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Erickson P, Jetley G, Amin P, Mejevdiwala A, Patel A, Cheng K, Parekkadan B. A cell culture system to model pharmacokinetics using adjustable-volume perfused mixing chambers. Toxicol In Vitro 2023; 91:105623. [PMID: 37236431 PMCID: PMC10526707 DOI: 10.1016/j.tiv.2023.105623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/03/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023]
Abstract
The pharmacokinetic (PK) profile of a drug is an essential factor in determining its efficacy, yet it is often neglected during in vitro cell culture experiments. Here, we present a system in which standard well plate cultures may be "plugged in" and perfused with PK drug profiles. Timed drug boluses or infusions are passed through a mixing chamber that simulates the PK volume of distribution specific to the desired drug. The user-specified PK drug profile generated by the mixing chamber passes through the incubated well plate culture, exposing cells to in vivo-like PK drug dynamics. The effluent stream from the culture may then optionally be fractionated and collected by a fraction collector. This low-cost system requires no custom parts and perfuses up to six cultures in parallel. This paper demonstrates a range of PK profiles the system can produce using a tracer dye, describes how to find the correct mixing chamber volumes to mimic PK profiles of drugs of interest, and presents a study exploring the effects of differing PK exposure on a model of lymphoma treatment with chemotherapy.
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Affiliation(s)
- Patrick Erickson
- Department of Chemical and Biochemical Engineering, Rutgers University, Piscataway, NJ 08854, USA
| | - Gunjan Jetley
- Department of Biomedical Engineering, Rutgers University, Piscataway, NJ 08854, USA
| | - Param Amin
- Department of Biomedical Engineering, Rutgers University, Piscataway, NJ 08854, USA
| | - Aamena Mejevdiwala
- Department of Biomedical Engineering, Rutgers University, Piscataway, NJ 08854, USA
| | - Ashna Patel
- Department of Biomedical Engineering, Rutgers University, Piscataway, NJ 08854, USA
| | - Kelli Cheng
- Department of Biomedical Engineering, Rutgers University, Piscataway, NJ 08854, USA
| | - Biju Parekkadan
- Department of Biomedical Engineering, Rutgers University, Piscataway, NJ 08854, USA; Department of Medicine, Rutgers Biomedical Health Sciences, New Brunswick, NJ 08852, USA.
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Liu Z, Garcia Reino EJ, Harschnitz O, Guo H, Chan YH, Khobrekar NV, Hasek ML, Dobbs K, Rinchai D, Materna M, Matuozzo D, Lee D, Bastard P, Chen J, Lee YS, Kim SK, Zhao S, Amin P, Lorenzo L, Seeleuthner Y, Chevalier R, Mazzola L, Gay C, Stephan JL, Milisavljevic B, Boucherit S, Rozenberg F, Perez de Diego R, Dix RD, Marr N, Béziat V, Cobat A, Aubart M, Abel L, Chabrier S, Smith GA, Notarangelo LD, Mocarski ES, Studer L, Casanova JL, Zhang SY. Encephalitis and poor neuronal death-mediated control of herpes simplex virus in human inherited RIPK3 deficiency. Sci Immunol 2023; 8:eade2860. [PMID: 37083451 PMCID: PMC10337828 DOI: 10.1126/sciimmunol.ade2860] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 08/05/2022] [Accepted: 03/30/2023] [Indexed: 04/22/2023]
Abstract
Inborn errors of TLR3-dependent type I IFN immunity in cortical neurons underlie forebrain herpes simplex virus-1 (HSV-1) encephalitis (HSE) due to uncontrolled viral growth and subsequent cell death. We report an otherwise healthy patient with HSE who was compound heterozygous for nonsense (R422*) and frameshift (P493fs9*) RIPK3 variants. Receptor-interacting protein kinase 3 (RIPK3) is a ubiquitous cytoplasmic kinase regulating cell death outcomes, including apoptosis and necroptosis. In vitro, the R422* and P493fs9* RIPK3 proteins impaired cellular apoptosis and necroptosis upon TLR3, TLR4, or TNFR1 stimulation and ZBP1/DAI-mediated necroptotic cell death after HSV-1 infection. The patient's fibroblasts displayed no detectable RIPK3 expression. After TNFR1 or TLR3 stimulation, the patient's cells did not undergo apoptosis or necroptosis. After HSV-1 infection, the cells supported excessive viral growth despite normal induction of antiviral IFN-β and IFN-stimulated genes (ISGs). This phenotype was, nevertheless, rescued by application of exogenous type I IFN. The patient's human pluripotent stem cell (hPSC)-derived cortical neurons displayed impaired cell death and enhanced viral growth after HSV-1 infection, as did isogenic RIPK3-knockout hPSC-derived cortical neurons. Inherited RIPK3 deficiency therefore confers a predisposition to HSE by impairing the cell death-dependent control of HSV-1 in cortical neurons but not their production of or response to type I IFNs.
