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Rao AR, Noronha V, Ramaswamy A, Kumar A, Pillai A, Gattani S, Sehgal A, Kumar S, Castelino R, Dhekale R, Krishnamurthy J, Mahajan S, Daptardar A, Sonkusare L, Deodhar J, Ansari N, Vagal M, Mahajan P, Timmanpyati S, Nookala M, Chitre A, Kapoor A, Gota V, Banavali S, Badwe RA, Prabhash K. Correlation of the Geriatric Assessment with Overall Survival in Older Patients with Cancer. Clin Oncol (R Coll Radiol) 2024; 36:e61-e71. [PMID: 37953073 DOI: 10.1016/j.clon.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/09/2023] [Accepted: 11/02/2023] [Indexed: 11/14/2023]
Abstract
AIMS Global guidelines recommend that all older patients with cancer receiving chemotherapy should undergo a geriatric assessment. However, utilisation of the geriatric assessment is often constrained by its time-intensive nature, which limits its adoption in settings with limited resources and high demand. There is a lack of evidence correlating the results of the geriatric assessment with survival from the Indian subcontinent. Therefore, the aims of the present study were to assess the impact of the geriatric assessment on survival in older Indian patients with cancer and to identify the factors associated with survival in these older patients. MATERIALS AND METHODS This was an observational study, conducted in the geriatric oncology clinic of the Tata Memorial Hospital (Mumbai, India). Patients aged 60 years and older with cancer who underwent a geriatric assessment were enrolled. We assessed the non-oncological geriatric domains of function and falls, nutrition, comorbidities, cognition, psychology, social support and medications. Patients exhibiting impairment in two or more domains were classified as frail. RESULTS Between June 2018 and January 2022, we enrolled 897 patients. The median age was 69 (interquartile range 65-73) years. The common malignancies were lung (40.5%), oesophagus (31.9%) and genitourinary (12.1%); 54.6% had metastatic disease. Based on the results of the geriatric assessment, 767 (85.4%) patients were frail. The estimated median overall survival in fit patients was 24.3 (95% confidence interval 18.2-not reached) months, compared with 11.2 (10.1-12.8) months in frail patients (hazard ratio 0.54; 95% confidence interval 0.41-0.72, P < 0.001). This difference in overall survival remained significant after adjusting for age, sex, primary tumour and metastatic status (hazard ratio 0.56; 95% confidence interval 0.41-0.74, P < 0.001). In the patients with a performance status of 0 or 1 (n = 454), 365 (80.4%) were frail; the median overall survival in the performance status 0-1 group was 33.0 months (95% confidence interval 24.31-not reached) in the fit group versus 14.4 months (95% confidence interval 12.25-18.73) in the frail patients (hazard ratio 0.50; 95% confidence interval 0.34-0.74, P = 0.001). In the multivariate analysis, the geriatric assessment domains that were predictive of survival were function (hazard ratio 0.68; 95% confidence interval 0.52-0.88; P = 0.003), nutrition (hazard ratio 0.64; 95% confidence interval 0.48-0.85, P = 0.002) and cognition (hazard ratio 0.67; 95% confidence interval 0.49-0.91, P = 0.011). DISCUSSION The geriatric assessment is a powerful prognostic tool for survival among older Indian patients with cancer. The geriatric assessment is prognostic even in the cohort of patients thought to be the fittest, i.e. performance status 0 and 1. Our study re-emphasises the critical importance of the geriatric assessment in all older patients planned for cancer-directed therapy.
