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Memon SS, Srivastava P, Karlekar M, Thakkar H, Bandgar T. Ambulatory blood pressure monitoring in pheochromocytoma - paraganglioma: A single center experience. J Postgrad Med 2024; 70:84-90. [PMID: 37555422 DOI: 10.4103/jpgm.jpgm_208_23] [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] [Received: 03/21/2023] [Accepted: 05/02/2023] [Indexed: 08/10/2023] Open
Abstract
CONTEXT/AIMS Pheochromocytoma and paraganglioma (PPGL) are rare tumors, and data on ambulatory blood pressure monitoring (ABPM) in these patients and the effect of blocking on ABPM parameters is limited. We aimed to describe ABPM parameters in a cohort of PPGL at our center in western India. METHODS Retrospective study of patients with PPGL whose ABPM data was available. Demographic details, secretory status, and ABPM data were retrieved. Coefficient of variability (CV) was calculated as standard deviation/mean in percentage. RESULTS In the 39 included patients, mean age at presentation was 39.3 ± 14.2 yr; 20 (51.3%) were males, 25 (64.1%) hypertensive, and mean tumor diameter was 5.3 cm. In 18 patients whose baseline ABPM was done without medications, those with nocturnal blood pressure dipping (6/18, 33%) had higher serum metanephrines (median 313.2 vs. 34.7 pg/ml, P = 0.028). Despite normal office blood pressure (BP), 8.9% of systolic BP readings were >140 mmHg, and 1.2% were >160 mmHg. Among 29 patients with both pre and post-block ABPM, mean BP (systolic 121.6 vs. 132.5 mmHg, P = 0.014; diastolic 68.9 vs. 76.4 mmHg, P = 0.005) and percentage of BP readings above 140 mmHg (median 9.4% vs. 24.4%, P = 0.016) were significantly lowered after the preoperative blockade in hypertensive ( n = 19) patients, whereas CV was similar. The post-blockade ABPM characteristics were similar in patients blocked with amlodipine or prazosin. CONCLUSION ABPM provides additional information about BP characteristics in PPGL. The preoperative blocking decreases the magnitude of BP excursions but does not affect BP variability.
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Affiliation(s)
- S S Memon
- Department of Endocrinology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - P Srivastava
- Department of Endocrinology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - M Karlekar
- Department of Endocrinology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - H Thakkar
- Department of Radiology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - T Bandgar
- Department of Endocrinology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Kumar P, Parashar M, Chauhan K, Chakraborty N, Sarkar S, Chandra A, Das NS, Chattopadhyay KK, Ghoari A, Adalder A, Ghorai UK, Saini S, Agarwal D, Ghosh S, Srivastava P, Banerjee D. Significant enhancement in the cold emission characteristics of chemically synthesized super-hydrophobic zinc oxide rods by nickel doping. Nanoscale Adv 2023; 5:6944-6957. [PMID: 38059027 PMCID: PMC10696928 DOI: 10.1039/d3na00776f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/28/2023] [Indexed: 12/08/2023]
Abstract
The current article presents a huge enhancement in the field emission characteristics of zinc oxide (ZnO) micro/nanorods by nickel doping. The synthesis of pure and nickel-doped zinc oxide (ZnO) micro/nanorods was done by a simple low-temperature chemical method. Both the as-prepared pure and doped samples were analyzed by X-ray diffraction and electron microscopy to confirm the proper phase formation and the developed microstructure. UV-vis transmittance spectra helped in determining the band gap of the samples. Fourier-Transform Infrared Spectroscopy (FTIR) spectra showed the different bonds present in the sample, whereas X-ray Photoelectron Spectroscopy (XPS) confirmed the presence of nickel in the doped sample. Photoluminescence (PL) spectra showed that after doping, the band-to-band transition was affected, whereas defect-induced transition had increased significantly. After the nickel doping, contact angle measurement revealed a significant decrease in the sample's surface energy, leading to a remarkably high water contact angle (within the superhydrophobic region). Simulation through ANSYS suggested that the doped sample has the potential to function as an efficient cold emitter, which was also verified experimentally. The cold emission characteristics of the doped sample showed a significant improvement, with the turn-on field (corresponding to J = 1 μA cm-2) reduced from 5.34 to 2.84 V μm-1. The enhancement factor for the doped sample reached 3426, approximately 1.5 times higher compared to pure ZnO. Efforts have been made to explain the results, given the favorable band bending as well as the increased number of effective emission sites.
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Affiliation(s)
- P Kumar
- Thin Film and Nanotechnology Laboratory, Faculty of Engineering and Computing Sciences, Teerthanker Mahaveer University Moradabad UP 244001 India
| | - M Parashar
- Thin Film and Nanotechnology Laboratory, Faculty of Engineering and Computing Sciences, Teerthanker Mahaveer University Moradabad UP 244001 India
| | - K Chauhan
- Thin Film and Nanotechnology Laboratory, Faculty of Engineering and Computing Sciences, Teerthanker Mahaveer University Moradabad UP 244001 India
| | - N Chakraborty
- Thin Film and Nanoscience Laboratory, Department of Physics, Jadavpur University Kolkata West Bengal 700032 India
| | - S Sarkar
- Thin Film and Nanoscience Laboratory, Department of Physics, Jadavpur University Kolkata West Bengal 700032 India
| | - A Chandra
- Thin Film and Nanoscience Laboratory, Department of Physics, Jadavpur University Kolkata West Bengal 700032 India
| | - N S Das
- Department of Basic Science and Humanities, Techno International Batanagar Maheshtala Kolkata 700141 India
| | - K K Chattopadhyay
- Thin Film and Nanoscience Laboratory, Department of Physics, Jadavpur University Kolkata West Bengal 700032 India
| | - A Ghoari
- Department of Industrial Chemistry, Ramakrishna Mission Vidyamandira Belur Math Howrah-711202 India
| | - A Adalder
- Department of Industrial Chemistry, Ramakrishna Mission Vidyamandira Belur Math Howrah-711202 India
| | - U K Ghorai
- Department of Industrial Chemistry, Ramakrishna Mission Vidyamandira Belur Math Howrah-711202 India
| | - S Saini
- Department of Physics, Indian Institute of Technology Hauz Khas South West Delhi 110016 India
| | - D Agarwal
- Department of Physics, Indian Institute of Technology Hauz Khas South West Delhi 110016 India
| | - S Ghosh
- Department of Physics, Indian Institute of Technology Hauz Khas South West Delhi 110016 India
| | - P Srivastava
- Department of Physics, Indian Institute of Technology Hauz Khas South West Delhi 110016 India
| | - D Banerjee
- Thin Film and Nanotechnology Laboratory, Faculty of Engineering and Computing Sciences, Teerthanker Mahaveer University Moradabad UP 244001 India
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Srivastava P, Zhang X, Moriguchi J, Chang D, Czer L, Cole R, Kittleson M, Kransdorf E, Kobashigawa J, Patel J. Extreme HLA Homozygosity Contributing to Extreme HLA Sensitization. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.452] [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: 04/05/2023] Open
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Srivastava P, Kransdorf E, Kittleson M, Chang D, Nikolova A, Patel J, Kobashigawa J. Mixed Rejection in Orthotopic Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1105] [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: 04/05/2023] Open
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5
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Morthekai P, Tiwari P, Murari M, Singh P, Thakur B, Manoj M, Ali S, Singh V, Kumar K, Rai J, Dubey N, Srivastava P. Further investigations towards luminescence dating of diatoms. RADIAT MEAS 2022. [DOI: 10.1016/j.radmeas.2022.106803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Basheer A, Agarwal A, Misra B, Gupta A, Srivastava P, Kirubakaran R, Vishnu V. Bacopa monnieri in the treatment of dementia due to Alzheimer's disease: A systematic review of randomised controlled trials. Interact J Med Res 2022; 11:e38542. [PMID: 35612544 PMCID: PMC9379783 DOI: 10.2196/38542] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/21/2022] [Accepted: 05/25/2022] [Indexed: 11/14/2022] Open
Abstract
Background Bacopa monnieri, a herb that has been used for many centuries in India, has shown neuroprotective effects in animal and in vitro studies; human studies on patients with Alzheimer disease have been inconclusive. Objective The primary objective of this review was to determine the clinical efficacy and safety of B. monnieri in persons with mild, moderate, or severe dementia, or mild cognitive impairment, due to Alzheimer disease. Methods We searched PubMed, Embase, Cochrane Library, clinical trial registries (World Health Organization, Australia-New Zealand, United States, and South Africa), the metaRegister of Controlled Trials, and CINAHL. We intended to include all randomized and quasi-randomized controlled trials that compared B. monnieri, its extract or active ingredients (at any dosage), with a placebo or a cholinesterase inhibitor among adults with dementia due to Alzheimer disease and in those with mild cognitive impairment due to Alzheimer disease. Results Our comprehensive search yielded 5 eligible studies. A total of 3 studies used B. monnieri in combination with herbal extracts while the remaining 2 used B. monnieri extracts only. Two studies compared B. monnieri with donepezil while the others used a placebo as the control. There was considerable variation in the B. monnieri dose used (ranging between 125 mg to 500 mg twice daily) and heterogeneity in treatment duration, follow-up, and outcomes. The major outcomes were Mini-Mental State Examination scores reported in 3 trials, Cognitive subscale scores of the Alzheimer’s Disease Assessment Scale in 1 study, and a battery of cognitive tests in 2 studies. Using the Cochrane risk-of-bias tool, overall, we judged all 5 studies to be at high risk of bias. While all studies reported a statistically significant difference between B. monnieri and the comparator in at least one outcome, we rated the overall quality of evidence for the Alzheimer’s Disease Assessment Scale-Cognitive Subscale, Postgraduate Institute Memory Scale, Mini-Mental State Examination, and Wechsler Memory Scale to be very low due to downgrading by 2 levels for high risk of bias and 1 more level for impreciseness due to small sample sizes and wide CIs. Conclusions There was no difference between B. monnieri and the placebo or donepezil in the treatment of Alzheimer disease based on very low certainty evidence. No major safety issues were reported in the included trials. Future randomized controlled trials should aim to recruit more participants and report clinically meaningful outcomes. Trial Registration PROSPERO CRD42020169421; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=169421
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Affiliation(s)
- Aneesh Basheer
- DM Wayanad Institute of Medical Sciences (DM WIMS), Wayanad, IN
| | - Ayush Agarwal
- All India Institute of Medical Sciences, New Delhi, RN 704, 7th floor, CN CenterAnsari Nagar, New Delhi, IN
| | - Biswamohan Misra
- All India Institute of Medical Sciences, New Delhi, RN 704, 7th floor, CN CenterAnsari Nagar, New Delhi, IN
| | - Anu Gupta
- All India Institute of Medical Sciences, New Delhi, RN 704, 7th floor, CN CenterAnsari Nagar, New Delhi, IN
| | - Padma Srivastava
- All India Institute of Medical Sciences, New Delhi, RN 704, 7th floor, CN CenterAnsari Nagar, New Delhi, IN
| | | | - Venugopalan Vishnu
- All India Institute of Medical Sciences, New Delhi, RN 704, 7th floor, CN CenterAnsari Nagar, New Delhi, IN
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Mishra NK, Engel J, Liebeskind DS, Sharma VK, Hirsch LJ, Kasner SE, French JA, Devinsky O, Friedman A, Dawson J, Quinn TJ, Selim M, de Havenon A, Yasuda CL, Cendes F, Benninger F, Zaveri HP, Burneo JG, Srivastava P, Bhushan Singh M, Bhatia R, Vishnu VY, Bentes C, Ferro J, Weiss S, Sivaraju A, Kim JA, Galovic M, Gilmore EJ, Pitkänen A, Davis K, Sansing LH, Sheth KN, Paz JT, Singh A, Sheth S, Worrall BB, Grotta JC, Casillas-Espinos PM, Chen Z, Nicolo JP, Yan B, Kwan P. International Post Stroke Epilepsy Research Consortium (IPSERC): A consortium to accelerate discoveries in preventing epileptogenesis after stroke. Epilepsy Behav 2022; 127:108502. [PMID: 34968775 DOI: 10.1016/j.yebeh.2021.108502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/07/2021] [Indexed: 12/18/2022]
Affiliation(s)
| | - Jerome Engel
- Department of Neurology, University of California Los Angeles, Los Angeles, USA
| | - David S Liebeskind
- Department of Neurology, University of California Los Angeles, Los Angeles, USA
| | - Vijay K Sharma
- YLL School of Medicine, National University of Singapore and Division of Neurology, National University Health System, Singapore
| | | | - Scott E Kasner
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | - Jacqueline A French
- Department of Neurology, NYU Grossman School of Medicine, New York City, USA
| | - Orrin Devinsky
