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Ghosh Laskar S, Sinha S, Kumar A, Samanta A, Mohanty S, Kale S, Khan F, Lewis Salins S, Murthy V. Reducing Salivary Toxicity with Adaptive Radiotherapy (ReSTART): A Randomized Controlled Trial Comparing Conventional IMRT to Adaptive IMRT in Head and Neck Squamous Cell Carcinomas. Clin Oncol (R Coll Radiol) 2024; 36:353-361. [PMID: 38575432 DOI: 10.1016/j.clon.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 02/14/2024] [Accepted: 03/13/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND The utility of Adaptive Radiotherapy (ART) in Head and Neck Squamous Cell Carcinoma (HNSCC) remains to be ascertained. While multiple retrospective and single-arm prospective studies have demonstrated its efficacy in decreasing parotid doses and reducing xerostomia, adequate randomized evidence is lacking. METHODS AND ANALYSIS ReSTART (Reducing Salivary Toxicity with Adaptive Radiotherapy) is an ongoing phase III randomized trial of patients with previously untreated, locally advanced HNSCC of the oropharynx, larynx, and hypopharynx. Patients are randomized in a 1:1 ratio to the standard Intensity Modulated Radiotherapy (IMRT) arm {Planning Target Volume (PTV) margin 5 mm} vs. Adaptive Radiotherapy arm (standard IMRT with a PTV margin 3 mm, two planned adaptive planning at 10th and 20th fractions). The stratification factors include the primary site and nodal stage. The RT dose prescribed is 66Gy in 30 fractions for high-risk PTV and 54Gy in 30 fractions for low-risk PTV over six weeks, along with concurrent chemotherapy. The primary endpoint is to compare salivary toxicity between arms using salivary scintigraphy 12 months' post-radiation. To detect a 25% improvement in the primary endpoint at 12 months in the ART arm with a two-sided 5% alpha value and a power of 80% (and 10% attrition ratio), a sample size of 130 patients is required (65 patients in each arm). The secondary endpoints include acute and late toxicities, locoregional control, disease-free survival, overall survival, quality of life, and xerostomia scores between the two arms. DISCUSSION The ReSTART trial aims to answer an important question in Radiation Therapy for HNSCC, particularly in a resource-limited setting. The uniqueness of this trial, compared to other ongoing randomized trials, includes the PTV margins and the xerostomia assessment by scintigraphy at 12 months as the primary endpoint.
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Affiliation(s)
- S Ghosh Laskar
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
| | - S Sinha
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
| | - A Kumar
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
| | - A Samanta
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
| | - S Mohanty
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
| | - S Kale
- Department of Medical Physics, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
| | - F Khan
- Clinical Research Secretariat (CRS), Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
| | - S Lewis Salins
- Department of Radiation Oncology, Kasturba Medical College, Manipal, India.
| | - V Murthy
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
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Mohanty S, Patil D, Joshi K, Gamre P, Mishra A, Khairnar S, Kakoti S, Nayak L, Punatar S, Jain J, Phurailatpam R, Goda JS. Dosimetric Impact of Voluntary Deep Inspiration Breath Hold (DIBH) in Mediastinal Hodgkin Lymphomas: A Comparative Evaluation of Three Different Intensity Modulated Radiation Therapy (IMRT) Delivery Methods Using Voluntary DIBH and Free Breathing Techniques. Cancers (Basel) 2024; 16:690. [PMID: 38398081 PMCID: PMC10886974 DOI: 10.3390/cancers16040690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/26/2023] [Accepted: 01/08/2024] [Indexed: 02/25/2024] Open
Abstract
Hodgkin lymphomas are radiosensitive and curable tumors that often involve the mediastinum. However, the application of radiation therapy to the mediastinum is associated with late effects including cardiac and pulmonary toxicities and secondary cancers. The adoption of conformal IMRT and deep inspiration breath- hold (DIBH) can reduce the dose to healthy normal tissues (lungs, heart and breast). We compared the dosimetry of organs at risk (OARs) using different IMRT techniques for two breathing conditions, i.e., deep inspiration breath hold (DIBH) and free breathing. Twenty-three patients with early-stage mediastinal Hodgkin lymphomas were accrued in the prospective study. The patients were given treatment plans which utilized full arc volumetric modulated arc therapy (F-VMAT), Butterfly VMAT (B-VMAT), and fixed field IMRT (FF-IMRT) techniques for both DIBH and free breathing methods, respectively. All the plans were optimized to deliver 95% of the prescription dose which was 25.2 Gy to 95% of the PTV volume. The mean dose and standard error of the mean for each OAR, conformity index (CI), and homogeneity index (HI) for the target using the three planning techniques were calculated and compared using Student's t-test for parametric data and Wilcoxon signed-rank test for non-parametric data. The HI and CI of the target was not compromised using the DIBH technique for mediastinal lymphomas. The mean values of CI and HI for both DIBH and FB were comparable. The mean heart doses were reduced by 2.1 Gy, 2.54 Gy, and 2.38 Gy in DIBH compared to FB for the F-VMAT, B-VMAT, and IMRT techniques, respectively. There was a significant reduction in V5Gy, V10Gy, and V15Gy to the heart (p < 0.005) with DIBH. DIBH reduced the mean dose to the total lung by 1.19 Gy, 1.47 Gy, and 1.3 Gy, respectively. Among the 14 female patients, there was a reduction in the mean right breast dose with DIBH compared to FB (4.47 Gy vs. 3.63 Gy, p = 0.004). DIBH results in lower heart, lung, and breast doses than free breathing in mediastinal Hodgkin Lymphoma. Among the different IMRT techniques, FF-IMRT, B-VMAT, and F-VMAT showed similar PTV coverage, with similar conformity and homogeneity indices. However, the time taken for FF-IMRT was much longer than for the F-VMAT and B-VMAT techniques for both breathing methods. B-VMAT and F-VMAT emerged as the optimal planning techniques able to achieve the best target coverage and lower doses to the OARs, with less time required to deliver the prescribed dose.
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Affiliation(s)
- Samarpita Mohanty
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 410210, India; (S.M.); (D.P.); (K.J.); (P.G.); (A.M.); (S.K.); (S.K.); (J.J.); (R.P.)
| | - Divya Patil
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 410210, India; (S.M.); (D.P.); (K.J.); (P.G.); (A.M.); (S.K.); (S.K.); (J.J.); (R.P.)
| | - Kishore Joshi
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 410210, India; (S.M.); (D.P.); (K.J.); (P.G.); (A.M.); (S.K.); (S.K.); (J.J.); (R.P.)
| | - Poonam Gamre
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 410210, India; (S.M.); (D.P.); (K.J.); (P.G.); (A.M.); (S.K.); (S.K.); (J.J.); (R.P.)
| | - Ajay Mishra
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 410210, India; (S.M.); (D.P.); (K.J.); (P.G.); (A.M.); (S.K.); (S.K.); (J.J.); (R.P.)
| | - Sunil Khairnar
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 410210, India; (S.M.); (D.P.); (K.J.); (P.G.); (A.M.); (S.K.); (S.K.); (J.J.); (R.P.)
| | - Sangeeta Kakoti
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 410210, India; (S.M.); (D.P.); (K.J.); (P.G.); (A.M.); (S.K.); (S.K.); (J.J.); (R.P.)
| | - Lingaraj Nayak
- Department of Hemato Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 410210, India; (L.N.); (S.P.)
| | - Sachin Punatar
- Department of Hemato Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 410210, India; (L.N.); (S.P.)
| | - Jeevanshu Jain
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 410210, India; (S.M.); (D.P.); (K.J.); (P.G.); (A.M.); (S.K.); (S.K.); (J.J.); (R.P.)
| | - Reena Phurailatpam
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 410210, India; (S.M.); (D.P.); (K.J.); (P.G.); (A.M.); (S.K.); (S.K.); (J.J.); (R.P.)
| | - Jayant S. Goda
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 410210, India; (S.M.); (D.P.); (K.J.); (P.G.); (A.M.); (S.K.); (S.K.); (J.J.); (R.P.)
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Sinha S, Kumar A, Maheshwari G, Mohanty S, Joshi K, Shinde P, Gupta D, Kale S, Phurailatpam R, Swain M, Budrukkar A, Kinhikar R, Ghosh-Laskar S. Development and Validation of Single-Optimization Knowledge-Based Volumetric Modulated Arc Therapy Model Plan in Nasopharyngeal Carcinomas. Adv Radiat Oncol 2024; 9:101311. [PMID: 38260222 PMCID: PMC10801663 DOI: 10.1016/j.adro.2023.101311] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 06/27/2023] [Indexed: 01/24/2024] Open
Abstract
Purpose Knowledge-based planning (KBP) has evolved to standardize and expedite the complex process of radiation therapy planning for nasopharyngeal cancer (NPC). Herein, we aim to develop and validate the suitability of a single-optimization KBP for NPC. Methods and Materials Volumetric modulated arc therapy plans of 103 patients with NPC treated between 2016 and 2020 were reviewed and used to generate a KBP model. A validation set of 15 patients was employed to compare the quality of single optimization KBP and clinical plans using the paired t test and the Wilcoxon signed rank test. The time required for either planning was also analyzed. Results Most patients (86.7%) were of locally advanced stage (III/IV). The median dose received by 95% of the high-risk planning target volume was significantly higher for the KBP (97.1% vs 96.4%; P = .017). The median homogeneity (0.09 vs 0.1) and conformity (0.98 vs 0.97) indices for high-risk planning target volume and sparing of the normal tissues like optic structures, spinal cord, and uninvolved dysphagia and aspiration-related structures were better with the KBP (P < .05). In the blinded evaluation, the physician preferred the KBP plan in 13 out of 15 patients. The median time required to generate the KBP and manual plans was 53 and 77 minutes, respectively. Conclusions KBP with a single optimization is an efficient and time saving alternative for manual planning in NPC.
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Affiliation(s)
- Shwetabh Sinha
- Department of Radiation Oncology and Medical Physics, ACTREC/TMH, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Anuj Kumar
- Department of Radiation Oncology and Medical Physics, ACTREC/TMH, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Guncha Maheshwari
- Department of Radiation Oncology and Medical Physics, ACTREC/TMH, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Samarpita Mohanty
- Department of Radiation Oncology and Medical Physics, ACTREC/TMH, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Kishore Joshi
- Department of Radiation Oncology and Medical Physics, ACTREC/TMH, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Prakash Shinde
- Department of Radiation Oncology and Medical Physics, ACTREC/TMH, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Deeksha Gupta
- Department of Radiation Oncology and Medical Physics, ACTREC/TMH, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Shrikant Kale
- Department of Radiation Oncology and Medical Physics, ACTREC/TMH, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Reena Phurailatpam
- Department of Radiation Oncology and Medical Physics, ACTREC/TMH, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Monali Swain
- Department of Radiation Oncology and Medical Physics, ACTREC/TMH, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Ashwini Budrukkar
- Department of Radiation Oncology and Medical Physics, ACTREC/TMH, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Rajesh Kinhikar
- Department of Radiation Oncology and Medical Physics, ACTREC/TMH, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Sarbani Ghosh-Laskar
- Department of Radiation Oncology and Medical Physics, ACTREC/TMH, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
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Sahoo S, Rathod W, Vardikar H, Biswal M, Mohanty S, Nayak SK. Biomedical waste plastic: bacteria, disinfection and recycling technologies-a comprehensive review. Int J Environ Sci Technol (Tehran) 2023:1-18. [PMID: 37360566 PMCID: PMC10189688 DOI: 10.1007/s13762-023-04975-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/27/2023] [Accepted: 04/25/2023] [Indexed: 06/28/2023]
Abstract
Plastic recycling reduces the wastage of potentially useful materials as well as the consumption of virgin materials, thereby lowering the energy consumption, air pollution by incineration, soil and water pollution by landfilling. Plastics used in the biomedical sector have played a significant role. Reducing the transmission of the virus while protecting the human life in particular the frontline workers. Enormous volumes of plastics in biomedical waste have been observed during the outbreak of the pandemic COVID-19. This has resulted from the extensive use of personal protective equipment such as masks, gloves, face shields, bottles, sanitizers, gowns, and other medical plastics which has created challenges to the existing waste management system in the developing countries. The current review focuses on the biomedical waste and its classification, disinfection, and recycling technology of different types of plastics waste generated in the sector and their corresponding approaches toward end-of-life option and value addition. This review provides a broader overview of the process to reduce the volume of plastics from biomedical waste directly entering the landfill while providing a knowledge step toward the conversion of "waste" to "wealth." An average of 25% of the recyclable plastics are present in biomedical waste. All the processes discussed in this article accounts for cleaner techniques and a sustainable approach to the treatment of biomedical waste. Graphical abstract
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Affiliation(s)
- S. Sahoo
- Laboratory for Advanced Research in Polymeric Materials, Central Institute of Petrochemical Engineering and Technology, Bhubaneswar, Odisha 751024 India
- Ravenshaw University, Cuttack, Odisha 753003 India
| | - W. Rathod
- Laboratory for Advanced Research in Polymeric Materials, Central Institute of Petrochemical Engineering and Technology, Bhubaneswar, Odisha 751024 India
| | - H. Vardikar
- Laboratory for Advanced Research in Polymeric Materials, Central Institute of Petrochemical Engineering and Technology, Bhubaneswar, Odisha 751024 India
| | - M. Biswal
- Laboratory for Advanced Research in Polymeric Materials, Central Institute of Petrochemical Engineering and Technology, Bhubaneswar, Odisha 751024 India
| | - S. Mohanty
- Laboratory for Advanced Research in Polymeric Materials, Central Institute of Petrochemical Engineering and Technology, Bhubaneswar, Odisha 751024 India
| | - S. K. Nayak
- Ravenshaw University, Cuttack, Odisha 753003 India
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Scheltes D, Mohanty S, Smits G, van der Steen-Banasik E, Murthy V, Hoskin P. Function Preservation With Brachytherapy: Reviving the Art. Improving Quality of Life With Brachytherapy for Urological Malignancies. Clin Oncol (R Coll Radiol) 2023:S0936-6555(23)00022-5. [PMID: 36764876 DOI: 10.1016/j.clon.2023.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/29/2022] [Accepted: 01/23/2023] [Indexed: 02/03/2023]
Abstract
Brachytherapy for localised prostate, muscle-invasive bladder and penile cancer is well established, providing high tumour dose delivery and minimising normal tissue doses compared with external beam techniques. In prostate cancer, the main impact on quality of life relates to diminished sexual function and irritative or obstructive urinary symptoms, which are seen up to 15 years after treatment. Significant changes in bowel function are rare. Compared with radical prostatectomy or external beam radiotherapy, irritative or obstructive urinary symptoms are more prominent, whereas incontinence is less than after radical prostatectomy and bowel changes are less than after external beam radiotherapy. For muscle-invasive bladder cancer, when compared with radical cystectomy, although no difference is seen for urinary symptoms or fatigue, role and social functioning scores are higher and there is better post-treatment sexual function in both men and women. Compared with surgical treatment for penile cancer, brachytherapy results in better erectile function scores than after glansectomy and partial penectomy and high quality of life scores, with good satisfaction ratings for cosmetic appearance.
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Affiliation(s)
- D Scheltes
- Radiotherapy Group, Location Arnhem, Arnhem, the Netherlands
| | - S Mohanty
- Department of Radiation Oncology, ACTREC, Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, India
| | - G Smits
- Rijnstate Hospital, Arnhem, the Netherlands
| | | | - V Murthy
- Department of Radiation Oncology, ACTREC, Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, India
| | - P Hoskin
- Mount Vernon Cancer Centre, Northwood, UK; Division of Cancer Sciences, University of Manchester, Manchester, UK.
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Panda S, Moharana L, Biswas G, Parida P, Mishra S, Pattnaik J, Devaraj S, Mohanty S, Karunanidhi S, Singuluri S, Saju S, Sehrawat A, Mudgal S, Subudhi G, Rathnam K, Cyriac S, Philips A, Jose A, Ganesan P. 382P Real-world data on treatment outcome of ALK positive non-small cell lung cancer from an Indian multi-centric cancer registry. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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Vegendla P, Bergeron A, Mohanty S, Talamo A, Heidet F, Ade B, Betzler BR. Ex-Core Thermo-Fluidics Optimization for Transformational Challenge Reactor. NUCL SCI ENG 2022. [DOI: 10.1080/00295639.2022.2123195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Prasad Vegendla
- Argonne National Laboratory, Nuclear Science and Engineering Division, 9700 South Cass Avenue, Lemont, Illinois 60439
| | - A. Bergeron
- Argonne National Laboratory, Nuclear Science and Engineering Division, 9700 South Cass Avenue, Lemont, Illinois 60439
| | - S. Mohanty
- Argonne National Laboratory, Nuclear Science and Engineering Division, 9700 South Cass Avenue, Lemont, Illinois 60439
| | - A. Talamo
- Argonne National Laboratory, Nuclear Science and Engineering Division, 9700 South Cass Avenue, Lemont, Illinois 60439
| | - F. Heidet
- Argonne National Laboratory, Nuclear Science and Engineering Division, 9700 South Cass Avenue, Lemont, Illinois 60439
| | - B. Ade
- Oak Ridge National Laboratory, P.O. Box 2008, Oak Ridge, Tennessee 37831-6170
| | - B. R. Betzler
- Oak Ridge National Laboratory, P.O. Box 2008, Oak Ridge, Tennessee 37831-6170
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Singh N, Patel G, Dogra Y, Mohanty S, Seth T. P-795 Comparison of intra-ovarian platelet rich plasma versus autologous bone marrow derived stem cell instillation in women with diminished ovarian reserve for ovarian rejuvenation. Hum Reprod 2022. [PMCID: PMC9384354 DOI: 10.1093/humrep/deac107.731] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
To compare role of intra-ovarian platelet rich plasma (PRP) versus marrow derived stem cell (SC) instillation for improvement in ovarian reserve (AFC, AMH and FSH)
Summary answer
Both PRP and SC therapy improves the ovarian reserve however, response to PRP is superior to SC post intervention
What is known already
With increasing incidence of females with diminished ovarian reserve (DOR), posing a serious challenge in terms of limited treatment options for these couples. Clinicians are trying to find effective strategies besides oocyte donation or adoption Of late, novel ovarian rejuvenation approaches has been investigated which are currently available for research purposes only. Multiple studies are evaluating effect of intra-ovarian PRP or autologous SC instillation, the results are encouraging as they are showing improvement in ovarian reserve thus bringing a paradigm shift in treatment options. None of the published studies so far have compared PRP versus SC in DOR population.
