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Wasser T, Strockbine B, Uyanwune Y, Kapoor R. Restraint and Seclusion Practices and Policies in U.S. Forensic Psychiatric Hospitals. J Am Acad Psychiatry Law 2023; 51:566-574. [PMID: 38065618 DOI: 10.29158/jaapl.230099-23] [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] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Over the last 30 years, there have been significant efforts to reduce the use of restraint and seclusion in psychiatric hospitals. Although authors have previously described restraint policies and practices in general psychiatry settings across the United States, this study is the first to attempt to describe policies regarding those practices in forensic hospital settings. We review the history of restraint and seclusion use in the United States, placing it within an international context. We then describe the results of a national survey of state forensic services directors regarding restraint modalities and policies in forensic hospital facilities. Twenty-nine respondents representing 25 states completed the survey. The results indicate that physical holds are the most frequently available method of restraint and that restraint chairs are the least frequently available. Most respondents reported having a policy regulating the use of restraint in their facilities, most commonly at the institutional level.
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Affiliation(s)
- Tobias Wasser
- Dr. Wasser is an Associate Professor of Psychiatry, Yale School of Medicine, New Haven, CT. Dr. Strockbine is the Chief Medical Officer, Whiting Forensic Hospital, Middletown, CT. Dr. Uyanwune is a Psychiatry Resident, Yale School of Medicine, New Haven, CT. Dr. Kapoor is an Associate Professor of Psychiatry, Yale School of Medicine, New Haven, CT.
| | - Bentley Strockbine
- Dr. Wasser is an Associate Professor of Psychiatry, Yale School of Medicine, New Haven, CT. Dr. Strockbine is the Chief Medical Officer, Whiting Forensic Hospital, Middletown, CT. Dr. Uyanwune is a Psychiatry Resident, Yale School of Medicine, New Haven, CT. Dr. Kapoor is an Associate Professor of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Yvonne Uyanwune
- Dr. Wasser is an Associate Professor of Psychiatry, Yale School of Medicine, New Haven, CT. Dr. Strockbine is the Chief Medical Officer, Whiting Forensic Hospital, Middletown, CT. Dr. Uyanwune is a Psychiatry Resident, Yale School of Medicine, New Haven, CT. Dr. Kapoor is an Associate Professor of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Reena Kapoor
- Dr. Wasser is an Associate Professor of Psychiatry, Yale School of Medicine, New Haven, CT. Dr. Strockbine is the Chief Medical Officer, Whiting Forensic Hospital, Middletown, CT. Dr. Uyanwune is a Psychiatry Resident, Yale School of Medicine, New Haven, CT. Dr. Kapoor is an Associate Professor of Psychiatry, Yale School of Medicine, New Haven, CT
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Betz ME, Frattaroli S, Knoepke CE, Johnson R, Christy A, Schleimer JP, Pear VA, McCarthy M, Kapoor R, Norko MA, Rowhani-Rahbar A, Ma W, Wintemute GJ, Swanson JW, Zeoli AM. Extreme Risk Protection Orders in Older Adults in Six U.S. States: A Descriptive Study. Clin Gerontol 2023:1-8. [PMID: 37688772 DOI: 10.1080/07317115.2023.2254279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/11/2023]
Abstract
OBJECTIVES Extreme Risk Protection Orders (ERPOs) allow a court to restrict firearm access for individuals ("respondents") at imminent risk of harm to self/others. Little is known about ERPOs use for older adults, a population with higher rates of suicide and dementia. METHODS We abstracted ERPO cases through June 30, 2020, from California, Colorado, Connecticut, Florida, Maryland, and Washington. We restricted our analysis to petitions for older (≥65 years) respondents, stratified by documented cognitive impairment. RESULTS Among 6,699 ERPO petitions, 672 (10.0%) were for older adults; 13.7% (n = 92) of these noted cognitive impairment. Most were white (75.7%) men (90.2%). Cognitively impaired (vs. non-impaired) respondents were older (mean age 78.2 vs 72.7 years) and more likely to have documented irrational/erratic behavior (30.4% vs 15.7%), but less likely to have documented suicidality (33.7% vs 55.0%). At the time of the petition, 56.2% of older adult respondents had documented firearm access (median accessible firearms = 3, range 1-160). CONCLUSIONS Approximately 14% of ERPO petitions for older adults involved cognitive impairment; one-third of these noted suicide risk. Studies examining ERPO implementation across states may inform usage and awareness. CLINICAL IMPLICATIONS ERPOs may reduce firearm access among older adults with cognitive impairment, suicidality, or risk of violence.
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Affiliation(s)
- Marian E Betz
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
- Firearm Injury Prevention Initiative, University of Colorado School of Medicine, Aurora, Colorado, USA
- VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, Colorado, USA
| | - Shannon Frattaroli
- Center for Gun Violence Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Christopher E Knoepke
- Firearm Injury Prevention Initiative, University of Colorado School of Medicine, Aurora, Colorado, USA
- Adult & Child Consortium for Outcomes Research & Delivery Science, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Division of Cardiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Rachel Johnson
- Center for Innovative Design & Analysis, Department of Biostatistics & Informatics, Colorado School of Public health, Aurora, Colorado, USA
| | - Annette Christy
- Department of Mental Health Law and Policy at the de la Parte Florida Mental Health Institute, College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida, USA
| | - Julia P Schleimer
- Violence Prevention Research Program, University of California Davis School of Medicine, Sacramento, California, USA
- Firearm Injury & Policy Research Program, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Veronica A Pear
- Violence Prevention Research Program, University of California Davis School of Medicine, Sacramento, California, USA
| | - Megan McCarthy
- Firearm Injury Prevention Initiative, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Reena Kapoor
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Michael A Norko
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Ali Rowhani-Rahbar
- Firearm Injury & Policy Research Program, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Wenjuan Ma
- Center for Statistical Training and Consulting, Michigan State University, Lansing, Michigan, USA
| | - Garen J Wintemute
- Violence Prevention Research Program, University of California Davis School of Medicine, Sacramento, California, USA
| | - Jeffrey W Swanson
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - April M Zeoli
- Department of Health Management and Policy, University of Michigan, School of Public Health, Ann Arbor, Michigan, USA
- Institute for Firearm Injury Prevention, University of Michigan, Ann Arbor, Michigan, USA
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Khosla D, Kapoor R, Kataria V, Sekar A, Das C, Kumar D, Gupta R, Gupta V, Singh H, Dey T, Madan R, Nada R. 75P Primary sarcomas of gastrointestinal tract: A single-institution experience of a rare entity. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Zeoli AM, Frattaroli S, Barnard L, Bowen A, Christy A, Easter M, Kapoor R, Knoepke C, Ma W, Molocznik A, Norko M, Omaki E, Paruk JK, Pear VA, Rowhani-Rahbar A, Schleimer JP, Swanson JW, Wintemute GJ. Extreme risk protection orders in response to threats of multiple victim/mass shooting in six U.S. states: A descriptive study. Prev Med 2022; 165:107304. [PMID: 36265579 DOI: 10.1016/j.ypmed.2022.107304] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 10/06/2022] [Accepted: 10/08/2022] [Indexed: 12/05/2022]
Abstract
Extreme risk protection orders (ERPOs), also known as red flag laws, are a potential tool to prevent firearm violence, including mass shootings, but little is currently known about the extent of their use in cases of mass shooting threats or about the threats themselves. We collected and abstracted information from ERPO cases from six states (California, Colorado, Connecticut, Florida, Maryland, and Washington). Ten percent (N = 662) of all ERPO cases (N = 6787) were in response to a threat of killing at least 3 people. Using these cases, we created a typology of multiple victim/mass shooting threats, the most common of which was the maximum casualty threat. The most common target for a multiple victim/mass shooting threat was a K-12 school, followed by businesses, then intimate partners and their children and families. Judges granted 93% of petitions that involved these threats at the temporary ERPO stage and, of those cases in which a final hearing was held, judges granted 84% of final ERPOs. While we cannot know how many of the 662 ERPO cases precipitated by a threat would have resulted in a multiple victim/mass shooting event had ERPO laws not been used to prohibit the purchase and possession of firearms, the study provides evidence at least that ERPOs are being used in six states in a substantial number of these kinds of cases that could have ended in tragedy.