- Department of Neurology, NYU Grossman School of Medicine, New York City, USA
| | - Alon Friedman
- Department of Brain and Cognitive Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Department of Medical Neuroscience, Dalhousie University, Halifax, Canada
| | - Jesse Dawson
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, UK
| | - Terence J Quinn
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, UK
| | - Magdy Selim
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | | | - Clarissa L Yasuda
- Department of Neurology, School of Medical Sciences, University of Campinas - UNICAMP, Sao Paulo, Brazil
| | - Fernando Cendes
- Department of Neurology, School of Medical Sciences, University of Campinas - UNICAMP, Sao Paulo, Brazil
| | - Felix Benninger
- Department of Neurology, Rabin Medical Center, Tel Aviv, Israel
| | | | - Jorge G Burneo
- Epilepsy Program, Department of Clinical Neurological Sciences, and Neuroepidemiology Unit, Western University, London, Ontario, Canada
| | - Padma Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Mamta Bhushan Singh
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Bhatia
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - V Y Vishnu
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Carla Bentes
- Department of Neurology, University of Lisboa, Lisbon, Portugal
| | - Jose Ferro
- Department of Neurology, University of Lisboa, Lisbon, Portugal
| | - Shennan Weiss
- Department of Neurology, State University of New York (SUNY) Downstate, NY, USA
| | | | - Jennifer A Kim
- Department of Neurology, Yale University, New Haven, USA
| | - Marian Galovic
- Department of Neurology, University of Zurich, Zurich, Switzerland
| | | | - Asla Pitkänen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Kathryn Davis
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | | | - Kevin N Sheth
- Department of Neurology, Yale University, New Haven, USA
| | - Jeanne T Paz
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, USA; Department of Neurology, University of California San Francisco, San Francisco, USA
| | - Anuradha Singh
- Department of Neurology, Icahn School of Medicine at Mt. Sinai, NY, USA
| | - Sunil Sheth
- Department of Neurology, University of Texas Health Sciences Center, Houston, USA
| | - Bradford B Worrall
- Departments of Neurology and Public Health Sciences, University of Virginia, Charlottesville, USA
| | - James C Grotta
- Department of Neurology, Memorial-Hermann Texas Medical Center, Houston, USA
| | - Pablo M Casillas-Espinos
- Department of Neuroscience, Monash University, Alfred Hospital, Melbourne, Australia; Departments of Neurology and Medicine, The University of Melbourne, Royal Melbourne Hospital, Melbourne, Australia
| | - Zhibin Chen
- Department of Neuroscience, Monash University, Alfred Hospital, Melbourne, Australia; Departments of Neurology and Medicine, The University of Melbourne, Royal Melbourne Hospital, Melbourne, Australia
| | - John-Paul Nicolo
- Department of Neuroscience, Monash University, Alfred Hospital, Melbourne, Australia; Departments of Neurology and Medicine, The University of Melbourne, Royal Melbourne Hospital, Melbourne, Australia
| | - Bernard Yan
- Departments of Neurology and Medicine, The University of Melbourne, Royal Melbourne Hospital, Melbourne, Australia
| | - Patrick Kwan
- Department of Neuroscience, Monash University, Alfred Hospital, Melbourne, Australia; Departments of Neurology and Medicine, The University of Melbourne, Royal Melbourne Hospital, Melbourne, Australia.
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Vibha D, Pillai K, Gupta P, Sudheer P, Mishra B, Oinam R, Mohan A, Tayade K, Srivastava P, Tripathi M, Srivastava A, Bhatia R, Rajan R, Pandit A, Singh R, Elavarasi A, Agarwal A, Gupta A, Das A, Radhakrishnan D, Ramanujam B, Soni K, Aggarwal R, Wig N, Trikha A. Comparison of disease profiles and three-month outcomes of patients with neurological disorders with and without COVID-19: An ambispective cohort study. Ann Indian Acad Neurol 2022; 25:218-223. [PMID: 35693663 PMCID: PMC9175394 DOI: 10.4103/aian.aian_602_21] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/12/2021] [Accepted: 10/12/2021] [Indexed: 11/04/2022] Open
Abstract
Objective: Methods: Results: Conclusion:
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Patel S, Ramchand J, Kearney L, Srivastava P, Burrell L. Reduced Gene Expression and Genetic Variation in Kruppel-Like Factor 15 Are Associated with Left Ventricular Hypertrophy and All-Cause Mortality in Patients with Aortic Stenosis. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Doumtsis N, Patel S, Ramchand J, Lu K, Srivastava P, Patel S, Burrell L. Circulating Angiotensin Converting Enzyme 2 Activity in Hospitalised Patients With Acute Heart Failure. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.075] [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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Sharma A, Agarwal A, Srivastava P, Garg A, Rajan R, Gupta A, Bhatia R, Singh MB, Sharma MC, Vishnu V. Hypertension with recurrent focal deficits. Pract Neurol 2021; 21:555-558. [PMID: 34059557 DOI: 10.1136/practneurol-2021-003020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2021] [Indexed: 11/04/2022]
Affiliation(s)
| | | | | | - Ajay Garg
- Neuroradiology, AIIMS, New Delhi, India
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Puri R, Mehta V, Iyengar SS, Srivastava P, Yusuf J, Pradhan A, Pandian JD, Sharma VK, Renjen PN, Muruganathan A, Mugundhan K, Srinivasan AV, Shetty S, Narasingan SN, Nair DR, Bansal M, Prabhakar D, Varma M, Paliwal VK, Kapoor A, Mukhopadhyay S, Mehrotra R, Patanwala RM, Aggarwal R, Mahajan K, Kumar S, Bardoloi N, Pareek KK, Manoria PC, Pancholia AK, Nanda R, Wong ND, Duell PB. Management of Dyslipidaemia for the Prevention of Stroke: Clinical Practice Recommendations from the Lipid Association of India. Curr Vasc Pharmacol 2021; 20:134-155. [PMID: 34751121 DOI: 10.2174/1570161119666211109122231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 08/03/2021] [Revised: 08/21/2021] [Accepted: 09/28/2021] [Indexed: 02/08/2023]
Abstract
Stroke is the second most common cause of death worldwide. The rates of stroke are increasing in less affluent countries predominantly because of a high prevalence of modifiable risk factors. The Lipid Association of India (LAI) has provided a risk stratification algorithm for patients with ischaemic stroke and recommended low density lipoprotein cholesterol (LDL-C) goals for those in a very high risk group and extreme risk group (category A) of <50 mg/dl (1.3 mmol/l) while the LDL-C goal for extreme risk group (category B) is ≤30 mg/dl (0.8 mmol/l). High intensity statins are the first-line lipid lowering therapy. Non-statin therapy like ezetimibe and proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors may be added as an adjunct to statins in patients who do not achieve LDL-C goals statins alone. In acute ischaemic stroke, high intensity statin therapy improves neurological and functional outcomes regardless of thrombolytic therapy. Although conflicting data exist regarding increased risk of intracerebral haemorrhage (ICH) with statin use, the overall benefit risk ratio favors long-term statin therapy necessitating detailed discussion with the patient. Patients who have statins withdrawn while being on prior statin therapy at the time of acute ischaemic stroke have worse functional outcomes and increased mortality. LAI recommends that statins be continued in such patients. In patients presenting with ICH, statins should not be started in the acute phase but should be continued in patients who are already taking statins. ICH patients, once stable, need risk stratification for atherosclerotic cardiovascular disease (ASCVD).
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Affiliation(s)
| | - Vimal Mehta
- Department of Cardiology, G. B. Pant Institute of Postgraduate Medical Education and Research, New Delhi. 0
| | - S S Iyengar
- Department of Cardiology, Manipal Hospital, Bangalore, Karnataka. India
| | - Padma Srivastava
- Department of Neurology, Neurosciences Centre, AIIMS, New Delhi. India
| | - Jamal Yusuf
- Department of Cardiology, G. B. Pant Institute of Postgraduate Medical Education and Research, New Delhi. India
| | - Akshaya Pradhan
- Department of Cardiology King George's Medical University, Lucknow, U.P. India
| | | | - Vijay K Sharma
- Yong Loo Lin School of Medicine, National University of Singapore and National University Hospital. Singapore
| | - P N Renjen
- Department of Neurology, Indraprastha Apollo Hospital, New Delhi. India
| | - A Muruganathan
- Consultant Internal Medicine, AG Hospital, Tirupur, Tamil Nadu. India
| | - K Mugundhan
- Department of Neurology, Govt, Stanley Medical College, Chennai. India
| | - A V Srinivasan
- Department of Neurology, The Tamil Nadu,Dr MGR Medical University. India
| | - Sadanand Shetty
- Department of Cardiology, K.J Somaiya Super Speciality Institute Sion (East), Mumbai. India
| | - S N Narasingan
- The Tamil Nadu Dr MGR Medical University and Managing Director, SNN Specialities Clinic, Chennai, Tamil Nadu. India
| | - Devaki R Nair
- Department of Lipidology and Chemical pathologist, Royal Free Hospital, London. United Kingdom
| | - Manish Bansal
- Department of Cardiology, Medanta Hospital, Gurugram, Haryana. India
| | - D Prabhakar
- Department of Cardiology, Apollo Hospitals, Chennai, Tamil Nadu. India
| | - Mukul Varma
- Department of Neurology, Indraprastha Apollo Hospital, New Delhi. India
| | | | | | - Saibal Mukhopadhyay
- Department of Cardiology, G. B. Pant Institute of Postgraduate Medical Education and Research, New Delhi. India
| | - Rahul Mehrotra
- Non-Invasive Cardiology, Max Super Speciality Hospital, Saket, New Delhi. India
| | | | - Rajeev Aggarwal
- Jaswant Rai Speciality Hospital, Meerut, Uttar Pradesh. India
| | - Kunal Mahajan
- Department of Cardiology, Indra Gandhi Govt. Medical College and Hospital, Shimla. India
| | - Soumitra Kumar
- Department of Cardiology, Vivekananda Institute of Medical Sciences, Kolkata. India
| | - Neil Bardoloi
- Cardiology, Excel Care Hospital, Guwahati, Assam. India
| | - K K Pareek
- Department of Medicine, S. N. Pareek Hospital, Dadabari, Kota, Rajasthan. India
| | - P C Manoria
- Heart and Critical Care Hospital, Bhopal, Madhya Pradesh. India
| | - A K Pancholia
- Medicine and Preventive Cardiology, Arihant Hospital and Research Center, Indore, Madhya Pradesh. India
| | - Rashmi Nanda
- Consultant Physician and Lipidologist, Cardiac Care Centre, South Extension, New Delhi and Professor and Director University of California Irvine School of Medicine, Irvine, CA. United States
| | - Nathan D Wong
- Heart Disease Prevention Program, Division of Cardiology, University of California Irvine. United States
| | - P Barton Duell
- Knight Cardiovascular Institute and Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health and Science University, Portland, OR. United States
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Bhasin A, Srivastava P, Kumaran SS. Correlation of DTI-Derived Measures to Therapy-Mediated Recovery after Stroke: Preliminary Findings. Neurol India 2021; 69:1210-1216. [PMID: 34747786 DOI: 10.4103/0028-3886.329584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Introduction Corticospinal tracts (CST) forms the basis of motor neurophysiology after stroke. Motor skill recovery has been correlated well to the microstructural properties of CST in both hemispheres. Functional imaging has opened up new possibilities of imaging functionality of cortex and fiber tracts in the brain. We studied therapy-induced changes in blood oxygenation level-dependent (BOLD) and DTI imaging on 20 chronic stroke patients at baseline, 8, and 24 weeks. Settings and Design All the patients were subjected to MR imaging on a 1.5 T MR scanner. We used block design for BOLD with alternate baseline and activation cycles (repetition time (TR) =4520 ms, echo time (TE) = 44 ms, slices = 31, slice thickness = 4 mm). DTI parameters were as follows: TE = 76 ms, TR = 10,726 ms, EPI factor = 127, resolution = 128 × 128 matrix, field of view = 230 mm and a slice thickness of 4.0 mm. Statistical Analysis Used The data was analyzed on SPSS software and tractography/DTI processing software (M/s. Siemens Medical Solutions, Erlangen Germany. Results The mean axial diffusivity (λ[INSIDE:1]) and radial diffusivity (λ[INSIDE:2]) in the affected hemisphere were 0. 30 and 0.18, respectively. The mean number (FN) ratio (± SD) was 0.27 ± 0.14 at baseline, 0.33 ± 0.19 at 8 weeks, and 0.41 ± 0.23 at 24 weeks. Multivariate regression analysis at baseline showed that rFA was well-correlated to the Fugl-Meyer score (regression coefficient: 0.198, F = 10.382, P = 0.001), MI followed by signal intensity. Discussion All patients had high % signal intensity after 8 weeks of physiotherapy regime with a greater percentage change in rFA as compared at follow-up suggesting that a focused exercise regime in stroke patients helps in the reconnection of neural and myelin networks. Conclusion Clinical and functional recovery after stroke is well-correlated with the DTI and BOLD parameters i.e., rFA ratios, CST involvement fiber numbers, and % signal intensity of the ipsilesional cortex.
