (LGIB) is a common reason for emergency hospitalization. In most patients, bleeding resolves spontaneously but some cases can be fatal. Risk prediction scores can be useful in risk stratifying patients with LGIB at the time of presentation although the most discriminative LGIB risk score is unknown.
Aims
To perform a systematic review and meta-analysis comparing LGIB risk prediction scores.
Methods
Following the PRISMA statement, a systematic search for relevant publications after 1990 was conducted in Ovid Medline, EMBASE, Web of Science and CENTRAL electronic databases. We also searched published conference abstracts over the past 5 years. Studies with a primary aim of deriving or validating a LGIB risk score were included. Title and abstracts were reviewed by two independent reviewers followed by full text review and data extraction by both reviewers. Diagnostic classification data for combinations of risk score and clinical outcome were meta-analyzed using a hierarchical summary receiver operator characteristic curve (ROC) model, allowing for random-effects by study, and fixed-effect of the risk score thresholds to influence both sensitivity and specificity. Area under the summary ROC were estimated from model parameters for the pre-specified LGIB risk score thresholds-of-interest.
Results
Our search identified 2,331 citations for review, of which 100 remained after the title and abstract screen, and 18 ultimately met criteria for inclusion in the meta-analysis after full text review. From these, we identified 21 risk prediction scores for LGIB, although only four had sufficient number of papers to meta-analyze (Oakland, Strate, NOBLADS, and BLEED score). For the outcome safe discharge from hospital, the Oakland score had an area under the receiver operating characteristics curve (AUROC) of 85.5% (95% CI: 82.1%, 88.3%). For the outcome major bleeding, the Oakland score had an AUROC of 78.9% (95% CI: 75.1%, 82.2%); the Strate score had an AUROC of 74.4% (95% CI: 70.4%, 78.0%); the NOBLADS score had an AUROC of 60.3% (95% CI: 55.9%, 64.5%); and the BLEED score had an AUROC of 65.6% (95% CI: 61.4%, 69.7%). For the outcome, need for hemostasis, the Oakland had an AUROC of 99.0% (95% CI: 97.7%, 99.6%); the Strate score had an AUROC of 82.1% (95% CI: 78.5%, 85.2%); the NOBLADS score had an AUROC of 23.9% (95% CI: 20.3%, 27.8%). For the outcome, need for transfusion, the Oakland score had an AUROC of 99.0% (95% CI: 97.7%, 99.6%); the NOBLADS score had an AUROC of 87.7% (95% CI: 84.5%, 90.3%).
Conclusions
The Oakland score was the most discriminative risk prediction model for safe discharge from hospital, major bleeding, need for hemostasis, and need for transfusion.
Funding Agencies
None
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Affiliation(s)
| | - M Gandhi
- Grand River Hospital, Kitchener, ON, Canada
| | | | | | - K Oakland
- HCA International Ltd, London, London, United Kingdom
| | - V Jairath
- Medicine, Western University, London, ON, Canada
| | - M Sey
- Western University, London, ON, Canada
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Russo ML, Gandhi M, Al-Kouatly HB, Morris SA. Prenatal ultrasound features of Loeys-Dietz syndrome Type 4. Ultrasound Obstet Gynecol 2021; 57:504-506. [PMID: 32119163 PMCID: PMC8274625 DOI: 10.1002/uog.22003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/21/2020] [Accepted: 02/26/2020] [Indexed: 06/10/2023]
Affiliation(s)
- M L Russo
- Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Women and Infants Hospital of Rhode Island, Providence, RI, USA
| | - M Gandhi
- Department of Obstetrics and Gynecology, Texas Children's Pavilion for Women and Baylor College of Medicine, Houston, TX, USA
| | - H B Al-Kouatly
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA
| | - S A Morris
- Section of Cardiology, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA
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15
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Batham S, Yadav R, Roy P, Toprani R, Jani K, Gandhi M, Hirapara P. PO-0825: To analyze the feasibility, effectiveness and toxicity of re-irradiation in head and neck cancers. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00842-2] [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: 11/30/2022]
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16
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Hirapara P, Patidar A, Viroliya K, Jani K, Batham S, Jain M, Gandhi M. PO-0797: Postoperative radiation to open head and neck wounds. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00814-8] [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]
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17
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Batham S, Yadav R, Kothari J, Jani K, Roy P, Gandhi M, Hirapara P, Parikh D, Kaushal A, Lavingia V. PO-1067: Outcomes of combined modality treatment in resectable esophageal carcinoma patients. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01084-7] [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]
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18
