Diffusion MR tractography permits investigating the 3D structure of cortical pathways as interwov... more Diffusion MR tractography permits investigating the 3D structure of cortical pathways as interwoven paths across the entire brain. We use high-resolution scans from diffusion spectrum imaging and high angular resolution diffusion imaging to investigate the evolution of cortical pathways within the euarchontoglire (i.e., primates, rodents) lineage. More specifically, we compare cortical fiber pathways between macaques (Macaca mulatta), marmosets (Callithrix jachus), and rodents (mice, Mus musculus). We integrate these observations with comparative analyses of Neurofilament heavy polypeptide (NEFH) expression across the cortex of mice and primates. We chose these species because their phylogenetic position serves to trace the early evolutionary history of the human brain. Our comparative analysis from diffusion MR tractography, cortical white matter scaling, and NEFH expression demonstrates that the examined primates deviate from mice in possessing increased long-range cross-cortical projections, many of which course across the anterior to posterior axis of the cortex. Our study shows that integrating gene expression data with diffusion MR data is an effective approach in identifying variation in connectivity patterns between species. The expansion of corticocortical pathways and increased anterior to posterior cortical integration can be traced back to an extension of neurogenetic schedules during development in primates.
Background Aortic stenosis (AS) has been established as a precipitating factor in the development... more Background Aortic stenosis (AS) has been established as a precipitating factor in the development of colonic angiodysplasia, resulting in lower gastrointestinal bleeding (LGIB). While the association between AS and LGIB, termed "Heyde syndrome," has been examined extensively, few studies assess the impact of comorbid AS on rates of LGIB in patients with colorectal cancer (CRC). Our goal is to examine this association. Methods Patients hospitalized from 2001 to 2013 diagnosed with CRC were identified via ICD-9 codes, further stratified by a diagnosis of AS. Continuous and categorical variables were analyzed by independent sample ttests and chi-squared analyses respectively. Assessed outcomes included mortality, length of stay (LOS), hospital costs, rates of LGIB, colonic obstruction, colonic perforation, iron-deficiency anemia (IDA), and colectomy. Multivariate analysis via binary logistic regression was utilized to control confounding variables. Results Patients with CRC and AS had higher rates of mortality, lower gastrointestinal bleeding, iron deficiency anemia, and colectomy, while those without AS had higher rates of colonic obstruction. Length of stay and total hospital charges were higher in patients with AS. Discussion CRC outcomes were worse in patients with AS. This could be due to higher rates of LGIB secondary to the prevalence of angiodysplasia among AS patients. More retrospective studies are required to assess the impact of comorbid AS in patients with CRC.
Multiple studies have been conducted comparing inpatient versus outpatient pre-induction cervical... more Multiple studies have been conducted comparing inpatient versus outpatient pre-induction cervical ripening with the Foley catheter in low risk women. We performed a metanalysis and systematic review of all existing data. METHODS: This systematic review was completed via PubMed search. Articles published prior to July 31, 2019 were included for review. We included two randomized control trials, one pilot randomized control trial, a clinical cohort study, and a retrospective cohort study in our review which met the following criteria: 1) compared outpatient versus inpatient use of Foley catheter for preinduction cervical ripening in low-risk women at term (.37 weeks), Bishop score ,5, cephalic presentation with an unfavorable cervix 2) detailed maternal and neonatal outcomes 3) full article text was available 4) article published in English. Five maternal and two neonatal primary outcomes were captured for analysis. Meta-analysis was completed via Stata v15.1 software. RESULTS: Five studies were included with 1,346 subjects. The final Bishop score, oxytocin infusion time, and induction-to-delivery time were greater in the outpatient group (Table 1, P,.05). However, there was no difference in cesarean delivery, vaginal delivery, initial Bishop score, NICU admission, and Apgar score ,7 at 5 minutes between the outpatient and inpatient groups. CONCLUSION: In this large cohort, outcomes between low risk women who received the Foley catheter for pre-induction cervical ripening in the outpatient and inpatient setting were similar.
Diffusion MR tractography permits investigating the 3D structure of cortical pathways as interwov... more Diffusion MR tractography permits investigating the 3D structure of cortical pathways as interwoven paths across the entire brain. We use high-resolution scans from diffusion spectrum imaging and high angular resolution diffusion imaging to investigate the evolution of cortical pathways within the euarchontoglire (i.e., primates, rodents) lineage. More specifically, we compare cortical fiber pathways between macaques (Macaca mulatta), marmosets (Callithrix jachus), and rodents (mice, Mus musculus). We integrate these observations with comparative analyses of Neurofilament heavy polypeptide (NEFH) expression across the cortex of mice and primates. We chose these species because their phylogenetic position serves to trace the early evolutionary history of the human brain. Our comparative analysis from diffusion MR tractography, cortical white matter scaling, and NEFH expression demonstrates that the examined primates deviate from mice in possessing increased long-range cross-cortical ...
