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Article ; Online: A Review of 1228 In-Office Hand Surgery Procedures With Wide Awake Local Anesthesia No Tourniquet (WALANT) at a Single Private Practice.

Coffman, Jason R / Dela Cruz, Jeffrey A / Stein, Brandon A / Bagg, Mark R / Person, David W / Desai, Kunj K / Srinivasan, Ramesh C

Hand (New York, N.Y.)

2024 , Page(s) 15589447241235251

Abstract: Background: This study examined the complication rate of Wide Awake Local Anesthesia No Tourniquet (WALANT) technique in the clinic setting with field sterility at a single private practice. We hypothesized that WALANT is safe and effective with a low ... ...

Abstract	Background: This study examined the complication rate of Wide Awake Local Anesthesia No Tourniquet (WALANT) technique in the clinic setting with field sterility at a single private practice. We hypothesized that WALANT is safe and effective with a low complication rate. Methods: This retrospective chart review included 1228 patients who underwent in-office WALANT hand procedures at a single private practice between 2015 and 2022. Patients were divided into groups based on type of procedure: carpal tunnel release, A1 pulley release, first dorsal compartment release, extensor tendon repair, mass excision, foreign body removal, and needle aponeurotomy. Patient demographics and complications were recorded; statistical comparisons of cohort demographics and risk factors for complications were completed, and Results: The overall complication rate for all procedures was 2.77% for 1228 patients including A1 pulley release (n = 962, 2.7%), mass excision (n = 137, 3.7%), extensor tendon repair (n = 23, 4.3%), and first dorsal compartment release (n = 22, 8.3%). Carpal tunnel release, foreign body removal, and needle aponeurotomy groups experienced no complications. No adverse events (e.g. vasovagal reactions, digital ischemia, local anesthetic toxicity, inadequate vasoconstriction) were observed in any group. Patients with known autoimmune disorders and those who were currently smoking had a statistically significant higher complication rate. Conclusions: Office-based WALANT procedures with field sterility are safe and effective for treating common hand maladies and have a similar complication profile when compared to historical controls from the standard operating room in an ambulatory center or hospital.
Language	English
Publishing date	2024-03-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2277325-3
ISSN	1558-9455 ; 1558-9447
ISSN (online)	1558-9455
ISSN	1558-9447
DOI	10.1177/15589447241235251
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Zs.A 6820: Show issues

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Article: Arthroscopic TFCC Ulnar Bone Tunnel Foveal Repair in Adult Patients.

Srinivasan, Ramesh C / Dela Cruz, Jeffrey A / Eubanks, Ryan D / Desai, Kunj K / Mithani, Suhail K / Richard, Marc J / Ruch, David S

Arthroscopy techniques

2022 Volume 11, Issue 10, Page(s) e1753–e1761

Abstract: Triangular fibrocartilage complex (TFCC) tears may cause persistent ulnar-sided wrist pain, loss of grip strength, and associated loss of function. Although the majority of TFCC tears can be treated nonoperatively, surgical repair is considered when ... ...

Abstract	Triangular fibrocartilage complex (TFCC) tears may cause persistent ulnar-sided wrist pain, loss of grip strength, and associated loss of function. Although the majority of TFCC tears can be treated nonoperatively, surgical repair is considered when conservative measures fail. TFCC tears with foveal disruption and instability of the distal radioulnar joint (DRUJ) require direct repair of the TFCC to the ulnar fovea. The traditional method of foveal TFCC repair involves an open surgical approach through the floor of the 5th dorsal compartment. However, this open approach causes disruption of structures such as the dorsal ulnocarpal capsule, the extensor retinaculum, and, potentially, the distal radioulnar ligament (DRUL). This article describes, in detail, the recently developed arthroscopic assisted ulnar foveal bone tunnel repair. This method spares dorsal structures that may be disrupted during an open surgical approach and creates a robust repair of the TFCC deep fibers with restoration of DRUJ stability.
Language	English
Publishing date	2022-09-17
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2653101-X
ISSN	2212-6287
ISSN	2212-6287
DOI	10.1016/j.eats.2022.06.011
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Article: Cat bite cellulitis.

Nocera, Nadia F / Desai, Kunj K / Granick, Mark S

Eplasty

2014 Volume 14, Page(s) ic25

Language	English
Publishing date	2014-08-08
Publishing country	United States
Document type	Case Reports
ZDB-ID	2412803-X
ISSN	1937-5719
ISSN	1937-5719
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Article ; Online: Ministering to the dead in critical care medicine: has its time come?