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McDonald V, Gandhi M, Wang Y, Black D. Physician's opinions regarding salpingectomy as a risk-reducing procedure for ovarian cancer. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.087] [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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Shamshirsaz AA, Lee TC, Hair AB, Erfani H, Espinoza J, Shamshirsaz AA, Fox KA, Gandhi M, Nassr AA, Abrams SA, Mccullough LB, Chervenak FA, Olutoye OO, Belfort MA. Elective delivery at 34 weeks vs routine obstetric care in fetal gastroschisis: randomized controlled trial. Ultrasound Obstet Gynecol 2020; 55:15-19. [PMID: 31503365 DOI: 10.1002/uog.21871] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 05/21/2019] [Revised: 08/26/2019] [Accepted: 08/30/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To evaluate whether elective preterm delivery (ED) at 34 weeks is of postnatal benefit to infants with isolated gastroschisis compared with routine obstetric care (RC). METHODS Between May 2013 and September 2015, all women with a sonographic diagnosis of fetal gastroschisis referred to a single tertiary center, before 34 weeks' gestation, were invited to participate in this study. Eligible patients were randomized to ED (induction of labor at 34 weeks) or RC (spontaneous labor or delivery by 37-38 weeks, based on standard obstetric indications). The primary outcome measure was length of time on total parenteral nutrition (TPN). Secondary outcomes were time to closure of gastroschisis and length of stay in hospital. Outcome variables were compared using appropriate statistical methods. Analysis was based on intention-to-treat. RESULTS Twenty-five women were assessed for eligibility, of whom 21 (84%; 95% CI, 63.9-95.5%) agreed to participate in the study; of these, 10 were randomized to ED and 11 to RC. The trial was stopped at the first planned interim analysis due to patient safety concerns and for futility; thus, only 21 of the expected 86 patients (24.4%; 95% CI, 15.8-34.9%) were enrolled. Median gestational age at delivery was 34.3 (range, 34-36) weeks in the ED group and 36.7 (range, 27-38) weeks in the RC group. One patient in the ED group delivered at 36 weeks following unsuccessful induction at 34 weeks. Neonates of women who underwent ED, compared to those in the RC group, showed no difference in the median number of days on TPN (54 (range, 17-248) vs 21 (range, 9-465) days; P = 0.08), number of days to closure of gastroschisis (7 (range, 0-15) vs 5 (range, 0-8) days; P = 0.28) and length of stay in hospital (70.5 (range, 22-137) vs 31 (range, 19-186) days; P = 0.15). However, neonates in the ED group were significantly more likely to experience late-onset sepsis compared with those in the RC group (40% (95% CI, 12.2-73.8%) vs 0%; P = 0.03). CONCLUSION This study demonstrates no benefit of ED of fetuses with gastroschisis when postnatal gastroschisis management is similar to that used in routine care. Rather, the data suggest that ED is detrimental to infants with gastroschisis. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- A A Shamshirsaz
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - T C Lee
- Division of Pediatric Surgery, Department of Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - A B Hair
- Division of Pediatric Surgery, Department of Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - H Erfani
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - J Espinoza
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - A A Shamshirsaz
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - K A Fox
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - M Gandhi
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - A A Nassr
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - S A Abrams
- University of Texas at Austin, Austin, TX, USA
| | - L B Mccullough
- Department of Obstetrics and Gynecology, Weill Medical College of Cornell University/New York Presbyterian Hospital, New York, NY, USA
| | - F A Chervenak
- Department of Obstetrics and Gynecology, Weill Medical College of Cornell University/New York Presbyterian Hospital, New York, NY, USA
| | - O O Olutoye
- Division of Pediatric Surgery, Department of Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - M A Belfort
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
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Shaikh I, Ansari A, Ayachit G, Gandhi M, Sharma P, Bhairappanavar S, Joshi CG, Das J. Differential gene expression analysis of HNSCC tumors deciphered tobacco dependent and independent molecular signatures. Oncotarget 2019; 10:6168-6183. [PMID: 31692905 PMCID: PMC6817442 DOI: 10.18632/oncotarget.27249] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 09/16/2019] [Indexed: 12/15/2022] Open
Abstract
Head and neck cancer is the sixth most common cancer worldwide, with tobacco as the leading cause. However, it is increasing in non-tobacco users also, hence limiting our understanding of its underlying molecular mechanisms. RNA-seq analysis of cancers has proven as effective tool in understanding disease etiology. In the present study, RNA-Seq of 86 matched Tumor/Normal pairs, of tobacco smoking (TOB) and non-smokers (N-TOB) HNSCC samples analyzed, followed by validation on 375 similar datasets. Total 2194 and 2073 differentially expressed genes were identified in TOB and N-TOB tumors, respectively. GO analysis found muscle contraction as the most enriched biological process in both TOB and N-TOB tumors. Pathway analysis identified muscle contraction and salivary secretion pathways enriched in both categories, whereas calcium signaling and neuroactive ligand-receptor pathway was more enriched in TOB and N-TOB tumors respectively. Network analysis identified muscle development related genes as hub node i. e. ACTN2, MYL2 and TTN in both TOB and N-TOB tumors, whereas EGFR and MYH6, depicts specific role in TOB and N-TOB tumors. Additionally, we found enriched gene networks possibly be regulated by tumor suppressor miRNAs such as hsa-miR-29/a/b/c, hsa-miR-26b-5p etc., suggestive to be key riboswitches in regulatory cascade of HNSCC. Interestingly, three genes PKLR, CST1 and C17orf77 found to show opposite regulation in each category, hence suggested to be key genes in separating TOB from N-TOB tumors. Our investigation identified key genes involved in important pathways implicated in tobacco dependent and independent carcinogenesis hence may help in designing precise HNSCC diagnostics and therapeutics strategies.
