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Zou M, Bhatia A, Dong H, Jayaprakash P, Guo J, Sahu D, Hou Y, Tsen F, Tong C, O'Brien K, Situ AJ, Schmidt T, Chen M, Ying Q, Ulmer TS, Woodley DT, Li W. Correction: Evolutionarily conserved dual lysine motif determines the non-chaperone function of secreted Hsp90alpha in tumour progression. Oncogene 2024; 43:1397-1398. [PMID: 38575761 PMCID: PMC11065679 DOI: 10.1038/s41388-024-03017-0] [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: 04/06/2024]
Affiliation(s)
- M Zou
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
- Department of Endocrinology and Metabolism, and Department of Respiratory and Critical Care Medicine, Chronic Airways Diseases Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - A Bhatia
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - H Dong
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
- Department of Endocrinology and Metabolism, and Department of Respiratory and Critical Care Medicine, Chronic Airways Diseases Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - P Jayaprakash
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - J Guo
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - D Sahu
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Y Hou
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - F Tsen
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - C Tong
- Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research and Department of Cell and Neurobiology, Los Angeles, CA, USA
| | - K O'Brien
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - A J Situ
- Department of Biochemistry and Molecular Biology and Zilkha Neurogenetic Institute University of Southern California Keck Medical Center, Los Angeles, CA, USA
| | - T Schmidt
- Department of Biochemistry and Molecular Biology and Zilkha Neurogenetic Institute University of Southern California Keck Medical Center, Los Angeles, CA, USA
| | - M Chen
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
- Department of Medical Research, Greater Los Angeles Veterans Affairs Heath Care System, Los Angeles, CA, USA
| | - Q Ying
- Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research and Department of Cell and Neurobiology, Los Angeles, CA, USA
| | - T S Ulmer
- Department of Biochemistry and Molecular Biology and Zilkha Neurogenetic Institute University of Southern California Keck Medical Center, Los Angeles, CA, USA
| | - D T Woodley
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
- Department of Medical Research, Greater Los Angeles Veterans Affairs Heath Care System, Los Angeles, CA, USA
| | - W Li
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA.
- Department of Medical Research, Greater Los Angeles Veterans Affairs Heath Care System, Los Angeles, CA, USA.
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Lim CCW, Punjabi LS, Bhatia A, Ng QJ, Jevon GP, Aggarwal IM. Navigating an unexpected diagnosis - experience of a tertiary referral centre with two cases of intraplacental choriocarcinoma. Malays J Pathol 2024; 46:91-94. [PMID: 38682848] [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: 05/01/2024]
Abstract
Intraplacental choriocarcinoma is a rare tumour, with approximately 62 reported cases. It may manifest as a spectrum of disease ranging from an incidental lesion diagnosed on routine placental examination to disseminated maternal and/or neonatal disease. In this case series, we presented two rare cases of intraplacental choriocarcinoma with extremely varied clinical presentations. The extremely varied clinical presentations of both patients described in the case series complicated the process of arriving at the diagnosis. In both cases, subsequent investigations showed no maternal or neonatal metastasis, and maternal serum beta-hCG levels downtrended with conservative management. We aim to highlight the importance of performing a detailed physical examination and evaluation of the patient and multidisciplinary management with oncology opinion. A detailed examination of the placenta should also be considered when faced with obstetric complications so that early diagnosis and the required management can be executed in a prompt fashion.
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Affiliation(s)
- C C W Lim
- KK Women's & Children's Hospital, Department of Obstetrics & Gynaecology, Singapore.
| | - L S Punjabi
- KK Women's & Children's Hospital, Department of Pathology & Laboratory Medicine, Singapore
| | - A Bhatia
- KK Women's & Children's Hospital, Department of Maternal-Fetal Medicine, Singapore
| | - Q J Ng
- KK Women's & Children's Hospital, Department of Gynaecological Oncology, Singapore
| | - G P Jevon
- KK Women's & Children's Hospital, Department of Pathology & Laboratory Medicine, Singapore
| | - I M Aggarwal
- KK Women's & Children's Hospital, Department of Gynaecological Oncology, Singapore
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Bhatia A. Surfing stress: A practical and paradigm changing approach to improving personal resilience. Future Healthc J 2024; 11:100022. [PMID: 38646056 PMCID: PMC11025055 DOI: 10.1016/j.fhj.2024.100022] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Affiliation(s)
- Ashish Bhatia
- Three Shires Medical Centre, Bristol, UK
- University of Bristol, Bristol, UK
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Farahbakhsh N, Bhatia A, Graves M, Mishra V, Motaparthi K. Effectiveness of a leadership conference for chief residents in dermatology. Clin Dermatol 2024; 42:96-99. [PMID: 38042438 DOI: 10.1016/j.clindermatol.2023.11.006] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023]
Abstract
The position of chief resident involves increased leadership, mentorship, and management responsibilities. There is no standardized procedure in which dermatology chief residents are trained and prepared for their final year of residency. In 2008, an annual Dermatology Chief Academy conference was initiated in which incoming chief residents were given formal leadership training for their new role. At the 2020 conference, residents completed a survey regarding their expectations and experience of this conference. After the conference, residents felt significantly better prepared for their new role as chief residents, handling conflicts, and effective leadership. A formal leadership conference for incoming chief residents is vital for improving the success of a residency program.
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Affiliation(s)
- Navid Farahbakhsh
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Ashish Bhatia
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Michael Graves
- Division of Dermatology, University of Texas Dell Medical School, Austin, Texas, USA
| | | | - Kiran Motaparthi
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA.
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Morris BA, Burr A, Harari C, Grogan PT, Bhatia A, Bayliss RAB, Tome WA, Robins I, Howard SP. Pulsed Reduced Dose Rate Re-Irradiation for Recurrent Grade 4 Gliomas: A Retrospective Analysis of Safety and Efficacy. Int J Radiat Oncol Biol Phys 2023; 117:e138-e139. [PMID: 37784707 DOI: 10.1016/j.ijrobp.2023.06.946] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Despite maximal treatment, nearly all patients with grade 4 gliomas develop recurrent disease. Treatment options for these patients are limited and overall survival is poor. Re-irradiation may be considered in certain patients, though risk of side effects often limits the effective dose able to be delivered. Pulsed reduced dose rate (PRDR) radiation is a treatment technique that reduces effective dose rate and increases treatment time allowing for intrafraction repair. Here, we report safety and efficacy of PRDR re-irradiation for recurrent grade 4 gliomas. MATERIALS/METHODS We performed a retrospective review of patients treated with PRDR between 2001 and 2022. Patients were treated with reduced dose rate radiation delivered in 0.2 Gy pulses every 3 minutes in 2 Gy daily fractions. Both 3D conformal and step and shoot IMRT radiation plans were utilized. Toxicities were evaluated based on Common Terminology Criteria for Adverse Events (CTCAE) v5.0 criteria. Kaplan Meier analysis was used to calculate overall survival (OS). Cox regression analysis was performed for multivariate analysis. RESULTS A total of 168 grade 4 glioma patients treated with PRDR re-irradiation were identified. The median age was 55 years old. The median initial radiation dose was 60 Gy (range 36 Gy - 72 Gy) and the median PRDR dose was 54 Gy (range 37.5 - 60 Gy). Seventy percent of patients received systemic therapy for recurrent disease prior to PRDR, while 30% received PRDR as first treatment for recurrent disease (or following re-resection without other treatment). The median survival following PRDR was 6.3 months. Multivariate analysis showed time since initial radiation of 14+ months (HR 0.66, p = 0.005, 95% CI 0.44 - 0.98), pre-PRDR use of steroids (HR 1.78, p = 0.005, 95% CI 1.2 - 2.66), and Karnofsky performance status of 70 or greater to be a significant predictor of survival (HR = 0.6, p = 0.008, 95% CI 0.44 - 0.98). No grade 4 or 5 toxicity was noted. Grade 3 new onset seizures was noted in 6% of patients, all subsequently controlled with medication. The most common grade 1-2 side effect after treatment was fatigue. CONCLUSION In this large, retrospective cohort, PRDR re-irradiation for recurrent grade 4 gliomas was well tolerated with low rates of grade 3 toxicity. Overall survival outcomes were encouraging, especially in heavily pre-treated patients. Prospective studies are ongoing to further evaluate the efficacy of PRDR for recurrent glioma treatment.
