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Sethi S, Ju X, Logan R, Hedges J, Garvey G, Jamieson L. Lip, oral and oropharyngeal cancer incidence among Aboriginal and Torres Strait Islander Peoples: First report from Australian population-based cancer registry, 1999-2018. Aust Dent J 2024. [PMID: 38469883 DOI: 10.1111/adj.13013] [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] [Accepted: 02/28/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND The Australian Burden of Disease Study has shown that cancer is the single most important entity responsible for the greatest cause of health burden in Australia. Unfortunately, Aboriginal and Torres Strait Islander peoples experience a greater burden of this disease, with cancer of the lung, breast, bowel and prostrate being the most common. Lip, oral cavity and pharyngeal cancer incidence is rapidly rising globally and is now the sixth most common cancer in Australia. This paper aims to summarize, for the first time, the incidence and prevalence trends of lip, oral cavity and pharyngeal cancers in Aboriginal and Torres Strait Islander Australians. METHODS Data were obtained from the Australian Cancer Database (ACD), which is compiled at the Australian Institute of Health and Welfare (AIHW) from 1999 to 2018 to estimate the incidence and prevalence of certain head and neck cancers (ICD-10 codes C00-C10, C14). The other variables requested were age groups and sex. RESULTS Results were stratified by ICD-10 code, sex and age group at diagnosis and time period (i.e. grouped years of diagnosis). The total incidence of lip, oral cavity and pharyngeal cancers increased by 1.3 times from 1999 to 2008 (107/100 000) to 2009-2018 (135/100 000). The overall 5-year prevalence of lip, oral cavity and pharyngeal cancers was 0.17% (0.24% for men and 0.09% for women). CONCLUSIONS The significantly increased incidence of lip, oral cavity and pharyngeal cancers in Aboriginal and Torres Strait Islander peoples in Australia is concerning and should be explored. A targeted, comprehensive and culturally safe model of care for Aboriginal and Torres Strait Islander peoples with lip, oral cavity and pharyngeal cancers is imperative.
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Affiliation(s)
- S Sethi
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - X Ju
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - R Logan
- Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - J Hedges
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - G Garvey
- Faculty of Medicine, School of Public Health, University of Queensland, Herston, Queensland, Australia
| | - L Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
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2
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Di Felice C, Sharma P, Matta M, Sethi S, Machuzak M, Young BP, Avasarala SK, Argento AC, Batra H, Akulian JA. The Need for Ergonomics Training in Interventional Pulmonary Fellowship. ATS Sch 2024; 5:45-52. [PMID: 38638917 PMCID: PMC11025561 DOI: 10.34197/ats-scholar.2023-0098br] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 10/24/2023] [Indexed: 04/20/2024] Open
Affiliation(s)
- Christopher Di Felice
- Department of Pulmonary and Critical Care
Medicine, Louis Stokes Cleveland Department of Veterans Affairs Medical Center,
Cleveland, Ohio
| | - Pallavi Sharma
- Department of Pulmonary and Critical Care
Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Maroun Matta
- Department of Pulmonary and Critical Care
Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Sonali Sethi
- Department of Pulmonary, Allergy, and
Critical Care Medicine, Respiratory Institute, Cleveland Clinic Foundation,
Cleveland, Ohio
| | - Michael Machuzak
- Department of Pulmonary, Allergy, and
Critical Care Medicine, Respiratory Institute, Cleveland Clinic Foundation,
Cleveland, Ohio
| | - Benjamin P. Young
- Department of Pulmonary and Critical Care
Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Sameer K. Avasarala
- Department of Pulmonary and Critical Care
Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - A. Christine Argento
- Section of Interventional Pulmonology,
Division of Pulmonary and Critical Care Medicine, The Johns Hopkins University
School of Medicine, Baltimore, Maryland
| | - Hitesh Batra
- Division of Pulmonary, Allergy, and
Critical Care Medicine, University of Alabama at Birmingham, Birmingham,
Alabama; and
| | - Jason A. Akulian
- Section of Interventional Pulmonology and
Pulmonary Oncology, Division of Pulmonary and Critical Care Medicine, University
of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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3
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Sachdeva A, Sethi S. Motivation and Learning: Leveraging Artificial Intelligence to Improve Bronchoscopy Performance. Chest 2024; 165:243-245. [PMID: 38336435 DOI: 10.1016/j.chest.2023.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 09/18/2023] [Indexed: 02/12/2024] Open
Affiliation(s)
- Ashutosh Sachdeva
- Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD.
| | - Sonali Sethi
- Pulmonary Department, Cleveland Clinic, Cleveland, OH
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4
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Shaller BD, Sethi S, Cicenia J. Imaging in peripheral bronchoscopy. Curr Opin Pulm Med 2024; 30:17-24. [PMID: 37933680 DOI: 10.1097/mcp.0000000000001028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
PURPOSE OF REVIEW Historically the sampling of peripheral lung lesions via bronchoscopy has suffered from inferior diagnostic outcomes relative to transthoracic needle aspiration, and neither a successful bronchoscopic navigation nor a promising radial ultrasonographic image of one's target lesion guarantees a successful biopsy. Fortunately, many of peripheral bronchoscopy's shortcomings - including an inability to detect and compensate for computed tomography (CT)-body divergence, and the absence of tool-in-lesion confirmation - are potentially remediable through the use of improved intraprocedural imaging techniques. RECENT FINDINGS Recent advances in intraprocedural imaging, including the integration of cone beam CT, digital tomosynthesis, and augmented fluoroscopy into bronchoscopic procedures have yielded promising results. These advanced imaging modalities may improve the outcomes of peripheral bronchoscopy through the detection and correction of navigational errors, CT-body divergence, and malpositioned biopsy instruments. SUMMARY The incorporation of advanced imaging is an essential step in the improvement of peripheral bronchoscopic procedures.
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Affiliation(s)
- Brian D Shaller
- Division of Pulmonary, Allergy and Critical Care Medicine, Stanford University School of Medicine, Stanford, California
| | - Sonali Sethi
- Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Joseph Cicenia
- Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, USA
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5
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Sethi S, Murgu S. Interventional Pulmonologists and Advanced Bronchoscopists in 2022 America: Who We Are and How Much We Earn. J Bronchology Interv Pulmonol 2023; 30:315-317. [PMID: 37784236 DOI: 10.1097/lbr.0000000000000939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Affiliation(s)
- Sonali Sethi
- Cleveland Clinic, Interventional Pulmonary, Cleveland, OH
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6
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Dang B, Gamage S, Sethi S, Jensen ED, Sambrook P, Goss A. The role of hyperbaric oxygen in osteoradionecrosis-a prophylactic insight. Aust Dent J 2023; 68:171-178. [PMID: 37345410 DOI: 10.1111/adj.12963] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Osteoradionecrosis (ORN) is an uncommon and debilitating consequence of head and neck radiotherapy and hyperbaric oxygen therapy (HBOT) has been advocated for prophylaxis prior to performing dentoalveolar procedures. The aim of this study was to evaluate a prophylactic HBOT protocol and describe the outcomes of susceptible individuals. METHODS A retrospective audit of adults who attended the Oral and Maxillofacial Surgery department at the Royal Adelaide Hospital (South Australia) who received dental extractions with a history of radiotherapy to the jaws from 2008 to 2020. Data including demographic information and outcomes of osteoradionecrosis and delayed healing was recorded. RESULTS A total of 121 individuals were eligible for case note review; 68.6% of individuals were male and 55.4% were aged over 67 years. Osteoradionecrosis occurred in 9.1% of individuals and delayed healing for 3.3%; fifteen individuals (12.4%) were unable to complete the HBOT protocol. The individuals who were diagnosed with ORN had a significant association with age (P = 0.006) and binary analysis showed alcohol consumption to be a significant predictor. CONCLUSIONS Prophylactic HBOT protocol had a lower proportion of individuals diagnosed with ORN and those who were diagnosed were more likely to be younger males and have current alcohol consumption.
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Affiliation(s)
- B Dang
- Oral and Maxillofacial Surgery Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - S Gamage
- Oral and Maxillofacial Surgery Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - S Sethi
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - E D Jensen
- Oral and Maxillofacial Surgery Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - P Sambrook
- Oral and Maxillofacial Surgery Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - A Goss
- Oral and Maxillofacial Surgery Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
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7
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Kristensen AE, Kurman JS, Hogarth DK, Sethi S, Sørensen SS. Systematic Review and Cost-Consequence Analysis of Ambu aScope 5 Broncho Compared with Reusable Flexible Bronchoscopes: Insights from Two US University Hospitals and an Academic Institution. Pharmacoecon Open 2023:10.1007/s41669-023-00417-y. [PMID: 37184625 PMCID: PMC10184637 DOI: 10.1007/s41669-023-00417-y] [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] [Accepted: 04/25/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVE The aim of this study was to perform a systematic review, meta-analysis and cost-consequence analysis of the single-use bronchoscope, Ambu aScopeTM 5 Broncho, in relation to reusable flexible bronchoscopes (RFB) available within three high procedure volume university hospitals and academic institutions in the USA. METHODS The primary outcome was incremental cost and the secondary outcome was incremental cross-infection risk of use for both the single-use flexible bronchoscope (SUFB) and RFBs. Cost estimates included capital, repair, and reprocessing costs derived from a prospective observational micro-costing approach within three large university hospitals and academic institutions. All costs were valued in 2022 US dollars (USD). A meta-analysis based on literature covering cross-contamination and infection from 2010 to 2020 investigated cross-infection risk following bronchoscopy procedures with RFBs. Capital costs were discounted at 3% over 5-8 years. All parameters were evaluated using both univariate deterministic and probabilistic sensitivity analyses. RESULTS In high-volume hospitals, RFBs were cost minimizing compared to SUFBs. Probabilistic sensitivity analysis showed that RFBs were cost saving in 88% of iterations. Univariate analyses illustrated sensitivity of the base-case result to the procedure volume. Data from sensitivity analyses suggest that the two interventions are cost neutral at a break-even point of 756 procedures per year or 46 procedures per bronchoscope per year. CONCLUSION Assuming equivalent clinical performance, single-use flexible bronchoscopes are not cost minimizing when including the costs associated with cross-infection in high-volume US university hospitals and academic institutions. Overall, the benefits of conversion from RFBs to SUFBs are dependent on the annual procedure volume of individual hospitals, expected cross-infection risk, and purchase price of the aScope 5 Broncho.