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Affiliation(s)
- April M Zeoli
- University of Michigan, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
| | - Shannon Frattaroli
- Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States
| | - Leslie Barnard
- University of Colorado Anschutz Medical Campus, 13001 East 17th Place, Aurora, CO 80045, United States
| | - Andrew Bowen
- School of Public Health, University of Washington, 3980 15th Avenue NE, Box 351616, Seattle, WA 98195, United States
| | - Annette Christy
- College of Behavioral and Community Sciences, University of South Florida, 4202 E. Fowler Avenue Tampa, FL 33612, United States
| | - Michele Easter
- Duke University School of Medicine, 40 Duke Medicine Circle, Durham, NC 27710, United States
| | - Reena Kapoor
- Yale School of Medicine, 333 Cedar Street, New Haven, CT 06510, United States
| | - Christopher Knoepke
- University of Colorado Anschutz Medical Campus, 13001 East 17th Place, Aurora, CO 80045, United States
| | - Wenjuan Ma
- College of Social Science, Michigan State University, 509 East Circle Drive, East Lansing, MI 48824, United States
| | - Amy Molocznik
- Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States
| | - Michael Norko
- Yale School of Medicine, 333 Cedar Street, New Haven, CT 06510, United States
| | - Elise Omaki
- Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States
| | - Jennifer K Paruk
- College of Social Science, Michigan State University, 509 East Circle Drive, East Lansing, MI 48824, United States
| | - Veronica A Pear
- University of California, Davis School of Medicine, 2315 Stockton Blvd., Sacramento, CA 95817, United States
| | - Ali Rowhani-Rahbar
- School of Public Health, University of Washington, 3980 15th Avenue NE, Box 351616, Seattle, WA 98195, United States
| | - Julia P Schleimer
- University of California, Davis School of Medicine, 2315 Stockton Blvd., Sacramento, CA 95817, United States
| | - Jeffrey W Swanson
- Duke University School of Medicine, 40 Duke Medicine Circle, Durham, NC 27710, United States
| | - Garen J Wintemute
- University of California, Davis School of Medicine, 2315 Stockton Blvd., Sacramento, CA 95817, United States
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Singh R, Rathod G, Meletharayil G, Kapoor R, Sankarlal V, Amamcharla J. Invited review: Shelf-stable dairy protein beverages—Scientific and technological aspects. J Dairy Sci 2022; 105:9327-9346. [DOI: 10.3168/jds.2022-22208] [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] [Received: 04/19/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022]
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Singla A, Madan R, Kumar N, Goyal S, Tripathi M, Gupta K, Gupta D, Kapoor R. PO-1149 Clinico-pathological and prognostic factors of Medulloblastoma - Tertiary care centre in India. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03113-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Singla A, Khosla D, Kapoor R, Kumar D, Madan R, Periasamy K, Goyal S, Gupta R, Gupta V. 1486P Clinicopathological characteristics and prognostic factors of ampullary cancer: A tertiary care centre experience over 10 years. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.813] [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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Dimitriou F, Lo S, Tan A, Emmett L, Kapoor R, Carlino M, Long G, Menzies A. 1054P FDG-PET to predict long-term outcome from anti-PD1 (PD1) therapy in metastatic melanoma. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1439] [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] Open
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Khosla D, Rana S, Kapoor R, Periasamy K, Madan R, Kumar N, Gupta R. P-243 A prospective study to assess the impact of colostomy on psychosocial aspects of quality of life in colorectal cancer patients. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.297] [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] Open
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Tripathi T, Singh AR, Kapoor R, Sinha A, Ghosh S, Kaur K, Pokhariya D, Maity S, Tapadar A, Chandra A. Dapsone-induced methaemoglobinaemia in leprosy: a close mimic of 'happy hypoxia' in the COVID-19 pandemic. J Eur Acad Dermatol Venereol 2021; 35:e568-e571. [PMID: 34037283 PMCID: PMC8242520 DOI: 10.1111/jdv.17394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- T Tripathi
- Department of Dermatology, Base Hospital Barrackpore, Kolkata, India
| | - A R Singh
- Department of Medicine, Base Hospital Barrackpore, Kolkata, India
| | - R Kapoor
- Departments of Medicine and Haematology, Command Hospital Eastern Command, Kolkata, India
| | - A Sinha
- Department of Dermatology, Military Hospital Kirkee, Pune, India
| | - S Ghosh
- Department of Medicine, Base Hospital Barrackpore, Kolkata, India
| | - K Kaur
- Department of Pathology, Base Hospital Barrackpore, Kolkata, India
| | - D Pokhariya
- Department of Radiology, Base Hospital Barrackpore, Kolkata, India
| | - S Maity
- Department of Anaesthesiology and Critical Care, Base Hospital Barrackpore, Kolkata, India
| | - A Tapadar
- Department of Medicine, Base Hospital Barrackpore, Kolkata, India
| | - A Chandra
- Department of Medicine, Base Hospital Barrackpore, Kolkata, India
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Singh N, Ravi N, Bal A, Garg M, Kapoor R, Prasad K. 168P Changes in cfDNA levels in squamous non-small cell lung cancer with chemotherapy: Correlation with symptom scores and radiological responses. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)02010-4] [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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12
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Carter B, Cheng N, Kapoor R, Meletharayil G, Drake M. Invited review: Microfiltration-derived casein and whey proteins from milk. J Dairy Sci 2021; 104:2465-2479. [DOI: 10.3168/jds.2020-18811] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 10/05/2020] [Indexed: 01/26/2023]
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Singh J, Ronsard L, Pandey M, Kapoor R, Ramachandran VG, Banerjea AC. Molecular and Genetic Characterization of Natural Variants of HIV-1 Nef Gene from North India and its Functional Implication in Down-Regulation of MHC-I and CD-4. Curr HIV Res 2021; 19:172-187. [PMID: 32981506 DOI: 10.2174/1570162x18666200925160755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/05/2020] [Accepted: 08/14/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND HIV-1 Nef is an important accessory protein with multiple effector functions. Genetic studies of the HIV-1 Nef gene show extensive genetic diversity and the functional studies have been carried out mostly with Nef derived from regions dominated by subtype B (North America & Europe). OBJECTIVE This study was carried out to characterize genetic variations of the Nef gene from HIV-1 infected individuals from North India and to find out their functional implications. METHODS The unique representative variants were sub-cloned in a eukaryotic expression vector and further characterized with respect to their ability to downregulate cell surface expression of CD4 and MHC-1 molecules. RESULTS The phylogenetic analysis of Nef variants revealed sequence similarity with either consensus subtype B or B/C recombinants. Boot scan analysis of some of our variants showed homology to B/C recombinant and some to wild type Nef B. Extensive variations were observed in most of the variants. The dN/dS ratio revealed 80% purifying selection and 20% diversifying selection implying the importance of mutations in Nef variants. Intracellular stability of Nef variants differed greatly when compared with wild type Nef B and C. There were some variants that possessed mutations in the functional domains of Nef and responsible for its differential CD4 and MHC-1 downregulation activity. CONCLUSION We observed enhanced biological activities in some of the variants, perhaps arising from amino acid substitutions in their functional domains. The CD4 and MHC-1 down-regulation activity of Nef is likely to confer immense survival advantage allowing the most rare genotype in a population to become the most abundant after a single selection event.
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Affiliation(s)
- J Singh
- National Institute of Immunology, New Delhi, India
| | - L Ronsard
- National Institute of Immunology, New Delhi, India
| | - M Pandey
- King George`s Medical University, India
| | - R Kapoor
- National Institute of Immunology, New Delhi, India
| | - V G Ramachandran
- Department of Virology, National Institute of Immunology, New Delhi-110067, India
| | - A C Banerjea
- Department of Virology, National Institute of Immunology, New Delhi-110067, India
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Majumdar S, Kishor J, Behera AN, Vishwanadh B, Borgohain A, Kapoor R, Tewari R, Kain V, Krishnan M, Dey GK, Banerjee S. Preparation and Characterization of Nb-1Zr-0.1C Alloy Suitable for Liquid Metal Coolant Channels of High Temperature Reactors. Journal of Nuclear Engineering and Radiation Science 2021. [DOI: 10.1115/1.4047919] [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: 11/08/2022]
Abstract
Abstract
A novel process comprising of aluminothermic coreduction of mixed oxides followed by arc and electron beam melt refining was developed for preparation of Nb-1Zr-0.1C alloy. The parameters of the process were optimized by considering the thermodynamic (heat) and mass balance phenomenon. The ingots of the homogenized alloy produced after electron beam melt consolidation were further extruded into tubes. The alloy was vacuum annealed at 1350–1800 °C to study the stability of Nb2C and Nb(Zr)C carbide precipitates in the microstructure. Compression creep tests conducted at 900 and 1000 °C revealed a stress exponent value of 2 and activation energy of 508 kJ/mol. NbSi2-based coatings were developed on the Nb-1Zr-0.1C alloy tubes using pack siliconizing process. The coated alloy was tested for oxidation at 1250 °C, and corrosion in liquid lead-bismuth eutectic (LBE) alloy at 875 °C for prolonged duration. The silicide-coated alloy showed superior oxidation and LBE corrosion resistance at high temperatures. The alloy was found to be a promising material for coolant channels of high temperature reactors.
