10 results on '"Dhristie Bhagat"'
Search Results
2. Treatment of Periodic Alternating Nystagmus as a Consequence of Ataxia–Telangiectasia
- Author
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Ruben Jauregui, Dhristie Bhagat, Mekka R. Garcia, Claire Miller, and Scott N. Grossman
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Ophthalmology ,Neurology (clinical) - Published
- 2022
3. Life stressors significantly impact long-term outcomes and post-acute symptoms 12-months after COVID-19 hospitalization
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Jennifer A. Frontera, Sakinah Sabadia, Dixon Yang, Adam de Havenon, Shadi Yaghi, Ariane Lewis, Aaron S. Lord, Kara Melmed, Sujata Thawani, Laura J. Balcer, Thomas Wisniewski, Steven L. Galetta, Shashank Agarwal, Andres Andino, Vito Arena, Samuel Baskharoun, Kristie Bauman, Lena Bell, Stephen Berger, Dhristie Bhagat, Matthew Bokhari, Steven Bondi, Melanie Canizares, Alexander Chervinsky, Barry M. Czeisler, Levi Dygert, Taolin Fang, Brent Flusty, Daniel Friedman, David Friedman, Benjamin Fuchs, Andre Granger, Daniel Gratch, Lindsey Gurin, Josef Gutman, Lisena Hasanaj, Manisha Holmes, Jennifer Horng, Joshua Huang, Haruki Ishii, Ruben Jauregui, Yuan Ji, D. Ethan Kahn, Ethan Koch, Penina Krieger, Alexandra Kvernland, Rebecca Lalchan, Kaitlyn Lillemoe, Jessica Lin, Susan B. Liu, Maya Madhavan, Chaitanya Medicherla, Patricio Millar-Vernetti, Nicole Morgan, Anlys Olivera, Mirza Omari, George Park, Palak Patel, Milan Ristic, Jonathan Rosenthal, Michael Sonson, Thomas Snyder, Rebecca S. Stainman, Brian Sunwoo, Daniel Talmasov, Michael Tamimi, Betsy Thomas, Eduard Valdes, Ting Zhou, and Yingrong Zhu
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Hospitalization ,Neurology ,Activities of Daily Living ,Quality of Life ,Humans ,COVID-19 ,Female ,Neurology (clinical) ,Prospective Studies ,Longitudinal Studies ,Fatigue - Abstract
Limited data exists evaluating predictors of long-term outcomes after hospitalization for COVID-19.We conducted a prospective, longitudinal cohort study of patients hospitalized for COVID-19. The following outcomes were collected at 6 and 12-months post-diagnosis: disability using the modified Rankin Scale (mRS), activities of daily living assessed with the Barthel Index, cognition assessed with the telephone Montreal Cognitive Assessment (t-MoCA), Neuro-QoL batteries for anxiety, depression, fatigue and sleep, and post-acute symptoms of COVID-19. Predictors of these outcomes, including demographics, pre-COVID-19 comorbidities, index COVID-19 hospitalization metrics, and life stressors, were evaluated using multivariable logistic regression.Of 790 COVID-19 patients who survived hospitalization, 451(57%) completed 6-month (N = 383) and/or 12-month (N = 242) follow-up, and 77/451 (17%) died between discharge and 12-month follow-up. Significant life stressors were reported in 121/239 (51%) at 12-months. In multivariable analyses, life stressors including financial insecurity, food insecurity, death of a close contact and new disability were the strongest independent predictors of worse mRS, Barthel Index, depression, fatigue, and sleep scores, and prolonged symptoms, with adjusted odds ratios ranging from 2.5 to 20.8. Other predictors of poor outcome included older age (associated with worse mRS, Barthel, t-MoCA, depression scores), baseline disability (associated with worse mRS, fatigue, Barthel scores), female sex (associated with worse Barthel, anxiety scores) and index COVID-19 severity (associated with worse Barthel index, prolonged symptoms).Life stressors contribute substantially to worse functional, cognitive and neuropsychiatric outcomes 12-months after COVID-19 hospitalization. Other predictors of poor outcome include older age, female sex, baseline disability and severity of index COVID-19.