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Affiliation(s)
- Inayatullah Shaikh
- Gujarat Biotechnology Research Centre (GBRC), Department of Science and Technology (DST), Government of Gujarat, Gandhinagar 382011, India
| | - Afzal Ansari
- Gujarat Biotechnology Research Centre (GBRC), Department of Science and Technology (DST), Government of Gujarat, Gandhinagar 382011, India
| | - Garima Ayachit
- Gujarat Biotechnology Research Centre (GBRC), Department of Science and Technology (DST), Government of Gujarat, Gandhinagar 382011, India
| | - Monika Gandhi
- Gujarat Biotechnology Research Centre (GBRC), Department of Science and Technology (DST), Government of Gujarat, Gandhinagar 382011, India
| | - Priyanka Sharma
- Gujarat Biotechnology Research Centre (GBRC), Department of Science and Technology (DST), Government of Gujarat, Gandhinagar 382011, India
| | - Shivarudrappa Bhairappanavar
- Gujarat Biotechnology Research Centre (GBRC), Department of Science and Technology (DST), Government of Gujarat, Gandhinagar 382011, India
| | - Chaitanya G Joshi
- Gujarat Biotechnology Research Centre (GBRC), Department of Science and Technology (DST), Government of Gujarat, Gandhinagar 382011, India
| | - Jayashankar Das
- Gujarat Biotechnology Research Centre (GBRC), Department of Science and Technology (DST), Government of Gujarat, Gandhinagar 382011, India
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Witzig T, Maddocks K, de Vos S, Lyons R, Edenfield W, Sharman J, Vose J, Yimer H, Wei H, Chan E, Patel P, Di Simone C, Gandhi M, Vaughn J, Kolibaba K, Cheson B, Samaniego F. ACALABRUTINIB PLUS PEMBROLIZUMAB IN RELAPSED/REFRACTORY DIFFUSE LARGE B-CELL LYMPHOMA: A PHASE 1/2 STUDY. Hematol Oncol 2019. [DOI: 10.1002/hon.139_2630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- T.E. Witzig
- Division of Hematology; Mayo Clinic; Rochester MN United States
| | - K. Maddocks
- Internal Medicine; Ohio State University; Columbus United States
| | - S. de Vos
- Assistant Professor; Medicine, David Geffen School of Medicine at University of California Los Angeles; Los Angeles United States
| | - R. Lyons
- Hematology; Texas Oncology-San Antonio Medical Center, US Oncology Research; San Antonio United States
| | - W. Edenfield
- Hematology and Oncology; Greenville Health System Cancer Institute; Greenville United States
| | - J. Sharman
- Hematology; Willamette Valley Cancer Institute and Research Center, US Oncology Research; Eugene United States
| | - J. Vose
- Internal Medicine; Nebraska Medical Center; Omaha United States
| | - H. Yimer
- Hematology; Texas Oncology-Tyler, US Oncology Research; Tyler United States
| | - H. Wei
- Bio statistics; Acerta Pharma; South San Francisco United States
| | - E. Chan
- Clinical Director; Acerta Pharma; South San Francisco United States
| | - P. Patel
- Clinical Director; Acerta Pharma; South San Francisco United States
| | - C. Di Simone
- Medical Oncology & Hematology; Arizona Oncology, US Oncology Research; Tucson United States
| | - M. Gandhi
- Medical Oncologist; Virginia Cancer Specialists, US Oncology Research; Woodbridge United States
| | - J. Vaughn
- Hematology; Fred Hutchinson Cancer Research Center; Seattle United States
| | - K. Kolibaba
- Medical Oncology & Hematology; Northwest Cancer Specialists, US Oncology Research; Vancouver United States
| | - B. Cheson
- Division of Hematology and Oncology; Georgetown University Hospital; Washington DC United States
| | - F. Samaniego
- Department of Lymphoma/Myeloma; The University of Texas MD Anderson Cancer Center, Houston; United States
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22
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Brandt B, Sioulas V, LaVigne K, Shahin M, Bruce S, Black D, Gandhi M, Scalici J, Jones N, Paladugu R, Brown J, Levine M, Naumann R, Mendivil A, Goldstein B, Lim P, Kang E, Cantrell L, Sullivan M, Abu-Rustum N, Leitao M. Multicenter study of minimally invasive surgery versus laparotomy for radical hysterectomy in the management of early-stage cervical cancer: Survival outcomes. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.063] [Citation(s) in RCA: 1] [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: 10/26/2022]
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23
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Gandhi M, Cocco S, McDonald C, Hindi Z, Chakraborty D, French K, Siddiqi O, Blier M, Markandey B, Siebring V, Brahmania M, Khanna N, Jairath V, Yan B, Sey M. A276 CLINCAL PREDICTORS FOR SESSILE SERRATED ADENOMA DETECTION: AN ANALYSIS OF 17,524 COLONOSCOPIES. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Gandhi
- Department of Gastroenterology, Western University, London, ON, Canada
| | - S Cocco
- Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - C McDonald
- Department of Gastroenterology, Western University, London, ON, Canada
| | - Z Hindi
- Department of Medicine, Western University, London, ON, Canada
| | - D Chakraborty
- Department of Medicine, Western University, London, ON, Canada
| | - K French
- Department of Pathology, Western University, London, ON, Canada
| | | | - M Blier
- Department of Medicine, Western University, London, ON, Canada
| | - B Markandey
- Department of Medicine, Western University, London, ON, Canada
| | - V Siebring
- Southwest Ontario Regional Cancer Program, London, ON, Canada
| | - M Brahmania
- Department of Gastroenterology, Western University, London, ON, Canada
| | - N Khanna
- Department of Gastroenterology, Western University, London, ON, Canada
| | - V Jairath
- Department of Gastroenterology, Western University, London, ON, Canada
| | - B Yan
- Department of Gastroenterology, Western University, London, ON, Canada
| | - M Sey