Desai, Kunj K / Koneru, Baburao

Critical care medicine

2009 Volume 37, Issue 8, Page(s) 2480–2481

MeSH term(s)	Biomarkers/blood ; Hemodynamics ; Humans ; Hypovolemia/blood ; Hypovolemia/diagnosis ; Interleukin-6/blood ; Systemic Inflammatory Response Syndrome/blood ; Systemic Inflammatory Response Syndrome/prevention & control ; Tissue and Organ Harvesting
Chemical Substances	Biomarkers ; Interleukin-6
Language	English
Publishing date	2009-08
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0b013e3181abf8ba
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Article ; Online: Negative pressure wound therapy: an algorithm.

Desai, Kunj K / Hahn, Edward / Pulikkottil, Benson / Pulikkotill, Benson / Lee, Edward

Clinics in plastic surgery

2012 Volume 39, Issue 3, Page(s) 311–324

Abstract: Negative pressure wound therapy (NPWT) has overwhelmed the wound-healing world. A systematic review puts it into perspective. The authors have developed an algorithm after careful evaluation and analysis of the scientific literature supporting the use of ...

Abstract	Negative pressure wound therapy (NPWT) has overwhelmed the wound-healing world. A systematic review puts it into perspective. The authors have developed an algorithm after careful evaluation and analysis of the scientific literature supporting the use of these devices. This article describes mechanisms of action, technical considerations, wound preparation, and clinical evidence, reviews the literature, and discusses NPWT use in specific wounds, such as diabetic foot ulcers, open abdomen, pressure ulcers, open fractures, sterna wounds, grafts, and flaps. Contraindications for and complications of NPWT are outlined, and specific recommendations given for the situations in which the authors use NPWT.
MeSH term(s)	Algorithms ; Bacterial Load ; Burns/therapy ; Contraindications ; Diabetic Foot/therapy ; Evidence-Based Medicine ; Foot Ulcer/therapy ; Fractures, Open/therapy ; Humans ; Negative-Pressure Wound Therapy/methods ; Negative-Pressure Wound Therapy/standards ; Pressure Ulcer/therapy ; Skin Transplantation ; Surgical Flaps ; Varicose Ulcer/therapy ; Wound Healing ; Wounds and Injuries/microbiology ; Wounds and Injuries/therapy
Language	English
Publishing date	2012-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	193117-9
ISSN	1558-0504 ; 0094-1298
ISSN (online)	1558-0504
ISSN	0094-1298
DOI	10.1016/j.cps.2012.05.002
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Article ; Online: Self-reported non-adherence to immune-suppressant therapy in liver transplant recipients: demographic, interpersonal, and intrapersonal factors.

Lamba, Sangeeta / Nagurka, Roxanne / Desai, Kunj K / Chun, Shaun J / Holland, Bart / Koneru, Baburao

Clinical transplantation

2012 Volume 26, Issue 2, Page(s) 328–335

Abstract: Adherence to immune suppressants and follow-up care regimen is important in achieving optimal long-term outcomes after organ transplantation. To identify patients most at risk for non-adherence, this cross-sectional, descriptive study explores the ... ...

Abstract	Adherence to immune suppressants and follow-up care regimen is important in achieving optimal long-term outcomes after organ transplantation. To identify patients most at risk for non-adherence, this cross-sectional, descriptive study explores the prevalence and correlates of non-adherence to immune-suppressant therapy among liver recipients. Anonymous questionnaires mailed consisted of the domains: (i) adherence barriers to immune suppressants, (ii) immune suppressants knowledge, (iii) demographics, (iv) social support, (v) medical co-morbidities, and (vi) healthcare locus of control and other beliefs. Overall response was 49% (281/572). Data analyzed for those transplanted within 10 yr of study reveal 50% (119/237) recipients or 9.2/100 person years reporting non-adherence. Non-adherence was reported highest in the 2-5 yr post-transplant phase (69/123, 56%). The highest immune-suppressant non-adherence rates were in recipients who are: divorced (26/34, 76%, p=0.0093), have a history of substance or alcohol use (42/69, 61%, p=0.0354), have mental health needs (50/84, 60%, p=0.0336), those who missed clinic appointments (25/30, 83%, p<0.0001), and did not maintain medication logs (71/122, 58%, p=0.0168). Respondents who were non-adherent with physician appointments were more than four and a half times as likely (OR 4.7, 95% CI 1.5-14.7, p=0.008) to be non-adherent with immune suppressants. In conclusion, half of our respondents report non-adherence to immune suppressants. Factors identified may assist clinicians to gauge patients' non-adherence risk and target resources.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Immunosuppressive Agents/therapeutic use ; Internal-External Control ; Liver Transplantation ; Male ; Medication Adherence ; Middle Aged ; Social Support ; Socioeconomic Factors ; Substance-Related Disorders ; Surveys and Questionnaires ; Young Adult
Chemical Substances	Immunosuppressive Agents
Language	English
Publishing date	2012-03
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	639001-8
ISSN	1399-0012 ; 0902-0063
ISSN (online)	1399-0012
ISSN	0902-0063
DOI	10.1111/j.1399-0012.2011.01489.x
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Zs.A 2204: Show issues

