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Cullen S, Flaherty D, Fitzpatrick N, Ali A, Elkhidir I, Pillai A. Outcomes following surgical fixation of Gustilo-Anderson IIIb open tibial fractures. Acta Orthop Belg 2024; 90:83-89. [PMID: 38669655 DOI: 10.52628/90.1.12387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
There is no consensus as to the optimal skeletal fixation method for Gustilo-Anderson IIIb fractures. External fixation methods have previously shown higher rates of superficial infection, whilst internal fixation has shown higher risk of deep infection, but lower risk of other complications. This paper investigates outcomes in open tibial fractures based on fixation method. A retrospective review was performed for patients presenting to an ortho-plastic unit with GA IIIb tibial fractures between June 2013 and October 2021. 85 patients were identified. The most common implant was an intramedullary nail (IMN), used in 29 patients (34.1%); open reduction and internal fixation (ORIF) was performed in 16 patients (18.8%). 18 patients (21.2%) were definitively managed with a frame alone. Mean follow-up from was 18 months (2-77). Patients with ORIF needed a mean of 3.37 operations; it was 2.48 for IMN which was significantly different from frames at 5.00 (p=0.000). The mean time to bony union after definitive fixation was 11.4 months. This differed depending on the implant used for fixation, with ORIF at 7.1 months, 10.1 for IMN, and frames at 17.2 months; ORIF significantly differed from frames (p=0.009). Superficial infection was common, seen in 38.8% of patients, and only 3 patients (4%) developed deep infections involving metalwork, with no difference in rates of either based on fixation method This study supports that ORIF has faster healing times, with less time to union compared to frames. It also shows that no implant was superior to another in terms of outcomes.
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Rao AR, Noronha V, Ramaswamy A, Kumar A, Pillai A, Gattani S, Sehgal A, Kumar S, Castelino R, Dhekale R, Krishnamurthy J, Mahajan S, Daptardar A, Sonkusare L, Deodhar J, Ansari N, Vagal M, Mahajan P, Timmanpyati S, Nookala M, Chitre A, Kapoor A, Gota V, Banavali S, Badwe RA, Prabhash K. Correlation of the Geriatric Assessment with Overall Survival in Older Patients with Cancer. Clin Oncol (R Coll Radiol) 2024; 36:e61-e71. [PMID: 37953073 DOI: 10.1016/j.clon.2023.11.003] [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: 07/18/2023] [Revised: 10/09/2023] [Accepted: 11/02/2023] [Indexed: 11/14/2023]
Abstract
AIMS Global guidelines recommend that all older patients with cancer receiving chemotherapy should undergo a geriatric assessment. However, utilisation of the geriatric assessment is often constrained by its time-intensive nature, which limits its adoption in settings with limited resources and high demand. There is a lack of evidence correlating the results of the geriatric assessment with survival from the Indian subcontinent. Therefore, the aims of the present study were to assess the impact of the geriatric assessment on survival in older Indian patients with cancer and to identify the factors associated with survival in these older patients. MATERIALS AND METHODS This was an observational study, conducted in the geriatric oncology clinic of the Tata Memorial Hospital (Mumbai, India). Patients aged 60 years and older with cancer who underwent a geriatric assessment were enrolled. We assessed the non-oncological geriatric domains of function and falls, nutrition, comorbidities, cognition, psychology, social support and medications. Patients exhibiting impairment in two or more domains were classified as frail. RESULTS Between June 2018 and January 2022, we enrolled 897 patients. The median age was 69 (interquartile range 65-73) years. The common malignancies were lung (40.5%), oesophagus (31.9%) and genitourinary (12.1%); 54.6% had metastatic disease. Based on the results of the geriatric assessment, 767 (85.4%) patients were frail. The estimated median overall survival in fit patients was 24.3 (95% confidence interval 18.2-not reached) months, compared with 11.2 (10.1-12.8) months in frail patients (hazard ratio 0.54; 95% confidence interval 0.41-0.72, P < 0.001). This difference in overall survival remained significant after adjusting for age, sex, primary tumour and metastatic status (hazard ratio 0.56; 95% confidence interval 0.41-0.74, P < 0.001). In the patients with a performance status of 0 or 1 (n = 454), 365 (80.4%) were frail; the median overall survival in the performance status 0-1 group was 33.0 months (95% confidence interval 24.31-not reached) in the fit group versus 14.4 months (95% confidence interval 12.25-18.73) in the frail patients (hazard ratio 0.50; 95% confidence interval 0.34-0.74, P = 0.001). In the multivariate analysis, the geriatric assessment domains that were predictive of survival were function (hazard ratio 0.68; 95% confidence interval 0.52-0.88; P = 0.003), nutrition (hazard ratio 0.64; 95% confidence interval 0.48-0.85, P = 0.002) and cognition (hazard ratio 0.67; 95% confidence interval 0.49-0.91, P = 0.011). DISCUSSION The geriatric assessment is a powerful prognostic tool for survival among older Indian patients with cancer. The geriatric assessment is prognostic even in the cohort of patients thought to be the fittest, i.e. performance status 0 and 1. Our study re-emphasises the critical importance of the geriatric assessment in all older patients planned for cancer-directed therapy.
