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Yadav S, Samant R, Patankar A, Sankhla C. Clinical Features and Imaging Characteristics of Intracranial Vascular Involvement in Takayasu Arteritis: An Analysis of Nine Cases. J Clin Rheumatol 2024; 30:e54-e57. [PMID: 37723626 DOI: 10.1097/rhu.0000000000002024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Affiliation(s)
| | | | | | - Charulata Sankhla
- Neurology, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
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Baliga S, Agrawal U, Sunavala A, Madnani N, Joshi R, Shaikh A, Nanavati R, Patil P, Kadam S, Samant R. An unusual case of disseminated histoplasmosis mimicking an autoimmune disease! Indian J Rheumatol 2023. [DOI: 10.4103/injr.injr_163_22] [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: 02/04/2023] Open
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Patankar A, Samant R. Erythema nodosum: A harbinger of takayasu arteritis. Indian J Rheumatol 2023. [DOI: 10.4103/injr.injr_200_22] [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: 02/16/2023] Open
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Babadagli E, Kulkarni A, Le T, Fung-Kee-Fung M, Lupe K, Gaudet M, E C, Samant R. Locoregional Control Following Adjuvant Chemotherapy and Radiotherapy for Treatment of High-Risk Endometrial Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Samant R, Cisa-Paré E, Balchin K, Renaud J, Bunch L, Wheatley-Price P, McNeil A, Murray S, Meng J. Assessment of Patient Satisfaction Among Cancer Patients Undergoing Radiotherapy. J Cancer Educ 2022; 37:1296-1303. [PMID: 33432468 PMCID: PMC9550720 DOI: 10.1007/s13187-020-01950-8] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 06/12/2023]
Abstract
The patient-provider relationship is a key driver of patient satisfaction as it relates to overall healthcare experience. We surveyed patients undergoing radiation therapy to determine what they consider to be the most valued qualities in their interactions with the healthcare team. An ethics-approved 35-item patient satisfaction survey was developed in-house to gain insights on patients' perception of their relationship with the healthcare team throughout their cancer journey. There were 199 completed survey, median age 68 years, 54% women and 45% men. Almost all (95%) "agreed" or "strongly agreed" that their physicians had been sensitive and compassionate. Over 90% felt that they received adequate explanations about their treatment, and had their questions answered. The vast majority (93%) felt included in the decision-making process. Patients reported the 5 most highly rated qualities among their healthcare providers (HCPs) as knowledge, kindness, honesty, good communication, and a cheerful attitude. Overall satisfaction was high but areas for improvement were identified including being offered future appointments for further discussion, more information about clinical trials, other treatments, and community resources. Patients noted their HCPs tended to focus on the physical and emotional needs of patients, but spiritual and cultural needs were rarely addressed. Patients receiving radiotherapy reported high rates of satisfaction across many aspects of their care. These findings also reinforce the different aspects of holistic care that can be improved, and serve as a reminder to clinicians that patients perceive their role as more than just that of a medical expert.
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Affiliation(s)
- R Samant
- The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada.
| | - E Cisa-Paré
- The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada
| | - K Balchin
- The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada
| | - J Renaud
- The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada
| | - L Bunch
- The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada
| | - P Wheatley-Price
- The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada
| | - A McNeil
- The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada
| | - S Murray
- The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada
| | - J Meng
- The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada
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Abstract
Methotrexate leading to hypercalcaemia is a rarely reported adverse event. We present three elderly patients with inflammatory arthritis who developed hypercalcemia probably due to methotrexate-induced granulomatous pneumonitis. All patients presented with worsening non-productive cough with dyspnea, nausea, loss of appetite, and confusion. Their clinical and radiologic features were consistent with methotrexate-induced pneumonitis. On evaluation, all patients concurrently had hypercalcemia with normal 25OH D3, and low PTH with markedly elevated levels of 1,25OH D3 seen in two patients. In all three patients, hypercalcemia and pneumonia responded to hydration, corticosteroids, and methotrexate withdrawal. There was no relapse of symptoms on long term follow-up. In these three patients with inflammatory arthritis, methotrexate-induced pneumonitis led to symptomatic hypercalcemia. Unless hypercalcemia is looked for and treated in this setting, the morbidity can be high.
