Publications by authors named "Ramanathan K"
Background: The clinical impact of bariatric surgery (BS) prior to pancreas transplantation (PTx) is unclear.
Setting: University of Minnesota Hospital, Minneapolis, MN.
Methods: This was a single center retrospective case-controlled study of all patients January 1, 1998 and May 1, 2024 with a history of BS prior to PTx.
Background: Critical care of patients on extracorporeal membrane oxygenation (ECMO) with acute brain injury (ABI) is notable for a lack of high-quality clinical evidence. Here, we offer guidelines for neurological care (neurological monitoring and management) of adults during and after ECMO support.
Methods: These guidelines are based on clinical practice consensus recommendations and scientific statements.
Background: For emergency department (ED) patients with cardiac chest pain, introduction of high-sensitivity troponin (hsTnT) pathways has been associated with reductions in length of stay of less than 1 h.
Methods: At two urban Canadian sites, we introduced hsTnT on January 26, 2016. While the prior diagnostic algorithm required troponin testing at 0 and 6 h, serial hsTnT serial testing was conducted at 0 and 3 h.
Glutathione (GSH) and its oxidized dimer (GSSG) play an important role in living systems as an antioxidant, balancing the presence of reactive oxygen species (ROS). The central thiol (-S-S-) bond in GSSG can undergo free rotation, providing multiple conformations with respect to the S-S bridge. The six titratable sites of GSSG, which are influenced by pH variations, affect these conformations in solution, whereas in solids, additionally crystal packing effects come into play.
View Article and Find Full Text PDFAlterations in the gut microbiome have been implicated in various pathologies. Fecal microbiota transplantation (FMT) has been offered as a novel treatment for conditions implicated in the disruption of the gut-microbiota axis. This case report details the successful treatment of recurrent nonobstructive cholangitis following a single FMT application in a patient who had previously undergone a hepatobiliary tract surgical diversion.
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- This study looked at patients with tuberculosis who needed a special life support system called ECMO, which helps patients with serious breathing problems.
- Researchers checked data from 2003 to 2022 to see how well these patients did after using ECMO.
- The results showed that while ECMO can help, it’s really important to start it on time and manage it carefully to reduce problems and help patients recover better.
Article Synopsis
- * Key questions have emerged regarding differences between COVID-19 and non-COVID-19 respiratory failures, the role of personalized therapy, and alternative respiratory support options to intubation.
- * The chapter discusses advances in understanding respiratory failure, the significance of international collaboration among medical professionals, and the need for skepticism when evaluating rapidly evolving medical evidence during a pandemic.
Article Synopsis
- Chronic pancreatitis (CP) increases the likelihood of developing calcium-oxalate kidney stones, and this study focuses on assessing that risk in patients who have undergone total pancreatectomy with islet autotransplantation (TPIAT).
- A retrospective analysis of 629 TPIAT patients found that the risk for kidney stones is significant, with about 29.4% experiencing at least one episode within 15 years post-surgery.
- Key factors associated with increased kidney stone risk included older age, smoking, mild chronic kidney disease, and a history of kidney stones or renal cysts, highlighting the need for clinician awareness and patient counseling on preventative measures.
The management of cardiogenic shock is an ongoing challenge. Despite all efforts and tremendous use of resources, mortality remains high. Whilst reversing the underlying cause, restoring/maintaining organ perfusion and function are cornerstones of management.
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- - The text discusses the lack of strong clinical evidence in the critical care of ECMO patients with acute brain injury (ABI) and presents guidelines for their neurological care.
- - Guidelines were developed using input from an international panel of 30 ECMO experts through a structured voting process, focusing on five key clinical areas.
- - The consensus emphasizes the importance of early detection and intervention for ABI in ECMO patients to improve health outcomes and outlines multiple recommendations to guide clinical practice and highlight research needs.
Introduction: Myopericarditis is a rare but serious coronavirus disease 2019 (COVID-19) vaccine-related adverse event primarily affecting adolescents. Given recent approvals for childhood vaccination, we performed a meta-analysis investigating myopericarditis following messenger ribonucleic acid COVID-19 vaccination in children aged <19 years, focusing on its overall risk and high-risk subgroups.
Methods: We searched MEDLINE via PubMed, Embase and Scopus from inception to 1 August 2022 for observational studies reporting myopericarditis in temporal relation to paediatric COVID-19 vaccination.
