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  1. Article ; Online: Acute keratoconjunctivitis associated with tisotumab vedotin-tftv for metastatic cervical cancer.

    Parikh, Ankur A / Hanna, Jovana / Shah, Amar P

    American journal of ophthalmology case reports

    2023  Volume 33, Page(s) 101979

    Abstract: Purpose: Tisotumab vedotin-tftv, an antibody-drug conjugate, was recently FDA-approved for metastatic or treatment-resistant cervical cancer. A high rate of ocular comorbidities was seen in pivotal clinical trials. We present a case of a 46-year-old ... ...

    Abstract Purpose: Tisotumab vedotin-tftv, an antibody-drug conjugate, was recently FDA-approved for metastatic or treatment-resistant cervical cancer. A high rate of ocular comorbidities was seen in pivotal clinical trials. We present a case of a 46-year-old woman who experienced prolonged ocular surface adverse effects associated with use of the drug.
    Observations: Our patient was initiated on tri-weekly 2mg/kg infusions of tisotumab for metastatic cervical cancer. Baseline ophthalmic exam was unremarkable. One week after the second infusion, she developed bilateral eyelid edema and chalazia managed with initiation of lid hygiene measures. Preceding the fourth infusion, she developed unilateral pseudomembranous conjunctivitis and bilateral meibomitis that improved with topical corticosteroids. The fifth infusion was subsequently given at a reduced dosage. Despite this, she experienced decreased vision, bilateral diffuse punctate epitheliopathy, and subepithelial haze. The patient was subsequently referred to the cornea service. Symptomatic and clinical improvement was initially achieved with the addition of bandage contact lenses (BCLs). As the keratitis improved, topical steroids were tapered and BCLs removed. She is currently maintained on a regimen that includes eyelid hygiene, preservative-free artificial tears, punctal plugs, autologous serum tears, and lifitegrast. Given the severity of the ophthalmic adverse effects, however, further tisotumab infusions were held.
    Conclusions and importance: This is a report of a patient with prolonged ocular surface disease following the initiation of tisotumab, significant enough to lead to discontinuation. Antibody-drug conjugates are an emerging class of therapeutics across oncology, and ophthalmologists should be aware of their potential effects on ocular health.
    Language English
    Publishing date 2023-12-26
    Publishing country United States
    Document type Case Reports
    ISSN 2451-9936
    ISSN (online) 2451-9936
    DOI 10.1016/j.ajoc.2023.101979
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Herpes Simplex Virus Esophagitis in an Immunocompetent Patient.

    Shah, Raj / Patel, Stuti / Henriquez, Richard / Parikh, Jignesh / Mandalia, Amar

    Cureus

    2023  Volume 15, Issue 9, Page(s) e44668

    Abstract: Esophagitis due to herpes simplex virus (HSV) infection is a rare entity in the immunocompetent population. It is usually seen in immunocompromised hosts, those with human immunodeficiency virus (HIV) infection, malignancies, and patients on ... ...

    Abstract Esophagitis due to herpes simplex virus (HSV) infection is a rare entity in the immunocompetent population. It is usually seen in immunocompromised hosts, those with human immunodeficiency virus (HIV) infection, malignancies, and patients on immunosuppressive medications. We present a case of a young immunocompetent man with anabolic steroid use who presented with esophagitis symptoms found to be from HSV infection. So far, the use of corticosteroids has been reported as a predisposing factor for HSV esophagitis in immunocompetent hosts in multiple case reports. However, our case suspects that transient immunosuppression with similar medication can cause HSV esophagitis in otherwise immunocompetent hosts.
    Language English
    Publishing date 2023-09-04
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.44668
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Cardio-Oncology Care in the Time of COVID-19 and the Role of Telehealth.

    Parikh, Amar / Kumar, Anupam A / Jahangir, Eiman

    JACC. CardioOncology

    2020  Volume 2, Issue 2, Page(s) 356–358

    Keywords covid19
    Language English
    Publishing date 2020-04-22
    Publishing country United States
    Document type Editorial
    ISSN 2666-0873
    ISSN (online) 2666-0873
    DOI 10.1016/j.jaccao.2020.04.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Stereotactic Body Radiotherapy for Prostate Cancer.

    Parikh, Neil R / Kishan, Amar U

    American journal of men's health

    2020  Volume 14, Issue 3, Page(s) 1557988320927241

    Abstract: Prostate cancer remains the most common and second most deadly cancer diagnosed amongst U.S. men. External beam radiotherapy is a standard-of-care definitive treatment option for localized prostate cancer and historically constituted an 8-9-week ... ...

