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Gupta D, Mehta A, Shetty NA, Pradeep R, Mahendra JV, Acharya PT, Srinivasa R. Medically Refractory Idiopathic Intracranial Hypertension and HIV: A Rare Association. Neurol India 2022; 70:2229-2230. [PMID: 36352655 DOI: 10.4103/0028-3886.359268] [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: 01/22/2023]
Affiliation(s)
- Dhananjay Gupta
- Department of Neurology, Ramaiah Medical College, Bengaluru, Karnataka, India
| | - Anish Mehta
- Department of Neurology, Ramaiah Medical College, Bengaluru, Karnataka, India
| | - Nikith A Shetty
- Department of Neurology, Ramaiah Medical College, Bengaluru, Karnataka, India
| | - R Pradeep
- Department of Neurology, Ramaiah Medical College, Bengaluru, Karnataka, India
| | - J V Mahendra
- Department of Neurology, Ramaiah Medical College, Bengaluru, Karnataka, India
| | - P T Acharya
- Department of Neurology, Ramaiah Medical College, Bengaluru, Karnataka, India
| | - R Srinivasa
- Department of Neurology, Ramaiah Medical College, Bengaluru, Karnataka, India
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Dugani P, Mehta A, Furtado SV, Pradeep R, Javali M, Acharya P, Thyagaraj V, Srinivasa R. Spectrum of neurological manifestations among acute COVID-19 and long COVID-19 – A retrospective observational study. Ro J Neurol 2022. [DOI: 10.37897/rjn.2022.2.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective. Preliminary clinical data indicate that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with neurological symptoms. To compare the clinical features, imaging and treatments in patients with and without COVID-19. To compare the mortality and in-hospital stay among patients with and without COVID-19 and negative patients. Materials and methods. In this retrospective, single-center study, we included all the patients who attended the department of neurology with neurologic symptoms with confirmed COVID-19 and long COVID-19 from June 2020 to January 2021. Data on clinical signs, diagnosis, laboratory findings were collected and analyzed from the records for positive patients and compared with neurologic patients without COVID-19 admitted in the same period. Statistical analysis: The mean values between study groups were compared using an independent sample t-test and Mann Whitney u test. Categorical outcomes were compared using the Chi square test. Data was analyzed using coGuide software. Results. Headache was the common neurologic manifestation present in COVID positive patients compared to COVID negative patients (39.13%). There was no statistically significant difference between the two groups in baseline parameters. Laboratory parameters like CRP, Serum Ferritin, LDH, D-dimer, ESR, and IL-6 showed a significant increase in COVID positive patients (P <0.05). In-hospital mortality was more in COVID positive patients than COVID negative patients (P <0.011). Conclusion. The study showed varied neurologic symptoms in COVID patients, with headache as the common symptom. Hospital stay, morbidity, mortality, and inflammatory parameters were more in COVID positive patients compared to COVID negative patients.
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Singh L, Javali M, Mehta A, Pradeep R, Srinivasa R, Acharya PT. Study of cerebrospinal fluid levels of lactate, lactate dehydrogenase and adenosine deaminase in the diagnosis and outcome of acute meningitis. Neurol Res 2021; 44:463-467. [PMID: 34850673 DOI: 10.1080/01616412.2021.2004366] [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] [Indexed: 10/19/2022]
Abstract
BACKGROUND Meningitis is a serious clinical health issue in most developing countries. Late diagnosis and treatment result in significant morbidity and mortality. This research aims to study the utility of CSF lactate, lactate dehydrogenase (LDH), and adenosine deaminase (ADA) as diagnostic markers in acute meningitis, and to differentiate among varied aetiologies of acute meningitis and their outcomes. METHOD A cross-sectional observational case-control study was conducted in 30 patients of suspected meningitis of varied aetiologies and 30 controls without any pre-existing neurological disorder and who underwent lumbar puncture during spinal anesthesia. A fresh CSF sample was collected in a heparinized vial following an aseptic lumbar puncture. The levels of lactate, LDH and ADA were estimated and recorded. RESULT CSF lactate was significantly elevated in bacterial meningitis (BM) and cryptococcal meningitis, with 100% sensitivity when compared to controls. Elevated LDH was found only in BM, hence elevated LDH levels may strongly signify bacterial etiology. Significantly elevated ADA levels were noted in tuberculous meningitis. Significantly elevated levels of lactate and ADA were suggestive of slower clinical recovery and a prolonged hospital stay (p < 0.001). CONCLUSION Estimation of CSF lactate, LDH, and ADA levels is a rapid, inexpensive and simple procedure and can play a major role in the early differentiation of bacterial, viral, tuberculous, and fungal meningitis. This would facilitate the initiation of appropriate treatment as early as possible, thereby decreasing mortality and complications.