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Affiliation(s)
- S. Majumdar
- Materials Group, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
| | - J. Kishor
- Materials Group, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
| | - A. N. Behera
- Materials Group, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
| | - B. Vishwanadh
- Materials Group, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
| | - A. Borgohain
- Reactor Engineering Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
| | - R. Kapoor
- Materials Group, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
| | - R. Tewari
- Materials Group, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
| | - V. Kain
- Materials Group, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
| | - Madangopal Krishnan
- Materials Group, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
| | - G. K. Dey
- Homi Bhabha National Institute, Mumbai 400094, India
| | - S. Banerjee
- Homi Bhabha National Institute, Mumbai 400094, India
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Wasser TD, Zhong R, Mufson J, Danzig A, Koka L, Kapoor R. Violent Video Games in Forensic Psychiatric Hospitals. J Am Acad Psychiatry Law 2020; 48:521-529. [PMID: 32675329 DOI: 10.29158/jaapl.200004-20] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Popular media and the lay public have long expressed concerns about the association between violent video games and violent behavior. The current scientific literature exploring this connection focuses primarily on the relationship between violent video games and aggression in healthy populations. We are unaware of prior publications exploring the effect of such games on aggression in institutional settings or with forensic populations. Here we examine whether state psychiatric institutions, particularly forensic hospitals, have set policies to govern the use of violent video games for patients under their care. We present data from a national survey of such institutions in the United States, with some anecdotal international data included. The results demonstrate that hospital policies, when they exist, are inconsistent in their approaches to the use of violent video games. We argue that hospitals should devise policies that acknowledge the limited evidence in this area and that optimally balance the relevant stakeholders' interests. We propose guiding principles that balance these competing interests for institutions to consider when developing such policies. Finally, we advocate for further research regarding the safety and potential therapeutic effects of video games in forensic settings so that an evidence-based approach can be initiated future.
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Affiliation(s)
- Tobias D Wasser
- Dr. Wasser is Assistant Professor of Psychiatry, Yale School of Medicine, New Haven, Connecticut, and Chief Medical Officer, Whiting Forensic Hospital, Department of Mental Health and Addiction Services, Middletown, Connecticut. Dr. Zhong is Lecturer in Psychiatry, Yale School of Medicine, New Haven, Connecticut and Adjunct Instructor, Department of Medical Education, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama. Dr. Mufson and Dr. Danzig are Psychiatry Residents, Yale School of Medicine, New Haven, Connecticut. Ms. Koka is Medical Student, University of Connecticut School of Medicine, Farmington, Connecticut. Dr. Kapoor is Associate Professor of Psychiatry, Yale School of Medicine, New Haven, and Chief of Forensic Services, Whiting Forensic Hospital, Department of Mental Health and Addiction Services, Middletown, Connecticut.
| | - Rocksheng Zhong
- Dr. Wasser is Assistant Professor of Psychiatry, Yale School of Medicine, New Haven, Connecticut, and Chief Medical Officer, Whiting Forensic Hospital, Department of Mental Health and Addiction Services, Middletown, Connecticut. Dr. Zhong is Lecturer in Psychiatry, Yale School of Medicine, New Haven, Connecticut and Adjunct Instructor, Department of Medical Education, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama. Dr. Mufson and Dr. Danzig are Psychiatry Residents, Yale School of Medicine, New Haven, Connecticut. Ms. Koka is Medical Student, University of Connecticut School of Medicine, Farmington, Connecticut. Dr. Kapoor is Associate Professor of Psychiatry, Yale School of Medicine, New Haven, and Chief of Forensic Services, Whiting Forensic Hospital, Department of Mental Health and Addiction Services, Middletown, Connecticut
| | - Jeffrey Mufson
- Dr. Wasser is Assistant Professor of Psychiatry, Yale School of Medicine, New Haven, Connecticut, and Chief Medical Officer, Whiting Forensic Hospital, Department of Mental Health and Addiction Services, Middletown, Connecticut. Dr. Zhong is Lecturer in Psychiatry, Yale School of Medicine, New Haven, Connecticut and Adjunct Instructor, Department of Medical Education, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama. Dr. Mufson and Dr. Danzig are Psychiatry Residents, Yale School of Medicine, New Haven, Connecticut. Ms. Koka is Medical Student, University of Connecticut School of Medicine, Farmington, Connecticut. Dr. Kapoor is Associate Professor of Psychiatry, Yale School of Medicine, New Haven, and Chief of Forensic Services, Whiting Forensic Hospital, Department of Mental Health and Addiction Services, Middletown, Connecticut
| | - Ayala Danzig
- Dr. Wasser is Assistant Professor of Psychiatry, Yale School of Medicine, New Haven, Connecticut, and Chief Medical Officer, Whiting Forensic Hospital, Department of Mental Health and Addiction Services, Middletown, Connecticut. Dr. Zhong is Lecturer in Psychiatry, Yale School of Medicine, New Haven, Connecticut and Adjunct Instructor, Department of Medical Education, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama. Dr. Mufson and Dr. Danzig are Psychiatry Residents, Yale School of Medicine, New Haven, Connecticut. Ms. Koka is Medical Student, University of Connecticut School of Medicine, Farmington, Connecticut. Dr. Kapoor is Associate Professor of Psychiatry, Yale School of Medicine, New Haven, and Chief of Forensic Services, Whiting Forensic Hospital, Department of Mental Health and Addiction Services, Middletown, Connecticut
| | - Livja Koka
- Dr. Wasser is Assistant Professor of Psychiatry, Yale School of Medicine, New Haven, Connecticut, and Chief Medical Officer, Whiting Forensic Hospital, Department of Mental Health and Addiction Services, Middletown, Connecticut. Dr. Zhong is Lecturer in Psychiatry, Yale School of Medicine, New Haven, Connecticut and Adjunct Instructor, Department of Medical Education, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama. Dr. Mufson and Dr. Danzig are Psychiatry Residents, Yale School of Medicine, New Haven, Connecticut. Ms. Koka is Medical Student, University of Connecticut School of Medicine, Farmington, Connecticut. Dr. Kapoor is Associate Professor of Psychiatry, Yale School of Medicine, New Haven, and Chief of Forensic Services, Whiting Forensic Hospital, Department of Mental Health and Addiction Services, Middletown, Connecticut
| | - Reena Kapoor
- Dr. Wasser is Assistant Professor of Psychiatry, Yale School of Medicine, New Haven, Connecticut, and Chief Medical Officer, Whiting Forensic Hospital, Department of Mental Health and Addiction Services, Middletown, Connecticut. Dr. Zhong is Lecturer in Psychiatry, Yale School of Medicine, New Haven, Connecticut and Adjunct Instructor, Department of Medical Education, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama. Dr. Mufson and Dr. Danzig are Psychiatry Residents, Yale School of Medicine, New Haven, Connecticut. Ms. Koka is Medical Student, University of Connecticut School of Medicine, Farmington, Connecticut. Dr. Kapoor is Associate Professor of Psychiatry, Yale School of Medicine, New Haven, and Chief of Forensic Services, Whiting Forensic Hospital, Department of Mental Health and Addiction Services, Middletown, Connecticut
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Raftopoulos R, Kuhle J, Grant D, Hickman SJ, Altmann DR, Leppert D, Blennow K, Zetterberg H, Kapoor R, Giovannoni G, Gnanapavan S. Neurofilament results for the phase II neuroprotection study of phenytoin in optic neuritis. Eur J Neurol 2020; 28:587-594. [PMID: 33058438 DOI: 10.1111/ene.14591] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/05/2020] [Accepted: 10/08/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND A randomized trial of phenytoin in acute optic neuritis (ON) demonstrated a 30% reduction in retinal nerve fiber layer (RNFL) loss with phenytoin versus placebo. Here we present the corresponding serum neurofilament analyses. METHODS Eighty-six acute ON cases were randomized to receive phenytoin (4-6 mg/kg/day) or placebo for 3 months, and followed up for 6 months. Serum was collected at baseline, 3 and 6 months for analysis of neurofilament heavy chain (NfH) and neurofilament light chain (NfL). RESULTS Sixty-four patients had blood sampling. Of these, 58 and 56 were available at 3 months, and 55 and 54 were available at 6 months for NfH and NfL, respectively. There was no significant correlation between serum NfH and NfL at the time points tested. For NfH, the difference in mean placebo - phenytoin was -44 pg/ml at 3 months (P = 0.019) and -27 pg/ml at 6 months (P = 0.234). For NfL, the difference was 1.4 pg/ml at 3 months (P = 0.726) and -1.6 pg/ml at 6 months (P = 0.766). CONCLUSIONS At 3 months, there was a reduction in NfH, but not NFL, in the phenytoin versus placebo group, while differences at 6 months were not statistically significant. This suggests a potential neuroprotective role for phenytoin in acute ON, with the lower NfH at 3 months, when levels secondary to degeneration of the anterior visual pathway are still elevated, but not at 6 months, when levels have normalized.
