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Alagiakrishnan K, Mah D, Aronow WS, Lam PH, Frishman WH, Ahmed A, Deedwania P. Considerations Regarding Management of Heart Failure in Older Adults. Cardiol Rev 2024:00045415-990000000-00223. [PMID: 38421170 DOI: 10.1097/crd.0000000000000677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Understanding noncardiovascular comorbidities and geriatric syndromes in elderly patients with heart failure (HF) is important as the average age of the population increases. Healthcare professionals need to consider these complex dynamics when managing older adults with HF, especially those older than 80. A number of small studies have described associations between HF and major geriatric domains. With information on patients' cognitive, functional decline, and ability to adhere to therapy, physicians can plan for individualized treatment goals and recommendations for these patients.
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Affiliation(s)
| | - Darren Mah
- Department of Radiology, University of Alberta, Edmonton, Alberta, Canada
| | - Wilbert S Aronow
- Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY
| | - Phillip H Lam
- Department of Medicine, Georgetown University, MedStar Washington Hospital Center, Washington, DC
| | | | - Ali Ahmed
- Center for Data Science and Outcomes Research, Veterans Affairs Medical Center, George Washington University, Georgetown University, Washington, DC; and
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Mah D, Kneteman M, Przybojewski SJ, Kotha V, Kline GA, Leung AA, So CB. Multiple radiologist review of adrenal CT still frequently misses lateralized surgical primary aldosteronism. J Clin Hypertens (Greenwich) 2024; 26:47-52. [PMID: 38083996 PMCID: PMC10795078 DOI: 10.1111/jch.14747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/23/2023] [Accepted: 10/25/2023] [Indexed: 01/19/2024]
Abstract
Patients with primary aldosteronism (PA) have increased morbidity and mortality compared to those with essential hypertension. Accurate detection of lateralized PA is important so that affected patients can receive potentially curative adrenalectomy. However, around 40% of patients with lateralized PA have "normal" adrenal glands on computed tomography (CT). Additional independent review of imaging has been shown to improve diagnostic accuracy in many areas of imaging. Therefore, the authors sought to establish if multi-reader re-assessment of previously reported normal CT scans would result in increased detection of surgically remediable disease. The authors found that re-assessment of CT imaging by one, two, or three additional radiologists (or a combination thereof) slightly increased the detection of lateralized disease, but these differences were not statistically significant (p > .05). Readers had low inter-observer agreement (kappa = 0.17). If detection of a discrete nodule on CT was made a prerequisite for adrenal vein sampling (AVS), a second read by another reviewer would still result in an excess of missed cases (84.2%, 36.8%, and 65.8%, respectively, for each of the three independent reviewers). Therefore, a "normal" CT does not preclude the possibility of lateralized PA. Adrenal vein sampling should still be strongly considered wherever available and whenever surgery is considered for treatment of PA, irrespective of CT findings.
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Affiliation(s)
- Darren Mah
- Department of RadiologyUniversity of CalgaryCalgaryABCanada
| | - Mark Kneteman
- Department of RadiologyUniversity of CalgaryCalgaryABCanada
| | | | - Vamshi Kotha
- Clinical Assistant ProfessorUniversity of CalgaryCalgaryABCanada
| | - Gregory A. Kline
- Department of MedicineDivision of Endocrinology and MetabolismUniversity of CalgaryCalgaryABCanada
| | - Alexander A. Leung
- Department of MedicineDivision of Endocrinology and MetabolismUniversity of CalgaryCalgaryABCanada
- Department of Community Health SciencesUniversity of CalgaryCalgaryABCanada
| | - C. Benny So
- Department of RadiologyUniversity of CalgaryCalgaryABCanada
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Yu V, Liu H, Zhang L, Fox P, Lonsberry C, Mah D, Cervino L, Yamada Y. Proton and Photon Dosimetry of Carbon Fiber-PEEK Implants for Paraspinal Stereotactic Body Radiation Therapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1494] [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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Choi I, Khan A, Mah D, McCormick B, Tsai H, Rosario GD, Mamary J, Liu H, Fox P, Gillespie E, Braunstein L, Powell S, Cahlon O. Proton Reirradiation for Recurrent or New Primary Breast Cancer in the Setting of Prior Breast Irradiation. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.253] [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]