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Affiliation(s)
| | - Jonathan S Kurman
- Division of Pulmonary and Critical Care, Medical College of Wisconsin, Milwaukee, WI, USA
| | - D K Hogarth
- Section of Pulmonary and Critical Care Medicine/Interventional Pulmonology, Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Sonali Sethi
- Interventional Pulmonology, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sabrina S Sørensen
- Danish Center for Healthcare Improvements, Department of Clinical Medicine, Aalborg University, Aalborg Oest, Denmark
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8
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Smart G, Jensen ED, Poirier BF, Sethi S. The impact of enzyme replacement therapy on the oral health manifestations of hypophosphatasia among children: a scoping review. Eur Arch Paediatr Dent 2023:10.1007/s40368-023-00796-0. [PMID: 37036643 DOI: 10.1007/s40368-023-00796-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/22/2023] [Indexed: 04/11/2023]
Abstract
PURPOSE A scoping review to describe the use of enzyme replacement therapy (ERT) in the form of asfotase alfa to decrease the severity of oral manifestations in children with hypophosphatasia (HPP). METHODS Six databases were searched using keywords and index terms related to "hypophosphatasia," "children," and "enzyme replacement therapy." Duplicates were removed and two independent reviewers screened the titles and abstracts to identify articles for full-text review. Extracted data was summarised narratively. RESULTS The systematic search identified 3548 articles, with 171 suitable for full-text review and a final 22 that met inclusion criteria. Enzyme replacement therapy generally resulted in a reduction in the presence and severity of oral manifestations of HPP. However, numerous studies failed to report specific details regarding the nature of oral health outcomes and there were reported cases of further loss of primary teeth. CONCLUSIONS The available evidence suggests that that ERT in the form of asfotase alfa for HPP in infants and young children leads to improved oral health outcomes. It is recommended that the outcomes are improved with earlier initiation of ERT. Further, well-designed clinical research is required to assess oral health improvements and decreased morbidity associated with the early loss of teeth.
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Affiliation(s)
- G Smart
- Department of Paediatric Dentistry, Women's and Children's Hospital, 72 King William Road, North Adelaide, SA, 5006, Australia.
| | - E D Jensen
- Department of Paediatric Dentistry, Women's and Children's Hospital, 72 King William Road, North Adelaide, SA, 5006, Australia
- Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - B F Poirier
- Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - S Sethi
- Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
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9
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Dardik G, Ning Y, Kurlansky P, Sethi S, Berman E, Takeda K. Modified Body Mass Index But Not Conventional Body Mass Index Predicts Mortality after Pulmonary Thromboendarterectomy. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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10
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Persaud P, Morillas J, Budev M, Mukhopadhyay S, Sethi S, Almeida F, Lum J. Acrophialophora Anastomotic Site Infection in a Re-Do Lung Transplant Recipient with Cystic Fibrosis. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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11
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Jensen ED, Sethi S, Poirier BF, Meade MJ. Advertising and general dental practice: how compliant are practice websites in Australia with legal requirements? Aust Dent J 2023. [PMID: 36811194 DOI: 10.1111/adj.12953] [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] [Accepted: 02/15/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND The Australian Health Practitioner Regulation Agency (AHPRA) requires general dental practitioners (GDPs) to agree to regulatory advertising guidelines on initial registration and annual renewal. The aim of this study was to determine the compliance of GDPs websites to these requirements. METHODS A representative sample of GDPs websites from each state and territory in Australia was based on the total AHPRA registrant distribution. Assessment of compliance was used across five domains consisting of 17 criteria related to AHPRA's advertising of regulated health services guidelines, as well as section 133 of the National Law. Inter-rater reliability was estimated using Fleiss's Kappa. RESULTS One hundred and ninety-two GDPs websites were reviewed with 85% non-compliant with at least one of the legal and regulatory requirements relating to advertising. Of these websites, 52% displayed false and misleading information, 12.8% had offers and inducement without clear terms and conditions, 11.5% used written testimonials, 33.9% created unrealistic expectation of benefit and 39.6% encouraged indiscriminate and unnecessary use of health services. CONCLUSIONS More than 85% of GDP websites in Australia did not comply with legal and regulatory requirements related to advertising. A multi-stakeholder approach involving AHPRA, professional dental bodies and dental registrants is necessary to improve compliance.
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Affiliation(s)
- E D Jensen
- Adelaide Dental School, the University of Adelaide, Adelaide, South Australia, Australia
| | - S Sethi
- Adelaide Dental School, the University of Adelaide, Adelaide, South Australia, Australia
| | - B F Poirier
- Adelaide Dental School, the University of Adelaide, Adelaide, South Australia, Australia
| | - M J Meade
- PR Begg Chair in Orthodontics, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
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12
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Lim C, Jensen ED, Poirier BF, Sethi S, Smart G, Peña AS. Molar-incisor hypomineralisation prevalence in a cohort of Australian children with type 1 diabetes. Eur Arch Paediatr Dent 2023; 24:117-123. [PMID: 36348176 PMCID: PMC9992226 DOI: 10.1007/s40368-022-00765-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 10/27/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE Systemic diseases or drugs administered early in life may cause a disruption in amelogenesis and contribute to the qualitative defect of enamel described as molar-incisor hypomineralisation (MIH). Therefore, an increase in prevalence of MIH in children with type 1 diabetes (T1D) may be expected as this systemic disorder is commonly diagnosed in early childhood. The aim of this study was to determine the prevalence of MIH in a cohort of children with T1D and investigate diagnosis of MIH with T1D factors. METHODS Cross-sectional study of children with T1D recruited from paediatric diabetes clinics at the Women's and Children's Hospital (South Australia). A detailed medical history, comprehensive dental and MIH examination according to the European Academy of Paediatric Dentistry (EAPD) long form classification was collected for each child. All upper and lower first permanent molars and central incisors were scored. RESULTS A total number of 73 participants; 35 (47.95%) males were examined including 584 teeth. The mean age of the participants was 13.25 ± 2.58 years, with a mean age of diagnosis 7.75 ± 3.58 years, and a mean HbA1c of 8.5 ± 1.6%. 42 out of 73 children (54.8%) had enamel defects on at least one of the teeth examined. However, 19.2% met the criteria for MIH. Univariate and bivariate analyses were conducted but no significant associations were noted between MIH and risk factors including diabetes control (p > 0.1). CONCLUSION There was a high prevalence of enamel defects and MIH amongst children with T1D. More research is required to establish association between T1D and MIH.
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Affiliation(s)
- C Lim
- Adelaide Dental School, University of Adelaide, 4 North Terrace, Adelaide, SA, 5000, Australia
| | - E D Jensen
- Adelaide Dental School, University of Adelaide, 4 North Terrace, Adelaide, SA, 5000, Australia.
- Department of Paediatric Dentistry, Women's and Children's Hospital, Adelaide, SA, Australia.
| | - B F Poirier
- Adelaide Dental School, University of Adelaide, 4 North Terrace, Adelaide, SA, 5000, Australia
| | - S Sethi
- Adelaide Dental School, University of Adelaide, 4 North Terrace, Adelaide, SA, 5000, Australia
| | - G Smart
- Department of Paediatric Dentistry, Women's and Children's Hospital, Adelaide, SA, Australia
| | - A S Peña
- Discipline of Paediatrics and Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
- Department of Diabetes and Endocrinology, Women's and Children's Hospital, Adelaide, SA, Australia
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13
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Di Felice C, Alraiyes AH, Gillespie C, Machuzak M, Gildea TR, Sethi S, Cicenia J, Mehta AC, Almeida FA. Short-term Endoscopic Outcomes of Balloon and Rigid Bronchoplasty in the Management of Benign Subglottic and Tracheal Stenosis. J Bronchology Interv Pulmonol 2023; 30:54-59. [PMID: 35696593 DOI: 10.1097/lbr.0000000000000852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/01/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Endoscopic therapies are firmly established in the management algorithm of benign subglottic and tracheal stenosis (SGTS). The optimal dilation strategy, however, has yet to be elucidated. The objective of this study was to compare the efficacy and safety of balloon versus rigid bronchoplasty in the treatment of benign SGTS. METHODS De novo cases of benign SGTS at our institution over a 9-year period were retrospectively identified. Patients were divided into 2 groups based on the initial dilation strategy of balloon or rigid bronchoplasty. Demographics, clinical findings, concurrent interventions, lesion characteristics, and complications were analyzed. Two reviewers independently assigned an index and follow-up endoscopic stenosis grade for each case. The mean stenosis grade at follow-up in both groups was then calculated and compared. RESULTS Sixty-three patients with benign SGTS were included. Most stenoses in the rigid (80%) and balloon (63%) bronchoplasty groups were complex ( P =0.174). In addition, 94% (59/63) of index stenoses were classified as Cotton Myer Grade 3. At follow-up, no significant difference was found in the mean stenosis grade between dilation strategies (1.97 vs. 2.2, P =0.287). Furthermore, no procedural-related complications were observed in either group. CONCLUSION Balloon and rigid bronchoplasty are safe and effective endoscopic tools in the early management of benign SGTS. A multimodality approach centered around mucosal sparing techniques remains vitally important to the overall and likely long-term success of treating this challenging disease entity.
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Affiliation(s)
- Christopher Di Felice
- Division of Pulmonary, Critical Care, and Sleep Medicine, Case Western Reserve University
- Louis Stokes Cleveland Veterans Affairs Medical Center
| | - Abdul H Alraiyes
- Department of Medicine, Rosalind Franklin University, North Chicago, IL
| | - Colin Gillespie
- Department of Pulmonary, Allergy, and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - Michael Machuzak
- Department of Pulmonary, Allergy, and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - Thomas R Gildea
- Department of Pulmonary, Allergy, and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - Sonali Sethi
- Department of Pulmonary, Allergy, and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - Joseph Cicenia
- Department of Pulmonary, Allergy, and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - Atul C Mehta
- Department of Pulmonary, Allergy, and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - Francisco A Almeida
- Department of Pulmonary, Allergy, and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH
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14
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Verma AK, Sethi S, Kohli N. Partial anomalous pulmonary venous connection: state-of-the-art review with assessment using a multidetector computed tomography angiography. Pol J Radiol 2022; 87:e549-e556. [PMID: 36420124 PMCID: PMC9673975 DOI: 10.5114/pjr.2022.120513] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 02/21/2022] [Indexed: 03/21/2024] Open
Abstract
Pulmonary venous anomalies occur as a result of failure in normal embryological development. These anomalies may present as a spectrum ranging from normal variation to partial anomalous pulmonary venous connection (PAPVC) and total anomalous pulmonary venous connection (TAPVC). Though not rare, PAPVC is an uncommon anomaly in which some of the pulmonary veins abnormally connect and drain into the vascular compartments other than the left atrium (LA); however, the others drain normally into the LA. The clinical presentation and severity of affected patients depend on the morphological heterogeneity of the disease. PAPVC associated with other complex conge-nital cardiac diseases present early and are more severe than isolated PAPVC-associated atrial septal defect only. This radiological review gives a detailed description of PAPVC in terms of morphological variability and associated anomalies along with a discussion of the role of multidetector dual-source computed tomography scan in the diagnostic assessment.
