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Sampat V, Whitinger J, Flynn-O'Brien K, Kim I, Balakrishnan B, Mehta N, Sawdy R, Patel ND, Nallamothu R, Zhang L, Yan K, Zvara K, Farias-Moeller R. Accuracy of Early Neuroprognostication in Pediatric Severe Traumatic Brain Injury. Pediatr Neurol 2024; 155:36-43. [PMID: 38581727 DOI: 10.1016/j.pediatrneurol.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 02/15/2024] [Accepted: 03/12/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Children with severe traumatic brain injury (sTBI) are at risk for neurological sequelae impacting function. Clinicians are tasked with neuroprognostication to assist in decision-making. We describe a single-center study assessing clinicians' neuroprognostication accuracy. METHODS Clinicians of various specialties caring for children with sTBI were asked to predict their patients' functioning three to six months postinjury. Clinicians were asked to participate in the study if their patient had survived but not returned to baseline between day 4 and 7 postinjury. The outcome tool utilized was the functional status scale (FSS), ranging from 6 to 30 (best-worst function). Predicted scores were compared with actual scores three to six months postinjury. Lin concordance correlation coefficients were used to estimate agreement between predicted and actual FSS. Outcome was dichotomized as good (FSS 6 to 8) or poor (FSS ≥9). Positive and negative predictive values for poor outcome were calculated. Pessimistic prognostic prediction was defined as predicted worse outcome by ≥3 FSS points. Demographic and clinical variables were collected. RESULTS A total of 107 surveys were collected on 24 patients. Two children died. Fifteen children had complete (FSS = 6) or near-complete (FSS = 7) recovery. Mean predicted and actual FSS scores were 10.8 (S.D. 5.6) and 8.6 (S.D. 4.1), respectively. Predicted FSS scores were higher than actual scores (P < 0.001). Eight children had collective pessimistic prognostic prediction. CONCLUSIONS Clinicians predicted worse functional outcomes, despite high percentage of patients with near-normal function at follow-up clinic. Certain patient and provider factors were noted to impact accuracy and need to be studied in larger cohorts.
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Affiliation(s)
- Varun Sampat
- Division of Pediatric Neurology, Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - John Whitinger
- Division of Pediatric Neurology, Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Katherine Flynn-O'Brien
- Division of Pediatric Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Irene Kim
- Division of Pediatric Neurosurgery, Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Binod Balakrishnan
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Niyati Mehta
- Division of Pediatric Neurology, Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Rachel Sawdy
- Division of Pediatric Neurology, Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Namrata D Patel
- Division of Pediatric Neurology, Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Rupa Nallamothu
- Division of Pediatric Neurology, Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Liyun Zhang
- Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Ke Yan
- Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Kimberley Zvara
- Division of Pediatric Physical Medicine and Rehabilitation, Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Raquel Farias-Moeller
- Division of Pediatric Neurology, Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Pediatric Critical Care Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.
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Jain V, Gupta H, Mehta N, Joshi D, Kataria H. Retrospective Comparative Analysis of Clinical and Functional Outcome After Arthroscopic Bankart Repair using All-Suture Anchor and Metal Anchor. Malays Orthop J 2024; 18:11-18. [PMID: 38638665 PMCID: PMC11023345 DOI: 10.5704/moj.2403.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 05/19/2023] [Indexed: 04/20/2024] Open
Abstract
Introduction Both knotted all suture anchors and metal anchors are used for arthroscopic Bankart repair. We retrospectively evaluated and compared clinical and functional outcomes after arthroscopic Bankart repair using the knotted all-suture anchors and knotted metal anchors. Materials and methods In a retrospective cohort analysis, patients who underwent arthroscopic Bankart repair without any concomitant additional lesion repair using either all-suture anchors or metal anchors, between January 2015 and May 2018 were identified. Their pre- and post-operative functional and clinical outcomes were compared using Rowe and WOSI scores. The recurrence rate in the two groups was also compared. Results A total of 41 patients in all suture anchors group and 47 in the metal anchors group were identified as per inclusion and exclusion criteria. The demographic profile of both groups was comparable. There was no significant difference in clinical and functional outcome between the two suture anchor groups as per Rowe (pre-operative 40.13+6.51 vs 38.09+6.24 and post-operative 2 years 93.28+7.09 vs 92.55+9.2) and WOSI (pre-operative 943.05+216.64 vs 977.55+165.46 and post-operative 2 years 278.21+227.56 vs 270.94+186.25) scores. There was a significant improvement in both the groups between preoperative and post-operative ROWE and WOSI scores at 6 months and 2 years follow-up as compared to pre-operative scores (p<0.001). Re-dislocation rates were also comparable (4.8% vs 6.3%). Conclusion All-suture anchors showed comparable clinical and functional results as the metal anchors for arthroscopic Bankart repair at two-year follow-up.
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Affiliation(s)
- V Jain
- Sports Injury Centre, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, India
| | - H Gupta
- Sports Injury Centre, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, India
| | - N Mehta
- Sports Injury Centre, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, India
| | - D Joshi
- Sports Injury Centre, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, India
| | - H Kataria
- Sports Injury Centre, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, India
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Griffith G, Lamotte G, Mehta N, Fan P, Nikolich J, Springman V, Suttman E, Joslin E, Balfany K, Dunlap M, Kohrt WM, Christiansen CL, Melanson EL, Josbeno D, Chahine LM, Patterson CG, Corcos DM. Chronotropic Incompetence During Exercise Testing as a Marker of Autonomic Dysfunction in Individuals with Early Parkinson's Disease. J Parkinsons Dis 2024; 14:121-133. [PMID: 38189712 PMCID: PMC10836543 DOI: 10.3233/jpd-230006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/19/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND An attenuated heart rate response to exercise, termed chronotropic incompetence, has been reported in Parkinson's disease (PD). Chronotropic incompetence may be a marker of autonomic dysfunction and a cause of exercise intolerance in early stages of PD. OBJECTIVE To investigate the relationship between chronotropic incompetence, orthostatic blood pressure change (supine - standing), and exercise performance (maximal oxygen consumption, VO2peak) in individuals with early PD within 5 years of diagnosis not on dopaminergic medications. METHODS We performed secondary analyses of heart rate and blood pressure data from the Study in Parkinson's Disease of Exercise (SPARX). RESULTS 128 individuals were enrolled into SPARX (63.7±9.3 years; 57.0% male, 0.4 years since diagnosis [median]). 103 individuals were not taking chronotropic medications, of which 90 had a normal maximal heart rate response to exercise testing (155.3±14.0 bpm; PDnon-chrono) and 13 showed evidence of chronotropic incompetence (121.3±11.3 bpm; PDchrono, p < 0.05). PDchrono had decreased VO2peak compared to PDnon-chrono (19.7±4.5 mL/kg/min and 24.3±5.8 mL/kg/min, respectively, p = 0.027). There was a positive correlation between peak heart rate during exercise and the change in systolic blood pressure from supine to standing (r = 0.365, p < 0.001). CONCLUSIONS A subgroup of individuals with early PD not on dopaminergic medication had chronotropic incompetence and decreased VO2peak, which may be related to autonomic dysfunction. Evaluation of both heart rate responses to incremental exercise and orthostatic vital signs may serve as biomarkers of early autonomic impairment and guide treatment. Further studies should investigate whether cardiovascular autonomic dysfunction affects the ability to exercise and whether exercise training improves autonomic dysfunction.
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Affiliation(s)
- Garett Griffith
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Guillaume Lamotte
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Niyati Mehta
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Peng Fan
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Juliana Nikolich
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Victoria Springman
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Erin Suttman
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Elizabeth Joslin
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Katherine Balfany
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Wendy M. Kohrt
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Eastern Colorado Veterans Affairs Geriatric Research, Education, and Clinical Center, Denver, CO, USA
| | - Cory L. Christiansen
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Eastern Colorado Veterans Affairs Geriatric Research, Education, and Clinical Center, Denver, CO, USA
| | - Edward L. Melanson
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Eastern Colorado Veterans Affairs Geriatric Research, Education, and Clinical Center, Denver, CO, USA
| | - Deborah Josbeno
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lana M. Chahine
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Daniel M. Corcos
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
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Mehta N, Luthra NS, Corcos DM, Fantuzzi G. C-reactive protein as the biomarker of choice to monitor the effects of exercise on inflammation in Parkinson's disease. Front Immunol 2023; 14:1178448. [PMID: 37251392 PMCID: PMC10213511 DOI: 10.3389/fimmu.2023.1178448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/02/2023] [Indexed: 05/31/2023] Open
Abstract
Parkinson's disease (PD), a heterogeneous disease with no disease-modifying treatments available, is the fastest growing neurological disease worldwide. Currently, physical exercise is the most promising treatment to slow disease progression, with evidence suggesting it is neuroprotective in animal models. The onset, progression, and symptom severity of PD are associated with low grade, chronic inflammation which can be quantified by measuring inflammatory biomarkers. In this perspective, we argue that C-reactive protein (CRP) should be used as the primary biomarker for monitoring inflammation and therefore disease progression and severity, particularly in studies examining the impact of an intervention on the signs and symptoms of PD. CRP is the most studied biomarker of inflammation, and it can be detected using relatively well-standardized assays with a wide range of detection, allowing for comparability across studies while generating robust data. An additional advantage of CRP is its ability to detect inflammation irrespective of its origin and specific pathways, an advantageous characteristic when the cause of inflammation remains unknown, such as PD and other chronic, heterogeneous diseases.