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Affiliation(s)
- A R Rao
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - V Noronha
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - A Ramaswamy
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - A Kumar
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - A Pillai
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - S Gattani
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - A Sehgal
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Mumbai, India
| | - S Kumar
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Mumbai, India
| | - R Castelino
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Mumbai, India
| | - R Dhekale
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - J Krishnamurthy
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - S Mahajan
- Department of Physiotherapy, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - A Daptardar
- Department of Physiotherapy, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - L Sonkusare
- Department of Psycho-oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - J Deodhar
- Department of Psycho-oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - N Ansari
- Department of Occupational Therapy, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - M Vagal
- Department of Occupational Therapy, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - P Mahajan
- Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - S Timmanpyati
- Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - M Nookala
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Mumbai, India
| | - A Chitre
- Department of Physiotherapy, Mahamana Pandit Madan Mohan Malviya Cancer Center & Homi Bhabha Cancer Hospital, Varanasi, India
| | - A Kapoor
- Department of Medical Oncology, Mahamana Pandit Madan Mohan Malviya Cancer Center & Homi Bhabha Cancer Hospital, Varanasi, India
| | - V Gota
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Mumbai, India
| | - S Banavali
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - R A Badwe
- Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - K Prabhash
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India.
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Yu Q, Kwak D, Ungchusri E, Van Ha T, Kumari D, Patel M, Marshall E, Pillai A, Liao A, Zhang M, Hwang G, Ahmed O. Abstract No. 265 Segmental Radioembolization using Yttrium-90 Glass Microspheres Greater than 400 Gray: A Real-World Experience. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Kalva P, Akram M, Kakkilaya A, Pillai A. Abstract No. 236 Political Campaign Contributions by Endovascular Medical Societies. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
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Guirguis M, Alnablsi M, Xi Y, Quadri R, Bayona Molano M, Benjamin J, Pillai A, Rice S. Abstract No. 226 Evaluating Intra-Procedural Cytological Touch Preparation in Percutaneous Lung Biopsy. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Yu Q, Pillai A, Liao A, Baker T, Fung J, DiSabato D, Van Ha T, Ungchusri E, Hwang G, Ahmed O. Abstract No. 125 Selective Internal Radiation Therapy using Yttrium-90 Microspheres for Treatment of Localized and Locally Advanced Intrahepatic Cholangiocarcinoma. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Dabholkar H, Pillai A, Gaonkar D, Deuri SP, Naik S, Chatterjee S. Exploring the feasibility and public health impact of integrating a community-based recovery-oriented intervention for people living with schizophrenia in partnership with a tertiary care mental hospital in India. Implement Res Pract 2023; 4:26334895231175528. [PMID: 37790166 PMCID: PMC10209590 DOI: 10.1177/26334895231175528] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
Background There is a priority need to make community-based care widely available for people living with schizophrenia (PLwS) in low- and middle-income countries. An innovative approach for increasing access could be to integrate clinical services available in tertiary care hospitals with community-based care through a task-sharing approach. We describe such an integrated intervention that was implemented at Tezpur in northeast India in collaboration with the Lokopriya Gopinath Bordoloi Regional Institute of Mental Health (LGBRIMH). Method The objectives of the study were to illustrate the feasibility of integrating and implementing the intervention and to describe its individual, systemic, and public health impacts. Due to the limited resources available, we conducted a pragmatic single-arm longitudinal evaluation of the intervention cohort over 24 months. Results Of the 239 PLwS enrolled in the intervention, 198 (83%) were followed up for 24 months, with nearly three-quarters reporting a >70% reduction in disabilities, most notably between 6 and 18 months. There was a marked reduction in unmet needs across multiple domains, and at 24 months, 62% of the cohort was engaged in individual jobs or other market-linked livelihood opportunities. There was greater uptake and retention with outpatient contacts at the LGBRIMH, and PLwS experienced a marked (82%) reduction in inpatient admissions rates, as compared to before enrolment. Over a period of 24 months, primary caregivers reported that their families experienced significantly fewer social difficulties such as unemployment, interpersonal conflicts, and social isolation. The intervention had a significant public health impact, with an estimated 51.8% effective treatment coverage rate for the integrated intervention. Conclusion Our findings provide preliminary evidence of the feasibility of implementing the integrated intervention and its effectiveness. We believe that there is merit in further in-depth refinement and exploration of this implementation-related research and cost analysis while replicating the intervention in other tertiary care institutions.
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Affiliation(s)
| | | | | | - Sonia Pereira Deuri
- Department of Psychiatric Social Work, Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur, Assam, India
| | - Smita Naik
- Parivartan Trust, Satara, Maharashtra, India
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Bhardwaj A, Pillai A, Satheesh S, Anantharaj A. Routine use of 3-dimensional zoom modality with 2-dimensional transesophageal echocardiography to decide the candidacy for transcatheter device closure of atrial septal defect. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.161] [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
2-dimensional transesophageal echocardiography (2D-TEE) and balloon sizing are commonly used for assessment of Ostium secundum atrial septal defect (OS-ASD) prior to device closure but complications do occur. Therefore, assessment of accurate morphology and anatomy of the defect in three-dimensional plane is essential for transcatheter device closure to be successful, which the 2D TEE fails to reveal.
Purpose
2D TEE has long been used to decide size of the device required for transcatheter closure of OS-ASD and the appropriate candidates. However, complications like inadequate closure, leaving behind residual defect or device embolization often come into picture. The reason behind this is complex anatomy of some defects in the three-dimensional plane. Purpose of this study was to see if the routine use of 3D zoom with 2D TEE can better help to select the appropriate patients for device closure than that by 2 TEE alone.