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- 2022
4. Trajectories of Neurologic Recovery 12 Months After Hospitalization for COVID-19: A Prospective Longitudinal Study
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Jennifer A. Frontera, Dixon Yang, Chaitanya Medicherla, Samuel Baskharoun, Kristie Bauman, Lena Bell, Dhristie Bhagat, Steven Bondi, Alexander Chervinsky, Levi Dygert, Benjamin Fuchs, Daniel Gratch, Lisena Hasanaj, Jennifer Horng, Joshua Huang, Ruben Jauregui, Yuan Ji, D. Ethan Kahn, Ethan Koch, Jessica Lin, Susan Liu, Anlys Olivera, Jonathan Rosenthal, Thomas Snyder, Rebecca Stainman, Daniel Talmasov, Betsy Thomas, Eduard Valdes, Ting Zhou, Yingrong Zhu, Ariane Lewis, Aaron S. Lord, Kara Melmed, Sharon B. Meropol, Sujata Thawani, Andrea B. Troxel, Shadi Yaghi, Laura J. Balcer, Thomas Wisniewski, and Steven Galetta
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Hospitalization ,Activities of Daily Living ,Humans ,COVID-19 ,Neurology (clinical) ,Prospective Studies ,Longitudinal Studies ,Research Article - Abstract
Background and ObjectiveLittle is known about trajectories of recovery 12 months after hospitalization for severe COVID-19.MethodsWe conducted a prospective, longitudinal cohort study of patients with and without neurologic complications during index hospitalization for COVID-19 from March 10, 2020, to May 20, 2020. Phone follow-up batteries were performed at 6 and 12 months after COVID-19 onset. The primary 12-month outcome was the modified Rankin Scale (mRS) score comparing patients with or without neurologic complications using multivariable ordinal analysis. Secondary outcomes included activities of daily living (Barthel Index), telephone Montreal Cognitive Assessment (t-MoCA), and Quality of Life in Neurologic Disorders (Neuro-QoL) batteries for anxiety, depression, fatigue, and sleep. Changes in outcome scores from 6 to 12 months were compared using nonparametric paired-samples sign test.ResultsTwelve-month follow-up was completed in 242 patients (median age 65 years, 64% male, 34% intubated during hospitalization) and 174 completed both 6- and 12-month follow-up. At 12 months, 197/227 (87%) had ≥1 abnormal metric: mRS >0 (75%), Barthel Index p = 0.037). Significant improvements in outcome trajectories from 6 to 12 months were observed in t-MoCA scores (56% improved, median difference 1 point; p = 0.002) and Neuro-QoL anxiety scores (45% improved; p = 0.003). Nonsignificant improvements occurred in fatigue, sleep, and depression scores in 48%, 48%, and 38% of patients, respectively. Barthel Index and mRS scores remained unchanged between 6 and 12 months in >50% of patients.DiscussionAt 12 months after hospitalization for severe COVID-19, 87% of patients had ongoing abnormalities in functional, cognitive, or Neuro-QoL metrics and abnormal cognition persisted in 50% of patients without a history of dementia/cognitive abnormality. Only fatigue severity differed significantly between patients with or without neurologic complications during index hospitalization. However, significant improvements in cognitive (t-MoCA) and anxiety (Neuro-QoL) scores occurred in 56% and 45% of patients, respectively, between 6 and 12 months. These results may not be generalizable to those with mild or moderate COVID-19.
- Published
- 2022
5. Trajectories of Neurological Recovery 12 Months after Hospitalization for COVID-19: A Prospective Longitudinal Study
- Author
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Jennifer A. Frontera, Dixon Yang, Chaitanya Medicherla, Samuel Baskharoun, Kristie Bauman, Lena Bell, Dhristie Bhagat, Steven Bondi, Alexander Chervinsky, Levi Dygert, Benjamin Fuchs, Daniel Gratch, Lisena Hasanaj, Jennifer Horng, Joshua Huang, Ruben Jauregui, Yuan Ji, D. Ethan Kahn, Ethan Koch, Jessica Lin, Susan B. Liu, Anlys Olivera, Jonathan Rosenthal, Thomas Snyder, Rebecca S. Stainman, Daniel Talmasov, Betsy Thomas, Eduard Valdes, Ting Zhou, Yingrong Zhu, Ariane Lewis, Aaron S. Lord, Kara Melmed, Sharon B. Meropol, Sujata Thawani, Andrea B. Troxel, Shadi Yaghi, Laura J. Balcer, Thomas Wisniewski, and Steven L. Galetta
- Abstract
Background/ObjectivesLittle is known about trajectories of recovery 12-months after hospitalization for severe COVID.MethodsWe conducted a prospective, longitudinal cohort study of patients with and without neurological complications during index hospitalization for COVID-19 from March 10, 2020-May 20, 2020. Phone follow-up batteries were performed at 6- and 12-months post-COVID symptom onset. The primary 12-month outcome was the modified Rankin Scale (mRS) comparing patients with or without neurological complications using multivariable ordinal analysis. Secondary outcomes included: activities of daily living (Barthel Index), telephone Montreal Cognitive Assessment (t-MoCA) and Neuro-QoL batteries for anxiety, depression, fatigue and sleep. Changes in outcome scores from 6 to 12-months were compared using non-parametric paired-samples sign test.ResultsTwelve-month follow-up was completed in N=242 patients (median age 65, 64% male, 34% intubated during hospitalization) and N=174 completed both 6- and 12-month follow-up. At 12-months 197/227 (87%) had ≥1 abnormal metric: mRS>0 (75%), Barthel50% of patients.DiscussionAt 12-months post-hospitalization for severe COVID, 87% of patients had ongoing abnormalities in functional, cognitive or Neuro-QoL metrics and abnormal cognition persisted in 50% of patients without a prior history of dementia/cognitive abnormality. Only fatigue severity differed significantly between patients with or without neurological complications during index hospitalization. However, significant improvements in cognitive (t-MoCA) and anxiety (Neuro-QoL) scores occurred in 56% and 45% of patients, respectively, between 6- to 12-months. These results may not be generalizable to those with mild/moderate COVID.
