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| 1 | Operative complications and economic outcomes of cholecystectomy for acute cholecystitis显示文摘BACKGROUND Recent management of acute cholecystitis favors same admission(SA)or emergent cholecystectomy based on overall shorter hospital stay and therefore cost savings.We adopted the practice of SA cholecystectomy for the treatment of acute cholecystitis at our tertiary care center and wanted to evaluate the economic benefit of this practice.We hypothesized that the existence of complications,particularly among patients with a higher degree of disease severity,during SA cholecystectomy could negate the cost savings.AIM To compare complication rates and hospital costs between SA vs delayed cholecystectomy among patients admitted emergently for acute cholecystitis.METHODS Under an IRB-approved protocol,complications and charges for were obtained for SA,later after conservative management(Delayed),or elective cholecystectomies over an 8.5-year period.Patients were identified using the acute care surgery registry and billing database.Data was retrieved via EMR,operative logs,and Revenue Cycle Operations.The severity of acute cholecystitis was graded according to the Tokyo Guidelines.TG18 categorizes acute cholecystitis by Grades 1,2,and 3 representing mild,moderate,and severe,respectively.Comparisons were analyzed withχ2,Fisher’s exact test,ANOVA,ttests,and logistic regression;significance was set at P<0.05.RESULTS Four hundred eighty-six(87.7%)underwent a SA while 68 patients(12.3%)received Delayed cholecystectomy.Complication rates were increased after SA compared to Delayed cholecystectomy(18.5%vs 4.4%,P=0.004).The complication rates of patients undergoing delayed cholecystectomy was similar to the rate for elective cholecystectomy(7.4%,P=0.35).Mortality rates were 0.6%vs 0%for SA vs Delayed.Patients with moderate disease(Tokyo 2)suffered more complications among SA while none who were delayed experienced a complication(16.1%vs 0.0%,P<0.001).Total hospital charges for SA cholecystectomy were increased compared to a Delayed approach($44500±$59000 vs$35300±$16700,P=0.019).The relative risk of developing a complication was 4.2x[95%confidence interval(CI):1.4-12.9]in the SA vs Delayed groups.Among eight patients(95%CI:5.0-12.3)with acute cholecystitis undergoing SA cholecystectomy,one patient will suffer a complication.CONCLUSION Patients with Tokyo Grade 2 acute cholecystitis had more complications and increased hospital charges when undergoing SA cholecystectomy.This data supports a selective approach to SA cholecystectomy for acute cholecystitis. | Christopher P Rice Krishnamurthy B Vaishnavi Celia Chao Daniel Jupiter August B Schaeffer Whitney R Jenson Lance W Griffin William J Mileski | 2019 | World Journal of Gastroenterology2019，25，48： | 8 |
| 2 | Characterization of biofilms in biliary stents and potential factors involved in occlusion显示文摘AIM To quantify the components in biofilms and analyze the predisposing factors involved in occlusion of biliary stents. METHODS In a prospective study conducted from April 2011 to March 2014 at a tertiary care hospital, all consecutive patients who required endoscopic biliary stent exchange/removal were included. Etiology of the biliary disease was diagnosed by imaging, cytology and on follow-up. Clinical details of patients with biliary stent retrieval were noted. All extracted stents were collected in sterile containers and immediatelyprocessed for quantification of biofilm proteins and polysaccharides. Molecular identification of commonly known and unknown bacteria was performed by polymerase chain reaction and density gradient gel electrophoresis methods. RESULTS Eighty one patients(41 males) with age range of 20-86 years were studied. The underlying causes for stent insertion were bile duct stones(n = 46; 56.8%) benign stricture(n = 29; 35.8%) and malignancy(n = 6; 7.4%) with cholangitis in 50(61.7%) patients. The retrieved stent sizes were 7 Fr(n = 62; 76.5%) and 10 Fr(n = 19; 23.5%) with 65 days median insertion duration. Polybacterial consortia were detected in 90.1% of the stents. The most common bacteria identified by polymerase chain reaction alone and/or sequencing were Pseudomonas(n = 38), Citrobacter(n = 23), Klebsiella(n = 22), Staphylococcus(n = 20), Serratia(n = 16), Escherichia coli(n = 14), Streptococcus(n = 13), Enterococcus(n = 13), Aeromonas(n = 12), Proteus(n = 10) and Enterobacter(n = 9). Protein concentration according to gender(0.547 ± 0.242 mg/ml vs 0.458 ± 0.259 mg/ml; P = 0.115) as well as age > 60 years and < 60 years(0.468 ± 0.295 mg/ml vs 0.386 ± 0.238 mg/ml; P = 0.205) was non-significant. However, polysaccharide concentration was significant both according to gender(0.052 ± 0.021 mg/ml vs 0.049 ± 0.016 mg/ml; P < 0.0001) and age(0.051 ± 0.026 mg/ml vs 0.038 ± 0.016 mg/ml; P < 0.011). Protein concentration in the biofilm was significantly higher(0.555 ± 0.225 mg/ml vs 0.419 ± 0.276 mg/ml; P = 0.018) in patients with cholangitis, lower(0.356 ± 0.252 mg/ml vs 0.541 ± 0.238 mg/ml; P = 0.005) in the 10 Fr group than the 7 Fr group, and significantly higher(0.609 ± 0.240 mg/ml vs 0.476 ± 0.251 mg/ml; P = 0.060) in stents of ≥ 6 mo of indwelling time. However presence/absence of cholangitis, size of stent, indication of stent insertion and indwelling time did not affect the quantity of polysaccharide concentration.CONCLUSION Plastic stents retrieved from patients with biliary tract disease showed polymicrobial organisms with higher protein content among patients with cholangitis and those with smaller diameter stents. longer indwelling duration had more biofilm formation. | Chetana Vaishnavi Jayanta Samanta Rakesh Kochhar | 2018 | World Journal of Gastroenterology2018，24，1： | 8 |
