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Jayaprasad N, Madhavan S. Double-chambered right ventricle in a patient with pulmonary atresia and ventricular septal defect. BMJ Case Rep 2024; 17:e257480. [PMID: 38359952 PMCID: PMC10875559 DOI: 10.1136/bcr-2023-257480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024] Open
Abstract
Double-chambered right ventricle is a rare form of right ventricular outflow tract obstruction caused by anomalous hypertrophy of muscle bundles in right ventricle. Cases most often occur in children and rarely in adults. Most cases (80-90%) are associated with ventricular septal defect. We describe a case of pulmonary atresia and ventricular septal defect with double-chambered right ventricle. The interesting clinical findings, ECG, echocardiography and angiocardiography features are described here.
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Affiliation(s)
| | - Suresh Madhavan
- Cardiology, Goverment Medical College, Kottayam, Kerala, India
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Madhavan S, Balasubramanian V, Ramajayam D, Raju DVS, Prasad KV, Selvarajan R. Occurrence of Banana bract mosaic virus on Musa ornata Roxb based hybrids in India. Virusdisease 2022; 33:397-403. [PMID: 36447814 PMCID: PMC9701267 DOI: 10.1007/s13337-022-00788-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 08/15/2022] [Indexed: 11/30/2022] Open
Abstract
Musa ornata, wild species of banana is being used as a cut flower, potted plants and for landscape gardening etc., They are also being utilized in banana hybridization programmes for introgressing pest and disease tolerant traits into banana cultivars in addition to the development of inter specific ornamental banana hybrids. Symptoms of banana bract mosaic virus (BBrMV) was observed in the bracts of interspecific M. ornata based hybrid developed using another wild species i.e., Musa rubra Kurz at ICAR-National Research Centre for Banana (NRCB), Tiruchirapalli. Presence of the virus in the bracts, leaves and roots of symptomatic plants was confirmed through triple antibody sandwich enzyme linked immunosorbent assay with BBrMV monoclonal and polyclonal antibodies. BBrMV HC-Pro (1370 bp), CP (900 bp) and VPg (570 bp) genes were amplified from the infected bracts using reverse transcriptase polymerase chain reaction with BBrMV respective gene primers. The amplicons of these three genes were cloned and sequenced. Blastn analysis revealed that HC-Pro, VPg and CP gene sequences has 97.67%, 97.72% and 99.67% similarity with the respective gene sequences of BBrMV infecting banana. Phylogenetic analysis clustered the test isolate with other BBrMV isolates of banana and other hosts based on CP and HC-Pro and VPg gene sequences. The virus is transmitted through Pentalonia nigronervosa and the transmitted plants expressed symptoms under glass house conditions. To the best of our knowledge, this is the first report of BBrMV on ornamental M. ornata hybrid in India and its transmission occurs through Pentalonia nigronervosa. Supplementary Information The online version contains supplementary material available at 10.1007/s13337-022-00788-6.
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Affiliation(s)
- S. Madhavan
- ICAR-Directorate of Floricultural Research- Regional Station, Vemagiri, Andhra Pradesh 533125 India
| | - V. Balasubramanian
- Molecular Virology Lab, Division of Crop Protection, ICAR-National Research Centre for Banana, Thogamalai Road, Thayanur Post, Tiruchirapalli, Tamil Nadu 620102 India
| | - D. Ramajayam
- Molecular Virology Lab, Division of Crop Protection, ICAR-National Research Centre for Banana, Thogamalai Road, Thayanur Post, Tiruchirapalli, Tamil Nadu 620102 India
| | - D. V. S. Raju
- ICAR-Directorate of Floricultural Research- Regional Station, Vemagiri, Andhra Pradesh 533125 India
| | - K. V. Prasad
- ICAR-Directorate of Floricultural Research, College of Agriculture Campus Shivajinagar, Pune, Maharashtra 411 005 India
| | - R. Selvarajan
- Molecular Virology Lab, Division of Crop Protection, ICAR-National Research Centre for Banana, Thogamalai Road, Thayanur Post, Tiruchirapalli, Tamil Nadu 620102 India
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Narayanapillai J, Madhavan S. Left atrial myxoma in a patient with hypertrophic obstructive cardiomyopathy. J Clin Prev Cardiol 2022. [DOI: 10.4103/jcpc.jcpc_12_22] [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: 11/04/2022] Open
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Tsui D, Polito L, Madhavan S, Adler L, Ogale S, Camidge D. 1650P Adoption and early clinical outcomes of atezolizumab (atezo) + carboplatin and etoposide (CE) in patients with extensive-stage small cell lung cancer (ES-SCLC) in the real-world (RW) setting. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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5
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Shah D, Zheng W, Allen L, Wei W, LeMasters T, Madhavan S, Sambamoorthi U. Using a machine learning approach to investigate factors associated with treatment-resistant depression among adults with chronic non-cancer pain conditions and major depressive disorder. Curr Med Res Opin 2021; 37:847-859. [PMID: 33686881 PMCID: PMC8393457 DOI: 10.1080/03007995.2021.1900088] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Presence of chronic non-cancer pain conditions (CNPC) among adults with major depressive disorder (MDD) may reduce benefits of antidepressant therapy, thereby increasing the possibility of treatment resistance. This study sought to investigate factors associated with treatment-resistant depression (TRD) among adults with MDD and CNPC using machine learning approaches. METHODS This retrospective cohort study was conducted using a US claims database which included adults with newly diagnosed MDD and CNPC (January 2007-June 2017). TRD was identified using a clinical staging algorithm for claims data. Random forest (RF), a machine learning method, and logistic regression was used to identify factors associated with TRD. Initial model development included 42 known and/or probable factors that may be associated with TRD. The final refined model included 20 factors. RESULTS Included in the sample were 23,645 patients (73% female mean age: 55 years; 78% with ≥2 CNPC, and 91% with joint pain/arthritis). Overall, 11.4% adults (N = 2684) met selected criteria for TRD. The five leading factors associated with TRD were the following: mental health specialist visits, polypharmacy (≥5 medications), psychotherapy use, anxiety, and age. Cross-validated logistic regression model indicated that those with TRD were younger, more likely to have anxiety, mental health specialist visits, polypharmacy, and psychotherapy use with adjusted odds ratios (AORs) ranging from 1.93 to 1.27 (all ps < .001). CONCLUSION Machine learning identified several factors that warrant further investigation and may serve as potential targets for clinical intervention to improve treatment outcomes in patients with TRD and CNPC.