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- 2022
6. Prevalence and Risk Factors of Neurologic Manifestations in Hospitalized Children Diagnosed with Acute SARS-CoV-2 or MIS-C
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Ericka L. Fink, Courtney L. Robertson, Mark S. Wainwright, Juan D. Roa, Marlina E. Lovett, Casey Stulce, Mais Yacoub, Renee M. Potera, Elizabeth Zivick, Adrian Holloway, Ashish Nagpal, Kari Wellnitz, Theresa Czech, Katelyn M. Even, Werther Brunow de Carvalho, Isadora Souza Rodriguez, Stephanie P. Schwartz, Tracie C. Walker, Santiago Campos-Miño, Leslie A. Dervan, Andrew S. Geneslaw, Taylor B. Sewell, Patrice Pryce, Wendy G. Silver, Jieru Egeria Lin, Wendy S. Vargas, Alexis Topjian, Alicia M. Alcamo, Jennifer L. McGuire, Jesus Angel Domínguez Rojas, Jaime Tasayco Muñoz, Sue J. Hong, William J. Muller, Matthew Doerfler, Cydni N. Williams, Kurt Drury, Dhristie Bhagat, Aaron Nelson, Dana Price, Heda Dapul, Laura Santos, Robert Kahoud, Conall Francoeur, Brian Appavu, Kristin P. Guilliams, Shannon C. Agner, Karen H. Walson, Lindsey Rasmussen, Anna Janas, Peter Ferrazzano, Raquel Farias-Moeller, Kellie C. Snooks, Chung-Chou H. Chang, James Yun, and Michelle E. Schober
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Male ,Adolescent ,Intensive Care Units, Pediatric ,Pediatrics ,Child Development ,Developmental Neuroscience ,Risk Factors ,Prevalence ,Research Letter ,Humans ,Child ,Brain Diseases ,SARS-CoV-2 ,Headache ,COVID-19 ,Infant ,South America ,Systemic Inflammatory Response Syndrome ,United States ,Cross-Sectional Studies ,Logistic Models ,Neurology ,Child, Preschool ,Acute Disease ,Pediatrics, Perinatology and Child Health ,Neurological manifestations ,Female ,Neurology (clinical) ,Nervous System Diseases - Abstract
Our objective was to characterize the frequency, early impact, and risk factors for neurological manifestations in hospitalized children with acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or multisystem inflammatory syndrome in children (MIS-C).Multicenter, cross-sectional study of neurological manifestations in children aged18 years hospitalized with positive SARS-CoV-2 test or clinical diagnosis of a SARS-CoV-2-related condition between January 2020 and April 2021. Multivariable logistic regression to identify risk factors for neurological manifestations was performed.Of 1493 children, 1278 (86%) were diagnosed with acute SARS-CoV-2 and 215 (14%) with MIS-C. Overall, 44% of the cohort (40% acute SARS-CoV-2 and 66% MIS-C) had at least one neurological manifestation. The most common neurological findings in children with acute SARS-CoV-2 and MIS-C diagnosis were headache (16% and 47%) and acute encephalopathy (15% and 22%), both P 0.05. Children with neurological manifestations were more likely to require intensive care unit (ICU) care (51% vs 22%), P 0.001. In multivariable logistic regression, children with neurological manifestations were older (odds ratio [OR] 1.1 and 95% confidence interval [CI] 1.07 to 1.13) and more likely to have MIS-C versus acute SARS-CoV-2 (OR 2.16, 95% CI 1.45 to 3.24), pre-existing neurological and metabolic conditions (OR 3.48, 95% CI 2.37 to 5.15; and OR 1.65, 95% CI 1.04 to 2.66, respectively), and pharyngeal (OR 1.74, 95% CI 1.16 to 2.64) or abdominal pain (OR 1.43, 95% CI 1.03 to 2.00); all P 0.05.In this multicenter study, 44% of children hospitalized with SARS-CoV-2-related conditions experienced neurological manifestations, which were associated with ICU admission and pre-existing neurological condition. Posthospital assessment for, and support of, functional impairment and neuroprotective strategies are vitally needed.