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Miller RJH, Cadet S, Mah D, Pournazari P, Chan D, Fine NM, Berman DS, Slomka PJ. Diagnostic and prognostic value of Technetium-99m pyrophosphate uptake quantitation for transthyretin cardiac amyloidosis. J Nucl Cardiol 2021; 28:1835-1845. [PMID: 33689152 PMCID: PMC8497047 DOI: 10.1007/s12350-021-02563-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/06/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND 99mTc-pyrophosphate imaging has emerged as an important non-invasive method to diagnose transthyretin cardiac amyloidosis (ATTR-CM). Quantitation of 99mTc-pyrophosphate activity, on SPECT images, could be a marker of ATTR-CM disease burden. We assessed the diagnostic accuracy and clinical significance of 99mTc-pyrophosphate quantitation. METHODS AND RESULTS Patients who underwent 99mTc-pyrophosphate imaging for suspected ATTR-CM were included. Using SPECT images, radiotracer activity in the myocardium was calculated using cardiac pyrophosphate activity (CPA) and volume of involvement (VOI), with thresholds for abnormal activity derived from LVBP activity. Diagnostic accuracy was assessed using area under the receiver operating characteristic curve (AUC). In total, 124 patients were identified, mean age 73.9 ± 11.4, with ATTR-CM diagnosed in 43 (34.7%) patients. CPA had the highest diagnostic accuracy (AUC .996, 95% CI .987-1.00), and was significantly higher compared to the Perugini score (AUC .952, P = .016). In patients with ATTR-CM, CPA was associated with reduced left ventricular ejection fraction (adjusted odds ratio 1.28, P = .035) and heart failure hospitalizations (adjusted hazard ratio 1.29, P = .006). CONCLUSION Quantitative assessment of myocardial radiotracer activity with CPA or VOI have high diagnostic accuracy for ATTR-CM. Both measures are potential non-invasive markers to follow progression of disease or response to therapy.
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Affiliation(s)
- Robert J H Miller
- Department of Cardiac Sciences, University of Calgary, GAA08, 3230 Hospital Drive NW, Calgary, AB, T2N 2T9, Canada.
| | - Sebastien Cadet
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Darren Mah
- Department of Nuclear Medicine, University of Calgary, Calgary, AB, Canada
| | - Payam Pournazari
- Department of Cardiac Sciences, University of Calgary, GAA08, 3230 Hospital Drive NW, Calgary, AB, T2N 2T9, Canada
| | - Denise Chan
- Department of Nuclear Medicine, University of Calgary, Calgary, AB, Canada
| | - Nowell M Fine
- Department of Cardiac Sciences, University of Calgary, GAA08, 3230 Hospital Drive NW, Calgary, AB, T2N 2T9, Canada
| | - Daniel S Berman
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Piotr J Slomka
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States
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Yan S, Darwish H, Danzi C, Liu H, Mamary J, Sine K, Mah D, Tsai H, Chon B, Cooper B. Reirradiation with Hypofractionated Proton Therapy for Recurrent Lung Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1284] [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: 10/23/2022]
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Mah D, Branson R. Case Study: Dupuytren's Contracture in a Young Female Powerlifter. J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mah D, Yorke E, George J, Han Z, Liu H, Lambiase J, Zemanaj E, Czmielewski C, Gelb E, Li H, McKnight D, Lovelock D, Rimner A, Shepherd A. A Planning Comparison of IMRT Versus Pencil Beam Scanning for Deep Inspiration Breath Hold Lung Cancers. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.877] [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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Alagiakrishnan K, Mah D, Padwal R. Classic challenges and emerging approaches to medication therapy in older adults. Discov Med 2018; 26:137-146. [PMID: 30586537] [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: 06/09/2023]
Abstract
Prescribing medications safely and effectively in older adults is a complex process. This review discusses challenges with medication prescribing in older adults and outlines a holistic approach to medication management in older adults. Well-known challenges including the alterations in pharmacokinetics and pharmacodynamics that often occur with aging are discussed. Other classic concerns including polypharmacy, potentially inappropriate medication use, prescribing cascades, suboptimal prescribing, paradoxical harm and unintended consequences of medications, and drug interactions are reviewed. Newer approaches, including deprescribing, pharmacogenomics, and the future potential for senolytic therapy are also discussed. All healthcare providers should consider these challenges when prescribing medications in older adults. Choosing a drug that fits both a patient's pathophysiology and biology, avoiding drugs with significant side effects, titrating doses, and deprescribing are all critical in optimizing medication therapy.
