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102. The role of extracorporeal membrane oxygenation in adult liver transplant patients: A qualitative systematic review of literature

Author

Reid, Trista D., primary, Kratzke, Ian M., additional, Dayal, Diana, additional, Raff, Lauren, additional, Serrano, Pablo, additional, Kumar, Aman, additional, Zendel, Alex, additional, Herdman, Victoria, additional, Gallaher, Jared, additional, Carlson, Rebecca, additional, Charles, Anthony G., additional, and Desai, Chirag S., additional

Published
2021
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109. Early Survivorship After Liver Transplantation: A Qualitative Study Identifying Challenges in Recovery From the Patient and Caregiver Perspective

Author

Lieber, Sarah R., primary, Kim, Hannah P., additional, Baldelli, Luke, additional, Nash, Rebekah, additional, Teal, Randall, additional, Magee, Gabrielle, additional, Desai, Chirag S., additional, Loiselle, Marci M., additional, Lee, Simon C., additional, Singal, Amit G., additional, Marrero, Jorge A., additional, Barritt, A. Sidney, additional, and Evon, Donna M., additional

Published
2021
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111. Whole exome sequencing in a multi-generation family from India reveals a genetic variation c.10C>T (p.Gln4Ter) in keratin 5 gene associated with Dowling-Degos disease

Author

Virmani, Neha, Vellarikkal, Shamsudheen, Verma, Ankit, Jayarajan, Rijith, Sakhiya, Jagdish, Desai, Chirag, Sivasubbu, Sridhar, and Scaria, Vinod

Subjects
Health
Abstract

Byline: Neha. Virmani, Shamsudheen. Vellarikkal, Ankit. Verma, Rijith. Jayarajan, Jagdish. Sakhiya, Chirag. Desai, Sridhar. Sivasubbu, Vinod. Scaria Sir, Dowling-Degos disease (OMIM: 179850) is a rare genodermatosis characterized by reticulate pigmentation [...]

Published
2018

112. 'Refractory Intertrigo' in an Elderly Woman

Author

Buhles Norbert, Desai Chirag, Boer-Auer Almut, and Arens Mari

Subjects
medicine.medical_specialty, Intertrigo, Refractory, business.industry, Concise Communication, medicine, MEDLINE, lcsh:Dermatology, medicine.symptom, lcsh:RL1-803, business, Dermatology
Published
2020

113. Management of Major Injuries to the Bile Duct at a Hepatobiliary Specialty Referral Center

Author

Zendel, Alex, Kumar, Aman, Serrano, Pablo, de Oliveira, Guilherme C., Button, Julia, Gebre, Betelhme, Gerber, David A., and Desai, Chirag S.

Abstract

Introduction Aim is to evaluate geographical and demographic factors influencing management of bile duct injuries occurring during cholecystectomy in a tertiary hepato-pancreato-biliary center in Southeast US.Methods All referrals for biliary injuries during cholecystectomy, between Jan 2017 and December 2020 were included.Results 19 patients were identified with a median age of 59 (47-65), average BMI of 30.3 (18-49), and the prevalence of diabetes mellitus, hypertension and cardiovascular disease of 11%, 47% and 16%, respectively. The average transfer distance was 76 miles (8-102) and median transfer time was 3 days (1-12). 16 (84%) had Strasberg E injury, with 4 (21%) having a concomitant vascular injury (3 - right hepatic artery, 1 - right portal vein). Two (10.5%) were managed non-operatively, immediate surgical repair was performed in 2 (10.5%) and 15 (78.9%) patients underwent a delayed repair with a median of 87 days (69-118) from injury to repair. Median operative time was 5 hours (4-7), blood loss was 150 mL (100-200) and hospital stay was 8 days (6-12).Discussion Factors including distance between hospitals, delays in patient transfer due to bed availability and transportation, play a role in the decision-making towards delayed repair. The delayed repair has the benefit of medical optimization of our high-risk patients’ population.

Published
2023
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114. Radiologic Reporting of Simple Hepatic Cyst Versus Biliary Cystadenoma May Lead to Unnecessary Surgery

Author

Kumar, Aman, Zendel, Alex, Batres, Michael, Gerber, David A., and Desai, Chirag S.

