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Article ; Online: Assessing Frailty in Gastrointestinal Cancer: Two Diseases in One?

Patel, Ishan / Winer, Arthur

2024 Volume 26, Issue 1, Page(s) 90–102

Abstract: Purposeof review: This review examines the challenges of treating gastrointestinal cancer in the aging population, focusing on the importance of frailty assessment. Emphasized are the rise in gastrointestinal cancer incidence in older adults, advances ... ...

Abstract	Purposeof review: This review examines the challenges of treating gastrointestinal cancer in the aging population, focusing on the importance of frailty assessment. Emphasized are the rise in gastrointestinal cancer incidence in older adults, advances in frailty assessments for patients with gastrointestinal cancer, the development of novel frailty markers, and a summary of recent trials. Recent findings: Increasing evidence suggests that the use of a Comprehensive Geriatric Assessment (CGA) to identify frail older adults and individualize cancer care leads to lower toxicity and improved quality of life outcomes. However, the adoption of a full CGA prior to chemotherapy initiation in older cancer patients remains low. Recently, new frailty screening tools have emerged, including assessments designed to specifically predict chemotherapy-related adverse events. Additionally, frailty biomarkers have been developed, such as blood tests like IL-6 and performance tracking through physical activity monitors. The relevance of nutrition and muscle mass is discussed. Highlights from recent trials suggest the feasibility of successfully identifying patients most at risk of serious adverse events. There have been promising developments in identifying novel frailty markers and methods to screen for frailty in the older adult population. Further prospective trials that focus on and address the needs of the geriatric population for early identification of frailty in cancer care, facilitating a more tailored treatment approach. Practicing oncologists should select a frailty assessment to implement into their routine practice and adjust treatment accordingly.
MeSH term(s)	Humans ; Aged ; Frailty/diagnosis ; Quality of Life ; Frail Elderly ; Gastrointestinal Neoplasms/diagnosis ; Risk Assessment ; Geriatric Assessment/methods
Language	English
Publishing date	2024-01-02
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2057359-5
ISSN	1534-6269 ; 1523-3790
ISSN (online)	1534-6269
ISSN	1523-3790
DOI	10.1007/s11912-023-01483-5
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Article: Anorectal Gastrointestinal Stromal Tumor: Report of a Rare Case.

Patel, Akash / Shah, Akash / Patel, Ishan / Patel, Sunil

Cureus

2023 Volume 15, Issue 5, Page(s) e38690

Abstract: Gastrointestinal stromal tumors (GIST) are mesenchymal spindle cell tumors of the gastrointestinal tract with the rarest occurrence in anal canal sites accounting for approximately only 2-8% of the anorectal GISTs. GISTs involve the expression of KIT ( ... ...

Abstract	Gastrointestinal stromal tumors (GIST) are mesenchymal spindle cell tumors of the gastrointestinal tract with the rarest occurrence in anal canal sites accounting for approximately only 2-8% of the anorectal GISTs. GISTs involve the expression of KIT (CD117) tyrosine kinase with the presence of mutations in KIT or platelet-derived growth factor alpha (PDGFRα) and are identified as an important target in therapy. The elderly population in the age of 70s appears to be at the highest risk with abdominal pain, GI bleeding, anemia, or weight loss as non-specific presenting symptoms. Here, we describe a case of a 56-year-old man who presented with vague dull pain in his left buttock diagnosed with GIST with a submucosal mass in the posterior wall of the anal canal and rectum and a tumor size of 45x42x37 mm. An immunohistological study of the biopsy sample reported positive for CD 117, CD 34, and DOG 1. The patient was prescribed neoadjuvant imatinib for 8 months with a good response and subsequently underwent transanal endoscopic microsurgical resection. Post-operatively, the patient was continued on adjuvant imatinib followed by regular restaging CT chest/abdomen/pelvis and surveillance flexible sigmoidoscopy every 6 months.
Language	English
Publishing date	2023-05-07
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.38690
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Article ; Online: Lymphatic Plastic Bronchitis.

