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Bhat AK, Vyas R, Acharya AM, Rajagopal KV. De Quervain's tenosynovitis: a non-randomized two-armed study comparing ultrasound-guided steroid injection with surgical release. Musculoskelet Surg 2023; 107:105-114. [PMID: 35195844 PMCID: PMC10020267 DOI: 10.1007/s12306-022-00735-0] [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: 09/28/2020] [Accepted: 01/29/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Ultrasonography is currently used for both diagnostic and therapeutic purposes in de Quervain's tenosynovitis. There is a dearth of information on how effective an ultrasound-guided (USG) steroid injection is when compared to surgical release of the first extensor compartment. Hence, we performed a non-randomized two-armed comparison study to test our hypothesis that USG guided steroid injection is equally effective as surgery. METHOD 62 consecutive patients participated in the study with 32 of them selecting the option of USG guided injection (Set A), and the rest undergoing surgical release (Set B). We reviewed them after 3 and 6 weeks and 6 months for functional outcome using DASH, PRWE and VAS scores, recurrence, or any complications. They were further followed if they were symptomatic. RESULTS The DASH/PRWE/VAS scores improved at the end of 6 months from 81.7/79.3/6.8 to 1.0/1.7/1.0, respectively for patients undergoing USG guided steroid injection. Similarly, for the patient undergoing surgery, the scores improved from 82.2/81.5/6.7 to 1.7/3.4/1.0, respectively. This was statistically significant in both the groups (p < 0.05) and was comparable to each other. Two patients in Set A came back with recurrence at eight and 10 months and two reported occasional pain on heavy work. Three patients had tenderness and two had numbness in Set B at the scar site. CONCLUSION We observed that USG guided steroid injections are comparable to surgical release in terms of pain relief, functional outcome, complications.
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Affiliation(s)
| | | | - A M Acharya
- Division of Hand and Microsurgery, Department of Orthopaedics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, 576104, India.
| | - K V Rajagopal
- Department of Radiodiagnosis, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, 576104, India
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Mahtani K, Parker M, Maclean E, Vyas R, Bo Wang R, Roelas M, Zemrak F, Muthumala A, Moore P, Sporton S, Chow A, Monkhouse C. Emergency pacemaker implantation in nonagenarians with complete heart block: is single chamber pacing sufficient? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.711] [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: 11/13/2022] Open
Abstract
Abstract
Background
In ambulatory patients with complete heart block and preserved sinus node activity (CHBs), dual chamber pacing confers well-established physiological benefits versus single chamber pacing. There is limited evidence as to whether these benefits extend to very frail patients, especially those over 90 years of age.
Purpose
In nonagenarians presenting with emergent CHBs from 2016–2019, we compared the clinical characteristics of patients selected for single versus dual chamber pacemakers (PPM), and evaluated the symptomatic and prognostic implications of these devices.
Methods
Baseline characteristics were discerned from electronic records, and physiological data extracted from serial PPM interrogations. Frailty was quantified according to the Rockwood clinical frailty scale (1–9). Cause of death was provided by the patients' General Practitioner. Cox proportional hazards analysis (HR, 95% CI) examined associations with all-cause mortality and death from congestive cardiac failure (CCF).
Results
168 consecutive patients were included (44.3% Male, Median age: 91 (2) years) and followed-up for 26.9±14.6 months. 22 patients (13.1%) were implanted with single chamber pacemakers (all programmed VVIR); when compared with patients receiving dual chamber devices, these patients had similar median age (93 (3) versus 91 (2) years, p=0.15) and LV systolic function (LVEF: 49.2% ±9.7 versus 50.7% ±10.1, p=0.71), but were more frail (Rockwood scale: 5.2±1.8 versus 4.3±1.1, p=0.004) and more likely to have severe cognitive impairment (27.3% versus 9.2%, p=0.018). Post implant, patients who received single chamber devices had higher average respiratory rates (21.3±2.4 breaths per minute versus 17.5±2.6 breaths per minute, p=0.002), lower average heart rates (65.5±10.1 bpm versus 71.9±8.6 bpm, p=0.002), and lower daily activity levels (0.57±0.3 hours of activity versus 1.5±1.1 hours of activity, p=0.016) than those with dual chamber devices. Death from CCF was more common in patients receiving single chamber devices (40.9% versus 6.2%, log rank p<0.0001); this association persisted when adjusting for age, frailty and cognitive impairment (adjusted HR: 6.2 (2.2–17.3, p=0.0005). However, in this age group, single chamber pacing was not independently associated with all-cause mortality when compared with dual chamber pacing (adjusted HR: 1.9 (0.95–3.6, p=0.07).
Conclusions
In nonagenarians with CHBs, dual chamber pacing was associated with improved symptomatic outcomes and a reduced risk of death from CCF, but did not affect all-cause mortality when compared with single chamber pacing.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Mahtani
- St Bartholomew's Hospital , London , United Kingdom
| | - M Parker
- St Bartholomew's Hospital , London , United Kingdom
| | - E Maclean
- St Bartholomew's Hospital , London , United Kingdom
| | - R Vyas
- St Bartholomew's Hospital , London , United Kingdom
| | - R Bo Wang
- St Bartholomew's Hospital , London , United Kingdom
| | - M Roelas
- St Bartholomew's Hospital , London , United Kingdom
| | - F Zemrak
- St Bartholomew's Hospital , London , United Kingdom
| | - A Muthumala
- St Bartholomew's Hospital , London , United Kingdom
| | - P Moore
- St Bartholomew's Hospital , London , United Kingdom
| | - S Sporton
- St Bartholomew's Hospital , London , United Kingdom
| | - A Chow
- St Bartholomew's Hospital , London , United Kingdom
| | - C Monkhouse
- St Bartholomew's Hospital , London , United Kingdom
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Roelas M, Vyas R, Maclean E, Mahtani K, Butcher C, Ahluwalia N, Honarbakhsh S, Finlay M, Chow A, Earley MJ, Sporton S, Lambiase PD, Schilling RJ, Hunter RJ, Segal OR. Transseptal puncture for left atrial ablation: risk factors for cardiac tamponade and a proposed causative classification system. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.448] [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: 11/13/2022] Open
Abstract
Abstract
Background
Cardiac tamponade is a high morbidity complication of transseptal puncture (TSP).
Purpose
We examined the associations of TSP-related cardiac tamponade (TRCT) for all patients undergoing left atrial ablation at our centre from 2016–2020.
Methods
Patient and procedural variables were extracted retrospectively. Cases of cardiac tamponade were scrutinised to adjudicate TSP culpability. Adjusted multivariate analysis examined predictors of TRCT.
Results
3,239 consecutive TSPs were performed; cardiac tamponade occurred in 51 patients (incidence: 1.6%) and was adjudicated as TSP-related in 35 (incidence: 1.1%; 68.6% of all tamponades). Patients of above-median age (OR 2.4 (1.19–4.2), p=0.006) and those undergoing re-do procedures (OR 1.95 (1.29–3.43, p=0.042) were at higher risk of TRCT. Of the operator-dependent variables, choice of transseptal needle (Endrys vs Brockenbrough, p>0.1) or puncture sheath (Swartz vs Mullins vs Agilis vs Vizigo vs Cryosheath, all p>0.1) did not predict TRCT. Adjusting for operator, equipment and demographics, failure to cross the septum first pass increased TRCT risk (OR 4.42 (2.45–8.2), p=0.001), whilst top quartile operator experience (OR 0.4 (0.17–0.85, p=0.002), transoesophageal echocardiogram (TOE prevalence: 26%, OR 0.51 (0.11–0.94), p=0.023), and use of the SafeSept guidewire (OR 0.22 (0.08–0.62), p=0.001) reduced TRCT risk. An increase in SafeSept wire use over time (2016: 15.6%, 2020: 60.2%) correlated with an annual reduction in TRCT (R2=0.72, p<0.001) and was associated with a relative risk reduction of 70%.