Diffusion MR tractography permits investigating the three-dimensional structure of cortical pathw... more Diffusion MR tractography permits investigating the three-dimensional structure of cortical pathways as interwoven paths across the entire brain. We use high-resolution scans from diffusion spectrum imaging and high angular resolution diffusion imaging to investigate the evolution of cortical pathways within the euarchontoglire (i.e., primates, rodents) lineage. More specifically, we compare cortical fiber pathways between macaques (Macaca mulatta), marmosets (Callithrix jachus), and rodents (mice, Mus musculus). We integrate these observations with comparative analyses of Neurofilament heavy polypeptide (NEFH) expression across the cortex of mice and primates. We chose these species because their phylogenetic position serves to trace the early evolutionary history of the human brain. Our comparative analysis from diffusion MR tractography and NEFH expression demonstrates that the examined primates deviate from mice in possessing increased long-range cross-cortical projections, many...
Bradycardia, renal failure, atrioventricular nodal blockade, shock and hyperkalemia (BRASH) syndr... more Bradycardia, renal failure, atrioventricular nodal blockade, shock and hyperkalemia (BRASH) syndrome is named after the pentad of symptoms experienced by patients with this clinical entity, and is propagated via a synergistic mechanism. Herein, we describe a case of an 81-year-old male who presented with bradycardia, dyspnoea on exertion, and confusion. He was also initially found to be in cardiogenic shock. In a setting of elevated digoxin levels, acute renal failure and hyperkalemia, he was diagnosed with BRASH syndrome. Prompt interventions of continuous renal replacement therapy and digoxin antibody administration were performed to treat this patient. His renal function improved and his hyperkalemia and bradycardia resolved over the course of 4 days, and the patient was discharged to a subacute rehabilitation facility after stabilization. BRASH syndrome is a clinical entity requiring prompt diagnosis for life-saving treatment, including renal replacement therapy, vasoactive medi...
Diffusion MR tractography permits investigating the 3D structure of cortical pathways as interwov... more Diffusion MR tractography permits investigating the 3D structure of cortical pathways as interwoven paths across the entire brain. We use high-resolution scans from diffusion spectrum imaging and high angular resolution diffusion imaging to investigate the evolution of cortical pathways within the euarchontoglire (i.e., primates, rodents) lineage. More specifically, we compare cortical fiber pathways between macaques (Macaca mulatta), marmosets (Callithrix jachus), and rodents (mice, Mus musculus). We integrate these observations with comparative analyses of Neurofilament heavy polypeptide (NEFH) expression across the cortex of mice and primates. We chose these species because their phylogenetic position serves to trace the early evolutionary history of the human brain. Our comparative analysis from diffusion MR tractography, cortical white matter scaling, and NEFH expression demonstrates that the examined primates deviate from mice in possessing increased long-range cross-cortical projections, many of which course across the anterior to posterior axis of the cortex. Our study shows that integrating gene expression data with diffusion MR data is an effective approach in identifying variation in connectivity patterns between species. The expansion of corticocortical pathways and increased anterior to posterior cortical integration can be traced back to an extension of neurogenetic schedules during development in primates.
Background Aortic stenosis (AS) has been established as a precipitating factor in the development... more Background Aortic stenosis (AS) has been established as a precipitating factor in the development of colonic angiodysplasia, resulting in lower gastrointestinal bleeding (LGIB). While the association between AS and LGIB, termed "Heyde syndrome," has been examined extensively, few studies assess the impact of comorbid AS on rates of LGIB in patients with colorectal cancer (CRC). Our goal is to examine this association. Methods Patients hospitalized from 2001 to 2013 diagnosed with CRC were identified via ICD-9 codes, further stratified by a diagnosis of AS. Continuous and categorical variables were analyzed by independent sample ttests and chi-squared analyses respectively. Assessed outcomes included mortality, length of stay (LOS), hospital costs, rates of LGIB, colonic obstruction, colonic perforation, iron-deficiency anemia (IDA), and colectomy. Multivariate analysis via binary logistic regression was utilized to control confounding variables. Results Patients with CRC and AS had higher rates of mortality, lower gastrointestinal bleeding, iron deficiency anemia, and colectomy, while those without AS had higher rates of colonic obstruction. Length of stay and total hospital charges were higher in patients with AS. Discussion CRC outcomes were worse in patients with AS. This could be due to higher rates of LGIB secondary to the prevalence of angiodysplasia among AS patients. More retrospective studies are required to assess the impact of comorbid AS in patients with CRC.