- Department of Gastroenterology, Western University, London, ON, Canada
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24
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von Pawel J, Bordoni R, Satouchi M, Fehrenbacher L, Cobo M, Han J, Hida T, Moro-Sibilot D, Conkling P, Gandara D, Rittmeyer A, Gandhi M, Yu W, Matheny C, Patel H, Sandler A, Ballinger M, Kowanetz M, Park K. Long-term survival in patients with advanced non–small-cell lung cancer treated with atezolizumab versus docetaxel: Results from the randomised phase III OAK study. Eur J Cancer 2019; 107:124-132. [DOI: 10.1016/j.ejca.2018.11.020] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 11/09/2018] [Indexed: 01/05/2023]
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25
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Rothenstein J, Spira A, Velcheti V, Natale R, Kozloff M, Kosty M, Goldschmidt J, Mazieres J, Ponce Aix S, Yu W, Gandhi M, Lee A, Shankar G, Lin W, Thomas C. P1.01-83 IMpower150: Impact of Chemotherapy Cycles in 1L Metastatic NSCLC in Patients Treated With Atezolizumab + Bevacizumab. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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26
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Rusch V, Chaft J, Johnson B, Wistuba I, Kris M, Lee J, Bunn P, Kwiatkowski D, Reckamp K, Finley D, Haura E, Waqar S, Doebele R, Garon E, Blasberg J, Nicholas A, Schulze K, Phan S, Gandhi M, Carbone D. MA04.09 Neoadjuvant Atezolizumab in Resectable Non-Small Cell Lung Cancer (NSCLC): Updated Results from a Multicenter Study (LCMC3). J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.346] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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27
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Teivaanmäki T, Cheung YB, Maleta K, Gandhi M, Ashorn P. Depressive symptoms are common among rural Malawian adolescents. Child Care Health Dev 2018; 44:531-538. [PMID: 29667219 DOI: 10.1111/cch.12567] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 02/21/2018] [Accepted: 03/17/2018] [Indexed: 12/30/2022]
Affiliation(s)
- T Teivaanmäki
- Center for Child Health Research, University of Tampere, Faculty of Medicine and Life, Tampere, Finland.,Department of Paediatrics, Helsinki University Hospital, Helsinki, Finland
| | - Y B Cheung
- Centre for Quantitative Medicine, Duke-National University of Singapore Medical School, Singapore, Singapore
| | - K Maleta
- School Of Public Health and Family Medicine, College Of Medicine, University of Malawi, Blantyre, Malawi
| | - M Gandhi
- Center for Child Health Research, University of Tampere, Faculty of Medicine and Life, Tampere, Finland.,Centre for Quantitative Medicine, Duke-National University of Singapore Medical School, Singapore, Singapore.,Head of Biostatisctics, Singapore Clinical Research Institute, Singapore, Singapore
| | - P Ashorn
- Center for Child Health Research, University of Tampere, Faculty of Medicine and Life Sciences and Tampere University Hospital, Department of Paediatrics, Tampere, Finland
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28
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WONG K, Smith B, Taner T, Kushwaha S, Edwards B, Gandhi M, Kremers W, Daly R, Pereira N. Development of Rejection Risk Prediction Model by Routine Monitoring for De-novo Donor Specific Antibodies After Heart Transplantation. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.365] [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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29
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Gandhi M, Stitt L, Gregor JC. A126 SERUM ADALIMUMAB LEVELS IN CROHN DISEASE. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy009.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Gandhi
- Medicine, Western University, London, ON, Canada
| | - L Stitt
- Medicine, Western University, London, ON, Canada
| | - J C Gregor
- Medicine, Los Alamos National Laboratory, London, ON, Canada
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30
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Gandhi M, Stitt L, Gregor JC. A282 DOES SERUM ADALIMUMAB LEVEL CORRELATE WITH DISEASE SEVERITY IN PATIENTS WITH CROHN’S DISEASE? J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Gandhi
- Medicine, Western University, London, ON, Canada
| | - L Stitt
- Western University, London, ON, Canada
| | - J C Gregor
- Medicine, Western University, London, ON, Canada
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31
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Mave V, Chandanwale A, Kinikar A, Khadse S, Kagal A, Gupte N, Suryavanshi N, Nimkar S, Koli H, Khwaja S, Bharadwaj R, Joshi S, Horng H, Benet LZ, Ramachandran G, Dooley KE, Gupta A, Gandhi M. Isoniazid hair concentrations in children with tuberculosis: a proof of concept study. Int J Tuberc Lung Dis 2018; 20:844-7. [PMID: 27155191 PMCID: PMC4889729 DOI: 10.5588/ijtld.15.0882] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Assessing treatment adherence and quantifying exposure to anti-tuberculosis drugs among children is challenging. We undertook a 'proof of concept' study to assess the drug concentrations of isoniazid (INH) in hair as a therapeutic drug monitoring tool. Children aged <12 years initiated on a thrice-weekly treatment regimen including INH (10 mg/kg) for newly diagnosed tuberculosis were enrolled. INH concentrations in hair were measured using liquid chromatography-tandem mass spectrometry at 1, 2, 4 and 6 months after initiating anti-tuberculosis treatment. We found that INH hair concentrations in all children on thrice-weekly INH were detectable and displayed variability across a dynamic range.