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Affiliation(s)
- Zhiyong Liu
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY, USA
| | - Eduardo J Garcia Reino
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY, USA
| | - Oliver Harschnitz
- The Center for Stem Cell Biology, Sloan Kettering Institute for Cancer Research, New York, NY, USA
- Human Technopole, Viale Rita Levi-Montalcini, Milan, Italy
| | - Hongyan Guo
- Department of Microbiology and Immunology, Emory Vaccine Center, Emory University, GA, USA
- School of Medicine, Atlanta, GA, USA
- Louisiana State University Health Sciences Center at Shreveport (LSUHSC-S), Shreveport, LA, USA
| | - Yi-Hao Chan
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY, USA
| | - Noopur V Khobrekar
- The Center for Stem Cell Biology, Sloan Kettering Institute for Cancer Research, New York, NY, USA
| | - Mary L Hasek
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY, USA
| | - Kerry Dobbs
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA
| | - Darawan Rinchai
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY, USA
| | - Marie Materna
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Paris City University, Imagine Institute, Paris, France
| | - Daniela Matuozzo
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Paris City University, Imagine Institute, Paris, France
| | - Danyel Lee
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Paris City University, Imagine Institute, Paris, France
| | - Paul Bastard
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Paris City University, Imagine Institute, Paris, France
- Pediatric Hematology-Immunology and Rheumatology Unit, Necker Hospital for Sick Children, AP-HP, Paris, France
| | - Jie Chen
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY, USA
| | - Yoon Seung Lee
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY, USA
| | | | - Shuxiang Zhao
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY, USA
| | - Param Amin
- The Center for Stem Cell Biology, Sloan Kettering Institute for Cancer Research, New York, NY, USA
| | - Lazaro Lorenzo
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Paris City University, Imagine Institute, Paris, France
| | - Yoann Seeleuthner
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Paris City University, Imagine Institute, Paris, France
| | - Remi Chevalier
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Paris City University, Imagine Institute, Paris, France
| | - Laure Mazzola
- Department of Pediatrics, Hôpital Nord, Saint-Etienne, Paris, France
| | - Claire Gay
- Department of Pediatrics, Hôpital Nord, Saint-Etienne, Paris, France
| | | | - Baptiste Milisavljevic
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY, USA
| | - Soraya Boucherit
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Paris City University, Imagine Institute, Paris, France
| | - Flore Rozenberg
- Laboratory of Virology, Assistance Publique-Hôpitaux de Paris (AP-HP), Cochin Hospital, Paris, France
| | - Rebeca Perez de Diego
- Laboratory of Immunogenetics of Human Diseases, IdiPAZ Institute for Health Research, La Paz Hospital, Madrid, Spain
- Innate Immunity Group, IdiPAZ Institute for Health Research, La Paz Hospital, Madrid, Spain
- Interdepartmental Group of Immunodeficiencies, Madrid, Spain
| | - Richard D Dix
- Viral Immunology Center, Department of Biology, Georgia State University, Atlanta, GA, USA
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA
| | - Nico Marr
- Research Branch, Sidra Medicine, Doha, Qatar
- Institute of Translational Immunology, Brandenburg Medical School, Brandenburg an der Havel, Germany
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Vivien Béziat
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Paris City University, Imagine Institute, Paris, France
| | - Aurelie Cobat
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Paris City University, Imagine Institute, Paris, France
| | - Mélodie Aubart
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Pediatric Neurology Department, Necker Hospital for Sick Children, APHP, Paris City University, Paris, France
| | - Laurent Abel
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Paris City University, Imagine Institute, Paris, France
| | - Stephane Chabrier
- Department of Pediatrics, Hôpital Nord, Saint-Etienne, Paris, France
| | - Gregory A Smith
- Department of Microbiology-Immunology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Luigi D Notarangelo
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA
| | - Edward S Mocarski
- Department of Microbiology and Immunology, Emory Vaccine Center, Emory University, GA, USA
| | - Lorenz Studer
- The Center for Stem Cell Biology, Sloan Kettering Institute for Cancer Research, New York, NY, USA
| | - Jean-Laurent Casanova
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Paris City University, Imagine Institute, Paris, France
- Department of Pediatrics, Necker Hospital for Sick Children, Paris, France
- Howard Hughes Medical Institute, New York, NY, USA
| | - Shen-Ying Zhang
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Paris City University, Imagine Institute, Paris, France
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Erickson P, Doshi A, Jetley G, Amin P, Mejevdiwala A, Patel A, Bento R, Parekkadan B. Multi-Stream Perfusion Bioreactor Integrated with Outlet Fractionation for Dynamic Cell Culture. J Vis Exp 2022:10.3791/63935. [PMID: 35938803 PMCID: PMC9631111 DOI: 10.3791/63935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Abstract
Certain cell and tissue functions operate within the dynamic time scale of minutes to hours that are poorly resolved by conventional culture systems. This work has developed a low-cost perfusion bioreactor system that allows culture medium to be continuously perfused into a cell culture module and fractionated in a downstream module to measure dynamics on this scale. The system is constructed almost entirely from commercially available parts and can be parallelized to conduct independent experiments in conventional multi-well cell culture plates simultaneously. This video article demonstrates how to assemble the base setup, which requires only a single multichannel syringe pump and a modified fraction collector to perfuse up to six cultures in parallel. Useful variants on the modular design are also presented that allow for controlled stimulation dynamics, such as solute pulses or pharmacokinetic-like profiles. Importantly, as solute signals travel through the system, they are distorted due to solute dispersion. Furthermore, a method for measuring the residence time distributions (RTDs) of the components of the perfusion setup with a tracer using MATLAB is described. RTDs are useful to calculate how solute signals are distorted by the flow in the multi-compartment system. This system is highly robust and reproducible, so basic researchers can easily adopt it without the need for specialized fabrication facilities.