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Affiliation(s)
- Niyati Mehta
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States
| | - Nijee S. Luthra
- Movement Disorder and Neuromodulation Center, University of California, San Francisco, San Francisco, CA, United States
| | - Daniel M. Corcos
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States
| | - Giamila Fantuzzi
- Department of Kinesiology and Nutrition, College of Applied Health Science, University of Illinois at Chicago, Chicago, IL, United States
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Yadav SK, Kumar A, Mehta N. Synthesis and characterization of nanostructured graphene-doped selenium. RSC Adv 2023; 13:13564-13574. [PMID: 37152579 PMCID: PMC10155193 DOI: 10.1039/d3ra01199b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/18/2023] [Indexed: 05/09/2023] Open
Abstract
In this work, we explore various properties of elemental selenium glass (g-Se) by doping with graphene through the facile melt-quench technique. The structural information of the synthesized sample was found by X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), and Raman spectroscopy. The analyses confirm that the graphene-doped g-Se behaves like a glass-ceramic material. Electrical and dielectric measurements were performed to discover the consequences of graphene incorporation on the nano-structure of g-Se. The electrical measurements of the dielectric parameters (i.e., dielectric constant ε' and loss ε'') and conductivity (σ ac) reveal that graphene incorporation causes a rise in the dielectric constant but simultaneously increases dielectric loss. The enhancement in ε' and ε'' values is thought to be a consequence of the interface effect between graphene and the host selenium glass. Calorimetric experiments were performed in a standard differential scanning calorimetry (DSC) unit on the glassy nanocomposite in non-isothermal mode. By measuring the kinetic temperatures at four heating rates, the kinetics of the crystallization/glass transition were studied. The results were examined to understand the role of graphene doping on the well-known phase transitions (i.e., glass transition and crystallization) of g-Se.
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Affiliation(s)
| | - Amit Kumar
- Department of Physics, Banaras Hindu University Varanasi 221005 India
- Sunbeam College for Women Bhagwanpur Varanasi 221005 India
| | - N Mehta
- Department of Physics, Banaras Hindu University Varanasi 221005 India
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Howe CL, Johnson RK, Overlee BL, Sagen JA, Mehta N, Farias‐Moeller R. Drug-resistant seizures associated with hyperinflammatory monocytes in FIRES. Ann Clin Transl Neurol 2023; 10:719-731. [PMID: 36924141 PMCID: PMC10187718 DOI: 10.1002/acn3.51755] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/16/2023] [Accepted: 02/23/2023] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVE Therapeutic strategies for patients with febrile infection-related epilepsy syndrome (FIRES) are limited, ad hoc, and frequently ineffective. Based on evidence that inflammation drives pathogenesis in FIRES, we used ex vivo stimulation of peripheral blood mononuclear cells (PBMCs) to characterize the monocytic response profile before and after therapy in a child successfully treated with dexamethasone delivered intrathecally six times between hospital Day 23 and 40 at 0.25 mg/kg/dose. METHODS PBMCs were isolated from serial blood draws acquired during refractory status epilepticus (RSE) and following resolution associated with intrathecal dexamethasone therapy in a previously healthy 9-year-old male that presented with seizures following Streptococcal pharyngitis. Cells were stimulated with bacterial or viral ligands and cytokine release was measured and compared to responses in age-matched healthy control PBMCs. Levels of inflammatory factors in the blood and CSF were also measured and compared to pediatric healthy control ranges. RESULTS During RSE, serum levels of IL6, CXCL8, HMGB1, S100A8/A9, and CRP were significantly elevated. IL6 was elevated in CSF. Ex vivo stimulation of PBMCs collected during RSE revealed hyperinflammatory release of IL6 and CXCL8 in response to bacterial stimulation. Following intrathecal dexamethasone, RSE resolved, inflammatory levels normalized in serum and CSF, and the PBMC hyperinflammatory response renormalized. SIGNIFICANCE FIRES may be associated with a hyperinflammatory monocytic response to normally banal bacterial pathogens. This hyperinflammatory response may induce a profound neutrophil burden and the consequent release of factors that further exacerbate inflammation and drive neuroinflammation. Intrathecal dexamethasone may resolve RSE by resetting this inflammatory feedback loop.
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Affiliation(s)
- Charles L. Howe
- Translational Neuroimmunology LabMayo ClinicRochesterMinnesotaUSA
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
- Center for MS and Autoimmune NeurologyMayo ClinicRochesterMinnesotaUSA
- Division of Experimental NeurologyMayo ClinicRochesterMinnesotaUSA
| | - Renee K. Johnson
- Translational Neuroimmunology LabMayo ClinicRochesterMinnesotaUSA
| | | | - Jessica A. Sagen
- Translational Neuroimmunology LabMayo ClinicRochesterMinnesotaUSA
- Center for MS and Autoimmune NeurologyMayo ClinicRochesterMinnesotaUSA
| | - Niyati Mehta
- Department of NeurologyMedical College of WisconsinMilwaukeeWisconsinUSA
- Division of Child NeurologyMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Raquel Farias‐Moeller
- Department of NeurologyMedical College of WisconsinMilwaukeeWisconsinUSA
- Division of Child NeurologyMedical College of WisconsinMilwaukeeWisconsinUSA
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Saraswat V, Pal SK, Mehta N, Kumar A, Imran MMA. Thermal analysis of novel third-generation phase-change materials with zinc as a chemical modifier. RSC Adv 2023; 13:3602-3611. [PMID: 36756576 PMCID: PMC9890671 DOI: 10.1039/d2ra07041c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 01/07/2023] [Indexed: 01/27/2023] Open
Abstract
The thermal analysis in the present work is done to analyze the glass/crystal phase transformation in a newly synthesized glassy system (i.e., glassy SeTeSnZn alloys) consisting of chalcogenides Se and Te as major elements, Sn as a third element of the parent alloy and Zn as a chemical modifier. The role of increasing the Zn concentration at the cost of Se has been understood by correlating the kinematics of structural relaxation during the glass transition phenomenon and devitrification during the crystallization phenomenon in the chalcogenide glasses (ChGs) of the quaternary STSZ [i.e., Se78-x Zn x Te20Sn2 (0 ≤ x ≤ 6)] system and their different physicochemical properties. A noticeable rise in the crystallization rate is observed after the addition of Zn in the parent SeTeSn glass. With the rise in the zinc content, the values of average heat of atomization and overall mean bond energy are found to be decreased with the decrease in cohesive energy of samples. An inverse correlation is observed between the thermal stability parameter and the enthalpy released during the glass/crystalline phase transformation.
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Affiliation(s)
- Vishnu Saraswat
- Physics Department, Banaras Hindu University Varanasi-221005 India
| | - Shiv Kumar Pal
- Physics Department, Banaras Hindu University Varanasi-221005 India
| | - N. Mehta
- Physics Department, Banaras Hindu UniversityVaranasi-221005India
| | - Arun Kumar
- Physics Department, IIT RoorkeeRoorkee-247667India
| | - M. M. A. Imran
- Physics Department, Al-Balqa Applied UniversityAl-Salt-19117Jordan
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Bajaj JS, Sharma S, Mehta N, Shah A, Nimje G, Gorade M, Deshpande G. Frequency of Positive Cuff Leak Test Before Extubation in Robotic Surgeries Done in Steep Trendelenburg Position. Indian J Surg Oncol 2022; 13:896-901. [PMID: 36687248 PMCID: PMC9845466 DOI: 10.1007/s13193-022-01605-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/19/2022] [Indexed: 01/25/2023] Open
Abstract
Anaesthesia for robotic surgeries done in steep trendelenburg position are associated with risks such as facial oedema, conjunctival chemosis, raised intraocular pressure, laryngeal oedema, and delayed awakening. We proposed the use of the cuff leak test in them to record the frequency of laryngeal oedema at the end of surgery and attempted to find its correlation with probable risk factors. We conducted a prospective observational study of 100 patients aiming primarily to assess the frequency of positive cuff leak test in robotic abdominal surgeries performed in trendelenburg position. The secondary outcomes were to check its correlation with intravenous fluid administration, duration of pneumoperitoneum, and angle of trendelenburg position. We also recorded the frequency of chemosis, the frequency of post-extubation stridor in 24 h post-operatively, and the frequency of reintubation. Out of 100 participants undergoing elective abdominal robotic surgery in trendelenburg position, ninety were analysed. Total 31.6% (n = 30) participants showed positive cuff leak test. Chemosis was observed in 31 (32.6%) participants. No patient experienced post-extubation stridor or required reintubation during post-operative follow up. There was a no correlation between cuff leak test and intravenous fluid, duration of pneumo-peritoneum, or with angle of trendelenburg. The frequency of positive cuff leak test was high in patients at the end of robotic surgery but none of these patients had post-extubation stridor or required reintubations. There was no correlation with the fluid, angle, or duration of surgery. Clinical Trials Registry of India (CTRI/2017/04/008289), ctri.nic.in.