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Affiliation(s)
- V Mave
- Byramjee-Jeejeebhoy Medical College Clinical Trials Unit, Pune, India; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - A Chandanwale
- Byramjee-Jeejeebhoy Medical College Clinical Trials Unit, Pune, India
| | - A Kinikar
- Byramjee-Jeejeebhoy Medical College Clinical Trials Unit, Pune, India
| | - S Khadse
- Byramjee-Jeejeebhoy Medical College Clinical Trials Unit, Pune, India
| | - A Kagal
- Byramjee-Jeejeebhoy Medical College Clinical Trials Unit, Pune, India
| | - N Gupte
- Byramjee-Jeejeebhoy Medical College Clinical Trials Unit, Pune, India; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - N Suryavanshi
- Byramjee-Jeejeebhoy Medical College Clinical Trials Unit, Pune, India
| | - S Nimkar
- Byramjee-Jeejeebhoy Medical College Clinical Trials Unit, Pune, India
| | - H Koli
- Byramjee-Jeejeebhoy Medical College Clinical Trials Unit, Pune, India
| | - S Khwaja
- Byramjee-Jeejeebhoy Medical College Clinical Trials Unit, Pune, India
| | - R Bharadwaj
- Byramjee-Jeejeebhoy Medical College Clinical Trials Unit, Pune, India
| | - S Joshi
- Byramjee-Jeejeebhoy Medical College Clinical Trials Unit, Pune, India
| | - H Horng
- University of California, San Francisco, California, USA
| | - L Z Benet
- University of California, San Francisco, California, USA
| | - G Ramachandran
- National Institute of Research in Tuberculosis, Chennai, India
| | - K E Dooley
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - A Gupta
- Byramjee-Jeejeebhoy Medical College Clinical Trials Unit, Pune, India; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - M Gandhi
- University of California, San Francisco, California, USA
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32
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Kumar M, Akshat V, Kanwariya A, Gandhi M. A Prospective Study to Evaluate the Management of Sub-trochanteric Femur Fractures with Long Proximal Femoral Nail. Malays Orthop J 2018; 11:36-41. [PMID: 29326764 PMCID: PMC5753526 DOI: 10.5704/moj.1711.014] [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] [Indexed: 11/05/2022] Open
Abstract
Introduction: Sub-trochanteric fractures of the femur remains one of the most challenging fractures faced by orthopaedic surgeons. This study was done to analyse the management and complications of sub-trochanteric fractures using long proximal femoral nail (PFN). Materials and Methods: This was a prospective study of 50 patients with sub-trochanteric fractures of femur who were treated with long PFN at a tertiary care center from July 2012 to June 2016. The fractures were classified according to Seinsheimer classification. All patients were assessed functionally by Harris Hip Score. Results: Average duration of union was 17.08 weeks (range 13 to 32 weeks), union was achieved in 92% cases. Closed reduction was achieved in 68% cases and open reduction was required in 32% cases. Various intraoperative complications were seen in 12% and delayed complications in 26% of cases. Good anatomical results were achieved in 86% of cases and 14% were fair. As per Harris Hip score, excellent results were noted in 28% cases, good in 56% cases and fair in 16% cases. Conclusion: The long PFN is a reliable implant for subtrochanteric femur fractures, with high rate of bone union and minimal soft tissue damage. Intramedullary fixation has biological and biomechanical advantages, but the surgery is technically demanding.