Mehta, Ishan / Patel, Kavita

The New England journal of medicine

2022 Volume 386, Issue 8, Page(s) e19

MeSH term(s)	Adult ; Airway Obstruction/etiology ; Bronchitis/diagnostic imaging ; Bronchitis/pathology ; Bronchoalveolar Lavage ; Embolization, Therapeutic ; Humans ; Lung/diagnostic imaging ; Lymphatic Vessels/diagnostic imaging ; Lymphatic Vessels/pathology ; Lymphography ; Male ; Thoracic Duct/diagnostic imaging ; Thoracic Duct/pathology
Language	English
Publishing date	2022-02-19
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMicm2107066
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Article: Iatrogenic dissection in paediatric cardiac surgery.

Gohil, Ishan / Patel, Kartik / Kakkar, Deepti / Gajjar, Trushar

Indian journal of thoracic and cardiovascular surgery

2023 Volume 39, Issue 4, Page(s) 399–401

Abstract: Iatrogenic dissection due to aortic cannulation is extremely rare. We are reporting here a case of 11-month-old child who developed an iatrogenic aortic dissection during repair of supracardiac total anomalous pulmonary venous connection (TAPVC). ...

Abstract	Iatrogenic dissection due to aortic cannulation is extremely rare. We are reporting here a case of 11-month-old child who developed an iatrogenic aortic dissection during repair of supracardiac total anomalous pulmonary venous connection (TAPVC).
Language	English
Publishing date	2023-03-28
Publishing country	India
Document type	Case Reports
ZDB-ID	2164386-6
ISSN	0973-7723 ; 0970-9134
ISSN (online)	0973-7723
ISSN	0970-9134
DOI	10.1007/s12055-023-01498-4
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Article: Microglia-mediated synaptic pruning in the nucleus accumbens during adolescence: A preliminary study of the proteomic consequences and putative female-specific pruning target.

Kirkland, J M / Patel, Ishan / Kopec, Ashley M

bioRxiv : the preprint server for biology

2023

Abstract: Adolescence is a period of copious neural development, particularly in the 'reward' circuitry of the brain, and reward-related behavioral development, including social development. One neurodevelopmental mechanism that appears to be common across brain ... ...

Abstract	Adolescence is a period of copious neural development, particularly in the 'reward' circuitry of the brain, and reward-related behavioral development, including social development. One neurodevelopmental mechanism that appears to be common across brain regions and developmental periods is the requirement for synaptic pruning to produce mature neural communication and circuits. We published that microglia-C3-mediated synaptic pruning also occurs in the nucleus accumbens (NAc) reward region during adolescence to mediate social development in male and female rats. However, both the adolescent stage in which microglial pruning occurred, and the synaptic pruning target, were sex specific. NAc pruning occurred between early and mid-adolescence in male rats to eliminate dopamine D1 receptors (D1rs), and between pre- and early adolescence in female rats (P20-30) to eliminate an unknown, non-D1r target. In this report, we sought to better understand the proteomic consequences of microglial pruning in the NAc, and what the female pruning target might be. To do this, we inhibited microglial pruning in the NAc during each sex's pruning period and collected tissue for mass spectrometry proteomic analysis and ELISA validation. We found that the proteomic consequences of inhibiting microglial pruning in the NAc were inversely proportional between the sexes, and a novel, female-specific pruning target may be Lynx1. Please note, if this preprint will be pushed further to publication it will not be by me (AMK), as I am leaving academia. So, I'm going to write more conversationally.
Language	English
Publishing date	2023-05-03
Publishing country	United States
Document type	Preprint
DOI	10.1101/2023.05.02.539121
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Article: Endovascular Alternatives to Transhepatic Shunt Creation.

Sinha, Ishan / Goldman, Daryl T / Patel, Rahul S / Nowakowski, Francis S

Seminars in interventional radiology

2023 Volume 40, Issue 1, Page(s) 73–78

Abstract: Portomesenteric decompression is often necessary to treat patients with refractory symptoms of portal hypertension. When transjugular or direct intrahepatic portosystemic shunt creation is not feasible or is inadequate, surgical portosystemic shunt ... ...