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Affiliation(s)
- Amit Kumar Verma
- Department of Radiodiagnosis, King George’s Medical University, India
| | | | - Neera Kohli
- Department of Radiodiagnosis, King George’s Medical University, India
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15
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Gadde A, Jha P, Bansal S, Rana A, Bansal D, Yadav D, Jain M, Mahapatra A, Sethi S, Kher V. POS-095 ARE ABO INCOMPATIBLE KIDNEY TRANSPLANT RECIPIENTS AT HIGHER RISK OF INFECTIONS?-A SINGLE CENTER EXPERIENCE. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.07.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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16
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Abstract
OBJECTIVE Although the elderly population remains at high risk for tuberculosis, studies addressing tuberculous meningitis (TBM) in this age group are scarce. The present study aimed to evaluate the spectrum and outcome of geriatric TBM and document differences between older and young patients. METHODS A prospective cohort study was conducted in the adult TBM patients admitted at PGIMER, Chandigarh (India). Consecutive older patients aged 60 years and above were enrolled from January 2019 to December 2020, and young adults aged 18-59 years were enrolled from July 2019 to December 2019. RESULTS Fifty-five older patients with a mean age of 66.6 years and 73 young patients with a mean age of 35.1 years were enrolled. At admission, older patients were more likely to have altered mental status (96.4% vs. 78.1%, P = 0.003) and advanced disease with British medical research council staging 2 or 3 (98.2% vs. 89.0%, P = 0.043); however, headache (38.2% vs. 67.1%, P = 0.001), vomiting (18.2% vs. 35.6%, P = 0.030) and fever (80.0% vs. 91.8%, P = 0.052) were less common. Cerebrospinal fluid (CSF) abnormalities were less marked in older patients, with a significant difference in median total cells (70 vs. 110/µl, P = 0.013). Hydrocephalous and infarct were common neuroimaging abnormalities in both groups; however, tuberculomas were significantly less in the elderly (15.1% vs. 35.2%, P = 0.012). Older patients had a significantly low survival rate (56.4% vs. 76.7%, P = 0.021). CONCLUSION Significant differences in clinical, CSF and radiological characteristics exist between elderly and young TBM patients, with survival remains dismal in the elderly.
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Affiliation(s)
- N Rahman
- From the 1Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Nehru Hospital, 4th floor, F block, Sector 12, Chandigarh 160012, India
| | - A K Pannu
- From the 1Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Nehru Hospital, 4th floor, F block, Sector 12, Chandigarh 160012, India
| | - R Yadav
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Research Block A, Sector 12, Chandigarh 160012, India
| | - S Sethi
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Research Block A, Sector 12 , Chandigarh 160012, India
| | - A Saroch
- From the 1Department of Internal Medicine , Postgraduate Institute of Medical Education and Research, Nehru Hospital, 4th floor, F block, Sector 12, Chandigarh 160012, India
| | - M Garg
- Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Nehru Hospital, Sector 12, Chandigarh 160012, India
| | - D Kumar
- From the 1Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Nehru Hospital, 4th floor, F block, Sector 12, Chandigarh 160012, India
| | - A Bhalla
- From the 1Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Nehru Hospital, 4th floor, F block, Sector 12, Chandigarh 160012, India
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Yong C, Tan S, Yang Z, Saw S, Sethi S. M120 AN Unusual case of haemolysis in the clinical biochemistry laboratory: A case report and literature review. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.218] [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: 11/03/2022]
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18
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Sethi S, Oh S, Chen A, Bellinger C, Lofaro L, Johnson M, Huang J, Bhorade SM, Bulman W, Kennedy GC. Percepta Genomic Sequencing Classifier and decision-making in patients with high-risk lung nodules: a decision impact study. BMC Pulm Med 2022; 22:26. [PMID: 34991528 PMCID: PMC8740045 DOI: 10.1186/s12890-021-01772-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Incidental and screening-identified lung nodules are common, and a bronchoscopic evaluation is frequently nondiagnostic. The Percepta Genomic Sequencing Classifier (GSC) is a genomic classifier developed in current and former smokers which can be used for further risk stratification in these patients. Percepta GSC has the capability of up-classifying patients with a pre-bronchoscopy risk that is high (> 60%) to "very high risk" with a positive predictive value of 91.5%. This prospective, randomized decision impact survey was designed to test the hypothesis that an up-classification of risk of malignancy from high to very high will increase the rate of referral for surgical or ablative therapy without additional intervening procedures while increasing physician confidence. METHODS Data were collected from 37 cases from the Percepta GSC validation cohort in which the pre-bronchoscopy risk of malignancy was high (> 60%), the bronchoscopy was nondiagnostic, and the patient was up-classified to very high risk by Percepta GSC. The cases were randomly presented to U.S pulmonologists in three formats: a pre-post cohort where each case is presented initially without and then with a GSG result, and two independent cohorts where each case is presented either with or without with a GSC result. Physicians were surveyed with respect to subsequent management steps and confidence in that decision. RESULTS One hundred and one survey takers provided a total of 1341 evaluations of the 37 patient cases across the three different cohorts. The rate of recommendation for surgical resection was significantly higher in the independent cohort with a GSC result compared to the independent cohort without a GSC result (45% vs. 17%, p < 0.001) In the pre-post cross-over cohort, the rate increased from 17 to 56% (p < 0.001) following the review of the GSC result. A GSC up-classification from high to very high risk of malignancy increased Pulmonologists' confidence in decision-making following a nondiagnostic bronchoscopy. CONCLUSIONS Use of the Percepta GSC classifier will allow more patients with early lung cancer to proceed more rapidly to potentially curative therapy while decreasing unnecessary intervening diagnostic procedures following a nondiagnostic bronchoscopy.
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Affiliation(s)
- Sonali Sethi
- Division of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, 9500 Euclid Avenue, Mail Code A90, Cleveland, OH, 44195, USA.
| | - Scott Oh
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Alexander Chen
- Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Christina Bellinger
- Pulmonary, Critical Care, Allergy and Immunologic Disease, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Lori Lofaro
- Veracyte, Inc., South San Francisco, CA, USA
| | | | - Jing Huang
- Veracyte, Inc., South San Francisco, CA, USA
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19
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Sethi S, Prakash O, Kumar R, Dubey SK, Arya M, Pant AK. Phytochemical Analysis, Antioxidant and Antifungal Activity of Essential oil and Extracts of Alpinia malaccensis (Burm.f.) Roscoe flowers. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e201209] [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: 01/17/2023] Open
Affiliation(s)
- Sonali Sethi
- G.B. Pant University of Agriculture and Technology, India
| | - Om Prakash
- G.B. Pant University of Agriculture and Technology, India
| | - Ravendra Kumar
- G.B. Pant University of Agriculture and Technology, India
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20
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Chauhan P, Sethi S, Jindal R, Meena D. Dermatoscopy of a case of erythema elevatum diutinum. J Eur Acad Dermatol Venereol 2021; 36:e316-e317. [PMID: 34812537 DOI: 10.1111/jdv.17835] [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: 01/19/2023]
Affiliation(s)
- P Chauhan
- Department of Dermatology, All India Institute of Medical Sciences, Bilaspur, India
| | - S Sethi
- Department of Dermatology, Himalayan Institute of Medical Sciences, Dehradun, India
| | - R Jindal
- Department of Dermatology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India
| | - D Meena
- Department of Dermatology, Venereology and Leprology, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, India
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21
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Hitchman L, Cai P, Sethi S, Stirrup A, Lathan R, Sidapra M, Smith G, Carradice D, Chetter I. 1026 Assessing the Reliability of 3D Imaging for Wound Measurements. Br J Surg 2021. [DOI: 10.1093/bjs/znab258.019] [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
Aim
To investigate the inter and intra reliability of using 3D imaging to measure wounds.
Method
20 wound models of 4 different shaped wounds in 5 different colours were created from plastic mouldable beads. 3D images were taken using the BlasterX Senz3D camera and measured using the GPC Wound Measure application (version 3.15.0.0, UK). Intra-user reliability was determined comparing 20 wound measurements of each wound model. Inter-user reliability was determined by 5 different clinicians photographing each model and independently measuring each wound photo. The inter- and intra-rater measurements for wound surface area and volume were compared using the ICC and differences from the overall mean plotted on Bland-Altman graphs.
Results
The interclass co-efficient (ICC) for inter-rater reliability in measuring surface area was 0.958 (95% CI 0.919-0.981, p < 0.005). The intra-rater reliability when measuring wound surface area was 0.996 (95% CI 0.993-0.998, p < 0.005). For wound volume, the ICC for inter-rater reliability was 0.925 (95% CI 0.857-0.967, p < 0.005) and 0.999 (95% CI 0.998-0.999, p < 0.005) for intra-user reliability. 5.5% of measurements were outside 2 SD of the mean for wound volume.
Conclusions
3D imaging offers a quick, reliable, and easy to use solution to measuring wounds. We have shown it is a reliable and reproducible method of measuring wounds between different clinicians.
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Affiliation(s)
- L Hitchman
- Academic Vascular Surgery Unit, Hull, United Kingdom
| | - P Cai
- Academic Vascular Surgery Unit, Hull, United Kingdom
| | - S Sethi
- Academic Vascular Surgery Unit, Hull, United Kingdom
| | - A Stirrup
- Academic Vascular Surgery Unit, Hull, United Kingdom
| | - R Lathan
- Academic Vascular Surgery Unit, Hull, United Kingdom
| | - M Sidapra
- Academic Vascular Surgery Unit, Hull, United Kingdom
| | - G Smith
- Academic Vascular Surgery Unit, Hull, United Kingdom
| | - D Carradice
- Academic Vascular Surgery Unit, Hull, United Kingdom
| | - I Chetter
- Academic Vascular Surgery Unit, Hull, United Kingdom
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22
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Hitchman L, Palmer J, Sethi S, Chetter I. 1023 An Audit of The Prevalence of Frailty and The Impact on Surgical Management and Resource Use, For Vascular Inpatients Using the National Vascular Registry (NVR) Frailty Classifications. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.117] [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
Aim
To determine if the NVR frailty score was being routinely collected on all relevant vascular patients on admission, identify the prevalence of frailty in vascular inpatients and determine if frailty was associated with a higher mortality and morbidity.
Method
A prospective audit of consecutive patients admitted onto the vascular ward who were eligible for inclusion on the NVR. Data was collected from electronic patient records and paper case notes between November 2019 and February 2020. The primary outcome was completeness of frailty assessment. Secondary outcomes were prevalence of frailty and mortality and morbidity associated with frailty score.
Results
Frailty status was documented in 65% of patients. 43% (28/65) were assessed to be frail. The 30-day mortality rate was 1.53% (1/65). 26.15% (17/65) had one or more complication. The commonest complications were graft occlusions, acute kidney injury, hospital acquired pneumonia and groin infections. 93.84% (61/65) were discharged home. There was no correlation between frailty and number of post-operative complications (p = 0.394), length of stay (p = 0.171) or mortality (p = 0.371).