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- 2021
7. Treatment and Prognosis After Hypoxic-Ischemic Injury
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Dhristie Bhagat and Ariane Lewis
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medicine.medical_specialty ,Neurology ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Multimodal therapy ,Targeted temperature management ,Electroencephalography ,Neuroprotection ,Somatosensory evoked potential ,Anesthesia ,medicine ,Wakefulness ,Neurology (clinical) ,Cardiopulmonary resuscitation ,business - Abstract
This review summarizes current and emerging treatments for hypoxic-ischemic brain injury (HIBI). Guidance on neuroprognostication after HIBI is also presented. After two 2002 studies demonstrated cooling improved neurologic outcome after HIBI, a 2013 trial found targeting 36 °C was non-inferior to targeting 33 °C. Research is ongoing, but there is no other definitive human data on therapies to prevent secondary brain injury after HIBI. Guideline-recommended treatment of HIBI includes early, optimal cardiopulmonary resuscitation to prevent primary brain injury, and targeted temperature management to mitigate secondary brain injury. Multiple novel treatment options, including anti-inflammatory agents, anesthetics, and neuroprotective cocktails, are currently being investigated. Additionally, neurostimulants may help promote wakefulness after HIBI. Neuroprognostication after HIBI requires a multimodal approach using the neurologic exam, electroencephalography, somatosensory evoked potentials, neuroimaging, and serum biomarkers. It is important to avoid premature prognostication and nihilism.
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- 2021
8. The Case Against Solicitation of Consent for Apnea Testing
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Ariane Lewis and Dhristie Bhagat
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Issues, ethics and legal aspects ,Health Policy ,Apnea testing ,medicine ,Medical emergency ,Psychology ,medicine.disease - Abstract
Berkowitz and Garrett (2020) provide an excellent overview of the ethical and legal discussion about the need for consent prior to apnea testing (Berkowitz and Garrett 2020). However, we disagree w...
- Published
- 2020
9. A prospective study of long-term outcomes among hospitalized COVID-19 patients with and without neurological complications
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Michael Tamimi, Yingrong Zhu, Palak Patel, Michael Sonson, Chaitanya Medicherla, Jessica Lin, Kristie Bauman, George Park, Eva Petkova, Benjamin Fuchs, Taolin Fang, Haruki Ishii, Vito Arena, Lindsey Gurin, Milan Rustic, Kara Melmed, Eduard Valdes, Sharon B. Meropol, Dixon Yang, Steven L. Galetta, Chris Morrison, Brian Sunwoo, Laura J. Balcer, Maya Madhavan, Dhristie Bhagat, Levi Dygert, Rebecca Stainman, Jennifer A. Frontera, Joshua Huang, Andres Andino, Ting Zhou, Barry M Czseiler, Ariane Lewis, Daniel Talmasov, Melanie Canizares, Anlys Olivera, Betsy Thomas, Daniel Gratch, Shadi Yaghi, D. Ethan Kahn, Jonathan Rosenthal, Mirza Omari, Ruben Jauregui, Thomas Wisniewski, Andrea B. Troxel, Aaron Lord, Alexa Dessy, and Thomas Snyder
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Quality of life ,medicine.medical_specialty ,Activities of daily living ,Cognitive ,Coronavirus disease 2019 (COVID-19) ,Post-acute sequelae of COVID ,Outcomes ,Anxiety ,Article ,03 medical and health sciences ,0302 clinical medicine ,Modified Rankin Scale ,Internal medicine ,Activities of Daily Living ,Long term outcomes ,Long-hauler ,Neurologic ,Medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Function ,Prospective cohort study ,Post-COVID syndrome ,Depression (differential diagnoses) ,Fatigue ,business.industry ,SARS-CoV-2 ,Depression ,Montreal Cognitive Assessment ,COVID-19 ,Brain ,Long-COVID ,Neurology ,Neurology (clinical) ,medicine.symptom ,business ,Sleep ,030217 neurology & neurosurgery ,Readmission - Abstract