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Affiliation(s)
- M Kumar
- Department of Orthopaedics, Dr SN Medical College and Hospital, Jodhpur, India
| | - V Akshat
- Department of Orthopaedics, Jhalawar Hospital and Medical College, Jhalawar, India
| | - A Kanwariya
- Department of Anaesthesia, Dr SN Medical College and Hospital, Jodhpur, India
| | - M Gandhi
- Department of Paediatric Dentistry, Government Dental College, Jaipur, India
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33
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Park K, Lewanski C, Gadgeel S, Fehrenbacher L, Mazieres J, Rittmeyer A, Han J, Artal-Cortes A, Braiteh F, Gandhi M, Yu W, Matheny C, He P, Sandler A, Ballinger M, Vansteenkiste J. MA 10.03 3-Year Survival and Duration of Response in Randomized Phase II Study of Atezolizumab vs Docetaxel in 2L/3L NSCLC (POPLAR). J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.535] [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: 11/26/2022]
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34
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Ross H, Kozono D, Urbanic J, Williams T, Dufrane C, Bara I, Gandhi M, Schulze K, Brockman J, Wang X, Vokes E, Stinchcombe T. P3.04-003 Phase II Trial of Atezolizumab Before and After Definitive Chemoradiation for Patients with Unresectable Stage III NSCLC. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1661] [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: 11/17/2022]
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35
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Satouchi M, Fehrenbacher L, Dols MC, Han J, Von Pawel J, Bordoni R, Hida T, Park K, Moro-Sibilot D, Conkling P, Matheny C, Yu W, He P, Kowanetz M, Gandhi M, Ballinger M, Sandler A, Gandara D. OA 17.07 Long-Term Survival in Atezolizumab-Treated Patients with 2L+ NSCLC from Ph III Randomized OAK Study. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.432] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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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36
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Gandhi M. Use of sponge heel boots as a temporary splint for paediatric elbow supracondylar fractures. Ann R Coll Surg Engl 2017; 100:79-80. [PMID: 29022809 DOI: 10.1308/rcsann.2017.0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- M Gandhi
- Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust , UK
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37
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de Marinis F, Barlesi F, Rittmeyer A, von Pawel J, Han JY, Kozloff M, Spira A, Fehrenbacher L, Gandara D, Yu W, He P, Yun C, Ballinger M, Gandhi M, Gadgeel S. Survival and safety of atezolizumab by best overall response (BOR) in the phase III NSCLC OAK study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx380.013] [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: 11/14/2022] Open
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38
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von Pawel J, Syrigos K, Mazieres J, Cortinovis D, Dziadziuszko R, Gandara D, Conkling P, Goldschmidt J, Thomas C, Bordoni R, Kosty M, Braiteh F, Hu S, Ballinger M, Patel H, Gandhi M, Fehrenbacher L. Association between immune-related adverse events (irAEs) and atezolizumab efficacy in advanced NSCLC: analyses from the phase III study OAK. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx380.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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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39
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Jafar T, Gandhi M, Naheed A, Jehan I, De Silva H, Finkelstein E, Quigley H, Ebrahim S, Khan A, Clemens J, Kasturiratne A. P6256Large cardiovascular risk burden in rural Bangladesh, Pakistan, and Sri Lanka: design and preliminary findings in a Cluster Randomized Controlled Trial (COBRA-BPS). Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T.H. Jafar
- Duke-NUS Graduate Medical School Singapore, HSSR, Singapore, Singapore
| | - M. Gandhi
- Duke-NUS Graduate Medical School Singapore, HSSR, Singapore, Singapore
| | - A. Naheed
- International Centre for Diarrhoeal Disease Research, Bangladesh, Bangladesh, Bangladesh
| | - I. Jehan
- Aga Khan University, Karachi, Pakistan
| | - H.A. De Silva
- University of Kelaniya, Faculty of Medicine, University of Kelaniya, Colombo, Sri Lanka
| | - E. Finkelstein
- Duke-NUS Graduate Medical School Singapore, HSSR, Singapore, Singapore
| | - H.L. Quigley
- National University of Singapore, Singapore, Singapore
| | - S. Ebrahim
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - A.H. Khan
- Aga Khan University, Karachi, Pakistan
| | - J. Clemens
- International Centre for Diarrhoeal Disease Research, Bangladesh, Bangladesh, Bangladesh
| | - A. Kasturiratne
- University of Kelaniya, Faculty of Medicine, University of Kelaniya, Colombo, Sri Lanka
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Pereira N, Valero MJ, Wong M, Kushwaha S, Smith B, Kremers W, Gandhi M, Richard D. De Novo Donor Specific Antibodies (dnDSA) Is Associated with Cardiac Allograft Hypertrophy After Heart Transplantation (HT). J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.603] [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: 10/19/2022] Open
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41
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Lukas R, Gandhi M, O’Hear C, Hu S, Lai C, Patel J. Safety and efficacy analyses of atezolizumab in advanced non-small cell lung cancer (NSCLC) patients with or without baseline brain metastases. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx091.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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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42
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Gandhi M, Koelle DM, Ameli N, Bacchetti P, Greenspan JS, Navazesh M, Anastos K, Greenblatt RM. Prevalence of Human Herpesvirus-8 Salivary Shedding in HIV Increases with CD4 Count. J Dent Res 2016; 83:639-43. [PMID: 15271974 DOI: 10.1177/154405910408300811] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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] [Indexed: 11/17/2022] Open
Abstract
Human herpesvirus-8 (HHV-8) is the etiologic agent of Kaposi’s sarcoma (KS), which occurs in epidemic form in human immunodeficiency virus(HIV)-infected individuals. Saliva is the only mucosal fluid in which infectious HHV-8 has been identified, although factors associated with HHV-8 salivary shedding remain unclear. Our study performed PCR analysis for HHV-8 DNA in saliva (and other body fluids) in 66 HIV- and HHV-8-co-infected women without KS so that we could examine predictors for HHV-8 DNA detection. CD4 count was the most significant predictor of HHV-8 salivary shedding, with increased prevalence of HHV-8 salivary DNA at higher CD4 counts. The odds of salivary HHV8 shedding at CD4 counts > = 350 cells/μL was 63 times the odds of shedding at CD4 < 350 (95%CI, 1.3–3078), with an increase in effect size when the analysis was restricted to those with a CD4 nadir > 200. Analysis of these data suggests an increased potential for HHV-8 transmission early in HIV infection, with implications for HHV-8 prevention.
