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Neel Shah

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https://www.readbyqxmd.com/read/29221840/a-multicenter-study-of-irrigation-and-debridement-in-total-knee-arthroplasty-periprosthetic-joint-infection-treatment-failure-is-high
#1
Kenneth L Urish, Andrew G Bullock, Alexander M Kreger, Neel B Shah, Kwonho Jeong, Scott D Rothenberger
BACKGROUND: In total knee arthroplasty (TKA) periprosthetic joint infection (PJI), irrigation and debridement (I&D) with component retention is a treatment option with a wide variation in reported failure rates. The purpose of this study was to determine failure rates, outcomes, and factors that predict failure in I&D for TKA PJI. METHODS: A multicenter observational study of patients with a TKA PJI and subsequently undergoing an I&D with retention of components was conducted...
November 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29211338/look-then-leap-quality-and-improving-maternity-care
#2
Neel Shah
Obstetricians learned this lesson the hard way. A century ago, very little in obstetric practice was codified. Care was artisanal, variable, and sometimes dangerous. Based on a theory that childbirth is inherently "pathogenic," prominent American obstetricians recommended sweeping reforms. (DeLee, JB, Principles and Practice of Obstetrics, 1913, first edition). This article is protected by copyright. All rights reserved.
December 6, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29181359/articular-reconstruction-using-subchondral-cementation-and-threaded-kirschner-wires-in-giant-cell-tumor-a-novel-technique
#3
Padmanabh H Vora, Rameez Musa, Neel M Bhavsar, Darshan Shah
Introduction: Giant Cell Tumor(GCT) is one of an infrequently encountered tumor by orthopaedic surgeons in clinical practice. It is described as 'locally malignant' tumor found in epimetaphyseal region of long bones, peculiarly around knee. We present a case of a solitary, benign Campanacci Grade 2 GCT in right lateral femoral condyle in 38 year old female and our treatment. Case Report: A 38 year old female presented to our outpatient department with chief complaint of constant, moderate pain in right knee increasing in duration since 3 months...
July 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29112747/what-we-know-about-tuberculosis-transmission-an-overview
#4
REVIEW
Gavin Churchyard, Peter Kim, N Sarita Shah, Roxana Rustomjee, Neel Gandhi, Barun Mathema, David Dowdy, Anne Kasmar, Vicky Cardenas
Tuberculosis remains a global health problem with an enormous burden of disease, estimated at 10.4 million new cases in 2015. To stop the tuberculosis epidemic, it is critical that we interrupt tuberculosis transmission. Further, the interventions required to interrupt tuberculosis transmission must be targeted to high-risk groups and settings. A simple cascade for tuberculosis transmission has been proposed in which (1) a source case of tuberculosis (2) generates infectious particles (3) that survive in the air and (4) are inhaled by a susceptible individual (5) who may become infected and (6) then has the potential to develop tuberculosis...
November 3, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29112744/research-roadmap-for-tuberculosis-transmission-science-where-do-we-go-from-here-and-how-will-we-know-when-we-re-there
#5
REVIEW
Sara C Auld, Anne G Kasmar, David W Dowdy, Barun Mathema, Neel R Gandhi, Gavin J Churchyard, Roxana Rustomjee, N Sarita Shah
High rates of tuberculosis transmission are driving the ongoing global tuberculosis epidemic, and there is a pressing need for research focused on understanding and, ultimately, halting transmission. The ongoing tuberculosis-human immunodeficiency virus (HIV) coepidemic and rising rates of drug-resistant tuberculosis in parts of the world add further urgency to this work. Success in this research will require a concerted, multidisciplinary effort on the part of tuberculosis scientists, clinicians, programs, and funders and must span the research spectrum from biomedical sciences to the social sciences, public health, epidemiology, cost-effectiveness analyses, and operations research...
November 3, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29083975/factors-associated-with-direct-health-care-costs-among-patients-with-migraine
#6
Machaon Bonafede, Qian Cai, Katherine Cappell, Gilwan Kim, Sandhya J Sapra, Neel Shah, Katherine Widnell, Paul Winner, Pooja Desai
BACKGROUND: Migraine imposes substantial economic burden on patients and the health care system. Approximately 18% of women and 6% of men suffer from migraine in the United States. This is a heterogeneous group, and little data are available to evaluate factors associated with migraine costs. OBJECTIVE: To evaluate characteristics associated with high costs among commercially insured patients with migraine. METHODS: This retrospective analysis identified patients with migraine in the Truven Health MarketScan Research Databases between January 2008 and June 2013...
