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Book ; Online ; E-Book: Evidence-based management of head and neck vascular anomalies

Perkins, Jonathan A. / Balakrishnan, Karthik

2018

Author's details	Jonathan A. Perkins, Karthik Balakrishnan editors
Keywords	Otorhinolaryngology
Language	English
Size	1 Online-Ressource (xvii, 316 Seiten), Illustrationen
Publisher	Springer
Publishing place	Cham
Publishing country	Switzerland
Document type	Book ; Online ; E-Book
Remark	Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
HBZ-ID	HT019868082
ISBN	978-3-319-92306-2 ; 9783319923055 ; 3-319-92306-4 ; 3319923056
DOI	10.1007/978-3-319-92306-2
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Article ; Online: Hepatocellular carcinoma stage: an almost loss of fatty acid metabolism and gain of glucose metabolic pathways dysregulation.

Balakrishnan, Karthik

Medical oncology (Northwood, London, England)

2022 Volume 39, Issue 12, Page(s) 247

Abstract: Cancer cells rewire the metabolic processes beneficial for cancer cell proliferation, survival, and their progression. In this study, metabolic processes related to glucose, glutamine, and fatty acid metabolism signatures were collected from the ... ...

Abstract	Cancer cells rewire the metabolic processes beneficial for cancer cell proliferation, survival, and their progression. In this study, metabolic processes related to glucose, glutamine, and fatty acid metabolism signatures were collected from the molecular signatures database and investigated in the context of energy metabolic pathways through available genome-wide expression profiles of liver cancer cohorts by gene sets-based pathway activation scoring analysis. The outcomes of this study portray that the fatty acid metabolism, transport, and its storage related signatures are highly expressed across early stages of liver tumors and on the contrary, the gene sets related to glucose transport and glucose metabolism are prominently activated in the hepatocellular carcinoma (HCC) stage. Based on the results, these metabolic pathways are clearly dysregulated across specific stages of carcinogenesis. The identified dimorphic metabolic pathway dysregulation patterns are further reconfirmed by examining corresponding metabolic pathway genes expression patterns across various stages encompassing profiles. Recurrence is the primary concern in the carcinogenesis of liver tumors due to liver tissues regeneration. Hence, to further explore these dysregulation effects on recurrent cirrhosis and recurrent HCC sample containing profile GSE20140 was examined and interestingly, this result also reiterated these differential metabolic pathways dysregulation. In addition, a recently established metabolome profile for the massive panel of cancer cell-lines, including liver cancer cell-lines, was used for further exploration. These findings also reassured those differential metabolites abundance of the fatty acid and glucose metabolic pathways enlighten those dimorphic metabolic pathways dysregulation. Moreover, ROC curves of fatty acid metabolic pathway genes such as acetyl-CoA carboxylase (ACACB), acyl-CoA dehydrogenase long chain (ACADL), and acyl-CoA dehydrogenase medium chain (ACADM) as well as glucose metabolic pathway genes such as phosphoglycerate kinase (PGK1), pyruvate dehydrogenase (PDHA1), pyruvate dehydrogenase kinase (PDK1) demonstrated greater sensitivity and specificity in the corresponding stage-specific tumors with significant p-values (p < 0.05). Furthermore, overall survival (OS) and recurrence-free survival (RFS) studies also reconfirmed that the rate-limiting genes expression of fatty acid and glucose metabolic pathways reveal better and poor survival in HCC patient cohorts, respectively. In conclusion, all these results clearly show that metabolic rewiring and the existence of two diverse metabolic pathways dysregulation involving fatty acid and glucose metabolism across the stages of liver tumors have been identified. These findings might be useful for developing therapeutic target treatments in stage-specific tumors.
MeSH term(s)	Acetyl-CoA Carboxylase/genetics ; Acetyl-CoA Carboxylase/metabolism ; Acyl-CoA Dehydrogenases/metabolism ; Carcinogenesis ; Carcinoma, Hepatocellular/pathology ; Fatty Acids/metabolism ; Glucose/metabolism ; Glutamine/metabolism ; Humans ; Liver Neoplasms/pathology ; Metabolic Networks and Pathways ; Oxidoreductases ; Phosphoglycerate Kinase/metabolism ; Pyruvate Dehydrogenase Acetyl-Transferring Kinase ; Pyruvates
Chemical Substances	Fatty Acids ; Pyruvate Dehydrogenase Acetyl-Transferring Kinase ; Pyruvates ; Glutamine (0RH81L854J) ; Oxidoreductases (EC 1.-) ; Acyl-CoA Dehydrogenases (EC 1.3.-) ; Phosphoglycerate Kinase (EC 2.7.2.3) ; Acetyl-CoA Carboxylase (EC 6.4.1.2) ; Glucose (IY9XDZ35W2)
Language	English
Publishing date	2022-10-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	1201189-7
ISSN	1559-131X ; 0736-0118 ; 1357-0560
ISSN (online)	1559-131X
ISSN	0736-0118 ; 1357-0560
DOI	10.1007/s12032-022-01839-0
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Article ; Online: Language Matters.