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Article ; Online: Does liver ischemic preconditioning in brain death donors induce kidney preconditioning? A retrospective analysis.

Desai, Kunj K / Mora-Esteves, Cesar / Holland, Bart K / Dikdan, George / Fisher, Adrian / Wilson, Dorian J / Koneru, Baburao

Transplantation

2014 Volume 97, Issue 3, Page(s) 337–343

Abstract: Background: It is unclear whether ischemic preconditioning (IPC) of solid organs induces remote IPC (RIPC) in donors after brain death (DBD).: Methods: Outcomes in kidney recipients from 163 DBD in two randomized trials of liver IPC (5 min=62 and 10 ... ...

Abstract	Background: It is unclear whether ischemic preconditioning (IPC) of solid organs induces remote IPC (RIPC) in donors after brain death (DBD). Methods: Outcomes in kidney recipients from 163 DBD in two randomized trials of liver IPC (5 min=62 and 10 min=101) were obtained retrospectively from the Scientific Registry of Transplant Recipients. Controls were kidney recipients from donors without IPC. Mean cold ischemia times were less than 20 hr. Primary outcomes were delayed graft function, defined as dialysis during the first posttransplantation week, and death-censored graft survival. Secondary outcomes were duration of initial hospital stay, patient survival, and estimated glomerular filtration rate 6, 12, 36, and 60 months after transplantation. Results: After exclusions (40 kidneys not recovered, 21 not transplanted, 8 en bloc, 23 with extrarenal organs, and 6 with missing records), 228 recipients were included. Delayed graft function occurred in 23% of No RIPC and 28% of RIPC kidneys (P=0.54). One- and 3-year graft survival rates were 92% and 90%, respectively, in the No RIPC and 90% and 81%, respectively, in the RIPC group (P=0.12), and mean hospital stay was 9.3±13.9 and 9.7±8.2 days, respectively (P=0.15). There were no significant between group differences in patient survival and estimated glomerular filtration rate at any time point. Conclusions: Despite design and power limitations, our results suggest that liver IPC in DBD is of no clinical benefit to kidney recipients. Inconsistent efficacy and impracticality severely limit the usefulness of IPC in DBD. Other modalities of preconditioning should be tested.
MeSH term(s)	Adult ; Brain Death ; Delayed Graft Function/etiology ; Delayed Graft Function/prevention & control ; Female ; Glomerular Filtration Rate ; Graft Survival ; Humans ; Ischemic Preconditioning/methods ; Kidney Transplantation/methods ; Length of Stay ; Liver/pathology ; Liver Transplantation/methods ; Male ; Middle Aged ; Organ Preservation/methods ; Randomized Controlled Trials as Topic ; Registries ; Renal Insufficiency/mortality ; Renal Insufficiency/therapy ; Retrospective Studies ; Time Factors ; Tissue Donors ; Tissue and Organ Harvesting/methods ; Treatment Outcome
Language	English
Publishing date	2014-02-15
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	208424-7
ISSN	1534-6080 ; 0041-1337
ISSN (online)	1534-6080
ISSN	0041-1337
DOI	10.1097/01.TP.0000436926.30897.56
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Zs.A 488: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 509: Show issues

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Article ; Online: Ischemic preconditioning of the liver: a few perspectives from the bench to bedside translation.

Desai, Kunj K / Dikdan, George S / Shareef, Asif / Koneru, Baburao

Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society

2008 Volume 14, Issue 11, Page(s) 1569–1577

Abstract: Utilization of ischemic preconditioning to ameliorate ischemia/reperfusion injury has been extensively studied in various organs and species for the past two decades. While hepatic ischemic preconditioning in animals has been largely beneficial, ... ...