Conclusions
During left atrial ablation, the independent predictors of TRCT were patient age, re-do procedure, operator experience, unsuccessful first pass, TOE-guidance, and use of the SafeSept wire. A novel classification system for the causes of cardiac tamponade is proposed (table 1); this may be of interest to clinical trialists or auditors evaluating patient safety.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Roelas
- Barts Heart Centre, St. Bartholomew's Hospital , London , United Kingdom
| | - R Vyas
- Barts Heart Centre, St. Bartholomew's Hospital , London , United Kingdom
| | - E Maclean
- Barts Heart Centre, St. Bartholomew's Hospital , London , United Kingdom
| | - K Mahtani
- Barts Heart Centre, St. Bartholomew's Hospital , London , United Kingdom
| | - C Butcher
- Barts Heart Centre, St. Bartholomew's Hospital , London , United Kingdom
| | - N Ahluwalia
- Barts Heart Centre, St. Bartholomew's Hospital , London , United Kingdom
| | - S Honarbakhsh
- Barts Heart Centre, St. Bartholomew's Hospital , London , United Kingdom
| | - M Finlay
- Barts Heart Centre, St. Bartholomew's Hospital , London , United Kingdom
| | - A Chow
- Barts Heart Centre, St. Bartholomew's Hospital , London , United Kingdom
| | - M J Earley
- Barts Heart Centre, St. Bartholomew's Hospital , London , United Kingdom
| | - S Sporton
- Barts Heart Centre, St. Bartholomew's Hospital , London , United Kingdom
| | - P D Lambiase
- Barts Heart Centre, St. Bartholomew's Hospital , London , United Kingdom
| | - R J Schilling
- Barts Heart Centre, St. Bartholomew's Hospital , London , United Kingdom
| | - R J Hunter
- Barts Heart Centre, St. Bartholomew's Hospital , London , United Kingdom
| | - O R Segal
- Barts Heart Centre, St. Bartholomew's Hospital , London , United Kingdom
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Maclean E, Mahtani K, Roelas M, Vyas R, Butcher C, Ahluwalia N, Honarbakhsh S, Creta A, Finlay M, Chow A, Earley MJ, Sporton S, Lowe MD, Sawhney V, Ezzat V, Ahsan S, Khan F, Dhinoja M, Lambiase PD, Schilling RJ, Hunter RJ, Segal OR. Transseptal puncture for left atrial ablation: risk factors for cardiac tamponade and a proposed causative classification system. J Cardiovasc Electrophysiol 2022; 33:1747-1755. [PMID: 35671359 PMCID: PMC9543389 DOI: 10.1111/jce.15590] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/28/2022] [Accepted: 04/06/2022] [Indexed: 12/01/2022]
Abstract
Aims Cardiac tamponade is a high morbidity complication of transseptal puncture (TSP). We examined the associations of TSP‐related cardiac tamponade (TRCT) for all patients undergoing left atrial ablation at our center from 2016 to 2020. Methods and Results Patient and procedural variables were extracted retrospectively. Cases of cardiac tamponade were scrutinized to adjudicate TSP culpability. Adjusted multivariate analysis examined predictors of TRCT. A total of 3239 consecutive TSPs were performed; cardiac tamponade occurred in 51 patients (incidence: 1.6%) and was adjudicated as TSP‐related in 35 (incidence: 1.1%; 68.6% of all tamponades). Patients of above‐median age [odds ratio (OR): 2.4 (1.19–4.2), p = .006] and those undergoing re‐do procedures [OR: 1.95 (1.29–3.43, p = .042] were at higher risk of TRCT. Of the operator‐dependent variables, choice of transseptal needle (Endrys vs. Brockenbrough, p > .1) or puncture sheath (Swartz vs. Mullins vs. Agilis vs. Vizigo vs. Cryosheath, all p > .1) did not predict TRCT. Adjusting for operator, equipment and demographics, failure to cross the septum first pass increased TRCT risk [OR: 4.42 (2.45–8.2), p = .001], whilst top quartile operator experience [OR: 0.4 (0.17–0.85), p = .002], transoesophageal echocardiogram [TOE prevalence: 26%, OR: 0.51 (0.11–0.94), p = .023], and use of the SafeSept transseptal guidewire [OR: 0.22 (0.08–0.62), p = .001] reduced TRCT risk. An increase in transseptal guidewire use over time (2016: 15.6%, 2020: 60.2%) correlated with an annual reduction in TRCT (R2 = 0.72, p < .001) and was associated with a relative risk reduction of 70%. Conclusions During left atrial ablation, the risk of TRCT was reduced by operator experience, TOE‐guidance, and use of a transseptal guidewire, and was increased by patient age, re‐do procedures, and failure to cross the septum first pass.
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Affiliation(s)
- E Maclean
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK.,William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
| | - K Mahtani
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - M Roelas
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - R Vyas
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - C Butcher
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - N Ahluwalia
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - S Honarbakhsh
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - A Creta
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - M Finlay
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - A Chow
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - M J Earley
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - S Sporton
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - M D Lowe
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - V Sawhney
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - V Ezzat
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - S Ahsan
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - F Khan
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - M Dhinoja
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - P D Lambiase
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - R J Schilling
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK.,William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
| | - R J Hunter
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK.,William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
| | - O R Segal
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
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Apparaju V, Vaddamanu SK, Vyas R, Vishwanath S, Gurumurthy V, Kanji MA. Is balloon-assisted maxillary sinus floor augmentation before dental implant safe and promising? A systematic review and meta-analysis. Niger J Clin Pract 2020; 23:275-283. [PMID: 32134023 DOI: 10.4103/njcp.njcp_238_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
We aimed to assess the complications of minimally invasive balloon-assisted maxillary sinus floor augmentation, compared with the conventional sinus floor augmentation procedures done before placing a dental implant. A structured question was formulated and an electronic search was conducted in three databases (MEDLINE via PubMed, Google Scholar, and Scopus). A separate search of gray literature and a hand search for missing articles were also conducted. Apart from animal studies, in-vitro studies, and case reports, all other types of studies where maxillary sinus floor augmentation was done using a balloon were considered for review. Our review was registered in International Prospective Registration of Systematic Reviews (PROSPERO) under number CRD42018086770. Our search produced 73 articles. However, only eight articles were found eligible to be included in our review (seven case series and one case-control study). Quality check was done using Methodological Index for Non-Randomized Studies (MINORS). Results suggest that balloon-assisted augmentation is associated with low rates of membrane tears (9 out of 272 sinus augmentation attempts), and high follow-up bone gain levels (mean 212.91%, 95% confidence interval 158.07%-267.75%, I2 = 97.62%). Balloon-assisted augmentation seems to be safe. More clinical trials are needed to assess the advantages and disadvantages of balloon-assisted maxillary sinus floor augmentation compared with other procedures.