Methods
We enrolled 71 OS-ASD patients from October 2020 to December 2021. All the patients underwent transesophageal echocardiography (TEE). Assessment of quantitative (number, shape and size of defect and size of residual rims) and qualitative (aneurysm, malalignment, fenestration) parameters was done by both 2D and 3D zoom. The measurements by 2D and 3D TEE clips were done by different operators. Transcatheter device closure was done for the patients with defect morphology and residual rims amenable for the same, with acceptable pulmonary pressure. Patients found to be adequate for the device closure by 2D TEE, when further found to have an unfavorable morphology by 3D TEE, were referred for surgical management. Follow up transthoracic echo was done after 1 month.
Results
Of the 71 patients, 65% were females and mean age was 26.23±10.75 years. By 3D TEE, 66% had circular defect,19% had oval defect and 14% had complex defect. 2 patients had spiral defect. Malalignment of the septum was seen in 4 (5.6%) patients by 2D TEE whereas in 13 (18.3%) patients by 3D TEE. Septal aneurysm was seen in 1 (1.4%) by 2D TEE whereas in 3 (4.2%) patients by 3D TEE. Mean largest size obtained by 2D was 24.82±9 mm and that by 3D was 26.23±8.42. By 3D TEE, 37 patients had at least one rim deficient (<5 mm). 3D Maximal diameter strongly correlated with 2D Maximal diameter (correlation coefficient 0.860; p<0.01). 9 (12.6%) patients found adequate for the device closure by 2D TEE were further found to have an unfavorable morphology by 3D TEE. 38 (53.5%) patients underwent device closure and 20 (28.2%) patients underwent surgical patch closure. At 1 month follow up all the 38 patients had device in-situ and had no residual shunt.
Conclusions
In OS-ASD patients, routine use of 3D zoom modality can complement 2D TEE in deciding appropriate patients for transcatheter device closure and help prevent many unforeseeable complications.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Jawaharlal Institute of Postgraduate Medical Education and Research
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Affiliation(s)
- A Bhardwaj
- Jawaharlal institute of postgraduate education and research , Gorimedu , India
| | - A Pillai
- Jawaharlal institute of postgraduate education and research , Gorimedu , India
| | - S Satheesh
- Jawaharlal institute of postgraduate education and research , Gorimedu , India
| | - A Anantharaj
- Jawaharlal institute of postgraduate education and research , Gorimedu , India
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Groenewold MR, Flinchum A, Pillai A, Konkle S, Moulton-Meissner H, Tosh PK, Thoroughman DA. Investigation of a cluster of rapidly growing mycobacteria infections associated with joint replacement surgery in a Kentucky hospital, 2013-2014 with 8-year follow-up. Am J Infect Control 2022; 51:454-460. [PMID: 35732255 PMCID: PMC9896514 DOI: 10.1016/j.ajic.2022.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND We describe the investigation of a nosocomial outbreak of rapidly growing mycobacteria (RGM) infections and the results of mitigation efforts after 8 years. METHODS A cluster of RGM cases in a Kentucky hospital in 2013 prompted an investigation into RGM surgical site infections following joint replacement surgery. A case-control study was conducted to identify risk factors. RESULTS Eight cases were identified, 5 caused by M. wolinskyi and 3 by M. goodii. The case-control study showed the presence of a particular nurse in the operating room was significantly associated with infection. Environmental sampling at the nurse's home identified an outdoor hot tub as the likely source of M. wolinskyi, confirmed by pulsed-field gel electrophoresis and whole genome sequencing. The hot tub reservoir was eliminated, and hospital policies were revised to correct infection control lapses. No new cases of RGM infections have been identified as of 2021. DISCUSSION Breaches in infection control practices at multiple levels may have led to a chain of infection from a nurse's hot tub to surgical sites via indirect person-to-person transmission from a colonized health care worker (HCW). CONCLUSIONS The multifactorial nature of the outbreak's cause highlights the importance of overlapping or redundant layers of protection preventing patient harm. Future investigations of RGM outbreaks should consider the potential role of colonized HCWs as a transmission vector.
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Affiliation(s)
- Matthew R. Groenewold
- Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Frankfort, KY, USA,Division of Epidemiology and Health Planning, Kentucky Department for Public Health, Frankfort, KY, USA,Address correspondence to Matthew R. Groenewold, PhD, MSPH, Centers for Disease Control and Prevention, NIOSH, 1090 Tusculum Ave. MS R-17, Cincinnati, OH 45226.