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Affiliation(s)
- Kannayiram Alagiakrishnan
- Division of Geriatric Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta T6G 2G3, Canada
| | - Darren Mah
- Department of Medicine, University of Alberta, Edmonton, Alberta T6G 2G3, Canada
| | - Raj Padwal
- Division of General Internal Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta T6G 2G3, Canada
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Alagiakrishnan K, Banach M, Mah D, Ahmed A, Aronow WS. Role of Geriatric Syndromes in the Management of Atrial Fibrillation in Older Adults: A Narrative Review. J Am Med Dir Assoc 2018; 20:123-130. [PMID: 30270028 DOI: 10.1016/j.jamda.2018.07.021] [Citation(s) in RCA: 5] [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] [Received: 03/31/2018] [Revised: 07/15/2018] [Accepted: 07/28/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Atrial fibrillation (AF) is common in older adults and associated with increased risk of cardiovascular events including thromboembolism. However, less is known about its association with noncardiovascular events, especially geriatric syndromes and conditions such as dementia, depression, impaired physical function, polypharmacy, falls, and poor quality of life. This review aims to help healthcare professionals integrate the special needs of older adults into their management of AF. DESIGN Nonsystematic review. A literature search on published articles on AF and geriatric syndromes and conditions was performed using the electronic databases MEDLINE, EMBASE and SCOPUS, and DARE until December 2017. Non-English articles were excluded. SETTINGS AND PARTICIPANTS Older adults with and without AF from different settings. MEASURES Various cognitive, mood, and functional measurements were used in these studies. In studies regarding polypharmacy, the Beers or PRISCUS criteria were used to identify inappropriate medications. In quality of life measurements studies, instruments like Medical Outcomes Study Short Form 36 and Atrial Fibrillation Quality of Life questionnaire were used. RESULTS This literature review finds that AF has a substantial association with geriatric syndromes and conditions and that AF is a risk factor for the development of geriatric syndromes and conditions. Evidence is limited regarding the potential benefit of long-term treatment of AF in lowering the risk of developing geriatric syndromes and conditions. CONCLUSIONS/IMPLICATIONS Considering the impact of AF on cardiovascular outcomes and geriatric syndromes and conditions in older adults, healthcare professionals need to consider these complex dynamics while managing AF in older adults. An individual approach to AF management is needed in older adults with multiple comorbidity and polypharmacy that may help lower the risk of disease-disease, disease-drug, and drug-drug interactions. Special consideration needs to be given to patients' cognitive and functional impairment and ability to adhere to therapy.
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Affiliation(s)
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Zeronskiego, Poland
| | - Darren Mah
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Ali Ahmed
- Veterans Affairs Medical Center and George Washington University, Washington DC
| | - Wilbert S Aronow
- Division of Cardiology, Geriatrics, Pulmonary, and Critical Care, Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY
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Abstract
INTRODUCTION Cardiac rehabilitation program is an evidence-based intervention and established model of exercise delivery following myocardial infarction and heart failure. Although it forms an important part of recovery and helps to prevent future events and complications, there has been little focus on its potential cognitive benefits. Areas covered: Coronary artery disease and heart failure are common heart problems associated with significant morbidity and mortality, and cognitive decline is commonly seen in affected individuals. Cognitive impairment may influence patient self-management by reducing medication adherence, rendering patients unable to make lifestyle modifications and causing missed healthcare visits. Cognitive assessment in cardiac rehabilitation as an outcome measure has the potential to improve clinical, functional and behavioral domains as well as help to reduce gaps in the quality of care in these patients. Expert commentary: Limited evidence at present has shown that cardiac rehabilitation and exercise has potential in preventing cognitive decline. Cardiac prehabilitation, a rehabilitation-like program delivered before cardiac surgery, may also play a role in preventing postoperative cognitive dysfunction, but needs future research studies to support it.