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Affiliation(s)
- R Raftopoulos
- University College London Institute of Neurology, London, UK
| | - J Kuhle
- Department of Neurology, University Hospital Basel, Basel, Switzerland
| | - D Grant
- University College London Institute of Neurology, London, UK
| | - S J Hickman
- Department of Neurology, Royal Hallamshire Hospital, Sheffield, UK
| | - D R Altmann
- Medical Statistics Department, London School of Hygiene & Tropical Medicine, London, UK
| | - D Leppert
- Department of Neurology, University Hospital Basel, Basel, Switzerland
| | - K Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - H Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | - R Kapoor
- University College London Institute of Neurology, London, UK
| | - G Giovannoni
- Department of Neuroscience & Trauma, QMUL, London, UK
| | - S Gnanapavan
- Department of Neuroscience & Trauma, QMUL, London, UK
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Khosla D, Kapoor R, Rana S, Tomar P, Periasamy K, Madan R, Goyal S, Kumar N. Dosimetric Comparison of Three-Dimensional Conformal Radiotherapy (3DCRT) and Volumetric Modulated Arc Therapy (VMAT) Plans for Hypofractionated Whole Breast and Regional Nodes Irradiation in Breast Cancer Patients Following Breast Conservative Surgery. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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18
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Lewis P, Amankwaa-Frempong E, Makwani H, Nsingo M, Addison E, Acquah G, Yusufu S, Makufa R, Edusa C, Dharsee N, Grover S, Court L, Palta J, Kapoor R, Aggarwal A. Implementation of a Novel Cloud-based Platform for Facilitating Remote Radiotherapy Peer Review and Training in Resource-Limited Settings: Results of Feasibility Assessments in 4 Radiotherapy Centers in Botswana, Ghana and Tanzania. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
Specific guidance on how to manage COVID-19 in forensic psychiatric institutions is necessary because these settings differ substantially from both acute-care psychiatric hospitals and correctional institutions. The challenges raised by COVID-19 in these settings are unique, given the nature of the patients treated, length of stay, and need to collaborate with various partners in the criminal justice system during both the admission and discharge planning processes. This column outlines these specific challenges, which are likely to recur in subsequent epidemics, and suggests potential strategies to address them.
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Affiliation(s)
- Tobias Wasser
- Whiting Forensic Hospital, Middletown, Connecticut (all authors); Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut (Wasser, Kapoor). Paul S. Appelbaum, M.D., is editor of this column
| | - Lori Hauser
- Whiting Forensic Hospital, Middletown, Connecticut (all authors); Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut (Wasser, Kapoor). Paul S. Appelbaum, M.D., is editor of this column
| | - Reena Kapoor
- Whiting Forensic Hospital, Middletown, Connecticut (all authors); Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut (Wasser, Kapoor). Paul S. Appelbaum, M.D., is editor of this column
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Kapoor R, Wasser TD, Funaro MC, Norko MA. Hospital treatment of persons found not guilty by reason of insanity. Behav Sci Law 2020; 38:426-440. [PMID: 32897589 DOI: 10.1002/bsl.2484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/08/2020] [Accepted: 08/08/2020] [Indexed: 06/11/2023]
Abstract
After being found not guilty by reason of insanity (NGRI), individuals are typically admitted to a secure forensic hospital for evaluation and treatment. This patient population can pose a challenge to clinicians in the hospital setting due to significant violence risk, complex psychiatric presentations, and scrutiny from oversight boards and the public. This article reviews the scientific literature around several key aspects of hospital-based treatment of insanity acquittees, including the management of inpatient aggression, the provision of specific treatments to acquittees, the assessment of violence risk and readiness for release, and the process of community transition. The authors conclude that the existing literature is heavily weighted toward the study of risk assessment and recidivism, with relatively little attention paid to the study of therapeutic modalities and recovery-oriented care in this population.
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Affiliation(s)
- Reena Kapoor
- Law & Psychiatry Division, Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06519, USA
| | - Tobias D Wasser
- Law & Psychiatry Division, Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06519, USA
| | - Melissa C Funaro
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, 333 Cedar St, New Haven, CT, 06520-8014, USA
| | - Michael A Norko
- Law & Psychiatry Division, Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06519, USA
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21
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Madan R, Kumar N, Gupta A, Gupta K, Salunke P, Khosla D, Yadav BS, Kapoor R. Effect of prophylactic granulocyte-colony stimulating factor (G-CSF) on acute hematological toxicity in medulloblastoma patients during craniospinal irradiation (CSI). Clin Neurol Neurosurg 2020; 196:105975. [PMID: 32505868 DOI: 10.1016/j.clineuro.2020.105975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/24/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Haematological toxicity and treatment breaks are common during cranio-spinal irradiation (CSI) due to irradiation of large volume of bone marrow. We conducted this study to see the effect of prophylactic granulocyte colony stimulating factor (GCSF) in reducing treatment breaks. PATIENTS AND METHODS The study was conducted over a period of 15 months from August 2017 to November 2018. Histopathologically proven Medulloblastoma patients received prophylactic GCSF during CSI. Acute hematological toxicities and treatment breaks were noted and effect of age and pretreatment blood counts were analyzed by SPSS (Statistical Package for Social Sciences) version 23. RESULTS A total of 28 patients were included in the study. During CSI, hematological toxicity leading to treatment breaks was observed in 11 (39.3 %) patients, of which grade 3 and 2 toxicities were seen in ten and one patients respectively. Younger age (<10 years) at diagnosis was significantly associated with the development of hematological toxicity (p = 0.028, Chi-Square). No correlation was found with pre-treatment blood counts. CONCLUSION Prophylactic use of GCSF may be effective in preventing radiation induced hematological toxicity and treatment breaks.
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Affiliation(s)
- R Madan
- Department of Radiotherapy and Oncology, PGIMER, Chandigarh, India
| | - N Kumar
- Department of Radiotherapy and Oncology, PGIMER, Chandigarh, India.
| | - A Gupta
- Department of Radiotherapy and Oncology, PGIMER, Chandigarh, India
| | - K Gupta
- Department of Pathology, PGIMER, Chandigarh, India
| | - P Salunke
- Department of Neurosurgery, PGIMER, Chandigarh, India
| | - D Khosla
- Department of Radiotherapy and Oncology, PGIMER, Chandigarh, India
| | - B S Yadav
- Department of Radiotherapy and Oncology, PGIMER, Chandigarh, India
| | - R Kapoor
- Department of Radiotherapy and Oncology, PGIMER, Chandigarh, India
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22
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Kapoor R, Dhatwalia S, Kumar R, Rani S, Parsad D. Emerging role of dermal compartment in skin pigmentation: comprehensive review. J Eur Acad Dermatol Venereol 2020; 34:2757-2765. [DOI: 10.1111/jdv.16404] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 03/03/2020] [Indexed: 12/16/2022]
Affiliation(s)
- R. Kapoor
- Department of Zoology Panjab University Chandigarh Chandigarh India
| | - S.K. Dhatwalia
- Department of Zoology Panjab University Chandigarh Chandigarh India
| | - R. Kumar
- Department of Zoology Panjab University Chandigarh Chandigarh India
| | - S. Rani
- Department of Zoology Panjab University Chandigarh Chandigarh India
| | - D. Parsad
- Department of Dermatology PGIMER Chandigarh India
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Agarwal N, Dave C, Patel R, Shukla R, Kapoor R, Bajpai A. Factors Associated With Cerebral Edema at Admission in Indian Children with Diabetic Ketoacidosis. Indian Pediatr 2020; 57:310-313. [PMID: 32038036] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To evaluate the time course and predictors of cerebral edema in diabetic ketoacidosis (DKA). METHODS Review of hospital records of 107 episodes of DKA between January 2013 to March 2019. RESULTS Cerebral edema was identified in 26 (24.3%; 22 at presentation and 4 during treatment). Cerebral edema at presentation was associated with lower (<10 mmHg) arterial carbon dioxide (OR 3.6, 95% CI 1.0,12.7; P=0.04), prior fluid treatment (OR 4.7, 95% CI 1.8,12.7; P=0.001) and new onset diabetes (OR 3.5, 95% CI 1.1,11.1; P=0.03). Prior fluid was the only significant predictor on multivariate analysis (P=0.013). Cerebral edema resulted in a longer ICU stay [4.1 (2.3) vs 1.8 (0.9) d; P<0.001]. CONCLUSIONS Cerebral edema at admission is common in Indian children with DKA and should be suspected with severe metabolic acidosis and inappropriate prior fluid treatment.
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Affiliation(s)
- N Agarwal
- Department of Pediatric Endocrinology, Regency Center for Diabetes Endocrinology and Research, Kanpur, Uttar Pradesh, India, and Growth and Obesity Workforce (GROW)
| | - C Dave
- Department of Pediatric Endocrinology, Regency Center for Diabetes Endocrinology and Research, Kanpur, Uttar Pradesh, India, and Growth and Obesity Workforce (GROW)
| | - R Patel
- Department of Pediatric Endocrinology, Regency Center for Diabetes Endocrinology and Research, Kanpur, Uttar Pradesh, India, and Growth and Obesity Workforce (GROW)
| | - R Shukla
- Department of Pediatric Endocrinology, Regency Center for Diabetes Endocrinology and Research, Kanpur, Uttar Pradesh, India
| | - R Kapoor
- Department of Pediatric Critical Care, Regency Center for Diabetes Endocrinology and Research, Kanpur, Uttar Pradesh, India, and Growth and Obesity Workforce (GROW)
| | - A Bajpai
- Department of Pediatric Endocrinology, Regency Center for Diabetes Endocrinology and Research, Kanpur, Uttar Pradesh, India, and Growth and Obesity Workforce (GROW). Correspondence to: Dr Anurag Bajpai, Department of Pediatric Endocrinology, Regency Center for Diabetes Endocrinology and Research, Kanpur 208 001, Uttar Pradesh, India.