Losorelli, Steven / Su-Velez, Brooke / Balakrishnan, Karthik

Annals of surgery

2022 Volume 277, Issue 1, Page(s) e5–e7

Language	English
Publishing date	2022-08-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000005652
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Article ; Online: Identification of oncogenic signaling pathways associated with the dimorphic metabolic dysregulations in gastric cancer subtypes.

Balakrishnan, Karthik / Ganesan, Kumaresan

Medical oncology (Northwood, London, England)

2022 Volume 39, Issue 9, Page(s) 132

Abstract: Metabolic dysregulations have been identified as intrinsic hallmarks of cancer cells. Investigations of altered metabolic processes, in the context of the associated oncogenic signaling pathways are expected to pave way for the development of targeted ... ...

Abstract	Metabolic dysregulations have been identified as intrinsic hallmarks of cancer cells. Investigations of altered metabolic processes, in the context of the associated oncogenic signaling pathways are expected to pave way for the development of targeted cancer therapeutics. We have recently identified the enrichment of glucose and glutamine metabolism in a subset of intestinal subtype gastric tumors at the level of expression of genes, gene sets and the occurrence of metabolites. On the other hand, glucose transport, glucan and fatty acid metabolism were enriched in a subset of diffuse subtype gastric tumors. In the current study, along with glucose metabolism, mTOR, HSP90, MYC, E2F, P53 and proteasome pathways were found enriched in a subset of intestinal subtype and a part of MSI subtype gastric tumors. On the other hand, along with fatty acid metabolism, the oncogenic pathway KRAS was found to be enriched in a subset of GS tumors among diffuse subtype gastric tumors. Thus, oncogenic signaling pathways associated with two distinct metabolic rewiring which differentially occurs between major gastric cancer subtypes were identified. These pathways seem the potential targets to differentially target these gastric cancer subtypes. Exploratory integrative genomic analyses reveal HSP90 inhibitors, AKT/mTOR inhibitors, and cell cycle inhibitors as potential agents to target the gastric tumors with the rewired glucose metabolism and MEK/MAPK inhibitors as suitable drug candidates to target the diffuse subtype tumors with the dysregulated fatty acid metabolism. This observation would pave way for the selective and targeted use of signaling pathway modulators for targeted and stratified gastric cancer therapeutics.
MeSH term(s)	Carcinogenesis ; Fatty Acids ; Glucose ; Humans ; Signal Transduction ; Stomach Neoplasms/pathology
Chemical Substances	Fatty Acids ; Glucose (IY9XDZ35W2)
Language	English
Publishing date	2022-06-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	1201189-7
ISSN	1559-131X ; 0736-0118 ; 1357-0560
ISSN (online)	1559-131X
ISSN	0736-0118 ; 1357-0560
DOI	10.1007/s12032-022-01717-9
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Article ; Online: Comparison Between ChatGPT and Google Search as Sources of Postoperative Patient Instructions.

Ayoub, Noel F / Lee, Yu-Jin / Grimm, David / Balakrishnan, Karthik

JAMA otolaryngology-- head & neck surgery

2023 Volume 149, Issue 6, Page(s) 556–558

MeSH term(s)	Humans ; Search Engine ; Health Literacy
Language	English
Publishing date	2023-04-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2701825-8
ISSN	2168-619X ; 2168-6181
ISSN (online)	2168-619X
ISSN	2168-6181
DOI	10.1001/jamaoto.2023.0704
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Article: Protein phosphatase 2A regulation of GABA

Hleihil, Mohammad / Balakrishnan, Karthik / Benke, Dietmar

Frontiers in molecular neuroscience

2022 Volume 15, Page(s) 1015906

Abstract: One major factor regulating the strength of ... ...

