Publications by authors named "Aakrith D Dewan"

Background: How different combinations of comorbidities influence risk at the patient level and population level in patients with heart failure with mildly reduced ejection fraction/heart failure with preserved ejection fraction is unknown. We aimed to investigate the prevalence of different combinations of cardiovascular and noncardiovascular comorbidities (ie, multimorbidity) and associated risk of death at the patient level and population level.

Methods: Using patient-level data from the TOPCAT trial (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) and PARAGON-HF trial (Prospective Comparison of ARNI With ARB Global Outcomes in HF With Preserved Ejection Fraction), we investigated the 5 most common cardiovascular and noncardiovascular comorbidities and the resultant 45 comorbidity pairs.

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Introduction:  Vitamin D deficiency is an important problem when facing a viral disease. Vitamin D deficiency is widely prevalent in India and plays an important role in immunoregulation. The deficiency can lead to severe viral infections.

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Background: Cognitive impairment is common in patients with heart failure and preserved ejection fraction but its clinical correlates and prognostic associations are poorly understood.

Methods: We analyzed cognitive function, using the Mini-Mental State Examination (MMSE), in patients with heart failure and preserved ejection fraction enrolled in a prespecified substudy of the PARAGON-HF trial (Prospective Comparison of Angiotensin Receptor Neprilysin Inhibitor With Angiotensin Receptor Blocker Global Outcomes in Heart Failure With Preserved Ejection Fraction). Logistic regression analyses were performed to determine the variables associated with lower MMSE scores at baseline and postbaseline decline in MMSE scores at 48 weeks.

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Cough is a common and commonly ignored symptom of lung disease. Cough is often perceived as difficult to quantify, frequently self-limiting, and non-specific. However, cough has a central role in the clinical detection of many lung diseases including tuberculosis (TB), which remains the leading infectious disease killer worldwide.

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Background: Trust is a foundation of the therapeutic relationship and is associated with important patient outcomes. Building trust between parents of children with medical complexity (CMC) and physicians during inpatient care is complicated by lack of relational continuity, cumulative (sometimes negative) parent experiences and the need to adjust roles and expectations to accommodate parental expertise. This study's objective was to describe how parents of CMC conceptualize trust with physicians within the pediatric inpatient setting and to provide recommendations for building trust in these relationships.

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Article Synopsis
  • The study examined the effectiveness and safety of reducing linezolid doses in a treatment regimen for adults with pre-extensively drug-resistant or treatment-intolerant multidrug-resistant tuberculosis.
  • Patients were enrolled in a clinical trial where they were randomly assigned to three different dosing regimens of linezolid, alongside bedaquiline and pretomanid, for a total duration of 26 weeks.
  • Results showed that the reduced dose of linezolid (300 mg/day) maintained similar cure rates as the standard dose (600 mg/day) while leading to fewer reported cases of peripheral neuropathy, suggesting a safer approach for treating this condition.
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Pineal parenchymal tumors are rare neoplasms for which evidence-based treatment recommendations are lacking. These tumors vary in biology, clinical characteristics, and prognosis, requiring treatment that ranges from surgical resection alone to intensive multimodal antineoplastic therapy. Recently, international collaborative studies have shed light on the genomic landscape of these tumors, leading to refinement in molecular-based disease classification in the 5th edition of the World Health Organization (WHO) classification of tumors of the central nervous system.

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  • - The study investigated whether the heart failure medication sacubitril/valsartan could lead to cognitive impairment, as it affects enzymes that degrade amyloid-β peptides, which are linked to Alzheimer's disease.
  • - Researchers used the Mini-Mental State Examination (MMSE) to assess cognitive function changes over 96 weeks in a subset of heart failure patients from the PARAGON-HF trial, comparing those on sacubitril/valsartan to those on valsartan alone.
  • - Results showed no significant difference in cognitive decline between the two groups, with both medications resulting in nearly identical changes in MMSE scores, suggesting sacubitril/valsartan does not have a negative effect on cognitive function in these patients. *
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Context: Children with medical complexity have substantial medical needs and their caregivers must make many challenging decisions about their care. Caregivers often become more involved in decisions over time, but it is unclear what skills they develop that facilitate this engagement.

Objectives: To describe the skills that caregivers developed as they gained experience making medical decisions.

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[Purpose] To compare humeral head translation (HHT) during shoulder elevation between dominant and non-dominant shoulders in participants with limited dominant shoulder internal rotation range of motion (ROM). To determine if joint mobilization alters HHT, and if relationships exist between the bicipital forearm angle and HHT. [Participants and Methods] Fifteen (9 female) participants (age 25.

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With an increasing number of patients eligible for immune checkpoint inhibitors, the incidence of immune-related adverse events (irAEs) is on the rise. Dermatologic immune-related adverse events (D-irAEs) are the most common and earliest to manifest, often with important downstream consequences for the patient. Current guidelines lack clarity in terms of diagnostic criteria for D-irAEs.

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Background: Maxillary molar endodontic treatments require the right post and core system. This study tested cast metal, glass fiber with composite resin, carbon fiber with composite resin, and zirconia post and core materials.

Materials And Methods: Sixty removed human maxillary teeth were randomly divided into four post and core material groups ( = 15 per group).

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Cough is a common and commonly ignored symptom of lung disease. Cough is often perceived as difficult to quantify, frequently self-limiting, and non-specific. However, cough has a central role in the clinical detection of many lung diseases including tuberculosis (TB), which remains the leading infectious disease killer worldwide.