BackgroundLittle is known regarding long-term outcomes of patients hospitalized with COVID-19.MethodsWe conducted a prospective study of 6-month outcomes of hospitalized COVID-19 patients. Patients with new neurological complications during hospitalization who survived were propensity score-matched to COVID-19 survivors without neurological complications hospitalized during the same period. The primary 6-month outcome was multivariable ordinal analysis of the modified Rankin Scale(mRS) comparing patients with or without neurological complications. Secondary outcomes included: activities of daily living (ADLs;Barthel Index), telephone Montreal Cognitive Assessment and Neuro-QoL batteries for anxiety, depression, fatigue and sleep.ResultsOf 606 COVID-19 patients with neurological complications, 395 survived hospitalization and were matched to 395 controls; N=196 neurological patients and N=186 controls completed follow-up. Overall, 346/382 (91%) patients had at least one abnormal outcome: 56% had limited ADLs, 50% impaired cognition, 47% could not return to work and 62% scored worse than average on ≥1 Neuro-QoL scale (worse anxiety 46%, sleep 38%, fatigue 36%, and depression 25%). In multivariable analysis, patients with neurological complications had worse 6-month mRS (median 4 vs. 3 among controls, adjusted OR 2.03, 95%CI 1.22-3.40, P=0.01), worse ADLs (aOR 0.38, 95%CI 0.29-0.74, P=0.01) and were less likely to return to work than controls (41% versus 64%, P=0.04). Cognitive and Neuro-QOL metrics were similar between groups.ConclusionsAbnormalities in functional outcomes, ADLs, anxiety, depression and sleep occurred in over 90% of patients 6-months after hospitalization for COVID-19. In multivariable analysis, patients with neurological complications during index hospitalization had significantly worse 6-month functional outcomes than those without.
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- 2021
10. Prostate volume and its correlation with histopathological outcomes in prostate cancer
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Sivaram Rajan, Dhristie Bhagat, Sonal Grover, Prasanna Sooriakumaran, Abhishek K. Srivastava, Robert Leung, Y. El-Douaihy, Ashutosh Tewari, and Majnu John
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Male ,PCA3 ,medicine.medical_specialty ,Biopsy ,Urology ,medicine.medical_treatment ,Medical Oncology ,Correlation ,Prostate cancer ,Prostate ,medicine ,Humans ,Extraprostatic extension ,Aged ,Prostatectomy ,business.industry ,Prostatic Neoplasms ,Organ Size ,Robotics ,Middle Aged ,Prostate-Specific Antigen ,Prognosis ,medicine.disease ,Treatment Outcome ,medicine.anatomical_structure ,Histopathology ,Tumour volume ,business - Abstract
Introduction: There is a paucity of data investigating the relationship between histopathological variables of oncologic importance and prostate volume, and we aimed to investigate this. Patients and Methods: 2,207 consecutive patients who underwent robotic-assisted radical prostatectomy were studied. Preoperative demographic and both pre- and postoperative histopathological parameters were compared among the small (3), intermediate (40–70 cm3), and large (>70 cm3) prostate groups. Results: Patients with smaller prostates were younger, had slightly lower BMIs, and lower prostate-specific antigen (PSA) levels than those with larger prostates (p < 0.001). They also had worse histopathological criteria (Gleason, core positivity, and maximum percent cancer) on preoperative biopsy and had worse radical specimen Gleason sums (p < 0.001), percent cancer (p < 0.001), and pathological stage (p = 0.016). 11.5% of the men in the small prostate group suffered a positive surgical margin (PSM) compared to 8.3 and 5.6% in the intermediate and large prostate groups, respectively (p = 0.008). Basilar, posterolateral, and multifocal PSMs were commoner in the small prostate group. Conclusions: Younger men have smaller prostates and worse preoperative histopathological parameters despite lower PSA values. Men with small prostates undergoing robotic-assisted radical prostatectomy have worse final Gleason sums, tumour volume, extraprostatic extension, and PSM rates than those with larger prostates.
- Published
- 2011
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