Study design, size, duration
A prospective comparative study was conducted at Division of Reproductive Medicine of a tertiary care institute. 72 infertile females (20-39 years) with poor ovarian reserve (AMH <1.2 ng /ml; AFC<5) were enrolled in the study between January 2020 to December 2021. The two comparative groups underwent either intra-ovarian PRP instillation (n = 42) or autologous SC transplantation (n = 30).
Participants/materials, setting, methods
After the two groups were matched (PRP vs SC) for baseline characteristics (Age, AMH, AFC, FSH, Estradiol), 30 subjects in each group were compared for change in serum FSH/AMH/Estradiol levels, AFC, right and left ovarian volume at 1st month and 3rd month post intervention from the baseline. This was also compared between the two groups using Student t-test. The cost and procedural pain measured using Visual analog scale (VAS) were also compared between the groups.
Main results and the role of chance
After matching for baseline characteristics, significant ∼ 1.8/2 and ∼1.5/1.6 fold increase in AFC at 1st/3rd month post intervention (p<0.001) was observed after PRP instillation and SC transplantation respectively. This significant improvement was observed more in PRP group than SC group at 3rd month post intervention (7.07 vs 5.60, p=0.02), while no significant difference existed at 1st month of follow up. However, there was no significant improvement in serum FSH, AMH and Estradiol levels (p0.05) from the baseline at 1st and 3rd month post intervention in both the groups. Similarly, there was no significant difference between the two groups in serum FSH level (7.98 IU/ml vs 9.62 IU/ml, p=0.062; 8.26 IU/ml vs 9.50 IU/ml, p=0.15), AMH level (1.62 ng/ml vs 1.02 ng/ml, p=0.27; 1.35 ng/ml vs 0.95 ng/ml, p=0.24), Estradiol level (49.12 pg/ml vs 56.48 pg/ml p=0.443; 54.7 pg/ml vs 61.12 pg/ml, p=0.44), right ovarian volume (3.13 cm3 vs 2.49 cm3, p=0.06; 3.37 cm3 vs 2.74 cm3,p=0.063) and left ovarian volume (2.98 cm3 vs 2.47 cm3, p=0.102; 2.87 cm3 vs 2.34 cm3,p=0.103) at 1st and 3rd month post intervention respectively. PRP was more cost-effective and associated with less pain (32.5 mm vs 28.13 mm, p=0.02), and better patient compliance.
Limitations, reasons for caution
This was a comparative study and the participants were not randomized but were matched for the baseline characteristics. Also due to impact of Covid-19 causing intermittent pause in nonessential facilities like IVF services, a smaller sample size could be enrolled and also clinical outcomes could not be evaluated
Wider implications of the findings
This study, although comparative, for the first time highlights the beneficial role of PRP over SC, thus can establish superiority of PRP as minimally invasive, economical, patient friendly and a recommended therapy for ovarian rejuvenation and folliculogenesis, providing the DOR females an opportunity to produce their own offspring.
Trial registration number
CTRI/2020/01/022726
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Affiliation(s)
- N Singh
- All India Institute Of Medical Sciences AIIMS, Department of Obstetrics & Gynaecology , New Delhi, India
| | - G Patel
- All India Institute Of Medical Sciences AIIMS, Department of Obstetrics & Gynaecology , New Delhi, India
| | - Y Dogra
- Indira Gandhi Institute of Medical Sciences, Reproductive Medicine , Shimla, India
| | - S Mohanty
- All India Institute Of Medical Sciences AIIMS, National Stem Cell Facility , New Delhi, India
| | - T Seth
- All India Institute Of Medical Sciences AIIMS, Department of Haematology , New Delhi, India
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Magnocavallo M, Della Rocca D, Vetta G, Lavalle C, Mariani M, Schiavone M, Carola G, Mohanty S, Bassiouny M, Forleo G, Burkhardt D, Al–Ahmad A, Gallinghouse J, Horton R, Lakireddy D, Di Biase L, Natale A. P94 LOWER RATE OF MAJOR BLEEDING IN HIGH–RISK PATIENTS UNDERGOING LEFT ATRIAL APPENDAGE OCCLUSION: A PROPENSITY MATCHED COMPARISON WITH DIRECT ORAL ANTICOAGULATION. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Background
Stroke prophylaxis in very high risk (CHA2DS2–VASc ≥ 5) patients with atrial fibrillation (AF) is one of the major challenges faced by physicians. Specifically, initiating direct oral anticoagulants (DOACs) in these patients poses a therapeutic conundrum due to the concomitant high risk of bleeding. Left atrial appendage occlusion (LAAO) might be a potential alternative for thromboembolic (TE) prevention; however, there are no studies comparing these two strategies in very high–risk patients.
Objective
To evaluate the efficacy of LAAO versus DOACs in AF patients at very high TE risk.
Methods
Data were extracted from two prospective databases including 1053 Watchman and 1328 DOAC patients. Watchman patients with a CHA2DS2–VASc ≥ 5 accounted for 26.3% (n = 277). In order to attenuate the imbalance in covariates, a 1:1 propensity score matching technique was used (co–variates: age, sex, CHA2DS2–VASc and HAS–BLED scores). This method resulted in 554 matched patients (277 patients per group; mean age: 79±7y; 57.4% F; CHA2DS2–VASc: 5.8±0.9). The primary endpoint was a composite of cardiovascular (CV) death, TE events (Stroke/TIA/peripheral embolism) and clinically significant bleeding. The annual TE and major bleeding risks were estimated based on the CHA2DS2–VASc score and compared with the annualized observed risk.
Results
After a mean follow–up of 26±7 months, total events were 55 (9.4 event rates per 100 patient–years) in LAAO group vs. 78 (14.9 event rates per 100 patient–years) in DOAC group. DOACs had a significantly higher risk of the primary endpoint (hazard ratio [HR]: 1.30; 95% confidence interval [CI]: 1.08 to 1.56; p = 0.03). TE events (HR: 1.15; 95% CI: 0.84 to 1.57; p = 0.63) and CV death (HR: 1.13; 95% CI: 0.84 to 1.54; p = 0.63) did not differ between groups. Major bleeding events were significantly lower in LAAO patients (HR: 0.75; 95% CI: 0.51 to 0.82; p = 0.04). The unadjusted estimated risk of TE events was 12.3% with LAAO and 12.4% with DOACs. The annualized incidence of TE was 3.2% with LAAO and 4.1% with DOACs, which led to a risk reduction of 74% and 67%, respectively.
Conclusion
In a large cohort of AF patients at very high TE risk (CHA2DS2–VASc ≥ 5), LAAO showed similar stroke prevention but a significantly lower risk of major bleeding than DOACs during a > 2year follow–up.
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Affiliation(s)
- M Magnocavallo
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - D Della Rocca
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - G Vetta
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - C Lavalle
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - M Mariani
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - M Schiavone
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - G Carola
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - S Mohanty
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - M Bassiouny
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - G Forleo
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - D Burkhardt
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - A Al–Ahmad
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - J Gallinghouse
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - R Horton
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - D Lakireddy
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - L Di Biase
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
| | - A Natale
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME, ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER, AUSTIN; HEART RHYTHM CENTER, CENTRO CARDIOLOGICO MONZINO IRCCS, MILANO
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Magnocavallo M, Della Rocca D, Lavalle C, Mohanty S, Carola G, Bassiouny M, Al–Ahmad A, Burkhardt D, Gallinghouse J, Lakireddy D, Horton R, Di Biase L, Natale A. C32 TRANSCATHETER LEAK OCCLUSION WITH ENDOVASCULAR COILS FOLLOWING LEFT ATRIAL APPENDAGE CLOSURE: PROCEDURAL SUCCESS AND OUTCOMES BEFORE AND AFTER LEAK CLOSURE. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac011.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Background
Whether residual peri–device leaks after left atrial appendage occlusion (LAAO) portend a higher risk of thromboembolism (TE), it is still a matter of debate.
Objectives
We report the TE risk in patients with incomplete LAA closure before and after leak closure with endovascular coils.
Methods
One hundred twenty–four Watchman patients with a significant (≥3mm) leak (mean age: 74 ± 9 years; 66.9% males; CHA2DS2–VASc: 4.4 ± 1.7; HAS–BLED: 3.1 ± 1) underwent LAA leak coiling. The expected annual TE risk was estimated based on the patients’ CHA2DS2–VASc and compared with the annualized incidence observed before and after coiling (Fig.1B).
Results
The time between LAAO and leak coiling was 8±6 months [83 patients–year (PY)]; before leak closure, 6 (4.8%) patients had a TE event (annualized rate: 7.2%). Coil deployment was successful in all cases [median n. of coils deployed: 5 (IQR: 2–10)]. Procedure time was 79 ± 40 min; the mean volume of iodinated contrast medium used was 80 ± 43mL. The overall complication rate was 2.4% (1 pericardial tamponade, 2 pericardial effusion). Follow–up TEE after 61±14 days revealed complete LAA sealing or a negligible leak in 117 cases (94.4%); the remaining 7 patients had a moderate leak. During 14±6 months post–coiling (145 PY), 1 (0.8%) patient suffered from stroke. The incidence of TE events was significantly lower after leak closure than before coiling (0.8% vs 4.8%; log–rank p = 0.02; Fig.1A). The annualized TE rates were 7.2% before and 0.7% after leak closure (Fig. 1A). According to the expected rate estimated from the patients’ CHA2DS2–VASc (9.8%), LAAO with and without significant leaks yielded to a risk reduction of 26.5% and 92.9% (Fig. 1B).
Conclusions
Transcatheter leak occlusion via endovascular coils was safe. LAA closure led to a significant reduction in TE events.
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Affiliation(s)
- M Magnocavallo
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - D Della Rocca
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - C Lavalle
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - S Mohanty
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - G Carola
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - M Bassiouny
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - A Al–Ahmad
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - D Burkhardt
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - J Gallinghouse
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - D Lakireddy
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - R Horton
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - L Di Biase
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - A Natale
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
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11
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Magnocavallo M, Della Rocca D, Lavalle C, Vetta G, Mariani M, Carola G, Mohanty S, Fengwei Z, Tarantino N, Aung L, Alisara A, Xiaodong Z, Bassiouny M, Gallinghouse J, Burkhardt D, Al–Ahmad A, Rodney H, Di Biase L, Natale A. P4 LEFT ATRIAL APPENDAGE ANATOMICAL CHANGES FOLLOWING RADIOFREQUENCY–BASED OSTIAL ISOLATION. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Left atrial appendage (LAA) electrical isolation (ei) may be achieved via radiofrequency (RF) energy applications at the level of the appendage ostium targeting the sites of earliest activation recorded by a mapping catheter. Notably, RF has long been used in vascular, orthopedic, and aesthetic surgery to promote thermal–induced collagen matrix contraction, fibrosis, and tissue retraction. LAA anatomical changes associated to RF–induced tissue retraction have never been reported.
Objective
To quantify the anatomical changes of the LAA ostium following RF–based LAAei.
Methods
Thirty–four consecutive patients requiring AF ablation with LAAei underwent transesophageal echocardiography (TEE) within 7 days before (baseline TEE) and >6 months after (follow–up TEE) ablation. The diameter of LAA orifice and landing zone were measured at 4 different views (0°, 45°, 90°, 135°). Measurements were performed by two independent reviewers blinded to the patient’s identity.
Results
Among 34 AF patients (68±7yrs, 73.5% males), the LAA morphology was classified as chicken wing in 15 (44%) patients, windsock in 10 (29%), cactus in 6 (18%), and cauliflower in 3 (9%). At baseline TEE, the mean maximum and mean minimum ostial diameters were 25±4mm and 22±4mm, respectively. The mean maximum and mean minimum diameters of the landing zone were 26±4mm and 23±3mm, respectively. On average, LAAei was achieved after 16±7 minutes of RF at a power of 45–47W. Follow–up TEE was performed 257±148 days after LAAei. The median LAA contraction velocity was 0.1 m/s (IQR: 0.04–0.18) and was significantly impaired in all patients. At follow–up TEE, the mean maximum and mean minimum ostial diameters were 19±4mm and 17±3mm, respectively. The mean maximum and mean minimum diameters of the landing zone were 20±4mm and 18±4mm, respectively. The mean relative reduction of the ostium and the landing zone were –24.4% and –22.5%, respectively. Box–Whisker plots of the maximum and minimum ostial diameters before and after LAAei are reported in Fig. 1.
Conclusion
RF led to a > 20% reduction of the diameters of the ostium and the landing zone. These changes may have important implications for a successful percutaneous occlusion procedure and justify a staged approach of isolation and occlusion.
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Affiliation(s)
- M Magnocavallo
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - D Della Rocca
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - C Lavalle
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - G Vetta
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - M Mariani
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - G Carola
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - S Mohanty
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - Z Fengwei
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - N Tarantino
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - L Aung
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - A Alisara
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - Z Xiaodong
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - M Bassiouny
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - J Gallinghouse
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - D Burkhardt
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - A Al–Ahmad
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - H Rodney
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - L Di Biase
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
| | - A Natale
- DEPARTMENT OF CLINICAL, INTERNAL, ANESTHESIOLOGY AND CARDIOVASCULAR SCIENCES, POLICLINICO UNIVERSITARIO UMBERTO I, SAPIENZA UNIVERSITY OF ROME., ROMA; TEXAS CARDIAC ARRHYTHMIA INSTITUTE, ST. DAVID‘S MEDICAL CENTER., AUSTIN
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Murthy V, Chilukuri S, Mallick I, Maitre P, Agarwal A, Moses A, James F, Narang K, Kataria T, Anand A, Dutta D, Mitra S, Pavamani S, Mallick S, Mahale N, Chandra M, Narayan A, Shahid T, Sairam M, Kannan V, Mohanty S, Basu T, Hotwani C, G B. OC-0606 Multi-institutional outcomes of Gleason grade group 5 prostate cancers treated with EBRT and ADT. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02628-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Nongrum DL, Devi YS, Mohanty S, Singh LJ, Baidya K, Chyrmang D, Rai HK. COMPARATIVE STUDY OF CONCURRENT CHEMORADIATION USING PACLITAXEL IN TWO HISTOPATHOLOGICAL SUBTYPES (SQUAMOUS CELL CARCINOMA/ADENOCARCINOMA) OF UNRESECTABLE NON-SMALL CELL LUNG CANCER. IJMMR 2022. [DOI: 10.11603/ijmmr.2413-6077.2021.2.12253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background. Lung cancer is still a global burden and with rising population and increasing life expectancy the incidence of lung cancer is still on the rise.
Objective. To compare the treatment response and toxicity of weekly paclitaxel in locally advanced unresectable non-small cell lung cancer (NSCLC), when administered concurrently with external beam radiation to the chest in two different histopathological types – adenocarcinoma and squamous cell carcinoma.
Methods. A prospective randomised control trial was conducted in 60 NSCLC patients who were divided into two arms; adenocarcinoma and squamous cell carcinoma arm. All patients were treated with chemoradiation with concurrent paclitaxel 60 mg/m2. Data were evaluated with SPSS version 21.0 for windows with p-value <0.05.
Results. Haematological toxicity was the most common side effects evident from the third week of chemotherapy. At the end of 1 month of treatment, two (6.7%) patients had complete response in Arm A and one (3.3%) patient had complete response in Arm B. One (3.3%) patient had disease progression in Arm A and two patients progressed in Arm B. At 7 months post treatment three (10%) patients had complete response in both Arm A and Arm B. Four (13.3%) patients had disease progression in Arm A and ten (33.4%) patients progressed in Arm B.
Conclusions. Paclitaxel can be used as an alternative chemotherapeutic agent to the standard cisplatin. However, further studies with larger sample size are required to confirm the findings.
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Gurram L, Mohanty S, Chopra S, Grover S, Engineer R, Gupta S, Ghosh J, Gulia S, Sawant S, Daddi A, Deodhar K, Menon S, Rekhi B, Shylasree TS, Maheshwari A, Mahantshetty U. Outcomes of Cervical Cancer in HIV-Positive Women Treated With Radiotherapy at a Tertiary Care Center in India. JCO Glob Oncol 2022; 8:e2100312. [PMID: 35324255 PMCID: PMC9071252 DOI: 10.1200/go.21.00312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Indexed: 01/16/2023] Open
Abstract
There are limited data on management of cervical cancer in women living with HIV in the modern antiretroviral therapy era. The study aimed to evaluate outcomes and toxicities of these patients treated with radiotherapy.