Abstract

Background and Aims Simple liver cyst (SHC) is a benign condition with no malignant potential. They are typically discovered incidentally due to the increased use of abdominal imaging, but some patients may present with abdominal pain. A radiologist’s differential diagnosis in cases of SHC will often include “rule out biliary cystadenoma.” Under these circumstances, patients and surgeons are more likely to pursue surgical options even in asymptomatic cases. The aim of this study is to conduct a retrospective analysis of presentation, radiologic reporting, management plan, and histopathology of patients referred to a tertiary hospital in order to determine the correlation between radiology and histology.Methods We retrospectively analyzed the clinical, radiological, and histopathological data of 20 patients operated for a diagnosis of a cystic lesion in the liver.Result The CT/MRI of 6 (30%) patients was reported as a biliary cystadenoma, 13 (65%) were reported as a simple hepatic cyst and 1 patient (5%) had hepatocellular carcinoma (HCC) with the additional diagnosis of multiple hepatic cysts. The lesion reported as HCC on the scan was separate from the cystic lesions. The modality of imaging for these cysts was evenly split, 50% of patients had a CT scan, and 50% had an MRI performed. All imaging studies were interpreted by an attending radiologist and most of them were discussed in multidisciplinary meetings. Nineteen patients (95%) had an intraoperative diagnosis of a simple liver cyst based on its visual appearance and clear fluid within the cyst. These patients underwent cyst wall fenestration and de-roofing with the cyst wall sent for histopathology. One patient (5%) with HCC underwent a non-anatomical liver resection. Histopathology was conclusive for a benign hepatic cystic lesion from the cyst wall biopsy. All 20 patients in this study underwent surgery, either due to symptoms or due to radiologic diagnosis of BCA. Four of the 20 cases (20%) were asymptomatic and out of these four cases, 3 (75%) were diagnosed as cystadenoma on the preoperative imaging studies. All 19 cases were diagnosed as a simple liver cyst on pathology.Conclusion In summary, there is a growing trend of “ruling-out the diagnosis of biliary cystadenoma” in patients who present with liver cysts. Patients are appropriately more anxious after this preoperative diagnosis and the treating surgeons have medico-legal concerns regarding conservative management in asymptomatic patients diagnosed as BCA. This single center experience draws attention to the radiology criteria utilized for diagnosing a biliary cystadenoma and suggests that it is time to revisit the imaging interpretation and differential diagnosis.

Published
2023
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116. Type 3c: Understanding pancreatogenic diabetes.

Author

Vonderau, Jennifer Shurney and Desai, Chirag S.

Subjects
DIAGNOSIS of diabetes, DIABETES, LANGERHANS-cell histiocytosis, CONTINUING education units, PANCREATIC diseases, DISEASE complications, SYMPTOMS
Abstract

Type 3c diabetes, also known as pancreatogenic diabetes, occurs when primary pancreatic disorders damage the pancreatic islets of Langerhans. Although often misdiagnosed as type 2 diabetes, type 3c diabetes is different in cause, clinical presentation, treatment, and prognosis. Patients with type 3c diabetes are more likely to experience complications and death related to hypoglycemic events. This article reviews the causes and management of type 3c diabetes, which is estimated to affect 5% to 10% of all patients with diabetes. [ABSTRACT FROM AUTHOR]

Published
2022
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117. Skin biopsy in the pediatric age group.

Author

Khullar, Geeti and Desai, Chirag

Subjects
*SKIN biopsy, *AGE groups, *DERMATOLOGIC surgery, *PEDIATRIC dermatology
Abstract

Skin biopsy has a crucial place in arriving at a definitive diagnosis in many pediatric dermatologic conditions. The need to perform a skin biopsy on a child may provoke apprehension in the parents/caregivers, which can be alleviated by establishing a good rapport with them. The details of the procedure, including benefits and risks involved, and the expected result should be communicated to the parents in an easy-to-understand language to have an informed decision. In this review, literature search was done across the PubMed database from January 1992 to January 2022 using the following keywords "skin biopsy in children," "skin biopsy in pediatric age group," "pediatric dermatopathology," "dermatologic surgery in children," "dermatologic surgery in pediatric age group," "pediatric dermatologic surgery," and "procedures in pediatric dermatology." Articles not written in the English language were excluded. [ABSTRACT FROM AUTHOR]

Published
2022
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120. Is pseudophakic astigmatism a desirable goal?