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Affiliation(s)
| | - Darren Mah
- a Faculty of Medicine and Dentistry , University of Alberta , Edmonton , Canada
| | - Gabor Gyenes
- a Faculty of Medicine and Dentistry , University of Alberta , Edmonton , Canada
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Cooper B, Mah D, Chen C, McCarthy A, Darwish H, Cahlon O, Tsai H, Chon B. Hypofractionated Proton Therapy for Early Stage Non–small Cell Lung Cancer: Clinical Outcomes and Comparative Dosimetric Analysis. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Luo L, Cuaron J, Braunstein L, McCormick B, Mah D, Chon B, Tsai H, Powell S, Cahlon O. Outcome and Late Toxicity of Breast Cancer Patients Treated with Post-Mastectomy Proton Therapy. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.671] [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]
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Alagiakrishnan K, Mah D, Dyck JR, Senthilselvan A, Ezekowitz J. Comparison of two commonly used clinical cognitive screening tests to diagnose mild cognitive impairment in heart failure with the golden standard European Consortium Criteria. Int J Cardiol 2017; 228:558-562. [DOI: 10.1016/j.ijcard.2016.11.193] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 11/06/2016] [Indexed: 01/08/2023]
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Tang S, Ho M, Rice I, Doan D, Chen C, Mac Rae B, Mah D. SU-F-T-172: A Method for Log File QA On An IBA Proteus System for Patient Specific Spot Scanning Quality Assurance. Med Phys 2016. [DOI: 10.1118/1.4956309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ju N, Chen C, Gans S, Hug E, Cahlon O, Wolden S, Chon B, Yeh B, Tsai H, Sine K, Mah D. SU-F-T-208: An Efficient Planning Approach to Posterior Fossa Tumor Bed Boosts Using Proton Pencil Beam Scanning in Fixed-Beam Room. Med Phys 2016. [DOI: 10.1118/1.4956346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Zheng Y, Flanz J, Mah D, Pankuch M, Beltran C, Robison B, Kreydick B, Schreuder A. SU-F-T-163: Improve Proton Therapy Efficiency: Report of a Workshop. Med Phys 2016. [DOI: 10.1118/1.4956299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Chan M, Chen C, Li J, Tang X, Li X, Tang G, Mah D. SU-F-T-173: One-Scan Protocol: Verifying the Delivery of Spot-Scanning Proton Beam. Med Phys 2016. [DOI: 10.1118/1.4956310] [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: 11/07/2022] Open
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Bui D, Twibill K, Ee D, Mah D, Aleemullah T, Luk S, Kopecny R. Social Media and UNSW Sports Medicine Society: A new face in Sports and Exercise Medicine. J Sci Med Sport 2015. [DOI: 10.1016/j.jsams.2015.12.478] [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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Tang S, Song L, Chen C, Chang C, Chon B, Tsai H, Soffen E, Cahlon O, Mah D. SU-E-T-603: PBS Prostate Plan Robustness: A Tool for Patient Specific Setup Tolerance. Med Phys 2015. [DOI: 10.1118/1.4924966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Chang C, Mah D. SU-E-T-120: Analytic Dose Verification for Patient-Specific Proton Pencil Beam Scanning Plans. Med Phys 2015. [DOI: 10.1118/1.4924481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Hsi W, Lee T, Gao M, Boyer S, Pillainayagam M, Schultz T, Arjomandy B, Park S, Pankuch M, Schreuder A, Mah D. WE-D-17A-02: Evaluation of a Two-Dimensional Optical Dosimeter On Measuring Lateral Profiles of Proton Pencil Beams. Med Phys 2014. [DOI: 10.1118/1.4889405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Fontenla S, Zhou Y, Mah D, Kowalski A, Leven T, Cahlon O, Lee N, Hunt M, Mechalakos J. SU-E-T-460: Comparison of Proton and IMRT Planning for Head and Neck Cancer. Med Phys 2014. [DOI: 10.1118/1.4888793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Zheng Y, Ramirez E, Rana S, Pankuch M, Mah D, Wong T, Schreuder A. SU-E-T-138: Range Verification for Proton Therapy Systems: A Multi-Center Study. Med Phys 2013. [DOI: 10.1118/1.4814573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Chang C, Cahlon O, Hug E, Mah D. SU-E-T-727: MR-Based Contour Density Override for Proton Dose Calculation: A Dosimetric Evaluation On Head and Neck Cases. Med Phys 2013. [DOI: 10.1118/1.4815153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Tou S, Tou W, Mah D, Karatassas A, Hewett P. Effect of preoperative two-dimensional animation information on perioperative anxiety and knowledge retention in patients undergoing bowel surgery: a randomized pilot study. Colorectal Dis 2013; 15:e256-65. [PMID: 23350660 DOI: 10.1111/codi.12152] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 11/21/2012] [Indexed: 02/08/2023]
Abstract