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Affiliation(s)
- Lovelina Singh
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, India
| | - Mahendra Javali
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, India
| | - Anish Mehta
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, India
| | - R Pradeep
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, India
| | - R Srinivasa
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, India
| | - P T Acharya
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bengaluru, India
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Sharma S, Mahendra JV, A John AJU, Mehta A, Srinivasa R. Complete Bilateral Ptosis: An Early Clinical Sign of Herniation in Right Hemispheric Infarction. Neurol India 2021; 69:232-233. [PMID: 33642315 DOI: 10.4103/0028-3886.310085] [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: 11/04/2022]
Affiliation(s)
- Suryanarayana Sharma
- Senior Consultant Neurologist and Stroke Specialist, Apollo Hospitals, Opposite I.I.M-B, Bannerghatta Road, Bangalore, Karnataka, India
| | - J V Mahendra
- Department of Neurology, M.S. Ramaiah Medical College, M.S.R.I.T Post, Bangalore, Karnataka, India
| | - A J U A John
- Department of Neurology, M.S. Ramaiah Medical College, M.S.R.I.T Post, Bangalore, Karnataka, India
| | - Anish Mehta
- Department of Neurology, M.S. Ramaiah Medical College, M.S.R.I.T Post, Bangalore, Karnataka, India
| | - R Srinivasa
- Department of Neurology, M.S. Ramaiah Medical College, M.S.R.I.T Post, Bangalore, Karnataka, India
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Srinivasa R, Sinha S, Parthasarthy S, Kothari S, Baviskar R, Jayalakshmi S, Sharma B, Garg RK, Desai J, Yardi N, Salvadeeswaran MS, Ravat S, Das M, Gursahani R, Suresh S, Rasal A, Elmoufti S. Adjunctive Brivaracetam in Indian Patients with Uncontrolled Focal Epilepsy: Results from a Pooled Analysis of Two Double-Blind, Randomized, Placebo-Controlled Trials. Neurol India 2020; 68:1400-1408. [PMID: 33342876 DOI: 10.4103/0028-3886.304103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Nearly one-third of patients don't achieve seizure control with existing antiepileptic drugs. Brivaracetam (BRV) is a new member of the racetam class of drug, designed to selectively target SV2A, with binding affinity 15- to 30-fold greater than that of levetiracetam. Objective This pooled analysis reports efficacy and tolerability data of adjunct BRV (50, 100, and 200 mg/day) compared with placebo in Indian patients with uncontrolled focal epilepsy. Methods Data of 104 patients (aged 16-80 years) from 2 studies (N01252 and N01358) were pooled for this analysis. The studies comprised an 8-week prospective baseline period, and a 12-week treatment period. The study endpoints included median percent reduction from baseline in focal seizure frequency/28-days, ≥50% responder rate, and seizure freedom (all seizure types). The safety analysis included treatment-emergent adverse events (TEAEs). Results The efficacy population comprised 101 patients. In the Indian sub-group population, median percent reduction from baseline in focal seizure frequency/28-days was greater in the BRV dose groups: 39.7% (p = 0.00868), 46.8% (p = 0.00180) and 48.2% (p = 0.05224), for BRV 50, 100, 200 mg/day, respectively, compared with 20.6% for placebo. Responder rates (≥50%) were 38.1%, 45.7%, and 45.5% for BRV 50, 100, and 200 mg/day, respectively, compared with 11.7% for placebo. Complete seizure freedom was reported by 4.8% (1/21) and 2.9% (1/35) of patients on BRV50 and 100 mg/day, respectively, and none out of the 11 and 34 patients on BRV200 mg/day and placebo, respectively. In the safety population (n = 104), most commonly reported TEAEs (reported by ≥5% of patients taking brivaracetam) were headache and cough; most TEAEs were mild or moderate in intensity. Conclusion This pooled analysis has provided evidence that adjunct brivaracetam, was effective and well-tolerated in Indian patients with uncontrolled focal epilepsy.
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Affiliation(s)
- R Srinivasa
- MS Ramaiah Medical College, Bengaluru, Karnataka, India
| | - Sanjib Sinha
- National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | | | | | | | - Sita Jayalakshmi
- Krishna Institute of Medical Sciences, Hyderabad, Telangana, India
| | | | - Ravindra K Garg
- King George Medical University, Lucknow, Uttar Pradesh, India
| | - Joy Desai
- Jaslok Hospital, Mumbai, Maharashtra, India
| | | | | | | | - Mohan Das
- Krishna Institute of Medical Sciences, Hyderabad, Telangana, India
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Roberts D, Patel R, Genshaft S, Padia S, McWilliams J, Moriarty J, Srinivasa R. 3:45 PM Abstract No. 113 Image-guided suprapubic catheter placement using trocar versus Seldinger technique: a comparative analysis of outcomes and complications. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.143] [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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Bundy J, Hage A, Jiao A, Wadhwa V, Gutta N, Srinivasa R, Gemmete J, Chick J. Abstract No. 577 Limited clinical utility of chest radiography in asymptomatic patients after interventional radiology-performed ultrasound-guided thoracentesis: analysis of 3022 consecutive patients. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Jiang J, McWilliams J, Yuen A, Moriarty J, Padia S, Lee E, Kee S, Srinivasa R. 3:45 PM Abstract No. 369 Safety and efficacy of empiric embolization for upper and lower gastrointestinal hemorrhage: a single-institution experience. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.429] [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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Jiao A, Wadhwa V, Bundy J, Hage A, Srinivasa R, Gemmete J, Lee E, Chick J. Abstract No. 462 Scholarly activities and indices among academic endovascular specialists: a comparative analysis between interventional radiologists and vascular surgeons. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.523] [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] Open