November 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29028800/spatial-distribution-of-extensively-drug-resistant-tuberculosis-xdr-tb-patients-in-kwazulu-natal-south-africa
#7
Thandi Kapwata, Natashia Morris, Angela Campbell, Thuli Mthiyane, Primrose Mpangase, Kristin N Nelson, Salim Allana, James C M Brust, Pravi Moodley, Koleka Mlisana, Neel R Gandhi, N Sarita Shah
BACKGROUND: KwaZulu-Natal province, South Africa, has among the highest burden of XDR TB worldwide with the majority of cases occurring due to transmission. Poor access to health facilities can be a barrier to timely diagnosis and treatment of TB, which can contribute to ongoing transmission. We sought to determine the geographic distribution of XDR TB patients and proximity to health facilities in KwaZulu-Natal. METHODS: We recruited adults and children with XDR TB diagnosed in KwaZulu-Natal...
2017: PloS One
https://www.readbyqxmd.com/read/28939455/neurocognitive-dysfunction-in-hematopoietic-cell-transplant-recipients-expert-review-from-the-late-effects-and-quality-of-life-working-committee-of-the-center-for-international-blood-and-marrow-transplant-research-and-complications-and-quality-of-life-working
#8
REVIEW
Debra Lynch Kelly, David Buchbinder, Rafael F Duarte, Jeffrey J Auletta, Neel Bhatt, Michael Byrne, Melissa Gabriel, Anuj Mahindra, Maxim Norkin, Helene Schoemans, Ami J Shah, Ibrahim Ahmed, Yoshiko Atsuta, Grzegorz W Basak, Sara Beattie, Sita Bhella, Christopher Bredeson, Nancy Bunin, Jignesh Dalal, Andrew Daly, James Gajewski, Robert Peter Gale, John Galvin, Mehdi Hamadani, Robert J Hayashi, Kehinde Adekola, Jason Law, Catherine J Lee, Jane Liesveld, Adriana K Malone, Arnon Nagler, Seema Naik, Taiga Nishihori, Susan K Parsons, Angela Scherwath, Hannah-Lise Schofield, Robert Soiffer, Jeff Szer, Ida Twist, Anne Warwick, Baldeep M Wirk, Jean Yi, Minoo Battiwalla, Mary E Flowers, Bipin Savani, Bronwen E Shaw
Hematopoietic cell transplantation (HCT) is a potentially curative treatment for children and adults with malignant and nonmalignant diseases. Despite increasing survival rates, long-term morbidity after HCT is substantial. Neurocognitive dysfunction is a serious cause of morbidity, yet little is known about neurocognitive dysfunction after HCT. To address this gap, collaborative efforts of the Center for International Blood and Marrow Transplant Research and the European Group for Blood and Marrow Transplantation undertook an expert review of neurocognitive dysfunction after HCT...
September 20, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28891793/regulation-of-the-glucocorticoid-receptor-via-a-bet-dependent-enhancer-drives-antiandrogen-resistance-in-prostate-cancer
#9
Neel Shah, Ping Wang, John Wongvipat, Wouter R Karthaus, Wassim Abida, Joshua Armenia, Shira Rockowitz, Yotam Drier, Bradley E Bernstein, Henry W Long, Matthew L Freedman, Vivek K Arora, Deyou Zheng, Charles L Sawyers
In prostate cancer, resistance to the antiandrogen enzalutamide (Enz) can occur through bypass of androgen receptor (AR) blockade by the glucocorticoid receptor (GR). In contrast to fixed genomic alterations, here we show that GR-mediated antiandrogen resistance is adaptive and reversible due to regulation of GR expression by a tissue-specific enhancer. GR expression is silenced in prostate cancer by a combination of AR binding and EZH2-mediated repression at the GR locus, but is restored in advanced prostate cancers upon reversion of both repressive signals...
September 11, 2017: ELife
https://www.readbyqxmd.com/read/28871456/queueing-theoretic-analysis-of-labor-and-delivery-understanding-management-styles-and-c-section-rates
#10
Matthew Gombolay, Toni Golen, Neel Shah, Julie Shah
Childbirth is a complex clinical service requiring the coordinated support of highly trained healthcare professionals as well as management of a finite set of critical resources (such as staff and beds) to provide safe care. The mode of delivery (vaginal delivery or cesarean section) has a significant effect on labor and delivery resource needs. Further, resource management decisions may impact the amount of time a physician or nurse is able to spend with any given patient. In this work, we employ queueing theory to model one year of transactional patient information at a tertiary care center in Boston, Massachusetts...