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Affiliation(s)
- V Apparaju
- Department of Periodontology and Oral Implantology, Dr. Vijay's Multispeciality Dental Care, Implant and LASER Center, Abha, Saudi Arabia
| | - S K Vaddamanu
- Department of Dental Technology, College of Applied Medical Science, King Khalid University, Abha, Saudi Arabia
| | - R Vyas
- Department of Dental Technology, College of Applied Medical Science, King Khalid University, Abha, Saudi Arabia
| | - S Vishwanath
- All Care Dental Center, V.V. Puram, Bengaluru, Karnataka, India
| | - V Gurumurthy
- Department of Dental Technology, College of Applied Medical Science, King Khalid University, Abha, Saudi Arabia
| | - M A Kanji
- Department of Dental Technology, College of Applied Medical Science, King Khalid University, Abha, Saudi Arabia
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Talluri S, Vaddamanu SK, Apparaju V, Vyas R, Ahuja S, Kanji MA. Evaluating cortico-cancellous ratio using virtual implant planning and its relation with immediate and long-term stability of a dental implant- A CBCT-assisted prospective observational clinical study. Niger J Clin Pract 2019; 22:982-987. [PMID: 31293265 DOI: 10.4103/njcp.njcp_22_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Primary and long-term implant stabilities are crucial in predicting the success of dental implants. We aimed to evaluate corticocancellous ratio (CCR) around virtual implant using cone beam computed tomography (CT) and assess its relationship with immediate and long-term stability of the implants placed. MATERIALS AND METHODS A total of 135 image records of posterior mandibular implant sites planned for dental implant were included in our study. CCR was calculated using CT images and implants were placed after stent preparation. Implant stability was calculated immediately, 4 months later, and 2 years later. RESULTS Pearson's correlation test showed a significant correlation (P and lt; 0.001) between CCR and implant stability. ANOVA and post-hoc Tukey tests showed a significant difference in implant stability between groups with different CCRs at all follow-up timepoints. No significant difference was found between mean implant stability quotient values for low CCR at 2-year follow-up and high CCR immediately after implant placement. CONCLUSIONS Implant stability is improved with greater CCR. Cortical bone seems to be crucial factor for immediate and long-term stability of a dental implant. Virtual planning using CT can assess implant stability. Further histological studies are required to confirm the relation between CCR and implant stability. The escalating demand of the implant treatment in the dental practice necessitates measuring the several predictors of procedure success. This study introduces a novel predictor (CCR) around virtual implant for detecting the immediate and long-term stability of a dental implant.
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Affiliation(s)
- S Talluri
- Department of Periodontology and Oral Implantology, Rambabu Dental Hospital, Ongole, India
| | - S K Vaddamanu
- Department of Dental Technology, College of Applied Medical Science, King Khalid University, Abha, Saudi Arabia
| | - V Apparaju
- Department of Periodontics, Dr. Vijay's Multi Speciality Dental Care, Implant and Laser Center, Bangalore, India
| | - R Vyas
- Department of Dental Technology, College of Applied Medical Science, King Khalid University, Abha, Saudi Arabia
| | - S Ahuja
- Department of Occupational Health and Safety Management, Lambton College of Applied Arts and Technology, Scarborough, Toronto, Ontario, Canada
| | - M A Kanji
- Department of Dental Technology, College of Applied Medical Science, King Khalid University, Abha, Saudi Arabia
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Abstract
γ-Aminobutyric acid (GABA)-transaminase deficiency is an ultra-rare disorder of GABA metabolism that was described for decades as an early-onset epileptic encephalopathy plus movement disorder and hypersomnolence with mortality in early childhood. We report 2 affected siblings in adolescence and adulthood, both with profound developmental impairment, intractable epilepsy, movement disorder, and behavioral fluctuations. This considerably expands the phenotype and longevity of this inherited neurotransmitter disease.
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Affiliation(s)
| | | | | | | | - P. Ellen Grant
- Boston Children’s Hospital, Harvard Medical School,
Boston, MA, USA
| | - Phillip L. Pearl
- Boston Children’s Hospital, Harvard Medical School,
Boston, MA, USA
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Player EL, Morris P, Thomas T, Chan WY, Vyas R, Dutton J, Tang J, Alexandre L, Forbes A. Bioelectrical impedance analysis (BIA)-derived phase angle (PA) is a practical aid to nutritional assessment in hospital in-patients. Clin Nutr 2018; 38:1700-1706. [PMID: 30170780 DOI: 10.1016/j.clnu.2018.08.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [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: 03/13/2018] [Accepted: 08/01/2018] [Indexed: 01/31/2023]
Abstract
BACKGROUND Nutritional status can be difficult to assess. Bioelectrical impedance analysis (BIA)-derived phase angle (PA), and the plasma markers citrulline and transthyretin (pre-albumin) have the potential to assist, but the protocol of fasting and resting for BIA renders the investigation impractical for routine use, especially so in populations at high risk of malnutrition. AIMS 1 To clarify whether starving and resting are necessary for reliable measurement of PA. 2 To identify whether PA, citrulline and transthyretin correlate with nutritional status. METHODS Eighty consenting adult in-patients were recruited. Nutritional status was determined by subjective global assessment (SGA) used as gold standard. The Malnutrition Universal Screening Tool (MUST) was used and anthropometric measurements were performed. Serum was analysed for citrulline and transthyretin. PA was measured using Bodystat 4000. The PA was considered to define malnutrition when lower than reference ranges for sex and age, and severe malnutrition if more than 2 integers below the lower limit. Anthropometric measurements were categorised according to WHO reference centiles. Ordinal logistic regression estimated the strength of association of PA, citrulline and transthyretin with SGA. PA values in the different metabolic states were compared using paired t tests. RESULTS All 80 subjects completed the BIA and the nutritional assessments in the 3 different states; 14 declined to provide blood samples for the biochemical assays. Malnutrition was identified in 32 cases, severe malnutrition in 14 cases, the remaining 34 cases were deemed not to be malnourished. PA was strongly inversely associated with SGA (Odds Ratio [OR] per unit increase = 0.21, CI 0.12-0.37, p < 0.001). PA was not influenced by exercise (p = 0.134) or food intake (p = 0.184). Transthyretin was inversely associated with malnourished/severely malnourished states (OR = 0.98, 95% CI 0.97-0.99, p = 0.001), but had poorer predictive values than PA. There was no significant association between citrulline concentration and SGA (OR = 1.01, 95% CI 0.99-1.04, p = 0.348). CONCLUSIONS The BIA-derived PA reliably identifies malnutrition. It is strongly associated with SGA but requires less skill and experience, and out-performs circulating transthyretin, rendering it a promising and less operator-dependent tool for assessing nutritional status in hospital patients. Our novel demonstration that fasting and bed-rest are unnecessary consolidates that position.
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Affiliation(s)
- E L Player
- Norwich Medical School, University of East Anglia, Norwich, NR4 7UQ, UK.
| | - P Morris
- Norwich Medical School, University of East Anglia, Norwich, NR4 7UQ, UK.
| | - T Thomas
- Norwich Medical School, University of East Anglia, Norwich, NR4 7UQ, UK.
| | - W Y Chan
- Norwich Medical School, University of East Anglia, Norwich, NR4 7UQ, UK.
| | - R Vyas
- Norwich Medical School, University of East Anglia, Norwich, NR4 7UQ, UK.
| | - J Dutton
- Norwich Medical School, University of East Anglia, Norwich, NR4 7UQ, UK.
| | - J Tang
- Norwich Medical School, University of East Anglia, Norwich, NR4 7UQ, UK.
| | - L Alexandre
- Norwich Medical School, University of East Anglia, Norwich, NR4 7UQ, UK.
| | - A Forbes
- Norwich Medical School, University of East Anglia, Norwich, NR4 7UQ, UK.
