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Article ; Online: Disparities in diagnosis of cerebral amyloid angiopathy based on hospital characteristics.

Nagaraja, Nandakumar / Patel, Urvish K

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

2021 Volume 89, Page(s) 39–42

Abstract: Cerebral amyloid angiopathy (CAA) categorized as a cerebral small vessel disease can cause lobar intracerebral hemorrhage (ICH), convexity subarachnoid hemorrhage (SAH) and ischemic stroke (IS). The purpose of this study was to evaluate the differences ... ...

Abstract	Cerebral amyloid angiopathy (CAA) categorized as a cerebral small vessel disease can cause lobar intracerebral hemorrhage (ICH), convexity subarachnoid hemorrhage (SAH) and ischemic stroke (IS). The purpose of this study was to evaluate the differences in the diagnosis of CAA based on hospital characteristics and to assess the discharge outcomes of patients with CAA admitted for IS, ICH and SAH. Adult patients admitted with secondary diagnosis of CAA were identified in National Inpatient Sample in 2016 and 2017. Multivariable logistic regression analysis was performed to evaluate outcomes. A total of 16,040 patients had a secondary diagnosis of CAA. Among CAA patients, 1810 (11.3%) patients were admitted for IS, 4765 (29.7%) for ICH and 490 (3.1%) for SAH. Diagnosis of CAA was five-fold higher among patients admitted to urban teaching hospitals (aOR = 5.4;95% CI = 4.1-7.2) compared to rural hospitals and two-fold higher in large bed size hospitals (aOR = 2.3;95% CI = 2.0-2.7) compared to small bed size hospitals. Compared to non-CAA group, patients with history of CAA had lower odds of in-hospital mortality among patients admitted for ICH (10% vs 23%, aOR = 0.35; 95%CI = 0.27-0.44) and SAH (6% vs 19%, aOR = 0.24; 95%CI = 0.10-0.55); and higher odds of discharge to home among patients admitted for ICH (17% vs 18%, aOR = 1.27; 95%CI = 1.05-1.53). CAA diagnosis is less common in rural and small bed size hospitals compared to urban and large bedside hospitals, respectively. Patients with CAA admitted for ICH have better discharge outcomes compared to non-CAA patients admitted for ICH.
Language	English
Publishing date	2021-04-30
Publishing country	Scotland
Document type	Journal Article
ZDB-ID	1193674-5
ISSN	1532-2653 ; 0967-5868
ISSN (online)	1532-2653
ISSN	0967-5868
DOI	10.1016/j.jocn.2021.04.021
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Zs.A 3999: Show issues

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Article ; Online: Community Paramedicine: An Innovative Model for Value-Based Care Delivery.

Rahim, Faraan / Jain, Bhav / Patel, Tej / Jain, Urvish / Jain, Pankaj / Palakodeti, Sandeep

Journal of public health management and practice : JPHMP

2022 Volume 29, Issue 2, Page(s) E65–E68

MeSH term(s)	Humans ; Paramedicine ; Emergency Medical Services ; Community Health Services
Language	English
Publishing date	2022-12-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2027860-3
ISSN	1550-5022 ; 1078-4659
ISSN (online)	1550-5022
ISSN	1078-4659
DOI	10.1097/PHH.0000000000001683
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Zs.A 5302: Show issues

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Article ; Online: Trends in Volume and Charges of Retinal Tear Patients in the Emergency Department.

Taneja, Kamil / Diaz, Michael Joseph / Taneja, Tanisha / Patel, Karan / Batchu, Sai / Oak, Solomon / Zhang, Alex / Joshi, Aditya / Patel, Urvish K

Ophthalmic epidemiology

2023 Volume 31, Issue 1, Page(s) 55–61

Abstract: Purpose: To characterize retinal tears (RTs) and calculate the economic burden of RTs that present to the emergency department (ED) in the US.: Methods: We used a large national ED database to retrospectively analyze RTs that presented to the ED from ...