September 4, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28793157/association-of-previous-cesarean-delivery-with-surgical-complications-after-a-hysterectomy-later-in-life
#11
Sofie A I Lindquist, Neel Shah, Charlotte Overgaard, Christian Torp-Pedersen, Karin Glavind, Thomas Larsen, Avery Plough, Grace Galvin, Aage Knudsen
Importance: In recent decades, the global rates of cesarean delivery have rapidly increased. Nonetheless, the influence of cesarean deliveries on surgical complications later in life has been understudied. Objective: To investigate whether previous cesarean delivery increases the risk of reoperation, perioperative and postoperative complications, and blood transfusion when undergoing a hysterectomy later in life. Design, Setting, and Participants: This registry-based cohort study used data from Danish nationwide registers on all women who gave birth for the first time between January 1, 1993, and December 31, 2012, and underwent a benign, nongravid hysterectomy between January 1, 1996, and December 31, 2012...
August 9, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28728882/variation-in-the-cost-of-5-common-operations-in-the-united-states
#12
COMPARATIVE STUDY
Elliot Wakeam, George Molina, Neel Shah, Stuart R Lipsitz, David C Chang, Atul A Gawande, Alex B Haynes
BACKGROUND: Health care costs are an important policy focus in the United States. The magnitude and drivers of variation in the costs of common operative procedures are not well understood. We sought to characterize variation in costs across hospitals. METHODS: We used data from the Nationwide Inpatient Sample from 2001-2011 for 5 elective operations: colectomy, coronary artery bypass graft, total knee arthroplasty, cesarean section, and lung resection. Hospitals were benchmarked for each using hierarchical risk- and reliability-adjustment methods to generate an observed-to-expected cost ratio, which was adjusted for patient demographics, comorbidity, wage index, and procedure complexity...
September 2017: Surgery
https://www.readbyqxmd.com/read/28700743/polymorphisms-in-the-vitamin-d-receptor-gene-are-associated-with-reduced-rate-of-sputum-culture-conversion-in-multidrug-resistant-tuberculosis-patients-in-south-africa
#13
Matthew J Magee, Yan V Sun, James C M Brust, N Sarita Shah, Yuming Ning, Salim Allana, Angela Campbell, Qin Hui, Koleka Mlisana, Pravi Moodley, Neel R Gandhi
BACKGROUND: Vitamin D modulates the inflammatory and immune response to tuberculosis (TB) and also mediates the induction of the antimicrobial peptide cathelicidin. Deficiency of 25-hydroxyvitamin D and single nucleotide polymorphisms (SNPs) in the vitamin D receptor (VDR) gene may increase the risk of TB disease and decrease culture conversion rates in drug susceptible TB. Whether these VDR SNPs are found in African populations or impact multidrug-resistant (MDR) TB treatment has not been established...
2017: PloS One
https://www.readbyqxmd.com/read/28697107/relationship-between-labor-and-delivery-unit-management-practices-and-maternal-outcomes
#14
REVIEW
Avery C Plough, Grace Galvin, Zhonghe Li, Stuart R Lipsitz, Shehnaz Alidina, Natalie J Henrich, Lisa R Hirschhorn, William R Berry, Atul A Gawande, Doris Peter, Rory McDonald, Donna L Caldwell, Janet H Muri, Debra Bingham, Aaron B Caughey, Eugene R Declercq, Neel T Shah
OBJECTIVE: To define, measure, and characterize key competencies of managing labor and delivery units in the United States and assess the associations between unit management and maternal outcomes. METHODS: We developed and administered a management measurement instrument using structured telephone interviews with both the primary nurse and physician managers at 53 diverse hospitals across the United States. A trained interviewer scored the managers' interview responses based on management practices that ranged from most reactive (lowest scores) to most proactive (highest scores)...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28686159/deconstruction-of-the-ras-switching-cycle-through-saturation-mutagenesis
#15
Pradeep Bandaru, Neel H Shah, Moitrayee Bhattacharyya, John P Barton, Yasushi Kondo, Joshua C Cofsky, Christine L Gee, Arup K Chakraborty, Tanja Kortemme, Rama Ranganathan, John Kuriyan
Ras proteins are highly conserved signaling molecules that exhibit regulated, nucleotide-dependent switching between active and inactive states. The high conservation of Ras requires mechanistic explanation, especially given the general mutational tolerance of proteins. Here, we use deep mutational scanning, biochemical analysis and molecular simulations to understand constraints on Ras sequence. Ras exhibits global sensitivity to mutation when regulated by a GTPase activating protein and a nucleotide exchange factor...