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Rambhia P, Scott J, Rambhia S, Vyas R, Gerstenblith M. 1267 Primary female genitourinary melanoma: A systematic review. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1282] [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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Karmacharya S, Gagoski B, Ning L, Vyas R, Cheng HH, Soul J, Newberger JW, Shenton ME, Rathi Y, Grant PE. Advanced diffusion imaging for assessing normal white matter development in neonates and characterizing aberrant development in congenital heart disease. Neuroimage Clin 2018; 19:360-373. [PMID: 30013919 PMCID: PMC6044185 DOI: 10.1016/j.nicl.2018.04.032] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 04/23/2018] [Accepted: 04/25/2018] [Indexed: 12/21/2022]
Abstract
Background Elucidating developmental trajectories of white matter (WM) microstructure is critically important for understanding normal development and regional vulnerabilities in several brain disorders. Diffusion Weighted Imaging (DWI) is currently the method of choice for in-vivo white matter assessment. A majority of neonatal studies use the standard Diffusion Tensor Imaging (DTI) model although more advanced models such as the Neurite Orientation Dispersion and Density Imaging (NODDI) model and the Gaussian Mixture Model (GMM) have been used in adult population. In this study, we compare the ability of these three diffusion models to detect regional white matter maturation in typically developing control (TDC) neonates and regional abnormalities in neonates with congenital heart disease (CHD). Methods Multiple b-value diffusion Magnetic Resonance Imaging (dMRI) data were acquired from TDC neonates (N = 16) at 38 to 47 gestational weeks (GW) and CHD neonates (N = 19) aged 37 weeks to 41 weeks. Measures calculated from the diffusion signal included not only Mean Diffusivity (MD) and Fractional Anisotropy (FA) derived from the standard DTI model, but also three advanced diffusion measures, namely, the fiber Orientation Dispersion Index (ODI), the isotropic volume fraction (Viso), and the intracellular volume fraction (Vic) derived from the NODDI model. Further, we used two novel measures from a non-parametric GMM, namely the Return-to-Origin Probability (RTOP) and Return-to-Axis Probability (RTAP), which are sensitive to axonal/cellular volume and density respectively. Using atlas-based registration, 22 white matter regions (6 projection, 4 association, and 1 callosal pathways bilaterally in each hemisphere) were selected and the mean value of all 7 measures were calculated in each region. These values were used as dependent variables, with GW as the independent variable in a linear regression model. Finally, we compared CHD and TDC groups on these measures in each ROI after removing age-related trends from both the groups. Results Linear analysis in the TDC population revealed significant correlations with GW (age) in 12 projection pathways for MD, Vic, RTAP, and 11 pathways for RTOP. Several association pathways were also significantly correlated with GW for MD, Vic, RTAP, and RTOP. The right callosal pathway was significantly correlated with GW for Vic. Consistent with the pathophysiology of altered development in CHD, diffusion measures demonstrated differences in the association pathways involved in language systems, namely the Uncinate Fasciculus (UF), the Inferior Fronto-occipital Fasciculus (IFOF), and the Superior Longitudinal Fasciculus (SLF). Overall, the group comparison between CHD and TDC revealed lower FA, Vic, RTAP, and RTOP for CHD bilaterally in the a) UF, b) Corpus Callosum (CC), and c) Superior Fronto-Occipital Fasciculus (SFOF). Moreover, FA was lower for CHD in the a) left SLF, b) bilateral Anterior Corona Radiata (ACR) and left Retrolenticular part of the Internal Capsule (RIC). Vic was also lower for CHD in the left Posterior Limb of the Internal Capsule (PLIC). ODI was higher for CHD in the left CC. RTAP was lower for CHD in the left IFOF, while RTOP was lower in CHD in the: a) left ACR, b) left IFOF and c) right Anterior Limb of the Internal Capsule (ALIC). Conclusion In this study, all three methods revealed the expected changes in the WM regions during the early postnatal weeks; however, GMM outperformed DTI and NODDI as it showed significantly larger effect sizes while detecting differences between the TDC and CHD neonates. Future studies based on a larger sample are needed to confirm these results and to explore clinical correlates.
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Affiliation(s)
- S Karmacharya
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - B Gagoski
- Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - L Ning
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - R Vyas
- Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - H H Cheng
- Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - J Soul
- Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - J W Newberger
- Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - M E Shenton
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Boston VA Healthcare, Boston, MA, United States
| | - Y Rathi
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
| | - P E Grant
- Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
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11
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Sharma V, Vyas R, Bazylewski P, Chang GS, Asokan K, Sachdev K. Probing the highly transparent and conducting SnOx/Au/SnOx structure for futuristic TCO applications. RSC Adv 2016. [DOI: 10.1039/c5ra24422f] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A SnOx/Au/SnOx transparent conductive oxide (TCO) multilayered film was fabricated with a total thickness of 75 nm using both e-beam and thermal evaporation techniques.
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Affiliation(s)
- V. Sharma
- Department of Physics
- Malaviya National Institute of Technology
- Jaipur-302017
- India
| | - R. Vyas
- Department of Physics
- School of Basic Sciences
- Jaipur National University
- Jaipur-302017
- India
| | - P. Bazylewski
- Department of Physics & Astronomy
- University of Western
- London-N6A 3K7
- Canada
| | - G. S. Chang
- Department of Physics & Engineering Physics
- University of Saskatchewan
- Saskatoon-S7N 5E2
- Canada
| | - K. Asokan
- Materials Science Division
- Inter-University Accelerator Centre
- New Delhi-110067
- India
| | - K. Sachdev
- Department of Physics
- Malaviya National Institute of Technology
- Jaipur-302017
- India
- Materials Research Centre
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12
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Vyas R, Gotow EK, DePry JL, Lazarus HM, Caimi PF, Bordeaux JS, Gerstenblith MR. Multiple skin cancers in a patient within 1 year of allogeneic haematopoietic cell transplant for chronic lymphocytic leukaemia. Clin Exp Dermatol 2015; 40:927-9. [DOI: 10.1111/ced.12473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2014] [Indexed: 12/21/2022]
Affiliation(s)
- R. Vyas
- Department of Dermatology; University Hospitals Case Medical Center; Case Comprehensive Cancer Center; Case Western Reserve University School of Medicine; 11100 Euclid Avenue Cleveland OH 44106 USA
| | - E. K. Gotow
- Department of Dermatology; University Hospitals Case Medical Center; Case Comprehensive Cancer Center; Case Western Reserve University School of Medicine; 11100 Euclid Avenue Cleveland OH 44106 USA
| | - J. L. DePry
- Department of Dermatology; University Hospitals Case Medical Center; Case Comprehensive Cancer Center; Case Western Reserve University School of Medicine; 11100 Euclid Avenue Cleveland OH 44106 USA
| | - H. M. Lazarus
- Division of Haematology and Oncology; Department of Internal Medicine; University Hospitals Case Medical Center; Case Comprehensive Cancer Center; Case Western Reserve University School of Medicine; 11100 Euclid Avenue Cleveland OH 44106 USA
| | - P. F. Caimi
- Division of Haematology and Oncology; Department of Internal Medicine; University Hospitals Case Medical Center; Case Comprehensive Cancer Center; Case Western Reserve University School of Medicine; 11100 Euclid Avenue Cleveland OH 44106 USA
| | - J. S. Bordeaux
- Department of Dermatology; University Hospitals Case Medical Center; Case Comprehensive Cancer Center; Case Western Reserve University School of Medicine; 11100 Euclid Avenue Cleveland OH 44106 USA
| | - M. R. Gerstenblith
- Department of Dermatology; University Hospitals Case Medical Center; Case Comprehensive Cancer Center; Case Western Reserve University School of Medicine; 11100 Euclid Avenue Cleveland OH 44106 USA
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13
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Ambuj A, Vyas R, Singh S. Diffraction of orbital angular momentum carrying optical beams by a circular aperture. Opt Lett 2014; 39:5475-8. [PMID: 25360906 DOI: 10.1364/ol.39.005475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Far field diffraction of Laguerre-Gauss vortex (LGV) beams of different angular momentum index by a circular aperture placed at different locations with respect to incident beam waist is studied experimentally. The experiments reveal a surprisingly simple structure for the diffraction pattern and its dependence on the orbital angular momentum index of the incident beam when the aperture size is small compared to the beam radius.