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Affiliation(s)
- B A Morris
- Department of Human Oncology, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - A Burr
- Department of Human Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - C Harari
- Department of Human Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - P T Grogan
- Division of Hematology and Oncology, Department of Medicine, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - A Bhatia
- Department of Human Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI; Division of Neuro-Oncology, Department of Neurology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - R A B Bayliss
- Department of Human Oncology, University of Wisconsin Hospital and Clinics, Madison, WI
| | - W A Tome
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY; Institute for Onco-Physics, Albert Einstein College of Medicine, Bronx, NY
| | - I Robins
- Department of Human Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI; Division of Hematology and Oncology, Department of Medicine, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - S P Howard
- Department of Human Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
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Bhatia A, Burgess CM, Munavalli G, Smith JL. Photopneumatic Technology for the Treatment of Mild-to-moderate Acne Vulgaris-A Review and Expert Perspectives. J Clin Aesthet Dermatol 2023; 16:S3. [PMID: 37361385 PMCID: PMC10286869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Affiliation(s)
- Ashish Bhatia
- Dr. Bhatia is with Oak Dermatology in Naperville, Illinois
| | - Cheryl M Burgess
- Dr. Burgess is with the Center for Dermatology and Dermatologic Surgery in Washington, DC
| | - Gilly Munavalli
- Dr. Munavalli is Medical Director and Founder of Dermatology, Laser, & Vein Specialists of the Carolinas in Charlotte, North Carolina
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Bhatia A, Burgess CM, Munavalli GS, Smith JL. Photopneumatic Technology for the Treatment of Mild-to-moderate Acne Vulgaris-Expert Perspectives. J Clin Aesthet Dermatol 2023; 16:S7-S11. [PMID: 37361383 PMCID: PMC10286868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Affiliation(s)
| | | | - Gilly S Munavalli
- Medical Director, Founder, Dermatology, Laser & Vein Specialists of the Carolinas, Charlotte
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Richardson A, Richardson K, Shah K, Maini A, Aldajani M, Romeus L, Hall D, Bhatia A, Kumar J, Jalaeian H, Bhatia S. Abstract No. 284 Comparison of PAE for BPH on Prostate Gland Size <80 g versus >80 g: Retrospective Review of Short-Term to Mid-Term Outcomes in a Single Center. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.351] [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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Richardson A, Shah K, Maini A, Richardson K, Aldajani M, Boateng J, Bhatia A, Sanan A, Jalaeian H, Bhatia S. Abstract No. 599 Comparison of Safety and Feasibility of Prostate Artery Embolization via Transradial Access versus Transfemoral Access: A Single-Center Experience. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.457] [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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Richardson A, Maini A, Richardson K, Shah K, Bhatia A, Reddy R, Sanan A, Kumar J, Jalaeian H, Bhatia S. Abstract No. 3 ▪ ABSTRACT OF THE YEAR Prostate Artery Embolization—Single-Center Experience of 1,000 Patients with Short-, Mid- and Long-Term Follow-Up. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.041] [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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Dorjee L, Chakraborty S, Bhatia A, Manu CB, Medhi R. Migrated and Impacted Foreign Body of Retropharyngeal Space: A Case Report. Indian J Otolaryngol Head Neck Surg 2022; 74:5664-5667. [PMID: 36742513 PMCID: PMC9895500 DOI: 10.1007/s12070-021-02928-8] [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: 12/21/2020] [Accepted: 10/14/2021] [Indexed: 02/07/2023] Open
Abstract
Foreign body upper aerodigestive tract is a common presentation but foreign body migrating into retropharyngeal space is not only uncommon, but its management also differs and is challenging too. Here we present a case of a foreign body migrating into the retropharyngeal space which was removed intraorally. A 28- year old male patient presented with complaints of pain while swallowing following consumption of sausage and pork two days earlier to the onset of symptoms. X-Ray Neck AP and lateral view were done which revealed a thin metallic foreign body at the level of the T4 vertebra. Upper gastrointestinal endoscopy and rigid esophagoscopy were done in which a foreign body was not visualized in the esophageal lumen. NCCT neck was done which gave precise location and was removed intraorally with the patient in Rose position. A repeat x-ray was done on the 5th day which revealed no foreign body, the patient was discharged on the 7th day. Although the upper aerodigestive tract foreign body is common, foreign body migrating to the posterior pharyngeal wall or into the retropharyngeal space is not common and it is difficult to remove a migrated foreign body many cases requiring open procedures, thoracoscopy, thoracotomy.
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Affiliation(s)
- L. Dorjee
- Dept. of Otorhinolaryngology, NEIGRIHMS, Shillong, Meghalaya 793018 India
| | - S. Chakraborty
- Dept. of Otorhinolaryngology, NEIGRIHMS, Shillong, India
| | - A. Bhatia
- Dept. of Otorhinolaryngology, NEIGRIHMS, Shillong, India
| | - C. B. Manu
- Dept. of Otorhinolaryngology, NEIGRIHMS, Shillong, India
| | - R. Medhi
- Dept. of Otorhinolaryngology, NEIGRIHMS, Shillong, India
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Gold MH, Bhatia A, Kaur A, Doucette M, Kothare A. Picture-based acne lesion counts: A validation study to assess accuracy and reliability of acne lesion counts via photography. J Cosmet Dermatol 2022; 21:6965-6975. [PMID: 36161460 DOI: 10.1111/jocd.15413] [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: 07/15/2022] [Revised: 08/27/2022] [Accepted: 09/14/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Acne lesion counting (ALC) is widely used to evaluate efficacy of new acne treatments. Although such evaluations are precise and highly discriminative, if assessed live, it can be a time-consuming and intrusive measurement. Photographic assessment is a viable mode for ALCs and for training and/or qualifying evaluators. AIMS The purpose of this study was to validate photographic methods for performing ALCs and to provide an objective measurement tool to train and/or qualify lesion count evaluators for deployment in both small- and large-scale studies. PATIENTS/METHODS Assess accuracy and reliability of acne lesion counting via photographic methods in 8 subjects aged 16 to 40 years, with Fitzpatrick Skin Types I to VI. Frontal and 45°angle images taken at the single in-clinic visit. Each subject underwent 3 counts per 4 evaluators: 1 set of live counts and 2 sets of photo counts. Intra-evaluator and inter-evaluator reliability measures for photo counts were evaluated using calculations of intraclass correlation coefficients (ICCs). RESULTS Eight subjects (2 males and 6 females) age between 16 and 40 (min 16 years, max 25 years) diagnosed with facial acne vulgaris participated in the study. Fitzpatrick Skin Types ranged from III to V (three Type-III, four Type-IV, and one Type-V). ICC values for intra-evaluator reliability were found to be >0.95 for each evaluator, and ICC for inter-evaluator reliability was found to be 0.98. CONCLUSIONS Photographic lesion count methodology is a reliable and accurate tool for objective measurement of ALCs and additionally, for training and/or qualifying evaluators.
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Affiliation(s)
- Michael H Gold
- Gold Skin Care Center, Nashville, Tennessee, USA.,Tennessee Clinical Research Center, Nashville, Tennessee, USA
| | - Ashish Bhatia
- Oak Dermatology, Naperville, Illinois, USA.,Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Bhatia A, Chen Z, Bruce J, Steuer C, Zandberg D, Riess J, Mitchell D, Davis T, Patel M, Kaur V, Arnold S, Owonikoko T. 656MO Phase I study of M6620 (VX-970, berzosertib) in combination with cisplatin and XRT in patients with locally advanced head and neck squamous cell carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.780] [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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14
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Dayal A, Bhatia A, Hsu JTS. Fat grafting in aesthetics. Clin Dermatol 2022; 40:35-44. [DOI: 10.1016/j.clindermatol.2021.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Bhatia A, Palacio M, Wright AM, Yeo GSH. Lower uterine segment scar assessment at 11-14 weeks' gestation to screen for placenta accreta spectrum in women with prior Cesarean delivery. Ultrasound Obstet Gynecol 2022; 59:40-48. [PMID: 34254386 DOI: 10.1002/uog.23734] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/03/2021] [Accepted: 07/05/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To validate prospectively transvaginal ultrasound assessment of the lower uterine segment (LUS) scar at the time of first-trimester screening in women with previous Cesarean section (CS) and to determine its feasibility and accuracy in stratifying women according to the risk for placenta accreta spectrum (PAS) disorder. METHODS Women with a history of CS were recruited between 11 + 0 and 13 + 6 weeks' gestation and underwent LUS scar assessment using transvaginal ultrasound. A standardized midsagittal plane, which included the cervicoisthmic canal (CIC), the uterine scar and the placental site, was obtained. The scar was described in terms of its size (narrow or dehiscent) and its location in relation to the CIC (within or above), with each LUS scar classified into one of four groups based on these features. Placental location was assessed and classified as high- or low-lying. Women were stratified according to the risk of PAS, based on the relationship between the scar location and placental site. Women were considered high risk when the scar was above the CIC and the placenta was low-lying (i.e. when the placenta was overlying an exposed scar) and low risk when the scar was within the CIC and/or the placenta was high. High-risk patients were followed up at 20 weeks and 28-30 weeks for the development of PAS. Maternal demographics, detailed obstetric history and obstetric outcome were collected. RESULTS First-trimester transvaginal ultrasound was offered to 535 women with prior CS during the study period. A LUS scar was visualized in 79.9% (401/502) of those who agreed to undergo the examination. At this scan, the LUS scar was above the CIC in 9.0% (36/401) of women, but only 5.7% (23/401) additionally had a low-lying placenta overlying the scar. Of these 23 high-risk women, two were found to have PAS on the mid-trimester screening scan and one was noted to have placental adherence during evacuation following mid-trimester termination of pregnancy. On the first-trimester scan, 94.3% (378/401) of women were at low risk of PAS. This screening protocol yielded a positive likelihood ratio of 21.33 (95% CI, 13.02-34.96), sensitivity of 100% (95% CI, 29.24-100%), specificity of 95.31% (95% CI, 92.39-97.35%), positive predictive value of 16.7% (95% CI, 5.8-39.2%) and negative predictive value of 100% (95% CI, 98.4-100%). On multivariable regression analysis performed to identify confounding variables associated with a LUS scar above the CIC, only maternal body mass index ≥ 30 kg/m2 was significant (odds ratio (OR), 2.42 (95% CI, 1.04-5.39); P = 0.03). Although there was a trend towards an increased risk of a LUS scar above the CIC in women with prior elective prelabor CS (OR, 1.72 (95% CI, 0.80-3.68)), this association did not reach statistical significance. CONCLUSIONS Routine transvaginal ultrasound assessment of the location of the LUS scar and placenta at the time of first-trimester screening between 11 + 0 and 13 + 6 weeks' gestation in women with prior CS is a feasible and effective tool to identify those at risk of subsequent development of PAS disorder. A finding of placental implantation over an exposed LUS scar seems to be cardinal in predicting the risk of PAS disorder in women with prior CS, with an excellent negative predictive value. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- A Bhatia
- Department of Maternal-Fetal Medicine, KK Women's and Children's Hospital, Singapore
| | - M Palacio
- Hospital Clinic of Barcelona (BCNatal), IDIBAPS, University of Barcelona, CIBER-ER, Barcelona, Spain
| | - A M Wright
- Department of Maternal-Fetal Medicine, KK Women's and Children's Hospital, Singapore
| | - G S H Yeo
- Department of Maternal-Fetal Medicine, KK Women's and Children's Hospital, Singapore
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Bhatia A, Hutchinson NC. Really Well Being Groups. Eur J Integr Med 2021. [DOI: 10.1016/j.eujim.2021.101942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Feygin T, Goldman-Yassen AE, Licht DJ, Schmitt JE, Mian A, Vossough A, Castelo-Soccio L, Treat JR, Bhatia A, Pollock AN. Neuroaxial Infantile Hemangiomas: Imaging Manifestations and Association with Hemangioma Syndromes. AJNR Am J Neuroradiol 2021; 42:1520-1527. [PMID: 34244133 DOI: 10.3174/ajnr.a7204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 01/14/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE Infantile hemangiomas are common lesions in the pediatric population; in rare cases, an infantile hemangioma can be detected along the neural axis. The purposes of our study included determination of the incidence, location, and imaging appearance of neuroaxial infantile hemangiomas and their syndromic association. We also assessed additional features of cerebral and cardiovascular anomalies that may be associated with neuroaxial lesions. MATERIALS AND METHODS A retrospective cohort study was performed, searching the radiology database for patients with segmental infantile hemangiomas referred for assessment of possible hemangioma syndromes. We retrospectively reviewed brain and spine MR imaging studies, with particular attention paid to neuroaxial vascular lesions, as well as the relevant clinical data. Neuroaxial hemangioma imaging findings were described, and comparison of segmental cutaneous infantile hemangioma location with the imaging findings was performed in patients with confirmed hemangioma syndromes and in patients with isolated skin infantile hemangioma. RESULTS Ninety-five patients with segmental infantile hemangioma were included in the study, 42 of whom had a hemangioma syndrome; of those, 41 had posterior fossa brain malformations, hemangioma, arterial lesions, cardiac abnormalities, and eye abnormalities (PHACE) syndrome and 1 had diffuse neonatal hemangiomatosis. Neuroaxial involvement was detected in 20/42 patients (48%) with hemangioma syndromes and in no subjects with isolated segmental infantile hemangioma (P < .001). The most common intracranial hemangioma location was within the ipsilateral internal auditory canal (83%). CONCLUSIONS Many pediatric patients with segmental infantile hemangioma in the setting of hemangioma syndromes, especially those with PHACE, had neuroaxial hemangiomas. This finding may potentially lead to requiring additional clinical evaluation and management of these patients.
