Publications by authors named "Krishnamurthy J"

Background: Paclitaxel has a boxed warning for causing severe hypersensitivity reactions, however, the majority (95%) of these reactions occur during the first or second infusion. Corticosteroids can reduce the incidence of paclitaxel hypersensitivity reactions from 30% to around 1%-3% but are not without adverse effects. Current practice at our institution is to prescribe dexamethasone 20 mg to be given orally 12 and 6 hours prior to paclitaxel infusion, however, some medical oncology providers have elected to decrease or omit dexamethasone premedication.

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  • Emerging research shows a significant link between diet quality in breast cancer patients and their cardiovascular health.
  • A study of 108 patients in the midwestern US found their average diet quality score was significantly lower than the national average and did not improve over time after diagnosis, despite their willingness to make dietary changes.
  • Barriers like unpredictable schedules and time constraints hindered these patients from adopting healthier eating habits, indicating a need for targeted interventions to improve their diet quality.
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Aim: To evaluate the prognostic impact of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) on overall survival (OS) among Indian older patients with cancer.

Methods: This observational study was conducted in the geriatric oncology clinic of Tata Memorial Hospital (India). We included all patients who underwent a geriatric assessment (GA) and had a complete blood count available for analysis.

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  • New diagnostic criteria have classified small-for-size syndrome (SFSS) after living donor liver transplantation into three severity groups, and this study focuses on grade A SFSS and its mortality risk.
  • Data from 406 patients were analyzed, categorizing them into up-trend, down-trend, and ascites groups based on their bilirubin levels and ascites presence after surgery.
  • While survival rates were similar for SFSS and non-SFSS patients, those in the up-trend group had significantly higher 90-day mortality and should receive aggressive intervention if they have additional risk factors.
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Purpose: Research investigating gastrointestinal (GI) symptoms from oil spill-related exposures is sparse. We evaluated prevalent GI symptoms among U.S.

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Background: The evolution of systemic therapies has improved outcomes for patients with human epidermal growth factor receptor 2 positive (HER2+) breast cancer. Nonetheless, the tolerability and safety profile of systemic therapies represent an area for further improvement. Here we report the results of a phase 2 trial evaluating a nonanthracycline, nonplatinum adjuvant treatment regimen for patients following initial surgical resection.

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Aging is a consequence of complex molecular changes, but whether a single microRNA (miRNA) can drive aging remains unclear. A miRNA known to be upregulated during both normal and premature aging is miR-29. We find miR-29 to also be among the top miRNAs predicted to drive aging-related gene expression changes.

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  • Breast cancer treatment involves a team of specialists from surgical, radiation, and medical oncology fields.
  • The NCCN Guidelines provide recommendations for various types of breast cancer, including different stages and specific conditions like Paget's disease and treatment during pregnancy.
  • This issue highlights the management of systemic therapies for nonmetastatic breast cancer, both before and after surgery.
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Neoadjuvant chemoimmunotherapy with pembrolizumab now defines the standard of care for early high-risk triple-negative breast cancer (TNBC). However, the role of pembrolizumab in neoadjuvant therapy (NAT) for estrogen receptor-positive (ER+) breast cancer remains uncertain. A 39-year-old G2P2 female discovered a palpable mass in the right breast while breastfeeding her 7-month-old child, leading to the diagnosis of a high-grade ER+ (80% moderate staining), human epidermal growth factor receptor 2-negative (ErbB2-) invasive ductal carcinoma with axillary nodal involvement.

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Objective: Celiac disease (CD) is an immune-mediated enteropathy that is associated with pneumococcal infections in adults. The objective of this study is to evaluate the association between CD and pneumococcal infections in hospitalized pediatric patients in the United States (US).

Study Design: The triennial Healthcare Cost and Utilization Project Kids' Inpatient Database was used in a retrospective analysis of children hospitalized in the US from 1997 to 2019.

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Background: Metastatic triple-negative breast cancer (TNBC) is aggressive with poor median overall survival (OS) ranging from 8 to 13 months. There exists considerable heterogeneity in survival at the individual patient level. To better understand the survival heterogeneity and improve risk stratification, our study aims to identify the factors influencing survival, utilizing a large patient sample from the National Cancer Database (NCDB).