| 3 | Mining the 3′UTR of Autism-implicated Genes for SNPs Perturbing MicroRNA Regulation显示文摘Autism spectrum disorder(ASD) refers to a group of childhood neurodevelopmental disorders with polygenic etiology. The expression of many genes implicated in ASD is tightly regulated by various factors including microRNAs(miRNAs), a class of noncoding RNAs 22 nucleotides in length that function to suppress translation by pairing with ‘miRNA recognition elements'(MREs) present in the 30untranslated region(30UTR) of target mRNAs. This emphasizes the role played by miRNAs in regulating neurogenesis, brain development and differentiation and hence any perturbations in this regulatory mechanism might affect these processes as well. Recently, single nucleotide polymorphisms(SNPs) present within 30UTRs of mRNAs have been shown to modulate existing MREs or even create new MREs. Therefore, we hypothesized that SNPs perturbing miRNA-mediated gene regulation might lead to aberrant expression of autism-implicated genes, thus resulting in disease predisposition or pathogenesis in at least a subpopulation of ASD individuals. We developed a systematic computational pipeline that integrates data from well-established databases. By following a stringent selection criterion, we identified 9 MRE-modulating SNPs and another 12 MRE-creating SNPs in the 30UTR of autism-implicated genes. These high-confidence candidate SNPs may play roles in ASD and hence would be valuable for further functional validation. | Varadharajan Vaishnavi Mayakannan Manikandan Arasambattu Kannan Munirajan | 2014 | Genomics, Proteomics & Bioinformatics2014，12，2： | 2 |
| 4 | Spatial correlation between brain aerobic glycolysis and amyloid-beta (Abeta) deposi- tion显示文摘 | Vlassenko AG Vaishnavi SN Couture L | 2010 | Proc Natl Acad Sci U S A2010，107，17： | 1 |
| 5 | Clostridium perfringens type A& antibiotic associated diarrhen显示文摘 | Vaishnavi C Kaur S Singh K | 2005 | Indian J Med Res2005，122，1： | 1 |
| 6 | Technical effi- ciency and scale efficiency of district hospitals显示文摘 | Umakant D Vaishnavi SD Muraleedharan VR | 2010 | Journal of Health Management2010，12，3： | 1 |
| 7 | Fidaxomicin -:the new drug for Clostridium difficile infection显示文摘 | Vaishnavi C | 2015 | Indian J Med Res2015，141，4： | 1 |
| 8 | Speciation of fecal Candida isolates in antibiotic-associated diarrhea in non-HIV patients显示文摘 | Vaishnavi C Kaur S Prakash S | 2008 | Jpn J Infect Dis2008，61，1： | 1 |
| 9 | Predicting maintenance performance using object-oriented design complexity metrics 显示文摘 | Bandi R K Vaishnavi V K Turk D E | 2003 | IEEE Transactions on Software Engineering2003，29，1： | 1 |
| 10 | Established and potential risk factors for Clostridum difficile infection显示文摘 | Vaishnavi C | | 0，，4： | 1 |
| 11 | Clostridium perfringens type A & antiblotic-associated diarrhea显示文摘 | Vaishnavi C Kaur S Singh K | 2005 | Indian J Med Res2005，122，1： | 1 |
| 12 | Regional white matter hyperintensity burden in automated segmentation distinguishes late-life depressed subjects from comparison subjects matched for vascular risk factors显示文摘 | Sheline YI Price JL Vaishnavi SN | 2008 | Am J Psychiatry2008，165，4： | 1 |
| 13 | CLostridium perfringens type A & antibiotic associated diarrhea显示文摘 | Vaishnavi C Kaur S Singh K | 2005 | Indian J Med Res2005，122，1： | 1 |
| 14 | Characterization and propertiesofmetallieironnanoparticles spectroscopy, electrochemistry, and kinetics 显示文摘 | Nurmi J T Paul G T Vaishnavi S | 2005 | Environmental Science & Technology2005，39，5： | 1 |
| 15 | Rapid communication copper complexation by dissolved organic matter from surface water and wastewater effuent 显示文摘 | Vaishnavi Sarathy Herbert E Allen | 2005 | Ecotoxicology and Environmental Safety2005，61，： | 1 |
| 16 | Spatial correlation between brain aerobic glycolysis and amyloid-13 (A) deposition 显示文摘 | Vlassenko AG Vaishnavi SN Couture L | 2010 | Proc Natl Acad Sci USA2010，107，17： | 1 |
| 17 | Spatial correlation between brain aerobic glycolysis and amyloid-beta(Abeta) deposition显示文摘 | Vlassenko AG Vaishnavi SN Couture L | 2010 | Proc Natl Acad Sci USA2010，，17： | 1 |
| 18 | Supporting optimization of business-to-business e-commerce relationships显示文摘 | KUECHLER Jr VAISHNAVI W VIJAY K | 2001 | Decision Support Systems2001，31，3： | 1 |
| 19 | Interaction of silver nanoparticles (SNPs) with bacterial extracellular proteins (ECPs) and its adsorption isotherms and kinetics显示文摘 | Khan S S Srivatsan P Vaishnavi N | 2011 | Journal of Hazardous Materials2011，192，1： | 1 |
| 20 | Prevalence and types of sleep disturbances acutely after traumatic brain injury显示文摘 | Rao V Spiro J Vaishnavi Sv | 2008 | Brain Inj2008，22，5： | 1 |
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