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Affiliation(s)
- T Feygin
- Division of Neuroradiology (T.F., A.V., A.N.P.), Department of Radiology, The C hildren's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - A E Goldman-Yassen
- Department of Radiology (A.E.G.-Y.), Children's Healthcare of Atlanta, Atlanta, Georgia
| | - D J Licht
- Department of Neurology (D.J.L.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - J E Schmitt
- Division of Neuroradiology (J.E.S.), Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - A Mian
- Division of Neuroradiology (A.M.), Department of Radiology, Mallinckrodt Institute of Radiology, St. Louis, Missouri
| | - A Vossough
- Division of Neuroradiology (T.F., A.V., A.N.P.), Department of Radiology, The C hildren's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - L Castelo-Soccio
- Department of Dermatology (L.C.-S, J.R.T.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - J R Treat
- Department of Dermatology (L.C.-S, J.R.T.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - A Bhatia
- Department of Radiology (A.B.), The Children's Hospital of Pittsburg, Philadelphia, Pennsylvania
| | - A N Pollock
- Division of Neuroradiology (T.F., A.V., A.N.P.), Department of Radiology, The C hildren's Hospital of Philadelphia, Philadelphia, Pennsylvania
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18
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Abstract
BACKGROUND The intrauterine environment is a key determinant for long-term health outcomes. Adverse fetal environments, such as maternal diabetes, obesity and placental insufficiency are strongly associated with long-term health risks in children. Little is known about differences in fetal cardiac output hemodynamics of diabetic mothers (DM) vs. non-diabetic mothers (NDM). Our study aims to investigate the left-sided, right-sided, and combined cardiac output (CCO) in fetuses of DM vs. NDM. METHODS Retrospective data were collected in fetuses of DM (N = 532) and NDM (103) at mean gestational age 24 weeks. Examination included 2D echo and pulse wave Doppler. Wilcoxon rank sum tests and Chi-square tests were used to test for distribution difference of maternal and fetal continuous and categorical measures respectively between DM and NDM. Intraclass correlation coefficients were calculated to assess intra-observer reliability of fetal cardiac measurements. RESULTS DM mothers had higher mean weight (89.7±22.2 kg) than NDM (76.8±19.8 kg), p < 0.0001 and higher mean BMI (33.4±7.5) than NDM (28.3±5.8), p < 0.0001. C-section delivery occurred in 66% of DM vs. 35% of NDM fetuses. Fetuses of DM mothers had significantly larger semilunar valve diameter, higher left ventricular (LV) output, higher combined cardiac output and lower right ventricle /left ventricle ratio compared to NDM. CONCLUSION The greater CCO (adjusted for fetal weight), left sided cardiac output in the fetuses of DM, compared to NDM, represent differences in cardiac adaptation to the diabetic environment.
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Affiliation(s)
- S L Narasimhan
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - A Eid
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - A Bhatia
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - C Davey
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J Steinberger
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
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19
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Patel S, Bansal T, Chouhan DK, Bhatia A, Medhi B, Kakkar N, Singh Dhillon M. Adding Injectable Chitosan Poloxamer to Platelet Rich Plasma PRP Has no Beneficial Effect in Knee OA. A prospective Experimental Study in Guinea Pigs. Muscles Ligaments Tendons J 2020. [DOI: 10.32098/mltj.04.2020.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- S. Patel
- Department of Orthopaedics, Post Graduate Institute of Medical Education and Research PGIMER, Chandigarh, India
| | - T. Bansal
- Department of Orthopaedics, Post Graduate Institute of Medical Education and Research PGIMER, Chandigarh, India
| | - D. K. Chouhan
- Department of Orthopaedics, Post Graduate Institute of Medical Education and Research PGIMER, Chandigarh, India
| | - A. Bhatia
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research PGIMER, Chandigarh, India
| | - B. Medhi
- Department of Pharmacology, Post Graduate Institute of Medical Education and Research PGIMER, Chandigarh, India
| | - N. Kakkar
- DDepartment of Pathology, Post Graduate Institute of Medical Education and Research PGIMER, Chandigarh, India
| | - M. Singh Dhillon
- Department of Orthopaedics, Post Graduate Institute of Medical Education and Research PGIMER, Chandigarh, India
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20
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Bhatia A, McLane M, Priestley T, Vljyan S, Gelbard M. Human Pharmacokinetics and Safety of Subcutaneous Collagenase Clostridium Histolyticum in Women. J Drugs Dermatol 2020. [DOI: 10.36849/jdd.2020.5048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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21
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Bhatia A, Mastim M, Shah M, Gutte R, Joshi P, Kumbhar D, Periasamy H, Palwe SR, Chavan R, Bhagwat S, Patel M, Llorens L, Friedland HD. Efficacy and Safety of a Novel Broad-Spectrum Anti-MRSA Agent Levonadifloxacin Compared with Linezolid for Acute Bacterial Skin and Skin Structure Infections: A Phase 3, Openlabel, Randomized Study. J Assoc Physicians India 2020; 68:30-36. [PMID: 32738837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Levonadifloxacin is a novel broad-spectrum anti-MRSA agents belonging to the benzoquinolizine subclass of quinolone. It is developed for oral or intravenous administration for the treatment of infections caused by Gram-positive organisms including methicillin-resistant Staphylococcus aureus (MRSA). OBJECTIVES To establish the non-inferiority of levonadifloxacin compared with linezolid for the treatment of acute bacterial skin and skin structure infections (ABSSSI) and to compare the safety of the two antimicrobials. SUBJECTS AND METHODS This was a Phase 3, multicentre, randomized, open-label, active- comparator study with 500 subjects. Oral levonadifloxacin 1000 mg was compared with oral linezolid 600 mg whereas IV levonadifloxacin 800mg was compared with IV linezolid 600 mg, each treatment was administered twice daily for 7-10 days. Non-inferiority was evaluated by comparing oral levonadifloxacin to oral linezolid and IV levonadifloxacin to IV linezolid for overall clinical response at TOC (Test of Cure) Visit. RESULTS The clinical cure rates observed at the TOC in the mITT (modified Intent to treat) populations for levonadifloxacin was numerically higher compared to linezolid in the IV sub-group [(91.0% verses 87.8%); treatment difference of 3.2% (95%CI, -4.5 to 10.9)] and in the oral sub-group (95.2% versus 93.6%); treatment difference of 1.6 % [95%CI, -4.2 to 7.3]). As the lowerbound of the 95% CI around the treatment difference was greater than -15% for both subgroups, the primary objective of the study was met. Therefore, both IV levonadifloxacin and oral levonadifloxacin were non-inferior to IV linezolid and oral linezolid, respectively. The majority of subjects in the micro-ITT population had a baseline infection caused by S. aureus with approximately 30% of subjects having MRSA. Levonadifloxacin (IV and oral) had a higher clinical cure rate at TOC for MRSA patients compared with linezolid (IV and oral), (95.0% vs. 89.3% respectively). Levonadifloxacin showed evidence of favourable clinical and microbiological efficacy in subjects with concurrent bacteraemia as well as in subjects with diabetes including diabetic foot infections caused by Gram-positive pathogens including MRSA. Pharmacokinetic analysis showed that bioavailability of oral levonadifloxacin was 90% and similar pharmacokinetic profile of levonadifloxacin by both routes provide an option for IV to oral switch for the treatment of subjects. Incidences of treatment-emergent adverse events (TEAEs) were similar between treatment groups and between IV (20.8% vs. 22.4%, for levonadifloxacin and linezolid, respectively) and oral therapy (16.0% vs. 13.5%, respectively), There were no SAEs or deaths related to study drug and the majority of the AEs observed were mild in nature. Overall, the administration of both IV and oral levonadifloxacin was well-tolerated in subjects with ABSSSI. CONCLUSIONS The results demonstrate that IV and oral levonadifloxacin therapy has excellent clinical activity against MRSA and offers advantage compared to other quinolones which generally lack MRSA coverage. Levonadifloxacin is safe and well tolerated in the treatment of ABSSSI caused by Gram -positive pathogens including MRSA as well as non-inferior to IV and oral linezolid, respectively. Similar pharmacokinetic profile of IV and oral levonadifloxacin provides an option for IV to oral switch for the treatment of subjects. Both oral and IV levonadifloxacin have recently been granted approval in India for the treatment of ABSSSI including diabetic foot infections and concurrent bacteraemia in adults (18 years of age or older). ClinicalTrials.gov Registration: NCT03405064. CTRI No.: CTRI/2017/06/008843.