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Affiliation(s)
| | - Sudivya Sharma
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Pin 400012 India
| | | | - Akshat Shah
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Pin 400012 India
| | - Ganesh Nimje
- Mahatma Gandhi Hospital and Medical College, Jaipur, India
| | - Manoj Gorade
- Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Gargi Deshpande
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Pin 400012 India
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Cooper M, Mehta N, Chen E. A Nutrition Labeling Online Course (NLOC) Evaluation: Assessing Users’ Feedback. J Acad Nutr Diet 2022. [DOI: 10.1016/j.jand.2022.06.141] [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: 10/15/2022]
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10
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Hamilton E, Melero I, Lugowska I, Arance Fernandez A, Vila Martinez L, Powderly J, Gutierrez M, Serino T, Mehta N, Shapiro I, Whalen K, Michaelson J, Jones J, Janik J, Moreno Garcia V. 780TiP A phase I dose-escalation study to investigate the safety, efficacy, pharmacokinetics, and pharmacodynamic activity of CLN-619 (anti-MICA/MICB Antibody) alone and in combination with pembrolizumab in patients with advanced malignancies. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.906] [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: 11/01/2022] Open
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Gonzalez-Cantero Á, Patel N, Hong C, Abbad-Jaime de Aragón C, Berna-Rico E, Solis J, Ballester A, Sorokin A, Teague H, Playford M, Barderas M, Fernandez-Friera L, Mehta N. 845 HDL composition, particle number and size is associated with non-calcified coronary plaque in psoriasis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hsu L, Bui V, O'Hagan R, Sorokin A, Zhou W, Jones E, Mehta N, Chen M. 404 Fully Automated Quantification Of Epicardial And Thoracic Adipose Tissue From Cardiovascular Computed Tomography. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Bui V, Hsu L, Sun A, Tran L, Shanbhag S, Chang L, Zhou W, Mehta N, Chen M. 401 Deepheartct: A Fully Automatic Hybrid Structure Segmentation Framework Based On Atlas, Reverse Ranking, And Convolutional Neural Network For Computed Tomography Angiography. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Waghchaure SS, Bhad WA, Chavan SJ, Mehta N, Baheti N. Effectiveness of Surgical Mandibular Advancement in Improving Airway Dimensions in Nongrowing Skeletal Class II Patients With Obstructive Sleep Apnea—A CBCT Study. J Indian Orthod Soc 2022. [DOI: 10.1177/03015742221076914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Skeletal nongrowing class II patients with retrognathic mandible are often at risk of developing obstructive sleep apnea (OSA). This skeletal discrepancy, when severe enough, is often addressed by surgical mandibular advancement which not only achieves aesthetics, structural balance, and functional efficiency but also improves the airway function. Objective: The aim of the study was to evaluate the effectiveness of surgical mandibular advancement on airway dimensions, in nongrowing skeletal class II patients with mandibular retrognathism associated with OSA. Materials and Methods: The sample consisted of 8 patients with skeletal class II due to retrognathic mandible associated with OSA. Screening was done with functional outcomes of sleep questionnaire (FOSQ) score and confirmed with polysomnography. Pretreatment and posttreatment airway dimensions/volume were assessed and calculated on cone beam computed tomography (CBCT). Three months post surgery, oxygen saturation was recorded. Results: A statistically significant improvement in mean oxygen saturation level was observed from 87.62 ± 7.70 to 97.75 ± 0.46 and mean increase in airway volume was from 48.60 ± 7.17 to 69.48 ± 26.22. The smallest cross section increased from 137 ± 74.37 to 253.75 ± 76.67. Anteroposterior dimensions increased significantly from 6.17 ± 1.78 to 9.33 ± 2.07 and transversed from 24.56 ± 6.41 to 30.14 ± 3.35. FOSQ score improved from 9.37 ± 2.61 to 15.25 ± 0.88. Conclusion: Surgical mandibular advancement is an effective treatment option in improving airway dimensions in nongrowing skeletal class II patients with mandibular retrognathism associated with OSA.
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Affiliation(s)
- Saurabh S. Waghchaure
- Department of Orthodontics & Dentofacial Orthopaedics, Government Dental College & Hospital, Nagpur, Maharashtra, India
| | - Wasundhara A. Bhad
- Department of Orthodontics & Dentofacial Orthopaedics, Government Dental College & Hospital, Nagpur, Maharashtra, India
| | - Santosh J. Chavan
- Department of Orthodontics & Dentofacial Orthopaedics, Government Dental College & Hospital, Nagpur, Maharashtra, India
| | - Niyati Mehta
- Department of Orthodontics & Dentofacial Orthopaedics, Government Dental College & Hospital, Nagpur, Maharashtra, India
| | - Nikita Baheti
- Department of Orthodontics & Dentofacial Orthopaedics, Government Dental College & Hospital, Nagpur, Maharashtra, India
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Sharma S, Mehta N, Sauer T, Parikh K, Zhang H, Mehta B, Torrano V, Grilley B, Heslop H, Rooney C. Immunotherapy: EPSTEIN-BARR VIRUS (EBV) SPECIFIC T-CELLS WITH BROADER TARGET ANTIGEN REPERTOIRE FOR THE TREATMENT OF EBV+ MALIGNANCIES. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00315-2] [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: 11/26/2022]
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Missig G, Mehta N, Robbins JO, Good CH, Iliopoulos-Tsoutsouvas C, Makriyannis A, Nikas SP, Bergman J, Carlezon WA, Paronis CA. Altered sleep during spontaneous cannabinoid withdrawal in male mice. Behav Pharmacol 2022; 33:195-205. [PMID: 35288510 PMCID: PMC8928162 DOI: 10.1097/fbp.0000000000000674] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 11/26/2022]
Abstract
Cessation of cannabinoid use in humans often leads to a withdrawal state that includes sleep disruption. Despite important health implications, little is known about how cannabinoid abstention affects sleep architecture, in part because spontaneous cannabinoid withdrawal is difficult to model in animals. In concurrent work we report that repeated administration of the high-efficacy cannabinoid 1 (CB1) receptor agonist AM2389 to mice for 5 days led to heightened locomotor activity and paw tremor following treatment discontinuation, potentially indicative of spontaneous cannabinoid withdrawal. Here, we performed parallel studies to examine effects on sleep. Using implantable electroencephalography (EEG) and electromyography (EMG) telemetry we examined sleep and neurophysiological measures before, during, and after 5 days of twice-daily AM2389 injections. We report that AM2389 produces decreases in locomotor activity that wane with repeated treatment, whereas discontinuation produces rebound increases in activity that persist for several days. Likewise, AM2389 initially produces profound increases in slow-wave sleep (SWS) and decreases in rapid eye movement (REM) sleep, as well as consolidation of sleep. By the third AM2389 treatment, this pattern transitions to decreases in SWS and total time sleeping. This pattern persists following AM2389 discontinuation and is accompanied by emergence of sleep fragmentation. Double-labeling immunohistochemistry for hypocretin/orexin (a sleep-regulating peptide) and c-Fos (a neuronal activity marker) in lateral hypothalamus revealed decreases in c-Fos/orexin+ cells following acute AM2389 and increases following discontinuation, aligning with the sleep changes. These findings indicate that AM2389 profoundly alters sleep in mice and suggest that sleep disruption following treatment cessation reflects spontaneous cannabinoid withdrawal.
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Affiliation(s)
- Galen Missig
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, MA, USA
| | - Niyati Mehta
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, MA, USA
| | - James O. Robbins
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, MA, USA
| | - Cameron H. Good
- Neurolux Inc, Northfield, IL, USA
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | | | | | | | - Jack Bergman
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, MA, USA
| | - William A. Carlezon
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, MA, USA
| | - Carol A. Paronis
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, MA, USA
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Missig G, Fritsch EL, Mehta N, Damon ME, Jarrell EM, Bartlett AA, Carroll FI, Carlezon WA. Blockade of kappa-opioid receptors amplifies microglia-mediated inflammatory responses. Pharmacol Biochem Behav 2022; 212:173301. [PMID: 34826432 PMCID: PMC8748402 DOI: 10.1016/j.pbb.2021.173301] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/11/2021] [Accepted: 11/18/2021] [Indexed: 01/03/2023]
Abstract
Brain kappa-opioid receptors (KORs) are implicated in the pathophysiology of depressive and anxiety disorders, stimulating interest in the therapeutic potential of KOR antagonists. Research on KOR function has tended to focus on KOR-expressing neurons and pathways such as the mesocorticolimbic dopamine system. However, KORs are also expressed on non-neuronal cells including microglia, the resident immune cells in the brain. The effects of KOR antagonists on microglia are not understood despite the potential contributions of these cells to overall responsiveness to this class of drugs. Previous work in vitro suggests that KOR activation suppresses proinflammatory signaling mediated by immune cells including microglia. Here, we examined how KOR antagonism affects microglia function in vivo, together with its effects on physiological and behavioral responses to an immune challenge. Pretreatment with the prototypical KOR antagonist JDTic potentiates levels of proinflammatory cytokines (IL-1β, IL-6) in blood following administration of lipopolysaccharide (LPS), an immune-activating agent, without triggering effects on its own. Using magnetic-activated cell sorting (MACs), we found that KOR antagonism potentiates LPS-induced cytokine expression within microglia. This effect is accompanied by potentiation of LPS-induced hyperthermia, although reductions in body weight and locomotion were not affected. Histological analyses confirm that LPS produces visible changes in microglia morphology consistent with activation, but this effect is not altered by KOR antagonism. Considering that inflammation is increasingly implicated in depressive and anxiety disorders, these findings raise the possibility that KOR antagonist actions on microglia may detract from actions on neurons that contribute to their therapeutic potential.
