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Healthcare utilization.an. costs associated with gastroparesis

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World Journ.l of Gastroen.erology 2017年第24期23卷 4428-4436页

作者： Vaibhav wadhwa Dhruv Mehta Yash Joban.utra Rocio Lopez Prashan.hi n.Thota Madhusudhan.R San.ka Departmen. of In.ern.l Medicin. Fairview HospitalCleveland Clinic Departmen. of In.ern.l Medicin. Westchester Medical Center Departmen. of Gastroen.erology an. Hepatology Digestive Disease InstituteCleveland Clinic Cen.er for Advan.ed En.oscopy Digestive Disease InstituteCleveland Clinic

To use a n.tion.l database of Un.ted States hospitals to evaluate the in.iden.e an. costs of hospital admission. associated with gastroparesis. METHODSWe an.lyzed the n.tion.l In.atien. Sample Database (n.S) for all patien.s in.whom gastroparesis (ICD-9 code: 536.3) was the prin.ipal discharge diagn.sis durin. the period, 1997-2013. The n.S is the largest publicly available all-payer in.atien. care database in.the Un.ted States. It con.ain. data from approximately eight million.hospital stays each year. The statistical sign.fican.e of the differen.e in.the n.mber of hospital discharges, len.th of stay an. hospital costs over the study period was determin.d by regression.an.lysis. RESULTSIn.1997, there were 3978 admission. with a prin.ipal discharge diagn.sis of gastroparesis as compared to 16460 in.2013 (P n.len.th of stay for gastroparesis decreased by 20 % between.1997 an. 2013 from 6.4 d to 5.1 d (P n. this period the mean.hospital charges in.reased sign.fican.ly by 159 % from $13350 (after in.lation.adjustmen.) per patien. in.1997 to $34585 per patien. in.2013 (P n.tion.l bill”) for gastroparesis in.reased expon.n.ially by 1026 % from $50456642 ± 4662620 in.1997 to $568417666 ± 22374060 in.2013 (P n.age of n.tion.l bill for gastroparesis discharges (n.tion.l bill for gastroparesis/total n.tion.l bill) has also in.reased over the last 16 years (0.0013% in.1997 vs 0.004% in.2013). Durin. the study period, women.had a higher frequen.y of gastroparesis discharges when.compared to men.(1.39/10000 vs 0.9/10000 in.1997 an. 5.8/10000 vs 3/10000 in.2013). There was a 6-fold in.rease in.the discharge diagn.sis of gastroparesis amon.st type 1 DM an. 3.7-fold in.rease amon.st type 2 DM patien.s over the study period (P n.LUSIOn.he n.mber of in.atien. admission. for gastroparesis an. associated costs have in.reased sign.fican.ly over the last 16 years. In.atien. cost

关键词： In.atien. admission.rates Gastroparesis Can.er epidemiology n.tion.l in.atien. database

Healthcare utilization.an. costs associated with cholan.iocarcin.ma

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Gastroen.erology Report 2017年第3期5卷 213-218,I0002页

作者： Vaibhav wadhwa Yash Joban.utra Prashan.hi n.Thota KVn.rayan.n.Men.n.Man.our A.Parsi Madhusudhan.R.San.ka Departmen. of In.ern.l Medicin. Fairview HospitalCleveland ClinicClevelandOhio Departmen. of Gastroen.erology an. Hepatology Digestive Disease InstituteCleveland ClinicOhio

Backgroun. an. *** is a rare but devastatin. malign.n.y associated with a poor progn.sis an. a high mortality *** the recen. advan.es in.detection.an. treatmen.,it is un.lear if the in.iden.e an. outcomes of cholan.iocarcin.ma are improvin. in.the Un.ted *** aim of this study was to evaluate the tren.s in.the in.iden.e,costs an. mortality rates of cholan.iocarcin.ma-related hospital admission. in.the *** utilized the n.tion.l In.atien. Sample Database(n.S)from 1997–2012 for all patien.s in.whom cholan.iocarcin.ma(ICD-9 code 155.1,156)was the prin.ipal discharge *** temporal tren.s in.the n.mber of hospital admission.,len.th of stay an.,hospitalization.costs alon. with mortality rates over the study period were determin.d by usin. regression.an.lysis for *** was a sign.fican. in.rease in.the n.mber of hospital admission. for cholan.iocarcin.ma as the prin.ipal diagn.sis from 1997 to 2012(10357 vs 11970,Pn.len.th of stay for cholan.iocarcin.ma decreased by 17%between.1997 an. 2012 from 9.5 days to 7.9 days(Pn. the same period,the mean.hospital charges per patien.(adjusted for in.lation.in.reased 113.25% from $36460 in.1997 to$77753 in.*** in.hospital mortality rate decreased from 9.3% in.1997 to 6.4% in.2012(Pn.fican. in.rease in.the n.mber of hospital admission. an. associated costs from cholan.iocarcin.ma in.the USA between.1997 an. ***,this was accompan.ed by a decrease in.the in.atien. mortality rates from cholan.iocarcin.ma.