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Affiliation(s)
- Patrick Erickson
- Department of Chemical and Biochemical Engineering, Rutgers University
| | - Aneesha Doshi
- Department of Biomedical Engineering, Rutgers University
| | - Gunjan Jetley
- Department of Biomedical Engineering, Rutgers University
| | - Param Amin
- Department of Biomedical Engineering, Rutgers University
| | | | - Ashna Patel
- Department of Biomedical Engineering, Rutgers University
| | - Raphaela Bento
- Department of Biomedical Engineering, Rutgers University
| | - Biju Parekkadan
- Department of Biomedical Engineering, Rutgers University; Department of Medicine, Rutgers Biomedical Health Sciences;
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Amin P, Riyadi P, Kurniasih R, Husni A. Utilization of κ-carrageenan as stabilizer and thickener of honey pineapple
(Ananas comosus [L. Merr]) jam. Food Res 2022. [DOI: 10.26656/fr.2017.6(2).060] [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: 11/12/2022] Open
Abstract
Honey pineapple jam is an intermediate moisture food that often has low stability; hence it
is not strong enough to hold the fruit tissue sugar in position during storage. Therefore, it
is necessary to add hydrocolloid in fruit jam processing to increase stability and
consistency, one of which is κ-carrageenan. The purpose of this study was to determine
the effect of adding κ-carrageenan towards stability and preference for honey pineapple
jam. The κ-carrageenan concentrations used were 0%, 0.5%, 1%, and 1.5% (w/w) of total
ingredients. The ratio of honey pineapple pulp and sugar was 4:1 (w/w). The results
showed that the addition of κ-carrageenan had a significant effect (p<0.05) on the hedonic
evaluation of colour, smearing ability, and texture; moisture content, water activity (Aw),
syneresis and texture (hardness, cohesiveness, and adhesiveness). The addition of κcarrageenan had no significant effect (p>0.05) on the hedonic evaluation (preference) of
aroma and taste. Increasing the κ-carrageenan concentration can increase the hedonic
value for colour and decrease the hedonic value for smearing ability and texture.
Increasing the concentration of κ-carrageenan can also increase the value of hardness and
cohesiveness but decrease water activity, syneresis, and adhesiveness. The addition of κcarrageenan 0.5% was more efficient in shortening the cooking time until 25%, inhibiting
syneresis by 30%, and improving the colour of honey pineapple jam.
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Amin P, Chan T. 597 Counting on You to do The Count: An Unusual Case Report of a Delayed and Missed Gossypiboma Secondary to Swiss Cheese Model Failings. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.306] [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: 11/13/2022]
Abstract
Abstract
Introduction
Gossypiboma is a term describing a retained surgical swab which is a serious complication following any surgical intervention. The incidence of these cases is wholly under reported, partly due to medicolegal aspects, but also due to the misnomer of diagnosis. In this case, we discuss the multifactorial deficiencies which led to a significant morbidity in a patient who had remained asymptomatic for nine years since index surgery.
Case Presentation
A 40-year-old woman presented to the emergency department febrile with a one week history of abdominal pain, on a background of a one year history of chronic pain. The patient’s surgical history demonstrated an ovarian fibroid excision and a subtotal hysterectomy nine and six years ago, respectively. It was later noted the chronic abdominal pain had been previously investigated with positive findings on imaging and biopsy, however, she was lost to follow up. A year later, she presented with an acute abdomen and operative findings of a large abscess cavity, containing a retained swab, with small bowel fistulation were noted.
Conclusions
This reiterates the importance of surgical safety checklists, and often despite this there are many factors that can eventually lead to complete alignment of the holes in the Swiss Cheese leading to unfavourable outcomes. It is imperative to remain hypervigilant during checkpoints, particularly in emergencies where the unpredictability of the operation leads to human error. Gossypiboma remains a serious cause for morbidity and mortality, thus the potential for modified safety checklists or alternative methods for surgical counts.
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Affiliation(s)
- P Amin
- Dartford & Gravesham Trust, Dartford, United Kingdom
| | - T Chan
- Dartford & Gravesham Trust, Dartford, United Kingdom
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Ansari O, Kus J, Somnay V, Sullivan I, Molvar C, Amin P. Abstract No. 461 Hepatic tumor response to Y90 radioembolization in anemic versus non-anemic patients. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.270] [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] Open
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Ansari O, Kus J, Somnay V, Molvar C, Amin P. Abstract No. 460 Absence of gluteal necrosis following pelvic embolization in trauma patients. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.269] [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: 11/16/2022] Open
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Sullivan I, Fonseca A, Brown M, Ness J, Borge M, Amin P, Molvar C. Abstract No. 476 Portal vein recanalization using Inari FlowTriever system: a single-center experience. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.285] [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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9
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Divatia JV, Chawla R, Kapadia F, Myatra SN, Rajagopalan R, Amin P, Khilnani P, Prayag S, Todi SK, Uttam R. Guidelines for end-of-life and palliative care in Indian intensive care to units: ISCCM consensus Ethical Position Statement. Indian J Crit Care Med 2020. [DOI: 10.5005/ijccm-17-s1-26] [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: 11/23/2022] Open
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Amin P, Herath D, Rajput-Ray M, Ray S, Golubic R. First insights into expressed nutrition training needs of a sample of trainee doctors in Cambridge. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Alsafi Z, Hameed Y, Amin P, Shamsad S, Raja U, Alsafi A, Hamady MS. Assessing the effects of manual dexterity and playing computer games on catheter-wire manipulation for inexperienced operators. Clin Radiol 2017; 72:795.e1-795.e5. [PMID: 28522259 DOI: 10.1016/j.crad.2017.03.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 03/12/2017] [Accepted: 03/21/2017] [Indexed: 11/15/2022]
Abstract
AIM To investigate the effect of playing computer games and manual dexterity on catheter-wire manipulation in a mechanical aortic model. MATERIAL AND METHODS Medical student volunteers filled in a preprocedure questionnaire assessing their exposure to computer games. Their manual dexterity was measured using a smartphone game. They were then shown a video clip demonstrating renal artery cannulation and were asked to reproduce this. All attempts were timed. Two-tailed Student's t-test was used to compare continuous data, while Fisher's exact test was used for categorical data. RESULTS Fifty students aged 18-22 years took part in the study. Forty-six completed the task at an average of 168 seconds (range 103-301 seconds). There was no significant difference in the dexterity score or time to cannulate the renal artery between male and female students. Students who played computer games for >10 hours per week had better dexterity scores than those who did not play computer games: 9.1 versus 10.2 seconds (p=0.0237). Four of 19 students who did not play computer games failed to complete the task, while all of those who played computer games regularly completed the task (p=0.0168). CONCLUSION Playing computer games is associated with better manual dexterity and ability to complete a basic interventional radiology task for novices.