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Affiliation(s)
- Lavanya Gurram
- Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Samarpita Mohanty
- Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Supriya Chopra
- Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Surbhi Grover
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Reena Engineer
- Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Sudeep Gupta
- Advanced Centre for Training, Research Education in Cancer, Navi Mumbai, India
| | - Jaya Ghosh
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Seema Gulia
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Sheela Sawant
- Department of Medicine, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Anuprita Daddi
- Department of Medicine, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Kedar Deodhar
- Department of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Santosh Menon
- Department of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Bharat Rekhi
- Department of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - T S Shylasree
- Department of Gynecologic Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Amita Maheshwari
- Department of Gynecologic Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
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15
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Cao L, Sutcliffe W, Van Tonder R, Bernlochner FU, Adachi I, Aihara H, Asner DM, Aushev T, Ayad R, Babu V, Bahinipati S, Behera P, Belous K, Bennett J, Bessner M, Bilka T, Biswal J, Bobrov A, Bračko M, Branchini P, Browder TE, Budano A, Campajola M, Červenkov D, Chang MC, Chang P, Cheon BG, Chilikin K, Cho HE, Cho K, Cho SJ, Choi Y, Choudhury S, Cinabro D, Cunliffe S, Czank T, Dash N, De Pietro G, Dhamija R, Di Capua F, Dingfelder J, Doležal Z, Dong TV, Dubey S, Epifanov D, Ferber T, Ferlewicz D, Frey A, Fulsom BG, Garg R, Gaur V, Gabyshev N, Garmash A, Giri A, Goldenzweig P, Gu T, Gudkova K, Halder S, Hara T, Hartbrich O, Hayasaka K, Hernandez Villanueva M, Hou WS, Hsu CL, Inami K, Ishikawa A, Itoh R, Iwasaki M, Jacobs WW, Jang EJ, Jia S, Jin Y, Joo KK, Kahn J, Kang KH, Kichimi H, Kiesling C, Kim CH, Kim DY, Kim SH, Kim YK, Kimmel TD, Kinoshita K, Kodyš P, Konno T, Korobov A, Korpar S, Kovalenko E, Križan P, Kroeger R, Krokovny P, Kuhr T, Kulasiri R, Kumar M, Kumar R, Kumara K, Kuzmin A, Kwon YJ, Lee SC, Li CH, Li J, Li LK, Li YB, Li Gioi L, Libby J, Lieret K, Liventsev D, MacQueen C, Masuda M, Merola M, Metzner F, Miyabayashi K, Mizuk R, Mohanty GB, Mohanty S, Mrvar M, Nakao M, Natochii A, Nayak L, Niiyama M, Nisar NK, Nishida S, Nishimura K, Ogawa S, Ono H, Onuki Y, Oskin P, Pakhlova G, Pardi S, Park H, Park SH, Passeri A, Patra S, Paul S, Pedlar TK, Piilonen LE, Podobnik T, Popov V, Prencipe E, Prim MT, Röhrken M, Rostomyan A, Rout N, Rozanska M, Russo G, Sahoo D, Sandilya S, Sangal A, Santelj L, Sanuki T, Savinov V, Schnell G, Schueler J, Schwanda C, Schwartz AJ, Seino Y, Senyo K, Sevior ME, Shapkin M, Sharma C, Shen CP, Shiu JG, Shwartz B, Simon F, Sokolov A, Solovieva E, Starič M, Strube JF, Sumihama M, Sumiyoshi T, Takizawa M, Tamponi U, Tanida K, Tao Y, Tenchini F, Trabelsi K, Uchida M, Uglov T, Uno S, Urquijo P, Vahsen SE, Varner G, Varvell KE, Waheed E, Wang CH, Wang E, Wang MZ, Wang P, Wang XL, Watanabe M, Watanuki S, Werbycka O, Won E, Yabsley BD, Yan W, Yang SB, Ye H, Yin JH, Zhang ZP, Zhilich V, Zhukova V. Measurement of Differential Branching Fractions of Inclusive B→X_{u}ℓ^{+}ν_{ℓ} Decays. Phys Rev Lett 2021; 127:261801. [PMID: 35029480 DOI: 10.1103/physrevlett.127.261801] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/09/2021] [Indexed: 06/14/2023]
Abstract
The first measurements of differential branching fractions of inclusive semileptonic B→X_{u}ℓ^{+}ν_{ℓ} decays are performed using the full Belle data set of 711 fb^{-1} of integrated luminosity at the ϒ(4S) resonance and for ℓ=e, μ. With the availability of these measurements, new avenues for future shape-function model-independent determinations of the Cabibbo-Kobayashi-Maskawa matrix element |V_{ub}| can be pursued to gain new insights in the existing tension with respect to exclusive determinations. The differential branching fractions are reported as a function of the lepton energy, the four-momentum-transfer squared, light-cone momenta, the hadronic mass, and the hadronic mass squared. They are obtained by subtracting the backgrounds from semileptonic B→X_{c}ℓ^{+}ν_{ℓ} decays and other processes, and corrected for resolution and acceptance effects.
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Affiliation(s)
- L Cao
- University of Bonn, 53115 Bonn
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | | | | | | | - I Adachi
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - H Aihara
- Department of Physics, University of Tokyo, Tokyo 113-0033
| | - D M Asner
- Brookhaven National Laboratory, Upton, New York 11973
| | - T Aushev
- National Research University Higher School of Economics, Moscow 101000
| | - R Ayad
- Department of Physics, Faculty of Science, University of Tabuk, Tabuk 71451
| | - V Babu
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - S Bahinipati
- Indian Institute of Technology Bhubaneswar, Satya Nagar 751007
| | - P Behera
- Indian Institute of Technology Madras, Chennai 600036
| | - K Belous
- Institute for High Energy Physics, Protvino 142281
| | - J Bennett
- University of Mississippi, University, Mississippi 38677
| | - M Bessner
- University of Hawaii, Honolulu, Hawaii 96822
| | - T Bilka
- Faculty of Mathematics and Physics, Charles University, 121 16 Prague
| | - J Biswal
- J. Stefan Institute, 1000 Ljubljana
| | - A Bobrov
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - M Bračko
- J. Stefan Institute, 1000 Ljubljana
- Faculty of Chemistry and Chemical Engineering, University of Maribor, 2000 Maribor
| | | | - T E Browder
- University of Hawaii, Honolulu, Hawaii 96822
| | - A Budano
- INFN-Sezione di Roma Tre, I-00146 Roma
| | - M Campajola
- INFN-Sezione di Napoli, I-80126 Napoli
- Università di Napoli Federico II, I-80126 Napoli
| | - D Červenkov
- Faculty of Mathematics and Physics, Charles University, 121 16 Prague
| | - M-C Chang
- Department of Physics, Fu Jen Catholic University, Taipei 24205
| | - P Chang
- Department of Physics, National Taiwan University, Taipei 10617
| | - B G Cheon
- Department of Physics and Institute of Natural Sciences, Hanyang University, Seoul 04763
| | - K Chilikin
- P.N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - H E Cho
- Department of Physics and Institute of Natural Sciences, Hanyang University, Seoul 04763
| | - K Cho
- Korea Institute of Science and Technology Information, Daejeon 34141
| | - S-J Cho
- Yonsei University, Seoul 03722
| | - Y Choi
- Sungkyunkwan University, Suwon 16419
| | - S Choudhury
- Indian Institute of Technology Hyderabad, Telangana 502285
| | - D Cinabro
- Wayne State University, Detroit, Michigan 48202
| | - S Cunliffe
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - T Czank
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), University of Tokyo, Kashiwa 277-8583
| | - N Dash
- Indian Institute of Technology Madras, Chennai 600036
| | | | - R Dhamija
- Indian Institute of Technology Hyderabad, Telangana 502285
| | - F Di Capua
- INFN-Sezione di Napoli, I-80126 Napoli
- Università di Napoli Federico II, I-80126 Napoli
| | | | - Z Doležal
- Faculty of Mathematics and Physics, Charles University, 121 16 Prague
| | - T V Dong
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE) and Institute of Modern Physics, Fudan University, Shanghai 200443
| | - S Dubey
- University of Hawaii, Honolulu, Hawaii 96822
| | - D Epifanov
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - T Ferber
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - D Ferlewicz
- School of Physics, University of Melbourne, Victoria 3010
| | - A Frey
- II. Physikalisches Institut, Georg-August-Universität Göttingen, 37073 Göttingen
| | - B G Fulsom
- Pacific Northwest National Laboratory, Richland, Washington 99352
| | - R Garg
- Panjab University, Chandigarh 160014
| | - V Gaur
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061
| | - N Gabyshev
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - A Garmash
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - A Giri
- Indian Institute of Technology Hyderabad, Telangana 502285
| | - P Goldenzweig
- Institut für Experimentelle Teilchenphysik, Karlsruher Institut für Technologie, 76131 Karlsruhe
| | - T Gu
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260
| | - K Gudkova
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - S Halder
- Tata Institute of Fundamental Research, Mumbai 400005
| | - T Hara
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - O Hartbrich
- University of Hawaii, Honolulu, Hawaii 96822
| | | | | | - W-S Hou
- Department of Physics, National Taiwan University, Taipei 10617
| | - C-L Hsu
- School of Physics, University of Sydney, New South Wales 2006
| | - K Inami
- Graduate School of Science, Nagoya University, Nagoya 464-8602
| | - A Ishikawa
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - R Itoh
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - M Iwasaki
- Osaka City University, Osaka 558-8585
| | - W W Jacobs
- Indiana University, Bloomington, Indiana 47408
| | - E-J Jang
- Gyeongsang National University, Jinju 52828
| | - S Jia
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE) and Institute of Modern Physics, Fudan University, Shanghai 200443
| | - Y Jin
- Department of Physics, University of Tokyo, Tokyo 113-0033
| | - K K Joo
- Chonnam National University, Gwangju 61186
| | - J Kahn
- Institut für Experimentelle Teilchenphysik, Karlsruher Institut für Technologie, 76131 Karlsruhe
| | - K H Kang
- Kyungpook National University, Daegu 41566
| | - H Kichimi
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - C Kiesling
- Max-Planck-Institut für Physik, 80805 München
| | - C H Kim
- Department of Physics and Institute of Natural Sciences, Hanyang University, Seoul 04763
| | - D Y Kim
- Soongsil University, Seoul 06978
| | - S H Kim
- Seoul National University, Seoul 08826
| | - Y-K Kim
- Yonsei University, Seoul 03722
| | - T D Kimmel
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061
| | - K Kinoshita
- University of Cincinnati, Cincinnati, Ohio 45221
| | - P Kodyš
- Faculty of Mathematics and Physics, Charles University, 121 16 Prague
| | - T Konno
- Kitasato University, Sagamihara 252-0373
| | - A Korobov
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - S Korpar
- J. Stefan Institute, 1000 Ljubljana
- Faculty of Chemistry and Chemical Engineering, University of Maribor, 2000 Maribor
| | - E Kovalenko
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - P Križan
- J. Stefan Institute, 1000 Ljubljana
- Faculty of Mathematics and Physics, University of Ljubljana, 1000 Ljubljana
| | - R Kroeger
- University of Mississippi, University, Mississippi 38677
| | - P Krokovny
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - T Kuhr
- Ludwig Maximilians University, 80539 Munich
| | - R Kulasiri
- Kennesaw State University, Kennesaw, Georgia 30144
| | - M Kumar
- Malaviya National Institute of Technology Jaipur, Jaipur 302017
| | - R Kumar
- Punjab Agricultural University, Ludhiana 141004
| | - K Kumara
- Wayne State University, Detroit, Michigan 48202
| | - A Kuzmin
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | | | - S C Lee
- Kyungpook National University, Daegu 41566
| | - C H Li
- Liaoning Normal University, Dalian 116029
| | - J Li
- Kyungpook National University, Daegu 41566
| | - L K Li
- University of Cincinnati, Cincinnati, Ohio 45221
| | - Y B Li
- Peking University, Beijing 100871
| | - L Li Gioi
- Max-Planck-Institut für Physik, 80805 München
| | - J Libby
- Indian Institute of Technology Madras, Chennai 600036
| | - K Lieret
- Ludwig Maximilians University, 80539 Munich
| | - D Liventsev
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
- Wayne State University, Detroit, Michigan 48202
| | - C MacQueen
- School of Physics, University of Melbourne, Victoria 3010
| | - M Masuda
- Research Center for Nuclear Physics, Osaka University, Osaka 567-0047
- Earthquake Research Institute, University of Tokyo, Tokyo 113-0032
| | - M Merola
- INFN-Sezione di Napoli, I-80126 Napoli
- Università di Napoli Federico II, I-80126 Napoli
| | - F Metzner
- Institut für Experimentelle Teilchenphysik, Karlsruher Institut für Technologie, 76131 Karlsruhe
| | | | - R Mizuk
- National Research University Higher School of Economics, Moscow 101000
- P.N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - G B Mohanty
- Tata Institute of Fundamental Research, Mumbai 400005
| | - S Mohanty
- Tata Institute of Fundamental Research, Mumbai 400005
- Utkal University, Bhubaneswar 751004
| | - M Mrvar
- Institute of High Energy Physics, Vienna 1050
| | - M Nakao
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - A Natochii
- University of Hawaii, Honolulu, Hawaii 96822
| | - L Nayak
- Indian Institute of Technology Hyderabad, Telangana 502285
| | - M Niiyama
- Kyoto Sangyo University, Kyoto 603-8555
| | - N K Nisar
- Brookhaven National Laboratory, Upton, New York 11973
| | - S Nishida
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - K Nishimura
- University of Hawaii, Honolulu, Hawaii 96822
| | - S Ogawa
- Toho University, Funabashi 274-8510
| | - H Ono
- Nippon Dental University, Niigata 951-8580
- Niigata University, Niigata 950-2181
| | - Y Onuki
- Department of Physics, University of Tokyo, Tokyo 113-0033
| | - P Oskin
- P.N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - G Pakhlova
- National Research University Higher School of Economics, Moscow 101000
- P.N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - S Pardi
- INFN-Sezione di Napoli, I-80126 Napoli
| | - H Park
- Kyungpook National University, Daegu 41566
| | - S-H Park
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - A Passeri
- INFN-Sezione di Roma Tre, I-00146 Roma
| | - S Patra
- Indian Institute of Science Education and Research Mohali, SAS Nagar, 140306
| | - S Paul
- Max-Planck-Institut für Physik, 80805 München
- Department of Physics, Technische Universität München, 85748 Garching
| | | | - L E Piilonen
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061
| | - T Podobnik
- J. Stefan Institute, 1000 Ljubljana
- Faculty of Mathematics and Physics, University of Ljubljana, 1000 Ljubljana
| | - V Popov
- National Research University Higher School of Economics, Moscow 101000
| | | | | | - M Röhrken
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - A Rostomyan
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - N Rout
- Indian Institute of Technology Madras, Chennai 600036
| | - M Rozanska
- H. Niewodniczanski Institute of Nuclear Physics, Krakow 31-342
| | - G Russo
- Università di Napoli Federico II, I-80126 Napoli
| | - D Sahoo
- Tata Institute of Fundamental Research, Mumbai 400005
| | - S Sandilya
- Indian Institute of Technology Hyderabad, Telangana 502285
| | - A Sangal
- University of Cincinnati, Cincinnati, Ohio 45221
| | - L Santelj
- J. Stefan Institute, 1000 Ljubljana
- Faculty of Mathematics and Physics, University of Ljubljana, 1000 Ljubljana
| | - T Sanuki
- Department of Physics, Tohoku University, Sendai 980-8578
| | - V Savinov
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260
| | - G Schnell
- Department of Physics, University of the Basque Country UPV/EHU, 48080 Bilbao
- IKERBASQUE, Basque Foundation for Science, 48013 Bilbao
| | - J Schueler
- University of Hawaii, Honolulu, Hawaii 96822
| | - C Schwanda
- Institute of High Energy Physics, Vienna 1050
| | - A J Schwartz
- University of Cincinnati, Cincinnati, Ohio 45221
| | - Y Seino
- Niigata University, Niigata 950-2181
| | - K Senyo
- Yamagata University, Yamagata 990-8560
| | - M E Sevior
- School of Physics, University of Melbourne, Victoria 3010
| | - M Shapkin
- Institute for High Energy Physics, Protvino 142281
| | - C Sharma
- Malaviya National Institute of Technology Jaipur, Jaipur 302017
| | - C P Shen
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE) and Institute of Modern Physics, Fudan University, Shanghai 200443
| | - J-G Shiu
- Department of Physics, National Taiwan University, Taipei 10617
| | - B Shwartz
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - F Simon
- Max-Planck-Institut für Physik, 80805 München
| | - A Sokolov
- Institute for High Energy Physics, Protvino 142281
| | - E Solovieva
- P.N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - M Starič
- J. Stefan Institute, 1000 Ljubljana
| | - J F Strube
- Pacific Northwest National Laboratory, Richland, Washington 99352
| | | | - T Sumiyoshi
- Tokyo Metropolitan University, Tokyo 192-0397
| | - M Takizawa
- J-PARC Branch, KEK Theory Center, High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
- Meson Science Laboratory, Cluster for Pioneering Research, RIKEN, Saitama 351-0198
- Showa Pharmaceutical University, Tokyo 194-8543
| | - U Tamponi
- INFN-Sezione di Torino, I-10125 Torino
| | - K Tanida
- Advanced Science Research Center, Japan Atomic Energy Agency, Naka 319-1195
| | - Y Tao
- University of Florida, Gainesville, Florida 32611
| | - F Tenchini
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - K Trabelsi
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay
| | - M Uchida
- Tokyo Institute of Technology, Tokyo 152-8550
| | - T Uglov
- National Research University Higher School of Economics, Moscow 101000
- P.N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - S Uno
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - P Urquijo
- School of Physics, University of Melbourne, Victoria 3010
| | - S E Vahsen
- University of Hawaii, Honolulu, Hawaii 96822
| | - G Varner
- University of Hawaii, Honolulu, Hawaii 96822
| | - K E Varvell
- School of Physics, University of Sydney, New South Wales 2006
| | - E Waheed
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - C H Wang
- National United University, Miao Li 36003
| | - E Wang
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260
| | - M-Z Wang
- Department of Physics, National Taiwan University, Taipei 10617
| | - P Wang
- Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049
| | - X L Wang
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE) and Institute of Modern Physics, Fudan University, Shanghai 200443
| | | | - S Watanuki
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay
| | - O Werbycka
- H. Niewodniczanski Institute of Nuclear Physics, Krakow 31-342
| | - E Won
- Korea University, Seoul 02841
| | - B D Yabsley
- School of Physics, University of Sydney, New South Wales 2006
| | - W Yan
- Department of Modern Physics and State Key Laboratory of Particle Detection and Electronics, University of Science and Technology of China, Hefei 230026
| | | | - H Ye
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - J H Yin
- Korea University, Seoul 02841
| | - Z P Zhang
- Department of Modern Physics and State Key Laboratory of Particle Detection and Electronics, University of Science and Technology of China, Hefei 230026
| | - V Zhilich
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - V Zhukova
- P.N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
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Bajpai J, Ventrapati P, Joshi S, Wadasadawala T, Rath S, Pathak R, Nandhana R, Mohanty S, Chougle Q, Engineer M, Abraham N, Ghosh J, Nair N, Gulia S, Popat P, A P, Sheth T, Desai S, Thakur M, Rangrajan V, Parmar V, Sarin R, Gupta S, Badwe RA. Unique challenges and outcomes of young women with breast cancers from a tertiary care cancer centre in India. Breast 2021; 60:177-184. [PMID: 34655887 PMCID: PMC8527043 DOI: 10.1016/j.breast.2021.09.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 08/03/2021] [Revised: 09/26/2021] [Accepted: 09/27/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Young (≤40 years) breast cancers (YBC) are uncommon, inadequately represented in trials and have unique concerns and merit studying. METHODS The YBC treated with a curative intent between 2015 and 2016 at our institute were analysed. RESULTS There were 1228 patients with a median age of 36 (12-40) years; 38 (3.1%) had Stage I, 455 (37.1%) - II, 692 (56.3%) -III, and remaining 43 (3.5%) Stage IV (oligo-metastatic) disease; 927 (75.5%) were node positive; 422 (34.4%) were Triple negatives (TNBC), 331 (27%) were HER-2 positive. There were 549 (48.2%) breast conservations and 591 (51.8%) mastectomies of which 62 (10.4%) underwent breast reconstruction. 1143 women received chemotherapy, 617 (53.9%) received as neoadjuvant and 142 (23.1%) had pathological complete response; 934 (81.9%) received adjuvant radiotherapy. At the median follow-up of 48 (0-131) months, 5-year overall and disease-free survival was 79.6% (76.8-82.5) and 59.1% (55.8-62.6). For stage I, II, III and IV, the 5-year overall-survival was 100%, 86.7% (82.8-90.6), 77.3% (73.4-81.2), 69.7% (52.5-86.9) and disease-free survival was 94% (85.9-100), 65.9% (60.3-71.5), 55% (50.5-59.5), and 29.6% (14-45.2) respectively. On multivariate analysis, TNBC and HER-2+ subgroups had poorer survival (p = 0.0035). 25 patients had BRCA mutations with a 5-year DFS of 65.1% (95% CI:43.6-86.6). Fertility preservation was administered in 104 (8.5%) patients; seven women conceived and 5 had live births. Significant postmenopausal symptoms were present in 153 (13%) patients. CONCLUSION More than half of the YBC in India were diagnosed at an advanced stage with aggressive features leading to suboptimal outcomes. Awareness via national registry and early diagnosis is highly warranted. Menopausal symptoms and fertility issues are prevalent and demand special focus.
