Publications by authors named "Swapnil Khose"

Article Synopsis
  • Prehospital routing of patients with large vessel occlusion (LVO) acute ischemic stroke (AIS) to comprehensive stroke centers (CSCs) can potentially improve clinical outcomes, and this study investigates factors influencing such routing, particularly focusing on distance, stroke severity, and sex.
  • The study analyzed 503 patients in the greater Houston area, revealing that while 82% were routed to CSCs, women were 9% less likely to be routed compared to men, despite presenting with more severe stroke symptoms and similar distances to CSCs.
  • Findings indicate that women were older and had higher stroke severity scores; further research is necessary to understand the reasons behind the lower routing rates for women.
View Article and Find Full Text PDF

Background: Delays in endovascular reperfusion for patients with large vessel occlusion stroke are known to worsen outcomes, and the mechanism is believed to be time-dependent expansion of the ischemic infarction. In this study, we hypothesize that delays in onset to reperfusion (OTR) assert an effect on outcomes independent of effects of final infarct (FI).

Methods: We performed a subgroup analysis from the prospective multicenter COMPLETE (International Acute Ischemic Stroke Registry With the Penumbra System Aspiration Including the 3D Revascularization Device; Penumbra, Inc) registry for 257 patients with anterior circulation large vessel occlusion who underwent endovascular therapy with successful reperfusion (modified treatment in cerebral infarction score 2b/3).

View Article and Find Full Text PDF

Background And Purpose: Tectal gliomas (TGs) are rare tumors that involve critical locations in the brainstem, including the superior and inferior colliculi and the Sylvian aqueduct. The rarity of these tumors and the lack of large clinical studies have hindered adequate understanding of this disease. We sought to determine the association between imaging characteristics of TG and progression-free survival (PFS).

View Article and Find Full Text PDF

Background: Respiratory-related complaints prompt most pediatric visits to Karl Heusner Memorial Hospital Authority's (KHMHA) Emergency Department (ED) in Belize. We developed and taught a novel pediatric respiratory emergencies module for generalist practitioners there. We assessed the curriculum's clinical impact on pediatric asthma emergency management.

View Article and Find Full Text PDF
Article Synopsis
  • Primary spinal high-grade gliomas (S-HGG) are rare and aggressive tumors primarily managed with radiation therapy, and a retrospective study analyzed 29 patients who received treatment from 2001 to 2020.
  • The study found that most patients did not achieve complete tumor resection and the majority had mutations associated with a poorer prognosis; only 21.3 months was the median overall survival after diagnosis.
  • Findings revealed that most patients experienced tumor recurrence despite treatment, highlighting a need for more effective therapies and a better understanding of the molecular factors involved in spinal HGGs.
View Article and Find Full Text PDF

Background And Purpose: Brain tumors are the most common cause of cancer-related deaths among the pediatric population. Among these, pediatric glioblastomas (GBMs) comprise 2.9% of all central nervous system tumors and have a poor prognosis.

View Article and Find Full Text PDF

Objective: Sepsis is a major public health problem. Understanding the epidemiology of sepsis subtypes is important to quantify the magnitude of the problem and identify targets for system wide treatment strategies. We sought to describe the current national epidemiology of community-acquired (CAS), hospital-acquired (HAS) and healthcare-associated sepsis (HCAS) hospitalizations among academic medical centers in the United States using current discharge diagnosis taxonomies.

View Article and Find Full Text PDF

Purpose: Gliosarcoma (GS) is classified by the World Health Organization as a subtype of glioblastoma with sarcomatous features. GS have a propensity to metastasize, as opposed to other gliomas, with lower 5-year survival rates than GBM patients. In this study, we identified differences in survival between patients with primary and secondary GS.

View Article and Find Full Text PDF

Background And Purpose: Endovascular therapy (EVT) is a very effective treatment but relies on specialized capabilities that are not available in every hospital where acute ischemic stroke is treated. Here, we assess whether access to and utilization of this therapy has extended uniformly across racial and ethnic groups.

Methods: We conducted a retrospective, population-based study using the 2019 Texas Inpatient Public Use Data File.

View Article and Find Full Text PDF

Coronavirus disease 2019 (COVID-19) has been associated with coagulopathy, and D-dimer levels have been used to predict disease severity. However, the role of D-dimer in predicting mortality in COVID-19 patients with acute ischemic stroke (AIS) remains incompletely characterized. We conducted a retrospective cohort study using the Optum® de-identified COVID-19 Electronic Health Record dataset.

View Article and Find Full Text PDF

Objective: In patients with large-vessel occlusion (LVO) acute ischemic stroke (AIS), determinations of infarct size play a key role in the identification of candidates for endovascular stroke therapy (EVT). An accurate, automated method to quantify infarct at the time of presentation using widely available imaging modalities would improve screening for EVT. Here, the authors aimed to compare the performance of three measures of infarct core at presentation, including an automated method using machine learning.

View Article and Find Full Text PDF
Article Synopsis
  • A nationwide study analyzed COVID-19 data from 1,052 counties to examine the initial community spread and case fatality risk (CFR) during the first 4 weeks of the pandemic.
  • The study found a median incidence of 193.4 cases per 100,000 population and a median CFR of 3.6%.
  • Key factors positively influencing COVID-19 incidence included median age and rural population, while variables like population size and race were negatively associated; similarly, factors impacting CFR included age and education, while Hispanic ethnicity and obesity had a paradoxical relationship.
View Article and Find Full Text PDF

The pandemic of novel Coronavirus (SARS-CoV-2) is currently spreading rapidly across the United States. We provide a comprehensive overview of COVID-19 epidemiology across the state of Texas, which includes vast rural & vulnerable communities that may be disproportionately impacted by the spread of this new disease. All 254 Texas counties were included in this study.

View Article and Find Full Text PDF

There have been many technological advances improving the work up and treatment of patients in the emergency department (ED). Point of care testing (POCT) is becoming more common, especially in the time compressed clinically high-pressured environment of the emergency department. In present times, emphasis of POCT has spurred search of novel biomarkers which promise earlier and more specific detection of disease.

View Article and Find Full Text PDF