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Affiliation(s)
- R Samant
- Department of Rheumatology, P.D. Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai, Maharashtra, India
| | - S Yadav
- Department of Rheumatology, P.D. Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai, Maharashtra, India
| | - A Khune
- Department of Rheumatology, P.D. Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai, Maharashtra, India
| | - R Shah
- Department of Rheumatology, P.D. Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai, Maharashtra, India
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Yadav S, Samant R. AB1108 IMPACT OF THE FIRST WAVE OF THE COVID 19 PANDEMIC ON HEALTHCARE ACCESSIBILITY, DISEASE BEHAVIOUR, ANXIETY, AND PHYSICAL ACTIVITY IN RHEUMATIC DISEASE PATIENTS: AN ONLINE SURVEY AND POTENTIAL SOLUTIONS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundCoronavirus Disease (covid 19) negatively impacted psychosocial health, health care accessibility and exercise regimen but problem’s scope and potential solutions remain elusive. We conducted a patient based online survey to understand these impacts and discussed potential solutions.ObjectivesAssess impact of Covid 19 on rheumatological disease status, accessibility to health care, patient anxiety and behavior and continuation of physical activity during pandemic.MethodsGoogle form (18-question) based questionnaire was sent via SMS/WhatsApp in Aug 2020, at height of first pandemic and responses were collected over next month.ResultsOnly 339 /2700 patients (12.5 %) responded to the survey. Other authors (1)(2) have observed a similar low response rate to online surveys. We recognise questionnaires with fewer questions tend to generate more responses, which should be considered critical in constructing future health-related surveys. Patients’ global assessment of their disease score was 7/10, with 0 representing the worst disease status and10 representing best disease status, also 1/3 patients not felt need for rheumatological consultation during six months (March 2020- Aug 2020) of lockdown. These may imply adequate rheumatic disease control over long periods and during subsequent waves of pandemic, rheumatology patients can be shielded by avoiding non-urgent hospital follow up visits. Significant number of patients (20%) were unable to contact their rheumatologist, implying a significant impact of covid 19 and lockdown on rheumatology care, as suggested by other authors (1). As expected, there was switch to tele consultancy mode of communication, with 22 per cent of patients already using it within 3 months of its introduction, which appears to be a good indicator of future adaptability and feasibility of teleconsultation. Identifying specific profile of patients during physical consultation who can be easily managed via teleconsultation, may reduce unnecessary hospital visits while also improving healthcare delivery. 1/3 of our patients had anxiety about disease flare, and 41 %were concerned about increased risk of covid 19 infection as they were on immunosuppressive medications as noted by other authors (3). Improving access to health care and increasing public awareness could help alleviate this anxiety. Reaching out to isolated rheumatology patients through SMS / educational video may improve the sense of health security. Contrary to our expectations, overall medication adherence was reasonable, likely due to be management of supply chains by local authorities .15% completely stopped exercising and 25% reduced their exercise regimen by 50%. Shifting to home-based exercise, educational videos on physical therapy and online teleconsultation with physiotherapists could overall have positive impact.ConclusionCovid 19 has significantly impacted rheumatological patients in terms of increased anxiety, decreased healthcare accessibility and decreased exercise and physical activities. Modifications in teleconsultation methodology are needed in the future. Patients’ anxiety can be alleviated by educating them through digital and social media platforms and enrolling them in online patient support groups.References[1]Ganapati A, Padiyar S, Nair A, et al. Impact of COVID-19 Pandemic and Resultant Lockdown in India on Patients with Chronic Rheumatic Diseases: An Online Survey. Indian J Rheumatol. 2021;16(1):30. doi:10.4103/injr.injr_231_20[2]McKee P, Irvine A, Riddell C, Ball E. IMPACT OF THE COVID PANDEMIC ON RHEUMATOLOGY PATIENTS IN NORTHERN IRELAND - A WEB BASED CROSS-SECTIONAL SURVEY OF PATIENT REPORTED OUTCOMES. Ulster Med J. 2021;90(3):197[3]Hammad MAH, Eissa M, Dawa GA. Impact of coronavirus disease 2019 (COVID-19) pandemic on attitude, behavior, and mental health of patients with rheumatic diseases. Egypt Rheumatol Rehabil. 2020;47(1). doi:10.1186/s43166-020-00045-yDisclosure of InterestsNone declared
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Agrawal U, Samant R, Kothari J, Sunavala A. Melioidosis: Missed opportunities and opportunistic pathogens. Med J Armed Forces India 2022; 78:239-242. [PMID: 35463536 PMCID: PMC9023556 DOI: 10.1016/j.mjafi.2021.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/19/2021] [Indexed: 11/18/2022] Open
Abstract
A 31-year Indian homemaker, known to have Systemic Lupus Erythematosus (SLE) and lupus nephritis, was admitted previously in another medical care unit with fever, hemoptysis, arthralgia, and joint swelling. She had been treated with antibiotics and corticosteroids for probable diffuse alveolar hemorrhage (DAH) with clinical and radiological resolution. She was readmitted one month later for similar complaints. Her autoimmune workup revealed evidence of active lupus. Her chest imaging showed the presence of well-circumscribed macronodular lesions with halo sign, but Bronchoalveolar Lavage (BAL) cultures and serum galactomannan were negative. BAL tested positive for hemosiderin-laden macrophages. She was treated with corticosteroids, plasmapheresis, and empiric antibiotics with partial clinical response. One week later, her fever recurred, and she developed new-onset myositis. Bactec blood cultures grew Burkholderia pseudomallei. She received treatment for 3 months with good clinical and radiological resolution. In hindsight, a CT-guided biopsy of the lung lesion may have provided an earlier diagnosis of melioidosis.