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Affiliation(s)
- Galen Missig
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont MA, 02478, USA
| | - Emma L. Fritsch
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont MA, 02478, USA
| | - Niyati Mehta
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont MA, 02478, USA
| | - Miles E. Damon
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont MA, 02478, USA
| | - Erica M. Jarrell
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont MA, 02478, USA
| | - Andrew A. Bartlett
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont MA, 02478, USA
| | - F. Ivy Carroll
- Center for Organic and Medicinal Chemistry, Research Triangle Institute, P. O. Box 12194, Research Triangle Park NC, 27709, USA
| | - William A. Carlezon
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont MA, 02478, USA
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Pal S, Mehta N, Mikla V, Horvat A, Minkovich V, Dahshan A. Response to “Comment on ‘Insights into the physical aging in chalcogenide glasses: A case study of a first-generation As2Se3 binary glass’” [Coord. Chem. Rev. 442 (2021) 213992]. Coord Chem Rev 2021. [DOI: 10.1016/j.ccr.2021.214205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Alsahaf M, Mehta N, Satouf A, Elliott S, Christian K. Increasing attendance of patient support groups. Physiotherapy 2021. [DOI: 10.1016/j.physio.2021.10.280] [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]
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Gottlieb AB, Mehta N, Menter A, Mendelsohn AM, Rozzo S, Lebwohl M. AB0544 EFFICACY AND SAFETY OF TILDRAKIZUMAB IN PATIENTS WITH AND WITHOUT METABOLIC SYNDROME: 5-YEAR POOLED DATA FROM reSURFACE 1 AND reSURFACE 2. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1827] [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:Patients with psoriasis and metabolic syndrome (MetS) may have reduced absolute Psoriasis Area and Severity Index (PASI) response and long-term drug survival. Tildrakizumab is approved for the treatment of moderate to severe plaque psoriasis in the US, EU, Australia, and Japan. Efficacy and safety of tildrakizumab were previously shown to be comparable in patients with vs without MetS after 1 and 3 years of treatment.1Objectives:This post hoc analysis of pooled data from reSURFACE 1 and reSURFACE 2 (NCT01722331/NCT01729754) assessed tildrakizumab efficacy and safety through up to 5 years of treatment in patients with psoriasis with and without MetS.Methods:reSURFACE 1 and 2 were 3-part, double-blind, randomized controlled phase 3 trials with long-term extensions evaluating tildrakizumab 100 or 200 mg monotherapy at Weeks 0, 4, and every 12 weeks thereafter in adults with moderate to severe plaque psoriasis.2 Patients who achieved ≥50% improvement from baseline PASI score (PASI 50 response) at both week 28 and at the end of the phase 3 studies could enter the long-term extension studies continuing the same dose of tildrakizumab.1 This post hoc analysis reports results from a pooled data analysis through up to 5 years of tildrakizumab exposure from patients with and without MetS by National Cholesterol Education Program-Adult Treatment Panel III criteria who continuously received the same dose of tildrakizumab throughout the base studies and entered the long-term extensions. Efficacy was assessed as change from baseline PASI score; missing data were handled using multiple imputation. Safety was assessed from exposure adjusted incidence rates of serious adverse events (SAEs) and treatment-emergent AEs of special interest.Results:Analyses included 70/265 patients with/without MetS receiving tildrakizumab 100 mg and 64/241 patients with/without MetS receiving tildrakizumab 200 mg. Median percentage change from baseline PASI score is shown in Figure 1. Among patients with/without MetS receiving tildrakizumab 100 mg, 78.6%/87.9% achieved PASI 75, 57.1%/63.8% achieved PASI 90, and 25.7%/32.5% achieved PASI 100 response at week 244; the PASI 75, PASI 90, and PASI 100 response rates at week 244 in patients with/without MetS receiving tildrakizumab 200 mg were 76.6%/85.1%, 46.9%/61.4%, and 26.6%/36.5%, respectively. Safety outcomes over the 5-year extension period were consistent with the known safety profile of tildrakizumab. Rates of SAEs were <8.5 per 100 patient-years among all patients, and there were no new safety signals in patients with vs without MetS (Table 1).Table 1.SAEs and TEAEs of special interest by MetS status through up to 5 years of tildrakizumab exposureTIL 100 mgTIL 200 mgWithout MetSWithMetSWithout MetSWithMetSn = 265n = 70n = 241n = 64n (EAIR per 100 PY)1149.1 PY304.1 PY1057.1 PY287.6 PYSAEs53 (4.61)22 (7.23)52 (4.92)24 (8.35)TEAEs of special interest24 (2.09)6 (1.97)27 (2.55)15 (5.22)Infections and infestations10 (0.87)2 (0.66)13 (1.23)6 (2.09)Malignanciesa5 (0.44)1 (0.33)4 (0.38)3 (1.04)Nonmelanoma skin cancer3 (0.26)1 (0.33)6 (0.57)1 (0.35)Confirmed extended MACE3 (0.26)1 (0.33)3 (0.28)3 (1.04)Drug hypersensitivity2 (0.17)1 (0.33)1 (0.09)2 (0.70)Melanoma skin cancer2 (0.17)000Injection site reactionsb1 (0.09)000Incidence rates reported as events per 100 PY.aExcluding nonmelanoma and melanoma skin cancer.bNot considered of special interest in the extension study.AE, adverse event; EAIR, exposure adjusted incidence rate; MACE, major adverse cardiovascular events; MetS, metabolic syndrome; PY, patient-years; SAE, serious AE; TEAE, treatment-emergent AE; TIL, tildrakizumab.Conclusion:The efficacy and safety of tildrakizumab were maintained in patients with and without MetS following 5 years of treatment.References:[1]Lebwohl, M et al. JAAD. 2020;S0190-9622(20)32637-2.[2]Reich K, et al. Lancet. 2017;390:276–88.Disclosure of Interests:Alice B Gottlieb Shareholder of: Xbiotech (only stock options, which she has not used)., Consultant of: Anaptyps Bio, Avotres Therapeutics; Beiersdorf; Boehringer Ingelheim; Bristol-Myers Squibb Co.; Eli Lilly; Janssen; LEO Pharma; Novartis; Sun Pharmaceutical Industries, Inc.; UCB; and Xbiotech, Grant/research support from: Boehringer Ingelheim; Janssen; Novartis; Sun Pharmaceutical Industries, Inc.; UCB; and Xbiotech., Nehal Mehta Grant/research support from: Grants to the NIH from AbbVie, Celgene, Janssen, and Novartis., Employee of: Full-time employee of the US government., Alan Menter Speakers bureau: AbbVie, Abbott Labs, Amgen, Anacor, Boehringer Ingelheim, Celgene, Eli Lilly, Janssen Biotech, LEO Pharma, Merck & Co., Novartis, Sienna, and UCB., Consultant of: AbbVie, Abbott Labs, Amgen, Anacor, Boehringer Ingelheim, Celgene, Eli Lilly, Janssen Biotech, LEO Pharma, Merck & Co., Novartis, Sienna, and UCB., Grant/research support from: AbbVie, Abbott Labs, Amgen, Anacor, Boehringer Ingelheim, Celgene, Eli Lilly, Janssen Biotech, LEO Pharma, Merck & Co., Novartis, Sienna, and UCB., Alan M Mendelsohn Shareholder of: Has individual shares in Johnson and Johnson, and as part of retirement account/mutual funds, Employee of: Sun Pharmaceutical Industries, Inc., Stephen Rozzo Employee of: Sun Pharmaceutical Industries, Inc., Mark Lebwohl Consultant of: Aditum Bio; Allergan; Almirall; Arcutis; Avotres Therapeutics; BirchBioMed, Inc.; BMD Skincare; Boehringer Ingelheim; Bristol-Myers Squibb; Cara Therapeutics; Castle Biosciences; Corrona; Dermavant Sciences; Evelo; Facilitate International Dermatologic Education; Foundation for Research and Education in Dermatology; Inozyme Pharma; Kyowa Kirin; LEO Pharma; Meiji Seika Pharma; Menlo; Mitsubishi; Neuroderm; Pfizer; Promius/Dr. Reddy’s Laboratories; Serono; Theravance; and Verrica., Grant/research support from: AbbVie; Amgen; Arcutis; Boehringer Ingelheim; Dermavant; Eli Lilly; Incyte; Janssen Research & Development, LLC; LEO Pharma; Ortho Dermatologics; Pfizer; and UCB.