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Affiliation(s)
- A R Rao
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - V Noronha
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - A Ramaswamy
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - A Kumar
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - A Pillai
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - S Gattani
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - A Sehgal
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Mumbai, India
| | - S Kumar
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Mumbai, India
| | - R Castelino
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Mumbai, India
| | - R Dhekale
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - J Krishnamurthy
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - S Mahajan
- Department of Physiotherapy, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - A Daptardar
- Department of Physiotherapy, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - L Sonkusare
- Department of Psycho-oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - J Deodhar
- Department of Psycho-oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - N Ansari
- Department of Occupational Therapy, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - M Vagal
- Department of Occupational Therapy, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - P Mahajan
- Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - S Timmanpyati
- Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - M Nookala
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Mumbai, India
| | - A Chitre
- Department of Physiotherapy, Mahamana Pandit Madan Mohan Malviya Cancer Center & Homi Bhabha Cancer Hospital, Varanasi, India
| | - A Kapoor
- Department of Medical Oncology, Mahamana Pandit Madan Mohan Malviya Cancer Center & Homi Bhabha Cancer Hospital, Varanasi, India
| | - V Gota
- Department of Clinical Pharmacology, Advanced Centre for Treatment Research and Education in Cancer, Mumbai, India
| | - S Banavali
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - R A Badwe
- Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - K Prabhash
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India.
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Ghoshal A, Muckaden MA, Garg C, Iyengar J, Ganpathy KV, Damani A, Deodhar J, Vora T, Chinnaswamy G. Parents’ experiences with prognosis communication in advanced pediatric cancers. Progress in Palliative Care 2022. [DOI: 10.1080/09699260.2022.2152169] [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: 12/29/2022]
Affiliation(s)
- A. Ghoshal
- Department of Palliative Medicine, Tata Memorial Hospital, Homi Bhaba National Institute, Mumbai, India
| | - M. A. Muckaden
- Department of Palliative Medicine, Tata Memorial Hospital, Homi Bhaba National Institute, Mumbai, India
| | - C. Garg
- Village Mosaic, Fontbonne Ministries, Sisters of St. Joseph, Toronto, Canada
| | - J. Iyengar
- Department of Palliative Medicine, Tata Memorial Hospital, Homi Bhaba National Institute, Mumbai, India
| | - K. V. Ganpathy
- JASCAP (JEET ASSOCIATION FOR SUPPORT TO CANCER PATIENTS), Mumbai, India
| | - A. Damani
- Department of Palliative Medicine, Tata Memorial Hospital, Homi Bhaba National Institute, Mumbai, India
| | - J. Deodhar
- Department of Palliative Medicine, Tata Memorial Hospital, Homi Bhaba National Institute, Mumbai, India
| | - T. Vora
- Division of Paediatric Oncology, Tata Memorial Hospital, Homi Bhaba National Institute, Mumbai, India
| | - G. Chinnaswamy
- Division of Paediatric Oncology, Tata Memorial Hospital, Homi Bhaba National Institute, Mumbai, India
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Ghoshal A, Muckaden MA, Garg C, Iyengar J, Ganpathy KV, Damani A, Deodhar J, Vora T, Chinnaswamy G. Experience with Prognosis Communication in Parents of Children Having Advanced Cancer. Indian J Pediatr 2022; 89:924. [PMID: 35767176 DOI: 10.1007/s12098-022-04244-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 04/08/2022] [Indexed: 11/05/2022]
Affiliation(s)
- A Ghoshal
- Department of Palliative Medicine, Tata Memorial Hospital, Homi Bhaba National Institute, Mumbai, Maharashtra, 400012, India.