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Affiliation(s)
- A Bhatia
- Wockhardt Ltd., Mumbai, Maharashtra
| | - M Mastim
- Wockhardt Ltd., Mumbai, Maharashtra
| | - M Shah
- Wockhardt Ltd., Mumbai, Maharashtra
| | - R Gutte
- Wockhardt Ltd., Mumbai, Maharashtra
| | - P Joshi
- Wockhardt Ltd., Mumbai, Maharashtra
| | | | - H Periasamy
- Wockhardt R and D Centre, Aurangabad, Maharashtra
| | - S R Palwe
- Wockhardt R and D Centre, Aurangabad, Maharashtra
| | - R Chavan
- Wockhardt R and D Centre, Aurangabad, Maharashtra
| | - S Bhagwat
- Wockhardt R and D Centre, Aurangabad, Maharashtra
| | - M Patel
- Wockhardt R and D Centre, Aurangabad, Maharashtra
| | - L Llorens
- Wockhardt's Morton Grove Pharmaceuticals Inc., Morton Grove, Illinois, USA
| | - H D Friedland
- Wockhardt's Morton Grove Pharmaceuticals Inc., Morton Grove, Illinois, USA
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22
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Shanthanna H, Strand NH, Provenzano DA, Lobo CA, Eldabe S, Bhatia A, Wegener J, Curtis K, Cohen SP, Narouze S. Caring for patients with pain during the COVID-19 pandemic: consensus recommendations from an international expert panel. Anaesthesia 2020; 75:935-944. [PMID: 32259288 PMCID: PMC7262200 DOI: 10.1111/anae.15076] [Citation(s) in RCA: 162] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2020] [Indexed: 12/17/2022]
Abstract
Chronic pain causes significant suffering, limitation of daily activities and reduced quality of life. Infection from COVID-19 is responsible for an ongoing pandemic that causes severe acute respiratory syndrome, leading to systemic complications and death. Led by the World Health Organization, healthcare systems across the world are engaged in limiting the spread of infection. As a result, all elective surgical procedures, outpatient procedures and patient visits, including pain management services, have been postponed or cancelled. This has affected the care of chronic pain patients. Most are elderly with multiple comorbidities, which puts them at risk of COVID-19 infection. Important considerations that need to be recognised during this pandemic for chronic pain patients include: ensuring continuity of care and pain medications, especially opioids; use of telemedicine; maintaining biopsychosocial management; use of anti-inflammatory drugs; use of steroids; and prioritising necessary procedural visits. There are no guidelines to inform physicians and healthcare providers engaged in caring for patients with pain during this period of crisis. We assembled an expert panel of pain physicians, psychologists and researchers from North America and Europe to formulate recommendations to guide practice. As the COVID-19 situation continues to evolve rapidly, these recommendations are based on the best available evidence and expert opinion at this present time and may need adapting to local workplace policies.
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Affiliation(s)
- H Shanthanna
- Department of Anesthesia, McMaster University, ON, Canada
| | - N H Strand
- Division of Pain Medicine, Mayo Clinic Alix School of Medicine, Phoenix, AZ, USA
| | - D A Provenzano
- Pain Diagnostics and Interventional Care, Sewickley, PA, USA
| | - C A Lobo
- Department of Anaesthesiology, Hospital das Forças Armadas, Pólo Porto, Portugal
| | - S Eldabe
- Department of Pain Medicine, James Cook University Hospital, Middlesbrough, UK
| | - A Bhatia
- Comprehensive Integrated Pain Program-Interventional Pain Service, Department of Anesthesia and Pain Medicine, University of Toronto and Toronto Western Hospital, Toronto, ON, Canada
| | - J Wegener
- Department of Anesthesiology, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - K Curtis
- Comprehensive Integrated Pain Program-Interventional Pain Service, Department of Anesthesia and Pain Medicine, Toronto Western Hospital, Toronto, ON, Canada
| | - S P Cohen
- Department of Anesthesiology and Critical Care Medicine, Neurology and Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - S Narouze
- Northeast Ohio Medical University and Chairman, Center for Pain Medicine, Western Reserve Hospital, Cuyahoga Falls, OH, USA
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23
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Chawla D, Olet S, Mortada ME, Zilinski J, Ammar KA, Nangia V, Bhatia A, Niazi I, Sra J, Tajik AJ, Jahangir A. P5658Incorporation of severity of left atrial enlargement in clinical risk factors improves identification of patients at risk for development of atrial fibrillation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0601] [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: 11/14/2022] Open
Abstract
Abstract
Background
Early identification of patients at risk for atrial fibrillation (AF) is desirable to prevent its development and complications. Clinical predictors have been recognized but need refinement to improve predictability. We evaluated whether severity of left atrial enlargement (LAE) added to a scoring system (CHA2DS2VASC) in an unselected non-AF population improves risk stratification for incident AF.
Purpose
To assess the incremental benefit of LAE severity added to CHA2DS2VASc in predicting future AF in non-AF patients.
Methods
From 2012–2017, consecutive adult patients with an echocardiogram and no prior AF were identified. CHA2DS2VASc was used to define baseline AF risk, and the incremental risk of AF with addition of LAE was assessed through increased LA volume index (LAVI; moderate 42–48 ml/m2, severe >48 ml/m2). To quantify improvement in risk prediction, logistic regression model was fitted and odds ratios (OR) and ROC curves obtained.
Results
Out of 155,597 patients with no prior AF, 13.8% developed AF over 1.5±1.3 years. OR for AF with CHA2DS2VASc was 1.68 (95% CI 1.66–1.69). With addition of moderately or severely increased LAVI to the model, OR for AF increased to 2.3 (2.2–2.5) and 3.8 (3.6–4.0), respectively. ROC analysis showed c-statistics of 0.66 with CHA2DS2VASc, 0.63 with LAVI, and 0.71 with incorporation of both (Fig).
AF CHAD score
Conclusion(s)
In non-AF patients, predictability for future AF can be improved by using clinical factors (CHA2DS2VASc) and increased LAVI. This information may guide closer monitoring and initiation of therapies to prevent progression to AF or stroke.
Acknowledgement/Funding
None
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Affiliation(s)
- D Chawla
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - S Olet
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - M E Mortada
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - J Zilinski
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - K A Ammar
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - V Nangia
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - A Bhatia
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - I Niazi
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - J Sra
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - A J Tajik
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - A Jahangir
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
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24
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Loganadane V G, Kann B, Park H, Johnson S, Mehra S, Judson B, Bhatia A, Belkacemi Y, Yarbrough W, Burtness B, Husain Z. Clinical Outcomes of Head and Neck Cancer Patients who Undergo Resection, but Forgo Adjuvant Therapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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25
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Reynolds BB, By S, Weinberg QR, Witt AA, Newton AT, Feiler HR, Ramkorun B, Clayton DB, Couture P, Martus JE, Adams M, Wellons JC, Smith SA, Bhatia A. Quantification of DTI in the Pediatric Spinal Cord: Application to Clinical Evaluation in a Healthy Patient Population. AJNR Am J Neuroradiol 2019; 40:1236-1241. [PMID: 31196859 PMCID: PMC7048550 DOI: 10.3174/ajnr.a6104] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 05/16/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND PURPOSE The purpose of the study is to characterize diffusion tensor imaging indices in the developing spinal cord, evaluating differences based on age and cord region. Describing the progression of DTI indices in the pediatric cord increases our understanding of spinal cord development. MATERIALS AND METHODS A retrospective analysis was performed on DTI acquired in 121 pediatric patients (mean, 8.6 years; range, 0.3-18.0 years) at Monroe Carell Jr. Children's Hospital at Vanderbilt from 2017 to 2018. Diffusion-weighted images (15 directions; b = 750 s/mm2; slice thickness, 5 mm; in-plane resolution, 1.0 × 1.0 mm2) were acquired on a 3T scanner in the cervicothoracic and/or thoracolumbar cord. Manual whole-cord segmentation was performed. Images were masked and further segmented into cervical, upper thoracic, thoracolumbar, and conus regions. Analyses of covariance were performed for each DTI-derived index to investigate how age affects diffusion across cord regions, and 95% confidence intervals were calculated across age for each derived index and region. Post hoc testing was performed to analyze regional differences. RESULTS Analyses of covariance revealed significant correlations of age with axial diffusivity, mean diffusivity, and fractional anisotropy (all, P < .001). There were also significant differences among cord regions for axial diffusivity, radial diffusivity, mean diffusivity, and fractional anisotropy (all, P < .001). CONCLUSIONS This research demonstrates that diffusion evolves in the pediatric spinal cord during development, dependent on both cord region and the diffusion index of interest. Future research could investigate how diffusion may be affected by common pediatric spinal pathologies.