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14
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Patel P, Vyas R, Mehta M. Efficacy and Toxicity of Gefitinib in Palliative Treatment in Recurrent Squamous Cell Carcinoma of Head and Neck in Poor Performance Elderly Patients. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu340.16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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15
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Vyas R, Zacharah A, Swamidasan I, Doris P, Harris I. Blended distance education program for junior doctors working in rural hospitals in India. Rural Remote Health 2014; 14:2420. [PMID: 24617728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
CONTEXT Distance learning, supported with supervised clinical work, has been successful in helping doctors located in remote rural areas to practice effectively. Graduates of Christian Medical College (CMC), Vellore, India, have a 2-year service obligation to work in small hospitals mainly located in rural areas. The Fellowship in Secondary Hospital Medicine (FSHM) program is a year-long blended on-site and distance learning program, designed by CMC to support and provide education opportunities for its recent graduates working in small hospitals in rural areas. The FSHM program was designed to help junior doctors develop the knowledge and skills to practice effectively in rural hospitals. ISSUES The FSHM program consists of 15 paper-based distance learning modules focused on helping to develop knowledge to practice in rural hospitals; three contact sessions at CMC, which focused on developing the necessary skills; project work focused on improving local health services; and networking between peers and with faculty. Two years after implementation of the FSHM program in 2007, the vast majority of students (81%) and faculty (80%) rated the distance learning modules as very good or excellent in helping students develop the knowledge to practice in secondary hospitals. Also, most of the students (88%) and faculty (87%) rated the contact sessions as good or very good in helping students to apply what they had learned in secondary hospitals. Focus group discussions revealed that all of the program participants recognized that the distance learning modules and contact sessions helped them in providing patient care in rural hospitals. LESSONS LEARNED Well-designed distance learning modules, supported with contact sessions by medical school faculty members, help junior doctors to practice effectively in rural hospitals and reduce their isolation.
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Affiliation(s)
- R Vyas
- Medical Education Unit, Christian Medical College, Vellore, India.
| | - A Zacharah
- Medical Education Unit, Christian Medical College, Vellore, India.
| | - I Swamidasan
- Medical Education Unit, Christian Medical College, Vellore, India.
| | - P Doris
- Medical Education Unit, Christian Medical College, Vellore, India.
| | - I Harris
- Department of Medical Education, University of Illinois, Chicago, USA.
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Kumar B, Khanna M, Kumar P, Sood V, Vyas R, Banerjea AC. Nucleic acid-mediated cleavage of M1 gene of influenza A virus is significantly augmented by antisense molecules targeted to hybridize close to the cleavage site. Mol Biotechnol 2012; 51:27-36. [PMID: 21744034 DOI: 10.1007/s12033-011-9437-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Influenza A virus genome segment 7 encodes protein M1, which is the matrix protein playing crucial role in the virus life cycle. Any antiviral strategy that aims at reducing, in particular, the expression of this genome segment should, in principle, reduce the infectivity of the virus. We developed a specific antiviral approach at the molecular level and designed several novel 10-23 DNAzymes (Dz) and hammerhead ribozymes (Rz), specifically targeted to cleave at the conserved domains of the influenza virus M1 RNA. We sought to use antisense molecules with the hope that it will facilitate the ribozyme-mediated cleavage. We observed that the Mg(2+)-dependent sequence-specific cleavage of M1 RNA was achieved by both the Dz and Rz in a dose-dependent manner. This combination of catalytic Dz and Rz with antisense molecules, in principle, resulted in more effective gene suppression, inhibited the whole virus replication in host cell, and thus could be exploited for therapeutic purposes.
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Affiliation(s)
- B Kumar
- Department of Respiratory Virology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi 110007, India
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17
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Vyas R, Zachariah A, Swamidasan I, Doris P, Harris I. A networking approach to reduce academic and social isolation for junior doctors working in rural hospitals in India. Educ Health (Abingdon) 2012; 25:70-74. [PMID: 23787388 DOI: 10.4103/1357-6283.99212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Graduates from Christian Medical College (CMC) Vellore face many challenges while doing their service obligation in smaller hospitals, including academic and social isolation. To overcome these challenges, CMC aspired through its Fellowship in Secondary Hospital Medicine (FSHM), a 1-year blended on-site and distance-learning program, to provide academic and social support through networking for junior doctors working in rural areas. The purpose of this paper is to report the evaluation of the networking components of the FSHM program, with a focus on whether it succeeded in providing academic and social support for these junior doctors. METHODS A mixed method evaluation was done using written surveys for students and faculty and telephone interviews for students. Evidence for validity was gathered for the written survey. Criteria for validity were also applied for the qualitative data analysis. RESULTS The major strengths of networking with faculty and peers identified were that it provided social support,, academic support through discussion about patient management problems and a variety of cases seen in the hospital, guidance on projects and reminders about deadlines. Recommendations for improvement included use of videoconferencing and Yahoo Groups. CONCLUSION It is useful to incorporate networking into distance-learning educational programs for providing support to junior doctors working in rural hospitals.
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Affiliation(s)
- R Vyas
- Department of Physiology, Christian Medical College, Vellore, India.
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18
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Nandwani P, Vyas R, Mehta M, Pelagade S. Dose Delivery Verification And Accuracy Assessment Of Stereotaxy In Patients Treated With X Knife: Indian Experience. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1548] [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: 10/16/2022]
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19
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Mehta M, Nandwani Patel P, Neema J, Vyas R. Efficacy and Response Analysis of TPF (docetaxel, Cisplatin, 5-fu) Followed by Concurrent Chemoradiation versus Concurrent Chemoradiation Only in Patients with Locally Advanced Squamous Cell Carcinomas of Head and Neck. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.848] [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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20
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Charkravarti A, Wang M, Robins I, Guha A, Curren W, Brachman D, Schultz C, Choucair A, Dolled-Filhart M, Christiansen J, Gustavson M, Molinaro A, Mischel P, Lautenschlaeger T, Dicker A, Mehta M, Phillips CA, Dhulibala S, Hallahan D, Jaboin J, Cardinale FS, Dickey P, Goodrich I, Gorelick J, Sinha R, Dest VM, Chen C, Olsen C, Franklin W, Kleinschmidt-DeMasters B, Kavanagh BD, Lillehei K, Waziri A, Damek D, Gaspar LE, Stauder MC, Laack NN, Link MJ, Pollock BE, Schomberg PJ, Fraser JF, Pannullo SC, Moliterno J, Cobb W, Stieg PE, Vinchon-Petit S, Jarnet D, Michalak S, Lewis A, Benoit JP, Menei P, Desmarais G, Paquette B, Bujold R, Mathieu D, Fortin D, Cuneo KC, Vredenburgh JJ, Sampson JH, Reardon DA, Desjardins A, Peters KL, Kirkpatrick JP, Patel PN, Vyas R, Suryanarayan U, Bhavsar D, Mehta M, Hayhurst C, Monsalves E, Van Prooijen M, Menard C, Zadeh G, Chung C, Burrell K, Lindsey P, Menard C, Zadeh G, Burri SH, Asher AL, Kelly RB, Boltes P, Fraser RW, Dilmanian FA, Rusek A, Desnoyers NR, Park JY, Dane B, Dioszegi I, Hurley SD, O'Banion MK, Tomasi D, Wang R, Meek AG, Sleire L, Wang J, Heggdal J, Pedersen PH, Enger PO, Clump DA, Srinivas R, Wegner RE, Heron DE, Burton SA, Mintz AH, Howard SP, Robins HI, Tome WA, Paravati AJ, Heron DE, Gardner PA, Snyderman C, Ozhasoglu C, Quinn A, Burton SA, Seelman K, Seelman K, Mintz AH, Chang JH, Park YG, Mehta MJ, Patel PN, Vyas RK, Bhavsar DC, Guarnaschelli JN, Imwalle L, Ying J, McPherson C, Warnick R, Breneman J, Khwaja SS, Laack NN, Wetjen NM, Brown PD, Siedow M, Nestler U, Perry J, Huebner A, Chakravarti A, Lautenschlaeger T, Glass J, Andrews D, Werner-Wasik M, Evans J, Lawrence R, Martinez N, Anuradha G, David M, Sara M, Mark L, Ricardo B, Jeff J, Juan H, Kozono D, Zinn P, Ng K, Chen C, Melian E, Prabhu V, Sethi A, Barton K, Anderson D, Rockne RC, Mrugala M, Rockhill J, Swanson KR. Radiation Therapy. Neuro Oncol 2010. [DOI: 10.1093/neuonc/noq116.s15] [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: 11/13/2022] Open