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Affiliation(s)
- Ashu Bhasin
- Department of Neurology, AIIMS, New Delhi, India
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Garg K, Mishra S, Raheja A, Verma S, Tandon V, Agrawal S, Suri A, Chandra PS, Prada F, Servadei F, Kale SS, Srivastava P. Hybrid Workshops During the COVID-19 Pandemic-Dawn of a New Era in Neurosurgical Learning Platforms. World Neurosurg 2021; 157:e198-e206. [PMID: 34624519 PMCID: PMC8523585 DOI: 10.1016/j.wneu.2021.09.132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 02/02/2023]
Abstract
Background During the COVID-19 pandemic, disruption of surgical hands-on training has hampered the skills acquisition by budding neurosurgeons. Online and virtual classrooms have not been able to substitute the hands-on experience and learning via direct interaction with senior colleagues. To overcome these challenges, we organized a hybrid workshop where simulation-based learning modules, and direct and virtual interaction with surgeons during live surgeries or didactic lectures were utilized to help delegates in understanding the nuances of neurosurgery. Methods A 3-day hybrid workshop was held in March 2021, which was attended by 133 delegates. A structured questionnaire was utilized to record their feedback. Results An overwhelming majority of the respondents (94.1%, n = 64) found hybrid conferences to be better than an online conference. Most of the respondents (88.3%, n = 60) rated the utility of direct face-to-face interaction to be more satisfying as compared with online interaction with faculty during a webinar. Again, many the respondents (86.8%, n = 59) believed that similar hybrid events will be the new normal given the current situation of COVID-19 pandemic. A large majority (88.2%, n = 60) of the respondents reported that they will prefer a hybrid event over an online conference. Conclusions In this era of the COVID-19 pandemic, “hybrid” microneurosurgery workshops offer unique opportunities to enhance surgical skills acquisition by hands-on simulation-based learning and observing live surgical demonstrations, apart from 2-way interactions with experts under one roof. This may be a stepping stone for what lies ahead in the future of neurosurgical training.
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Affiliation(s)
- Kanwaljeet Garg
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Shashwat Mishra
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Amol Raheja
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Satish Verma
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Vivek Tandon
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
| | - Siddharth Agrawal
- Department of Ophthalmology, King George's Medical University, Lucknow, India
| | - Ashish Suri
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - P S Chandra
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Francesco Prada
- Neurosurgery Unit, Department of Neuroscience, Ospedale A. Manzoni, ASST Lecco, Italy; Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA; Acoustic Neuroimaging and Therapy Laboratory, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Focused Ultrasound Foundation, Charlottesville, Virginia, USA
| | - Franco Servadei
- Department of Neurosurgery, Humanitas University and Research Hospital, Milano, Italy
| | - S S Kale
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Padma Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
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15
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Srivastava P, May-Miller H, Gilroy JA, Blackie K, Worku D, Siddiqui N, Tweddle A, Droney J, Gruber P. 1442O Proactive early palliative care referral for cancer patients in the intensive care unit: Implementing a novel “triggers” checklist. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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16
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Bajpai S, Nehra A, Pandey RM, Sati H, Singh RK, Vishnu VY, Rajan R, Singh M, Srivastava A, Srivastava P, Tripathi M. Cognitive Capacity Assessment: The Fundamental Element of Neurological Disability Guidelines in India. Neurol India 2021; 69:703-706. [PMID: 34169872 DOI: 10.4103/0028-3886.319214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Disability evaluation as per World Health Organization includes assessment of impairments, activity limitations, and participation restriction, which unfortunately is not assessed by the existing guidelines of disability in India. Aim The aim of this study wasto comparea new study criterion with the existing guidelines for assessing cognitive disability for chronic neurological conditions. Methodology A cross-sectional pilot study was conducted on 41 participants. They were assessed on an existing guideline (Gazette India 200,1 assessing physical domain and Intelligence Quotient[IQ]) and study criterion assessing three aspects of cognitive capacity: IQ, neurocognitive functioning, and QOL. Results The existing guideline underestimated 84% of cases for disability. The average percentage of disability measured by the study criterion was 33.2% more as compared to existing guidelines with S.D of 26.6. Conclusion Cognitive capacity assessment is an important element to be measured in chronic neurological disability certification. However, a large sample is required to make an affirmative claim for the same.
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Affiliation(s)
- Swati Bajpai
- Departments of Neurology, and Biostatistics, Division of Neuropsychology, All India Institute of Medical Sciences, New Delhi, India
| | - Ashima Nehra
- Departments of Neurology, and Biostatistics, Division of Neuropsychology, All India Institute of Medical Sciences, New Delhi, India
| | - R M Pandey
- Departments of Neurology, and Biostatistics, Division of Neuropsychology, All India Institute of Medical Sciences, New Delhi, India
| | - Hemchand Sati
- Departments of Neurology, and Biostatistics, Division of Neuropsychology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Kumar Singh
- Departments of Neurology, and Biostatistics, Division of Neuropsychology, All India Institute of Medical Sciences, New Delhi, India
| | - Venugopalan Y Vishnu
- Departments of Neurology, and Biostatistics, Division of Neuropsychology, All India Institute of Medical Sciences, New Delhi, India
| | - Roopa Rajan
- Departments of Neurology, and Biostatistics, Division of Neuropsychology, All India Institute of Medical Sciences, New Delhi, India
| | - Manmohan Singh
- Departments of Neurology, and Biostatistics, Division of Neuropsychology, All India Institute of Medical Sciences, New Delhi, India
| | - Achal Srivastava
- Departments of Neurology, and Biostatistics, Division of Neuropsychology, All India Institute of Medical Sciences, New Delhi, India
| | - Padma Srivastava
- Departments of Neurology, and Biostatistics, Division of Neuropsychology, All India Institute of Medical Sciences, New Delhi, India
| | - Manjari Tripathi
- Departments of Neurology, and Biostatistics, Division of Neuropsychology, All India Institute of Medical Sciences, New Delhi, India
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Mishra B, Rajan R, Gupta A, Faruq M, Shamim U, Parveen S, Garg A, Tripathi M, Vishnu VY, Singh MB, Bhatia R, Srivastava P. Cerebellar Ataxia in Adults with SQSTM1-Associated Frontotemporal Dementia-Amyotrophic Lateral Sclerosis Spectrum of Disorders. Mov Disord Clin Pract 2021; 8:800-802. [PMID: 34307757 DOI: 10.1002/mdc3.13218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/09/2021] [Accepted: 03/16/2021] [Indexed: 11/08/2022] Open
Affiliation(s)
| | - Roopa Rajan
- All India Institute of Medical Sciences New Delhi India
| | - Anu Gupta
- All India Institute of Medical Sciences New Delhi India
| | - Mohammed Faruq
- Genomics and Molecular Medicine Council of Scientific and Industrial Research Institute of Genomics and Integrative Biology New Delhi India
| | - Uzma Shamim
- Genomics and Molecular Medicine Council of Scientific and Industrial Research Institute of Genomics and Integrative Biology New Delhi India
| | - Shaista Parveen
- Genomics and Molecular Medicine Council of Scientific and Industrial Research Institute of Genomics and Integrative Biology New Delhi India
| | - Ajay Garg
- All India Institute of Medical Sciences New Delhi India
| | | | | | | | - Rohit Bhatia
- All India Institute of Medical Sciences New Delhi India
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18
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Rajan R, Srivastava AK, Anandapadmanabhan R, Saini A, Upadhyay A, Gupta A, Vishnu VY, Pandit AK, Vibha D, Singh MB, Bhatia R, Goyal V, Dwivedi SN, Srivastava P, Prasad K. Assessment of Botulinum Neurotoxin Injection for Dystonic Hand Tremor: A Randomized Clinical Trial. JAMA Neurol 2021; 78:302-311. [PMID: 33346814 DOI: 10.1001/jamaneurol.2020.4766] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance There is an unmet need for safe and efficacious treatments for upper-extremity dystonic tremor (DT). To date, only uncontrolled retrospective case series have reported the effect of botulinum neurotoxin (BoNT) injections on upper-extremity DT. Objective To assess the effect of BoNT injections on tremor in patients with upper-extremity DT. Design, Setting, and Participants In this placebo-controlled, parallel-group randomized clinical trial, 30 adult patients with upper-extremity DT treated at a movement disorder clinic in a tertiary care university hospital were randomized in a 1:1 ratio to BoNT or saline injection, 0.9%, using a computer-generated randomization sequence. Randomization was masked using opaque envelopes. The participant, injector, outcome assessor, and statistician were blinded to the randomization. Participants were recruited between November 20, 2018, and December 12, 2019, and the last follow-up was completed in March 2020. Interventions Participants received electromyographically guided intramuscular injections of BoNT or placebo into the tremulous muscles of the upper extremity. Injection patterns and doses were individualized according to tremor phenomenologic findings. Main Outcomes and Measures The primary outcome was the total score on the Fahn-Tolosa-Marin Tremor Rating Scale 6 weeks after the intervention. Outcomes were assessed at baseline, 6 weeks, and 12 weeks. All patients were offered open-label BoNT injections after 12 weeks and reassessed 6 weeks later. Results A total of 48 adult patients with a diagnosis of brachial dystonia with DT were screened. Fifteen were ineligible and 3 refused consent; therefore, 30 patients (mean [SD] age, 46.0 [18.6] years; 26 [86.7%] male) were recruited, with 15 randomized to receive BoNT and 15 to receive placebo. In the intention-to-treat group, the Fahn-Tolosa-Marin Tremor Rating Scale total score was significantly lower in the BoNT group at 6 weeks (adjusted mean difference, -10.9; 95% CI, -15.4 to -6.5; P < .001) and 12 weeks (adjusted mean difference, -5.7; 95% CI, -11.0 to -0.5; P = .03). More participants in the BoNT group reported global improvement on the Global Impression of Change (PGIC) assessment (PGIC 1, 2, and 3: BoNT: 4 [26.7%], 6 [40.0%], and 5 [33.3%]; placebo: 5 [33.3%], 10 [66.7%], and 0, respectively; P = .047). Subjective hand weakness (BoNT: 6 [40.0%]; placebo: 4 [28.6%], P = .52) and dynamometer-assessed grip strength (mean difference, -0.2 log10[kgf/m2]2/Hz-Hz; 95% CI, -0.9 to 0.4 log10[kgf/m2]2/Hz-Hz; P = .45) were similar in both groups. Conclusions and Relevance In this randomized clinical trial, botulinum neurotoxin injections were superior to placebo in reducing tremor severity in upper-extremity DT. An individualized approach to muscle selection and dosing was beneficial without unacceptable adverse effects. Trial Registration Clinical Trials Registry of India (http://ctri.nic.in) Identifier: CTRI/2018/02/011721.