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Affiliation(s)
- Drishti Shah
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - Wanhong Zheng
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, USA
| | - Lindsay Allen
- Health Policy, Management, and Leadership Department, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Wenhui Wei
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
- Regeneron Pharmaceuticals, Tarrytown, NY, USA
| | - Traci LeMasters
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - Suresh Madhavan
- University of North Texas Health Sciences Center, College of Pharmacy, TX, USA
| | - Usha Sambamoorthi
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
- University of North Texas Health Sciences Center, College of Pharmacy, TX, USA
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Montenegro GB, Serzan M, Belouali A, Sackstein P, Chen K, Rao S, Veytsman I, Madhavan S, Liu S, Kim C. P21.07 Immune-Related Adverse Events with Durvalumab Consolidation in a Real-World Cohort of Patients with Non–Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Madhavan S, Narayanapillai J. Spontaneous coronary artery dissection in acute coronary syndromes: A single-center experience. Heart India 2019. [DOI: 10.4103/heartindia.heartindia_1_19] [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: 11/04/2022] Open
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Madhavan S, Narayanapillai J, Paikada J, Jayaprakash K, Jayaprakash VL. Two-dimensional speckle tracking echocardiography as a predictor of significant coronary artery stenosis in female patients with effort angina who are treadmill test positive: An angiographic correlation. J Clin Prev Cardiol 2019. [DOI: 10.4103/jcpc.jcpc_6_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Jayaprasad N, Anish PG, Madhavan S, George R. Echocardiographic abnormalities in patients with cirrhosis and relation to disease severity. Heart India 2019. [DOI: 10.4103/heartindia.heartindia_37_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Nair Rajesh G, Jayaprasad N, Madhavan S, Sudha Kumary V, Jayaprakash K, Raihanathul Misiriya KJ, Jayaprakash VL, George R. Predictors and prognosis of no-reflow during primary percutaneous coronary intervention. Proc (Bayl Univ Med Cent) 2018; 32:30-33. [PMID: 30956576 DOI: 10.1080/08998280.2018.1509577] [Citation(s) in RCA: 4] [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: 05/17/2018] [Revised: 07/30/2018] [Accepted: 08/06/2018] [Indexed: 01/08/2023] Open
Abstract
The no-reflow phenomenon occurs in a considerable number of patients with ST elevation myocardial infarction (STEMI) undergoing primary reperfusion therapy. Our study aimed to identify clinical, angiographic, and procedural variables that predict this phenomenon in patients with STEMI undergoing primary percutaneous coronary intervention (PPCI), as well as determine the impact of no-reflow on in-hospital mortality. Prospective observational data from 410 patients with STEMI undergoing PPCI were obtained. In this study, diabetes mellitus, late presentation, higher Killip class at admission, anterior wall infarction, proximal site of occlusion, presence of high-grade thrombus, and left ventricular systolic dysfunction at admission were significantly associated with suboptimal coronary flow. Diabetes mellitus, a high thrombus burden, prolonged total ischemic time, and low left ventricular ejection fraction on admission were independent predictors of no-reflow. No-reflow during PPCI was associated with in-hospital mortality more than twice that for normal flow.
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Affiliation(s)
| | | | - Suresh Madhavan
- Department of Cardiology, Government Medical CollegeKottayamKeralaIndia
| | | | | | | | | | - Raju George
- Department of Cardiology, Government Medical CollegeKottayamKeralaIndia
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King J, Bender R, Ciupek A, Jaitly A, Perloff T, Mason K, Madhavan S, Petricoin E. P2.15-13 Implementation of a Democratized Approach to Multi-Omic Molecular Profiling Via the LungMATCH Program. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Shah N, Puthiamadathil J, Serzan M, Belouali A, Kelly W, MA B, blackburn M, Knoedler A, OchoaGonzaelz S, Janni M, Madhavan S, Gibney G, Atkins M. Clinical outcome of immune related hepatitis (IrHep) in patients with advanced melanoma (AM) treated with single agent or combination immune checkpoint inhibitors (ICIs). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.093] [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: 11/13/2022] Open
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Narayanapillai J, Madhavan S, Shankaragouda BH. Cystic mediastinal mass. Heart Asia 2018; 10:e011071. [PMID: 30116306 DOI: 10.1136/heartasia-2018-011071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/03/2018] [Accepted: 07/04/2018] [Indexed: 11/03/2022]
Abstract
Case presentation A 32-year-old woman with no other medical history presented with 1-month history of fever, weight loss and dyspnoea. On examination she had elevated jugular venous pressure and tachycardia. Her chest X-ray posterioranterior view (figure 1A) showed a rounded mass in the right cardiophrenic angle obscuring the right atrial margin, producing a 'silhouette' sign. Echocardiography showed a large cystic mass with thickened pericardium, lateral to the right atrium, causing right atrial compression (figure 1B). CT image of the chest showed a cystic lesion compressing the right atrium with thickened pericardium (figure 2A). There were no other lesions found in the lungs or other organs. Laboratory tests showed elevated erythrocyte sedimentation rate (ESR: 96 mm/hour) and C reactive protein (CRP: 32 mg/L). Excision of the mass with partial pericardiectomy was done. Intraoperatively, there was a cyst with thickened pericardial wall and thick yellowish brown fluid. Histopathology of the tissue is shown in figure 2B.Figure 1(A) Chest X-ray posterioranterior view showing a rounded mass in the right cardiophrenic angle. (B) Transthoracic echocardiography apical four-chamber view showing the cystic mass.Figure 2(A) CT of the chest sagittal view showing cystic lesion compressing the right atrium with thickened pericardium. (B) Histopathology specimen of the pericardial tissue. Question What is the diagnosis and what should be the management strategy?Congenital pericardial cyst and no further evaluation required.Features are suggestive of tuberculous pericardial cyst and needs treatment with antituberculosis regimen.Features suggestive of pericardial hydatid cyst and requires treatment with albendazole.Features are suggestive of viral pericarditis with encysted effusion.
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Affiliation(s)
| | - Suresh Madhavan
- Department of Cardiology, Government Medical College, Kottayam, Kerala, India
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Abstract
Intussusception is a rare cause for postoperative intestinal obstruction. We report a case of intussusception in the early postoperative period following resection of proximal jejunum and end to end anastomosis. Computed tomography showed jejunal intussusception, which was confirmed on exploration. The anastomotic site was acting as the lead point, which was resected after reduction and reanastomosed in a single layer. The patient had uneventful recovery. Very few similar cases are reported in the literature and all the reported cases are following free jejunal transfer for pharyngo-oesophageal reconstruction.
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Affiliation(s)
- S Madhavan
- Department of General Surgery, Kasturba Medical College Mangalore, Manipal Academy of Higher Education , Karnataka , India
| | - A Augustine
- Department of General Surgery, Kasturba Medical College Mangalore, Manipal Academy of Higher Education , Karnataka , India
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Chacko P, Jayaprakash K, Misiriya KJR, Madhavan S, Kumary VS, Jayaprasad N, Jayaprakash VL, George R. Effect of thrombus aspiration on angiography and outcome in patients undergoing primary coronary angioplasty. Proc (Bayl Univ Med Cent) 2017; 30:273-275. [PMID: 28670055 DOI: 10.1080/08998280.2017.11929613] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Thrombus exerts a major impact on the performance and outcome of primary and rescue interventions in acute ST-elevation myocardial infarction. Although the optimal treatment of thrombotic lesions is still controversial, thrombus aspiration provides an effective method to achieve successful reperfusion during primary angioplasty. We compared clinical and angiographic outcomes in 286 patients with acute ST-elevation myocardial infarction undergoing primary percutaneous transluminal coronary angioplasty (PTCA) and thrombus aspiration with those who underwent conventional PTCA without thrombus aspiration. Thrombus aspiration during primary percutaneous coronary intervention in patients with high thrombus burden resulted in better Thrombolysis in Myocardial Infarction (TIMI) 3 flow in the infarct-related artery and helped achieve faster ST-segment resolution on the electrocardiogram compared with conventional angioplasty without thrombus aspiration.