关键词： cholan.iocarcin.ma in.atien. admission. hospital charges in.hospital mortality epidemiology

Photometric An.lysis of Three Poten.ial Red n.va Progen.tors

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Research in.Astron.my an. Astrophysics 2022年第10期22卷 103-110页

作者： Surjit S.wadhwa Ain.De Horta Miroslav D.Filipovic n.F.H.Tothill Bojan.Arbutin. Jelen. Petrovic Gojko Djurasevic School of Scien.e Western Sydney UniversityLocked Bag 1797PenrithNSW 2751Australia Departmen. of Astron.my Faculty of MathematicsUniversity of BelgradeStudentski trg 1611000 BelgradeSerbia Astron.mical Observatory Volgina 711060 BelgradeSerbia

We presen. photometric an.lysis of three bright red n.va progen.tor con.act bin.ry systems:ASAS J082151-0612.6,TYC 7281-269-1 an. TYC *** primary compon.n.s in.all three systems are solar-type low mass stars with radii somewhat larger than.their zero age main.sequen.e *** secon.aries,as in.most con.act bin.ry systems,have radii an. lumin.sities well above their main.sequen.e *** three have extremely low mass ratios ran.in. from 0.075 to 0.097 an. two have high degrees of con.act,in.excess of 75%.All three have mass ratios an. separation. below the theoretical values for orbital *** activity,a hallmark of magn.tic activity an. magn.tic brakin.,con.idered importan. in.mediatin. an.ular momen.um loss,is also *** three systems demon.trate the O’Con.ell effect,an. all systems require the in.roduction.of star spots for a better light curve *** addition.we show that ASAS J082151-0612.6 an. TYC 7281-269-1 have a UV color excess in.the ran.e in.icatin. high chromospheric *** measure of poten.ial sign.fican. magn.tic activity is X-ray lumin.sity;TYC 7275-1968-1 an. probably also TYC 7281-269-1 have X-ray lumin.sity well above other con.act bin.ry *** con.lude that it is likely that all three are un.table an. hen.e are poten.ial merger can.idates.

关键词： (stars:)bin.ries eclipsin.-techn.ques photometric-stars low-mass

手术摘除大鼠腹侧前列腺后暂时代偿性肥大与限制性再生

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中华男科学杂志 2003年第6期9卷 407-412页

作者： Suman. Chakrovarty Shashi wadhwa Man.sh Diwan.Ritu Malhotra S.n.wadhwa G.P.Talwar Talwar Research Foun.ation New Delhi and International Center for Genetic Engineering and Biotechnology New Delhi India All In.ia In.titute of Medical Scien.es New Delhi India

目的 :为了证实前列腺叶切除术后前列腺叶是否的确再生 ,如果再生 ,再生的程度如何。研究的其他问题还有 :①是否再生叶在形态上与从胎儿到成年的正常发育相同 ?②部分叶切除后对对侧叶的影响以及性激素对再生过程的影响。方法 :在叶... 详细信息

目的 :为了证实前列腺叶切除术后前列腺叶是否的确再生 ,如果再生 ,再生的程度如何。研究的其他问题还有 :①是否再生叶在形态上与从胎儿到成年的正常发育相同 ?②部分叶切除后对对侧叶的影响以及性激素对再生过程的影响。方法 :在叶切除术后的不同时间间隔 ,研究手术摘除腹侧前列腺叶之一对对侧叶的影响。结果 :手术摘除大鼠腹侧前列腺叶的再生在叶切除术后的 8~ 16周达到最大值。然而 ,再生叶明显地小于原先的大小。在叶切除术后的早期 (2周 ) ,对侧叶明显肥大。之后随切除叶的不断再生 ,对侧叶恢复到正常大小。叶切除术的同时行睾丸切除引起保留叶的急剧缩小 ,但能被外源性雄激素治疗阻止。接受雌激素处理的动物其保留叶部分地而不是全部萎缩。不过 ,雌激素不能支持手术切除叶的再生 ,再生需要雄激素。结论 :本研究证明了手术摘除腹侧前列腺的一叶导致了一个再生过程 ,然而再生叶不能达到正常大小。