Abstract	Purpose: To characterize retinal tears (RTs) and calculate the economic burden of RTs that present to the emergency department (ED) in the US. Methods: We used a large national ED database to retrospectively analyze RTs that presented to the ED from 2006 to 2019. Using extrapolation methods, national of the RT patient ED volume, demographics, comorbidities, disposition, inpatient (IP) charges, and ED charges were calculated. Results: During the period between 2006 and 2019, 15841 ED encounters had RT listed as the primary diagnosis. The average annual RT ED encounters was 2,640 ± 856 and comprised an average of 6.4 × Conclusion: Despite the stable number of RT patients presenting to the ED, RTs place a significant economic burden to the healthcare system, which increases yearly. We recommend physicians and policy makers to work together to pass laws that could prevent the increasing healthcare charges.
MeSH term(s)	Male ; Humans ; United States/epidemiology ; Female ; Retrospective Studies ; Retinal Perforations ; Hospital Charges ; Hospitalization ; Emergency Service, Hospital
Language	English
Publishing date	2023-04-21
Publishing country	England
Document type	Journal Article
ZDB-ID	1213070-9
ISSN	1744-5086 ; 0928-6586
ISSN (online)	1744-5086
ISSN	0928-6586
DOI	10.1080/09286586.2023.2203227
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Zs.A 4138: Show issues

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Article ; Online: Stroke-like migraine attacks after radiation therapy (SMART) syndrome-a case series and review.

Patel, Urvish K / Patel, Khush / Malik, Preeti / Elkady, Ahmed / Patel, Nidhi / Lunagariya, Abhishek

Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

2022 Volume 41, Issue 11, Page(s) 3123–3134

Abstract: Introduction: Cranial irradiation is used both prophylactically and for the treatment of brain tumors. There are various complications associated with it. The rare complication of stroke-like migraine attacks after radiation therapy (SMART) syndrome ... ...

Abstract	Introduction: Cranial irradiation is used both prophylactically and for the treatment of brain tumors. There are various complications associated with it. The rare complication of stroke-like migraine attacks after radiation therapy (SMART) syndrome usually occurs several years after radiation therapy but is a reversible phenomenon. It usually presents with headaches, seizures, or other focal neurological deficits concerning stroke or recurrence of the underlying disease. Objectives: We aim to present two cases of SMART syndrome highlighting the typical presentation, imaging findings, and differential diagnosis. We also conducted the literature review since the early recognition of this rare delayed onset complication is crucial, given its self-limited course and to avoid misinterpretations of the cases. Conclusion: Our extensive review favors MRI, CT, and prolonged EEG monitoring to rule out other differentials and showed that initiation of corticosteroid therapy and antiepileptic treatment were helpful in the resolution of symptoms and prevent recurrences. Therefore, future studies should be focused on early identification and management guidelines for SMART syndrome.
MeSH term(s)	Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/radiotherapy ; Humans ; Migraine Disorders/diagnostic imaging ; Migraine Disorders/etiology ; Neoplasm Recurrence, Local ; Radiation Injuries/diagnostic imaging ; Radiation Injuries/etiology ; Stroke/diagnostic imaging ; Stroke/etiology
Language	English
Publishing date	2022-07-13
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	2016546-8
ISSN	1590-3478 ; 1590-1874
ISSN (online)	1590-3478
ISSN	1590-1874
DOI	10.1007/s10072-020-04586-0
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Zs.A 1877: Show issues

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Article ; Online: Predictors of inpatient admission likelihood and prolonged length of stay among cerebrovascular disease patients: A nationwide emergency department sample analysis.

Patel, Karan / Diaz, Michael Joseph / Taneja, Kamil / Batchu, Sai / Zhang, Alex / Mohamed, Aleem / Wolfe, Jared / Patel, Urvish K

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

2023 Volume 32, Issue 3, Page(s) 106983

Abstract: Purpose: To examine the hospital- and patient-related factors associated with increased likelihood of inpatient admission and extended hospitalization.: Methods: We applied multivariate logistic regression to a subset of ED hospital and patient ... ...