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Affiliation(s)
- Praveen Chacko
- Department of Cardiology, Government Medical College, Kottayam, Kerala, India
| | | | | | - Suresh Madhavan
- Department of Cardiology, Government Medical College, Kottayam, Kerala, India
| | | | | | | | - Raju George
- Department of Cardiology, Government Medical College, Kottayam, Kerala, India
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Tregay N, Begg M, Cahn A, Povey K, Madhavan S, Simmonds R, Wilson F, Peters A, Hessel E, Chilvers E. Use of autologous radiolabelled neutrophils to quantify lung neutrophil retention in healthy volunteers, experimental LPS-induced lung inflammation, and COPD. Respir Med 2017. [DOI: 10.1016/j.rmed.2017.07.025] [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: 11/29/2022]
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King J, Ciupek A, Perloff T, Blanchard A, Mason K, Blais E, Halverson D, Bender J, Madhavan S, Petricoin E. P1.01-036 Identifying and Addressing Gaps in Molecular Testing for Patients with Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Alwhaibi M, Madhavan S, Bias T, Kelly K, Walkup J, Sambamoorthi U. Depression Treatment Among Elderly Medicare Beneficiaries With Incident Cases of Cancer and Newly Diagnosed Depression. Psychiatr Serv 2017; 68:482-489. [PMID: 28045347 PMCID: PMC5513147 DOI: 10.1176/appi.ps.201600190] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Depression treatment can improve the health outcomes of elderly cancer survivors. There is a paucity of studies on the extent to which depression is treated among elderly cancer survivors. Therefore, this study estimated the rates of depression treatment among elderly cancer survivors and identified the factors affecting depression treatment. METHODS A retrospective cohort study design was adopted, and data were obtained from the linked Surveillance, Epidemiology and End Results (SEER) and Medicare database. Elderly individuals (≥ 66 years) with incident cases of breast, colorectal, or prostate cancer and newly diagnosed depression (N=1,673) were followed for six months after the depression diagnosis to identify depression treatment (antidepressants only, psychotherapy only, combined treatment with both antidepressants and psychotherapy, and no depression treatment). Chi-square tests and multinomial logistic regressions were used to analyze the factors associated with depression treatment. RESULTS In this study population, 46% received antidepressants only, 27% received no treatment, 18% received combined therapy, and 9% received psychotherapy only. Factors associated with depression treatment included anxiety, the percentage of psychologists at the county level, the number of visits to primary care physicians, ongoing cancer treatment, the presence of other chronic conditions, and race-ethnicity. CONCLUSIONS The study findings indicate that two-thirds of cancer survivors received depression treatment in the first six months after depression diagnosis. Our study findings indicate that racial-ethnic disparities in depression treatment persist and competing demands for cancer treatment may take priority over depression care. Also, the availability of psychologists may influence receipt of psychotherapy among cancer survivors.
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Affiliation(s)
- Monira Alwhaibi
- Dr. Alwhaibi, Dr. Madhavan, Dr. Bias, Dr. Kelly, and Dr. Sambamoorthi are with the School of Pharmacy, West Virginia University, Morgantown, and Dr. Alwhaibi is also with the School of Pharmacy, King Saud University, Riyadh, Saudi Arabia (e-mail: ). Dr. Walkup is with the Graduate School of Applied and Professional Psychology, Rutgers University, New Brunswick, New Jersey
| | - Suresh Madhavan
- Dr. Alwhaibi, Dr. Madhavan, Dr. Bias, Dr. Kelly, and Dr. Sambamoorthi are with the School of Pharmacy, West Virginia University, Morgantown, and Dr. Alwhaibi is also with the School of Pharmacy, King Saud University, Riyadh, Saudi Arabia (e-mail: ). Dr. Walkup is with the Graduate School of Applied and Professional Psychology, Rutgers University, New Brunswick, New Jersey
| | - Thomas Bias
- Dr. Alwhaibi, Dr. Madhavan, Dr. Bias, Dr. Kelly, and Dr. Sambamoorthi are with the School of Pharmacy, West Virginia University, Morgantown, and Dr. Alwhaibi is also with the School of Pharmacy, King Saud University, Riyadh, Saudi Arabia (e-mail: ). Dr. Walkup is with the Graduate School of Applied and Professional Psychology, Rutgers University, New Brunswick, New Jersey
| | - Kimberly Kelly
- Dr. Alwhaibi, Dr. Madhavan, Dr. Bias, Dr. Kelly, and Dr. Sambamoorthi are with the School of Pharmacy, West Virginia University, Morgantown, and Dr. Alwhaibi is also with the School of Pharmacy, King Saud University, Riyadh, Saudi Arabia (e-mail: ). Dr. Walkup is with the Graduate School of Applied and Professional Psychology, Rutgers University, New Brunswick, New Jersey
| | - Jamie Walkup
- Dr. Alwhaibi, Dr. Madhavan, Dr. Bias, Dr. Kelly, and Dr. Sambamoorthi are with the School of Pharmacy, West Virginia University, Morgantown, and Dr. Alwhaibi is also with the School of Pharmacy, King Saud University, Riyadh, Saudi Arabia (e-mail: ). Dr. Walkup is with the Graduate School of Applied and Professional Psychology, Rutgers University, New Brunswick, New Jersey
| | - Usha Sambamoorthi
- Dr. Alwhaibi, Dr. Madhavan, Dr. Bias, Dr. Kelly, and Dr. Sambamoorthi are with the School of Pharmacy, West Virginia University, Morgantown, and Dr. Alwhaibi is also with the School of Pharmacy, King Saud University, Riyadh, Saudi Arabia (e-mail: ). Dr. Walkup is with the Graduate School of Applied and Professional Psychology, Rutgers University, New Brunswick, New Jersey
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Jayaprasad N, Madhavan S. Severe pulmonary arterial hypertension in a patient with small ventricular septal defect. BMJ Case Rep 2017; 2017:bcr-2016-218972. [DOI: 10.1136/bcr-2016-218972] [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: 11/04/2022] Open
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Jayaprasad N, Madhavan S, Baiju S, Jayaprakash VL. Prospective validation of San Francisco Syncope Rule in Indian population. J Clin Prev Cardiol 2017. [DOI: 10.4103/2250-3528.196642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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22