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Affiliation(s)
- M Gandhi
- University of California, San Francisco (UCSF), 405 Irving Street, 2nd floor, San Francisco, CA 94122, USA.
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43
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Yim Y, Gandhi M, Guerin A, Ionescu-Ittu R, Pivneva I, Shi S, Wu E. Impact of severe adverse events during second-line therapy on healthcare costs in patients with advanced non-small cell lung cancer (aNSCLC). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw383.27] [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: 11/13/2022] Open
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44
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45
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Wakefield L, Kroning C, Henderson N, Schneider B, Kreuter J, Gandhi M. P117 Swapping the swab for bmt confirmatory typing. Hum Immunol 2016. [DOI: 10.1016/j.humimm.2016.07.182] [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]
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46
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Goldman M, Magnussen K, Gorlin J, Lozano M, Speedy J, Keller A, Pink J, Leung JNS, Chu CCY, Lee CK, Faed J, Chay J, Tan HH, Teo D, Djoudi R, Woimant G, Fillet AM, Castrén J, Miflin G, Vandewalle GC, Compernolle V, Cardenas JM, Infanti L, Holbro A, Buser A, van den Hurk K, Yahalom VJ, Gendelman V, Shinar E, Eder AF, Steele WR, O'Neill EM, Kamel H, Vassallo R, Delage G, Lebrun A, Robillard P, Germain M, Gandhi M, West KA, Klein HG. International Forum regarding practices related to donor haemoglobin and iron. Vox Sang 2016; 111:449-455. [DOI: 10.1111/vox.12431] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M. Goldman
- Medical Services and Innovation; Canadian Blood Services; Ottawa ON Canada
| | - K. Magnussen
- Clinical Immunology/Blood Centre; Copenhagen University Hospital; Hvidovre Denmark
| | - J. Gorlin
- Physician Services; Innovative Blood Centers; St. Paul MN USA
| | - M. Lozano
- Hospital Clinic; Department of Hemotherapy and Hemostasis; Barcelona Spain
| | - J. Speedy
- Australian Red Cross Blood Service; Adelaide South Australia Australia
| | - A. Keller
- Australian Red Cross; Perth Western Australia Australia
| | - J. Pink
- Australian Red Cross Blood Service; Stafford Queensland Australia
| | - J. N. S. Leung
- Blood Collection and Donor Recruitment Department; Hong Kong Red Cross Blood Transfusion Service; Kowloon Hong Kong
| | - C. C. Y. Chu
- Blood Collection and Donor Recruitment Department; Hong Kong Red Cross Blood Transfusion Service; Kowloon Hong Kong
| | - C.-K. Lee
- Blood Collection and Donor Recruitment Department; Hong Kong Red Cross Blood Transfusion Service; Kowloon Hong Kong
| | - J. Faed
- Otago Site, New Zealand Blood Service; Department of Haematology; University of Otago; Dunedin New Zealand
| | - J. Chay
- Blood Services Group; Health Sciences Authority; 11 Outram Road Singapore City 169078 Singapore
| | - H. H. Tan
- Blood Services Group; Health Sciences Authority; 11 Outram Road Singapore City 169078 Singapore
| | - D. Teo
- Centre for Transfusion Medicine; Singapore City Singapore
| | - R. Djoudi
- Qualification Biologique du Don; Etablissement Français du Sang; St. Denis France
| | - G. Woimant
- EFS, Médecine, la Recherche et l'Innovation; La Plaine Saint-Denis France
| | - A.-M. Fillet
- Medical Department; Etablisement Français du Sang; 20 Avenue du Stade de France La Plaine Saint-Denis 93218 France
| | - J. Castrén
- Medical Support in Blood Donation; Finnish Red Cross Blood Service; Kivihaantie 7 Helsinki FI-00310 Finland
| | - G. Miflin
- NHS Blood and Transplant; Watford UK
| | | | - V. Compernolle
- Blood Services; Belgian Red Cross; Ottergemsesteenweg 413 Ghent B-9000 Belgium
| | - J. M. Cardenas
- Tejidos Humanos; Centro Vasco de Transfusion y Tejidos Humanos; Labeaga s/n Galdakao 48960 Spain
| | - L. Infanti
- Blood Donation Center; Swiss Red Cross; Hebelstrasse 10 Basel CH-4031 Switzerland
| | - A. Holbro
- Blood Transfusion Centre; Swiss Red Cross; Hebelstrasse 10 Basel CH-4031 Switzerland
- Department of Hematology; University Hospital Basel; Basel Switzerland
| | - A. Buser
- Blood Transfusion Centre; Swiss Red Cross; Hebelstrasse 10 Basel CH-4031 Switzerland
- Department of Hematology; University Hospital Basel; Basel Switzerland
| | - K. van den Hurk
- Donor Studies; Sanquin Research; Plesmanlaan 125 Amsterdam 1066 CX The Netherlands
| | - V. J. Yahalom
- National Blood Services; Magen David Adom-National Blood Services; Ramat Gan 5262100 Israel
| | - V. Gendelman
- National Blood Services; Magen David Adom-National Blood Services; Ramat Gan 5262100 Israel
| | - E. Shinar
- National Blood Services; Magen David Adom-National Blood Services; Ramat Gan 5262100 Israel
| | - A. F. Eder
- Biomedical Headquarters; American Red Cross; 15601 Crabbs Branch Way Rockville MD 20855 USA