Abstract	Purpose: To examine the hospital- and patient-related factors associated with increased likelihood of inpatient admission and extended hospitalization. Methods: We applied multivariate logistic regression to a subset of ED hospital and patient characteristics linearly extrapolated from the 2019 National Emergency Department Sample database (n=626,508). Patient characteristics with 10 or fewer ED visits after national extrapolation were not reported in the current study to maintain patient confidentiality, in accordance with the HCUP Data Use Agreement. All selected ED visits represented a primary diagnosis of CVD (ICD-10 codes 160-168). All reported hospital and patient characteristics were subject to adjustment for covariates. P-values < 0.05 were considered statistically significant. Main findings: Medicare beneficiaries report higher inpatient admission rates than uninsured OR 0.81 (0.73-0.91) and privately insured OR 0.86 (0.79-0.94) individuals. Black and Native-American patients were 37% and 55% more likely to be hospitalized long (>75 Principal conclusions: Likelihoods of inpatient admission and long hospital stays were observably stratified through multiple, independently acting hospital and patient characteristics. Significant associations were stratified by race/ethnicity, location, and clinical presentation, among others. Attention to the factors reported here may serve well to mitigate emergency department crowding and its sobering impact on United States healthcare systems and patients.
MeSH term(s)	Humans ; Aged ; United States/epidemiology ; Length of Stay ; Inpatients ; Medicare ; Hospitalization ; Emergency Service, Hospital ; Cerebrovascular Disorders/diagnosis ; Cerebrovascular Disorders/epidemiology ; Cerebrovascular Disorders/therapy
Language	English
Publishing date	2023-01-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	1131675-5
ISSN	1532-8511 ; 1052-3057
ISSN (online)	1532-8511
ISSN	1052-3057
DOI	10.1016/j.jstrokecerebrovasdis.2023.106983
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Zs.A 3519: Show issues

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Article ; Online: Effectiveness of Repetitive Transcranial Magnetic Stimulation in Depression, Schizophrenia, and Obsessive-Compulsive Disorder: An Umbrella Meta-Analysis.

Patel, Shweta / Silvi, Suraiya / Desai, Saral / Rahman, Fayaz / Depa, Nishitha / Hanif, Sarah / Rizvi, Syeda / Hsieh, Ya-Ching / Malik, Preeti / Patel, Urvish / Mansuri, Zeeshan / Mercy, Rana Prathap / Aedma, Kapil / Parikh, Tapan

The primary care companion for CNS disorders

2023 Volume 25, Issue 5

MeSH term(s)	Humans ; Schizophrenia/therapy ; Depressive Disorder, Major/therapy ; Transcranial Magnetic Stimulation/methods ; Depression ; Obsessive-Compulsive Disorder/therapy ; Treatment Outcome
Language	English
Publishing date	2023-09-26
Publishing country	United States
Document type	Meta-Analysis ; Journal Article
ZDB-ID	2675414-9
ISSN	2155-7780 ; 2155-7780
ISSN (online)	2155-7780
ISSN	2155-7780
DOI	10.4088/PCC.22r03423
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Article ; Online: Expansion of the dimensions in the current management of acute ischemic stroke.

Malik, Preeti / Anwar, Arsalan / Patel, Ruti / Patel, Urvish

Journal of neurology

2020 Volume 268, Issue 9, Page(s) 3185–3202

Abstract: Stroke is the fifth leading cause of death in the United States with a huge burden on health care. Acute ischemic stroke (AIS) accounts for 87% of all stroke. The use of thrombolytic agents in AIS treatment is well known since 1950 but no FDA approval ... ...

Abstract	Stroke is the fifth leading cause of death in the United States with a huge burden on health care. Acute ischemic stroke (AIS) accounts for 87% of all stroke. The use of thrombolytic agents in AIS treatment is well known since 1950 but no FDA approval until 1996, due to lack of strong evidence showing benefits outweigh the risk of intracranial hemorrhage. The NINDS trial led to the approval of intravenous tissue plasminogen activator treatment (IV recombinant tPA) within 3 h of stroke. Due to this limitation of 3-4.5 h. window, evolution began in the development of effective endovascular therapy (EVT). Multiple trials were unsuccessful in establishing the strong evidence for effectiveness of EVT. In 2015, MR CLEAN trial made progress and showed improved outcomes with EVT in AIS patients with large vessel occlusion (LVO), with 6-h window period. In 2018, two major trials-DAWN and DEFUSE 3-along with few other trials had shown improved outcomes with EVT and stretched window period from 6 to 24 h. AHA Stroke Council is constantly working to provide focused guidelines and recommendations in AIS management since 2013. SVIN had started the initiative "Mission Thrombectomy-2020" to increase global EVT utilization rate 202,000 procedures by 2020. Physicians are using safer and easier approach like brachial and radial approach for EVT. TeleNeurology and artificial intelligence also played a significant role in increasing the availability of IV recombinant tPA in AIS treatment in remote hospitals and also in screening, triaging and identifying LVO patients for EVT. In this review article, we aim to describe the history of stroke management along with the new technological advancements in AIS treatment.
MeSH term(s)	Artificial Intelligence ; Brain Ischemia/complications ; Brain Ischemia/drug therapy ; Endovascular Procedures ; Humans ; Ischemic Stroke ; Stroke/drug therapy ; Thrombectomy ; Tissue Plasminogen Activator/therapeutic use ; Treatment Outcome
Chemical Substances	Tissue Plasminogen Activator (EC 3.4.21.68)
Language	English
Publishing date	2020-05-20
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	187050-6
ISSN	1432-1459 ; 0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
ISSN (online)	1432-1459
ISSN	0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
DOI	10.1007/s00415-020-09873-6
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Article ; Online: Correction to: Pre-existing cerebrovascular disease and poor outcomes of COVID-19 hospitalized patients: a meta-analysis.