Abstract	Utilization of ischemic preconditioning to ameliorate ischemia/reperfusion injury has been extensively studied in various organs and species for the past two decades. While hepatic ischemic preconditioning in animals has been largely beneficial, translational efforts in the two clinical contexts--liver resection and decreased donor liver transplantation--have yielded mixed results. This review is intended to critically examine the translational data and identify some potential reasons for the disparate clinical results, and highlight some issues for further studies.
MeSH term(s)	Aged ; Animals ; Brain Death ; Clinical Trials as Topic ; Disease Models, Animal ; Humans ; Ischemic Preconditioning ; Liver/surgery ; Liver Function Tests ; Liver Transplantation/methods ; Middle Aged ; Reperfusion Injury ; Time Factors
Language	English
Publishing date	2008-11
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2006866-9
ISSN	1527-6473 ; 1527-6465
ISSN (online)	1527-6473
ISSN	1527-6465
DOI	10.1002/lt.21630
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Zs.A 4702: Show issues

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Article: Management of hydrofluoric Acid burns.

Alper, Netanel / Desai, Kunj / Rabinowitz, Sidney

Eplasty

2014 Volume 14, Page(s) ic42

Language	English
Publishing date	2014-10-27
Publishing country	United States
Document type	Case Reports
ZDB-ID	2412803-X
ISSN	1937-5719
ISSN	1937-5719
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Article ; Online: Global gene expression profiles of ischemic preconditioning in deceased donor liver transplantation.

Raza, Ali / Dikdan, George / Desai, Kunj K / Shareef, Asif / Fernandes, Helen / Aris, Virginie / de la Torre, Andrew N / Wilson, Dorian / Fisher, Adrian / Soteropoulos, Patricia / Koneru, Baburao

Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society

2010 Volume 16, Issue 5, Page(s) 588–599

Abstract: The benefits of ischemic preconditioning (IPC) in reducing ischemia/reperfusion injury (IRI) remain indistinct in human liver transplantation (LT). To further understand mechanistic aspects of IPC, we performed microarray analyses as a nested substudy in ...

Abstract	The benefits of ischemic preconditioning (IPC) in reducing ischemia/reperfusion injury (IRI) remain indistinct in human liver transplantation (LT). To further understand mechanistic aspects of IPC, we performed microarray analyses as a nested substudy in a randomized trial of 10-minute IPC in 101 deceased donor LTs. Liver biopsies were performed after cold storage and at 90 minutes postreperfusion in 40 of 101 subjects. Global gene expression profiles in 6 biopsy pairs in IPC and work standard organ recovery groups at both time points were compared using the Affymetrix GeneChip Human Gene 1.0 ST array. Transcripts with >1.5-fold change and P < 0.05 were considered significant. IPC altered expression of 82 transcripts in antioxidant, immunological, lipid biosynthesis, cell development and growth, and other groups. Real-time polymerase chain reaction and immunoblotting validated our microarray data. IPC-induced overexpression of glutathione S-transferase mu transcripts (GSTM1, GSTM3, GSTM4, and GSTM5) was accompanied by increased protein expression and may contribute to a decrease in oxidative stress. However, the increased expression of fatty acid synthase may increase oxidative stress, and tumor necrosis factor ligand superfamily member 10 may promote apoptosis. These changes, in combination with decreased expression of heparin-binding epidermal growth factor-like growth factor and insulin-like growth factor binding protein-1, both of which inhibit apoptosis, may increase IRI. In our study of deceased donor LT, IPC induces changes in gene expression, some of which are potentially beneficial but some which are potentially injurious. Thus, our findings of changes in gene expression mirror the outcomes in our clinical trial.
MeSH term(s)	Adult ; Antioxidants ; Biopsy ; Blotting, Western ; Cadaver ; Cell Division/genetics ; Enzymes/genetics ; Female ; Gene Expression Profiling ; Humans ; Ischemic Preconditioning ; Lipid Metabolism/genetics ; Liver/pathology ; Liver/physiology ; Liver Transplantation ; Male ; Middle Aged ; Oligonucleotide Array Sequence Analysis ; Reverse Transcriptase Polymerase Chain Reaction ; Tissue Donors
Chemical Substances	Antioxidants ; Enzymes
Language	English
Publishing date	2010-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	2006866-9
ISSN	1527-6473 ; 1527-6465
ISSN (online)	1527-6473
ISSN	1527-6465
DOI	10.1002/lt.22049
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