Conclusions
This audit found frailty assessment is poorly assessed and the current NVR frailty classification did not correlate to increase mortality or morbidity in this patient cohort.
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Affiliation(s)
- L Hitchman
- Academic Vascular Surgery Unit, Hull, United Kingdom
| | - J Palmer
- Academic Vascular Surgery Unit, Hull, United Kingdom
| | - S Sethi
- Academic Vascular Surgery Unit, Hull, United Kingdom
| | - I Chetter
- Academic Vascular Surgery Unit, Hull, United Kingdom
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Roy A, Dadwal R, Yadav R, Singh P, Krishnamoorthi S, Dasgupta A, Chakraborti A, Sethi S. Association of Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Ureaplasma species infection and organism load with cervicitis in north Indian population. Lett Appl Microbiol 2021; 73:506-514. [PMID: 34089202 DOI: 10.1111/lam.13520] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 05/29/2021] [Accepted: 06/01/2021] [Indexed: 11/29/2022]
Abstract
Cervicitis is predominantly caused by Neisseria gonorrhoeae and Chlamydia trachomatis, which accounts for almost half of all the cases of cervicitis. The role of newer organisms like Mycoplasma genitalium and Ureaplasma sp. and association of bacterial load with cervicitis are also not well established. So the study aimed to determine the relative frequency of these organisms and their load in association with cervicitis cases from north India. A case-control study involving 300 women was conducted using quantitative real-time PCR from endocervical swabs for identification of organisms and quantification of bacterial load. Among 150 cervicitis cases, C. trachomatis, N. gonorrhoeae, M. genitalium and Ureaplasma parvum were detected in 5 (3·3%), 10 (6·6%), 37(24·6%) and 47 (31·3%) respectively. Old age (<0·001, chi-squared test) and irregular menstrual cycles (<0·001, chi-squared test) were significantly associated with cervicitis. M genitalium was the only organism to be associated significantly with cervicitis with regard to age (<0·031) and symptoms like discharge (P < 0·033, chi-squared test) and dysuria (P < 0·044, chi-squared test) in multivariate analysis. Our finding suggests that the bacterial load of these organisms is not significantly associated with cervicitis. However, we found significant association of M. genitalium infection with clinical characteristics of cervicitis cases.
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Affiliation(s)
- A Roy
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Dadwal
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Yadav
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - P Singh
- Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - S Krishnamoorthi
- Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Bathinda, Punjab, India
| | - A Dasgupta
- Department of Biochemistry, Sharda University, Greater Noida, Uttar Pradesh, India
| | - A Chakraborti
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Sethi
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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24
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Sethi S, Oh S, Chen A, Bellinger C, Lofaro L, Tom J, Johnson M, Huang J, Bhorade SM, Kennedy G. The impact of a genomic sequencing classifier (GSC) on clinical decision making in patients with a high-risk lung nodule. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.8549] [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] Open
Abstract
8549 Background: Current guidelines recommend that patients who have lung nodules with high risk of malignancy (ROM) ( > 65%) should undergo surgical and other ablative therapies. However, prior studies have shown that clinicians may opt for more conservative management in these high-risk patients. Percepta Genomic Sequencing Classifier (GSC), a RNA-seq based classifier derived from bronchial epithelial cells to assess risk of lung cancer, was designed to risk stratify lung nodules by both down classifying ROM as a “rule -out“ test with high sensitivity as well as up-classifying ROM as a “rule- in” test with high specificity for malignancy. This study assesses the impact of up-classification of high ROM to very high- risk (ROM > 90%) by Percepta GSC in increasing the number of ablative therapies recommended for high-risk lung nodules. Methods: This prospective randomized decision impact survey included 37 patients from the AEGIS I/ II cohorts and the Percepta Registry who were undergoing work up of a lung nodule and had a high ROM that was up-classified to very high ROM by Percepta GSC. 97 physicians assessed 10 randomly assigned patient cases. They then responded to a survey designed to test the hypothesis that including a Percepta GSC result will increase the recommendation for surgical or other ablative therapy in very high- risk patients as well as their level of confidence of this recommendation. Physicians were first presented with the patient’s clinical information without Percepta GSC and then with Percepta GSC. Results: 97 physicians provided a total of 682 evaluations of 37 patients. In this study, the recommendation for surgical or other ablative therapy increased from 19/341 (5.6%) prior to the Percepta GSC result to 157/341 (46%) after the Percepta GSC result (odds ratio of 4.76, p-value < 0.001). The number of extremely confident recommendations increased from 72/341 (21%) without Percepta GSC to 106/341 (31%) with Percepta GSC. Significantly more physicians had increased confidence in their recommended next step post-Percepta GSC when collapsing the confidence level responses into increased confidence (n = 93) and decreased confidence (n = 44) (p-value = 0.002). Conclusions: Percepta GSC had a quantifiable impact on clinical decision making. It increased the number of surgical and other ablative therapies recommended when patients were re-classified from high to very high- risk of lung cancer with a higher confidence in the recommended next step. By up-classifying nodules from high to very high ROM, Percepta GSC will improve the likelihood and timeliness of appropriate therapies and assist clinicians more effectively manage patients to improve patient outcomes.
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Affiliation(s)
| | - Scott Oh
- University of California, Los Angeles, Los Angeles, CA
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25
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Martinez-Zayas G, Almeida FA, Yarmus L, Steinfort D, Lazarus DR, Simoff MJ, Saettele T, Murgu S, Dammad T, Duong DK, Mudambi L, Filner JJ, Molina S, Aravena C, Thiboutot J, Bonney A, Rueda AM, Debiane LG, Hogarth DK, Bedi H, Deffebach M, Sagar AES, Cicenia J, Yu DH, Cohen A, Frye L, Grosu HB, Gildea T, Feller-Kopman D, Casal RF, Machuzak M, Arain MH, Sethi S, Eapen GA, Lam L, Jimenez CA, Ribeiro M, Noor LZ, Mehta A, Song J, Choi H, Ma J, Li L, Ost DE. Predicting Lymph Node Metastasis in Non-small Cell Lung Cancer: Prospective External and Temporal Validation of the HAL and HOMER Models. Chest 2021; 160:1108-1120. [PMID: 33932466 DOI: 10.1016/j.chest.2021.04.048] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 04/02/2021] [Accepted: 04/08/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Two models, the Help with the Assessment of Adenopathy in Lung cancer (HAL) and Help with Oncologic Mediastinal Evaluation for Radiation (HOMER), were recently developed to estimate the probability of nodal disease in patients with non-small cell lung cancer (NSCLC) as determined by endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA). The objective of this study was to prospectively externally validate both models at multiple centers. RESEARCH QUESTION Are the HAL and HOMER models valid across multiple centers? STUDY DESIGN AND METHODS This multicenter prospective observational cohort study enrolled consecutive patients with PET-CT clinical-radiographic stages T1-3, N0-3, M0 NSCLC undergoing EBUS-TBNA staging. HOMER was used to predict the probability of N0 vs N1 vs N2 or N3 (N2|3) disease, and HAL was used to predict the probability of N2|3 (vs N0 or N1) disease. Model discrimination was assessed using the area under the receiver operating characteristics curve (ROC-AUC), and calibration was assessed using the Brier score, calibration plots, and the Hosmer-Lemeshow test. RESULTS Thirteen centers enrolled 1,799 patients. HAL and HOMER demonstrated good discrimination: HAL ROC-AUC = 0.873 (95%CI, 0.856-0.891) and HOMER ROC-AUC = 0.837 (95%CI, 0.814-0.859) for predicting N1 disease or higher (N1|2|3) and 0.876 (95%CI, 0.855-0.897) for predicting N2|3 disease. Brier scores were 0.117 and 0.349, respectively. Calibration plots demonstrated good calibration for both models. For HAL, the difference between forecast and observed probability of N2|3 disease was +0.012; for HOMER, the difference for N1|2|3 was -0.018 and for N2|3 was +0.002. The Hosmer-Lemeshow test was significant for both models (P = .034 and .002), indicating a small but statistically significant calibration error. INTERPRETATION HAL and HOMER demonstrated good discrimination and calibration in multiple centers. Although calibration error was present, the magnitude of the error is small, such that the models are informative.