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Affiliation(s)
- Roopa Rajan
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Achal K Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Arti Saini
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Ashish Upadhyay
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Anu Gupta
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Venugopalan Y Vishnu
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Awadh K Pandit
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Deepti Vibha
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Mamta B Singh
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Bhatia
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Vinay Goyal
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Sada Nand Dwivedi
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Padma Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Kameshwar Prasad
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
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Agarwal M, Arushi A, Dhingra LS, Patel LJ, Agrawal S, Srivastava P, Tripathi M, Srivastava A, Bhatia R, Singh MB, Prasad K, Vibha D, Vishnu VY, Rajan R, Pandit AK, Singh RK, Gupta A, Radhakrishnan DM, Das A, Ramanujam B, Agarwal A, Elavarasi A. Patient Experience of a Neurology Tele-Follow-Up Program Initiated During the Coronavirus Disease 2019 Pandemic: A Questionnaire-Based Study. Telemed Rep 2021; 2:88-96. [PMID: 35720744 PMCID: PMC8989087 DOI: 10.1089/tmr.2020.0034] [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] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/04/2021] [Indexed: 06/15/2023]
Abstract
Background: Teleneurology consultations can be highly advantageous since neurological diseases and disabilities often limit patient's access to health care, particularly in a setting where they need to travel long distances for specialty consults. Patient satisfaction is an important outcome assessing success of a telemedicine program. Materials and Methods: A cross-sectional study was conducted to determine satisfaction and perception of patients toward an audio call based teleneurology follow-up initiated during the coronavirus disease 2019 pandemic. Primary outcomes were satisfaction to tele-consult, and proportion of patients preferring telemedicine for future follow-up. Results: A total of 261 patients who received tele-consult were enrolled. Satisfaction was highest for domain technological quality, followed by patient-physician dialogue (PPD) and least to quality of care (QoC). Median (interquartile range) patient satisfaction on a 5-point Likert scale was 4 (3-5). Eighty-five (32.6%; 95% confidence interval 26.9-38.6%) patients preferred telemedicine for future follow-up. Higher overall satisfaction was associated with health condition being stable/better, change in treatment advised on tele-consult, diagnosis not requiring follow-up examination, higher scores on domains QoC and PPD (p < 0.05). Future preference for telemedicine was associated with patient him-/herself consulting with doctor, less duration of follow-up, higher overall satisfaction, and higher scores on domain QoC (p < 0.05). On thematic analysis, telemedicine was found convenient, reduced expenditure, and had better physician attention; in-person visits were comprehensive, had better patient-physician relationship, and better communication. Discussion: Patient satisfaction was lower in our study than what has been observed earlier, which may be explained by the primitive nature of our platform. Several variables related to the patients' disease process have an effect on patient satisfaction. Conclusion: Development of robust, structured platforms is necessary to fully utilize the potential of telemedicine in developing countries.
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Affiliation(s)
- Mudit Agarwal
- MBBS, All India Institute of Medical Sciences, New Delhi, India
| | - Arushi Arushi
- MBBS, All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | - Padma Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Achal Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Bhatia
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Mamta Bhushan Singh
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Kameshwar Prasad
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Deepti Vibha
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Roopa Rajan
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Awadh Kishor Pandit
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Kumar Singh
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Anu Gupta
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Animesh Das
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Bhargavi Ramanujam
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Ayush Agarwal
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
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Toner L, Chen J, Ramchand J, O'Donnell D, Srivastava P, Calafiore P, Jones E. Biventricular Function is Impaired in RV Septal Pacing – A Prospective Study Using Myocardial Strain Imaging. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Goyal M, Ospel JM, Menon B, Almekhlafi M, Jayaraman M, Fiehler J, Psychogios M, Chapot R, van der Lugt A, Liu J, Yang P, Agid R, Hacke W, Walker M, Fischer U, Asdaghi N, McTaggart R, Srivastava P, Nogueira RG, Moret J, Saver JL, Hill MD, Dippel D, Fisher M. Challenging the Ischemic Core Concept in Acute Ischemic Stroke Imaging. Stroke 2020; 51:3147-3155. [DOI: 10.1161/strokeaha.120.030620] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Endovascular treatment is a highly effective therapy for acute ischemic stroke due to large vessel occlusion and has recently revolutionized stroke care. Oftentimes, ischemic core extent on baseline imaging is used to determine endovascular treatment-eligibility. There are, however, 3 fundamental issues with the core concept: First, computed tomography and magnetic resonance imaging, which are mostly used in the acute stroke setting, are not able to precisely determine whether and to what extent brain tissue is infarcted (core) or still viable, due to variability in tissue vulnerability, the phenomenon of selective neuronal loss and lack of a reliable gold standard. Second, treatment decision-making in acute stroke is multifactorial, and as such, the relative importance of single variables, including imaging factors, is reduced. Third, there are often discrepancies between core volume and clinical outcome. This review will address the uncertainty in terminology and proposes a direction towards more clarity. This theoretical exercise needs empirical data that clarify the definitions further and prove its value.
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Affiliation(s)
- Mayank Goyal
- Department of Clinical Neurosciences, University of Calgary, Canada. (M.G., J.M.O., B.M., M.A., M.D.H.)
- Department of Radiology, University of Calgary, Canada. (M.G., B.M., M.A., M.D.H.)
| | - Johanna M. Ospel
- Department of Clinical Neurosciences, University of Calgary, Canada. (M.G., J.M.O., B.M., M.A., M.D.H.)
- Division of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Switzerland (J.M.O., M.P.)
| | - Bijoy Menon
- Department of Clinical Neurosciences, University of Calgary, Canada. (M.G., J.M.O., B.M., M.A., M.D.H.)
- Department of Radiology, University of Calgary, Canada. (M.G., B.M., M.A., M.D.H.)
| | - Mohammed Almekhlafi
- Department of Clinical Neurosciences, University of Calgary, Canada. (M.G., J.M.O., B.M., M.A., M.D.H.)
- Department of Radiology, University of Calgary, Canada. (M.G., B.M., M.A., M.D.H.)
| | - Mahesh Jayaraman
- Department of Interventional Radiology, Warren Alpert Medical School of Brown University, Providence, RI (M.J., R.M.)
| | - Jens Fiehler
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Germany (J.F.)
| | - Marios Psychogios
- Division of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Switzerland (J.M.O., M.P.)
| | - Rene Chapot
- Department of Neuroradiology, Alfred Krupp Krankenhaus, Essen, Germany (R.C.)
| | - Aad van der Lugt
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands (A.v.d.L.)
| | - Jianmin Liu
- Department of Neurosurgery, Changhai Hospital, Naval Medical University, Shanghai, China (J.L.)
| | - Pengfei Yang
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China (P.Y.)
| | - Ronit Agid
- Department of Medical Imaging, University of Toronto, Canada (R.A.)
| | - Werner Hacke
- Department of Neurology, University Hospital Heidelberg, Germany (W.H.)
| | - Melanie Walker
- Department of Neurological Surgery, University of Washington School of Medicine, Seattle (M.W.)
| | - Urs Fischer
- Department of Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Switzerland (U.F.)
| | - Negar Asdaghi
- Department of Neurology, University of Miami Miller School of Medicine (N.A.)
| | - Ryan McTaggart
- Department of Interventional Radiology, Warren Alpert Medical School of Brown University, Providence, RI (M.J., R.M.)
| | - Padma Srivastava
- Department of Neurology, All India Institute of Medicine, New Delhi, India (P.S.)
| | - Raul G. Nogueira
- Department of Neurology, Emory University School of Medicine, Atlanta (R.G.N.)
| | - Jacques Moret
- The Brain Vascular Center, Baujon University Hospital, Paris, France (J.M.)
| | - Jeffrey L. Saver
- Department of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine, University of California, Los Angeles (J.L.S.)
| | - Michael D. Hill
- Department of Clinical Neurosciences, University of Calgary, Canada. (M.G., J.M.O., B.M., M.A., M.D.H.)
- Department of Radiology, University of Calgary, Canada. (M.G., B.M., M.A., M.D.H.)
| | - Diederik Dippel
- Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands (D.D.)
| | - Marc Fisher
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA (M.F.)