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Affiliation(s)
- Umang Agrawal
- Junior Consultant (Infectious Diseases), PD Hinduja National Hospital & Medical Research Centre, Mumbai, India
- Corresponding author.
| | - Rohini Samant
- Consultant Rheumatologist, PD Hinduja National Hospital & Medical Research Centre, Mumbai, India
| | - Jatin Kothari
- Consultant Nephrologist, PD Hinduja National Hospital and Medical Research Centre, Mumbai, India
| | - Ayesha Sunavala
- Consultant (Infectious Diseases), PD Hinduja National Hospital & Medical Research Centre, Mumbai, India
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Samant R, Dubey S, Hinduja I. Can GnRH analogs cause autoimmunity postinfertility treatment? Indian J Rheumatol 2022. [DOI: 10.4103/injr.injr_271_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Volpini M, Jooya A, La Russa D, Sutherland J, Samant R, Nair V. PO-1730 Feasibility of Virtual Reality-based target volume delineation for craniospinal irradiation. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08181-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dubey S, Rodrigues C, Nikam C, Samant R. Cytomegalovirus in Indian systemic lupus erythematosus patients: troublemaker or onlooker? Pan Afr Med J 2020; 37:38. [PMID: 33209165 PMCID: PMC7648478 DOI: 10.11604/pamj.2020.37.38.18836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 04/22/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction cytomegalovirus (CMV) infection has been reported to be associated with onset/exacerbation of systemic lupus erythematosus (SLE). In an attempt to verify this, we studied CMV infection in SLE patients. Methods forty-two SLE patients were studied at 3-time points; disease onset/flare, at peak of immunosuppression (at 6 weeks) and at low doses of immunosuppression (at 6 months). We studied healthy blood donors as controls, only once. Clinical assessment and SLE Disease Activity Index scoring were done at each visit. RT-PCR and ELISA were performed to detect CMV viral-load and anti-CMV antibodies (Ab) respectively. Results nine of 106 patients had detectable viral-load (145-50,000 copies/ml). Of these nine, three patients had significant viral-load, 6 patients had low viral-loads of doubtful clinical significance. None of the patients developed CMV disease. Six of 42 cases were positive for IgM Abs. All controls were negative for CMV DNA as well as CMV IgM Abs. All samples from patients and controls were positive for CMV IgG Ab indicating widespread prevalence. Conclusion significantly, a higher seroprevalence of CMV IgM Abs against CMV observed in SLE patients when compared to controls, indicating possible reactivation due to immune modulation.
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Affiliation(s)
- Shalini Dubey
- Research Laboratories, P.D. Hinduja Hospital and Medical Research Centre, Mumbai, India
| | - Camilla Rodrigues
- Research Laboratories, P.D. Hinduja Hospital and Medical Research Centre, Mumbai, India
| | - Chaitali Nikam
- Research Laboratories, P.D. Hinduja Hospital and Medical Research Centre, Mumbai, India
| | - Rohini Samant
- Rheumatology Department, P. D. Hinduja Hospital and Medical Research Centre, Mumbai, India
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Samant R, Balchin K, Cisa-Paré E, Renaud J, Bunch L, McNeil A, Murray S, Meng J. The importance of humour in oncology: a survey of patients undergoing radiotherapy. Curr Oncol 2020; 27:e350-e353. [PMID: 32905157 PMCID: PMC7467787 DOI: 10.3747/co.27.5875] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Humour has long been considered an important coping tool for patients with cancer, but published quantitative data about its significance are limited. The purpose of our study was to survey patients with cancer undergoing radiotherapy regarding their opinions about the use of humour in their care. Methods An anonymous 35-item questionnaire evaluating the patient experience, including the value of humour, was developed by an interdisciplinary team of health care providers (hcps) working within the Radiation Medicine program. This anonymous, voluntary, paper-based survey for self-completion required approximately 10 minutes to finish and was administered during the fall of 2018 and the spring of 2019. Results For the 199 patients who completed the survey [108 women, 89 men (2 respondents did not specify)], median age was 68 years. That group represents approximately 30%-35% of the patients on treatment during the study period. Almost all respondents (86%) indicated that, during their visits to the cancer centre, it was "somewhat important" or "very important" for health care providers (hcps) to use appropriate humour, and 61% of respondents indicated using humour "frequently" or "always" when dealing with their individual cancers. Most respondents (79%) said that humour decreased anxiety, and 86% indicated that laughing was considered "somewhat important" or "very important." Approximately 4% of respondents even listed "sense of humour" as being the most important quality that they looked for in their interactions with their hcps. Conclusions Cancer patients undergoing radiotherapy clearly view humour as being important for coping and dealing with their disease, and oncology hcps should routinely consider incorporating the use of appropriate humour into the care that they provide.