    Abstract Prostate cancer remains the most common and second most deadly cancer diagnosed amongst U.S. men. External beam radiotherapy is a standard-of-care definitive treatment option for localized prostate cancer and historically constituted an 8-9-week treatment course comprised of 39-45 doses of 1.8-2.0 Gy each (conventional fractionation, CF). Based on the notion that prostate cancer may respond favorably to a higher dose per day, considerable research efforts have been focused on characterizing the safety and efficacy profile of shorter and shorter radiation courses. Ultrahypofractionation (UHF) involves condensing the radiation course into just 5-7 treatments of 6-8 Gy each. When utilizing modern techniques that allow the precise sculpting of a dose distribution that delivers high doses to the prostate and lower doses to surrounding normal tissues over five or fewer treatments, this treatment is called stereotactic body radiotherapy (SBRT). Two randomized trials (HYPO-RT-PC and PACE-B) have compared UHF to longer radiation courses. The former demonstrated that UHF and CF have similar long-term toxicity and efficacy, while the latter demonstrated that modern SBRT has equivalent short-term toxicity as well. A separate report from a consortium of studies data provides prospective, albeit nonrandomized, data supporting the longer-term safety and efficacy of SBRT specifically. Thus, mounting high-level evidence suggests that SBRT is an acceptable standard care of option for men with localized prostate cancer.
    MeSH term(s) Humans ; Male ; Patient Reported Outcome Measures ; Prospective Studies ; Prostate-Specific Antigen/blood ; Prostatic Neoplasms/radiotherapy ; Radiation Dose Hypofractionation
    Chemical Substances Prostate-Specific Antigen (EC 3.4.21.77)
    Language English
    Publishing date 2020-06-05
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2275106-3
    ISSN 1557-9891 ; 1557-9883
    ISSN (online) 1557-9891
    ISSN 1557-9883
    DOI 10.1177/1557988320927241
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Esophageal Granular Cell Tumor: An Uncommon Cause of Dysphagia.

    Revia, Richard A / Shah, Raj / Mandalia, Amar / Parikh, Jignesh / Zayat, Vania

    Cureus

    2023  Volume 15, Issue 7, Page(s) e41846

    Abstract: Granular cell tumors (GCTs) are rare, typically benign, solitary neoplasms that can arise throughout the body, with reports of cases in the tongue, esophagus, colon, skin, vulva, and skeletal muscle, among others. Although GCTs are usually asymptomatic, ... ...

    Abstract Granular cell tumors (GCTs) are rare, typically benign, solitary neoplasms that can arise throughout the body, with reports of cases in the tongue, esophagus, colon, skin, vulva, and skeletal muscle, among others. Although GCTs are usually asymptomatic, esophageal GCTs can grow large enough to cause dysphagia. When developing the differential diagnosis for dysphagia, a broad consideration includes routine etiologies such as esophageal strictures, eosinophilic esophagitis, carcinoma, webs and rings, achalasia, and motility disorders, but GCTs may not readily come to mind. Due to their scarcity, this case report is presented to raise awareness of esophageal GCTs and emphasize key goals for diagnosing and managing this uncommon yet treatable cause of dysphagia. This case report details the clinical course of a patient presenting with a chief complaint of difficulty swallowing that was found to be caused by a subepithelial esophageal tumor discovered with esophagogastroduodenoscopy (EGD) and endoscopic ultrasound (EUS). Histopathological studies paired with immunohistochemical investigations of a tissue biopsy confirmed the etiology of the offending esophageal mass to be a GCT. The patient's dysphagia resolved after endoscopic mucosal resection of the GCT, and follow-up evaluations have remained negative for recurrence. This case highlights the esophageal GCT as an uncommon source of dysphagia and the need for EGD and EUS evaluations of subepithelial esophageal lesions accompanied by histopathological analysis for a definitive diagnosis of GCT.
    Language English
    Publishing date 2023-07-13
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.41846
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Ophthalmologist Turnover in the United States: Analysis of Workforce Changes from 2014 through 2021.

    Patel, Prem N / Patel, Parth A / Sheth, Amar H / Ahmed, Harris / Begaj, Tedi / Parikh, Ravi

    Ophthalmology

    2023  Volume 130, Issue 9, Page(s) 973–981

    Abstract: Purpose: Physician turnover is costly to health care systems and affects patient experience due to discontinuity of care. This study aimed to assess the frequency of turnover by ophthalmologists and identify physician and practice characteristics ... ...

