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  1. Article ; Online: Alarming tones: the unexplored phenomenon of auditory roughness.

    Watson, Naomi / Shah, Akshay / Patel, Parind / Soni, Sanooj

    British journal of anaesthesia

    2023  Volume 131, Issue 4, Page(s) e103–e106

    MeSH term(s) Humans ; Auditory Perception ; Acoustic Stimulation
    Language English
    Publishing date 2023-06-15
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 80074-0
    ISSN 1471-6771 ; 0007-0912
    ISSN (online) 1471-6771
    ISSN 0007-0912
    DOI 10.1016/j.bja.2023.05.010
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  2. Article ; Online: The ongoing dilemma of prophylactic platelet transfusions pre-procedure and the development of evidence-based recommendations.

    Stanworth, Simon J / Shah, Akshay / Doidge, James / Watkinson, Peter

    Transfusion medicine (Oxford, England)

    2023  Volume 33, Issue 5, Page(s) 428–430

    Language English
    Publishing date 2023-09-15
    Publishing country England
    Document type Letter
    ZDB-ID 1067989-3
    ISSN 1365-3148 ; 0958-7578
    ISSN (online) 1365-3148
    ISSN 0958-7578
    DOI 10.1111/tme.12994
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    Zs.A 3177: Show issues Location:
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  3. Article ; Online: How I use platelet transfusions.

    Stanworth, Simon J / Shah, Akshay

    Blood

    2022  Volume 140, Issue 18, Page(s) 1925–1936

    Abstract: Platelet transfusions are commonly administered for the prevention or treatment of bleeding in patients with acquired thrombocytopenia across a range of clinical contexts. Recent data, including randomized trials, have highlighted uncertainties in the ... ...

    Abstract Platelet transfusions are commonly administered for the prevention or treatment of bleeding in patients with acquired thrombocytopenia across a range of clinical contexts. Recent data, including randomized trials, have highlighted uncertainties in the risk-benefit balance of this therapy, which is the subject of this review. Hemovigilance systems report that platelets are the most frequently implicated component in transfusion reactions. There is considerable variation in platelet count increment after platelet transfusion, and limited evidence of efficacy for clinical outcomes, including prevention of bleeding. Bleeding events commonly occur despite the different policies for platelet transfusion prophylaxis. The underlying mechanisms of harm reported in randomized trials may be related to the role of platelets beyond hemostasis, including mediating inflammation. Research supports the implementation of a restrictive platelet transfusion policy. Research is needed to better understand the impact of platelet donation characteristics on outcomes, and to determine the optimal thresholds for platelet transfusion before invasive procedures or major surgery (eg, laparotomy). Platelet transfusion policies should move toward a risk-adapted approach that does not focus solely on platelet count.
    MeSH term(s) Humans ; Platelet Transfusion/adverse effects ; Thrombocytopenia/therapy ; Thrombocytopenia/etiology ; Hemorrhage/etiology ; Hemorrhage/prevention & control ; Blood Platelets ; Platelet Count
    Language English
    Publishing date 2022-08-03
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 80069-7
    ISSN 1528-0020 ; 0006-4971
    ISSN (online) 1528-0020
    ISSN 0006-4971
    DOI 10.1182/blood.2022016558
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  4. Article ; Online: Frailty in the ICU: what are we doing with all this information?

    Shah, Akshay / Gustafson, Owen / Swarbrick, Claire / King, Elizabeth / Shah, Kunal

    Intensive care medicine

    2022  Volume 48, Issue 9, Page(s) 1258–1259

    MeSH term(s) Aged ; Frail Elderly ; Frailty ; Humans ; Intensive Care Units
    Language English
    Publishing date 2022-06-29
    Publishing country United States
    Document type Letter
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0340-0964 ; 0342-4642 ; 0935-1701
    DOI 10.1007/s00134-022-06787-x
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    Zs.A 1089: Show issues Location:
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  5. Article ; Online: Unilateral Pulmonary Artery Agenesis with Aneurysm of the Contralateral Pulmonary Artery.