Abstract	Portomesenteric decompression is often necessary to treat patients with refractory symptoms of portal hypertension. When transjugular or direct intrahepatic portosystemic shunt creation is not feasible or is inadequate, surgical portosystemic shunt creation is considered, which carries significant morbidity and mortality in these high-risk patients. Surgery is further complicated in patients with portomesenteric thrombosis who require concurrent thrombectomy and long-term anticoagulation. In this article, we outline the technique for performing advanced endovascular alternatives to intrahepatic portosystemic shunt creation including mesocaval and splenorenal shunting. We will also discuss some of the clinical considerations for treating these patients with symptomatic portal hypertension and portomesenteric thrombosis.
Language	English
Publishing date	2023-05-04
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	848341-3
ISSN	1098-8963 ; 0739-9529
ISSN (online)	1098-8963
ISSN	0739-9529
DOI	10.1055/s-0043-1767687
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Article: Advanced Techniques for Accessing the Portal Vein during Transjugular Intrahepatic Portosystemic Shunt Creation.

Sinha, Ishan / Goldman, Daryl T / Patel, Rahul S / Nowakowski, Francis S

Seminars in interventional radiology

2023 Volume 40, Issue 1, Page(s) 79–86

Abstract: Transjugular portosystemic shunt (TIPS) placement is a widely accepted method for reducing portal pressures in conditions including symptomatic varices, refractory ascites, hepatic hydrothorax, portomesenteric thrombosis, and Budd-Chiari syndrome. The ... ...

Abstract	Transjugular portosystemic shunt (TIPS) placement is a widely accepted method for reducing portal pressures in conditions including symptomatic varices, refractory ascites, hepatic hydrothorax, portomesenteric thrombosis, and Budd-Chiari syndrome. The traditional method for performing TIPS involves "blind" access into a portal vein branch from a hepatic vein, typically right portal vein to right hepatic vein, using preoperative imaging and intraoperative wedged portography for guidance. However, standard access technique may not always be feasible due to occluded portal or hepatic veins, distorted anatomy, or prior TIPS. In this article we discuss alternative techniques for accessing the portal vein for TIPS placement when standard methods are not sufficient.
Language	English
Publishing date	2023-05-04
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	848341-3
ISSN	1098-8963 ; 0739-9529
ISSN (online)	1098-8963
ISSN	0739-9529
DOI	10.1055/s-0043-1767688
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Article ; Online: Synaptic pruning during adolescence shapes adult social behavior in both males and females.

Kirkland, Julia M / Edgar, Erin L / Patel, Ishan / Feustel, Paul / Belin, Sophie / Kopec, Ashley M

Developmental psychobiology

2024 Volume 66, Issue 3, Page(s) e22473

Abstract: Evolutionarily conserved, peer-directed social behaviors are essential to participate in many aspects of human society. These behaviors directly impact psychological, physiological, and behavioral maturation. Adolescence is an evolutionarily conserved ... ...

Abstract	Evolutionarily conserved, peer-directed social behaviors are essential to participate in many aspects of human society. These behaviors directly impact psychological, physiological, and behavioral maturation. Adolescence is an evolutionarily conserved period during which reward-related behaviors, including social behaviors, develop via developmental plasticity in the mesolimbic dopaminergic "reward" circuitry of the brain. The nucleus accumbens (NAc) is an intermediate reward relay center that develops during adolescence and mediates both social behaviors and dopaminergic signaling. In several developing brain regions, synaptic pruning mediated by microglia, the resident immune cells of the brain, is important for normal behavioral development. We previously demonstrated that during adolescence, in rats, microglial synaptic pruning shapes the development of NAc and social play behavior in males and females. In this report, we hypothesize that interrupting microglial pruning in NAc during adolescence will have persistent effects on male and female social behavior in adulthood. We found that inhibiting microglial pruning in the NAc during adolescence had different effects on social behavior in males and females. In males, inhibiting pruning increased familiar exploration and increased nonsocial contact. In females, inhibiting pruning did not change familiar exploration behavior but increased active social interaction. This leads us to infer that naturally occurring NAc pruning serves to reduce social behaviors toward a familiar conspecific in both males and females.
MeSH term(s)	Adolescent ; Humans ; Adult ; Female ; Male ; Animals ; Rats ; Social Behavior ; Brain ; Exploratory Behavior ; Social Interaction ; Dopamine ; Neuronal Plasticity
Chemical Substances	Dopamine (VTD58H1Z2X)
Language	English
Publishing date	2024-03-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	4107-5
ISSN	1098-2302 ; 0012-1630
ISSN (online)	1098-2302
ISSN	0012-1630
DOI	10.1002/dev.22473
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Article ; Online: lncRNA-miRNA-mRNA network in kidney transcriptome of Labeo rohita under hypersaline environment.