AIM The use of multimedia information provided preoperatively can potentially reduce anxiety in patients and improve the hospital experience. However, the use of two-dimensional (2D) animation (cartoon) to provide information to patients undergoing colorectal surgery has not been investigated. This study investigated the effect of preoperative 2D information on anxiety and knowledge retention in patients undergoing bowel surgery. METHOD Patients were randomized to one of two groups; the video group watched a 13-min cartoon animation whereas the nonvideo group did not. Anxiety levels were measured at the preadmission clinic, postvideo, on the day of admission for surgery, within 24-h after surgery and before discharge using the Spielberger state-trait anxiety inventory and visual analogue scale. Both groups completed a knowledge retention questionnaire and the video group completed a feedback questionnaire about the animation. RESULTS Thirty-one patients (16 video, 15 nonvideo) participated in the study. There was no significant difference in baseline anxiety score between two groups. An immediate reduction (P = 0.03) in anxiety score was observed in the video group after watching the video compared with baseline. There was a significant reduction in anxiety score in the video group at discharge compared with the nonvideo group (P = 0.03). There was no significant difference in knowledge retention between two groups. Eighty-eight per cent of patients who watched the video found it beneficial. CONCLUSION 2D animation is an effective medium for delivering information to patients undergoing bowel surgery and can potentially reduce anxiety related to surgery and improve the hospital experience.
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Affiliation(s)
- S Tou
- Department of Colorectal Surgery, The Royal Derby Hospital, Derby, UK.
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Landau E, Pinn D, Xue N, Wang D, Bodner W, Hong L, Mah D, Miller E, Garg M, Kalnicki S. The Factors Affecting Treatment Outcomes of a Single Institution's Experience with Locally Advanced NSCLC Treated with PET guided IMRT. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Mah D, Miller E, Scripes PG, Kuo H, Hong L, Yaparpalvi R, Kalnicki S. SU-E-T-618: Flattening Filter Free Beams for 3D Breast Planning. Med Phys 2011. [DOI: 10.1118/1.3612581] [Citation(s) in RCA: 5] [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: 11/07/2022] Open
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Mynampati D, Yaparpalvi R, Clift C, Tsai S, Mah D. SU-E-T-161: Small Field Surface Doses for 6X and 10X Photon Beams - FFF versus FF. Med Phys 2011. [DOI: 10.1118/1.3612111] [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: 11/07/2022] Open
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Clift C, Mynampati D, Yaparpalvi R, Mah D. SU-E-T-111: Radiochromic Film Measurements of Small Field Surface Doses from Flattened and Unflattened 6MV and 10MV Beams. Med Phys 2011. [DOI: 10.1118/1.3612062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Walker J, Mah D, Park K, Dieleman L, Meddings J, Vethanayagam DP. Altered gastrointestinal mucosal permeability in asthma. Allergy Asthma Clin Immunol 2010. [PMCID: PMC3374168 DOI: 10.1186/1710-1492-6-s2-p15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Garg M, Fang M, Skinner W, Scripes P, Haynes-Lewis H, Yaparpalvi R, Mah D, Guha C, Kalnicki S. Tube Feeding Dependence in Larynx Cancer Patients: Is There More to It Than Pharyngeal Constrictors? Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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34
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Yaparpalvi R, Garg M, Hannan R, Shen J, Lee C, Landau E, Bodner W, Mah D, Guha C, Kalnicki S. Evidence-based Definition of a “Safe” Dose-volume Curve for Reducing Rectal Toxicity from External Beam Prostate Radiation Therapy. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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35
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Hong L, Garg M, Lasala P, Kim M, Mah D, Chen C, Yaparpalvi R, Mynampati D, Guha C, Kalnicki S. Linear Accelerator Based Single Fraction Stereotactic Radiosurgery: Sharp Dose Fall off in Normal Tissues Depends on Dose Inhomogeneity in Tumor. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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36
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Kuo H, Mah D, Wu A, Chuang K, Hong L, Yaparpalvi R, Spierer M, Kalnicki S. SU-GG-J-85: A Method Incorporating 4DCT Data for Evaluating the Dosimetric Effects of Respiratory Motion in Single Arc IMAT. Med Phys 2010. [DOI: 10.1118/1.3468309] [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: 11/07/2022] Open
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37
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Kuo HC, Mah D, Chuang KS, Wu A, Hong L, Yaparpalvi R, Spierer M, Kalnicki S. A method incorporating 4DCT data for evaluating the dosimetric effects of respiratory motion in single-arc IMAT. Phys Med Biol 2010; 55:3479-97. [PMID: 20508324 DOI: 10.1088/0031-9155/55/12/014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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38