    Kordcal, Sandhya Rao / Bhatia, Anmol / Shah, Nainesh B / Mathew, Joseph L / Saxena, Akshay Kumar

    Indian journal of pediatrics

    2023  

    Language English
    Publishing date 2023-11-06
    Publishing country India
    Document type Journal Article
    ZDB-ID 218231-2
    ISSN 0973-7693 ; 0019-5456
    ISSN (online) 0973-7693
    ISSN 0019-5456
    DOI 10.1007/s12098-023-04895-0
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    Zs.A 826: Show issues Location:
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  6. Article ; Online: A 22-Year Course of a Case with Central Neurocytoma.

    Shah, Abhidha / Vutha, Ravikiran / Hawaldar, Akshay / Goel, Atul

    Neurology India

    2022  Volume 70, Issue 3, Page(s) 1314–1315

    MeSH term(s) Brain Neoplasms/diagnostic imaging ; Cerebral Ventricle Neoplasms ; Humans ; Magnetic Resonance Imaging ; Neurocytoma/diagnostic imaging
    Language English
    Publishing date 2022-07-22
    Publishing country India
    Document type Letter
    ZDB-ID 415522-1
    ISSN 1998-4022 ; 0028-3886
    ISSN (online) 1998-4022
    ISSN 0028-3886
    DOI 10.4103/0028-3886.349655
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    Zs.A 698: Show issues Location:
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  7. Article ; Online: Response to "Letter to the Editor for 'Hypertonic Saline Versus Other Intracranial-Pressure-Lowering Agents for Patients with Acute Traumatic Brain Injury: A Systematic Review and Meta-analysis'".

    Bernhardt, Keeley / McClune, William / Rowland, Matthew J / Shah, Akshay

    Neurocritical care

    2023  Volume 40, Issue 1, Page(s) 377–378

    MeSH term(s) Humans ; Brain Injuries, Traumatic/complications ; Brain Injuries, Traumatic/drug therapy ; Brain Injuries ; Saline Solution, Hypertonic
    Chemical Substances Saline Solution, Hypertonic
    Language English
    Publishing date 2023-11-13
    Publishing country United States
    Document type Meta-Analysis ; Systematic Review ; Letter
    ZDB-ID 2381896-7
    ISSN 1556-0961 ; 1541-6933
    ISSN (online) 1556-0961
    ISSN 1541-6933
    DOI 10.1007/s12028-023-01876-1
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    Zs.A 6538: Show issues Location:
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  8. Article ; Online: Assessment of clinical and economic impact of rivaroxaban plus aspirin vs. aspirin alone as a secondary prophylaxis in patients with chronic and symptomatic peripheral arterial disease in the United States.

    Shah, Anshul / Dabbous, Firas / Shah, Surbhi / Ashton, Veronica / Kharat, Akshay

    Journal of medical economics

    2023  Volume 27, Issue 1, Page(s) 10–15

    Abstract: Aim: The objective in this study was to assess the clinical and economic implications of the inclusion of rivaroxaban as a secondary prophylaxis in patients with chronic or symptomatic peripheral artery disease (PAD) in the United States (US).: ... ...

    Abstract Aim: The objective in this study was to assess the clinical and economic implications of the inclusion of rivaroxaban as a secondary prophylaxis in patients with chronic or symptomatic peripheral artery disease (PAD) in the United States (US).
    Methods: A cost-consequence model was adapted to evaluate the economic impact of rivaroxaban plus aspirin in a hypothetical 1-million-member health plan. The model inputs were taken from multiple sources: efficacy and safety of rivaroxaban + aspirin vs. aspirin alone were abstracted from COMPASS and VOYAGER randomized clinical trials; the prevalence of chronic and symptomatic PAD and incidence rates of clinical events (major adverse cardiac events [MACE], major adverse limb events [MALE], and major bleeding), were abstracted from the analysis of claims data; healthcare costs of clinical events and wholesale acquisition costs for rivaroxaban were abstracted from the literature and Red Book, respectively (2022 USD). One-way sensitivity analyses and subgroup analyses were also conducted.
    Results: Over one year, with a 5% uptake of rivaroxaban, the model estimated rivaroxaban + aspirin to reduce 21 MACE/MALE events in the PAD patient population. The reduction in these clinical events offsets the increased risk of major bleeding (16 additional events), demonstrating a positive health benefit of the rivaroxaban addition. These benefits led to a $0.27 incremental cost per member per month (PMPM) to a US plan. The major driver of the incremental cost was the cost of rivaroxaban. In a subgroup of patients with the presence of any high-risk factor (heart failure, diabetes, renal insufficiency, or history of vascular disease affecting two or more vascular beds), the incremental PMPM cost was $0.13.
    Conclusions: Rivaroxaban + aspirin was found to provide positive net clinical benefit on the annual number of MACE/MALE avoided, with a modest increase in the PMPM cost.
    MeSH term(s) Humans ; United States ; Aspirin/therapeutic use ; Rivaroxaban ; Factor Xa Inhibitors/therapeutic use ; Drug Therapy, Combination ; Hemorrhage/chemically induced ; Peripheral Arterial Disease/complications ; Platelet Aggregation Inhibitors/therapeutic use
    Chemical Substances Aspirin (R16CO5Y76E) ; Rivaroxaban (9NDF7JZ4M3) ; Factor Xa Inhibitors ; Platelet Aggregation Inhibitors
    Language English
    Publishing date 2023-12-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 2270945-9
    ISSN 1941-837X ; 1369-6998
    ISSN (online) 1941-837X
    ISSN 1369-6998
    DOI 10.1080/13696998.2023.2290386
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    Zs.A 6450: Show issues Location:
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  9. Article: Klebsiella pneumoniae Infection as a Mimicker of Multiple Metastatic Lesions.