    Abstract Purpose: Physician turnover is costly to health care systems and affects patient experience due to discontinuity of care. This study aimed to assess the frequency of turnover by ophthalmologists and identify physician and practice characteristics associated with turnover.
    Design: Retrospective cross-sectional study.
    Participants: Actively practicing United States ophthalmologists included in the Centers for Medicare and Medicaid Services Physician Compare and Physician and Other Supplier Public Use File between 2014 and 2021.
    Methods: We collected data for each ophthalmologist that was associated with practice/institution and then calculated the rate of turnover both annually in each year window and cumulatively as the total proportion from 2014 to 2021. Multivariable logistic regression analysis was used to identify physician and practice characteristics associated with turnover. We also evaluated turnover characteristics surrounding the Coronavirus disease 2019 (COVID-19) pandemic.
    Main outcome measures: Ophthalmologist turnover, defined as a change of an ophthalmologist's National Provider Identifier practice affiliation from one year to the next.
    Results: Of 13 264 ophthalmologists affiliated with 3306 unique practices, 34.1% separated from at least 1 practice between 2014 and 2021. Annual turnover ranged from 3.7% (2017) to 19.4% (2018), with an average rate of 9.4%. Factors associated with increased turnover included solo practice (adjusted odds ratio [aOR], 9.59), university affiliation (aOR, 1.55), practice location in the Northeast (aOR, 1.39), and practice size of 2 to 4 members (aOR, 1.21; P < 0.05 for all). Factors associated with decreased turnover included male gender (aOR, 0.87) and more than 5 years of practice: 6 to 10 years (aOR, 0.63), 11 to 19 years (aOR, 0.54), 20 to 29 years (aOR, 0.36), and ≥ 30 years (aOR, 0.18; P < 0.05 for all). In the initial year (2020) of the COVID-19 pandemic, annual turnover increased from 7.8% to 11.0%, then decreased to 8.7% in the postvaccine period (2021).
    Conclusions: One-third of United States ophthalmologists separated from at least 1 practice from 2014 through 2021. Turnover patterns differed by various physician and practice characteristics, which may be used to develop future strategies for workforce stability. Because administrative data cannot solely determine reasons for turnover, further investigation is warranted given the potential clinical and financial implications.
    Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
    MeSH term(s) Aged ; Humans ; Male ; United States/epidemiology ; Ophthalmologists ; Retrospective Studies ; Cross-Sectional Studies ; Pandemics ; Medicare ; COVID-19/epidemiology ; Workforce
    Language English
    Publishing date 2023-05-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 392083-5
    ISSN 1549-4713 ; 0161-6420
    ISSN (online) 1549-4713
    ISSN 0161-6420
    DOI 10.1016/j.ophtha.2023.05.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Percutaneous Transhepatic Embolization of a Bleeding Colic Vein in a Cirrhotic Patient With Massive Hematochezia: A Case Report and Literature Review.

    Parikh, Aaroh / Leon, David / Ghasemi Rad, Mohammad / Wynne, David / Amaresh, Amar

    Cureus

    2022  Volume 14, Issue 6, Page(s) e25736

    Abstract: Ectopic varices are an uncommon cause of gastrointestinal bleeding in patients with portal hypertension. A 43-year-old female with alcoholic cirrhosis developed massive hematochezia and hemorrhagic shock, requiring emergent angiography and image-guided ... ...

    Abstract Ectopic varices are an uncommon cause of gastrointestinal bleeding in patients with portal hypertension. A 43-year-old female with alcoholic cirrhosis developed massive hematochezia and hemorrhagic shock, requiring emergent angiography and image-guided intervention. Angiography revealed active extravasation from a branch of the right colic vein. The patient underwent percutaneous transhepatic embolization of the bleeding colic vein with technical success demonstrated on post-embolization angiography. Treatment of bleeding ectopic varices may require endoscopic, image-guided, or surgical approaches.
    Language English
    Publishing date 2022-06-07
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.25736
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Emerging cancer therapies and cardiovascular risk.

    Bottinor, Wendy / Parikh, Amar / Jahangir, Eiman

    Journal of thrombosis and thrombolysis

    2020  Volume 51, Issue 4, Page(s) 837–845

    Abstract: The cardiovascular (CV) toxicity profiles of traditional cancer therapies such as anthracyclines and radiation therapy are familiar to many cardiologists. With the development and widespread use of additional cancer therapeutics, CV toxicities related to ...

    Abstract The cardiovascular (CV) toxicity profiles of traditional cancer therapies such as anthracyclines and radiation therapy are familiar to many cardiologists. With the development and widespread use of additional cancer therapeutics, CV toxicities related to these agents are becoming more common. Cardiovascular specialists are often integrated into the care team for individuals with cancer and knowledge of the CV toxicities of cancer therapeutics has become essential. In this review, we provide a clinically focused summary of the current data regarding CV toxicities of common cancer therapies and identify potential management strategies for the CV specialist.
    MeSH term(s) Antineoplastic Agents/therapeutic use ; Cardiovascular Diseases/chemically induced ; Heart Disease Risk Factors ; Humans ; Neoplasms/drug therapy ; Risk Factors
    Chemical Substances Antineoplastic Agents
    Language English
    Publishing date 2020-09-04
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 1230645-9
    ISSN 1573-742X ; 0929-5305
    ISSN (online) 1573-742X
    ISSN 0929-5305
    DOI 10.1007/s11239-020-02263-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Cardio-Oncology Care in the Time of COVID-19 and the Role of Telehealth

    Parikh, Amar / Kumar, Anupam A. / Jahangir, Eiman

    JACC: CardioOncology

    2020  Volume 2, Issue 2, Page(s) 356–358

    Keywords covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ISSN 2666-0873
    DOI 10.1016/j.jaccao.2020.04.003
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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