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| 1 | Efficacy of peroral endoscopic myotomy vs other achalasia treatments in improving esophageal function显示文摘AIM: To assess and compare the esophageal function after peroral endoscopic myotomy(POEM) vs other conventional treatments in achalasia.METHODS: Chart review of all achalasia patients who underwent POEM, laparoscopic Heller myotomy(LHM) or pneumatic dilation(PD) at our institution between January 2012 and March 2015 was performed. Patient demographics, type of achalasia, prior treatments, pre- and post-treatment timed barium swallow(TBE) and high-resolution esophageal manometry(HREM) findings were compared between the three treatment groups. Patients who had both pre- and 2 mo posttreatment TBE or HREM were included in the final analysis. TBE parameters compared were barium column height, width and volume of barium remaining at 1 and 5 min. HREM parameters compared were basal lower esophageal sphincter(LES) pressures and LES-integrated relaxation pressures(IRP). Data are presented as mean ± SD, median [25th, 75 th percentiles] or frequency(percent). Analysis of variance, KruskalWallis test, Pearsons χ~2 test and Fishers Exact tests were used for analysis.RESULTS: A total of 200 achalasia patients were included of which 36 underwent POEM, 22 underwent PD and 142 underwent LHM. POEM patients were older(55.4 ± 16.8 years vs 46.5 ± 15.7 years, P = 0.013) and had higher BMI than LHM(29.1 ± 5.9 kg/m^2 vs 26 ± 5.1 kg/m^2, P = 0.012). More number of patients in POEM and PD groups had undergone prior treatments compared to LHM group(72.2% vs 68.2% vs 44.3% respectively, P = 0.003). At 2 mo post-treatment, all TBE parameters including barium column height, width and volume remaining at 1 and 5 min improved significantly in all three treatment groups(P = 0.01 to P < 0.001) except the column height at 1 min in PD group(P = 0.11). At 2 mo post-treatment, there was significant improvement in basal LES pressure and LES-IRP in both LHM(40.5 mm Hg vs 14.5 mm Hg and 24 mm Hg vs 7.1 mm Hg respectively, P < 0.001) and POEM groups(38.7 mm Hg vs 11.4 mm Hg and 23.6 mm Hg vs 6.6 mm Hg respectively, P < 0.001). However, when the efficacy of three treatments were compared to each other in terms of improvement in TBE or HREM parameters at 2 mo, there was no significant difference(P > 0.05).CONCLUSION: POEM, PD and LHM were all effective in improving esophageal function in achalasia at shortterm. There was no difference in efficacy between the three treatments. | Madhusudhan R Sanaka Umar Hayat Prashanthi N Thota Ramprasad Jegadeesan Monica Ray Scott L Gabbard Neha Wadhwa Rocio Lopez Mark E Baker Sudish Murthy Siva Raja | 2016 | World Journal of Gastroenterology2016，22，20： | 7 |
| 2 | Healthcare utilization and costs associated with gastroparesis显示文摘AIM To use a national database of United States hospitals to evaluate the incidence and costs of hospital admissions associated with gastroparesis.METHODS We analyzed the National Inpatient Sample Database(NIS)for all patients in whom gastroparesis(ICD-9 code:536.3)was the principal discharge diagnosis during the period,1997-2013.The NIS is the largest publicly available all-payer inpatient care database in the United States.It contains data from approximately eight million hospital stays each year.The statistical significance of the difference in the number of hospital discharges,length of stay and hospital costs over the study period was determined by regression analysis.RESULTS In 1997,there were 3978 admissions with a principal discharge diagnosis of gastroparesis as compared to16460 in 2013(P<0.01).The mean length of stay for gastroparesis decreased by 20%between 1997 and 2013from 6.4 d to 5.1 d(P<0.001).However,during this period the mean hospital charges increased significantly by 159%from$13350(after inflation adjustment)per patient in 1997 to$34585 per patient in 2013(P<0.001).The aggregate charges(i.e.,'national bill') for gastroparesis increased exponentially by 1026%from$50456642±4662620 in 1997 to$568417666±22374060 in 2013(P<0.001).The percentage of national bill for