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Moriarty J, Rueda V, Liao M, Srinivasa R, Plotnik A, Padia S, McWilliams J, Patel R, Desai K, Shavelle D, Dexter D, Golowa Y. 3:45 PM Abstract No. 287 Results of Registry of AngioVac Procedures in Detail (RAPID): prospective multicenter real-world experience in 206 patients with 214 procedures. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.337] [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] Open
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Sue M, Kee S, McWilliams J, Plotnik A, Padia S, Srinivasa R, Saab S, Busuttil R, Lee E. 3:09 PM Abstract No. 100 Complications in initial biliary drain placement: is the LEFT side really that bad? J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.129] [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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Shin D, Johnson G, Srinivasa R, Lee E, Agopian V, DiNorcia J, Padia S. 4:12 PM Abstract No. 145 Yttrium-90 radiation segmentectomy for hepatic metastases: a multi-institutional study of safety and efficacy. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.178] [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] Open
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Zucker D, Srinivasa R, Genshaft S, Yang E, Kwon M, Moriarty J. Abstract No. 678 Minimally invasive repair of ascending aortic pseudoaneurysms: an alternative to open surgical repair in high-risk patients. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.737] [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] Open
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Mahale R, Mehta A, Konnur A, Acharya P, Srinivasa R. Upper Limb Monochorea Due to Cerebral Venous Sinus Thrombosis: Rare Occurrence. Neurol India 2019; 67:1138-1139. [PMID: 31512659 DOI: 10.4103/0028-3886.266255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Rohan Mahale
- Department of Neurology, MS Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
| | - Anish Mehta
- Department of Neurology, MS Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
| | - Akshay Konnur
- Department of Neurology, MS Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
| | - Purushottam Acharya
- Department of Neurology, MS Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
| | - R Srinivasa
- Department of Neurology, MS Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
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John AA, Javali M, Mahale R, Mehta A, Acharya PT, Srinivasa R. Clinical impression and Western Aphasia Battery classification of aphasia in acute ischemic stroke: Is there a discrepancy? J Neurosci Rural Pract 2019; 8:74-78. [PMID: 28149086 PMCID: PMC5225728 DOI: 10.4103/0976-3147.193531] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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] [Indexed: 11/04/2022] Open
Abstract
Background: Language disturbance is a common symptom of stroke, a prompt identifier of the event, and can cause devastating cognitive impairments. There are many inconsistencies and discrepancies between the different methods used for its evaluation. The relationship between Western Aphasia Battery (WAB) and a simple bedside clinical examination is not clear. Aim: The aim of this study is to determine if bedside clinical impression of aphasia type can reliably predict WAB classification of aphasia and to describe the discrepancies between them. Materials and Methods: Eighty-two consecutive cases of acute ischemic stroke and aphasia were evaluated with bedside aphasia assessment, handedness by Edinburgh Handedness Inventory and WAB scoring was done. Kappa statistics was used to find the overall agreement of clinical impression and WAB. Results: Disagreement was seen predominantly for the nonfluent aphasias when the clinical impression was compared with WAB classification. WAB also had diagnosed three cases as having anomic aphasia using taxonomic classification, but same cases had normal language by aphasia quotient scoring of WAB. There was an overall agreement of 63.4% between patient's bedside clinical impression and WAB classification of aphasia, with a P < 0.001. Conclusion: Clinical impression was fairly reliable, as compared to WAB in assessing the type of aphasia. Clinical impression was appropriate in an acute setting, but WAB was required to quantify the severity of deficit, which may help in accessing prognosis, monitoring progression, and rehabilitation planning. Along with WAB, a bedside clinical impression should be done for all the patients to strengthen the description of aphasic deficit.
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Affiliation(s)
- Aju Abraham John
- Department of Neurology, M.S. Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
| | - Mahendra Javali
- Department of Neurology, M.S. Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
| | - Rohan Mahale
- Department of Neurology, M.S. Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
| | - Anish Mehta
- Department of Neurology, M.S. Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
| | - P T Acharya
- Department of Neurology, M.S. Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
| | - R Srinivasa
- Department of Neurology, M.S. Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
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Pradeep R, Gupta D, Mehta A, Srinivasa R, Javali M, Acharya PT. Wake-Up Sleepyhead: Unilateral Diencephalic Stroke Presenting with Excessive Sleepiness. J Neurosci Rural Pract 2019; 10:145-147. [PMID: 30765992 PMCID: PMC6337964 DOI: 10.4103/jnrp.jnrp_258_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Indexed: 11/04/2022] Open
Abstract
Altered sleep architecture and stroke share a reciprocal relationship. More than half of the stroke patients display sleep abnormalities including hypersomnia, insomnia, parasomnia, periodic limb movements, or sleep-disordered breathing. Conversely, one of the major causes of severe organic hypersomnia is acute brainstem strokes, involving thalamic infarctions, which may be reversible over 6-12 months. Here, we report a patient with increased lethargy and drowsiness who was diagnosed to have a right thalamic and hypothalamic ischemic stroke.