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Affiliation(s)
- Z Alsafi
- University College London Medical School, University College London, Gower St, Kings Cross, London WC1E 6BT, UK
| | - Y Hameed
- University College London Medical School, University College London, Gower St, Kings Cross, London WC1E 6BT, UK
| | - P Amin
- University College London Medical School, University College London, Gower St, Kings Cross, London WC1E 6BT, UK
| | - S Shamsad
- University College London Medical School, University College London, Gower St, Kings Cross, London WC1E 6BT, UK
| | - U Raja
- Imperial College Healthcare NHS, St Mary's Hospital, Praed St, London W2 1NY, UK
| | - A Alsafi
- Imperial College Healthcare NHS, St Mary's Hospital, Praed St, London W2 1NY, UK.
| | - M S Hamady
- Imperial College Healthcare NHS, St Mary's Hospital, Praed St, London W2 1NY, UK
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Dombrowski J, Ogilvie R, Glaenzer B, Molvar C, Ozga T, Borge M, Malamis A, Amin P. Managing tunneled/implanted central venous access devices in patients with bacteremia: A comparative analysis across two institutions. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.1180] [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: 11/15/2022] Open
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Patel M, Woerner A, Borge M, Fouad H, Amin P, Cotler S, Molvar C. Conventional transarterial chemoembolization for hepatocellular carcinoma in patients with total bilirubin levels ≥3.0 mg/dL. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.1110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Diamond J, Adams W, Mitchell R, Amin P, Molvar C, Malamis A. Predictors of cholecystostomy tube clinical outcomes. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.1137] [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] Open
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Lemay JF, Langenberger S, Amin P. Improving Diagnostic Efficiency in Children Aged 12-39 Months Referred for Autism Spectrum Disorder (ASD). Paediatr Child Health 2016. [DOI: 10.1093/pch/21.supp5.e93a] [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: 11/13/2022] Open
Abstract
Abstract
BACKGROUND: Early diagnosis and intervention for ASD is important. The increasing prevalence of ASD in Canada is challenging teams performing ASD diagnostic evaluations to keep pace with demand. In October 2013, the ASD clinic at our Pediatric Tertiary Care Centre (PTCC) faced a waitlist of more than twelve months for children under 39 months of age; it became necessary to engage in a quality improvement with the aim of looking for efficiencies with a focus of reducing our waitlist.
OBJECTIVES: To present a) two years of experience (Jan. 2014-Dec. 2015) using our diagnostic assessment model for evaluation of children aged 12-39 months referred for ASD evaluation to PTCC, and b) psychometric performance of RITA-T (Rapid Interactive Test for Autism in Toddlers-developed by Choueiri/Wagner – Boston).
DESIGN/METHODS: This quality improvement project incorporated evidence-based practice with process improvement methodology. Our team utilized a Plan-Do-Study-Act (PDSA) approach in the development of a ‘new’ ASD standardized diagnostic process. Our new model included: a) an initial mandatory parent education session followed one week later by b) a child visit using the face-to-face ‘level 2 screening tool’ (RITA-T) + completion of M-CHAT (questionnaire) followed in 7-10 days by c) an ASD diagnostic evaluation appointment, and finally 5-7 days after evaluation d) an “After ASD Diagnosis” parent group session.
RESULTS: We assessed a total of 173 patients (81% male, mean age 30.74±5.53 mo., interval 15.4-39.0 mo.). The diagnostic process was completed within a max 30-day cycle (previously a period >4 months) and required less hours/child (12 vs. 20 hours – overall 40% net gain or 1384 hours). Waitlist was reduced to <1 month (compared to >12 mo. in Oct. 2013). A total of 143 children (82.7% of total cohort; 116 male/27 female) were diagnosed with ASD. The discriminative properties of RITA-T were calculated: Sensitivity: 0.99; Specificity 0.53; Positive Predictive Value 0.91; Negative Predictive Value: 0.94.
CONCLUSION: By following a combination of quality improvement methodology with evidence-based practice, we successfully reduced wait and cycle times at our PTCC for children aged 12-39 months referred for ASD diagnostic assessment. RITA-T showed very good discriminative properties and was instrumental in the overall process improvement. This sustainable diagnostic approach promoted practice innovation. Consequently, patients are now able to access critical community supports and resources in a timely manner.
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Xu H, Lee S, Diwanji T, Amin P, Krudys K, Guerrero M. SU-F-T-40: Can CBCT Images Be Used for Volume Studies of Prostate Seed Implants for Boost Treatment? Med Phys 2016. [DOI: 10.1118/1.4956175] [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: 11/07/2022] Open
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17
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Annes J, Annes J, Mahon S, Turk T, Malamis A, Borge M, Molvar C, Amin P. Multiple-tract percutaneous nephroureteral access prior to percutaneous nephrolithotomy/-tripsy (PCNL) for large stone burden does not increase periprocedural morbidity compared to traditional single-tract access. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.341] [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: 10/22/2022] Open
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18
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Dalal JJ, Amin P, Ansari AS, Bhave A, Bhagwat RG, Challani A, Ganeshkumar AV, Gupta R, Hegde A, Karnik P, Khan Z, Mehta S, Ravat H, Rajan S, Tulsigiri C. Management of Acute Pulmonary Embolism: Consensus Statement for Indian Patients. J Assoc Physicians India 2015; 63:41-50. [PMID: 27666903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
UNLABELLED Pulmonary embolism (PE) is an important cause of morbidity and mortality among hospitalized patients. Although the exact epidemiology of PE is not known in India, Some of the studies show that more frequently it is missed and not managed appropriately leading to significant cardiovascular morbidity and mortality. Justification and purpose: Indian guidelines for the diagnosis and treatment of acute PE are not yet formulated. The objective of this consensus statement is to propose a diagnostic and management approach for acute PE in India. PROCESS A working group of 15 experts in the management of acute PE (cardiologists, pulmonologist, haematologist, emergency specialist and intensivists). This consensus statement makes recommendations for diagnosis and management for PE based on literature review, including Indian data.