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24
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Abstract
Competency restoration in jails has grown steadily over the past decade, driven primarily by cost considerations and long wait times for inpatient restoration programs. Although jail-based programs may offer an attractive temporary solution to the shortage of beds, a longer-term solution involves enhancing the continuum of competency restoration services available outside of the correctional system. Such a continuum includes inpatient, supportive residential, and outpatient services. If these services were adequately funded and managed, jail-based competency restoration services would provide no additional benefit to patients, mental health professionals, or the criminal justice system.
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Affiliation(s)
- Reena Kapoor
- Dr. Kapoor is Associate Professor of Psychiatry, Law and Psychiatry Division, Yale School of Medicine, New Haven, Connecticut.
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25
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Agarwal N, Dave C, Patel R, Shukla R, Kapoor R, Bajpai A. Factors Associated With Cerebral Edema at Admission in Indian Children with Diabetic Ketoacidosis. Indian Pediatr 2020. [DOI: 10.1007/s13312-020-1781-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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26
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Tan AC, Emmett L, Lo S, Liu V, Kapoor R, Carlino MS, Guminski AD, Long GV, Menzies AM. FDG-PET response and outcome from anti-PD-1 therapy in metastatic melanoma. Ann Oncol 2019; 29:2115-2120. [PMID: 30137228 DOI: 10.1093/annonc/mdy330] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Background Immune checkpoint inhibitor therapy has resulted in impressive and durable clinical activity for many cancers including melanoma; however, there remain few reliable predictors for long-term response. This study investigated whether [18F]2-fluoro-2-deoxy-D-glucose (FDG-PET) imaging may better predict long-term outcomes compared with standard computed tomography (CT) response criteria. Patients and methods Retrospective analysis of metastatic melanoma patients treated with anti-PD-1-based immunotherapy with baseline and 1-year FDG-PET and CT imaging at Melanoma Institute Australia. One-year response was determined using RECIST for CT and EORTC criteria for PET, coded as complete response (CR or CMR), partial response (PR or PMR), stable disease (SD or SMD) or progressive disease (PD or PMD). Progression-free survival (PFS) was determined from the 1-year landmark. Results Patients (n = 104) were evaluated with median follow-up 30.1 months and 98% remain alive. Most received anti-PD-1 as monotherapy (67%) or combined with ipilimumab (31%). At 1 year, 28% had CR, 66% had PR and 6% had SD on CT, while 75% had CMR, 16% PMR and 9% SMD/PMD on PET. CMR was observed in 68% of patients with PR on CT. RECIST PFS post 1-year landmark was similar in patients with CR versus PR/SD, but improved in patients with CMR versus non-CMR {median not reached [NR] versus 12.8 month; hazard ratio [HR] 0.06 [95% confidence interval (CI) 0.02-0.23]; P < 0.01}. In patients with PR on CT, PFS was improved in patients with PR + CMR versus PR + non-CMR (median NR versus 12.8 months; HR 0.07 [95% CI 0.02-0.27]; P < 0.01). In the 78 CMR patients, 78% had discontinued treatment and 96% had ongoing response. Conclusions Whilst only a small proportion of patients have a CR at 1 year, most patients with a PR have CMR on PET. Almost all patients with CMR at 1 year have ongoing response to therapy thereafter. PET may have utility in predicting long-term benefit and help guide discontinuation of therapy.
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Affiliation(s)
- A C Tan
- Melanoma Institute Australia and The University of Sydney, Sydney, Australia; Department of Medical Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, Australia
| | - L Emmett
- Melanoma Institute Australia and The University of Sydney, Sydney, Australia; Department of Nuclear Medicine, St Vincent's Hospital, Sydney, Australia; The University of New South Wales, Sydney, Australia
| | - S Lo
- Melanoma Institute Australia and The University of Sydney, Sydney, Australia
| | - V Liu
- Department of Nuclear Medicine, St Vincent's Hospital, Sydney, Australia
| | - R Kapoor
- Department of Radiology, Royal Prince Alfred Hospital, Sydney, Australia; Mater Hospital, Sydney, Australia
| | - M S Carlino
- Melanoma Institute Australia and The University of Sydney, Sydney, Australia; Department of Medical Oncology, Crown Princess Mary Cancer Centre, Westmead and Blacktown Hospitals, Sydney, Australia
| | - A D Guminski
- Melanoma Institute Australia and The University of Sydney, Sydney, Australia; Department of Medical Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, Australia; Mater Hospital, Sydney, Australia
| | - G V Long
- Melanoma Institute Australia and The University of Sydney, Sydney, Australia; Department of Medical Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, Australia; Mater Hospital, Sydney, Australia
| | - A M Menzies
- Melanoma Institute Australia and The University of Sydney, Sydney, Australia; Department of Medical Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, Australia; Mater Hospital, Sydney, Australia.
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Mishra K, Yanamandra U, Shukla A, Pramanik S, Kapoor R, Das S. Risk stratification of CML-CP in a real-world scenario, comparison of S.H.E. with rate of fall of BCR/ABL. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz427.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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28
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Kapoor R, Benedek E, Bonnie RJ, Gandhi T, Gold L, Judd S, Pinals DA. Resource Document on Risk-Based Gun Removal Laws. Focus (Am Psychiatr Publ) 2019; 17:443-451. [PMID: 32015728 DOI: 10.1176/appi.focus.17403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
(Reprinted with permission from APA Resource Document, June 2018).
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Das N, Kapoor R, Sood A, Oinam A, Miriyala R, Singh N. EP1.18-14 Algorithm for Deciding Radiotherapy Technique in Stage III Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Madan R, Thakur S, Salunke P, Ahuja C, Khosla D, Yadav BS, Kapoor R, Kumar N. P14.06 Phase II randomized trial of short course hypofractionated radiotherapy with or without temozolomide in elderly patients with Glioblastoma. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
Glioblastoma (GBM) is the most aggressive primary brain tumor. Although treatment advances and introduction of temozolomide has improved the outcome in young patients, it is still a concern in elderly patients. Elderly population is often excluded from the trials, thus established treatment guidelines are not available. Trials have shown that short course hypofractionated radiotherapy (HRT) is equally effective in terms of overall survival (OS) and progression free survival (PFS) as compared to standard RT in elderly population. While the benefit of adding Temozolomide (TMZ) to standard dose radiotherapy is well established, there is lack of evidence that addition of TMZ to HRT improves survival in elderly patients.We conducted this study to see if addition of temozolomide to HRT improves OS, PFS and quality of life (QOL) in elderly GBM patients.
MATERIAL AND METHODS
The study was conducted over a period of 21 months from January 2017 to September 2018. Histologically proven 70 newly diagnosed Glioblastoma patients (age>60 years) were enrolled and randomized into two arms (Arm I- HRT alone, Arm II- HRT and TMZ) using computer generated randomization table (1:1 ratio). The radiotherapy dose in both arms was same and consisted of a dose of 25Gy in 5 daily fractions over 1 week. In addition, arm II patients received daily concurrent TMZ 75mg/m2 1 hour prior to RT followed by adjuvant TMZ 175mg/m2 from Day1-5 for 6 cycles (q 4weeks), started after a month of RT completion. Quality of life score and global health status was assessed in both arms at baseline, 1, 3, 6 and 9 months after the treatment using QOL questionnaire EORTC QLQ-C 30 and QLQ-BN20. Data entry was done in Microsoft Excel 2016 and analysis was done in SPSS version 18. Kaplan Meier survival analysis was done for OS and PFS. To see the trend of time related observations at different point of time repeated ANOVA was used. A p value of <0.05 was taken significant.
RESULTS
The median OS in arm I and II was 121 (range 40–360 days) and 146 (range 40–450 days) days respectively (P=0.146). The median PFS in arm 1 and arm 2 were 77 (range 30–300 days) and 109.50 (range 30–300) days respectively (p-0.028). On further analysis, the prognostic factors were type of surgery (Median PFS 159 days in gross total excision and 129 days in subtotal excision or biopsy, p-0.03) and KPS (0.04). QOL score for symptom and functional domain was comparable in both arms. However score of nausea and vomiting was higher during concurrent chemoradiotherapy. A non significant improvement in QLQ BN 20 score was observed at 9 months in arm I.
CONCLUSION
Addition of Temozolomide to HRT is a compelling option in elderly Glioblastoma patients as it significantly improves the PFS and a non significant improvement in OS without compromising quality of life.