| | - Andrea Flinchum
- Division of Epidemiology and Health Planning, Kentucky Department for Public Health, Frankfort, KY, USA
| | - Aravind Pillai
- Division of Epidemiology and Health Planning, Kentucky Department for Public Health, Frankfort, KY, USA
| | - Stacey Konkle
- Division of Epidemiology and Health Planning, Kentucky Department for Public Health, Frankfort, KY, USA
| | - Heather Moulton-Meissner
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Pritish K. Tosh
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA
| | - Douglas A. Thoroughman
- Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Frankfort, KY, USA,Division of Epidemiology and Health Planning, Kentucky Department for Public Health, Frankfort, KY, USA
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O’Malley K, Khan F, Kalva S, Alnablsi M, Xi Y, Pillai A, Vongpatanasin W, Kathuria M. Abstract No. 399 Utility of unilateral adrenal vein sampling in primary hyperaldosteronism: a single center experience. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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11
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Ahmed O, Yu Q, Pillai A, Liao A, Baker T. Abstract No. 303 ▪ FEATURED ABSTRACT Combination yttrium-90 radioembolization with concomitant systemic gemcitabine, cisplatin, and capecitabine as first-line therapy for intrahepatic cholangiocarcinoma (iCCA). J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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12
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Ahmed O, Yu Q, Pillai A, Liao A, Baker T. Abstract No. 307 Y-90 radioembolization as a first line therapy for intrahepatic cholangiocarcinoma. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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13
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Binks R, Maronge L, Pillai A, Carlson-Hedges L, Bradley J. P.9 An observational study into the normal TEG6s values in term pregnant women undergoing elective caesarean section. Int J Obstet Anesth 2022. [DOI: 10.1016/j.ijoa.2022.103305] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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14
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Ellis R, Ling T, Pillai A. P.44 Forty years later: a comparison of changes in obstetric theatre case load at a single centre. Int J Obstet Anesth 2022. [DOI: 10.1016/j.ijoa.2022.103340] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sanchez-Somonte P, Padala S, Kolominsky J, Gul E, Pillai A, Kron J, Shepard R, Kalahasty G, Tsang B, Khaykin Y, Pantano A, Koneru J, Ellenbogen K, Verma A. INTERMEDIATE TERM PERFORMANCE AND SAFETY OF LEFT BUNDLE BRANCH AREA CONDUCTION SYSTEM PACING LEADS: A MULTICENTER PROSPECTIVE STUDY. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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16
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Carlson-Hedges L, Pillai A. P.100 Association between umbilical cord, maternal and neonatal sodium concentration using cord gas point- of-care analysis to expedite a diagnosis of peripartum hyponatraemia. Int J Obstet Anesth 2021. [DOI: 10.1016/j.ijoa.2021.103098] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Laviola M, Pillai A, Stolady D, Ellis R, Hardman J. O.2 A comparison of apnoeic oxygenation techniques in the obstetric population: A modelling investigation. Int J Obstet Anesth 2021. [DOI: 10.1016/j.ijoa.2021.102990] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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18
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Aljawadi A, Madhi I, Naylor T, Elmajee M, Islam A, Niazi N, Pillai A. 405 Radiological Analysis of Gentamicin Eluting Synthetic Bone Graft Substitute Used in The Management of Gustilo IIIB Open Fractures. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Management of traumatic bone void associated with Gustilo IIIB open fractures is challenging. Gentamicin eluting synthetic bone graft substitute (Cerament-G) had been recently utilised for the management of patients with these injuries. This study aims to assess radiological signs of Cerament-G remodelling.
Method
Retrospective data analysis of all patients admitted to our unit with IIIB open fractures who had Cerament-G applied as avoid filler. Postoperative radiographic images of the fracture site at 6-weeks, 3-months, 6-months and at the last follow-up were reviewed. The radiological signs of Cerament-G integration, percent of void healing, and bone cortical thickness at the final follow-up were assessed.
Results
34 patients met our inclusion criteria, mean age: 42 years. Mean follow-up time was 20 months. 59% of patients had excellent (>90%) void filling, 26.4% of patients had 50-90% void filling, and 14.6% had < 50% void filling. Normal bone cortical thickness was restored on AP and Lateral views in 55.8% of patients. No residual Cerement-G was seen on X-rays at the final follow-up in any of the patients.
Conclusions
Our results showed successful integration of Cerament-G with excellent void filling and normal cortical thickness achieved in more than half of the patients.
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Affiliation(s)
- A Aljawadi
- Wythenshawe Hospital, Manchester, United Kingdom
| | - I Madhi
- Wythenshawe Hospital, Manchester, United Kingdom
| | - T Naylor
- Wythenshawe Hospital, Manchester, United Kingdom
| | - M Elmajee
- Royal Orthopaedic Hospital, Birmingham, United Kingdom
| | - A Islam
- Wythenshawe Hospital, Manchester, United Kingdom
| | - N Niazi
- Wythenshawe Hospital, Manchester, United Kingdom
| | - A Pillai
- Wythenshawe Hospital, Manchester, United Kingdom
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Elmajee M, Munasinghe C, Aljawadi A, Elawady K, Shuweihde F, Pillai A. 413 Posterior Stabilisation Without Formal Debridement for The Treatment of Non-Tuberculous Pyogenic Spinal Infection in A Frail and Debilitated Population – A Systematic Review and Meta-Analysis. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Background
Non-tuberculous pyogenic spinal infection (PSI) incorporates a variety of different clinical conditions. Surgical interventions may be necessary for severe cases where there is evidence of spinal instability or neurological compromise. The primary surgical procedure focuses on the anterior approach with aggressive debridement of the infected tissue regions. We aim to evaluate the effectiveness of the posterior approach without debridement.
Method
Several databases including MEDLINE, NHS evidence and the Cochrane database were searched. The main clinical outcomes evaluated include pain, neurological recovery (Frankel Grading System, FGS) post-operative complications and functional outcomes (Kirkaldy-Willis Criteria and Spine Tango Combined Outcome Measure Index, COMI).
Results
From the four papers included in the meta-analysis, post-operative pain levels were found to be lower at a statistically significant level when a random effects model was applied, with the effect size found to be at 0.872 (p < 0.001, 95% CI: 0.7137 to 1.0308). Post-surgical neurological improvement was also demonstrated with a mean FGS improvement of 1.12 in 64 patients over the included articles.
Conclusions
Posterior approach with posterior stabilisation without formal debridement can results in successful infection resolution, improved pain scores and neurological outcomes. However, Larger series with longer follow-up duration are strongly recommended.