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Affiliation(s)
- Jyoti Bajpai
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India.
| | - Pradeep Ventrapati
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - Shalaka Joshi
- Department of Surgical Oncology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - Tabassum Wadasadawala
- Department of Radiation Oncology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - Sushmita Rath
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - Rima Pathak
- Department of Radiation Oncology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - Ravindra Nandhana
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - Samarpita Mohanty
- Department of Radiation Oncology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - Qurratulain Chougle
- Department of Surgical Oncology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - Mitchelle Engineer
- Department of Surgical Oncology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - Nissie Abraham
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - Jaya Ghosh
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - Nita Nair
- Department of Surgical Oncology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - Seema Gulia
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - Palak Popat
- Department of Radiology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - Patil A
- Department of Surgical Pathology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - Tanuja Sheth
- Department of Surgical Pathology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - Sangeeta Desai
- Department of Surgical Pathology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - Meenakshi Thakur
- Department of Surgical Pathology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - Venkatesh Rangrajan
- Department of Surgical Pathology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - Vani Parmar
- Department of Surgical Oncology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - R Sarin
- Department of Surgical Oncology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - S Gupta
- Department of Surgical Oncology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
| | - R A Badwe
- Department of Surgical Oncology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, India
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17
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Mohanty S, Trivedi C, Della Rocca DG, Gianni C, MacDonald B, Mayedo A, Bassiouny M, Gallinghouse GJ, Burkhardt JD, Horton R, Al-Ahmad A, Di Biase L, Natale A. Optimal ablation targets during second catheter ablation in patients with persistent AF. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0367] [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
Pulmonary vein isolation (PVI) is the cornerstone of ablative therapy in atrial fibrillation (AF). However, the one-year success rate after single ablation procedure is known to be up to 60%, necessitating repeat procedures in many.
Purpose
We evaluated the impact of different ablation strategies on procedural success at the second ablation in patients with persistent AF (PerAF).
Methods
Consecutive PerAF patients scheduled to undergo their second ablation were screened and only those that have received PVI plus isolation of left atrial posterior wall (PWI) and superior vena cava (SVC) at the first procedure (n=1390), were included in the analysis. At the second ablation, all reconnected structures were ablated. Additionally, based on operators' decision, non-PV triggers were targeted for ablation.
Patients were classified into two groups based on the ablation strategy: group 1: Re-isolation of reconnected PVs, PW, SVC and group 2: additional ablation of non-PV triggers (from inter-atrial septum, coronary sinus (CS), left atrial appendage (LAA) and crista terminalis). Arrhythmia-monitoring was performed quarterly for 1 year and biannually afterwards. Ablation success was assessed off-antiarrhythmic drugs (AAD).
Results
Of the 1390 patients included in the analysis, 698 were in group 1 and 692 were in group 2.
In group 1, reconnected PV, PW and SVC were re-isolated in 98 (14%), 311 (44.5%) and 173 (24.8%) respectively. In 131 (18.7%) patients, in the absence of any reconnection, CS was empirically isolated.
In group 2, PV, PW and SVC were re-isolated in 83 (12%), 270 (39%) and 113 (16.3%) patients respectively. Additionally, non-PV triggers were ablated in 505 (73%) and empirical isolation of LAA and CS in the absence of detectable triggers and PV reconnection was performed in 187 (27%).
At 2 years of follow-up, 425 (61%) and 602 (87%) from group 1 and 2 were arrhythmia-free off-AAD (p<0.001).
Conclusion
Including non-PV triggers as targets for ablation at the repeat procedure was associated with significantly higher success rate in persistent AF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Mohanty
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Trivedi
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - D G Della Rocca
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Gianni
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - B MacDonald
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Mayedo
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - M Bassiouny
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - G J Gallinghouse
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - J D Burkhardt
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - R Horton
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Al-Ahmad
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - L Di Biase
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Natale
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
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18
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Mohanty S, Trivedi C, Della Rocca DG, Gianni C, MacDonald B, Mayedo A, Bassiouny M, Gallinghouse GJ, Horton R, Al-Ahmad A, Di Biase L, Burkhardt JD, Natale A. Long-term outcome of endocardial-only versus combined endocardial-epicardial homogenization of the scar for treatment of ventricular tachycardia in patients with ischemic cardiomyopathy. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0364] [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
We investigated the ablation success of scar homogenization with combined (epicardial + endocardial) versus endocardial-only approach for ventricular tachycardia (VT) in patients with ischemic cardiomyopathy (ICM) at 5 years of follow-up.
Method
Consecutive ICM patients undergoing VT ablation at our center were classified into group 1: endocardial scar homogenization and group 2: endocardial +epicardial scar homogenization. Patients with previous open heart surgery were excluded.
All patients underwent bipolar substrate mapping with standard scar settings defined as normal tissue >1.5 mV and severe scar <0.5 mV. Non-inducibility of monomorphic VT was the procedural endpoint in both groups. Patients were followed up twice a year for 5 years with implantable device interrogations.
Results
A total of 361 (Group 1: 291 and group 2: 70) patients were included in the study (mean age: 67 years, male: 88.4%).
At 5 years, significantly higher number of patients from group 2 remained arrhythmia-free (figure 1). Of those patients, 87 (45%) and 51 (89%) from group 1 and 2 respectively were off-anti-arrhythmic drugs (AAD) (p<0.001). After adjusting for age, gender, hypertension, diabetes, and obstructive sleep apnea, scar homogenization using endo-epicardial approach was associated with 51% less recurrence compared to the endocardial ablation strategy (Hazard Ratio: 0.49, 95% CI: 0.27–0.89, p: 0.02).
Conclusion
In this series of patients with ischemic cardiomyopathy and VT, endo-epicardial scar homogenization was associated with a lower need for AAD and a significantly lower recurrence rate at 5-years of follow-up compared to the endocardial ablation alone.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
- S Mohanty
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Trivedi
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - D G Della Rocca
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Gianni
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - B MacDonald
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Mayedo
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - M Bassiouny
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - G J Gallinghouse
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - R Horton
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Al-Ahmad
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - L Di Biase
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - J D Burkhardt
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A.N.D.R.E.A Natale
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
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19
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Mohanty S, Trivedi C, Della Rocca DG, Gianni C, MacDonald B, Mayedo A, Burkhardt JD, Bassiouny M, Gallinghouse GJ, Horton R, Al-Ahmad A, Di Biase L, Natale A. Linear increase in the number of non-pulmonary vein triggers from paroxysmal to persistent and long-standing persistent AF in patients undergoing repeat procedure after successful isolation of pulmona. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0366] [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
This study evaluated the prevalent triggers responsible for recurrence following successful PVI in different types of atrial fibrillation (AF).
Methods
Consecutive AF patients undergoing repeat catheter ablation with permanently isolated PV were included in the analysis. High-dose isoproterenol challenge (20- 30μg/min for 15–20min) was used to confirm PV reconnection and identify non-PV triggers.
Circular mapping catheter (CMC) was used to map the site of origin of significant ectopic activity by comparing the activation sequence of the sinus beat with that of the ectopic beat. For the coronary sinus (CS), ablation catheter was positioned at the level of the mitral valve annulus, parallel to the one positioned in the CS. Left atrial appendage (LAA) firing was detected by placing the CMC in the left superior PV and thus recording far-field potentials from the LAA.
Results
This prospective study included 1850 AF patients undergoing repeat AF ablation (Table 1), of which 573 (31%) had received one and the remaining 1277 patients had received 2 earlier ablations. Permanent PVI was confirmed with isoproterenol challenge.
Table 1 shows the distribution of non-PV triggers. A linear increase in the number of non-PV triggers was observed from PAF to PerAF to LSPAF. Significantly higher number of LSPAF patients had detectable non-PV triggers compared to PerAF and PAF cases.
Conclusion
We observed a linear increase in the number of non-PV triggers in PAF to PerAF and LSPAF patients experiencing recurrence with successful isolation of PVs. As non-PV triggers are often not targeted by operators, this could be the underlying mechanism for more frequent recurrences in non-paroxysmal AF.
Funding Acknowledgement
Type of funding sources: None. Table 1
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Affiliation(s)
- S Mohanty
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Trivedi
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - D G Della Rocca
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Gianni
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - B MacDonald
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Mayedo
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - J D Burkhardt
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - M Bassiouny
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - G J Gallinghouse
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - R Horton
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Al-Ahmad
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - L Di Biase
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Natale
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
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20
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Mohanty S, Trivedi C, Della Rocca DG, Gianni C, MacDonald B, Mayedo A, Bassiouny M, Gallinghouse GJ, Burkhardt JD, Horton R, Al-Ahmad A, Di Biase L, Natale A. Benefits of early intervention with catheter ablation in patients with atrial fibrillation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0363] [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
Radiofrequency catheter ablation, a widely recognized therapeutic option for atrial fibrillation (AF) has limited success rate as it is influenced by several factors including duration of AF.
Purpose
We evaluated the ablation success in AF patients intervened early versus late in the disease course.
Methods
Consecutive AF patients undergoing their first catheter ablation in 2015–16 at our center were included in the analysis. Patients were classified into two groups based on the time to ablation after AF diagnosis; 1) early: ≤12 months and 2) late: >12 months.
All received PV isolation plus isolation of posterior wall and superior vena cava. Additionally, in non-paroxysmal AF cases, non-PV triggers were identified with isoproterenol-challenge and ablated. Patients were prospectively followed up for 3 years with regular rhythm monitoring.
Results
A total of 752 and 1248 patients were included in the “early” and “late” group respectively. Baseline characteristics of the study population is provided in Table 1 A. At 4 years of follow-up, overall success rate off-antiarrhythmic drugs was significantly higher in the “early” group (65.4% vs 57%, p<0.001). After stratification by AF type, “early” group was still associated with significantly higher success rate compared to the “late” group (Table 1B).
Conclusion
In this large series with standardized ablation strategy, early intervention with catheter ablation was associated with higher success rate in all AF types.
Funding Acknowledgement
Type of funding sources: None. Table 1
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Affiliation(s)
- S Mohanty
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Trivedi
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - D G Della Rocca
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Gianni
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - B MacDonald
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Mayedo
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - M Bassiouny
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - G J Gallinghouse
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - J D Burkhardt
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - R Horton
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Al-Ahmad
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - L Di Biase
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A.N.D.R.E.A Natale
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
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Mohanty S, Trivedi C, Della Rocca DG, Gianni C, MacDonald B, Mayedo A, Burkhardt JD, Bassiouny M, Gallinghouse GJ, Horton R, Al-Ahmad A, Di Biase L, Natale A. Recovery of conduction following high power short duration approach in radiofrequency catheter ablation for atrial fibrillation: a single-center experience. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0365] [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
High-power short-duration (HPSD) ablation is currently being adopted by many as the preferred procedural technique in atrial fibrillation (AF). However, the optimal duration of energy delivery to successfully create a durable lesion is not clear yet.
Purpose
We evaluated the association of electrical reconnection with lesion-duration in HPSD ablation.
Methods
Consecutive AF patients undergoing repeat procedure after a prior HPSD ablation with or without isolation of left atrial appendage (LAA) and coronary sinus (CS) were included in this analysis. HPSD ablation was defined as ablation with maximum temperature setting at 420C and power delivery at 45 W for 10–15 sec (5 seconds in the CS area and posterior wall near the esophagus). In some patients a mechanical esophageal deviation tool was used to deflect the esophagus away from the ablation site.
Results
A total of 2249 AF patients (with LAA and CS isolation: 1451; without LAA and CS isolation: 798) receiving redo ablation after a prior HPSD procedure were included in the analysis. At the prior procedure with the HPSD approach, mean duration of ablation was significantly shorter in the area facing the esophagus compared to elsewhere (5.2±1.5 vs 12.5±1.7 seconds, p<0.001). Application duration was reduced to <10 sec to avoid overheating and steam pops in 1221 (84%) patients receiving LAA and CS isolation.
At the redo, recovery of conduction was noted in the CS (592, 40.8%), LAA (493, 34%), and PV and left atrial posterior wall (LAPW) (310, 13.8%). Of the 310 patients with LAPW reconnection, 91% (n=282) had the conduction recovered in the area facing the esophagus.
In 73 patients, esophageal displacement device was used during the prior HPSD ablation. Average duration of ablation lesions in LAPW among those 73 patients was 9.2±2 seconds. PV-LAPW reconnection was observed in 3/73 (4.1%) patients.
