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Vasudeva Naik, Shetty Shivakumar, Varun Gosain
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Varun Gosain, Vasudeva Naik, Shetty Shivakumar
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Varun Gosain, Shruthi Bettegowda
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Varun Gosain, Vasudeva Naik, Shetty Shivakumar
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Benjamin Eithun, Ankush Gosain
BACKGROUND: Trauma activation and/or leveling criteria are designed to balance the potential harm to individual patients from undertriage (UT) of severe injuries versus overutilization of resources from overtriage (OT) of lesser injuries. The American College of Surgeons (ACS) recommends an acceptable UT rate ≤5% and OT 25%-50%. To improve UT or OT, an intervention was performed to (1) improve accuracy in following established leveling criteria and (2) modify activation criteria in an evidence-based manner to better identify severely injured children...
October 2016: Journal of Surgical Research
Ian Chow, Chad A Purnell, Philip J Hanwright, Arun K Gosain
BACKGROUND: Cleft lip represents one of the most common birth defects in the world. Although the timing of cleft lip repair is contingent on a number of factors, the "rule of 10s" remains a frequently quoted safety benchmark. Initially reported by Wilhelmsen and Musgrave in 1966 and modified by Millard in 1976, this rule referred to performing surgery once patients had reached cutoffs in weight, hemoglobin, and age/leukocyte count. Despite significant advances in both surgical and anesthetic technique, the oft-quoted "rule of 10s" has not been systematically investigated since its inception...
September 2016: Plastic and Reconstructive Surgery
Regan F Williams, Israel Fernandez-Pineda, Ankush Gosain
Pediatric sarcomas are a heterogeneous group of tumors accounting for approximately 10% of childhood solid tumors. Treatment is focused on multimodality therapy, which has improved the prognosis over the past two decades. Current regimens focus on decreasing treatment for low-risk patients to decrease the long-term side effects while maximizing therapy for patients with metastatic disease to improve survival. Pediatric sarcomas can be divided into soft tissue sarcomas and osseous tumors. Soft tissue sarcomas are further delineated into rhabdomyosarcomas, which affect young children and nonrhabdomyosarcomas, which are most common in adolescents...
October 2016: Surgical Clinics of North America
Donald J Harvey, Ali Totonchi, Arun K Gosain
BACKGROUND: Attempted separation of craniopagus twins has continued to be associated with devastating results since the first partially successful separation with one surviving twin in 1952. To understand the factors that contribute to successful separation in the modern era of neuroimaging and modern surgical techniques, the authors reviewed and analyzed cases reported since 1995. METHODS: All reported cases of craniopagus twin separation attempts from 1995 to 2015 were identified using PubMed (n = 19)...
July 2016: Plastic and Reconstructive Surgery
Teddy Chang, Pallavi Gosain, Martina H Stenzel, Megan S Lord
In this study polymeric micelles formed from poly(poly(ethylene glycol) methyl ether methacrylate)-block-poly(methyl methacrylate) (P(PEGMEMA75)-b-PMMA80) block copolymer of approximately 25nm in diameter were used to encapsulate the model drug, Nile Red, with a loading efficiency of 0.08wt% and a chemotherapeutic drug, doxorubicin (DOX), with an efficiency of 2.75wt%. The release of DOX from the micelles was sufficient to be cytotoxic to human colon carcinoma cells, WiDr, while Nile Red and the unloaded micelles were found not to be cytotoxic when exposed to the cells at polymer concentrations up to 200μg/mL...
August 1, 2016: Colloids and Surfaces. B, Biointerfaces
Tiffany J Zens, Deborah A Rusy, Ankush Gosain
BACKGROUND: Surgical wound classification (SWC) communicates the degree of contamination in the surgical field and is used to stratify risk of surgical site infection and compare outcomes among centers. We hypothesized that by changing from nurse-directed to surgeon-directed SWC during a structured operative debrief, we will improve accuracy of documentation. METHODS: An institutional review board-approved retrospective chart review was performed. Two time periods were defined: initially, SWC was determined and recorded by the circulating nurse (before debrief, June 2012-May 2013) and allowing 6 mo for adoption and education, we implemented a structured operative debriefing including surgeon-directed SWC (after debrief, January 2014-August 2014)...
April 2016: Journal of Surgical Research
Naira V Margaryan, Alina Gilgur, Elisabeth A Seftor, Chad Purnell, Nicoleta C Arva, Arun K Gosain, Mary J C Hendrix, Luigi Strizzi
Expression of Nodal, a Transforming Growth Factor-beta (TGF-β) related growth factor, is associated with aggressive melanoma. Nodal expression in adult dysplastic nevi may predict the development of aggressive melanoma in some patients. A subset of pediatric patients diagnosed with giant or large congenital melanocytic nevi (LCMN) has shown increased risk for development of melanoma. Here, we investigate whether Nodal expression can help identify the rare cases of LCMN that develop melanoma and shed light on why the majority of these patients do not...
2016: International Journal of Molecular Sciences
Priyanka Gosain, Maiteder Larrauri-Reyes, Christos G Mihos, Esteban Escolar, Orlando Santana
Pulmonary hypertension (PH) in the setting of left-sided valvular heart disease is common, and significantly increases the risk of perioperative morbidity and mortality in patients undergoing aortic and/or mitral valve surgery. Minimally invasive valve surgery is associated with a decreased incidence of perioperative complications, and a faster recovery, when compared with conventional sternotomy. In the present study, the outcomes of 569 patients with PH who underwent minimally invasive aortic and/or mitral valve surgery were analysed...