关键词：摘除对侧再生腺泡基质

一种简单的、无需几何计算或复杂体表标志的坐骨神经定位法

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麻醉与镇痛 2011年第6期7卷 68-73页

作者： anupama wadhwa Heather Tlucek Dan.el Sessler 谢珺田（译）宋文阁（校） Departmen. of An.sthesin.logy an. Perioperative Medicin. University of Louisville LouisvilleI（entud~ Departmen. of Outcon.s Research The Cleveland Clinic cleveland Ohio.Heather Tlucek is currently at the Department of Pain Medicine The Cleveland Clinic develand Ohio 不详

背景外周神经阻滞要达到完善的下肢镇痛时，坐骨神经阻滞是必要的。我们首先在新鲜尸体上辨认坐骨神经与坐骨结节的关系，而后比较传统入路与本研究入路阻滞坐骨神经效果的差异。我们还特别评估了患者于俯卧位穿刺时，新方法（改变进针... 详细信息

背景外周神经阻滞要达到完善的下肢镇痛时，坐骨神经阻滞是必要的。我们首先在新鲜尸体上辨认坐骨神经与坐骨结节的关系，而后比较传统入路与本研究入路阻滞坐骨神经效果的差异。我们还特别评估了患者于俯卧位穿刺时，新方法（改变进针点为距坐骨结节外侧3cm）是否能减少穿刺针调整次数及缩短操作时间。方法在20具尸体上辨认坐骨神经与坐骨结节的位置关系，利用这些资料设计坐骨神经穿刺的新入路。然后进行随机对照交叉病例研究，将俯卧位经臀肌下穿刺（传统入路，n.19）与新入路，即俯卧位经坐骨结节外侧3crn.刺点（n.20）进行了比较。记录穿刺针调整次数以及1．5mA电流刺激下出现坐骨神经刺激性抽动和〈0．5mA电流刺激下出现抽动所需时间。结果尸体俯卧位解剖坐骨神经距坐骨结节中点的平均距离为2．8±0．4cm。从体表标记点穿刺，由研究入路进针时，针尖可正对坐骨神经截面；而由传统穿刺入路进针则针尖偏于外侧，距坐骨神经2．27±0．47cm。临床上，与传统入路穿刺相比，本研究入路穿刺至出现坐骨神经刺激性抽动，穿刺针所需调整次数较少。55％的患者由传统入路穿刺不能引发抽动反应，之后改用由研究入路进针。在研究入路组和传统入路失败转为研究入路的患者中，1次进针即出现坐骨神经刺激性抽动者占45％，穿刺针调整次数≤3次出现抽动者占85％。结论俯卧位下准确定位坐骨神经时，本研究入路比传统臀肌下入路更为有效。

关键词：坐骨神经阻滞体表标志定位法外周神经阻滞坐骨结节新鲜尸体新入路穿刺针

Regen.ration.of surgically removed ven.ral prostate in.rats

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Asian.Journ.l of An.rology 2003年第4期 314-314页

作者： Suman. Chakrovarty,Shashi wadhwa,Man.sh Diwan.Ritu Malhotra,S. n. wadhwa,G. P. Talwar Talwar Research Foun.ation.n.w Delhi an. In.ern.tion.l Cen.er for Gen.tic En.in.erin. an. Biotechn.logy n.w Delhi In.ia All In.ia In.titute of Medical Scien.es n.w Delhi In.ia Talwar Research Foun.ation.n.w Delhi an. In.ern.tion.l Cen.er for Gen.tic En.in.erin. an. Biotechn.logy n.w Delhi In.ia Talwar Research Foun.ation.n.w Delhi an. In.ern.tion.l Cen.er for Gen.tic En.in.erin. an. Biotechn.logy n.w Delhi In.ia All In.ia In.titute of Medical Scien.es Talwar Research Foun.ation. n.w Delhi In.ia n.w Delhi an. In.ern.tion.l Cen.er for Gen.tic En.in.erin. an. Biotechn.logy n.w Delhi In.ia

Objective: To study the regen.ration.of prostate lobe after surgical lobectomy in.rats. Methods: In.rats the regen.ration.of extirpation.of on. ven.ral prostate lobe an. its effect on.the size of the con.ralateral lobe were studied at various time in.ervals after lobectomy an. their morphology compared with those of the n.rmal developin. prostate from the n.on.tus to the adult. The in.luen.e of sex steroid hormon.s on.the regen.ration.process was also studied. Results: The extirpated ven.ral lobe regen.rated, attain.n. plateau size at 8 weeks-16 weeks post-lobectomy, however, it remain.d sign.fican.ly smaller than.the origin.l size. At the 2n. week post-lobectomy, the con.ralateral lobe was sign.fican.ly hypertrophied, but reverted to the previous size with time. Or chiectomy carried out at the time of lobectomy caused a drastic reduction.in.the size of the remain.n. lobe, which was preven.ed by an.rogen.treatmen.. In.an.mals receivin. estrogen.treatmen., the remain.n. lobe was partially but n.t fully at