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Affiliation(s)
- R Samant
- The Ottawa Hospital Cancer Centre and University of Ottawa, Ottawa, ON
| | - K Balchin
- The Ottawa Hospital Cancer Centre and University of Ottawa, Ottawa, ON
| | - E Cisa-Paré
- The Ottawa Hospital Cancer Centre and University of Ottawa, Ottawa, ON
| | - J Renaud
- The Ottawa Hospital Cancer Centre and University of Ottawa, Ottawa, ON
| | - L Bunch
- The Ottawa Hospital Cancer Centre and University of Ottawa, Ottawa, ON
| | - A McNeil
- The Ottawa Hospital Cancer Centre and University of Ottawa, Ottawa, ON
| | - S Murray
- The Ottawa Hospital Cancer Centre and University of Ottawa, Ottawa, ON
| | - J Meng
- The Ottawa Hospital Cancer Centre and University of Ottawa, Ottawa, ON
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Samant R, Cisa-Pare E, Balchin K, Renaud J, Bunch L, McNeil A, Murray S, Meng J. Is Humor Really That Important to Cancer Patients? Survey Results from Patients Undergoing Radiotherapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Song J, Le T, Gaudet M, Ee C, Lupe K, Samant R. EP-1488 Treatment of early stage intermediate-risk endometrial cancer using MIS and adjuvant radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31908-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Song J, Le T, Gaudet M, Ee C, Lupe K, Samant R. EP-1489 How effective is adjuvant radiotherapy in the management of stage I high-risk endometrial cancer? Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31909-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Song J, Samant R, Fan X, Jay M, Chaudry H, MacDonald D, Bence-Bruckler I, Nair V. EP-1221 Palliative cranial irradiation improves survival in PCNSL patients ineligible for systemic therapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31641-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rasche L, Alapat D, Kumar M, Gershner G, McDonald J, Wardell CP, Samant R, Van Hemert R, Epstein J, Williams AF, Thanendrarajan S, Schinke C, Bauer M, Ashby C, Tytarenko RG, van Rhee F, Walker BA, Zangari M, Barlogie B, Davies FE, Morgan GJ, Weinhold N. Combination of flow cytometry and functional imaging for monitoring of residual disease in myeloma. Leukemia 2018; 33:1713-1722. [PMID: 30573775 PMCID: PMC6586541 DOI: 10.1038/s41375-018-0329-0] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 09/24/2018] [Accepted: 10/10/2018] [Indexed: 02/08/2023]
Abstract
The iliac crest is the sampling site for minimal residual disease (MRD) monitoring in multiple myeloma (MM). However, the disease distribution is often heterogeneous, and imaging can be used to complement MRD detection at a single site. We have investigated patients in complete remission (CR) during first-line or salvage therapy for whom MRD flow cytometry and the two imaging modalities positron emission tomography (PET) and diffusion-weighted magnetic resonance imaging (DW-MRI) were performed at the onset of CR. Residual focal lesions (FLs), detectable in 24% of first-line patients, were associated with short progression-free survival (PFS), with DW-MRI detecting disease in more patients. In some patients, FLs were only PET positive, indicating that the two approaches are complementary. Combining MRD and imaging improved prediction of outcome, with double-negative and double-positive features defining groups with excellent and dismal PFS, respectively. FLs were a rare event (12%) in first-line MRD-negative CR patients. In contrast, patients achieving an MRD-negative CR during salvage therapy frequently had FLs (50%). Multi-region sequencing and imaging in an MRD-negative patient showed persistence of spatially separated clones. In conclusion, we show that DW-MRI is a promising tool for monitoring residual disease that complements PET and should be combined with MRD.