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Affiliation(s)
- M Elmajee
- Royal Orthopaedic Hospital, Birmingham, United Kingdom
| | - C Munasinghe
- University of Birmingham, Munasinghe, United Kingdom
| | - A Aljawadi
- Wythenshawe Hospital, Manchester, United Kingdom
| | - K Elawady
- Birmingham Children Hospital, Birmingham, United Kingdom
| | | | - A Pillai
- Wythenshawe Hospital, Manchester, United Kingdom
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Zhu H, Odu A, Franklin A, Yang X, Lamus D, Xi Y, Pillai A. Abstract No. 511 Impact of practicing clinical interventional radiology: nephrostomy tube care in cancer patients, a quality improvement initiative. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.320] [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] Open
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Vazquez L, Kolber M, Lamus D, Pillai A, Xi Y. Abstract No. 588 Effect of relative increase in nurse and technologist staff: utilizing lower COVID-19 case volume as a model for examining increased staffing ratio on room turnover efficiency. J Vasc Interv Radiol 2021. [PMCID: PMC8079619 DOI: 10.1016/j.jvir.2021.03.398] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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22
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Franklin A, Odu A, Quadri R, Pillai A, Kolber M. Abstract No. 173 Cystic duct stenting via percutaneous cholecystostomy in non-operative calculous cholecystitis. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.179] [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] Open
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Vazquez L, Xi Y, Lamus D, Pillai A, Kolber M. Abstract No. 562 Process interventions for improving interventional radiology room turnover efficiency: effect of radiology transporters and dedicated clinical nurse coordinator in a tertiary care hospital practice. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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24
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Pillai A, Keyes KM, Susser E. Antidepressant prescriptions and adherence in primary care in India: Insights from a cluster randomized control trial. PLoS One 2021; 16:e0248641. [PMID: 33739982 PMCID: PMC7978355 DOI: 10.1371/journal.pone.0248641] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 03/02/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The World Health Organization recommends that treatment of depression in low and middle-income countries with a scarcity of psychiatrists could be done in primary care and should include prescription of antidepressant medications for moderate and severe depression. Little is known, however, about the actual practices of antidepressant prescription by primary care physicians in low and middle-income countries, nor about adherence by people receiving such prescriptions. In a large study of primary care clinics in Goa, India, we examined the relationship of actual to recommended prescribing practices for depression, among all patients who screened positive for common mental disorder. We also examined other patient and clinic characteristics associated with antidepressant prescription, and self-reported adherence over a one-month period. METHODS Patients attending 24 primary care clinics were screened for common mental disorders. Those who screened positive were eligible to enroll in a trial to assess the effectiveness of a collaborative stepped care (CSC) intervention for mental disorders. Physicians in the 12 intervention and 12 control clinics (usual care) were free to prescribe antidepressants and follow-up interviews were conducted at 2, 6 and 12 months. Screening results were shared with the physician, but they were blinded to the diagnosis generated later using a standardized diagnostic interview administered by a health counsellor. We categorized these later diagnoses as "moderate/severe depression", "mild depression or non-depression diagnosis", and "no diagnosis". We used a two-level hierarchical logistic regression model to examine diagnostic and other factors associated with antidepressant prescription and one-month adherence. RESULTS Overall, about 47% of screened positive patients (n = 1320) received an antidepressant prescription: 60% of those with moderate/severe depression, 48% of those with mild depression or non-depression diagnosis, and 31% with no diagnosis. Women (OR 1.29; 95%CI 1.04-1.60) and older adults (OR 1.80; 95%CI 1.32-2.47) were more likely to receive an antidepressant prescription. While the overall rate of antidepressant prescription was similar in clinics with and without CSC, patients without any diagnosis were more likely to receive a prescription (OR 2.20 95% CI 1.03-4.70) in the usual care clinics. About 47% of patients adhered to antidepressant treatment for one month or more and adherence was significantly better among older adults (OR 3.92; 95% CI 1.70-8.93) and those who received antidepressant as part of the CSC treatment model (OR 6.10 95% CI 3.67-10.14) compared with those attending the usual care clinic. CONCLUSION Antidepressants were widely prescribed following screening in primary care, but prescription patterns were in poor accord with WHO recommendations. The data suggest under-prescription for people with moderate/severe depression; over-prescription for people with mild depression or non-depression diagnoses; and over-prescription for people with no disorders. For all diagnoses adherence was low, especially in usual care clinics. To address these concerns, there is an urgent need to study and develop strategies in primary care practices to limit unnecessary antidepressant prescriptions, target prescription for those patients who clearly benefit, and to improve adherence to antidepressant treatment. ClinicalTrials.gov Identifier: NCT00446407.