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Affiliation(s)
- R Pradeep
- Department of Neurology, MS Ramaiah Medical College, Bengaluru, Karnataka, India
| | - Dhananjay Gupta
- Department of Neurology, MS Ramaiah Medical College, Bengaluru, Karnataka, India
| | - Anish Mehta
- Department of Neurology, MS Ramaiah Medical College, Bengaluru, Karnataka, India
| | - R Srinivasa
- Department of Neurology, MS Ramaiah Medical College, Bengaluru, Karnataka, India
| | - Mahendra Javali
- Department of Neurology, MS Ramaiah Medical College, Bengaluru, Karnataka, India
| | - P T Acharya
- Department of Neurology, MS Ramaiah Medical College, Bengaluru, Karnataka, India
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Bundy J, Hage A, Srinivasa R, Gemmete J, Srinivasa R, Jairath N, Anand R, Dasika N, Chauhan N, Chick J. 03:09 PM Abstract No. 249 Intra-arterial ampicillin and gentamicin and the incidence of splenic abscesses following splenic artery embolization: a 20-year case control study in 213 patients. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.310] [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] Open
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Beecham Chick J, Chen N, Gemmete J, Saad W, Dasika N, Srinivasa R, Srinivasa R. Pediatric Portal Interventions. Semin Intervent Radiol 2018; 35:143-150. [DOI: 10.1055/s-0038-1642043] [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: 10/14/2022]
Affiliation(s)
- Jeffrey Beecham Chick
- Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan
| | - Noah Chen
- Department of Biological Chemistry, School of Medicine, University of Michigan, Ann Arbor, Michigan
| | - Joseph Gemmete
- Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan
| | - Wael Saad
- Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan
| | - Narasimham Dasika
- Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan
| | - Rajiv Srinivasa
- Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan
| | - Ravi Srinivasa
- Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan
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Srinivasa R, Chick J, Chen N, Gemmete J, Saad W, Dasika N, Srinivasa R. Erratum: Pediatric Portal Interventions. Semin Intervent Radiol 2018; 35:e1. [DOI: 10.1055/s-0038-1667300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Rajiv Srinivasa
- Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan
| | - Jeffrey Chick
- Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan
| | - Noah Chen
- Department of Biological Chemistry, School of Medicine, University of Michigan, Ann Arbor, Michigan
| | - Joseph Gemmete
- Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan
| | - Wael Saad
- Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan
| | - Narasimham Dasika
- Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan
| | - Ravi Srinivasa
- Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan
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Srinivasa R, Chick J, Hage A, Shields J, Cooper K, Saad W, Majdalany B. Abstract No. 567 Transnasal and transgastric snare technique for the placement of retrograde primary jejunostomy tubes. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.612] [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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Srinivasa R, Chick J, Gemmete J. Abstract No. 598 Neonatal thoracic duct embolization: technical and clinical outcomes. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.643] [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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Bundy J, Srinivasa R, Gemmete J, Hage A, Majdalany B, Khaja M, Saad W, Chick J. Abstract No. 589 Vascular and lymphatic complications following thoracic duct cannulation: experience in 58 patients. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.634] [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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Bundy J, Srinivasa R, Gemmete J, Hage A, Majdalany B, Saad W, Chick J. 4:03 PM Abstract No. 168 Results of percutaneous cholecystostomy tube placement in 324 patients. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Hage A, Srinivasa R, Chick J. 3:45 PM Abstract No. 356 Technical Success, Complications, and Reinterventions of Sharp Recanalization for the Treatment of Chronic Venous Occlusions: Experience in 142 Patients. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.395] [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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Srinivasa R, Majdalany B, Saad W, Hage A, Gemmete J, Chick J. Abstract No. 419 Prone transradial catheterization for combined single-session endovascular and percutaneous interventions: approach, technical success, safety, and outcomes in 15 patients. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.464] [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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Mahale R, Mehta A, Shetty N, Srinivasa R. Does cerebral infarction ameliorate essential tremor? A mini-review. Neurol India 2018; 66:S152-S154. [DOI: 10.4103/0028-3886.226462] [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]
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Javali M, Acharya P, Mehta A, John AA, Mahale R, Srinivasa R. Use of multiplex PCR based molecular diagnostics in diagnosis of suspected CNS infections in tertiary care setting-A retrospective study. Clin Neurol Neurosurg 2017; 161:110-116. [PMID: 28866263 DOI: 10.1016/j.clineuro.2017.08.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 04/11/2017] [Revised: 07/22/2017] [Accepted: 08/27/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES CNS infections like meningitis and encephalitis pose enormous healthcare challenges due to mortality, sequelae and socioeconomic burden. In tertiary setting, clinical, microbiological, cytological and radiological investigations are not distinctive enough for diagnosing microbial etiology. Molecular diagnostics is filling this gap. We evaluated the clinical impact of a commercially available multiplex molecular diagnostic system - SES for diagnosing suspected CNS infections. PATIENTS AND METHODS This study was conducted in our tertiary level Neurology ICU. 110 patients admitted during Nov-2010 to April-2014 were included. CSF samples of patients clinically suspected of having CNS infections were subjected to routine investigation in our laboratory and SES test at XCyton Diagnostics. We studied the impact of SES in diagnosis of CNS infections and its efficacy in helping therapeutic management. RESULTS SES showed detection rate of 42.18% and clinical specificity of 100%. It had 10 times higher detection rate than conventional tests. Streptococcus pneumoniae and Mycobacterium tuberculosis were two top bacterial pathogens. VZV was most detected viral pathogen. SES results elicited changes in therapy in both positive and negative cases. We observed superior patient outcomes as measured by GCS scale. 75% and 82.14% of the patients positive and negative on SES respectively, recovered fully. CONCLUSION Detecting causative organism and ruling out infectious etiology remain the most critical aspect for management and prognosis of patients with suspected CNS infections. In this study, we observed higher detection rate of pathogens, target specific escalation and evidence based de-escalation of antimicrobials using SES. Institution of appropriate therapy helped reduce unnecessary use of antimicrobials.