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Ogdie A, Gustafson A, Lieberman A, Mason J, Armstrong A, Mehta N, Beidas R, Gelfand J. POS1063 RHEUMATOLOGIST AND PATIENT PERSPECTIVES ON IMPLEMENTING CARDIOVASCULAR RISK PREVENTION IN THE MANAGEMENT OF PSORIASIS: A QUALITATIVE STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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:Psoriatic arthritis (PsA) is an immune-mediated musculoskeletal disease associated with excess risk for cardiovascular disease (CVD). New US-based guidelines recognize psoriasis as a CVD risk enhancer; however, patients with PsA often do not have CVD risk factors identified nor managed.Objectives:This study examines strategies to improve CVD prevention care from the perspective of rheumatologists and patients with PsA.Methods:Semi-structured qualitative interviews were conducted using an interview guide based on the Consolidated Framework for Implementation Research to examine the perspectives of rheumatologists (N = 8) and patients with psoriatic arthritis managed by rheumatologists (N = 8) on barriers/facilitators to CVD prevention. Interviews were transcribed and coded using an integrated approach designed to enhance reliability and validity facilitated by NVivo software.Results:Most rheumatologists confirmed that they were not regularly engaging in CVD prevention care with psoriatic arthritis patients. Providers reported sometimes counseling and screening for CVD risk, but they were not regularly prescribing statins and not as willing to do so. Reasons included a lack of familiarity or comfort with guidelines, concern about working outside of their scope of practice, confusing boundaries between other clinicians, and time constraints. Most patients confirmed that it was uncommon for their rheumatologists to engage them in CVD prevention care but expressed desire for their rheumatologists inform them of the risk, and were open to CVD prevention care from them.Conclusion:We identified several potentially modifiable barriers to CVD screening and management. These findings will inform the design of a clinical trial comparing the effectiveness of rheumatologist implementation of CVD guideline-based counseling, screening and prescribing statins when appropriate in patients with PsA.Figure 1.Barriers to CVD screening and management among patients with PsA in a rheumatology practice setting and potential strategies to address those barriers. Abbreviations: CV = cardiovascular; SOC = standard of care.Disclosure of Interests:Alexis Ogdie Consultant of: Abbvie, Amgen, BMS, Celgene, Corrona, Gilead, Janssen, Lilly, Novartis, Pfizer, UCB, Grant/research support from: Pfizer to Penn, Novartis to Penn, Amgen to Forward/NDB, Alix Gustafson: None declared, Adina Lieberman: None declared, Jennifer Mason: None declared, April Armstrong: None declared, Nehal Mehta Consultant of: Amgen, Eli Lilly, and Leo Pharma receiving grants/other payments, Grant/research support from: AbbVie, Celgene, Janssen Pharmaceuticals, Inc, and Novartis receiving grants and/or research funding and as a principal investigator for the National Institute of Health receiving grants and/or research funding., Employee of: NNM is a full-time US government employee, Rinad Beidas Consultant of: Camden Coalition of Healthcare Providers in the past 3 years. She currently is a consultant for United Behavioral Health. She serves on the Optum Behavioral Health Clinical and Scientific Advisory Council. Dr. Beidas receives royalties from Oxford University Press., Joel Gelfand Shareholder of: Dr Gelfand is a co-patent holder of resiquimod for treatment of cutaneous T-cell lymphoma, and he is a deputy editor for the Journal of Investigative Dermatology, receiving honoraria from the Society for Investigative Dermatology., Paid instructor for: CME work related to psoriasis that was supported indirectly by Eli Lilly and Company and Ortho Dermatologics, Consultant of: Bristol-Myers Squibb, Boehringer Ingelheim, GlaxoSmithKline, Janssen Biologics, Novartis Corp, UCB (Data Safety and Monitoring Board), Sanofi, and Pfizer Inc, Grant/research support from: research grants (to the Trustees of the University of Pennsylvania) from AbbVie, Janssen, Novartis Corp, Celgene, OrthoDermatologics, and Pfizer Inc.
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Kuzmin R, Grabon N, Mehta N, Burshtein A, Goldstein M, Houzet M, Glazman LI, Manucharyan VE. Inelastic Scattering of a Photon by a Quantum Phase Slip. Phys Rev Lett 2021; 126:197701. [PMID: 34047614 DOI: 10.1103/physrevlett.126.197701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/09/2021] [Indexed: 06/12/2023]
Abstract
Spontaneous decay of a single photon is a notoriously inefficient process in nature irrespective of the frequency range. We report that a quantum phase-slip fluctuation in high-impedance superconducting waveguides can split a single incident microwave photon into a large number of lower-energy photons with a near unit probability. The underlying inelastic photon-photon interaction has no analogs in nonlinear optics. Instead, the measured decay rates are explained without adjustable parameters in the framework of a new model of a quantum impurity in a Luttinger liquid. Our result connects circuit quantum electrodynamics to critical phenomena in two-dimensional boundary quantum field theories, important in the physics of strongly correlated systems. The photon lifetime data represent a rare example of verified and useful quantum many-body simulation.
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Affiliation(s)
- R Kuzmin
- Department of Physics, Joint Quantum Institute, and Quantum Materials Center, University of Maryland, College Park, Maryland 20742, USA
| | - N Grabon
- Department of Physics, Joint Quantum Institute, and Quantum Materials Center, University of Maryland, College Park, Maryland 20742, USA
| | - N Mehta
- Department of Physics, Joint Quantum Institute, and Quantum Materials Center, University of Maryland, College Park, Maryland 20742, USA
| | - A Burshtein
- Raymond and Beverly Sackler School of Physics and Astronomy, Tel Aviv University, Tel Aviv 6997801, Israel
| | - M Goldstein
- Raymond and Beverly Sackler School of Physics and Astronomy, Tel Aviv University, Tel Aviv 6997801, Israel
| | - M Houzet
- Univ. Grenoble Alpes, CEA, Grenoble INP, IRIG, PHELIQS, 38000 Grenoble, France
| | - L I Glazman
- Departments of Physics and Applied Physics, Yale University, New Haven, Connecticut 06520, USA
| | - V E Manucharyan
- Department of Physics, Joint Quantum Institute, and Quantum Materials Center, University of Maryland, College Park, Maryland 20742, USA
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Barbieri J, Beidas R, Gondo G, Williams N, Armstrong A, Ogdie A, Mehta N, Gelfand J. 251 Dermatologist preferences regarding implementation strategies to improve statin use among patients with psoriasis. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gustafson A, Lieberman A, Mason J, Armstrong A, Ogdie A, Mehta N, Beidas R, Gelfand J. 406 Dermatologist and patient perspectives on implementing cardiovascular risk prevention in the management of psoriasis: A qualitative study. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.429] [Citation(s) in RCA: 1] [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: 11/26/2022]
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Kanthala L, Ray S, Aurobindo Prasad Das S, Nundy S, Mehta N. Recurrent giant retroperitoneal liposarcoma: Review of literature and a rare case report. Ann Med Surg (Lond) 2021; 65:102329. [PMID: 33996060 PMCID: PMC8091881 DOI: 10.1016/j.amsu.2021.102329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/11/2021] [Accepted: 04/13/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction and importance Retroperitoneal liposarcomas (RPLS) are usually grow large with frequent recurrences. Complete surgical excision remains the gold standard treatment for primary and even recurrent tumours. Their prognosis depends on their histological type and grade. We report a recurrent giant de-differentiated RPLS weighing 18.55 kg which was completely excised. To the best of our knowledge, this is one of the largest liposarcoma reported in the literature. Case presentation A 40 year old female presented with a gradually progressing large abdominal lump for 1year. She had had a similar large lump twice in the past and undergone excision of the tumour elsewhere. Firm non-tender mass felt all over abdomen with edema noted over abdominal wall and bilateral lower limbs. PET CT showed large heterogeneously enhancing mass occupying almost the entire abdominopelvic cavity. 50 × 40 × 40cm tumour was completely excised and biopsy showed grade 2 dedifferentiated liposarcoma (DDLS). She is under close follow up with no recurrence at 12months. Clinical discussion DDLS have lower risk of distant metastases but have a high risk of local recurrence. The most important favourable prognostic factor in these tumours is complete resection with negative margins. Because of the ineffectiveness of current chemotherapy and the requirement of intolerably high radiation doses, surgical excision remains the most effective treatment even for the localized recurrences of RPLS. Conclusion The dedifferentiated subtype should be suspected in locally aggressive RPLS. Close follow up with early detection of recurrences and prompt excision with negative margins lowers the risk of recurrences and improves survival.
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Affiliation(s)
- Lalith Kanthala
- Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, 110060, India
| | - Samrat Ray
- Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, 110060, India
| | - Sri Aurobindo Prasad Das
- Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, 110060, India
| | - S Nundy
- Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, 110060, India
| | - N Mehta
- Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, 110060, India
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Malhamé I, Danilack VA, Raker CA, Hardy EJ, Spalding H, Bouvier BA, Hurlburt H, Vrees R, Savitz DA, Mehta N. Cardiovascular severe maternal morbidity in pregnant and postpartum women: development and internal validation of risk prediction models. BJOG 2020; 128:922-932. [PMID: 32946639 DOI: 10.1111/1471-0528.16512] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To develop and internally validate risk prediction models identifying women at risk for cardiovascular severe maternal morbidity (CSMM). DESIGN A retrospective cohort study. SETTING An obstetric teaching hospital between 2007 and 2017. POPULATION A total of 89 681 delivery hospitalisations. METHODS We created and evaluated two models, one predicting CSMM at delivery (delivery model) and the other predicting CSMM postpartum following discharge from delivery hospitalisation (postpartum CSMM). We assessed model discrimination and calibration and used bootstrapping for internal validation. MAIN OUTCOME MEASURES Cardiovascular severe maternal morbidity comprised the following confirmed conditions: pulmonary oedema/acute heart failure, myocardial infarction, aneurysm, cardiac arrest/ventricular fibrillation, heart failure/arrest during surgery or procedure, cerebrovascular disorders, cardiogenic shock, conversion of cardiac rhythm and difficult-to-control severe hypertension. RESULTS The delivery model contained 11 variables and 3 interaction terms. The strongest predictors were gestational hypertension, chronic hypertension, multiple gestation, cardiac lesions or valvular heart disease, maternal age ≥40 years and history of poor pregnancy outcome. The postpartum model comprised eight variables. The strongest predictors were severe pre-eclampsia, non-Hispanic Black race/ethnicity, chronic hypertension, gestational hypertension, non-severe pre-eclampsia and maternal age ≥40 years at delivery. The delivery and postpartum models had an area under the receiver operating characteristic curve of 0.87 (95% CI 0.85-0.89) and 0.85 (95% CI 0.80-0.90), respectively. Both models were adequately calibrated and performed well on internal validation. CONCLUSIONS These tools may help providers to identify women at highest risk of CSMM and enable future prevention measures. TWEETABLE ABSTRACT Risk assessment tools for cardiovascular severe maternal morbidity were developed and internally validated.
