Publications by authors named "Samir Shah"
Background: Isolated complex perianal fistulas, without luminal evidence of inflammatory bowel disease in the gastrointestinal tract, pose diagnostic and treatment dilemmas for gastroenterologists and colorectal surgeons. For patients who develop recurrent complex fistulas, a presumptive diagnosis of Crohn's disease may be made. It is unclear whether these cases of isolated perianal disease in the absence of luminal inflammation truly represent isolated severe cryptoglandular fistulas or rather an early presentation of Crohn's disease.
View Article and Find Full Text PDFBackground: Major limb amputation can place a significant financial burden on patients and their families because of costs of care and loss of income, encapsulated by the concept of financial toxicity.We sought to measure and understand factors associated with financial toxicity among patients undergoing major lower limb amputation for diabetic foot ulcers or peripheral arterial disease.
Methods: We identified patients in an institutional database who received lower limb amputations and excluded patients who underwent amputation due to known trauma or cancer.
Article Synopsis
- The study focuses on adherence to imaging surveillance for patients with uncomplicated type B aortic dissections (uTBAD), highlighting its importance for preventing complications and long-term mortality.
- A total of 152 patients were analyzed, revealing that 46% underwent imaging surveillance, with no significant demographic differences between those who did and those who didn't.
- Factors influencing adherence included a higher prevalence of prior cardiovascular surgery in patients without surveillance, while those with surveillance had higher rates of being discharged home after hospital transfers.
Article Synopsis
- Radiologic imaging is often used in children's hospitals to assist with diagnoses, but variations in how it's performed can lead to unnecessary costs and risks.
- A study analyzed inpatient pediatric conditions across 50 hospitals from 2017 to 2019, focusing on those with high imaging prevalence and costs, and found that conditions like pectus excavatum and scoliosis had the highest imaging rates.
- The findings indicated significant variations in imaging-related costs among hospitals, highlighting the need for improved guidelines to reduce overuse and improve care in pediatric imaging.
Article Synopsis
- Patients with Alzheimer's Disease and related dementias (ADRD) experience worse outcomes after colorectal surgery compared to those without ADRD, as shown in a study analyzing Medicare data from 2017 to 2018.
- The study found that 8.3% of the colorectal surgery cohort had ADRD, and these patients were generally older, frailer, and had more comorbidities, leading to higher instances of complications and mortality.
- Additionally, ADRD patients required more hospital resources, including longer stays and more frequent discharges to higher-level care facilities.
Objective: To understand mortality and secondary outcomes in patients with both end-stage kidney disease (ESKD) and chronic limb-threatening ischemia (CLTI) after no procedural treatment, primary amputation, endovascular treatment, and open surgery.
Summary Background Data: ESKD and CLTI commonly cooccur and limited prior work has demonstrated poor outcomes including one-year survival despite treatment.
Methods: We conducted a retrospective national cohort study of United States Renal Data System data from January 1, 2016 to December 31, 2019 to determine mortality, major postoperative complications, and other outcomes.
Airway clearance therapies (ACT) are often used to optimize respiratory function for children with neurologic impairment (CNI) hospitalized with acute respiratory infections (ARI). In a five-center retrospective cohort study of CNI aged 1-18 years hospitalized between 2013 and 2015 with ARI, we assessed the association of admission ACT with hospital outcomes (days to return to baseline respiratory support and length of stay [LOS]). Generalized estimated equation (GEE) models examined the association between ACT and outcomes, while accounting for clustering.
View Article and Find Full Text PDFArticle Synopsis
- - This study focused on community-acquired pneumonia (CAP) in children, aiming to identify mucosal biomarkers that can aid in determining the severity and cause of the illness.
- - Researchers analyzed cytokine levels in nasopharyngeal samples from 182 children with CAP and 26 healthy controls, finding that those with atypical bacteria and influenza virus had significantly elevated cytokine concentrations compared to those with typical bacteria.
- - The findings suggest that differences in inflammatory and antiviral cytokine levels correlate with disease severity in CAP, indicating that mucosal biomarkers might be helpful for better assessing and classifying the condition in pediatric patients.
Background: The association between asymptomatic carotid artery stenosis and impaired cognition, and the cognitive changes after revascularization remain active areas of interest in the field of carotid disease. This narrative review focuses on the association between carotid artery atherosclerosis and impaired cognitive function, proposed mechanisms, and the effects of carotid revascularization on cognition.
Methods: A critical review of the literature to identify studies evaluating carotid artery stenosis, cognition, and carotid revascularization was performed using PubMed to query the MEDLINE database through March 2023.
Article Synopsis
- - The study evaluated the STEP program, aimed at improving post-discharge care for pediatric ECMO survivors in a hospital setting, focusing on guideline compliance.
- - After implementing STEP, there was a significant increase in the compliance rates for neurodevelopmental testing and follow-up evaluations in various therapeutic areas (e.g., neurology, audiology) among patients.
- - The results showed that STEP effectively enhanced adherence to follow-up guidelines, resulting in more timely and thorough neurodevelopmental assessments for ECMO survivors.
Objectives: To tackle the issue of late HIV diagnosis in the country, the Ministry of Health (MOH) in Oman introduced a national policy of routine opt-out HIV in medical admission units in September 2022. We hereby report the implementation and outcomes of this policy.
Method: All patients aged 16-65 years admitted to a medical ward in secondary and local hospitals were offered an HIV test regardless of their symptoms by medical doctors, with training and support from HIV teams.
Objective: Major lower limb amputation is a disfiguring operation associated with impaired mobility and high near-term mortality. Informed decision-making regarding amputation requires outcomes data. Despite the co-occurrence of both chronic limb-threatening ischemia (CLTI) and Alzheimer's disease and related dementias (ADRD), there is sparse data on the outcomes of major limb amputation in this population and the impact of frailty.
View Article and Find Full Text PDFThe expanding field of cardiorespiratory fitness (CRF) in individuals with and without atrial fibrillation (AF) presents a complex landscape, demanding careful interpretation of the existing research. AF, characterized by significant mortality and morbidity, prompts the exploration of strategies to mitigate its impact. Increasing physical activity (PA) levels emerges as a promising avenue to address AF risk factors, such as obesity, hypertension, and diabetes mellitus, through mechanisms of reduced vasoconstriction, endothelin-1 modulation, and improved insulin sensitivity.
View Article and Find Full Text PDF