| | - M A Muckaden
- Department of Palliative Medicine, Tata Memorial Hospital, Homi Bhaba National Institute, Mumbai, Maharashtra, 400012, India
| | - C Garg
- Village Mosaic, Fontbonne Ministries, Sisters of St. Joseph, Toronto, Canada
| | - J Iyengar
- Department of Palliative Medicine, Tata Memorial Hospital, Homi Bhaba National Institute, Mumbai, Maharashtra, 400012, India
| | - K V Ganpathy
- JASCAP (Jeet Association for Support to Cancer Patients), Mumbai, Maharashtra, India
| | - A Damani
- Department of Palliative Medicine, Tata Memorial Hospital, Homi Bhaba National Institute, Mumbai, Maharashtra, 400012, India
| | - J Deodhar
- Department of Palliative Medicine, Tata Memorial Hospital, Homi Bhaba National Institute, Mumbai, Maharashtra, 400012, India
| | - T Vora
- Division of Pediatric Oncology, Tata Memorial Hospital, Homi Bhaba National Institute, Mumbai, Maharashtra, India
| | - G Chinnaswamy
- Division of Pediatric Oncology, Tata Memorial Hospital, Homi Bhaba National Institute, Mumbai, Maharashtra, India
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Ghoshal A, Damani A, Deodhar J, Quadros L, Ganpathy KV, Muckaden MA. A novel nurse-coordinated home care model for palliative care in advanced cancer: A pilot interventional study from suburban Mumbai. Progress in Palliative Care 2022. [DOI: 10.1080/09699260.2022.2081440] [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: 10/17/2022]
Affiliation(s)
- A. Ghoshal
- Department of Palliative Medicine, Tata Memorial Centre, Homi Bhaba National Institute, Mumbai, India
| | - A. Damani
- Department of Palliative Medicine, Tata Memorial Centre, Homi Bhaba National Institute, Mumbai, India
| | - J. Deodhar
- Department of Palliative Medicine, Tata Memorial Centre, Homi Bhaba National Institute, Mumbai, India
| | - L. Quadros
- Department of Palliative Medicine, Tata Memorial Centre, Homi Bhaba National Institute, Mumbai, India
| | - K. V. Ganpathy
- JEET ASSOCIATION FOR SUPPORT TO CANCER PATIENTS (JASCAP), Mumbai
| | - M. A. Muckaden
- Department of Palliative Medicine, Tata Memorial Centre, Homi Bhaba National Institute, Mumbai, India
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Agarwal J, Sinha S, Lewis Salins S, Pandey S, Deodhar J, Salins N, Ghosh Laskar S, Budrukkar A, Gupta T, Murthy V, Swain M, Nair S, Chaturvedi P. OC-0592 Impact of palliative care referral on distress in patients undergoing RT for HNSCC: Randomized Trial. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02614-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ghoshal A, Damani A, Salins N, Deodhar J, Muckaden M. Patient's Decisional Control Preferences in Palliative Care: An Indian Survey. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.26000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: The frequency of passive decisional control (patients prefers physician to make decisions) has been reported to be variable but generally larger among patients living in developing countries. Aim: This study aimed to determine the frequency of passive DCP among patients with advanced cancer in a tertiary cancer center, and identify its association with their sociodemographic and clinical characteristics. Methods: 150 patients referred to palliative care underwent assessment of decisional control preferences using validated tools including control preference scale tool, satisfaction with decision scale and understanding of illness questionnaire. Information regarding patient characteristics including age, gender, education, marital status, employment, Karnofsky Performance Scale, cancer stage and type, religion were also collected. Descriptive statistics and logistic regression analysis were performed. Results: Median age was 48 years, Karnofsky 90, and 55.3% were men. Shared, active (patient prefers to make decision by his/her own) and passive DCP were 20.7%, 26.7% and 52.7% respectively (n = 150). 51.3 were satisfied by the way the actual decisions were made. 70.7% felt that their cancer was curable. Passive DCP did not vary across regions. Multivariate analysis shows that the passive DCP was significantly associated in better KPS [expB 1.07 (1.01-1.15), P = 0.03]. Conclusion: There are significant differences in DCP with KPS. Patients report high level of satisfaction with their treatment decision, though they have poor understanding of their prognosis and understand their treatment to be of curative intent. Individualized understanding DCP and focus on illness understanding may be important for quality care and patient satisfaction outcomes.