Conclusion
HPSD ablation with lesion duration of <10 sec was associated with conduction recovery in the LAA, CS and the LAPW area facing esophagus.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Mohanty
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Trivedi
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - D G Della Rocca
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Gianni
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - B MacDonald
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Mayedo
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - J D Burkhardt
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - M Bassiouny
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - G J Gallinghouse
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - R Horton
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Al-Ahmad
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - L Di Biase
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Natale
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
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22
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Talamo A, Bergeron A, Mohanty S, Vegendla SNP, Heidet F, Ade B, Betzler BR, Terrani K. Serpent and MCNP Calculations of the Energy Deposition in the Transformational Challenge Reactor. NUCL SCI ENG 2021. [DOI: 10.1080/00295639.2021.1977078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- A. Talamo
- Argonne National Laboratory, Nuclear Science and Engineering Division, 9700 South Cass Avenue, Lemont, Illinois 60439
| | - A. Bergeron
- Argonne National Laboratory, Nuclear Science and Engineering Division, 9700 South Cass Avenue, Lemont, Illinois 60439
| | - S. Mohanty
- Argonne National Laboratory, Nuclear Science and Engineering Division, 9700 South Cass Avenue, Lemont, Illinois 60439
| | - S. N. P. Vegendla
- Argonne National Laboratory, Nuclear Science and Engineering Division, 9700 South Cass Avenue, Lemont, Illinois 60439
| | - F. Heidet
- Argonne National Laboratory, Nuclear Science and Engineering Division, 9700 South Cass Avenue, Lemont, Illinois 60439
| | - B. Ade
- Oak Ridge National Laboratory, P.O. Box 2008, Oak Ridge, Tennessee 37831-6170
| | - B. R. Betzler
- Oak Ridge National Laboratory, P.O. Box 2008, Oak Ridge, Tennessee 37831-6170
| | - K. Terrani
- Oak Ridge National Laboratory, P.O. Box 2008, Oak Ridge, Tennessee 37831-6170
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Verma A, Mohanty S, Gupta A. Comparative Evaluation of Preoperative Local and Systemic Intramuscular Administration of Dexamethasone Injection in Mandibular Third Molar Impaction Surgery. J Oral Maxillofac Surg 2021. [DOI: 10.1016/j.joms.2021.08.036] [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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Mohanty S, Hemavathy S, Verma A. Deep Subfascial Approach as an Alternative to Explore Temporomandibular Joint: A Pilot Study. J Oral Maxillofac Surg 2021. [DOI: 10.1016/j.joms.2021.08.057] [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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Mohanty S, Rathaur A. Effectiveness and Pitfalls of Intraoral Distraction in Wide Alveolar Clefts: An Experience. J Oral Maxillofac Surg 2021. [DOI: 10.1016/j.joms.2021.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Singh N, Dogra Y, Mohanty S, Seth T. P–796 Trial of Autologous Marrow derived Stem Cell Ovarian Transplantation (TAMSCOT) in young infertile women with diminished ovarian reserve for ovarian rejuvenation – HOPE still persists. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Does autologous bone marrow derived stem cell (BMDSC) ovarian transplantation optimize ovarian reserve parameters in young infertile women with diminished ovarian reserve (DOR) ?
Summary answer
The autologous stem cell ovarian transplantation (ASCOT) improves AFC and AMH by facilitating the recruitment of existing dormant follicles in young women with DOR.
What is known already
Oocyte donation is the practical therapeutic option when patients with premature ovarian ageing desire pregnancy. It involves significant psychological burden in terms of not able to have their own biological child. ASCOT has opened new doors in poor responders and premature ovarian insufficiency through its beneficial effects on ovarian reserve and IVF outcomes. However recent studies have shown contradictory results in terms of its efficacy. No prior study has been contemplated in DOR group
Study design, size, duration
An open label non randomized controlled trial was conducted at Division of Reproductive Medicine in collaboration with stem cell facility at tertiary care institute. Forty two infertile women less than 35 years age with DOR (AFC<5, AMH<1.2ng/ml and /or high FSH>8IU/l) were enrolled in the study during a period from January 2020 to December 2020. 20 women who did not opt for the intervention were treated as control group whereas 22 women received the intervention.
Participants/materials, setting, methods
Baseline hormonal profile ( Day 2 FSH, estradiol, AMH and AFC) was done in all patients. Women with abnormal uterine cavity, endometriosis, prior ovarian surgery, abnormal karyotype were excluded. Bone marrow aspiration followed by mesenchymal stem cells isolation was performed. The stem cells were transplanted in both the ovaries through transvaginal route on the same day. Follow up visits were planned at one and six months to assess ovarian reserve parameters.
Main results and the role of chance
The mean age, BMI and duration of infertility were comparable between the control and study group (29.5±3.34vs29.36±2.95years, 21.51±1.40vs21.87±1.93kg/m2, 6.9±1.94vs7. 04±3.67 years) . The positive response in terms of improved AMH and AFC was seen in 68% (15/22) patients. The mean number of stem cells injected in these women were 77.71±25.33 million. At first follow up, there was no significant difference between mean FSH, estradiol levels and mean right and left ovarian volume (9.23±3.95 vs 9.02±3.92mIU/l, 61.46±29.25 vs 68.12±62.52 pg/ml, 2.82±2.18 vs 2.44±1.25 cc, 2.02±1.54 vs 2.72±1.06 cc, p < 0.05). There was significant increase in AMH and AFC values as compared to baseline (0.79±0.43 vs 1.26±0.82ng/ml, p = 0.03; 3.47±1.30 vs 6.40±2.23, p < 0.001). At second follow up visit, the significant increase in ovarian reserve persisted for AMH and AFC (0.79±0.43 vs 1.22±0.76 ng/ml, p = 0.02; 3.47±1.30 vs 6.93±1.71,p<0.001). There was no significant difference between serum FSH , Estradiol and ovarian volume. None of the patients developed any complication and the improvement in AFC and AMH persisted during 10 month follow up period.
Limitations, reasons for caution
The limitation of present study is small sample size and non randomization. However, time period for which positive effect lasts has not been documented in earlier studies. This study is currently being endeavored, and women with improved ovarian reserve are followed up for any spontaneous conception or following assisted reproduction.
Wider implications of the findings: The present study demonstrates beneficial role of stem cells in improving ovarian reserve parameters in women with DOR with no acquired cause. If supported by future randomized clinical studies, it could represent a paradigm shift for fertility treatment in these women providing an opportunity to have their own biological child.
Trial registration number
CTRI/2020/01/022726
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Affiliation(s)
- N Singh
- All India Institute Of Medical Sciences AIIMS, Department of Obstetrics & Gynaecology, New Delhi, India
| | - Y Dogra
- All India Institute Of Medical Sciences AIIMS, Department of Obstetrics & Gynaecology, New Delhi, India
| | - S Mohanty
- All India Institute Of Medical Sciences AIIMS, Stem cell facility, New Delhi, India
| | - T Seth
- All India Institute Of Medical Sciences AIIMS, Department of Haematology, New Delhi, India
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Singh N, Dogra Y, Mohanty S, Seth T. P-796 Trial of Autologous Marrow derived Stem Cell Ovarian Transplantation (TAMSCOT) in young infertile women with diminished ovarian reserve for ovarian rejuvenation – HOPE still persists. Hum Reprod 2021. [DOI: 10.1093/humrep/deab128.037] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Does autologous bone marrow derived stem cell (BMDSC) ovarian transplantation optimize ovarian reserve parameters in young infertile women with diminished ovarian reserve (DOR) ?
Summary answer
The autologous stem cell ovarian transplantation (ASCOT) improves AFC and AMH by facilitating the recruitment of existing dormant follicles in young women with DOR.
What is known already
Oocyte donation is the practical therapeutic option when patients with premature ovarian ageing desire pregnancy. It involves significant psychological burden in terms of not able to have their own biological child. ASCOT has opened new doors in poor responders and premature ovarian insufficiency through its beneficial effects on ovarian reserve and IVF outcomes. However recent studies have shown contradictory results in terms of its efficacy. No prior study has been contemplated in DOR group
Study design, size, duration
An open label non randomized controlled trial was conducted at Division of Reproductive Medicine in collaboration with stem cell facility at tertiary care institute. Forty two infertile women less than 35 years age with DOR (AFC<5, AMH<1.2ng/ml and /or high FSH>8IU/l) were enrolled in the study during a period from January 2020 to December 2020. 20 women who did not opt for the intervention were treated as control group whereas 22 women received the intervention.
Participants/materials, setting, methods
Baseline hormonal profile ( Day 2 FSH, estradiol, AMH and AFC) was done in all patients. Women with abnormal uterine cavity, endometriosis, prior ovarian surgery, abnormal karyotype were excluded. Bone marrow aspiration followed by mesenchymal stem cells isolation was performed. The stem cells were transplanted in both the ovaries through transvaginal route on the same day. Follow up visits were planned at one and six months to assess ovarian reserve parameters.
Main results and the role of chance
The mean age, BMI and duration of infertility were comparable between the control and study group (29.5±3.34vs 29.36±2.95years, 21.51±1.40vs21.87±1.93kg/m2, 6.9±1.94vs7.04±3.67 years). The positive response in terms of improved AMH and AFC was seen in 68% (15/22) patients. The mean number of stem cells injected in these women were 77.71±25.33 million. At first follow up, there was no significant difference between mean FSH, estradiol levels and mean right and left ovarian volume (9.23±3.95 vs 9.02±3.92mIU/l, 61.46±29.25 vs 68.12±62.52 pg/ml, 2.82±2.18 vs 2.44±1.25 cc, 2.02±1.54 vs 2.72±1.06 cc, p < 0.05). There was significant increase in AMH and AFC values as compared to baseline (0.79±0.43 vs 1.26±0.82ng/ml, p = 0.03; 3.47±1.30 vs 6.40±2.23, p < 0.001). At second follow up visit, the significant increase in ovarian reserve persisted for AMH and AFC (0.79±0.43 vs 1.22±0.76 ng/ml, p = 0.02; 3.47±1.30 vs 6.93±1.71,p<0.001). There was no significant difference between serum FSH, Estradiol and ovarian volume. None of the patients developed any complication and the improvement in AFC and AMH persisted during 10 month follow up period.
Limitations, reasons for caution
The limitation of present study is small sample size and non randomization. However, time period for which positive effect lasts has not been documented in earlier studies. This study is currently being endeavored, and women with improved ovarian reserve are followed up for any spontaneous conception or following assisted reproduction.
Wider implications of the findings
The present study demonstrates beneficial role of stem cells in improving ovarian reserve parameters in women with DOR with no acquired cause. If supported by future randomized clinical studies, it could represent a paradigm shift for fertility treatment in these women providing an opportunity to have their own biological child
Trial registration number
CTRI/2020/01/022726
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Affiliation(s)
- N Singh
- All India Institute Of Medical Sciences AIIMS, Department of Obstetrics & Gynaecology, New Delhi, India
| | - Y Dogra
- All India Institute Of Medical Sciences AIIMS, Department of Obstetrics & Gynaecology, New Delhi, India
| | - S Mohanty
- All India Institute Of Medical Sciences AIIMS, Stem cell facility, New Delhi, India
| | - T Seth
- All India Institute Of Medical Sciences AIIMS, Department of Haematology, New Delhi, India
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Mohanty S, Gurram L, Chopra S, Mahantshetty U, Grover S. Cervical Cancer Treatment in HIV-Positive Patients: A Survey of Treatment Practices in India. JCO Glob Oncol 2021; 7:843-848. [PMID: 34101485 PMCID: PMC8457850 DOI: 10.1200/go.21.00081] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Chemoradiation remains a challenge in women living with HIV (WLWH) and cervical cancer primarily because of concerns regarding immune status. With limited literature available to help guide the management of these patients, clinical practices among oncologists are variable across India. Hence, we conducted a survey among radiation oncologists in India to assess the patterns of current practices of treating cervical cancer with chemoradiation in WLWH.
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Affiliation(s)
- Samarpita Mohanty
- Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Lavanya Gurram
- Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Supriya Chopra
- Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | | | - Surbhi Grover
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Rajeswaran R, Chandrasekharan A, Mohanty S, Murali K, Joseph S. Role of MR cisternography in the diagnosis of cerebrospinal fluid rhinorrhoea with diagnostic nasal endoscopy and surgical correlation. Indian J Radiol Imaging 2021. [DOI: 10.4103/0971-3026.29005] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AbstractObjectives : To study the usefulness and accuracy of MR cisternography as noninvasive study in the diagnosis of cerebrospinal fluid (CSF) fistula with diagnostic sinonasal endoscopy and surgical correlation.
Material and Methods: Twenty four patients with clinically suspected CSF rhinorrhoea were examined for CSF fistula with MR cisternography. The MR imaging technique included 3mm thin T2 weighted coronal and sagittal sections using Fast spin echo. In addition 1.5mm thin T2 weighted coronal sections were also obtained using CISS (Constructive Interference in Steady State) sequence. MR findings were correlated with diagnostic sinonasal endoscopy and surgical findings.
Results : MR cisternography demonstrated the presence of fistula in 17 patients, absence of fistula in seven patients. Out of 17 patients with fistula, the diagnosis could be confirmed in 14 patients by diagnostic sinonasal endoscopy/surgery. Out of the seven patients without fistula, there was positive correlation in six patients when they were followed up clinically and by diagnostic nasal endoscopy. However in one patient, fistula was demonstrated on CT cisternography and was confirmed on sinonasal endoscopic surgery. The accuracy, sensitivity of MR cisternography was 96, 94% respectively.
Conclusion : MR cisternography is a useful and accurate noninvasive study in localizing the site and extent of CSF fistula.
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Affiliation(s)
- R Rajeswaran
- Department of Radiology and Imaging Sciences and Department of Otolaryngology, Sri Ramachandra Medical College and Research Institute, Chennai - 600 116, India
| | - A Chandrasekharan
- Department of Radiology and Imaging Sciences and Department of Otolaryngology, Sri Ramachandra Medical College and Research Institute, Chennai - 600 116, India
| | - S Mohanty
- Department of Radiology and Imaging Sciences and Department of Otolaryngology, Sri Ramachandra Medical College and Research Institute, Chennai - 600 116, India
| | - K Murali
- Department of Radiology and Imaging Sciences and Department of Otolaryngology, Sri Ramachandra Medical College and Research Institute, Chennai - 600 116, India
| | - S Joseph
- Department of Radiology and Imaging Sciences and Department of Otolaryngology, Sri Ramachandra Medical College and Research Institute, Chennai - 600 116, India
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Jandas PJ, Prabakaran K, Kumar R, Mohanty S, Nayak SK. Eco-friendly poly (hydroxybutyrate) nanocomposites: preparation and characterization. J Polym Res 2021. [DOI: 10.1007/s10965-021-02653-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kumar S, Panigrahi P, Mohanty S, Nayak SK, Palai AK. Tuning up the photovoltaic performances upon the utility of diketopyrrolopyrrole in PEO-based gel polymer electrolytes. Dalton Trans 2021; 50:7647-7655. [PMID: 33973615 DOI: 10.1039/d1dt00585e] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The role of diketopyrrolopyrrole (DPP-H) as an additive on the ionic conductivity of poly(ethylene oxide) (PEO)-based gel polymer electrolytes (GPE) was studied for DSSC applications. The pure PEO/PC/KI/TPAI/I2 GPE was prepared with a mixture of propylene carbonate (PC) as a non-volatile plasticizer and iodide salts, such as potassium iodide (KI), tetrapropylammonium iodide (TPAI) and iodine (I2), together with PEO. The modified GPEs were prepared with different weight percentage (wt%) ratios (0.5%, 0.75%, 1% and 1.25%) of DPP-H using acetonitrile as a solvent. The polymer gel electrolytes were characterized by X-ray diffractometer (XRD) and Fourier transform infrared spectroscopy (FTIR), and the electrochemical properties were analyzed to relate the nature of the polymer and iodine ion conducting properties. The pure PEO/PC/TPAI/KI/I2 electrolyte exhibited an ionic conductivity value of 0.084 mS·cm-1 at room temperature. Upon the optimized addition of DPP-H (0.75 wt%), the ionic conductivity was found to be improved to a maximum value of 0.393 mS·cm-1, and the highest diffusion coefficient of 1.02 × 10-6 cm2 s-1 was observed. The optimized GPEs photovoltaic characterization studies showed higher power conversion efficiency (PCE) of 6.69% for DSSC under light illumination intensity of 100 mW cm-2. The same was compared with pure electrolyte, which delivered PCE of 4.39%. To gain an in-depth understanding of the interfacial resistance of the fabricated devices, the electron lifetime and transient photo response was analyzed. These above studies showed that prepared GPE could be an efficient alternative for traditional DSSCs with liquid electrolyte.
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Affiliation(s)
- Sanath Kumar
- Laboratory for Advanced Research in Polymeric Materials, SARP:CIPET, Bhubaneswar, Odisha 751 024, India.
| | - Pranshula Panigrahi
- Laboratory for Advanced Research in Polymeric Materials, SARP:CIPET, Bhubaneswar, Odisha 751 024, India.
| | - S Mohanty
- Laboratory for Advanced Research in Polymeric Materials, SARP:CIPET, Bhubaneswar, Odisha 751 024, India.
| | - S K Nayak
- Laboratory for Advanced Research in Polymeric Materials, SARP:CIPET, Bhubaneswar, Odisha 751 024, India.
| | - Akshaya Kumar Palai
- Laboratory for Advanced Research in Polymeric Materials, SARP:CIPET, Bhubaneswar, Odisha 751 024, India.