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Affiliation(s)
- Aravind Pillai
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, United States of America
| | - Katherine M. Keyes
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, United States of America
| | - Ezra Susser
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, United States of America
- New York State Psychiatric Institute, New York, New York, United States of America
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Juloori A, Liao C, Lemons J, Singh A, Iyer R, Robbins J, George B, Fung J, Pillai A, Arif F, Sharma M, Liauw S. Phase I Study of Stereotactic Body Radiotherapy followed by Ipilimumab with Nivolumab vs. Nivolumab alone in Unresectable Hepatocellular Carcinoma. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jevons G, Edginton H, Mccall G, Pillai A, Haque S. AB1345-HPR THE MULTIDISCIPLINARY FOOT CLINIC: A SERVICE EVALUATION PROJECT. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Patients with rheumatological foot disease are an overlooked population, and it was noted locally that these patients received a fragmented service; attending multiple appointments for the management of one clinical issue. This led to delays in treatment; significant inter-departmental correspondence and variations in the peri-operative management of disease modifying anti-rheumatic drug (DMARD) and biologic therapies. To remedy this a foot multidisciplinary (MDT) clinic was established, including input from rheumatology, orthopaedic surgery, specialist rheumatology podiatry and physiotherapy. The outcomes from the foot MDT clinic have been analysed in this service evaluation project.Objectives:To evaluate the outcomes of the multidisciplinary foot MDT clinic, with particular reference to concordance to the British Rheumatology Society (BSR) guidelines on peri-operative medicine guidelines.Methods:Data was collected retrospectively across all clinics from January 2017 to February 2019. Clinic letters were obtained, and data was collected using a standardised data collection sheet. Data was collected on patient demographics, rheumatological diagnoses, treatment outcomes from the foot MDT, appropriateness of peri-operative plan and post-operative complications. No data was available on these outcomes prior to the advent of the foot MDT clinic.Results:Data from 12 clinics was analysed (n=40). Patients had a median age of 66 years (IQR 27.5 years); 65% of patients were female and 35% of patients were male. The commonest rheumatological foot disease seen was rheumatoid arthritis (67%), followed by psoriatic arthritis (15%). All patients were treated with biologic or non-biologic DMARDs. Treatment outcomes were as follows: 27.5% were offered surgical treatment; 10% were offered intra-articular (IA) injections under ultrasound guidance; 10% were offered IA injections under general anaesthetic; 25% underwent specialist rheumatology podiatry, and the remaining 30% elected for a conservative approach after careful consideration of treatment options. Of those who were offered surgical treatment, 72% of patients were provided with a peri-operative plan which accorded with British Rheumatology Society (BSR) guidelines. Of those whom underwent surgery, one patient’s surgical treatment was complicated by a post-operative infection; however, the peri-operative DMARD/biologic plan was not felt to be contributing factor.Conclusion:The foot MDT clinic provides a comprehensive review of rheumatological foot conditions, with readily available access to a full range of treatment options. Co-location of all relevant professionals allows for real-time interdepartmental communication; shared decision making between clinicians and patients; avoids multiple appointments; reduces uncertainty with peri-operative planning as well as providing a cost-effective and efficacious service. Discrepancies in the peri-operative plan for medicines arose when the treating orthopaedic surgeon was not present in clinic. In these cases, the plan for surgical treatment was made outside of this clinic, without input from the treating rheumatologist. To improve concordance with BSR peri-operative medicine guidelines, it is recommended that all treatment decisions are made during the clinic, allowing input from all relevant partners. Informal feedback from patients commended the foot MDT, this shall be formalised through further qualitative data.Disclosure of Interests:None declared
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Ahmed O, Badar W, Salaskar A, Zangan S, Navuluri R, Baker T, Pillai A, Van Ha T. Abstract No. 567 Yttrium-90 radioembolization therapy for combined hepatocellular and cholangiocarcinoma. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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28
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Kim C, Niekamp A, Pillai A, Leon R, Soni J, McNutt M, Pillai A. Abstract No. 637 Implementation of American College of Surgeons Committee on Trauma guidelines for interventional radiology: a retrospective review of prospective data compared with historic cohort. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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29
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Perez L, Prisacaru S, Cui Z, Pillai A, Kolber M. 3:09 PM Abstract No. 283 Denali and Option inferior vena cava filter placement and retrieval: effect of filter type and dwell time on ease of retrieval. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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30
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Wang H, Swaby K, Li X, Surabhi V, Bhatti Z, Patel M, Pillai A. 3:27 PM Abstract No. 193 Identification of mRNA-encoded prognostic biomarkers for hepatocellular carcinoma. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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31
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Sohner M, Prisacaru S, Habibollahi P, Sutphin P, Pillai A, Kolber M. 4:12 PM Abstract No. 281 Short dwell time (<30 day) inpatient retrievable inferior vena cava filters for averting pulmonary embolism in trauma. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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32
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Ahmed O, Badar W, Dalag L, Jeffries J, Li J, Zangan S, Navuluri R, Pillai A, Van Ha T, Salaskar A, Baker T. 3:45 PM Abstract No. 142 Safety and efficacy of repeat Y90 radioembolization to the same hepatic arterial territory. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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33
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Patel S, Pillai A, Guevara C, Celii F, Bhatti Z, Wang H. Abstract No. 467 A panel of mRNA molecules as prognostic biomarkers for patients with hepatocellular carcinoma. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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34
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Gorbacev D, Pillai A. An innovative and cost-effective method for the targeted delivery of autologous bone grafts in foot and ankle surgery. Ann R Coll Surg Engl 2018; 100:1. [PMID: 29968508 PMCID: PMC6204525 DOI: 10.1308/rcsann.2018.0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- D Gorbacev
- Trauma and Orthopaedics Department, University Hospital of South Manchester NHS Foundation Trust, Wythenshawe, Manchester, UK
| | - A Pillai
- Trauma and Orthopaedics Department, University Hospital of South Manchester NHS Foundation Trust, Wythenshawe, Manchester, UK
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Pillai A, Monteiro RS, Choi SW, Yentis SM, Bogod D. Strength of commonly used spinal needles: the ability to deform and resist deformation. Anaesthesia 2017; 72:1125-1133. [PMID: 28696015 DOI: 10.1111/anae.13959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2017] [Indexed: 11/29/2022]
Abstract
We investigated the strength of commonly used spinal needles in relation to the amount of deformation, and registered forces during standardised testing. We investigated differences between manufacturers for the same length and gauge of Luer and non-Luer needles, and examined the effect of the internal stylet in terms of needle strength. A specialised rig was designed to perform the testing in both the horizontal and axial plane, reflecting common industrial tests and clinical use. Needles from four commonly used manufacturers were used (Vygon, Becton Dickinson, B Braun, and Pajunk). Needles of 25 G and 27 G were tested in 90-mm and 120-mm lengths. We found significant differences in terms of the size of final deformation and 'toughness'/resistance to deformation between needles of different brands. There were also significant differences between horizontal tests conducted as an industry standard and our own axial test. This may have bearing on clinical use in terms of the incidence of bending and breakage. The presence of the internal stylet resulted in significantly greater toughness in many needles, but had little effect on the degree of deformation. Comparison of Luer and non-Luer needles of the same brand and size showed few significant differences in strength. This result is reassuring, given the imminent change from Luer to non-Luer needles that is to occur in the UK.