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Mah D, Chen C, Milan E, Tsai S, Garg M, Hong L, Yaparpalvi R, Kalnicki S. Potential Dose Escalation to Prostate Cancer using Electromagnetic Transponders: Effect of Margin Reduction on OAR and Treatment Time. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.1306] [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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39
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Mehta K, Scripes P, Yaparpalvi R, Skinner W, Thawani N, Sharma R, Mah D, Kalnicki S, Garg M. Low Rates of Acute Esophageal Toxicity using IMRT and Respiratory Gating in the Treatment of Lung Cancer. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.1050] [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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40
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Kuo H, Mah D, Wu A, Chuang K, Hong L, Yaparpalvi R. SU-FF-I-99: Multi-Level Regularization Approaches of Non-Parametric Deformable Registrations. Med Phys 2009. [DOI: 10.1118/1.3181219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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41
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Mynampati D, Yaparpalvi R, Hong L, Kuo H, Miller E, Mah D. SU-FF-T-647: RapidArc Versus DMLC IMRT: Planning Comparison Utilizing AAPM TG119 Guidelines. Med Phys 2009. [DOI: 10.1118/1.3182145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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42
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Chen C, Yaparpalvi R, Kuo H, Tsai S, Guha C, Mah D. SU-FF-T-401: Monte Carlo Simulation of Batch Assay of Iodine-125 Seeds Preloaded in Unshielded Cartridges. Med Phys 2009. [DOI: 10.1118/1.3181883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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43
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Lee C, Chen C, Mah D, Sharma R, Landau E, Garg M, Wu A. SU-FF-T-112: Dose Sparing of Brainstem and Spinal Cord for Re-Irradiating Recurrent Head and Neck Cancer with Intensity Modulated Radiotherapy. Med Phys 2009. [DOI: 10.1118/1.3181586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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44
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Chuang K, Kuo H, Wu A, Liu W, Mah D, Kalniki S, Guha C. Biological Effects of the Geometry Uncertainty in the Intensity Modulation Delivery of the Hepatocellular Carcinoma (HCC) Tumor. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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45
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Hong L, Yaparpalvi R, Garg M, Guha C, Kalnicki S, Mah D. Comparison of Dose Distribution between 3D-CRT and IMRT Plans for LINAC Based Stereotactic Radiosurgery (SRS): Tumor Dose Inhomogeneity and Normal Tissue Dose Fall Off. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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46
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Kuo H, Yaparpalvi R, Hong L, Mah D, Lee J. SU-GG-T-353: Validation of Calculation for Electrons and Feasibility Study of Penumbra Generator Utilized Electron Monte Carlo Algorithm. Med Phys 2008. [DOI: 10.1118/1.2962105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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47
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Garg M, Castillo M, Scripes P, Shen J, Milan E, Skinner W, Kalnicki S, Mah D. Effect of IMRT on Dose Sparing of Normal Lung and Esophagus for External Beam Gated Treatment for Lung Cancer. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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48
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Mah D, Hong L, Yaparpalvi R, Engler M. SU-FF-T-288: Initial Experience with a Commercial Monte Carlo Electron Treatment Planning System. Med Phys 2006. [DOI: 10.1118/1.2241205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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49
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Li X, Zhang P, Helminen H, Mah D, Kutcher G. WE-D-T-6E-01: A New Lung IMRT Planning Algorithm with Dose Shaping Strategy to Compensate for Respiratory Motion. Med Phys 2005. [DOI: 10.1118/1.1998570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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50
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Freedman G, Price R, Mah D, Milestone B, Movsas B, Horwitz E, Mitra R, Hanks G. Routine use of MRI and CT simulation for treatment planning of intensity modulated radiation therapy (IMRT) in prostate cancer. Int J Radiat Oncol Biol Phys 2001. [DOI: 10.1016/s0360-3016(01)02377-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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