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Pararajasingam A, Atwan A, Srivastava P, Chowdhury MMU, Stone NM. Shades of grey: an outbreak of tattoo-associated Mycobacterium chelonae. Br J Dermatol 2020; 184:e54. [PMID: 32875558 DOI: 10.1111/bjd.19487] [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] [Received: 06/11/2020] [Revised: 07/27/2020] [Accepted: 07/27/2020] [Indexed: 11/28/2022]
Affiliation(s)
- A Pararajasingam
- Department of Dermatology, Aneurin Bevan University Health Board, Newport, UK
| | - A Atwan
- Department of Dermatology, Aneurin Bevan University Health Board, Newport, UK
| | - P Srivastava
- Department of Dermatology, University Hospital of Wales, Cardiff, UK
| | - M M U Chowdhury
- Department of Dermatology, University Hospital of Wales, Cardiff, UK
| | - N M Stone
- Department of Dermatology, Aneurin Bevan University Health Board, Newport, UK
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23
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Jain N, Pandya S, Srivastava P, Chotalia P, Moorthy A. AB0694 IS THERE ANY HETEROGENEITY OF SPONDYLOARTHRITIS DISEASE MANIFESTATIONS BETWEEN TWO ETHNIC SUBGROUPS?:A MULTICENTRE INTERNATIONAL COMPARATIVE STUDY BETWEEN INDIA AND UK. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6497] [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: 11/04/2022]
Abstract
Background:Pathogenesis of Spondyloarthritis (SpA) multifactorial and remains unclear. Various hypothesis have been postulated genetics, HLAB27, IL17, Gut microbiome and Biomechanical stress. Many of these factors can be attributed to ethnic background and environment. HLAB27 accounts for 20–25 % of total heritability and 40% of genetic risk while <10% of HLA-B27 carriers in general population develop SpA1. Higher faecal calprotectin levels in SpA compared to control point towards microscopic gut inflammation2. Thus dietary habits and geographical factors can influence pathogenesis of disease. We looked in clinical manifestations of SpA patients of two very different ethnic background Caucasians and Indians from UK and India to shed more light in understanding the diseaseObjectives:To study any differences in the clinical manifestations of SpA patients of two ethnic groupsTo compare outcome measure (BASDAI and ASDAS) between Caucasians and IndiansTo study the difference in disease activity between Indian patients and British AsiansMethods:Multicentre observation study where data of SpA patients attending rheumatology clinics from two major teaching hospitals collected. In India data collected from Sheth VS Hospital and NHL Medical College, Gujarat and in United Kingdom from University Hospitals Leicester, NHS trust. Leicester has a multi-ethnic demography wherein almost 30%3of population is of south Asian ethnicity, making this study unique.Baseline demographic and clinical data was collected. Clinical and outcome measures compared to see any heterogeneity in disease manifestations. SPSS software usedResults:Total 200 patients analysed with 148 Indians and 52 Caucasians. The Indian cohort was subdivided into British Asians (second generation Indians) and those form Gujarat, IndiaWe found Indian subgroups were younger with shorter disease duration. Comparison in Table 1Table 1.CaucasianIndianPAge45.9±1231±12<0.001M:F34:193:10.74TDI years9.6 ±5.93.5± 5.2<0.001BASDAI4.05±2.173.1±1.70.002ASDAS2±0.82.4±1.20.02CRP12.8±23.624±12<0.001HLAB2767%26%<0.001Uveitis25%12%0.02IBP78%90%0.03Enthesitis21%60%<0.001Peripheral Arthritis19%36%0.02Dactylitis2%10%0.07Psoriasis10%20%0.1IBD2%5%0.35Comparing British Asians to Indians, Gujarat no significant difference in clinical parameters. (Table 2)British AsianIndianPBASDAI5.16±2.763.1±1.70.006ASDAS2.53±1.32.4±1.20.74CRP15.2 ±15.424±12<0.001Conclusion:We found Caucasians had more HLAB27 positivity and extra-articular manifestation of uveitis however the Indian population has more enthesitis and peripheral arthritis. Enthesitis is initiated during a mechano-sensation and the cultural difference including style of footwear could probably be one of the factors explaining our findings inflammatory back pain has been reported to be higher in Indians compared to Caucasians which could be due to life styleThe fact that ASDAS CRP behaves similarly in Indian patients across the two countries and is more when compared to Caucasians might point towards overall higher burden of disease in Indian populationTo our knowledge this is a first study comparing clinical manifestations of SpA between Indians and CaucasiansReferences:[1]Brown MAet al. Susceptibility to ankylosing spondylitis in twins: the role of genes, HLAand environment.Arthritis Rheum 1997;40: 1823–8[2]J Simione, et al. Fecal Calprotectin, GutInflammation and SpA Archives of Medical Research. 2019;50:41-46[3]http://www.ons.gov.uk/censusDisclosure of Interests:Nibha Jain: None declared, Sapan Pandya: None declared, Puja Srivastava: None declared, Prashant Chotalia: None declared, Arumugam Moorthy Speakers bureau: Abbvie, Novartis,UCB,MSD
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Srivastava P, Kumar P, Tiwari AK. Design, Synthesis, and In Silico Evaluation of Methyl 2-(2-(5-Bromo/chloro-2-oxobenzoxazol-3(2H)-yl)-acetamido)-3-phenylpropanoate for TSPO Targeting. Radiochemistry 2020. [DOI: 10.1134/s1066362220010142] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Lun R, Yogendrakumar V, Demchuk AM, Aviv RI, Rodriguez-Luna D, Molina CA, Silva Y, Dzialowski I, Kobayashi A, Boulanger JM, Gubitz G, Srivastava P, Roy J, Kase CS, Bhatia R, Hill MD, Dowlatshahi D. Calculation of Prognostic Scores, Using Delayed Imaging, Outperforms Baseline Assessments in Acute Intracerebral Hemorrhage. Stroke 2020; 51:1107-1110. [PMID: 32151235 DOI: 10.1161/strokeaha.119.027119] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose- Patients with intracerebral hemorrhage (ICH) are often subject to rapid deterioration due to hematoma expansion. Current prognostic scores are largely based on the assessment of baseline radiographic characteristics and do not account for subsequent changes. We propose that calculation of prognostic scores using delayed imaging will have better predictive values for long-term mortality compared with baseline assessments. Methods- We analyzed prospectively collected data from the multicenter PREDICT study (Prediction of Hematoma Growth and Outcome in Patients With Intracerebral Hemorrhage Using the CT-Angiography Spot Sign). We calculated the ICH Score, Functional Outcome in Patients With Primary Intracerebral Hemorrhage (FUNC) Score, and modified ICH Score using imaging data at initial presentation and at 24 hours. The primary outcome was mortality at 90 days. We generated receiver operating characteristic curves for all 3 scores, both at baseline and at 24 hours, and assessed predictive accuracy for 90-day mortality with their respective area under the curve. Competing curves were assessed with nonparametric methods. Results- The analysis included 280 patients, with a 90-day mortality rate of 25.4%. All 3 prognostic scores calculated using 24-hour imaging were more predictive of mortality as compared with baseline: the area under the curve was 0.82 at 24 hours (95% CI, 0.76-0.87) compared with 0.78 at baseline (95% CI, 0.72-0.84) for ICH Score, 0.84 at 24 hours (95% CI, 0.79-0.89) compared with 0.76 at baseline (95% CI, 0.70-0.83) for FUNC, and 0.82 at 24 hours (95% CI, 0.76-0.88) compared with 0.74 at baseline (95% CI, 0.67-0.81) for modified ICH Score. Conclusions- Calculation of the ICH Score, FUNC Score, and modified ICH Score using 24-hour imaging demonstrated better prognostic value in predicting 90-day mortality compared with those calculated at presentation.
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Affiliation(s)
- Ronda Lun
- From the Ottawa Stroke Program, Department of Medicine (Neurology), University of Ottawa, Canada (R.L., V.Y., D.D.)
| | - Vignan Yogendrakumar
- From the Ottawa Stroke Program, Department of Medicine (Neurology), University of Ottawa, Canada (R.L., V.Y., D.D.)
| | - Andrew M Demchuk
- Calgary Stroke Program, Department of Clinical Neurosciences (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Canada.,Department of Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Canada
| | - Richard I Aviv
- Division of Neuroradiology (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Canada.,Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Canada
| | - David Rodriguez-Luna
- Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.)
| | - Carlos A Molina
- Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.)
| | - Yolanda Silva
- Department of Neurology, Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Girona, Spain (Y.S.)
| | - Imanuel Dzialowski
- Department of Neurology, Elblandklinikum Meissen Academic Teaching Hospital of the Technische University, Dresden, Germany (I.D.)
| | - Adam Kobayashi
- Interventional Stroke and Cerebrovascular Treatment Center, Institute of Psychiatry and Neurology, Warsaw, Poland (A.K.).,2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.K.).,Department of Experimental and Clinical Pharmacology, Warsaw, Poland (A.K.)
| | - Jean-Martin Boulanger
- Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Canada (J.-M.B.)
| | - Gordon Gubitz
- Department of Neurology, Dalhousie University, Halifax, Canada (G.G.)
| | - Padma Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi (P.S., R.B.)
| | - Jayanta Roy
- Apollo Gleneagles Hospitals, Kolkata, India (J.R.)
| | - Carlos S Kase
- Department of Neurology, Boston Medical Center, MA (C.S.K.)
| | - Rohit Bhatia
- Department of Neurology, All India Institute of Medical Sciences, New Delhi (P.S., R.B.)
| | - Michael D Hill
- Calgary Stroke Program, Department of Clinical Neurosciences (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Canada.,Department of Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Canada
| | - Dar Dowlatshahi
- From the Ottawa Stroke Program, Department of Medicine (Neurology), University of Ottawa, Canada (R.L., V.Y., D.D.)
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Yogendrakumar V, Ramsay T, Fergusson DA, Demchuk AM, Aviv RI, Rodriguez-Luna D, Molina CA, Silva Y, Dzialowski I, Kobayashi A, Boulanger JM, Gubitz G, Srivastava P, Roy J, Kase CS, Bhatia R, Hill MD, Goldstein JN, Dowlatshahi D. Redefining Hematoma Expansion With the Inclusion of Intraventricular Hemorrhage Growth. Stroke 2020; 51:1120-1127. [PMID: 32078498 DOI: 10.1161/strokeaha.119.027451] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background and Purpose- Definitions of significant hematoma expansion traditionally focus on changes in intraparenchymal volume. The presence of intraventricular hemorrhage (IVH) is a predictor of poor outcome, but current definitions of hematoma expansion do not include IVH expansion. We evaluated whether including IVH expansion to current definitions of hematoma expansion improves the ability to predict 90-day outcome. Methods- Using data from the PREDICT-ICH study (Predicting Hematoma Growth and Outcome in Intracerebral Hemorrhage Using Contrast Bolus CT), we compared a standard definition of hematoma expansion (≥6 mL or ≥33%) to revised definitions that includes new IVH development or expansion (≥6 mL or ≥33% or any IVH; ≥6 mL or ≥33% or IVH expansion ≥1 mL). The primary outcome was poor clinical outcome (modified Rankin Scale score, 4-6) at 90 days. Diagnostic accuracy measures were calculated for each definition, and C statistics for each definition were compared using nonparametric methods. Results- Of the 256 patients eligible for primary analysis, 127 (49.6%) had a modified Rankin Scale score of 4 to 6. Sensitivity and specificity for the standard definition (n=80) were 45.7% (95% CI, 36.8-54.7) and 82.9% (95% CI, 75.3-88.9), respectively. The revised definition, ≥6 mL or ≥33% or any IVH (n=113), possessed a sensitivity of 63.8% (95% CI, 54.8-72.1) and specificity of 75.2% (95% CI, 66.8-82.4). Overall accuracy was significantly improved with the revised definition (P=0.013) and after adjusting for relevant covariates, was associated with a 2.55-fold increased odds (95% CI, 1.31-4.94) of poor outcome at 90 days. A second revised definition, ≥6 mL or ≥33% or IVH expansion ≥1 mL, performed similarly (sensitivity, 56.7% [95% CI, 47.6-65.5]; specificity, 78.3% [95% CI, 40.2-85.1]; aOR, 2.40 [95% CI, 1.23-4.69]). Conclusions- In patients with mild-to-moderate ICH, including IVH expansion to the definition of hematoma expansion improves sensitivity with only minimal decreases to specificity and improves overall prediction of 90-day outcome.
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Affiliation(s)
- Vignan Yogendrakumar
- From the Ottawa Stroke Program, Department of Medicine, Division of Neurology, (V.Y., D.D.), University of Ottawa, Canada
| | - Tim Ramsay
- Ottawa Methods Center (T.R., D.A.F.), University of Ottawa, Canada.,Ottawa Hospital Research Institute (T.R., D.A.F., D.D.), University of Ottawa, Canada
| | - Dean A Fergusson
- Ottawa Methods Center (T.R., D.A.F.), University of Ottawa, Canada.,Ottawa Hospital Research Institute (T.R., D.A.F., D.D.), University of Ottawa, Canada
| | - Andrew M Demchuk
- Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Canada.,Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Canada
| | - Richard I Aviv
- Department of Radiology (R.I.A.), University of Ottawa, Canada
| | - David Rodriguez-Luna
- Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.)
| | - Carlos A Molina
- Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (D.R.-L., C.A.M.)
| | - Yolanda Silva
- Department of Neurology, Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain (Y.S.)
| | - Imanuel Dzialowski
- Department of Neurology, Elblandklinikum Meissen Academic Teaching Hospital of the Technische University, Dresden, Germany (I.D.)
| | - Adam Kobayashi
- Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.K.).,Department of Experimental and Clinical Pharmacology, Warsaw, Poland (A.K.)
| | - Jean-Martin Boulanger
- Department of Medicine, Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Canada (J.-M.B.)
| | - Gord Gubitz
- Department of Neurology, Dalhousie University, Halifax, Canada (G.G.)
| | - Padma Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi (P.S., R.B.)
| | | | - Carlos S Kase
- Department of Neurology, Boston Medical Center, MA (C.S.K.)
| | - Rohit Bhatia
- Department of Neurology, All India Institute of Medical Sciences, New Delhi (P.S., R.B.)
| | - Michael D Hill
- Calgary Stroke Program, Departments of Clinical Neurosciences (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Canada.,Radiology (A.M.D., M.D.H.), Hotchkiss Brain Institute, University of Calgary, Canada
| | - Joshua N Goldstein
- Department of Emergency Medicine, Massachusetts General Hospital, Boston (J.N.G.)