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Affiliation(s)
- L Rasche
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Department of Internal Medicine 2, University Hospital of Würzburg, Würzburg, Germany
| | - D Alapat
- Pathology Department, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - M Kumar
- Radiology Department, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - G Gershner
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - J McDonald
- Radiology Department, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - C P Wardell
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - R Samant
- Radiology Department, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - R Van Hemert
- Radiology Department, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - J Epstein
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - A F Williams
- Pathology Department, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - S Thanendrarajan
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - C Schinke
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - M Bauer
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - C Ashby
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - R G Tytarenko
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - F van Rhee
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - B A Walker
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - M Zangari
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - B Barlogie
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - F E Davies
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - G J Morgan
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - N Weinhold
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
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Jadhav P, Samant R. Role of Right Heart Catheterization in Rheumatologic Diseases - The Indian Perspective. J Assoc Physicians India 2018; 66:11-13. [PMID: 31331141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Pulmonary artery hypertension is an infrequent accompaniment of rheumatologic diseases. It could result as a complication of diseases like systemic sclerosis (SSc), systemic lupus erythomatosus (SLE), and mixed connective tissues diseases (MCTD). Very rarely, rheumatoid arthritis, dermatomyositis and Primary Sjogren's syndrome can also be complicated by a rise in pulmonary artery pressure. Pulmonary artery hypertension (PAH) can also be found in many other non rheumatologic diseases. Right heart catheterization (RHC) is the gold standard investigation in diagnosing pulmonary hypertension. This article aims to discuss the role of RHC in diagnosing pulmonary hypertension, its comparison with other modalities, the procedure, and its role in treatment of connective tissue disorders, especially with a special reference to the Indian context.
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Affiliation(s)
- Praveen Jadhav
- 1Director, Omkar Rheumatology Clinic, Nasik, Maharashtra
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Samant R, Sabloff M, Atkins H, Altouri S, Kekre N, Bredeson C, Huebsch L, Ramsay T, Allan D, Fulcher J, Nair V. High Dose Total Body Irradiation for Refractory Acute Myeloid Leukemia. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.450] [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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Alyamani N, Bhattacharya G, Samant R, E C, Le T, Lupe K. EP-1777: Cervical cancer outcomes in the high-doserate brachytherapy era: A single institution experience. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)32139-4] [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: 11/24/2022]
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Tisseverasinghe S, Samant R, Sabloff M, Xu Y, Bredeson C, Huebsch L, Genest P. Total Body Irradiation in Relapsed Follicular Lymphoma: Outcomes and Early Toxicity. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Banka R, Gc Y, Balakrishnan C, Samant R, Pinto L, Sagdeo P. AB0917 Pulmonary Manifestations in Patients with IGG4-Related Disease at A Tertiary Care Institute: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Sagdeo P, Samant R, Balakrishnan C, Mangat G, Parikh T, Gc Y. AB0563 Takayasu's Arteritis: Experience from A Tertiary Care Centre in Western India: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Gc Y, Samant R, Mahashur A, Sagdeo P, Kakade G. AB0627 Predictors of Ild and Its Progression in A Cohort of Scleroderma Patients from Western India: A Prospective Observational Cohort Study: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Tisseverasinghe S, Samant R, Sabloff M, Xu Y, Bredeson C, Huebsch L, Genest P, Cross P. PO-0667: Second malignancies after TBI in AHCT for relapsed follicular lymphoma. