Radiographie contrast media-induced nephrotoxicity is an impor tant cause of acute renal failure.... more Radiographie contrast media-induced nephrotoxicity is an impor tant cause of acute renal failure. The indications of using contrast are usually unavoidable, compelling and continue to expand, especially in the vascular field. When acute renal failure follows such a procedure, it becomes important to establish the presence of contrast nephrotoxicity or an acute occlusive event which may have precipitated the failure.
Radioiodine scintigraphy and therapy has played a major role in the treatment and follow-up of th... more Radioiodine scintigraphy and therapy has played a major role in the treatment and follow-up of thyroid cancer patients for decades. Single-photon emission computed tomography/computed tomography in this setting is emerging as a useful tool in accurately localizing sites of pathological uptake and physiological mimics of disease, thus providing more accurate staging prognostic information for risk stratification, which in turn tailors management and follow-up regimes. This review presents the current evidence and potential indications of single-photon emission computed tomography/ computed tomography in thyroid cancer. R Changed planar interpretation 40% (19/48) Change in stage 21% (10/48) Changed proposed therapy dose 58% (28/48) DTC, differentiated thyroid carcinoma; FDG, fluorodeoxyglucose; FOV, field of view; LN, lymph node; P, prospective; R, retrospective; RAI, radioiodine; SPECT/CT, single-photon emission computed tomography/computed tomography; WBS, whole-body scan. A 73-year-old male with pT2N1a papillary thyroid cancer. Elevated thyroglobulin at follow-up. (a) Whole-body planar 123 I scintigraphy anterior view shows focal abnormal tracer uptake in the left supraclavicular region and asymmetric tracer uptake in the region of the submandibular glands, which turned out to be physiologic on SPECT/CT. (b) Axial SPECT/CT (SPECT, fusion and CT images) localizes the activity to a left level IV cervical node (arrowed). (c) Axial cervical ultrasound demonstrates a rounded hypoechoic node with classical puntate calcification seen in metastatic papillary thyroid cancer nodes. SPECT/CT, single-photon emission computed tomography/computed tomography. SPECT/CT in differentiated thyroid cancer Barwick et al. 791 A 64-year-old female diagnosed with T4NxMx follicular thyroid cancer after 131 I ablation imaging. Anterior planar image (a) shows mediastinal uptake (arrow) in addition to the expected uptake in the thyroid remnant, which could represent nodal disease. (b) SPECT/CT (fused image) localizes this to a large hiatus hernia. SPECT/CT, single-photon emission computed tomography/computed tomography.
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2011
Targeted parathyroidectomy is the gold standard for localized parathyroid disease. A robotic-assi... more Targeted parathyroidectomy is the gold standard for localized parathyroid disease. A robotic-assisted approach has not been investigated. The aim was to assess the feasibility of a robotic technique that avoids a neck scar. Feasibility study. Tertiary referral center. Eleven patients with primary hyperparathyroidism were prospectively evaluated. Triple modality concordant localization was a prerequisite. All patients underwent robotic-assisted parathyroidectomy (RAP). Outcome variables assessed were operative time, voice change, biochemical cure, and histopathological confirmation. Patient-reported outcome measures (PROMs) included subjective assessment of pain and scar cosmesis, Voice Handicap Index 2, and EQ-5D quality-of-life assessment. Mean follow-up was 6 months (range, 3-12 months). The parathyroid adenoma was successfully excised in all cases with negligible blood loss (<5 mL). There was 1 conversion. There was no voice change in any case. Robot docking time plateaued to ...
The TAX 324 trial showed that the proportion of HPV positive oropharyngeal tumors was nine times ... more The TAX 324 trial showed that the proportion of HPV positive oropharyngeal tumors was nine times higher in white versus black patients. HPV positive tumors exhibited a dramatically improved overall survival leading to an overall improved survival rate in white versus black patients. To confirm the racial disparity observed in Tax324 we performed a retrospective analysis in a larger sample size of 480 patients with oropharyngeal cancer treated at a single institution between 1995 and 2007. HPV-16 status was evaluated by PCR of DNA extracted from pretreatment biopsies embedded in paraffin. RESULTS: Among the 480 patients, detailed clinical information is available for 288 patients, and HPV status is known for 155 patients. 56% of patients are white and 44% are black. 84% of the patients are male. Median age is 56. The majority of patients (64%) are stage IV. Of patients with informative HPV samples, 40/95 (42%) of white patients are HPV positive while only 7 of 60 black patients (12%) are HPV positive (pϽ0.0001). CONCLUSION: This independent data set confirms the Tax324 trial observation that the prevalence of HPV positive oropharyngeal cancers is much lower in blacks than in whites. Together with the markedly favorable prognosis of HPV positive compared to HPV negative patients, this difference contributes significantly to overall racial survival disparities in oropharyngeal cancer.