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Affiliation(s)
- R Madan
- Postgarduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - S Thakur
- Postgarduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - P Salunke
- Postgarduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - C Ahuja
- Postgarduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - D Khosla
- Postgarduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - B S Yadav
- Postgarduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - R Kapoor
- Postgarduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - N Kumar
- Postgarduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Phillips R, Wang H, Malek R, Stachelek G, Yu C, Kapoor R, Holland A, Tran P. Radiosensitization and Micronucleus Formation are Induced by Centrosome Clustering Inhibition with Griseofulvin in Prostate Cancer Cell Lines. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1102] [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: 11/26/2022]
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Ansari MS, Yadav P, Srivastava A, Kapoor R, Ashwin Shekar P. Etiology and characteristics of pediatric urethral strictures in a developing country in the 21st century. J Pediatr Urol 2019; 15:403.e1-403.e8. [PMID: 31301979 DOI: 10.1016/j.jpurol.2019.05.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 03/07/2019] [Accepted: 05/20/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Urethral stricture disease in children is not uncommon as assumed; however, most of the information about the etiology, features, and natural history of pediatric strictures is extrapolations from adult series as the literature on this common entity is sparse, and most of the studies are small series. OBJECTIVE The current etiology and clinical features of urethral stricture disease in the pediatric population in the developing world were determined. MATERIALS AND METHODS The data of children with urethral stricture disease, who had undergone treatment in the tertiary center from 2001 to 2017, were retrospectively analyzed. After excluding girls, the database was analyzed for clinical presentation, possible causes of stricture, site and number of strictures, and length of stricture and for previous interventions. Subanalysis was performed for stricture etiology by patient age, stricture length, site, previous treatments, and presentation with paraurethral abscess. RESULTS A total of 195 boys with strictures were identified. The common causes of pediatric urethral stricture were traumatic (36.9%), iatrogenic (31.8%), and idiopathic (28.7%). The anterior urethra was the location of the stricture in 141 patients (72.3%). Iatrogenic causes (due to catheterization, hypospadias repair, and valve fulguration) accounted for the majority of anterior urethral strictures (61/141 or 43.2%). Younger children had a tendency to have an iatrogenic and idiopathic cause for strictures, whereas older children had a traumatic etiology; 18.6% of strictures in children younger than 10 years were secondary to trauma, whereas 44.9% of the strictures in patients older than 10 years were traumatic in origin. Trauma was the major cause of posterior urethral strictures (53/54 or 98.1%) and was always associated with pelvic fracture. Strictures due to lichen sclerosus or infectious cause were rare (5 patients or 2.6%). The length of strictures was longer in pan anterior urethral strictures (mean: 82.0 mm) than that of those due to lichen sclerosus (mean: 42.5 mm) and in patients who had undergone previous treatment (mean: 28.7 mm). CONCLUSION Iatrogenic causes such as catheterization and hypospadias repair account for the majority of anterior urethral stricture disease in the pediatric population, especially the younger age-group. However, as the child grows, there is a gradual preponderance of traumatic urethral strictures, including posterior urethral strictures.
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Affiliation(s)
- M S Ansari
- Pediatric Urology, Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
| | - P Yadav
- Pediatric Urology, Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - A Srivastava
- Pediatric Urology, Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - R Kapoor
- Pediatric Urology, Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - P Ashwin Shekar
- Pediatric Urology, Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Konert T, Vogel WV, Paez D, Polo A, Fidarova E, Carvalho H, Duarte PS, Zuliani AC, Santos AO, Altuhhova D, Karusoo L, Kapoor R, Sood A, Khader J, Al-Ibraheem A, Numair Y, Abubaker S, Soydal C, Kütük T, Le TA, Canh NX, Bieu BQ, Ha LN, Belderbos JSA, MacManus MP, Thorwarth D, Hanna GG. Introducing FDG PET/CT-guided chemoradiotherapy for stage III NSCLC in low- and middle-income countries: preliminary results from the IAEA PERTAIN trial. Eur J Nucl Med Mol Imaging 2019; 46:2235-2243. [PMID: 31367906 PMCID: PMC6717604 DOI: 10.1007/s00259-019-04421-5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/30/2019] [Indexed: 12/24/2022]
Abstract
Purpose Patients with stage III non-small-cell lung cancer (NSCLC) treated with chemoradiotherapy (CRT) in low- and middle-income countries (LMIC) continue to have a poor prognosis. It is known that FDG PET/CT improves staging, treatment selection and target volume delineation (TVD), and although its use has grown rapidly, it is still not widely available in LMIC. CRT is often used as sequential treatment, but is known to be more effective when given concurrently. The aim of the PERTAIN study was to assess the impact of introducing FDG PET/CT-guided concurrent CRT, supported by training and quality control (QC), on the overall survival (OS) and progression-free survival (PFS) of patients with stage III NSCLC. Methods The study included patients with stage III NSCLC from nine medical centres in seven countries. A retrospective cohort was managed according to local practices between January 2010 and July 2014, which involved only optional diagnostic FDG PET/CT for staging (not for TVD), followed by sequential or concurrent CRT. A prospective cohort between August 2015 and October 2018 was treated according to the study protocol including FDG PET/CT in treatment position for staging and multimodal TVD followed by concurrent CRT by specialists trained in protocol-specific TVD and with TVD QC. Kaplan–Meier analysis was used to assess OS and PFS in the retrospective and prospective cohorts. Results Guidelines for FDG PET/CT image acquisition and TVD were developed and published. All specialists involved in the PERTAIN study received training between June 2014 and May 2016. The PET/CT scanners used received EARL accreditation. In November 2018 a planned interim analysis was performed including 230 patients in the retrospective cohort with a median follow-up of 14 months and 128 patients in the prospective cohort, of whom 69 had a follow-up of at least 1 year. Using the Kaplan–Meier method, OS was significantly longer in the prospective cohort than in the retrospective cohort (23 vs. 14 months, p = 0.012). In addition, median PFS was significantly longer in the prospective cohort than in the retrospective cohort (17 vs. 11 months, p = 0.012). Conclusion In the PERTAIN study, the preliminary results indicate that introducing FDG PET/CT-guided concurrent CRT for patients with stage III NSCLC in LMIC resulted in a significant improvement in OS and PFS. The final study results based on complete data are expected in 2020. Electronic supplementary material The online version of this article (10.1007/s00259-019-04421-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- T Konert
- Nuclear Medicine Department, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
| | - W V Vogel
- Nuclear Medicine Department, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - D Paez
- Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - A Polo
- Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - E Fidarova
- Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - H Carvalho
- Department of Radiology and Oncology, Faculty of Medicine, University of São Paulo - Institute of Cancer of Sao Paulo State, São Paulo, Brazil
| | - P S Duarte
- Department of Radiology and Oncology, Faculty of Medicine, University of São Paulo - Institute of Cancer of Sao Paulo State, São Paulo, Brazil
| | - A C Zuliani
- Department of Radiation Oncology and Nuclear Medicine Department, Hospital das Clínicas, Campinas University, Campinas, Brazil
| | - A O Santos
- Department of Radiation Oncology and Nuclear Medicine Department, Hospital das Clínicas, Campinas University, Campinas, Brazil
| | - D Altuhhova
- Department of Radiation Oncology and Radiology Department, North Estonia Medical Center, Tallinn, Estonia
| | - L Karusoo
- Department of Radiation Oncology and Radiology Department, North Estonia Medical Center, Tallinn, Estonia
| | - R Kapoor
- Department of Radiation Oncology and Nuclear Medicine Department, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Sood
- Department of Radiation Oncology and Nuclear Medicine Department, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - J Khader
- Department of Radiation Oncology and Nuclear Medicine Department, King Hussein Cancer Center, Amman, Jordan
| | - A Al-Ibraheem
- Department of Radiation Oncology and Nuclear Medicine Department, King Hussein Cancer Center, Amman, Jordan
| | - Y Numair
- Department of Radiation Oncology and Nuclear Medicine Department, Institute of Nuclear Medicine and Oncology, Lahore, Pakistan
| | - S Abubaker
- Department of Radiation Oncology and Nuclear Medicine Department, Institute of Nuclear Medicine and Oncology, Lahore, Pakistan
| | - C Soydal
- Department of Radiation Oncology and Nuclear Medicine Department, Ankara University School of Medicine, Mamak/Ankara, Turkey
| | - T Kütük
- Department of Radiation Oncology and Nuclear Medicine Department, Ankara University School of Medicine, Mamak/Ankara, Turkey
| | - T A Le
- Department of Radiation Oncology and Nuclear Medicine Department, Cho Ray Hospital, University of Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - N X Canh
- Department of Radiation Oncology and Nuclear Medicine Department, Cho Ray Hospital, University of Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - B Q Bieu
- Department of Radiation Oncology and Radiosurgery, Tran Hung Dao Hospital, Hanoi, Vietnam
| | - L N Ha
- Department of Radiation Oncology and Radiosurgery, Tran Hung Dao Hospital, Hanoi, Vietnam
| | - J S A Belderbos
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M P MacManus
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | - D Thorwarth
- Section for Biomedical Physics, Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany
| | - G G Hanna
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia. .,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia.