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Affiliation(s)
- Gabriela Martinez-Zayas
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Lonny Yarmus
- Division of Pulmonary and Critical Care, Johns Hopkins University, Baltimore, MD
| | - Daniel Steinfort
- Department of Respiratory Medicine, Royal Melbourne Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia
| | - Donald R Lazarus
- Department of Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, Houston, TX
| | - Michael J Simoff
- Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI
| | - Timothy Saettele
- Department of Pulmonary Disease and Critical Care Medicine, Saint Luke's Hospital of Kansas City, Kansas City, MO
| | - Septimiu Murgu
- Division of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL
| | - Tarek Dammad
- Department of Pulmonary Medicine, University of New Mexico, Albuquerque, NM; Department of Pulmonary and Critical Care Medicine, CHRISTUS St. Vincent Medical Center, Santa Fe, NM
| | - D Kevin Duong
- Department of Pulmonary, Allergy and Critical Care Medicine, Stanford University Medical Center and School of Medicine, Stanford, CA
| | - Lakshmi Mudambi
- Division of Pulmonary and Critical Care, VA Portland Health Care System, Oregon Health and Science University, Portland, OR
| | - Joshua J Filner
- Department of Pulmonary Medicine, Northwest Permanente and The Center for Health Research, Kaiser Permanente Northwest, Portland, OR
| | - Sofia Molina
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Carlos Aravena
- Department of Respiratory Diseases, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Jeffrey Thiboutot
- Division of Pulmonary and Critical Care, Johns Hopkins University, Baltimore, MD
| | - Asha Bonney
- Department of Respiratory Medicine, Royal Melbourne Hospital, Melbourne, Australia
| | - Adriana M Rueda
- Department of Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, Houston, TX
| | - Labib G Debiane
- Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI
| | - D Kyle Hogarth
- Division of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL
| | - Harmeet Bedi
- Department of Pulmonary, Allergy and Critical Care Medicine, Stanford University Medical Center and School of Medicine, Stanford, CA
| | - Mark Deffebach
- Division of Pulmonary and Critical Care, VA Portland Health Care System, Oregon Health and Science University, Portland, OR
| | - Ala-Eddin S Sagar
- Department of Pulmonary Medicine, Banner MD Anderson Cancer Center, Gilbert, AZ
| | - Joseph Cicenia
- Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH
| | - Diana H Yu
- Division of Pulmonary, Critical Care and Sleep Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Avi Cohen
- Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI
| | - Laura Frye
- Division of Allergy, Pulmonary and Critical Care Medicine, University of Wisconsin, Madison, WI
| | - Horiana B Grosu
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Thomas Gildea
- Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH
| | - David Feller-Kopman
- Division of Pulmonary and Critical Care, Johns Hopkins University, Baltimore, MD
| | - Roberto F Casal
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael Machuzak
- Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH
| | - Muhammad H Arain
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sonali Sethi
- Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH
| | - George A Eapen
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Louis Lam
- Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH
| | - Carlos A Jimenez
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Manuel Ribeiro
- Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH
| | - Laila Z Noor
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Atul Mehta
- Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH
| | - Juhee Song
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Humberto Choi
- Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH
| | - Junsheng Ma
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Liang Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - David E Ost
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
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Yadav R, Daroch P, Gupta P, Agarwal P, Aggarwal AN, Sethi S. Diagnostic accuracy of TB-LAMP assay in patients with pulmonary tuberculosis-a case-control study in northern India. Pulmonology 2020; 28:449-453. [PMID: 33288469 DOI: 10.1016/j.pulmoe.2020.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 05/21/2020] [Revised: 10/11/2020] [Accepted: 10/11/2020] [Indexed: 11/17/2022] Open
Abstract
SETTING A tertiary care hospital in North India. OBJECTIVE Tuberculosis (TB) remains a major public health problem in developing countries. The diagnosis of tuberculosis is still challenging in primary care settings in endemic countries like India. WHO has endorsed loop mediated isothermal amplification assay (LAMP) for TB as a replacement for smear microscopy for peripheral settings, however, more data is required to establish the specificity of this modality for the diagnosis of TB. In this study we aim to determine the diagnostic accuracy of the TB-LAMP assay in pulmonary tuberculosis. DESIGN A total of 236 patients (117 cases suspected of TB and 119 patients with non-TB pulmonary disease) were enrolled between February to July, 2018. Microbiological workups consisting of mycobacterial smear microscopy, culture, Xpert MTB/Rif and TB-LAMP were performed. RESULTS From 236 samples, 18 (7.6%) were excluded from the study. TB-LAMP and Xpert MTB/RIF were positive in 46 (21.1%) and 49 (22.5%) of the samples, respectively. The sensitivity of Xpert MTB/RIF and TB-LAMP, when culture was taken as a reference standard, was 90% (95%CI: 78.2-96.7) and 82% (95%CI: 68.6-91.4), respectively. The specificity, positive predictive value (PPV), and negative predictive value (NPV) of TB-LAMP assay were 96.8% (95%CI: 92.8-98.9), 89.1% (95%CI: 77.4-95.2), and 94.4% (95%CI: 90.4-96.5), respectively. CONCLUSION The TB-LAMP assay showed a good specificity and sensitivity for detection ofM. tuberculosis in adults, however, for programmatic implementation, more studies are required to be conducted at peripheral level healthcare settings.
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Affiliation(s)
- R Yadav
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - P Daroch
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - P Gupta
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - P Agarwal
- WHO Country Office for India, New Delhi, India
| | - A N Aggarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Sethi
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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Singhal L, Verma S, Sharma M, Sethi S, Ray P, Gautam V. In-house pre-prepared broth microdilution plates: A simple, cheap and pragmatic approach for susceptibility testing of colistin. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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28
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Yadav R, Vaidya P, Mathew JL, Singh S, Khaneja R, Agarwal P, Singh M, Sethi S. Diagnostic accuracy of Xpert MTB/RIF ultra for detection of Mycobacterium tuberculosis in children: a prospective cohort study. Lett Appl Microbiol 2020; 72:225-230. [PMID: 33090531 DOI: 10.1111/lam.13402] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 09/29/2020] [Accepted: 09/29/2020] [Indexed: 12/11/2022]
Abstract
The Xpert MTB/RIF Ultra is a recent advancement in molecular diagnostics of tuberculosis (TB) with higher sensitivity compared to its predecessor, the Xpert MTB/RIF assay. Prospective studies evaluating the performance of Xpert MTB/RIF Ultra in children with suspected TB are lacking. In this study, we evaluated the Xpert MTB/RIF Ultra for detection of Mycobacterium tuberculosis in samples from 156 children, of which one was excluded from the analysis. Of the remaining 155 samples, 6·5% (10/155), 21·3% (33/155), 20% (31/155) and 21·9% (34/155) were positive by smear examination, MGIT culture, Xpert MTB/RIF and Xpert MTB/RIF Ultra, respectively. The Xpert MTB/RIF and Xpert MTB/RIF Ultra had a similar overall sensitivity of 81·8% (95% CI: 64·5-93) and 84·8% (95% CI: 68·1-94·9), respectively. In suspected pediatric TB patients, the Xpert MTB/RIF Ultra had higher sensitivity compared to the Xpert MTB/RIF (72·7 vs 63·6). The AUC (area under the curve) of 0·905 for the Xpert MTB/RIF and 0·893 for the Xpert MTB/RIF Ultra indicate similar and good overall performance. Both Xpert assays were found to be equally efficient, however Xpert MTB/RIF Ultra showed better detection rate in suspected TB cases.
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Affiliation(s)
- R Yadav
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - P Vaidya
- Pediatric Medicine, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - J L Mathew
- Pediatric Medicine, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Singh
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - P Agarwal
- WHO Country Office for India, New Delhi, India
| | - M Singh
- Pediatric Medicine, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Sethi
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Lamb CR, Desai NR, Angel L, Chaddha U, Sachdeva A, Sethi S, Bencheqroun H, Mehta H, Akulian J, Argento AC, Diaz-Mendoza J, Musani A, Murgu S. Use of Tracheostomy During the COVID-19 Pandemic: American College of Chest Physicians/American Association for Bronchology and Interventional Pulmonology/Association of Interventional Pulmonology Program Directors Expert Panel Report. Chest 2020; 158:1499-1514. [PMID: 32512006 PMCID: PMC7274948 DOI: 10.1016/j.chest.2020.05.571] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [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: 04/30/2020] [Revised: 05/19/2020] [Accepted: 05/30/2020] [Indexed: 01/08/2023] Open
Abstract
Background The role of tracheostomy during the coronavirus disease 2019 (COVID-19) pandemic remains unknown. The goal of this consensus statement is to examine the current evidence for performing tracheostomy in patients with respiratory failure from COVID-19 and offer guidance to physicians on the preparation, timing, and technique while minimizing the risk of infection to health care workers (HCWs). Methods A panel including intensivists and interventional pulmonologists from three professional societies representing 13 institutions with experience in managing patients with COVID-19 across a spectrum of health-care environments developed key clinical questions addressing specific topics on tracheostomy in COVID-19. A systematic review of the literature and an established modified Delphi consensus methodology were applied to provide a reliable evidence-based consensus statement and expert panel report. Results Eight key questions, corresponding to 14 decision points, were rated by the panel. The results were aggregated, resulting in eight main recommendations and five additional remarks intended to guide health-care providers in the decision-making process pertinent to tracheostomy in patients with COVID-19-related respiratory failure. Conclusion This panel suggests performing tracheostomy in patients expected to require prolonged mechanical ventilation. A specific timing of tracheostomy cannot be recommended. There is no evidence for routine repeat reverse transcription polymerase chain reaction testing in patients with confirmed COVID-19 evaluated for tracheostomy. To reduce the risk of infection in HCWs, we recommend performing the procedure using techniques that minimize aerosolization while wearing enhanced personal protective equipment. The recommendations presented in this statement may change as more experience is gained during this pandemic.
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Affiliation(s)
- Carla R Lamb
- Department of Medicine, Division of Pulmonary and Critical Care, Lahey Hospital and Medical Center, Burlington, MA
| | - Neeraj R Desai
- Chicago Chest Center, AMITA Health, Lisle, IL; Department of Medicine, Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago, Chicago, IL
| | - Luis Angel
- Department of Medicine, Division of Pulmonary and Critical Care, New York University Langone Health, NY
| | - Udit Chaddha
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ashutosh Sachdeva
- Department of Medicine, Division of Pulmonary and Critical Care, University of Maryland School of Medicine, Baltimore, MD
| | - Sonali Sethi
- Respiratory Institute, Division of Pulmonary and Critical Care, Cleveland Clinic, Cleveland, OH
| | - Hassan Bencheqroun
- Department of Medicine, Division of Pulmonary and Critical Care, University of California Riverside, CA
| | - Hiren Mehta
- Division of Pulmonary and Critical Care and Sleep Medicine, University of Florida, FL
| | - Jason Akulian
- Division of Pulmonary and Critical Care, UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, NC
| | - A Christine Argento
- Department of Medicine, Division of Pulmonary and Critical Care, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Javier Diaz-Mendoza
- Division of Pulmonary and Critical Care, Henry Ford Hospital and Department of Medicine, Wayne State University, Detroit, MI
| | - Ali Musani
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Denver, CO
| | - Septimiu Murgu
- Division of Pulmonary and Critical Care Medicine, The University of Chicago, Chicago, IL.
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Dermawan JK, Hsi ED, Sethi S, Arrossi AV. Endobronchial pseudocarcinomatous hyperplasia mimicking squamous cell carcinoma associated with primary pulmonary ALK‐negative anaplastic large cell lymphoma. Histopathology 2020; 76:781-784. [DOI: 10.1111/his.14032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Josephine K. Dermawan
- Department of Pathology R.J. Tomisch Pathology and Laboratory Medicine Institute Cleveland Clinic Cleveland OH USA
| | - Eric D. Hsi
- Department of Laboratory Medicine R.J. Tomisch Pathology and Laboratory Medicine Institute Cleveland Clinic Cleveland OH USA
| | - Sonali Sethi
- Department of Pulmonary Medicine Cleveland Clinic Cleveland OH USA
| | - Andrea V. Arrossi
- Department of Pathology R.J. Tomisch Pathology and Laboratory Medicine Institute Cleveland Clinic Cleveland OH USA
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31
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CHANCHLANI R, Young C, Farooq A, Sangar S, Sethi S, Raina R. SAT-232 HEMODIALYSIS IN CHILDREN AND ADOLESCENTS: A SYSTEMATIC REVIEW. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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32
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Khurana S, Dadwal R, Sharma N, Mewara A, Singh S, Bagga R, Yadav R, Sethi S. Loop mediated isothermal amplification assay for detection of Trichomonas vaginalis in vaginal swabs among symptomatic women from North India. Lett Appl Microbiol 2020; 70:196-202. [PMID: 31808556 DOI: 10.1111/lam.13260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 12/04/2019] [Accepted: 12/04/2019] [Indexed: 11/30/2022]
Abstract
Trichomonas vaginalis is one of the most common curable sexually transmitted pathogens infecting both men and women worldwide. Unlike traditional methods such as microscopy and culture, nucleic acid amplification tests rapidly detect this agent, assisting in treatment. Conventional polymerase chain reaction (PCR), the loop-mediated isothermal amplification (LAMP), and the Xpert TV assay were evaluated using 28 microscopy positive T. vaginalis samples and 125 microscopy negative samples from symptomatic females of reproductive age. The sensitivity of all tests was 100% and the specificity was 100%, 100%, and 99·2% for PCR, Xpert TV, and LAMP, respectively. The inter-rater reliability was excellent for PCR: Xpert TV (kappa-coefficient = 1) and good for LAMP assay: Xpert TV/PCR (kappa-coefficient = 0·98) and conventional PCR: LAMP (kappa-coefficient = 0·98). The study highlights the importance of PCR for screening T. vaginalis in women, particularly in laboratories where the Xpert-TV assay is not available or not affordable. The LAMP assay showed a lower positive predictive value which merits further evaluation. SIGNIFICANCE AND IMPACT OF THE STUDY: Trichomonas vaginalis is a common sexually transmitted pathogen associated with considerable morbidity and risk of complications. Due to the limitations of traditional diagnostic modalities, three molecular assays were compared: conventional polymerase chain reaction (PCR), Xpert TV assay, and loop mediated isothermal amplification (LAMP) assay for detecting T. vaginalis in symptomatic females. All tests had a sensitivity of 100% and the inter-rater reliability was excellent for PCR: Xpert TV, and good for LAMP assay: Xpert TV/PCR. The translational impact of this study lies in the possible use of conventional PCR and LAMP in laboratories where the Xpert TV assay is not available or not affordable.