Tuberculosis (TB), caused by infection with Mycobacterium tuberculosis, is a major cause of morbi... more Tuberculosis (TB), caused by infection with Mycobacterium tuberculosis, is a major cause of morbidity and mortality worldwide. Efforts to control it are hampered by difficulties with diagnosis, prevention and treatment. Most people infected with M. tuberculosis remain asymptomatic, termed latent TB, with a 10% lifetime risk of developing active TB disease. Current tests, however, cannot identify which individuals will develop disease. The immune response to M. tuberculosis is complex and incompletely characterized, hindering development of new diagnostics, therapies and vaccines. Here we identify a whole-blood 393 transcript signature for active TB in intermediate and high-burden settings, correlating with radiological extent of disease and reverting to that of healthy controls after treatment. A subset of patients with latent TB had signatures similar to those in patients with active TB. We also identify a specific 86-transcript signature that discriminates active TB from other inf...
Open reduction and internal fixation of clavicular nonunions with allograft bone substitute Art... more Open reduction and internal fixation of clavicular nonunions with allograft bone substitute Arthroscopic evaluation and treatment of biceps brachii long head tendon injuries: A survey of the MOON shoulder group Combined single photon emission computerized tomography and conventional computerized tomography: Clinical value for the shoulder surgeons? Innovative use of computer-assisted tomography in the management of an irreducible anterior shoulder dislocation Isolated supraspinatus muscle atrophy and fatty infiltration associated with recurrent anterior shoulder instability: A case report and review of the literature
Radiographie contrast media-induced nephrotoxicity is an impor tant cause of acute renal failure.... more Radiographie contrast media-induced nephrotoxicity is an impor tant cause of acute renal failure. The indications of using contrast are usually unavoidable, compelling and continue to expand, especially in the vascular field. When acute renal failure follows such a procedure, it becomes important to establish the presence of contrast nephrotoxicity or an acute occlusive event which may have precipitated the failure.
Radioiodine scintigraphy and therapy has played a major role in the treatment and follow-up of th... more Radioiodine scintigraphy and therapy has played a major role in the treatment and follow-up of thyroid cancer patients for decades. Single-photon emission computed tomography/computed tomography in this setting is emerging as a useful tool in accurately localizing sites of pathological uptake and physiological mimics of disease, thus providing more accurate staging prognostic information for risk stratification, which in turn tailors management and follow-up regimes. This review presents the current evidence and potential indications of single-photon emission computed tomography/ computed tomography in thyroid cancer. R Changed planar interpretation 40% (19/48) Change in stage 21% (10/48) Changed proposed therapy dose 58% (28/48) DTC, differentiated thyroid carcinoma; FDG, fluorodeoxyglucose; FOV, field of view; LN, lymph node; P, prospective; R, retrospective; RAI, radioiodine; SPECT/CT, single-photon emission computed tomography/computed tomography; WBS, whole-body scan. A 73-year-old male with pT2N1a papillary thyroid cancer. Elevated thyroglobulin at follow-up. (a) Whole-body planar 123 I scintigraphy anterior view shows focal abnormal tracer uptake in the left supraclavicular region and asymmetric tracer uptake in the region of the submandibular glands, which turned out to be physiologic on SPECT/CT. (b) Axial SPECT/CT (SPECT, fusion and CT images) localizes the activity to a left level IV cervical node (arrowed). (c) Axial cervical ultrasound demonstrates a rounded hypoechoic node with classical puntate calcification seen in metastatic papillary thyroid cancer nodes. SPECT/CT, single-photon emission computed tomography/computed tomography. SPECT/CT in differentiated thyroid cancer Barwick et al. 791 A 64-year-old female diagnosed with T4NxMx follicular thyroid cancer after 131 I ablation imaging. Anterior planar image (a) shows mediastinal uptake (arrow) in addition to the expected uptake in the thyroid remnant, which could represent nodal disease. (b) SPECT/CT (fused image) localizes this to a large hiatus hernia. SPECT/CT, single-photon emission computed tomography/computed tomography.