Author

Nagpal Kamal, Desai Chirag, Trivedi Rupal, and Vasavada Abhay

Subjects
Astigmatism, complications, etiology, Cataract Extraction, adverse effects, Comparative Study, Humans, Lens Implantation, Intraocular, Prospective Studies, Ophthalmology, RE1-994
Abstract

PURPOSE: To determine whether pseudophakic astigmatism is a desirable goal, and if so, which one is better: against-the-rule (ATR) or with-the-rule (WTR). METHOD: Eyes were included only if they had an uncorrected vision > or = 6/18 and N/18. Three groups, of 40 patients each were evaluated: group 1, pseudophakes with neutral astigmatism; group 2, with ATR and group 3, with WTR astigmatism Unaided distance and near visual acuity was recorded. Statistical analysis was performed using the chi-square test for independence. RESULTS: Unaided distance vision of > or = 6/7.5 was achieved in 19 eyes (47.5%) of group 1 (neutral), 12 eyes (30%) in group 2 (ATR), and 5 eyes (12.5%) in group 3 (WTR) (p = 0.0133, significant). Unaided near vision of > or = N/9 was achieved in 17 eyes (42.5%) in group 1 (neutral), 34 eyes (85%) in group 2 (ATR), and 10 eyes (25%) in group 3 (WTR) (P < 0.001, significant). Group 1 (neutral) fared the best for unaided distance visual acuity. Group 2 (ATR) was better than in group 3 (WTR) for distant vision. Group 2 (ATR) fared the best for unaided near vision. CONCLUSION: ATR astigmatism could be a desirable goal after cataract extraction in selected populations because the largest proportion of these cases achieved good unaided near vision with acceptable distant vision.

Published
2000

122. What Survivorship Means to Liver Transplant Recipients: Qualitative Groundwork for a Survivorship Conceptual Model

Author

Lieber, Sarah R., primary, Kim, Hannah P., additional, Baldelli, Luke, additional, Nash, Rebekah, additional, Teal, Randall, additional, Magee, Gabrielle, additional, Loiselle, Marci M., additional, Desai, Chirag S., additional, Lee, Simon C., additional, Singal, Amit G., additional, Marrero, Jorge A., additional, Barritt, A. Sidney, additional, and Evon, Donna M., additional

Published
2021
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132. Current Treatment Options for Human Epidermal Growth Factor Receptor 2-Directed Therapy in Metastatic Breast Cancer: An Indian Perspective

Author

Nag Shona, Chatterjee Sanjoy, Swarup Binay, RR Rao, Kukreja Anil, Aggarwal Shyam, Nigade Jagdish, Bhattacharya Priyanka, Prasad Krishna, Warrier Arun, Patil Poonam, Suresh H. Advani, BK Smruti, Singh Randeep, Singhal Manish, Raju Titus Chacko, SS Alurkar, TP Sahoo, Srinivasan Sankar, Keechilat Pavithran, Singh Ashish, Rajendranath Rejiv, Goswami Chanchal, Agarwal Amit, Agarwal Vijay, Desai Chirag, and Gupta Sudeep

Subjects
Oncology, medicine.medical_specialty, medicine.medical_treatment, Population, Lapatinib, Targeted therapy, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Breast cancer, Trastuzumab, Internal medicine, medicine, 030212 general & internal medicine, skin and connective tissue diseases, education, neoplasms, education.field_of_study, business.industry, medicine.disease, Metastatic breast cancer, chemistry, Trastuzumab emtansine, 030220 oncology & carcinogenesis, Pediatrics, Perinatology and Child Health, Pertuzumab, business, medicine.drug
Abstract