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21
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Vyas R, Jacob M, Faith M, Isaac B, Rabi S, Sathishkumar S, Selvakumar D, Ganesh A. An effective integrated learning programme in the first year of the medical course. Natl Med J India 2008; 21:21-26. [PMID: 18472699] [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: 05/26/2023]
Abstract
BACKGROUND An integrated approach to teaching medical subjects is an effective educational strategy. Yet, this has not become popular in medical colleges in India. We describe an integrated learning programme to teach the gastrointestinal system in the first year of the medical course. METHODS The integrated learning programme was conducted for 3 years (2003-2005). It incorporated elements of problem-based learning, early clinical exposure, lectures and small group laboratory work. Student assessment was formative (for problem-based learning sessions) and summative (using problem-based learning and knowledge tests). Evaluation of the programme was based on feedback from the students and faculty members. RESULTS Ninety-six per cent of the students obtained more than 60% marks in the problem-based learning test. The mean (SD) score in the knowledge test was 62 (0.89)%. The majority of students received satisfactory and more than satisfactory grades for their performance in the problem-based learning sessions. The feedback from faculty members and students was positive, which highlighted benefits such as integrated learning of the basic sciences, their application to clinical cases and active student learning. The challenges encountered included the higher input required from faculty members. Most of the faculty members and students recommended that the integrated programme should be continued and extended to other parts of the curriculum. CONCLUSION An integrated learning programme is feasible within a conventional medical curriculum of an Indian medical college.
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Affiliation(s)
- R Vyas
- Department of Physiology, Christian Medical College, Vellore 632002, Tamil Nadu, India.
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Gower DJ, Dharne M, Bhatta G, Giri V, Vyas R, Govindappa V, Oommen OV, George J, Shouche Y, Wilkinson M. Remarkable genetic homogeneity in unstriped, long-tailedIchthyophisalong 1500 km of the Western Ghats, India. J Zool (1987) 2007. [DOI: 10.1111/j.1469-7998.2006.00266.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [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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Samimi D, Vyas R, Soohoo N. 488 TESTING THE VALIDITY OF SURGICAL OUTCOME MEASURES FOR THE FOOT AND ANKLE. J Investig Med 2005. [DOI: 10.2310/6650.2005.00005.487] [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: 11/18/2022]
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Kaushal SK, Chugh R, Dagar KS, Vyas R, Radhakrishnan S, Shrivastva S, Iyer KS. Types of AR with VSD: Which one is malignant? Indian J Thorac Cardiovasc Surg 2004. [DOI: 10.1007/s12055-004-0383-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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25
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Kaushal SK, Collison S, Dagar KS, Vyas R, Radhakrishnan S, Shrivastva S, Iyer KS. Concurrent repair of supramitral ring and associated defects. Indian J Thorac Cardiovasc Surg 2004. [DOI: 10.1007/s12055-004-0380-5] [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: 10/22/2022] Open
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26
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Vyas R, Tudor G, Rickett A, Kotecha S. Serial bronchoalveolar lavage of preterm infants is not associated with chest radiological changes. Eur J Pediatr 2002; 161:313-8. [PMID: 12029449 DOI: 10.1007/s00431-002-0949-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2001] [Accepted: 02/13/2002] [Indexed: 11/26/2022]
Abstract
UNLABELLED Concern has been raised that serial non-bronchoscopic bronchoalveolar lavage (NB-BAL) may constantly remove surfactant which may result in localised radiological changes. Radiological scores for the lavaged right lower lobe (RLL) were compared with (1) the scores for the unlavaged contra-lateral left lower lobe (LLL) in the NB-BAL group and (2) with the scores of the RLL of control infants not undergoing any formal lavage procedure. NB-BAL was performed daily for 2 weeks and twice weekly thereafter until 28 days of age or until extubation. Two paediatric radiologists obtained chest radiological scores at 1 (pre-lavage radiograph), 7 and 28 days of age. A total of 28 infants in the NB-BAL group (mean birth weight 1350 g and gestation 28.6 weeks) and 26 control infants (1450 g, 29.9 weeks) were studied. Radiological scores for the lavaged RLL and the unlavaged LLL in the NB-BAL group were similar at all time points studied. Although the RLL score in the NB-BAL group was higher on day 1 prior to NB-BAL when compared to control infants (3.2 versus 2.5, P<0.05), the subsequent scores at day 7 (2.6 versus 2.9) and 28 (2.7 versus 2.8) were similar in both groups. No differences were found between the two groups for any clinical parameter including ventilation, oxygen dependency, retinopathy of prematurity or intracranial haemorrhage. CONCLUSION repeated non-bronchoscopic bronchoalveolar lavage in newborn infants does not appear to be associated with radiological changes suggesting that surfactant is not constantly removed.
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Affiliation(s)
- R Vyas
- Department of Child Health, University of Leicester, Leicester LE2 7LX, United Kingdom
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Deng H, Erenso D, Vyas R, Singh S. Entanglement, interference, and measurement in a degenerate parametric oscillator. Phys Rev Lett 2001; 86:2770-2773. [PMID: 11290035 DOI: 10.1103/physrevlett.86.2770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2000] [Indexed: 05/23/2023]
Abstract
Quantum dynamical equations of motion for homodyne detection of the degenerate optical parametric oscillator are solved exactly. Nonclassical photon statistics are shown to be a consequence of interference of probability amplitudes, entanglement of photon pairs from such an oscillator, and the role of measurement in quantum evolution.
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Affiliation(s)
- H Deng
- Department of Physics, University of Arkansas, Fayetteville, AR 72701, USA
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28
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Chanda BM, Vyas R, Bedekar AV. Investigations in the transition metal catalyzed aziridination of olefins, amination, and other insertion reactions with Bromamine-T as the source of nitrene. J Org Chem 2001; 66:30-4. [PMID: 11429913 DOI: 10.1021/jo000013v] [Citation(s) in RCA: 127] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Investigations into the transition metal catalyzed aziridination of olefins with Bromamine-T as a new source of nitrene is presented in this account. Comparison of Chloramine-T and Bromamine-T in this reaction indicates that the latter is superior as the source of nitrene. Systematic study with several transition metal based catalysts suggests that Cu-halides are the best catalysts. A first report of aziridination under microwave and ultrasound irradiation conditions is also presented. Copper-catalyzed aziridination of methyl cinnamate with Bromamine-T did not proceed at ambient temperature but was effected smoothly under ultrasound irradiation to furnish trans-aziridine selectively, while under microwave irradiation, a mixture of cis and trans isomers, was obtained. It has been demonstrated that aziridination of olefins proceeds smoothly with inexpensive bleaching powder. Preliminary results of Rh-catalyzed benzylic insertion reactions with Bromamine-T are included in this account.