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Mathew AS, Agarwal JP, Munshi A, Laskar SG, Pramesh CS, Karimundackal G, Jiwnani S, Prabhash K, Noronha V, Joshi A, Rangarajan V, Purandare NC, Jambhekar N, Tandon S, Mahajan A, Kumar R, Deodhar J. A prospective study of telephonic contact and subsequent physical follow-up of radically treated lung cancer patients. Indian J Cancer 2017; 54:241-252. [PMID: 29199699 DOI: 10.4103/0019-509x.219599] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND We tested the hypothesis that telephonic follow-up (FU) may offer a convenient and equivalent alternative to physical FU of radically treated lung cancer patients. DESIGN Prospective study carried out at a tertiary referral cancer care institute, Mumbai. MATERIALS AND METHODS Two hundred consecutive lung cancer patients treated with curative intent were followed up regularly with telephonic interviews paired with their routine physical FU visits. Patient satisfaction with the telephonic call and the physical visit, the anxiety level of the patient after meeting the physician and the economic burden of the visit to the patient were noted in a descriptive manner. Kappa statistics was used to assess concurrence between the telephonic and physical impression of disease status. RESULTS With a median FU duration of 21.5 months, the median satisfaction scores for telephonic and physical FU were 8 and 9, respectively. The prevalence and bias adjusted kappa (PABAK) score of the entire cohort of patients was 0.64 (95% confidence interval [CI] =0.58-0.70). Data analyzed up to first disease progression/relapse on FU had a PABAK score of 0.71 (95% CI = 0.64-0.77) indicating substantial agreement. Patients with disease controlled at the FU had a significant PABAK score of 0.88 (95% CI = 0.80-0.94) indicating excellent concurrence. On average, each patient spent Rs. 5117.10 on travel and Rs. 3079.06 on lodging per FU visit. CONCLUSION Telephonic FU is substantially accurate in assessing disease status until the first relapse. In a resource-constrained country like India, it is worthwhile to further explore the benefits of such an alternative strategy.
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Affiliation(s)
- A S Mathew
- Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - J P Agarwal
- Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - A Munshi
- Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - S G Laskar
- Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - C S Pramesh
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - G Karimundackal
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - S Jiwnani
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - K Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - V Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - A Joshi
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - V Rangarajan
- Department of Nuclear Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - N C Purandare
- Department of Nuclear Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - N Jambhekar
- Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - S Tandon
- Department of Pulmonary Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - A Mahajan
- Department of Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - R Kumar
- Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - J Deodhar
- Department of Clinical Psychology, Tata Memorial Hospital, Mumbai, Maharashtra, India
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Patil V, Joshi A, Noronha V, Deodhar J, Bhattacharjee A, Dhumal S, M V C, Karpe A, Talreja V, Chandrasekharan A, Turkar S, Prabhash K. 386P Expectations and preferences for palliative chemotherapy in head and neck cancers patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw587.028] [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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Patil V, Joshi A, Noronha V, Deodhar J, Bhattacharjee A, Dhumal S, Mv C, Karpe A, Talreja V, Chandrasekharan A, Turkar S, Prabhash K. 386P Expectations and preferences for palliative chemotherapy in head and neck cancers patients. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00544-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
BACKGROUND Population aging is one of the most distinctive demographic events of this century. United Nations projections suggest that the number of older persons is expected to increase by more than double from 841 million in 2013 to >2 billion by 2050. It is estimated that 60% of the elderly patients may be affected by cancer and may present in the advanced stage. The aim of this paper was to develop a brief cancer-specific comprehensive geriatric assessment tool for use in a geriatric population with advanced cancer that would identify the various medical, psychosocial, and functional issues in the older person. METHODS Literature on assessment of geriatric needs in an oncology setting was reviewed such that validated tools on specific domains were identified and utilized. The domains addressed were socioeconomic, physical symptoms, comorbidity, functional status, psychological status, social support, cognition, nutritional status and spiritual issues. Validated tools identified were Kuppuswamy scale (socioeconomic), Edmonton Symptom Assessment Scale (Physical symptoms) and SAKK cancer-specific geriatric assessment tool, which included six standard geriatric measures covering five geriatric domains (comorbidity, functional status, psychological status, social support, cognition, nutritional status). The individual measures were brief, reliable, and valid and could be administered by the interviewer. CONCLUSION The tool was developed for use under the geriatric palliative care project of the department of palliative medicine at Tata Memorial Hospital, Mumbai. We plan to test the feasibility of the tool in our palliative care set-up, conduct a needs assessment study and based on the needs assessment outcome institute a comprehensive geriatric palliative care project and reassess outcomes.