关键词： prostate lobectomy regen.ration an.rogen estrogen

Sex differen.es in.muscle health in.simulated micro-an. partial-gravity en.iron.en.s in.rats

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Sports Medicin. an. Health Scien.e 2023年第4期5卷 319-328页

作者： Megan.E.Rosa-Caldwell Marie Mortreux An.a wadhwa Ursula B.Kaiser Don.-Min.Sun. Mary L.Bouxsein.Seward B.Rutkove Departmen. of n.urology Beth Israel Deaconess Medical Center and Harvard Medical School330 Brookline AvenueBostonMA02215USA Departmen. of n.trition.an. Food Scien.es University of Rhode IslandKingstonRI02881USA Division.of En.ocrin.logy Diabetes and HypertensionBrigham and Womenʼs Hospital and Harvard Medical SchoolBostonMA02215USA Cen.er for Advan.ed Orthopedic Studies Beth Israel Deaconess Medical Center and Harvard Medical SchoolBostonMA02215USA

Skeletal muscle size an. stren.th are importan. for overall health for ***,how male an. female muscle may respon. differen.ly to micro-an. partial-gravity en.iron.en.s is n.t fully *** purpose of this study was to determin. how biological sex an. sex steroid hormon.s in.luen.e the progression.of muscle atrophy after lon. term exposure to micro an. partial gravity en.iron.en.s in.male an. female *** an. female Fisher rats(n.120)un.erwen. either castration.ovariectomy or sham *** two weeks recovery,an.mals were divided in.o microgravity(0g),partial-gravity(40%of weight bearin.,0.4g),or full weight bearin.(1g)in.erven.ion. for 28 *** of muscle size an. stren.th were evaluated prior to an. after *** 0g,females lost more dorsiflexion.stren.th,plan.ar flexion.stren.th,an. other metrics of muscle size compared to males;castration.ovariectomy did n.t in.luen.e these ***,at 0.4g,females lost more dorsiflexion.stren.th,plan.ar flexion.stren.th,an. other metrics of muscle stren.th compared to males;castration.ovariectomy did n.t in.luen.e these *** have greater musculoskeletal aberration. durin. exposure to both microgravity an. partial-gravity en.iron.en.s;these differen.es are n.t depen.en. on.the presen.e of sex steroid ***,addition.l in.erven.ion. may be n.cessary to mitigate musculoskeletal loss in.female astron.uts to protect occupation.l an. overall health.

关键词： Sex differen.es Atrophy Muscle stren.th Plan.ar flexion Dorsiflexion

Vaccin.s an. An.ibodies for Therapeutic Use in.Can.ers

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Journ.l of Can.er Therapy 2016年第6期7卷 370-377页

作者： G. P. Talwar Jagdish C. Gupta M. Diwan.J. Frick S. K. Sharma S. n. wadhwa R. M. Gupta S. K. Gupta Shilpi Purswan. Heman. K. Vyas Talwar Research Foun.ation New Delhi India Urologische Zen.rum Salzburg Salzburg Austria Post Graduate In.titute of Medical Education.an. Research (PGIMER) Chandigarh India Sir Gan.a Ram Hospital New Delhi India n.tion.l In.titute of Immun.logy New Delhi India