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Introduction: Frailty, characterized by ageing-related vulnerability, influences outcomes in older adults. Our study aimed to investigate the relationship between frailty and clinical outcomes in older Indian patients with cancer.

Materials And Methods: Our observational single-centre study, conducted at Tata Memorial Hospital from February 2020 to July 2022, enrolled participants aged 60 years and above with cancer.

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Purpose: The Targeted Agent and Profiling Utilization Registry Study is a phase II basket trial evaluating the antitumor activity of commercially available targeted agents in patients with advanced cancer and genomic alterations known to be drug targets. Results from cohorts of patients with metastatic breast cancer (BC) with and alterations treated with sunitinib are reported.

Methods: Eligible patients had measurable disease, Eastern Cooperative Oncology Group performance status 0-2, adequate organ function, and no standard treatment options.

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Background: Pathological complete response (pCR) is associated with favorable prognosis in patients with triple-negative breast cancer (TNBC). However, only 30-40% of TNBC patients treated with neoadjuvant chemotherapy (NAC) show pCR, while the remaining 60-70% show residual disease (RD). The role of the tumor microenvironment in NAC response in patients with TNBC remains unclear.

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Background: Polypharmacy and potentially inappropriate medication (PIM) use are common problems in older adults. Safe prescription practices are a necessity. The tools employed for the identification of PIM sometimes do not concur with each other.

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Aims: Global guidelines recommend that all older patients with cancer receiving chemotherapy should undergo a geriatric assessment. However, utilisation of the geriatric assessment is often constrained by its time-intensive nature, which limits its adoption in settings with limited resources and high demand. There is a lack of evidence correlating the results of the geriatric assessment with survival from the Indian subcontinent.

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Introduction: The USA is experiencing an opioid epidemic. Active duty service members (ADSMs) are at risk for opioid use disorder (OUD). The Coronavirus disease 2019 (COVID-19) pandemic has disrupted health care and introduced additional stressors.

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Geriatric oncology in India is relatively new. The number of older persons with cancer is increasing exponentially; at our institution, 34% of patients registered are 60 years and over. Apart from the Tata Memorial Hospital in Mumbai, there are currently no other Indian centers that have a dedicated geriatric oncology unit.

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Background: Pathological complete response (pCR) is associated with favorable prognosis in patients with triple-negative breast cancer (TNBC). However, only 30-40% of TNBC patients treated with neoadjuvant chemotherapy (NAC) show pCR, while the remaining 60-70% show residual disease (RD). The role of the tumor microenvironment (TME) in NAC response in patients with TNBC remains unclear.

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 Breast cancer is an epithelial malignancy; however, stroma plays a key role with its stimulatory and inhibitory factors in modulating tumor invasion and metastasis. CD10, a matrix metalloproteinase, is known to regulate cell adhesion, migration and helps in determining the progression of tumor. This knowledge helps to identify specific signals that promote growth, dedifferentiation, invasion, metastasis and serve as target for better therapeutic management.

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Introduction: The number of older patients with cancer is increasing exponentially worldwide, and a similar trend has also been noted in India. The Multidimensional Prognostic Index (MPI) strongly correlates the presence of individual comorbidities with mortality, and the Onco-MPI prognosticates patients accurately for overall mortality. However, limited studies have evaluated this index in patient populations beyond Italy.

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The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Breast Cancer address all aspects of management for breast cancer. The treatment landscape of metastatic breast cancer is evolving constantly. The therapeutic strategy takes into consideration tumor biology, biomarkers, and other clinical factors.

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  • - The study investigates the effects of using alkalinized lignocaine 2% versus normal saline to fill endotracheal tube (ETT) cuffs during general anesthesia, aiming to reduce post-intubation complications like sore throat and nausea.
  • - High-volume low-pressure cuffs can cause damage to tracheal mucosa due to increased pressure from gas diffusion, and using lignocaine may help alleviate this irritation due to its local anesthetic properties.
  • - The research involved a randomized, double-blind trial with 120 participants, focusing on the benefits of lignocaine inflation in reducing post-intubation morbidities compared to saline.
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