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Alwhaibi M, Sambamoorthi U, Madhavan S, Bias T, Kelly K, Walkup J. Cancer Type and Risk of Newly Diagnosed Depression Among Elderly Medicare Beneficiaries With Incident Breast, Colorectal, and Prostate Cancers. J Natl Compr Canc Netw 2016; 15:46-55. [DOI: 10.6004/jnccn.2017.0006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 09/07/2016] [Indexed: 11/17/2022]
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Alwhaibi M, Sambamoorthi U, Madhavan S, Walkup JT. Depression treatment and healthcare expenditures among elderly Medicare beneficiaries with newly diagnosed depression and incident breast, colorectal, or prostate cancer. Psychooncology 2016; 26:2215-2223. [PMID: 27891701 DOI: 10.1002/pon.4325] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 04/25/2016] [Revised: 11/11/2016] [Accepted: 11/21/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Depression is associated with high healthcare expenditures, and depression treatment may reduce healthcare expenditures. However, to date, there have not been any studies on the effect of depression treatment on healthcare expenditures among cancer survivors. Therefore, this study examined the association between depression treatment and healthcare expenditures among elderly with depression and incident cancer. METHODS The current study used a retrospective longitudinal study design, the linked Surveillance, Epidemiology, and End Results-Medicare database. Elderly (≥66 years) fee-for-service Medicare beneficiaries with newly diagnosed depression and incident breast, colorectal, or prostate cancer (N = 1502) were followed for a period of 12 months after depression diagnosis. Healthcare expenditures were measured every month for a period of 12-month follow-up period. Depression treatment was identified during the 6-month follow-up period. The adjusted associations between depression treatment and healthcare expenditures were analyzed with generalized linear mixed model regressions with gamma distribution and log link after controlling for other factors. RESULTS The average 1-year total healthcare expenditures after depression diagnosis were $38 219 for those who did not receive depression treatment; $42 090 for those treated with antidepressants only; $46 913 for those treated with psychotherapy only; and $51 008 for those treated with a combination of antidepressants and psychotherapy. As compared to no depression treatment, those who received antidepressants only, psychotherapy only, or a combination of antidepressants and psychotherapy had higher healthcare expenditures. However, second-year expenditures did not significantly differ among depression treatment categories. CONCLUSIONS Among cancer survivors with newly diagnosed depression, depression treatment did not have a significant effect on expenditures in the long term.
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Affiliation(s)
- Monira Alwhaibi
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA.,Department of Clinical Pharmacy, School of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Usha Sambamoorthi
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - Suresh Madhavan
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - James T Walkup
- Clinical Psychology Department, Graduate School of Applied and Professional Psychology, Rutgers University, New Brunswick, NJ, USA
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Abstract
A retrospective data analysis using 2000-2008 three state Medicaid Analytic eXtract was conducted to examine the prevalence and association of comorbidities (psychiatric and non-psychiatric) with healthcare utilization and expenditures of fee-for-service enrolled adults (22-64 years) with and without autism spectrum disorders (International Classification of Diseases, Ninth Revision-clinical modification code: 299.xx). Autism spectrum disorder cases were 1:3 matched to no autism spectrum disorder controls by age, gender, and race using propensity scores. Study outcomes were all-cause healthcare utilization (outpatient office visits, inpatient hospitalizations, emergency room, and prescription drug use) and associated healthcare expenditures. Bivariate analyses (chi-square tests and t-tests), multinomial logistic regressions (healthcare utilization), and generalized linear models with gamma distribution (expenditures) were used. Adults with autism spectrum disorders (n = 1772) had significantly higher rates of psychiatric comorbidity (81%), epilepsy (22%), infections (22%), skin disorders (21%), and hearing impairments (18%). Adults with autism spectrum disorders had higher mean annual outpatient office visits (32ASD vs 8noASD) and prescription drug use claims (51ASD vs 24noASD) as well as higher mean annual outpatient office visits (US$4375ASD vs US$824noASD), emergency room (US$15,929ASD vs US$2598noASD), prescription drug use (US$6067ASD vs US$3144noASD), and total expenditures (US$13,700ASD vs US$8560noASD). The presence of a psychiatric and a non-psychiatric comorbidity among adults with autism spectrum disorders increased the annual total expenditures by US$4952 and US$5084, respectively.
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Trusheim MR, Shrier AA, Antonijevic Z, Beckman RA, Campbell RK, Chen C, Flaherty KT, Loewy J, Lacombe D, Madhavan S, Selker HP, Esserman LJ. PIPELINEs: Creating Comparable Clinical Knowledge Efficiently by Linking Trial Platforms. Clin Pharmacol Ther 2016; 100:713-729. [PMID: 27643536 PMCID: PMC5142736 DOI: 10.1002/cpt.514] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 09/13/2016] [Accepted: 09/14/2016] [Indexed: 12/16/2022]
Abstract
Adaptive, seamless, multisponsor, multitherapy clinical trial designs executed as large scale platforms, could create superior evidence more efficiently than single-sponsor, single-drug trials. These trial PIPELINEs also could diminish barriers to trial participation, increase the representation of real-world populations, and create systematic evidence development for learning throughout a therapeutic life cycle, to continually refine its use. Comparable evidence could arise from multiarm design, shared comparator arms, and standardized endpoints-aiding sponsors in demonstrating the distinct value of their innovative medicines; facilitating providers and patients in selecting the most appropriate treatments; assisting regulators in efficacy and safety determinations; helping payers make coverage and reimbursement decisions; and spurring scientists with translational insights. Reduced trial times and costs could enable more indications, reduced development cycle times, and improved system financial sustainability. Challenges to overcome range from statistical to operational to collaborative governance and data exchange.