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Affiliation(s)
| | - N Salins
- Department of Palliative Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India
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Jalali R, Gupta T, Goswami S, Krishna U, Dutta D, Deodhar J, Kannan S, Sarin R. PT-06 * RANDOMIZED TRIAL OF HIGH-PRECISION CONFORMAL RADIATION THERAPY COMPARED TO CONVENTIONAL RADIOTHERAPY IN PRESERVATION OF LONG-TERM NEURO-COGNITIVE OUTCOMES IN YOUNG PATIENTS WITH PROGRESSIVE OR RESIDUAL BENIGN/LOW-GRADE BRAIN TUMORS. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou266.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kunheri B, Arjunan A, Krishnan P, Pillai B, Prasad S, Bernier-Chastagner V, Desandes E, Carrie C, Alapetite C, Hankinson T, Jones D, Handler M, Foreman N, Liu A, Smiley NP, Alden T, Hartsell W, Fangusaro J, Hill-Kayser CE, Lustig RA, Minturn JE, Both S, Waanders AJ, Belasco JB, Armstrong C, Phillips PC, Fisher MJ, Hill-Kayser CE, Paltin I, Lustig RA, Fisher MJ, Both S, Belasco JB, Cole KA, Waanders AJ, Phillips PC, Minturn JE, Wells E, Vezina G, Kilburn L, Rood B, Crozier F, Hwang E, Packer R, Janssens GO, van den Bosch S, van Kollenburg PG, Gidding CE, Schieving JH, Kaanders JH, van Lindert EJ, Kramer K, Pandit-Taskar N, Souweidane MM, Wolden S, DeSelm C, Cheung NKV, Lassen-Ramshad Y, Hansen J, Seiersen K, Petersen JBB, Mahajan A, Grosshans D, Ris D, Chintagumpala M, Okcu F, McAleer MF, Moore B, Stancel H, Minard C, Guffey D, Kahalley L, Blomgren K, Zhou K, Xie C, Zhu C, McAleer MF, Zhao Z, Weinberg J, Sandberg D, Hughes D, Mahajan A, Anderson P, Guha-Thakurta N, Muller K, Hoffmann M, Seidel C, Warmuth-Metz M, Pietsch T, Kordes U, Sander A, Rossler J, Graf N, Scheithauer H, Kortmann RD, Kramm CM, von Bueren AO, Gunther J, Sato M, Chintagumpala M, Jo E, Paulino A, Adesina A, Ketonen L, Jones J, Su J, Okcu F, Khatua S, Dauser R, Whitehead W, Weinberg J, Mahajan A, Gandola L, Pecori E, Biassoni V, Chiruzzi C, Schiavello E, Meroni S, Spreafico F, Pignoli E, Massimino M, Jalali R, Krishna U, Gupta T, Goswami S, Deodhar J, Dutta D, Kannan S, Goel A, Sarin R, Sastry J, Ronghe M, Murphy D, Forbes K, Jones R, Cowie F, Brown J, Indelicato D, Goksel EO, Tezcanli E, Bilge H, Yasemin, Yarar Y, Sato M, Gunther J, Mahajan A, Jo E, Paulino A, Adesina A, Jones J, Ketonen L, Su J, Okcu M, Khatua S, Dauser R, Whitehead W, Weinberg J, Chintagumpala M, Paulino A, Jo E, Sato M, Su J, Okcu MF, Mahajan A, Dauser R, Whitehead W, Adesina A, Chintagumpala M, Danielsson A, Tisell M, Rydenhag B, Caren H. RADIATION ONCOLOGY. Neuro Oncol 2014; 16:i117-i122. [PMCID: PMC4046296 DOI: 10.1093/neuonc/nou080] [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: 09/10/2023] Open
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Deodhar J, Kadam S, Pharande P, Vaidya U, Pandit A. Maternal blood aspiration: an unusual cause of respiratory distress in a neonate. Ann Trop Paediatr 2006; 26:255-7. [PMID: 16925965 DOI: 10.1179/146532806x120372] [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] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Maternal blood aspiration is an unusual cause of respiratory distress in neonates. It is occasionally seen in babies born to mothers with antepartum haemorrhage (APH). We report a term neonate with a history of maternal APH who developed respiratory distress soon after birth with a radiological appearance compatible with aspiration syndrome. The infant required ventilation for 36 hours. The aspirated blood was the mother's.