| | - Dar Dowlatshahi
- From the Ottawa Stroke Program, Department of Medicine, Division of Neurology, (V.Y., D.D.), University of Ottawa, Canada.,Ottawa Hospital Research Institute (T.R., D.A.F., D.D.), University of Ottawa, Canada
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Pedapati R, Vishnu VY, Singh MB, Goyal V, Garg A, Srivastava P. CADASIL and Cavernomas: A Common Mechanism. Ann Indian Acad Neurol 2020; 23:570-572. [PMID: 33223688 PMCID: PMC7657275 DOI: 10.4103/aian.aian_684_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 01/23/2020] [Accepted: 01/02/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- Radhakrishna Pedapati
- Department of Neurology, Neurosciences Center, All India Institute of Medical Sciences, New Delhi, India
| | - Venugopalan Y. Vishnu
- Department of Neurology, Neurosciences Center, All India Institute of Medical Sciences, New Delhi, India
| | - Mamta B. Singh
- Department of Neurology, Neurosciences Center, All India Institute of Medical Sciences, New Delhi, India
| | - Vinay Goyal
- Department of Neurology, Neurosciences Center, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Garg
- Department of Neuroradiology, Neurosciences Center, All India Institute of Medical Sciences, New Delhi, India
| | - Padma Srivastava
- Department of Neurology, Neurosciences Center, All India Institute of Medical Sciences, New Delhi, India,Address for correspondence: Dr. Padma Srivastava, Department of Neurology, Room Number - 702, Cardiothoracic and Neurosciences Center, AIIMS, New Delhi - 110 029, India. E-mail:
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Eccleston D, Cehic D, Cross D, Srivastava P. P2448Evolution of clinical quality activities within a national echocardiography database: seven-year trends from the GenesisCare Outcomes Registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Despite rapid technologic advances and sustained growth, less attention has been focused on quality in imaging than in other areas of cardiovascular medicine. To address this deficit, the ACC proposed additional areas of effort such as data standardisation, structured reporting identifying key data elements and imaging registries. We explored these changes within a large multi-centre Australian registry.
Methods
From 2010–2014 we introduced direct online entry of echocardiographic studies into an electronic database, selection and auditing of key data elements and quality improvement pathways to maximise completeness of data acquisition and reporting across 4 states. We compared completeness of key data elements (AV peak velocity, EF, E/E', LA area, rhythm, RVSP) by time and state using de-identified data.
Results
464,688 echocardiographic procedures were captured from 2011 to 2018.
Data completeness improved significantly from 2011 to 2018 (72.0±26.8 vs 88.2±13.5%, p=0.02). Inter-practice variability fell from 2011 to 2018 for both EF and E/E', p<0.002
Conclusion
Identification, systematic capture and auditing of key echo data elements can significantly improve the quality and reduce inter-practice variability of echo data. Developing a national database allows rapid adoption of local quality improvements.
Acknowledgement/Funding
None
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Affiliation(s)
- D Eccleston
- University of Melbourne and GenesisCare, Melbourne, Australia
| | - D Cehic
- University of Adelaide and GenesisCare, Adelaide, Australia
| | - D Cross
- University of Queensland and GenesisCare, Brisbane, Australia
| | - P Srivastava
- University of Melbourne and GenesisCare, Melbourne, Australia
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Dixit P, Anwar M, Saif J, Chamorro-Jorganes A, Dumas M, Angelini G, Punjabi P, Srivastava P, Katare R, Petretto E, Emanueli C. P6309Impaired secretion of clusterin in pericardial fluid of diabetics, a deleterious outcome for the cardiac micro-vasculature. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Extracellular vesicles are vital mediators of cell-to-cell communications. We previously demonstrated that in the adult heart, exosomes released in the pericardial fluid (PF) have the functional capability to induce cell survival and angiogenesis in recipient endothelial cells. It has previously been shown that PF exosomes from patients with an existing myocardial infarction (MI) contain clusterin (CLU). Remarkably, secreted CLU is cardio-protective as evidenced by enhanced arteriogenesis and reduced apoptosis in animal models of MI. We hypothesize that type 2 Diabetes Mellitus (T2DM) along with ischemic heart disease (IHD) alters PF EV content impairing its reparative angiogenic potential.
Aim
To investigate the role of T2DM in modulating human PF exosomal content and its vascular action.
Methods and results
PF samples were collected from 3 different groups of patients (N=3): 1) Ischemic heart disease (IHD) with or 2) without T2DM, and 3) non-ischaemic, non-diabetic controls operated for mitral valve repair.
The impact of PF exosomes on human coronary microvascular ECs (HCMECs) was evaluated by cell based functional assays for measuring apoptosis, proliferation and angiogenesis. Interestingly, unlike PF exosomes from control patients, PF exosomes from DM patients with IHD promoted EC apoptosis and impaired angiogenesis.
To investigate the effect of T2DM on PF content, we performed high throughput proteomic and metabolomic analysis of whole PF and PF EVs. We identified proteins and metabolites that were differentially expressed under T2DM condition by using the R package Limma. Employing a network approach, protein and metabolic data were integrated by using our newly developed inhouse R package Metabosignal. This networks approach revealed an interesting interaction circuit involving protein CLU. The T2DM-associated reduction of CLU level in the PF, identified from the “omics” analyses was confirmed by ELISA (n=8 patients per group).
To examine the effects of DM and ischemia on CLU intracellular expression and secretion, HCMECs were exposed to high D-glucose (HG, 25 mM) and hypoxia (1%O2). In line with our PF data, HCMECs exposed to HG and hypoxia showed lower levels of both CLU mRNA and secreted CLU (ELISA). Importantly, recombinant CLU (rCLU) treatment on HCMECs rescued their angiogenic potential, induced cell proliferation and protected them from apoptosis under both HG and hypoxia conditions. In addition, silencing of endogenous levels of CLU in HCMECs impaired angiogenesis, suggesting that CLU might be an inherent component of the angiogenesis machinery in ECs.
Conclusions
This study suggests that DM reduces the level of secreted CLU in the PF, depriving myocardial micro-vessels of this protective and regenerative mediator. Restoring diminished CLU levels in the diabetic heart could be a possible therapeutic approach for contrasting diabetic micro-angiopathy.
Acknowledgement/Funding
British Heart Foundation Program Grant
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Affiliation(s)
- P Dixit
- Imperial College London, London, United Kingdom
| | - M Anwar
- Imperial College London, London, United Kingdom
| | - J Saif
- Imperial College London, London, United Kingdom
| | | | - M Dumas
- Imperial College London, London, United Kingdom
| | - G Angelini
- Bristol Heart Institute, Bristol, United Kingdom
| | - P Punjabi
- Imperial College London, London, United Kingdom
| | | | - R Katare
- University of Otago, Physiology, Dunedin, New Zealand
| | - E Petretto
- Duke-NUS Graduate Medical School Singapore, Singapore, Singapore
| | - C Emanueli
- Imperial College London, London, United Kingdom
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Vishnu V, Vinny P, Rajan R, Goyal V, Srivastava P, Lal V, Sylaja P, Narasimhan L, Dwivedi S, Nair P, Ramachandran D, Gupta A. Neurology residents versus a mobile medical application in deducing differential diagnoses in movement disorders: A multi-center, cross-sectional, observational study. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sharma S, Srivastava P, Kuthiala N. Comparison of knowledge, attitude, practices among the different age group of Himachal Pradesh. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Cailes B, Koshy AN, Han H, Sajeev JK, Ko J, Weinberg L, Gow P, Testro A, Srivastava P, Lim H, Teh A, Farouque O. P3465Inducible left ventricular outflow tract obstruction is associated with a higher incidence of perioperative cardiac arrest in liver transplantation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0337] [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
Inducible left ventricular outflow tract obstruction (LVOTO) is not infrequently encountered in liver transplant (LT) candidates undergoing cardiac workup. While the impact of LVOTO on adverse cardiovascular haemodynamics is well reported, it is unclear whether it predisposes to perioperative cardiovascular complications following LT.
Purpose
To investigate the effect of inducible left ventricular outflow tract obstruction on perioperative cardiovascular complications in a modern cohort of liver transplant patients.
Methods
Consecutive patients undergoing dobutamine stress echocardiography (DSE) were evaluated from a quaternary LT centre between 2010 and 2017. Inducible LVOTO was defined as LVOT gradient ≥36mmHg. Perioperative major adverse cardiovascular events (MACE) at 30 days and all-cause death were recorded from a prospectively maintained transplantation database and augmented by electronic medical record review.
Results
We evaluated 560 patients who underwent DSE as part of a workup for LT. Of these, 319 progressed to transplant. Inducible LVOTO was observed in 68 patients (21.3%). A higher baseline cardiac output (7.7 L/min vs 7.0 L/min, p=0.002) predicted for development of inducible LVOTO. Seventy-seven patients (4.1%) experienced a MACE including five deaths, 19 cases of heart failure, 11 cardiac arrests, 10 acute coronary syndromes and 46 cases of arrhythmias (VT/AF). Overall MACE occurred in 17/68 patients (25.0%) with LVOTO and 60/251 patients (23.9%) without LVOTO (p=0.85). However, there was a significantly increased risk of resuscitated perioperative cardiac arrest in patients with LVOTO (7.4% vs 2.4%, p=0.04). Patients with LVOTO also required significantly greater volumes of fluid intra-operatively (8.37L vs. 6.71L, p=0.043).
Cardiac Arrest in LT Patients with LVOTO
Conclusions
Inducible LVOTO is a frequent finding occurring in 21.3% of LT candidates. Despite higher intraoperative fluid resuscitation, LVOTO increased the risk of a perioperative cardiac arrest. Further studies are required to confirm these findings and to assess whether patients with LVOTO undergoing liver transplantation may benefit from heightened perioperative surveillance.
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Affiliation(s)
- B Cailes
- Austin Health Hospital, Department of Cardiology, Melbourne, Australia
| | - A N Koshy
- Austin Health Hospital, Department of Cardiology, Melbourne, Australia
| | - H Han
- Austin Health Hospital, Department of Cardiology, Melbourne, Australia
| | - J K Sajeev
- Austin Health Hospital, Department of Cardiology, Melbourne, Australia
| | - J Ko
- Austin Health Hospital, Department of Cardiology, Melbourne, Australia
| | - L Weinberg
- Austin Health Hospital, Department of Anaesthesia, Melbourne, Australia
| | - P Gow
- Austin Health Hospital, Victorian Liver Transplant Unit, Melbourne, Australia
| | - A Testro
- Austin Health Hospital, Victorian Liver Transplant Unit, Melbourne, Australia
| | - P Srivastava
- Austin Health Hospital, Department of Cardiology, Melbourne, Australia
| | - H Lim
- Austin Health Hospital, Department of Cardiology, Melbourne, Australia
| | - A Teh
- Austin Health Hospital, Department of Cardiology, Melbourne, Australia
| | - O Farouque
- Austin Health Hospital, Department of Cardiology, Melbourne, Australia
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Majumdar A, Hoang L, Loc LT, Srivastava P, Ramamurthy C, Chakravorty R, Nandanwar YS, Rashmi MD, Mayekar RV, Sridhar J, Divekar GH, John J. A Multicenter Phase IV Study to Investigate the Immunogenicity of Recombinant Human Follicle-Stimulating Hormone and Its Impact on Clinical Outcomes in Females Undergoing Controlled Ovarian Stimulation. J Hum Reprod Sci 2019; 12:303-309. [PMID: 32038080 PMCID: PMC6937766 DOI: 10.4103/jhrs.jhrs_33_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/25/2019] [Accepted: 11/01/2019] [Indexed: 11/29/2022] Open
Abstract
CONTEXT Therapeutic proteins can cause immune responses, which may have clinical implications. AIMS The aim of the study was to assess the immunogenicity of recombinant human follicle-stimulating hormone (r-hFSH), when used for controlled ovarian stimulation (COS). SETTINGS AND DESIGN Prospective, multicenter study conducted at reproductive medicine clinics in India and Vietnam. MATERIALS AND METHODS A total of 285 women, aged 20-40 years, undergoing 354 COS cycles for either intrauterine insemination (IUI) or in vitro fertilization (IVF) were studied. The primary outcome measure was the incidence of development of anti-drug antibodies (ADA) and their neutralization potential. Other outcome measures were follicle development, dose and duration of r-hFSH, positive serum pregnancy test, clinical pregnancy, cycle cancellation, and adverse events (AEs). STATISTICAL ANALYSIS USED A sample size of 250 was planned. Descriptive statistics are presented. RESULTS Four patients tested positive for ADA after r-hFSH administration at different time points; all of them tested negative, subsequently. None were found to have neutralization potential. The mean dose and duration of r-hFSH were 816 IU and 8.1 days in IUI and 2183 IU and 9.5 days in IVF, respectively. The serum and clinical pregnancy rates were 12.4% and 11.6% in IUI and 32.7% and 29.9% in IVF cycles, respectively. Seven AEs were reported, including two cases of ovarian hyperstimulation syndrome; two AEs were judged to be serious. CONCLUSIONS The tested r-hFSH has very low immunogenic potential and did not lead to the development of neutralizing antibodies. The overall efficacy and safety of the drug were in-line with existing literature data, and no specific clinical impact of immunogenicity could be identified.