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Affiliation(s)
- B B Reynolds
- Institute of Imaging Science (B.B.R., S.B., Q.R.W., A.A.W., A.T.N., H.R.F., B.R., S.A.S., A.B.), Vanderbilt University, Nashville, Tennessee
| | - S By
- Institute of Imaging Science (B.B.R., S.B., Q.R.W., A.A.W., A.T.N., H.R.F., B.R., S.A.S., A.B.), Vanderbilt University, Nashville, Tennessee
| | - Q R Weinberg
- Institute of Imaging Science (B.B.R., S.B., Q.R.W., A.A.W., A.T.N., H.R.F., B.R., S.A.S., A.B.), Vanderbilt University, Nashville, Tennessee
| | - A A Witt
- Institute of Imaging Science (B.B.R., S.B., Q.R.W., A.A.W., A.T.N., H.R.F., B.R., S.A.S., A.B.), Vanderbilt University, Nashville, Tennessee
| | - A T Newton
- From the Department of Radiology and Radiological Sciences (A.T.N., P.C., S.A.S., A.B.).,Pediatrics (A.T.N.).,Institute of Imaging Science (B.B.R., S.B., Q.R.W., A.A.W., A.T.N., H.R.F., B.R., S.A.S., A.B.), Vanderbilt University, Nashville, Tennessee
| | - H R Feiler
- Institute of Imaging Science (B.B.R., S.B., Q.R.W., A.A.W., A.T.N., H.R.F., B.R., S.A.S., A.B.), Vanderbilt University, Nashville, Tennessee
| | - B Ramkorun
- Institute of Imaging Science (B.B.R., S.B., Q.R.W., A.A.W., A.T.N., H.R.F., B.R., S.A.S., A.B.), Vanderbilt University, Nashville, Tennessee
| | | | - P Couture
- From the Department of Radiology and Radiological Sciences (A.T.N., P.C., S.A.S., A.B.)
| | - J E Martus
- Division of Pediatric Orthopaedics (J.E.M.), Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee
| | | | - J C Wellons
- From the Department of Radiology and Radiological Sciences (A.T.N., P.C., S.A.S., A.B.).,Department of Ophthalmology (S.A.S., J.C.W. III), Vanderbilt University Medical Center, Nashville, Tennessee
| | - S A Smith
- From the Department of Radiology and Radiological Sciences (A.T.N., P.C., S.A.S., A.B.).,Department of Biomedical Engineering (S.A.S.).,Institute of Imaging Science (B.B.R., S.B., Q.R.W., A.A.W., A.T.N., H.R.F., B.R., S.A.S., A.B.), Vanderbilt University, Nashville, Tennessee.,Department of Ophthalmology (S.A.S., J.C.W. III), Vanderbilt University Medical Center, Nashville, Tennessee
| | - A Bhatia
- From the Department of Radiology and Radiological Sciences (A.T.N., P.C., S.A.S., A.B.) .,Institute of Imaging Science (B.B.R., S.B., Q.R.W., A.A.W., A.T.N., H.R.F., B.R., S.A.S., A.B.), Vanderbilt University, Nashville, Tennessee
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26
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Chakrabarti B, Singh SD, Bhatia A, Kumar V, Harit RC. Yield and Nitrogen Uptake in Wheat and Chickpea Grown Under Elevated Carbon Dioxide Level. Natl Acad Sci Lett 2019. [DOI: 10.1007/s40009-019-00816-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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27
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Bhatia A, Husaini M, Lin C, LeClair J, De Togni E, Becker N, Scott A, Terng M, Acevedo-Cintron J, Schilling J. How Dynamic are Hemodynamics?: Short-Term Changes in Hemodynamic Measures and Indices among Heart Failure Patients. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.962] [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: 10/27/2022] Open
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28
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Bhatia A, Ji J, Peacock J, Hartupee J, Ewald G. Echocardiographic Characteristics Associated with Left Ventricular Recovery in Donor Hearts. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.654] [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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29
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30
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Mathew PJ, Madan R, Subramaniam R, Bhatia A, Mala CG, Soodan A, Kaul HL. Efficacy of Low-dose Dexamethasone for Preventing Postoperative Nausea and Vomiting following Strabismus Repair in Children. Anaesth Intensive Care 2019; 32:372-6. [PMID: 15264733 DOI: 10.1177/0310057x0403200312] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We studied the efficacy of a range of doses of dexamethasone for prevention of postoperative nausea and vomiting following strabismus repair in children in a hospital-based, prospective, double-blinded, randomized, placebo-controlled trial. Two hundred and ten children were randomized to receive either dexamethasone in one of four dosages: 50 μg/kg (Group 1), 100 μg/kg (Group 2), 200 μg/kg (Group 3) and 250 μg/kg (Group 4) or normal saline (Group 5) prior to corrective surgery for strabismus. Anaesthesia was standardized and included nitrous oxide, pethidine, intubation and the use of muscle relaxant and reversal with neostigmine. Postoperative nausea and vomiting were evaluated in epochs of 0-2 hours, 2-6 hours and 6-24 hours after surgery. Parent satisfaction was assessed 24 hours after surgery and the operated eye was examined for wound infection and delayed healing one week later. Dexamethasone was effective in preventing nausea and vomiting after strabismus repair: 57.1% children in Group 1, 42.9% in Group 2, 52.4% in Group 3, and 59.5% in Group 4 were free from postoperative nausea and vomiting compared with 7.1% in placebo group. The lowest dose of 50 μg/kg was as efficacious as the higher dosages of dexamethasone during the 24 hours studied. Of the children who developed postoperative nausea and vomiting, those who received dexamethasone had significantly fewer episodes than those in the placebo group. We conclude that dexamethasone 50 μg/kg is effective for the prevention of postoperative nausea and vomiting following strabismus repair in children.
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Affiliation(s)
- P J Mathew
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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31
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Aspenberg M, Karna S, Dhatt S, Behera P, Bhatia A. Can Platelet rich plasma stimulate human ACL growth in culture? A preliminary experience. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.03.2015.03] [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: 11/05/2022]
Affiliation(s)
- M.S. Aspenberg
- Department of Orthopedics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | - S.S. Dhatt
- Department of Orthopedics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - P. Behera
- Department of Orthopedics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - A. Bhatia
- Department of Experimental Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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32
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Ramdas M, Sharma S, Kaul D, Bhatia A. Possible role of miR-2909 RNomics in arsenic mediated pancreatic β-cell dysfunction. J Trace Elem Med Biol 2018; 50:263-267. [PMID: 30262289 DOI: 10.1016/j.jtemb.2018.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 07/01/2018] [Accepted: 07/09/2018] [Indexed: 12/12/2022]
Abstract
Chronic exposure of humans to inorganic arsenic as a potential risk for the incidence of diabetes has received wide attention. However, the biological mechanism through which arsenic plays a role in the development of diabetes is still being evaluated. One of the hallmark of diabetes is the β-cell dysfunction followed by the changes in the insulin secretion. Pancreatic duodenal homeobox 1 (PDX1) has been widely recognized to play crucial role in the β-cell development, survival and its regulation of insulin gene expression. Many of the arsenic mediated cellular affects have been shown to be regulated by miR-2909 in vitro. Our present study provides evidence to reveal that arsenic affects miR-2909 expression in the pancreatic β-cell and this novel miRNA regulates PDX1 transcriptional expression indirectly through genes coding for c-Jun, MafA, PI3K and directly at the translational level by targeting the PDX1 mRNA. We provide further evidence for this miR-2909 RNomics in pancreatic tissue obtained from NOD mice where the expression of miR-2909 was high compared to the control mice. Keeping in view the fact that arsenic is known to cause β-cell dysfunction and most of the cellular effects of arsenic have been shown to be mediated through miR-2909 RNomics, our study revealed that arsenic employs miR-2909 (at low doses) and c-Jun (at high doses) to down regulate PDX1 in order to cause β-cell dysfunction leading to diabetic state.