Human epidermal growth factor receptor 2 (HER2)-positive is an aggressive subtype of breast cancer and has historically been associated with poor outcomes. The availability of various anti-HER2 therapies, including trastuzumab, lapatinib, pertuzumab, and trastuzumab emtansine (TDM-1), has remarkably improved the clinical outcomes in patients with HER2-positive metastatic breast cancer (mBC). However, there is a need to optimize treatment within this population, given the wide variability in clinical presentation. Additionally, geographical and socio-economic considerations too need to be taken into account. To clarify and collate evidence pertaining to HER2-positive metastatic breast cancer, a panel of medical and clinical oncologists from across India developed representative clinical scenarios commonly encountered in clinical practice in the country. This was followed by two meetings wherein each clinical scenario was discussed in detail and relevant evidence appraised. The result of this process is presented in this manuscript as evidence followed by therapeutic recommendations of this panel for management of HER2-positive mBC in the Indian population.

Published
2018

134. What Liver Transplant Recipients Want in a Smartphone Intervention to Enhance Recovery: Prototype for the LiveRight Transplant App

Author

Lieber, Sarah R., primary, Kim, Hannah P., additional, Baldelli, Luke, additional, Evon, Donna M., additional, Teal, Randall, additional, Nash, Rebekah, additional, Magee, Gabrielle, additional, Desai, Chirag S., additional, Gerber, David, additional, Serrano, Pablo, additional, Shah, Neil, additional, and Barritt, A. Sidney, additional

Published
2021
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136. Anticoagulation practices in total pancreatectomy with autologous islet cell transplant patients: an international survey of clinical programs

Author

Desai, Chirag S., primary, Szempruch, Kristen R., additional, Vonderau, Jennifer S., additional, Chetboun, Mikael, additional, Pattou, Francois, additional, Coates, Toby, additional, De Paep, Diedert Luc, additional, Hawthorne, Wayne J., additional, Khan, Khalid M., additional, Koning, Eelco J. P., additional, Naziruddin, Bashoo, additional, Posselt, Andrew, additional, Schrope, Beth A., additional, Wijkstrom, Martin, additional, Witkowski, Piotr, additional, and Shapiro, A. M. James, additional

Published
2021
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137. Local Food Delivery System

Author

Shah, Neel, primary, Shah, Harshil, additional, Sheth, Sakshi, additional, Chauhan, Rahul, additional, and Desai, Chirag, additional

Published
2021
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142. The role of extracorporeal membrane oxygenation in adult liver transplant patients: A qualitative systematic review of literature.

Author

Reid, Trista D., Kratzke, Ian M., Dayal, Diana, Raff, Lauren, Serrano, Pablo, Kumar, Aman, Zendel, Alex, Herdman, Victoria, Gallaher, Jared, Carlson, Rebecca, Charles, Anthony G., and Desai, Chirag S.

Subjects
EXTRACORPOREAL membrane oxygenation, LIVER transplantation, MULTIPLE organ failure, ADULTS, OXYGENATORS
Abstract

Background: A paucity of evidence exists regarding risks and benefits of extracorporeal membrane oxygenation (ECMO) in adult liver transplantation. Methods: This was a systematic review conducted from January 1, 2000 to April 24, 2020 of adult liver transplant recipients (pre‐ or post‐transplant) and donors who underwent Veno‐arterial or Veno‐venous ECMO cannulation. Death was the primary outcome, with graft function and complications as secondary outcomes. Results: Forty‐one articles were identified that fit criteria. A total of 183 donors were placed on ECMO, with recipient complication profiles and mortality that mirrored rates from standard criteria donors. Sixty‐one recipients were placed on ECMO intraoperatively or postoperatively. Most patients experienced at least one complication with infections as the most common cause and minimal complications specifically related to ECMO use. Multisystem organ failure (MSOF) and infections were more common among liver recipients who died compared to those who survived. Overall mortality at 90 days was 45.9%. Causes of death were most commonly MSOF and infections. Conclusions: ECMO use in adult liver transplantation is a useful adjunct. Recipient morbidity and mortality from donors placed on ECMO parallel that of recipients from standard criteria donors, and morbidity and mortality of recipients placed on ECMO are similar to other ECMO populations. [ABSTRACT FROM AUTHOR]

Published
2022
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