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Affiliation(s)
- S Khurana
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Dadwal
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - N Sharma
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Mewara
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Singh
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Bagga
- Department of Gynecology and Obstetrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Yadav
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Sethi
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Varshney A, Vanidassane I, Ramavth D, Malik P, Khurana S, Garg V, Vadlamani S, Kalra K, Gunasekar S, Kumar S, Sethi S, Yadav M, Pathy S, Jain D. Chemotherapy in advanced thymic malignancies. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz436.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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34
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Cicenia J, Sethi S. NAVIGATION TO PERIPHERAL LUNG NODULES USING AN ARTIFICIAL INTELLIGENCE-DRIVEN AUGMENTED IMAGE FUSION PLATFORM (LUNGVISION): A PILOT STUDY. Chest 2019. [DOI: 10.1016/j.chest.2019.08.793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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35
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Leon CA, Inaty H, Urbas A, Grafmeyer K, Machuzak M, Sethi S, Gildea T. EARLY OUTCOMES WITH 3D PRINTING AND AIRWAY STENTS. Chest 2019. [DOI: 10.1016/j.chest.2019.08.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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36
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Bordon J, Slomka M, Gupta R, Furmanek S, Cavallazzi R, Sethi S, Niederman M, Ramirez JA. Hospitalization due to community-acquired pneumonia in patients with chronic obstructive pulmonary disease: incidence, epidemiology and outcomes. Clin Microbiol Infect 2019; 26:220-226. [PMID: 31254714 DOI: 10.1016/j.cmi.2019.06.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 06/08/2019] [Accepted: 06/17/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Community-acquired pneumonia (CAP) is an important complication in patients with chronic obstructive pulmonary disease (COPD). This study aimed to define incidence, and outcomes of COPD patients hospitalized with pneumonia in the city of Louisville, and to estimate the burden of disease in the US population. METHODS This was a secondary analysis of a prospective population-based cohort study of residents in Louisville, Kentucky, 40 years old and older, from 1 June 2014 to 31 May 2016. All adults hospitalized with CAP were enrolled. The annual incidence of pneumonia in COPD patients in Louisville was calculated and the total number of adults with COPD hospitalized in the United States was estimated. Clinical outcomes included time to clinical stability (TCS), length of hospital stay (LOS) and mortality. RESULTS From a Louisville population of 18 246 patients with COPD, 3419 pneumonia hospitalizations were documented during the 2-year study. The annual incidence was 9369 patients with pneumonia per 100 000 COPD population, corresponding to an estimated 506 953 adults with COPD hospitalized due to pneumonia in the United States. The incidence of CAP in patients without COPD was 509 (95% CI 485-533) per 100 000. COPD patients had a median (interquartile range) TCS and LOS of 2 (1-4) and 5 (3-9) days respectively. The mortality of COPD patients during hospitalization, at 30 days, 6 months and 1 year was 193 of 3419 (5.6%), 400 of 3374 (11.9%), 816 of 3363 (24.3%) and 1104 of 3349 (33.0%), respectively. CONCLUSIONS There was an annual incidence of 9369 cases of hospitalized CAP per 100 000 COPD patients in the city of Louisville. This was an approximately 18-fold greater incidence of CAP in COPD patients than in those without COPD.
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Affiliation(s)
- J Bordon
- Providence Health Center, Section of Infectious Diseases, Washington, DC, USA.
| | - M Slomka
- University of Maryland Medical Center, Division of Infectious Diseases, Baltimore, MD, USA
| | - R Gupta
- Cleveland Clinic, Department of Medicine, Division of Hematology and Oncology, Cleveland, OH, USA
| | - S Furmanek
- University of Louisville, Department of Medicine, Division of Infectious Diseases, Louisville, KY, USA
| | - R Cavallazzi
- University of Louisville, Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Disorders, Louisville, KY, USA
| | - S Sethi
- University at Buffalo, Jacobs School of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Buffalo, NY, USA
| | - M Niederman
- Weill Cornell Medical College, Pulmonary and Critical Care Medicine, New York, NY, USA
| | - J A Ramirez
- University of Louisville, Department of Medicine, Division of Infectious Diseases, Louisville, KY, USA
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Das M, Duggal R, Dewan A, Sharma S, Jain D, Narrendran A, Prasad S, Sethi S, Kini L, Mohanty S. 'NOT SO CLASSICAL': A STUDY OF THE IMMUNOPROFILE IN CLASSICAL HODGKIN LYMPHOMA, AN EXPERIENCE FROM A REFERRAL CENTER. Hematol Oncol 2019. [DOI: 10.1002/hon.29_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- M. Das
- Department of Pathology; Core Diagnostics; Gurugram India
| | - R. Duggal
- Department of Pathology; Core Diagnostics; Gurugram India
| | - A. Dewan
- Department of Pathology; Core Diagnostics; Gurugram India
| | - S. Sharma
- Department of Pathology; Core Diagnostics; Gurugram India
| | - D. Jain
- Department of Pathology; Core Diagnostics; Gurugram India
| | - A. Narrendran
- Department of Pathology; Core Diagnostics; Gurugram India
| | - S. Prasad
- Department of Pathology; Core Diagnostics; Gurugram India
| | - S. Sethi
- Department of Pathology; Core Diagnostics; Gurugram India
| | - L. Kini
- Department of Pathology; Core Diagnostics; Gurugram India
| | - S. Mohanty
- Department of Pathology; Core Diagnostics; Gurugram India
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38
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Sharma G, Tewari R, Dhatwalia SK, Yadav R, Behera D, Sethi S. A loop-mediated isothermal amplification assay for the diagnosis of pulmonary tuberculosis. Lett Appl Microbiol 2019; 68:219-225. [PMID: 30636048 DOI: 10.1111/lam.13115] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 06/22/2018] [Revised: 09/08/2018] [Accepted: 10/08/2018] [Indexed: 11/28/2022]
Abstract
Quantitated Mycobacterium tuberculosis (M.tb) H37Rv DNA was used to analyse the sensitivity and the specificity was assessed using DNA isolated from the reference strain H37Rv, 12 nontuberculous mycobacterium (NTM) species and five nonmycobacterium species. Furthermore, performance of the assay was evaluated on the sputum samples and compared with smear microscopy, culture and PCR. mpt64 (also called mpb64 or Rv1980c) loop-mediated isothermal amplification (LAMP) successfully detected 1 pg DNA within 40 min and successfully rejected NTMs and other bacterial species tested. It specifically detected all the 119 confirmed TB cases and 100 of the 104 control cases. The resulting sensitivity and specificity of LAMP assay was found to be 100% (95% CI: 96·79-100%) and 96·15% (95% CI; 90·44-98·94%) respectively. SIGNIFICANCE AND IMPACT OF THE STUDY: Loop-mediated isothermal amplification (LAMP) is a technique for isothermal DNA amplification suitable for cost-limited settings as it prevents the use of sophisticated instruments. Using mpt64 antigenic protein gene, we developed a LAMP assay especially for organisms of the M. tuberculosis complex. mpt64 LAMP assay showed 100% sensitivity and detected all the bacteriologically and clinically positive TB cases not detected by smear, culture or PCR methods.
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Affiliation(s)
- G Sharma
- Department of Microbial Biotechnology, Panjab University, Chandigarh, India
| | - R Tewari
- Department of Microbial Biotechnology, Panjab University, Chandigarh, India
| | - S K Dhatwalia
- Department of Biophysics, Panjab University, Chandigarh, India
| | - R Yadav
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - D Behera
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Sethi
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Affiliation(s)
- Sonali Sethi
- Department of Radiology, Govind Ballabh Pant Hospital, New Delhi, India
| | - Sunil Kumar Puri
- Department of Radiology, Govind Ballabh Pant Hospital, New Delhi, India
| | - Anil Agarwal
- Department of Gastrointestinal Surgery, Govind Ballabh Pant Hospital, New Delhi, India
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40
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Ranga A, Goenka S, Sethi S, Pandey N. Effect of early treatment with zoledronic acid on prevention of bone loss in spinal cord injury patients a randomized prospective interventional study. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.544] [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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41
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Yadav R, Sharma N, Khaneja R, Agarwal P, Kanga A, Behera D, Sethi S. Evaluation of the TB-LAMP assay for the rapid diagnosis of pulmonary tuberculosis in Northern India. Int J Tuberc Lung Dis 2018; 21:1150-1153. [PMID: 28911360 DOI: 10.5588/ijtld.17.0035] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING A tertiary care hospital in North India. OBJECTIVE To evaluate a commercial kit-based loop-mediated isothermal amplification (TB-LAMP) assay for the diagnosis of pulmonary tuberculosis (PTB). DESIGN A total of 530 patients presenting with PTB symptoms were enrolled and one sputum sample was collected from each patient. The TB-LAMP assay (Loopamp™ MTBC Detection kit) was performed on the raw sputum sample. The remaining sample was used for smear microscopy and mycobacterial culture. A cartridge-based nucleic acid amplification test (NAAT, Xpert® MTB/RIF assay) was also performed on the processed pellet. RESULTS The sensitivity and specificity of the TB-LAMP assay in culture-positive samples obtained from 453 patients presenting with PTB symptoms (77 specimens were excluded) were respectively 100% (95%CI 94.7-100) and 99.2% (95%CI 97.8-99.8). The sensitivity and specificity of Xpert in culture-positive samples were respectively 82.6% (95%CI 71.5-90.6) and 94.9% (95%CI 92.2-96.8). A concordance of 0.75 was obtained between the two NAATs (TB-LAMP assay and Xpert) using the κ statistic. CONCLUSION The TB-LAMP assay showed high sensitivity and specificity with limited requirement of testing infrastructure, and is thus a promising diagnostic tool for TB diagnosis in resource-poor settings.