July 7, 2017: ELife
https://www.readbyqxmd.com/read/28680904/risk-factors-associated-with-outpatient-parenteral-antibiotic-therapy-program-failure-among-intravenous-drug-users
#16
Deanna J Buehrle, Ryan K Shields, Neel Shah, Christopher Shoff, Kathleen Sheridan
Sixty-one percent of intravenous drug users (IVDUs) who received outpatient parenteral antibiotic therapy (OPAT) failed treatment. Hospital readmission and adverse drug reactions occurred in 25%. By multivariate analysis, time since last IVDU was associated with failure (P = .04). Intravenous drug users requiring OPAT are at high risk for failure; additional studies are needed to explore alternatives.
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28614298/erf-mutations-reveal-a-balance-of-ets-factors-controlling-prostate-oncogenesis
#17
Rohit Bose, Wouter R Karthaus, Joshua Armenia, Wassim Abida, Phillip J Iaquinta, Zeda Zhang, John Wongvipat, Elizabeth V Wasmuth, Neel Shah, Patrick S Sullivan, Michael G Doran, Ping Wang, Anna Patruno, Yilin Zhao, Deyou Zheng, Nikolaus Schultz, Charles L Sawyers
Half of all prostate cancers are caused by the TMPRSS2-ERG gene-fusion, which enables androgens to drive expression of the normally silent E26 transformation-specific (ETS) transcription factor ERG in prostate cells. Recent genomic landscape studies of such cancers have reported recurrent point mutations and focal deletions of another ETS member, the ETS2 repressor factor ERF. Here we show these ERF mutations cause decreased protein stability and mostly occur in tumours without ERG upregulation. ERF loss recapitulates the morphological and phenotypic features of ERG gain in normal mouse prostate cells, including expansion of the androgen receptor transcriptional repertoire, and ERF has tumour suppressor activity in the same genetic background of Pten loss that yields oncogenic activity by ERG...
June 29, 2017: Nature
https://www.readbyqxmd.com/read/28549612/variation-in-cesarean-birth-rates-by-labor-and-delivery-nurses
#18
Joyce K Edmonds, Michele O'Hara, Sean P Clarke, Neel Shah
OBJECTIVE: To examine variation in the cesarean birth rates of women cared for by labor and delivery nurses. DESIGN: Retrospective cohort study. SETTING: One high-volume labor and delivery unit at an academic medical center in a major metropolitan area. PARTICIPANTS: Labor and delivery nurses who cared for nulliparous women who gave birth to term, singleton fetuses in vertex presentation. METHODS: Data were extracted from electronic hospital birth records from January 1, 2013 through June 30, 2015...
May 23, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/28540148/clinical-and-microbiological-characteristics-of-bacteroides-prosthetic-joint-infections
#19
Neel Shah, Douglas Osmon, Aaron J Tande, James Steckelberg, Rafael Sierra, Randall Walker, Elie F Berbari
Clinical and microbiological characteristics of patients with Bacteroides prosthetic joint infection (PJI) have not been well described in the literature. The aim of this retrospective cohort study was to assess the outcome of patients with Bacteroides PJI and to review risk factors associated with failure of therapy. Between 1/1969 and 12/2012, 20 episodes of Bacteroides PJI in 17 patients were identified at our institution. The mean age of the patients in this cohort at the time of diagnosis was 55.6 years; 59% (n=10) had knee involvement...
2017: Journal of Bone and Joint Infection
https://www.readbyqxmd.com/read/28334585/uptake-and-utilization-of-practice-guidelines-in-hospitals-in-the-united-states-the-case-of-routine-episiotomy
#20
Katy B Kozhimannil, Pinar Karaca-Mandic, Cori J Blauer-Peterson, Neel T Shah, Jonathan M Snowden
BACKGROUND: The gap between publishing and implementing guidelines differs based on practice setting, including hospital geography and teaching status. On March 31, 2006, a Practice Bulletin published by the American College of Obstetricians and Gynecologists (ACOG) recommended against the routine use of episiotomy and urged clinicians to make judicious decisions to restrict the use of the procedure. OBJECTIVE: This study investigated changes in trends of episiotomy use before and after the ACOG Practice Guideline was issued in 2006, focusing on differences by hospital geographic location (rural/urban) and teaching status...
January 2017: Joint Commission Journal on Quality and Patient Safety
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