May 2016: Interactive Cardiovascular and Thoracic Surgery
Salah Mansour, Anna S Tocheva, Chris Cave-Ayland, Moritz M Machelett, Barbara Sander, Nikolai M Lissin, Peter E Molloy, Mark S Baird, Gunthard Stübs, Nicolas W J Schröder, Ralf R Schumann, Jörg Rademann, Anthony D Postle, Bent K Jakobsen, Ben G Marshall, Rajendra Gosain, Paul T Elkington, Tim Elliott, Chris-Kriton Skylaris, Jonathan W Essex, Ivo Tews, Stephan D Gadola
Cluster of differentiation 1c (CD1c)-dependent self-reactive T cells are abundant in human blood, but self-antigens presented by CD1c to the T-cell receptors of these cells are poorly understood. Here we present a crystal structure of CD1c determined at 2.4 Å revealing an extended ligand binding potential of the antigen groove and a substantially different conformation compared with known CD1c structures. Computational simulations exploring different occupancy states of the groove reenacted these different CD1c conformations and suggested cholesteryl esters (CE) and acylated steryl glycosides (ASG) as new ligand classes for CD1c...
March 1, 2016: Proceedings of the National Academy of Sciences of the United States of America
Joshua M Adkinson, Mia T Casale, John Y S Kim, Nima Khavanin, Karol A Gutowski, Arun K Gosain
Plastic surgery research using large databases has increased dramatically over the past 20 years. With the magnitude and breadth of information available in these databases, researchers are able to more easily answer a wide variety of research questions. This study sought to provide a comprehensive comparative analysis of the relevant databases for plastic surgery research. Database information, data collection methods, acquisition details, and variable availability were collected for 19 large databases. Examples of potential future research utility were ascribed to each database based on this comprehensive analysis...
February 2016: Plastic and Reconstructive Surgery
Ankush Gosain
Hirschsprung's disease (HSCR) is a common cause of neonatal bowel obstruction and the approach to diagnosis and surgical treatment is well defined and accepted. Hirschsprung's-associated enterocolitis (HAEC) remains a frequent cause of pre-operative and post-operative morbidity and mortality, with unchanged treatment guidelines over multiple decades. Recent advances in our understanding of the genetics underlying HSCR have allowed the development of animal models, some of which recapitulate the HAEC phenotype...
April 2016: Pediatric Surgery International
Brendan Alleyne, Davood Varghai, Ufuk Askeroglu, Samantha Zwiebel, Kathryn Tobin, Arun K Gosain
BACKGROUND: The current study was performed to elucidate changes in growth factor expression over time in critical-sized calvarial defects in rats from infancy to skeletal maturity. MATERIALS AND METHODS: Critical-sized parietal defects of 5, 6, and 8 mm were created in postnatal day 6 (P6), postnatal day (P20), and postnatal day (P84) adult rats, respectively. Dura was harvested at 3, 7, or 14 days after surgery, and serial micro-computed tomography imaging was performed through 12 weeks postoperatively...
January 2016: Journal of Craniofacial Surgery
Lisa Block, Timothy W King, Ankush Gosain
Significance: Traumatic injuries are the leading cause of morbidity and mortality in children. The purpose of this review is to provide an overview of the initial assessment and management of traumatic and burn wounds in children. Special attention is given to wound cleansing, debridement techniques, and considerations for pain management and psychosocial support for children and families. Recent Advances: Basic and translational research over the last 5-7 years has advanced our knowledge related to the optimal care of acute pediatric traumatic and burn wounds...
October 1, 2015: Advances in Wound Care
Sundeep G Keswani
The overarching goals of the International Society of Pediatric Wound Care (ISPeW) are to (1) set global standards for the assessment and treatment of pediatric wounds of varying etiologies; (2) provide a forum for international interprofessional collaboration among healthcare professionals, researchers, educators, and industry leaders dedicated to the care of pediatric wounds; (3) promote and support clinical research focused on the prevention, assessment, and treatment of pediatric wounds; (4) collaborate with wound care organizations worldwide on pediatric wound care issues; and (5) provide evidence-based pediatric wound care education to healthcare professionals, parents, and lay caregivers...
October 1, 2015: Advances in Wound Care
S Neeta, Madhusudan Upadya, Anuradha Gosain, Jesni Joseph Manissery
BACKGROUND: Hyperbaric bupivacaine along with either fentanyl or sufentanil as additive, has been widely used in spinal anesthesia. In the present study, we compared the analgesic effects of intrathecal fentanyl versus sufentanil combined with bupivacaine for surgical procedures over the abdomen and lower limbs. SETTINGS AND DESIGN: This was randomized controlled study conducted in a tertiary care hospital attached to a medical school. METHODS: Sixty American Society of Anesthesiologists I and II patients were randomized into three groups by sealed envelope technique...
May 2015: Anesthesia, Essays and Researches
Adrian Buganza Tepole, Michael Gart, Chad A Purnell, Arun K Gosain, Ellen Kuhl
Skin expansion is a common surgical technique to correct large cutaneous defects. Selecting a successful expansion protocol is solely based on the experience and personal preference of the operating surgeon. Skin expansion could be improved by predictive computational simulations. Towards this goal, we model skin expansion using the continuum framework of finite growth. This approach crucially relies on the concept of incompatible configurations. However, aside from the classical opening angle experiment, our current understanding of growth-induced incompatibilities remains rather vague...
May 2016: Annals of Biomedical Engineering
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