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Affiliation(s)
- I Malhamé
- Department of Medicine, McGill University Health Centre, McGill University, Montreal, Quebec, Canada.,Department of Medicine, Women and Infants Hospital, Warren Alpert School of Brown University, Providence, RI, USA
| | - V A Danilack
- Department of Obstetrics and Gynecology, Women & Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA.,Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - C A Raker
- Department of Obstetrics and Gynecology, Women & Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - E J Hardy
- Department of Medicine, Women and Infants Hospital, Warren Alpert School of Brown University, Providence, RI, USA.,Department of Obstetrics and Gynecology, Women & Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - H Spalding
- Department of Medicine, Women and Infants Hospital, Warren Alpert School of Brown University, Providence, RI, USA
| | - B A Bouvier
- Department of Medicine, Women and Infants Hospital, Warren Alpert School of Brown University, Providence, RI, USA
| | - H Hurlburt
- Department of Medicine, Brigham and Women's Cardiovascular Associates of Care New England, Harvard Medical School, Boston, MA, USA
| | - R Vrees
- Department of Obstetrics and Gynecology, Women & Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - D A Savitz
- Department of Obstetrics and Gynecology, Women & Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA.,Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - N Mehta
- Department of Medicine, Women and Infants Hospital, Warren Alpert School of Brown University, Providence, RI, USA.,Department of Medicine, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
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Mehta N, Le A, Chatterjee-Shin P. P507 CHRONIC RHINOSINUSITIS WITH NASAL POLYPS: AS ASSESSMENT OF CURRENT CLINICAL PRACTICES. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.165] [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: 10/23/2022]
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Mehta N, Armagan A, Chatterjee-Shin P, Cohen J. P222 SEVERE ASTHMA: VIRTUAL PATIENT SIMULATION IMPROVES CLINICAL DECISIONS OF ALLERGISTS AND PULMONOLOGISTS. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.119] [Citation(s) in RCA: 1] [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: 11/16/2022]
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Gupta A, Aggarwal V, Mehta N, Abraham D, Singh A. Diabetes mellitus and the healing of periapical lesions in root filled teeth: a systematic review and meta‐analysis. Int Endod J 2020; 53:1472-1484. [DOI: 10.1111/iej.13366] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 07/08/2020] [Indexed: 12/17/2022]
Affiliation(s)
- A. Gupta
- Department of Conservative Dentistry and Endodontics Manav Rachna University FaridabadIndia
| | - V. Aggarwal
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry Jamia Milia Islamia New Delhi India
| | - N. Mehta
- Department of Conservative Dentistry and Endodontics Manav Rachna University FaridabadIndia
| | - D. Abraham
- Department of Conservative Dentistry and Endodontics Manav Rachna University FaridabadIndia
| | - A. Singh
- Department of Conservative Dentistry and Endodontics Manav Rachna University FaridabadIndia
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Abbas Y, Abdelkader M, Adams M, Addison A, Advani R, Ahmed T, Alexander V, Alexander V, Alli B, Alvi S, Amiraraghi N, Ashman A, Balakumar R, Bewick J, Bhasker D, Bola S, Bowles P, Campbell N, Can Guru Naidu N, Caton N, Chapman J, Chawdhary G, Cherko M, Coates M, Conroy K, Coyle P, Cozar O, Cresswell M, Dalton L, Danino J, Daultrey C, Davies K, Carrie S, Dick D, Dimitriadis PA, Doddi N, Dowling M, Easto R, Edmiston R, Ellul D, Erskine S, Evans A, Farboud A, Forde C, Fussey J, Gaunt A, Gilchrist J, Gohil R, Gosnell E, Grech Marguerat D, Green R, Grounds R, Hall A, Hardman J, Harris A, Harrison L, Hone R, Hoskison E, Howard J, Ioannidis D, Iqbal I, Janjua N, Jolly K, Kamal S, Kanzara T, Keates N, Kelly A, Khan H, Korampalli T, Kuet M, Kul‐loo P, Lakhani R, Lambert A, Lancer H, Leonard C, Lloyd G, Lowe E, Mair J, Maughan E, Gao C, Mayberry T, McCadden L, McClenaghan F, McKenzie G, Mcleod R, Meghji S, Mian M, Millington A, Mirza O, Mistry S, Molena E, Morris J, Myuran T, Navaratnam A, Noon E, Okonkwo O, Oremule B, Pabla L, Papesch E, Puranik V, Roplekar R, Ross E, Rudd J, Schechter E, Senior A, Sethi N, Sharma S, Sharma R, Shelton F, Sherazi Z, Tahir A, Tikka T, Tkachuk Hlinicanova O, To K, Tse A, Toll E, Ubayasiri K, Unadkat S, Upile N, Vijendren A, Walijee H, Wilkie M, Williams R, Williams M, Wilson G, Wong W, Wong G, Xie C, Yao A, Zhang H, Ellis M, Mehta N, Milinis K, Tikka T, Slovick A, Swords C, Hutson K, Smith ME, Hopkins C, Ng Kee Kwong F. Nasal Packs for Epistaxis: Predictors of Success. Clin Otolaryngol 2020; 45:659-666. [DOI: 10.1111/coa.13555] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 03/08/2020] [Accepted: 04/13/2020] [Indexed: 11/30/2022]
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Mehta N, Fagerlie S, Maeglin J. THU0582 EFFECTIVE MANAGEMENT OF REFRACTORY GOUT: EFFECT OF ONLINE CONTINUING EDUCATION ON RHEUMATOLOGISTS’ KNOWLEDGE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5874] [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:Gout is a chronic condition with a considerable effect on patient health and quality of life. Despite the availability of multiple pharmacologic treatments and evidence-based management guidelines, treatment targets are often not achieved in patients with gout. Identification and optimal management of patients with severe or refractory gout is specially challenging.Objectives:The objective of this study was to determine if an online, continuing education activity could improve knowledge of rheumatologists regarding strategies to ensure effective and safe use of urate-lowering therapies in the management of patients with refractory gout.Methods:Educational design included an online, 30-minute, video-based discussion among two faculty experts with synchronized slides. Educational effectiveness was assessed with a repeated-pairs pre-/post-assessment study design using 3 knowledge questions and 1 confidence question, in which each individual served as his/her own control. A chi-squared test assessed differences from pre- to post-assessment. P values <.05 are statistically significant. Cramer’s V was used to calculate the effect size (<0.06 modest effect; 0.06-0.15 noticeable effect; 0.16-0.26 considerable effect; >0.26 extensive effect). The activity launched May 1, 2019, with data collected through December 30, 2019.Results:The analysis set consisted of responses from rheumatologists (n=300) who answered all assessment questions during the study period. Analysis of pre- vs post-intervention responses demonstrated a significant improvement in overall knowledge of rheumatologists with considerable educational impact (V = .201, P<.001). Average correct responses increased from 54% pre to 74% post education. Specific areas of improvement in knowledge include:•Optimal strategies for reducing the risk for immunogenicity associated with the use of pegloticase in patients with refractory gout (40% pre, 73% post; P<.001; V = .326)•Serum uric acid targets to optimize management of the patient with severe or refractory gout (45% pre, 57% post; P<.05; V = .120)•Selection of pegloticase for rapid decreases in tophi and serum uric acid in patients with refractory gout (77% pre, 91% post; P<.001; V = .187)Post-education, 32% of rheumatologists were more confident in their ability to manage patients with refractory gout.Conclusion:This study demonstrated the success of online, 30-minute, video-based discussion among two faculty experts with synchronized slides on improving the knowledge of rheumatologists regarding appropriate management of patients with refractory gout.Disclosure of Interests:None declared
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Maripuri S, Sadi H, Nevius A, Terenzi G, Mehta N, Dragan IF. Using Evidence-Based Dentistry in the Clinical Management of Methadone Maintenance Therapy Patients. J Evid Based Dent Pract 2020; 20:101399. [PMID: 32381408 DOI: 10.1016/j.jebdp.2020.101399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 11/23/2019] [Accepted: 01/17/2020] [Indexed: 10/25/2022]
Abstract
AIMS AND OBJECTIVES There is an increased interest to incorporate interprofessional educational models in the academic dental institutions to serve both student education and patient care. The aim of this report is to integrate evidence-based dentistry (EBD) with an interprofessional approach to treat methadone maintenance therapy (MMT) patients. Current example illustrates the case of a 26-year-old man receiving MMT who presented at Tufts University School of Dental Medicine with the chief complaint of "I want to fix my teeth." He presented with a collapsed vertical dimension of occlusion, extensive partial edentulism on both arches with bone loss, and a past history of drug abuse since the age of 16 years. MATERIALS AND METHODS The 5-step (ask, acquire, appraise, apply, assess) framework for the EBD process was used. First, the PICO (population, intervention, comparison, and outcome) question was asked, and then the literature was acquired and appraised. An expert librarian assisted in finding articles on the effects of methadone on the oral cavity and consequences that will affect dental treatment. The search was conducted on PubMed, using the following keywords: oral health, dentistry, dental health, and methadone. The search was performed from 1/1/2005 to 1/1/2018. After appraisal, the studies were applied in the clinical setting and treatment outcomes were assessed both subjectively and objectively. RESULTS The initial search identified there is sparse evidence on the topic. Only 34 articles were acquired. Based on the scientific evidence published, the interprofessional expertise of the clinical care team, and patient's perspective, 4 treatment plan options were proposed. The selected treatment plan was considered the best option considering an EBD person-centered approach. Progress of treatment, outcomes, and lessons learned were assessed. CONCLUSIONS This study demonstrates that incorporating EBD concepts and an interprofessional approach, MMT patients can be successfully treated. Future studies on this topic are recommended, specially considering the growth of the opioid epidemic in the past years and the need to treat the MMT patients and educate students.