Article Synopsis
- Acute hypoxaemic respiratory failure (AHRF) is a significant cause for ICU admissions, comprising over 52% of patients, with differing mortality rates based on severity.
- A study from 2005 to 2022 revealed that the survival rate has improved overall in ICUs, with in-hospital mortality decreasing from 13.3% to 8.2%, even amidst the high risks associated with severe AHRF.
- Researchers emphasize the need for better identification of AHRF patients to manage and reduce the risk of deterioration effectively, as the healthcare impact of AHRF may be larger than previously understood.
A Model mesogen and its symmetrical Dimer made up of phenyl benzoate core unit are investigated by C NMR spectroscopy. The existence of layer order in smectic A and smectic C phases of Dimer mesogen is established by powder X-ray diffraction. The chemical shift anisotropy (CSA) tensors of Model mesogen are determined by 2D separation of undistorted powder patterns by effortless recoupling (SUPER) experiment and are utilized for calculating the order parameters employing the alignment-induced chemical shifts (AIS).
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- Parry-Romberg syndrome is a rare condition that leads to progressive shrinkage of one side of the face, with significant effects on a person's appearance and mental health.
- The case report discusses a 14-year-old girl with a history of linear morphea who experienced seizures and was ultimately diagnosed with Parry-Romberg syndrome.
- It emphasizes the importance of a coordinated approach among different specialists, including rheumatologists, dermatologists, neurologists, and ophthalmologists, in the comprehensive management of the syndrome.
Article Synopsis
- A study analyzed data from over 7,000 COVID-19 patients on ECMO from 2020 to 2021 to investigate the impact of different immunomodulator treatments on mortality rates.
- Results showed that patients receiving no immunomodulators had the highest 90-day survival rate (58.1%), while those getting only corticosteroids had the lowest (50.7%), and patients on other immunomodulators alone had better outcomes (62.2%).
- The study concluded that using corticosteroids alone or with other immunomodulators leads to shorter survival, while other immunomodulators alone may improve survival, but all immunomodulator treatments were linked to increased secondary infections.
Article Synopsis
- The study looks at how the location where doctors put tubes in the arteries for heart support affects brain health after surgery.
- They compared three methods: using the aorta, subclavian/axillary arteries, and femoral artery to see which had the least brain problems.
- Results showed that patients using the subclavian/axillary method had more major brain issues compared to the others, and also had more seizures after the surgery.
Article Synopsis
- - The study focuses on veno-venous extracorporeal membrane oxygenation (VV-ECMO) for patients with severe respiratory failure, highlighting the significant impact of right ventricular injury (RVI) on patient outcomes amid the lack of a standard RVI definition and management strategies.
- - An international panel of experts, using a Delphi process, identified key areas of uncertainty about RVI and formulated expert position statements, achieving consensus on 31 out of 35 statements regarding nomenclature, diagnostic approaches, and management strategies related to RVI in the context of VV-ECMO.
- - While recommendations for RVI management were made, there was no consensus on specific strategies, such as RV-protective driving pressure thresholds
Background: Chronic immunosuppression following pancreas transplantation carries significant risk, including posttransplant lymphoproliferative disease (PTLD). We sought to define the incidence, risk factors, and long-term outcomes of PTLD following pancreas transplantation at a single center.
Methods: All adult pancreas transplants between February 1, 1983 and December 31, 2023 at the University of Minnesota were reviewed, including pancreas transplant alone (PTA), simultaneous pancreas-kidney transplants (SPK), and pancreas after kidney transplants (PAK).
Article Synopsis
- Knee osteoarthritis (KOA) is a degenerative condition causing pain and mobility issues, prompting interest in regenerative treatments like bone marrow aspirate concentrate (BMAC), rich in stem cells and growth factors.
- A study involving 75 patients tested three BMAC dosage levels (low, medium, and high) to assess their effects on knee cartilage repair over a year, using a specialized scoring system (MOCART 2.0).
- Results indicated that medium and high doses of BMAC showed significant improvements in radiological scores compared to low doses, although these improvements did not result in notable clinical differences across the treatment groups.
Introduction: Knee osteoarthritis (KOA), a chronic degenerative disease, significantly impairs quality of life due to pain and mobility limitations. Traditional treatments focus on symptom management without addressing the underlying disease progression, leading to a growing interest in regenerative medicine approaches. Bone marrow aspirate concentrate (BMAC), rich in mesenchymal stem cells and growth factors, has shown potential for cartilage repair and symptom relief in KOA.
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