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Affiliation(s)
- M Ramdas
- Department of Experimental Medicine & Biotechnology, Post-graduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - S Sharma
- Department of Experimental Medicine & Biotechnology, Post-graduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - D Kaul
- Department of Experimental Medicine & Biotechnology, Post-graduate Institute of Medical Education & Research, Chandigarh, 160012, India.
| | - A Bhatia
- Department of Experimental Medicine & Biotechnology, Post-graduate Institute of Medical Education & Research, Chandigarh, 160012, India
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Jiang L, Hino PD, Bhatia A, Stephens TJ, Jimenez F. Efficacy of Trifecting ® Night Cream, a Novel Triple acting Skin Brightening Product: A Double-blind, Placebo-controlled Clinical Study. J Clin Aesthet Dermatol 2018; 11:21-25. [PMID: 30666274 PMCID: PMC6334832] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Background: Melasma is a common, persistent disorder of hyperpigmented facial skin predominantly attributed to ultraviolet light exposure, hormonal influences, and genetic predisposition. Objectives: This double-blind, placebo-controlled, randomized clinical trial was conducted to assess the efficacy and tolerance of a multimodality night cream when used over a course of 24 weeks followed by a four-week regression in female subjects with moderate to severe melasma, presence of solar lentigines, and periocular lines and wrinkles. Methods: Subjects were randomized into one of two groups: Cell 1 received Trifecting® Night Cream (Envy Medical, Long Beach, California) 1.0 and Cell 2 did not. All subjects were supplied with a two-product regimen comprising a cleanser and sunscreen to use during the trial. Clinical grading, tolerability assessments, and Chroma Meter measurements (Konica Minolta, Tokyo, Japan) were performed at baseline and at Weeks 8, 16, 24, and 28 (regression). Standardized digital photographs were taken and self-assessment questionnaires were completed. Results: Twenty-five subjects completed the 28-week study, with 14 subjects in Cell 1 and 11 subjects in Cell 2. Subjects in both groups showed improvements in facial conditions. Cell 1 outperformed Cell 2 in improving fine lines, solar lentigines, and melasma conditions. These improvements were sustained during regression period. Conclusions: Trifecting® Night Cream 1.0, is effective for the treatment of moderate to severe melasma, solar lentigines, and periocular lines and wrinkles over 24 weeks of usage, with its benefits sustained for at least four weeks after treatment.
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Affiliation(s)
- Lily Jiang
- Drs. Jiang, Hino, and Stephens are with Thomas J. Stephens & Associates in Richardson, Texas
- Dr. Bhatia is Associate Professor of Clinical Dermatology in the Department of Dermatology at Northwestern University Feinberg School of Medicine in Chicago, Illinois and Director of Dermatologic, Laser & Cosmetic Surgery at Oak Dermatology in Itasca, Illinois
- Dr. Jimenez is with Envy Medical Inc. in Long Beach, California
| | - Peter D Hino
- Drs. Jiang, Hino, and Stephens are with Thomas J. Stephens & Associates in Richardson, Texas
- Dr. Bhatia is Associate Professor of Clinical Dermatology in the Department of Dermatology at Northwestern University Feinberg School of Medicine in Chicago, Illinois and Director of Dermatologic, Laser & Cosmetic Surgery at Oak Dermatology in Itasca, Illinois
- Dr. Jimenez is with Envy Medical Inc. in Long Beach, California
| | - Ashish Bhatia
- Drs. Jiang, Hino, and Stephens are with Thomas J. Stephens & Associates in Richardson, Texas
- Dr. Bhatia is Associate Professor of Clinical Dermatology in the Department of Dermatology at Northwestern University Feinberg School of Medicine in Chicago, Illinois and Director of Dermatologic, Laser & Cosmetic Surgery at Oak Dermatology in Itasca, Illinois
- Dr. Jimenez is with Envy Medical Inc. in Long Beach, California
| | - Thomas J Stephens
- Drs. Jiang, Hino, and Stephens are with Thomas J. Stephens & Associates in Richardson, Texas
- Dr. Bhatia is Associate Professor of Clinical Dermatology in the Department of Dermatology at Northwestern University Feinberg School of Medicine in Chicago, Illinois and Director of Dermatologic, Laser & Cosmetic Surgery at Oak Dermatology in Itasca, Illinois
- Dr. Jimenez is with Envy Medical Inc. in Long Beach, California
| | - Felipe Jimenez
- Drs. Jiang, Hino, and Stephens are with Thomas J. Stephens & Associates in Richardson, Texas
- Dr. Bhatia is Associate Professor of Clinical Dermatology in the Department of Dermatology at Northwestern University Feinberg School of Medicine in Chicago, Illinois and Director of Dermatologic, Laser & Cosmetic Surgery at Oak Dermatology in Itasca, Illinois
- Dr. Jimenez is with Envy Medical Inc. in Long Beach, California
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Saeed N, Kelly J, Deshpande H, Bhatia A, Burtness B, Judson B, Mehra S, Osborn H, Yarbrough W, Peter P, Holt E, Decker R, Husain Z, Park H. Adjuvant External Beam Radiation Therapy for Surgically Resected, Non-Metastatic Anaplastic Thyroid Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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35
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Anwar M, Kochhar R, Bhatia A, Singh R, Mahmood S. Expression and mutational analysis of Exon 17 of TCF4 transcription factor in sporadic colorectal cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx659.048] [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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36
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Narula S, Sharma R, Tewari S, Bala K, Tanwar N, Kundu B, Bhatia A. Carotid artery wall imaging and improved post periodontal surgery cerebral blood flow assessment. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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37
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Narula S, Sharma R, Bala K, Tewari S, Tanwar N, Sharma N, Bhatia A. Neuroinflammatory marker (HSCRP) in early vs normal menopause and duration of menopause. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3079] [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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38
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Narula S, Sharma R, Bala K, Tewari S, Verma R, Tanwar N, Bhatia A. Neuroesthetic perception,interpretation and perioesthetic experience among different dental professionals. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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39
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Narula S, Sharma R, Bala K, Tewari S, Daiya S, Tanwar N, Bhatia A. SOD levels in healthy and chronic periodontitis perimnopausal women indicate neurodegeneration protection. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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40
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Bhatia A, Charet P. Action de la chloroquine sur le métabolisme du glutathion chez l’hématie parasitée par Plasmodium berghei. ACTA ACUST UNITED AC 2017. [DOI: 10.1051/parasite/1984593317] [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] [Indexed: 11/14/2022]
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41
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Spring LK, Krakowski AC, Alam M, Bhatia A, Brauer J, Cohen J, Del Rosso JQ, Diaz L, Dover J, Eichenfield LF, Gurtner GC, Hanke CW, Jahnke MN, Kelly KM, Khetarpal S, Kinney MA, Levy ML, Leyden J, Longaker MT, Munavalli GS, Ozog DM, Prather H, Shumaker PR, Tanzi E, Torres A, Velez MW, Waldman AB, Yan AC, Zaenglein AL. Isotretinoin and Timing of Procedural Interventions: A Systematic Review With Consensus Recommendations. JAMA Dermatol 2017; 153:802-809. [PMID: 28658462 DOI: 10.1001/jamadermatol.2017.2077] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
Importance The notion that systemic isotretinoin taken within 6 to 12 months of cutaneous surgery contributes to abnormal scarring or delayed wound healing is widely taught and practiced; however, it is based on 3 small case series from the mid-1980s. Objective To evaluate the body of literature to provide evidence-based recommendations regarding the safety of procedural interventions performed either concurrently with, or immediately following the cessation of systemic isotretinoin therapy. Evidence Review A panel of national experts in pediatric dermatology, procedural/cosmetic dermatology, plastic surgery, scars, wound healing, acne, and isotretinoin was convened. A systematic PubMed review of English-language articles published from 1982 to 2017 was performed using the following search terms: isotretinoin, 13-cis-retinoic acid, Accutane, retinoids, acitretin, surgery, surgical, laser, ablative laser, nonablative laser, laser hair removal, chemical peel, dermabrasion, wound healing, safety, scarring, hypertrophic scar, and keloid. Evidence was graded, and expert consensus was obtained. Findings Thirty-two relevant publications reported 1485 procedures. There was insufficient evidence to support delaying manual dermabrasion, superficial chemical peels, cutaneous surgery, laser hair removal, and fractional ablative and nonablative laser procedures for patients currently receiving or having recently completed isotretinoin therapy. Based on the available literature, mechanical dermabrasion and fully ablative laser are not recommended in the setting of systemic isotretinoin treatment. Conclusions and Relevance Physicians and patients may have an evidence-based discussion regarding the known risk of cutaneous surgical procedures in the setting of systemic isotretinoin therapy. For some patients and some conditions, an informed decision may lead to earlier and potentially more effective interventions.
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Affiliation(s)
- Leah K Spring
- Dermatology Department, Naval Hospital Camp Lejeune, Camp Lejeune, North Carolina
| | | | - Murad Alam
- Department of Dermatology, Northwestern University, Chicago, Illinois
| | - Ashish Bhatia
- DuPage Medical Group, Department of Dermatology, Northwestern University, Chicago, Illinois
| | - Jeremy Brauer
- Laser and Skin Surgery Center of New York, New York
- Department of Dermatology, New York University School of Medicine, New York
| | - Joel Cohen
- AboutSkin Dermatology, Lone Tree, Colorado
- DermSurgery, Lone Tree, Colorado
| | - James Q Del Rosso
- Dermatology Department, Touro University Nevada College of Health and Human Services, Henderson
| | - Lucia Diaz
- Dell Children's Medical Center, University of Texas Austin Dell Medical School, Austin
| | | | - Lawrence F Eichenfield
- Department of Dermatology, University of California-San Diego
- Rady Children's Hospital, San Diego, California
| | | | | | - Marla N Jahnke
- Department of Dermatology, Henry Ford Health System, Detroit, Michigan
- Division of Pediatric Dermatology, Children's Hospital of Michigan, Detroit, Michigan
| | | | | | | | - Moise L Levy
- Dell Children's Medical Center, University of Texas Austin Dell Medical School, Austin
| | | | - Michael T Longaker
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California
| | - Girish S Munavalli
- Department of Dermatology, School of Medicine, Wake Forest University, Charlotte, North Carolina
- Dermatology, Laser, and Vein Specialists of the Carolinas, PLLC, Charlotte, North Carolina
| | - David M Ozog
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | | | | | - Elizabeth Tanzi
- Dermatology Department, George Washington University School of Medicine, Washington, DC
| | - Abel Torres
- Loma Linda University Medical Center, Loma Linda, California
| | | | | | - Albert C Yan
- Section of Dermatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics and Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
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42
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Wani S, Kaul D, Mavuduru RS, Kakkar N, Bhatia A. Urinary-exosomal miR-2909: A novel pathognomonic trait of prostate cancer severity. J Biotechnol 2017; 259:135-139. [PMID: 28764970 DOI: 10.1016/j.jbiotec.2017.07.029] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/24/2017] [Accepted: 07/25/2017] [Indexed: 11/15/2022]
Abstract
The global occurrence of prostate cancer with a range of patient outcome has prompted various investigators to explore novel molecular biomarkers that can precisely detect and track this type of cancer severity. Several studies suggest that micro-RNAs have emerged to act as a new largely unexplored class of biomarkers because of their inherent stability, resilience and recruitment into exosomes present in various human body fluids. With this study, we aim to reveal the nature of urinary-exosomal miR-2909 & miR-615-3p recruitment in patients suffering from either prostate cancer (n=90) or bladder cancer (n=60) as compared to that in either prostate disease-control subjects having benign prostate hyperplasia (n=10) or healthy subjects (n=50). Unlike miR-615-3p, the urinary- exosomal miR-2909 recruitment was not only observed conspicuously in subjects having prostate cancer in comparison to bladder cancer but also the extent of urinary exosomal miR-2909 recruitment showed characteristic variation as a function of prostate cancer aggressiveness as compared to that of either urinary- exosomal miR-615-3p level or existing widely recognised serum prostate specifics antigen (PSA) biomarker of this cancer. In summary, we propose that the extent of urinary exosomal miR-2909 recruitment may provide a potential non-invasive candidate diagnostic marker for the detection of prostate cancer and its aggressiveness.