Multiple studies have been conducted comparing inpatient versus outpatient pre-induction cervical... more Multiple studies have been conducted comparing inpatient versus outpatient pre-induction cervical ripening with the Foley catheter in low risk women. We performed a metanalysis and systematic review of all existing data. METHODS: This systematic review was completed via PubMed search. Articles published prior to July 31, 2019 were included for review. We included two randomized control trials, one pilot randomized control trial, a clinical cohort study, and a retrospective cohort study in our review which met the following criteria: 1) compared outpatient versus inpatient use of Foley catheter for preinduction cervical ripening in low-risk women at term (.37 weeks), Bishop score ,5, cephalic presentation with an unfavorable cervix 2) detailed maternal and neonatal outcomes 3) full article text was available 4) article published in English. Five maternal and two neonatal primary outcomes were captured for analysis. Meta-analysis was completed via Stata v15.1 software. RESULTS: Five studies were included with 1,346 subjects. The final Bishop score, oxytocin infusion time, and induction-to-delivery time were greater in the outpatient group (Table 1, P,.05). However, there was no difference in cesarean delivery, vaginal delivery, initial Bishop score, NICU admission, and Apgar score ,7 at 5 minutes between the outpatient and inpatient groups. CONCLUSION: In this large cohort, outcomes between low risk women who received the Foley catheter for pre-induction cervical ripening in the outpatient and inpatient setting were similar.
Diffusion MR tractography permits investigating the 3D structure of cortical pathways as interwov... more Diffusion MR tractography permits investigating the 3D structure of cortical pathways as interwoven paths across the entire brain. We use high-resolution scans from diffusion spectrum imaging and high angular resolution diffusion imaging to investigate the evolution of cortical pathways within the euarchontoglire (i.e., primates, rodents) lineage. More specifically, we compare cortical fiber pathways between macaques (Macaca mulatta), marmosets (Callithrix jachus), and rodents (mice, Mus musculus). We integrate these observations with comparative analyses of Neurofilament heavy polypeptide (NEFH) expression across the cortex of mice and primates. We chose these species because their phylogenetic position serves to trace the early evolutionary history of the human brain. Our comparative analysis from diffusion MR tractography, cortical white matter scaling, and NEFH expression demonstrates that the examined primates deviate from mice in possessing increased long-range cross-cortical ...
Diffusion MR tractography permits investigating the three-dimensional structure of cortical pathw... more Diffusion MR tractography permits investigating the three-dimensional structure of cortical pathways as interwoven paths across the entire brain. We use high-resolution scans from diffusion spectrum imaging and high angular resolution diffusion imaging to investigate the evolution of cortical pathways within the euarchontoglire (i.e., primates, rodents) lineage. More specifically, we compare cortical fiber pathways between macaques (Macaca mulatta), marmosets (Callithrix jachus), and rodents (mice, Mus musculus). We integrate these observations with comparative analyses of Neurofilament heavy polypeptide (NEFH) expression across the cortex of mice and primates. We chose these species because their phylogenetic position serves to trace the early evolutionary history of the human brain. Our comparative analysis from diffusion MR tractography and NEFH expression demonstrates that the examined primates deviate from mice in possessing increased long-range cross-cortical projections, many...
Bradycardia, renal failure, atrioventricular nodal blockade, shock and hyperkalemia (BRASH) syndr... more Bradycardia, renal failure, atrioventricular nodal blockade, shock and hyperkalemia (BRASH) syndrome is named after the pentad of symptoms experienced by patients with this clinical entity, and is propagated via a synergistic mechanism. Herein, we describe a case of an 81-year-old male who presented with bradycardia, dyspnoea on exertion, and confusion. He was also initially found to be in cardiogenic shock. In a setting of elevated digoxin levels, acute renal failure and hyperkalemia, he was diagnosed with BRASH syndrome. Prompt interventions of continuous renal replacement therapy and digoxin antibody administration were performed to treat this patient. His renal function improved and his hyperkalemia and bradycardia resolved over the course of 4 days, and the patient was discharged to a subacute rehabilitation facility after stabilization. BRASH syndrome is a clinical entity requiring prompt diagnosis for life-saving treatment, including renal replacement therapy, vasoactive medi...
Uploads
Papers by Arthi Palani