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Affiliation(s)
- Abha Majumdar
- Department of Obstetrics and Gynaecology, Sir Ganga Ram Hospital, New Delhi, India
| | - Le Hoang
- Center for Assisted Reproduction, National Hospital of Obstetrics and Gynecology, Hanoi, Vietnam
| | - Ly T. Loc
- Infertility Department, Hung Vuong Hospital, Ho Chi Minh City, Vietnam
| | - Padma Srivastava
- Department of Obstetrics and Gynaecology, Inamdar Multispeciality Hospital, Pune, Maharashtra, India
| | - Chitra Ramamurthy
- Department of Obstetrics and Gynaecology, Apollo Hospitals, Bengaluru, Karnataka, India
| | - Ratnabali Chakravorty
- Department of Obstetrics and Gynaecology, ILS Hospitals, Kolkata, West Bengal, India
| | - Yogeshwar S. Nandanwar
- Department of Obstetrics and Gynaecology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - M. D Rashmi
- Department of Obstetrics and Gynaecology, Apollo BGS Hospitals, Mysore, Karnataka, India
| | - Rahul V. Mayekar
- Department of Obstetrics and Gynaecology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - Jayashree Sridhar
- Department of Obstetrics and Gynaecology, Choithram Hospital and Research Centre, Indore, Madhya Pradesh, India
| | - Ganesh H. Divekar
- Department of Clinical Research and Pharmacovigilance, Bharat Serums and Vaccines Limited, Navi Mumbai, Maharashtra, India
| | - James John
- Department of Clinical Research and Pharmacovigilance, Bharat Serums and Vaccines Limited, Navi Mumbai, Maharashtra, India
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Bhasin A, Srivastava P, Kumaran S, Pawan K, Mewar S. Bone marrow derived mononuclear stem cells in chronic stroke: Functional imaging & spectroscopic analysis. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sharma J, Srivastava P, Bhatia R, Rajan R, Singh R, Goyal V, Singh M, Garg A, Vishnu V. ‘Prehospital’ delay in acute stroke reperfusion therapy in Delhi: Time for introspection. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Yogendrakumar V, Ramsay T, Fergusson D, Demchuk AM, Aviv RI, Rodriguez-Luna D, Molina CA, Silva Y, Dzialowski I, Kobayashi A, Boulanger JM, Lum C, Gubitz G, Srivastava P, Roy J, Kase CS, Bhatia R, Hill MD, Warren AD, Anderson CD, Gurol ME, Greenberg SM, Viswanathan A, Rosand J, Goldstein JN, Dowlatshahi D. New and expanding ventricular hemorrhage predicts poor outcome in acute intracerebral hemorrhage. Neurology 2019; 93:e879-e888. [PMID: 31371565 DOI: 10.1212/wnl.0000000000008007] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 04/04/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To describe the relationship between intraventricular hemorrhage (IVH) expansion and long-term outcome and to use this relationship to select and validate clinically relevant thresholds of IVH expansion in 2 separate intracerebral hemorrhage (ICH) populations. METHODS We used fractional polynomial analysis to test linear and nonlinear models of 24-hour IVH volume change and clinical outcome with data from the Predicting Hematoma Growth and Outcome in Intracerebral Hemorrhage Using Contrast Bolus CT (PREDICT)-ICH study. The primary outcome was poor clinical outcome (modified Rankin Scale [mRS] score 4-6) at 90 days. We derived dichotomous thresholds from the selected model and calculated diagnostic accuracy measures. We validated all thresholds in an independent single-center ICH cohort (Massachusetts General Hospital). RESULTS Of the 256 patients from PREDICT, 127 (49.6%) had an mRS score of 4 to 6. Twenty-four-hour IVH volume change and poor outcome fit a nonlinear relationship, in which minimal increases in IVH were associated with a high probability of an mRS score of 4 to 6. IVH expansion ≥1 mL (n = 53, sensitivity 33%, specificity 92%, adjusted odds ratio [aOR] 2.68, 95% confidence interval [CI] 1.11-6.46) and development of any new IVH (n = 74, sensitivity 43%, specificity 85%, aOR 2.53, 95% CI 1.22-5.26) strongly predicted poor outcome at 90 days. The dichotomous thresholds reproduced well in a validation cohort of 169 patients. CONCLUSION IVH expansion as small as 1 mL or any new IVH is strongly predictive of poor outcome. These findings may assist clinicians with bedside prognostication and could be incorporated into definitions of hematoma expansion to inform future ICH treatment trials.
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Affiliation(s)
- Vignan Yogendrakumar
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston.
| | - Tim Ramsay
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Dean Fergusson
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Andrew M Demchuk
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Richard I Aviv
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - David Rodriguez-Luna
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Carlos A Molina
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Yolanda Silva
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Imanuel Dzialowski
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Adam Kobayashi
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Jean-Martin Boulanger
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Cheemun Lum
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Gord Gubitz
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Padma Srivastava
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Jayanta Roy
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Carlos S Kase
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Rohit Bhatia
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Michael D Hill
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Andrew D Warren
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Christopher D Anderson
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Mahmut E Gurol
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Steve M Greenberg
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Anand Viswanathan
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Jonathan Rosand
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Joshua N Goldstein
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
| | - Dar Dowlatshahi
- From the Ottawa Stroke Program (V.Y., D.D.), Department of Medicine (Neurology), Department of Radiology (C.L.), Ottawa Methods Center (T.R., D.F.), and Ottawa Hospital Research Institute (T.R., D.F., D.D.), University of Ottawa, Ontario; Calgary Stroke Program (A.M.D., M.D.H.), Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Alberta; Division of Neuroradiology and Department of Medical Imaging (R.I.A.), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Department of Neurology (D.R.-L., C.A.M.), Hospital Universitari Vall d'Hebron, Barcelona; Department of Neurology (Y.S.), Dr. Josep Trueta University Hospital, Institut d'Investigació Biomèdica Girona Foundation, Spain; Department of Neurology (I.D.), Elblandklinikum Meissen Academic Teaching Hospital of Technische University, Dresden, Germany; Interventional Stroke and Cerebrovascular Treatment Center and 2nd Department of Neurology (A.K.), Institute of Psychiatry and Neurology, and Department of Experimental and Clinical Pharmacology, Warsaw, Poland; Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, University of Sherbrooke, Longueuil, Quebec; Department of Neurology (G.G.), Dalhousie University, Halifax, Nova Scotia, Canada; Department of Neurology (P.S., R.B.), All India Institute of Medical Sciences, New Delhi; Apollo Gleneagles Hospitals (J.R.), Kolkata, India; Department of Neurology (C.S.K.), Boston Medical Center; and Department of Neurology (A.D.W., C.D.A., M.E.G., S.M.G., A.V., J.R.), Henry and Allison McCance Center for Brain Health (J.R.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston
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Yogendrakumar V, Ramsay T, Fergusson DA, Demchuk AM, Aviv RI, Rodriguez-Luna D, Molina CA, Silva Blas Y, Dzialowski I, Kobayashi A, Boulanger JM, Lum C, Gubitz G, Srivastava P, Roy J, Kase CS, Bhatia R, Hill MD, Selim M, Dowlatshahi D. Independent Validation of the Hematoma Expansion Prediction Score: A Non-contrast Score Equivalent in Accuracy to the Spot Sign. Neurocrit Care 2019; 31:1-8. [DOI: 10.1007/s12028-019-00740-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Koshy A, Cailes B, Testro A, Ramchand J, Sajeev J, Han H, Calafiore P, Jones E, Srivastava P, Salehi H, Teh A, Lim H, Gow P, Farouque O. Impaired Cardiac Reserve on Dobutamine Stress Echocardiography Predicts Development of Hepatorenal Syndrome. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.014] [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: 11/15/2022]
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Cailes B, Koshy A, Han H, Sajeev J, Ko J, Weinberg L, Gow P, Testro A, Srivastava P, Lim H, Teh A, Farouque O. Inducible Left Ventricular Outflow Tract Obstruction is Associated with a Higher Incidence of Perioperative Cardiac Arrest in Liver Transplantation. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Singh M, Elavarasi A, Srivastava P, Goyal V. Neuropsychiatric lupus: The devil is in the detail. Ann Indian Acad Neurol 2019; 22:253-255. [PMID: 31007455 PMCID: PMC6472238 DOI: 10.4103/aian.aian_236_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Oosthuizen S, Srivastava P, Eccleston D, Kearney L. A Technical Perspective of Improving Detail and Consistency in the Performance and Reporting of Echocardiography: An Eight–Year Trend from a National Database. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Koshy A, Cailes B, Gow P, Testro A, Han H, Sajeev J, Ko J, Weinberg L, Srivastava P, Lim H, Teh A, Farouque O. Cardiac Output in End-Stage Liver Disease Increases Proportional to the Degree of Liver Dysfunction. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Radhakrishnan DM, Ramanujam B, Srivastava P, Dash D, Tripathi M. Effect of providing sudden unexpected death in epilepsy (SUDEP) information to persons with epilepsy (PWE) and their caregivers-Experience from a tertiary care hospital. Acta Neurol Scand 2018; 138:417-424. [PMID: 29984404 DOI: 10.1111/ane.12994] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 11/27/2017] [Accepted: 06/19/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The primary objective of present study was to observe the effect of providing SUDEP (Sudden Unexpected Death in Epilepsy) information on drug adherence in persons with epilepsy (PWE). We also looked at impact of disclosing SUDEP information on patient's quality of life and mood. MATERIAL AND METHODS This prospective study had a pretest/post-test design. A total of 231 consecutive PWE (>15 years) were enrolled. Of these 121 PWE received information about SUDEP in addition to standard epilepsy care. One hundred and ten PWE (control group) received routine standard epilepsy care but did not receive SUDEP information. Follow up assessment was done at 6 months. The primary outcome was a change in drug adherence (measured by Modified Morisky Medication Adherence Scale, MMAS) in PWE following disclosure of SUDEP information. RESULTS After 6 months, 116 PWE in the SUDEP information group and 106 in control group were available for follow up. A non-significant higher adherence was observed in the SUDEP information group as compared to the control group (Mean MMAS change 0.51 ± 1.66 vs 0.25 ± 1.26, P value = 0.194). No significant change was perceived in patient's anxiety and depression levels or quality of life in either group. CONCLUSION The present study suggests that providing information on SUDEP to PWE and their caregivers may increase drug adherence without adverse effect on quality of life or mood. Well-designed studies with high methodological quality are required to determine the precise effect size associated with disclosure of SUDEP information on drug adherence in PWE.