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Affiliation(s)
- M R Trusheim
- MIT, Center for Biomedical Innovation, Cambridge, Massachusetts, USA
| | - A A Shrier
- MIT, Center for Biomedical Innovation, Cambridge, Massachusetts, USA.,Riptide Management, Cambridge, Massachusetts, USA
| | | | - R A Beckman
- Georgetown University Medical Center, Lombardi Comprehensive Cancer Center and Innovation Center for Biomedical Informatics, Washington, DC, USA
| | | | - C Chen
- Merck & Co., Philadelphia, Pennsylvania, USA
| | - K T Flaherty
- Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
| | - J Loewy
- DataForeThought, Winchester, Massachusetts, USA
| | - D Lacombe
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - S Madhavan
- Georgetown University Medical Center, Innovation Center for Biomedical Informatics, Washington, DC, USA
| | - H P Selker
- Tufts Medical Center and Tufts University, Institute for Clinical Research and Health Policy Studies and Tufts Clinical and Translational Science Institute, Boston, Massachusetts, USA
| | - L J Esserman
- University of California San Francisco Medical Center, Carol Franc Buck Breast Care Center, San Francisco, California, USA
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Madhavan S. Adequacy of FDA'S Prescription to over-the-Counter Switch Criteria in Physician Evaluation of Proposed Switches of Drug Products. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/009286159402800235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Suresh Madhavan
- School of Pharmacy, West Virginia University, Morgantown, West Virginia
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Raval AD, Madhavan S, Mattes MD, Sambamoorthi U. Types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer. Int J Clin Pract 2016; 70:606-18. [PMID: 27291866 PMCID: PMC4927389 DOI: 10.1111/ijcp.12838] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To examine the association between types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer. METHODS A population-based retrospective cohort study was conducted using the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database. The study cohort consisted of elderly men (≥ 66 years) with localised prostate cancer diagnosed between 2002 and 2009 (N = 98,264). The initial cancer treatment received during the 6 months after cancer diagnosis consisted of (i) radical prostatectomy (RP); (ii) radiation therapy (RT); (iii) hormone therapy; and (iv) no treatment. Pre-existing chronic conditions were classified into the following eight groups: (i) only cardiometabolic conditions (CM); (ii) only mental health conditions (MH); (iii) only respiratory conditions (RESP); (iv) CM and MH; (v) CM and RESP; (vi) MH and RESP; (vii) all three conditions, CM, MH and RESP; and (viii) none of the three types of conditions. RESULTS Only 20% did not receive any cancer treatment; 47.4%, 22.1% and 10.5% received RT, RP, and hormone therapy, respectively. In multinomial logistic regression, elderly men with only RESP were more likely to receive RP as compared with those with all the three types of chronic conditions; those with only CM, only RESP, CM and MH or CM and RESP were more likely to receive RT. No significant associations were observed between the receipt of hormone therapy and types of chronic conditions. CONCLUSIONS A significant proportion of elderly men with chronic conditions have received aggressive initial cancer treatment. Our study findings suggest a conservative approach for the initial prostate cancer treatment among elderly men with significant chronic conditions and localised prostate cancer.
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Affiliation(s)
- A D Raval
- Healthcore Inc., Wilmington, DE, USA
- Department of Urology, School of Medicine, West Virginia University, Morgantown, WV, USA
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - S Madhavan
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - M D Mattes
- Department of Radiation Oncology, School of Medicine, West Virginia University, Morgantown, WV, USA
| | - U Sambamoorthi
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
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Vinayakumar D, Vinod GV, Madhavan S, Krishnan MN. Maternal and fetal outcomes in pregnant women undergoing balloon mitral valvotomy for rheumatic mitral stenosis. Indian Heart J 2016; 68:780-782. [PMID: 27931546 PMCID: PMC5143819 DOI: 10.1016/j.ihj.2016.04.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 04/15/2016] [Accepted: 04/19/2016] [Indexed: 12/02/2022] Open
Abstract
Background Rheumatic mitral stenosis constitutes a major cause of acquired heart disease complicating pregnancy in India. In the present study, we have studied the fetal and maternal outcomes of women undergoing balloon mitral valvotomy during pregnancy. Methods and results 49 pregnant ladies were included in this study in whom balloon mitral valvotomy was performed. The mean age of these patients was 25.7 ± 3.1 years. The mean gestational age was 23.5 ± 5.2 weeks (12–36 weeks). The procedure was successful in 48 patients (95.9%). Mean two-dimensional MVA increased from baseline value of 0.93 ± 0.17 cm2 to 1.75 ± 0.27 cm2 (p value <0.0001). Pre-procedure peak pulmonary artery pressure was 43.05 ± 15.88 mmHg, which decreased to 22.31 ± 6.36 mmHg (p value <0.0001). Hemodynamic data showed pre-BMV left atrial mean pressure of 29.6 ± 6.6 mmHg, which decreased to 13.7 ± 4.8 mmHg after the procedure (p value <0.0001). Mean fluoroscopy time was 6.4 ± 1.2 min. There was no maternal mortality in our study. One procedure had to be abandoned, because of failed septal puncture. One of the patients developed cardiac tamponade and another patient developed severe mitral regurgitation, which were managed medically. The patient who developed severe mitral regurgitation later underwent mitral valve replacement. Post-procedure follow-up showed an improvement in NYHA status by at least one class in 81.3% of patients. Thirty-nine (81.3%) patients had a term normal vaginal delivery and 8 (16.7%) underwent cesarean section for obstetric indications. One of the patients had abortion on the second day of the procedure. Conclusion Percutaneous mitral valvotomy during pregnancy is safe and provides excellent symptomatic relief and hemodynamic improvement. This should be considered as the treatment of choice when managing pregnant women with severe mitral stenosis.
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Affiliation(s)
| | - G V Vinod
- Department of Cardiology, Government Medical College, Kozhikode, Kerala, India
| | - Suresh Madhavan
- Department of Cardiology, Government Medical College, Kottayam, Kerala, India
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Agarwal P, Bias TK, Madhavan S, Sambamoorthi N, Frisbee S, Sambamoorthi U. Factors Associated With Emergency Department Visits: A Multistate Analysis of Adult Fee-for-Service Medicaid Beneficiaries. Health Serv Res Manag Epidemiol 2016; 3. [PMID: 27512721 PMCID: PMC4977022 DOI: 10.1177/2333392816648549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective: The objective of this study was to examine the association of patient- and county-level factors with the emergency department (ED) visits among adult fee-for-service (FFS) Medicaid beneficiaries residing in Maryland, Ohio, and West Virginia. Methods: A cross-sectional design using retrospective observational data was implemented. Patient-level data were obtained from 2010 Medicaid Analytic eXtract files. Information on county-level health-care resources was obtained from the Area Health Resource file and County Health Rankings file. Results: In adjusted analyses, the following patient-level factors were associated with higher number of ED visits: African Americans (incidence rate ratios [IRR] = 1.47), Hispanics (IRR = 1.63), polypharmacy (IRR = 1.89), and tobacco use (IRR = 2.23). Patients with complex chronic illness had a higher number of ED visits (IRR = 3.33). The county-level factors associated with ED visits were unemployment rate (IRR = 0.94) and number of urgent care clinics (IRR = 0.96). Conclusion: Patients with complex healthcare needs had a higher number of ED visits as compared to those without complex healthcare needs. The study results provide important baseline context for future policy analysis studies around Medicaid expansion options.