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Affiliation(s)
- S Maripuri
- DMD Class of 2019, Tufts University School of Dental Medicine, Boston, MA, USA
| | - H Sadi
- Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, MA, USA
| | - A Nevius
- Tufts University Hirsh Health Sciences Library, Boston, MA, USA
| | - G Terenzi
- Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, MA, USA
| | - N Mehta
- Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, MA, USA
| | - I F Dragan
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA, USA.
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Mehta N, Fujino T, Dela Cruz M, Holzhauser L, Rodgers D, Kalantari S, Smith B, Sarswat N, Nguyen A, Chung B, Uriel N, Raikhelkar J, Sayer G, Ota T, Song T, Jeevanandam V, Kim G, Grinstein J. Absence of Aortic Valve Opening after Hemodynamic Ramp Optimization Study Does Not Impact LVAD Morbidity of Mortality. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.408] [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: 10/24/2022] Open
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Mehta N, Fujino T, Belkin M, DelaCruz M, Yu D, Holzhauser L, Rodgers D, Smith B, Kalantari S, Sarswat N, Chung B, Nguyen A, Uriel N, Raikhelkar J, Sayer G, Song T, Ota T, Jeevanandam V, Kim G, Grinstein J. Prognostication of Residual Mitral Regurgitation or Aortic Insufficiency after Invasive Hemodynamic Ramp Optimization. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.994] [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: 10/24/2022] Open
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Wallace D, Cowling TE, Walker K, Suddle A, Gimson A, Rowe I, Callaghan C, Sapisochin G, Mehta N, Heaton N, van der Meulen J. Liver transplantation outcomes after transarterial chemotherapy for hepatocellular carcinoma. Br J Surg 2020; 107:1183-1191. [DOI: 10.1002/bjs.11559] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/05/2020] [Accepted: 01/27/2020] [Indexed: 12/19/2022]
Abstract
Abstract
Background
Transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC) awaiting liver transplantation is widespread, although evidence that it improves outcomes is lacking and there exist concerns about morbidity. The impact of TACE on outcomes after transplantation was evaluated in this study.
Methods
Patients with HCC who had liver transplantation in the UK were identified, and stratified according to whether they received TACE between 2006 and 2016. Cox regression methods were used to estimate hazard ratios (HRs) for death and graft failure after transplantation adjusted for donor and recipient characteristics.
Results
In total, 385 of 968 patients (39·8 per cent) received TACE. Five-year patient survival after transplantation was similar in those who had or had not received TACE: 75·2 (95 per cent c.i. 68·8 to 80·5) and 75·0 (70·5 to 78·8) per cent respectively. After adjustment for donor and recipient characteristics, there were no differences in mortality (HR 0·96, 95 per cent c.i. 0·67 to 1·38; P = 0·821) or graft failure (HR 1·01, 0·73 to 1·40; P = 0·964). The number of TACE treatments (2 or more versus 1: HR 0·97, 0·61 to 1·55; P = 0·903) or the time of death after transplantation (within or after 90 days; P = 0·291) did not alter the outcome. The incidence of hepatic artery thrombosis was low in those who had or had not received TACE (1·3 and 2·4 per cent respectively; P = 0·235).
Conclusion
TACE delivered to patients with HCC before liver transplant did not affect complications, patient death or graft failure after transplantation.
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Affiliation(s)
- D Wallace
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, UK
| | - T E Cowling
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - K Walker
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - A Suddle
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, UK
| | - A Gimson
- Liver Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - I Rowe
- Liver Unit, St James's Hospital and University of Leeds, Leeds, UK
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| | - C Callaghan
- Department of Nephrology and Transplantation, Renal Unit, Guy's Hospital, London, UK
| | - G Sapisochin
- Multi-Organ Transplant, Toronto General Surgery, Toronto, Ontario, Canada
- Department of General Surgery, University of Toronto, Toronto, Ontario, Canada
| | - N Mehta
- Division of Gastroenterology, Department of Medicine, University of California, San Francisco, California, USA
| | - N Heaton
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, UK
| | - J van der Meulen
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Hardy E, Spelke M, Emont J, Mehta N. Peripartum clostridium difficile infection: a 10-year experience at a single obstetric hospital, 2008-2018. Am J Obstet Gynecol 2019. [DOI: 10.1016/j.ajog.2019.10.026] [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: 10/25/2022]
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Susalka D, Mehta N, Dermer S. P217 PATHOPHYSIOLOGIC AND THERAPEUTIC TARGETS FOR ALLERGIC ASTHMA: ONLINE EDUCATION IMPROVES ON ALLERGISTS’ KNOWLEDGE AND COMPETENCE. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.283] [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: 10/25/2022]
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Mehta N, Dermer S, Susalka D. P157 CHRONIC IDIOPATHIC URTICARIA MANAGEMENT: ONLINE EDUCATION HAS EXTENSIVE IMPACT ON ALLERGISTS’ CLINICAL DECISIONS. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Morgaenko K, Noshin S, Stevenson W, Mehta N. P2842Sequential application of horizontal and vertical orientation on radiofrequency ablation lesions produced by thermocool smarttouch SF catheter. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Ablation lesions represent a complex interaction between the ablation catheter configuration and tissue anatomy. An understanding of each variable can assist in determination of the optimal lesion set. One such variable is the catheter orientation. With an irrigated radiofrequency ablation catheter with 6 pores (6P) near the distal tip, lesion surface area and volumes are smaller in the horizontal catheter orientation compared to the vertical catheter orientation. This finding is explained by the 6P irrigation catheter design, where irrigation fluid is discharged from six ports around the circumference of the electrode. Introduced in 2015, the ThermoCool SmartTouch® SF catheter has a 56-pore (56P) distribution to provide high density low volume irrigation settings. Irrigation catheters create smaller lesions in horizontal orientation compared to vertical orientation, however this has not been studied for the 56P irrigated catheter.
Purpose
Evaluate the impact of catheter orientation with sequential application of 56P catheter.
Methods
Ablation lesions were created on additive-free chicken model in a saline bath heated to 37°C using the 56P catheter under standard flow rate (8cc/min) conditions. Ablation energy of 20W and 30W was delivered twice for 30 seconds with 3 minutes interval between applications. Contact force (CF) of 5, 10, 15, and 20g was applied with the following conditions: horizontal catheter orientation followed by horizontal (HH), vertical by vertical (VV), horizontal by vertical (HV), and vertical by horizontal catheter orientation (VH). Measurements were obtained by lesion dissection through the midpoint by 3 independent operators. Kruskal-Wallis test was used for comparison of lesion depth, surface area and volume.
Results
Ninety-six lesions were analyzed. No coagulum or steam pops were included in the analysis. The minimum and maximum lesion depth, surface area and volume were 1.5 & 6.0 mm, 14.1 & 117.7mm2, 47.1 & 471.0 mm3 respectively. There was no significant difference in the lesion depth, surface area or volume in HH, VV, HV or VH orientation at different CF with 20W and 30W. (Fig 1)
Figure 1
Conclusion
Unlike other irrigated catheters, catheter orientation with sequential application with different CF and power did not impact lesion depth, surface area and volume with 56P catheter. This finding could be considered useful in situations where the catheter orientation could be challenging owing to tissue anatomy to achieve adequate lesion size.
Acknowledgement/Funding
UVA Health System
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Affiliation(s)
- K Morgaenko
- University of Virginia, Cardiovascular Medicine, Charlottesville, United States of America
| | - S Noshin
- University of Virginia, Cardiovascular Medicine, Charlottesville, United States of America
| | - W Stevenson
- Vanderbilt University, Heart and Vascular Center, Nashville, United States of America
| | - N Mehta
- University of Virginia, Cardiovascular Medicine, Charlottesville, United States of America
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LOOMBA BSN G, Sharma A, Mehta N. MON-158 EFFECTIVENESS OF EXERCISE REGIMEN ON SLEEL QUALITY IN PATIENTS WITH END STAGE RENAL DISEASE ON MAINTENANCE HEMODIALYSIS. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Mehta N, Gava A, Zhang D, Gao B, KREPINSKY J. SUN-189 FOLLISTATIN PROTECTS AGAINST ER STRESS-INDUCED OXIDATIVE STRESS AND APOPTOSIS BOTH IN VITRO AND IN VIVO IN CKD. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.592] [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: 10/26/2022] Open
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Pal SK, Chandel N, Mehta N. Synthesis and thermal characterization of novel phase change materials (PCMs) of the Se-Te-Sn-Ge (STSG) multi-component system: calorimetric studies of the glass/crystal phase transition. Dalton Trans 2019; 48:4719-4729. [PMID: 30900720 DOI: 10.1039/c8dt03729a] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
According to recent literature, germanium-containing chalcogenide glasses (ChGs) show improvement in thermal stability and glass-forming ability because of the self-organization of the glass network towards a more rigid structure. The Ge-containing ChGs play a potential role as PCMs in phase-change optical memory (PCOM) applications. This endeavor reports the synthesis of some novel PCMs with Ge as the chemical modifier to improve the kinetic parameters of glass/crystal phase transition. The compositional variation of the various kinetic parameters in the present STSG chalcogen-rich non-oxide glasses Se78-yGeyTe20Sn2 (0 ≤ y ≤ 6) has been studied by means of the state-of-the-art differential scanning calorimetric (DSC) technique in the non-isothermal mode. The thermally assisted glass transition and crystallization phenomena have been investigated by examining the variation in various kinetic parameters like the characteristic kinetic temperatures (glass transition temperature Tg, on-set crystallization temperature To and peak crystallization temperature Tc), the activation energies involved in both phenomena, the thermal stability factor S and the glass-forming ability (GFA). The thermal stability factor S and GFA increase appreciably at higher concentrations of Ge as a signature of stiffness transition followed by the self-organization of the corner-sharing and the edge-sharing arrangements of the GeSe4 phase.