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Affiliation(s)
- J J Dalal
- Director, Centre for Cardiac Sciences
| | | | | | | | | | | | | | | | - A Hegde
- Consultant Physician and Intensivist, Department of Medicine and Critical Care, Hinduja Hospital, Mumbai
| | | | - Z Khan
- Cardiologist, Fortis Hospital, Kalyan, Maharashtra
| | - S Mehta
- Emergency Physician, Kokilaben Dhirubhai Ambani Hospital, Mumbai
| | - H Ravat
- Cardiologist, Fortis Hospital, Mumbai
| | - S Rajan
- Pulmonologist, Bombay Hospital and Medical Research Centre, Mumbai
| | - C Tulsigiri
- Intensivist, Fortis Hiranandani Hospital,Navi Mumbai
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Amin P. Re: Are we (mis)guided by current guidelines on intrapartum fetal heart rate monitoring? Case for a more physiological approach to interpretation. BJOG 2015; 122:588. [PMID: 25702549 DOI: 10.1111/1471-0528.13269] [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] [Accepted: 11/05/2014] [Indexed: 11/30/2022]
Affiliation(s)
- P Amin
- Department of O & G, University Hospital of Wales, Cardiff, Wales, UK
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20
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Rutenberg M, Schinkel C, Yang X, Amin P, Vujaskovic Z, Prado K, Yi B. Dosimetric Advantages of an Adaptive Strategy Using Dual-Plan Superposition for Whole Pelvis Radiation Therapy in High-Risk Prostate Cancer. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.2666] [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: 11/15/2022]
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21
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Divatia JV, Chawla R, Kapadia F, Myatra SN, Rajagopalan R, Amin P, Khilnani P, Prayag S, Todi SK, Uttam R. Guidelines for end-of-life and palliative care in Indian intensive care to units: ISCCM consensus Ethical Position Statement. Indian J Crit Care Med 2013. [DOI: 10.5005/ijccm-17-5-26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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22
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Grabowski S, Earl M, Chung H, Citron W, Oh M, Amin P, Kwok Y, Hanlon A, Cohen R. Androgen Deprivation Therapy Is Associated With a Significant Change in Prostate Volume Throughout Definitive Radiation Therapy for Localized Prostate Cancer. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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23
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Schinkel C, Rutenberg M, Yang X, Amin P, Vujaskovic Z, Prado K, Yi B. Dosimetric Effects of Daily Anatomic Variations When Treating High Risk Prostate With Whole Pelvis IMRT Using an Adaptive Strategy and Dual-Plan Superposition. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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24
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Edelman RR, Giri S, Dunkle E, Galizia M, Amin P, Koktzoglou I. Quiescent-inflow single-shot magnetic resonance angiography using a highly undersampled radial k-space trajectory. Magn Reson Med 2013; 70:1662-8. [PMID: 23348595 DOI: 10.1002/mrm.24596] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 11/01/2012] [Accepted: 11/26/2012] [Indexed: 11/09/2022]
Abstract
PURPOSE We hypothesized that high undersampling factors could be used in conjunction with radial quiescent-inflow single-shot magnetic resonance angiography (MRA) to accelerate the data acquisition and enable multislice acquisitions. METHODS Seven subjects were imaged on a 1.5 T MRI system. For multislice quiescent-inflow single-shot MRA, the venous saturation radiofrequency pulse, in-plane saturation radiofrequency pulse, and quiescent interval were applied only once before the first slice. RESULTS The mean (standard deviation) measurements for the intra-arterial signal-to-noise ratio were as follows: Cartesian 1 slice-29.3 (5.5); radial 1 slice, 92 views-22.3 (3.6); radial 1 slice, 46 views-18.5 (2.0); radial 2 slices, 46 views-18.3 (3.2); and radial 3 slices, 32 views-21.7 (3.9), normalized for pixel size to 15.8. Horizontal striping was present with multislice radial quiescent-inflow single-shot MRA (especially with the three-slice acquisition) due to variable T1 relaxation between the concurrently acquired slices, but the image quality remained diagnostic. Vascular pathology in patients with peripheral arterial disease was well shown by all techniques. CONCLUSION Very high undersampling factors in excess of 18 have been demonstrated for nonenhanced MRA using a radial quiescent-inflow single-shot technique, enabling the acquisition of two to three slices per cardiac cycle. Scan time for a complete peripheral MRA could be shortened to 2 min or less.