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Article Synopsis
  • Peripheral artery disease (PAD) affects over 200 million people globally, and researchers are exploring its genetic factors to improve diagnosis and treatment.
  • A systematic review analyzed 231 DNA variants from various studies, revealing inconsistencies in how PAD is defined and controlled.
  • While some consistent genetic variants linked to PAD were identified through genome-wide studies, more research is necessary to better understand the disease's progression and enhance patient outcomes.
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As the life expectancy in thalassemia is improving, pain is being recognized as an emerging problem. To document the pain prevalence and severity in patients with transfusion-dependent thalassemia all transfusion-dependent thalassemia patients >10 years of age ( = 165) attending the Thalassemia Day Care Center were assessed for pain prevalence, severity, and its effect on various life activities using the Brief Pain Inventory. Their medical records were reviewed for the presence of various co-morbidities.

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  • - SJS/TEN is a severe, drug-induced skin condition with a high mortality rate of 15-20% and requires multidisciplinary expertise for effective treatment; it's rare, with an incidence of 1-5 cases per million annually in the U.S., but more common globally.
  • - The SJS/TEN 2021 research meeting, held virtually, aimed to build an international research network involving 428 scientists and 140 survivors and family members to enhance collaboration between science and the community.
  • - The workshop covered vital themes such as mental health, pediatric cases, long-term complications, skin care for diverse populations, and the impact of COVID-19 vaccines, identifying key areas for future research and clinical focus.
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Fibrillar collagen is the major protein in the extracellular matrix and regulates cell behavior via chemical and mechanical cues. The key structural element of collagen fibrils is the axially repeating -period, formed by the lateral association of collagen triple helices. We have developed fibril-forming collagen mimetic peptides (FCMPs) with repeated amino acid sequences, which form fibrils having -period-like structures.

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Introduction: In edentulous individuals, single implant-retained mandibular overdentures are an effective substitute for double implant-retained overdentures. In this current research, the oral health-related quality of life (OHRQoL) was assessed for the immediate loading overdenture using the implants. The comparisons are drawn between the single and double implants.

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Introduction: We sought to compare outcomes after early discharge in patients with and without predischarge diagnosis of arrhythmia following minimally invasive valve surgery (MIVS).

Materials And Methods: We retrospectively reviewed ambulatory electrocardiography (AECG) datasheets and medical records of patients discharged with 14-d AECG monitoring from our facility between October 2019 and March 2022 ≤ 3 d after MIVS. Baseline and clinical characteristics, arrhythmias during AECG monitoring, and 30-d adverse outcomes were reported for the population and stratified by presence or absence of predischarge arrhythmia.

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Background: Recent guidelines proposed a classification for heart failure (HF) on the basis of left ventricular ejection fraction (LVEF), although it remains unclear whether the divisions chosen were biologically rational. Using patients spanning the full range of LVEF, we examined whether there was evidence of LVEF thresholds in patient characteristics or inflection points in clinical outcomes.

Methods: Using patient-level information, we created a merged dataset of 33 699 participants who had been enrolled in 6 randomized controlled HF trials including patients with reduced and preserved ejection fraction.

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  • Fetal adaptations to pregnancy complications like preeclampsia (PE) can disrupt offspring metabolism, leading to lasting metabolic issues.
  • Overexpression of sFLT1 in mice mimics PE, resulting in growth-restricted fetuses with reduced liver size, altered glycogen storage, and liver damage.
  • Male offspring showed more severe metabolic alterations post-birth, including increased weight gain and changes in hormone levels, indicating that PE may cause specific metabolic disturbances that affect males more significantly.
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Background: Management of patella instability remains a challenge particularly in the presence of trochlea dysplasia. The aim of this study is to assess the recurrence rates of those with patellar instability who have undergone a combined tibial tuberosity transfer (TTT) and medial patellofemoral ligament reconstruction (MPFLR) in the setting of trochlea dysplasia.

Methods: All skeletally mature patients who underwent combined TTT and MPFLR for recurrent patella instability were identified between January 2009 and December 2019.

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Background: The ratio of ucGMP (urinary cyclic guanosine monophosphate) to BNP (B-type natriuretic peptide) is thought to reflect the responsiveness of tissues to natriuretic peptides.

Methods: We examined the relationship between ucGMP/BNP ratio and clinical outcomes, the effect of sacubitril/valsartan, compared with enalapril, on the ucGMP/BNP ratio, and the efficacy of sacubitril/valsartan on clinical outcomes according to baseline ucGMP/BNP ratio in PARADIGM-HF trial (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure). ucGMP/BNP ratio was available at baseline (N=2031), 1 month (N=1959), and 8 months after randomization (N=1746).

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Background: Preeclampsia is a leading cause of maternal morbidity, and dyslipidemia has been associated with preeclampsia in observational studies. We use Mendelian randomization analyses to estimate the association between lipid levels, their pharmacological targets, and the risk of preeclampsia in 4 ancestry groups.

Methods: We extracted uncorrelated (<0.

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Background: As heart failure therapeutic care becomes increasingly complex, a composite medical therapy score could be useful to conveniently summarize background medical therapy. We applied the composite medical therapy score developed by the Heart Failure Collaboratory (HFC) to the Danish heart failure with reduced ejection fraction population to evaluate its external validation including assessing the distribution of the score and its association with survival.

Methods: In a retrospective nationwide cohort study, we identified all Danish heart failure with reduced ejection fraction patients alive on July 1, 2018, and assessed their treatment doses.

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