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Affiliation(s)
- Parul Agarwal
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - Thomas K Bias
- Department of Health Policy, Management and Leadership, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Suresh Madhavan
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | | | - Stephanie Frisbee
- Department of Health Policy, Management and Leadership, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Usha Sambamoorthi
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
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Raval AD, Madhavan S, Mattes MD, Sambamoorthi U. Association between Types of Chronic Conditions and Cancer Stage at Diagnosis among Elderly Medicare Beneficiaries with Prostate Cancer. Popul Health Manag 2016; 19:445-453. [PMID: 27031642 DOI: 10.1089/pop.2015.0141] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
The current retrospective observational study was conducted to examine the association between types of chronic conditions and cancer stage at diagnosis among elderly Medicare beneficiaries with prostate cancer using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. The study cohort consisted of elderly men (≥66 years) with prostate cancer diagnosed between 2002 and 2009 (N = 103,820). Cancer stage at diagnosis (localized versus advanced) was derived using the American Joint Committee on Cancer classification. Chronic conditions were identified during the year before cancer diagnosis and classified as: (1) only cardiometabolic (CM); (2) only mental health (MH); (3) only respiratory (RESP); (4) CM + MH; (5) CM + RESP; (6) MH + RESP; (7) CM+ MH + RESP; and (8) none of the 3 types of conditions. Chi-square tests and multivariable logistic regressions were used to test the unadjusted and adjusted associations between types of chronic conditions and cancer stage at diagnosis. The highest percentage (5.8%) of advanced prostate cancer was observed among elderly men with none of the 3 types of chronic conditions (CM, RESP, MH). In the adjusted logistic regression, those with none of the 3 types of chronic conditions were 44% more likely to be diagnosed with advanced prostate cancer compared to men with all the 3 types of chronic conditions. Elderly men without any of the selected chronic conditions were more likely to be diagnosed with advanced prostate cancer; therefore, strategies to reduce the risk of advanced prostate cancer should be targeted toward elderly men without these conditions.
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Affiliation(s)
- Amit D Raval
- 1 Healthcore Inc. , Wilmington, Delaware.,2 Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University , Morgantown, West Virginia
| | - Suresh Madhavan
- 2 Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University , Morgantown, West Virginia
| | - Malcolm D Mattes
- 3 Department of Radiation Oncology, School of Medicine, West Virginia University , Morgantown, West Virginia
| | - Usha Sambamoorthi
- 2 Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University , Morgantown, West Virginia
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Mee P, Kahn K, Kabudula C, Wagner R, Gómez-Olivé FX, Madhavan S, Collinson MA, Tollman S, Byass P. The development of a localised HIV epidemic and the associated excess mortality burden in a rural area of South Africa. Glob Health Epidemiol Genom 2016; 1:e7. [PMID: 29302331 PMCID: PMC5738674 DOI: 10.1017/gheg.2016.3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 08/19/2015] [Revised: 02/12/2016] [Accepted: 02/16/2016] [Indexed: 01/25/2023] Open
Abstract
The human immunodeficiency virus (HIV) epidemic in South Africa rapidly developed into a major pandemic. Here we analyse the development of the epidemic in a rural area of the country. The data used were collected between 1992 and 2013 in a longitudinal population survey, the Agincourt Health and Demographic Surveillance Study, in the northeast of the country. Throughout the period of study mortality rates were similar in all villages, suggesting that there were multiple index cases evenly spread geographically. These were likely to have been returning migrant workers. For those aged below 39 years the HIV mortality rate was higher for women, above this age it was higher for men. This indicates the protective effect of greater access to HIV testing and treatment among older women. The recent convergence of mortality rates for Mozambicans and South Africans indicates that the former refugee population are being assimilated into the host community. More than 60% of the deaths occurring in this community between 1992 and 2013 could be attributed directly or indirectly to HIV. Recently there has been an increasing level of non-HIV mortality which has important implications for local healthcare provision. This study demonstrates how evidence from longitudinal analyses can support healthcare planning.
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Affiliation(s)
- P. Mee
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden
- Department of Population Health, Faculty of Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, London,UK
| | - K. Kahn
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden
- International Network for the Demographic Evaluation of Populations and Their Health (INDEPTH) Network, Accra, Ghana
| | - C.W. Kabudula
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- International Network for the Demographic Evaluation of Populations and Their Health (INDEPTH) Network, Accra, Ghana
| | - R.G. Wagner
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden
- International Network for the Demographic Evaluation of Populations and Their Health (INDEPTH) Network, Accra, Ghana
| | - F. X. Gómez-Olivé
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- International Network for the Demographic Evaluation of Populations and Their Health (INDEPTH) Network, Accra, Ghana
| | - S. Madhavan
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of African-American Studies, University of Maryland-College Park, College Park, MD, USA
| | - Mark A. Collinson
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden
- International Network for the Demographic Evaluation of Populations and Their Health (INDEPTH) Network, Accra, Ghana
| | - S.M. Tollman
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden
- International Network for the Demographic Evaluation of Populations and Their Health (INDEPTH) Network, Accra, Ghana
| | - P. Byass
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden
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Raval AD, Madhavan S, Mattes MD, Salkini M, Sambamoorthi U. Impact of Prostate Cancer Diagnosis on Noncancer Hospitalizations Among Elderly Medicare Beneficiaries With Incident Prostate Cancer. J Natl Compr Canc Netw 2016; 14:186-94. [PMID: 26850489 DOI: 10.6004/jnccn.2016.0022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Accepted: 01/05/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The purpose of this study was to analyze the impact of cancer diagnosis on noncancer hospitalizations (NCHs) by comparing these hospitalizations between the precancer and postcancer periods in a cohort of fee-for-service Medicare beneficiaries with incident prostate cancer. METHODS A population-based retrospective cohort study was conducted using the SEER-Medicare linked database for 2000 through 2010. The study cohort consisted of 57,489 elderly men (aged ≥ 67 years) with incident prostate cancer. NCHs were identified in 6 periods (t1-t6) before and after the incidence of prostate cancer. Each period consisted of 120 days. For each period, NCHs were defined as inpatient admissions with primary diagnosis codes not related to prostate cancer, prostate cancer-related procedures, or bowel, sexual, and urinary dysfunction. Bivariate and multivariate comparisons on rates of NCHs between the precancer and postcancer periods accounted for the repeated measures design. RESULTS The rate of NCHs was higher during the postcancer period (5.1%) compared with the precancer period (3.2%). In both unadjusted and adjusted models, elderly men were 37% (odds ratio [OR], 1.37; 95% CI, 1.32, 1.41) and 38% (adjusted OR, 1.38; 95% CI, 1.33, 1.46) more likely to have any NCHs during the postcancer period compared with the precancer period. CONCLUSIONS Elderly men with prostate cancer had a significant increase in the risk of NCHs after the diagnosis of prostate cancer. This study highlights the need to design interventions for reducing the excess NCHs after prostate cancer diagnosis among elderly men.