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Affiliation(s)
- R Yadav
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh
| | - N Sharma
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh
| | | | - P Agarwal
- State TB Cell, Chandigarh, World Health Organization Country Office of India, New Delhi
| | - A Kanga
- Indira Gandhi Medical College, Shimla
| | - D Behera
- Pulmonary Medicine, PGIMER, Chandigarh, India
| | - S Sethi
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh
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Yadav R, Saini A, Kaur P, Behera D, Sethi S. Diagnostic accuracy of GenoType® MTBDRsl VER 2.0 in detecting second-line drug resistance to M. tuberculosis. Int J Tuberc Lung Dis 2018; 22:419-424. [DOI: 10.5588/ijtld.17.0663] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- R. Yadav
- Department of
Medical Microbiology and
| | - A. Saini
- Department of
Medical Microbiology and
| | - P. Kaur
- Department of
Medical Microbiology and
| | - D. Behera
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S. Sethi
- Department of
Medical Microbiology and
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Patrick Y, Lee A, Raha O, Pillai K, Gupta S, Sethi S, Mukeshimana F, Gerard L, Moghal M, Saleh S, Smith S, Morrell M, Moss J. Effects of sleep deprivation on cognitive and physical performance in university students. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Gastric duplication cysts are rare and mostly present in the first year of life. In adulthood presentation is in the form of obstruction, ulceration, bleeding, fistulization etc. Malignancy is extremely rare with only 12 cases reported to date. We came across a gastric duplication cyst with papillary adenocarcinoma in a 63 year old man. He underwent cyst excision with radical subtotal gastrectomy. The awareness of such a condition made it possible for us to have a suspicion of malignancy preoperatively based on imaging and thus a radical surgery was performed. High index of suspicion is necessary to diagnose this condition preoperatively on CT scan. Literature review revealed that this is the first case to be reported from India.
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Affiliation(s)
| | | | - Sunil Kumar Puri
- Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, Delhi, India
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Winters ZE, Afzal M, Rutherford C, Holzner B, Rumpold G, da Costa Vieira RA, Hartup S, Flitcroft K, Bjelic-Radisic V, Oberguggenberger A, Panouilleres M, Mani M, Catanuto G, Douek M, Kokan J, Sinai P, King MT, Spillane A, Snook K, Boyle F, French J, Elder E, Chalmers B, Kabir M, Campbell I, Wong A, Flay H, Scarlet J, Weis J, Giesler J, Bliem B, Nagele E, del Angelo N, Andrade V, Assump¸ão Garcia D, Bonnetain F, Kjelsberg M, William-Jones S, Fleet A, Hathaway S, Elliott J, Galea M, Dodge J, Chaudhy A, Williams R, Cook L, Sethi S, Turton P, Henson A, Gibb J, Bonomi R, Funnell S, Noren C, Ooi J, Cocks S, Dawson L, Patel H, Bailey L, Chatterjee S, Goulden K, Kirk S, Osborne W, Harter L, Sharif MA, Corcoran S, Smith J, Prasad R, Doran A, Power A, Devereux L, Cannon J, Latham S, Arora P, Ridgway S, Coulding M, Roberts R, Absar M, Hodgkiss T, Connolly K, Johnson J, Doyle K, Lunt N, Cooper M, Fuchs I, Peall L, Taylor L, Nicholson A. International validation of the European Organisation for Research and Treatment of Cancer QLQ-BRECON23 quality-of-life questionnaire for women undergoing breast reconstruction. Br J Surg 2017; 105:209-222. [PMID: 29116657 DOI: 10.1002/bjs.10656] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 03/02/2017] [Accepted: 06/23/2017] [Indexed: 11/12/2022]
Abstract
Abstract
Background
The aim was to carry out phase 4 international field-testing of the European Organisation for Research and Treatment of Cancer (EORTC) breast reconstruction (BRECON) module. The primary objective was finalization of its scale structure. Secondary objectives were evaluation of its reliability, validity, responsiveness, acceptability and interpretability in patients with breast cancer undergoing mastectomy and reconstruction.
Methods
The EORTC module development guidelines were followed. Patients were recruited from 28 centres in seven countries. A prospective cohort completed the QLQ-BRECON15 before mastectomy and the QLQ-BRECON24 at 4–8 months after reconstruction. The cross-sectional cohort completed the QLQ-BRECON24 at 1–5 years after reconstruction, and repeated this 2–8 weeks later (test–retest reliability). All participants completed debriefing questionnaires.
Results
A total of 438 patients were recruited, 234 in the prospective cohort and 204 in the cross-sectional cohort. A total of 414 reconstructions were immediate, with a comparable number of implants (176) and donor-site flaps (166). Control groups comprised patients who underwent two-stage implant procedures (72, 75 per cent) or delayed reconstruction (24, 25 per cent). Psychometric scale validity was supported by moderate to high item-own scale and item-total correlations (over 0·5). Questionnaire validity was confirmed by good scale-to-sample targeting, and computable scale scores exceeding 50 per cent, except nipple cosmesis (over 40 per cent). In known-group comparisons, QLQ-BRECON24 scales and items differentiated between patient groups defined by clinical criteria, such as type and timing of reconstruction, postmastectomy radiotherapy and surgical complications, with moderate effect sizes. Prospectively, sexuality and surgical side-effects scales showed significant responsiveness over time (P < 0·001). Scale reliability was supported by high Cronbach's α coefficients (over 0·7) and test–retest (intraclass correlation more than 0·8). One item (finding a well fitting bra) was excluded based on high floor/ceiling effects, poor test–retest and weak correlations in factor analysis (below 0·3), thus generating the QLQ-BRECON23 questionnaire.
Conclusion
The QLQ-BRECON23 is an internationally validated tool to be used alongside the EORTC QLQ-C30 (cancer) and QLQ-BR23 (breast cancer) questionnaires for evaluating quality of life and satisfaction after breast reconstruction.
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Affiliation(s)
- Z E Winters
- Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol, UK
- Surgical and Interventional Trials Unit, Division of Surgical Sciences, University College London, London, UK
- Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, New South Wales, Australia
| | - M Afzal
- Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol, UK
| | - C Rutherford
- Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, New South Wales, Australia
| | - B Holzner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria
| | - G Rumpold
- Department of Medical Psychology, Evaluation Software Development, Rum, Austria
| | | | - S Hartup
- St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - K Flitcroft
- Breast and Surgical Oncology, Poche Centre, University of Sydney, New South Wales, Australia
| | - V Bjelic-Radisic
- Department of Breast Surgery and Gynaecology, Medical University Graz, Graz, Austria
| | - A Oberguggenberger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria
| | - M Panouilleres
- Department of Plastic Surgery, Besançon University Hospital, Besançon, France
| | - M Mani
- Department of Surgical Sciences, Plastic and Reconstructive Surgery, Uppsala University, Uppsala, Sweden
| | - G Catanuto
- Multidisciplinary Breast Care, Cannizzaro Hospital, Catania, Italy
| | - M Douek
- Department of Surgical Oncology, Guy's Hospital, London, London, UK
| | - J Kokan
- Cancer Resource Centre, Macclesfield Hospital, Macclesfield, UK
| | - P Sinai
- Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol, UK
| | - M T King
- Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, New South Wales, Australia
- Sydney Medical School, Faculty of Medicine, University of Sydney, New South Wales, Australia
| | - A Spillane
- Poche Centre, Sydney, New South Wales, Australia
| | - K Snook
- Poche Centre, Sydney, New South Wales, Australia
| | - F Boyle
- Poche Centre, Sydney, New South Wales, Australia
| | - J French
- The Crown Princess Mary Westmead Breast Cancer Centre and Specialist Services, Sydney, New South Wales, Australia
| | - E Elder
- The Crown Princess Mary Westmead Breast Cancer Centre and Specialist Services, Sydney, New South Wales, Australia
| | - B Chalmers
- The Crown Princess Mary Westmead Breast Cancer Centre and Specialist Services, Sydney, New South Wales, Australia
| | - M Kabir
- The Crown Princess Mary Westmead Breast Cancer Centre and Specialist Services, Sydney, New South Wales, Australia
| | | | - A Wong
- Waikato Hospital, Hamilton, New Zealand
| | - H Flay
- Waikato Hospital, Hamilton, New Zealand
| | - J Scarlet
- Waikato Hospital, Hamilton, New Zealand
| | - J Weis
- University of Freiburg, Freiberg, Germany
| | - J Giesler
- University of Freiburg, Freiberg, Germany
| | - B Bliem
- Medical University Graz, Graz, Austria
| | - E Nagele
- Medical University Graz, Graz, Austria
| | | | - V Andrade
- Barretos Cancer Hospital, Sao Paolo, Brazil
| | | | - F Bonnetain
- Besançon University Hospital, Besançon, France
| | | | - S William-Jones
- Clinical Research Network, West Midlands, Queen-s Hospital, Burton upon Trent, UK
| | - A Fleet
- Clinical Research Network, West Midlands, Queen-s Hospital, Burton upon Trent, UK
| | - S Hathaway
- Clinical Research Network, West Midlands, Queen-s Hospital, Burton upon Trent, UK
| | - J Elliott
- Clinical Research Network, West Midlands, Queen-s Hospital, Burton upon Trent, UK
| | - M Galea
- Cancer Research Unit, Great Western Hospital, Swindon, UK
| | - J Dodge
- Cancer Research Unit, Great Western Hospital, Swindon, UK
| | - A Chaudhy
- Cancer Research Unit, Great Western Hospital, Swindon, UK
| | | | - L Cook
- Guy's Hospital, London, UK
| | | | - P Turton
- Leeds Teaching Hospital, Leeds, UK
| | - A Henson
- Leeds Teaching Hospital, Leeds, UK
| | - J Gibb
- Leeds Teaching Hospital, Leeds, UK
| | - R Bonomi
- Worthing Hospital, Western Sussex Hospitals, Worthing, UK
| | - S Funnell
- Worthing Hospital, Western Sussex Hospitals, Worthing, UK
| | - C Noren
- Worthing Hospital, Western Sussex Hospitals, Worthing, UK
| | - J Ooi
- Royal Bolton Hospital, Bolton, UK
| | - S Cocks
- Royal Bolton Hospital, Bolton, UK
| | - L Dawson
- Royal Bolton Hospital, Bolton, UK
| | - H Patel
- Royal Bolton Hospital, Bolton, UK
| | - L Bailey
- Royal Bolton Hospital, Bolton, UK
| | | | | | - S Kirk
- Salford Royal Hospital, UK
| | | | | | | | | | - J Smith
- Stepping Hill Hospital, Stockport, UK
| | - R Prasad
- Royal AlbertEdward Infirmary, Wigan, UK
| | - A Doran
- Royal AlbertEdward Infirmary, Wigan, UK
| | - A Power
- Royal AlbertEdward Infirmary, Wigan, UK
| | | | - J Cannon
- Royal AlbertEdward Infirmary, Wigan, UK
| | - S Latham
- Royal AlbertEdward Infirmary, Wigan, UK
| | - P Arora
- Tameside General Hospital, Ashton-under-Lyne, UK
| | - S Ridgway