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Swamidas J, Pradhan S, Chopra S, Panda S, Gupta Y, Sood S, Mohanty S, Jain J, Joshi K, Ph R, Gurram L, Mahantshetty U, Prakash Agarwal J. Development and clinical validation of Knowledge-based planning for Volumetric Modulated Arc Therapy of cervical cancer including pelvic and para aortic fields. Phys Imaging Radiat Oncol 2021; 18:61-67. [PMID: 34258410 PMCID: PMC8254199 DOI: 10.1016/j.phro.2021.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 05/12/2021] [Accepted: 05/14/2021] [Indexed: 12/24/2022]
Abstract
A knowledge-based planning model was configured for VMAT of cervical cancer. Knowledge-based plans were comparable, and for some OARs, outperformed clinical plans. Improved organ sparing was observed, when individual patient geometry was considered.
Background and Purpose Knowledge-based planning (KBP) is based on a model to estimate dose-volume histograms, configured using a library of historical treatment plans to efficiently create high quality plans. The aim was to report configuration and validation of KBP for Volumetric Modulated Arc Therapy of cervical cancer. Materials and methods A KBP model was configured from the institutional database (n = 125), including lymph node positive (n = 60) and negative (n = 65) patients. KBP Predicted plans were compared with Clinical Plans (CP) and Re-plans (Predicted plan as a base-plan) to validate the model. Model quality was quantified using coefficient of determination R2, mean square error (MSE), standard two-tailed paired t-test and Wilcoxon signed rank test. Results Estimation capability of the model was good for the bowel bag (MSE = 0.001, R2 = 0.84), modest for the bladder (MSE = 0.008) and poor for the rectum (MSE = 0.02 R2 = 0.78). KBP resulted in comparable target coverage, superior organ sparing as compared to CP. Re-plans outperformed CP for the bladder, V30 (66 ± 11% vs 74 ± 11%, p < .001), V40 (48 ± 14% vs 52 ± 14%, p < .001), however sparing was modest for the bowel bag V30 (413 ± 191cm3 vs 445 ± 208cm3, p = .037) V40 (199 ± 105cm3 vs 218 ± 127cm3, p = .031). All plans were comparable for rectum, while KBP resulted in significant sparing for spinal cord, kidneys and femoral heads. Conclusion KBP yielded comparable and for some organs superior performance compared to CP resulting in conformal and homogeneous target coverage. Improved organ sparing was observed when individual patient geometry was considered.
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Affiliation(s)
- Jamema Swamidas
- Department of Radiation Oncology, ACTREC, Tata Memorial Centre, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India.,Department of Medical Physics, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
| | - Sangram Pradhan
- Department of Radiotherapy, All India Institute of Medical Sciences, New Delhi, India.,Department of Medical Physics, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
| | - Supriya Chopra
- Department of Radiation Oncology, ACTREC, Tata Memorial Centre, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India.,Department of Medical Physics, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
| | - Subhajit Panda
- Department of Radiation Oncology, ACTREC, Tata Memorial Centre, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India.,Department of Medical Physics, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
| | - Yashna Gupta
- Department of Radiotherapy, All India Institute of Medical Sciences, Rishikesh, India.,Department of Medical Physics, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
| | - Sahil Sood
- Homi Bhabha National Institute, Mumbai, India.,Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India.,Department of Medical Physics, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
| | - Samarpita Mohanty
- Homi Bhabha National Institute, Mumbai, India.,Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India.,Department of Medical Physics, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
| | - Jeevanshu Jain
- Department of Radiation Oncology, ACTREC, Tata Memorial Centre, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India.,Department of Medical Physics, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
| | - Kishore Joshi
- Department of Radiation Oncology, ACTREC, Tata Memorial Centre, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India.,Department of Medical Physics, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
| | - Reena Ph
- Department of Radiation Oncology, ACTREC, Tata Memorial Centre, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India.,Department of Medical Physics, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
| | - Lavanya Gurram
- Homi Bhabha National Institute, Mumbai, India.,Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India.,Department of Medical Physics, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
| | - Umesh Mahantshetty
- Homi Bhabha National Institute, Mumbai, India.,Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Vishakapatnam, India.,Department of Medical Physics, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
| | - Jai Prakash Agarwal
- Homi Bhabha National Institute, Mumbai, India.,Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India.,Department of Medical Physics, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
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Das A, Mohanty S, Gharami RC, Chowdhury SN, Kumar P, Das NK, Bandyopadhyay D. Linear lesions in dermatology: a clinicoaetiopathological study. Clin Exp Dermatol 2021; 46:1452-1461. [PMID: 34022084 DOI: 10.1111/ced.14753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 05/15/2021] [Accepted: 05/18/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Linear lesions are fairly common in our daily practice. However, the appearance of these lesions can vary, thus complicating the diagnosis. AIMS To study the various clinical presentations, the demographic profile of patients and the clinicopathological correlations of dermatoses presenting with a linear distribution. METHODS We conducted an institution-based, cross-sectional, descriptive study of 281 consecutive patients with linear lesions attending dermatology clinics. MedCalc software (V11.6) was used for statistical analysis. RESULTS Patients were divided into eight groups: lesions along the lines of Blaschko (n = 136), lesions along blood vessels (n = 3), lesions along lymphatics (n = 3), Koebner phenomenon (n = 24), autoinoculation (n = 24), external factors (n = 45), infestations (n = 2) and 'other' (n = 44). The mean age at presentation was 24.50 ± 18.82 years and the male/female ratio was 1.32 : 1. The commonest symptom was itching/burning (56.94% of patients), while the commonest site was the arm (44.48%); followed by the leg (30.60%), trunk and abdomen (22.42%), head and neck (19.20%), and genitalia (0.35%). Apart from the common cases, there was a wide gamut of rare conditions (e.g. angiokeratoma circumscriptum naeviforme, porokeratotic eccrine ostial and dermal duct naevus, Blaschko-linear syringocystadenoma papilliferum, progressive cribriform and zosteriform hyperpigmentation, unilateral naevoid acanthosis nigricans, fixed drug eruption, discoid lupus erythematosus). CONCLUSION Linear lesions act as diagnostic clues to many dermatological conditions, therefore, the importance of meticulous examination in clinical dermatology cannot be overemphasized.
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Affiliation(s)
- A Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - S Mohanty
- Department of Dermatology, ERA's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India
| | - R C Gharami
- Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India
| | - S N Chowdhury
- Department of Dermatology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India
| | - P Kumar
- Department of Dermatology, Katihar Medical College and Hospital, Katihar, Bihar, India
| | - N K Das
- Department of Dermatology, Bankura Sammilani Medical College and Hospital, Bankura, West Bengal, India
| | - D Bandyopadhyay
- Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India
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Bajpai J, Pradeep V, Nandhana R, Mohanty S, Chougle Q, Engineer M, Rath S, Joshi S, Wadasadawala T, Popat P, Pathak R, Gulia S, Ghosh J, Bhargava P, Srinivas S, Shet T, Sarin R, Badwe R, Gupta S. 162P Unique challenges and outcomes of young breast cancers from a tertiary care cancer centre in India. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Teramoto Y, Uehara S, Masuda M, Adachi I, Aihara H, Al Said S, Asner DM, Atmacan H, Aushev T, Ayad R, Babu V, Behera P, Beleño C, Bennett J, Bhardwaj V, Bhuyan B, Bilka T, Biswal J, Bonvicini G, Bozek A, Bračko M, Browder TE, Campajola M, Červenkov D, Chang MC, Chang P, Chekelian V, Chen A, Cheon BG, Chilikin K, Cho K, Cho SJ, Choi SK, Choi Y, Choudhury S, Cinabro D, Cunliffe S, De Nardo G, Di Capua F, Doležal Z, Dong TV, Eidelman S, Ferber T, Fulsom BG, Garg R, Gaur V, Gabyshev N, Garmash A, Giri A, Goldenzweig P, Greenwald D, Hadjivasiliou C, Hara T, Hartbrich O, Hayasaka K, Hayashii H, Hedges MT, Hernandez Villanueva M, Hou WS, Hsu CL, Iijima T, Inami K, Inguglia G, Ishikawa A, Itoh R, Iwasaki M, Iwasaki Y, Jacobs WW, Jang EJ, Jia S, Jin Y, Joo CW, Joo KK, Kahn J, Kaliyar AB, Kang KH, Karyan G, Kato Y, Kawasaki T, Kichimi H, Kiesling C, Kim BH, Kim DY, Kim SH, Kim YK, Kimmel TD, Kinoshita K, Kodyš P, Korpar S, Kotchetkov D, Križan P, Kroeger R, Krokovny P, Kuhr T, Kulasiri R, Kumar R, Kumara K, Kuzmin A, Kwon YJ, Lalwani K, Lange JS, Lee IS, Lee SC, Lewis P, Li LK, Li YB, Li Gioi L, Libby J, Lieret K, Liptak Z, Liventsev D, Luo T, MacQueen C, Matsuda T, Matvienko D, Merola M, Miyabayashi K, Miyata H, Mohanty GB, Mohanty S, Moon TJ, Mori T, Mrvar M, Mussa R, Nakano E, Nakao M, Nakazawa H, Natkaniec Z, Natochii A, Nayak M, Nisar NK, Nishida S, Ogawa K, Ogawa S, Ono H, Onuki Y, Pakhlov P, Pakhlova G, Pardi S, Park H, Park SH, Patra S, Paul S, Pedlar TK, Pestotnik R, Piilonen LE, Podobnik T, Popov V, Prencipe E, Prim MT, Ritter M, Rostomyan A, Rout N, Russo G, Sahoo D, Sakai Y, Sandilya S, Sangal A, Santelj L, Sanuki T, Savinov V, Schnell G, Schueler J, Schwanda C, Seino Y, Senyo K, Sevior ME, Shapkin M, Shebalin V, Shiu JG, Singh JB, Solovieva E, Starič M, Stottler ZS, Sumihama M, Sumisawa K, Sumiyoshi T, Sutcliffe W, Takizawa M, Tamponi U, Tenchini F, Uchida M, Uglov T, Unno Y, Uno S, Urquijo P, Usov Y, Van Tonder R, Varner G, Vinokurova A, Vorobyev V, Waheed E, Wang CH, Wang E, Wang MZ, Wang P, Wang XL, Watanabe M, Won E, Xu X, Yabsley BD, Yang SB, Ye H, Yelton J, Yin JH, Zhang ZP, Zhilich V, Zhukova V, Zhulanov V. Evidence for X(3872)→J/ψπ^{+}π^{-} Produced in Single-Tag Two-Photon Interactions. Phys Rev Lett 2021; 126:122001. [PMID: 33834793 DOI: 10.1103/physrevlett.126.122001] [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] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 12/14/2020] [Accepted: 02/22/2021] [Indexed: 06/12/2023]
Abstract
We report the first evidence for X(3872) production in two-photon interactions by tagging either the electron or the positron in the final state, exploring the highly virtual photon region. The search is performed in e^{+}e^{-}→e^{+}e^{-}J/ψπ^{+}π^{-}, using 825 fb^{-1} of data collected by the Belle detector operated at the KEKB e^{+}e^{-} collider. We observe three X(3872) candidates, where the expected background is 0.11±0.10 events, with a significance of 3.2σ. We obtain an estimated value for Γ[over ˜]_{γγ}B(X(3872)→J/ψπ^{+}π^{-}) assuming the Q^{2} dependence predicted by a cc[over ¯] meson model, where -Q^{2} is the invariant mass squared of the virtual photon. No X(3915)→J/ψπ^{+}π^{-} candidates are found.
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Affiliation(s)
| | - S Uehara
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - M Masuda
- Research Center for Nuclear Physics, Osaka University, Osaka 567-0047
- Earthquake Research Institute, University of Tokyo, Tokyo 113-0032
| | - I Adachi
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - H Aihara
- Department of Physics, University of Tokyo, Tokyo 113-0033
| | - S Al Said
- Department of Physics, Faculty of Science, King Abdulaziz University, Jeddah 21589
- Department of Physics, Faculty of Science, University of Tabuk, Tabuk 71451
| | - D M Asner
- Brookhaven National Laboratory, Upton, New York 11973
| | - H Atmacan
- University of Cincinnati, Cincinnati, Ohio 45221
| | - T Aushev
- Higher School of Economics (HSE), Moscow 101000
| | - R Ayad
- Department of Physics, Faculty of Science, University of Tabuk, Tabuk 71451
| | - V Babu
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - P Behera
- Indian Institute of Technology Madras, Chennai 600036
| | - C Beleño
- II. Physikalisches Institut, Georg-August-Universität Göttingen, 37073 Göttingen
| | - J Bennett
- University of Mississippi, University, Mississippi 38677
| | - V Bhardwaj
- Indian Institute of Science Education and Research Mohali, SAS Nagar, 140306
| | - B Bhuyan
- Indian Institute of Technology Guwahati, Assam 781039
| | - T Bilka
- Faculty of Mathematics and Physics, Charles University, 121 16 Prague
| | - J Biswal
- J. Stefan Institute, 1000 Ljubljana
| | - G Bonvicini
- Wayne State University, Detroit, Michigan 48202
| | - A Bozek
- H. Niewodniczanski Institute of Nuclear Physics, Krakow 31-342
| | - M Bračko
- J. Stefan Institute, 1000 Ljubljana
- University of Maribor, 2000 Maribor
| | - T E Browder
- University of Hawaii, Honolulu, Hawaii 96822
| | - M Campajola
- INFN-Sezione di Napoli, 80126 Napoli
- Università di Napoli Federico II, 80126 Napoli
| | - D Červenkov
- Faculty of Mathematics and Physics, Charles University, 121 16 Prague
| | - M-C Chang
- Department of Physics, Fu Jen Catholic University, Taipei 24205
| | - P Chang
- Department of Physics, National Taiwan University, Taipei 10617
| | - V Chekelian
- Max-Planck-Institut für Physik, 80805 München
| | - A Chen
- National Central University, Chung-li 32054
| | - B G Cheon
- Department of Physics and Institute of Natural Sciences, Hanyang University, Seoul 04763
| | - K Chilikin
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - K Cho
- Korea Institute of Science and Technology Information, Daejeon 34141
| | - S-J Cho
- Yonsei University, Seoul 03722
| | - S-K Choi
- Gyeongsang National University, Jinju 52828
| | - Y Choi
- Sungkyunkwan University, Suwon 16419
| | - S Choudhury
- Indian Institute of Technology Hyderabad, Telangana 502285
| | - D Cinabro
- Wayne State University, Detroit, Michigan 48202
| | - S Cunliffe
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - G De Nardo
- INFN-Sezione di Napoli, 80126 Napoli
- Università di Napoli Federico II, 80126 Napoli
| | - F Di Capua
- INFN-Sezione di Napoli, 80126 Napoli
- Università di Napoli Federico II, 80126 Napoli
| | - Z Doležal
- Faculty of Mathematics and Physics, Charles University, 121 16 Prague
| | - T V Dong
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE) and Institute of Modern Physics, Fudan University, Shanghai 200443
| | - S Eidelman
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
- Novosibirsk State University, Novosibirsk 630090
| | - T Ferber
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - B G Fulsom
- Pacific Northwest National Laboratory, Richland, Washington 99352
| | - R Garg
- Panjab University, Chandigarh 160014
| | - V Gaur
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061
| | - N Gabyshev
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - A Garmash
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - A Giri
- Indian Institute of Technology Hyderabad, Telangana 502285
| | - P Goldenzweig
- Institut für Experimentelle Teilchenphysik, Karlsruher Institut für Technologie, 76131 Karlsruhe
| | - D Greenwald
- Department of Physics, Technische Universität München, 85748 Garching
| | - C Hadjivasiliou
- Pacific Northwest National Laboratory, Richland, Washington 99352
| | - T Hara
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - O Hartbrich
- University of Hawaii, Honolulu, Hawaii 96822
| | | | | | - M T Hedges
- University of Hawaii, Honolulu, Hawaii 96822
| | | | - W-S Hou
- Department of Physics, National Taiwan University, Taipei 10617
| | - C-L Hsu
- School of Physics, University of Sydney, New South Wales 2006
| | - T Iijima
- Graduate School of Science, Nagoya University, Nagoya 464-8602
- Kobayashi-Maskawa Institute, Nagoya University, Nagoya 464-8602
| | - K Inami
- Graduate School of Science, Nagoya University, Nagoya 464-8602
| | - G Inguglia
- Institute of High Energy Physics, Vienna 1050
| | - A Ishikawa
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - R Itoh
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - M Iwasaki
- Osaka City University, Osaka 558-8585
| | - Y Iwasaki
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - W W Jacobs
- Indiana University, Bloomington, Indiana 47408
| | - E-J Jang
- Gyeongsang National University, Jinju 52828
| | - S Jia
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE) and Institute of Modern Physics, Fudan University, Shanghai 200443
| | - Y Jin
- Department of Physics, University of Tokyo, Tokyo 113-0033
| | - C W Joo
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), University of Tokyo, Kashiwa 277-8583
| | - K K Joo
- Chonnam National University, Gwangju 61186
| | - J Kahn
- Institut für Experimentelle Teilchenphysik, Karlsruher Institut für Technologie, 76131 Karlsruhe
| | - A B Kaliyar
- Tata Institute of Fundamental Research, Mumbai 400005
| | - K H Kang
- Kyungpook National University, Daegu 41566
| | - G Karyan
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - Y Kato
- Graduate School of Science, Nagoya University, Nagoya 464-8602
| | - T Kawasaki
- Kitasato University, Sagamihara 252-0373
| | - H Kichimi
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - C Kiesling
- Max-Planck-Institut für Physik, 80805 München
| | - B H Kim
- Seoul National University, Seoul 08826
| | - D Y Kim
- Soongsil University, Seoul 06978
| | - S H Kim
- Seoul National University, Seoul 08826
| | - Y-K Kim
- Yonsei University, Seoul 03722
| | - T D Kimmel
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061
| | - K Kinoshita
- University of Cincinnati, Cincinnati, Ohio 45221
| | - P Kodyš
- Faculty of Mathematics and Physics, Charles University, 121 16 Prague
| | - S Korpar
- J. Stefan Institute, 1000 Ljubljana
- University of Maribor, 2000 Maribor
| | | | - P Križan
- J. Stefan Institute, 1000 Ljubljana
- Faculty of Mathematics and Physics, University of Ljubljana, 1000 Ljubljana
| | - R Kroeger
- University of Mississippi, University, Mississippi 38677
| | - P Krokovny
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - T Kuhr
- Ludwig Maximilians University, 80539 Munich
| | - R Kulasiri
- Kennesaw State University, Kennesaw, Georgia 30144