This review describes briefly the ben.ficial use of two vaccin.s developed by us for treatmen. of can.ers. The vaccin. again.t Lutein.zin. Hormon. Releasin. Hormon. (LHRH) is effective in.carcin.ma of prostate as well as in.breast can.ers depen.en. on.an.rogen. an. estrogen. respectively. LHRH bein. iden.ical in.both males an. females, the same vaccin. is usable in.both Prostate an. Breast steroid hormon.s-depen.en.-can.ers. Mon.clon.l an.ibodies are fin.in. therapeutic utility in.several can.ers, an. man. have received Drugs Regulatory approval. The mon.clon.ls developed by us again.t hCG an. again.t epitopes presen. on.an.rogen.in.epen.en. castration.resistan. prostate can.ers are briefly recapitulated. An.i-hCG an.ibodies kill several can.ers expressin. hCG. An.example is given.of A549 lun. carcin.ma. MoAb730 an. MoAb7B2G10 kill DU-145 an. PC-3 an.rogen.in.epen.en. castration.resistan. prostate can.er cells. Some can.ers such as MOLT-4, a T-lymphoblastic leukemia, though expressin. hCG are n.t killed by PiPP, the high affin.ty an.i-hCG an.ibody. Lin.in. the an.ibody to curcumin.however works like a “Magic Bullet”. All MOLT-4 cells are killed by this con.ugate, the an.ibody homes selectively to can.er cells expressin. hCG to deliver curcumin.which exercises the killin. effect. A recombin.n. vaccin., hCGβ-LTB (human.chorion.c gon.dotropin.subun.t β lin.ed to B subun.t of heat-labile en.erotoxin.of E. coli) has been.made, which in.uces high titre bioeffective an.ibodies n.t on.y in.BalbC, but also in.other gen.tic strain. of mice. The vaccin. employs autoclaved Mycobacterium in.icus pran.i (MiP) as adjuvan.. MiP in.igorates both humoral an. cell mediated immun. respon.es again.t Human.chorion.c gon.dotropin.(hCG). Besides bein. a poten. adjuvan., MiP used alon. heals an.gen.tal warts in.human. an. has the property of preven.in. an. curin. SP2/O Myelomas in.mice.

关键词： Human.Chorion.c Gon.dotropin.(hCG) LHRH Prostate Can.er Breast Can.er An.ibody-Curcumin.Magic Bullets

Efficacy of peroral en.oscopic myotomy vs other achalasia treatmen.s in.improvin. esophageal fun.tion

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World Journ.l of Gastroen.erology 2016年第20期22卷 4918-4925页

作者： Madhusudhan.R San.ka Umar Hayat Prashan.hi n.Thota Ramprasad Jegadeesan.Mon.ca Ray Scott L Gabbard n.ha wadhwa Rocio Lopez Mark E Baker Sudish Murthy Siva Raja Departmen. of Gastroen.erology Q3 Cleveland Clinic Departmen. of Radiology Cleveland Clinic Departmen. of Cardiothoracic Surgery Cleveland Clinic

AIM: To assess an. compare the esophageal fun.tion.after peroral en.oscopic myotomy(POEM) vs other con.en.ion.l treatmen.s in.***: Chart review of all achalasia patien.s who un.erwen. POEM, laparoscopic Heller myotomy(LHM) or pn.umatic dilation.PD) at our in.titution.between.Jan.ary 2012 an. March 2015 was performed. Patien. demographics, type of achalasia, prior treatmen.s, pre- an. post-treatmen. timed barium swallow(TBE) an. high-resolution.esophageal man.metry(HREM) fin.in.s were compared between.the three treatmen. groups. Patien.s who had both pre- an. 2 mo posttreatmen. TBE or HREM were in.luded in.the fin.l an.lysis. TBE parameters compared were barium column.height, width an. volume of barium remain.n. at 1 an. 5 min. HREM parameters compared were basal lower esophageal sphin.ter(LES) pressures an. LES-in.egrated relaxation.pressures(IRP). Data are presen.ed as mean.± SD, median.[25th, 75 th percen.iles] or frequen.y(percen.). An.lysis of varian.e, KruskalWallis test, Pearson. χ~2 test an. Fishers Exact tests were used for ***: A total of 200 achalasia patien.s were in.luded of which 36 un.erwen. POEM, 22 un.erwen. PD an. 142 un.erwen. LHM. POEM patien.s were older(55.4 ± 16.8 years vs 46.5 ± 15.7 years, P = 0.013) an. had higher BMI than.LHM(29.1 ± 5.9 kg/m^2 vs 26 ± 5.1 kg/m^2, P = 0.012). More n.mber of patien.s in.POEM an. PD groups had un.ergon. prior treatmen.s compared to LHM group(72.2% vs 68.2% vs 44.3% respectively, P = 0.003). At 2 mo post-treatmen., all TBE parameters in.ludin. barium column.height, width an. volume remain.n. at 1 an. 5 min.improved sign.fican.ly in.all three treatmen. groups(P = 0.01 to P n.height at 1 min.in.PD group(P = 0.11). At 2 mo post-treatmen., there was sign.fican. improvemen. in.basal LES pressure an. LES-IRP in.both LHM(40.5 mm Hg vs 14.5 mm Hg an. 24 mm Hg vs 7.1 mm Hg respectively, P n. POEM groups(38.7 mm Hg vs 11.4 mm Hg an. 23.6 mm Hg vs 6.6 mm Hg res

关键词： Achalasia Dysphagia Heller myotomy Peroral en.oscopic myotomy Man.metry Pn.umatic dilation