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Affiliation(s)
| | | | - Aneesh Mehta
- Dept. of Neurology, MS Ramaiah Memorial Hospital, India
| | | | - Rohan Mahale
- Dept. of Neurology, MS Ramaiah Memorial Hospital, India
| | - R Srinivasa
- Dept. of Neurology, MS Ramaiah Memorial Hospital, India
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Srinivasa R, Anderson M, Dackiw A, Pillai A, Trimmer C, Kalva S, Reis S. Combined Efficacy of Adrenal Vein Sampling and Imaging Findings in Predicting Clinical Outcomes Following Unilateral Adrenalectomy for Primary Aldosteronism. J Clin Interv Radiol ISVIR 2017. [DOI: 10.1055/s-0037-1602769] [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: 10/19/2022] Open
Abstract
AbstractThe objective of this study was to investigate the combined efficacy of adrenal vein sampling (AVS) and imaging findings in predicting successful clinical outcomes following unilateral adrenalectomy for primary aldosteronism (PA). A retrospective chart review of 137 patients who underwent AVS between 2009 and 2014 at two hospitals in a single academic institution was performed. Preprocedure demographic, imaging, medication, and laboratory values were reviewed. In general, patients were considered for adrenalectomy when lateralization was suggested on AVS. Clinical outcomes such as improved blood pressure control and preserved renal function after adrenalectomy were correlated with preprocedure variables. AVS was technically successful in 120 out of 137 patients. Lateralization was seen in 64 patients and 48 out of 64 patients underwent adrenalectomy. Out of 48, 43 patients had an adrenal nodule on preoperative imaging, while 5 did not. 28 patients showed improvement in blood pressure after adrenalectomy, all of which had a nodule on imaging. Of the 28 patients, 22 also showed preservation of renal function. None of the remaining 5 (out of 48) patients who demonstrated lateralization on AVS and had no nodule on imaging showed clinical improvement following adrenalectomy. The presence of an adrenal nodule on preoperative imaging was also associated with improved blood pressure control (p = 0.022) and preserved renal function (p = 0.048) following adrenalectomy. Improved blood pressure control and preserved renal function in patients with PA who underwent adrenalectomy following lateralization on AVS are associated with the identification of an adrenal nodule on preoperative imaging.
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Affiliation(s)
- Rajiv Srinivasa
- Division of Interventional Radiology, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Matthew Anderson
- Division of Interventional Radiology, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Alan Dackiw
- Division of Endocrine Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Anil Pillai
- Division of Interventional Radiology, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Clayton Trimmer
- Division of Interventional Radiology, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Sanjeeva Kalva
- Division of Interventional Radiology, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Stephen Reis
- Department of Radiology, Columbia University Medical Center, New York, New York, United States
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Mahale RR, Mehta A, Srinivasa R. Photosensitive Posthypoxic Reflex Myoclonus in a Postcardiac Arrest Individual: An Interesting Finding. J Neurosci Rural Pract 2017; 8:489-490. [PMID: 28694648 PMCID: PMC5488589 DOI: 10.4103/jnrp.jnrp_13_17] [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: 11/19/2022] Open
Affiliation(s)
- Rohan R. Mahale
- Department of Neurology, M. S. Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
| | - Anish Mehta
- Department of Neurology, M. S. Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
| | - R. Srinivasa
- Department of Neurology, M. S. Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
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John A, Abbas M, Javali M, Mahale R, Mehta A, Srinivasa R. A rare presentation of trigeminal neuralgia in lateral medullary syndrome. Neurol India 2017; 65:638-640. [DOI: 10.4103/neuroindia.ni_1323_15] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mirza MA, John AA, Javali M, Mahale R, Mehta A, Srinivasa R. Alien limb phenomenon in pontine hemorrhage: A rare presentation. Neurol India 2016; 64:554-6. [PMID: 27147169 DOI: 10.4103/0028-3886.181554] [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: 11/04/2022]
Affiliation(s)
| | - Aju Abraham John
- Department of Neurology, M. S. Ramaiah Institute of Neurosciences, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India
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Mahale RR, Mehta A, Shankar A, Buddaraju K, Srinivasa R. A surprising cause of isolated oculomotor nerve palsy with pupillomotor palsy. Ann Indian Acad Neurol 2016; 19:159-60. [PMID: 27011657 PMCID: PMC4782542 DOI: 10.4103/0972-2327.173300] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Rohan R Mahale
- Department of Neurology, Mathikere Sampangappa Ramaiah Medical College and Hospital, Bangalore, Karnataka, India
| | - Anish Mehta
- Department of Neurology, Mathikere Sampangappa Ramaiah Medical College and Hospital, Bangalore, Karnataka, India
| | - Abhinandan Shankar
- Department of Neurology, Mathikere Sampangappa Ramaiah Medical College and Hospital, Bangalore, Karnataka, India
| | - Kiran Buddaraju
- Department of Neurology, Mathikere Sampangappa Ramaiah Medical College and Hospital, Bangalore, Karnataka, India
| | - R Srinivasa
- Department of Neurology, Mathikere Sampangappa Ramaiah Medical College and Hospital, Bangalore, Karnataka, India
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Srinivasa R, Malguria N, Chopra R, Reis S. How to create 3D printable models from CT angiographic images for patient and trainee education. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.591] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Trailokya A, Hiremath JS, Sawhney J, Mishra YK, Kanhere V, Srinivasa R, Tiwaskar M. Acenocoumarol: A Review of Anticoagulant Efficacy and Safety. J Assoc Physicians India 2016; 64:88-93. [PMID: 27730796] [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
Anticoagulant treatment is required for the treatment and prevention of thromboembolic disorders. Vitamin K antagonists are commonly used oral anticoagulants worldwide. Acenocoumarol is mono-coumarin derivative with racemic mixture of R (+) and S (-) enantiomers. Efficacy and safety of acenocoumarol has been evaluated in atrial fibrillation, cardiac valve replacement, after myocardial infarction, treatment of deep vein thrombosis, after major surgeries and after critical illness requiring prolonged hospitalization. Acenocoumarol is effective and safe in all age groups. It offers an advantage over warfarin in terms of better stability of anti-coagulant effect. Due to its economic advantage acenocoumarol may be suitable oral anticoagulant for long term use in countries like India.