Patel, Urvish / Malik, Preeti / Shah, Dhaivat / Patel, Achint / Dhamoon, Mandip / Jani, Vishal

Journal of neurology

2020 Volume 268, Issue 1, Page(s) 248

Keywords	covid19
Language	English
Publishing date	2020-08-24
Publishing country	Germany
Document type	Published Erratum
ZDB-ID	187050-6
ISSN	1432-1459 ; 0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
ISSN (online)	1432-1459
ISSN	0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
DOI	10.1007/s00415-020-10198-7
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Article: A Comprehensive Overview of Antibiotic Selection and the Factors Affecting It.

Patel, Karan / Bunachita, Sean / Agarwal, Ank A / Bhamidipati, Akshay / Patel, Urvish K

Cureus

2021 Volume 13, Issue 3, Page(s) e13925

Abstract: In order to prescribe an antibiotic, a physician must go through a series of decision-making processes that involve both the drug and the host. In this review article, we outline exactly what those decision-making processes are and some of their ... ...

Abstract	In order to prescribe an antibiotic, a physician must go through a series of decision-making processes that involve both the drug and the host. In this review article, we outline exactly what those decision-making processes are and some of their limitations. Before a medication can be prescribed, a physician has to determine if the antibiotic works against the host pathogen. To do this, basic science techniques are employed including phenotypic methods such as broth dilution methods, Kirby-Bauer susceptibility testing, Epsilometer test (E-test), and genotypic methods such as the new and upcoming automated tests. After determining if a drug has potential to work, the physician must consider the drug's mechanism of action in order to determine a dosing regimen. Some groups of drugs should be administered at high concentrations infrequently, others should be given more frequently in smaller doses, and others lie somewhere between this spectrum. Finally, external factors such as the patient's age, especially for pediatrics and geriatrics patients, need to be considered, as these groups have the highest health care burden but are among the most vulnerable when it comes to the side effects of drugs.
Language	English
Publishing date	2021-03-16
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.13925
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Article: Elder Abuse: A Comprehensive Overview and Physician-Associated Challenges.

Patel, Karan / Bunachita, Sean / Chiu, Hannah / Suresh, Prakul / Patel, Urvish K

Cureus

2021 Volume 13, Issue 4, Page(s) e14375

Abstract: Elder abuse can present in many forms, including physical abuse, psychological/emotional abuse, sexual abuse, financial abuse, and neglect. Many studies estimate that about 10% of all people over the age of 65 experience some form of abuse. These rates ... ...

Abstract	Elder abuse can present in many forms, including physical abuse, psychological/emotional abuse, sexual abuse, financial abuse, and neglect. Many studies estimate that about 10% of all people over the age of 65 experience some form of abuse. These rates are often higher in long-term care facilities such as nursing homes, despite government regulations aimed toward addressing this issue. Because patients who experience abuse tend to have higher rates of hospitalization and mortality, it is important for physicians to be able to accurately identify cases of abuse. However, many studies have found that healthcare professionals are often undertrained and ill-equipped in diagnosing elder abuse. In this article, we outline tools that may be able to aid healthcare professionals in their diagnoses, such as survey-based methodology and common physical signs of abuse. In addition, we propose evidence-based solutions, including the use of multidisciplinary teams and increased training on the subject, so that healthcare professionals can more easily identify victims of abuse. Essentially, it is our hope that this article further spotlights elder abuse and its challenges, while serving as a guide to healthcare professionals.
Language	English
Publishing date	2021-04-08
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.14375
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