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Affiliation(s)
- A Pillai
- Department of Anaesthesia, Nottingham University Hospitals, Nottingham, UK
| | - R S Monteiro
- Department of Anaesthesia, Brighton and Sussex University Hospitals, Brighton, UK
| | - S W Choi
- Laboratory and Clinical Research Institute for Pain, Department of Anaesthesiology, The University of Hong Kong, China
| | - S M Yentis
- Magill Department of Anaesthesia, Chelsea and Westminster Hospital, London, UK
| | - D Bogod
- Department of Anaesthesia, Nottingham University Hospitals, Nottingham, UK
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Mohammad HR, A'Court J, Pillai A. Extruded talus treated with reimplantation and primary tibiotalocalcaneal arthrodesis. Ann R Coll Surg Engl 2017; 99:e115-e117. [PMID: 28349756 PMCID: PMC5449685 DOI: 10.1308/rcsann.2017.0042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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] [Accepted: 02/04/2017] [Indexed: 11/22/2022] Open
Abstract
Extruded talus is a rare serious result from a high-energy injury to a supinated and plantar flexed foot. Treatment remains controversial with a lack of congruent evidence for talar reimplantation. A 34-year-old woman was involved in a road traffic accident at 40 mph. Imaging revealed a left talus extruded anterolaterally with a talar neck fracture. Additional injuries included right acetabular fracture, transverse process fractures and rib fractures, which were treated conservatively. The talus was reimplanted and the talar neck fixed with a cortical screw. A hindfoot nail was used to fuse the calcaneus, talus and tibia. Follow-up at two years showed solid tibiotalocalcaneal fusion, with no evidence of avascular development, and the patient was fully weight bearing without pain. We believe this is the first published case of successful primary tibiotalocalcaneal fusion for extruded talus injuries.
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Affiliation(s)
- H R Mohammad
- Department of Orthopaedics, University Hospital South Manchester , Manchester , UK
- University of Manchester , Manchester , UK
| | - J A'Court
- Department of Orthopaedics, University Hospital South Manchester , Manchester , UK
| | - A Pillai
- Department of Orthopaedics, University Hospital South Manchester , Manchester , UK
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Monteiro RS, Pillai A, Choi SW, Bogod D, Yentis SM. Flow characteristics of Luer and non-Luer spinal needles. Anaesthesia 2017; 72:749-754. [DOI: 10.1111/anae.13851] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2017] [Indexed: 11/28/2022]
Affiliation(s)
- R. S. Monteiro
- Department of Anaesthesia; Chelsea and Westminster Hospital; London UK
| | - A. Pillai
- Department of Anaesthesia; Nottingham University Hospitals; Nottingham UK
| | - S. W. Choi
- Laboratory and Clinical Research Institute for Pain; Department of Anaesthesiology; The University of Hong Kong; Hong Kong China
| | - D. Bogod
- Department of Anaesthesia; Nottingham University Hospitals; Nottingham UK
| | - S. M. Yentis
- Department of Anaesthesia; Chelsea and Westminster Hospital; London UK
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38
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McDevitt J, Acosta-Torres S, Zhang N, Hu T, Odu A, Wang J, Yin X, Lamus D, Miller D, Pillai A. Determination of optimal routine exchange frequency to minimize costs associated with long-term percutaneous nephrostomy (PCN) management for patients with malignant urinary obstruction. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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39
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Motara H, Olusoga T, Russell G, Jamieson S, Ahmed S, Brindle N, Pillai A, Scarsbrook A, Patel C, Chowdhury F. Clinical impact and diagnostic accuracy of 2-[18F]-fluoro-2-deoxy-d-glucose positron-emission tomography/computed tomography (PET/CT) brain imaging in patients with cognitive impairment: a tertiary centre experience in the UK. Clin Radiol 2017; 72:63-73. [DOI: 10.1016/j.crad.2016.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 08/04/2016] [Accepted: 08/11/2016] [Indexed: 01/06/2023]
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40
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George A, Philip A, Poorna D, Makunny D, Pillai A, M.r B, Pillai R, Jose W, Pavithran K. 145P Outcomes of treatment of glioblastoma multiforme: A single institution experience from South India. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw578.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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41
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George A, Philip A, Poorna D, Makunny D, Pillai A, Mr B, Pillai R, Jose W, Pavithran K. 145P Outcomes of treatment of glioblastoma multiforme: A single institution experience from South India. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00303-3] [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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42
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Pillai A. Apnoeic oxygenation in pregnancy - a reply. Anaesthesia 2016; 71:1491-1492. [PMID: 27870187 DOI: 10.1111/anae.13718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A Pillai
- Nottingham University Hospitals NHS Trust, Nottingham, UK
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Ahmad K, Ballal M, Somasundaram K, Pillai A. Patient reported outcome and experience measures for hallux-rigidus. Cheilectomy vs. fusion. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.387] [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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44