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Affiliation(s)
- R R Edelman
- NorthShore University HealthSystem, Evanston, Illinois, USA; Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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25
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Mani RK, Amin P, Chawla R, Divatia JV, Kapadia F, Khilnani P, Myatra SN, Prayag S, Rajagopalan R, Todi SK, Uttam R. Guidelines for end-of-life and palliative care in Indian intensive care units' ISCCM consensus Ethical Position Statement. Indian J Crit Care Med 2012. [PMID: 23188961 PMCID: PMC3506078 DOI: 10.4103/0972-5229.102112] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- R K Mani
- Committee for the Development of Guidelines for limiting life-prolonging interventions and providing palliative care towards the end-of-life: Indian Society of Critical Care Medicine
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26
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Kwok Y, Saltos A, Boggs D, Naslund M, Hussain A, Amin P. Long-term Follow-up of Combined Modality Therapy With Pelvic External Radiation Followed by Cs-131 Brachytherapy Boost in Men With High-Risk Prostate Cancer. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1069] [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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27
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Sharma N, Nichols E, Grabowski S, Amin P, Garofalo M, Hanlon A, Hanna N, Patel R, Horiba M, Moeslein F. PO-405 EARLY INTERVENTION WITH SELECTIVE INTERNAL RADIATION THERAPY (SIRT) IMPROVES SURVIVAL AND LOCAL/SYSTEMIC OPTIONS. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)72371-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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28
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Amin P, Zangan S, Ahmed O, Thomas S. Abstract No. 64: Does a new lung lesion in patients with a known primary malignancy warrant a CT-guided percutaneous biopsy? A retrospective review at a cancer center. J Vasc Interv Radiol 2012. [DOI: 10.1016/j.jvir.2011.12.102] [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: 10/28/2022] Open
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29
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Grabowski S, Nichols E, Kudryasheva S, Patel R, Garofalo M, Amin P, Moeslein F, Regine W, Sharma N. The Efficacy of Selective Internal Radiation Therapy (SIRT) With Yttrium-90 (Y90) is Enhanced When Given in Low Volume Disease and in Conjunction With Other Liver-Directed Therapies. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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30
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Yi B, Yu C, Lerma F, Prado K, Amin P. SU-E-T-448: A Dual-Plan Superposition and Adaptive Setup Strategy for the Reduction of Planning Margins in Whole-Pelvis and Prostate IMRT. Med Phys 2011. [DOI: 10.1118/1.3612402] [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: 11/07/2022] Open
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31
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Calderon K, Amin P, Hazzan A, Gitman M, Jhaveri K. 45 Multi-Organ Crystal Deposition in a Rare Case of Crystalglobulinemia. Am J Kidney Dis 2011. [DOI: 10.1053/j.ajkd.2011.02.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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32
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Amin P, Mithani S, Ponda P. Possible Causes Of New Onset Food Allergies In Adult Patients. J Allergy Clin Immunol 2011. [DOI: 10.1016/j.jaci.2010.12.138] [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: 11/16/2022]
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33
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Mohammed AR, Amin P. An unusual cause of a sellar mass. Case Reports 2010; 2010:2010/dec17_1/bcr0520103025. [DOI: 10.1136/bcr.05.2010.3025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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34
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Kwok Y, Wu Y, Mirmiran A, DiBiase S, Goloubeva O, Bridges B, Mannuel H, Dawson N, Amin P, Hussain A. Prospective Trial of Escalating Doses of Paclitaxel, Concurrent Radiation and Androgen Deprivation in High-risk Prostate Cancer with or without Prior Prostatectomy. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.839] [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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35
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Makam VA, George L, Amin P, Sagi S. P2 Use of inhalable insulin in pregnancy: A case report. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)61494-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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36
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Makam VA, George L, Amin P, Sagi SV, Varma S. Use of inhalable insulin in pregnancy. J OBSTET GYNAECOL 2009; 29:662-3. [PMID: 19757278 DOI: 10.1080/01443610903144599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- V Adinarayana Makam
- Department of Obstetrics and Gynaecology, University Hospital of Wales, Cardiff, UK.
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Abstract
We conducted a retrospective study to determine the efficacy and safety of self-administration of vaginal misoprostol (following oral mifeprestone) for medical termination of pregnancy. This study revealed that self-administration was accepted by the majority of the patients (90%) and the success rate (98.4%) and duration of hospital stay was not altered significantly compared to our previous year's data, where women were administered vaginal misoprostol by the staff. Based on this study's results, we are of the opinion that this regimen not only demedicalises the problem but also decreases the workload for the medical staff.
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Affiliation(s)
- U Kiran
- Department of Obstetrics and Gynaecology, University Hospital of Wales, Cardiff, UK.
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38
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Lerma F, MacVittie T, Farese A, Wang Z, Amin P. SU-FF-T-484: Late Survival Post Acute Total Body Irradiation in the Rhesus Macaque With Bone Marrow Sparing. Med Phys 2009. [DOI: 10.1118/1.3181982] [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: 11/07/2022] Open
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39
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Wu Y, Kwok Y, Mirmiran A, Goloubeva O, Mannuel H, Dawson N, Amin P, Hussain A. Weekly paclitaxel (P) with concurrent external beam radiation (EBRT) and androgen deprivation therapy (ADT) in high-risk prostate cancer (PC) patients with or without prior prostatectomy (RP). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5122 Background: EBRT with ADT (4 mos to 2–3 yrs) is standard treatment for high risk PC. In this trial, we evaluated weekly P given concurrently with EBRT and ADT in high risk PC. Methods: For pts undergoing RP, high risk was defined as: pT3 and/or pN+, M0, and/or rising PSA (> 0.5) post RP. For pts not undergoing RP (i.e. locally advanced PC [LAPC]) high risk included: cT2b-4N0, N+, M0; bGS 8–10; bGS ≥ 7 + PSA ≥ 10 but ≤ 150; and/or PSA ≥ 20 but ≤ 150. Treatment included ADT (4 or 24 mos, preplanned based on clinical presentation), P (40, 50, or 60 mg/m2/wk) x 7 with EBRT, and whole pelvis EBRT 45 Gy with 19.8 Gy boost (total 64.8 Gy) to prostate bed in RP pts and 25.2 Gy boost (total 70.2 Gy) to prostate in LAPC pts. Results: Between October 1999 and December 2006, 59 pts (29 W, 28 AA) were enrolled (n = 29 LAPC, n = 30 RP); median age 67 yrs, median PSA at trial entry 5.9 (27.5 LAPC, 1.6 RP), median GS 8. Pts were enrolled at different weekly doses of P: 40 mg/m2 n = 10 pts; 50 mg/m2 n = 31 pts; 60 mg/m2 n = 18 pts. ADT for 4 mos was given in 29 pts and for 24 mos in 30 pts. At 40 mg/m2 67/70 (96%), 50 mg/m2 202/217 (93%), and 60 mg/m2 98/126 (78%) planned doses of P were given. There were no acute grade 4 toxicities. Most common grade 3 toxicities were diarrhea 15%, urinary urgency or incontinence 10%, tenesmus 5%, and leukopenia 3%. Median duration of f/u was 75.3 mos, OS 78%, biochemical progression 24/59 (41%) pts, clinical progression 11/59 (19%) pts. Time to biochemical progression was similar between RP vs. LAPC (p = 0.17), between ADT 4 mos vs. 24 mos (p = 0.61), and between AA vs. W (p = 0.54). Conclusions: This trial establishes the feasibility of tri-modality therapy with ADT, EBRT and weekly paclitaxel in high risk PC, both in RP pts and in LAPC pts with intact prostate glands. The maximum tolerated dose of paclitaxel is 50 mg/m2 /wk when given weekly with concurrent radiation to the pelvis and hormone ablation. No significant financial relationships to disclose.