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31917-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Samant R, Tay J, Nyiri B, Carty K, Gerig L, Andrusyk S, Montgomery L, Atkins H. Dose-Escalated Total-Marrow Irradiation (TMI) for Relapsed Multiple Myeloma. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Parikh T, Balakrishnan C, Yathish GC, Joshi P, Doshi B, Mangat G, Samant R, Joshi V. Radiological resolution of peri-aortic thickening in a patient with IgG4 disease. Indian Journal of Rheumatology 2015. [DOI: 10.1016/j.injr.2014.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Parmar A, Yathish G, Parikh T, Sagdeo P, Samant R, Mahasur A. Non scleroderma connective tissue disease interstitial lung disease. Indian Journal of Rheumatology 2014. [DOI: 10.1016/j.injr.2014.10.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Dubey S, Rodrigues C, Nikam C, Samant R. A study of CMV infection in SLE patients. Indian Journal of Rheumatology 2014. [DOI: 10.1016/j.injr.2014.10.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Joshi P, Yathish G, Balakrishnan C, Mangat G, Samant R, Joshi V, Parikh T, Sagdeo P, Parmar A, Doshi B. Study of demographic profile and observing efficacy of systemic immunosupressants in patients with autoimmune inflammatory eye diseases. Indian Journal of Rheumatology 2014. [DOI: 10.1016/j.injr.2014.10.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Parmar A, Yathish G, Parikh T, Sagdeo P, Samant R, Mahasur A. Isolated pulmonary hypertension in connective tissue disease. Indian Journal of Rheumatology 2014. [DOI: 10.1016/j.injr.2014.10.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Joshi P, Parikh T, Sharma V, Yathish G, Doshi B, Samant R, Mangat G, Balakrishnan C, Amin S, Joshi V. AB0592 A Study of Short Term Progression of Takayasu Arteritis: Table 1. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.6087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Joshi PN, Parikh T, Sharma V, Nagaraj S, Yathish G, Doshi B, Samant R, Mangat G, Balakrishnan C, Amin S, Joshi V. 340. A Study of Short-Term Progression of Takayasu Arteritis. Rheumatology (Oxford) 2014. [DOI: 10.1093/rheumatology/keu129.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Chitnis N, Nagnur-Metha P, Samant R, Bhojani KS, Joshi VR. Lag time between disease onset and first visit to a tertiary rheumatology centre by patients with rheumatoid arthritis. Indian Journal of Rheumatology 2013. [DOI: 10.1016/j.injr.2013.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Ujaimi R, Isfahanian N, La Russa D, Samant R, Bredeson C, Genest P. Pulmonary Toxicity Following Total Body Irradiation for Acute Lymphoblastic Leukemia: The Ottawa Hospital Cancer Centre (TOHCC) Experience. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bhanabhai H, Samant R, E C, Grenier L, Lowry S. Pain assessment during conscious sedation for cervical cancer high-dose-rate brachytherapy. ACTA ACUST UNITED AC 2013; 20:e307-10. [PMID: 23904769 DOI: 10.3747/co.20.1404] [Citation(s) in RCA: 16] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND This observational study set out to evaluate the effectiveness of conscious sedation anesthesia for pain control during high-dose-rate (hdr) brachytherapy using a ring-and-tandem applicator system for patients with cervical cancer. METHODS At the time of initiation of the hdr cervical cancer brachytherapy program at our institution, patients received a detailed symptom assessment during the procedures. Brachytherapy was carried out using a Smit sleeve, together with a ring-and-tandem applicator. Midazolam and an opioid-hydromorphone, morphine, or fentanyl-were the main agents used to achieve conscious sedation. RESULTS From January 2009 to October 2010, 20 patients (median age: 45 years) underwent 57 procedures. All patients received chemoradiation with curative intent. The median duration of the procedures was 1.4 hours, and no significant cardiovascular events were noted. The total dose of intravenous midazolam used ranged from 0.5 mg to 8.5 mg (median: 2.5 mg). The total dose of intravenous morphine equivalent used ranged from 2.5 mg to 60 mg (median: 8 mg). The mean and median pain scores during the procedures were 1.4 and 1.1 respectively. Brief moments of moderate to severe incidental pain were noted at the time of certain events during the procedure-specifically during insertion of the ring-and-tandem applicator. The maximal pain score during the entire procedure ranged from 0 to 10 (median: 4.7). The period of recovery from conscious sedation was relatively brief (median discharge time: 1 hour). CONCLUSIONS We were able to demonstrate that patients undergoing hdr brachytherapy for cervical cancer can achieve good pain control with conscious sedation.