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Affiliation(s)
- B M Chanda
- Division of Organic Chemistry: Technology, National Chemical Laboratory, Pune-411 008, India.
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Kaushal SK, Dagar KS, Vyas R, Singh A, Iyer PU, Radhakrishnan S, Shrivastava S, Iyer KS. Surgical options for Ebstein’s anomaly for optimal functional outcome. Indian J Thorac Cardiovasc Surg 2000. [DOI: 10.1007/s12055-000-0005-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Wan M, Sun T, Vyas R, Zheng J, Granada E, Dubeau L. Suppression of tumorigenicity in human ovarian cancer cell lines is controlled by a 2 cM fragment in chromosomal region 6q24-q25. Oncogene 1999; 18:1545-51. [PMID: 10102624 DOI: 10.1038/sj.onc.1202476] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Multiple distinct regions of chromosome 6 are frequently affected by losses of heterozygosity in primary human ovarian carcinomas. We introduced a normal human chromosome 6 into HEY and SKOV-3 ovarian carcinoma cell lines using microcell-mediated chromosome transfer techniques to further investigate the role of this chromosome in ovarian tumorigenesis. The exogenous chromosome was stably propagated in the recipient cells based on fluorescence in situ hybridization (FISH) analyses with a chromosome 6 painting probe. The tumorigenicity of HEY and SKOV-3 cells was completely suppressed after transfer of chromosome 6, but not after transfer of a chromosome 11q13-qter fragment used as control. Using 46 polymorphic microsatellite markers, the region bounded by D6S1649 and D6S1564 was found to be commonly deleted in HEY: chromosome 6 tumorigenic revertant clones. The boundaries of the commonly deleted region could be further narrowed down to a 2 cM (based on the Whitehead genetic map) or 0.36 megabase (based on gdb mapping data) region between D6S1637 and D6S1564 after transferring the exogenous chromosome from revertants into mouse L cells and performing allelic deletion mapping studies against this mouse background. We conclude that this region contains a tumor suppressor gene important for the control of ovarian tumor development.
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Affiliation(s)
- M Wan
- Department of Pathology, USC/Norris Comprehensive Cancer Center, USC School of Medicine, Los Angeles, California 90033, USA
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31
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32
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Abstract
Photothermal lensing signal shapes are experimentally investigated and compared with those predicted theoretically in our earlier paper. The investigation included flowing and stationary media and pulsed and cw excitations. Good qualitative agreement between theory and experiment is found. Since the lensing signal is almost always accompanied by a deflection signal, the influence of the deflection signal on the detection of lensing signal is investigated. For a perfectly aligned detection geometry the influence of the deflection signal on the lensing signal is negligible, but in the presence of misalignments a significant amount of deflection signal could be superimposed on the lensing signal. The effect of lensing on the deflection signal is also been considered. The effect of the finite size of the probe beam on the lensing signals is also investigated.
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Affiliation(s)
- Q He
- Department of Physics, University of Arkansas, Fayetteville, Arkansas 72701-1201, USA
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33
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Lakhotia M, Shah PK, Vyas R, Jain SS, Yadav A, Parihar MK. Clinical dysautonomia in diabetes mellitus--a study with seven autonomic reflex function tests. J Assoc Physicians India 1997; 45:271-4. [PMID: 12521082] [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: 02/28/2023]
Abstract
Thirty-eight patients of NIDDM, 12 of IDDM and 10 healthy age matched controls were subjected to seven standardised autonomic reflex function tests. A scoring criteria was utilised for diagnosing and grading the severity of dysautonomia. Eight patients of IDDM and 24 of NIDDM had dysautonomia. One-third of the patients in each group had grade IV autonomic dysfunction. Severity of autonomic dysfunction was directly related to the duration of disease in NIDDM whereas in IDDM this relation was not seen. Peripheral neuropathy was almost always associated with dysautonomia in NIDDM. On the contrary, in IDDM dysautonomia was independent of peripheral neuropathy. Charcot's arthopathy, dysphagia, constipation and nocturnal diarrhea were always associated with evidence of dysautonomia. Other symptoms viz. gustatory sweating, postural dizziness and impotence did not necessarily indicate dysautonomia.
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Affiliation(s)
- M Lakhotia
- Department of Medicine, Dr. SN Medical College and Attached Hospital, Jodhpur
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34
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Abstract
The theory of photothermal spectroscopy in an optically dense fluid is presented. The general case is considered in which the fluid may be flowing or stationary, and the excitation could be cw (modulated or unmodulated) or pulsed (arbitrary pulse length). All three detection schemes, deflection, phase shift, and lensing, are considered. This is the most complete theory of photothermal spectroscopy in fluids to date.
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35
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Abstract
We present the case of a patient whose acute myelopathy almost completely resolved with empirical therapy for toxoplasmosis, and we review thirteen previously reported cases of myelopathy thought to have been caused by Toxoplasma gondii in patients with AIDS. The most common symptoms and abnormal physical findings were motor loss (usually paraparesis), bilateral sensory loss, urinary bladder dysfunction, and local pain. The majority of patients had magnetic resonance images that showed abnormalities of the spinal cord and brain in association with positive serology for Toxoplasma. Therapy for toxoplasmosis, when administered soon after the onset of symptoms, has resulted in clinical and radiographic improvement in the conditions of patients with toxoplasmosis.
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Affiliation(s)
- R Vyas
- Department of Internal Medicine, Wayne State University, Detroit Medical Center, Michigan, USA
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36
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Wang C, Vyas R. Fokker-Planck equation in the good-cavity limit and single-atom optical bistability. Phys Rev A 1996; 54:4453-4460. [PMID: 9913996 DOI: 10.1103/physreva.54.4453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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37
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38
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Vyas R, Dixit S, Singhal S, Neema JP, Suryanarayan U, Baboo HA. Plasmacytoma of scalp. J Postgrad Med 1996; 42:27. [PMID: 9715293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
An interesting case of plasmacytoma of the scalp is described. Extramedullary plasmocytoma of scalp is rarely reported. This patient was treated with external radiotherapy dose of which was 40 Gy/20 fraction. Disease responded very well to radiotherapy.
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Affiliation(s)
- R Vyas
- Department of Radiotherapy, Gujrat Cancer & Research Institute, Ahmedabad, Gujrat
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39
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Chaba AN, Baseia B, Vyas R. Statistical properties of a charged oscillator in the presence of a time-dependent electromagnetic field. Phys Rev A 1995; 52:1518-1524. [PMID: 9912391 DOI: 10.1103/physreva.52.1518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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40
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Vyas R, Singh S. Exact quantum distribution for parametric oscillators. Phys Rev Lett 1995; 74:2208-2211. [PMID: 10057870 DOI: 10.1103/physrevlett.74.2208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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41
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Wang C, Vyas R. Fokker-Planck equation for a single two-level atom: Applications in the bad-cavity limit. Phys Rev A 1995; 51:2516-2529. [PMID: 9911868 DOI: 10.1103/physreva.51.2516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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42
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Lyublinskaya IE, Vyas R. Single-atom fluorescence with nonclassical light. Phys Rev A 1993; 48:3966-3979. [PMID: 9910072 DOI: 10.1103/physreva.48.3966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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43
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Dixit S, Singhal S, Vyas R, Murthy A, Baboo HA. Adenoid cystic carcinoma of the cervix. J Postgrad Med 1993; 39:211-5. [PMID: 7996499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Adenoid cystic carcinoma constitute around 0.4 to 1.7% of all carcinomas of cervix. It generally presents in elderly age group, however few cases in younger age have also been reported. Majority of cases present in early stage. Though concluding statement regarding the results cannot be made from the cases accumulated from the various reported series, nonetheless this review shows that radiotherapy too is effective in early stage and even in stage I results with radiotherapy appear better than surgery. In advanced stage outcome is invariably poor. In early stage main pattern of failure is distant metastasis. Both local and distant failure are observed in stage III and IV. Though lung is the commonest site of metastases (51%), abdominal cavity and brain are also found to be involved in some cases. Limited experience shows effectiveness of high doses of cisplatin and multiagent chemotherapy. Cases of early stage disease having risk for metastases and local failure should be identified and managed with multimodality treatment using surgery for bulky disease with post-operative radiotherapy and chemotherapy. In advanced stages combination of chemotherapy and radiotherapy is required. Exenterative surgery for central failure has been used effectively. Overall no evidence of disease rate is found to be about 48%, with mean follow-up of 39 months.