Abstract	One major factor regulating the strength of GABA
Language	English
Publishing date	2022-10-13
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2452967-9
ISSN	1662-5099
ISSN	1662-5099
DOI	10.3389/fnmol.2022.1015906
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Article ; Online: Price Transparency and Compliance With Federal Regulation for Pediatric Tonsillectomy.

Ayoub, Noel Fahed / Balakrishnan, Karthik

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

2021 Volume 167, Issue 2, Page(s) 248–252

Abstract: Objective: To improve hospital price transparency, the Centers for Medicare & Medicaid Services (CMS) requires, as of January 2021, that all hospitals reveal charges for specific items and services. This analysis investigates whether otolaryngology ... ...

Abstract	Objective: To improve hospital price transparency, the Centers for Medicare & Medicaid Services (CMS) requires, as of January 2021, that all hospitals reveal charges for specific items and services. This analysis investigates whether otolaryngology residency-affiliated hospitals have complied with this new regulation, and it evaluates the variability in hospital-reported charges for pediatric tonsillectomy. Study design: Cross-sectional analysis. Settings: Subset of hospitals affiliated with otolaryngology residency programs. Methods: Hospital websites were searched to determine compliance rates with CMS guidelines by posting a price transparency tool and specific charges for Results: Overall 104 unique hospitals were analyzed: 81 (78%) provided pricing data, but only 28 (27%) complied with CMS guidelines. The median reported total gross charge was $13,239 (range, $600-$41,957); deidentified minimum negotiated charge, $9222 (range, $337-$25,164); and deidentified maximum negotiated charge, $17,355 (range, $1002-$54,987). Hospital fees (median, $11,900; range, $2304-$38,831) were consistently higher than physician fees (median, $1827; range, $420-$5063). All estimates included a disclaimer stating that values likely underrepresent true prices. Conclusion: Hospital compliance with the new regulation remains low, which limits efforts toward improved price transparency. There is wide variability in reported charges for pediatric tonsillectomy and adenoidectomy.
MeSH term(s)	Adenoidectomy ; Aged ; Child ; Cross-Sectional Studies ; Hospital Charges ; Humans ; Medicare ; Tonsillectomy ; United States
Language	English
Publishing date	2021-09-21
Publishing country	England
Document type	Journal Article
ZDB-ID	392085-9
ISSN	1097-6817 ; 0161-6439 ; 0194-5998
ISSN (online)	1097-6817
ISSN	0161-6439 ; 0194-5998
DOI	10.1177/01945998211047146
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Article: Targeting the Interaction of GABA

Bhat, Musadiq A / Esmaeili, Abolghasem / Neumann, Elena / Balakrishnan, Karthik / Benke, Dietmar

Frontiers in pharmacology

2022 Volume 13, Page(s) 870861

Abstract: ... ...

Abstract	GABA
Language	English
Publishing date	2022-03-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2587355-6
ISSN	1663-9812
ISSN	1663-9812
DOI	10.3389/fphar.2022.870861
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Article ; Online: Redefining "Value" in Surgery: Development of a Comprehensive Value Score for Outpatient Endocrine Surgery.

Ayoub, Noel F / Noel, Julia / Orloff, Lisa A / Balakrishnan, Karthik

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

2023 Volume 170, Issue 1, Page(s) 151–158

Abstract: Objective: The value-based healthcare model aims to improve the quality of care and lower health care costs. The standard value equation (ie, Value = Quality/Cost), while conceptually useful, is grossly oversimplified and lacks clinical relevance. This ... ...