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Affiliation(s)
| | - Bhargavi Ramanujam
- Department of Neurology; All India Institute of Medical Sciences; New Delhi India
| | - Padma Srivastava
- Department of Neurology; All India Institute of Medical Sciences; New Delhi India
| | - Deepa Dash
- Department of Neurology; All India Institute of Medical Sciences; New Delhi India
| | - Manjari Tripathi
- Department of Neurology; All India Institute of Medical Sciences; New Delhi India
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Abu Hishmeh M, Srivastava P, Lougheide Q, Srinivasan M, Murthy S. Massive Spontaneous Hemothorax as a Complication of Apixaban Treatment. Case Rep Pulmonol 2018; 2018:8735036. [PMID: 30410811 PMCID: PMC6206516 DOI: 10.1155/2018/8735036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 03/27/2018] [Accepted: 06/19/2018] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Hemothorax is usually related to chest or iatrogenic trauma from procedures such as central lines and thoracentesis. Spontaneous hemothorax is defined as pleural fluid hematocrit greater than 50% of serum hematocrit in absence of natural or iatrogenic trauma affecting the lung or pleural space. Coagulopathy secondary to anticoagulant use has been associated with spontaneous hemothorax. We present a case of spontaneous hemothorax in a patient taking apixaban for venous thromboembolism disease. To our knowledge, this is the first case report of apixaban as a cause of spontaneous hemothorax. CASE PRESENTATION A 56-year-old woman with end-stage renal disease (ESRD) was diagnosed with upper extremity deep vein thrombosis (DVT) one month prior to presentation and was started on apixaban presented with dyspnea and left-sided pleuritic chest pain for two weeks. She was found to have left-sided large pleural effusion which was diagnosed as hemothorax. Other etiologies for spontaneous hemothorax were excluded and drainage by 12-French pigtail catheter achieved total resolution of hemothorax in three days. DISCUSSION Apixaban is a DOAC used to prevent stroke or thromboembolic events in patients with nonvalvular atrial fibrillation and to prevent recurrent venous thromboembolic disease. Events such as gastrointestinal, intracranial, and soft tissue bleeding have been well-documented. However, bleeding manifestation as hemothorax is seldom reported. Our patient presented with isolated left-sided large pleural effusion which was diagnosed as spontaneous hemothorax. 12-Fr pigtail catheter drainage was effective in the management of our patient and provided total resolution in three days. CONCLUSION Spontaneous hemothorax is a rare complication of anticoagulant therapy and might not exhibit the usual radiological signs of traumatic hemothorax. Health care providers should have high index of suspicion for spontaneous hemothorax when evaluating new pleural effusion in patients receiving DOACs therapy. Drainage by small bore pigtail catheter might be as effective as larger chest tubes.
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Affiliation(s)
- M. Abu Hishmeh
- Lincoln Medical and Mental Health Center, Westchester Medical Center, New York Medical College, USA
| | - P. Srivastava
- Lincoln Medical and Mental Health Center, Westchester Medical Center, New York Medical College, USA
| | | | | | - S. Murthy
- Lincoln Medical and Mental Health Center, USA
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Pihlak R, Almond R, Srivastava P, Raja H, Broadbent R, Hopewell L, Higham C, Lamarca A, Hubner R, Valle J, McNamara M. Effects of random glucose (Glc) levels on outcomes of patients (pts) with pancreatic ductal adenocarcinoma (PDAC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Aggarwal A, Phatak S, Srivastava P, Lawrence A, Agarwal V, Misra R. Outcomes in juvenile onset lupus: single center cohort from a developing country. Lupus 2018; 27:1867-1875. [DOI: 10.1177/0961203318791046] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction About 10–20% of systemic lupus erythematosus (SLE) patients have onset in childhood and have more severe organ involvement. Survival of juvenile SLE patients is improving worldwide. Long-term data of childhood onset SLE from developing countries is scarce. Methods Clinical and laboratory data at initial presentation and follow-up visits were retrieved from clinic files, hospital information system and personal interviews. Treatment received, complications, flares, outcomes and death were recorded. Survival was calculated using Kaplan–Meier survival curves and regression analysis was done for predictors of mortality. Results Children with SLE ( n = 273, 250 girls) had a median age at onset of 14 years and duration of illness prior to diagnosis at our hospital of 1 year. Fever and arthritis were the most common presenting manifestations. Renal disease was seen in 60.5% and central nervous system (CNS) disease in 29%. The median follow-up period in 248 patients was 3.5 years. Fourteen children died, and 10 of these had active disease at the time of death. The mean actuarial survival was 24.5 years and survival rates at 1, 5 and 10 years were 97.9%, 95% and 89% respectively. Fever, CNS disease, anti-dsDNA levels and serious infections predicted death on univariate and multivariate analysis. Infections were seen in 72 children (26.3%), and 38 of these infections were serious. One-third of the patients had damage on the last follow-up. Flares were seen in 120 children, the majority being major flares. Conclusion Outcomes of pediatric SLE in North Indian children are similar to those seen in developed countries. Infections pose a major challenge in these patients.
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Affiliation(s)
- A Aggarwal
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - S Phatak
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - P Srivastava
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - A Lawrence
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - V Agarwal
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - R Misra
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Srivastava A, Singh S, Rajpurohit CS, Srivastava P, Pandey A, Kumar D, Khanna VK, Pant AB. Secretome of Differentiated PC12 Cells Restores the Monocrotophos-Induced Damages in Human Mesenchymal Stem Cells and SHSY-5Y Cells: Role of Autophagy and Mitochondrial Dynamics. Neuromolecular Med 2018; 20:233-251. [PMID: 29603067 DOI: 10.1007/s12017-018-8487-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 03/28/2018] [Indexed: 12/16/2022]
Abstract
A perturbed cellular homeostasis is a key factor associated with xenobiotic exposure resulting in various ailments. The local cellular microenvironment enriched with secretory components aids in cell-cell communication that restores this homeostasis. Deciphering the underlying mechanism behind this restorative potential of secretome could serve as a possible solution to many health hazards. We, therefore, explored the protective efficacy of the secretome of differentiated PC12 cells with emphasis on induction of autophagy and mitochondrial biogenesis. Monocrotophos (MCP), a widely used neurotoxic organophosphate, was used as the test compound at sublethal concentration. The conditioned medium (CM) of differentiated PC12 cells comprising of their secretome restored the cell viability, oxidative stress and apoptotic cell death in MCP-challenged human mesenchymal stem cells and SHSY-5Y, a human neuroblastoma cell line. Delving further to identify the underlying mechanism of this restorative effect we observed a marked increase in the expression of autophagy markers LC3, Beclin-1, Atg5 and Atg7. Exposure to autophagy inhibitor, 3-methyladenine, led to a reduced expression of these markers with a concomitant increase in the expression of pro-apoptotic caspase-3. Besides that, the increased mitochondrial fission in MCP-exposed cells was balanced with increased fusion in the presence of CM facilitated by AMPK/SIRT1/PGC-1α signaling cascade. Mitochondrial dysfunctions are strongly associated with autophagy activation and as per our findings, cellular secretome too induces autophagy. Therefore, connecting these three potential apices can be a major breakthrough in repair and rescue of xenobiotic-damaged tissues and cells.
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Affiliation(s)
- A Srivastava
- System Toxicology and Health Risk Assessment Group, CSIR-Indian Institute of Toxicology Research (CSIR-IITR), MG Marg, Lucknow, Uttar Pradesh, 226001, India
| | - S Singh
- System Toxicology and Health Risk Assessment Group, CSIR-Indian Institute of Toxicology Research (CSIR-IITR), MG Marg, Lucknow, Uttar Pradesh, 226001, India
- Academy of Scientific and Innovative Research, CSIR-IITR Campus, Lucknow, India
| | - C S Rajpurohit
- System Toxicology and Health Risk Assessment Group, CSIR-Indian Institute of Toxicology Research (CSIR-IITR), MG Marg, Lucknow, Uttar Pradesh, 226001, India
- Academy of Scientific and Innovative Research, CSIR-IITR Campus, Lucknow, India
| | - P Srivastava
- System Toxicology and Health Risk Assessment Group, CSIR-Indian Institute of Toxicology Research (CSIR-IITR), MG Marg, Lucknow, Uttar Pradesh, 226001, India
| | - A Pandey
- System Toxicology and Health Risk Assessment Group, CSIR-Indian Institute of Toxicology Research (CSIR-IITR), MG Marg, Lucknow, Uttar Pradesh, 226001, India
| | - D Kumar
- System Toxicology and Health Risk Assessment Group, CSIR-Indian Institute of Toxicology Research (CSIR-IITR), MG Marg, Lucknow, Uttar Pradesh, 226001, India
- Academy of Scientific and Innovative Research, CSIR-IITR Campus, Lucknow, India
| | - V K Khanna
- System Toxicology and Health Risk Assessment Group, CSIR-Indian Institute of Toxicology Research (CSIR-IITR), MG Marg, Lucknow, Uttar Pradesh, 226001, India
- Academy of Scientific and Innovative Research, CSIR-IITR Campus, Lucknow, India
| | - A B Pant
- System Toxicology and Health Risk Assessment Group, CSIR-Indian Institute of Toxicology Research (CSIR-IITR), MG Marg, Lucknow, Uttar Pradesh, 226001, India.
- Academy of Scientific and Innovative Research, CSIR-IITR Campus, Lucknow, India.
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Omair M, Salehi H, Jones R, Ord M, Calafiore P, Jones E, Srivastava P. Postoperative Atrial Fibrillation and Cardiac Complications After Liver Transplantation. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.655] [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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Salehi H, Calafiore P, Neef P, Lim R, Smith G, Keraney L, Jones R, Ord M, Hughes T, Jones E, Srivastava P. Dobutamine Stress Echocardiography Compared with Coronary Computed Tomography Angiography in Screening for Coronary Artery Disease in End-Stage Liver Disease Patients Being Assessed for Liver Transplantation. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.431] [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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Parashar R, Gupt A, Bajpayee D, Gupta A, Thakur R, Sangwan A, Sharma S, Mohanty JS, Kumar A, Srivastava P, Shah A. Lessons from implementation of ‘community based use of Misoprostol tablets to prevent PPH, in India’. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx189.099] [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: 11/12/2022] Open
Affiliation(s)
- R Parashar
- USAID Vriddhi (Scaling Up RMNCH+A interventions) Project, New Delhi, India
| | - A Gupt
- USAID Vriddhi (Scaling Up RMNCH+A interventions) Project, New Delhi, India
| | - D Bajpayee
- USAID Vriddhi (Scaling Up RMNCH+A interventions) Project, New Delhi, India
| | - A Gupta
- USAID Vriddhi (Scaling Up RMNCH+A interventions) Project, New Delhi, India
| | - R Thakur
- USAID Vriddhi (Scaling Up RMNCH+A interventions) Project, New Delhi, India
| | - A Sangwan
- USAID Vriddhi (Scaling Up RMNCH+A interventions) Project, New Delhi, India
| | - S Sharma
- USAID Vriddhi (Scaling Up RMNCH+A interventions) Project, New Delhi, India
| | - JS Mohanty
- USAID Vriddhi (Scaling Up RMNCH+A interventions) Project, New Delhi, India
| | - A Kumar
- USAID Vriddhi (Scaling Up RMNCH+A interventions) Project, New Delhi, India
| | - P Srivastava
- USAID Vriddhi (Scaling Up RMNCH+A interventions) Project, New Delhi, India
| | - A Shah
- USAID Vriddhi (Scaling Up RMNCH+A interventions) Project, New Delhi, India
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