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Abstract
During the early part of the past century, hundreds of clinical studies involving more than 37,000 patients were conducted that showed radiotherapy (RT) to be a successful and safe alternative to drug therapy for the treatment of many diverse inflammatory conditions and diseases (e.g. tendonitis, bursitis, arthritis, and serious inflammatory lung conditions). Data from these studies were collected and analyzed with the intent of estimating an optimal dosing range for RT that would induce an efficacious treatment response. RT was reported to be frequently effective after only a single treatment, with a rapid (within 24 h) and often long-lasting (from months to years) relief from symptoms. Over a two-decade span from the 1920s to the 1940s, the therapeutic responses to a single RT treatment consistently improved as the dosing for multiple ailments decreased over time to between 30 roentgen (r) and 100 r. These findings are significant and in agreement with a number of contemporary reports from Germany where RT has been commonly and successfully employed in treating ailments with an inflammatory origin. A proposed mechanism by which RT mitigates inflammation and facilitates healing is via the polarization of macrophages to an anti-inflammatory or M2 phenotype.
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Affiliation(s)
- EJ Calabrese
- Department of Environmental Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - G Dhawan
- Mass Venture Center, Research Compliance, University of Massachusetts, Hadley, MA, USA
| | - R Kapoor
- Saint Francis Hospital and Medical Center, Hartford, CT, USA
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Gaur P, Srivastava A, Sureka SK, Kapoor R, Ansari MS, Singh UP. Outcomes of Primary Arteriovenous Fistula for Hemodialysis in Elderly Patients (>65 Years) with End Stage Renal Disease: A Study on Indian Population. Indian J Nephrol 2019; 29:387-392. [PMID: 31798219 PMCID: PMC6883857 DOI: 10.4103/ijn.ijn_65_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 11/23/2022] Open
Abstract
Introduction: The outcome of arteriovenous fistula (AVF) for hemodialysis (HD) in elderly population remains an issue. The aim of our study was to evaluate the outcomes of arteriovenous fistulas created at our institute in patients older than 65 years. Methods: All chronic HD patients with age >65 years who had an AVF created between January 1, 2010 and January 1, 2017 were included retrospectively. Baseline demographic information including age, gender, etiology of renal failure and comorbidities were recorded. Access characteristics including access type and anatomic location were recorded. The end point of study was primary and secondary patency. Minimum follow up period of study was 1 year. Results: A total of 422 AVF were created within the study period. The mean age was 69.3 years. The anatomical site of AVF creation was radiocephalic (RCF) in 74.8% (n = 316), brachiocephalic (BCF) in 18.9% (n = 80) and brachiobasilic (BBF) in 6.1% (n = 26). At one year after creation, cumulative survival of the AVF was 64.7%. At 36 months the primary and secondary patency of RCF, BCF and BBF was 43.6%, 58.6%, 42.6% and 47.3%, 62.5%, 56.9% respectively. The overall median survival did not differ between RCF and BBF fistulas. However, when both were compared with BCF (median survival 1034 days), BBF (median survival 741 days) and RCF (median survival 592 days) had significantly poorer survival (P = 0.004). The most common reason for access failure was thrombosis (28.4%) followed by failure to mature (9%) and aneurysm related complications (9%). Conclusions: Age should not be a limiting factor when choosing AVF as the preferred HD access. Brachiocephalic AVF has better primary and secondary patency with higher overall median survival. However RCF also provides reasonably good survival rates with acceptable complications in elderly population. Thrombosis and fistulas that fail to mature present as a primary concern to patients in elderly population, and demand further study.
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Affiliation(s)
- P Gaur
- Department of Urology and Renal Transplant, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - A Srivastava
- Department of Urology and Renal Transplant, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - S K Sureka
- Department of Urology and Renal Transplant, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - R Kapoor
- Department of Urology and Renal Transplant, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - M S Ansari
- Department of Urology and Renal Transplant, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - U P Singh
- Department of Urology and Renal Transplant, SGPGIMS, Lucknow, Uttar Pradesh, India
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Kapoor R. An Education on Race and Forensic Psychiatry. J Am Acad Psychiatry Law 2018; 46:498-500. [PMID: 30593479 DOI: 10.29158/jaapl.003793-18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Reena Kapoor
- Dr. Kapoor is Associate Professor of Psychiatry and Associate Program Director of the Forensic Psychiatry Fellowship at the Yale School of Medicine.
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Muthu V, Prasad K, Bal A, Gupta N, Behera D, Kapoor R, Singh N. P1.09-31 Preliminary Experience with Liquid Biopsies in a Resource Constrained Setting and Its Impact on Treatment Decision Making. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.807] [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]
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Mayo CS, Phillips M, McNutt TR, Palta J, Dekker A, Miller RC, Xiao Y, Moran JM, Matuszak MM, Gabriel P, Ayan AS, Prisciandaro J, Thor M, Dixit N, Popple R, Killoran J, Kaleba E, Kantor M, Ruan D, Kapoor R, Kessler ML, Lawrence TS. Treatment data and technical process challenges for practical big data efforts in radiation oncology. Med Phys 2018; 45:e793-e810. [PMID: 30226286 DOI: 10.1002/mp.13114] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 10/12/2017] [Revised: 06/26/2018] [Accepted: 06/26/2018] [Indexed: 12/20/2022] Open
Abstract
The term Big Data has come to encompass a number of concepts and uses within medicine. This paper lays out the relevance and application of large collections of data in the radiation oncology community. We describe the potential importance and uses in clinical practice. The important concepts are then described and how they have been or could be implemented are discussed. Impediments to progress in the collection and use of sufficient quantities of data are also described. Finally, recommendations for how the community can move forward to achieve the potential of big data in radiation oncology are provided.
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Affiliation(s)
- C S Mayo
- University of Michigan, Ann Arbor, MI, USA
| | - M Phillips
- University of Washington, Seattle, WA, USA
| | - T R McNutt
- Johns Hopkins University, Baltimore, MD, USA
| | - J Palta
- Virginia Commonwealth University, Richmond, VA, USA
| | - A Dekker
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | | | - Y Xiao
- University of Pennsylvania, Philadelphia, PA, USA
| | - J M Moran
- University of Michigan, Ann Arbor, MI, USA
| | | | - P Gabriel
- University of Pennsylvania, Philadelphia, PA, USA
| | - A S Ayan
- Ohio State University, Columbus, OH, USA
| | | | - M Thor
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - N Dixit
- University of California at San Francisco, San Francisco, CA, USA
| | - R Popple
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - E Kaleba
- University of Michigan, Ann Arbor, MI, USA
| | - M Kantor
- MD Anderson Cancer Center, Houston, TX, USA
| | - D Ruan
- University of California at Los Angeles, Los Angeles, CA, USA
| | - R Kapoor
- Johns Hopkins University, Baltimore, MD, USA
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Sundaram A, Elangovan A, Rajwanshi A, Srinivasan R, Kapoor R. Proximal-type epithelioid sarcoma of the vulva: Cytopathological diagnosis of a rare neoplasm. Cytopathology 2018; 29:471-473. [PMID: 29683530 DOI: 10.1111/cyt.12561] [Citation(s) in RCA: 2] [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] [Accepted: 03/07/2018] [Indexed: 11/28/2022]
Affiliation(s)
- A Sundaram
- Department of Cytology and Gynaecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Elangovan
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Rajwanshi
- Department of Cytology and Gynaecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Srinivasan
- Department of Cytology and Gynaecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Kapoor
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Srivastava A, Sureka SK, Prabhakaran S, Lal H, Ansari MS, Kapoor R. Role of Preoperative Duplex Ultrasonography to Predict Functional Maturation of Wrist Radiocephalic Arteriovenous Fistula: A Study on Indian Population. Indian J Nephrol 2018. [PMID: 29515295 PMCID: PMC5830803 DOI: 10.4103/ijn.ijn_134_16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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
Radiocephalic arteriovenous fistula (RCAVF) is the first choice for native arteriovenous fistula (AVF). Preoperative vessel assessment with ultrasonography (USG) has been reported to enhance the outcome of native AVF, but data regarding its predictive value for functional maturation of RCAVF are scanty. We aimed to determine the role of preoperative duplex USG (DUS) for prediction of functional maturity of radiocephalic fistula in the wrist. The data from 173 patients were analyzed prospectively. The estimated duplex variable included size, patency, and continuity of cephalic vein and size, peak systolic velocity, and wall calcifications in radial artery at the wrist. The subjects underwent RCAVF creation and were reviewed 6-8 weeks post procedure for adequacy of maturation. Doppler variables between successful and failed maturation groups were compared. Successful functional fistula maturation was noted in 138 (80.9%) patients. Values of radial artery diameter, cephalic vein diameter, and peak systolic velocity were >2 mm, 2.2 mm, and 32.8 cm/s, respectively, for successful maturation of RCAVF in more than 90% of cases. Vascular calcifications were detected preoperatively in 15 diabetic patients and 9 (60%) of them had fistula failure. Preoperative DUS can provide a good prediction on functional maturation of RCAVF. Vascular calcifications were associated with high risk of maturation failure in diabetics.