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Affiliation(s)
- Abhijit Trailokya
- Medical Services Division, Abbott Healthcare Private Limited, Mumbai, Maharashtra
| | - J S Hiremath
- Director, Cath Lab, Ruby Hall Clinic, Pune, Maharashtra
| | | | - Y K Mishra
- Director, Department of Cardiovascular Surgery, Fortis Escorts Heart Institute & Research Centre, Delhi
| | - Vivek Kanhere
- Consultant Cardiac Surgeon, Chirayu Cardiac Centre, Bhopal
| | - R Srinivasa
- Senior Professor of Neurology and Head, Dept. of Neurology, MS Ramaiah Medical college and Hospitals, Bangalore, Karnataka
| | - Mangesh Tiwaskar
- Consultant Physician, Asian Heart Institute & Research Centre, Karuna Hospital, Mumbai, Maharashtra
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Andring B, Kalva SP, Sutphin P, Srinivasa R, Anene A, Burrell M, Xi Y, Pillai AK. Effect of technical parameters on transjugular intrahepatic portosystemic shunts utilizing stent grafts. World J Gastroenterol 2015; 21:8110-8117. [PMID: 26185383 PMCID: PMC4499354 DOI: 10.3748/wjg.v21.i26.8110] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 03/25/2015] [Accepted: 05/04/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess the effect of technical parameters on outcomes of transjugular intrahepatic portosystemic shunt (TIPS) created using a stent graft.
METHODS: The medical records of 68 patients who underwent TIPS placement with a stent graft from 2008 to 2014 were reviewed by two radiologists blinded to the patient outcomes. Digital Subtraction Angiographic images with a measuring catheter in two orthogonal planes was used to determine the TIPS stent-to-inferior vena cava distance (SIVCD), hepatic vein to parenchymal tract angle (HVTA), portal vein to parenchymal tract angle (PVTA), and the accessed portal vein. The length and diameter of the TIPS stent and the use of concurrent variceal embolization were recorded by review of the patient’s procedure note. Data on re-intervention within 30 d of TIPS placement, recurrence of symptoms, and survival were collected through the patient’s chart. Cox proportional regression analysis was performed to assess the effect of these technical parameters on primary patency of TIPS, time to recurrence of symptoms, and all-cause mortality.
RESULTS: There was no significant association between the SIVCD and primary patency (P = 0.23), time to recurrence of symptoms (P = 0.83), or all-cause mortality (P = 0.18). The 3, 6, and 12-mo primary patency rates for a SIVCD ≥ 1.5 cm were 82.4%, 64.7%, and 50.3% compared to 89.3%, 83.8%, and 60.6% for a SIVCD of < 1.5 cm (P = 0.29). The median time to stenosis for a SIVCD of ≥ 1.5 cm was 19.1 mo vs 15.1 mo for a SIVCD of < 1.5 cm (P = 0.48). There was no significant association between the following factors and primary patency: HVTA (P = 0.99), PVTA (P = 0.65), accessed portal vein (P = 0.35), TIPS stent diameter (P = 0.93), TIPS stent length (P = 0.48), concurrent variceal embolization (P = 0.13) and reinterventions within 30 d (P = 0.24). Furthermore, there was no correlation between these technical parameters and time to recurrence of symptoms or all-cause mortality. Recurrence of symptoms was associated with stent graft stenosis (P = 0.03).
CONCLUSION: TIPS stent-to-caval distance and other parameters have no significant effect on primary patency, time to recurrence of symptoms, or all-cause mortality following TIPS with a stent-graft.
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MESH Headings
- Angiography, Digital Subtraction
- Blood Vessel Prosthesis
- Blood Vessel Prosthesis Implantation/adverse effects
- Blood Vessel Prosthesis Implantation/instrumentation
- Blood Vessel Prosthesis Implantation/mortality
- Female
- Graft Occlusion, Vascular/etiology
- Graft Occlusion, Vascular/physiopathology
- Graft Occlusion, Vascular/surgery
- Humans
- Hypertension, Portal/diagnosis
- Hypertension, Portal/mortality
- Hypertension, Portal/physiopathology
- Hypertension, Portal/surgery
- Kaplan-Meier Estimate
- Male
- Middle Aged
- Multivariate Analysis
- Phlebography/methods
- Portal Vein/diagnostic imaging
- Portal Vein/physiopathology
- Portal Vein/surgery
- Portasystemic Shunt, Transjugular Intrahepatic/adverse effects
- Portasystemic Shunt, Transjugular Intrahepatic/instrumentation
- Portasystemic Shunt, Transjugular Intrahepatic/mortality
- Proportional Hazards Models
- Prosthesis Design
- Recurrence
- Reoperation
- Retrospective Studies
- Risk Factors
- Stents
- Time Factors
- Treatment Outcome
- Vascular Patency
- Vena Cava, Inferior/diagnostic imaging
- Vena Cava, Inferior/physiopathology
- Vena Cava, Inferior/surgery
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Gupta M, King KS, Srinivasa R, Weiner MF, Hulsey K, Ayers CR, Whittemore A, McColl RW, Rossetti HC, Peshock RM. Association of 3.0-T brain magnetic resonance imaging biomarkers with cognitive function in the Dallas Heart Study. JAMA Neurol 2015; 72:170-5. [PMID: 25485570 DOI: 10.1001/jamaneurol.2014.3418] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Understanding the relationships between age-related changes in brain structure and cognitive function has been limited by inconsistent methods for assessing brain imaging, small sample sizes, and racially/ethnically homogeneous cohorts with biased selection based on risk factors. These limitations have prevented the generalizability of results from brain morphology studies. OBJECTIVE To determine the association of 3.0-T structural brain magnetic resonance (MR) imaging measurements with cognitive function in the multiracial/multiethnic, population-based Dallas Heart Study. DESIGN, SETTING, AND PARTICIPANTS Whole-brain, 