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Affiliation(s)
- H Bhanabhai
- Division of Radiation Oncology, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON
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Erdem E, Samant R, Malak SF, Culp WC, Brown A, Peterson L, Lensing S, Barlogie B. Vertebral augmentation in the treatment of pathologic compression fractures in 792 patients with multiple myeloma. Leukemia 2013; 27:2391-3. [PMID: 23728152 PMCID: PMC3865531 DOI: 10.1038/leu.2013.162] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- E Erdem
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Nagaraj S, Joshi P, Sharma V, Buche A, Mangat G, Samant R, Balakrishnan C. THU0227 Anca-associated vasculitis: A retrospective study from western india. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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39
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Sharma V, Nagaraj S, Mangat G, Balakrishnan C, Krishna B, Samant R. AB0778 Role of pet scan in the management of patients with takayasu arteritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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40
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Chitnis N, Nagnur-Metha P, Sharma V, Samant R. Case of pulmonary rheumatoid nodules in rheumatoid arthritis. J Assoc Physicians India 2012; 60:46. [PMID: 23781669] [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: 06/02/2023]
Affiliation(s)
- Neena Chitnis
- Department of Rheumatology, PD Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai
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41
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Abstract
OBJECTIVE To review the clinical profile of patients with plasma cell dyscrasias presenting with inflammatory arthritis. MATERIAL AND METHODS Retrospective analysis was performed on clinical, laboratory and imaging data of patients who presented with inflammatory arthritis between May 2009 and April 2010 and were subsequently diagnosed as having plasma cell dyscrasias. Six out of 630 patients presenting with inflammatory arthritis were identified. The demographic, clinical and laboratory characteristics of these patients were analyzed. The diagnosis of monoclonal gammopathy was based on protein electrophoresis, immunoelectrophoresis and bone marrow biopsy. The outcomes of the treatments were analyzed. RESULTS Four patients had monoclonal gammopathy of unknown significance and two patients had multiple myeloma. Mean age of the patients was 65 years (range 59-74). Three patients presented with oligoarticular arthritis, two with symmetrical polyarticular joint pains and one with fleeting periarticular pains. Wrist and shoulder were the most commonly involved joints. Three patients had carpal tunnel syndrome. Five patients were seronegative for both rheumatoid factor and anti-cyclic citrullinated peptide antibodies. Mean erythrocyte sedimentation rate (ESR) was high in all patients (range: 82-120 mm/h with a mean of 99.6 mm/h). Arthritis improved with chemotherapy in patients with multiple myeloma. CONCLUSION Occurrence of inflammatory arthritis with plasma dyscrasias is more than a chance association. Plasma cell dyscrasias should be ruled out in any elderly patient presenting with atypical arthritis with disproportionately high ESR, high creatinine and hyperglobulinemia.
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Affiliation(s)
- Nagaraj Srinivasulu
- Department of Rheumatology, PD Hinduja National Hospital and MRC, Mumbai, India.
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42
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Abstract
We report the success of oral cyclosporine therapy in a patient with severe vision-threatening vernal keratoconjunctivitis. A child presented with severe allergy which was not controlled with topical steroids, cyclosporine and mast cell stabilizers. Oral steroids were required repeatedly to suppress inflammation. Child showed a dramatic improvement and stabilization with oral cyclosporine therapy. Oral cyclosporine therapy can be tried in severe vision-threatening allergy refractory to conventional therapy.
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Affiliation(s)
- Nikhil S Gokhale
- Gokhale Eye Hospital and Eyebank, Dadar, Mumbai, Maharashtra, India
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Golfam M, Samant R, Eapen L, Malone S. Effects of radiation and total androgen blockade on serum hemoglobin, testosterone, and erythropoietin in patients with localized prostate cancer. ACTA ACUST UNITED AC 2012; 19:e258-63. [PMID: 22876154 DOI: 10.3747/co.19.963] [Citation(s) in RCA: 10] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The objective of the present study was to evaluate the incidence, time of onset, and extent of hemoglobin, testosterone, and erythropoietin changes in patients with localized prostate cancer receiving either radiation alone or radiation combined with total androgen blockade (tab). METHODS The study enrolled 35 patients (median age: 69 years) with clinically localized prostate cancer who received 3-dimensional conformal radiation with or without tab. Patients were generally treated with radiation alone (group 1), radiation plus short-term (≤6 months) tab (group 2), or radiation plus long-term (≥2 years) tab (group 3). Serum hemoglobin, testosterone, and erythropoietin in these patients were prospectively evaluated. RESULTS The mean baseline serum hemoglobin for group 1 (n = 20), group 2 (n = 6), and group 3 (n = 9) was 149 g/L, 153 g/L, and 143 g/L respectively. We observed no significant decline in serum hemoglobin, testosterone, or erythropoietin among patients treated with radiotherapy alone. A significant drop in serum testosterone was noted in the group 2 and 3 patients within 1 month (p < 0.001), reaching a plateau at approximately 6 months. That change was followed by a significant decline (p < 0.001) in serum hemoglobin at 3-6 months (137 g/L in group 2 and 129 g/L in group 3). We observed a small but statistically significant increase in serum erythropoietin (p < 0.001) of 8 U/L in group 2 and 4 U/L in group 3 after 6 months of tab. No immediate recovery in serum hemoglobin, testosterone, or erythropoietin was observed upon completion of tab. CONCLUSIONS Although conformal radiotherapy alone for localized prostate cancer had no effect on serum hemoglobin, testosterone, or erythropoietin, tab led to a significant decline in testosterone, which was followed by decline in hemoglobin that was not a result of a deficiency of erythropoietin.