| | - W. R. Steele
- Transmissible Disease Department; American Red Cross; 15601 Crabbs Branch Way Rockville MD 20855 USA
| | - E. M. O'Neill
- National Headquarters; Biomedical Services; American Red Cross; 15601 Crabbs Branch Way Rockville MD 20855 USA
| | - H. Kamel
- Medical Affairs; Blood Systems, Inc.; 6210 E. Oak Street Scottsdale AZ 85257 USA
| | - R. Vassallo
- Blood Systems, Inc.; 6210 E. Oak Street Scottsdale AZ 85257 USA
| | - G. Delage
- Medical Affairs; Héma-Quebec; 4045 boul. Cote-Vertu, Ville Saint-Laurent Montreal QC Canada
| | - A. Lebrun
- Medical Affairs; Héma-Quebec; 4045 boul. Cote-Vertu, Ville Saint-Laurent Montreal QC Canada
| | - P. Robillard
- Medical Affairs; Héma-Quebec; 4045 boul. Cote-Vertu, Ville Saint-Laurent Montreal QC Canada
| | - M. Germain
- Medical Affairs; Héma-Quebec; 4045 boul. Cote-Vertu, Ville Saint-Laurent Montreal QC Canada
| | - M. Gandhi
- Laboratory of Medicine and Pathology; Mayo Clinic Minnesota; 200 1st Street SW Rochester MN 55905 USA
| | - K. A. West
- Department of Transfusion Medicine; National Institutes of Health Clinical Center; 10 Center Drive, Room 1N226 Bethesda MD 20892 USA
| | - H. G. Klein
- Department of Transfusion Medicine; National Institute of Health; Warren G. Magnuson Clinical Center; 10 Center Drive, Room IC711 Bethesda MD 20892 USA
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Reynolds D, Gandhi M, Todd A. Recruiting consultants in a shortage speciality: factors influencing radiology trainees preferred choice of centre after completion of core training. Rural Remote Health 2016. [DOI: 10.22605/rrh4105] [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] Open
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Gustafson DR, Shi Q, Thurn M, Holman S, Minkoff H, Cohen M, Plankey MW, Havlik R, Sharma A, Gange S, Gandhi M, Milam J, Hoover D. Frailty and Constellations of Factors in Aging HIV-infected and Uninfected Women--The Women's Interagency HIV Study. J Frailty Aging 2016; 5:43-8. [PMID: 26980368 DOI: 10.14283/jfa.2016.79] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Biological similarities are noted between aging and HIV infection. Middle-aged adults with HIV infection may present as elderly due to accelerated aging or having more severe aging phenotypes occurring at younger ages. OBJECTIVES We explored age-adjusted prevalence of frailty, a geriatric condition, among HIV+ and at risk HIV- women. DESIGN Cross-sectional. SETTING The Women's Interagency HIV Study (WIHS). PARTICIPANTS 2028 middle-aged (average age 39 years) female participants (1449 HIV+; 579 HIV-). MEASUREMENTS The Fried Frailty Index (FFI), HIV status variables, and constellations of variables representing Demographic/health behaviors and Aging-related chronic diseases. Associations between the FFI and other variables were estimated, followed by stepwise regression models. RESULTS Overall frailty prevalence was 15.2% (HIV+, 17%; HIV-, 10%). A multivariable model suggested that HIV infection with CD4 count<200; age>40 years; current or former smoking; income ≤$12,000; moderate vs low fibrinogen-4 (FIB-4) levels; and moderate vs high estimated glomerular filtration rate (eGFR) were positively associated with frailty. Low or moderate drinking was protective. CONCLUSIONS Frailty is a multidimensional aging phenotype observed in mid-life among women with HIV infection. Prevalence of frailty in this sample of HIV-infected women exceeds that for usual elderly populations. This highlights the need for geriatricians and gerontologists to interact with younger 'at risk' populations, and assists in the formulation of best recommendations for frailty interventions to prevent early aging, excess morbidities and early death.
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Affiliation(s)
- D R Gustafson
- Deborah Gustafson, PhD, MS, Professor, Department of Neurology, SUNY Downstate Medical Center, 450 Clarkson Ave, MSC 1213, Brooklyn, NY 11203, United States, , Phone: +1-718-270-1581, Fax: 718-221-5761
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Quach K, Gandhi M, Brimble KS, Walsh M. THE EFFECTIVENESS OF PHARMACOLOGICAL AND NON-PHARMACOLOGICAL INTERVENTIONS IN IMPROVING RESTLESS LEGS SYNDROME SEVERITY AMONG PATIENTS ON DIALYSIS: A SYSTEMATIC REVIEW. Br J Soc Med 2015. [DOI: 10.1136/jech-2014-205217.2] [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: 11/03/2022]
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Lim SG, Gandhi M, Chan E. Editorial: patients' preferences and health utility assessment in those with HCV treated with sofosbuvir - stating the obvious? Aliment Pharmacol Ther 2014; 40:1115. [PMID: 25280256 DOI: 10.1111/apt.12945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- S G Lim
- Department of Gastroenterology and Hepatology, National University Health System, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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