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Affiliation(s)
- Y. Wu
- University of Maryland, Baltimore, MD; Georgetown University Medical Center, Washington, DC
| | - Y. Kwok
- University of Maryland, Baltimore, MD; Georgetown University Medical Center, Washington, DC
| | - A. Mirmiran
- University of Maryland, Baltimore, MD; Georgetown University Medical Center, Washington, DC
| | - O. Goloubeva
- University of Maryland, Baltimore, MD; Georgetown University Medical Center, Washington, DC
| | - H. Mannuel
- University of Maryland, Baltimore, MD; Georgetown University Medical Center, Washington, DC
| | - N. Dawson
- University of Maryland, Baltimore, MD; Georgetown University Medical Center, Washington, DC
| | - P. Amin
- University of Maryland, Baltimore, MD; Georgetown University Medical Center, Washington, DC
| | - A. Hussain
- University of Maryland, Baltimore, MD; Georgetown University Medical Center, Washington, DC
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40
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Diebel L, Amin P, Liberati D. QS216. Synergistic Effect of Hypoxia/Reoxygenation and Alcohol Exposure on Intestinal Cell Mediated Pulmonary Endothelial Cell Dysfunction. J Surg Res 2009. [DOI: 10.1016/j.jss.2008.11.517] [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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41
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Bhagat S, Bansal M, Jandhyala R, Sharma H, Amin P, Pandit JP. Wide excision and ulno-carpal arthrodesis for primary aggressive and recurrent giant cell tumours. Int Orthop 2008; 32:741-5. [PMID: 17643243 PMCID: PMC2898956 DOI: 10.1007/s00264-007-0416-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2007] [Revised: 04/25/2007] [Accepted: 04/27/2007] [Indexed: 11/28/2022]
Abstract
Twenty-five patients underwent wide resection of the distal radial giant cell tumours (GCTs) followed by ulno-carpal arthrodesis. There were 15 male and ten female patients, with an average age of 21.5 years. Tumours included ten primary aggressive and 15 recurrent GCTs. Mean follow up was 2.4 years. Pain, swelling and reduced range of movement (ROM) were noted. Average time to fusion was 7.6 months. Five patients had persistent pain in the proximal forearm. Grip strength was 65% compared to the uninvolved side. Two patients had superficial wound infection, two underwent additional bone grafting and three implant removals due to hardware prominence were carried out. There was no evidence of carpal instability or arthritis on clinical or radiological examination at the time of final follow up. Fusion of the carpus to the ulna is a simple method of producing a painless stable wrist, though at the expense of mobility. The procedure allows wide resection with a lower rate of recurrence. Pain in the proximal forearm seems to persist for 3 to 4 months only to improve at subsequent follow up. The procedure provides a valid option for the management of primary aggressive and recurrent GCTs of distal radius.
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Affiliation(s)
- S Bhagat
- M.P. Shah Cancer Hospital, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India.
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42
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Kwok Y, Kataria R, Amin P, Naslund M, Hussain A, Dawson N, DiBiase S. Long-term Results of a Prospective Phase II Trial of Androgen Ablation, Pelvic External Beam Radiation Therapy, Brachytherapy Boost, and Adjuvant Docetaxel in High-risk Prostate Cancer. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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43
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Mahmood U, Richards L, D'Souza W, Naslund M, Amin P, Kwok Y. Dosimetric Analysis of the Effect of Prostate Edema on Cs-131 Brachytherapy. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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44
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Lerma F, Liu S, Liu B, Li H, Yi B, Amin P, Yu C. Image Guided Intermediate-stage Prostate Cancer IMRT: Minimum Margins and an Ideal Alignment Strategy. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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45
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Mirmiran A, Kwok Y, Amin P, Hussain A. Analysis of Late Toxicity of a Phase I/II Trial of Weekly Paclitaxel, Concurrent Radiation (RT) and Androgen Ablation (AA) in Locally Advanced Prostate Cancer (LAPC) or after Radical Prostatectomy (RP). Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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46
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Bhagat S, Bansal M, Sharma H, Jandhyala R, Amin P, Pandit J. A rare case of progressive bilateral congenital abduction contracture with shoulder dislocations treated with proximal deltoid release. Arch Orthop Trauma Surg 2008; 128:293-6. [PMID: 17285270 DOI: 10.1007/s00402-007-0291-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2006] [Indexed: 11/30/2022]
Abstract
The contracture of the deltoid muscle is an uncommon disorder. Amongst the various causes reported, post intramuscular injection and trauma leading to the fibrosis of the muscle are common. However, congenital cases are extremely rare. We report a case of congenital progressive bilateral abduction contracture left untreated for a long time leading to anteroinferior subluxation. A proximal release was performed with satisfactory outcome on both sides.
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Affiliation(s)
- S Bhagat
- Kettering General Hospital, 1/2 Mawsley Crescent, Kettering, Northants, UK.