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Affiliation(s)
- S Wani
- Department of Experimental Medicine & Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - D Kaul
- Department of Experimental Medicine & Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
| | - R S Mavuduru
- Department of Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - N Kakkar
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - A Bhatia
- Department of Experimental Medicine & Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
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43
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Zou M, Bhatia A, Dong H, Jayaprakash P, Guo J, Sahu D, Hou Y, Tsen F, Tong C, O'Brien K, Situ AJ, Schmidt T, Chen M, Ying Q, Ulmer TS, Woodley DT, Li W. Evolutionarily conserved dual lysine motif determines the non-chaperone function of secreted Hsp90alpha in tumour progression. Oncogene 2017; 36:2160-2171. [PMID: 27721406 PMCID: PMC5386837 DOI: 10.1038/onc.2016.375] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [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: 02/23/2016] [Revised: 08/30/2016] [Accepted: 09/01/2016] [Indexed: 12/16/2022]
Abstract
Both intracellular and extracellular heat shock protein-90 (Hsp90) family proteins (α and β) have been shown to support tumour progression. The tumour-supporting activity of the intracellular Hsp90 is attributed to their N-terminal ATPase-driven chaperone function. What molecular entity determines the extracellular function of secreted Hsp90 and the distinction between Hsp90α and Hsp90β was unclear. Here we demonstrate that CRISPR/Case9 knocking out Hsp90α nullifies tumour cells' ability to migrate, invade and metastasize without affecting the cell survival and growth. Knocking out Hsp90β leads to tumour cell death. Extracellular supplementation with recombinant Hsp90α, but not Hsp90β, protein recovers tumourigenicity of the Hsp90α-knockout cells. Sequential mutagenesis identifies two evolutionarily conserved lysine residues, lys-270 and lys-277, in the Hsp90α subfamily that determine the extracellular Hsp90α function. Hsp90β subfamily lacks the dual lysine motif and the extracellular function. Substitutions of gly-262 and thr-269 in Hsp90β with lysines convert Hsp90β to a Hsp90α-like protein. Newly constructed monoclonal antibody, 1G6-D7, against the dual lysine region of secreted Hsp90α inhibits both de novo tumour formation and expansion of already formed tumours in mice. This study suggests an alternative therapeutic approach to target Hsp90 in cancer, that is, the tumour-secreted Hsp90α, instead of the intracellular Hsp90α and Hsp90β.
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Affiliation(s)
- M Zou
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - A Bhatia
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - H Dong
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - P Jayaprakash
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - J Guo
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - D Sahu
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Y Hou
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - F Tsen
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - C Tong
- Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research and Department of Cell and Neurobiology, Los Angeles, CA, USA
| | - K O'Brien
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - A J Situ
- Department of Biochemistry and Molecular Biology and Zilkha Neurogenetic Institute University of Southern California Keck Medical Center, Los Angeles, CA, USA
| | - T Schmidt
- Department of Biochemistry and Molecular Biology and Zilkha Neurogenetic Institute University of Southern California Keck Medical Center, Los Angeles, CA, USA
| | - M Chen
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
- Department of Medical Research, Greater Los Angeles Veterans Affairs Heath Care System, Los Angeles, CA, USA
| | - Q Ying
- Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research and Department of Cell and Neurobiology, Los Angeles, CA, USA
| | - T S Ulmer
- Department of Biochemistry and Molecular Biology and Zilkha Neurogenetic Institute University of Southern California Keck Medical Center, Los Angeles, CA, USA
| | - D T Woodley
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
- Department of Medical Research, Greater Los Angeles Veterans Affairs Heath Care System, Los Angeles, CA, USA
| | - W Li
- Department of Dermatology and the Norris Comprehensive Cancer Center, Los Angeles, CA, USA
- Department of Medical Research, Greater Los Angeles Veterans Affairs Heath Care System, Los Angeles, CA, USA
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44
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Anyanwu E, Bhatia A, Tehrani D, Deshmukh A, Rodgers D, Adatya S, Sarswat N, Kim G, Sayer G, Ota T, Jeevanandam V, Uriel N. The Accuracy of Physical Exam Compared to RHC in LVAD Patients. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.957] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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45
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Deshmukh A, Bhatia A, Sarswat N, Adatya S, Kim G, Sayer G, Ozcan C, Ota T, Jeevanandam V, Uriel N. Left Atrial Appendage Occlusion Is Associated with Decreased Thromboembolic Events in LVAD Patients. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.284] [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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46
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Fagodiya RK, Pathak H, Kumar A, Bhatia A, Jain N. Global temperature change potential of nitrogen use in agriculture: A 50-year assessment. Sci Rep 2017; 7:44928. [PMID: 28322322 PMCID: PMC5359602 DOI: 10.1038/srep44928] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 02/10/2017] [Indexed: 11/09/2022] Open
Abstract
Nitrogen (N) use in agriculture substantially alters global N cycle with the short- and long-term effects on global warming and climate change. It increases emission of nitrous oxide, which contributes 6.2%, while carbon dioxide and methane contribute 76% and 16%, respectively of the global warming. However, N causes cooling due to emission of NOx, which alters concentrations of tropospheric ozone and methane. NOx and NH3 also form aerosols with considerable cooling effects. We studied global temperature change potential (GTP) of N use in agriculture. The GTP due to N2O was 396.67 and 1168.32 Tg CO2e on a 20-year (GTP20) and 439.94 and 1295.78 Tg CO2e on 100-year scale (GTP100) during years 1961 and 2010, respectively. Cooling effects due to N use were 92.14 and 271.39 Tg CO2e (GTP20) and 15.21 and 44.80 Tg CO2e (GTP100) during 1961 and 2010, respectively. Net GTP20 was 369.44 and 1088.15 Tg CO2e and net GTP100 was 429.17 and 1264.06 Tg CO2e during 1961 and 2010, respectively. Thus net GTP20 is lower by 6.9% and GTP100 by 2.4% compared to the GTP considering N2O emission alone. The study shows that both warming and cooling effects should be considered to estimate the GTP of N use.
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Affiliation(s)
- R. K. Fagodiya
- Centre for Environment Science and Climate Resilient Agriculture, ICAR-Indian Agricultural Research Institute, New Delhi 110012, India
| | - H. Pathak
- Centre for Environment Science and Climate Resilient Agriculture, ICAR-Indian Agricultural Research Institute, New Delhi 110012, India
| | - A. Kumar
- Centre for Environment Science and Climate Resilient Agriculture, ICAR-Indian Agricultural Research Institute, New Delhi 110012, India
| | - A. Bhatia
- Centre for Environment Science and Climate Resilient Agriculture, ICAR-Indian Agricultural Research Institute, New Delhi 110012, India
| | - N. Jain
- Centre for Environment Science and Climate Resilient Agriculture, ICAR-Indian Agricultural Research Institute, New Delhi 110012, India
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Bhat OM, Uday Kumar P, Harishankar N, Ravichandaran L, Bhatia A, Dhawan V. Interleukin-18-induced cell adhesion molecule expression is associated with feedback regulation by PPAR-γ and NF-κB in Apo E-/- mice. Mol Cell Biochem 2017; 428:119-128. [PMID: 28176248 DOI: 10.1007/s11010-016-2922-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 09/01/2016] [Accepted: 12/21/2016] [Indexed: 10/20/2022]
Abstract
Focal recruitment of monocytes and lymphocytes is one of the earliest detectable cellular responses in atherosclerotic lesion formation. Endothelium may regulate leukocyte recruitment by expressing specific adhesion molecules. Interleukin-18 is a proinflammatory cytokine that plays an important role in vascular pathologies. The present study highlights the modulation of adhesion molecules and PPAR-γ by IL-18 and proposes a novel feedback mechanism by which PPAR-γ may regulate IL-18 expression. Three groups of normal chow diet-fed, male Apo E-/- mice, aged 12 weeks (n = 6/group) were employed: Gp I, phosphate-buffered saline (PBS) (2 mo): Gp II, recombinant IL-18 (rIL-18) (1 mo) followed by PBS (1 mo); Gp III, rIL-18 (1 mo) followed by pyrrolidine dithiocarbamate (PDTC) (1 mo). Significantly augmented mRNA expression of ICAM-1 (~5.7-fold), VCAM-1 (~3.6-fold), and NF-κB (~7-fold) was observed in Gp II mice as compared to Gp I, whereas PPAR-γ expression was not altered. PDTC treatment caused a significant downregulation of ICAM-1 (~4.2-fold), VCAM-1(~2-fold), and NF-κB (~4.5-fold) and upregulation of PPAR-γ expression (~5-fold) in Gp III mice. A similar trend was observed in protein expression. In vivo imaging results demonstrated a marked increase in probe (CF750 dye conjugated to VCAM-1 antibody) fluorescence intensity for VCAM-1 expression in Gp II mice, whereas it was moderately decreased in Gp III. PPAR-γ was found to significantly downregulate both IL-18 levels and IL-18-induced adhesion molecules. The underlying mechanism was found to be via inhibition of NF-κB activity by PDTC, thereby leading to decreased adherence of monocytes to the activated endothelial cells and a step to halt the progression and development of atherosclerotic lesions.