2-dimensional, fluid-attenuated inversion recovery and 3-dimensional, magnetization-prepared, rapid acquisition with gradient echo MR imaging at 3.0 T was performed in 1645 Dallas Heart Study participants (mean [SD] age, 49.9 [10.5] years; age range, 19-85 years) who received both brain MR imaging and cognitive screening with the Montreal Cognitive Assessment between September 18, 2007, and December 28, 2009. Measurements were obtained for white matter hyperintensity volume, total brain volume, gray matter volume, white matter volume, cerebrospinal fluid volume, and hippocampal volume. Linear regression and a best predictive model were developed to determine the association of MR imaging biomarkers with the Montreal Cognitive Assessment total score and domain-specific questions. MAIN OUTCOMES AND MEASURES High-resolution anatomical MR imaging was used to quantify brain volumes. Scores on the screening Montreal Cognitive Assessment were used for cognitive assessment in participants. RESULTS After adjustment for demographic variables, total brain volume (P < .0001, standardized estimate [SE] = .1069), gray matter volume (P < .0001, SE = .1156), white matter volume (P = .008, SE = .0687), cerebrospinal fluid volume (P = .012, SE = -.0667), and hippocampal volume (P < .0001) were significantly associated with cognitive performance. A best predictive model identified gray matter volume (P < .001, SE = .0021), cerebrospinal fluid volume (P = .01, SE = .0024), and hippocampal volume (P = .004, SE = .1017) as 3 brain MR imaging biomarkers significantly associated with the Montreal Cognitive Assessment total score. Questions specific to the visuospatial domain were associated with the most brain MR imaging biomarkers (total brain volume, gray matter volume, white matter volume, cerebrospinal fluid volume, and hippocampal volume), while questions specific to the orientation domain were associated with the least brain MR imaging biomarkers (only hippocampal volume). CONCLUSIONS AND RELEVANCE Brain MR imaging volumes, including total brain volume, gray matter volume, cerebrospinal fluid volume, and hippocampal volume, were independently associated with cognitive function and may be important early biomarkers of risk for cognitive insult in a young multiracial/multiethnic population. A best predictive model indicated that a combination of multiple neuroimaging biomarkers may be more effective than a single brain MR imaging volume measurement.
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Affiliation(s)
- Mohit Gupta
- Department of Radiology, The University of Texas Southwestern Medical Center, Dallas
| | - Kevin S King
- Department of Radiology, The University of Texas Southwestern Medical Center, Dallas
| | - Rajiv Srinivasa
- Department of Radiology, The University of Texas Southwestern Medical Center, Dallas
| | - Myron F Weiner
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas
| | - Keith Hulsey
- Department of Radiology, The University of Texas Southwestern Medical Center, Dallas
| | - Colby R Ayers
- Donald W. Reynolds Cardiovascular Clinical Research Center, The University of Texas Southwestern Medical Center, Dallas
| | - Anthony Whittemore
- Department of Radiology, The University of Texas Southwestern Medical Center, Dallas
| | - Roderick W McColl
- Department of Radiology, The University of Texas Southwestern Medical Center, Dallas
| | - Heidi C Rossetti
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas
| | - Ronald M Peshock
- Department of Radiology, The University of Texas Southwestern Medical Center, Dallas3Donald W. Reynolds Cardiovascular Clinical Research Center, The University of Texas Southwestern Medical Center, Dallas4Department of Internal Medicine, The University of
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Mahale R, Mehta A, Sharma S, Javali M, Malavika K, Srinivasa R. Central retinal artery occlusion with ophthalmoparesis in spontaneous carotid artery dissection. Neurol India 2015; 63:116-8. [PMID: 25751487 DOI: 10.4103/0028-3886.152685] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Rohan Mahale
- Department of Neurology, MS Ramaiah Medical College and Hospital, Bangalore, Karnataka, India
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Govind Babu K, Srinivasa R, Venkatesh T, Vidyasagar C. Acute Mountain Sickness – Can it be Predicted? Wilderness Environ Med 2015. [DOI: 10.1016/j.wem.2014.11.021] [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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Affiliation(s)
| | - Rohan R Mahale
- Department of Neurology, MS Ramaiah Medical College and Hospital, Bangalore, Karnataka, India
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Mahale R, Mehta A, Srinivasa R. Ipsilateral hemisensory syndrome in a patient with lateral medullary infarction: A new sensory pattern. Neurol India 2015; 63:972-5. [DOI: 10.4103/0028-3886.170070] [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: 11/04/2022]
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Mahale R, Mehta A, Srinivasa R. Unilateral spatial neglect as a presenting manifestation of nonconvulsive status epilepticus. Neurol India 2015; 63:262-4. [DOI: 10.4103/0028-3886.156301] [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: 11/04/2022]
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Madhusudhan BK, Mahendra JV, Rohan M, Srinivasa R. Hematomyelia as a cause of brown-sequard's syndrome in a hypofibrinogenemic patient. Neurol India 2014; 62:473. [PMID: 25237974 DOI: 10.4103/0028-3886.141296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- B K Madhusudhan
- Department of Neurology, M S Ramaiah Medical College, Bengaluru, Karnataka, India