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Affiliation(s)
- Amit D Raval
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, School of Medicine, West Virginia University, Morgantown, West Virginia
| | - Suresh Madhavan
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, School of Medicine, West Virginia University, Morgantown, West Virginia
| | - Malcolm D Mattes
- Department of Radiation Oncology, School of Medicine, West Virginia University, Morgantown, West Virginia
| | - Mohamad Salkini
- Department of Urology, School of Medicine, West Virginia University, Morgantown, West Virginia
| | - Usha Sambamoorthi
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, School of Medicine, West Virginia University, Morgantown, West Virginia
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Raval AD, Mattes MD, Madhavan S, Pan X, Wei W, Sambamoorthi U. Association between Metformin Use and Cancer Stage at Diagnosis among Elderly Medicare Beneficiaries with Preexisting Type 2 Diabetes Mellitus and Incident Prostate Cancer. J Diabetes Res 2016; 2016:2656814. [PMID: 27547763 PMCID: PMC4983375 DOI: 10.1155/2016/2656814] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Accepted: 05/09/2016] [Indexed: 11/25/2022] Open
Abstract
Objective. To examine the association between metformin use and cancer stage at diagnosis among elderly men with preexisting diabetes mellitus and incident prostate cancer. Methods. This study used a population-based observational cohort of elderly men (≥66 years) with preexisting diabetes and incident prostate cancer between 2008 and 2009 (N = 2,652). Cancer stage at diagnosis (localized versus advanced) was based on the American Joint Cancer Committee classification. Metformin use and other independent variables were measured during the one year before cancer diagnosis. Logistic regressions with inverse probability treatment weights were used to control for the observed selection bias. Results. A significantly lower percentage of metformin users were diagnosed with advanced prostate cancer as compared to nonusers (4.7% versus 6.7%, p < 0.03). After adjusting for the observed selection bias and other independent variables, metformin use was associated with a 32% reduction in the risk of advanced prostate cancer (adjusted odds ratio, AOR: 0.68, 95% confidence interval, CI: 0.48, 0.97). Conclusions. This is the first epidemiological study to support the role of metformin in reducing the risk of advanced prostate cancer. Randomized clinical trials are needed to confirm the causal link between metformin use and prostate cancer diagnosis stage.
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Affiliation(s)
- Amit D. Raval
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV 26505, USA
- Healthcore, Inc., Wilmington, DE 19801, USA
- *Amit D. Raval:
| | - Malcolm D. Mattes
- Department of Radiation Oncology, School of Medicine, West Virginia University, Morgantown, WV 26505, USA
| | - Suresh Madhavan
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV 26505, USA
| | | | - Wenhui Wei
- Sanofi U.S., Inc., Bridgewater, NJ 08807, USA
| | - Usha Sambamoorthi
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV 26505, USA
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Jayaprakash K, Madhavan S, Sudha Kumary V, George R, Cletus N, Baiju S. Wong's anomaly - a rare variant of cor triatriatum. Indian Heart J 2015; 67:469-71. [PMID: 26432738 DOI: 10.1016/j.ihj.2015.04.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 04/01/2015] [Accepted: 04/08/2015] [Indexed: 11/25/2022] Open
Abstract
Cor triatriatum sinistrum is an extremely rare congenital heart disease. It is even more uncommon in adults, and clinically significant mitral valve lesion complicating cor triatriatum is distinctly rare. Wong et al reported for the first time the rare combination of cor triatriatum sinister associated with severe mitral regurgitation and abnormal tensor apparatus of the mitral valve. We report a similar case and used the term Wong's anomaly for the syndrome, having membranous type of cor triatriatum sinistrum, severe mitral regurgitation and hypoplasia of the papillary muscles and short chordae. Color Doppler Echocardiography showed peculiar 'helmet sign' of mitral regurgitation, wherein the mitral regurgitation color jet fills the distal atrial chamber and abruptly ends in a horizontal plane as it is halted by the intra-atrial membrane.
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Affiliation(s)
- K Jayaprakash
- Associate Professor, Department of Cardiology, Government Medical College, Kottayam 686008, Kerala, India.
| | - Suresh Madhavan
- Assistant Professor, Department of Cardiology, Government Medical College, Kottayam, Kerala, India
| | - V Sudha Kumary
- Assistant Professor, Department of Cardiology, Government Medical College, Kottayam, Kerala, India
| | - Raju George
- Professor & Head, Department of Cardiology, Government Medical College, Kottayam, Kerala, India
| | - Nigil Cletus
- Senior Resident, Department of Cardiology, Government Medical College, Kottayam, Kerala, India
| | - S Baiju
- Senior Resident, Department of Cardiology, Government Medical College, Kottayam, Kerala, India
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Abstract
We report a case of a second recurrence of a right atrial myxoma in a 38-year-old woman who had surgical excision in March 2008 and excision of a recurrence in August 2012. She presented with a similar clinical picture in December 2014 and again underwent surgical excision. The case is unusual both for its location in the right atrium and its multiple recurrences in a sporadic form without any sign of the myxoma complex.
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Affiliation(s)
- V Sudha Kumary
- Department of Cardiology, Government Medical College, Kottayam, South India
| | - Suresh Madhavan
- Department of Cardiology, Government Medical College, Kottayam, South India
| | - P C Akhil
- Department of Cardiology, Government Medical College, Kottayam, South India
| | - K Jayaprakash
- Department of Cardiology, Government Medical College, Kottayam, South India
| | - Raju George
- Department of Cardiology, Government Medical College, Kottayam, South India
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Jayaprakash K, Madhavan S, Kumary VS, Akhil PC, Cardoz J, George R. Multivessel Transradial Percutaneous Coronary Angioplasty in a Single Coronary Artery Originating from the Right Sinus of Valsalva. Proc (Bayl Univ Med Cent) 2015; 28:504-6. [DOI: 10.1080/08998280.2015.11929324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Madhavan S, Jayaprakash K, Jayaprasad N, Sathish G, George R. Blood cyst of the anterior mitral leaflet causing severe mitral regurgitation. Proc (Bayl Univ Med Cent) 2015; 28:363-4. [PMID: 26130890 DOI: 10.1080/08998280.2015.11929275] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
We report a case of blood cyst of the anterior mitral leaflet leading to severe mitral regurgitation and heart failure in a 70-year-old woman with no other factors that could explain the severe mitral regurgitation.
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Affiliation(s)
| | - K Jayaprakash
- Government Medical College, Kottayam, Kerala State, India
| | - N Jayaprasad
- Government Medical College, Kottayam, Kerala State, India
| | - Gargi Sathish
- Government Medical College, Kottayam, Kerala State, India
| | - Raju George
- Government Medical College, Kottayam, Kerala State, India
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Vyas A, Madhavan S, Sambamoorthi U, Pan X(L, Regier M, Hazard H. Timeliness of care among elderly women with breast cancer. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e17720] [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: 11/20/2022] Open
Affiliation(s)
- Ami Vyas
- Rutgers University, Piscataway, NJ
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Raval AD, Thakker D, Vyas A, Salkini M, Madhavan S, Sambamoorthi U. Impact of metformin on clinical outcomes among men with prostate cancer: A systematic review and meta-analysis. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e16000] [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: 11/20/2022] Open
Affiliation(s)
- Amit D Raval
- School of Pharmacy West Virginia University, Morgantown, WV
| | - Divyesh Thakker
- Shrimati Kaumudiniben Health Economics and Outcomes Research Group, Dhrangadhra, India
| | - Ami Vyas
- School of Pharmacy West Virginia University, Morgantown, WV
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Jayaprasad N, Madhavan S. LEOPARD Syndrome with Patent Ductus Arteriosus and Hypertrophic Cardiomyopathy. J Assoc Physicians India 2015; 63:76-77. [PMID: 26591153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A sixteen year old girl presented with history of hemoptysis of one week duration. She had history of dyspnea on exertion and frequent respiratory infections in childhood. She had short stature, hypertelorism, neurofibroma, café au lait spots and multiple lentigines. She had features of severe pulmonary hypertension and differential clubbing and cyanosis. A final diagnosis of LEOPARD syndrome with hypertrophic cardiomyopathy and patent ductus arteriosus (PDA) Eisenmenger syndrome was made.