gastroparesis discharges(national bill for gastroparesis/total national bill)has also increased over the last 16 years(0.0013%in 1997 vs 0.004%in2013).During the study period,women had a higher frequency of gastroparesis discharges when compared to men(1.39/10000 vs 0.9/10000 in 1997 and 5.8/10000vs 3/10000 in 2013).There was a 6-fold increase in the discharge diagnosis of gastroparesis amongst type 1 DM and 3.7-fold increase amongst type 2 DM patients over the study period(P<0.001).CONCLUSION The number of inpatient admissions for gastroparesis and associated costs have increased significantly over the last 16 years.Inpatient costs associated with gastroparesis contribute significantly to the national healthcare bill.Further research on cost-effective evaluation and management of gastroparesis is required. | Vaibhav Wadhwa Dhruv Mehta Yash Jobanputra Rocio Lopez Prashanthi N Thota Madhusudhan R Sanaka | 2017 | World Journal of Gastroenterology2017，23，24： | 3 |
| 3 | Assessment of pain control, quality of life, and predictors of success after gamma knife surgery for the treatment of trigeminal neuralgia 显示文摘 | Jawahar A Wadhwa R Berk C | 2005 | Neurosurg Focus2005，18，5： | 1 |
| 4 | Use of a randomized hybrid ribozyme library for identification of genes involved in mscle differentiation显示文摘 | WADHWA R YAGUCHI T KAUR K | 2004 | J Biol Chem2004，279，51： | 1 |
| 5 | Vectors for RNA interference显示文摘 | Wadhwa R Kaul SC Miyagishi M | 2004 | Curr Opin Mol Ther2004，6，4： | 1 |
| 6 | Evaluation of cd64expression on neutrophils as an early indicator ofneonatal sepsis显示文摘 | Soni S Wadhwa N Kumar R | 2013 | Pediatr Infect Dis J2013，32，1： | 1 |
| 7 | A novel testis-specific metallothionein-like protei,tesmin,is an early marker of male germ cell differentiation显示文摘 | Sugihara T Wadhwa R Kaul SC | 1999 | Genomics1999，57，1： | 1 |
| 8 | Reduction in mortalin level by its antisense expression causes senescence-like growth arrest in human immortalized cells显示文摘 | Wadhwa R Takano S Taira K | 2004 | Gene Med2004，6，4： | 1 |
| 9 | Investigation of magnesi- um isotope fractionation during basalt differentiation: Impli- cations for a chondritie composition of the terrestrial mantle 显示文摘 | Teng F Z Wadhwa M Helz R T | 2007 | Earth and Planetary Science Letters2007，261，： | 1 |
| 10 | Differential subcellular distribution of mortalin in mortal and immortal mouse and human fibroblasts显示文摘 | Wadhwa R Kaul S C Mitsui Y | 1993 | Exp Cell Res1993，207，2： | 1 |
| 11 | Accuracy or bias in nurses' ratings of patient compliance: a comparison of treatment modality显示文摘 | Edelman R Eitel P Wadhwa NK | 1996 | Perit Dial Int1996，16，3： | 1 |
| 12 | Induction of cellular senescence by transfection of cytosolic mortalin cDNA in NIH 3T3 cells显示文摘 | Wadhwa R Kaul S C Sugimoto Y | 1993 | Cancer Res1993，268，22： | 1 |
| 13 | Senescence and immortalization of human cells显示文摘 | Duncan EL Wadhwa R Kaul SC | 2000 | Biogerontology2000，1，2： | 1 |
| 14 | Mouse and human chromosomal assignments of mortalin,a novel member of the murine hsp70 family of proteins显示文摘 | Kaul S C Wadhwa R Matsuda Y | 1995 | FEBS Letters1995，361，23： | 1 |
| 15 | Vendor selection in outsourcing显示文摘 | Wadhwa V Ravindran A R | 2007 | Computersand Operations Research2007，34，12： | 1 |
| 16 | Risk adjusted multicriteria supplier selection models with applieations显示文摘 | RAVINDRAN A R BILSEL R U WADHWA V | 2010 | International Journal of Production Research2010，48，2： | 1 |
| 17 | Extramitochondrial localization of mortalin/mthsp70/PBP74/GRP75显示文摘 | Ran Q Wadhwa R Kawai R | 2000 | Bioch Bioph Res Comm2000，275，1： | 1 |
| 18 | On the brotherhood of the mitoehondrial chaperones mortalin and heat shock protein 60 显示文摘 | Deocaris CC Kaul SC Wadhwa R | 2006 | Cell Stress Chaperones2006，11，： | 1 |
| 19 | Peptidemediated gene delivery:influence of peptide structure on gene expression 显示文摘 | WADHWA M S COLLARD W T ADAMI R C | 1997 | Bioconjug Chem1997，8，1： | 1 |
| 20 | Knowledge, net works,and knowledge networks: a review and research a genda显示文摘 | PHELPS C HEIDL R WADHWA A | 2011 | Journal of Management2011，38，4： | 1 |
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