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Kiran U, Amin P, Penketh RJ. Self-administration of vaginal misoprostol after mifepristone for termination of pregnancy: patient acceptability. J OBSTET GYNAECOL 2007; 26:679-81. [PMID: 17071439 DOI: 10.1080/01443610600913940] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This was a questionnaire survey involving women who self-administered vaginal misoprostol in the hospital setting following oral mifepristone for medical termination of pregnancy. The sample number was 89 with a median gestational age of 9 weeks; median dose of misoprostol used was 1600 mug and median induction abortion interval was 5.3 h. The success rate was 100% with the majority finding it easy to self-administer vaginal misoprostol and two-thirds did not mind doing this. Only one-third experienced adverse effects of the medication and 83% were satisfied with the procedure. Only one-third was willing to try it at home in future if necessary. Self-administration of vaginal misoprostol for termination of pregnancy in the hospital is safe and effective. Although women were comfortable in self administering the pessaries in the hospital, they do not appear to be keen to do it at home without any supervision. However, as this is the first study in the UK involving women expressing their views regarding this issue, added research in this area is required.
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Affiliation(s)
- U Kiran
- Department of Obstetrics and Gynaecology, University Hospital of Wales, Cardiff, Wales, UK.
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Gutt R, Yovino S, Chin L, Regine W, Amin P, Tkaczuk K, Kwok Y. Gamma Knife stereotactic radiosurgery in the treatment of brain metastases from breast cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.10555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10555 Background: Outcomes of gamma knife stereotactic radiosurgery (GK-SRS) for patients with brain metastases specifically from breast cancer have not been well-defined. This study was undertaken to report the long-term experience with GK-SRS in this subset of patients. Methods: From 1995 to 2005, 75 patients with 162 brain lesions were treated with GK-SRS at the University of Maryland Medical Center. Complete follow-up data were available in 65 patients. Additional whole brain radiation therapy (WBRT) was administered to 53 (81.5%) patients. The median WBRT dose was 36.75 Gy (30.0–45.0 Gy). The median number of lesions treated with GK-SRS was 2 (1–8 lesions). The median follow-up, age, and KPS were 7.2 months (0.4–75.7 months), 53.5 years (23–81 years), and 90 (40–100), respectively. The factors included in the univariate and multivariate analyses for overall survival (OS) and progression free survival (PFS) were age, Karnofsky Performance Status (KPS), tumor histology, estrogen receptor status, Her-2-neu status, number of intracranial lesions, and presence of systemic disease. Results: Median PFS and OS from GK-SRS were 5.3 months (0.4–33.2 months) and 8.1 months (0.4–75.7 months), respectively. The 6, 12, and 24 month actuarial PFS were 47.8%, 24.9%, and 9.6% respectively. The 6, 12, and 24 month actuarial OS were 60.7%, 39.1%, and 18.1% respectively. The tumor local control after WBRT and GK-SRS was 87.7%. Radiation necrosis was a complication in 10.8% of patients. Forty-seven (72.3%) patients had neurological symptoms prior to gamma knife treatment. Seven (14.9%) and 9 (19.1%) of these patients experienced symptom resolution and significant symptomatic improvement, respectively. Multivariate and univariate analysis did not reveal any of the prognostic factors in question to be significantly associated with OS nor PFS. Conclusions: This relatively large cohort of patients experienced poor survival outcomes despite aggressive therapy with WBRT and GK-SRS. However, GK-SRS can provide significant symptomatic relief, with acceptable complication rates. More research is required to improve the survival of breast cancer patients with intracranial metastases. No significant financial relationships to disclose.
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Affiliation(s)
- R. Gutt
- University of Maryland School of Medicine, Baltimore, MD
| | - S. Yovino
- University of Maryland School of Medicine, Baltimore, MD
| | - L. Chin
- University of Maryland School of Medicine, Baltimore, MD
| | - W. Regine
- University of Maryland School of Medicine, Baltimore, MD
| | - P. Amin
- University of Maryland School of Medicine, Baltimore, MD
| | - K. Tkaczuk
- University of Maryland School of Medicine, Baltimore, MD
| | - Y. Kwok
- University of Maryland School of Medicine, Baltimore, MD
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Abstract
Abstract
Castleman′s disease is a rare, benign disease of unknown cause that induces reactive lymph node hyperplasia. It has two histologic subtypes: hyaline vascular and plasma cellular. A definitive diagnosis necessitates tissue biopsy. A specimen may be even misdiagnosed as lymphoma in frozen section. Surgery is the treatment of choice for the solitary form, whereas chemotherapy, radiotherapy, and steroids are proposed for the multicentric type. When this condition affects the neck, it usually presents as a solitary neck mass. Multiple neck masses are an uncommon presentation of Castleman disease affecting the neck. Most Castleman′s disease lesions appear as nonspecific, well-defined hypoechoic masses on sonography. Sonography remains useful for the evaluation of cervical and axillary Castleman′s diseases, in which the depiction of prominent peripheral vessels and penetrating feeding vessels on Doppler sonograms can suggest the diagnosis of this uncommon disease. Castleman′s disease of the neck on CT and MRI scan has been described as well-circumscribed homogeneous mass lesion with moderate to intense enhancement.
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Affiliation(s)
- S Raniga
- Urmi Imaging Center, Vadodara, Gujarat - 390001, India
| | - C Shah
- Urmi Imaging Center, Vadodara, Gujarat - 390001, India
| | - A Shrivastava
- Urmi Imaging Center, Vadodara, Gujarat - 390001, India
| | - P Amin
- Urmi Imaging Center, Vadodara, Gujarat - 390001, India
| | - P Patel
- Urmi Imaging Center, Vadodara, Gujarat - 390001, India
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50
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Patel S, Kwok Y, Shepard D, Chin L, Slawson R, Amin P, Regine W. Evaluating the Influence of Dose-Rate on Outcome with Gamma-Knife Stereotactic Radiosurgery in the Treatment of Trigeminal Neuralgia. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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