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Affiliation(s)
- A Srivastava
- Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - S K Sureka
- Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - S Prabhakaran
- Department of Urology, Renai Medicity Hospital, Mamangalam, Palarivattom, Kochi - 682 025, Kerala, India
| | - H Lal
- Department of Radiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - M S Ansari
- Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - R Kapoor
- Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Singh N, Baldi M, Kaur J, Prasad K, Kapoor R, Behera D. MA 03.02 Timing of B12/Folate Supplementation in NSCLC Patients on Pemetrexed Based Chemotherapy: Final Results of the PEMVITASTART Randomized Trial. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.461] [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]
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Mahajan R, Yadav B, Sharma S, Ghoshal S, Kapoor R, Kumar N. Primary bone lymphoma: An experience of a regional cancer centre from India. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx664.017] [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: 11/12/2022] Open
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Bishnoi A, Narang T, Handa S, Vishwajeet V, Saikia UN, Kapoor R, Mavuduru RS. Paraneoplastic bullous pemphigoid associated with penile squamous cell carcinoma. J Eur Acad Dermatol Venereol 2017; 32:e140-e141. [PMID: 29024082 DOI: 10.1111/jdv.14635] [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: 11/30/2022]
Affiliation(s)
- A Bishnoi
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - T Narang
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - S Handa
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - V Vishwajeet
- Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - U N Saikia
- Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - R Kapoor
- Radiotherapy, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - R S Mavuduru
- Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Kapoor R, Palta J, Hagan M. Lessons Learned From the VA Radiotherapy Incident Reporting and Analysis System (RIRAS). Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Menzies A, Gonzalez M, Guminski A, Nieweg O, Shannon K, Thompson J, Kefford R, Ch'Ng S, Stretch J, Spillane A, Lee J, Lee H, Kapoor R, Emmett L, Rizos H, Saw R, Scolyer R, Long G. Phase 2 study of neoadjuvant dabrafenib + trametinib (D+T) for resectable stage IIIB/C BRAF V600 mutant melanoma. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx377.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Newton AJH, Seidenstein AH, McDougal RA, Pérez-Cervera A, Huguet G, M-Seara T, Haimerl C, Angulo-Garcia D, Torcini A, Cossart R, Malvache A, Skiker K, Maouene M, Ragognetti G, Lorusso L, Viggiano A, Marcelli A, Senatore R, Parziale A, Stramaglia S, Pellicoro M, Angelini L, Amico E, Aerts H, Cortés J, Laureys S, Marinazzo D, Stramaglia S, Bassez I, Faes L, Almgren H, Razi A, Van de Steen F, Krebs R, Aerts H, Kanari L, Dlotko P, Scolamiero M, Levi R, Shillcock J, de Kock CP, Hess K, Markram H, Ly C, Marsat G, Gillespie T, Sandström M, Abrams M, Grethe JS, Martone M, De Gernier R, Solinas S, Rössert C, Haelterman M, Massar S, Pasquale V, Pastore VP, Martinoia S, Massobrio P, Capone C, Tort-Colet N, Sanchez-Vives MV, Mattia M, Almasi A, Cloherty SL, Grayden DB, Wong YT, Ibbotson MR, Meffin H, Prince LY, Tsaneva-Atanasova K, Mellor JR, Mazzoni A, Rosa M, Carpaneto J, Romito LM, Priori A, Micera S, Migliore R, Lupascu CA, Franchina F, Bologna LL, Romani A, Saray S, Van Geit W, Káli S, 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Volo M, Vezzani A, Menzat B, Vogels TP, Wagatsuma N, Saha S, Kapoor R, Kerr R, Wagner J, del Molino LCG, Yang GR, Mejias JF, Wang XJ, Song H, Goodliffe J, Luebke J, Weaver CM, Thomas J, Sinha N, Shaju N, Maszczyk T, Jin J, Cash SS, Dauwels J, Brandon Westover M, Karimian M, Moerel M, De Weerd P, Burwick T, Westra RL, Abeysuriya R, Hadida J, Sotiropoulos S, Jbabdi S, Woolrich M, Bensmail C, Wrobel B, Zhou X, Ji Z, Liu X, Xia Y, Wu S, Wang X, Zhang M, Wu S, Ofer N, Shefi O, Yaari G, Carnevale T, Majumdar A, Sivagnanam S, Yoshimoto K, Smirnova EY, Amakhin DV, Malkin SL, Zaitsev AV, Chizhov AV, Zaleshina M, Zaleshin A, Barranca VJ, Zhu G, Skilling QM, Maruyama D, Ognjanovski N, Aton SJ, Zochowski M, Wu J, Aton S, Rich S, Booth V, Budak M, Dura-Bernal S, Neymotin SA, Suter BA, Shepherd GMG, Felton MA, Yu AB, Boothe DL, Oie KS, Franaszczuk PJ, Shuvaev SA, Başerdem B, Zador A, Koulakov AA, López-Madrona VJ, Pereda E, Mirasso CR, Canals S, Masoli S, Rongala UB, Mazzoni A, Spanne A, Jorntell H, Oddo CM, Vartanov AV, Neklyudova AK, Kozlovskiy SA, Kiselnikov AA, Marakshina JA, Teleńczuk M, Teleńczuk B, Destexhe A, Kuokkanen PT, Kraemer A, McColgan T, Carr CE, Kempter R. 26th Annual Computational Neuroscience Meeting (CNS*2017): Part 3. BMC Neurosci 2017. [PMCID: PMC5592441 DOI: 10.1186/s12868-017-0372-1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Owusu-Agyemang P, Zavala AM, Williams UU, Van Meter A, Soliz J, Kapoor R, Shah A, Hernandez M, Gottumukkala V, Cata JP. Assessing the impact of perioperative blood transfusions on the survival of adults undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for appendiceal carcinomatosis. Vox Sang 2017; 112:567-577. [DOI: 10.1111/vox.12546] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 05/08/2017] [Accepted: 05/10/2017] [Indexed: 01/02/2023]
Affiliation(s)
- P. Owusu-Agyemang
- Department of Anesthesiology and Perioperative Medicine; The University of Texas MD Anderson Cancer Center; Houston TX USA
- Anesthesiology and Surgical Oncology Research Group; Houston TX USA
| | - A. M. Zavala
- Department of Anesthesiology and Perioperative Medicine; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - U. U. Williams
- Department of Anesthesiology and Perioperative Medicine; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - A. Van Meter
- Department of Anesthesiology and Perioperative Medicine; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - J. Soliz
- Department of Anesthesiology and Perioperative Medicine; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - R. Kapoor
- Department of Anesthesiology and Perioperative Medicine; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - A. Shah
- The University of Texas Medical School; Houston TX USA
| | - M. Hernandez
- Department of Biostatistics; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - V. Gottumukkala
- Department of Anesthesiology and Perioperative Medicine; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - J. P. Cata
- Department of Anesthesiology and Perioperative Medicine; The University of Texas MD Anderson Cancer Center; Houston TX USA
- Anesthesiology and Surgical Oncology Research Group; Houston TX USA
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Abstract
Imaging plays a critical role in the current multi-disciplinary management of patients with melanoma. It is used for primary disease staging, surgical planning, and surveillance in high-risk patients, and for monitoring the effects of systemic or loco-regional therapies. Several different imaging modalities have been utilised in the past. Contemporary imaging practises vary geographically depending on clinical guidelines, physician preferences, availability and cost. Targeted therapies and immunotherapies have revolutionised the treatment of patients with metastatic melanoma over the last few years. With this have come new patterns of disease that were not observed after conventional therapies, and new criteria to assess therapeutic responses. In this article we review the role of imaging for patients with melanoma in the era of effective systemic therapies and discuss likely future developments.
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Affiliation(s)
- M Stodell
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | - J F Thompson
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Discipline of Surgery, The University of Sydney, Sydney, NSW, Australia; Division of Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - L Emmett
- Garvan Institute of Medical Research, Discipline of Medicine, The University of New South Wales, Sydney, NSW, Australia
| | - R F Uren
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Alfred Nuclear Medicine and Ultrasound, Newtown, NSW, Australia
| | - R Kapoor
- Mater Imaging, The Mater Hospital Sydney, North Sydney, NSW, Australia
| | - R P M Saw
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Discipline of Surgery, The University of Sydney, Sydney, NSW, Australia; Division of Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
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Singh Yadav B, Chander Sharma S, Ghoshal S, Kapoor R, Kumar N. Hypofractionated radiotherapy in breast cancer – a large institutional data set from India. Breast 2017. [DOI: 10.1016/s0960-9776(17)30255-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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