- Tameside General Hospital, Ashton-under-Lyne, UK
| | - M Coulding
- Tameside General Hospital, Ashton-under-Lyne, UK
| | - R Roberts
- Tameside General Hospital, Ashton-under-Lyne, UK
| | - M Absar
- North ManchesterGeneral Hospital, Manchester, UK
| | - T Hodgkiss
- North ManchesterGeneral Hospital, Manchester, UK
| | - K Connolly
- North ManchesterGeneral Hospital, Manchester, UK
| | - J Johnson
- North ManchesterGeneral Hospital, Manchester, UK
| | - K Doyle
- North ManchesterGeneral Hospital, Manchester, UK
| | - N Lunt
- Cancer Resource Centre, Macclesfield Hospital, Macclesfield, UK
| | - M Cooper
- Bristol Breast Care Centre, Southmead Hospital, Bristol, UK
| | - I Fuchs
- Bristol Breast Care Centre, Southmead Hospital, Bristol, UK
| | - L Peall
- Bristol Breast Care Centre, Southmead Hospital, Bristol, UK
| | - L Taylor
- Bristol Breast Care Centre, Southmead Hospital, Bristol, UK
| | - A Nicholson
- Bristol Breast Care Centre, Southmead Hospital, Bristol, UK
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Sethi S, Yadav R, Singh S, Khaneja R, Aggarwal A, Agarwal P, Behera D. GenoType MTBDRplus assay for screening and characterization of isoniazid and rifampicin resistance-associated mutations in multidrug-resistant Mycobacterium tuberculosis from India. Lett Appl Microbiol 2017; 65:373-380. [PMID: 28793376 DOI: 10.1111/lam.12787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/28/2017] [Accepted: 07/31/2017] [Indexed: 11/29/2022]
Abstract
Multidrug resistant tuberculosis (MDR-TB) is rising and the World Health Organization has recommended the line probe assay (LPA) for screening. In this study we assess LPA at a tertiary care centre from North India in 1758 samples from suspected MDR-TB cases. All smear-positive and/or Mycobacterium tuberculosis culture confirmed cases (n = 1170) were subjected to the GenoType-MTBDR assay. Amongst these the majority were retreatment cases, smear-positive at diagnosis (n = 637). An MDR prevalence of 7·8% was observed with the highest cases reported amongst MDR contacts (33·3%). The most common rifampicin resistance encoding mutation seen overall and in individual patient groups was H531L (53·3%). A higher prevalence of H526D mutation was observed in retreatment cases, smear-positive at 4 months of anti-tubercular therapy vs other patient groups (P = 0·052). The most common mutation encoding isoniazid resistance was S315T1 in the katG (79·9%) and C-15T in the inhA gene (91·1%). Thirty rifampicin and nine isoniazid resistant isolates had wild type gene deletion but no detectable mutation by LPA. Although LPA is a practical and rapid screening method for most mutations expected to result in MDR-TB, we observed that it only detects the known major mutations in specific genes. Such studies can provide the knowledge required to formulate customized strips based on prevalent mutations in our region and in specific patient groups. SIGNIFICANCE AND IMPACT OF THE STUDY To the best of our knowledge this is the largest study evaluating the GenoType-MTBDR line probe assay from India. We have studied the prevalence of mutations encoding rifampicin and isoniazid resistance in different patient groups based on criteria for multidrug resistance (MDR) suspicion. The translational impact of this study is in the design of customized country- or region-wise line probe assay strips. The identification of a few mutations in particular patient groups and the detection of wild type deletion mutants with no observable mutations both point toward the need for such customization enabling us to combat the rising trend of MDR tuberculosis.
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Affiliation(s)
- S Sethi
- Department of Medical Microbiology, Post Graduate Institute of Medical education and Research, Chandigarh, India
| | - R Yadav
- Department of Medical Microbiology, Post Graduate Institute of Medical education and Research, Chandigarh, India
| | - S Singh
- Department of Medical Microbiology, Post Graduate Institute of Medical education and Research, Chandigarh, India
| | - R Khaneja
- State TB Cell, State TB Office, Chandigarh, India
| | - A Aggarwal
- Department of Pulmonary Medicine, Post Graduate Institute of Medical education and Research, Chandigarh, India
| | | | - D Behera
- Department of Pulmonary Medicine, Post Graduate Institute of Medical education and Research, Chandigarh, India
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Kumar R, Sethi S, Prakash O, Pant AK, Kumar M, Isidorov VA, Szczepaniak L. Chemical composition of rhizome oleoresin and anti-inflammatory, antinociceptive and antipyretic activity of oleoresins of Alpinia allughas Roscoe. from tarai region of Uttarakhand. Indonesian J Pharm 2017. [DOI: 10.14499/indonesianjpharm28iss3pp136] [Citation(s) in RCA: 2] [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: 11/11/2022] Open
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Sethi S, Chen X, Kass PH, Puschner B. Polychlorinated biphenyl and polybrominated diphenyl ether profiles in serum from cattle, sheep, and goats across California. Chemosphere 2017; 181:63-73. [PMID: 28426942 PMCID: PMC5494844 DOI: 10.1016/j.chemosphere.2017.04.059] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 04/13/2017] [Accepted: 04/13/2017] [Indexed: 05/02/2023]
Abstract
It has been previously been shown by our lab and others that persistent organic pollutants, such as polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs), are contaminants in milk produced for human consumption. To further this research we determined the concentration of 21 PCB and 14 PBDE congeners in livestock serum, mainly bovine, across California. Congeners were extracted from serum using solid phase extraction (SPE), cleaned up by silica cartridge and quantified using gas chromatography-triple quadruple mass spectrometry. We detected significant differences among species and the production class of cattle (beef or dairy). The sum of all 21 PCB congeners (ΣPCBs) in caprine and ovine sera had a mean value of 9.26 and 9.13 ng/mL, respectively, compared to 3.98 ng/mL in bovine sera. The mean value for the sum of all 14 PBDE congeners (ΣPBDEs) in caprine and ovine sera was 2.82 and 2.39 ng/mL, respectively, compared to 0.91 ng/mL in bovine sera. Mean ΣPCBs in dairy cattle was 5.92 ng/mL compared to 2.70 ng/mL in beef cattle. Mean ΣPBDEs in dairy cattle was 1.33 ng/mL compared to 0.70 ng/mL in beef cattle. There were no regional differences in the ΣPCBs or ΣPBDEs in cattle distributed across California. These results highlight the fact that livestock are still being exposed to these pollutants yet little is known about where this exposure may be coming from.
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Affiliation(s)
- S Sethi
- Department of Molecular Biosciences, University of California, Davis, CA, United States
| | - X Chen
- Department of Molecular Biosciences, University of California, Davis, CA, United States
| | - P H Kass
- Department of Population Health and Reproduction, University of California, Davis, CA, United States
| | - B Puschner
- Department of Molecular Biosciences, University of California, Davis, CA, United States.
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O'Connell OJ, Almeida FA, Simoff MJ, Yarmus L, Lazarus R, Young B, Chen Y, Semaan R, Saettele TM, Cicenia J, Bedi H, Kliment C, Li L, Sethi S, Diaz-Mendoza J, Feller-Kopman D, Song J, Gildea T, Lee H, Grosu HB, Machuzak M, Rodriguez-Vial M, Eapen GA, Jimenez CA, Casal RF, Ost DE. A Prediction Model to Help with the Assessment of Adenopathy in Lung Cancer: HAL. Am J Respir Crit Care Med 2017; 195:1651-1660. [PMID: 28002683 DOI: 10.1164/rccm.201607-1397oc] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
RATIONALE Estimating the probability of finding N2 or N3 (prN2/3) malignant nodal disease on endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in patients with non-small cell lung cancer (NSCLC) can facilitate the selection of subsequent management strategies. OBJECTIVES To develop a clinical prediction model for estimating the prN2/3. METHODS We used the AQuIRE (American College of Chest Physicians Quality Improvement Registry, Evaluation, and Education) registry to identify patients with NSCLC with clinical radiographic stage T1-3, N0-3, M0 disease that had EBUS-TBNA for staging. The dependent variable was the presence of N2 or N3 disease (vs. N0 or N1) as assessed by EBUS-TBNA. Univariate followed by multivariable logistic regression analysis was used to develop a parsimonious clinical prediction model to estimate prN2/3. External validation was performed using data from three other hospitals. MEASUREMENTS AND MAIN RESULTS The model derivation cohort (n = 633) had a 25% prevalence of malignant N2 or N3 disease. Younger age, central location, adenocarcinoma histology, and higher positron emission tomography-computed tomography N stage were associated with a higher prN2/3. Area under the receiver operating characteristic curve was 0.85 (95% confidence interval, 0.82-0.89), model fit was acceptable (Hosmer-Lemeshow, P = 0.62; Brier score, 0.125). We externally validated the model in 722 patients. Area under the receiver operating characteristic curve was 0.88 (95% confidence interval, 0.85-0.90). Calibration using the general calibration model method resulted in acceptable goodness of fit (Hosmer-Lemeshow test, P = 0.54; Brier score, 0.132). CONCLUSIONS Our prediction rule can be used to estimate prN2/3 in patients with NSCLC. The model has the potential to facilitate clinical decision making in the staging of NSCLC.
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Affiliation(s)
| | | | - Michael J Simoff
- 3 Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan; and
| | - Lonny Yarmus
- 4 Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
| | | | - Benjamin Young
- 2 Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Yu Chen
- 3 Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan; and
| | - Roy Semaan
- 3 Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan; and
| | | | - Joseph Cicenia
- 2 Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Harmeet Bedi
- 3 Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan; and
| | - Corrine Kliment
- 4 Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Liang Li
- 5 Department of Biostatistics, MD Anderson Cancer Center, Houston, Texas
| | - Sonali Sethi
- 2 Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Javier Diaz-Mendoza
- 3 Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan; and
| | - David Feller-Kopman
- 4 Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Juhee Song
- 5 Department of Biostatistics, MD Anderson Cancer Center, Houston, Texas
| | - Thomas Gildea
- 2 Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Hans Lee
- 4 Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
| | | | - Michael Machuzak
- 2 Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, Ohio
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