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Affiliation(s)
- J Deodhar
- Division of Neonatology, Department of Pediatrics, KEM Hospital, Rasta Peth, Pune, India.
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Chaudhari R, Deodhar J, Kadam S, Bavdekar A, Pandit A. Gastric aspirate shake test for diagnosis of surfactant deficiency in neonates with respiratory distress. ACTA ACUST UNITED AC 2005; 25:205-9. [PMID: 16156986 DOI: 10.1179/146532805x58148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
UNLABELLED The gastric aspirate shake test (GST) was evaluated in 77 newborns with respiratory distress for predicting hyaline membrane disease (HMD) at KEM Hospital, Pune, India. METHODS Over 0.5 ml of gastric fluid was obtained within 30 min of birth and mixed with an equal volume of normal saline for 10 sec; 1 ml of 95% ethanol was then added and the mixture agitated for 10 sec. After standing for 15 min, the air-liquid interface was examined for bubbles. RESULTS All 21 infants with a negative GST developed HMD. However, 12 infants with an intermediate and nine with a positive test also developed HMD. None of the infants with other respiratory disorders, e.g. transient tachypnoea and pneumonia, had a negative GST. A negative GST had a specificity of 100%, sensitivity of 70% and positive predictive value of 100% for developing HMD. CONCLUSION GST is a useful test for predicting HMD and might be of particular value in developing countries.
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Affiliation(s)
- R Chaudhari
- Division of Neonatology, Department of Pediatrics, KEM Hospital, Pune, India
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Abstract
This observational study was done to discover the prevalence of fetal malnutrition (FM) in term newborns using clinical assessment of nutritional status (CANS score) and to identify associated risk factors. All term babies born in a referral teaching hospital during the 1-year study period were included in the sample. Gestational age and weight-for-gestational-age were assessed, and babies were classified as appropriate-for-gestational-age (AGA), small-for-gestational-age (SGA) or large-for-gestational-age (LGA). Maternal risk factors were recorded in each case. Fetal malnutrition was present in 19.6% of babies, of whom 40.7% had intrauterine growth retardation. Of the babies with FM, 59.9% were AGA and 1.9% were SGA even though they had no signs of FM. FM was evident in 84.2% of SGA babies, and 12.9% of AGA babies showed FM. The weights of babies with FM were significantly lower than of those without FM. Maternal risk factors for FM included adverse age, primiparity, low pre-pregnancy weight and height, a bad obstetric history and pregnancy-induced hypertension. Malnutrition in the newborn might be missed if intrauterine growth curves only are used for assessment. The CANS score is a simple and rapid clinical scoring system for diagnosing fetal malnutrition. Not all SGA babies are malnourished and those without FM have a better outcome and faster catch-up growth.
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Affiliation(s)
- J Deodhar
- Department of Paediatrics, K.E.M. Hospital, Pune, India.
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Patil J, Deodhar J, Wagh S, Pandit AN. High risk factors for development of retinopathy of prematurity. Indian Pediatr 1997; 34:1024-7. [PMID: 9567533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- J Patil
- Department of Pediatrics, K.E.M. Hospital, Pune
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Borse N, Deodhar J, Pandit AN. Effects of thermal environment on neonatal thermoregulation. Indian Pediatr 1997; 34:718-20. [PMID: 9492401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- N Borse
- Department of Pediatrics, K.E.M. Hospital, Pune
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Patil S, Deodhar J, Tawade Y, Pandit AN. Neonatal skin lesions. Indian Pediatr 1997; 34:651-2. [PMID: 9401265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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