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Affiliation(s)
- Shiv Kumar Pal
- Physics Department, Institute of Science, Banaras Hindu University, Varanasi-221005, India.
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Hirankumar G, Mehta N. Effect of incorporation of different plasticizers on structural and ion transport properties of PVA-LiClO 4 based electrolytes. Heliyon 2018; 4:e00992. [PMID: 30623123 PMCID: PMC6313818 DOI: 10.1016/j.heliyon.2018.e00992] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [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: 06/30/2018] [Revised: 08/17/2018] [Accepted: 11/27/2018] [Indexed: 11/14/2022] Open
Abstract
To date high ionic conducting polymer electrolytes are of great interest because of their potential applications in various electrochemical devices such as batteries, fuel cells, solar cells and super capacitors etc., as electrolytes. Ion conduction through polymer electrolytes can occur mostly in amorphous environment exists above their glass transition temperature (Tg). In order to improve ionic conductivity, many approaches such as addition of plasticizer, blending of polymers, nano composite have been employed. This paper reviews the influence of different plasticizers/additives on the ion transport mechanism of Poly(vinyl alcohol) (PVA)-LiClO4 polymer electrolytes since poly vinyl alcohol is a semi crystalline, synthetic biodegradable polymer and lithium perchlorate is one of the most moisture resistant lithium salts. This review also reveals the relation between dynamical disorder in polymer electrolyte with ionic conductivity.
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Affiliation(s)
- G Hirankumar
- Department of Physics, Ramakrishna Mission Vivekananda College, Chennai, 600004, India
| | - N Mehta
- Physics Department, Institute of Science, Banaras Hindu University, Varanasi 221005, India
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Hussain SA, Dey B, Bhattacharjee D, Mehta N. Unique supramolecular assembly through Langmuir - Blodgett (LB) technique. Heliyon 2018; 4:e01038. [PMID: 30582053 PMCID: PMC6298938 DOI: 10.1016/j.heliyon.2018.e01038] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [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: 04/14/2018] [Revised: 06/30/2018] [Accepted: 12/07/2018] [Indexed: 12/05/2022] Open
Abstract
The Langmuir-Blodgett (LB) technique is a way of making supra-molecular assembly in ultrathin films with a controlled layered structure and crystal parameter, which have many envisioned technological applications for optical and molecular electronic devices as well as signal processing and transformation. Probably LB technique is the best method to manipulate materials at molecular level and provides a scope to realize the molecular electronics in reality. In this review article, we have discussed about the general introduction of LB technique and recent development on LB and related system including (i) LB methodology, (ii) characterizations of LB films, (iii) LB films and molecular electronics, (iv) historical review of LB films, (v) research and applications including fundamental research and application towards devices.
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Affiliation(s)
- Syed Arshad Hussain
- Thin Film and Nanoscience Laboratory, Department of Physics, Tripura University, Suryamaninagar 799022, Tripura, India
| | - Bapi Dey
- Thin Film and Nanoscience Laboratory, Department of Physics, Tripura University, Suryamaninagar 799022, Tripura, India
| | - D. Bhattacharjee
- Thin Film and Nanoscience Laboratory, Department of Physics, Tripura University, Suryamaninagar 799022, Tripura, India
| | - N. Mehta
- Physics Department, Institute of Science, Banaras Hindu University, Varanasi 221005, India
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Abrams L, Mehta N. DEPRESSION TRAJECTORIES IN OLDER ADULTS: DIFFERENCES BY GENDER, RACE/ETHNICITY, EDUCATION, AND COHORT. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1797] [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: 11/13/2022] Open
Affiliation(s)
| | - N Mehta
- University of Michigan Department of Health Management and Policy
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Mehta N, Dermer S. PEANUT ALLERGEN IMMUNOTHERAPY: ONLINE EDUCATION IMPROVES KNOWLEDGE OF ALLERGIST LEARNERS. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.031] [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: 10/27/2022]
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Sorokin A, Kotani K, Dey A, Harrington C, Lerman J, Chung J, Rodante J, Bluemke D, Chen M, Playford M, Mehta N. Psoriasis specific changes in oxidized lipoproteins and its association with non-calcified coronary plaque. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Amin A, Sinha V, Sullivan T, Mehta N, Doshi M, Kuker R, Lencioni R, Narayanan G. 3:27 PM Abstract No. 184 Using FDG PET/CT to predict response to IRE in nonresectable pancreatic cancer: a retrospective analysis of 50 patients. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.207] [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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Phillips E, Kohlbrenner R, True-Yasaki A, Fidelman N, Taylor A, Lehrman E, Kohi M, Kolli K, Kerlan R, Mehta N. Abstract No. 522 Outcomes of TACE for hepatocellular carcinoma in patients with HIV infection. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.567] [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] Open
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Kowalski AJ, Poongothai S, Chwastiak L, Hutcheson M, Tandon N, Khadgawat R, Sridhar GR, Aravind SR, Sosale B, Anjana RM, Rao D, Sagar R, Mehta N, Narayan KMV, Unutzer J, Katon W, Mohan V, Ali MK. The INtegrating DEPrEssioN and Diabetes treatmENT (INDEPENDENT) study: Design and methods to address mental healthcare gaps in India. Contemp Clin Trials 2017. [PMID: 28642211 DOI: 10.1016/j.cct.2017.06.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Depression and diabetes are highly prevalent worldwide and often co-exist, worsening outcomes for each condition. Barriers to diagnosis and treatment are exacerbated in low and middle-income countries with limited health infrastructure and access to mental health treatment. The INtegrating DEPrEssioN and Diabetes treatmENT (INDEPENDENT) study tests the sustained effectiveness and cost-effectiveness of a multi-component care model for individuals with poorly-controlled diabetes and depression in diabetes clinics in India. MATERIALS AND METHODS Adults with diabetes, depressive symptoms (Patient Health Questionnaire-9 score≥10), and ≥1 poorly-controlled cardiometabolic indicator (either HbA1c≥8.0%, SBP≥140mmHg, and/or LDL≥130mg/dl) were enrolled and randomized to the intervention or usual care. The intervention combined collaborative care, decision-support, and population health management. The primary outcome is the between-arm difference in the proportion of participants achieving combined depression response (≥50% reduction in Symptom Checklist score from baseline) AND one or more of: ≥0.5% reduction in HbA1c, ≥5mmHg reduction in SBP, or ≥10mg/dl reduction in LDL-c at 24months (12-month intervention; 12-month observational follow-up). Other outcomes include control of individual parameters, patient-centered measures (i.e. treatment satisfaction), and cost-effectiveness. RESULTS The study trained seven care coordinators. Participant recruitment is complete - 940 adults were screened, with 483 eligible, and 404 randomized (196 to intervention; 208 to usual care). Randomization was balanced across clinic sites. CONCLUSIONS The INDEPENDENT model aims to increase access to mental health care and improve depression and cardiometabolic disease outcomes among complex patients with diabetes by leveraging the care provided in diabetes clinics in India (clinicaltrials.gov number: NCT02022111).
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Affiliation(s)
- A J Kowalski
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, United States
| | - S Poongothai
- Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, 4, Conran Smith Road, Gopalapuram, Chennai 600 086, Tamil Nadu, India
| | - L Chwastiak
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - M Hutcheson
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, United States
| | - N Tandon
- All India Institute of Medical Sciences, Department of Endocrinology & Metabolism, Biotechnology Block, 3rd Floor, Rm #312, Ansari Nagar, New Delhi 110 029, India
| | - R Khadgawat
- All India Institute of Medical Sciences, Department of Endocrinology & Metabolism, Biotechnology Block, 3rd Floor, Rm #312, Ansari Nagar, New Delhi 110 029, India
| | - G R Sridhar
- Endocrine and Diabetes Centre, Visakhapatnam, Andhra Pradesh, India
| | - S R Aravind
- Diacon Hospital, Diabetes Care and Research Center, Rajajinagar, Bangalore 560 010, Karantaka, India
| | - B Sosale
- Diacon Hospital, Diabetes Care and Research Center, Rajajinagar, Bangalore 560 010, Karantaka, India
| | - R M Anjana
- Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, 4, Conran Smith Road, Gopalapuram, Chennai 600 086, Tamil Nadu, India
| | - D Rao
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States; Department of Global Health, University of Washington, Seattle, WA, United States
| | - R Sagar
- All India Institute of Medical Sciences, Department of Psychiatry, Ansari Nagar, New Delhi 110 029, India
| | - N Mehta
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, United States
| | - K M V Narayan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, United States
| | - J Unutzer
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - W Katon
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - V Mohan
- Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, 4, Conran Smith Road, Gopalapuram, Chennai 600 086, Tamil Nadu, India
| | - M K Ali
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, United States.
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