    Shah, Ayushi / Shetty, Akshay / Victor, David / Kodali, Sudha

    Cureus

    2022  Volume 14, Issue 12, Page(s) e32669

    Abstract: We describe the case of a 42-year-old man with cirrhosis who presented with fever and imaging concerning for metastatic disease from suspected renal cell carcinoma. He had a right renal mass with multiple pulmonary masses and underwent a lung biopsy and ... ...

    Abstract We describe the case of a 42-year-old man with cirrhosis who presented with fever and imaging concerning for metastatic disease from suspected renal cell carcinoma. He had a right renal mass with multiple pulmonary masses and underwent a lung biopsy and oncology consultation. Blood cultures revealed
    Language English
    Publishing date 2022-12-18
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.32669
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  10. Article: Unique way of chest wall reconstruction using Integra Dermal Regeneration Template (IDRT) in a patient with post traumatic mucormycosis: A case report.

    Shah, Sanjay / Budania, Pushpa / Shah, Akshay / Parmar, Uvaish

    International journal of surgery case reports

    2022  Volume 95, Page(s) 107229

    Abstract: Introduction and importance: Necrotizing soft tissue infections (NSTI) are caused by toxin-producing bacteria and fungi that results in rapid progression of disease with significant local tissue destruction.: Case presentation: We present a case ... ...

    Abstract Introduction and importance: Necrotizing soft tissue infections (NSTI) are caused by toxin-producing bacteria and fungi that results in rapid progression of disease with significant local tissue destruction.
    Case presentation: We present a case report of a 57-year-old male patient in line with the SCARE 2020 criteria. He was admitted to the emergency department with a small abrasion on the right antero-lateral chest wall, and a diffuse necrotic patch of skin and soft tissues with purulent discharge.
    Clinical discussion: Clinical examination, routine blood investigations, CT scan chest, and chest x-ray were performed. Patient underwent debridement six times, followed by negative pressure wound therapy (NPWT). After negative culture report, Integra Meshed Dermal Regeneration Template (IMDRT), measuring 4 × 5 in. was applied and NPWT continued. The outer layer of IDRT was removed on Day 19. Split thickness skin grafting (STSG) was performed once neodermis formation was confirmed. NPWT was continued post skin grafting for a week. IDRT was successfully taken up over the raw area with exposed lung. Patient was discharged 10 days after STSG. The patient's condition improved remarkably and he was able to breathe normally. There was no puckering or tethering effect on the grafted area and not much fibrosis. He showed speedy recovery with healed donor site and 100% uptake of grafted tissue.
    Conclusion: IDRT along with NPWT is an effective and useful technique for spontaneous regeneration of the dermis and basement membrane to promote wound healing in traumatic patients with NSTIs.
    Level of evidence: Level V.
    Study type: Therapeutic.
    Language English
    Publishing date 2022-05-20
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2210-2612
    ISSN 2210-2612
    DOI 10.1016/j.ijscr.2022.107229
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