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2011
Targeted parathyroidectomy is the gold standard for localized parathyroid disease. A robotic-assi... more Targeted parathyroidectomy is the gold standard for localized parathyroid disease. A robotic-assisted approach has not been investigated. The aim was to assess the feasibility of a robotic technique that avoids a neck scar. Feasibility study. Tertiary referral center. Eleven patients with primary hyperparathyroidism were prospectively evaluated. Triple modality concordant localization was a prerequisite. All patients underwent robotic-assisted parathyroidectomy (RAP). Outcome variables assessed were operative time, voice change, biochemical cure, and histopathological confirmation. Patient-reported outcome measures (PROMs) included subjective assessment of pain and scar cosmesis, Voice Handicap Index 2, and EQ-5D quality-of-life assessment. Mean follow-up was 6 months (range, 3-12 months). The parathyroid adenoma was successfully excised in all cases with negligible blood loss (<5 mL). There was 1 conversion. There was no voice change in any case. Robot docking time plateaued to ...
The TAX 324 trial showed that the proportion of HPV positive oropharyngeal tumors was nine times ... more The TAX 324 trial showed that the proportion of HPV positive oropharyngeal tumors was nine times higher in white versus black patients. HPV positive tumors exhibited a dramatically improved overall survival leading to an overall improved survival rate in white versus black patients. To confirm the racial disparity observed in Tax324 we performed a retrospective analysis in a larger sample size of 480 patients with oropharyngeal cancer treated at a single institution between 1995 and 2007. HPV-16 status was evaluated by PCR of DNA extracted from pretreatment biopsies embedded in paraffin. RESULTS: Among the 480 patients, detailed clinical information is available for 288 patients, and HPV status is known for 155 patients. 56% of patients are white and 44% are black. 84% of the patients are male. Median age is 56. The majority of patients (64%) are stage IV. Of patients with informative HPV samples, 40/95 (42%) of white patients are HPV positive while only 7 of 60 black patients (12%) are HPV positive (pϽ0.0001). CONCLUSION: This independent data set confirms the Tax324 trial observation that the prevalence of HPV positive oropharyngeal cancers is much lower in blacks than in whites. Together with the markedly favorable prognosis of HPV positive compared to HPV negative patients, this difference contributes significantly to overall racial survival disparities in oropharyngeal cancer.
Tuberculosis (TB), caused by infection with Mycobacterium tuberculosis, is a major cause of morbi... more Tuberculosis (TB), caused by infection with Mycobacterium tuberculosis, is a major cause of morbidity and mortality worldwide. Efforts to control it are hampered by difficulties with diagnosis, prevention and treatment. Most people infected with M. tuberculosis remain asymptomatic, termed latent TB, with a 10% lifetime risk of developing active TB disease. Current tests, however, cannot identify which individuals will develop disease. The immune response to M. tuberculosis is complex and incompletely characterized, hindering development of new diagnostics, therapies and vaccines. Here we identify a whole-blood 393 transcript signature for active TB in intermediate and high-burden settings, correlating with radiological extent of disease and reverting to that of healthy controls after treatment. A subset of patients with latent TB had signatures similar to those in patients with active TB. We also identify a specific 86-transcript signature that discriminates active TB from other inf...
Open reduction and internal fixation of clavicular nonunions with allograft bone substitute Art... more Open reduction and internal fixation of clavicular nonunions with allograft bone substitute Arthroscopic evaluation and treatment of biceps brachii long head tendon injuries: A survey of the MOON shoulder group Combined single photon emission computerized tomography and conventional computerized tomography: Clinical value for the shoulder surgeons? Innovative use of computer-assisted tomography in the management of an irreducible anterior shoulder dislocation Isolated supraspinatus muscle atrophy and fatty infiltration associated with recurrent anterior shoulder instability: A case report and review of the literature
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Papers by Ranju Dhawan