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Affiliation(s)
- S Dixit
- Dept. of Radiotherapy, Gujarat Cancer and Research Center, Asarwa, Ahmedabad
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44
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45
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Abstract
A Green's function solution to the tissue bioheat equation including blood flow in cylindrical geometry is obtained. Numerical results for temperature variation in the bovine muscle are reported when the tissue is exposed to neodymium-yttrium-aluminum garnett (Nd:YAG) lasers with Gaussian profile and a comparison with recent measurements is made. A strong dependence of the tissue temperature on the beam radius and pulse time is found.
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Affiliation(s)
- R Vyas
- Department of Physics, University of Arkansas, Fayetteville 72701
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46
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Vyas R. Photon-counting statistics of the subthreshold nondegenerate parametric oscillator. Phys Rev A 1992; 46:395-400. [PMID: 9907876 DOI: 10.1103/physreva.46.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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47
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Vyas R, Singh S. Resonance fluorescence with squeezed-light excitation. Phys Rev A 1992; 45:8095-8109. [PMID: 9906904 DOI: 10.1103/physreva.45.8095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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48
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Wiernik PH, Dutcher JP, Paietta E, Hittelman WN, Vyas R, Strack M, Castaigne S, Degos L, Gallagher RE. Treatment of promyelocytic blast crisis of chronic myelogenous leukemia with all trans-retinoic acid. Leukemia 1991; 5:504-9. [PMID: 2056773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Two recent reports have described major clinical benefits from all-trans-retinoic acid (tRA) therapy of patients with promyelocytic leukemia (APL). This paper describes the first patient with a blast crisis of chronic myelogenous leukemia (CML-BC) who responded to oral tRA therapy. In vitro marrow studies, including clonogenic assays, immunopheno-typing, cytogenetics and premature chromosome condensation together with chromosome painting provided evidence for the in vivo differentiation and maturation of the malignant cells. The patient achieved a partial remission with reversal of all clinical features of disease, including normalization of peripheral blood counts, complete resolution of fever, fatigue and splenomegaly, and marked maturation of the bone marrow. This response to tRA in CML-BC is unique, and broadens the spectrum of diseases which may respond to retinoids.
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MESH Headings
- Antineoplastic Agents/therapeutic use
- Blast Crisis/drug therapy
- Blast Crisis/pathology
- Bone Marrow/drug effects
- Bone Marrow/pathology
- Cell Differentiation/drug effects
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Leukemia, Promyelocytic, Acute/drug therapy
- Leukemia, Promyelocytic, Acute/pathology
- Male
- Middle Aged
- Remission Induction
- Tretinoin/therapeutic use
- Tumor Cells, Cultured/drug effects
- Tumor Cells, Cultured/pathology
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Affiliation(s)
- P H Wiernik
- Department of Oncology, Albert Einstein Cancer Center, Montefiore Medical Center, New York, NY 10467
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49
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Warrell RP, Frankel SR, Miller WH, Scheinberg DA, Itri LM, Hittelman WN, Vyas R, Andreeff M, Tafuri A, Jakubowski A. Differentiation therapy of acute promyelocytic leukemia with tretinoin (all-trans-retinoic acid). N Engl J Med 1991; 324:1385-93. [PMID: 1850498 DOI: 10.1056/nejm199105163242002] [Citation(s) in RCA: 877] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND METHODS Patients with acute promyelocytic leukemia have a characteristic (15;17) translocation, with a breakpoint on chromosome 17 in the region of the retinoic acid receptor-alpha (RAR-alpha). Since this receptor has been shown to be involved with growth and differentiation of myeloid cells in vitro, and since recent clinical studies have reported that tretinoin (all-trans-retinoic acid) induces complete remission in patients with acute promyelocytic leukemia we studied the effects of tretinoin on cellular maturation and molecular abnormalities in patients undergoing the induction of remission with this agent. RESULTS Eleven patients with acute promyelocytic leukemia were treated with tretinoin administered orally at a dose of 45 mg per square meter of body-surface area per day. Nine of the 11 patients entered complete remission. In two patients, complete remission was preceded by striking leukocytosis that then resolved despite continued drug treatment. Serial studies of cellular morphologic features, cell-surface immunophenotypic analysis, and fluorescence in situ hybridization with a chromosome 17 probe revealed that clinical response was associated with maturation of the leukemic clone. All patients who responded to treatment who were tested by Northern blot analysis had expression of aberrant RAR-alpha. As patients entered complete remission, the expression of the abnormal RAR-alpha message decreased markedly; however, it was still detectable in several patients after complete morphologic and cytogenetic remission had been achieved. CONCLUSIONS Tretinoin is a safe and highly effective agent for inducing complete remission in patients with acute promyelocytic leukemia. Clinical response to this agent is associated with leukemic-cell differentiation and is linked to the expression of an aberrant RAR-alpha nuclear receptor. Molecular detection of the aberrant receptor may serve as a useful marker for residual leukemia in patients with this disease.
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Affiliation(s)
- R P Warrell
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021
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50
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Zwelling LA, Mayes J, Deisseroth K, Hinds M, Grant G, Pathak S, Ledley FD, Vyas R, Hittelman W. A restriction fragment length polymorphism for human topoisomerase II: possible relationship to drug-resistance. Cancer Commun (Lond) 1990; 2:357-61. [PMID: 1978687 DOI: 10.3727/095535490820874047] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
In previous studies we used Southern blotting to examine the topoisomerase II locus (on chromosome 17) in human leukemia cell lines and noted a difference in the XmnI restriction endonuclease digestion pattern between an m-AMSA-resistant line and its m-AMSA-sensitive parent line (Zwelling, L. A.; Hinds, M,; Chan, D.; Mayes, J.; Sie, K. L.; Parker, E.; Silberman, L.; Radcliffe, A.; Beran, M.; Blick, M. Characterization of an amsacrine-resistant line of human leukemia cells. Evidence for a drug-resistant form of topoisomerase II. Journal of Biological Chemistry 264:16411-16420; 1989). We now demonstrate that the variable XmnI digestion pattern represents a normal restriction fragment length polymorphism (RFLP) which is observed in subjects without malignant disease and exhibits an autosomal pattern of inheritance. These data suggest that the previously described deviation in the genomic structure of topoisomerase II in the m-AMSA-resistant cell line did not reflect a new mutation, but rather a reduction to homozygosity at the topoisomerase II locus. This reduction to homozygosity is not due to chromosomal loss, as chromosome 17-specific gene probes clearly identify two chromosome 17's in the sensitive line and four in the resistant line, using chromosome painting with a chromosome 17-specific library. Some other genetic change must be the cause of the resistance of HL-60/AMSA and its topoisomerase II to the inhibiting actions of m-AMSA.
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Affiliation(s)
- L A Zwelling
- Department of Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston 77030
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