| | - R Kumar
- Punjab Agricultural University, Ludhiana 141004
| | - K Kumara
- Wayne State University, Detroit, Michigan 48202
| | - A Kuzmin
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | | | - K Lalwani
- Malaviya National Institute of Technology Jaipur, Jaipur 302017
| | - J S Lange
- Justus-Liebig-Universität Gießen, 35392 Gießen
| | - I S Lee
- Department of Physics and Institute of Natural Sciences, Hanyang University, Seoul 04763
| | - S C Lee
- Kyungpook National University, Daegu 41566
| | - P Lewis
- University of Bonn, 53115 Bonn
| | - L K Li
- University of Cincinnati, Cincinnati, Ohio 45221
| | - Y B Li
- Peking University, Beijing 100871
| | - L Li Gioi
- Max-Planck-Institut für Physik, 80805 München
| | - J Libby
- Indian Institute of Technology Madras, Chennai 600036
| | - K Lieret
- Ludwig Maximilians University, 80539 Munich
| | - Z Liptak
- Hiroshima University, Hiroshima 739-8511
| | - D Liventsev
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
- Wayne State University, Detroit, Michigan 48202
| | - T Luo
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE) and Institute of Modern Physics, Fudan University, Shanghai 200443
| | - C MacQueen
- School of Physics, University of Melbourne, Victoria 3010
| | - T Matsuda
- University of Miyazaki, Miyazaki 889-2192
| | - D Matvienko
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
- Novosibirsk State University, Novosibirsk 630090
| | - M Merola
- INFN-Sezione di Napoli, 80126 Napoli
- Università di Napoli Federico II, 80126 Napoli
| | | | - H Miyata
- Niigata University, Niigata 950-2181
| | - G B Mohanty
- Tata Institute of Fundamental Research, Mumbai 400005
| | - S Mohanty
- Tata Institute of Fundamental Research, Mumbai 400005
- Utkal University, Bhubaneswar 751004
| | - T J Moon
- Seoul National University, Seoul 08826
| | - T Mori
- Graduate School of Science, Nagoya University, Nagoya 464-8602
| | - M Mrvar
- Institute of High Energy Physics, Vienna 1050
| | - R Mussa
- INFN-Sezione di Torino, 10125 Torino
| | - E Nakano
- Osaka City University, Osaka 558-8585
| | - M Nakao
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - H Nakazawa
- Department of Physics, National Taiwan University, Taipei 10617
| | - Z Natkaniec
- H. Niewodniczanski Institute of Nuclear Physics, Krakow 31-342
| | - A Natochii
- University of Hawaii, Honolulu, Hawaii 96822
| | - M Nayak
- School of Physics and Astronomy, Tel Aviv University, Tel Aviv 69978
| | - N K Nisar
- Brookhaven National Laboratory, Upton, New York 11973
| | - S Nishida
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - K Ogawa
- Niigata University, Niigata 950-2181
| | - S Ogawa
- Toho University, Funabashi 274-8510
| | - H Ono
- Nippon Dental University, Niigata 951-8580
- Niigata University, Niigata 950-2181
| | - Y Onuki
- Department of Physics, University of Tokyo, Tokyo 113-0033
| | - P Pakhlov
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
- Moscow Physical Engineering Institute, Moscow 115409
| | - G Pakhlova
- Higher School of Economics (HSE), Moscow 101000
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - S Pardi
- INFN-Sezione di Napoli, 80126 Napoli
| | - H Park
- Kyungpook National University, Daegu 41566
| | | | - S Patra
- Indian Institute of Science Education and Research Mohali, SAS Nagar, 140306
| | - S Paul
- Max-Planck-Institut für Physik, 80805 München
- Department of Physics, Technische Universität München, 85748 Garching
| | | | | | - L E Piilonen
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061
| | - T Podobnik
- J. Stefan Institute, 1000 Ljubljana
- Faculty of Mathematics and Physics, University of Ljubljana, 1000 Ljubljana
| | - V Popov
- Higher School of Economics (HSE), Moscow 101000
| | | | - M T Prim
- Institut für Experimentelle Teilchenphysik, Karlsruher Institut für Technologie, 76131 Karlsruhe
| | - M Ritter
- Ludwig Maximilians University, 80539 Munich
| | - A Rostomyan
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - N Rout
- Indian Institute of Technology Madras, Chennai 600036
| | - G Russo
- Università di Napoli Federico II, 80126 Napoli
| | - D Sahoo
- Tata Institute of Fundamental Research, Mumbai 400005
| | - Y Sakai
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - S Sandilya
- University of Cincinnati, Cincinnati, Ohio 45221
| | - A Sangal
- University of Cincinnati, Cincinnati, Ohio 45221
| | - L Santelj
- J. Stefan Institute, 1000 Ljubljana
- Faculty of Mathematics and Physics, University of Ljubljana, 1000 Ljubljana
| | - T Sanuki
- Department of Physics, Tohoku University, Sendai 980-8578
| | - V Savinov
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260
| | - G Schnell
- University of the Basque Country UPV/EHU, 48080 Bilbao
- IKERBASQUE, Basque Foundation for Science, 48013 Bilbao
| | - J Schueler
- University of Hawaii, Honolulu, Hawaii 96822
| | - C Schwanda
- Institute of High Energy Physics, Vienna 1050
| | - Y Seino
- Niigata University, Niigata 950-2181
| | - K Senyo
- Yamagata University, Yamagata 990-8560
| | - M E Sevior
- School of Physics, University of Melbourne, Victoria 3010
| | - M Shapkin
- Institute for High Energy Physics, Protvino 142281
| | - V Shebalin
- University of Hawaii, Honolulu, Hawaii 96822
| | - J-G Shiu
- Department of Physics, National Taiwan University, Taipei 10617
| | - J B Singh
- Panjab University, Chandigarh 160014
| | - E Solovieva
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - M Starič
- J. Stefan Institute, 1000 Ljubljana
| | - Z S Stottler
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061
| | | | - K Sumisawa
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - T Sumiyoshi
- Tokyo Metropolitan University, Tokyo 192-0397
| | | | - M Takizawa
- J-PARC Branch, KEK Theory Center, High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
- Showa Pharmaceutical University, Tokyo 194-8543
| | - U Tamponi
- INFN-Sezione di Torino, 10125 Torino
| | - F Tenchini
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - M Uchida
- Tokyo Institute of Technology, Tokyo 152-8550
| | - T Uglov
- Higher School of Economics (HSE), Moscow 101000
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - Y Unno
- Department of Physics and Institute of Natural Sciences, Hanyang University, Seoul 04763
| | - S Uno
- SOKENDAI (The Graduate University for Advanced Studies), Hayama 240-0193
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - P Urquijo
- School of Physics, University of Melbourne, Victoria 3010
| | - Y Usov
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | | | - G Varner
- University of Hawaii, Honolulu, Hawaii 96822
| | - A Vinokurova
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - V Vorobyev
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
- Novosibirsk State University, Novosibirsk 630090
| | - E Waheed
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801
| | - C H Wang
- National United University, Miao Li 36003
| | - E Wang
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260
| | - M-Z Wang
- Department of Physics, National Taiwan University, Taipei 10617
| | - P Wang
- Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049
| | - X L Wang
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE) and Institute of Modern Physics, Fudan University, Shanghai 200443
| | | | - E Won
- Korea University, Seoul 02841
| | - X Xu
- Soochow University, Suzhou 215006
| | - B D Yabsley
- School of Physics, University of Sydney, New South Wales 2006
| | | | - H Ye
- Deutsches Elektronen-Synchrotron, 22607 Hamburg
| | - J Yelton
- University of Florida, Gainesville, Florida 32611
| | - J H Yin
- Korea University, Seoul 02841
| | - Z P Zhang
- Department of Modern Physics and State Key Laboratory of Particle Detection and Electronics, University of Science and Technology of China, Hefei 230026
| | - V Zhilich
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
| | - V Zhukova
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Moscow 119991
| | - V Zhulanov
- Budker Institute of Nuclear Physics SB RAS, Novosibirsk 630090
- Novosibirsk State University, Novosibirsk 630090
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Mohanty S, Dabas J, Verma A, Gupta S, Urs AB, Hemavathy S. Surgical management of the odontogenic keratocyst: A 20-year experience. Int J Oral Maxillofac Surg 2021; 50:1168-1176. [PMID: 33663899 DOI: 10.1016/j.ijom.2021.02.015] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 12/31/2020] [Accepted: 02/09/2021] [Indexed: 10/22/2022]
Abstract
The objective of this study was to describe the authors' long-term experience with the management of odontogenic keratocysts (OKCs). All OKC cases treated at the study centre between 1999 and 2015, with a minimum of 5 years of follow-up by December 2019, were reviewed retrospectively. Operative procedures including decompression/marsupialization, enucleation (E), E+Carnoy's solution (CS), E+CS+peripheral ostectomy (PO), and resection were assessed for complete resolution, partial resolution, and recurrence rates. In the parakeratinized non-syndromic group, E+CS+PO resulted in the lowest recurrence rate among the minimally invasive procedures (4.3%), while enucleation resulted in the highest rate (60%). Regarding the other modalities, recurrence was 12.5% for decompression, 11.5% for marsupialization, 16.7% for E+CS, 26.7% for E+PO, and 0% for resection. In the syndromic group, marsupialization resulted in a significantly higher recurrence (23.1%), while E+CS+PO cases showed no recurrence. No recurrence was observed in the orthokeratinized group patients treated with marsupialization or with E+CS. Based on clinico-radiographic features and observed results, it is concluded that OKC, although having a high recurrence rate, is a benign lesion and responds well to conservative procedures in most cases. Radical procedures should be reserved for unresponsive lesions and those with extensive tissue destruction.
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Affiliation(s)
- S Mohanty
- Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, New Delhi, India.
| | - J Dabas
- Department of Oral and Maxillofacial Surgery, Bensups Hospital, New Delhi, India.
| | - A Verma
- Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, New Delhi, India.
| | - S Gupta
- Department of Oral Medicine and Radiology, Maulana Azad Institute of Dental Sciences, New Delhi, India.
| | - A B Urs
- Department of Oral and Maxillofacial Pathology, Maulana Azad Institute of Dental Sciences, New Delhi, India.
| | - S Hemavathy
- Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, New Delhi, India.
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Andama A, Jaganath D, Crowder R, Asege L, Nakaye M, Katumba D, Mukwatamundu J, Mwebe S, Semitala CF, Worodria W, Joloba M, Mohanty S, Somoskovi A, Cattamanchi A. The transition to Xpert MTB/RIF ultra: diagnostic accuracy for pulmonary tuberculosis in Kampala, Uganda. BMC Infect Dis 2021; 21:49. [PMID: 33430790 PMCID: PMC7802232 DOI: 10.1186/s12879-020-05727-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 12/21/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) has endorsed the next-generation Xpert MTB/RIF Ultra (Ultra) cartridge, and Uganda is currently transitioning from the older generation Xpert MTB/RIF (Xpert) cartridge to Ultra as the initial diagnostic test for pulmonary tuberculosis (TB). We assessed the diagnostic accuracy of Ultra for pulmonary TB among adults in Kampala, Uganda. METHODS We sampled adults referred for Xpert testing at two hospitals and a health center over a 12-month period. We enrolled adults with positive Xpert and a random 1:1 sample with negative Xpert results. Expectorated sputum was collected for Ultra, and for solid and liquid culture testing for Xpert-negative patients. We measured sensitivity and specificity of Ultra overall and by HIV status, prior history of TB, and hospitalization, in reference to Xpert and culture results. We also assessed how classification of results in the new "trace" category affects Ultra accuracy. RESULTS Among 698 participants included, 211 (30%) were HIV-positive and 336 (48%) had TB. The sensitivity of Ultra was 90.5% (95% CI 86.8-93.4) and specificity was 98.1% (95% CI 96.1-99.2). There were no significant differences in sensitivity and specificity by HIV status, prior history of TB or hospitalization. Xpert and Ultra results were concordant in 670 (96%) participants, with Ultra having a small reduction in specificity (difference 1.9, 95% CI 0.2 to 3.6, p=0.01). When "trace" results were considered positive for all patients, sensitivity increased by 2.1% (95% CI 0.3 to 3.9, p=0.01) without a significant reduction in specificity (- 0.8, 95% CI - 0.3 to 2.0, p=0.08). CONCLUSIONS After 1 year of implementation, Ultra had similar performance to Xpert. Considering "trace" results to be positive in all patients increased case detection without significant loss of specificity. Longitudinal studies are needed to compare the benefit of greater diagnoses to the cost of overtreatment.
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Affiliation(s)
- A Andama
- Department of Internal Medicine, Makerere University College of Health Sciences, Ground Floor Pathology Building, Room A4, Kampala, Uganda. .,Infectious Diseases Research Collaboration, Kampala, Uganda.
| | - D Jaganath
- Department of Medicine, Division of Pulmonary & Critical Care Medicine, University of California San Francisco, San Francisco, California, USA.,Center for Tuberculosis, University of California San Francisco, San Francisco, California, USA.,Department of Pediatrics, Division of Pediatric Infectious Diseases, University of California San Francisco, San Francisco, California, USA
| | - R Crowder
- Department of Medicine, Division of Pulmonary & Critical Care Medicine, University of California San Francisco, San Francisco, California, USA.,Center for Tuberculosis, University of California San Francisco, San Francisco, California, USA
| | - L Asege
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - M Nakaye
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - D Katumba
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - J Mukwatamundu
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - S Mwebe
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - C F Semitala
- Department of Internal Medicine, Makerere University College of Health Sciences, Ground Floor Pathology Building, Room A4, Kampala, Uganda.,Infectious Diseases Research Collaboration, Kampala, Uganda
| | - W Worodria
- Department of Internal Medicine, Makerere University College of Health Sciences, Ground Floor Pathology Building, Room A4, Kampala, Uganda.,Mulago National Referral Hospital, Kampala, Uganda
| | - M Joloba
- Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda
| | - S Mohanty
- Department of Chemical Engineering, Department of Materials Science Engineering, University of Utah, Salt Lake City, USA
| | - A Somoskovi
- Global Good Intellectual Ventures Laboratory, Seattle, USA
| | - A Cattamanchi
- Department of Medicine, Division of Pulmonary & Critical Care Medicine, University of California San Francisco, San Francisco, California, USA.,Center for Tuberculosis, University of California San Francisco, San Francisco, California, USA.,Center for Vulnerable Populations, Department of Medicine, University of California San Francisco, San Francisco, USA.,Curry International Tuberculosis Center, University of California San Francisco, San Francisco, USA
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Champati BB, Jena S, Ray A, Padhiari BM, Haldar T, Mohanty S, Sahoo A, Kar B, Ghosh B, Nayak S. Quality Control and Discrimination of Andrographis paniculata (Burm. f.) Nees based on High Performance Liquid Chromatography Fingerprinting Combined with Chemometric Approaches. Indian J Pharm Sci 2021. [DOI: 10.36468/pharmaceutical-sciences.868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Li Y, Jia S, Shen C, Adachi I, Aihara H, Al Said S, Asner D, Aushev T, Ayad R, Babu V, Bahinipati S, Behera P, Belous K, Bennett J, Bessner M, Bhardwaj V, Bhuyan B, Bilka T, Biswal J, Bonvicini G, Bozek A, Bračko M, Browder T, Campajola M, Červenkov D, Chang MC, Chang P, Chen A, Cheon B, Chilikin K, Cho K, Cho SJ, Choi SK, Choi Y, Choudhury S, Cinabro D, Cunliffe S, Das S, Dash N, De Nardo G, Di Capua F, Dingfelder J, Doležal Z, Dong T, Eidelman S, Epifanov D, Ferber T, Fulsom B, Garg R, Gaur V, Garmash A, Giri A, Goldenzweig P, Guan Y, Hadjivasiliou C, Hartbrich O, Hayasaka K, Hayashii H, Hedges M, Hou WS, Hsu CL, Inami K, Inguglia G, Ishikawa A, Itoh R, Iwasaki M, Iwasaki Y, Jacobs W, Jeon H, Jin Y, Joo C, Joo K, Kaliyar A, Kang K, Karyan G, Kawasaki T, Kiesling C, Kim D, Kim KH, Kim S, Kim YK, Kinoshita K, Kodyš P, Konno T, Korpar S, Kotchetkov D, Križan P, Kroeger R, Krokovny P, Kuhr T, Kulasiri R, Kumar M, Kumar R, Kumara K, Kwon YJ, Lalwani K, Lange J, Lee I, Lee S, Li C, Li J, Li L, Li Y, Li Gioi L, Libby J, Lieret K, Liptak Z, MacQueen C, Masuda M, Matsuda T, Matvienko D, Merola M, Miyabayashi K, Miyata H, Mizuk R, Mohanty G, Mohanty S, Mori T, Mussa R, Nakao M, Natkaniec Z, Natochii A, Nayak L, Nayak M, Niiyama M, Nisar N, Nishida S, Ono H, Onuki Y, Oskin P, Pakhlov P, Pakhlova G, Pang T, Pardi S, Park H, Park SH, Patra S, Paul S, Pedlar T, Pestotnik R, Piilonen L, Podobnik T, Popov V, Prencipe E, Prim M, Ritter M, Röhrken M, Rostomyan A, Rout N, Russo G, Sahoo D, Sakai Y, Sandilya S, Sangal A, Santelj L, Sanuki T, Savinov V, Schnell G, Schueler J, Schwanda C, Seino Y, Senyo K, Sevior M, Shapkin M, Sharma C, Shiu JG, Shwartz B, Sokolov A, Solovieva E, Starič M, Stottler Z, Sumihama M, Sumisawa K, Sumiyoshi T, Sutcliffe W, Takizawa M, Tamponi U, Tanida K, Tenchini F, Uchida M, Uglov T, Unno Y, Uno S, Vahsen S, Van Tonder R, Varner G, Vinokurova A, Vorobyev V, Wang C, Wang E, Wang MZ, Wang P, Watanabe M, Watanuki S, Won E, Xu X, Yabsley B, Yan W, Yang S, Ye H, Yelton J, Yin J, Yuan C, Zhang Z, Zhilich V, Zhukova V, Zhulanov V. Search for a doubly charged
DDK
bound state in
ϒ(1S, 2S)
inclusive decays and via direct production in
e+e−
collisions at
s=10.520
, 10.580, and 10.867 GeV. Int J Clin Exp Med 2020. [DOI: 10.1103/physrevd.102.112001] [Citation(s) in RCA: 4] [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: 11/07/2022]
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Mohanty S, Trivedi C, Della Rocca D, Gianni C, Salwan A, Macdonald B, Mayedo A, Bassiouny M, Gallinghouse G, Burkhardt J, Horton R, Al-Ahmad A, Di Biase L, Natale A. Risk factors for progression of paroxysmal to persistent atrial fibrillation following successful PV isolation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0592] [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
Progression from paroxysmal (PAF) to persistent atrial fibrillation (PerAF) following effective PV isolation (PVI) has important clinical implications, as it is relevant for subsequent management of the arrhythmia.