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Pillai A, Daga V, Lewis J, Mahmoud M, Mushambi M, Bogod D. High-flow humidified nasal oxygenation vs. standard face mask oxygenation. Anaesthesia 2016; 71:1280-1283. [DOI: 10.1111/anae.13607] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2016] [Indexed: 11/27/2022]
Affiliation(s)
- A. Pillai
- Anaesthetic Department; Royal Perth Hospital; Perth Western Australia Australia
| | - V. Daga
- Anaesthetic Department; University Hospitals of Coventry and Warwickshire NHS Trust; Coventry UK
| | - J. Lewis
- Anaesthetic Department; Nottingham University Hospitals NHS Trust; Nottingham UK
| | - M. Mahmoud
- Anaesthetic Department; Nottingham University Hospitals NHS Trust; Nottingham UK
| | - M. Mushambi
- Anaesthetic Department; University Hospitals of Leicester NHS Trust; Leicester UK
| | - D. Bogod
- Anaesthetic Department; Nottingham University Hospitals NHS Trust; Nottingham UK
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Pillai A, Lewis J, Mahmoud M, Daga V, Mushambi M, Bogod D. Abstract PR571. Anesth Analg 2016. [DOI: 10.1213/01.ane.0000492952.72689.d6] [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: 11/05/2022]
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46
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Pillai A, Monteiro R, Choi SW, Yentis S, Bogod D. Abstract PR507. Anesth Analg 2016. [DOI: 10.1213/01.ane.0000492891.69799.5c] [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: 11/05/2022]
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Abstract
Recent studies have shown that nasal oxygen delivery can prolong the time to desaturation during apnoea in the non-pregnant population. We investigated the benefits of apnoeic oxygenation during rapid sequence induction in the obstetric population using computational modelling. We used the Nottingham Physiology Simulator, and pre-oxygenated seven models of pregnancy for 3 min using Fi O2 1.0, before inducing apnoea. We found that increasing Fi O2 at the open glottis increased the time to desaturation, extending the time taken for Sa O2 to reach 40% from 4.5 min to 58 min in the average parturient model (not in labour). Our study suggests that a small increase in time to desaturation could be achieved at Fi O2 0.4-0.6, which could be delivered by standard nasal cannulae. The greatest increases in time to desaturation were seen at Fi O2 1.0, which could be delivered by high-flow nasal cannulae under ideal conditions.
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Affiliation(s)
- A Pillai
- Academic Anaesthesia and Critical Care, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.,Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - M Chikhani
- Academic Anaesthesia and Critical Care, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.,Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - J G Hardman
- Academic Anaesthesia and Critical Care, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.,Nottingham University Hospitals NHS Trust, Nottingham, UK
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Collins PY, Kondos L, Pillai A, Joestl SS, Frohlich J. Passive Suicidal Ideation and Community Mental Health Resources in South Africa. Community Ment Health J 2016; 52:541-50. [PMID: 27100867 PMCID: PMC4900909 DOI: 10.1007/s10597-016-0003-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 04/01/2016] [Indexed: 11/29/2022]
Abstract
South African communities continue to experience elevated incidence and prevalence of HIV infection. Passive suicidal ideation (PSI) may be one expression of distress in high prevalence communities. We report the prevalence of PSI and examine the relationship between PSI and participation in community organizations in a semi-rural sample of South African adults (N = 594). The prevalence of PSI in the 2 weeks prior to the interview was 9.1 %. Members of burial societies (Χ (2) = 7.34; p = 0.01) and stokvels (Χ (2) = 4.1; p = 0.04) (community-based savings groups) reported significantly less PSI compared to other respondents. Using a multivariate model adjusted for demographic characteristics, psychological distress, and socioeconomic status, we found lower odds of reporting PSI for members of burial societies (OR 0.48, CI 0.25 -0.91). Participation in community organizations that provide contextually salient resources in settings with high levels of distress may be a resource for mental health.
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Affiliation(s)
| | - Leeza Kondos
- Public Health Institute, Global Health Bureau, United States Agency for International Development, Washington, DC, USA
| | - Aravind Pillai
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Sarah S. Joestl
- National Center for Health Statistics, Center for Disease Control, Hyattsville, MD, USA
| | - Janet Frohlich
- Center for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa
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Alian A, McLennan G, Bennett S, Kapoor B, Gill A, Levitin A, Sands M, Obuchowski N, Aucejo F, Menon K, Estfan B, Pillai A, Kalva S. Yttrium-90 radioembolization versus doxorubicin-eluting beads chemoembolization in patients with infiltrative hepatocellular carcinoma: single center comparison of survival and toxicity. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Patel A, Chamarthy M, Pillai A, Sutphin P, Reddick M, Kalva S. Above and beyond TIPS: procedural challenges and alternative techniques. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.707] [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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