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Affiliation(s)
- Owais Mohammad Bhat
- Department of Experimental Medicine and Biotechnology, Research Block-B, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.,Department of Pharmacology and Toxicology, Virginia Common Wealth University, Richmond, VA, USA
| | - P Uday Kumar
- Department of Histopathology, National Centre for Laboratory Animal Sciences (NCLAS), National Institute of Nutrition (NIN), Hyderabad, India
| | - N Harishankar
- Department of Histopathology, National Centre for Laboratory Animal Sciences (NCLAS), National Institute of Nutrition (NIN), Hyderabad, India
| | - L Ravichandaran
- Department of Histopathology, National Centre for Laboratory Animal Sciences (NCLAS), National Institute of Nutrition (NIN), Hyderabad, India
| | - A Bhatia
- Department of Experimental Medicine and Biotechnology, Research Block-B, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Veena Dhawan
- Department of Experimental Medicine and Biotechnology, Research Block-B, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
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Affiliation(s)
- B Gupta
- Department of Obstetrics and Gynecology, University College of Medical Sciences and GuruTeg Bahadur Hospital, New Delhi, India
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49
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Rajagopalan B, Shah Z, Narasimha D, Bhatia A, Kim CH, Switzer DF, Gudleski GH, Curtis AB. Efficacy of Intravenous Magnesium in Facilitating Cardioversion of Atrial Fibrillation. Circ Arrhythm Electrophysiol 2016; 9:CIRCEP.116.003968. [DOI: 10.1161/circep.116.003968] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 07/11/2016] [Indexed: 11/16/2022]
Abstract
Background—
Low serum magnesium (Mg) levels are associated with an increased risk of atrial fibrillation. Some studies have shown a benefit of Mg in facilitating pharmacological cardioversion. The role of an intravenous infusion of Mg alone in facilitating electric cardioversion is not clear.
Methods and Results—
In a prospective, randomized, double-blind, placebo-controlled trial, we enrolled patients with atrial fibrillation who were scheduled for electric cardioversion. Patients were randomized to receive Mg or placebo before cardioversion using a step-up protocol with 75, 100, 150, and 200 J biphasic shocks. Patients with hypokalemia, hypermagnesemia, or postcardiac surgery atrial fibrillation were excluded. Patients on antiarrhythmic drugs were included as long as they were at steady state. All patients were monitored for 1 hour post procedure for the maintenance of sinus rhythm. A total of 261 patients (69% male, mean age 65.5±11.1 years) were randomized (132 and 129 patients receiving Mg and placebo, respectively). Baseline characteristics were similar between both the groups. There was no statistically significant difference in the success rate of cardioversion between the 2 groups (86.4% versus 86.0%;
P
=0.94), cumulative amount of energy required for successful cardioversion (123.3±55.5 versus 129.5±52.6 J;
P
=0.40), or the number of shocks required to convert to sinus rhythm (2.25±1.24 versus 2.41±1.22,
P
=0.31). No adverse events were noted in either group.
Conclusions—
In patients undergoing electric cardioversion for persistent atrial fibrillation, Mg infusion does not increase the rate of successful cardioversion.
Clinical Trial Information—
URL:
https://clinicaltrials.gov
. Unique identifier: NCT01597557.
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Affiliation(s)
- Bharath Rajagopalan
- From the Department of Medicine, University at Buffalo, NY (B.R., G.H.G., A.B.C.); Department of Medicine, University of Kansas, Kansas City (Z.S.); Department of Medicine, Loma Linda University, CA (D.N.); and Division of Cardiac Electrophysiology, Great Lakes Cardiology P.C., Buffalo, NY (A.B., C.H.K., D.F.S.)
| | - Zubair Shah
- From the Department of Medicine, University at Buffalo, NY (B.R., G.H.G., A.B.C.); Department of Medicine, University of Kansas, Kansas City (Z.S.); Department of Medicine, Loma Linda University, CA (D.N.); and Division of Cardiac Electrophysiology, Great Lakes Cardiology P.C., Buffalo, NY (A.B., C.H.K., D.F.S.)
| | - Deepika Narasimha
- From the Department of Medicine, University at Buffalo, NY (B.R., G.H.G., A.B.C.); Department of Medicine, University of Kansas, Kansas City (Z.S.); Department of Medicine, Loma Linda University, CA (D.N.); and Division of Cardiac Electrophysiology, Great Lakes Cardiology P.C., Buffalo, NY (A.B., C.H.K., D.F.S.)
| | - Ashish Bhatia
- From the Department of Medicine, University at Buffalo, NY (B.R., G.H.G., A.B.C.); Department of Medicine, University of Kansas, Kansas City (Z.S.); Department of Medicine, Loma Linda University, CA (D.N.); and Division of Cardiac Electrophysiology, Great Lakes Cardiology P.C., Buffalo, NY (A.B., C.H.K., D.F.S.)
| | - Chee H. Kim
- From the Department of Medicine, University at Buffalo, NY (B.R., G.H.G., A.B.C.); Department of Medicine, University of Kansas, Kansas City (Z.S.); Department of Medicine, Loma Linda University, CA (D.N.); and Division of Cardiac Electrophysiology, Great Lakes Cardiology P.C., Buffalo, NY (A.B., C.H.K., D.F.S.)
| | - Donald F. Switzer
- From the Department of Medicine, University at Buffalo, NY (B.R., G.H.G., A.B.C.); Department of Medicine, University of Kansas, Kansas City (Z.S.); Department of Medicine, Loma Linda University, CA (D.N.); and Division of Cardiac Electrophysiology, Great Lakes Cardiology P.C., Buffalo, NY (A.B., C.H.K., D.F.S.)
| | - Gregory H. Gudleski
- From the Department of Medicine, University at Buffalo, NY (B.R., G.H.G., A.B.C.); Department of Medicine, University of Kansas, Kansas City (Z.S.); Department of Medicine, Loma Linda University, CA (D.N.); and Division of Cardiac Electrophysiology, Great Lakes Cardiology P.C., Buffalo, NY (A.B., C.H.K., D.F.S.)
| | - Anne B. Curtis
- From the Department of Medicine, University at Buffalo, NY (B.R., G.H.G., A.B.C.); Department of Medicine, University of Kansas, Kansas City (Z.S.); Department of Medicine, Loma Linda University, CA (D.N.); and Division of Cardiac Electrophysiology, Great Lakes Cardiology P.C., Buffalo, NY (A.B., C.H.K., D.F.S.)
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50
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Abstract
OBJECTIVE Complex wounds are often difficult to close and sometimes require a split-thickness skin graft (STSG). However, epidermal skin grafts, which contain only an epidermal layer of skin, are a viable option for wound coverage in these challenging wounds. We report our experience using an automated epidermal harvesting tool to harvest epidermal skin grafts for the treatment of complex wounds. METHOD Epidermal skin grafts were harvested from the patient's thigh, which was first washed with isopropyl alcohol. After harvesting, they were transferred to the recipient site using a film dressing. A bolster dressing using gauze and a self-adherent wrap held the grafts in place. RESULTS We selected 34 patients with wounds that had been present from several weeks to over a year. Prior treatments, included skin substitutes, alginate dressings, Unna Boot, and collagen dressings. There were 17 female and 17 male patients with a mean age of 67.1 years (range: 37-103). Wound types were: traumatic wounds, diabetic foot ulcers, venous stasis ulcers, pressure ulcers, and surgical wounds. Patient comorbidities included hypertension, diabetes, congestive heart failure, and osteoarthritis. Mean epithelialisation rate at the recipient site was 7.0 weeks (range: 1-35 weeks). Wound complications included drainage, hypergranulation, and oedema. At follow-up 82.4% (28/34) of wounds were healed, 2.9% (1/34) wounds showed improved healing, 11.8% (4/34) of wounds did not heal, and 2.9% (1/34) were lost to follow-up. All donor sites healed without complications. CONCLUSION In our cohort, use of epidermal skin grafts in conjunction with bolster dressings resulted in full closure or wound improvement of a majority of patients. Epidermal grafting provides another treatment option to physicians when only the epidermal layer is needed. DECLARATION OF INTEREST Dr. Bhatia is a consultant for KCI, an Acelity company.
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Affiliation(s)
- A Bhatia
- President and CEO, Columbus Podiatry and Surgery, Inc. and Total Healing Wound Centers, Columbus, OH, US, Assistant Medical Director, Wound Clinic, Fairfield Medical Center, Lancaster, OH, US
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