Publications by authors named "Sagar Patel"

This study aims to develop a digital twin (DT) framework to achieve adaptive proton prostate stereotactic body radiation therapy (SBRT) with fast treatment plan selection and patient-specific clinical target volume (CTV) setup uncertainty. Prostate SBRT has emerged as a leading option for external beam radiotherapy due to its effectiveness and reduced treatment duration. However, interfractional anatomy variations can impact treatment outcomes.

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  • * Diagnosis relies on cerebrospinal fluid analysis and neuroimaging techniques like MRI and SPECT, and there are recent advances in testing methods and imaging to monitor treatment effectiveness.
  • * The main treatment is Penicillin G, while ceftriaxone is an alternative for those allergic to penicillin; both aim to improve patient outcomes by enhancing understanding of neurosyphilis pathophysiology and refining diagnostic and treatment methods.
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Purpose: While the benefit of short-term androgen deprivation therapy (ADT) has been established for patients with intermediate-risk (IR) prostate cancer (PCa) receiving dose-escalated external beam radiation therapy (EBRT), the role of ADT for patients treated with brachytherapy (BT) with or without supplemental EBRT (sEBRT) is less clear.

Material And Methods: We conducted a single-institution retrospective analysis of men with National Comprehensive Cancer Network (NCCN) unfavorable IR (UIR) PCa. All patients received BT with or without sEBRT, and were stratified by the receipt of 4-6 months of ADT.

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Japanese encephalitis (JE) is widely prevalent in the Asia-Pacific region. There is limited information on JE virus (JEV) seroprevalence as well as the associated epidemiologic and ecological factors in India. This study aimed to determine the seroprevalence of JEV and associated risk factors in swine populations from climatically diverse regions of the country.

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The ability of the Veterans Health Administration System to care for veterans with bladder cancer is influenced by the increased complexity of both veterans and the system's capacity to do so, which is determined by personnel and equipment allocation. Herein, we review the guidelines for bladder cancer management in the context of this population and highlight unique veteran characteristics that impact the delivery of bladder cancer care within the Veterans Health Administration System. There are opportunities for standardization and implementation, which can improve the quality of this care, and we summarize the questions for which coordinated research efforts may provide answers.

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Purpose: To evaluate the effectiveness of prophylactic mesh placement in reducing the incidence of parastomal hernias following colostomy, ileostomy, and ileal conduit formation.

Methods: A systematic review identified relevant studies evaluating parastomal hernia incidence with prophylactic mesh use during stoma formation. Pairwise meta-analysis and network meta-analysis using Bayesian modeling were performed.

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  • - The study investigates how the timing of radiotherapy (RT) after radical prostatectomy influences long-term health-related quality of life (HRQOL) in men with prostate cancer, focusing on sexual, urinary, and bowel health.
  • - Researchers analyzed data from two cohorts, comparing outcomes between three groups: men who had just prostatectomy, those who received early RT (within 12 months), and those who had late RT (12 months or later).
  • - Findings revealed that men who underwent RT after prostatectomy experienced greater declines in aspects of HRQOL compared to those who did not receive RT, highlighting the potential negative effects of post-surgery radiation timing.
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  • - A systematic review and meta-analysis examined the effectiveness of AI algorithms in screening for aortic stenosis (AS), finding that they can accurately diagnose the condition before severe symptoms develop.
  • - The analysis included data from diverse sources (like ECGs and wearable sensors) and assessed various diagnostic metrics, concluding with a sensitivity of 83% and specificity of 81% for the AI algorithms.
  • - Results indicated high diagnostic accuracy (AUC of 0.909), while various factors (geographic region, AS type, data sources, AI methods) contributed to variations in performance, with a noted potential for publication bias affecting the findings.
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The flavoenzyme proline dehydrogenase (PRODH) catalyzes the first step of proline catabolism, the oxidation of l-proline to Δ-pyrroline-5-carboxylate. The enzyme is a target for chemical probe discovery because of its role in the metabolism of certain cancer cells. -propargylglycine is the first and best characterized mechanism-based covalent inactivator of PRODH.

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  • This study examines pelvic organ-preserving radical cystectomy in women with muscle-invasive bladder cancer, aiming to understand its oncological outcomes compared to standard radical cystectomy.
  • A systematic review analyzed six studies totaling 597 patients, finding no significant differences in overall survival, cancer-specific survival, or recurrence-free survival between the two surgical approaches.
  • While most studies had a moderate risk of bias, the findings suggest that pelvic organ preservation does not adversely affect cancer outcomes, but further research is needed for clearer insights.
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Purpose: Previous studies have shown that external beam radiation therapy is associated with an increased risk of second primary cancer (SPC) among prostate cancer (PCa) patients, but the relative risks associated with newer and advanced radiation modalities such as proton beam therapy (PBT) and stereotactic body radiation therapy (SBRT) are unclear. This study aimed to assess the relative probability of SPC among patients treated with these newer modalities compared to intensity-modulated radiation therapy (IMRT).

Patients And Methods: Using the National Cancer Database (NCDB), N0M0 PCa cases diagnosed between 2004 and 2018 were identified.