Abstract	Objective: The value-based healthcare model aims to improve the quality of care and lower health care costs. The standard value equation (ie, Value = Quality/Cost), while conceptually useful, is grossly oversimplified and lacks clinical relevance. This study introduces a more detailed value equation that generates disease-specific value scores and incorporates real-world clinical and cost data to demonstrate its use. Study design: Prospective observational study. Setting: Tertiary institution. Methods: A comprehensive new health care value equation was developed that includes 23 unique inputs. Sixteen inputs represent quality (numerator) and 7 inputs represent cost (denominator). Patients undergoing thyroid or parathyroid surgery were enrolled, and data were entered into the new equation to generate surgery-specific value scores for each patient. A subanalysis was performed for telehealth visits. Results: Ten patients were enrolled (60% female) with an average age of 62 years. The average total monetary cost per patient was $41,884 ($27,885 direct). Across all patients, the average total quality score was 0.99, and the cost score was 6.1, resulting in a final value score of 0.19. A subanalysis showed that changing a postoperative visit from in-person to telehealth would increase the value score by 0.66%. Conclusion: This analysis creates a comprehensive value equation for surgical services that incorporates the complexity of modern surgical care. The new equation includes objective and subjective outcomes and health equity, quantitatively compares the value of different surgical interventions and health care services, illustrates how specific interventions can lead to the higher value of care, and can serve as the framework for future value equations.
MeSH term(s)	Humans ; Female ; Middle Aged ; Male ; Outpatients ; Health Care Costs ; Delivery of Health Care ; Prospective Studies ; Endocrine Surgical Procedures
Language	English
Publishing date	2023-07-12
Publishing country	England
Document type	Observational Study ; Journal Article
ZDB-ID	392085-9
ISSN	1097-6817 ; 0161-6439 ; 0194-5998
ISSN (online)	1097-6817
ISSN	0161-6439 ; 0194-5998
DOI	10.1002/ohn.427
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Article ; Online: Time-Driven Activity-Based Cost Comparison of Thyroid Lobectomy and Radiofrequency Ablation.

Ayoub, Noel F / Balakrishnan, Karthik / Orloff, Lisa A / Noel, Julia E

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

2023 Volume 169, Issue 4, Page(s) 830–836

Abstract: Objective: Radiofrequency ablation (RFA) of benign thyroid nodules has gained traction for its therapeutic effectiveness, thyroid function preservation, and minimally invasive nature. While a growing body of evidence reports positive outcomes from ... ...

Abstract	Objective: Radiofrequency ablation (RFA) of benign thyroid nodules has gained traction for its therapeutic effectiveness, thyroid function preservation, and minimally invasive nature. While a growing body of evidence reports positive outcomes from thyroid RFA, financial comparisons between both procedures remain limited. This analysis aims to more accurately measure the direct cost of thyroid RFA in comparison to thyroid lobectomy. Study design: Bottom-up financial cost analysis. Setting: Tertiary endocrine head and neck surgery center. Methods: Time-driven activity-based costing was utilized to obtain unit-based cost estimates. The care cycles for thyroid lobectomy and RFA were defined, and process maps were developed comprising all personnel and work in the care cycle. Time estimates were calculated for all personnel involved, and public government data were used to obtain capacity cost rates for each component of the care cycle. Consumable supply and overhead costs were obtained for both procedures, and overall costs were compared. Results: For thyroid lobectomy, total personnel costs were $1087.97, consumable supplies were $942.68, and overhead costs $17,199.10. For thyroid nodule RFA performed in an office setting, the total personnel cost calculated was $379.90, consumable supplies $1315.28, and overhead $7031.20. Overall, the total cost for thyroid lobectomy was $19,229.75 compared to $8726.38 for RFA. Conclusion: In-office thyroid nodule RFA is associated with lower direct costs than thyroid lobectomy, and overhead is the greatest cost driver for both procedures. If clinical and patient-centered outcomes are comparable, then RFA may provide higher value for appropriately selected patients.
MeSH term(s)	Humans ; Thyroid Nodule/surgery ; Catheter Ablation/methods ; Treatment Outcome ; Retrospective Studies ; Radiofrequency Ablation/methods ; Costs and Cost Analysis
Language	English
Publishing date	2023-05-09
Publishing country	England
Document type	Journal Article
ZDB-ID	392085-9
ISSN	1097-6817 ; 0161-6439 ; 0194-5998
ISSN (online)	1097-6817
ISSN	0161-6439 ; 0194-5998
DOI	10.1002/ohn.360
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