Objective
We evaluated risk factors responsible for progression of PAF to PerAF following successful PVI.
Methods
Consecutive AF patients that received their first catheter ablation as well as the first redo at our center were identified (n=1352). Patients were included in group 1 if the diagnosis was PAF at both first and redo procedure (PAF to PAF) and group 2 if PAF at index progressed to PerAF at redo. All patients received PVI plus isolation of LA posterior wall and SVC at the first procedure.
Results
A total of 822 patients remained as PAF at redo, whereas 530 (39%) progressed from PAF to PerAF. Clinical characteristics of the study population are presented in table 1. In multivariate analysis, BMI (OR 1.02, 1.01–1.04, p=0.04), hypertension (1.4, 1.08–1.8, p=0.01), heart failure (1.67, 1.03–2.69, p=0.03), LA size (2.75, 2.29–3.31, p<0.001) were independent predictors of progression of PAF to PerAF. Data on serum-transthyretin level was available for 37 and 48 patients in group 1 and 2 respectively. It was <18 mg/dL (normal) in 33 (68.7%) patients in group 2 vs 6 (16.2%) in group 1 (p<0.001).
Conclusion
In our patients, after successful PVI, progression of PAF to PerAF was mediated by independent risk factors such as high BMI, heart failure, hypertension, larger LA size and lower LVEF.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Mohanty
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Trivedi
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - D.G Della Rocca
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Gianni
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Salwan
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - B Macdonald
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Mayedo
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - M Bassiouny
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - G.J Gallinghouse
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - J.D Burkhardt
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - R Horton
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Al-Ahmad
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - L.D Di Biase
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Natale
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
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Mohanty S, Trivedi C, Della Rocca D, Gianni C, Salwan A, Macdonald B, Mayedo A, Bassiouny M, Gallinghouse J, Burkhardt J, Horton R, Al-Ahmad A, Di Biase L, Natale A. Extended Pulmonary Vein Isolation: is it sufficient to achieve long-term sinus rhythm in octogenarian women with atrial fibrillation? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0585] [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: 11/12/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is a disease of the elderly and women typically present with AF at an older age than men do. Moreover, they tend to experience more symptoms and post-ablation recurrences, have worse quality of life and increased risk of stroke and mortality.
Objective
We evaluated long-term efficacy of our standard ablation approach of extended pulmonary vein isolation (PVI) in octogenarian women undergoing their first AF ablation.
Methods
Consecutive female AF patients aged ≥80 years receiving their first catheter ablation at our center were included in the analysis. Our standard ablation approach at the first procedure includes PVI + empirical isolation of left atrial posterior wall (LAPW) and superior vena cava (SVC). Complete abolition of all potentials rather than decrease in amplitudes was the procedural end point. Patients were prospectively monitored at regular intervals for 3 years after the index procedure with event recorders, 12-lead ECG, cardiology evaluation at office visits and 7-day Holter monitoring.
Results
A total of 194 patients with mean age of 84.2±1.4 years were included in the analysis. Of the 194, 120 (61.8%) had non-paroxysmal AF. All received PVI+ isolation of LAPW and SVC. Acute procedural success was achieved in 100% of cases.
At 3 years of follow-up, 24 (12.4%) patients remained in sinus rhythm; 22 on- and 2 off-antiarrhythmic drugs (AAD). All of the 23 patients had paroxysmal AF as their initial diagnosis.
Of the 170 patients experiencing recurrence, 147 underwent repeat ablation. PV/PW/SVC reconnection was noted in only 6 (4.1%) patients at redo. Triggers originating from non-PV sites were targeted for ablation in all. At 1.5 years after the repeat procedure, 136 (92.5%) patients were in sinus rhythm; 131 off-AAD and 5 patients on-AAD.
Conclusion
Extended PVI including isolation of posterior wall and SVC was not sufficient to maintain long-term sinus rhythm in majority of octogenarian women, regardless of AF type. Moreover, non-PV triggers rather than PV reconnection was the major cause of recurrence in this subset of AF population.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Mohanty
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Trivedi
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - D.G Della Rocca
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Gianni
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Salwan
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - B Macdonald
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Mayedo
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - M Bassiouny
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - J.G Gallinghouse
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - J.D Burkhardt
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - R Horton
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Al-Ahmad
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - L Di Biase
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Natale
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
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Barik S, Panda N, C P, N G, Moharana P, Sahni K, Priyadarsini I, Mohanty S, A S, Meher R. PO-0830: Observation versus Adjuvant Radiotherapy in Early Stage Head and Neck Cancer of Oral Cavity. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00847-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mohanty S, Trivedi C, Della Rocca D, Gianni C, Salwan A, Macdonald B, Mayedo A, Bassiouny M, Gallinghouse G, Burkhardt J, Horton R, Al-Ahmad A, Natale A. Risk factors and effective ablation strategy in patients presenting with left atrial flutter with no previous ablation for atrial fibrillation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0590] [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
A typical left atrial flutter (LAFL) may occur as a proarrhythmic complication of ablation for atrial fibrillation (AF).
Objective
We evaluated the risk factors and the best ablation strategy for LAFL in patients with no prior AF ablation.
Methods
Consecutive patients undergoing first catheter ablation for AFL with no prior procedure for AF were included in this prospective analysis. Based on the ablation strategy, patients were divided into, Group 1: PVI+ Flutter ablation (ablation of re-entry circuits) and Group 2: PVI+ Non-PV trigger ablation (targeting areas of focal activity as triggers). 3-D mapping of the LA was performed during tachycardia to identify the reentrant circuit.
PV isolation was performed in all patients. In group 1, ablation line was chosen to transect the area critical for the circuit (roof and mitral line). In group 2, ectopic beats arising from extra-PV foci detected by isoproterenol challenge were ablated. Off-drug success rate was assessed in all.
Results
A total of 92 and 90 patients were included in group 1 and 2 respectively. Baseline characteristics are provided in table 1. Pre-existent LA scar was detected in 91.3% and 90% of patients in group 1 and 2 respectively.
At 2 years of follow-up, 11/92 (12%) from group 1 and 60/90 (66.7%) from group 2 remained arrhythmia-free off-drugs (p<0.001). In the multivariate analysis, PVI +flutter ablation was detected to be associated with significantly high risk of recurrence [HR: 3.92 (95% CI: 2.52–6.1, p<0.001)]
Conclusion
In this series of patients presenting with LAFL with no earlier AF ablations, pre-existent left atrial scar was detected in majority of cases and PVI+ non-PV trigger ablation provided significantly better success rate than PVI+ flutter ablation.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Mohanty
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Trivedi
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - D.G Della Rocca
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - C Gianni
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Salwan
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - B Macdonald
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Mayedo
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - M Bassiouny
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - G.J Gallinghouse
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - J.D Burkhardt
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - R Horton
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Al-Ahmad
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
| | - A Natale
- St. David's Medical Center, Texas Cardiac Arrhythmia Institute, Austin, United States of America
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Mohanty S, Sukarom I, Mears G, Owusu-Edusei K, Hu T. PRS3 Health and Economic Burden Associated with 15-Valent Pneumococcal Conjugate Vaccine (V114) Serotypes in Children in Australia. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Mohanty S, Sukarom I, Owusu-Edusei K, Hu T. PIN18 Health and Economic Burden Associated with 15-Valent Pneumococcal Conjugate Vaccine (V114) Serotypes in Children in New Zealand. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.265] [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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Shewade HD, Gupta V, Satyanarayana S, Chadha SS, Pandurangan S, Mohanty S, Kumar AMV. History of household member with tuberculosis or related death in newly diagnosed patients in India. Public Health Action 2020; 10:53-56. [PMID: 32639482 DOI: 10.5588/pha.19.0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 03/07/2020] [Indexed: 11/10/2022] Open
Abstract
Among new smear-positive pulmonary tuberculosis (TB) patients aged ⩾15 years from marginalised populations in India, one in four had a history of a household member with TB and one in 10 had a TB-related death in the household. This contribution of household transmission to overall TB transmission provides evidence for a potential population-level benefit of TB preventive treatment for all household contacts (without active TB). Females with TB had a significantly higher household TB exposure than males. Targeted TB preventive treatment (if implemented in a phased manner) among female household contacts may be explored after considering other factors.
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Affiliation(s)
- H D Shewade
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.,The Union South-East Asia (USEA), New Delhi, India
| | - V Gupta
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - S S Chadha
- Foundation for Innovative New Diagnostics (FIND), New Delhi, India
| | | | - S Mohanty
- The Union South-East Asia (USEA), New Delhi, India
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.,The Union South-East Asia (USEA), New Delhi, India.,Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru, India
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Belem TS, Chaudhary B, Mohanty S, Mafi G, VanOverbeke D, Ramanathan R. Effect of Temperature on Oxymyoglobin and Metmyoglobin Denaturation Properties. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb.10832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
ObjectivesPremature browning is a condition where the interior of patty/steak will appears fully cooked before the temperature necessary to kill foodborne pathogens is reached. Previous research reported that approximately 50% of ground beef retailed in the US is susceptible to premature browning. Myoglobin form present in the interior of steak or patties determines the cooked color appearance. Although previous studies noted that myoglobin denaturation is primarily responsible for the cooked color appearance, limited knowledge is currently available about the effect of temperature on oxymyoglobin and metmyoglobin denaturation properties. The objective of the current study was to determine the effects of myoglobin forms on thermal stability using circular dichroism spectroscopy.Materials and MethodsOxymyoglobin and metmyoglobin solutions at pH 5.6 in 50 mM sodium phosphate buffer were incubated in a continuous heat increment water bath for 10 min. At specific temperature points (65, 71, 73, and 76°C), myoglobin denaturation was determined by changes in myoglobin concentration and by protein unfolding (fluorescence and absorbance) methods. The myoglobin thermal stability was also determined by circular dichroism spectroscopy. Changes in secondary protein structure were determined every 2°C from 52 to 92°C. The data were analyzed as completely randomized using the Mixed Procedure of SAS. A significance level of 0.05 was used to determine differences between means.ResultsOxymyoglobin had greater (p < 0.05) unfolding (as indicated by absorbance changes) than metmyoglobin at all temperatures. However, at 65, 71, and 73°C there were no differences (p > 0.05) in fluorescence intensities between myoglobin forms. Circular dichroism spectroscopy indicates that oxymyoglobin is more heat labile than metmyoglobin.ConclusionThe results indicate that oxymyoglobin had greater denaturation and unfolding than metmyoglobin. Use of appropriate myoglobin denaturation quantification technique will help characterize premature browning.
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Affiliation(s)
- T. S. Belem
- Oklahoma State University Animal & Food Sciences
| | | | | | - G. Mafi
- Oklahoma State University Animal & Food Sciences
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Mazunder S, Denzer M, Suman S, Mohanty S, Mafi G, VanOverbeke D, Ramanathan R. Myoglobin Modeling to Study Species-Specific Differences in the Distance Between Heme Iron and Proximal and Distal Histidines. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb.10818] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
ObjectivesSpecies-specific differences in amino acid sequence influence myoglobin redox properties. Previous studies reported that the number and location of histidine residues can influence myoglobin redox stability. However, limited knowledge is currently available on the species-specific differences in the distances between the proximal (His 93) and distal (His 64) histidines and the heme iron in myoglobin. The objective of the current research was to utilize homology-based modeling to determine the distances between the proximal and distal histidines and the heme iron in the myoglobins from beef, pork, goat, bison, sheep, water-buffalo, venison, and emu.Materials and MethodsThe homology-based modeling was conducted using the Iterative Threading Assembly Refinement server (I-TASSER), which identifies the homologous structure models of myoglobins (beef, pork, goat, bison, sheep, water-buffalo, venison, and emu) from Protein Data Bank (PDB) using an algorithm named Local Meta-Threading-Server. The secondary structure of the target protein was predicted based on sequence information from the Protein Secondary Structure PREDiction algorithm. The lowest free energy conformations of the proteins were determined by SPICKER (a clustering approach to identify near-native protein folds). Refinement of the low free energy conformations were done by using Fragment Guided Molecular Dynamics simulations and ModRefiner. Prediction of the ligand-binding site of the target proteins were made by COACH algorithm. The distances between histidines (His 64 and His 93) and the iron in the heme group in the predicted structure of eight different species were determined using PyMOL, a computer software used for molecular visualization.ResultsThe homology-based modeling has shown that despite having 80% sequence similarity and conserved histidine residues (His 64 and His 93), the distance between the distal histidine (His 64) and heme iron varied between 4.3–5.5 Angstrom. Pork myoglobin has the shortest distance, and beef myoglobin has the longest distance. The distance between the proximal histidine (His 93) to the heme varied between 1.9 to 3 Angstrom; sheep myoglobin had the shortest and bison had the longest.ConclusionThe results suggest that in addition to the inherent differences in muscle biochemistry, variations in myoglobin structure also contributes to species-specific differences in meat color.
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Affiliation(s)
| | - M. Denzer
- Oklahoma State University Animal & Food Sciences
| | - S. Suman
- University of Kentucky Animal & Food Sciences
| | | | - G. Mafi
- Oklahoma State University Animal & Food Sciences
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Kumar A, Patham B, Mohanty S, Nayak SK. Simulation-Based Approach for Probing Rheology-Processing-Structure Relationships in Foam Blow Molding. INT POLYM PROC 2019. [DOI: 10.3139/217.3801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AbstractThe broad objective of this work was to demonstrate a modelling and simulation framework for foam blow molding using commercially available simulation software. The simulation framework would have to account for the initial morphology of the foam, the relationship between the morphology and the rheological and deformation characteristics of the foam at high temperatures and high strains that are typically encountered during blow molding, and correlate the strains developed during blow molding to the morphological aspects in the resulting blow molded part. These aspects are addressed in this paper using simulations of uniaxial tensile deformation of a virtual representative volume element of a foam microstructure (rendered in DIGIMAT-FE) to derive the nonlinear tensile response of the foam at high temperatures (using ABAQUS). The resulting simulated stress-strain curve is employed to parameterize a nonlinear rheological constitutive equation. These parameters are then employed for the homogenized representation of the foam in the blow molding simulation carried out in B-SIM, a commercially available simulation software for blow molding. The regions where the simulated parison has undergone primarily uniaxial elongation are then mapped back to the expected local foam morphology using the transfer functions derived from the RVE simulations. These steps result in a preliminary and simple demonstration of the simulation framework, and offer a template that can be detailed further with experimental rheological information on actual foamed parisons, and more detailed post-processing algorithms to correlate multiaxial elongations with microstructure.
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Affiliation(s)
- A. Kumar
- 1Central Institute of Plastics Engineering and Technology (CIPET), Chennai, India
| | - B. Patham
- 2SABIC Technology Centre, Bangalore, India
| | - S. Mohanty
- 3Laboratory for Advanced Research in Polymeric Materials (LARPM-CIPET), Bhubaneswar, India
| | - S. K. Nayak
- 1Central Institute of Plastics Engineering and Technology (CIPET), Chennai, India
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