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Campbell S, Cole W, Boynewicz K, Zawacki L, Clark A, Kale D, Madhavan S. Target kicking accuracy in infants with periventricular brain insults: does early experience matter? Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Madhavan S, Sathish G. Left main coronary artery ostial occlusion in a young man: late sequelae of Kawasaki's disease?: Figure 1. Heart Asia 2015; 7:15. [DOI: 10.1136/heartasia-2014-010598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Raval AD, Thakker D, Vyas A, Salkini M, Madhavan S, Sambamoorthi U. Impact of metformin on clinical outcomes among men with prostate cancer: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis 2015; 18:110-21. [PMID: 25667109 DOI: 10.1038/pcan.2014.52] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 10/18/2014] [Accepted: 11/19/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND Conflicting evidence exists regarding the beneficial effects of metformin in prostate cancer. To determine the association between metformin and clinical outcomes in prostate cancer using systematic review and meta-analysis. METHODS Original articles published in English until third week of July, 2014 were searched in electronic databases (Medline-Ovid, Scopus, The Cochrane Library, Web of Science, ProQuest) for studies on metformin use in prostate cancer. The clinical outcomes assessed were: development of biochemical recurrence, metastases or castration-resistant metastatic cancer, all-cause and prostate cancer-specific mortality. Meta-analysis was performed to calculate the pooled hazard ratio (pHR) and their 95% confidence interval (95% CI). Heterogeneity between the studies was examined using I2 statistics. Sensitivity analysis was conducted to assess the robustness of findings and publication bias was assessed by the Egger's regression asymmetry test and contour plot. RESULTS Out of 230 retrieved citations, eight retrospective cohort studies and one nested-case-control study met the inclusion criteria. Metformin use was marginally associated with reduction in the risk of biochemical recurrence (pHR: 0.82, 95% CI: 0.67, 1.01, P-value=0.06, I2=25%, five studies). Metformin use was not significantly associated with metastases (pHR: 0.59, 95% 0.30-1.18, P-value=0.14, I2=74%, three studies), all-cause mortality (pHR: 0.86; 95% CI, 0.67, 1.10, P-value=0.23, I2: 73%, six studies) and prostate cancer-specific mortality (pHR: 0.76, 95% CI: 0.43, 1.33, P-value = 0.33, I2=60%, four studies). Pooled estimates for all outcomes varied in sensitivity analysis by diabetes status and primary treatment of prostate cancer. Systematic review revealed mixed findings on metformin use and the risk of CRPC. CONCLUSIONS Metformin may reduce the risk of biochemical recurrence in prostate cancer. Given the potential of selection bias in the observational studies, randomized trials should be designed to assess the efficacy of metformin use in prostate cancer.
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Affiliation(s)
- A D Raval
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - D Thakker
- Shrimati Kaumudiniben Health Outcomes Research Group (SKHORG), Dhrangadhra, Gujarat, India
| | - A Vyas
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - M Salkini
- Department of Surgery/Urology, School of Medicine, West Virginia University, Morgantown, WV, USA
| | - S Madhavan
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - U Sambamoorthi
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
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Madhavan S, Sathish G, Kumar V, Krishnan MN. Amplatzer Duct Occluder for treatment of displaced PDA coil induced late haemolysis. Heart Asia 2015; 7:7. [DOI: 10.1136/heartasia-2014-010590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Jayaprakash K, Madhavan S, Kumary VS, Anish PG, George R. Benign neoplasms in the right ventricular outflow tract. Proc (Bayl Univ Med Cent) 2015; 28:67-8. [PMID: 25552804 DOI: 10.1080/08998280.2015.11929192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
We describe benign neoplasms in the right ventricular outflow tract in two patients: one, a 2-month-old male with a rhabdomyoma, and the other, a 48-year-old woman with a myxoma. Each of these tumors is rare in that location.
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Affiliation(s)
- K Jayaprakash
- Department of Cardiology, Government Medical College, Kottayam, South India
| | - Suresh Madhavan
- Department of Cardiology, Government Medical College, Kottayam, South India
| | - V Sudha Kumary
- Department of Cardiology, Government Medical College, Kottayam, South India
| | - P G Anish
- Department of Cardiology, Government Medical College, Kottayam, South India
| | - Raju George
- Department of Cardiology, Government Medical College, Kottayam, South India
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Kasturi J, Brown AP, Brown P, Madhavan S, Prabakar L, Wally JL. Interconnectivity of Disparate Nonclinical Data Silos for Drug Discovery and Development. Ther Innov Regul Sci 2014; 48:498-506. [DOI: 10.1177/2168479014531421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Madhavan S, Sathish G. A perilous cause for cardiogenic shock. Heart Asia 2014; 6:184. [DOI: 10.1136/heartasia-2014-010596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Vyas A, Madhavan S, Sambamoorthi U. Association between persistence with mammography screening and stage at diagnosis among elderly women diagnosed with breast cancer. Breast Cancer Res Treat 2014; 148:645-54. [PMID: 25399230 PMCID: PMC4450353 DOI: 10.1007/s10549-014-3204-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [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: 08/23/2014] [Accepted: 11/09/2014] [Indexed: 10/24/2022]
Abstract
Previous studies on the association between mammography screening and stage at breast cancer (BC) diagnosis have limitations because they did not analyze persistence with mammography screening and did not distinguish screening from diagnostic mammograms. The objective of this study is to determine the association between persistence with mammography screening and stage at BC diagnosis among elderly women. A retrospective observational study of 39,006 women age ≥70 diagnosed with incident BC from 2005 to 2009 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare dataset was conducted. A validated algorithm with high sensitivity and specificity was used to distinguish between screening and diagnostic mammograms. Persistence with mammography screening was measured as having at least three screening mammograms in five years before BC diagnosis. Multinomial logistic regressions were performed to analyze the association between persistence with mammography screening and stage at diagnosis, in a multivariate framework. Overall, 46% of elderly women were persistent with mammography screening, 26% were not persistent, and 28% did not have any screening mammogram in five years before BC diagnosis. As compared to women who were not persistent with mammography screening, women who were persistent with mammography screening were significantly more likely to be diagnosed at earlier stages of BC. The adjusted odds ratios were 3.28, 2.37, and 1.60 for in situ, local, and regional stages, respectively. A lower proportion of elderly women was persistent with mammography and it was highly associated with earlier stages of BC diagnosis. Interventions designed to promote persistent mammography screening among elderly women are warranted.
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Affiliation(s)
- Ami Vyas
- Department of Pharmaceutical Systems & Policy, School of Pharmacy, Robert C. Byrd Health Sciences Center, West Virginia University, P.O. Box 9510, Morgantown, WV, 26506-9510, USA,
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