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Mahale RR, Mehta A, Javali M, Srinivasa R. Co-occurrence of basilar artery and cerebral venous sinus thrombosis in antiphospholipid antibody syndrome. Neurol India 2014; 62:552-4. [PMID: 25387632 DOI: 10.4103/0028-3886.144462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Rohan R Mahale
- Department of Neurology, Mathikere Sampangappa Ramaiah Medical College and Hospital, Bangalore, Karnataka, India
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Mahale R, Mehta A, Javali M, Srinivasa R. A case of bilateral occipital lobe infarcts following Indian tree viper bite. J Stroke 2014; 16:205-7. [PMID: 25328881 PMCID: PMC4200596 DOI: 10.5853/jos.2014.16.3.205] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 07/02/2014] [Accepted: 07/03/2014] [Indexed: 11/11/2022] Open
Affiliation(s)
- Rohan Mahale
- Department of Neurology, M S Ramaiah Medical College & Hospital, Karnataka, India
| | - Anish Mehta
- Department of Neurology, M S Ramaiah Medical College & Hospital, Karnataka, India
| | - Mahendra Javali
- Department of Neurology, M S Ramaiah Medical College & Hospital, Karnataka, India
| | - R Srinivasa
- Department of Neurology, M S Ramaiah Medical College & Hospital, Karnataka, India
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Roopa Manjunatha G, Rajanna K, Mahapatra DR, Nayak MM, Krishnaswamy UM, Srinivasa R. Polyvinylidene fluoride film based nasal sensor to monitor human respiration pattern: an initial clinical study. J Clin Monit Comput 2013; 27:647-57. [PMID: 23771706 DOI: 10.1007/s10877-013-9486-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 05/31/2013] [Indexed: 10/26/2022]
Abstract
Design and development of a piezoelectric polyvinylidene fluoride (PVDF) thin film based nasal sensor to monitor human respiration pattern (RP) from each nostril simultaneously is presented in this paper. Thin film based PVDF nasal sensor is designed in a cantilever beam configuration. Two cantilevers are mounted on a spectacle frame in such a way that the air flow from each nostril impinges on this sensor causing bending of the cantilever beams. Voltage signal produced due to air flow induced dynamic piezoelectric effect produce a respective RP. A group of 23 healthy awake human subjects are studied. The RP in terms of respiratory rate (RR) and Respiratory air-flow changes/alterations obtained from the developed PVDF nasal sensor are compared with RP obtained from respiratory inductance plethysmograph (RIP) device. The mean RR of the developed nasal sensor (19.65 ± 4.1) and the RIP (19.57 ± 4.1) are found to be almost same (difference not significant, p > 0.05) with the correlation coefficient 0.96, p < 0.0001. It was observed that any change/alterations in the pattern of RIP is followed by same amount of change/alterations in the pattern of PVDF nasal sensor with k = 0.815 indicating strong agreement between the PVDF nasal sensor and RIP respiratory air-flow pattern. The developed sensor is simple in design, non-invasive, patient friendly and hence shows promising routine clinical usage. The preliminary result shows that this new method can have various applications in respiratory monitoring and diagnosis.
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Affiliation(s)
- G Roopa Manjunatha
- Department of Instrumentation and Applied Physics, Indian Institute of Science, Bangalore, 560 012, India
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Srinivasa R, Stavropoulos W. Abstract No. 317: The utility of a dedicated interventional radiology fellow website. J Vasc Interv Radiol 2012. [DOI: 10.1016/j.jvir.2011.12.373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Bhatta G, Dinesh K, Prashanth P, Srinivasa R. New site record of Ichthyophis kodaguensis Wilkinson et al., 2007 (Amphibia: Ichthyophiidae) in the Western Ghats, Indi. J Threat Taxa 2011. [DOI: 10.11609/jott.o2729.2104-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Roopakala MS, Dayananda G, Manjula P, Konde AS, Acharya PT, Srinivasa R, Nirmala KS. A comparative study of brainstem auditory evoked potentials in preterm and full-term infants. Indian J Physiol Pharmacol 2011; 55:44-52. [PMID: 22315809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Preterm infants can have many neurological problems. An enormous amount of fetal brain development occurs during the last trimester of pregnancy. They include myelination, glial cell migration and the development of a complex gyral pattern. The brain doesn't show the normal growth after birth in preterm infants. Brainstem auditory evoked potentials (BAEPs) are a noninvasive neurophysiologic assessment of brainstem maturation in babies. METHODS BAEPs in 25 preterm and 25 full-term infants were considered for the study. Infants having history of birth trauma, metabolic disorders or intracranial infection were excluded. BAEP waveforms (absolute and interpeak latencies) were recorded and analyzed. Student t test was used to analyze the data thus acquired. RESULTS Analysis of data revealed a significant increase in latency of BAEP waveform V (P<0.05). Other latencies and interpeak latencies of BAEP waveforms were comparable. CONCLUSION The preterm infants have a prolonged latency of BAEP waveform V suggestive of a retarded myelination of the central auditory pathway. Thus BAEP could be a useful electrophysiological test to assess neuronal myelination and maturation in preterm infants.
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Affiliation(s)
- M S Roopakala
- Department of Physiology, M. S. Ramaiah Medical College and Hospital, Bangalore - 560 054, Karnataka
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