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Background: Cardiovascular disease (CVD) and cancer frequently co-occur due to shared risk factors such as obesity, which is linked to CVD and 14 cancer types. This study explores whether CVD pathophysiologies, combined with obesity, increase cancer risk, impacting clinical management.

Methods And Results: Data from the ARIC (Atherosclerosis Risk in Communities) study, spanning 28 years, were analyzed.

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  • - Cancer survivors have a significantly higher risk of cardiovascular disease (CVD) and death from CVD, especially those under 65 years old, who face a 41% increased risk.
  • - Allostatic load (AL), which measures the cumulative effects of chronic stress, plays a role in this increased risk, mediating between cancer survivorship and CVD mortality by varying percentages depending on age and race.
  • - The study highlights disparities in CVD death risk among different racial groups, notably that Black cancer survivors under 65 years old have an 84% increased risk, possibly influenced by social determinants of health.
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  • The study aimed to find links between military exposures and the risk of bladder cancer in veterans.
  • A total of 25 studies involving over 4.3 million patients were reviewed, focusing on specific military agents that could contribute to cancer risk.
  • Results indicated significant bladder cancer risks associated with Agent Orange and depleted uranium, highlighting the need for better screening and prevention protocols for veterans.
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To report a case of a suspected open-globe injury and globe penetration complicated by a rhegmatogenous retinal detachment (RRD) after administration of intraoral anesthetic injections during an endodontic procedure. A retrospective chart review was performed. A 34-year-old woman presented with acute onset of flashes, floaters, and a curtain-like shadow across her field of vision.

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Metastatic urothelial carcinoma (muC) has historically had few effective therapeutic options. Recently, immune checkpoint inhibitors (ICIs), were introduced as therapeutic options for cisplatin-ineligible patients, however, direct head-to-head trials comparing these treatments are lacking. To address this gap, this study employs a Bayesian framework to indirectly compare the performance of ICIs as first-line agents for muC.

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Purpose: Rectal toxicity after prostate cancer (PCa) radiation therapy (RT) may be greater with protons compared with photon intensity-modulated RT, perhaps due to lateral penumbra and end-of-range uncertainty. Rectal spacers (RSs) have been shown to mitigate RT-associated acute/late rectal toxicity in men treated with photons. The relative benefit of RS in men treated with protons versus photons is unknown.

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Inflammation of the bile ducts and surrounding tissues can impede bile flow from the liver into the intestines. If this occurs, a plastic or self-expanding metal (SEM) stent is placed to restore bile drainage. United States (US) Food and Drug Administration (FDA)-approved plastic biliary stents are less expensive than SEMs but have limited patency and can occlude bile flow if placed spanning a duct juncture.

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Purpose: This study was designed to investigate retinal nerve fiber layer circumpapillary optical coherence tomography to determine posterior vitreous detachment (PVD) status and to develop a clinically relevant PVD grading scale based on retinal nerve fiber layer circumpapillary optical coherence tomography to determine the incidence of PVD by age and association with vitreomacular traction disorders.

Methods: Ophthalmic images and medical records of patients with retinal diseases were retrospectively analyzed by three masked graders using retinal nerve fiber layer circumpapillary optical coherence tomography and macular optical coherence tomography. Based on PVD status, eyes were categorized into five newly defined PVD stages.

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Purpose: Whole-pelvis (WP) radiation therapy (radiation) improved biochemical relapse-free survival (bRFS) compared with prostate bed (PB)-only radiation in the Radiation Therapy Oncology Group 0534, but was performed in an era prior to positron emission tomography (PET) staging. Separately, 18F-fluciclovine PET/CT-guided postprostatectomy radiation improved 3-year bRFS versus radiation guided by conventional imaging alone. We hypothesized that patients who were changed from WP to PB-only radiation after PET would have bRFS that was: (a) no higher than patients initially planned for PB-only radiation; and (b) lower than patients planned for WP radiation without PET guidance.

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  • Multi-target directed ligands (MTDLs) are being researched for their effectiveness against Alzheimer's disease by addressing multiple aspects of the condition, like enzyme inhibition and metal balance.
  • The study synthesized piperazine-quinoline-based MTDLs using a specific chemical reaction and found that certain compounds showed strong activity against the enzymes AChE and BuChE.
  • Among the compounds, compound (95) showed the best inhibitory effects on both enzymes, while also demonstrating antioxidant properties and metal-chelating abilities, suggesting it could be a promising candidate for further Alzheimer's research.
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Purpose Of Review: Pain management is a critical aspect of care during and following a cesarean delivery. Without proper control of pain, individuals can experience poor mobility, increased thromboembolic events, and difficulty caring for the neonate in the postpartum period. There have been multiple methods for pain management for cesarean delivery and intrathecal morphine (ITM) has emerged as a prominent option for post-operative analgesia due to its efficacy, safety, and potential benefits over other treatments.

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Angiotensin-II (Ang-II) production is driven by deviations in blood volume and osmolality, and serves the role of regulating blood pressure and fluid intake to maintain cardiovascular and hydromineral homeostasis. These actions are mediated by Ang-II acting on its type 1a receptor (AT1aR) within the central nervous system and periphery. Of relevance, AT1aR are expressed on sensory afferents responsible for conveying cardiovascular information to the nucleus of the solitary tract (NTS).

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