Shukla, Nitin / Harshini, Vemula / Raval, Ishan / Patel, Amrutlal K / Joshi, Chaitanya G

Scientific data

2024 Volume 11, Issue 1, Page(s) 226

Abstract: The present study describes the kidney transcriptome of Labeo rohita, a freshwater fish, exposed to gradually increased salinity concentrations (2, 4, 6 and 8ppt). A total of 10.25 Gbps data was generated, and a suite of bioinformatics tools, including ... ...

Abstract	The present study describes the kidney transcriptome of Labeo rohita, a freshwater fish, exposed to gradually increased salinity concentrations (2, 4, 6 and 8ppt). A total of 10.25 Gbps data was generated, and a suite of bioinformatics tools, including FEELnc, CPC2 and BLASTn were employed for identification of long non-coding RNAs (lncRNAs) and micro RNAs (miRNAs). Our analysis revealed a total of 170, 118, 99, and 269 differentially expressed lncRNA and 120, 118, 99, and 124 differentially expressed miRNAs in 2, 4, 6 and 8 ppt treatment groups respectively. Two competing endogenous RNA (ceRNA) networks were constructed i.e. A* ceRNA network with up-regulated lncRNAs and mRNAs, down-regulated miRNAs; and B* ceRNA network vice versa. 2ppt group had 131 and 83 lncRNA-miRNA-mRNA pairs in A* and B* networks, respectively. 4ppt group featured 163 pairs in A* network and 191 in B* network, while the 6ppt had 103 and 105 pairs. 8ppt group included 192 and 174 pairs. These networks illuminate the intricate RNA interactions in freshwater fish to varying salinity conditions.
MeSH term(s)	Animals ; Gene Regulatory Networks ; Kidney ; MicroRNAs/genetics ; RNA, Long Noncoding/genetics ; RNA, Messenger/genetics ; Transcriptome ; Cypriniformes/genetics ; Salinity
Chemical Substances	MicroRNAs ; RNA, Long Noncoding ; RNA, Messenger
Language	English
Publishing date	2024-02-22
Publishing country	England
Document type	Journal Article
ZDB-ID	2775191-0
ISSN	2052-4463 ; 2052-4463
ISSN (online)	2052-4463
ISSN	2052-4463
DOI	10.1038/s41597-024-03056-y
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Article: Impaired microglia-mediated synaptic pruning in the nucleus accumbens during adolescence results in persistent dysregulation of familiar, but not novel social interactions in sex-specific ways.

Kirkland, Julia M / Edgar, Erin L / Patel, Ishan / Kopec, Ashley M

bioRxiv : the preprint server for biology

2023

Abstract	Evolutionarily conserved, peer-directed social behaviors are essential to participate in many aspects of human society. These behaviors directly impact psychological, physiological, and behavioral maturation. Adolescence is an evolutionarily conserved period during which reward-related behaviors, including social behaviors, develop via developmental plasticity in the mesolimbic dopaminergic 'reward' circuitry of the brain. The nucleus accumbens (NAc) is an intermediate reward relay center that develops during adolescence and mediates both social behaviors and dopaminergic signaling. In several developing brain regions, synaptic pruning mediated by microglia, the resident immune cells of the brain, is important for normal behavioral development. In rats, we previously demonstrated that microglial synaptic pruning also mediates NAc and social development during sex-specific adolescent periods and via sex-specific synaptic pruning targets. In this report, we demonstrate that interrupting microglial pruning in NAc during adolescence persistently dysregulates social behavior towards a familiar, but not novel social partner in both sexes, via sex-specific behavioral expression. This leads us to infer that
Language	English
Publishing date	2023-05-03
Publishing country	United States
Document type	Preprint
DOI	10.1101/2023.05.02.539115
Database	MEDical Literature Analysis and Retrieval System OnLINE

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