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Affiliation(s)
- M Golfam
- The Ottawa Hospital Cancer Center, Ottawa, ON
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Sharma V, Samant R, Hegde A, Bhaja K. Autoimmune hemolysis in malaria: a report of three cases. J Assoc Physicians India 2012; 60:129-131. [PMID: 22715566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We have recently treated three patients with malaria who developed post malaria immune mediated hemolysis. These cases, seen with in a span of three month period (September 09 to November 09) form the basis of this report. Out of three patients, two were treated with steroids and both responded favorably.
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Affiliation(s)
- Vishnu Sharma
- Department of Rheumatology, PD Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai--400016
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Nagnur-Metha PK, Samant R, Mulani S. Can treatment of prepulseless Takayasu prevent progress to pulseless phase? Indian Journal of Rheumatology 2011. [DOI: 10.1016/s0973-3698(11)60213-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Chitnis N, Nagnur-Metha P, Samant R, Joshi VR. P17 Profile of rheumatoid arthritis at first visit to a tertiary rheumatology centre. Indian Journal of Rheumatology 2011. [DOI: 10.1016/s0973-3698(11)60127-1] [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: 10/14/2022] Open
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47
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Sharma V, Nagaraj S, Samant R, Mangat G, Balakrishnan C, Joshi VR. P41 Takayasu's arteritis at diagnosis: a 10-year single centre study from western India. Indian Journal of Rheumatology 2011. [DOI: 10.1016/s0973-3698(11)60151-9] [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: 11/17/2022] Open
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Sharma V, Nagaraj S, Choksey U, Hegde A, Samant R, Balakrishnan C. Bisphosphonate-induced osteonecrosis of the jaw. J Assoc Physicians India 2011; 59:516-517. [PMID: 21887911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Bisphosphonates are routinely used in the prevention and treatment of osteoporosis. Osteonecrosis of the jaw is known to be an important but rare complication of bisphosphonate usage. We present our experience with two patients of osteonecrosis of the jaw due to bisphosphonate usage.
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Affiliation(s)
- Vishnu Sharma
- Department of Rheumatology, PD Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai 400016
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Samant R, Gerig L, Montgomery L, Macrae R, Fox G, Nyiri B, Carty K, Macpherson M. The emerging role of IG-IMRT for palliative radiotherapy: a single-institution experience. ACTA ACUST UNITED AC 2011; 16:40-5. [PMID: 19526084 PMCID: PMC2695710 DOI: 10.3747/co.v16i3.304] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [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] [Indexed: 11/29/2022]
Abstract
Many modern radiotherapy centers now have image-guided intensity-modulated radiotherapy (ig-imrt) tools available for clinical use, and the technique offers many options for patients requiring palliative radiotherapy. We describe a single-institution experience with ig-imrt for short-course palliative radiotherapy, highlighting the unique situations in which the technique can be most effectively used.
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Affiliation(s)
- R Samant
- Division of Radiation Oncology, The Ottawa Hospital Cancer Centre and University of Ottawa, ON.
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Abstract
OBJECTIVE Using an interview-guided survey, our descriptive study aimed to document the extent to which cancer patients perceive they are involved in making treatment decisions and the factors that influence patient involvement. PATIENTS AND METHODS Our study enrolled patients from a Canadian ambulatory oncology program who were undergoing chemotherapy or radiation therapy, or both, for cancer. The adapted Control Preferences Scale was used to survey perceived and preferred roles in decision-making. The study survey also included items from the Decisional Conflict Scale and the Preparation for Decision-Making Scale. RESULTS Of 192 participants, 98 (51%) perceived that they were offered treatment choices. Of those 98, 47 (48%) thought that the options were presented equally. Compared with the patients not offered choices, those who were given choices were less passive (4% vs. 29%, p < 0.001) and more satisfied (100% vs. 95%, p < 0.03) in decision-making. Participants whose preferred and perceived roles were different would have preferred more involvement in decision-making. To attain the preferred involvement, patients wanted to receive more information on treatment options, to be given a choice, to have more discussion with the health care team, and to have providers better listen to their needs. CONCLUSIONS Only half of surveyed patients thought that they were offered choices for their cancer treatment. When offered choices, patients were more active in decision-making. Further initiatives are required to determine approaches for supporting patients with cancer so that they can be more involved in decision-making.
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Affiliation(s)
- D Stacey
- School of Nursing, University of Ottawa, Ottawa, ON.
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